Effect of body change positions on endotracheal tube cuff pressure in patients with head injury treated with mechanical ventilation

Background: Maintaining endotracheal tube cuff pressure in the normal range of 25-30 cmH2o plays an important role in the prevention of related complications. Objective: The present study aimed to determine the effect of body change position on level of endotracheal tube cuff pressure in patients with head trauma under mechanical ventilation admitted in ICUs. Methods: This quasi-experimental study was implemented on 30 patients with head injury under mechanical ventilation who admitted in ICUs in 2014. Available method was used for sampling. The mean of endotracheal cuff pressure was measured in 6 different body positions in the two-hour intervals using standard manometer, immediately before, immediately after, 15 minutes and 2 hours after the change positions. Data was analyzed using Chi-square, t and Bonferroni tests. Findings: The mean of endotracheal cuff pressure in the left and right lateral position with an angle of 30 degrees and head to the body (Respectively 31.5±0.68 and 34.1±0.68 cmH2o) and also the left and right lateral and a 45-degree angle to the body at the end of the period of 15 minutes and 2 hours after change positions was higher than the normal range (Respectively 31.9±0.92 and 30.4±1.5 cmH2o). In all cases, the mean of pressure differences were statistically significant (p<0.001) Conclusion: According to the unnatural changes in endotracheal tube cuff pressure due to body change positions, it is suggested that after changing position of the patient, measure the cuff pressure and correct it if it’s necessary. Keywords: Head Injury, Mechanical Ventilation, Body Position, Endotracheal Tube Cuff Pressur

Effect of Silybum marianum methanolic extract on nutritional indices, crustacean cardioactive peptide, α-amylase and protease activities of Helicoverpa armigera (Lep.: Noctuidae)

The efficacy of milk thistle, Silybum  marianum methanolic extract was investigated on the third instar larvae of cotton bollworm, Helicoverpa armigera (Hübner). The experiments were done at 25±1 °C, 65±5 RH and photoperiod of 16:8 (L: D) h. The LC50 and LC20 values were estimated 10449 and 5654 ppm, respectively. One hundred microliters of the plant extract at 5654 ppm was added to 0.9 grs of artificial diet. Nutritional indices, crustacean cardioactive peptide (CCAP) content and digestive enzymatic (α-amylase and protease) activities were measured after 72 h. Plant extract decreased nutritional indices including approximate digestibility (AD), relative growth rate (RGR), relative consumption rate (RCR), efficiency of conversion of ingested food (ECI) and efficiency of digested food (ECD). Methanolic extract of S. marianum decreased α-amylase and protease activities in the midgut of H. armigera. The activity of α-amylase from 194 mU in control decreased to 86.8 mU in treatment. It also decreased protease activity from 108.2 mU in control to 60.6 mU in treatment. Incubation of dissected midgut with CCAP increased α-amylase and protease activities in H. armigera whereas the buffer alone had no effect. Feeding on artificial diet containing methanolic extract of S. marianum caused CCAP level in the midgut of the insect to decrease. Feeding on artificial diet containing methanolic extract of  S. marianum inhibits release of CCAP in the midgut and leads to reduction of α-amylase and protease activities

Evaluation of relationship between reproductive health literacy and demographic factors in women

Background and objective: Introduction: Health literacy is the ability of people to acquire, understand and use health information that is necessary to decide on this field.  Since, reproductive health literacy promotion is known as one of the strategies to meet reproductive health goals in different groups of women. This study aimed to evaluate the relationship between reproductive health literacy and demographic factors in women of Isfahan city. Methods:This study was a descriptive-analytic research that was evaluated women's reproductive health literacy and its related factors in Isfahan using the questionnaire of health literacy scale for women of reproductive age. Sampling method was easy and 235 women were enrolled in the study. Data analysis was performed using the software SPSS20. Results: The average age of these women was 27/8 ± 11/01 years, most were high school graduates and married. The reproductive health literacy score was desirable in 91% of women and two variables of marital status and age had correlation with reproductive health literacy scores. Conclusion: The results showed marital status and age were two related factors to women's reproductive health literacy level. Accordingly, the reproductive health literacy scores of women younger than 25 years old and unmarried women were lower than other groups. Paper Type:Research Article

Women's Needs on Bed Rest during High-risk pregnancy and Postpartum Period: A Qualitative Study

Background & aim: pregnancy is a normal part of life, however, high-risk pregnancy that need bed rest can be stressful and affect woman and her family. Therefore, understanding the needs of women on bed rest seems to be necessary to enhance the quality of care services. The present study was conducted to investigate the women's needs on bed rest during high-risk pregnancy and postpartum period. Methods: This qualitative study was performed among women with high-risk pregnancy using purposeful sampling method. Data were collected by conducting 31 semi-structured interviews with 21 pregnant women, 10 spouses, and 7 medical staff involved in their healthcare. Data analysis was carried out using conventional content analysis developed by Hsieh and Shannon. Results: According to the results, there were four main categories of needs entailing the need for psychosocial support, support for family and personal affairs, support for looking after children, and the need for economic support. The final category was the need for comprehensive support. Conclusion: The personal and family life of pregnant women is affected during bed rest. Accordingly, comprehensive support is needed to enable women to cope with these problems. To reach this goal, the provision of family-centered support services based on coordination among health sections, supporting organizations, charities, social workers, and systems providing psychological and consultation services are recommended

A novel pathogenic variant in an Iranian Ataxia telangiectasia family revealed by next-generation sequencing followed by in silico analysis

Ataxia telangiectasia (A-T) is a neurodegenerative autosomal recessive disorder with the main characteristics of progressive cerebellar degeneration, sensitivity to ionizing radiation, immunodeficiency, telangiectasia, premature aging, recurrent sinopulmonary infections, and increased risk of malignancy, especially of lymphoid origin. Ataxia Telangiectasia Mutated gene, ATM, as a causative gene for the A-T disorder, encodes the ATM protein, which plays an important role in the activation of cell-cycle checkpoints and initiation of DNA repair in response to DNA damage. Targeted next-generation sequencing (NGS) was performed on an Iranian 5-year-old boy presented with truncal and limb ataxia, telangiectasia of the eye, Hodgkin lymphoma, hyper pigmentation, total alopecia, hepatomegaly, and dysarthria. Sanger sequencing was used to confirm the candidate pathogenic variants. Computational docicing was done using the HEX software to examine how this change affects the interactions of ATM with the upstream and downstream proteins. Three different variants were identified comprising two homozygous SNPs and one novel homozygous frameshift variant (c.80468047delTA, p.Thr2682ThrfsX5), which creates a stop codon in exon 57 leaving the protein truncated at its C-terminal portion. Therefore, the activation and phosphorylation of target proteins are lost. Moreover, the HEX software confirmed that the mutated protein lost its interaction with upstream and downstream proteins. The variant was classified as pathogenic based on the American College of Medical Genetics and Genomics guideline. This study expands the spectrum of ATM pathogenic variants in Iran and demonstrates the utility of targeted NGS in genetic diagnostics. (C) 2017 Published by Elsevier B.V