A Review of the Role of Interleukin-2 in the Pathophysiology of Major Depressive Disorder in Hospitalized Patients

Background: Hospitalization due to any reason or medical condition is associated with fear, anxiety, and depression. Psychological and physiological factors have a significant impact on hospitalization outcomes. Objectives: Given the functional importance of inflammatory cytokines and studies in previous studies on the relationship between inflammatory cytokines and major depressive disorder, we will focus more on studies on the role of interleukin 2 (IL-2) in the pathophysiology of major depressive disorder in hospitalized patients. Methods: We used PubMed, Scopus, and Elsevier databases to search for articles from 1999 to 2021, emphasizing the studies of the last five years. Results: In general, there was no consistent pattern in the observed relationships between cytokine concentrations or changes and clinical signs of significant depression. IL-2 and IL, two receptors in the body, play an essential role in the treatment and the pathophysiology of depression and major depression. Conclusion: Finally, it can be concluded that hospitalization generally exposes the patient to inflammation. Studies show an increased risk of inflammation following hospitalization of patients, and many studies confirm the association of major depression with inflammatory cytokines and, more concentrated, IL-2.

Punctuality of Patients and Physicians in an Outpatient Setting: Which Has a Greater Effect on Waiting Time?

Background: Patients’ waiting time for healthcare services is identified as one of the key measurements of an effective health system. This factor has an important role in patients’ satisfaction as well. One factor that is related to the waiting time is patients’ punctuality. Objectives: the objective of this study was assessing the effect of patients’ and physicians’ punctuality on outpatients’ waiting time. Methods: This was a cross-sectional study. The study population was outpatients that were admitted in clinics of a general non-educational hospital. 3500 samples were selected from all clinics. The sampling method was stratified randomized method. Samples were included after taking the informed consent. Data gathered by check lists that recorded the patients work flow at the clinic and the time of arrival to and departure of each station. Results: About 34% of patients had appointment that 98.5% of them were unpunctual. The correlation of patient unpunctuality (positive and negative) and their waiting time indicated that these variables had positive correlation (P<0.001). Assessing the correlation of physicians’ punctuality and patients’ waiting time indicated that these variables also had positive correlation (P<0.001). Conclusion: Appointment systems are very useful in controlling patients waiting time. This study identified that patient’s unpunctuality will increase patients waiting time. By the way negative punctuality will affect waiting time more that positive punctuality. Other important findings of this study were revealing the relation of physicians’ unpunctuality and patients’ waiting time. Punctuality of patients and providers are very important in the performance of appointment system in outpatient settings.

Examination of Physiological Changes Seen in Workers Using Breathing Masks During COVID-19 Pandemic

Background: There are very few studies in the literature evaluating the effects of mask use on physiological parameters. Objectives: This study aims to examine physiological changes due to masks in healthcare workers who use respiratory masks for long hours in the emergency room during the pandemic process. Methods: Cross-sectional and prospective study was carried out with healthcare professionals with an FFP2 type valve mask. The participants’ transcutaneous oxygen saturation, pulse, and respiratory rate were measured before wearing the respirator mask and at 30 and 60 minutes after wearing the mask. Results: SPO2 values of the participants decreased gradually at 0th, 30th, and 60th minutes and respiratory rate increased gradually at 0th, 30th, and 60th minutes. The statistically significant difference arises from the 0 and 60 minutes values. Higher SPO2 values were found at 0 and 30 minutes in non-smokers. SPO2 value gradually decreased in non-smokers at 0, 30, and 60 minutes, but no significant decrease was observed in non-smokers. Pulse rate was found to be higher at 60th minute compared to 0th minute in non-smokers. No significant difference was found between smokers and non-smokers. The respiratory rate gradually increased in smokers at 0th, 30th, and 60th minutes. SPO2 values were lower at the 60th minute compared to the 0th minute in both women and men. There was no significant difference in pulse rates. Respiratory rate was found to be higher at 60th minute in men than at 0th minute. Conclusion: It is recommended to follow the physiological parameters and to regulate the working conditions when necessary.

The Trend of Device-Associated Hospital Acquired Infections in an Adult Intensive Care Unit of a Tertiary Care Hospital: A Need to Revamp Preventive Strategies

Background: Device-associated infections (DAIs) like ventilator-associated pneumonia (VAP), central-line-associated blood stream infections (CLABSI), and catheter-related urinary tract Infection (CAUTI) constitute predominant healthcare-associated infections (HAIs) in intensive care units (ICUs). Objectives: The study aims to elucidate their trends in an adult ICU. Methods: Over 21 months, monthly VAP, CLABSI, and CAUTI rate, and device utilization ratios were calculated in an adult ICU of a tertiary care hospital as part of routine surveillance activity. All cases of VAP, CLABSI, and CAUTI during these 21 months were included. In addition, monthly hand hygiene compliance rates were assessed during the latter period of the study by direct observation method. Results: Nosocomial DAI rate was 49.38 DAI/1000 ICU days. CAUTI, CLABSI, and VAP rates were 17.38, 26.85, 21.08 per 1000 device days, and device utilization ratios were 0.99, 0.61, and 0.02, respectively. Conclusion: The institute had high DAI rates in comparison to other studies from the same city. The declining trend of CAUTI rates roughly coincided with surveillance for hand hygiene compliance in ICU. Thus, it establishes baseline data and underscores the need for focused HIC to maximize patient outcomes.

Comparison of Depression and Quality of Life after Coronary Artery Bypass Graft Surgery in Patients With and Without Type D Personalities

Background: Recently, some studies have investigated type D personality as a critical factor in developing depression and reducing the quality of life. Objectives: This study aimed to compare depression and quality of life after coronary artery bypass graft surgery in patients with and without type D personalities. Methods: Sixty-nine participants who underwent coronary artery bypass grafting at Imam Khomeini hospital, Ahvaz, Iran, referred to the cardiac surgery clinic for their first visit (1 to 1.5 months after surgery) were included in the study. All participants completed the World Health Organization Quality of Life questionnaire, type D personality scale, and Beck’s Depression Inventory. Finally, depression and quality of life were compared in two groups with and without type D personalities using ANOVA and correlation tests. Results: The two groups were significantly different in depression and quality of life scores after coronary artery bypass graft surgery. Depression and quality of life impairment were higher in participants with type D personality. There was no significant relationship between depression and quality of life with age, gender, and occupation in participants with type D personality. Conclusion: Depression and quality of life were higher in patients with type D personality after coronary artery bypass graft surgery than patients without type D personality. Episodic screening of these patients can prevent future somatic and psychological problems.

Prevalence of Renal Colic in the Emergency Departments: A Multi-center Study

Background: Kidney calculi are the most common cause of kidney failure. Objectives: This study aimed to investigate the prevalence of renal colic and its risk factors in the patients referred to two emergency departments during a year. Methods: This was a descriptive cross-sectional study conducted in two hospitals in Kerman city, south-east of Iran, for one year from March 2019 to March 2020. All the archives of the two emergency departments were reviewed, and the required information was recorded in a checklist. The data was analyzed in SPSS 20 software. Results: A total of 504 patients were included in the study. The prevalence of renal colic was 0.5%. Most of the patients (58.5%) had an age between 19 and 39 years, and the majority (60.1%) were males and had a body mass index (BMI) above 25. A family history of renal colic was reported in 68.7% of the patients, and 63.9% had either hypertension or diabetes. Most of the patients consumed less than 3 liters of water per day. The highest referrals were seen in autumn (31.5%) and summer (27.4%). Conclusion: Considering the relationship between renal colic and age, sex, BMI, occupation, a family history of the disease, the presence of underlying diseases, the amount and type of drinking water, and the season of referral, it is recommended to control these risk factors to reduce the incidence of the disease.

Neuromuscular Blocking Agent Use in Acute Respiratory Distress Syndrome: Which Variable is Important?

Background: The study of neuromuscular blocking agents (NMBAs) in the management of acute respiratory distress syndrome (ARDS) has provided conflicting results in terms of their effect on mortality. Objectives: The main purpose of this study was to evaluate mortality in ARDS patients who underwent NMBA. Methods: A retrospective secondary analysis of 4200 patients with ARDS was collected from two academic medical centers, Tehran, Iran. This study was performed to assess the impact of NMBAs use in ARDS patients with different subgroups including mild and moderate-to-severe ARDS, age more and less than 65 years, having medical turnover vs. not-having, and high acute nursing care vs. moderate to low nursing care. Results: Intensive care unit (ICU) mortality has occurred in 1169 (27.8%) participants. The mortality rate was 28.6% and 27.5% in patients with mild and moderate-to-severe ARDS, respectively. In the subjects without medical turnover, the moderate dose of NMBAs significantly reduces the mortality of patients (P=0.044). In patients who need high acute nursing care, increasing the NMBAs dose significantly reduces patients’ mortality (P=0.010). In addition, increasing the NMBAs doses significantly reduces ICU length of stay (LOS). Conclusion: This study provides evidence that the administration of different doses of NMBAs had no effect on patients’ mortality with mild or moderate-to-severe ARDS. However, higher doses of NMBAs than low doses increased the risk of mortality in patients over 80 years and can reduce the risk of death in patients less than 55 years.

Therapeutic Potential of Traditional Indian Herbal Medicine in COVID-19: A Narrative Review

Background: Coronavirus disease 2019 (COVID-19) has become a global challenge to the health care system. A novel agent to combat this deadly virus is still a matter of research. Herbal molecules have served humanity since the beginning. Objectives: This narrative review aims to study the antiviral properties of medicinal plants, which are already effectively used in the past against various viruses. It derives the importance of exploration of such phytochemicals, which can be complementarily used to treat COVID-19. Methods: Studies related to traditional medicine and treatment for viruses were retrieved from databases including PubMed, Google scholar until December 2020 using the keywords SARS-CoV-2, COVID-19, Immunological, Phyto-chemicals, Traditional Medicine. The resulting publications were analyzed to develop a narrative review on the traditional Indian phytochemicals that have been shown to effectively treat various viral infections and potentially treat or prevent COVID-19. Results: Many of the researches are showing that Indian herbal compounds have a significant potential against viral diseases. Plants like Azadirachta indica, Withania somnifera, Tinospora cordifolia, Ocimum basilicum, and many more have been shown tremendous antiviral, anti-inflammatory, and immune-modulatory activities. Conclusion: Phytochemicals obtained from the herbs can be helpful in the treatment and prevention of SARS-CoV-2via various modes such as inhibition of attachment, penetration, uncoating, replication, assembly, and release of respiratory viruses. Further analysis of the potential phytochemicals in treating SARS-CoV-2 in clinical trials is warranted.

Highlighting the Relevance of Motivation and Job Satisfaction of Nurses in Ghanaian Hospitals

Background: Provision of quality and accessible health services comes with its challenges. Therefore, the need to highlight how motivation and job satisfaction can impact nurses’ performances at the Korle-Bu teaching hospital. Objectives: The research aimed to practically highlight nurses’ motivation and job satisfaction by identifying what constituted motivation packages of nurses and how the work they did could give them satisfaction at the Korle-Bu teaching hospital. Methods: The research employed a qualitative method with a case study design. In-depth interviews and focus group discussions (data triangulation) were used for primary data collection. A total of 40 respondents, including ten key informants, were selected using the purposive and convenience sampling techniques. Results: The research found that the recognition of needs of nurses, improved remunerations, enhanced conditions of service of the nurses’, regular payment of nurses’ salaries’, the institution of study leave with pay policy, among others, were considered as factors that could contribute to nurses’ motivation and job satisfaction. These findings are consistent with the findings of other studies. Again, the study found that professional allowances paid to nurses, reduced rent, and the like are current motivation packages directed at nurses at the Korle-Bu teaching hospital. Conclusion: It is important to state that for motivation to accomplish its intended purpose, there is the need for the hospital to identify the individual needs to satisfy to enhance job satisfaction.