Internal Medicine and Medical Investigation Journal (IMMINV)
Not a member yet
148 research outputs found
Sort by
What is Emotional Pain? - A Review of Pathophysiology and Treatment Options
Full text linkPain is a dynamic process that involves multiple physiological systems for the perception and its outcomes. The basic pain process involves a complex neurological process. and biochemical changes. Emotional pain is an extended form of the already known pain where the stimuli are emotional of nature that involves abstract feelings, for example, losing a loved one. Like the pain, now there is a growing evidence that emotional pain also involves inflammatory process and the behavioral approach is directly linked with them. This association can help us modify the emotional pain by modulating the inflammatory processes that already known to us. Other than therapeutic and known interventions, mindfulness, writing therapy, exposure based intervention and other actions can help us in just not treating the condition but can serve as exploration of other avenues of the pain physiology. Emotional Pain has always been the part of human history but one of the least discussed form of pain. Multiple neuropsychiatric studies can help further in evaluation of this process
Highly Active Antiretroviral Therapy Induced Hematological and Dermatological Adverse Drug Reactions in People Living with HIV in India
No full textIntroduction: In India, HIV patients are at a high risk of developing hematological and dermatological adverse drug reactions (ADRs) leading to financial burden. Materials and Methods: A prospective observational study was conducted on hematological and dermatological ADRs in a South Indian teaching hospital from October 2011 to October 2012. The definition of ADRs established by the World Health Organization (WHO) was used to assess the causality. Predictability of ADRs was assessed by Micromedex database. Preventability of ADRs was assessed using the Schumock and Thornton criteria. Results: A total of 174 HIV patients were enrolled [133 (76.4%) males and 41 (23.6%) females], who reported 99 ADRs to HAART. Of the total ADRs, 70 (70.7%) were reported in males and 29 (29.3%) in females, indicating significantly higher reporting of ADRs in males. 67 of the 99 ADRs were hematological, while the remaining 32 were dermatological. A high number of hematological [40 (59.6%)] and dermatological [15 (46.8%)] ADRs were reported for zidovudine + lamivudine + nevirapine-based HAART regimen. In most of the reported ADRs, the suspected drug was withdrawn. The reported hematological ADRs were as follows: 1) anemia with zidovudine [35 (52.2%)]; 2) pancytopenia with zidovudine [20 (29.9%)]; 3) neutropenia with lamivudine; and 4) leucopenia, bicytopenia, and eosinophilia with zidovudine. Dermatological ADRs were maculopapular rash [7 (21.8%)] with nevirapine-, tenofovir + emtricitabine + efavirenz. Conclusion: Hematological ADRs was higher than that of dermatological ADRs. Physicians must focus on routine monitoring of all possible risk factors in PLW-HIV for early prevention of hematological and dermatological ADRs to HAART
Assessment of the Nursing Aides Performance in the Care of Elderly Patients Admitted to Ali ibn Abi Talib Hospital of Zahedan
Full text linkIntroduction: Improving the quality of care for the elderly patients in the care units requires improving the performance of health care providers such as nurse-aids from the standard guidelines of caring in this area. In this regard, the present study was aimed to determine the performance of nurse-aids in the safe care of elderly patients admitted to Ali ibn Abi Talib hospital of Zahedan in 2016. MAterials and Methods: This quasi-experimental study was carried out with pre-test design on 50 randomly selected nurse-aids in the hospital. The data were evaluated using a researcher-made checklist of nurse-aid's performance regarding care of the elderly patients in the care unit. Data were analyzed using SPSS software version 16 using Chi-square, Mann-Whitney, One-way ANOVA tests. Results: The results showed that according to Kruskal–Wallis test, work experience of the nurse-aids had a significant correlation with their performance in preventing bed sores in elderly patients admitted to care units (p=0.01). According to the means comparison test, there was no significant correlation between the performance of the nurse-aids regarding the infection control standards with the age of the elderly patients in the admission wards (p = 0.46). Conclusion: According to the results of this study, work experience and education level are more effective in improving the level of performance of nurse-aids and improving their performance in care of the elderly in the care units
Pathophysiology of Dyslipidemia and its Management by PCSK9 Inhibitors: A Literature Review
Full text linkDyslipidemia is a disease of abnormal lipid levels in the blood that contributes to the atherosclerotic process. This atherogenic process leads to the formation of plaque and also leads to thromboembolic events and other vascular accidents. It is known that high-density lipoprotein cholesterol serves as a protective effect on the vessel wall and causes the reduction in the progression of atherosclerosis. And multiple interventions are directed in maintaining a higher level of the aforementioned lipoprotein cholesterol. While the low-density lipoprotein stays controversial but lowering its levels through various therapeutic agents is the main goal in the management of dyslipidemia. A newer group of drugs, PCSK9 inhibitors lowers the levels of low-density lipoprotein through modulating PCKS9 gene involved in cholesterol metabolism and affects the levels of the lipoproteins by controlling the receptors. The inhibitors of this gene decrease PCSK9-induced low-density lipoprotein receptor degradation in the lysosomes of hepatocytes increasing its recycling and expression on the cell surface, causing increased clearance of low-density lipoprotein from the circulation. These drugs Alicuromab, Evolocumab and along with other agents can be a novel approach in controlling dyslipidemic state. This review revisits the literature in understanding the pathophysiology of dyslipidemia along with its management by PCKS9 inhibitors, its mechanism of action, its pharmacokinetics, the results of the clinical trials and the limitations in its application
Effects of Heparin on Early Patency of Arteriovenous Fistula in Angioaccess Surgery of Patients with End-Stage Renal Disease
Full text linkBackground: Arteriovenous fistula (AVF) is now the optimal method of obtaining vascular access for dialysis. Measures such as systemic anticoagulation have been proposed as means of increasing patency rates but enough evidence does not exist to support their application. We aimed to evaluate the efficacy of preoperative heparin injection on patency of AVF during the first 24 hours after surgery and to determine whether such measure can be used to prevent early thrombosis of the vascular access.Methods: The study was carried out on 150 patients admitted to Shohada-e-Tajrish hospital for permanent vascular access placement during 2011-2012. 75 patients were randomly assigned to receive 100 units/kg of heparin intraoperatively and at 24 hours post-surgery AVF patency rate was assessed and compared to the control group. Results: All the 75 patients who had received heparin intraoperatively had a patent arteriovenous fistula 24 hours post-surgery which showed a statistically significant difference compared to the control group among which only 69 (92%) patients had a functioning AV fistula (p-value= 0.028).Conclusions: Our results show that systemic anticoagulation with heparin can be considered as an effective option in preventing vascular access failure. However, considering the contradictory data on the usefulness of heparin injection, larger trials are needed to evaluate efficacy and adverse effects of systemic intraoperative anticoagulation in End-Stage Renal Disease (ESRD) patients before qualifying it as a method of increasing AVF patency in these patient
Evaluation of Longitudinal Tissue Velocity and Deformation Imaging in Akinetic Non-viable Apical Segments of Left Ventricular Myocardium
Full text linkIntroduction: The use of tissue velocity and strain rate imaging is proposed for the quantification of non-viable myocardium. This study is aimed at investigating the differences in tissue velocity and strain rate imaging indices between non-viable left ventricular apical segments and the normal segments using segment-by-segment comparison.Materials and Method: Thirty-two patients with akinetic left ventricular apical segments and without viability were selected using two-dimensional echocardiography and dobutamine stress echocardiography; 32 individuals with normal echocardiography and coronary angiography formed the normal group. Peak systolic velocity, peak systolic strain, and strain rate were measured in the four left ventricular apical segments and the apex 17th segment.Results: The patient group had a significantly lower ejection fraction (26.88±6.06% vs. 56.56±2.36%; p<0.001). Overall, the patient group had significantly lower resting peak systolic velocity, systolic strain, and strain rate. In the segment-by-segment comparison, only systolic strain showed a remarkable reduction in the patient group, while reduction in Sm and strain rate were not significant in all the segments. After dobutamine stress echocardiography, only systolic strain showed an insignificant increase compared to the resting values. In the apex 17th segment, Sm showed significant reduction in the patient group.Conclusion: The ST in apical segments may be used as a quantitative index for detecting akinesia both at rest and after dobutamine infusion. Reduction in Sm can be used as a marker of akinesia in the apical cap at rest
The impact of using BASNEF model on self-control behaviors among Patients with hypertension
Full text linkBackground: High blood pressure is the most important public health problem in developed countries. It is one reason for early mortality and risk factors for cardiovascular diseases like stroke and kidney failure. This study aimed to determine the effect of educational intervention based on BASNEF in blood pressure control in 1395.Methods and Materials: This study was a quasi-experimental study on 160 patients in two groups (each n = 80) suffering from hypertension in urban health centers of Urmia. Data collection questionnaire included: demographic questions, knowledge base questions, self-control behaviors questions and structures of BASNEF model. Validity and reliability were respectively 80% and 79%. Intervention group had taken three 45 minutes sessions using speeches, questions and answers, posters, booklets, pamphlets and whiteboard. Before training, information collected through questionnaires and after training questionnaires were completed again after 3 months. The data were analyzed in SPSS software with chi-square tests, Fisher, independent and paired sample t-test.Results: The average age of case and control group were 99.11 ± 01.56 and 75.12 ± 66.53 years. That there was no statistically significant difference (p=0.1). After intervention average systolic blood pressure significantly decreased in the intervention group from 43.157 to 24.147 mm Hg and diastolic blood pressure significantly decreased from 21.93 to 52.87 mm Hg (P <0.05)Conclusion: The training program using BASNEF model has provided better results in controlling blood pressure than conventional trainings
Comparison of the Nutrition of Patients with and without Non-alcoholic Fatty Liver in Tehran
Full text linkIntroduction: A high prevalence of non-alcoholic fatty liver disease is associated with obesity and lifestyle disorders. The present study was conducted to compare the nutritional pattern of patients with and without non-alcoholic fatty liver disease referred to the hospitals affiliated to Tehran University of Medical Sciences in 2017.Materials and Methods: The present case-control study was performed on a total of 300 outpatients and inpatients, aged 18–65 years. These patients were referred to the ultrasonography section of the hospitals, and those recruited in the study were selected by the convenience method of sampling. According to the results of ultrasonography, these subjects were divided into two groups: case (100 patients) and control (200 subjects for increasing the statistical power of study). The data were analyzed using the Statistical Package for the Social Sciences (version 19), descriptive statistics, and the Mann–Whitney test. P<0.05 was considered significant.Results: A significant difference was detected between the mean consumption of unhealthy foods in the case group as compared to the control group (P=0.001), while those with fatty liver reported a low average intake of fruits and vegetables with a significant difference (P=0.001).Conclusion: The results showed that patients with fatty liver complied with poor dietary habits as compared to individuals without the disease.
IgA Vasculitis in Middle Aged Man Followed by Influenza Virus Infection: A Case Report
Full text linkIntroduction: Immunoglobulin A vasculitis (formerly known as Henoch Schonlein Purpura) is the most common pediatric vasculitis, which occurs typically at the age of 3-15 years. Mononucleosis, group A Streptococcus, Campylobacter and Mycoplasma are some of the common infectious causes of immunoglobulin A vasculitis. Immunoglobulin A vasculitis is a clinically diagnosed disease. Most common clinical features include nonthrombocytopenic nonpruritic palpable purpura, gastrointestinal involvement, arthritis or arthralgia and renal involvement. Biopsy of skin and/or gastrointestinal lesions con rm the diagnosis, although this is not necessary. Immunoglobulin A vasculitis is a self-limiting disease, which resolves spontaneously. Steroids can be used for the treatment of moderate to severe disease and for the prevention of renal complications. Prognosis relies upon various factors among which involvement of kidneys dictates poor prognosis and requires close follow up. Case Presentation: We are presenting a case of immunoglobulin A vasculitis in a 39-year-old German male following in uenza virus infection. The infectious agent that cause immunoglobulin A vasculitis in our patient was In uenza A virus. Biopsy of the skin lesion con rmed the diagnosis of immunoglobulin A vasculitis in our patient. The patient responded to steroids and his skin and GI ndings resolved. Conclusion: Our case report adds to the literature of medicine by describing in uenza virus as a cause of immunoglobulin A vasculitis in young adult patients. Considering immunoglobulin A vasculitis after in uenza and outside of the typical age of 3-15 years, can help to make earlier diagnosis and prevent complications