scholarly journals Rituximab versus cyclophosphamide for the treatment of children with steroid resistance nephrotic syndrome; a clinical trial study

2019 ◽  
Vol 5 (2) ◽  
pp. e15-e15
Author(s):  
Mohsen Akhavan Sepahi ◽  
Najmeh Farahani ◽  
Mohammad Reza Razavi ◽  
Hossein Heydari ◽  
Shahram Arsang-Jang

Introduction: The most common complications of the nephrotic syndrome (NS) are the frequent relapses, steroid resistance, and long-term steroid administration. Objectives: This study aimed to compare the therapeutic effect of rituximab versus cyclophosphamide in the prevention of relapses and the complications of treatment in children with steroid-resistant NS. Patients and Methods: This clinical trial study was performed on 50 patients with resistant steroidal NS referred to Masoumeh hospital in Qom, Iran. Patients were randomly divided into the two groups including intervention (n=20) and control groups (n=30). In addition to the prednisolone, the intervention group received 375 mg/m2/weekly rituximab intravenously for 4 weeks. The control group received oral doses of cyclophosphamide 2 mg/kg/d for 3 months. During treatment, the frequency of relapses, the mean dose of steroid and the complications of treatment were compared with a paired t-test, independent t-test, and chi-square test. Results: A significant decrease in the mean dose of steroids and the mean number of relapses were seen in patients after administration of rituximab and cyclophosphamide (P<0.001). However, rituximab reduced the dose of steroid administration by 12.25 mg/d, while cyclophosphamide reduced only 2.83 mg/d (P<0.001). Rituximab reduced the relapse rate two times on average, while cyclophosphamide reduced only 0.5 times (P<0.001). The incidence of complications in the cyclophosphamide group was found to be more severe than the rituximab group. Conclusion: To compare rituximab versus cyclophosphamide regarding lower the frequency of recurrence after treatment, we found rituximab is a more suitable drug for the treatment of steroid-resistant NS than cyclophosphamide.

Author(s):  
Tayebeh Mokhtari Sorkhani ◽  
Atefeh Ahmadi ◽  
Moghaddameh Mirzaee ◽  
Victoria Habibzadeh ◽  
Katayoun Alidousti

Abstract Objective The psychosocial burden of infertility among couples can be one of the most important reasons for women's emotional disturbance. The goal of the present study was to investigate the effect of counseling on different emotional aspects of infertile women. Methods The present randomized clinical trial was performed on 60 couples with primary infertility who were referred for treatment for the first time and did not receive psychiatric or psychological treatment. Samples were allocated to an intervention group (30 couples) and a control group (30 couples) by simple randomization. The intervention group received infertility counseling for 6 45-minute sessions twice a week, and the control group received routine care. The Screening on Distress in Fertility Treatment (SCREENIVF) questionnaire was completed before and after the intervention. Samples were collected from November to December 2016 for 3 months. For the data analysis, we used the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Armonk, NY, United States) software, version 19.0, and the paired t-test, the independent t-test, the Mann-Whitney test, the Wilcoxon test, and the Chi-squared test. Results The mean age of the participants was 33.39 ± 5.67 years. All studied couples had primary infertility and no children. The mean duration of the couples' infertility was 3 years. There was a significant difference regarding depression (1.55 ± 1.92; p < 0.0001), social support (15.73 ± 3.41; p < 0.0001), and cognitions regarding domains of fertility problems (26.48 ± 3.05; p = 0.001) between the 2 groups after the intervention, but there was no significant difference regarding anxiety (25.03 ± 3.09; p = 0.35). Conclusion The findings showed that infertility counseling did not affect the total score of infertile women' emotional status, but improved the domains of it except, anxiety.


2021 ◽  
Vol 31 (3) ◽  
pp. 203-211
Author(s):  
Maryam Mirzaee Jirdehi ◽  
◽  
Arezoo Monfared ◽  
Fariborz Mansour Ghanaei ◽  
Ehsan Kazemnezhad Leili ◽  
...  

Introduction: Anxiety is one of the common problems among patients before undergoing invasive diagnostic techniques. One of these diagnostic techniques is gastrointestinal endoscopy. Aromatherapy is one of the complementary therapies to reduce anxiety. Objective: This study aimed to determine the effect of aromatherapy with Damask rose on the anxiety of the patients before undergoing endoscopy. Materials and methods: This study is a clinical trial performed on patients referred to the Endoscopy Department of one of the educational and therapeutic centers in Rasht City, Iran, in 2019. The study sample was 70 patients divided into the intervention and control groups. After giving the informed consent form, the samples completed the demographic information questionnaire and Spielberger anxiety questionnaire. The intervention group received aromatherapy with 10% Damask rose essential oil, and the control group received aromatherapy with a placebo for 30 minutes. The anxiety questionnaire was completed again 30 minutes after aromatherapy. The data were analyzed using descriptive and inferential statistics (the paired t test, Chi-square, independent t test, and covariance test). Results: Results showed that the mean ± SD age of participants was 41.05 ±13.15 years in the intervention (ranged 22-65 years) and 45.82 ±16.81 years in the control groups. Most participants were female (57.1%). After the intervention, the mean score of anxiety in the aromatherapy group (39.88±11.51) was lower than that in the control group with placebo (49.94±12.30), which was statistically significant (P=0.001). Because of significant differences in hospitalization history between the two study groups before the intervention, the covariance test was performed. The results showed no interaction between aromatherapy and hospitalization history. So it seems that the hospitalization variable did not affect post-intervention anxiety. Conclusions: This study showed that aromatherapy with Damask rose essential oil was effective on pre-endoscopic anxiety of the patients. Since complementary medicine is increasingly practiced in nursing care, Damask rose aromatherapy, because of its low cost, safety and simplicity, can be used as a complementary measure to reduce anxiety in patients before endoscopy. However, more studies with intervention, control, and routine groups are needed to confirm the effectiveness of aromatherapy in endoscopy.


2018 ◽  
Vol 5 (2) ◽  
pp. 121-129
Author(s):  
Siti Khoiroh

Background : Hypertension is a condition of high blood pressure in the arteries that lasted continuously for the long term. Hypertension can be overcome in two ways: pharmacology and non-pharmacology. Pharmacology treatment usually use medicine while one of the ways for non-pharmacology treatment is to consumes apple juice.Research Objective : The aim of this research is to know the effect of apple juice on blood pressure decrease in elderly people with hypertension at Muara Kaman Community Health Center.Methods : The design of this research used quasi experimental design (quasi experiment) with pretest posttest control group design. The sample of the research was hypertensive respondents at Muara Kaman Community Health Center as many as 30 respondents were divided into 2 groups, 15 intervention groups and 15 control groups. The sampling technique used purposive sampling. The research instruments were stethoscope and sphygmomanometer, data analysis using t test dependent and t test independent.Results : There were a significant influence between pretest and posttest of apple juice in the intervention group (P value = 0,000; P <0.005). The mean difference in systolic blood pressure in the intervention group and the control group also had significant differences (P value = 0.002; P <0.05), where as the mean difference in diastolic blood pressure in the intervention group and the control group also had significant differences (P value = 0,039; P <0,05).The Conclusions : The results of this research showed that consumes apple juice gives an effect on the blood pressure of hypertensive patients by consumes regularly.The Suggestions : Nurses and the public can use apple juice as one of the ways to handling to hypertension sufferers besides antihypertensive drugs.


2020 ◽  
Vol 9 (1) ◽  
pp. 39-45
Author(s):  
Masoume Rastegar ◽  
Zohreh Mahmoodi ◽  
Sara Esmaelzadeh Saeieh ◽  
Nasibeh Sharifi ◽  
Kourosh Kabir

Introduction: Breast cancer has a high prevalence, constituting a major cause of mortality in women around the world. Health literacy has a vital role in the self-care of chronic diseases such as cancer and is an essential element in the ability of each person to engage with health promotion. The aim of this study was to determine effect of health literacy counselling on selfcare in women after mastectomy. Methods: This study is a randomized, controlled, clinical trial carried out on 72 women with breast cancer after mastectomy in Fars province. The eligible women entered the study using convenience sampling and were then divided into an intervention and a control group through randomized blocks of four. Health literacy questionnaire and self-care questionnaire were distributed among the participants before, immediately after and three weeks following the intervention. Data analysis was performed in SPSS ver.13. Results: The results showed no significant differences between the two groups in terms of their health literacy and self-care scores before the intervention (P=0.299 and 0.059). A comparison of the mean values showed a greater increase in the mean score of health literacy and score of selfcare immediately and three weeks after the intervention in the intervention group compared to the control group. Also, the mean score of the dimensions of self-care in chemotherapy increased over time in the intervention group. Conclusion: The findings of this study confirm the higher effectiveness of counseling with a health literacy approach on overall self-care in chemotherapy and all its dimensions.


2020 ◽  
Vol 10 (3) ◽  
pp. 270-283
Author(s):  
Mohammad Ali Nahayati ◽  
◽  
Seyed Abolfazl Vaghar Seyyedin ◽  
Hamid Reza Bahrami-Taghanki ◽  
Zahra Rezaee ◽  
...  

Objective: Stress and anxiety are common in patients with Multiple Sclerosis (MS). These complications exacerbate the symptoms of MS. This study aims to evaluate the effect of acupressure on stress and anxiety of MS patients. Methods: In this randomized clinical trial, participants were 106 MS Patients referred to Multiple Sclerosis Society in Mashhad, Iran. After signing an informed consent form, they completed a demographic form and stress, and the Depression Anxiety Stress Scale - 42 items (DASS-42). Then, they were randomly assigned into intervention and sham groups by tossing a coin. Participants in the intervention group were asked apply a pressure on the Shenmen and Yin Tang acupoints for one month (once per day for 15 minutes), while the sham group applied pressure 2.5 cm below the Shenmen acupoint and 3 cm above the Yin Tang acupoint. Participants in each group were then completed the DASS-42 again one hour after the final session. Data were analyzed using chi-square test, Kolmogorov-Smirnov test, independent t-test, and Paired t-test. Results: In the intervention and sham groups, there was no statistically significant difference between the mean pre-test scores of stress (34.73±5.80 vs. 33.06±6.42) and anxiety (27.09±6.99 vs. 25.31±6.88), and neither between the mean post-test scores of stress (29.20±6.21 vs. 33.73±9.44) and anxiety (22.79±5.68 vs. 25.21±6.72) (P>0.05). However, comparison of DASS-42 scores between groups showed that the mean scores of stress and anxiety in the intervention group were significantly lower than in the sham group (P< 0.05). Conclusion: It seems that acupressure can be used along with other therapeutic and pharmacological interventions to reduce stress and anxiety in patients with MS.


2016 ◽  
Vol 3 (1) ◽  
pp. 20
Author(s):  
Fatma Siti Fatimah ◽  
Zulkhah Noor

<p>Merapi eruption in 2010 in Yogyakarta caused people losing their homes and triggering traumatic effect. Elderly is one of victims that vulnerable to psychological problem. The common psychological late respons due to disaster is insomnia. The impacts of insomnia are decrease the level of immunity, increase mortality and decrease quality of life, thus it needs to be solved. One of the solution is by listening murotal Al-Qur’an that will give relaxation effect. The study was aimed to know the effectiveness of listening murotal Al-Qur’an to the changing of elderly insomnia level in shelter Dongkelsari, Sleman, Yogyakarta.The design of study was a quasy experimental pre post test with control group. Technique of taking sample was probability sampling and it was found that there were 37 elderly who live in shelter Dongkelsari Sleman Yogyakarta that fulfilled the inclusion criteria. Research instrument which was used to measure insomnia level is KSPBJ questionnaire rating scale and to listen for murotal Al-Qur’an (Ar-Rahmaan) was used laptop and speaker. The duration of listening murotal Al-Qur’an was 8 days with 12 minutes for each day. Data analysis was used paired samples t test and independent samples t test. The level of insomnia for control group pre test and post test is in moderate insomnia by the mean ± SD each of them is 9.3 ± 3.7 and 10.3 ± 3.4 (p&gt;0.05) and for intervention group there was a changing from moderate insomnia to mild insomnia by the mean ± SD each of them is 10.9 ± 3.6 and 8.2 ± 4.2 (p&lt;0.05). There was a significant differences between the intervention group and control group by the mean ± SD each of them is -2.8 ± 3.0 and 0.9 ± 3.5 (p&lt;0.05). In conclusion, listening murotal Al-Qur’an was effective to reduce elderly insomnia level in shelter Dongkelsari Sleman Yogyakarta.</p>


2020 ◽  
pp. bmjspcare-2020-002618
Author(s):  
Azam Dehghani ◽  
Ali Hajibagheri ◽  
Ismail Azizi-Fini ◽  
Fatemeh Atoof ◽  
Noushin Mousavi

BackgroundPain is a common complication after laparoscopic surgery. This study aimed to examine the effect of an early mobilisation programme on postoperative pain intensity after laparoscopic surgery.MethodsA randomised controlled clinical trial was conducted on 80 patients who underwent laparoscopic surgery in Shahid Beheshti Hospital in Kashan, Iran. The patients were randomly allocated to intervention (n=40) and a control (n=40) group. In the intervention group, an early mobilisation programme was implemented in two rounds. The patient’s perceived pain was assessed using a Visual Analogue Scale 15 min before and 30 min after each round of early mobilisation. Data were analysed through the independent samples t, χ2 and Fisher’s exact tests and the repeated measures analysis.ResultsThe repeated measures analysis showed that the mean pain scores have been decreased over time (F=98.88, p<0.001). Considering the observed interaction between time and the intervention, the t test was used for pairwise comparisons and showed that the mean pain score was not significantly different between the two groups in 15 min before the first round of early mobilisation (p=0.95). However, the mean pain in the intervention group was significantly less than the control group in all subsequent measurements (p<0.05).ConclusionEarly mobilisation programmes such as the one implemented in the current study are easy and inexpensive and can be implemented safely for the reduction of pain after laparoscopic surgeries.


2021 ◽  
Vol 10 (4) ◽  
pp. 223-229
Author(s):  
Fereshteh Khaleghi ◽  
Batool Pouraboli ◽  
Leila Abadian ◽  
Mahlegha Dehghan ◽  
Sakineh Miri

Introduction: Depression is the most common psychological problem in patients with renal failure, and it can lead to mortality in severe cases. Effective interventions are required to promote mental health in patients on hemodialysis with various types of mental disorders. The current study aimed to evaluate the effect of emotional disclosure by writing on depression of patients on hemodialysis in Iran. Methods: This clinical trial study was carried out on 140 patients undergoing hemodialysis in hemodialysis centers of Kerman. Patients were randomly assigned into two groups of intervention and control after signing the written consent forms and completing the Depression Anxiety Stress Scale (DASS 21). The intervention group was requested to write daily the deepest emotions and intrusive thoughts within 15 to 20 minutes in four consecutive days. The control group received routine care. Then, the questionnaire was recompleted two weeks later. Finally, the data were analyzed by SPSS (version 13) using independent t-test and paired t-test. Results: The mean depression score was either moderate or high. While depression scores seemed to decrease in the intervention group after the intervention, the depression scores continued to rise following the intervention in the control group. The difference in depression scores was statistically significant between the two groups before and after the intervention. Conclusion: Emotional disclosure by writing can be effective on the level of depression in patients on hemodialysis.Simus adi omnimodipsa sam fugita dolenistiae inveles est doluptat.


2011 ◽  
Vol 51 (5) ◽  
pp. 266
Author(s):  
Eka Laksmi Hidayati ◽  
Sudung O. Pardede ◽  
Partini P. Trihono

Background There are variations in remission rates following treatment of steroid-resistant nephrotic syndrome (SRNS) with cyclophosphamide.Objective To compare the efficacy of oral versus intravenous cyclophosphamide (CPA) in the management of pediatric SRNS.Methods This was a prospective study of 41 children with SRNS treated with CPA. One group received oral CPA at a dose of 2 mg/kg body weight/day for 8-12 weeks, while the other group received intravenous CPA at a dose of 500mg/m2 body surface area (BSA) monthly for 6 months. All patients were concomitantly treated with prednisone on alternate days. The primary outcome was the number of patients attaining remission.Results The study was comprised of 20 children receiving oral CPA and 21 children receiving intravenous CPA. There were 29 boys and 12 girls. The mean age of children at the onset of nephrotic syndrome (NS) was 47 ± 40 months old (range 12 months – 13 years), and the mean duration of NS before initiation of CPA therapy was 15 ± 28 months (range 1 – 129 months). Remission was achieved in 29 (70.7%) patients, with no difference between oral and intravenous route of CPA administration. The mean time to achieve remission was 22.7 weeks (about 5 months). The oral route group required less time in achieving remission than the intravenous route group. No association was found between remission and other factors, such as onset of steroid resistance, route of CPA, hypertension and hematuria. Side-effects included infection, anemia, nausea/vomiting, and alopecia. None of the patients required discontinuation of the medication.Conclusion Oral CPA was as effective as intravenous CPA for children with steroid-resistant nephrotic syndrome. [Paediatr Indones. 2011;51:266-71].


Author(s):  
Fatemeh Masroor ◽  
Ehteramsadat Ilali ◽  
Nouroeddin Mousavinasab ◽  
Zohreh Taraghi

Background and Purpose: Changing the physical activity pattern is an important factor in reducing mortality and increasing longevity. The aim of the current study was to determine the effect of educational intervention on physical activity of elderly people. Materials and Methods: In this quasi-experimental study, 80 elderly people from two rural health centers in Ghaemshahr city were selected and assigned to intervention (n=40) and control (n=40) groups. The elderly in the intervention group received 4 training sessions of 30 to 45 minutes in a month, while the control group did not receive such training. Before and one month after the intervention, Rapid Assessment of Physical Activity (RAPA) questionnaire was completed by both groups. The collected data were analyzed using chi square, paired sample t-test, independent sample t-test and ANCOVA. Results: The mean total score of RAPA, before intervention, in the control group was significantly higher than the intervention group (P = 0.017). However, after the intervention, the mean total score in the intervention group was significantly higher than the control group (P <0.001).  One month after the intervention, the mean of the RAPA score in the intervention group significantly changed from 2.1 to 4.95 (P <0.001), however, the mean change in the RAPA score in the control group (from 2.4 to 2.5) was not significant (P = 0.352). Conclusion: Given the effect of educational intervention on the physical activity of the elderly, the design of such educational interventions is recommended.


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