Journal of Kerman University of Medical Sciences
Volume:30 Issue: 2, Ma-Apr 2023

Acute coronary syndrome (ACS) is one of the most serious diseases with high mortality. Concerning the influence of age and gender on ACS properties, this study aimed to determine gender and age-based differences in risk factors and symptoms of the ACS in a sample of Iranian patients. This cross-sectional study was conducted on 450 patients with ACS in Kerman from 10 September, 2018 to 25 February, 2019. The data were collected through face-to-face interviews in the coronary care unit (CCU) after ACS diagnosis. A trained interviewer collected the data using a demographic and clinical information checklist. Statistical analyses were performed using chi-square, Fisher exact test, and Mann‐Whitney U test and through SPSS software (version 23). In this study, more than half of the patients with ACS were males (n=240, 53.4%). In one-third of the patients, ACS symptoms were presented in the age range of 60-69 years (n = 145, 32.2%). In the female patients compared to the male patients, there were more cases of underweight [58 (27.6%) versus 45 (18.8%), P value: 0.02], positive family history of coronary heart disease (CHD) [102 (48.6%) versus 92 (38.3%), P value: 0.02], and hypertension [119 (56.7%) versus 113 (47.1%), P value: 0.04]. In contrast, there were no differences in common symptoms and pain severity in patients in various age and sex groups. Attention to the differences in the profile of risk factors and symptoms of ACS in males and females of different ages, would be helpful in choosing the best clinical approach.

During the COVID-19 pandemic, nurses experience a high workload and stressful psychological stimuli that affect their mental and emotional health, which may lead to burnout symptoms. Therefore, this study aimed to analyze the effect of COVID-19 on nurses’ job burnout and investigate its consequences. The present study is an applied descriptive study, and data collection was performed using surveys. The study was conducted on 107 nurses working in Shahid Mohammadi and Khalij-e-Fars hospitals of Bandar Abbas, Hormozgan. The level of job burnout was measured using the Oldenburg Burnout Inventory (OLBI), job satisfaction by Job Satisfaction Questionnaire, and depression by Beck Depression Inventory (BDI). The data were analyzed via structural equation modeling by PLS 3 software. Overall, the mean job burnout level was higher than the average (3.45). The results, at the 95% confidence level and the significance value of > 1.96, showed that poor organizational resources and traumatic events have a direct and significant effect on nurses’ job burnout; however, the impact of workload on job burnout was not confirmed. The results also showed that nurses’ job burnout has a direct and significant relevance with depression, job dissatisfaction, and low quality of care. Poor organizational resources and traumatic events increased job burnout. Job burnout increased depression, and also reduced job satisfaction and quality of care. Situational and personal factors have a significant role in decreasing nurses’ job burnout. It is necessary to provide a better work environment, good intrapersonal relationships, and personal skills training courses.

Consumption of a high-fat diet (HFD) is associated with an increased incidence of inflammatory diseases and metabolic disorders. Also, these disorders will increase in women with aging and menopause, which is probably due to the reduced role of estradiol (E2). Selective estrogen modulators including tamoxifen (TAM), which acts through estrogen receptors, have important metabolic effects. This study aimed to determine whether TAM and E2 have protective effects on inflammation caused by HFD in young and aged mice. Four-month-old (Sham and ovariectomized [OVX]) and 20-month-old female C57BL/6J mice were used in this study. After feeding them with HFD for 12 weeks, they were divided into nine groups consisting of Sham + Oil, Sham +TAM, Sham + E2, OVX + Oil, OVX +TAM, OVX + E2, Aged + Oil, Aged +TAM, and Aged + E2. TAM and E2 were injected subcutaneously every four days for four weeks. At the end of the experiments, the mice’s blood was sampled. The serum cytokines tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-10 (IL-10) were also determined using ELISA kits. The results revealed that HFD increased inflammation by reducing IL-10 and increasing TNF-a/IL-10 and IL-6/IL-10 ratio in young and aged mice, and TAM and E2 therapy resulted in a significant decrease in TNF-α and IL-6, and an increase in IL-10 in young and aged mice. In conclusion, the results of this study indicated that TAM, in addition to being used as an anticancer drug, can reduce HFD-induced inflammation in both young and aged mice. Therefore, probably it is a good candidate to substitute E2.

Sodium dodecyl sulfate (SDS) detergent is widely used in tissue decellularization to produce scaffolds for tissue engineering. Despite its strong decellularization, this substance has relatively high toxicity and causes changes in tissue composition. Sodium lauryl ether sulfate (SLES) is a new poly anionic detergent that is less toxic than SDS but weaker than it. The present study aimed to decellularize the intestinal tissue using SDS and SLES solutions, forming a cell scaffold, and examining scaffolds obtained from this tissue. Eighteen male Sprague-Dawley rats were divided into three groups. The intestines of all rats were removed after anesthesia. In the first group (controls), rats’ intestines were placed in a 10% formalin solution. In the second group, intestines were decellularized using an SLES solution. In the third group animals’ intestines were decellularized using an SDS solution. To evaluate decellularization, samples were stained with hematoxylin-eosin staining and Alcian blue staining for glycosaminoglycans (GAGs), and Masson’s trichrome for collagen fibers. A confocal Raman microscope was used to compare collagen, lipid, GAG, and genetic content. Hematoxylin-eosin staining showed that the nucleus and DNA were removed in the decellularized scaffolds by SDS or SLES. The SLES group, compared to the SDS group, showed fewer changes in the epithelial tissue, and muscle layers in both scaffolds were well preserved. The results of confocal Raman microscopy showed that tryptophan, lipid, glycogen, and protein were broken down by both detergents; however, the residual amount of glycogen was the same in both substances, but disulfide bonds of proteins, hydroxyproline, and lipids in the decellularized intestine with SLES were mostly preserved. Both substances were suitable for intestinal decellularization and removed the overall structure of intestinal tissue, but SLES retained collagen and GAG content better than SDS.

There is still no specific treatment strategy for COVID-19 other than supportive management. The potential biological benefits of ozone therapy include reduced tissue hypoxia, decreased hypercoagulability, modulated immune function by inhibiting inflammatory mediators, improved phagocytic function, and impaired viral replication. This study aimed to evaluate the effect of intravenous ozonated normal saline on patients with severe COVID-19 disease.

In this study, a single centralized randomized clinical trial was conducted on 80 hospitalized patients with severe COVID-19. The patients were selected by random allocation method and divided into two groups A and B. In group A (control group), patients were given standard drug treatment, and in group B (intervention group), patients received ozonated normal saline in addition to the standard drug treatment. In the intervention group, 400 mL of normal saline was weighed by 40 μg/ kg of body weight and was injected into patients within 15 to 30 minutes (80 to 120 drops per minute). This process was done daily every morning for a week. Primary and secondary outcomes of the disease included changes in the following items: length of hospital stay, inflammatory markers including C-reactive protein (CRP), clinical recovery, arterial blood oxygen status, improvement of blood disorders such as leukopenia and leukocytosis, duration of ventilator attachment, and rapid clearance of lung lesions on CT scans. The need for intensive care unit (ICU) hospitalization, the length of ICU stay, and the mortality rate in patients of the two groups was compared.

According to the results of the initial outcome variable analysis, the probability of discharge of patients who received the normal ozonated saline intervention was 33% higher than patients who did not receive this intervention; however, this relationship was not statistically significant (HR = 0.67, 95%, CI = 0.42-1.06, P value = 0.089). The chance of ICU hospitalization in patients of the intervention group was three times more than that of the comparison group, but this relationship was not significant (odds ratio = 4.4 95% CI = 1.32-14.50, P value = 0.016). The use of ozonated normal saline was found to increase the risk of death by 1.5 times but this relationship was not statistically significant (odds ratio=1.5, 95% CI=.24-9.75, P value=0.646). Ozonated normal saline had a significant effect on changes in respiration rate (in the intervention group the number of breaths was decreased) and the erythrocyte sedimentation rate (in the intervention group the erythrocyte sedimentation rate was increased); however, it had no significant effect on other indicators.

The present study showed that ozone therapy in hospitalized patients with severe COVID-19 could help improve some primary and secondary outcomes of the disease. Governments and health policymakers should make ozone therapy an available care service so that the need for advanced treatment facilities decreases; consequently, this measure may improve patient safety, prevent lung tissue destruction, and control cytokine storms in patients. Additionally, health decision-makers need to aim for the effective clinical improvement of patients, especially severe ones, and the reduction of their mortality. However, further large-scale multicenter studies with larger sample sizes considering drug side effects and other variables influencing the clinical course of COVID-19 can provide more information on the effectiveness and importance of ozone therapy.

COVID-19 pandemic has caused limitations, in patients’ accessibility in clinical and research settings. We sought whether telenutrition could be applied interchangeably with face-to-face interview for dietary intake assessment by 24-hour recall in patients with type 2 diabetes mellitus (T2DM) during the COVID-19 pandemic.

Sixty-eight females with T2DM aged 50-55 years were enrolled randomly in a descriptive-analytic cross-sectional study. The patients completed three consecutive 24-hour dietary recalls. The first one was a face-to-face interview, and the subsequent two recalls were conducted by telephone call. The total energy and 18 selected nutrients intake were calculated for the three interviews.

The mean (±SD) age of participants was 53.97±2.14 years. The face-to-face interview resulted in significantly higher total energy and 18 selected nutrients intake than the two telenutrition interviews (P value range: 0.031 - 0.001). No significant differences were found between the data provided from the two telenutrition interviews.

Telenutrition underreports and underestimates the total energy and nutrient intakes compared with the face-to-face interview in the 24-hour dietary recall. Therefore, it cannot be recommended to be applied interchangeably with a face-to-face interview for dietary intake assessment during the COVID-19 pandemic, especially in patients whose nutrition assessment is of clinical importance. A combination of the two methods using new communication applications (e.g. WhatsApp) may cover the defects of telenutrition method.

The novel coronavirus disease (COVID-19), as a global concern, has affected different economic and social aspects, as well as health costs in various communities. Finding effective and available treatment is an urgent need. A recent study has demonstrated that the ketogenic diet (KD) activates innate immunity and has a protective property against virus infection. Accordingly, we conducted this study to find the effect of oral medium-chain triglyceride (MCT) on COVID-19 and its clinical manifestations.

This was a randomized clinical trial on 195 patients clinically suspected of COVID-19 referred to infectious disease clinics of Kerman. Patients were randomly assigned into two groups. The Control group received standard supportive treatment, the recommendation for carbohydrate avoiding and diet modification. Patients in the intervention group received all mentioned recommendations beside MCT oil. Patients` clinical symptoms, including body temperature, respiratory rate, body pain, and dyspnea, were recorded in a checklist and analyzed.

The mean age of patients was 37.78 ± 12.42 years in the intervention group and 40.81 ± 13.23 years in controls (P = 0.231). The patients in the intervention group had lower duration of weakness (P = 0.004), body pain (P = 0.004), dyspnea (P = 0.004), gastrointestinal manifestations (P<0.001), sore throat (P<0.001), increased respiratory rate (P<0.001), and high intensity of cough (P=0.002). Indeed, weakness, cough frequency, sore throat, and gastrointestinal complications were significantly lower in the females of the intervention group (P=0.006, P=0.030, P=0.005, and P=0.001, respectively). In contrast, in the males of the intervention group, manifestations such as respiratory rates, dyspnea, cough intensity, and sore throat were significantly lower than those in the control group.

Administration of MCT in outpatients suspected of COVID-19 alleviated clinical symptoms such as increased respiratory rate, cough intensity, dyspnea, body pain, and gastrointestinal symptoms and helps them overcome the probable disease morbidity.

Liver cancer is the third most common cause of cancer mortality. Artificial intelligence, as a diagnostic tool, can reduce physicians’ working load. However, the main fear is that due to the existence of many causes and factors, liver diseases are not easily diagnosed. This study analyzes liver disease intelligently. Various decision tree models were used in this research.

The records of 583 patients in the North East of Andhra Pradesh, India, registered at the University of California in 2012, were collected. Decision tree models were compared by three measures of sensitivity, accuracy, and area under the ROC curve.

In this study, Decision-Stump showed better results than other models. Accuracy, sensitivity, and ROC curve of Decision-Stump were 71.3058, 1, and 0.646, respectively.

The superior model with the highest precision is the Decision-Stump model. Therefore, the Decision-Stump model is recommended for liver disease diagnosis. This paper is invaluable for the allocation of health resources for risky people.

Facial tissue loss is acquired as a result of congenital anomalies or acquisitional misshapen like tumoral lesions or accidents. These defects result in functional problems, esthetic concerns, and also psychosocial troubles and could be repaired by plastic surgery or reconstructed using facial prostheses. Conventional tissue-supported auricular prostheses meet lots of challenges due to dependence on tissue undercut or adhesive for retention. Implant-retained auricular prostheses lessen the complications related to adhesive-retained prostheses and alleviate the need for invasive plastic surgery. Implant-retained auricular prostheses provide patients with secure retention and avoid prosthesis disengagement caused by movable surrounding soft tissue. The impact of prostheses with secured retention and satisfactory esthetics on the self-confidence of patients with facial defects is promising. This paper aimed to describe the surgical and prosthetic workflow of a patient with acquired ear deformity due to basal cell carcinoma (BCC) which was rehabilitated with implant retained auricular prosthesis.

Several viral infections may lead to hearing loss. It›s still unknown whether COVID-19 has effects on the auditory system or not. In this regard, to evaluate the possibility of sudden sensorineural hearing loss due to COVID-19, this study aimed to report sudden sensorineural hearing loss (SSNHL) in patients with COVID-19 in Iran.

Case Report:

 The patient was a 7-year-old girl diagnosed with COVID-19 and sensorineural hearing loss. An audiogram revealed normal hearing in the right ear and severe sensorineural hearing loss in the left ear. The tympanometry test result was bilateral type A. The treatment started with prednisolone (1 mg/kg/d). The audiogram of follow-up pure-tone audiometry did not reveal any improvement.

SSNHL appears to be a possible complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. COVID-19 infection could have deleterious effects on cochlear hair cells and eight nerve functions. Therefore, audiological monitoring should be initiated in patients presenting with COVID-19.

Nurses are the largest group of health care providers spending most of their time in touch with patients and are often present at patient bedside immediately when a problem arises (1,2). In many countries around the world, nurses are allowed to prescribe some medications, but this is not the case for nurses working in Iran for some reasons (3) and although nurses are aware of medications used in emergency situations, in Iran, nurses have no legal right to prescribe medications without taking physicians permit and agreement (4,5). In this letter, we argued whether or not nurses should have the authority to prescribe medications for patients.