This is the first issue this year that is rich with papers from Qatar , the UK , and Australia and Turkey. Blanco, et al., stressed that the COVID-19 pandemic brought the world to a standstill, forcing businesses to close or adjust operations to online platforms. Nursing Educational Institutions (NEIs) were similarly affected by the implementation of public health measures to reduce the transmission of COVID-19, leading to abrupt lockdowns and campus closures, reduced or no face-to-face time in labs, and a sudden loss of clinical placement sites for students. To combat this problem, NEIs had to adjust their conventional practices and find alternative, novel approaches to fulfill the required hands-on lab teaching and clinical practice hours for their students. Many NEIs turned to simulation to close this gap for nursing students. Therefore, this integrative review seeks to explore what innovative simulation strategies were used during the pandemic era and the lessons that can be learned from these innovations.

Itaiwah, et al., stressed that Diabetic management programs play an important role in supporting people who live with diabetes and preventing diabetes related complications. These programs need to be culturally relevant to be successful. The authors explored culturally specific diabetic management programs within primary health care settings that can be adapted to the context of Qatar. This literature review was guided by Cronin et al.’s (2008) framework and included 17 scholarly articles published between 2011 and 2021. The Mixed Method Appraisal Tool was used to critically appraise the quality of these articles. The main components of culturally specific diabetic management programs are information and understanding, cultural norms, cultural interventions, and personal motivation. The authors concluded that in order to ameliorate diabetes management for clients, culture needs to be considered when providing education.

Helvaci, et al; looked at depression causing various inflammatory processes in human body. They followed consecutive patients with IBS and age and sex-matched control cases were included. The study included 936 patients with IBS (592 females) and 346 control cases. Although gastric sample biopsies were taken just in suspected cases, CG was diagnosed nearly in all of the patients with the IBS (80.4% vs 15.0%, p<0.001). Interestingly, prevalence of antidepressants use was also higher in the IBS cases, significantly (46.4% vs 16.1%, p<0.001). Similarly, smoking (35.2% vs 20.8%, p<0.001), hemorrhoids (37.1% vs 7.2%, p<0.001), and urolithiasis (22.0% vs 9.5%, p<0.001) were all higher in the IBS patients, again. The authors concluded because FPG and triglycerides are well-known acute phase reactants in the body, IBS and CG may be some low-grade inflammatory processes initiated with anxiety, depression, infection, inflammation, trauma, and cancer fear-like stresses of the body, and eventually terminate with hemorrhoids and urolithiasis. Due to the highly significant associations between IBS, CG, and depression, IBS and CG may actually be the two sides of the same paper, and just be two examples of depression-induced various inflammatory processes in human body.

Helvaci, et al; looked at the use of corticosteroids during acute painful crises of sickle cell diseases. The authors stated that sickle cell diseases (SCD) are severe inflammatory processes on vascular endothelium, particularly at the capillary level since the capillary system is the main distributor of hardened red blood cells (RBC) into the tissues.

The study included 222 males and 212 females with similar ages. The authors concluded that although the hardened RBC-induced capillary endothelial damage is present in whole body even at birth, severe exacerbations during additional stresses are called as acute painful crises. An increased basal metabolic rate, exaggerated sickling, diffuse capillary endothelial damage, exaggerated capillary endothelial inflammation and edema, generalized tissue hypoxia, and multiorgan insufficiencies may be the main causes of mortality during the crises. Although rapid RBC supports are the main treatment option, corticosteroids should also be added to decrease severity of endothelial inflammation and edema, and to prevent tissue hypoxia and multiorgan insufficiencies during such crises.

Dr Elghblawi. Reviewed the Purple urine bag syndrome (PUBS) is an exceptional clinical finding in the clinical setting and is featured by its distinctive purplish urine discolouration. It has been claimed due to many culprits namely, long term indwelling catheterisation, dementia, urinary tract infection with alkaline urine that is fully loaded with bacteria, bed or chair bound patients, female gender, constipation and chronic kidney disease. It is seen more in the geriatric words. It is said that it’s related to tryptophan aberrant metabolism by-products into red and blue pigments, due to the bacterial colonization in urinary catheter. Its distinctive colour is due to indigo-producing (bluish) and indirubin- producing (reddish) which react with the plastic tube to yield the striking purplish colour.

Abdulrazak Abyad
Chief Editor