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Introduction For more effective control and treatment of cardiac dysrhythmias caused by diseases, ischemia, or other causes, an implantable cardioverter defibrillator (ICD) is used. One of the effective ways for secondary prevention is the home-based cardiac rehabilitation (HBCR) which nurses have an effective role in its implementation. Objective The study aimed to investigate the effect of implementing HBCR programs on the self-efficacy of patients with ICD. Methods This is a semi-experimental study conducted on 70 patients who received ICD in Shahid Chamran Heart Center of Isfahan University of Medical Sciences (IUMS) in 2021. The patients were randomly assigned to intervention and control groups and were introduced to the practical concepts of HBCR during four training sessions. In the following, 3-month follow-up and trainings were continued by home visits, telephone follow-up, and use of social messaging networks due to the conditions of coronavirus disease 2019 (COVID-19) pandemic. The data were analyzed with SPSS/21. Results The findings showed that performing HBCR programs was effective in improving the self-efficacy of patients with ICDs. A significant trend in the implementation of the HBCR programs in two groups was shown using chi-square test and independent t-test and variance with repeated measurements (p < .001). There was no significant difference in self-efficacy score in both groups at the beginning of the study (p < .056). Conclusion Considering the effectiveness of HBCR programs on improving the self-efficacy of patients with ICDs, it can be used in the educational care programs of healthcare workers and in the strategic policies of health care services.
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BACKGROUND: Several diagnostic methods have been proposed and evaluated for the COVID-19 disease. However, the published studies have reported different diagnostic values for these methods. AIMS: The present study aimed to evaluate the diagnostic performance and accuracy of CT in the novel corona virus disease (COVID-19) and to develop and present a Corona CT severity index. METHODS: The CT diagnostic performance was measured based on sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy, and RT-PCR was regarded as a standard. Patients' CT reports were evaluated by a radiologist, and scoring and calculating of the CT severity index were performed. RESULTS: Of 208 patients, 82 showed positive and 126 showed negative RT-PCR results with a positive frequency of 39.4% (95% CI, 32.7-46.4). The chest CT scan related to 136 patients indicated COVID-19, whereas their initial RT-PCR assays of 56 patients were negative. Considering RT-PCR results as reference standard, the sensitivity, specificity, and accuracy of chest CT to indicate COVID-19 infection was 100%, 55.6% (95% CI 46.4-64.4%), and 72.8% (95% CI 66.2-78.8%), respectively. The severity of pulmonary involvement was assigned with different grades. For 60.7% of patients with severity grades of 2 to 6, who showed the involvement of at least one lung lobe in CT, PCR retrieved negative results. CONCLUSION: CT scan represents an appropriate sensitivity as well as a consistently higher specificity to diagnose COVID-19 pneumonia than PCR. It can be regarded as a primary tool to detect the current COVID-19 in epidemic regions.
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Background and aims: Due to the different levels of exposure of different people to the coronavirus and different levels of immune response among them, this study was designed to investigate the humoral immune responses against the coronavirus disease 2019 (COVID-19) in healthcare staff in hospitals and medical centers admitting COVID-19 patients. Methods: In this descriptive-analytical study, which was performed by call-out, the serum levels of IgM and IgG antibodies in 492 staff of hospitals and medical centers were evaluated using ELISA. Then, factors influencing the immune response of participants were determined. Results: IgG positivity was 11.6% among participants of this study, 19.2% of the staff had a positive polymerase chain reaction (PCR) test, and the IgG positivity rate among them was only 16%. There was no significant relationship between body mass index, underlying diseases, diabetes, immune system-related diseases, herpes simplex virus, workplace, blood type, education level, symptoms, and IgG response (P>0.05). Further, the rate of IgG positivity in healthcare staff indicated a significant relationship only with gender (P=0.005), history of hospitalization (P=0.002) due to COVID-19 and position (P=0.008). Conclusion: This study found that the prevalence of humoral immune response in healthcare staff was lower than the prevalence of the disease based on molecular tests. Based on the results of the present study, it is possible to provide an accurate estimate of the level of involvement and predisposition of healthcare staff in hospital wards and medical centers and to use this information for disease management and control. [ FROM AUTHOR] Copyright of Journal of Shahrekord University of Medical Sciences is the property of Journal of Shahrekord University of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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BACKGROUND & OBJECTIVE: Previous studies have addressed the electrolyte abnormalities such as hypocalcemia in COVID-19 patients. We aimed to compare the laboratory findings especially the electrolyte levels among COVID-19 patients and healthy controls and evaluate their prognostic values. METHODS: This case-control study included 91 COVID-19 patients and 169 healthy individuals. Their laboratory parameters including electrolytes, albumin, liver enzymes, complete blood count, vitamin D, and parathyroid hormone (PTH) were compared. We also analyzed the association between these markers and the major outcomes including severity, mortality and hospitalization. RESULTS: Among patients with COVID-19, 59.3% of the patients had hypocalcemia on admission while in control group only 32.5% had low calcium level (OR=3.02, 95% CI: 1.79-5.13, P<0.001). The rates of death and ICU admission were significantly higher among the patients in hypocalcemic group than those of eucalcemic group (85.7% vs 14.3% and 33.3% Vs 9.1%, respectively). However, there was no significant difference in the mean PTH and vitamin D levels between the two groups. In terms of the severity of the infection, 74.1% of patients in hypocalcemic group had a severe infection while 24.3% of the patients in eucalcemic group were diagnosed with severe infection (OR=8.89, 95% CI: 3.38-23.37, P<0.001). CONCLUSION: Patients with COVID-19 may present with considerable laboratory abnormalities including hypocalcemia. The hypocalcemia would be also associated with worse major clinical outcome and higher mortality risk.