Journal of Clinical and Nursing Research

Journal Information
ISSN / EISSN : 2208-3685 / 2208-3693
Total articles ≅ 534
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Amira B Kassem, Asmaa M Farrag, Dina Shafea, Osama Mohamed Ibrahim
Journal of Clinical and Nursing Research, Volume 6, pp 24-30; https://doi.org/10.26689/jcnr.v6i3.3844

Abstract:
Background: Warfarin is widely regarded as the main anticoagulant in lowering the risk of thromboembolism. This study used indicators to compare pharmacist-managed anticoagulation services, using a well-prepared protocol, with physician-managed anticoagulation services. Methods: A retrospective prospective pilot study was conducted to compare patient outcomes before and after transitioning patients to pharmacist-managed anticoagulation services, comparing the proportion of those with therapeutic international normalized ratio (INR), subtherapeutic INR, and supratherapeutic INR, as well as their bleeding occurrences as indicators of assuring quality care. Results: A significant improvement in anticoagulation management was noted in the transition to pharmacist-managed anticoagulation services. The proportion of those with subtherapeutic INR decreased from 61.8% to 11.8% (p < 0.001), those with supratherapeutic INR decreased from 20.6% to 2.9% (p < 0.001), those with therapeutic INR increased from 17.6% to 85.3% (p < 0.001), and the occurrence of bleeding decreased from 11.8% to 0.0%, without significant difference in warfarin doses (median from 4 before the transition to 5 after); in addition, the time to reach therapeutic INR decreased from 12-24 weeks to 2-8 weeks after transitioning to pharmacist-managed anticoagulation services. Conclusion: Pharmacist-managed anticoagulation services are considered safer and more effective than physician-managed anticoagulation services alone in terms of patients’ adherence and satisfaction, which provide an excellent opportunity for quality assurance care.
Sara M Tony, Mohamed Ea Abdelrahim
Journal of Clinical and Nursing Research, Volume 6, pp 54-72; https://doi.org/10.26689/jcnr.v6i3.3908

Abstract:
Inhaled drug delivery is mainly used to treat pulmonary airway disorders by transporting the drug directly to its targeted location for action. This decreases the dose required to exert a therapeutic effect and minimizes any potential adverse effects. Direct drug delivery to air passages facilitates a faster onset of action; it also minimizes irritation to the stomach, which frequently occurs with oral medications, and prevents the exposure of drugs to pre-systemic metabolism that takes place in the intestine and liver. In addition to that, the lung is regarded as a route for transporting medications throughout the entire body’s blood circulation. The type of medication and the device used to deliver it are both important elements in carrying the drug to its target in the lungs. Different types of inhalation methods are used in inhaled delivery. They differ in the dose delivered, inhalation technique, and other factors. This paper will discuss these factors in more detail.
Amira B Kassem, Mohamed Ea Abdelrahim, Alaa Mousa, Amira Harun, Heba Al-Husseini, Salma Khaled, Mahmoud Elhadidy, Osama Mohamed Ibrahim
Journal of Clinical and Nursing Research, Volume 6, pp 31-42; https://doi.org/10.26689/jcnr.v6i3.3823

Abstract:
Background: Diabetes and hypertension have been identified as risk factors for HCV complications in previous studies. This has sparked the interest in the field of prevention by identifying at-risk individuals and increasing investments for screening among pharmacists. The aim of this study was to screen for risk factors, including age, gender, BMI, hypertension, diabetes, and obesity, in Egyptian patients with HCV. Methods: A prospective cross-sectional study was carried out from September 2018 to February 2019, with a total of 1,959 medical records collected. By comparing the patients’ characteristics, variables related to metabolic risk, and body composition measurements, regression models have been established to determine any confounding factors. Results: The prevalence of HCV antibody was 41.0% in men and 59.0% in women. Among the variables included in the regression analysis, age, BMI, and uncontrolled hypertension were found to have statistically significant associations with diabetes in HCV positive cases (p < 0.001). HCV patients ? 40 years old with high BMI were found to have significant associations with both, diabetes and hypertension (p < 0.001). Hypertensive HCV patients were found to have significant associations with gender, age ? 40, and DM (p < 0.001). Conclusion: HCV infection and metabolic disorders have a closed cycle relationship. Reducing the complications of DM has a promising prospective of limiting the complications of HCV.
Marwa O Elgendy, Ahmed M Khalaf, Ahmed O El-Gendy, Mona A Abdelrahman, Sara O El Gendy, Ahmed M Abdel Hamied, Omar Essam, Karim Al Amir, Esraa M Yousry, Mohamed Ea Abdelrahim
Journal of Clinical and Nursing Research, Volume 6, pp 43-53; https://doi.org/10.26689/jcnr.v6i3.3852

Abstract:
Background: The purpose of this study was to evaluate the effectiveness of limited-resource hospitals in managing mild and moderate hospitalized cases of COVID-19 with comorbidities and in preventing their progression to severe illness. Methods: Data were obtained from 88 moderate COVID-19 patients with comorbidities who were admitted to limited-resource hospitals. The data were classified into several parts: comorbidities, chronic medication before hospital admission, symptoms of COVID-19 before and during hospitalization, clinical features, laboratory findings on hospital admission, complications during hospitalization, as well as worst laboratory values during hospitalization, hospital stay, and outcomes. The clinical features, laboratory results, type of oxygen therapy used, and the final treatment outcome were all evaluated to assess for any potential relationship. Results: All patients were alive upon discharge. Before admission, the majority of patients (60.2%) received COVID-19 treatment, and the average hospital stay was 12 days. The most common symptoms were fever (88.7%), cough (95.5%), shortness of breath (90.9%), myalgia (84.1%), confusion (63.6%), headache (62.5%), sore throat (88.7%), rhinorrhea (17%), chest pain (58%), diarrhea (19.3%), nausea and vomiting (38.6%), anosmia (62.5%), as well as dysgeusia (64.8%). Based on chest radiograph or computed tomography (CT) scan, 9.1% of the patients had unilateral pneumonia, 90.9% had bilateral pneumonia, and 96.6% had multiple mottling and ground-glass opacity. Age was found associated with a significant increase in headache (p = 0.005), rhinorrhea (p = 0.013), chest pain (p = 0.007), and the need for positive airway pressure (p = 0.008). Between pre- and post-hospital admissions, there was a significant increase in lactate dehydrogenase and ferritin but a decrease in platelet, D-dimer, hemoglobin, lymphocytes, neutrophils, and total leucocyte count (p < 0.001). There was a significant association between hospital stay and D-dimer level (p = 0.05). Conclusion: Limited-resource hospitals in Egypt were efficient in managing mild and moderate hospitalized cases of COVID-19 with comorbidities. Many of these cases did not escalate to severe illness and were all alive upon discharge. Early management of COVID-19 tends to delay the disease progression to severe illness and improves patients’ chances of survival. Treating COVID-19 or using oxygen therapy at home can also delay the need for hospitalization in mild or moderate cases.
Sara M Tony, Mona A Abdelrahman, Mogeda Abd Elsalam, Mahmoud Sameer Shafik, Mohamed Ea Abdelrahim
Journal of Clinical and Nursing Research, Volume 6, pp 89-103; https://doi.org/10.26689/jcnr.v6i3.3964

Abstract:
Asthma is the most common chronic pulmonary disease in the world, affecting more than three hundred million people from different races and age groups. Childhood asthma is considered one of the main causes of increased healthcare expenditures, particularly in developing countries. Spirometry is the most essential and commonly used lung function test. It is used mainly for the evaluation of lung function to obtain reliable data used for the detection of lung diseases, such as asthma, as well as for monitoring lung health. The two spirometry parameters, peak expiratory flow rate (PEFR) and forced expiratory volume in one second (FEV1), are effective in the diagnosis and management of patients with asthma. However, FEV1 is preferred as it is a more accurate parameter compared to PEFR for the evaluation and recognition of bronchoconstriction. In children with asthma, the most commonly used lung function parameter for asthma monitoring is FEV1. It was discovered that a decrease in FEV1 is associated with an increase in asthma severity.
Saeid Amel Jamehdar, Mohammad Hassan Aelami, Fahimeh Yarpour Mehrabadi, Samira Tabaei, Sahar Tahaghoghi Hajghorbani, Parnian Malakuti, Malihe Hasanzadeh
Journal of Clinical and Nursing Research, Volume 6, pp 1-6; https://doi.org/10.26689/jcnr.v6i3.3576

Abstract:
Background: Herpes simplex virus type 2 (HSV-2) infection is the main cause of genital and neonatal herpes infections. It has considerable public health importance among women as the virus may lead to adverse outcomes in pregnancy and neonatal infection. This study determines the molecular epidemiology and risk factors of HSV-2 infection among pregnant women. Methods: In this cross-sectional study, all pregnant women admitted to three university hospitals for natural birth and Caesarean sections were enrolled. HSV detection and typing were carried out based on PCR and reverse dot blotting method, respectively. ANOVA and bivariate correlations were used to analyze the data. Results: In this study, the prevalence of genital herpes infection was 5.7%. A significant positive correlation was found between age group < 25 years and HSV-2 shedding (P = 0.026). Twelve participants (60%) with HSV-2 shedding were younger than 25. A significant correlation was found between the presence of genital lesion and HSV-2 (? = 0.02). Among participants with HSV-2 infection, the use of condom was low. Neonatal complications were not seen in newborns from mothers with HSV-2 shedding. Conclusion: PCR assay may help in promoting early diagnosis and more effective treatment for patients. Also, it shortens hospital stay and enhances patients’ condition. HSV-2 transmission is rapid following the onset of sexual activity and likely to result in the significant prevalence of genital disease.
Kai Zhang, Xianling Zheng, Hongfeng Zhang, Xueqiang Zhang, Yanmin Xu, Shiying Jin, Shuang Huo
Journal of Clinical and Nursing Research, Volume 6, pp 7-13; https://doi.org/10.26689/jcnr.v6i3.3836

Abstract:
Bupleurum has been used as traditional medicine in China, Japan, South Korea, and other Asian countries for more than 2,000 years. The crude extracts and pure compounds isolated from Bupleurum have a variety of biological activities, such as anti-inflammatory, anti-cancer, antipyretic, antibacterial, anti-viral, liver protection, neuroprotection, and immune regulation. The pharmacological effects of Bupleurum have been classified and summarized in this paper by consulting literatures at home and abroad. At the same time, the quality analysis methods of bupleurum, including high-performance liquid chromatography, thin layer chromatography, ultra-high-performance liquid chromatography mass spectrometry, UPLC-QTOF-MS, and so on, are discussed. This paper provides a reference for further research, development, and application of Bupleurum.
Ahmed Mahmoud Abdelhaleem Ali, Mohamed Ea Abdelrahim
Journal of Clinical and Nursing Research, Volume 6, pp 14-23; https://doi.org/10.26689/jcnr.v6i3.3814

Abstract:
Background: Concerns have been raised about the efficacy of intravenous immunoglobulin and corticosteroids in pediatric myocarditis; however, the relationship between the risk and efficacy of these two therapies in children with myocarditis varies. Methods: A systematic review on seventeen studies was conducted in July 2020, which included 1,960 subjects at the baseline, with 788 receiving intravenous immunoglobulin and 142 receiving corticosteroids. The mean difference (MD) or odds ratio (OR) with 95% confidence intervals (CIs) was calculated to assess the prognostic role of both treatments using dichotomous and continuous methods with random or fixed-effect models. Results: The use of intravenous immunoglobulin was significantly associated with a lower mortality rate or heart transplantation in children with myocarditis (OR, 0.55; 95% CI, 0.40-0.77, p < 0.001) compared with the control group. However, corticosteroids were not significantly associated with the same parameters (OR, 0.72; 95% CI, 0.31-1.63, p = 0.43). The use of intravenous immunoglobulin was not significantly related to improving left ventricular ejection in children with myocarditis (OR, 2.30; 95% CI, -9.65-14.25, p = 0.71) and so were corticosteroids (MD, 5.17; 95% CI, -0.26-10.60, p = 0.06). Conclusion: The use of intravenous immunoglobulin might have an independent risk relationship with a lower mortality rate or heart transplantation and is recommended in children with myocarditis to prevent complications.
Sara M Tony, Mohamed Ea Abdelrahim
Journal of Clinical and Nursing Research, Volume 6, pp 73-88; https://doi.org/10.26689/jcnr.v6i3.3909

Abstract:
Aerosol delivery to the lungs can be achieved with several devices that differ in their operating mechanisms and efficacies of aerosol delivery. There are several methods to measure aerosol delivery and deposition in a subject’s lung, in order to assess the efficacy of aerosol generators and the impact of certain drugs. Instruments such as cascade impactors, imaging techniques, and laser diffraction are available for measuring the particle size of aerosols, which is the main factor in the deposition and distribution of the produced aerosol. From impactors to laser diffractors, they have different operating mechanisms, analysis times, and characteristics, in which each has its own advantages and limitations. Several models are available to investigate aerosol delivery and deposition, such as in vitro, in vivo, and ex vivo models.
Hui Li, Wenting Liu, Yaling Lei, Haizhe Zhou, Pei Wang, Jun Li
Journal of Clinical and Nursing Research, Volume 6, pp 67-75; https://doi.org/10.26689/jcnr.v6i1.2904

Abstract:
Professor Jun Li believes that the main etiology and pathogenesis of vascular dementia is the combination of phlegm and blood stasis. The symptoms include feeling faint and declined senses in organs of the head, caused by mystery reason. To cure phlegm and blood stasis simultaneously, the therapy promotes the notion of “resolving phlegm and stimulating the circulation of blood, liberate brain orifices,” and treatments with the addition and removal of “Naotaitong Decoction,” which has an amazing clinical curative effect. This paper examines Professor Jun Li’s theoretical foundations and ideas from the syndrome differentiation and treatment of phlegm and blood stasis, systematically examines the curative effect and mechanism of Naotaitong Decoction in the treatment of vascular dementia, and examines the prescription and medication of typical cases for readers, in the hopes of providing guidance to clinical diagnosis and treatment of this disease.
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