An Exploration of the Viewpoints of Parents and Nurses on Care Provision in Neonatal Intensive Care Units

Background: Infants are regarded as a vulnerable group in need of nursing care, particularly during NICU admission. Parents of these infants often experience emotional, psychological and physical upheavals. Therefore, nurses can be of great help to the parents and facilitate a healthy transition from this period. Improper communication with parents, who seek information on their infant's condition, intensifies their stress, fear and misunderstanding. In fact, inadequate communication with healthcare providers and lack of family support are major issues for the parents of NICU-admitted infants. Methods: In this qualitative study, via content analysis, we objectively selected and collected data from parents, physicians and nurses, residing in Isfahan, Iran in 2012. Data saturation was reached after conducting 25 in-depth, semi-structured interviews. Results: Based on the findings, five major categories were extracted: 1) care provision in NICUs; 2) diagnostic difficulties; 3) NICU admission process; 4) challenges of hospitalization; and 5) maintenance of infant viability. Conclusion: Nurses' proper response to parents' questions about the infant's condition reduced stress among parents. Based on the findings, training is essential to healthy family dynamics and infant's well-being, particularly for younger parents who support their infants at home. Also, regular updates on infant's condition could help reduce parents' stress and discomfort

The Iranian Parents of Premature Infants in NICU Experience Stigma of Shame

ntroduction: To explore experiences of Iranian parents with a hospitalized premature infant in Neonatal Intensive Care Unit (NICU) and examine socio-cultural factors associated with having a less than perfect infant. Methods: Purposely selected 21 participants in this study were 6 fathers, 7 mothers, 5 nurses and 3 physicians specialized in neonatology. Semi-structured in-depth interviews using inductive approach and content analysis helped obtain and analyze data by open encoding for classification and theme abstraction. Results: Findings revealed that parents of hospitalized NICU infants in Iran experienced: job and income loss; shattered confidence in parental role; challenges to family dynamics; shame as a social stigma; loss of control; overwhelmed with uncertainties; and stress induced physical and emotional problems. Conclusion: Unique and outstanding finding of this study was the social stigma of shame for parents of an NICU infant which directly explained the socio-cultural aspect of Iranian society where families place great importance on having a healthy and strong infant. Having a premature infant with anomalies is viewed as a family flaw. Physicians and nurses must focus more on communication with parents and fulfill an important role to educate, assure and comfort parents. Establishing support system for parents of NICU infants seem urgently needed to improve parentinfant bonding

The experiences of parents with infants in Neonatal Intensive Care Unit

Background: In recent years significant medical science advances have been made in the field midwifery and infant care. The premature, low birth weight and ill infants are admitted to the technologically advanced NICU for care and they often require long‑term stay. This study addresses parental experiences with the infant care in NICU, explores their concerns regarding nursing supports for parents and offers nurses’ perspectives on performing duties. Materials and Methods: A qualitative inductive content analysis method was applied in 2011 that included a purposely selected group of parents, nurses and physicians from neonatal unit at the Medical Science University of Isfahan. Participants were surveyed and interviewed according to the institutional ethics committee approval and signed informed consents. Results: The content analysis identified two main categories: 1) the definition of stress, which consisted of misgivings, nervous pressure, imbalance, separation and 2) the parents’ reaction to stress, which revealed emotional, psychotic and behavioral reactions as subcategories. Discussion: The medical team awareness of NICU parent experiences is essential to the quality of care. Recognizing the type of parents’ reaction to the whole process by the healthcare team seems essential to the optimum outcome

Hashimoto Encephalopathy with an Unusual Presentation of Status Epilepticus Seizures: A Case Report

A 33 yr old man, previously diagnosed with hypothyroidism, presented with decreased level of consciousness and generalized tonic-clonic (GTC) seizure to Namazi hospital, Shiraz, Iran, during April 2015. The patient later referred with another episode of seizure like attack for which he received phenytoin, carbamazepine and levothyroxine and was discharged. During his last admission, the patient was admitted with chief complaints of decreased consciousness and four GTC attacks. On admission, the patients had aphasia, ataxia, loss of verbal communication, eye contact and complete loss of obedience. Thyroid function tests showed low levels of T3 and T4 with high levels of thyroid stimulating hormone. Other blood tests were all either normal or slightly abnormal. Lumbar puncture and CSF analysis had a high titer of Anti-TPO antibodies. With high suspicion of Hashimoto encephalopathy, pulsed methyl prednisolone (10 mg) was administered, however the patient showed little improvement. Therefore, plasmaphresis was started, to which the patient showed dramatic response

32 CASES OF PSEUDOTUMOR CEREBRI IN TWO PEDIATRIC HOSPITALS OF TEHRAN, IRAN

Objective:Pseudotumor Cerbri (PTC) is a clinical syndrome characterized by increased Intra-Cranial Pressure (ICP) without any evidence of a mass lesion or any obstructive process. The incidence is 0.9-2 per 100.000 people. It is more frequent in adults in the 20-30 years age group, especially obese women, and less common in pediatric age groups; 11-16 years old children may however suffer from PTC, with no difference in the rates of occurrence in either sex.Material & Methods:In this descriptive retrospective study we reviewed the files of 32 children with diagnosis of PTC admitted during the past 15 years in the neurology ward of the Mofid Children's Hospital (25) and Ali Asghar Children Hospitals (7) between the years 1988 and 2003.Results:The results of this study revealed that children in the 5-10 years age group, girls in particular, are more vulnerable.Conclusion:The most frequent complaints that brought these patients to physician included headache, vomiting and strabismus. Common findings of neurological examination were papilledema, abducent nerve palsy and ataxic gait. While all cases recovered with medical treatment, one did need surgical intervention. Abbreviations; Pseudotumor Cerbri = PTC; Intra Cranial pressure = ICP.Keywords :PTC , papilledema , ICP

AC small signal modeling of PWM Y-source converter by circuit averaging and averaged switch modeling technique

© 2016 IEEE and EPE Association. Magnetically coupled Y-source impedance network is a newly proposed structure with versatile features intended for various power converter applications e.g. in the renewable energy technologies. The voltage gain of the Y-source impedance network rises exponentially as a function of turns ratio, which is inherited from a special coupled inductor with three windings. Due to the importance of modeling in the converter design procedure, this paper is dedicated to dc and ac small signal modeling of the PWM Y-source converter. The derived transfer functions are presented in detail and have been verified through simulation and experimental results

The effect of the various doses of atorvastatin on renal tubular cells; an experimental study

Recent retrospective observational studies suggest that high-potency statin therapy might increase the risk of acute kidney injury, however data on this subject is scares. Objectives: This study, was designed to investigate the renal tubular cell effect of different doses of atorvastatin to detect the possible aggravation of renal function or morphology of the kidney. Materials and Methods: In this experimental study 24 male Wistar rats were designated into 4 equal groups and treated as follows. Control group received phosphate buffer as the vehicle of atorvastatin for 7 days. Groups 1, II and III received atorvastatin at doses of 10, 50 and 150 mg/kg daily for 7 days, then on the day 8, all rats were anesthetized using ketamine and the blood samples were collected for evaluation of creatinine (Cr) and blood urea nitrogen (BUN) levels and then all rats were sacrificed, then the animals’ kidneys were dissected out and histopathological studies were performed Results: Mean (±SD) of scores of injury to renal tubular cells in control group was 4.2 ±2.2 and in groups I, II and III were 6.44 ± 4.9, 15.4± 8.5 and 25.8 ± 12.7 respectively. Group III which received 150 mg/kg/day of atorvastatin had significant renal damage in comparison to control group (P < 0.001). There was no significant difference of renal injury score between control group with groups of I and II. Conclusions: In the present study we found, atorvastatin with a dose of 150 mg/kg/day for 7 days was nephrotoxic for rats, while lower doses at 10 mg/kg/day or 50 mg/kg/day for 7 days were not accompanied by renal injury. These findings imply further attention to the administration of higher doses of atorvastatin in clinical conditions

The effect of occupational therapy on some aspects of quality of life in schizophrenic patients

چکیده: زمینه و هدف: بیماری اسکیزوفرنیا شدیدترین و مزمن شونده ترین بیماری روانپزشکی است که با اختلال در تواناییهای اجتماعی و شغلی همراه است. کار درمانی باعث افزایش اعتماد به نفس، خودسازی و تقویت رفتارهای کاری در بیمار می شود. این پژوهش با هدف تعیین تاثیر کاردرمانی بر ابعاد مختلف کیفیت زندگی بیماران اسکیزوفرنیک مزمن بستری در بیمارستان سینا انجام شده است. روش بررسی: این پژوهش یک مطالعه کار آزمایی بالینی است که ابتدا بیماران اسکیزوفرن مزمن بستری در بیمارستان سینای فارسان در استان چهارمحال و بختیاری بصورت سرشماری انتخاب و کیفیت زندگی آنان بوسیله پرسشنامه کیفیت زندگی بررسی و سپس بیماران بصورت تصادفی به دو گروه مورد (32 نفر) و شاهد (30 نفر) تقسیم گردیدند. کاردرمانی به مدت 20 ساعت در هفته در طی 6 ماه برای گروه مورد اجرا شد. بعد از اجرای کاردرمانی مجدداً کیفیت زندگی بیماران بررسی و اطلاعات با استفاده از آمار توصیفی و استنباطی (t مستقل) تجزیه و تحلیل شد. یافته ها: نتایج نشان داد در بدو مطالعه، تفاوت معنی داری بین میانگین نمره کیفیت زندگی گروه مورد و شاهد، وجود نداشت، بعد از مطالعه این تفاوت در حیطه انگیزه و انرژی و نمره کل کیفیت زندگی بین گروه مورد و شاهد معنی دار بود (001/0