Hormozgan Medical Journal
Volume:26 Issue: 3, Jul 2022

Multiple sclerosis (MS) is considered a chronic disease in which physical and mental disorders are common among these patients. This study aimed to evaluate the effectiveness of the Lazarus multimodal approach intervention on psychological distress, working memory, and anxiety in patients with MS.

A quasi-experimental research method with pre-test, post-test, and follow-up and a control group was used in this study. The statistical population of the study included the patients who were members of the “MS Patient Support Society” in Tehran who had been referred to this center during January and March 2017. The sample consisted of 32 people selected by the convenience sampling method from the members of the MS community. The data were obtained through the Kessler psychological distress scale (K10), the Wechsler’s Working Memory Index, and the Beck Anxiety Inventory. The experimental group underwent the Lazarus multimodal approach in ten 90-minute sessions of two sessions per week for one and a half months. The control group received no intervention. The follow-up was performed three months after the post-test. The repeated measurement method and SPSS 22 were used to analyze the data.

The findings showed that the Lazarus multimodal approach had a significant effect on decreasing anxiety (P<0.001), psychological distress (P<0.001), and increasing working memory (P<0.001).

It can be concluded that Lazarus’ multimodal approach was effective on anxiety, psychological distress, and working memory and can be employed to reduce psychological problems in patients with MS.

It is well-established that complications following cardiopulmonary bypass (CPB) such as acute kidney injury (AKI) lead to worse outcomes and higher mortality. Considering the importance of the post-CPB inflammatory cytokine cascade, we first assessed the post-operative interleukin (IL)-21 serum level and its association with AKI development after CPB.

In this experimental before-after study, 40 patients with confirmed CPB-AKI in the Jorjani Heart Center, Bandar Abbas (from January 2017 to September 2018) were compared with 50 non-AKI patients. AKI was defined according to the Acute Kidney Injury Network. The IL-21 serum level was measured using an enzyme-linked immunosorbent assay before and 12 hours after surgery. The association between IL-21 and other variables was evaluated by correlation analyses.

The IL-21 serum level was significantly higher post-operation compared to its level before surgery in AKI (21.4±6.3 and 15.7±5.5, P<0.001) and non-AKI (19.1±6.4 and 13.7±6.3, P<0.001) patients, but no significant differences were observed between AKI and non-AKI patients. Age, body mass index, and creatinine were not significantly correlated with the IL-21 serum level 12 hours post operations in AKI and non-AKI subjects.

Serum IL-21 concentrations were significantly increased in CPB patients after operation, which may contribute to the post-CPB inflammatory response syndrome. Our data did not confirm any association between increased IL-21 levels and CPB-AKI risk.

Diabetes is the fifth leading cause of death in most countries of the world and causes disability, disability, high medical costs, and increased mortality. This study aimed to predict the meaning of life based on moral development, cognitive styles, and hopefulness in patients with type 2 diabetes (T2D).

The statistical population of this descriptive-correlational study consisted of all patients of the Karaj Diabetes Association in 2019 (Iran), among whom 200 cases were selected by the convenience sampling method and Cochran formula. The Meaning of Life Questionnaire (2006), Kohlberg’s Moral development Test (1977), Kolb Cognitive Styles Scale (1981), and Snyder Hope scale (1996) were used for data collection. Pearson correlation test and multiple linear regression were applied to analyze the data by SPSS23, and the significance level was 0.05.

The results revealed that moral development (β=0.15, P=0.03), cognitive styles (β=0.38, P<0.001), and hopefulness (β=0.22, P<0.001) had a positive effect on the meaning of life.

It can be concluded that moral development, cognitive styles, and hopefulness can predict the meaning of life among people with T2D, highlighting the importance of the role of the meaning of life in people with T2D.

Diabetes mellitus is a global health challenge. Metabolic disorders in first-degree relatives (FDRs) of patients with type 2 diabetes mellitus (T2DM) have been linked to a family history of diabetes.

This study aimed to investigate the frequency of metabolic syndrome (MetS), diabetes, and prediabetes in FDRs of patients with T2DM.

This descriptive study included FDRs of patients with T2DM referred to the diabetes clinic of Shahid Mohammadi Hospital, Bandar Abbas, Iran in 2017. Waist circumference (WC) and blood pressure were measured for each participant. Fasting plasma glucose was measured in venous blood samples after 8-hour fasting. Two-hour plasma glucose was measured after a 75-g oral glucose tolerance test. Triglyceride and high-density lipoprotein were measured in venous blood samples after 12-hour fasting. The Adult Treatment Panel III (ATP III) and the International Diabetes Federation (IDF) criteria were used to diagnose MetS. Iranian-specific WC cutoffs from different studies were also used as alternatives for WC cutoffs in IDF criteria to form Iranian-specific MetS criteria.

This study included 300 FDRs (male: 33.7% vs. female: 66.3%) of patients with T2DM, with a mean age of 33.56±10.64 years. Among the participants, 19.7% had prediabetes and 8% had diabetes. MetS was diagnosed in 8.3% and 15% of the FDRs based on the ATP III and IDF criteria, respectively. The frequency of MetS ranged from 6.7% to 11.7% based on six different Iranian-specific WC cutoffs.

The frequency of MetS, diabetes, and prediabetes was quite high in the FDRs of patients with T2DM. Screening for these metabolic disorders can help prevent future cardiovascular events in this specific group.

Vitiligo is an autoimmune pigmentary skin disease. Recently, the association of chronic inflammatory conditions with metabolic syndrome (MS) and oxidative stress has been demonstrated in skin diseases such as lichen planus and psoriasis. In this study, the prevalence of MS in patients with vitiligo was compared to the control group.

This case-control study included 65 patients with vitiligo and 65 healthy participants in the control group who have referred to the dermatologic clinic in the Afzalipour Hospital of Kerman University of Medical Sciences, Iran. Demographic features and laboratory data of participants were collected and analyzed by SPSS 16 using chi-square and independent t tests.

There was no significant difference between the two groups in terms of age, gender, and body mass index (BMI). The mean values of MS parameters were not significant between the two groups. Systolic hypertension (HTN) was significantly higher in the vitiligo group than in the control group (P=0.03). Increasing the length of the disease by one year increased the chance of MS occurrence by 7%.

In the current study, systolic HTN was significantly higher in vitiligo patients compared to the control group. MS was also more common in vitiligo patients than in the control group, but the result was not statistically significant.

Renal disorders have been observed with the long-term treatment of some antiepileptic drugs (AEDs). We aimed to compare the effects of carbamazepine (CBZ) and valproate (VPA) on renal function in children with epilepsy.

This quasi-experimental study included children with epilepsy aged 2 months to 14 years who had persistently been receiving CBZ or VLP monotherapy for more than 6 months and were referred to Bandar Abbas Children’s Hospital, Bandar Abbas, Iran, 2019-2020. Demographic features, including age and sex, as well as family history of epilepsy, disease duration, and duration of treatment were recorded for each patient. Random blood and urine samples, along with 24-hour urine samples were collected from all the participants. Blood urea nitrogen (BUN), sodium, alkaline phosphatase (ALP), and pH were measured in blood samples. Glucose, protein, sodium, potassium, phosphorus, and creatinine were estimated in 24-hour urine samples. N-acetyl-beta-D-glucosaminidase (NAG) and pH were assessed in random urine samples.

Of the 80 children in this study with a mean age of 7.43±3.22 years, 58 (72.5%) were males. Children in both groups were comparable in terms of age, sex, family history of epilepsy, and disease and treatment duration. The urine NAG level was significantly higher in the VPA group compared to the CBZ group (P=0.010). Further, 24-hour urine protein and glucose levels were significantly higher in the VPA group. As for blood parameters, except for sodium (P=0.034), ALP (P<0.001), and pH (P=0.006) which were significantly higher in the CBZ group, other parameters were significantly higher in the VPA group.

Overall, CBZ appears to be safer than VPA regarding its effects on renal function in children treated for epilepsy.

It is necessary to help people with hypertension solve the related problems by identifying factors affecting their health control and self-care, which can be improved using different approaches. This study aimed to determine the effectiveness of mindfulness-based stress reduction (MBSR) therapy in improving health control and self-care in women with hypertension.

The statistical population of this randomized controlled trial study included all women with hypertension referred to the Farshchian Specialized Cardiovascular Clinic (Hamadan, Iran) in 2019. The sample size consisted of 30 subjects who were selected by the convenience sampling method and randomly assigned to two experimental and control groups each containing 15 subjects. The MBSR group was trained in eight 90-minute sessions, while the control group received no intervention. Data were analyzed using repeated-measure analysis of variance by SPSS 22.

The results revealed that MBSR significantly affected health control (P<0.001) and self-care (P<0.001) in women with hypertension.

Overall, MBSR could effectively improve health control and self-care in women with hypertension, thus it may be used for decreasing psychological problems in this group of women.

Since the spread of the coronavirus disease 2019 (COVID-19) pandemic, many countries have been suffering from the disease, and patients exhibit an extensive spectrum of symptoms from mild to severe, and in some cases, it leads to death. Identifying vulnerability factors may help detect very high-risk subjects to prevent disease mortality. Since people have different human leukocyte antigen (HLA) alleles, and the frequency of the alleles varies between different races and geographic regions, it is inferred that there is an association between HLA and the vulnerability of the population. The present study aimed to find the most frequent HLA alleles that profoundly affect COVID-19 outcomes. To find the relevant articles, medical databases (Medline, PubMed, EMBASE, Cochrane Library, and the like) were searched by the keywords, and the results related to the association between HLA and COVID-19 morbidity were selected and briefly presented. Regarding the extracted information from several studies, HLA alleles with a strong affinity to COVID-19 epitopes such as HLA-A*11:01, HLA-A*02:06, and HLA-B*54:01 could result in mild symptoms, while those with weak affinity such as HLA-B*44:06 and HLA-B*46:01 contributed to severe symptoms and high mortality rate. Further, heterozygosity and frequency of HLA alleles could affect the disease outcome within populations. As a result, the vulnerability of the patients can be predicted through their HLA pattern, and preventive measures can be taken instantly for populations expressing high-risk alleles. HLA can be assumed as a global predictor of COVID-19 disease outcomes. High frequent alleles which affect the outcome of the disease are introduced as susceptibility-determining alleles.

Context: 

Due to the increased freight traffic and illicit movement of drug packages disguised inside the body, as well as the shortage of adequate surgical textbook references regarding the management, we aimed to utilize our clinical experience and collect relevant content to present a plausible solution.

Evidence Acquisition: 

The PubMed, Scopus, Web of Sciences, and Google Scholar databases were systematically searched for related articles.

 Of the overall 294 retrieved articles, 37 articles remained for review after the exclusion of duplicates and unrelated papers. Imaging is beneficial in several cases of body packing. Abdominopelvic computed tomography without contrast, which is likely the best diagnostic tool for identifying the existence and quantity of packets in these patents, can help doctors avoid common diagnostic mistakes. Whether it be opioids, cocaine, or amphetamines, each drug class should have a customized course of action.

 Although conservative treatment is often employed for these individuals, early surgical intervention for packet removal is advised in the cases of ingesting cocaine and amphetamine packets due to the lack of an appropriate antagonist.

Teratoma is a tumor comprised of three germinal layers classified as mature or immature in most cases. Most mature solid teratomas are benign but may turn malignant; therefore, complete resection is advised in these cases. They usually occur in women. Primary rectal teratomas are infrequent, and only a few cases have been described in the literature. Teratomas are the most common cystic that rise in the ovary, testicle, and retroperitoneum. They can also be solid and are better known as dermoid cysts.

We report a 34-year-old woman who were presented with intermittent constipation and diarrhea in Urmia Imam Khomeini Hospital in January 2020. After examination, a solid intra-rectal teratoma occurring mainly in the rectum was detected in this case. The patient underwent segmental colectomy and histology, which revealed squamous epithelium, fat cells, hair follicles, cartilaginous material, and granuloma suggestive of mature teratoma.

The present case was a solid primary rectal teratoma, an uncommon disease with many misdiagnoses that can be differentiated from other diseases. In this case report, it is differentiated from irritable bowel syndrome (IBS).