Modern Care Journal
Volume:22 Issue: 2, Apr 2025

The COVID-19 pandemic has increased stress and anxiety levels in nurses, highlighting the need for effective interventions to prevent complications.

This study aimed to determine the impact of web-based progressive relaxation exercises (PRE) on the perceived stress and anxiety levels of nurses working in a corona epidemic hospital.

This randomised controlled trial was conducted in March-April 2021 with 64 nurses (32 per group), and the sample size was determined by power analysis. Participants were randomly assigned via computer, including nurses from a corona epidemic hospital who consented. The intervention group practised progressive muscle relaxation (PMR) for 25 - 30 minutes daily for 4 weeks, whereas the control group received no intervention. Both groups completed the Perceived Stress Scale (PSS) and the State-Trait Anxiety Inventory (STAI) online pre- and post-intervention. Data were analysed with SPSS 23.0 using the Shapiro-Wilk test for normality, Independent samples t-test for continuous variables, chi-square test for categorical variables, and paired samples t-test for pre- and post-test comparisons in the intervention group (P < 0.05).

Statistically significant decreases in PSS and STAI levels were observed in the intervention group (P = 0.006 and P = 0.002, respectively). No significant changes were seen in the control group. The intervention group showed a significant decrease in STAI scores compared to the control group (P = 0.037).

Results showed that web-based progressive relaxation significantly reduced stress and anxiety in nurses, suggesting that accessible interventions can improve mental health in high-stress healthcare settings.

Body image, perfectionism, and mental toughness can significantly influence self-acceptance in adolescent girls, affecting their psychological well-being.

This study investigated how body image and perfectionism influence self-acceptance in adolescent girls, with mental toughness as a mediating factor.

This correlational study included 400 female high school students from Kahnuj during the 2023 - 2024 academic year. Data were collected using Cash's (2015) Body Image Questionnaire, Clough et al.'s (2012) Mental Toughness Questionnaire, Chamberlain and Haaga's (2021) Unconditional Self-acceptance Questionnaire, and Short et al.'s (2010) Perfectionism Questionnaire. Analysis employed Pearson correlation, multiple regression, and the Sobel test using SPSS 25 and Amos 24.

Mental toughness significantly mediated the relationships between self-acceptance and body image [variance accounted for (VAF) = 0.321] and positive perfectionism (VAF = 0.263), but not negative perfectionism (VAF = 0.126). In addition, significant direct effects were observed between body image and mental toughness (β = 0.26, P = 0.001), positive perfectionism and mental toughness (β = 0.23, P = 0.007), negative perfectionism and mental toughness (β = -0.24, P = 0.004), body image and self-acceptance (β = 0.17, P = 0.001), positive perfectionism and self-acceptance (β = 0.20, P = 0.001), negative perfectionism and self-acceptance (β = -0.52, P = 0.001), and mental toughness and self-acceptance (β = 0.31, P = 0.001). Model fit showed acceptable values: Chi-square/degrees of freedom = 4.26, Goodness-of-Fit Index = 0.90, Incremental Fit Index = 0.926, Comparative Fit Index = 0.926, root mean square error of approximation = 0.078.

Positive body image and adaptive perfectionism enhance mental toughness, thereby fostering self-acceptance, whereas maladaptive perfectionism directly reduces self-acceptance. Interventions should target these factors to promote psychological well-being in adolescent girls.

Although chemotherapy and targeted therapies have improved survival outcomes, there is growing interest in incorporating herbal medicines, such as Artemisia annua, into cancer treatment.

This study aims to investigate the mechanisms underlying the effects of A. annua methanolic extract on HT-29 colorectal cancer cells, particularly focusing on cell viability and the modulation of p53 and BAX/Bcl2 ratio expression.

The half-maximal inhibitory concentration (IC50) of A. annua methanolic extract in HT-29 cells was determined via the MTT viability assay, while apoptosis was assessed using the propidium iodide (PI) staining method. Reverse transcription (RT)-PCR was performed to evaluate gene expression in the HT-29 cell line. Values are presented as the average of three separate determinations and expressed as mean ± SD.

The results showed that the viability of HT-29 cells significantly decreased in a dose- and time-dependent manner (IC50 for 48 h: 1358.1 μg.mL-1). Propidium iodide staining results confirmed the findings of the MTT assay. Gene expression analysis revealed a decrease in p53 expression and a two-fold increase in the BAX/Bcl2 ratio following exposure to 1000 μg.mL-1 of A. annua extract.

The findings from the MTT and PI assays confirm the cytotoxic effects of A. annua extract on HT-29 cells. However, the gene expression analysis of BAX, Bcl2, and p53 suggests that the observed cell death is not primarily due to apoptosis.

Cognitive disorder occurs when a person has difficulty remembering, learning new things, concentrating, or making decisions that affect their daily life. There is a relationship between cardiovascular-coronary diseases and the risk factors of these diseases with cognitive disorders.

The present study was conducted with the aim of investigating cognitive disorder in patients with unstable cardiac angina compared to non-sufferers.

This case-control study was conducted on 45 patients with unstable cardiac angina and 45 non-sufferers referred to Sayad Shirazi Hospital in 2024. The tool for data collection was the Montreal cognitive assessment test (MoCA). Data were analyzed using SPSS version 23 software with the Chi-square test and Fisher's exact test. The risk and effective factors associated with developing the disease were measured using logistic regression and expressed as odds ratios (OR) with a 95% confidence interval (CI).

Although the cognitive status of cardiac angina patients compared to non-sufferers was suggestive of mild cognitive disorders (MCI), the difference was not statistically significant (P = 0.31). The risk of cognitive disorder in people with cardiac angina was 1.71 times higher (OR = 1.71, P = 0.21, 95% CI: 0.74 - 3.94) than in those without cardiac angina. The risk of cognitive disorder in men with cardiac angina was 4.35 times higher (OR = 4.35, P = 0.21, 95% CI: 1.19 - 15.86) than in women, and in diabetics with cardiac angina, it was 5.78 times higher.

The risk of cognitive disorder is higher in people with cardiac angina. Also, men and diabetics with unstable angina are more susceptible to cognitive disorders.

Vaginal bleeding due to leech bites is a highly unusual and serious problem in postmenopausal women, potentially leading to severe complications and even death.

A 68-year-old rural woman, 13 years post-menopause, was admitted to a hospital in eastern Iran with a complaint of continuous vaginal bleeding with clot discharge for 12 days. During the medical examination, a dark worm moving in waves was observed in the labia minora of the vulva. The area was washed with 0.9% normal saline solution, and the leech was removed from the inner surface of the labia minora using forceps and pincers. The patient was monitored as an outpatient for 4 hours to control the bleeding and was subsequently discharged in good condition. She was advised to take iron tablets and folic acid for one month.Her test results were as follows: Hemoglobin = 10 mg/dL, hematocrit = 32%, platelet count = 145,000, prothrombin time = 13 seconds, partial thromboplastin time = 35 seconds, and INR = 1.1. Her vital signs at admission were: temperature = 37.5°C, pulse rate = 100/min, blood pressure = 120/60 mmHg, and respiratory rate = 30 breaths per minute.

Vulvar and vaginal leech bites can cause severe vaginal bleeding and anemia in postmenopausal women. To reduce complications caused by delays in diagnosis or treatment, healthcare workers should consider the possibility of vulvar and vaginal leech bites in postmenopausal rural women and individuals who use river water for drinking, bathing, or showering. Taking a detailed history and performing a thorough physical examination before any diagnostic procedure can help quickly and accurately diagnose the cause of bleeding in these patients.

Silicosis is an occupational lung condition that can lead to permanent physical disability, primarily due to inflammation, scarring of lung tissue, and breathing difficulties. In regions with high rates of tuberculosis (TB), such as South Asia, the presence of TB accelerates the development of pulmonary fibrosis. Additionally, smoking significantly increases the likelihood of further lung damage.

This case report presents a 65-year-old gentleman who presented to the Department of Pulmonology, Bahawal Victoria Hospital, Bahawalpur, with exertional shortness of breath for 6 months, which worsened in the last month to the extent that he experienced dyspnea at rest. This was associated with a productive cough and yellowish sputum for 3 weeks. He had a past history of pulmonary TB 4 years ago and was an active smoker with a 30-pack-year history. He had worked in a stone-crushing factory for the last 35 years but was unable to work in the last few months due to his illness. His chest X-ray and high-resolution computed tomography (HRCT) demonstrated loss of lung volume bilaterally, diffuse nodularity with ground-glass opacifications, bulky hilum, and a left upper lobe fibro-cavitary lesion. Sputum examination was positive for acid-fast bacilli (AFB) stain, and GeneXpert MTB/RIF PCR confirmed the presence of Mycobacterium TB but showed no drug resistance. Based on clinical and radiographic findings, he was diagnosed with active pulmonary TB (relapse) with underlying chronic silicosis by the pulmonology team and managed with supportive oxygen inhalation therapy, category II anti-TB therapy, smoking cessation counseling, and occupational rehabilitation.

This case underscores the significance of coexisting silicosis and TB, especially in individuals with a significant smoking history and occupational exposure to silica. This report emphasizes the importance of early detection, multidisciplinary management, and comprehensive treatment strategies, including anti-TB therapy, smoking cessation counseling, and occupational rehabilitation, to improve patient outcomes in complex cases with overlapping lung diseases.

Calcifying pseudoneoplasm of the neuraxis (CAPNON) is a rare, benign central nervous system (CNS) lesion, first described in 1978. With approximately 150 reported cases, it remains poorly understood due to its rarity, variable presentation, and nonspecific features, often leading to misdiagnosis. Calcifying pseudoneoplasm of the neuraxis can occur anywhere along the neuraxis, with a slight predilection for intracranial sites. Surgical resection is the primary treatment, typically curative with low recurrence rates. This case report presents a unique instance of CAPNON, contributing to the understanding of its clinical spectrum and management challenges.

A 54-year-old female presented with urinary incontinence, bilateral arm weakness, and depressed mood. She had a medical history of a hysterectomy and a vertebral fracture. Initial magnetic resonance imaging (MRI) revealed a 35 × 27 × 33 mm left frontal lobe mass with mixed solid and cystic components, central calcification, heterogeneous enhancement of the solid portion, and surrounding vasogenic edema — an atypical finding for CAPNON. Surgical resection confirmed CAPNON histopathologically, showing a chondromyxoid matrix with calcifications and inflammatory infiltrate. Post-surgery, the patient’s symptoms improved, but follow-up MRIs at 8 and 12 months showed residual tumor growth from 18 × 15 × 13 mm to 21 × 24 × 26 mm. Consequently, the patient underwent intensity-modulated radiation therapy (IMRT) with 54 Gy in 27 fractions.

This case of CAPNON is notable for its atypical presentation with vasogenic edema, post-surgical tumor regrowth, and the subsequent use of radiotherapy — features that challenge the conventional perception of CAPNON as uniformly benign and surgically curable. It underscores the potential for unexpected behaviors in CAPNON and the necessity for tailored management strategies beyond standard surgical resection.

The COVID-19 pandemic has led to a surge in acute respiratory failure cases, necessitating effective management strategies. Non-invasive ventilation (NIV) has emerged as a treatment option; however, its efficacy and associated mortality rates remain debated.

This study aims to evaluate the mortality and morbidity rates in COVID-19 patients treated with NIV.

We conducted a retrospective analysis of 50 patients diagnosed with COVID-19 [confirmed by positive nasopharyngeal polymerase chain reaction (PCR)] who received NIV at Imam Reza Hospital and Sina Medical Training Centers in Tabriz, Iran. Data were collected between April 2021 and January 2022, including demographic characteristics, clinical symptoms, laboratory findings, and outcomes, such as complications and mortality rates. For data analysis, we used logistic regression, the Mann-Whitney U test for comparing quantitative variables, and Fisher's exact test for qualitative variables.

Among the 50 patients, 28 (56%) died during hospitalization. The median age of non-survivors was 66 years, significantly higher than that of survivors (56 years, P = 0.018). Older age and higher Quick sepsis-related organ failure assessment (QSOFA) scores were predictive of increased mortality (OR = 1.24; P = 0.001). Additionally, complications such as pneumothorax were observed in 14% of patients.

Our findings highlight a concerning mortality rate following NIV failure in COVID-19 patients, emphasizing the need for careful patient selection and close monitoring. Clinicians should consider early intubation for patients showing signs of NIV failure, particularly those with risk factors such as older age and high QSOFA scores.