RESUMO
Tuberculosis (TB) is among the most common cause of serositis. There are many uncertainties in diagnostic and therapeutic approach to serous membranes tuberculosis. Our aim in the present review is to discuss the regional facilities for timely diagnosis, rapid decision-making and appropriate treatment regarding to serous membranes tuberculosis; with emphasis on situation in Iran. A comprehensive literature searches about the status of serous membranes tuberculosis in Iran were performed in English databases including Google Scholar, Science Direct, Scopus, Pub Med, and Web of Sciences, Persian SID databases, between 2000 and 2021. The main findings of the present review are as follow: a) pleural tuberculosis is more common than pericardial or peritoneal tuberculosis. b) Clinical manifestations are non-specific and so non-diagnostic. c) Smear and culture, PCR and characteristic granulomatous reaction have been used for definitive TB diagnosis by physicians. d) With Adenosine Deaminase Assays and Interferon-Gamma Release Assays in mononuclear dominant fluid, a possible diagnosis of TB is proposed by experienced physicians in Iran. e) In area of endemic for tuberculosis including Iran, a possible diagnosis of TB is enough to begin empirical treatment. f) In patients with uncomplicated tuberculosis serositis, treatment is similar to pulmonary tuberculosis. First line drugs are prescribed unless evidence of MDR-TB is detected. g) The prevalence of drug resistant tuberculosis (MDR-TB) in Iran is between 1% and 6%, and are treated by empirical standardized treatment. h) It is not known whether adjuvant corticosteroids are effective in preventing long term complication. i) Surgery may be recommended for MDR-TB. Tamponade or constrictive pericarditis and intestinal obstruction. In conclusion, it is recommended to consider serosal tuberculosis in patients who have unknown mononuclear dominant effusion and prolonged constitutional symptoms. Experimental treatment with first line anti-TB drugs can be started based on possible diagnostic findings.
RESUMO
The quality of family caregiver-patient interaction plays a crucial role in the context of chronic conditions. This study investigated the effects of a caregiver educational program on interactions between family caregivers and patients with advanced chronic obstructive pulmonary disease (COPD). In this trial, 92 pairs of family caregivers and patients in a subspecialty lung care clinic located in Birjand, Iran were allocated into intervention and control groups (n = 46 per group). The intervention consisted of eight sessions, including three educational sessions on COPD, two educational sessions on coping strategies, as well as three peer support sessions. The Dyadic Relationship Scale was completed at baseline, posttest, and follow-up (2 months after intervention). For caregivers in the intervention group, positive dyadic interaction improved significantly from baseline to follow-up and from posttest to follow-up in comparison with the control group (p < 0.05). Also, for these caregivers, negative dyadic strain enhanced significantly from baseline to posttest and from baseline to follow-up as compared with those in the control group (p < 0.05). Finally, in patients of the intervention group, negative dyadic strain from baseline to follow-up and from posttest to follow-up significantly improved when compared with that of control patients (p < 0.05).
