Managing Monkeypox Virus Infections: A Contemporary Review

Monkeypox is an infectious and contagious zoonotic disease caused by the Orthopoxvirus species and was first identified in Africa. Recently, this infectious disease has spread widely in many parts of the world. Fever, fatigue, headache, and rash are common symptoms of monkeypox. The presence of lymphadenopathy is another prominent and key symptom of monkeypox, which distinguishes this disease from other diseases and is useful for diagnosing the disease. This disease is transmitted to humans through contact with or eating infected animals as well as objects infected with the virus. One of the ways to diagnose this disease is through PCR testing of lesions and secretions. To prevent the disease, vaccines such as JYNNEOS and ACAM2000 are available, but they are not accessible to all people in the world, and their effectiveness and safety need further investigation. However, preventive measures such as avoiding contact with people infected with the virus and using appropriate personal protective equipment are mandatory. The disease therapy is based on medicines such as brincidofovir, cidofovir, and Vaccinia Immune Globulin Intravenous. The injectable format of tecovirimat was approved recently, in May 2022. Considering the importance of clinical care in this disease, awareness about the side effects of medicines, nutrition, care for conjunctivitis, skin rash, washing and bathing at home, and so on can be useful in controlling and managing the disease

Durability of the two-lumen catheter in hemodialysis patients; Ethanol 70%-heparin versus cefazolin-heparin: a randomized, double-blind clinical trial study

Introduction: Maintenance of hemodialysis catheters is essential for the patients and medical staff due to their repeated use for hemodialysis and other therapeutic interventions in the hospital. Objectives: This study aimed to comprise the effect of ethanol 70%-heparin versus cefazolin-heparin on the catheter durability time of hemodialysis patients. Patients and Methods: The study population consisted of 73 hemodialysis patients referred to Shahid Mohammadi hospital in Bandar Abbas. Patients were divided into two groups cefazolin (cefazolin 5 mg/dL, and heparin 2500 IU/mL) and ethanol (ethanol 70%, and heparin 2500 IU/mL). In both groups, after each hemodialysis session, 2.9 to 3.3 mL of the locking solution was locked in the catheter lumen and remained until the next session. This intervention was conducted for all patients continuously for five months. The time of catheter durability was calculated from the time of catheter placement in the central vein until the time that it has been taken out according to the doctor’s diagnosis. Data were collected and analyzed by SPSS version 26. Results: Results showed that demographic characteristics, including age, weight, gender, marital status, catheter type, underlying diseases, and dialysis adequacy between the two groups were similar (P>0.05). In the ethanol group, the mean time of the catheter durability was 27.5 days, and in the cefazolin group was 26.98 days. Although the time of the catheter durability was slightly higher in the ethanol group, this difference was not significant (P=0.194). Conclusion: Cefazolin and ethanol 70% did not show a significant difference in the catheter durability time of hemodialysis patients. Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trials (IRCT20210811052145N1; https://en.irct.ir/trial/58037, ethical code; IR.HUNS.REC.1398.052)

The Factors Affecting Successful Breast-feeding (SBF)

Background: No comprehensive definition of SBF leads to failure in identification of ineffective breast-feeding and clinical problems, which will end up in early hospitalization of the infants. The study tried to describe the factors affecting SBF by Walker and Avant approach.The quantitative, qualitative, and mixed papers using different approaches in nursing, midwifery, nutrition and medical literature from 1995 to 2017 were reviewed by the researchers using keywords “successful breast-feeding,” “infant,” and “SBF concept analysis,” in databases of Cinahel, PubMed, Scopus, Medline and Google Scholar.Methods: We used Walker and Avant approach in the analysis of the factors affecting successful breast-feeding. Searching for “successful breast-feeding” and “infant” triggered the initial study. Ultimately, 84 sources were selected as the sample of the study. Later, data was classified according to characteristics, effective factors, incidences, consequences, and empirical referents connected with successful breast-feeding.Results: As an interactive process, four main characteristics of SBF were holding the infant while breast-feeding, the method of placing the breast in the infant’s mouth, sucking, and milk transmission from mother to the infant. Furthermore, some incidents related to SBF were “posture of the infant while breast-feeding,” “breast physiology and anatomy,” and “infant’s mouth physiology and anatomy.” The aftermaths included “infant’s behavior when being full,” “letting go of the breast,” “not responding to sucking reflex,” “apparently calm infants,” and “lack of pain and discomfort in the breast.”Conclusion: The results showed that determining the characteristics, events, and aftermaths of SBF is absolutely essential and important for both clinical and nursing intentions. Indeed, accurate estimation of the concept of SBF ends in identification of the related problems and proposing strategies for solving them

Lived experience caring for a child with Covid-19 disease: A phenomenological study

Background: Caregivers of COVID-19 patients, including mothers with an infected child, are affected by adverse physical and psychological effects. Since mothers perform an important role in caring for a child with Covid-19, explaining their challenges and experiences positively affects the health conditions of children and society, in general. Aim: This study aimed to explain mothers' experiences with children diagnosed with COVID-19, who were referred to Bandar Abbas Children's Hospital. Method: The present study was qualitative and used the Van-Manen method. The statistical population included 13 mothers with children hospitalized for coronary heart disease and COVID-19, who were selected by purposive sampling. Semi-structured interviews were implemented to collect data until saturation. Data analysis was performed using MAXQDA 10 software. Lincoln and Guba's criteria were used to evaluate the data's accuracy and strength. Results: The mean age of mothers participating in the study was 37.92 ± 4.87. On the other hand, the mean age of children was 5.15 ± 2.07 years. Three main themes and 13 sub-themes were extracted from the data analysis. The main themes were “Inability to Caring”, “Mental and Physical drain” and “Conflict of Roles and Responsibilities”. In this study, when a child develops COVID-19 disease, the mother experiences a series of negative emotions, which lead to feelings of helplessness and inability to care for the child. Conclusion: Mental and physical manifestations strains were the most important issues that the mothers experienced. The majority of the participants need psychological support to cope with the disease. Therefore, it is recommended to make a proper design to psychologically and socially support these mothers, while alleviating the physical manifestations of their children's disease

Epidemiological evaluation quality of life in patients suffering from early rheumatoid arthritis: a pragmatic, prospective, randomized, blind allocation controlled of a modular program group intervention

OBJECTIVES: Epidemiology has taken on new roles in the management of health care services. In this study, we developed a non-pharmacological self-management modular program group intervention and evaluated its efficacy as an adjunct therapy in patients suffering from early rheumatoid arthritis (RA). METHODS: Patients were randomized to either participate in a non-equivalent intervention group along with the standard of care or only receive standard-of-care treatment at a community rheumatology center. The outcomes measured were a pain visual analog scale (VAS), patient general health (GH) on a VAS, and the Short Form 36 Health Survey version 2 scale measuring quality of life. These parameters were evaluated in the first week to obtain baseline values, and at 20, 32, 48, and 60 weeks to evaluate the efficacy of the intervention group. RESULTS: The patients were randomized, with 100 patients in the intervention group and 106 in the control group. The intervention and control groups were similar with regard to the percentage of women (86% vs. 89.6%), tobacco usage (25% vs. 19.8%), mean age (42.6±13.2 years vs. 46.6±10.9 years), and disease duration (15.3±6.7 months vs. 14.5±6.6 months). The mean outcomes were significantly different between the two groups, and post-hoc pairwise analysis demonstrated significant deterioration in the control group in contrast to improvement in the intervention group at the second, third, fourth, and fifth evaluations. Improvements were often seen as early as the 12-week and 24-week follow-up visits. CONCLUSIONS: Epidemiology contributes to the evaluation of how well specific therapies or other health interventions prevent or control health problems. The modular program group intervention implemented in this study appears to be a suitable and feasible method to facilitate much more comprehensive management of early RA in socioeconomically challenged communities