Journal of Isfahan Medical School
Year:2019 | Volume:37 | Issue:545|Papers Count:3

Background: The present study aimed to investigate the effect of psychosocial approach on depression and blood glucose control in patients with type 2 diabetes mellitus and depression. Methods: This was a controlled clinical trial study in patients with type 2 diabetes mellitus, who had records in comprehensive health care centers of Isfahan City, Iran, during the years 2018-2019. In both groups before the intervention, depression was assessed using standard Beck Depression Inventory (BDI-II) questionnaire, and if beck score is above 14 and informed consent was signed, the patients were included in the study. Fating blood sugar (FBS) and blood glycosylated hemoglobin (HbA1C) levels, weight, and height was measured. Then, psychosocial approach intervention was applied on 38 patients in intervention group; and the control group (41 patients) received routine health care services trainings. 3 months after the end of intervention, FBS, HBA1C, and BDI were assessed again. The results were analyzed using independent t, paired t, and chi-square tests via SPSS software. Findings: In posttest phase, HbA1c level and level of depression significantly decreased in the intervention group compared to the control group. Conclusion: Based on the results of this study, psychosocial approach can be effective in reducing depression and lowering HbA1c level in patients with type 2 diabetes mellitus and depression.

Background: Acute aortic dissection is one of the catastrophic cardiovascular events with high in-hospital mortality. We aimed to assess the distribution of ABO blood groups in patients with acute aortic dissection, and to identify any association between their blood groups and in-hospital mortality. Methods: In cross-sectional study, 147 patients with confirmed acute aortic dissection by computed tomography angiography were included. According to the type of their blood groups, patients were divided into non-O (including A, B, and AB blood groups) and O blood groups. According to the tearing location, patient were divided into proximal (ascending aorta) and distal (descending aorta) dissection groups. The data were statistically analyzed using chi-square, Fisher's exact, and independent t tests. Findings: The mean age of patients was 58. 77 ± 16. 04 and 59. 3 ± 15. 32 years in non-O and O blood groups, respectively. From 147 patients with thoracic aortic dissection, 93 patients had non-O and 54 patients had O blood groups. A and O blood groups were seen more frequently among the patients. 54 patients (36. 7%) died during their hospital course. Blood groups of AB [odds ratio (OR) = 3. 52] and A (OR = 1. 67) had stronger correlation with in-hospital mortality. Patients with blood group O had better in-hospital survival (OR = 0. 40). Conclusion: It seems that patients with aortic dissection and O blood group have a better in-hospital survival than patients with non-O blood groups.

Background: Laparoscopic cholecystectomy is now the gold standard for the treatment of gallbladder disease. The study evaluated the clinical preoperative effects of oral administration of clonidine on shoulder pain after surgery in patients undergoing laparoscopic cholecystectomy with general anesthesia. Methods: 64 patients, scheduled for elective laparoscopic cholecystectomy, were recruited for this prospective randomized double-blind comparative study. They were randomly allotted to either placebo or clonidine group. Patients of the placebo group (n = 32) were premedicated with placebo, while those in the clonidine group (n = 32) were premedicated with oral clonidine 150 micrograms prior to anesthesia. The premedication was given 90 minutes before the anticipated time of induction of anesthesia. Postoperative shoulder pain was recorded based on visual analog scale (VAS), and cumulative analgesic requirement was reported in 24 hours. Findings: The postoperative VAS scores of shoulder pain were significantly less in clonidine group compared with placebo group at recovery period (P = 0. 03). VAS scores were lower in clonidine group compared with the placebo group at 6, 12, and 24 hours postoperatively, but the differences were not significant (P > 0. 05). Analgesic consumption was significantly less in clonidine group during 24 hours postoperatively (P = 0. 02). Clonidine was not superior to placebo for attenuation of the hemodynamic responses to laryngoscopy and laparoscopy, but it increased the incidence of preoperative bradycardia (P = 0. 02). Conclusion: A single oral dose of 150 micrograms clonidine, 90 minutes before induction of anesthesia for laparoscopic cholecystectomy, significantly reduces postoperative shoulder pain only at recovery period.