مجله دانشگاه علوم پزشکی قم
سال پانزدهم شماره 12 (پیاپی 119، اسفند 1400)

Factors disrupting the quality of sleep in patients with COVID-19 are considered one of the most important issues in the treatment of this disease. In this study, we aim to investigate the factors that disrupt the sleep quality of patients with Covid-19.

This cross-sectional study was conducted on patients with COVID-19 admitted to Kamkar Arabnia Hospital in Qom, Iran in 2021. The used instrument was the Pittsburgh Sleep Quality Index (PSQI). Inclusion criterion was the diagnosis of COVID-19 (positive PCR) for at least two weeks. The patients with a history of neurological diseases during the past year, those were taking sedatives, patients with unwillingness to participate in the study, patients with a history of hospitalization in the psychiatric wards in the past 6 months, those with sleep disorders, and pregnant women were excluded from the study. Finally, all data entered into SPSS v. 22 software and were analyzed using Chi-square test, t-test and one-way ANOVA. Significance level was set at 0.05.

The mean age of patients was 52.76±14.84 years. It was found that 101 patients (50.5%) were male and 99 patients (49.5%) were female. The mean score of PSQI was 9.48±4.26. No significant relationship was found between patients in terms of age (P=0.32), gender (P=0.22) and PSQI score. A significant relationship was found between PSQI score and history of underlying diseases (P=0.02), but socioeconomic status (P=0.39), level of education (P=0.61) and occupation (P=0.29) had no statistically significant relationship with PSQI score. There was a statistically significant relationship between PSQI score and the disease severity and admission ward (P=0.00).

COVID-19 severity has a statistically significant relationship with sleep quality. Therefore, it is recommended to use relaxation methods and emotional support in the care programs of patients with COVID-19. Their sleep patterns should also be taken into account.

Considering the prevalence of emergency events in schools and the key role of teachers in preventing and controlling these events, the present study aimed to determine the knowledge, attitude and practice of primary school teachers regarding emergency events related to epilepsy and asthma in Rafsanjan, Iran.

This descriptive study was conducted on 101 primary school teachers in 2019-2020 who were selected by census sampling method. The data collection tool was a researcher-made questionnaire of knowledge, attitude and practice towards asthma and epilepsy and their subsequent emergencies. Data were analyzed in SPSS v.18 using Pearson correlation test, independent t-test and one-way ANOVA, considering the significance level at P<0.05.

Mean score of teachers’ knowledge, attitude and practice towards epilepsy were 77.9, 68.3, and 72.7 (out of 100), respectively; these scores towards asthma were 73.6, 81.5, and 71.6, respectively. There was a statistically significant correlation between the mean practice score of teachers in epilepsy with age (r= 0.221, P= 0.027) and level of education (F= 3.13, P= 0.029). Moreover, a significant relationship was observed between the mean knowledge score about asthma and educational level (F=2.85, P= 0.041), and between teachers’ practice in asthma and work experience (r = 0.303, P= 0.002).

The design and implementation of educational and retraining interventions regarding epilepsy and asthma for younger teachers with lower work experience is suggested.

The coronavirus disease 2019 (COVID-19) has become one of the crises in the health system. It is necessary to take actions for follow-up, remote care and development of home care for these patients. This study aims to investigate the challenges of tele-nursing in the follow-up of patients with COVID-19.

In this qualitative study, 15 patients and 20 nurses participated. For collecting data, 15 individual interviews with patients, 4 individual interviews and 2 focus group interviews with nurses were conducted. The semi-structured interviews lasted 30-40 minutes. The Graneheim & Lundman approach was used for content analysis.

Data analysis led to the extraction of two categories and ten subcategories. The category of “Tele-nursing challenges from the patients’ perspectives” included the subcategories of technical limitations, variability of nurses, non-compliance with patients’ conditions, inefficiency in complicated situations, and imposing a care burden on families.  The category of “tele-nursing challenges from nurses’ perspectives” included the subcategories of unsuitable in high-risk cases, poor acceptance by patients, uncertainty of care implementation, limitations in direct assessment, and nurses’ lack of preparedness.

The nurse’s lack of preparedness and the limitations of tele-nursing in patient assessment and care, control of high-risk and complicated cases, and continuous care should be considered in the management of health promotion and nursing education.

Sleep deprivation has negative effects on consciousness and performance. N-methyl-D-aspartate receptors are a subset of glutamate receptors consisting of subunits NR1 and NR2. In the present study, the effect of a traditional Chinese medicine supplement called NeuroAid on the levels of NR1 and NR2 proteins in the striatum and prefrontal cortex of rat under total sleep deprivation (TSD) was evaluated.

ats were randomly divided into four groups of control (n=5), sham (n=5), TSD (n=5), TSD + supplementation (n=5) and sham + supplemention (n=5). After 24 hours of testing, the prefrontal cortex and striatum of the rats were removed and the levels of NR1 and NR2 proteins were assessed by Western blotting. Differences between protein levels were analyzed using one-way analysis of variance (ANOVA) and t-test.

TSD reduced the expression of both NR1 and NR2 proteins in the striatum and prefrontal cortex of rats. There was no significant difference in the expression of any proteins in the two regions of sham group compared to the control rats. Two intraperitoneal injections of 0.8 mg/kg NeuroAid significantly increased the expression of both proteins in both regions compared to the TSD group. In the sham + supplemention group, the expression of both proteins in the two regions increased significantly compared to the sham group.

The use of NeuroAid supplement can increase the levels of NR1 and NR2 proteins in rats with TSD.

Panic disorder is one of the most common anxiety disorders that causes many problems for people and the community. This study aims to determine the severity of panic disorder based on cognitive avoidance, distress tolerance and cognitive flexibility in patients with panic disorder.

This is a correlational study with a predictive design conducted on 130 patients with panic disorder in Isfahan, Iran, who were selected by a sequential sampling method. In order to measure the study variables, the Panic Disorder Severity Scale, the Cognitive Avoidance Questionnaire, the Distress Tolerance Scale, and the Cognitive Flexibility Inventory were used. In order to analyze the collected data, we used Pearson correlation test and stepwise regression analysis in SPSS v. 23 software.

The results showed that the severity of panic disorder was directly and significantly related to cognitive avoidance (P<0.01) and significantly and indirectly related to distress tolerance (P<0.01). The severity of panic disorder was indirectly related to cognitive flexibility, but it was not significant (P> 0.05), although due to the direct and significant correlation between cognitive flexibility and cognitive avoidance (P<0.01), a part of the relationship between panic disorder severity and cognitive flexibility was expected after mediation by cognitive avoidance.

Cognitive avoidance, distress tolerance, and cognitive flexibility have the ability to predict the severity of panic disorder.

There is some evidence that medical students are at high risk of bloodborne pathogens transmitted via sharps injuries. This study aims to survey the prevalence of sharps injuries and its related knowledge among students in Hamadan University of Medical Sciences (HUMS).

In this cross-sectional study, 200 eligible students of anesthesiology, operating room and nursing in HUMS participated, who were selected using a stratified random sampling method. Data were collected using a demographic form, a researcher-made knowledge of sharps injuries questionnaire and a researcher-made checklist of sharps injuries related factors. Data were analyzed by independent t-test and one-way analysis of variance in SPSS v.22 software.

The frequency of sharps injuries was 80 (40%). The mean score of knowledge about sharps injuries was 6.38±1.83. The result of independent t-test showed a significant difference between the score of knowledge and the exposure to sharps injuries (P= 0.005). The most common sharp tool led to injury was needle (34.5 %). Moreover, 35.5% of the sharps injuries was due to being in a hurry.

The prevalence of sharps injuries among the students of HUMS is relatively high. The exposure to sharps injuries is related to the students’ knowledge level.

Bifid condyle is a rare anomaly in mandible with unknown etiology. Patients with this anomaly may have symptoms but they are usually asymptomatic and it is accidently found in routine radiographic examinations. In recent years with development of three-dimensional (3D) imaging modalities, the reported cases of bifid condyle have extremely increased. This article presents the report of two different cases of this anomaly which were diagnosed using panoramic radiography and cone-beam computed tomography (CBCT) techniques.

The first case was a 35-year-old man without any clinical symptoms referred to obtain panoramic radiography for routine dental checkups. Unilateral bifid condyle was accidentally found in panoramic view. The second case was a 40-year-old woman with chief complaint of pain in temporomandibular joints (TMJs) on both sides. There were no signs of abnormality of condyle in clinical examinations and panoramic radiography. Thus, for further assessment, CBCT images were obtained and the presence of bilateral bifid condyle was confirmed.

Since two-dimensional radiographs such as panoramic images have less accuracy in diagnosing the anomalies of TMJ, the 3D imaging modalities such as CBCT can be the gold standard for better assessment and definite diagnosis, especially in symptomatic patients.