The Impacts of Religious Tourism on Urban Sustainable Development Process; Zanjan City - Iran

This study with the goal of examining phenomena and positive features of Zanjan city that is recognized as one of religious cities as well one of tourism poles in Iran and its buildings are registered as in the world records and its relationship with sustainable development of the region has been analyzed. Research method in this research is descriptive-analytical and data gathering was done in forms of library and field (questionnaires, observation and interviews) gathering. The results obtained from the questionnaire shows that by analysis average number of tourism in the sample city based on single- sample t test showed high levels in all the disciplines of study that it shows religious tourism in aspects of social, economic, biology physical and environmental which by better planning and management of components in each aspects can lead to improved urban infrastructure development in the study region and in all aspects being impressible was positive and most of this impressible was in the economic dimension. On the other hand, using the Friedman test shows that the highest mean rank relates to environmental aspect and the lowest it relates to economic one

Health effects of air pollution in worldwide countries: an ecological study

Background and aims: Air pollution is one of the health problems worldwide. Previous epidemiological studies have investigated the impacts of air pollution on respiratory and cardiovascular diseases. The aim of this study was to determine the associations between air pollution levels and different health indicators among world countries. Methods: This ecological study was performed in 2013 by using dataset of World Health Organization (WHO). The main variable in our study was air pollution index. The data including Maternal Mortality Rate (MMR) (per 100000 live births), Life Expectancy at birth (LE), preterm birth rate (per 1000 live births) and Non-Communicable Diseases (NCD) death rate (per 100000 populations) from 91 countries were extracted. Pearson correlation coefficient was used to assess the linear correlation between air pollution and investigated indexes using Stata 11. Results: MMR (r=0.36, P=0.001) and NCD death rate (r=0.31, P=0.002) were positively associated with air pollution level. The rate of air pollution was also negatively associated with LE among world countries (r=-0.57, P=0.001). Our findings have not shown any significant liner association between air pollution and preterm birth rate (r=0.14, P=0.41). Conclusion: Our results are in agreement with other recent findings that there is an association between air pollution and health indexes, especially mortality rate. Accordingly, from a public health perspective, reducing pollutant emissions to outdoor air should be a high priority for all countries

Comparison of Endoscopic Balloon Dilation with Bougie Dilation in Children with Esophageal Atresia

Abstract Introduction: Esophageal stenosis is a complication that can occur following surgical treatment of esophageal atresia. Esophageal stenosis should be treated with some methods. One of these methods is using dilation and there are different devices for dilation. In this study we compared the outcome of the Balloon dilation and Bougie dilation for endoscopic treatment after esophageal atresia. material and methods: this is a cross-sectional study that was performed on 40 pediatrics in two groups including the Bougie group and the Balloon group with equal members. The balloon and bougie dilations were performed for patients and data of these procedures were collected and analyzed. Result: there were 20 pediatrics in both groups and the mean age of all of them was 21/33±12/46 months. All of stenosis symptoms were resolved by performing the bougie or the balloon dilation and these procedures were significantly effective but there was no difference about the balloon dilation or bougie dilation method. Conclusion: there is no difference between balloon and bougie dilation. Both of them can be use for esophageal stenosi

Comparison of Phototherapy Effect with and without Phenobarbital on the Newborns with Hyperbilirubinemia

ObjectivesJaundice occurs in 60% of full-term and 80% of pre-term newborns. This study compared the effect of phototherapy with and without phenobarbital on icteric newborns.Materials & MethodsThis study is a randomized clinical trial conducted from July until March 2018 at Imam Reza Hospital, Mashhad University of Medical Science, Iran. Full-term and near-term neonates with more than 2000 grams who were hospitalized in the mentioned period for jaundice were entered into the study. The newborns were divided into two groups using block randomization. Data were analyzed by SPSS version 19.ResultsThe average gestational age was 36.4 weeks (SD 2.39) in the intervention group and 36.9 weeks (SD 2.16) in the control group, with no significant difference between them. The mean hospital stay for the intervention group was 72 hours (SD 1.66), compared to 55 hours (SD 1.88) for the control group. At discharge, the serum bilirubin level in the intervention group was 11.53 mg/dL (SD 0.77), while it was 10.80 mg/dL (SD 1.09) in the control group, a statistically significant difference.ConclusionAccording to this study, phototherapy with phenobarbital is not more effective than phototherapy alone in neonatal hyperbilirubinemia.

Assessment of the Effect of Intravenous Pamidronate in the Treatment of Legg-Calve-Perthes Disease in Children

Background: Legg-Calvé-Perthes disease (LCPD) presents in childhood with idiopathic avascular necrosis of the femoral head(s), which can lead to disability and the need for corrective surgery at an early age. Bisphosphonates are a group of drugs that prevent osteoclastic bone resorption and may be helpful in the treatment of LCPD. So far, no trial has been conducted to investigate the effect of monthly intravenous pamidronate in the treatment of LCPD in children. Therefore, we assessed this issue in this study. Materials and Methods: This study was conducted as a clinical trial on children with LCPD who were referred to Mofid Children's Hospital (Iran-Tehran) during 2022 and 2023. Pamidronate was injected monthly and intravenously at a dose of 1 mg/kg/dose. Both groups were the same in terms of the type of treatment received (except pamidronate), the number of visits, and other follow-up parameters. The study was conducted for one year. The significance level was considered less than 0.05. Results: Forty-seven patients were included in the study. Twenty-one (60%) were in the pamidronate group, and 26 (40%) were in the control group. The mean age in the intervention group was 6.19 ± 1.69 years, and it was 6.15 ± 1.85 years in the control group (P-value=0.944). There was no statistically significant difference in children's gender (P-value = 0.731). Patients with pamidronate had a better overall score than the control group. The overall score in the pamidronate group was 2.37 more than the control group, but this difference was not statistically significant (P value=0.753). The scores of pain, lameness, walking, distance, squat, cross leg, and range of motion (ROM) in the pamidronate group were not significantly different from the control group (P value>0.05). Conclusion: Pamidronate can improve the clinical results of children with Legg-Calve-Perthes disease, and it is recommended that this drug be used along with the usual treatments for these patients

Anesthesia Depth Measurement with Bispectral Index Monitoring during Minor Surgery among Children With and Without Cerebral Palsy

Introduction: Unfortunately, few studies have been performed on the pharmacodynamic effects of anesthesia in children suffering cerebral palsy(CP).Patients were candidates for surgeryfor various reasons. Due to the lower need for anesthesiain these children, side effects of various anesthetic agents, adverse drug reactions, delayed awareness and higher costs can be prevented in these children. The present study aims to evaluate and compare the depth of anesthesia in minor surgeries using Bispectral Index (BSI) in children sufferingCP. Materials and Methods: This cohort study was performed on 64 children aged two to ten years in two groups with and without cerebral palsy inMofid Hospital, Tehran, Iran in 2020. BIS index, mean arterial blood pressure and heart rate were measured before and after anesthesia induction, every ten minutes during operation, after extubation and when being able to respond to verbal stimulation. Results: This studyexamined 64 patients equally divided into two study groups “with and without cerebral palsy”. The mean BIS level in children suffering CP was lower than children without cerebral palsy. The dosage of isoflurane gas used for anesthesia in CPpatientswas meaningfully lower than itsdosage in children without cerebral palsy. Conclusion: Monitoring of anesthesia in this study, showed that use of BIS could reduce the use of anesthetic agents and related side effects to provide the appropriate depth of anesthesia

Prophylactic Administration of Aminophylline to Prevent Renal Dysfunction in Asphyxiated Neonates

Background: Neonatal asphyxia is one of the most common neonatal problems. And kidney injuries are one of the most important complications of asphyxia in infants. Therefore, this study was designed to evaluate the effect of administering aminophylline on improving the renal function of asphyxiated preterm infants.Methods: In this single-blind randomized clinical trial, forty term neonates with perinatal asphyxia were randomized to intervention (n=21) and control (n=19) groups, respectively, receiving a intravenously single dose of aminophylline (5 mg/kg) or an equal volume of placebo (5% dextrose in water) during the first 3 hours of life. Daily urine output, 24-hour fluid intake, weight and serum creatinine were recorded during the first 5 days of life.Result: The incidence of severe kidney dysfunction was not significantly different between the two groups. (2 infants in the group of intervention with aminophylline and 3 in the control placebo group; p=0.23). Plasma creatinine (Pcr) levels were increased in both groups on the second day and reached the maximum in the third day. Then it gradually decreased during the fourth and fifth days of life. There was no significant difference in Pcr & GFR between the groups in these five days (p>0.05). However, urinary output/input ratio was higher in the aminophylline group in the first three days of life.Conclusion: Prophylactic administration of aminophylline in asphyxiated neonates could not change the process of renal failure in the patients but could increase urinary output in the first days of life

Comparison of the Effectiveness of Pharmacological and Non-Pharmacological Methods in Reducing the Pain of Retinopathy of Prematurity Examination

Background: Retinopathy of prematurity (ROP) is one of the common complications in premature neonates. ROP examination is one of the most important examinations for premature babies, which is associated with pain and can be very annoying. This study aimed to compare the effectiveness of pharmacological and non-pharmacological methods in reducing the pain of ROP examination. Materials and Methods: This study was conducted as a double-blind, randomized control trial on 300 ROP examinations of patients who were hospitalized in the NICU department of Mahdieh Hospital in Tehran. The neonates were randomly selected into three groups, and ketamine 2mg/kg nasally, fentanyl two µg/kg nasally10minutes before an examination, and acetaminophen 2drop/kg orally 30 minutes before each examination were given to each neonate as two pharmacological groups. In the non-pharmacological group, infants received saddling-pacifier oral sucrose 25% 0.5cc 2 minutes before examination. Pain was assessed based on PIPP (premature infant pain index). Results: The amount of pain after using oral sucrose was significantly lower than the ketamine-acetaminophen (P-value=0.011) and fentanyl-acetaminophen (P-value=0.027) groups, but there was not a statistically significant difference between the two groups of ketamine-acetaminophen and fentanyl-acetaminophen (P-value=0.953). The hypoxia was more prevalent in the ketamine-acetaminophen group (18.8%), and the least hypoxia occurred in the oral sucrose treatment group (7%) (P-value=0.028). Conclusion: It is concluded that the effect of non-pharmacological drugs is greater than pharmacological drugs in reducing the pain of neonates during ROP examination. The effect of oral sucrose in reducing pain was more significant than ketamine-acetaminophen and fentanyl-acetaminophen. However, there was no significant difference between the two groups of ketamine-acetaminophen and fentanyl-acetaminophen