فهرست مطالب

Canon Journal of Medicine - Volume:4 Issue: 2, Spring 2023

Canon Journal of Medicine
Volume:4 Issue: 2, Spring 2023

  • تاریخ انتشار: 1402/01/08
  • تعداد عناوین: 8
|
  • Sakineh Rakhshanderou *, Saba Ilkhani, Mohtasham Ghaffari, Hossein Hatami Pages 40-45
    Introduction
    Nursing is one of the most stressful professions worldwide. Job stressors can have a substantial impact on the mental health of nurses. This study aimed to assess how much workplace stressors can predict each component of this population's mmental health
    Methods
    419 nurses from eight tertiary hospitals in Tehran were enrolled for this observational survey, and data was collected from a three-part questionnaire including the Depression, Anxiety, and Stress Scale - 21 Items (DASS-21, Extended Nursing Stress Scale (ENSS), and demographic questions. Multivariate regression and factor analysis were performed to build a Structural equation modeling between variables
    Results
    The Correlation between Stress, anxiety, depression, and work stressor were significant (p-value=0.01). Based on the SEM model, for each component of DASS (Stress, anxiety, depression), seven items in the questionnaire were significant and internally consistent(p-value:0.05). In the ENSS questionnaire, all nine subscales significantly predicted the total nursing stress score.
    Conclusions
    Females, single, and nurses with more than six years of experience scored higher on the work stress scale. The workload is the most significant stressor in depression and, as a result, poor mental health.
    Keywords: Occupational stressors, mental health, Nurses, structural equation modeling
  • Zohre Makarem *, Somayeh Rezaei, Sayedali Naji, Samira Rezaei Pages 46-49
    Introduction
    The number of old people is rapidly rising in all regions of the world. Given the numerous psychological problems threatening elderlies and the poor social support of those living in retirement homes, this study attempts to evaluate two psychophysical health indicators in elderlies of the city of Bam (Kerman, Iran).
    Methods
    This study was an applied survey conducted on all elderlies living in Sepehr Senior Home in Bam. Participants were selected by census sampling. Data were gathered by the Pittsburgh Sleep Quality Index (PSQI) and the University of California Los Angeles (UCLA) Loneliness Scale and then analyzed in IBM SPSS Statistics.
    Results
    The mean score of social isolation was 48.06±15.7. Social isolation was most frequently observed in 43.8% of elderlies. The mean score of sleep quality was 16.76±8.65. Sleeping problems were frequently found in 38.8 of elderlies with poor quality of sleep.
    Conclusion
    Our findings can help clinical nurses and health caretakers of senior homes to reach a better recognition of older persons' mental health conditions and enable them to sleep better and socially interact more efficiently. This study further can highlight the problems of elderlies and inspire more nursing scholars to conduct more research in this context.
    Keywords: Elder, psychophysical health, Quality of sleep, Social isolation, Bam
  • Sajad Hatami, Samaneh Tahmasebi Ghorabi, Kamyar Mansouri, Zahrasadat Razavi, Arian Karimi Rouzbahani * Pages 50-54
    Introduction

    In recent years, platelet-rich plasma has been used in burn wound repair, plastic surgery, bone and tendon ligament injury repair and other treatment at home and abroad. In Platelet-Rich Plasma, the concentrated platelets of the patient's blood are used, which will lead to collagen production, production and regeneration of new cells in the damaged skin. Due to the many complications of burn wounds and response to treatment in a long period of time; It is possible that the PRP method is effective in the treatment of burn wounds and restores the skin with minimal scarring in a shorter period of time. Therefore, the aim of this study was the effect of human platelet-rich plasma on hospitalized burn patients.

    Methods

    This is a clinical trial study that was conducted on burn patients admitted to Emam Khomeini Hospital in Ilam city in 2018. In this study, due to the fact that the time period was determined and all the patients who met the conditions for entering the study were treated after obtaining informed consent, the sample size formula was not used. Based on patient referrals and during a period of 6 months, 25 people suffered burns, according to the inclusion criteria; 20 people were included in the study. According to different wounds in patients; In each patient, routine treatment was used in one part of the wound and PRP in the other part of the wound in addition to the usual treatment. Then, they were compared in terms of the duration of epithelialized tissue formation in the burn site.

    Results

    using PRP along with routine treatment compared to routine treatment alone, the time to create epithelialized tissue is reduced by about 29%. It was also shown that the variables of age, gender, weight, height, burn mechanism, percentage of burn, amount of platelets and white blood cells have no significant relationship (p<0.05) with the effect of PRP in the treatment of burn patients.

    Conclusion

    The use of PRP along with the routine treatment of burn patients brought positive results, which can become a routine method in all burn departments if expanded, and widely reduce the length of hospitalization of patients and the amount of costs incurred by patients and Also, reducing the costs of the health system is effective.

    Keywords: Burns, Centrifugation, Epithelialization, Platelet-Rich Plasma, PRP, Wounds
  • Hamidreza Taghipour, Sadra Taghipour, Saman Soltani Moghadam, Alireza Bolouriyan, Seyed MohammadJavad Mirlohi * Pages 55-58
    Introduction

    Coronary artery disease (CAD) is the leading cause of death in world. In addition, coronary artery bypass graft (CABG), which is known as one of its therapeutic approaches, can cause complications and morbidities that have high costs. We aimed to investigate the distribution of CAD risk factors in patients who underwent CABG in Tehran, Iran.

    Methods

    The present cross-sectional study included CAD patients who underwent CABG surgery from 20 March 2016 to 20 March 2017 in Baqiyatallah Hospital, Tehran, Iran. The data including the presence of CAD risk factors such as smoking, diabetes, hypertension, presence of CAD family history, and hyperlipidemia, were obtained from the patients’ medical records.

    Results

    out of 328 patients, 109 (33.3%) were female and 219(66.8%) were male. Their age ranged between 41 to 88 and the mean age (SD) was 62.15 (9.913) years. Finally, 296 patients (90.2%) had at least one symptom and 292 (89%) patients had at least one risk factor. Prevalence of hypertension, hyperlipidemia, diabetes, smoking, and positive familial history was 53.7%, 44.5%, 39.6%, 22.3%, and 16.2% respectively.

    Conclusion

    The most prevalent risk factor was hypertension followed by hyperlipidemia, smoking, diabetes, and familial history. Also, chest pain was the most frequent symptom among patients. A healthy lifestyle is essential to decrease the prevalence of modifiable risk factors and preventing the presence of CAD and future vascular bypass surgeries in the population.

    Keywords: CABG, CAD, Coronary Artery Disease
  • Aziz Eghbali, Roghayeh Rahimi Afzal, Aygin Eghbali, Ali Karbalaie *, Behnaz Shabani Fouladi, Seyed Amir Sanatkar Pages 59-63
    Background
    Hyperglycemia is a common complication during treatment for acute lymphoblastic leukemia (ALL) and can be associated with multiple adverse outcomes. In this study, we investigated the effect of chemotherapy-induced hyperglycemia on response to treatment in pediatric ALL patients.
    Material and methods
    192 ALL patients from 2009 to 2017 were divided into the case (glucose value ≥ 200 mg/dl) and control (no hyperglycemia) groups. The two groups were compared in terms of length of hospital stay, nosocomial infection, delay in chemotherapy and remission, and survival rate.
    Results
    Of the 192 patients, 44 (22.91%) met previously defined criteria of hyperglycemia. The mean (±SEM) length of hospital stay in the case and control groups was 30.23 (±0.71) and 27.49 (±0.42) days, respectively (P = 0.002). In the case group, 23 patients (52.28%) and in the control group 47 patients (31.75%) had delayed chemotherapy (P = 0.01). In the case group 23 people (52.27%), and in the control group 48 people (32.43%) developed nosocomial infections (P = 0.02). Everyone in the case group had a remission before a month, in the control also only 2 (1.3%) didn’t experience remission in a month. The rate of one-year survival in the case and control group were 88.64% and 84.09%, and three-year survival was 86.48% and 83.1%, respectively.
    Conclusion
    hyperglycemia in pediatrics with ALL is associated with increased length of hospital stay, delayed chemotherapy, and nosocomial infection, however, there was no significant difference between the two groups in terms of remission and survival.
    Keywords: Pediatric, Acute Lymphoblastic Leukemia, Hyperglycemia
  • Arezou Farajpour, Rasam Mashoufi * Pages 64-67
    Introduction

    One specific type of anxiety is test anxiety, which involves worry, stress, lack of confidence, fear of failure, or confusion that a person may feel before, during, or after an exam. The present study aimed to investigate the anxiety level of medical students of Azad University of Medical Sciences during their critical exams.

    Methods

    The present cross-sectional study was conducted on medical student of the Islamic Azad University, Mashhad Branch, Mashhad, Iran who were in the internship stage by census sampling method. State-Trait Anxiety Inventory (STAI) questionnaire was applied to measure the participants before their pre-internship written exam and Objective Structured Clinical Examination (OSCE).

    Results

    There was no statistically significant difference in the mean manifest anxiety score between genders in the clinical competency exam (p=0.17). Similarly, there was no significant difference in the mean manifest anxiety score between genders in the written exam (p=0.63). However, females presented higher levels of anxiety in both written exam (47.7±11.4) and OSCE (42.0±9.6)

    Conclusions

    OSCE not only does not cause more anxiety in the student than the written test but also less anxiety due to the direct interaction and proper communication between the examiner and the student is experienced.

    Keywords: medical education, test anxiety, OSCE, Exam
  • MohammadHossein Alaghmand, Hamideh Molaei, AliAkbar Karimi Zarchi, Seyyed Masoud Davoudi * Pages 68-70
    Introduction

    Mostly located in the dermo-epidermal junction, junctional nevus is a type of melanocytic nevi which is consisted of nevoid cells. A variety of treatment methods have been introduced so far for facial junctional nevi; however, they may be associated with scars. We aimed to evaluate the therapeutic efficacy of pulsed dye laser (PDL) and aesthetic improvement in patients with melanocytic junctional nevi.

    Methods

    This quasi-experimental study was conducted between January and April 2019 in Baqiyatallah dermatology clinic. We included patients with melanocytic junctional nevi in neck and face equal to or less than 10 mm as well as those between 15 and 30 years of age. Before intervention, we took a photograph of Nevus. Then this photograph was repeated at the beginning of each session and one month after the last session of laser therapy. The laser parameters for treatment were set to 10 joules energy and pulse width of 3 milliseconds. We asked a non-participant faculty member to determine the rate of improvement by visual analogue scale (VAS).

    Results

    Eventually, 37 patients (120 nevi in 25 male and 12 female) were analyzed. Male patients had a mean age of 24.9±2.3 years and this was 23.4±1.9 for female individuals. Four (10.8%) patients experienced an improvement of less than 50%, 10(27.1%) patients had an improvement rate between 50% and 75% and 23(62.1%) patients had improvements more than 75%.

    Conclusion

    it seems that PDL may efficiently and sufficiently improve the facial junctional nevus with no side effects.

    Keywords: PDL, Pulsed dye laser, Junctional nevi, Melanocytic Junctional Nevi
  • Alireza Omidi Farzin, Shahrzad Shahrokhi Nejad * Pages 71-77
    Background
    COVID-19 led to an outbreak making surgeons doubt continuing elective surgeriesduring the pandemic. There is little evidence about the outcomes of elective cardiac surgeries duringthe pandemic. Questions exist regarding a higher prevalence of perioperative complications and mortalityrates. This study aims to evaluate the outcomes of elective cardiac surgeries during the pandemicin comparison to the previous year.
    Method
    This cross-sectional study discusses electivecardiac surgeries performed during the COVID-19 peak from March 2020 to March 2021 at theShahid Modarres Hospital and compares the outcomes (mortality, infection, and stroke) with theprevious year. We included all candidates over 20 years old after evaluating them for COVID-19 withpolymerase chain reaction and chest computed tomography scan. We collected the data from our institutionaldatabase and performed data analysis.
    Results
    We performed 184 adult open-heart surgeriesduring the COVID-19 peak. The male-to-female ratio was 50.5% to 49.5% with a mean age of 61. 9patients died in total during the peak compared to 17 patients out of 341 surgeries in the previous year.2 patients were involved with sternal wound infection and 3 with stroke. We recognized no significantdifference in mortality, sternal wound infection, and stroke between the two periods.
    Conclusion
    Although we should consider the probable complications of the infection during the pandemic, cardiacsurgery can be performed safely in COVID-19 centers. Effective protocols are required to createan environment free of infection to alleviate the burden of perioperative complications during thisperiod.
    Keywords: COVID-19, Cardiac surgical procedures, mortality, Postoperative complications, elective cardiac surgery, elective heart surgery