مجله دانشکده پزشکی اصفهان
پیاپی 574 (هفته دوم تیر 1399)

Diabetes mellitus is a chronic metabolic disease with an increasing prevalence that has many complications such as depression. The comprehensive management of the disease requires assessment and treatment of mental problems. The aim of this study was to assess the effect of stress management based on positive psychology on mental health and glycemic control.

This randomized controlled clinical trial study was conducted in Imam Ali Health Care Center, Isfahan City, Iran, in 2018. 80 women with diabetes mellitus were selected from the health center using convenience sampling method, and were assigned randomly to two groups of control (n = 40) and intervention (n = 40). Both groups were under routine health care. In addition, the intervention group received 8 sessions of positive psychological education and 4 sessions of homework. The Depression, Anxiety, and Stress Scale-21 (DASS-21) questionnaire, fasting blood sugar (FBS), and glycated hemoglobin (HbA1C) were evaluated before and after the intervention.

There was no significant difference in HBA1C and FBS between the two groups before intervention, but after it, the mean of HbA1C in the intervention group was significantly lower than that of the control group. Moreover, depression, anxiety, and stress scores significantly decreased in the intervention group, but there was no significant difference between the two groups. By modulating the effect of mental health score, there was no significant difference in HbA1C after intervention within the two groups.

Positive psychology is effective in decreasing depression, anxiety, and stress, as well as controlling HbA1c in women with diabetes mellitus.

Tetralogy of Fallot (TOF) is the most common congenital cyanotic heart disease. The purpose of this study was to evaluate the efficacy of intraventional ventricular outflow tract stenting and insertion of surgical Gortex shunt in infants with less than 6 months of age before total correction surgery of these patients.

In this cross-sectional prospective study, 24 patients with TOF who were less than 6 months of age, were not eligible for total correction surgery, and were admitted to Chamran Hospital affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, were studied. 12 patients with less than of 2 months of age were stented and 12 patients were shunted. After 3 to 6 months, all patients underwent complete surgery, and the results were compared.

The length of intensive care unit (ICU) stay during the first procedure was shorter in stent group (1.41 ± 0.66 vs 2.83 ± 0.71 days, P = 0.001). Patients in stent group had less O2</sub> saturation levels at the time of stent implantation compared to the shunt group (67.50 ± 2.02 vs 74.50 ± 3.98 percent, P = 0.001). There were no significant differences between the two groups after total correction in ICU (P = 0.881) and hospital stay times (P = 0.559). One patient from each groups died in the follow-up period.

Stenting for the right ventricular outflow tract can be a better method in low-weight and young-age patients who are not good candidates for total correction; this method has fewer complications and hospital stay period.

Stress is unavoidable among the medical profession, and has become an integral part of professional life in some fields such as surgery and anesthesia. The aim of the present study was to determine the perceived stress with coping styles of stressful situations among the residents of surgery and anesthesiology.

 The present study was a cross-sectional descriptive-analytical study in Isfahan University of Medical Sciences, Isfahan, Iran, in 2019. The samples were enrolled the study using census sampling method. The data collection tool was a questionnaire that included three questionnaires of demographic characteristics, perceived stress scale, and questionnaire to deal with stressful situations. The data were evaluated using descriptive statistics, and chi-square, one-way ANOVA, and Tukey tests via SPSS software.

The mean perceived stress did not differ significantly between the two groups of surgery and anesthesiology residents (P = 0.370). There was a significant relationship between the age and frequency of stress management styles among surgery residents (P = 0.020). Surgery residents significantly used problem-oriented coping method more when the mean perceived stress level was lower (P = 0.011). In the anesthesiology group, the level of stress level was almost the same in all three coping styles, and there was no significant difference (P = 0.160). Moreover, using the Tukey test, in the surgical group, the mean perceived stress level was significantly less when using problem-oriented coping style, compared to emotion-centered stress coping style (P = 0.008).

 Among surgery residents, low perceived stress is an effective factor in the use of effective (problem-oriented) method in dealing with stress. Increasing in age and experience in the field of work, make people use effective coping style; possibly, having more responsibility in the operating room makes the surgery residents use more effective and efficient ways to deal with stress.