Jundishapur Journal of Chronic Disease Care
Volume:9 Issue: 3, Jul 2020

On February 19 2020, novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) reported in Qom, Iran. The number of cases has increased rapidly but information on the differences in clinical characteristics of affected patients in different countries is limited. It seems that people with underlying diseases not only have a higher risk of developing the NCIP disease but also are more likely to die from the virus infection.

This study aimed to describe which one of NCIP patients are at higher risk for severe illness and what is the epidemiological, clinical, laboratory, radiological characteristics, and outcomes of the disease.

Prospective, case series of the 50 hospitalized NCIP patients in two hospitals in Tehran, Iran, from March 1 to March 15, 2020, was implemented. The final date of follow-up was March 18, 2020. The final date of follow-up was March 18, 2020. Epidemiological, demographic, clinical, laboratory, radiological, treatment, and outcome data were collected from electronic or printed medical records with data collection forms and analyzed.

More than half of the patients were men (27 [54%]); the majority of them had underlying diseases, including hypertension (33 [66%]), diabetes mellitus (29 [58%]), chronic heart failure (19 [38%]), chronic renal failure (19 [38%]), and autoimmune diseases (18 [36%]). The median age was 60 years (IQR 41.5 - 68.5). Common symptoms of illness were fever (50 [100%]), sore throat (50 [100%]), dyspnea (44 [88%]), myalgia (43 [86%]), cough (42 [84%]), fatigue (39 [78%]), and diarrhea (28 [56%]). The majority of patients had lymphopenia 49 (98%), 24 (48%) leukocytosis, and 32 (64%) of them had thrombocytopenia. All patients had pneumonia with patchy shadows or ground-glass opacity on chest computed tomographic scans. Twelve (24%) patients had a decreased level of consciousness. Thirty-three patients (66%) were transferred to the intensive care unit (ICU) because of complications, including acute respiratory distress syndrome (ARDS) (18 [36%]), arrhythmia (19 [38%]), and shock (14 [28%]). As of March 18, 37 patients (74%) were discharged, and 13 died (26%).

Hospitalized NCIP patients who have serious underlying chronic illness might be at higher risk for severe illness. Common symptoms of illness were fever, sore throat, dyspnea, myalgia, cough, and fatigue. Major complications during hospitalization included ARDS, arrhythmia, and shock. Bilateral distribution of patchy shadows and ground-glass opacity was a typical hallmark of CT scans for NCIP. Currently, there is no effective drug treatment. Gaps in our knowledge need fulfillment by future studies with a higher sample size.

Malnutrition is still one of the most important and common problems in hospitals and increases the incidence, side effects, and mortality in hospitalized patients. In this regard, the Intensive Care Unit (ICU) patients are more at risk due to critical conditions.

The aim of this study was to determine the effect of nurses’ nutritional guidelines on the severity of malnutrition in ICU patients.

This single-blind clinical trial was conducted on 70 patients hospitalized in the ICU of Golestan and Imam Khomeini hospitals in Ahwaz in 2012. Available patients were randomly divided into the control and intervention groups. The data collection tool was a checklist of demographic data and the Maastricht index for malnutrition assessment. Patients were evaluated based on the Maastricht index at baseline and 10 days after feeding.

There was no significant difference between the two groups in terms of demographic variables. Mean and standard deviation of albumin, pre-albumin, and lymphocyte parameters before the intervention were 3.13 ± 0.571, 1.28 ± 0.31, 1638.2 ± 489.59, whereas, after the intervention, they were 536 3.32 ± 3.88, 1.88 ± 0.36, 2195 ± 40.85, respectively. Also, the amount of malnutrition intensity by the Maastricht formula before and after the intervention was 4.89 ± 2.17 and 2.00 ± 2.10, at a significance level of 0.001. Regarding the normal distribution of data, using the T-test, two groups showed significant differences (P = 0.001).

The prevalence of malnutrition is high in patients admitted to the ICUs, which is mainly due to inappropriate nutrition of patients in these sectors. Although nurses play a significant role in feeding patients, their knowledge in this field is less than needed. According to the results of this study, the use of the guideline by nurses reduced the severity of malnutrition. Therefore, it is essential to create the necessary backgrounds for increasing the knowledge of this group of treatment staff and to educate valid nutrition guides for them to improve the nutritional status, and subsequently accelerate the treatment process of the patients.

Studies on children and adolescents living with different chronic diseases show the importance of social support to face the disease. Social support affects the course of the disease in children with Type 1 Diabetes Mellitus (T1DM) or epilepsy.

This study was conducted to determine the level of social support of children with T1DM or epilepsy.

The sample consisted of a total of 100 children aged 11 - 17, including 50 diabetes and 50 epilepsy patients. No sample calculation was made in the study. The study was completed with 100 children who met the inclusion criteria. The data of the study were collected by the researchers in the hospital environment between April and October 2017 using the Child Introductory Form and the Child-Adolescent Social Support Scale (CASSS).

Children with epilepsy had lower social support scores than children with T1DM when the scores of the children on the subscales of CASSS were examined. As the ages of all children participating in the study decreased, the obtained importance of social support scores increased.

It may be proposed to know the social support levels of children with epilepsy or type 1 diabetes and plan nursing interventions to increase their awareness.

This study aimed at comparing emotional processing and quality of life among patients with major thalassemia, type 2 diabetes mellitus, and healthy individuals.

The present causal-comparative study was conducted on patients with thalassemia, type 2 diabetes mellitus, and healthy people in Saravan City in 2017. In this study, the available sampling method was conducted and 153 individuals (major thalassemia = 53, type 2 diabetes mellitus = 50, and healthy people = 50) were selected. Later, emotional processing and quality of life questionnaires were distributed among the participants. The data were analyzed using multivariate analysis of variance and Tukey post hoc test by running SPSS version 23.

In the thalassemia group, the mean score of emotional processing was higher than the other two groups; whereas, the mean score of the quality of life was lower compared with the other study groups. The three groups were significantly different in terms of emotional processing and the quality of life. The paired comparison between the groups showed that the signs of unprocessed emotion components of emotional processing were lower in the healthy group compared with the two patients’ groups. However, among the components of the quality of life, the mean scores of personal benefit, relationships, and environmental factors were higher among the healthy group.

Chronic diseases affect emotional processing and the individuals’ quality of life. Therefore, we recommend to health centers to conduct comprehensive and preventive programs to improve participants’ mental health.

Coronary angiography is an invasive procedure used to diagnose coronary artery disease, and standard nursing care before, during, and after this procedure. A comparison of the current care with the existing standards can lead to improved nursing care quality, increased patient safety, and reduced medical costs.

Therefore, the aim of this study was to audit the nursing care provided before angiography.

In this analytical descriptive study, the nursing care provided to 400 patients undergoing coronary angiography was evaluated using the event-based sampling method in the angiography ward of hospitals affiliated to Shahrekord University of Medical Sciences. Data were collected by a demographic form and a standard nursing care checklist. Data were analyzed using descriptive statistics (i.e., frequency, mean, and standard deviation) and analytical statistics (i.e., chi-square, independent t-test and analysis of variance) in SPSS 18 version.

Before angiography, nursing care compliance score was 51.63 ± 4.21, which was significantly different than the normal value (normal score: 61 - 81). At the preoperative stage, 25 (6.3%), 374 (93.5%), and 1 (3%) caring cases, the standard of nursing care was poor, moderate, and good, respectively.

Based on our results, in one case, the provided nursing care was in accordance with the standard of nursing care at the preoperative stage of angiography, which can be attributed to the lack of education, control, facilities and awareness among nurses about the importance of standard care.

Chronic use of anabolic-androgenic steroids (AAS) by athletes can cause detrimental effects on the liver, heart and arteries, kidneys, and hormonal systems. Besides, it may cause mental health problems.

The current study aimed to investigate the chronic effects of Winstrol and Oxandrolone anabolic steroids on liver enzymes in male bodybuilding athletes.

This causal-comparative study was conducted on 30 bodybuilding athletes living in Yasuj City in 2019. Participants were included using the available and non-random sampling technique. Then, were divided into three groups (each with 10 members), including: (1) athletes with no history of AAS; (2) athletes with a history of AAS (three months away from consumption); and (3) athletes with current AAS consumption. After 12 hours of fasting, blood samples were taken in the morning to measure liver enzymes (AST, ALT, and ALP). Data were analyzed by one-way analysis of variance (ANOVA) and Tukey post hoc test using SPSS version 21 at a significance level of < 0.05.

The results showed higher degradation of the two enzymes aspartate aminotransferase (AST) and alanine aminotransferase (AST) in the third group compared to the other two groups (P = 0.001, F = 130.84). Also, the damage of AST and ALT enzymes was more in the second group than the first group (P = 0.001, F = 188.178). Also, the results of one-way analysis of variance showed no significant difference between groups concerning serum ALP level (P = 0.227, F = 1.349).

Steroid drugs have devastating effects on liver cells, even after three months of discarding their use, and the effects never get fully remedy, as they continue to affect consumers after quitting; However, it appears that the adverse effects on some liver enzymes significantly reduce over time.

Increased life expectancy has increased the likelihood of chronic diseases. Depression, as the most common mental disorder for older adults, and fear of falling, which may lead to lower self-esteem and self-efficacy, can be barriers to proper physical activity.

The current study aimed to determine the relationship between depression and fear of falling in older adults.

This descriptive-correlational study was conducted in 2018 on 90 randomly selected older adults aged 60 years and older referred to comprehensive health centers in the city of Rasht. Data were collected using a questionnaire on demographic information, a 15-item Geriatric Depression scale, and Falls Efficacy Scale-International Form. Data were analyzed through SPSS version 21 using descriptive and inferential tests (the Spearman and the Mann-Whitney U correlation coefficient). A P value of < 0.005 was considered as statistically significant.

Most of the participants (60%) were female. The mean age was 68.44 ± 7.60 years, the mean depression score was 7.40 ± 2.03, and the mean fear of falling was 36.97 ± 12.73. There was a significant positive correlation between depression and fear of falling (r = 0.420, P = 0.0001).

These findings clarify the importance of proper planning by health authorities to prevent and treat mental disorders in older adults.

Subjective well-being (SWB) can be a buffer against mental health problems. Patients with multiple sclerosis (MS) tend to experience low levels of subjective well-being.

The two objectives were (1) to examine whether peer-led and nurse-led self-management training can improve SWB of patients with MS and (2) to compare the effect of these two interventions on SWB of patients with MS.

In this trial, 81 patients were randomly assigned to either nurse-led (n = 41) or peer-led (n = 40) groups. Both groups participated in six weekly-based 1.5‐hr self-management sessions. The cognitive and affective components of SWB were evaluated using the Satisfaction with Life Scale and the Scale for Positive and Negative Experience, respectively.

Life satisfaction increased in both groups over time (P < 0.001), although it was not significantly different between the two groups (P > 0.05). Positive and negative experiences increased in both groups over time (P < 0.05), but the increase in positive experience in the peer-led group was significantly larger than those in the nurse-led group (P < 0.05).

Peer-led and nurse-led self-management training, are feasible tools to enhance the cognitive component of SWB, i.e., life satisfaction. Considering the affective component of SWB, positive experience in the peer-led group improved better than in the nurse-led group over time. Therefore, if healthcare providers improve the SWB of patients with relapsing-remitting MS, the self-management intervention led by peers is preferred than nurse-led self-management training.