فهرست مطالب محسن حق شناس مجاوری

The performance quality of peripherally inserted central catheter (PICC) by nurses has a direct effect on the improvement of patient care and safety. The aim of this study is to audit the placement and nursing care of PICC in infants.

This cross-sectional study was conducted on 130 PICC procedures in the neonatal intensive care units of Rouhani and Amirkola hospitals in Babol in 2018-2021. All infants who needed PICC placement for any reason were selected. In order to collect the data, the observational researcher-made checklist and the infant demographic characteristics questionnaire were used. The checklist included 44 questions and four parts of nursing care before catheter insertion, hand washing, nursing care during the procedure, and nursing care after catheter placement. The scores obtained from the checklist were classified into conversion percentage and two groups of unfavorable placement (less than 67) and favorable placement (68-100). To confirm its reliability, intraclass correlation coefficient was used (ICC=0.90).

A total of 130 cases of PICC placement and nursing care were audited (Rouhani Hospital 98 cases 75.4%, Amirkola 32 cases 24.6%). In the studied sample, 83 (63.8%) were boys and 53 (43.1%) were diagnosed with prematurity. The most common PICC location was the armpit (42.3%). The percentages of compliance of nursing care before PICC insertion according to the standard (97.43%), hand washing (100%), nursing care during the procedure (87.14%) and nursing care after PICC insertion (94.84%) were favorable. Nurses did not use glasses and ultrasound guidance during PICC insertion; (85.4%) and (90%), respectively.

According to the results of this study, although the quality of PICC insertion and care in three stages was at a favorable level, nurses need training regarding the use of glasses and ultrasound guidance during PICC insertion.

</span> Retinopathy of Prematurity (ROP), as a retinal vasoproliferative disease, is affected by the incomplete development of the respiratory system of premature babies. Since premature babies suffering from ROP have a lower level of partial pressure of oxygen (PO2</sub>), the present study was conducted to investigate the effect of PO2</sub> and venous oxygen saturation in treatment response of ROP patients.</span></span></span>
</span> This retrospective cohort study (2010-2020) was conducted in the neonatal intensive care unit of Ayatollah Rouhani hospital in Babol among 502 premature babies (less than 34 weeks of pregnancy and with a birth weight of less than 2500 grams). ROP was diagnosed and determined by an ophthalmologist based on the ICROP index on the first day of birth. Data related to PO2</sub> and venous oxygen saturation were collected from patients' files. After receiving standard treatment for ROP, patients were examined and compared in two groups of “completely cured” and “other patients” (including partial recovery, no change, and disease progression) in terms of the effect of PO2</sub> and venous oxygen saturation on the decrease or increase in stage (I to IV) and zone (I, II, III).</span></span></span>
</span> Of the 502 babies examined, 193 had stage I, 232 had stage II, 76 had stage III, 1 had stage IV, and 55 had zone I, 245 had zone II, and 202 had zone III involvement. The mean level of PO2</sub> and oxygen saturation between the two groups of “completely cured” patients and “other patients” did not have a statistically significant difference. The mean level of PO2</sub> and oxygen saturation between the three groups of patients with partial recovery, patients with no change and patients with disease progression did not show a statistically significant difference. Furthermore, the levels of PO2</sub> and venous oxygen saturation were not related to the change of stage and zone in patients with ROP.</span></span></span>
</span></span> The results of the study showed that lack of oxygen is effective in causing ROP and oxygen therapy has an effective role in the treatment of ROP patients, but the amount of oxygen at the beginning of ROP diagnosis is not related to the treatment process of ROP.</span></span></span></div>

Retinopathy of Prematurity (ROP) is a vasoproliferative retinal disease in preterm infants that can lead to disorders and blindness throughout life if not diagnosed and treated at an early age. Therefore, this study was performed to investigate the relationship between retinopathy of prematurity and various maternal and neonatal diseases.

This case-control study was performed on 828 premature infants (303 infants with ROP and 525 infants without ROP as controls) born in Ayatollah Rouhani Hospital, Babol, Iran, in 2009-2019. All medical information about maternal and neonatal diseases was collected from patient files. Preliminary eye examinations and follow-up were performed based on the local ROP treatment and follow-up guide to diagnose the stage and zone of ROP. Then, neonates were compared based on retinopathy and lack of infection in both groups in terms of maternal and neonatal diseases including congenital heart defect, premature rupture of membranes, anemia, urinary tract infection, hypertension, sepsis, transient tachypnea of the newborn, respiratory distress syndrome, gestational diabetes and preeclampsia.

Out of 828 evaluated neonates, 303 had ROP, including infants with preeclampsia (odds ratio of 2.54, p<0.001), infants with respiratory distress syndrome (odds ratio of 2.2, p<0.001) and infants with congenital heart defects (odds ratio of 1.53, p=0.047) had a higher chance of developing ROP. Moreover, infants with transient tachypnea of the newborn (odds ratio of 0.7, p<0.001) and infants with anemia (odds ratio of 0.373, p<0.001) had a lower chance of developing ROP.

The results of the study showed that maternal preeclampsia, respiratory distress syndrome and congenital heart defects are among the diseases affecting the incidence of ROP.

Infantile colic which can cause nervousness and anxiety in parents by fussing and restlessness in babies. This study was done to determine the prevalence and associated risk factors of infantile colic in Babol, the North of IRAN.

This descriptive-analytical study was done on 591 breastfeeding babies (321 females, 270 males) born with birth weight 2500-4000 grams and gestational age ≥37 weeks without any medical problem during 2016-18. They visited in age 2, 4, 8, 12 weeks by neonatologist. On the basis of parents complain and Wesselchr('39')s criteria babies were divided into three groups: Cramp with crying (colicky group), Cramp without crying and normal group. Then possible risk factors of infantile colic have been compared in three groups.

45.5% of babies presented cramp with crying as colic group. Time of restlessness was significantly more than morning during night and afternoon (P<0.05). Colic was higher in infants born by cesarean section (P<0.05), and in the first-born child (P<0.05). However, there was not significant relation with gender, mothers’ education, parents smoking and taking dairy product.

According to this study’s findings, nearly half of infants had the symptoms of colic, which was higher in first children, infants born by cesarean section and during night.

To reduce neonatal death, it should be studied the causes of it in any region or medical centers and with appropriate measures we can improve quality of health care and treatment. To achive this goal, this study was conducted in one of the 3rd referral mother-infant care level centers.

This cross-sectional study was done in intensive care unit (NICU) of Ayatollah Rohani Hospital, affiliated by Babol University of medical science, from 2009 to 2017. The causes of neonatal death were identified based on ICD10 (International Classification of Diseases, Tenth Revision) by laboratory, clinical and Para clinical evidence recorded in patients sheets.

Of the total number of 4029 admitted infants in NICU, 276 cases (6.7%) died that 99 (35.9%)of them died within the first 24 hours. The average annual death was 6.7±1.85 and the gestational age was 29.9±4.77 weeks. These infants were born with an average birth weight (g) of 1300.5±810.04 and lived at average 7.99±10.14 days. The most common causes of death in neonates were sepsis and DIC fallowing it 33.4%, extreme premature less than 26 weeks 18.4%, congenital anomalies 14.8% and respiratory distress syndrome 14.1%.

According to the results of this study, although severe sepsis and prematurity were the most common causes of death after the first 24 hours, RDS management was more favorable than sepsis, and measures should be taken to reduce sepsis.

One of the important effects of kangaroo mother care (KMC) in preterm baby is improvement in weight gain and so shortening in hospitalization, but it is not clear that how long of kangaroo mother care is effective in weight gain. The aim of this study was to determine the least effective duration of kangaroo mother care in weight gain in very low birth weights.
Preterm babies with birth weight less than 1500 gr, without chronic cardiopulmonary disease, congenital anomaly and other medical problem when receiving to 140 ml/kg/d enteral feeding enrolled the study. KMC was started when the baby has been stabled, on the mother’s appetency and ability at bedside. The mean daily weight gain in KMC period was compared with expected that (15 mg/kg/d) for the same baby. The babies with KMC≥ 7 days were divided in three groups on the basis of mean daily KMC duration ( 60). Statistical study performed by using SPSS software, version 22 (IBM SPSS, Armonk, NY, USA) and P values of less than 0.05 were considered to be significant.
In this study, 103 preterm baby (47 boys, 56 girls) less than 1500 gr were enrolled, with mean birth weight 1107.85±190.87 gr. Mean weight gain of boys in KMC period and expected that were 324.78±162.66 gr Vs. 127.46±54.66 gr (P On the basis of this study KMC less than 1 hour per day is effective in weight gain of very low birth weight preterm babies.

Anxiety is a major symptom of menopause caused by loss of ovarian activity. Anxiety increases the intensity of vasomotor symptoms in menopausal women. This study aimed to compare the effects of exercise and estrogen on anxiety level of ovariectomized mice. This empirical study was conducted on 28 mice (weight: 25-35 grams) divided into four groups of seven, including ovariectomy, ovariectomy and exercise, ovariectomy and estrogen (40 mg/kg of estradiol valerate), and ovariectomy combined with exercise and estrogen. Animals were initially ovariectomized and one week later, they were placed on treadmills to run at medium intensity for 30 minutes per day. Intervention continued for five days per week, and after four weeks, anxiety was evaluated using elevated plus-maze. In this study, estrogen significantly increased the percentage of open arm entry (OAE) compared to ovariectomy group (22.13±4.72 vs. 4.91±3.18, respectively) (p<0.05). In addition, combination of estrogen and exercise significantly increased open arm time (OAT) compared to ovariectomy group (46.19±6.82 vs. 4.91±3.18, respectively) (p<0.001). However, no significant difference was observed between exercise and estrogen groups. Also, exercise alone increased OAE compared to ovariectomy group (24.54±3.18 vs. 13.79± 3.23, respectively) (p<0.05). Percentage of OAE in groups of estrogen, exercise and combined exercise and estrogen was 30.61±1.25, 24.54±3.18 and 46.08±1.04, respectively, which was indicative of no significant difference. However, estrogen and combined estrogen and exercise significantly increased OAE compared to ovariectomy group (p<0.001). According to the results of this study, similar to estrogen, exercise could reduce the anxiety induced by ovariectomy in mice.

Abdominal colic during infancy is a common complaint of parents within the first three months after the child’s birth. As the intestinal microflora in these infants is different from non-colic newborns, we aimed to determine the effects of probiotics on the balance of intestinal microflora and reducing restlessness in infants with colic. This randomized clinical trial was performed on 44 breastfed infants (20-60 days old), with a birth weight of > 2500 g, suffering from colic, based on Wessel’s definition. These infants received 1-5 drops of placebo (label 1) per day for five consecutive days. Afterwards, they were administered 2-5 drops of Lactobacillus reuteri (label2) (17938 DSM) per day for 14 consecutive days. The parents were contacted twice on a daily basis and the duration of cramps and restlessness in infants was recorded and evaluated (IRCT=2014012713489). Among 44 infants, 36 cases completed the study. The mean period of restlessness after 5 days of receiving placebo and L. reuteri was 275±142.8 and 172±88.3 min, respectively (p<0.001). Also, after 14 days of L. reuteri administration, the mean period of restlessness was 106±53.67 min. The results showed that probiotic L. reuteri reduced crying and restlessness duration in infants with colic.