Shiraz Emedical Journal
Volume:24 Issue: 10, Oct 2023

 Diabetes management self-efficacy (DMSE) positively affects diabetes self-care behaviors and can lead to better glycemic control and improved disease outcomes in diabetes patients.

 This study aimed to evaluate DMSE level and its relationship with medication adherence, glycemic control, and diabetes complications among type 2 diabetes (T2D) patients.

 A cross-sectional study was carried out from November 2019 to January 2020 on T2D patients who attended the Diabetes Center of the Kerman University of Medical Sciences. Data were collected using two validated questionnaires including the diabetes management self-efficacy scale (DMSES) to evaluate DMSE level and the eight-item Morisky medication adherence scale (MMAS) to assess adherence to medication. The SPSS statistical software version 22 was employed for data analysis.

 Of 440 T2D patients entering the study, 72% were female with a mean (SD) age of 59.60 (10.48). The mean (SD) DMSE score of the respondents was 5.76 (1.87). A significant negative correlation was observed between DMSE with HbA1c (r = -0.289, P < 0.0001) and also with FBS (r = -0.229, P < 0.0001), but there was a significant positive correlation between DMSE and adherence to medication (r = 0.208, P < 0.0001). FBS level (β = -0.252, P < 0.0001), number of visits by specialty or subspecialty physicians (β = -0.139, P = 0.002), medication adherence score (β = 0.165, P < 0.0001), neuropathy (β = 0.142, P = 0.002), marital status β = 0.125, P = 0.004), household income (β = -0.126, P = 0.004), and blood glucose checks at home (β = 0.109, P = 0.013) were considered predictors of DMSE score.

 Diabetes management self-efficacy is considered suboptimal among T2D patients. Patients with higher DMSE have better adherence to medication, better blood glucose control, lower risk of neuropathy, and fewer visits by specialty and subspecialty physicians.

 Diagnosis of cancer and its long and hard treatment process induce great stress and anxiety in patients. Cancer patients may also suffer from severe pain due to their primary disease, metastases, or the received treatments. However, the patients’ chief physical complaint is the main aspect that physicians pay attention to, and the mental health of these patients is usually neglected.

 This study aimed to predict the effect of music therapy (MT) on pain, perceived stress, anxiety, and biochemical parameters in patients with cancer.

 This semi-experimental study was conducted on cancer patients referring to the Oncology Clinic at Amir Hospital in Shiraz (affiliated with Shiraz University of Medical Sciences) from April to September 2016. A total number of sixty cancer patients were recruited using a random sampling method and divided into two groups of control and intervention. Patients in the intervention group listened to light music for at least 20 minutes for 8 weeks (two continuous sessions weekly). After the intervention group, a follow-up test and questionnaires were conducted on both groups. Data were analyzed by SPSS version 21 using the t-test, chi-square test, and paired t-test.

 The results of this study showed that the control group had no significant difference regarding the McGill Pain Questionnaire (MPQ) (P-value = 0.797), cortisol (P-value = 0.841), and the Perceived Stress Scale (PSS) (P-value = 0.001) variables before and after the study, but it had a significant increase in the Beck Anxiety Inventory (BAI) (P-value = 0.026). Our findings indicated a significant difference in the MPQ, BAI, and cortisol variables in the MT group (P-value ≤ 0.001). In general, the PSS showed no significant difference between the two groups.

 The results of the present study showed that MT for eight weeks, selected by patients from a list, could significantly reduce patients’ anxiety, pain, and perceived stress. Therefore, we recommend the inclusion of this intervention in the routine care of patients with cancer.

 This study explains learning and study strategies in virtual education among medical students during the coronavirus disease 2019 (COVID-19) pandemic and analyzes its relationship with their academic performance.

 This cross-sectional study included 298 medical students in preclinical disciplines in the medical curriculum at Mashhad University of Medical Sciences (MUMS), Mashhad, Iran. The data were collected from students who completed the Learning and Study Strategies Inventory (LASSI) within 2 weeks, from the 10th of June 2021 to the 24th of June 2021. This questionnaire measures three variables related to skill, self-regulation, and will. The data were analyzed using independent t-test, correlation, analysis of variance (ANOVA), and Tukey post hoc tests by SPSS software (version 23).

 The highest and lowest mean scores of the LASSI questionnaire were related to information processing (28.54 ± 4.10) and study aids (22.41 ± 4.07), respectively. Each scale’s possible score range was from 8 to 40 points. The results indicated significant statistical differences between different genders of students in anxiety, attitude, motivation, time management, and self-testing (P < 0.05). In all areas of the LASSI, except self-testing and study aids, the students’ mean scores with a grade point average (GPA) - range of 0 to 20 - higher than 17.5 were significantly higher than those with GPAs lower than 14.85 and those with GPAs between 14.86 to 17.50 (P < 0.05).

 Since learning and studying strategies contribute to student’s academic success and facilitate the learning process, they can be improved using educational involvement. Embedding learning and study strategies interventions in curriculum design and learning content could help promote academic performance.

 Chronic granulomatous disease (CGD) is the most common inherited defect of phagocytes. Although most female carriers of X-linked CGD have been considered to be unaffected, they may have similar problems to those of CGD patients. This study suggests that the CGD carrier state might be more complex than it was previously appreciated.

 A sixty-year-old woman visited our hospital in June 2021 due to pneumonia and pleural effusion. Chest computed tomography scan revealed left lower lobe pneumonia and mediastinal lymphadenopathies. In July 2021, her symptoms (high-grade fever, chills, and hemoptysis) were initially attributed to a hydatid cyst. Therefore, she underwent a lobectomy, resulting in purulent drainage on the excision site on the skin, refractory to local and systemic treatments. The refractory and recurrent nature of the lesions led to the immunological evaluation, which was completely normal with a 100% nitroblue tetrazolium (NBT) and a dihydrorhodamine (DHR) of 278 (normal > 100). Further DHR123 flow cytometry investigations with multiple stimulants revealed a carrier state of CGD, which was relevant to her history of chronic complications.

 Adult patients with unusual manifestations suggestive of neutrophil function defects in adulthood should be evaluated for the CGD carrier state. In these cases, NBT alone may miss the diagnosis of CGD. In such cases, DHR testing with multiple stimulants may establish a robust diagnosis.

 SARS-CoV-2, which emerged in China and spread globally, has been associated with adrenal insufficiency in numerous COVID-19 patients. The clinical evidence regarding adrenal involvement in COVID-19 patients is currently limited, primarily consisting of case reports and small patient series.

 This study aimed to assess the variations in serum cortisol levels and evaluate the response of hospitalized COVID-19 patients to the adrenocorticotropic hormone (ACTH) test.

 This study was performed on patients with COVID-19 admitted to Valiasr Hospital, Birjand, Iran, in 2021. Sixty patients with COVID-19 were included in this study by simple random sampling. Patients' venous blood (5 mL) was collected in an EDTA anticoagulant tube. Blood samples were placed in a cool place, then 250 μg intramuscular cosyntropin was injected, and blood samples were taken again 60 minutes later. According to the kit protocol, cortisol levels were measured by a quantitative luminescence kit (Saluggia, Italy).

 The study involved 60 participants, of which 32 were male (53.3%) and 28 were female (46.7%). The Mean participants' age was 63.1 ± 20.93. The median baseline cortisol serum levels were 28.075 µg /dL for men and 21.820 µg /dL for women. There was no significant difference between base cortisol serum levels (P-value = 0.248). After measuring the baseline cortisol levels in the studied patients, 21.7 % suffered from adrenal Insufficiency, 40 % were suspected of adrenal insufficiency and required cosyntropin injections, and 38.3 % did not have adrenal Insufficiency. Following the administration of cosyntropin injections, it was found that 33.3% of participants had adrenal insufficiency, while the remaining 66.7% did not exhibit any signs of adrenal insufficiency. Vital signs demonstrated that patients with adrenal insufficiency had notably lower mean systolic and diastolic blood pressures, and a statistically significant correlation was observed when comparing these two groups (P-value < 0.001 and P-value = 0.001, respectively). In assessing sodium and potassium serum levels between the two groups, individuals with adrenal insufficiency demonstrated lower average sodium levels (P-value < 0.001). At the same time, no noteworthy divergence was found in potassium levels between the groups (P-value = 0.587).Furthermore, no considerable discrepancy emerged in the in-hospital mortality rate during the patients' follow-up period (P-value = 0.322).

 As Adrenal insufficiency is life-threatening, early adrenal axis testing for COVID-19 patients with clinical suspicion of adrenal insufficiency should be carried out.