zahra kamiab

Patent ductus arteriosus is a short path of fetal blood circulation through the lungs that is necessary to maintain life inside the womb. Although this duct should be closed right after birth, in some cases, it remains open and may cause life threatening complications. The present study was conducted with the aim of investigating the effectiveness of injectable acetaminophen in closing patent ductus arteriosus in term infants.

This study was conducted as a randomized, blinded clinical trial on 80 infants diagnosed with patent ductus arteriosus in the neonatal intensive care unit in Afzalipur Hospital, Kerman. The infants were randomly divided into control and intervention groups. The intervention group received injectable acetaminophen at a dose of 20 mg based on weight in the first hour and 10 mg based on weight every six hours for three days after receiving the initial dose. And the placebo group received 10% dextrose serum equal to acetaminophen amount with the same treatment intervals. Echocardiography was performed again in both groups after three days and the state of PDA closure was evaluated.

Gestational age averages in the intervention and control groups were 37.88 ± 0.13 weeks and 37.95 ± 0.15 weeks, respectively (P=0.738); and the birth weight averages were 2996 ± 83.41 grams and 64.09 ± 2982 grams, respectively (P=0.899). The male gender in the intervention group (57.5%) was higher than that in the control group (40%) (P=0.158). The most common cause of hospitalization of newborns in the intervention and control groups was TTN (Transient Tachypnea of the newborn) (75.0% and 67.5%, respectively) and NAS (Neonatal Abstinence Syndrome) (15.0% and 20.0%, respectively) (P=0.985). In the intervention group with injectable acetaminophen, 85.5% of infants had their PDA closed after receiving the first course of acetaminophen, while this rate was 0.65% in the control group (P=0.016).

Based on the results of this study, injectable acetaminophen can effectively improve PDA disorder of term babies. While the effectiveness of routine drugs used in the treatment of this disorder decreases with increasing infants’ age, injectable acetaminophen showed its beneficial effects significantly.

Trauma is a leading cause of morbidity and mortality worldwide. The frequency of trauma-related deaths depends on various factors such as the severity and mechanism of the trauma. This study aimed to determine the frequency, causes, and outcomes of trauma in patients referred to the emergency department of Ali Ibn Abitaleb Hospital, Rafsanjan, Iran, in 2021. A case-series study was conducted, examining the medical files of 4689 trauma patients referred to the emergency department of Ali Ibn Abitaleb Hospital in 2021. Data on age, gender, marital status, place of residence, mode of transportation to the hospital, reasons for admission (extremity trauma, head and neck trauma, thorax trauma, abdominal trauma, spine trauma, multiple trauma), type of trauma (blunt or penetrating), and mechanisms of trauma (traffic accidents, falls, fights, burns, electrocutions, work-related accidents) were recorded. The mortality rate and factors influencing it were also evaluated. Among 4,689 trauma patients, the most common reasons for admission were organ trauma (46.4%), multiple trauma (23.5%), and cervical spine trauma (21.7%). The most common mechanisms of trauma were traffic accidents (68.3%) and fights (17.2%). Most patients (3506, 74.8%) had penetrating trauma. A total of 68 patients (1.5%) died from trauma. Significant factors related to mortality included old age (p<0.001), male gender (p=0.028), transportation by ambulance (p<0.001), initial admission to the trauma emergency department (p<0.001), hospitalization in the emergency or orthopedics department (p<0.001), and cause of trauma (extremity trauma, head and neck trauma, multiple trauma) (p=0.002). The findings of the present study showed that 1.5% of all deaths was due to trauma. Significant factors related to mortality included old age, male gender, transportation by ambulance, admission and hospitalization in the emergency department, and the cause of trauma. Although traffic accidents and fights were the most common mechanisms of trauma and car accidents caused the highest mortality rate, these findings were not significantly correlated with death.

Coronavirus disease increased concern about vulnerable groups of society including pregnant women and babies. This study was conducted in order to investigate maternal and neonatal outcomes in newborns admitted to Ali Ibn Abi Talib Hospital in Rafsanjan before and after the COVID-19 pandemic.

In this cross-sectional study, 337 infants admitted to the hospital in the first 3 months of 2019 (before the start of the COVID-19 pandemic) and 194 infants admitted in the first 3 months of 2020 (after the start of the COVID-19 pandemic) were included. Demographic characteristics and maternal and neonatal complications were extracted from the files and analyzed by independent two-sample t-test and chi-square test.

The Apgar scores of the first and fifth minutes had significantly decreased during the COVID-19 pandemic (p<0.001), while infant death (p=0.003) and asphyxia at birth (p<0.001) had significantly increased. The frequency of premature rupture of fetal membranes, pre-eclampsia, eclampsia, and diabetes in the pregnant mothers before and after the pandemic were not statistically significant (p>0.05).

According to the results of the present study, although there was no difference in the prevalence of maternal outcomes between the period of COVID-19 and before, but the outcomes of newborns during the period of COVID-19 were more than before, which indicates the need for more careful prenatal care, health protocols training, and careful monitoring of the fetus during and after delivery to reduce neonatal complications and outcomes during the COVID-19.

Infantile colic is a prevalent issue within the first three months of life. Research indicates that children of mothers who suffer from migraines are more than twice as likely to experience colic.

The aim of this study was to explore the association between a history of maternal migraines and the occurrence of infantile colic.

A case-control study involving 154 infants who visited the Rafsanjan Pediatric Clinic in 2022 was conducted. The participants were selected through convenience sampling and categorized into two groups based on the Wessel criteria for colic: Infants with colic (n = 77) and those without (n = 77), ensuring they were matched for age and sex. Data were collected using a questionnaire designed by the researchers, which gathered information on the mother and infant’s age, the infant’s sex, number of pregnancies, gestational age, birth weight, method of feeding, paternal history of migraines, and maternal fulfillment of the International Headache Society’s migraine criteria.

The analysis revealed that a history of maternal migraines was significantly more common in infants with colic than in the control group (Odds Ratio [OR]=6.17, P < 0.001). Further, multivariable logistic regression analysis, after adjusting for potential confounders, indicated that a maternal history of migraines increased the likelihood of infantile colic fivefold (OR = 5.008, 95% confidence interval: 2.258 to 11.104, P < 0.001).

This study confirms a significant association between maternal migraines and infantile colic, suggesting that maternal migraines could be a risk factor for colic in infants.

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease that can affect many organs, and due to its systemic nature, it seems that some types of surgeries are more prevalent in this disease. This study aimed to investigate the prevalence of different types of surgery in RA patients. This retrospective study using the RA registry was performed on 639 RA patients in the rheumatology clinic of Rafsanjan, Iran, 2022. All patients fulfilled the ACR/EULAR 2010 classification criteria for RA. Demographic information, clinical parameters, laboratory information, surgical history, and surgery time were collected from the medical records. The sample comprises 555 (86.9%) women and 84 (13.1%) men. The average age was 55.08 ± 12.52, and the mean duration of the disease was 7.32 ± 5.94. There was a history of at least one surgery in 252 (39.4%) patients. The prevalence of gastrointestinal, gynecological, orthopedic, eye, ear, nose, and throat, cardiovascular and urological surgeries was 18%, 16.4%, 9.2%, 8.3%, 3.9%, 0.9% and 0.9%, respectively. There were 69.8% of eye surgeries and 57.6% of orthopedic surgeries after disease diagnosis; other surgeries were more prevalent before the diagnosis. The average age (58.16 ± 11.89 vs. 53.07 ± 12.53, P-value < 0.001) and body mass index (29.65 ± 5.68 vs 28.63 ± 5.56, P-value = 0.025) were higher in participants with surgery than those with no surgery. The most prevalent surgeries were gastrointestinal, gynecological, and orthopedic surgeries, and Cardiovascular and urological surgeries were the least. The mean age and body mass index in patients with surgery were significantly higher than those without surgery. Also, physical activity was significantly lower in the participants with surgery.

Rheumatoid arthritis (RA) can affect bone density. Given the significant risk of low bone mass density (BMD) in RA patients, the present study aims to investigate the BMD in these patients. The present cross-sectional study included 415 RA patients from the Rafsanjan Rheumatology Clinic. The patients were included in the study by census based on the inclusion criteria, which included a physician's diagnosis of RA according to the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria, at least three months of disease history, and age between of 35 and 70 years. The BMD was measured using the dual-energy x-ray absorptiometry method in both the hip and the spine, and the RA severity was determined using the disease activity score-28 (DAS-28) index. The mean age of RA patients was 56.49 ± 11.73 years, with females accounting for 86.7% (300 people). The frequency of osteoporosis was 7.5% (26 people), and osteopenia was 43.6% (151 people) based on hip bone density, and 33% (137 people) and 38.1% (158 people) based on spine density, respectively. Age, fracture history, and DAS-28 score increased the probability of developing osteopenia or osteoporosis based on hip and spine bone density. According to the findings of a study in RA patients, increasing age, history of bone fracture, and DAS-28 score increase the probability of osteopenia or osteoporosis. Therefore, it is advised to pay close attention to the mentioned factors to prevent complications in these patients.

Stenting in patent ductus arteriosus (PDA) and Rashkind septostomy in neonates with pulmonary atresia improves pulmonary and systemic venous bloodmixing and oxygen saturation. In the present study, a case of embolized stent and Rashkind septostomy that suffered hemolysis due to the stent was reported in a 2-day neonate with pulmonary atresia and single ventricle.

The patient was a 2-day-old boy neonate with a gestational age of 35 ± 2 weeks and a birth weight of 2800 grams. Neonates’ vital signs after birth were abnormal, and in the examination, cyanosis, tachypnea, grunting, and respiratory distress were observed. Auscultation had a systolic murmur at the left upper edge of the sternum. O2 saturation was about 70%, with a nasal oxygen intake of 3 L/min. Echocardiography confirmed the presence of pulmonary atresia and PDA. The initial treatment was done with prostaglandin E1, stenting in PDA, and a Rashkind septostomy. The neonate’s cardiac arrest occurred during stenting, and the neonate was resuscitated. The angiography examination indicated PDA stent embolization in the pulmonary artery, and due to the unsuccessful restoration of the stent, a decision was made to use a larger stent in the PDA. The neonate suffered from hemolysis on the second day and was discharged with conservative treatment within 2 weeks with a good general condition.

Keeping the PDA open with a proper stent and creating a Rashkind atrial septostomy improves the two-way mixing of pulmonary and systemic venous blood and oxygen saturation of neonates with pulmonary atresia and eliminates the need for surgery.

 Cisplatin has potent antitumor properties. It has several toxic side effects, such as hepatotoxicity. It is thought that hepatotoxicity induced by cisplatin is caused by oxidative stress.

 It has shown that calcium dobesilate (CD) has potent antioxidant properties. The present study aimed to assess CD protective effects on cisplatin-induced hepatotoxicity in mice.

 In this study, 28 mice were selected randomly and were divided into four groups, including control, cisplatin (20 mg/kg, i.p., only on the first day of the experiment), Cisplatin+CD 50 (50 mg/kg CD, orally), and Cisplatin+CD 100 (cisplatin with 100 mg/kg CD, orally). A 4-day oral gavage of CD was applied to the treated groups. The mice were sacrificed on the 5th day, and serum glutamic pyruvic transaminase (SGPT), serum glutamic-oxaloacetic transaminase (SGOT), alkaline phosphatase (ALP), malondialdehyde (MDA) and reactive oxygen species (ROS) levels, superoxide dismutase (SOD), and glutathione peroxidase (GPx) enzyme activity levels in liver tissue were evaluated. Histopathological evaluation was assessed using hematoxylin and eosin-stained liver tissue sections.

 The results indicated that there was a significant increase in GSPT, SGOT, ALP, and MDA and also a significant reduction in the liver activity of SOD and GPx in cisplatin-treated animals. Treatment with CD (100 mg/kg) remarkably attenuated the GSPT, SGOT, ALP, MDA, and ROS levels. Moreover, CD (100 mg/kg) elevated the SOD and GPx activity in the liver tissue of cisplatin-treated mice.

 The findings showed that CD has a protective effect against cisplatin-induced hepatotoxicity, at least by improving the antioxidant parameters.

Renal involvement is one of the extra-articular manifestations of rheumatoid arthritis (RA). The current study aims to investigate renal function and its associated factors in RA patients. This cross-sectional study included 443 RA patients who were referred to Rafsanjan's only rheumatology clinic in 2021. Disease Activity Score 28 (DAS28) index was used to determine disease activity. Blood levels of creatinine, C-Reactive Protein test (CRP), Erythrocyte Sedimentation Rate (ESR), and urine analysis were also determined. Renal failure was classified based on Estimated Glomerular Filtration Rate (eGFR). SPSS.20 one-way ANOVA, Kruskal-Wallis test, the Mann-Whitney U test, and Chi-square were used to analyze the data. Patiens' mean age was 53.99 ± 12.34, and 85.8% (380 people) of the participants were female. Ther were 147 (33.2%) patients without renal failure, 260 (58.7%) with mild renal failure, and 36 (8.1%) with moderate/severe failure. Men had a 3.059 higher risk of renal failure than women (P = 0.001). The probability of developing renal failure in patients increased by 1.047 times with each year of age (P < 0.001). As a chronic disease, RA can directly or through the use of disease medications and other risk factors, adversely affect other organs of the body, including the kidney. The current study's findings revealed a high prevalence of mild renal failure in these patients.

 One of the most common psychiatric problems is depression. The utilization of traditional medicine, such as Jollab, as a complementary medicine in conjunction with modern medicine is likely to result in a more effective treatment of depression with fewer adverse effects. The current study aimed to evaluate the effectiveness of Jollab, as a Persian medicine in the depression treatment.

 A randomized, double-blind, placebo-controlled clinical trial was conducted in 50 patients with mild to moderate depression. Patients were randomly divided into two groups, including treatment and placebo groups. The participants received experimental drug (Jollab) or placebo 15 ml three times a day, after meals for one month. After this period, Beck Depression Questionnaire II (BDI II) was completed by two groups, as well as before this period. Post-collection data were analyzed using independent t-test, paired t-test and chi-square test.

 Regarding Beck Depression Inventory, the values of both groups were similar before the experiment (p-value=0.320). BDI II score significantly decreased in treament group after treatment (p-value < 0.001), and the score difference between the placebo and treatment groups were statistically significant (p-value< 0.001) at the end of experiment.

 Based on the results of the present research work, the Jollab treatment showed more effectiveness than the placebo. As a result, Jollab may be used as a pharmaceutical supplement to treat depression. However, more research is still needed in this subject. Furthermore, since medicinal plants are less expensive for both patients and medical personnel, this treatment strategy may be a viable option.

Inflammation plays a major part in brain ischemia. Propolis is a polyphenol-rich hive product with a set of pharmaceutical properties.

This research aims to investigate the impact of water extracts of brown propolis (WEPs) on stroke outcomes and inflammatory responses in a rat model of permanent middle cerebral artery occlusion (MCAO).

This experimental study was conducted in Rafsanjan, Iran, in 2017. WEPs were experimentally prepared from two regions in Iran. Gas chromatography–mass spectrometry and Folin–Ciocalteu assays were used to determine chemical portrayal and the total polyphenol content, respectively. A total of 66 male adult mice were divided randomly into the surgical sham, control (vehicle-treated), and four WEPs-treated animal groups. WEPs-treated groups received doses of 100 and 200 (mg/kg, IP) four times, and their behavioral tests, brain edema, infarct volume, and tumor necrosis factor-alpha (TNF-α) level were evaluated.

The samples were not significantly different in terms of the concentration of the total polyphenol content. Compared to the control, WEPs led to a substantial decrease in the TNF-α level (P<0.05) as well as a subsequent reduction in the brain edema and infarct volume (P<0.001) in all treatment groups. Furthermore, there was a significant improvement in neurological deficits and sensory-motor impairments level (P<0.05).

According to the study findings, WEPs reduce brain ischemia damage, perhaps by exerting a neuroprotective effect on stroke-induced neuroinflammatory responses

Rheumatoid arthritis (RA) is one of the most common autoimmune diseases causing many physical and mental complications, and disorders in patients. This study aimed to evaluate the mental health and sleep quality of RA patients referred to the Rafsanjan Rhematology Clinic. This descriptive-analytical study was conducted on 35 patients and 35 healthy people referring to Rheumatology Clinic of Rafsanjan. Data collection tools included demographic information, Depression, Anxiety and Stress Scale 21 (DASS21), and Pittsburgh Sleep Quality Index. Then, the data were analyzed by SPSS 20 and using independent t-test, Chi-square, and multivariate analysis of covariance. The total score of DASS21 indicated that stress, anxiety, and depression in the patient was significantly higher than the healthy group. In comparison to the healthy group, patients' mean total scores for sleep and all of its subscales (apart from subjective sleep quality) were considerably higher (P = 0.001). The mean total score of sleep, and all its subscales (except the subjective sleep quality) in the patients was significantly higher than the healthy group, indicating that they had a lower sleep quality. Based on the results of our study, mental health, and sleep quality are common problems in RA patients. Therefore, along with standard treatments for the disease, attention should be paid to mental health, and sleep status of affected patients.

Because osteoporosis is largely preventable and an essential principle in preventing this condition is the way of thinking, lifestyle, and daily habits of people, the current study aimed to determine the knowledge, attitude, and practice of nurses at Rafsanjan University of Medical Sciences regarding osteoporosis. The population of this descriptive study comprised 418 nurses at Ali-Ibn Abi-Talib Hospital in Rafsanjan by census in 2021. The data collection tool was a valid questionnaire that was completed through self-reporting. Data were entered into SPSS software version 24 and analyzed using the chi-square, independent t-test, and one-way analysis of variance tests. The mean age of participants was 34.15±7.28 years, and the mean work experience was 9.36±7.46 years. Of the 418 subjects, 214 (51.2%) were female, and 204 (48.8%) were male. The mean score in the field of knowledge was 20.84 (out of 28 points), in the field of attitude was 18.70 (out of 22 points), and in the field of practice was 9.32 (out of 18 points). The mean scores of knowledge (p=0.001), attitude (p=0.015), and practice (p<0.001) of nurses were significant according to different age groups. Women obtained higher mean scores for knowledge than men (p<0.001), but men achieved higher mean score for practice than women (p<0.001). The current finding indicate that nurses' knowledge and attitude towards osteoporosis in Rafsanjan are optimal. Nonetheless, their practice of preventing this disease is weak and requires influential factors.

Diagnosis and treatment of ventricular septal defect (VSD) during infancy is of great importance in improving the infant’s health. Patent ductus arteriosus (PDA) and coarctation of the aorta are the most common disorders associated with VSD. Patent ductus arteriosus needs to be closed using surgical or non-surgical procedures. This article aims to present a case of repairing coarctation of the aorta by stenting inaninfant withVSDdueto the placement of a large Amplatzer during ductus arteriosus closure.

The patient was a one-and-a-half-year-old girl with Down syndrome and congenital heart disease. In the initial examination, a second loud heart sound and a systolic ejection murmur could be heard at the left sternal border. The results of the previous echocardiography showed the presence of VSD, PDA, and coarctationof the aorta. She underwent angioplasty a fewmonths ago, and since the coarctation had not been repaired by balloon aortoplasty due to a large amplatzer. Therefore, the surgeon could not repair the VSD because of uncorrected pulmonary hypertension. Hence, we decided to repair the coarctation by stenting. After two weeks of medication treatment, the patient underwent angiography, and a formula stent placement was done for the patient.

Pulmonary artery blood flow correction is an effective factor in treating patients with VSD that can be achieved by using the correct amplatzer placement. We corrected the aortic coarctation caused by improper amplatzer placement using stenting.

Osteoarthritis (OA) is a degenerative joint disease that globally affects the elderly, leading to pain and disability. Herbal medications and alternative therapies have demonstrated positive effects on arthritis management. Pistacia vera has traditionally been used for inflammatory conditions and has also shown antinociceptive effects.

Given the limited available scientific evidence, our randomized controlled trial aimed to assess the potential protective role of topical P. vera seed oil preparation in patients with knee OA.

A total of 89 patients with kneeOA(n = 89) were randomly allocated into three groups: Placebo, piroxicam, and P. vera. The topical formulations were administered twice daily over a period of three months. Pain level, patient health status, andperformance were evaluated using the visual analog scale (VAS) andWestern Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Statistical analysis was performed using SPSS software.

The application of P. vera ointment demonstrated pain reduction in patients, as indicated by VAS andWOMACassessments. Additionally, WOMAC scores showed that P. vera ointment alleviated motion stiffness and improved activity difficulties in patients (P < 0.001). In certain parameters, the topical application of P. vera showed greater effectiveness in treating knee OA than piroxicam (P < 0.05).

Pistacia vera ointment shows promise as a potential therapeutic option for osteoarthritis, effectively addressing the detrimental effects of the disease. Further experimental and clinical studies are warranted to elucidate its efficacy and safety profile.

To investigate the correlation between health literacy and self-care behaviors among patients with COVID-19 in Rafsanjan, Iran. Due to the prevalence of corona disease worldwide and the lack of definitive and known treatment for it, the ability of patients to take care of themselves and Adherence to maintaining health is the best known way to prevent.  This descriptive study was performed in the first 6 months of 2020 on patients referred to health centers in Rafsanjan in 2020 with a confirmed COVID-19. Samples were selected by census method. The Health Literacy Questionnaire (HELIA) and the researcher-made self-care questionnaire were used and completed electronically.  One hundred and one eligible COVID-19 patients were enrolled in the study, 44.6% of participation having (THL < 132) and 55.4% of participation having (THL ≥ 133), and self-care had a significant weak and positive correlation only with Understand (one of the components of health literacy).   The results, showed that health literacy had a significant weak correlation with self-care in patients with COVID-19, therefore patients need proper knowledge and attitude to successfully develop self-care ability in order to successfully control their disease and prevent transmission to others.

Rheumatoid arthritis is a chronic disease with unknown etiology and can affect various aspects of women's lives, especially pregnancy and their consequences. The present study was performed aimed to evaluate fertility-related factors in women with rheumatoid arthritis.

This descriptive-analytic study was performed on 100 women with rheumatoid arthritis and 100 healthy women in 2020. The diagnosis of rheumatoid arthritis was based on ACR 2010 / EULAR criteria and rheumatologist approval. Demographic and fertility-related information included first menstrual age, age of menopause, menstrual regularity, number of pregnancies, history of infertility and use of assisted reproductive drugs, duration of infertility and disease severity according to DAS.28 criteria. Data were analyzed by SPSS software (version 20) and Independent T-test and Chi-square test. P<0.05 was considered statistically significant.

The mean duration of the disease was 49.14±49.57 months and the severity of the disease was moderate in half of the patients. The number of pregnancies and deliveries did not differ significantly between the two groups (P> 0.05). A history of abortion was reported in 33% of RA women and 56% of healthy women (P = 0.007). The history of primary and secondary infertility was less in women with rheumatoid arthritis than healthy women (P = 0.017 and P = 0.542, respectively) and the use of assisted reproductive drugs was more frequent in healthy women (P = 0.224).

In this study, pregnancy-related factors such as the frequency of abortion, history of primary infertility and the use of assisted reproductive drugs were reported less in women with rheumatoid arthritis than healthy women. It is necessary to examine these findings in future studies with more sample sizes and selection of more than one control group.

Gestational diabetes (GDM) can affect neonatal developmental indicators. The aim of this study was to evaluate and compare the growth process of infants less than 2 years of age with GDM and healthy mothers in Rafsanjan City.

This cross-sectional study was performed on 208 neonates under 2 years of age from healthy mothers (104 neonates) and GDM mothers (104 neonates) in Rafsanjan City in 2017. Weight, height and head circumference were measured at birth, 6, 12 and 18 months. Fasting serum glucose above 126 mg/dl after 8 hours of fasting was considered as GDM. Data analysis was performed using SPSS 16 software and independent t-test, Chi-square and repeated measures analysis. Significant level was considered 0.05.

The mean age of GDM mothers was 31.8±5.3 and healthy mothers were 29.2±5.5 years. Cesarean delivery was reported in 73.1% of mothers with GDM and in 57.7% of healthy mothers (P = 0.020). Changes in weight, height and head circumference in the two groups at birth, 6 months, 12 months and 18 months after birth had an increasing process that was higher in infants of mothers with GDM (P <0.001).

The process of weight, height and head circumference changes in infants born to mothers with GDM was higher.

Recent studies have shown conflicting results regarding the effect of the mother's pre-pregnancy body mass index on pregnancy outcomes. This study was conducted with the aim of determining the relationship between the body mass index of the mother before pregnancy and the anthropometric indices at the birth of the baby and some pregnancy outcomes.

This retrospective cohort study was conducted in 2019 on pregnant women referred to Nik Nafs and Ali Ibn Abi Talib Hospital in Rafsanjan. Three hundred eligible people were included in the study using convenience sampling. Information about mothers was collected using their health and preconception care records. After collecting the data, it was analyzed using chi-square test or Fisher's exact test, logistic regression, and multivariable proportional odds model.

The results showed that 147 (49%) mothers were overweight and obese (exposure group). The rate of caesarean delivery and premature delivery was significantly higher in the exposure group (p<0.05). The results of logistic regression and multivariable proportional odds model showed that the chance of having babies with short stature, abnormal head circumference, and overweight was higher in obese women than in normal women but it was not statistically significant (p<0.05).

Abnormal body mass index can play a role in causing adverse effects of mother and fetus and also anthropometric indices at the birth of the baby. Therefore, evaluating the weight and body mass index of the mother before pregnancy and controlling overweight and obesity, these complications can be prevented.

Tricuspid valve atresia is a congenital heart defect and if left untreated, the lesion has a high mortality rate. This study aimed to report a case of tricuspid valve atresia in a low-birth-weight three-day-old infant, who was treated by intra-ductal stenting and established pulmonary blood flow instead of routine shunting.The patient was a three-day-old male infant, weighing 2800 grams with a gestational age of 38 weeks. He was admitted with symptoms of tachypnea, cyanosis, 45% saturation, and severe metabolic and respiratory acidosis. On echocardiography, tricuspid valve atresia was observed. The infant was treated with prostaglandin E1 immediately after admission to the NICU and necessary interventions were taken to keep the patent ductus arteriosus (PDA) open. Angiography was performed through the aortic artery. First, a balloon was inserted, and then a stent was successfully placed inside the PDA. Preoperative saturation increased from 45% to 93% after stenting, and the infant was extubated after 48 hours in a good general condition.As the results of the current case report showed, stent placement can effectively keep the PDA open and establish pulmonary blood flow in high-risk infants. It is suggested that ductal stenting should be considered as the first treatment selection in newborns with tricuspid valve atresia or as a good alternative method for Blalock-Taussig shunt.

Early diagnosis of congenital heart disease (CHD) has a significant impact on the prognosis of the patient. This study aimed to determine the sensitivity and specificity of cardiomegaly according to Chest X-ray (CXR) indices in comparison with echocardiography in the diagnosis of CHD in infants. In this cross-sectional study, the clinical status of 166 infants aged 2 to 24 months who referred to the Pediatric Ward of Afzalipour Hospital in Kerman and needed CXR for any reason, was evaluated from November 2019 to November 2020. CXR and echocardiography were performed for all infants by a pediatric cardiologist and the probability of CHD was confirmed or ruled out. Therefore, the sensitivity and explicitness of CXR were determined. Data were analyzed using SPSS version 20. The most common anomalies observed in infants were Patent ductus arteriosus (PDA), atrial septal defect (ASD), ventricular septal defect (VSD) and pulmonary stenosis (PS), respectively. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CXR, for determining cardiomegaly in these infants were 65.7%, 51.1%, 26.4%, and 84.8%, respectively. The results of this study showed that the sensitivity and specificity of CXR for determining cardiomegaly were 65.7% and 51.1%, respectively. Therefore, when echocardiography is not available, the chances of finding congenital heart abnormalities with the help of CXR will be quite high.

The COVID-19 disease has affected patients with rheumatoid arthritis (RA). Drug adherence is essential for RA control. This study investigated self-medication among RA patients in the COVID-19 pandemic. This cross-sectional study was performed on 288 patients with RA referred to the Rheumatology Clinic of Rafsanjan in 2021. Data were extracted by a checklist. Patients were examined and the type of used drugs, drug dose, and dose change were recorded. Inclusion criteria were diagnosis of rheumatoid arthritis, care during the last year and being over 16 years of age. Data were analyzed using SPSS/18 software. The mean ± SD of patients' age was 53.3 ± 12.6 years and 53.8% of patients were male. The mean ± SD duration of the disease was 7.04 ± 6.37 years. Self-medication was observed in all drugs, where Alendronate (100.0%, n = 13), Folic Acid (100.0%, n = 7), Methotrexate (94.1%, n=32), and Prednisolone (89.3%, n = 25) had the highest frequency of changes among other drugs (P value < 0.001). The mean ± SD dose of Hydroxychloroquine increased from 1358.5 ± 304.4 to 1368.0 ± 336.2 mg before and during the COVID-19 pandemic (P value = 0.319). The odd ratio of self[1]medication was higher in women (OR = 6.130, 95%CI: 2.915-12.993), RA patients with academic education (OR = 2.727, 95%CI: 1.037- 7.166), and lower in RA patients with a governmental occupation (OR = 0.277, 95%CI: 0.086-0.893). Self-medication of rheumatoid arthritis drugs may occur due to the positive effect of these drugs on COVID-19 disease and further reduced drug accessibility. It is necessary to plan to prevent self-medication in these patients by physicians.

The professional quality of life (ProQOL) and occupational burnout are two central factors related to nurses' job performance. Nurses' job performance might be affected by work stress and compassion. In the present study, the association of ProQOL of nurses with burnout, depression, anxiety, and stress was investigated.

In this descriptive study, 282 nurses were invited to help with the survey. Demographics Scale, Maslach Burnout Questionnaire, Depression, Anxiety and Stress Scale (DASS-21), and ProQOL Questionnaire were used to collect the data.

Most participants have an average degree of compassion satisfaction (CS) (63.2%) and compassion fatigue (CF) (57.1%). Also, most nurses had low scores for occupational burnout (39.3%). A significant negative correlation was found between CS with CF (p < 0.001). Occupational burnout (p = 0.019), anxiety (p = 0.015), and depression (p < 0.008) subscales had a significant negative correlation with CS. There was a significant correlation between the CF and subscales of occupational burnout, anxiety, stress, and depression (p < 0.001). The CF predicted 18% of variance in CS (R2 = 18%) (p < 0.001). The CS, depression, and occupational burnout predicted 25% of variance in CF (R2 = 25%) (p < 0.001).

In this study, the CS, depression, and occupational burnout were important variables affecting the level of CF. Healthcare service leaders and nurse managers should make efforts promoting emotional wellbeing among nurses. Therefore, future studies need to pay more attention to the CF and its associated factors.

During the current worldwide pandemic of coronavirus disease 2019 (CPVID-19), this disease was first identified in Iran at the end of February. This study was conducted to examine patients with severe COVID-19 disease, who were treated with three medications, namely ReciGen, methylprednisolone, and Sovodak.

We identified 10 patients (3 males and 7 females) with the mean (± SD) age of 55.70 ± 21.48 years, who were admitted to the only referral hospital in Rafsanjan County (Iran) from March to July 2020 with confirmed infections with severe COVID-19. They were treated with the combination therapy of subcutaneous ReciGen interferon every other day, methylprednisolone at a dose of 250 mg every 6 hours for 5 days, and one tablet of Sovodak daily.

In the series of cases investigated in this study, the general conditions of all patients improved in terms of their clinical parameters after receiving the combination therapy, and all patients were discharged with a blood oxygen level of ≥ 93% and in good general conditions.

Various treatment approaches are used in different centers to treat infant bronchiolitis, some of which are not indicated and are not based on strong scientific evidence. W aimed to evaluate the treatment of admitted infants with acute bronchiolitis in the only medical hospital in Rafsanjan and compare it with modern treatment methods.

This descriptive study was conducted on 100 infants admitted to Ali-Ibn Abi Talib hospital in Rafsanjan, southern Iran. Demographic information and risk factors, including age, birth weight, history of exposure to cigarette smoke, and other factors affecting this disease, and all therapeutic measures were collected in a researcher-made checklist. The data were analyzed using SPSS software, version 20, and the treatment was compared to the latest clinical guidelines of the American Academy of Pediatrics (AAP) and England National Institute for Health and Care Excellence (NICE), and Cochrane meta-analyses.

79%, 37%, 41%, and 3% of the children received antibiotics, corticosteroids, bronchodilators, and epinephrine, respectively. The most important risk factors were smoking in parents (91%), malnutrition (60%), low birth weight (71%), male sex (62%), and being born in autumn (60%).

According to the results of this study, there is a large gap between treatment approaches and up-to-date and valid international guidelines. Therefore, compiling local treatment and care instructions for these patients to be used in medical centers would be useful.