Hormozgan Medical Journal
Volume:26 Issue: 4, Oct 2022

The increase in demand for emergency services causes overcrowding in emergency departments. Length of stay in emergency departments also influences overcrowding in emergency departments and is a key factor for monitoring the performance in emergency departments. This study investigated the factors affecting length of stay in patients referred to emergency department in Bandar Abbas, Iran.

This retrospective cross-sectional study was conducted from December 2018 and February 2019 by investigating 234 eligible patients referred to Emergency Department of Shahid Mohammadi. Demographic characteristics were also recorded, which included gender, age, type of disease, triage level, the time for entry to emergency specialist visit, specialist visit to order time, entry to imaging/lab assay, entry to other specialist consultants, and time for entry to final decision.

The results did not indicate any significant difference in both genders and all age groups (P>0.05), but entry time to lab/imaging assays was significantly lower in patients under 40 years old (P=0.001). Moreover, specialist visit to order time (P=0.001), entry to lab/imaging assays (P=0.003), and entry to final decision time (P=0.013) were significantly shorter in the patients with cardiac diseases. Furthermore, entry to specialist visit time (P=0.001), entry to lab/imaging assays time (P=0.0212), and entry to final decision time (P=0.004) were significantly lower in the patients with lower levels of triage.

Triage levels are contributing factors for lengths of stay in emergency department, and these factors can be used for decreasing emergency department lengths of stay.

 Cancer is the second largest cause of child mortality after accidents worldwide. Childhood cancers have an average incidence in Iran, with 176 cases in one million people. The objective of this study was to examine the efficacy of music therapy on anxiety, self-esteem, and social adjustment of children with cancer in Kerman in 2019.

 A quasi-experimental method with a pre-test and post-test design with a control group was used in this study. The statistical population of research included all children with cancer admitted to Afzalipour hospital in Kerman (Iran) in 2019, and thirty children were selected by the convenience sampling method and then randomly divided into experimental (n=15) and control (n=15) groups. Data were collected using the children’s Multidimensional Anxiety Scale, the Coopersmith Self-esteem Inventory, and California Social Adjustment Scale. Finally, the data were analyzed using SPSS22 through the multivariate analysis of covariance.

 The results indicated that music therapy was effective in reducing anxiety (P<0.001, F=179.29) while increasing self-esteem (P=0.001, F=120.60) and social adjustment (P=0.001, F=48.56) in children with cancer.

 It can be argued that music therapy in children with cancer has been successful for anxiety, self-esteem, and social adjustment and can be applied to alleviate psychological issues in children with cancer

 Multiple sclerosis (MS) is a common disease of the central nervous system. The main cause of this disease is related to the myelin damage of nerve cells. This study aimed to compare the effectiveness of acceptance and commitment therapy (ACT) and mindfulness-based cognitive therapy (MBCT) on illness perception and adherence to the treatment of patients with MS.

 This is a quasi-experimental study with a pre-test, post-test, and follow-up design with a control group. The statistical population of this study included all patients with MS under the auspices of the MS Society of Tehran (Iran) in 2019. Forty-five women with MS were purposefully selected and randomly divided into MBCT, ACT, and control (n=15) groups. Data were obtained using the revised illness perception questionnaire (IPQ-R) and the MS treatment adherence questionnaire (MS-TAQ). The repeated measurement analysis of variance and SPSS.22 were used to analyze data.

 The results showed that the effect of MBCT was greater than that of the acceptance and commitment-based therapy group on illness perceptions (P<0.001) and treatment adherence (P<0.001).

 Overall, the effectiveness of MBCT was greater than that of the ACT group on illness perceptions and adherence to treatment. MBCT and ACT can be employed as effective methods for patients with MS.

 To date, limited studies have evaluated the role of vitamin A in acute pyelonephritis (APN). Accordingly, we aimed to investigate the effect of this vitamin on the prevention of renal damage in children with APN.

 This assessor-blind randomized controlled trial included 108 children with APN, aged 3 months to 14 years, who were admitted to Bandar Abbas Children’s Hospital, Bandar Abbas, Iran, in 2020. Patients were randomly allocated to two equal groups. Children in the vitamin A group received vitamin A in addition to antibiotics (ceftriaxone), while those in the control group only received antibiotics. Then, children in both groups underwent dimercaptosuccinic acid (DMSA) scanning once at baseline and four months after treatment. Photopenic areas in the DMSA scan were regarded as damaged areas. Further, serum vitamin A levels, C-reactive protein (CRP) levels, and erythrocyte sedimentation rate (ESR) were measured in all participants before the initiation of treatment. Finally, the demographic features of the participants were noted, including age and gender.

 Patients in both groups were comparable regarding age and sex. Serum vitamin A levels, CRP, and ESR did not differ significantly between groups before treatment. The mean number of photopenic areas in the baseline DMSA scan was similar in both groups (P=0.481); however, the mean number of photopenic areas in the DMSA scan after four months was significantly lower in the vitamin A group compared to controls (P=0.004).

 Therefore, the use of vitamin A, along with antibiotics can significantly decrease renal damage in children with APN.

Forced expiratory volume in 6 seconds (FEV6) is a reliable substitute for forced vital capacity (FVC) to identify pulmonary diseases. This study aimed to determine the diagnostic performance of FEV6 in the detection of obstructive and restrictive spirometric patterns.

In this cross-sectional study, spirometry was performed on patients referred to the occupational medicine clinic of Shahid Mohammadi Hospital, Bandar Abbas, Iran, 2018. Spirometric parameters, including FEV1, FVC, and FEV6, were recorded for those tests meeting the American Thoracic Society (ATS) standards. Taken as the reference, the FEV1/FVC ratio<70% indicated airway obstruction, and the restrictive pattern was defined as FVC<80%.

In general, 1100 spirometries were included after meeting the ATS standards. The optimal cut-off of FEV1/FEV6 for the prediction of airway obstruction was 71.45% with a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of 97.22%, 98.22%, 89.17%, 99.57%, and 98.09%, respectively. The best cut-off of FEV6 for the prediction of the restrictive pattern was 79.23% with the corresponding diagnostic indices of 97.29%, 99.05%, 94.11%, 99.57%, and 98.81%, respectively. Based on the FEV1/FEV6 cut-off, the frequency of obstruction was 14.27% (157/1100) compared to 13.09% based on FEV1/FVC. The frequency of restriction was 13.90% (153/1100) according to the FEV6 cut-off compared to 13.45% with respect to FVC.

Overall, our results indicated the applicability of FEV1/FEV6 as an accepted surrogate for FEV1/FVC to diagnose airway obstruction, particularly to screen for chronic obstructive pulmonary disease (COPD) among high-risk patients. In addition, FEV6 is potentially an appropriate substitute for FVC to detect a restrictive pattern.

Stroke is a significant cause of morbidity and mortality worldwide. The association between non-hemorrhagic stroke and some electrocardiographic and echocardiographic findings shows its potential cardiac source. This study aimed to evaluate electrocardiographic and echocardiographic findings of patients with non-hemorrhagic stroke.

This cross-sectional study included 134 patients with non-hemorrhagic stroke admitted to the neurology ward of Shahid Mohammadi hospital, Bandar Abbas, Iran, from 2018 to 2019. Patients’ characteristics including age, gender, family history of stroke, diabetes, hypertension, dyslipidemia, inadequate physical activity, and smoking were recorded. All patients underwent electrocardiography (ECG) and echocardiography.

The patients’ mean age was 68.57±12.08 years. Additionally, 84 patients (62.7%) were male. The most common risk factor was dyslipidemia (72.4%) followed by hypertension (64.9%), diabetes (45.5%), smoking (44.8%), and family history of stroke (17.2%). Inadequate physical activity was found in 69.4% of the patients. The most common ECG finding was old myocardial infarction (MI) accounting for 24.6% of the patients, followed by atrial fibrillation (AF) (14.9%) and new MI (3.7%). The most common echocardiographic finding was significant mitral regurgitation (MR) (23.1%), followed by left ventricular systolic dysfunction (21.6%), significant tricuspid regurgitation (TR) (11.2%), mitral stenosis (MS) (4.5%), aortic stenosis (AS) (4.5%), and mitral annulus calcification (MAC) (2.2%).

The most common echocardiographic and ECG findings of patients with non-hemorrhagic stroke in this study were MR and old MI and the most common risk factor was dyslipidemia.

In March 2020, the world health organization declared the outbreak of novel coronavirus disease 2019 (COVID-19) as a pandemic. COVID-19 is a highly contagious disease. Kish is a touristic island that is located in the south of Iran. The aim of the present study was to investigate the epidemiology of COVID-19 on Kish island.

In the present cross-sectional study, the residents of Kish Island, Iran, who were checked with COVID-19 polymerase chain reaction (PCR) test from February to August 2020 were included. The PCR test was obtained from symptomatic individuals or those people who had exposure to suspected COVID-19 cases. Data were collected from their medical records and analyzed based on their PCR test results.

A total of 4859 individuals were checked with COVID-19 PCR test. The result was positive in 1251 (25.75%) cases and negative in 3608 (74.25%). The mean age was 37.32 years. The majority of the individuals were men. Most of the participants were office employees. The number of housewives was approximately double in COVID-19 positive patients compared with the patients with negative results. About 40% of the individuals with positive results had a history of exposure to suspected COVID-19 cases. The prevalence of exposure to suspected COVID-19 cases and recent travel was significantly higher among positive cases (P<0.001). There was a significant correlation between the delay between the onset of the symptoms and performing PCR. Longer delays were seen among the deceased patients.

It seems that more precise policies should be taken to avoid contact with symptomatic patients and people who had a history of travel to the island.

Zinc plays an important role in some metabolic and signaling pathways of the immune system and may improve the signs and symptoms of neonatal sepsis. This study aimed to evaluate the efficacy of zinc supplementation in neonatal sepsis.

This randomized controlled trial included 50 neonates with sepsis admitted to Bandar Abbas Children’s hospital, Iran, from 2018 to 2019. Patients were randomly allocated into two groups: the zinc group received standard antibiotics plus 1 mg/kg zinc gluconate twice a day for 7 days starting within the first 24 hours after admission, while the control group only received antibiotics. Complete blood count (CBC) with differential, C-reactive protein (CRP), and platelets were measured on the first day of admission. Blood sampling was done again after 48 hours based on the patients’ condition. Patients’ information such as age, sex, gestational age, birth weight, time to the improvement of clinical and laboratory findings, hospital length of stay, mortality, change in the antibiotic regimen, and signs of sepsis were noted.

The two study groups were similar concerning age and sex. Birth weight, gestational age, duration of hospital stay, time to the improvement of clinical findings, baseline CRP, and change in the antibiotic regimen were comparable in both groups (P>0.05). The time to the improvement of laboratory findings was significantly lower with zinc supplementation compared with controls (6.56±2.95 vs. 8.36±3.34 days, P=0.022). Further, final CRP significantly decreased compared to baseline CRP in both groups (P<0.001); however, this reduction was greater in the zinc group (final CRP: 3.60±1.87 vs. 5.12±2.11 mg/L, P=0.015). Moreover, no mortality was reported in either of the groups.

Zinc supplementation had no effect on hospital length of stay in neonatal sepsis; however, it reduced the time to the improvement of laboratory findings, especially CRP.

 It is necessary to help type 2 diabetic patients solve diabetes problems by identifying factors affecting healthy lifestyle and self-care indicators that can be improved using different psychological approaches. This research aimed at determining the effectiveness of the acceptance and commitment therapy (ACT) intervention on healthy lifestyle and self-care indicators in type 2 diabetic patients.

 This was a quasi-experimental study with a pre-test, post-test, and follow-up with a control group. The statistical population of the study consisted of patients with type 2 diabetes in the age range of 30-60 years at the Diabetes Clinic of Zahedan University of Medical Sciences in 2019. The sample included 40 patients with type 2 diabetes selected by a convenient sampling method and assigned to ACT (n=20) and control (n=20) groups using a simple randomization method. ACT training was performed in 9 sessions for 90 minutes. Data were collected through the lifestyle questionnaire and self-care behavior questionnaire and analyzed by the multivariate analysis of covariance using SPSS 22.

 The findings indicated that ACT was effective in increasing healthy lifestyle (P=0.022) and selfcare indices (P<0.001) in type 2 diabetic patients.

 Overall, ACT could affect healthy lifestyle and self-care indicators in type 2 diabetic patients. Thus, it can be used for decreasing type 2 diabetic patients’ psychological problems.