Jundishapur Journal of Chronic Disease Care
Volume:12 Issue: 4, Oct 2023

 Headache in migraine patients plays an important role in their quality of life.

 This study aimed to compare the effectiveness of transdiagnostic treatment and schema therapy in sleep quality and clinical symptoms of migraine in women with migraines in 2022.

 This semi-experimental study was conducted with a pre-test, mid-test, post-test, and follow-up with a control group. The statistical population included all women aged 20 to 40 years diagnosed with migraine in Shahrekord, Iran, in 2022. A total of 45 individuals were selected as the sample from the women referring to specialized clinics in Shahrekord using the available sampling method and taking into account the inclusion criteria of the subjects. Moreover, the subjects were randomly assigned into two experimental groups and one control group (each group with 15 subjects). The research tools included the Ahvaz Migraine Questionnaire (Najarian, 1997), the Sleep Quality Scale (Buysse et al., 1989), the transdiagnostic treatment protocol (Barlow et al., 2017), and the schema therapy protocol (Young et al., 2003). To analyze the data, multivariate and univariate analysis of covariance was used using SPSS software (version 27).

 The results showed that there was a significant difference in the overall mean scores of migraine clinical symptoms and sleep quality between the two groups of transdiagnostic treatment and schema therapy (P = 0.001). In general, it can be concluded that the transdiagnostic treatment method had a greater effect on the clinical syndrome scores of migraine and sleep quality than the schema therapy method (P = 0.001).

 The results supported the effect of transdiagnostic treatment and schema therapy, and paying attention to these two treatment methods is of particular importance for women with migraines. Therefore, the results of this study can become the basis for interventions to help migraine patients.

 When households have high out-of-pocket (OOP) expenses, they are more likely to experience poverty and encounter catastrophic health expenditures (CHE). Heart disease is a significant cause of health decline and mortality.

 This study aimed to provide essential knowledge about CHE and OOP for heart disease patients who underwent coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) in Shiraz, Iran.

 This cross-sectional study with two prospective follow-ups was conducted in three heart surgery centers in Shiraz, Iran. The data were collected using the world health survey (WHS). Catastrophic health expenditures and OOP were asked from the most informed family member. Generalized estimating equation (GEE) modeling was employed to identify the main factors related to CHE and OOP. Binary distribution with logit link and gamma distribution with log link were used for CHE and OOP, respectively. The significance level was set at 0.05.

 We found that OOP payment among patients who needed cardiovascular services in public-private partnership (PPP) hospitals was 76,953,100 Rials (R), equal to 2,506.78 $ (USD) (SD = 53,247,600 R/1,734.56 $) in the PCI group and 230,937,700 R equal to 7,522.89 $ (SD = 248,295,200 R/8,088.32 $) in the CABG group. This value in public hospitals was 15,083,800 R, equal to 491.36 $ (SD = 18,637,600 R/ 607.13 $) in the PCI group and 12,276,800 R, equal to 399.92 $ (SD = 11,131,900 R/ 362.63 $) in the CABG group. We also found that admission duration, age, type of hospital, and being currently a smoker were significant factors for OOP (P-value < 0.05). During baseline assessment, we also found that the percentage of PCI patients that faced CHE was 95.56% and 47.92% in PPP and public hospitals, respectively. This value in CABG patients was 92.31% and 40.45%. Our study showed that the type of hospital and socioeconomic status were significant factors (P-value < 0.05) that pushed a family facing CHE.

 The baseline CHE is very high in both PCI and CABG patients. Thus, the government should pay special attention to this issue. Further investigations are needed on factors affecting OOP and CHE.

 Numerous studies have demonstrated the positive effects of lavender on the mental health of patients undergoing hemodialysis.

 The present study aims to assess the effect of topical application of lipogel containing lavender essential oil on hemodialysis patients' sleep quality and well-being.

 The present randomized controlled clinical trial was conducted in a dialysis center in Iran. A total of 120 hemodialysis patients were assigned randomly to three groups (experimental, control, and placebo groups). In the experimental group, the lipogel containing lavender essential oil was applied on the back of the foot from the ankle to the toe. The same amount of lipogel without lavender essential oil was rubbed onto the patient’s feet in the same method in the placebo group. The control group received routine care. Yield Well-being Scale and Pittsburgh sleep quality index (PSQI) were used to assess the sense of well-being and sleep quality, respectively.

 The statistical test showed no significant difference among the experimental, control, and placebo groups regarding the sense of well-being before (P = 0.421) and after the intervention (P = 0.378). The groups (experimental, control, and placebo) did not differ significantly before the intervention in terms of the total score of sleep quality (P = 0.527), but a significant difference was observed among them after the intervention (P = 0.017).

 The lipogel containing the lavender essential oil is a cost-effective and easy method that can improve the sleep quality of hemodialysis patients. To confirm the present findings, additional studies are warranted.

 Management of common and unpleasant complications following the removal of the arterial sheath is one of the goals and priorities of nursing care in patients undergoing angiography.

 This study aimed to design and manufacture a FemoStop device and compare its effectiveness with sandbag pressure on hemostasis during sheath removal and reducing puncture site complications following transfemoral coronary angiography.

 This randomized controlled trial was conducted between 2019 and 2021. Eighty patients undergoing elective transfemoral coronary angiography referred to a Heart and Vascular Hospital in Tehran were recruited by convenience sampling and were randomly assigned to experimental (n = 40) and control (n = 40) groups. FemoStop devices and sandbags were used in the experimental and control groups to control angiography complications, respectively. The patient’s individual characteristics questionnaire, visual analog scale, checklist of complications, and laboratory indicators were used for data collection. Pain intensity, heart rate, respiratory rate, temperature, systolic and diastolic blood pressure, arterial oxygen saturation, and the amount of hematoma and bleeding of patients before, after 15 minutes, 1 h, 2 h, 2.5 h, 3 h, 3.5 h, 4 h, 4.5 h, 5 h, and 6 h were measured after the intervention.

 The trend of changes in pain intensity (P < 0.001), heart rate (P = 0.036), and systolic blood pressure (P < 0.001) of patients in the experimental and control groups after the intervention was significant, and in patients who had used the FemoStop device, it was less than the control group. However, the changes in respiratory rate (P = 0.308), diastolic blood pressure (P = 0.089), arterial oxygen saturation (P = 0.205), and temperature (P = 0.195) of patients in the 2 groups were not significant. The 2 groups were not significantly different in terms of these variables and the amount of hematoma and bleeding in the 12 stages of measurement.

 Compared to using a sandbag after transfemoral coronary angiography, the FemoStop device leads to fewer complications, such as pain intensity, lower heart rate, and systolic blood pressure in patients. Therefore, considering fewer complications, it is suggested to conduct more studies to confirm the use of this device to control complications in patients.

 Otitis media with effusion (OME), the most common ear disease in pediatrics, can lead to hearing loss (HL) and might have a significant impact on a child’s auditory and speech development.

 This study was conducted to indicate the audiologic profile of children with chronic OME who were scheduled for tympanostomy tube placement.

 Otoscopy, pure-tone audiometry, and tympanometry assessments were carried out in 663 children (420 males and 243 females) who had a chronic OME diagnosis and were scheduled for ear surgery. They were selected consecutively at Imam Khomeini Hospital, Ahvaz, Iran.

 The most frequent age groups affected by OME were 12 - 36 months (33.48%) and 36-72 months (31.67%). The majority of children (60.03%) showed retracted tympanic membrane (TM), and the most common color of the TM was yellowish-brown, observed in 74.20% of cases. Before surgery, the majority of patients demonstrated mild conductive hearing loss (61.08%) and a Type B tympanogram (73.75%). The myringotomy site of 61.53% of children was anterior-inferior. Four hundred-eight children indicated serous secretion. The mean pure-tone average before surgery was significantly reduced after surgery (45.23 ± 23.25 vs. 27.83 ± 15.86 dB HL, P = 0.001). This improvement was about 18 and 17 dB in the right and left ears 2 months after surgery, respectively. The postoperative findings also indicated that in 487 children (73.45%), hearing thresholds returned to normal limits.

 It is essential to address chronic OME promptly to prevent potential long-term impacts on a child’s hearing, speech, and language. Treatment options, such as watchful waiting or surgical intervention, depending on the severity and duration of the condition, are effective procedures in this group of patients.

 Oral and oropharyngeal cancer is known as one of the few lethal oral diseases with a great burden associated with a high cost of treatment and rehabilitation, life-long impairments, and a nearly 50% mortality rate; therefore, it should be considered an increasingly severe health and social problem in the world due to its increased incidence. This makes the burden of oral and oropharyngeal cancer very high, with a hefty economic burden.

 The current study was designed and conducted to investigate epidemiological features of oral and oropharyngeal cancer in the Khuzestan province of Iran.

 This cross-sectional study was conducted with raw data on cancer incidence obtained from the Khuzestan cancer registry as a subsequent of the Iranian population-based national cancer registry from 2014 to 2019. Recorded cases were standardized by ICD-10 and ICD-O-3 classifications and categorized by gender, age group, diagnosis, etc. The method of diagnosis in this study consisted of four categories. Descriptive data for the frequency and rate of each variable and analyses of associations between variables were conducted using the chi-squared test with a statistical significance of P < 0.05.

 A total of 941 valid cases were identified in the study period, with a composition of males 675 cases and females 266 cases in total. More than 85% of reported cases were submitted to a database with pathologic reports, verifying a high data validity level. The crude rate in female cases had an upward trend in contrast to the crude rate in males, which shows a downward trend. Squamous cell carcinoma was the most diagnosed malignancy, with 532 cases (55%).

 The data on oral and oropharyngeal cancer in Khuzestan suggest that the overall incidence of the disease increased, particularly in females and younger age groups in the study period. Concerning increasing trends and the presence of most oral and oropharyngeal cancer cases in the active and young members of society of Khuzestan province of Iran, an extensive program for screening, prevention, and rehabilitation should be prioritized.

 Reducing the care burden of family caregivers and improving their quality of life is one of the important goals of palliative care.

 This study aimed to determine the caregiver burden (CB) and its relationship with the quality of life (QOL) of family caregivers of cancer patients admitted to Baqai 2 Hospital in Ahvaz City from 2021 to 2022.

 Using a convenience-sampling method, this cross-sectional descriptive-analytical study was carried out on 178 family caregivers of cancer patients. The data collection instrument included a three-part questionnaire. The first part included demographic information of family caregivers of cancer patients, the second part included the caregiver burden scale (CBS) to investigate the CB of the caregivers, and the third part included the caregiver quality of life index-cancer (CQOLC) scale to investigate QOL in caregivers. This questionnaire was standardized and had acceptable validity and reliability. Data analysis was carried out using descriptive and analytical statistics tests using SPSS V22 software.

 The mean and SD of participants' CB and QOL were 15.79 ± 50.23 and 80.84 ± 23.29, respectively. The majority of caregivers (47.8%) had moderate CB, and the QOL of caregivers decreased significantly with an increasing CB (P < 0.001). The results showed that caregivers' QOL was influenced by factors such as CB, place of residence (rural area), duration, and type of disease (P < 0.001). Also, CB was influenced by factors such as marital and employment status, level of education, and the family relationship with patients (P < 0.001).

 The results of the present study showed that the QOL of family caregivers of cancer patients decreased with increasing CB. Therefore, authorities and oncology nurses should design necessary plans to develop interventions to reduce CB and improve the QOL of family caregivers of cancer patients.

 Bipolar II disorder (BD-II) is a chronic mental illness with recurrent episodes of depression that causes emotional disorders in patients.

 The present study aimed to investigate the effects of Emotional Schema Therapy (EST) and Dialectical Behavior Therapy (DBT) on psychological distress and cognitive-behavioral avoidance in patients with BD-II.

 This study was carried out using a quasi-experimental pretest-posttest design with a control group. The study population consisted of all patients with BD-II visiting the counseling centers in Dezful, Iran, in 2021, and the research sample included 45 eligible individuals selected using purposive sampling. The patients were randomly assigned to two intervention groups and one control group (n = 15 per group). The participants in the first and second intervention groups attended eleven 90-minute sessions of EST and DBT, respectively. However, those in the control group were placed on the waiting list. The research instruments included the Kessler Psychological Distress Scale (K10) and the Cognitive-Behavioral Avoidance Scale. The data were analyzed using analysis of covariance (ANCOVA) and Bonferroni post hoc test in SPSS software (version 26).

 According to the results, there was a significant reduction in levels of psychological distress and cognitive-behavioral avoidance among the participants of the EST and DBT groups, compared to those in the control group (P < 0.001).

 Emotional Schema Therapy and Dialectical Behavior Therapy reduced psychological distress and cognitive-behavioral avoidance in patients with BD-II. Therefore, therapists and health professionals can use EST and DBT interventions, along with other effective therapeutic approaches, to reduce psychological distress and cognitive-behavioral avoidance in patients with BD-II.

 Aggravation of tricuspid regurgitation (TR) is a predictable issue following cardiac device implantation, while its clinical importance is subject to debate.

 We aimed to recognize the alteration of TR following cardiac resynchronization therapy (CRT) and its effect on the response to CRT.

 In this prospective study, 70 candidates were recruited for CRT from those who visited two university hospitals in Tehran and Ahvaz (Iran) from January 2012 to March 2013. Baseline specifications were recorded for all the participants. All the patients underwent echocardiography before and 6 months after CRT administration. They were then divided into two categories for further comparison: (1) Patients with no or mild TR and (2) patients with moderate-to-severe TR. The echocardiographic response to CRT was defined as a left ventricular end-systolic volume (LVESV) decrease of >15% or left ventricular ejection fraction (LVEF) advancement of >5%. The clinical response to CRT was one class improvement based on the New York Heart Association (NYHA) class.

 Of the patients, 24 had moderate-to-severe TR. Although the increase in cases with moderate-to-severe TR after CRT was not significant, the aggravation of TR degree after the procedure was significant (P = 0.002). Moreover, the NYHA class significantly improved after the CRT (P = 0.02). The number of cases with a clinical response to CRT based on improvement of the NYHA class was significantly greater in patients with no TR or mild TR at baseline (P = 0.003). There was no significant variation in response to CRT among patients who experienced TR exacerbation after CRT compared with those who had no change or a reduction in TR.

 This study demonstrated that TR severity was exacerbated following CRT, but this alternation in TR severity had no significant effect on the response to CRT. Therefore, the presence and development of TR before and after CRT must not affect the criteria for choosing cardiac resynchronization therapy for appropriate patients.

 According to recent statistics, the rate of burns in Iran is higher than the world’s average. Therefore, it is necessary to improve the treatment protocols as much as possible.

 This study investigated the level of mineral intake (iron, zinc, selenium) and thyroid hormones (TSH, T3, T4) serum levels among burn patients.

 This cross-sectional study was conducted on 24 patients admitted to the intensive care unit (ICU) of Taleghani Hospital, Ahvaz, Iran. The Kolmogorov-Smirnov test was used to check the normality of the distribution of quantitative variables. Blood samples were taken on the first, third, and fifth days of hospitalization. Serum levels of zinc, selenium, iron, T3, T4, and TSH were measured. The correlation of qualitative variables was examined using the chi-square test, and the correlation of quantitative variables was examined using Spearman's correlation analysis. The t-test was used to compare the means in two different groups with the standard value. The generalized estimating equation (GEE) test was used to investigate the effect of time and compare the two groups. Statistical analysis of the data was performed in SPSS v. 22.

 The levels of iron, zinc, selenium, and thyroid hormones changed during the examined days, but these changes were not statistically significant. The amount of the analyzed elements in some cases was lower than their standard serum average, but this difference was significant only for selenium. Besides, there was no significant relationship between iron, zinc, T3, TSH, and the length of stay at the ICU; this relationship was positive and significant only for T4.

 Burn patients in the ICU have insufficient intake of minerals. Changes occur in the serum levels of micronutrients in these patients, affecting their physiological conditions and reducing the speed of recovery.