Interdisciplinary Journal of Acute Care
Volume:3 Issue: 2, Summer and Autumn 2022

Femur fracture in newborn with breech presentation during cesarean section: A rare but possible complication Background Cesarean section is considered safer than vaginal delivery in risks involved for birth injury. Birth injury is more common in vaginal breech deliveries but is also encountered in Cesarean section. Although femur fracture is a relatively rare complication, it represents one of the most Common fractures of the lower extremity presenting in newborns. A 3780 g male infant was delivered at 38 weeks and 5 days by elective cesarean section for breech presentation. The newborn sustained a fracture of the right femur. A simple immobilization of the limb in extension led to a complete healing of the fracture without sequelae. Conclusion The objective of our case report is to increase awareness of clinical complication of femur fracture during breech extraction in course of cesarean section.Keywords: cesarean section, breech presentation, trauma, femur fracture

The health system transformation plan has been implemented since 2013 and one of its goals was to reduce the cesarean rate to 25-30%. The purpose of this study was to investigate and compare the rate of cesarean delivery and natural delivery before and after the implementation of the health system reform plan in Khorramabad city.

This study was a descriptive analytical study that was conducted in 2019. The research population included all the women who had given birth in one of the public hospitals of Khorramabad during the years 1990-1995, which later became the implementation of the health reform plan. The sampling method was a census through the statistics of the vice-chancellor of treatment of Lorestan University of Medical Sciences. After the data was collected, it was analyzed through descriptive and analytical statistics.

The results of the study showed that in most hospitals, the rate of caesarean section increased after the implementation of the health system transformation plan compared to before the implementation of this plan, and this difference was statistically significant.

It seems that the inconsistency of the results of the current study with the goal of the transformation plan of the health system cannot be due to the implementation of the transformation plan. This issue can have various causes, such as: the increase in the age of marriage in recent years, followed by the high age of pregnant women, which increases the need for cesarean delivery. Also, today, due to the increasing age of primiparous mothers and the increase in the number of ultrasounds, the problems of the fetus and the mother are better diagnosed, and mothers are forced to have a cesarean section.It seems that according to the rate of caesarean delivery in this province that is higher than the standard and the ineffectiveness of the health system transformation plan in this field, more efforts should be made with the use of extensive programs in order to increase the awareness and culturalization of the society, maybe in the future. We will soon witness a decrease in the rate of cesarean section and reach its standard rate in this province.

COVID-19 is a respiratory illness for which no specific medication or treatment has yet been identified. This study was conducted to explore people’s experiences of using home remedies to treat COVID-19 symptoms during the pandemic. This qualitative study, which adopted a content analysis approach, was conducted on 29 people in Khorramabad (Iran) from January to December 2021. The participants were selected using the purposive sampling method and interviewed in depth. The interviews continued until data saturation. After transcribing the interviews, they were analyzed using the Graneheim and Lundman method. After analyzing the collected data, 459 initial codes were extracted and classified into two categories: “experience of COVID-19” and “resorting to home and traditional remedies”. Each category had four subcategories. People use home remedies for COVID-19 prevention and treatment. Participants engaged in home remedies for various reasons, including beliefs in their efficacy, dissatisfaction with medical treatments, and prior personal and familial experiences with home remedies. Some treatments mentioned by participants in this study may not be referenced in other literature and require further investigation.

Sleep disturbance profoundly impacts individuals' physical and mental well-being. Inadequate sleep is a crucial marker for numerous health conditions. This study was a descriptive, analytical, cross-sectional study. The statistical population was all students studying at Lorestam University of Medical Sciences, Iran, in 2019, who were selected through multi-stage sampling. 338 persons answered the standard Pittsburgh Sleep Quality Index questionnaire and a researcher made questionnaire to investigate the causes of sleep disorders in students. Findings showed that 204 students (59.6%) had a sleep disorder. There is no statistically significant relationship between gender and sleep disorders, but there is a statistically significant association between academic courses and sleep disorders. Most sleep disorder cases were among nursing and midwifery students, and the least were among laboratory sciences students. Sleep disorder was more common in those who did not take medicine, and a statistically significant relationship exists between having a mental illness history and sleep disorder. This study indicates that students' sleep quality could be better and should be recognized as a serious health issue. Student's academic performance and sleep quality can be enhanced by taking the proper steps to examine the reasons for their sleep difficulties and lessen the negative effects that follow from them.

Valid indices and optimal models in predicting mortality rates among patients hospitalized in the emergency department have attracted much attention due to the wide use of mortality prediction instruments and the differences in the prediction result and hospitalization outcome for patients with stroke with disease severity tools. The present study aims to determine the relationship between APACHE II mean score and mortality among patients with stroke admitted to the emergency department in Shohadaye Ashayer Hospital in 2022. To conduct this prospective descriptive cross-sectional study, the information related to 273 patients with stroke admitted to the emergency department of the specialized neurology center in Shohadaye Ashayer Hospital in Khorramabad was utilized non-randomly, sequentially, and conveniently by applying the data collection tools during 2022. Demographic data, laboratory values, vital signs, and hospitalization outcomes in the emergency department during the first 24 hours were employed to calculate the APACHE II score. Based on univariate logistic regression model analysis, a significant relationship was observed between the APACHE II score with mortality among patients with stroke (P<0.001). In other words, the APACHE II predicted the mortality rate among patients with stroke accurately. The results revealed that the APACHE II accurately predicts the mortality rate and prioritizes patients with stroke for allocating treatment resources.

The elderly's sleep quality and social support are important variables related to quality of life and factors affecting successful aging.Therefore, the present study was conducted to determine the relationship between the elderly's sleep quality and social support. In this descriptive cross-sectional analytical study, the research population included 150 older people referring to elderly care centers living in Qaem Shahr,Iran, and the sampling method was convenience. To collect information, the Pittsburgh Sleep Quality Index, and the Philips̍ Social Support Questionnaire used as self-report. The data were analyzed using SPSS software version 26. The results of the Spearman test showed a significant negative relationship between the sleep quality score and social support. However, there is a significant relationship between the social support score and the educational level of the elderly. This study's findings emphasize the major role of social support in ensuring adequate sleep quality in the elderly. Therefore, it is recommended that policymakers in this field develop programs centered on social support to improve the sleep quality and health of the elderly.