فهرست مطالب

Chronic Diseases Journal
Volume:5 Issue: 1, Winter-Spring 2017

  • تاریخ انتشار: 1396/06/25
  • تعداد عناوین: 6
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  • Shahla Afrasiabian, Azadeh Koolan, Mohammad Barari, Katayon Hajibagheri, Ghobad Moradi, Behzad Mohsenpour * Pages 1-7
    Background
    The aim of this study was to evaluate the status of the appropriate use of antibiotics by type, dosage, and length of treatment and the route of administration in Tohid teaching hospital, Sanandaj, Iran.
    Methods
    In a retrospective descriptive study, 400 patients were systematically selected from patients receiving antibiotics hospitalized in Tohid hospital from March 2016 to March 2017. Demographic characteristics, hospitalization ward, diagnosis, antibiotic prescribed, dosage, length of treatment, the route of administration, and prescribing physician were recorded. The treatments were compared with standard treatment based on Harrison reference. The data were analyzed using STATA software.
    Results
    Out of total patients, 54% were men and 46% were women with a mean age of 57.87 ± 9.87 years. The mean duration of hospitalization was 6.37 ± 2.69 days. More and less numbers of patients were admitted in the internal medicine ward (23.75%) and intensive care unit (ICU) (1.00%), respectively, The highest antibiotics were administered by internal medicine specialists (40.25%), the most commonly prescribed antibiotic was ceftriaxone (34.59%), and the most common cause of antibiotic therapy was pneumonia (20.50%). Out of 595 antibiotics prescribed, 28.50% of the administrations were inappropriate. In addition, the objective for the prescription of the first and second antibiotic was inappropriate in 27.50% and 33.70% of cases, respectively. Dosage, route of administration, and the length of treatment of the prescribed antibiotic was inappropriate in 9.00%, 0.50%, and 41.00% of cases, respectively. The highest and lowest rate of inappropriate antibiotic prescription was observed in surgical (51.31%) and infectious diseases (12.90%) wards.
    Conclusion
    Due to the increase inappropriate administration of antibiotics, it is necessary to train the specialists about the planning, appropriate medical consultations for antibiotic therapy, and limitation of the new antibiotics prescription.
    Keywords: Antibiotic, Prescription, Patients
  • Mehdi Amiri, Mohammad Hossein Harirchian, Saman Esmaeilnejad, Bahaadin Siroos, Mohammad Sajad Emami-Aleagha * Pages 8-11
    Background
    There are several studies indicating that an anti-aging protein, namely Klotho protein, participates in the regulation of calcium and phosphate metabolism. In addition, we showed that Klotho protein was involved in the pathogenesis of multiple sclerosis (MS). Hence, we hypothesized that Klotho protein changes in patients with multiple sclerosis might lead to alteration of calcium and phosphate metabolism. Accordingly, the aim of the present study was to evaluate the alteration of calcium and phosphate levels together with the concentration of Klotho protein in the serum of patients with multiple sclerosis.
    Methods
    In this case-control study, 14 patients with newly diagnosed relapsing-remitting multiple sclerosis (RRMS) along with 14 control individuals with noninflammatory neurological disorders were enrolled. The serum concentrations of Klotho protein, calcium, and phosphate were measured in serum of participants using commercial kits. The data were analyzed at the significant level of P
    Results
    There were no significant changes in serum concentrations of Klotho protein, and phosphate in patients with multiple sclerosis when compared to controls. However, the serum calcium concentration was significantly lower than the control group. Regarding patients with multiple sclerosis, there was a significant positive correlation between changes in serum concentrations of Klotho protein and calcium (r = 0.604, P = 0.022), whereas the other correlations were not statistically significant.
    Conclusion
    To our knowledge, this is the first study demonstrating a positive correlation between serum concentrations of secretory Klotho protein and calcium in patients with multiple sclerosis.
    Keywords: Klotho Protein, Calcium, Phosphorus, Multiple sclerosis
  • Salar Behzadnia, Narges Najafi, Kiana Marzban, Fatemeh Ahangarkani, Alireza Davoudi * Pages 12-18
    Background
    The clinical manifestations of brucellosis are very diverse. This study was conducted to investigate the epidemiological, laboratory, and clinical characteristics in pediatrics patients with brucellosis.
    Method
    In this descriptive cross-sectional study, the population included patients under age of 18 years who were hospitalized with a diagnosis of brucellosis in Razi hospital, Qaemshahr City, and Bu-ali Sina hospital, Sari City, Iran, during the years 2005-2015. 27 patients with a mean age of 12.5 years including 9 girls and 18 boys were selected. Most patients (70.3%) were in the age range of 12-18 years.
    Results
    21 patients (77.8%) consumed unpasteurized dairy products and 10 patients (37%) had direct contact with livestock. Most of the initial complaints were fever in 13 cases (48.1%), joint pain in 12 cases (44.4%), and limbs pain in 5 cases (18.5%). The most common clinical findings were arthritis (14.8%) and splenomegaly (7.4%). In laboratory findings, 11.1% had leukopenia, 48.1% had anemia, 3.7% had thrombocytopenia, 29.6% had a moderate increase in erythrocyte sedimentation rate (ESR)¡ 25.9% had high increase in ESR, and 18.5% had leukocytosis. Clinical signs and laboratory parameters in the study included chills and fever, joints and limbs pain, arthritis, splenomegaly, increase in ESR, anemia, leukocytosis, and leukopenia.
    Conclusion
    In every patient with fever and skeletal or joints pain, brucellosis should be considered as a possible disease, and initial diagnostic measures should be taken, especially in children. Signs and symptoms of brucellosis are various and nonspecific. Educating the high risk families plays an important role in management of disease.
    Keywords: Brucellosis, Pediatrics, Epidemiology, Clinical Medicine
  • Mohammad Abedi-Samakoosh *, Fatemeh Ahangarkani, Naiereh Aghaie, Farhad Gholami, Mahbobeh Shirzad, Zahra Naseripour Pages 19-27
    Background
    The present study was conducted in order to evaluate the factors affecting the adequacy of dialysis and determine the relationship of dialysis adequacy with laboratory parameters.
    Methods
    This descriptive study was performed on 60 hemodialysis patients of Razi Medical Center of Qaemshahr, Iran, with the history of more than 3 months of dialysis. The participants were selected using census method. Data collection was conducted through a researcher-made questionnaire. Blood samples were collected to evaluate laboratory parameters. The adequacy of dialysis was calculated through the Kt/V parameter. The obtained data were analyzed using descriptive statistical tests.
    Results
    According to the Kt/V criteria, the mean dialysis adequacy index was 1.6 ± 0.22 and 41.7% of the patients had the optimum dialysis adequacy (Kt/V of greater than 1.2), and 43.3% of patients had a dialysis adequacy which was close to the desirable level. There was a significant reverse relationship between dialysis adequacy and alkaline phosphatase (ALP), blood sugar, and body mass index (BMI). Nevertheless, there was no significant relationship between dialysis adequacy and parathyroid hormone ý(PTH), cholesterol, triglycerides, alanine aminotransferase (ALT), aspartate aminotransferase (AST), calcium, phosphorus, and the number of dialysis sessions per week, duration of each dialysis session, and the history of dialysis (P > 0.05).
    Conclusion
    In order to increase the adequacy of dialysis, the blood sugar level of patients should be controlled and patients should be advised to modify their weight using a suitable diet.
    Keywords: Dialysis, Hemodialysis, Enzymes
  • Fouad Rahimi *, Alireza Gharib Pages 28-36
    Background
    Considering the fact that hospitalization of a family member in the intensive care unit (ICU) can have a great impact on different aspects of the life of the patient’s family, the purpose of this study was to clarify the concept of family-centered care with chronic diseases admitted to ICU.
    Methods
    In this study, Rodgers’ evolutionary concept approach was used to analyze the concept of family-centered care for chronic patients. Criteria for entering articles, books and scientific information in English and Persian from 1980 to 2016 on family-based care and chronic diseases were selected using scientific databases.
    Results
    Family-based care in chronic diseases is a concept that process nature with care management, education and interaction. Also, three types of forerunners here include family-related predictions (family efficiency), self-confidence (system-related), adequate resources, social factors and cultural factors (related to care providers), participation (in this case).
    Conclusion
    The concept of family-centered care has evolved over the past few years in relation to chronic diseases. Nurses have significantly improved their knowledge of family care mainly focusing on improving the families of patients. Therefore, the nurses in the care groups have been significantly influenced and have been able to assume the responsibility of family-based care groups.
    Keywords: Concept Analysis, Concept Development, Family, Centred Care, Chronic Illness
  • Maryam Maddineshat *, Donya Torkashvand, Ghasem Sadat-Mosavi Pages 37-40
    Background
    Fever is the most common complaint in children. Some children frequently refer to treatment centers for long periods of continuous fever; and despite precise assessments, the cause of the fever is unknown. Since there is no evidence of relationship between fever of unknown origin (FUO) and child abuse, we report a case of fever of unknown origin case caused by child abuse.
    CASE REPORT: An 8-year-old boy was referred to a pediatric ward of Mehr hospital in Malayer City, west of Hamadan Province, Iran, followed by a fever of unknown origin to assess the disease. The patient repeatedly had severe fever twice a month, since he was seven years old. He did not presented to hospital due to normalization for his family. He then returned to the hospital with repetition of fever and not responding to the medications used at home. After a few days of admission to the hospital and performing examinations and laboratory procedures and pictograph, there was no finding to determine the cause of the fever. However, in the interview, child's mother secretly expresses child abuse and her harassment with the concern and fear of the child's father.
    Conclusion
    Cultural beliefs and parental power are two phenomena that prevent the use of appropriate tools for understanding stresses and bitter experiences of childhood. For these reasons, history taking and physical examination by doctors and nurses in the hospital are limited only to the physical examinations. Therefore, there is a need for laws and strong supporters who can support doctors and nurses to report child abuse.
    Keywords: Fever, Pyrexia, Child, Child Abuse, Child neglect