ABSTRACT
Quality of life has been defined in a variety of ways depending on the context and the orientation of scholars. The purpose of the this study was to evaluate caregivers ' quality of life and also to investigate the correlation between quality of life of caregivers and their satisfaction with social work section services. The present study employed a correlational design, with 125 caregivers of Iranian children with cancer. It was conducted at hospitals covered by MAHAK. Quality of life in caregivers was measured by the Iranian version of WHO, QOL-BREF. Satisfaction of social work section services was measured by questioner including six services. Data was analyzed by t-Test and ANOVA using SPSS-PC [v.17]. The scores of all dimensions of caregivers' quality of life were lower than general population. The difference was significant in physical [p<0.001], psychological [p=0.000] and environmental [p<0.001] dimensions. The lowest score and highest difference was found in psychological dimension of quality of life. The highest satisfaction rate was related to supporting the child and family and the highest dissatisfaction was related to services given to family. The highest positive correlation was found between satisfaction with services for child and psychological dimension of care givers' quality of life [r=0.28, p<0.001]. Understanding of factors that associate with caregivers' quality of life is of central importance to the improvement of care, treatment process and for effective interventions for children with cancer. These findings provide useful information for managers to enhance quality of services and to enhance caregivers' satisfaction
ABSTRACT
Purpose: to report the clinical features of 93 eyes with chronic and delayed onset mustard gas keratitis in 48 patients
Methods: forty-eight Iranian survivors of Iraqi chemical warfare with chronic or delayed onset mustard gas keratitis were enrolled. We reviewed the symptoms, signs, clinical course, and treatment of our patients. In 5 cases, histopathologic features of corneal and conjunctival specimens are presented
Results: of 48 patients, 3 1 [64.6%] had chronic symptomatology whereas 17 [3 5.4%] experienced delayed onset lesions. Visual acuity at referral ranged from hand motions to 20120. Ocular surface changes included chronic blepharitis and decreased tear meniscus in all, limbal ischemia [81.3%] and conjunctival vascular abnormalities [50%]. Corneal signs in order of frequency were: scar/opacity [87.5%], neovascularization [70.8%], thinning [58.3%], lipoid deposits [52. I%], amyloid deposits [43.8%], and epithelial defects and irregularity [3 1.3%]. Twenty patients received conservative treatment; others underwent allograft stem cell transplantation [20 eyes of 17 patients], penetrating keratoplasty [12 eyes of 12 patients], and lamellar keratoplasty [4 eyes of 3 patients]. Conjunctival specimens were evaluated by light microscopy. Decreased goblet cell density, attenuated or thickened epithelium, scarring in the substantia propria associated with plasmacytic and lymphocytic infiltration, and dilated lymphatic vessels were noted. Excised corneal buttons disclosed absence of epithelium and Bowman's layer, firbrovascular pannus, stromal scarring, and vascularization
Conclusion: mustard gas may cause chronic and delayed destructive lesions in the ocular surface and cornea leading to progressive visual deterioration and ocular irritation. The pathophysiology of these changes is not clearly identified. Excised conjunctival and corneal specimens revealed a mixed inflammatory response without any specific features. Based on the clinical appearance of the lesions and histopathologic findings, an immune-mediated component seems possible