Search results for: satisfaction of patients

Authors: Rady A., Elsheshai A., Eltawel M.

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Introduction and Aim of work: Literature suggest that antipsychotic medications may decrease cortisol level, an effect that seems to be more present with second generation antipsychotic. Our study aims at assessing effect of long term use of antipsychotics on cortisol level Subjects and Methods: 30 chronic schizophrenic patients on antipsychotics compared to 20 drug naive schizophrenic patients as regards serum cortisol level Results: Cortisol level was significantly lower in chronic schizophrenic patients receiving antipsychotics compared to drug naive patients (P=0.002 <0.05) Conclusion: Antipsychotic medications seem to have the potential to decrease cortisol level in blood. Among hypothesis proposed in literature is the good control of pseudo stress due to psychotic features.

Keywords: schizophrenia, antipsychotic, cortisol, HPA

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Authors: Soumaya Mrabet, Imen Akkari, Amira Atig, Elhem Ben Jazia

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Introduction: Celiac disease (CD) is a chronic autoimmune inflammatory enteropathy caused by gluten. The clinical presentation is very variable. Malabsorption in the MC is responsible for an alteration of the bone metabolism. Our purpose is to study the osteoarticular manifestations related to this condition. Material and methods: It is a retrospective study of 41 cases of CD diagnosed on clinical, immunological, endoscopic and histological arguments, in the Internal Medicine and Gastroenterology Department of Farhat Hached Hospital between September 2005 and January 2016. Results: Osteoarticular manifestations were found in 9 patients (22%) among 41 patients presenting CD. These were 7 women and 2 men with an average age of 35.7 years (25 to 67 years). These manifestations were revelatory of CD in 3 cases. Abdominal pain and diarrhea were present in 6 cases. Inflammatory polyarthralgia of wrists and knees has been reported in 7 patients. Mechanical mono arthralgia was noted in 2 patients. Biological tests revealed microcytic anemia by iron deficiency in 7 cases, hypocalcemia in 5 cases, Hypophosphatemia in 3 cases and elevated alkaline phosphatases in 3 cases. Upper gastrointestinal endoscopy with duodenal biopsy found villous atrophy in all cases. In immunology, Anti-transglutaminase antibodies were positive in all patients, Anti-endomysium in 7 cases. Measurement of bone mineral density (BMD) by biphotonic X-ray absorptiometer with evaluation of the T-score and the Z-score was performed in Twenty patients (48.8%). It was normal in 7 cases (33%) and showed osteopenia in 5 patients (25%) and osteoporosis in 2 patients (10%). All patients were treated with a Gluten-free diet associated with vitamin D and calcium substitution in 5 cases. The evolution was favorable in all cases with reduction of bone pain and normalization of the phosphocalcic balance. Conclusion: The bone impact of CD is frequent but often asymptomatic. Patients with CD should be evaluated by the measurement of bone mineral density and monitored for calcium and vitamin D deficiencies.

Keywords: bone mineral density, celiac disease, osteoarticular manifestations, vitamin D and calcium

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Authors: Jaroslav Belás, Anna Chochoľáková, Lenka Gabčová

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The aim of this article was to examine and quantify the dependence of additional purchases of banking products from customer loyalty and dependence of bank clients’ loyalty on the customers’ satisfaction. In this context, in our research from 2014, the respondents were divided into satisfied (loyal) and dissatisfied (disloyal) banking clients and their attitudes in the area of loyalty and additional purchases of banking products were compared. The differences in attitudes were examined by means of Pearson statistics. It was found out that satisfied customers compared with those dissatisfied clients significantly more advise their bank to their friends, also they often consider that they would use their bank in the future, they are more resistant to the offers from the other banks as well. Loyal customers are more interested in the services of their own banks when considering investments in the financial market, keep their savings in their own bank, take out a mortgage loan from their own bank and use other banking products and services offered by their own bank as well. According to the results of our research, with the different intensities the loyalty of customers is transforming into a potential purchase of additional banking products. The greatest potential interest of the bank customers was in keeping their own savings in the bank and mortgage loans. The intensity of interest in the purchase of financial investments and other products was relatively low.

Keywords: commercial bank, bank customers’ satisfaction, loyalty of bank clients, additional purchases of banking products and services

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Authors: Meriche Hacene

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Introduction: Allergy to animal hair is hypersensitivity to animal appendages to look for in front of any rhinoconjunctivitis or asthma. An anamnesis associated with the prick-tests makes it possible to guide the diagnosis, which will be supplemented in case of doubt by specific immunoglobulin E (IgE) assays. The objective of our study is to study the characteristics of patients sensitized to animal hair. Patients and methods: Retrospective study conducted on 105 adult patients and 69 children over a period of 3 years, including patients who received a specific IgE assay (respiratory panel and pediatric panel) by immunodot method. Result: 105 adult patients, including 74 women and 31 men, with an average age of 41 years, of which 8.5% had sensitization to animal hair (5 men and 4 women), namely: cat (5%), horse (4.7%) and dog (3.8%). For the 69 children, a slight female predominance was noted (56%), with an average age of 7.5 years, of which (13%) are sensitized to animal hair (5 girls and 4 boys): cat (10%), while awareness of dog and horse hair was less frequent with an identical prevalence of (4.34%). The dominant symptoms are rhinorrhea and sneezing for both categories, respectively (40% and 26.6% in adults and 23% for both symptoms in children). Cross-sensitization was observed in the 2 series: 1 single cat-dog and cat-horse case and 2 dog-horse cases in adults. In children, 100% of patients with sensitization to dog hair had cross-sensitization to cat hair, only 1 case was observed for cat-horse cross-reactivity. Conclusion This work shows that allergy to animal hair is common. Studies on more representative samples are recommended.

Keywords: specific IgE, allergy, cat, fed1

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Authors: Magdalena Barbara Kaziuk, Ilona Hubner, Jacek Hubner, Slawomir Kroczka

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Background: The motor neuron disease is a progressive neurodegenerative disease causing malfunction. Irrespective of the form of the disease and its onset always leads to the worsening of the quality of life, with patients usually depending on the family. Materials and methods: The study included 20 persons (5 females, 15 males, aged 65,5 ± 20 years) with clinically certain or probable diagnosis of the motor neuron disease. Patients were examined three times in the period of six months. The diagnosis was established based on the criteria of El Escorial. Manual dexterity was assessed using the test of the card Rene Zazzo and the test of shading in with lines Mira Stambak. Results: All patients achieved unsatisfactory results in Rene Zazzo’s test of the card and most of the patients (60%) in Mira Stambak’s test of shading with lines. Significantly higher test results were achieved for Rene Zazzo’s test and lower test results for Mira Stambak’s test in consecutive measurements. Conclusions: Impairment of manual dexterity is present already at the moment of diagnosing the disease and is growing significantly during its course. The quality of life for MND patients undergoes gradual deterioration as a result of the malfunction.

Keywords: manual dexterity, motor neuron disease, quality of life, malfunction

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Authors: John Faucett, Hao Wu, Bruce Moore, Sean Nadji

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The demands of the ministry often conflict with responsibilities at home, and clergy often experience domain ambiguity between the domains of work and family. However, the unique level of family involvement in the pastor’s profession might enrich the pastor’s ministry as well as the functioning of the family unit. Life in the church family might offer clergy family members a sense of meaning and purpose, social support, and a feeling of belonging. Church activities can offer enhanced opportunities for family interaction. The purpose of this study was to investigate the relationships of work/family enrichment to clergy job satisfaction, burnout, engagement, and withdrawal. Method: Participants were clergy serving within a state conference of the United Methodist Church. A survey was administered electronically, with e-mails and the United Methodist Church (UMC) Facebook page used as access points to the survey. Usable responses for this portion of the survey were obtained from 132 clergy. Participants completed The Work-Family Enrichment Scales, The Utrecht Work Engagement Scale, The Scale of Emotional Exhaustion in Ministry, The Satisfaction in Ministry Scale, and a scale of withdrawal developed for the present study. They also answered questions relating to how involved their spouses are in their ministry and the degree to which spouse involvement in church ministry strengthens church ministry. Findings: Higher scores for work to family enrichment correlated positively with job satisfaction (r = - .69, p < .01) and engagement (r = .50, p < .01), and negatively with burnout (r = -.48, p < .01) and withdrawal (r = -.46, p < .01). Higher scores for family to work enrichment correlated positively with job satisfaction (r = .29, p = .01) and engagement (.24, p < .05), and negatively with burnout (r = -.48, p < .01), and withdrawal (r = -.46, p < .01). Hierarchical regression analysis suggested that clergy perceptions concerning the degree to which spouse involvement in church ministry strengthens church ministry moderates the relationship between degree of spouse involvement in church activities and clergy withdrawal. To the degree that spouse involvement is believed to strengthen ministry, high spouse involvement is related to less clergy withdrawal (Multiple R-Squared = .068, Adj. R-Squared = .043, F = 2.69 on 3 & 110 DF, p = .05). Concluding Statement: Clergy job attitudes are related to work/family enrichment. Spouse involvement in parish ministry is associated with less clergy withdrawal, as long as clergy believe spouse involvement strengthens their ministry.

Keywords: clergy, emotional exhaustion, job engagement, job satisfaction, work/family enrichment

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Authors: A. Kumar, D. Himanshu, Ak Vaish, K. Usman , A. Singh, R. Misra, V. Atam, S. P. Verma, S. Singhal

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Introduction: Resistant and uncontrolled hypertension offer great challenge, in terms of higher risk of morbidity, mortality and not the least, difficulty in diagnosis and management. Our study tries to identify the importance of two crucial aspects of hypertension management, i.e. drug compliance and optimum dosing and also the effect of spironolactone on blood pressure in cases of resistant hypertension. Methodology: A prospective study was carried out among patients, who were referred as case of resistant hypertension to Hypertension Clinic at Gandhi memorial and associated hospital, Lucknow, India from August, 2013 to July 2014. A total of 122 Subjects having uncontrolled BP with ≥3 antihypertensives were selected. After ruling out secondary resistance and with appropriate lifestyle modifications, effect of adherence and optimum doses was seen with monitoring of BP. Only those having blood pressure still uncontrolled were true resistant. These patients were given spironolactone to see its effect on BP over next 12 weeks. Results: Mean baseline BP of all (n=122) patients was 150.4±7.2 mmHg systolic and 92.1±5.7 mmHg diastolic. After promoting adherence to the regimen, there was reduction of 4.20±3.65 mmHg systolic and 2.08±4.74 mmHg Diastolic blood pressure, with 26 patients achieving target blood pressure goal. Further reduction of 6.66±5.99 mmHg in systolic and 2.59±3.67 mmHg in diastolic BP was observed after optimizing the drug doses with another 66 patients achieving target blood pressure goal. Only 30 patients were true resistant hypertensive and prescribed spironolactone. Over 12 weeks, mean reduction of 20.62±3.65 mmHg in systolic and 10.08 ± 6.46 mmHg in diastolic BP was observed. Out of these 30, BP was controlled in 24 patients. Side effects observed were hyperkalemia in 2 patients and breast tenderness in 2 patients. Conclusion: Improper adherence and suboptimal regimen appear to be the important reasons for uncontrolled hypertension. By virtue of maintaining proper adherence to an optimum regimen, target BP goal can be reached in many without adding much to the regimen. Spironolactone is effective in patients with resistant hypertension, in terms of blood pressure reduction with minimal side effects.

Keywords: resistant, hypertension, spironolactone, blood pressure

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Authors: Fatemeh Keshavarz

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Background: Schizophrenia is a disease of the nervous system, and immune system disorders can affect its pathogenesis. Activation of microglia, proinflammatory cytokines, disruption of the blood-brain barrier (BBB) due to inflammation, activation of autoreactive B cells, and consequently the production of autoantibodies against system antigens are among the immune processes involved in neurological diseases. interleukin 32 (IL-32) a proinflammatory cytokine that important player in the activation of the innate and adaptive immune responses. This study aimed to measure the serum level of IL-32 as well as the frequency of autoantibody positivity against several nervous system antigens in patients with schizophrenia. Material and Methods: This study was conducted on 40 patients with schizophrenia and 40 healthy individuals in the control group. Serum IL-32 levels were measured by ELISA. The frequency of autoantibodies against Hu, Ri, Yo, Tr, CV2, Amphiphysin, SOX1, Zic4, ITPR1, CARP, GAD, Recoverin, Titin, and Ganglioside antigens were measured by indirect immunofluorescence method. Results: Serum IL-32 levels in patients with schizophrenia were significantly higher compared to the control group. Autoantibodies were positive in 8 patients for GAD antigen and 5 patients for Ri antigen, which showed a significant relationship compared to the control group. Autoantibodies were also positive in 2 patients for CV2, in 1 patient for Hu, and in 1 patient for CARP. Negative results were reported for other antigens. Conclusion: Our findings suggest that elevated the serum IL-32 level and autoantibody positivity against several nervous system antigens may be involved in the pathogenesis of schizophrenia.

Keywords: schizophrenia, microglia, autoantibodies, IL-32

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Authors: Kanikanun Photchong, Phusit Phukamchanoad

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The objective of this research is to study the people’s level of participation in activities of the community, their satisfaction towards the community, the attachment they have to the community, factors that influence the attachment, as well as the characteristics of the relationships of military families’ of the Royal Guards community of Dusit District. The method used was non-probability sampling by quota sampling according to people’s age. The determined age group was 18 years or older. One set of a sample group was done per family. The questionnaires were conducted by 287 people. Snowball sampling was also used by interviewing people of the community, starting from the Royal Guards Community’s leader, then by 20 of the community’s well-respected persons. The data was analyzed by using descriptive statistics, such as arithmetic mean and standard deviation, as well as by inferential statistics, such as Independent - Samples T test (T-test), One-Way ANOVA (F-test), Chi-Square. Descriptive analysis according to the structure of the interview content was also used. The results of the research is that the participation of the population in the Royal Guards Community in various activities is at a medium level, with the average participation level during Mother’s and Father’s Days. The people’s general level of satisfaction towards the premises of the Royal Guards Community is at the highest level. The people were most satisfied with the transportation within the community and in contacting with people from outside the premises. The access to the community is convenient and there are various entrances. The attachment of the people to the Royal Guards Community in general and by each category is at a high level. The feeling that the community is their home rated the highest average. Factors that influence the attachment of the people of the Royal Guards Community are age, status, profession, income, length of stay in the community, membership of social groups, having neighbors they feel close and familiar with, and as well as the benefits they receive from the community. In addition, it was found that people that participate in activities have a high level of positive relationship towards the attachment of the people to the Royal Guards Community. The satisfaction of the community has a very high level of positive relationship with the attachment of the people to the Royal Guards Community. The characteristics of the attachment of military families’ is that they live in big houses that everyone has to protect and care for, starting from the leader of the family as well as all members. Therefore, they all love the community they live in. The characteristics that show the participation of activities within the community and the high level of satisfaction towards the premises of the community will enable the people to be more attached to the community. The people feel that everyone is close neighbors within the community, as if they are one big family.

Keywords: community attachment, community satisfaction, royal guards community, activities of the community

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Authors: Kwok W. Mui, Ling T. Wong, Nai K. K. Fong

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Chronic obstructive pulmonary disease (COPD) is the fifth leading cause of death in Hong Kong. Investigators are eager to explore the environmental risk factors for COPD such as air pollution and occupational exposure. Through a cross-sectional survey, this study investigates the impact of air quality to the quality of life of patients with the COPD in terms of the scores of the (Chinese) chronic respiratory questionnaire (CCRQ) and the measurements of indoor air quality (IAQ) and Moser’s activities of daily living (ADL). Strong relationships between a number of indoor/outdoor environmental parameters were found and CRQ sub-scores for patients of COPD and thus indoor air pollutants must be monitored for future studies related to QOL for patients with COPD.

Keywords: chronic obstructive pulmonary disease (COPD), indoor air pollutants, quality of life, chronic respiratory questionnaire (CRQ)

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Authors: Shakir Iqbal, Muhammad Aqeel, Asghar Ali Shah, Aftab Hussain

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The present study was aimed to investigate and compare the emotional indicators of patients with schizophrenia on Draw a Person test in Pakistan. Draw a Person test was administered on a sample of 400 (Schizophrenia patients=200, Normal=200) age ranged from 20 to 50 years. The data was collected from two provinces of Pakistan (Punjab and Khyber Pakhtun Khwa). The sample was selected by the age levels. According to the Koppitz method of scoring a list of 40 Emotional indicators was selected that were derived from the literature review. It was found that 26 out of 40 emotional indicators (EIs) on Draw a Person test significantly differentiated between patients with schizophrenia and normal (healthy) population. Chi square analysis of the study indicated that 23 EIs were found significant at (p=.001) level, while three EIs were found significant at (P=.05) levels. It was also found that 9 exclusive and 4 frequent EIs on Human Figure Drawings may be significant diagnostic emotional indicators for schizophrenia. It was found that DAP test can be used as a diagnostic tool with the battery of psychological tests such as MCMI-III, MMPI, MSE, HTP for schizophrenia in Pakistan.

Keywords: draw a person test, normal population, Schizophrenia patients, psychological sciences

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Authors: Nassim Salmi

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Postoperative mobilization is an important part of fundamental care. Increased mobilization has a positive effect on recovery, but immobilization is still a challenge in postoperative care. Aims: To report how the establishment of a national nursing database was used to measure postoperative mobilization in patients undergoing surgery for ovarian cancer. Mobilization was defined as at least 3 hours out of bed on postoperative day 1, with the goal set at achieving this in 60% of patients. Clinical nurses on 4400 patients with ovarian cancer performed data entry. Findings: 46.7% of patients met the goal for mobilization on the first postoperative day, but variations in duration and type of mobilization were observed. Of those mobilized, 51.8% had been walking in the hallway. A national nursing database creates opportunities to optimize fundamental care. By comparing nursing data with oncological, surgical, and pathology data, it became possible to study mobilization in relation to cancer stage, comorbidity, treatment, and extent of surgery.

Keywords: postoperative care, gynecology, nursing documentation, database

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Authors: I. Iroka, L. Mgidlana, J. Willoughby, S. Dhlamini, P. Nxumalo, S. Sefadi, A. Mthembu, E. Gerber, E. Brits

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Introduction: Nephroblastoma is a common paediatric tumor with good survival rates when diagnosed and treated early. Method: This retrospective study aimed to describe the patients with nephroblastoma seen at Universitas Academic Hospital Complex between the years 2000 and 2020. Results: In the study period, there were 207 patients identified. The patient profile had slightly more male than female patients; the median age was under four years of age. The study found a median delay of one month between symptom onset and diagnosis; a common cause was a delay in seeking care. Patients diagnosed and treated more than a month after symptoms started had poorer survival rates. There was a higher rate of Stage IV disease compared to similar studies in South Africa. Good preoperative histology and no relapse had good survival rates.. Patients from Lesotho had longer delays and presented with more severe diseases than the South African cohort. Conclusion: Early identification and treatment lead to better outcomes. Health-seeking behaviour, misdiagnosis, and referral delays might contribute to the long delays. A targeted study for patients from Lesotho is recommended.

Keywords: nephroblastoma, South Africa, Lesotho, developing country

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Authors: Wieke Ellen Bouwes

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This study aims to unravel which factors enhance accessibility of video consultations (VCs) for patients with low digital literacy. Thirteen in-depth interviews with patients, hospital employees, eHealth experts, and digital support organizations were held. Patients with low digital literacy received in-home support during real-time video consultations and are observed during the set-up of these consultations. Key findings highlight the importance of patient acceptance, emphasizing video consultations benefits and avoiding standardized courses. The lack of a uniform video consultation system across healthcare providers poses a barrier. Familiarity with support organizations – to support patients in usage of digital tools - among healthcare practitioners enhances accessibility. Moreover, considerations regarding the Dutch General Data Protection Regulation (GDPR) law influence support patients receive. Also, provider readiness to use video consultations influences patient access. Further, alignment between learning styles and support methods seems to determine abilities to learn how to use video consultations. Future research could delve into tailored learning styles and technological solutions for remote access to further explore effectiveness of learning methods.

Keywords: video consultations, digital literacy skills, effectiveness of support, intra- and inter-organizational relationships, patient acceptance of video consultations

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Authors: Ace Mari S. Simbajon, Rhaella J. Ybañez, Mae G. Nadela, Cherry E. Sagun, Nera Mae A. Puyo

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This study determined the usability of the Philippine banknotes. An experimental design was used in the study involving twenty (n=20) randomly selected blind participants. The three aspects of usability were measured: effectiveness, efficiency, and satisfaction. It was found out that the effectiveness rate of the current Philippine Banknotes ranges from 20 percent to 35 percent which means it is not effective basing from Cauro’s threshold of average effectiveness rate which is 78 percent. Its efficiency rate is ranging from 18.06 to 26.22 seconds per denomination. The average satisfaction rate is 1.45 which means the blind are very dissatisfied. These results were used as a guide in making the proposed tactile codification using embossed dots or embossed lines. A round of simulation was conducted with the blind to assess the usability of the two proposals. Results were then statistically treated using t-test. Results show statistically significant difference between the usability of the current banknotes versus the proposed designs. Moreover, it was found out that the use of embossed dots is more effective, more efficient, and more satisfying than the embossed lines with an effectiveness rate ranging from 90 percent to 100 percent, efficiency rate ranging from 6.73 seconds to 12.99 seconds, and satisfaction rate of 3.4 which means the blind are very satisfied.

Keywords: blind, Philippine banknotes, tactile codification, usability

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Authors: Heiko Jessen, Laura Tanus, Slobodan Ruzicic

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Objectives: The efficacy of Stribild®, an integrase strand transfer inhibitor (INSTI) -based STR, has been evaluated in randomized clinical trials and it has demonstrated durable capability in terms of achieving sustained suppression of HIV-1 RNA-levels. However, differences in monitoring frequency, existing selection bias and profile of patients enrolled in the trials, may all result in divergent efficacy of this regimen in routine clinical settings. The aim of this study was to assess the virologic outcomes, safety and tolerability profile of Stribild® in a routine clinical setting. Methods: This was a retrospective monocentric analysis on HIV-1-infected patients, who started with or were switched to Stribild®. Virological failure (VF) was defined as confirmed HIV-RNA>50 copies/ml. The minimum time of follow-up was 24 weeks. The percentage of patients remaining free of therapeutic failure was estimated using the time-to-loss-of-virologic-response (TLOVR) algorithm, by intent-to-treat analysis. Results: We analyzed the data of 197 patients (56 ART-naïve and 141 treatment-experienced patients), who fulfilled the inclusion criteria. Majority (95.9%) of patients were male. The median time of HIV-infection at baseline was 2 months in treatment-naïve and 70 months in treatment-experienced patients. Median time [IQR] under ART in treatment-experienced patients was 37 months. Among the treatment-experienced patients 27.0% had already been treated with a regimen consisting of two NRTIs and one INSTI, whereas 18.4% of them experienced a VF. The median time [IQR] of virological suppression prior to therapy with Stribild® in the treatment-experienced patients was 10 months [0-27]. At the end of follow-up (median 33 months), 87.3% (95% CI, 83.5-91.2) of treatment-naïve and 80.3% (95% CI, 75.8-84.8) of treatment-experienced patients remained free of therapeutic failure. Considering only treatment-experienced patients with baseline VL<50 copies/ml, 83.0% (95% CI, 78.5-87.5) remained free of therapeutic failure. A total of 17 patients stopped treatment with Stribild®, 5.4% (3/56) of them were treatment-naïve and 9.9% (14/141) were treatment-experienced patients. The Stribild® therapy was discontinued in 2 (1.0%) because of VF, loss to follow-up in 4 (2.0%), and drug-drug interactions in 2 (1.0%) patients. Adverse events were in 7 (3.6%) patients the reason to switch from therapy with Stribild® and further 2 (1.0%) patients decided personally to switch. The most frequently observed adverse events were gastrointestinal side effects (20.0%), headache (8%), rash events (7%) and dizziness (6%). In two patients we observed an emergence of novel resistances in integrase-gene. The N155H evolved in one patient and resulted in VF. In another patient S119R evolved either during or shortly upon switch from therapy with Stribild®. In one further patient with VF two novel mutations in the RT-gene were observed when compared to historical genotypic test result (V106I/M and M184V), whereby it is not clear whether they evolved during or already before the switch to Stribild®. Conclusions: Effectiveness of Stribild® for treatment-naïve patients was consistent with data obtained in clinical trials. The safety and tolerability profile as well as resistance development confirmed clinical efficacy of Stribild® in a daily practice setting.

Keywords: ART, HIV, integrase inhibitor, stribild

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Authors: Alireza Monzavi Chaleshtari, Mahnaz Aliakbari Dehkordi, Afsaneh Bayat, Amin Asadi Hieh

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The purpose of this research was to investigate the pattern of structural relationships of quality of life based on anxiety and rumination with the mediation of personality types in psoriasis patients. Methods: The community of this research is made up of the members of Psoriasis Society of Iran - Sadafak. In the sample size of 2266 people, according to Morgan's table, 327 people will be considered as a statistical sample. To assess the quality of life, the 26-item questionnaire of the World Health Organization, anxiety with software SPSS and appropriate to the conditions were used to test the hypotheses, correlation matrix tests and factor analysis. Results: There is a relationship between quality of life with anxiety and rumination in psoriasis patients. The mediating role of personality types showed Psychotic annoyance has a significant relationship with anxiety (physical and emotional symptoms). Extraversion, agreeing and being conscientious play a mediating role in a significant relationship between quality of life in psoriasis patients. Also, irritability plays a mediating role in a meaningful relationship between rumination in psoriasis patients. Conclusion: According to the obtained results, it can be said that psoriasis patients with physical and emotional symptoms of anxiety and rumination have a low quality of life. Also, negative personality types (perfectionism and neuroticism) can cause or aggravate skin disorders in these patients. In other words, psychological factors are considered predisposing, accelerating and perpetuating factors in psoriasis skin disorders, so it is suggested to pay attention to these variables in the success of treating patients with psoriasis.

Keywords: quality of life, anxiety, rumination, personality types, psoriasis.

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Authors: Adisai Thovicha

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This study is the survey research, designed to study the work happiness level of personnel at Suan Sunandha Rajabhat University. The sample group consisted of 329 personnel. The results were collected by stratified sampling, using work positions for each stage. The results were analyzed and calculated by computer program. Statistics used during analyzing were percentage, mean, and standard deviation. From the study, the work happiness level of personnel were in very high score range in both overall and specific category. The top category which received the most score was positive attitude, work satisfaction, life satisfaction, and negative attitude.

Keywords: work happiness, Suan Sunandha Rajabhat University, personnel, positive attitude

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Authors: Alpana Meena

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Background: Tuberculosis is one of the major causes of death in south-east nations. Anti-TB–induced hepatotoxicity (AIH) is associated with a mortality of 6%–12%. The risk is increased when the drugs are combined. Reintroduction of anti-tuberculosis drugs in patients with AIH has never been studied systematically. The present study was planned to see the clinical profile of patients of AIH and the response to reintroduction of therapy. Methods: The trial was conducted in the Department of Medicine, Maulana Azad Medical College and associated Lok Nayak Hospital, on 32 patients with extra-pulmonary tuberculosis who developed AIH. Patients were randomly allocated into 3 groups. In group 1- Isoniazid (INH) and Rifampicin (RIF) were given at full dosages (weight calculated) from day 1. In group 2- RIF was given at maximum dosage from day 1 and INH at maximum dosage from day 8. In group 3- INH was given at maximum dosage from day 1 and RIF at maximum dosage from day 8. Pyrazinamide was added when above regimens were tolerated. Results: The mean age of presentation was 29.37±13.497 years. The incidence was found to be highest in patients with tubercular meningitis (41%) followed by abdominal, pericardial, disseminated, spinal, and lymph nodes. The mean latent period for development of AIH was 7.84 days ± 6.149 days and the median normalization days for LFT’s was 8.81 ± 4.22 days (3-21). In the study, 21% patients had recurrence of AIH with majority of patients having tolerated the reintroduction of drugs. Pyrazinamide was introduced after establishing isoniazid and rifampicin safety, thus emphasizing the role of gradual reintroduction of ATT to avoid the combined effects of hepatotoxicity. Conclusion: To conclude, the recurrence rate of hepatotoxicity was not statistically significant between the three groups studied (p > 0.05), and thus all 3 hepatotoxic drugs can be reintroduced safely in patients developing AIH.

Keywords: anti-tubercular therapy induced hepatotoxicity, extra-pulmonary tuberculosis, reintroduction regimens, risk factors

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Authors: Ali Soroush, Mehdi Mirzaei Alavijeh, Touraj Ahmadi Jouybari, Fazel Zinat-Motlagh, Abbas Aghaei, Mari Ataee

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Diabetes is a disease with long cardiovascular, renal, ophthalmic and neural complications. It is prevalent all around the world including Iran, and its prevalence is increasing. The aim of this study was to determine the factors related to self-care behavior based on health belief model among sample of Iranian diabetic patients. This cross-sectional study was conducted among 301 type 2 diabetic patients in Gachsaran, Iran. Data collection was based on an interview and the data were analyzed by SPSS version 20 using ANOVA, t-tests, Pearson correlation, and linear regression statistical tests at 95% significant level. Linear regression analyses showed the health belief model variables accounted for 29% of the variation in self-care behavior; and perceived severity and perceived self-efficacy are more influential predictors on self-care behavior among diabetic patients.

Keywords: diabetes, patients, self-care behaviors, health belief model

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Authors: Afrah Aladwani, Alexander Mullen, Mohammad AlRashidi, Omamah Alfarisi, Faisal Alterkit, Abdulwahab Aladwani, Asit Kumar, Emad Eldosouky

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Introduction: Trastuzumab is a HER-2 targeted humanized monoclonal antibody that significantly improves the therapeutic outcomes of metastatic and non-metastatic breast cancer. However, it is associated with increased risk of cardiotoxicity that ranges from mild decline in the cardiac ejection fraction to permanent cardiomyopathy. Concerns have been raised in treating eligible older patients. This study compares trastuzumab outcomes between two age cohorts in the Kuwait Cancer Control Centre (KCCC). Methods: In a prospective comparative observational study, 93 HER-2 positive breast cancer patients undergoing different chemotherapy protocols + trastuzumab were included and divided into two cohorts based on their age (˂60 and ≥60 years old). The baseline left ventricular ejection fraction (LVEF) was assessed and monitored every three months during trastuzumab treatment. Event of cardiotoxicity was defined as ≥10% decline in the LVEF from the baseline. The lower accepted normal limit of the LVEF was 50%. Results: The median baseline LVEF was 65% in both age cohorts (IQR 8% and 9% for older and younger patients respectively). Whereas, the median LVEF post-trastuzumab treatment was 51% and 55% in older and younger patients respectively (IQR 8%; p-value = 0.22), despite the fact that older patients had significantly lower exposure to anthracyclines compared to younger patients (60% and 84.1% respectively; p-value ˂0.001). 86.7% and 55.6% of older and younger patients, respectively, developed ≥10% decline in their LVEF from the baseline. Among those, only 29% of older and 27% of younger patients reached a LVEF value below 50% (p-value = 0.88). Statistically, age was the only factor that significantly correlated with trastuzumab induced cardiotoxicity (OR 4; p-value ˂0.012), but it did not increase the requirement for permanent discontinuation of treatment. A baseline LVEF value below 60% contributed to developing a post-treatment value below normal ranges (50%). Conclusion: Breast cancer patients aged 60 years and above in Kuwait were at 4-fold higher risk of developing ≥10% decline in their LVEF from the baseline than younger patients during trastuzumab treatment. Surprisingly, previous exposure to anthracyclines and multiple comorbidities were not associated with significant increased risk of cardiotoxicity.

Keywords: breast cancer, elderly, Trastuzumab, cardiotoxicity

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Authors: Kalyan Koganti

Abstract:

Background: In India, platelet transfusions are given to large no. of patients suffering from dengue due to the fear of bleeding especially when the platelet counts are low. Though many patients do not bleed when the platelet count falls to less than 20,000, certain patients bleed even if the platelet counts are more than 20,000 without any comorbid condition (like gastrointestinal ulcer) in the past. This fear has led to huge amounts of unnecessary platelet transfusions which cause significant economic burden to low and middle-income countries like India and also sometimes these transfusions end with transfusion-related adverse reactions. Objective: To identify the role of Activated Partial Thromboplastin Time (APTT) in comparison with thrombocytoenia as an indicator to assess the real need of platelet transfusions. Method: A prospective study was conducted at a hospital in South India which included 176 admitted cases of dengue confirmed by immunochromatography. APTT was performed in all these patients along with platelet count. Cut off values of > 60 seconds for APTT and < 20,000 for platelet count were considered to assess the bleeding manifestations. Results: Among the total 176 patients, 56 patients had bleeding manifestations like malena, hematuria, bleeding gums etc. APTT > 60 seconds had a sensitivity and specificity of 93% and 90% respectively in identifying bleeding manifestations where as platelet count of < 20,000 had a sensitivity and specificity of 64% and 73% respectively. Conclusion: Elevated APTT levels can be considered as an indicator to assess the need of platelet transfusion in dengue. As there is a significant variation among patients who bleed with respect to platelet count, APTT can be considered to avoid unnecessary transfusions.

Keywords: activated partial thromboplastin time, dengue, platelet transfusion, thrombocytopenia

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Authors: Chiung-Hua Chan, Fang-Yuan Chang, Li-Chi Huang

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Stroke patients received regular rehabilitation therapy have measurable advancement in muscle strength, balance, control upper and lower physical activity, walking speed and endurance. This study aimed to investigate the relationship between increases in bedside rehabilitation time and the function of activities and daily living (ADL) in stroke patients. The study was quasi-experimental research design and randomized sampling. The researcher collected 12 stroke patients of stroke patients transferred to rehabilitation ward unit of a medical center during 1 January to 31 March 2017. All participants then were assigned to case group and control group. Data collection was through direct observation of assessment ADL of stroke patients by researchers on Day 1. Case group received regular rehabilitation, exercises in increase of bedside rehabilitation schedules exercise programs by ward nurses. Bedside rehabilitation exercise content with physical, functional and linguistic frequency and time, Control group only give routine rehabilitation schedule care. This was a randomized study performed in 12 patients who were stroke patients and transferred to rehabilitation ward unit of a medical center during 1 January to 31 March 2017. First, the researcher explained the purpose and method of the study to the patients or the family members. All participants completed a consent informed before participation. Patients were randomly assigned to a ‘bedside rehabilitation program’ (BRP) group and a control (C) group. The BRP group received bedside rehabilitation schedules exercise programs by ward nurses. while the C group did not. Both groups received routine rehabilitation schedule. The Functional Independence Measure was used to measure outcome at the first, 14th and the 28th day of rehabilitation ward admitted. Data were analyzed using SPSS 22.0. After implementation of standardized ‘‘bedside rehabilitation program’, the results were: (1) the increasing of bedside rehabilitation had significant difference (p<.05) in promotion ADL function of stroke patients (2) the extend time of the bedside rehabilitation has significant difference (p<.05) in promotion ADL function of stroke patients compared with the control group. This study demonstrated that the ‘bedside rehabilitation program’ enhanced the ADL function in stroke patients. The nurses and rehabilitation ward managers need to understand that the extend time and frequency of rehabilitation provide a chance to enhanced the ADL function of stroke patients.

Keywords: stroke, bedside rehabilitation, functional activity, ADL

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Authors: Murad Gasanov, Shagen Danielyan, Ali Gasanov, Yuri Teterin, Peter Yartsev

Abstract:

Background: Despite the advances made in modern surgery, the treatment of patients with esophageal injuries remains one of the most topical and complex issues. In recent years, high-technology minimally invasive methods, such as endoscopic vacuum therapy (EVT) in the treatment of esophageal injuries. The effectiveness of EVT has been sufficiently studied in case of failure of esophageal anastomoses, however the application of this method in case of mechanical esophageal injuries is limited by a small series of observations, indicating the necessity of additional study. Aim: The aim was to аnalyzed of own experience in the use of endoscopic vacuum therapy (EVT) in a comprehensive examination of patients with esophageal injuries. Methods: We analyzed the results of treatment of 24 patients with mechanical injuries of the esophagus for the period 2019-2021. Complex treatment of patients included the use of minimally invasive technologies, including percutaneous endoscopic gastrostomy (PEG), EVT and video-assisted thoracoscopic debridement. Evaluation of the effectiveness of treatment was carried out using multislice computed tomography (MSCT), endoscopy and laboratory tests. The duration of inpatient treatment and the duration of EVT, the number of system replacements, complications and mortality were taken into account. Result: EVT in patients with mechanical injuries of the esophagus allowed to achieve epithelialization of the esophageal defect in 21 patients (87.5%) in the form of linear scar on the site of perforation or pseudodiverticulum. Complications were noted in 4 patients (16.6%), including bleeding (2) and and esophageal stenosis in the perforation area (2). Lethal outcome was in one observation (4.2%). Conclusion. EVT may be the method of choice in complex treatment in patients with esophageal lesions.

Keywords: esophagus injuries, damage to the esophagus, perforation of the esophagus, spontaneous perforation of the esophagus, mediastinitis, endoscopic vacuum therapy

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Authors: Riksa Parikrama, Bremmy Laksono, Dadang S. H. Effendi

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Disorder of sexual development (DSD) covers various conditions with a specific term such as Klinefelter syndrome, Turner syndrome, androgen insensitivity syndrome, and many more. The techniques to accurately diagnose those conditions has developed extensively. However, conventional karyotype and fluorescence in situ hybridization (FISH) are still widely used in many genetic laboratories as the basic method to determine chromosomal condition of DSD patients. Cytogenetic study was conducted on 36 DSD patients in Cell Culture and Cytogenetics Laboratory, Faculty of Medicine Universitas Padjadjaran, Indonesia. Most of the patients referred to the laboratory diagnosed with primary amenorrhea, hypospadias, micropenis, genitalia ambiguity, or congenital adrenal hyperplasia. The study used G-banding technique to acquire complete karyotype and followed by FISH as either confirmation or comparison method. Among 36 patients, G-banding karyotype and FISH results showed that two were diagnosed with 45, X (Turner syndrome); three with 47, XXY (Klinefelter syndrome); five with 46, XX DSD; 22 with 46, XY DSD; and four with 46,XY complete androgen insensitivity syndrome. G-banding karyotype analysis were paired with FISH using X and Y chromosome probe produced similar results. The present analysis showed that FISH is a reliable method to attain a rapid and accurate chromosome analysis result of DSD patients. Nevertheless, conventional karyotype technique is still vital if other condition appeared in DSD patients in order to get more detailed karyotype result which FISH method cannot achieve.

Keywords: chromosome, DSD, FISH, karyotype

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Authors: Elizabeth Behrens, Anne Timmermann, Alexander Yerkan, Joshua Thomas, Deborah Katz, Agne Paner, Melissa Larson, Shivi Jain, Seo-Hyun Kim, Celalettin Ustun, Ankur Varma, Parameswaran Venugopal, Jamile Shammo

Abstract:

Coronavirus Disease-2019 (COVID-19) causes persistent concern for poor outcomes in vulnerable populations. Patients with hematologic malignancies (HM) have been found to have higher COVID-19 case fatality rates compared to those without malignancy. While cytopenias are common in patients with HM, especially in those undergoing chemotherapy treatment, hemoglobin (Hgb) and platelet count have not yet been studied, to our best knowledge, as potential prognostic indicators for patients with HM and COVID-19. The goal of this study is to identify factors that may increase the risk of mortality in patients with HM and COVID-19. In this single-center, retrospective, observational study, 65 patients with HM and laboratory confirmed COVID-19 were identified between March 2020 and January 2021. Information on demographics, laboratory data the day of COVID-19 diagnosis, and prognosis was extracted from the electronic medical record (EMR), chart reviewed, and analyzed using the statistical software SAS version 9.4. Chi-square testing was used for categorical variable analyses. Risk factors associated with mortality were established by logistic regression models. Non-Hodgkin lymphoma (37%), chronic lymphocytic leukemia (20%), and plasma cell dyscrasia (15%) were the most common HM. Higher Hgb level upon COVID-19 diagnosis was related to decreased mortality, odd ratio=0.704 (95% confidence interval [CI]: 0.511-0.969; P = .0263). Platelet count the day of COVID-19 diagnosis was lower in patients who ultimately died (mean 127 ± 72K/uL, n=10) compared to patients who survived (mean 197 ±92K/uL, n=55) (P=.0258). Female sex was related to decreased mortality, odd ratio=0.143 (95% confidence interval [CI]: 0.026-0.785; P = .0353). There was no mortality difference between the patients who were on treatment for HM the day of COVID-19 diagnosis compared to those who were not (P=1.000). Lower Hgb and male sex are independent risk factors associated with increased mortality of HM patients with COVID-19. Clinicians should be especially attentive to patients with HM and COVID-19 who present with cytopenias. Larger multi-center studies are urgently needed to further investigate the impact of anemia, thrombocytopenia, and demographics on outcomes of patients with hematologic malignancies diagnosed with COVID-19.

Keywords: anemia, COVID-19, hematologic malignancy, prognosis

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Authors: Loubna Safar, Lama Youssef, Majd Aljamali

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Age-related macular degeneration (AMD) is one of the leading causes of blindness worldwide. Complement factor H polymorphism (Y402H) is thought to play a potential role in the predisposition to AMD and response of patients with exudative AMD to treatment with anti-Vascular Endothelial Growth Factor (anti-VEGF). This study aimed to investigate the frequency of Y402H among Syrians, its impact on their susceptibility to AMD, and the hypothesized role of Y402H in patients' response to intravitreal anti-VEGF (i.e.,, bevacizumab). Our case-control study encompassed unrelated 54 AMD cases and 44 controls. Genotyping was determined by standard sequencing of PCR products. Frequency was compared between patients and controls, and correlation between genotype and response to treatment was assessed in 20 patients with wet AMD who received a therapeutic course of three intravitreal bevacizumab injections (once monthly). Our results revealed a significantly higher prevalence of the risk allele C among AMD cases (51.9%) in comparison with controls (37.5%) (P= 0.04, OR= 1.386, CI= 0.999- 1.923). Patients with the TT genotype (no risk allele) exhibited a significantly better primary response rate, reached 87.5% compared to only 41.7% in patients carrying the risk allele C (TC + CC), (P= 0.04, OR= 9.8, CI=0.899- 106.84). The findings of this study prove the importance of investigating Y402H polymorphism as a prognostic marker for predicting response to bevacizumab in AMD patients.

Keywords: age-related macular degeneration, bevacizumab, complement factor H gene, polymorphism, Y402H

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Authors: Thiraporn Chumphuming, Nuttida Boonmathi, Supattra Thanomsiang, Tawatchai Noree, Suthee Boonchaloem, Rinyaphat Kecharananta

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This research aims to study about the formats of low-cost airlines’ services in domestic route by surveying customers’ requirements and satisfactions in choosing low-cost airlines to travel domestically. Chiang Mai International Airport and other regions in Chiang Mai are the bases where the information is quantitatively collected. Passengers and questionnaires of 400 are the data base in which the researchers collected information from. Statistic units used are Percentage, Weighted Average, and Standard Deviation. The result of the study reveals that the group of 400 representative samples chooses Air Asia the most from overall six low-cost airlines that provide domestic services. Most of the representative samples book plane tickets for their traveling and they book tickets during the promotion time that provides cheap-priced tickets. Averagely, the price for a seat in one flight is around 501-1,000 Thai baht. The result of the satisfaction’s survey analyzed by the Marketing Mix Factors (7Ps) of low-cost airlines, which is divided into 4 parts including services before ticket reservations, services before boarding/purchasing tickets (ground), In-flight services, and Services after boarding they are satisfied with the baggage claim point informing, also gives the information that the passengers are highly satisfied with every process or the services.

Keywords: low-cost airline, service, satisfaction, customers' behavior

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Authors: Pitchaporn Purngpiputtrakul, Suttasinee Petsakul, Sunisa Chatmongkolchart

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Nasogastric tube (NGT) insertion in anaesthetized and intubated patients can be challenging even for experienced anesthesiologists. Various techniques have been proposed to facilitate NGT insertion in these patients. This study aimed to compare the success rate and time required for NGT insertion between the GlideScope visualization and neck flexion with lateral neck pressure techniques. This randomized clinical trial was performed at a teaching hospital on 86 adult patients undergoing abdominal surgery under relaxant general anaesthesia who required intraoperative NGT insertion. The patients were randomized into two groups, the GlideScope group (group G) and the neck flexion with lateral neck pressure group (group F). The success rate of first and second attempts, duration of insertion, and complications were recorded. The total success rate was 79.1% in Group G compared with 76.7% in Group F (P=1) The median time required for NGT insertion was significantly longer in Group G, for both first and second attempts (97 vs 42 seconds P<0.001) and (70 vs 48.5 seconds P=0.015), respectively. Complications were reported in 23 patients (53.5%) in group G and 13 patients (30.2%) in group F. Bleeding and kinking were the most common complications in both techniques. Using GlideScope visualization to facilitate NGT insertion was comparable to neck flexion with lateral neck pressure technique in degree of success rate of insertion, while neck flexion with lateral neck pressure technique had fewer complications and was less time-consuming.

Keywords: anaesthesia, nasogastric tube, GlideScope, intubation

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Authors: Dorsa Rahi, Arghavan Tonkanbonbi, Soheila Manifar, Behzad Jafvarnejad

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Background and Aim: Intraoral manipulation is performed during endotracheal intubation for general anesthesia, which can traumatize the soft and hard tissue in the oral cavity and cause postoperative pain and discomfort. Dental trauma is the most common complication of intubation. This study aimed to assess the prevalence of dental complications due to intubation in patients hospitalized in Imam Khomeini Hospital during 2018-2019. Materials and Methods: A total of 805 patients presenting to the Cancer Institute of Imam Khomeini Hospital for preoperative anesthesia consultation were randomly enrolled. A dentist interviewed the patients and performed a comprehensive clinical oral examination preoperatively. The patients underwent clinical oral examination by another dentist postoperatively. Results: No significant correlation was found between dental trauma (tooth fracture, tooth mobility, or soft tissue injury) after intubation with the age or gender of patients. According to the Wilcoxon test and McNemar-Bowker Test, the rate of mobility before the intubation was significantly different from that after the intubation (P=0.000). Maxillary central incisors, maxillary left canine and mandibular right and left central incisors had the highest rate of fracture. Conclusion: Mobile teeth before the intubation are at higher risk of avulsion and aspiration during the procedure. Patients with primary temporomandibular joint disorders are more susceptible to post-intubation trismus.

Keywords: oral trauma, dental trauma, intubation, anesthesia

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