Disease aggravation following surgery in a rare patient suspected to Fibrodysplasia (Myositis) ossificans progressiva: a case report.

BACKGROUND: Fibrodysplasia ossificans progressiva (FOP) as a rare and heritable disorder with the infrequent genetic transmission of the condition is a catastrophic disorder of heterotopic ossification (HO) and a cause of extraskeletal bone formation in humans. Given the lack of effective treatment for this disease, the important point is to avoid aggravating factors such as bone biopsy, surgery, and intramuscular injection. CASE PRESENTATION: In this report, we present a 52-year-old female patient, Kurdish ethnic, suspected to FOP who had a surgical intervention on the second toe of the right foot, which subsequently, it caused further deterioration of the disease in the person including necrosis and amputation of the distal phalanx of the second toe. CONCLUSIONS: Although, based on our investigation and the available scientific evidence, surgery may a cause for faster progression and worsening of the FOP disorder, but its proof requires further studies.

Designing and validation: a questionnaire of hope for family members of patients hospitalized in intensive care unit.

BACKGROUND: Families of patients are faced with stressors in the intensive care unit (ICU) that cannot be controlled sometimes. Having hope is one of the strategies for obtaining self-control in patients' families, which deals with such situations. OBJECTIVE: The purpose of this study was to design and validate a questionnaire of hope for family members of patients hospitalized in intensive care units. METHODS: This study was conducted for family members of patients hospitalized in the intensive care units of Kurdistan and Tehran provinces, in Iran, between the years 2015-2016. In this study, 126 family members were selected using convenience sampling. The study was conducted using a questionnaire of hope scale for family members of patients hospitalized in intensive care units and demographic characteristics. During the study, construct and criterion validity of the tool was determined. The Reliability was determined using internal consistency and test-retest coefficient. Data were analyzed through factor analysis, correlation coefficient and Cronbach's alpha. Construct validity of the scale was analyzed using exploratory factor analysis (EFA). RESULTS: Participants in this study included 12 family members of patients hospitalized in the intensive care units. Cronbach's alpha coefficients obtained from analysis of questionnaires completed by family members of patients was 0.916. Cronbach's alpha under the first scale (compatibility) was 0.898, Cronbach's alpha of the second subscale (self-confidence) was 87%, Cronbach's alpha under the third subscale (Sense of responsibility) was 0.770. The fourth subscale (Looking to the future) was 0.571. Pearson correlation coefficients between the scores obtained from two family members responses to the hope scale were 0.939 which showed that scale stability was average. As a result, exploratory factor analysis, four factors were found that were named according to the statements of each group. CONCLUSION: Consistency coefficients between the two tests was 0.939 that the stability over time the questionnaire was confirmed. A questionnaire of hope in the intensive care unit can measure different dimensions of hope to the families of these patients and help to improve the care of these patients. Validity and reliability of "scale for hope of families of these patients" was appropriate and it could be used to measure hope in families of these patients.