Hospital Practices and Research
Volume:7 Issue: 2, Spring 2022

The field of neurology encompasses a wide range of disease types, and recognizing the most common manifestations of these diseases, particularly in subgroups, is critical for improving appropriate diagnostic and therapeutic measures.

The purpose of this study was to determine the frequency of common manifestations of neurological diseases in patients referred to a military hospital’s internal neurology clinic.

This was a cross-sectional descriptive study of patients referred to the internal neurology clinic of a reference military hospital, Tehran, Iran in 2020. The sampling was done at random using a checklist. Finally data was analyzed by using SPSS software.

Women made up the majority of patients in 336 samples 182 (54.2 %) versus 154 (45.8 %). The patients’ average age was 49.5 ± 16.5 years, with 28.3 % (n = 95) being elderly. The three most common complaints raised by patients were headache, movement disorder, and sensory disorder, accounting for 29.5%, 27.7%, and 27.7% of complaints, respectively. Seventeen patients (5.1%) also mentioned other issues, with anger, anxiety, depression, and nausea being the most common complaints.

Headache, movement disorder, and sensory disorder are the most common neurological disorders referred to a military hospital. Because of the high prevalence of these issues, it is necessary to establish specialized clinics and conduct additional research to determine the most common types of sensory and movement disorders, as well as the most effective methods of prevention and treatment in medical centers.

The risk of developing diabetes mellitus for an individual with a positive family history of the disease is two- to fourfold higher in an offspring of a diabetic compared with offspring of non-diabetic shown by serum glycated hemoglobin (HbA1c) levels. There is paucity of data on pre-diabetes in our environment. This study was designed to determine the baseline HbA1c levels of normoglycemic offspring of type 2 diabetes mellitus (T2DM) patients in Ijebu-ode, Nigeria. This is a cross-sectional study of offspring of T2DM patients (ODP) and those of offspring of non-diabetic parents (ONDP). Diabetic offspring were exempted from the study. FBS was determined using enzymatic hexokinase method to determine glucose concentrations and exclude diabetes. Serum HbA1c was measured using standard method. Height and weight were measured using standard methods. Body mass index (BMI) was calculated. There were 100 ODP and 100 ONDP aged 16 to 40 years. The most populated aged group was 21 to25 years which is 44% (n = 88). 6% (n = 12) of the study group were obese. 19% were overweight (n = 38). The mean weight of ODP was significantly higher than that of ONDP (P = 0.020). Also, the mean HBA1c of ODP was significantly higher than that of ONDP (P < 0.001). The serum HbA1c level was significantly higher among ODP than ONDP. The mean weight was significantly higher in ODP than ONDP.

High income is a protective factor against suicidality for children, youth, and adults, however, recent research has documented weaker health effects of high income for Black than White individuals, a pattern also called marginalization-related diminished returns (MDRs). In this study, we tested racial variation in the association between high income and suicidality in a national sample of 9-10-year-old Black and White American children. This cross-sectional study used data from the Adolescent Brain Cognitive Development (ABCD) study, which included 7298 White or Black children between the ages of 9 and 10. Of all the participants, 5652 were White and 1646 were Black. The predictor variable was family income, treated as a continuous measure. Race was the moderator. The outcome variable was suicidality, treated as a dummy variable, reflecting any positive suicidal thoughts or behaviors endorsed over the lifecourse. Covariates included sex, age, family structure (parental marital status), parental education, trauma, history of depression, neighborhood poverty, and family conflict. Logistic regression was used for data analysis. Overall, family income was inversely associated with children’s suicidality, net of all covariates. A statistically significant interaction was found between race and family income, suggesting that the inverse association between family income and suicidality is weaker in Black than White children. The observed weaker association between income and suicidality in Black than White children suggests that family income does not provide the same protection against suicidality for Black as White children. Due to racism, income and some other socioeconomic status indicators show weaker than expected health effects on Black families in the US.

Esophageal cancer is the eighth-most common cancer and the sixth-most common cause of cancer death worldwide. In Iran, its prevalence is high. Surgery is recommended for tumors in early stages. This study aims to determine demographic data, therapeutic approaches, postoperative mortality, and survival rate in patients with esophageal cancer who were managed in a referral hospital. In a cohort study, the patients hospitalized during six-year period were evaluated. Demographic data, tumor characteristics, laboratory data, surgical approaches, and survival time were obtained. Statistical analysis was performed using life tables, proportional hazard Cox regression, and the Kaplan-Meier method by SPSS version 20 software. Survival curves were compared by log-rank analysis. Over six years, 92 patients were admitted of which 54 (58.7%) were male. The average age was 63.08±12.03 years. Ten patients (10.8%) were below 50 years old. Squamous cell carcinoma (SCC) was the most common type (85.8%). Fifty-three patients (57.6%) were selected for the surgery. Postoperative mortality in 30 days occurred in 7 patients (13.2%). The median survival rate was 12.8±2.92 months. The survival rate for one, three and five years were 51.94%, 24.67% and 19.48%, respectively. Two factors that had significant statistical correlation with median survival time were metastasis (P = 0.01) and vomiting (P = 0.003). Esophageal cancer is a poor prognostic disease and esophagectomy is a morbid operation. To reduce postoperative mortality and increase the survival time, better patient selection and operations by expert surgeons must be considered.

Ankylosing spondylitis (AS) is a chronic, progressive, and disabling disease among rheumatological diseases. Current study aimed to investigate the Time lag between the onset of symptoms and final diagnosis of AS, and also identify the factors that contribute to that delay in Sulaymaniyah province. In this cross-sectional study, 104 (AS) patients who satisfied the modified New York 1984 criteria were enlisted. The time lag was defined as the diagnosis delay (DD) between the appearance of the first symptoms and the correct diagnosis of AS. Spearman correlation analysis was used to detect correlations between variables. The higher percentage of variables with DD ≥ 6 years were urban 32 (74.4%), housewife 15(34.9%), had no family history 42 (97.7%), with high diploma 33 (76.7%), and positive HLAB27 31 (72.1%), the first specialist consulted orthopedics 21(48.8%) then GP 6 (14.9). Moreover, the higher percentage of variables with DD < 6 years were diagnosis years between 2000 to 2020, rural 55 (90.2), 39 (63.9%) respectively, higher education 47 (77%), employee and worker 22 (36.1%), positive family history 44 (72.1%), positive human leukocyte antigen (HLAB27-61) (100%), inflammatory back pain 47 (77%), rheumatologist 29 (47.5%). The average year’s DD is 6.48. A statistically significant positive correlation was detected between the DD and age, age at diagnosis but, a negative correlation was found between the DD time and, age at symptom onset. The Time lag between the onset of symptoms of AS and the final diagnosis in Sulaymaniyah was 6.48 years. (HLA-B27), age, age at diagnosis, education level, occupation, 1st specialist, 1st symptom at onset of disease and family history are the factors that affect delayed diagnosis in Sulaymaniyah patients with AS.

To test the effectiveness of concept maps used in the education of nursing students in the field of health, we need to use measurement tools. The purpose of the study was to develop “Scale for the Effectiveness of Concept Maps in Nursing Education (SECMNE)”. This was a methodological instrument development study. This study was conducted in a university’s health of nursing department in Tokat, Turkey, between September and December 2019. The universe of this study, which used a methodological design, consisted of third and fourth-year nursing students, and the sample size was 174. The item pool was formed with 86 items. The content validity was assessed by 9 experts. The 86-item draft scale that had a 4-point Likert type scoring system. Content validity ratio (CVR), Kaiser-Meyer-Olkin (KMO) test, Bartlett test, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Cronbach’s alpha, and Pearson product-moment correlation analysis techniques were used for the validity and reliability analyses of the scale. The scale consists of 3 subscales (integration of information, integration of the care plan, perception) and 30 items. Scale’s Cronbach alpha is 0.97. The scale developed in this study was concluded to be a valid and reliable measurement tool that can be used to measure the effectiveness of the concept maps in nursing education. The SECMNE can help nursing student identify the lack of knowledge and negative attitudes about concept map in nursing education and prepare nursing care plan.

The main symptoms of new coronavirus in patients are fever or chills, tiredness, and dry cough. In this case, we reported a woman who got involved in COVID-19 pneumonia with gastrointestinal instead of lower respiratory symptoms.

A 67 years old woman was referred to an outpatient clinic in Tehran with fever, chills, sneezing, tiredness, severe nausea, anorexia, and diarrhea. She did not have a cough, dyspnea, or chest pain and her lung sound was normal. According to the blood O2 saturation decreasing, C-reactive protein increasing, and the lung imaging findings, she was admitted with COVID-19 pneumonia diagnosis in the infectious care department of a hospital. The 2019-nCoV real-time polymerase chain reaction (PCR) intranasal assay was negative. She was treated with intranasal oxygen therapy, anti-inflammatory drugs, and prednisone. After one week she was discharged in generally good condition and quarantined for two weeks later. After 25 days the COVID-19 IgM and IgG antibodies were in positive ranges.

Severe fatigue, mainly in elders caused the inability to cough, and light inspiration force especially in the lower lung lobes could explain the normal lung sounds in the physical examination. Also, we hypothesized that reverse circulation of the virus may occur from the gastro intestine to the respiratory system. The gut-lung microbial imbalance may affect the severity in patients with extrapulmonary symptoms, especially in old ages. Furthermore, damage to the vagus nerve along the path in the proximity to lungs infected with COVID-19 can cause nausea without gastrointestinal involvement.

Neurofibromas, benign peripheral nerve sheath tumors, are the most common among neural lesion. Neurofibromas are rare in head and neck location, although it may involve any part of oral cavity. However, tongue is the most common region.

A 27 year-old man was admitted to Otorhinolaryngology Department due to a swelling in the base of his tongue, since two weeks before. This mass was painless, and without any associated symptoms. He was suffered from a mild eating disorder, too. He had no any positive past medical history, and only a large soft 6 × 5 cm mass was found at the base of his tongue without bleeding in the oral cavity. Excisional biopsy was performed for him under general anesthesia and the tumor was easily enucleated. The final diagnosis was neurofibroma. After the diagnosis of neurofibroma, the physical reexamination revealed a series of café au lait spots on his skin.

the neurofibroma should be considered by otorhinolaryngologist, as a differential diagnosis of tongue mass, and more accurate physical examination are recommended for better management.