Comparison of fractional excretion of sodium, uric acid and urea nitrogen in diagnosis of pediatric acute prerenal failure

Background and aim: various factors, in terms of faster diagnosis of acute renal failure have been studied so far, but these studies have been done mostly on adults. Therefore, in this paper we made a comparison of fractional excretion of sodium (FeNa), uric acid (FeUa) and urea nitrogen (FeU) in acute prerenal failure in children to find out which one is more sensitive in diagnosis of acute prerenal failure. Material and Methods: In a cross-sectional study, 5 CC blood was taken from 29 children of 1 month to 15 years old, diagnosed with acute pre-renal failure; the amount of creatinine, sodium, uric acid and urea nitrogen was measured in their plasma. After taking a standard urine specimen, all the mentioned items were measured in patients' urine and put into the formula of FeNa, FeUa and FeU and compared. Results: In this study, 75.8% FeU, 68.9% FeUa and 58.6% FeNa are agreeable to prerenal criteria and the most sensitivity is assigned to FeU. Among the three groups, FeNa is more affected by treatment with diuretic. The difference between FeNa in the receiver group of normal saline and the receiver group of diuretic is more than those groups which did not receive any. Conclusion: Fractional excretion of urea nitrogen in children, especially in the receivers of diuretic is more sensitive in diagnosis of acute prerenal failure. Moreover, this index is more sensitive in diagnosis of acute prerenal failure than the other indexes

Evaluation of Clinical Manifestations, Laboratory Findings and Outcome of Children with Covid-19

Background: Coronavirus, a common infectious disease in the 21st century, has not been studied enough in children. Therefore, this study aimed to investigate the clinical manifestations, laboratory findings, and outcomes of children with Covid-19 admitted to Shahid Beheshti Hospital in Kashan during 2020-2022. Method: In this retrospective cohort study, the medical records of children with covid-19 referred to Shahid Beheshti hospital in Kashan between February 2020 and March 2022 were reviewed. The information extracted from the patient's medical records included demographic variables, clinical characteristics, laboratory findings, and the outcome of covid-19. The collected data were analyzed through SPSS 16, using descriptive statistics (frequency distribution, mean and standard deviation) and inferential statistics (chi-square test and ANOVA). Result: The findings of 271 children (159 boys; 52% of the age group≤5 years) showed that fever (57.6%), cough (39.9%), nausea-vomiting (31.7%), and diarrhea were the most common clinical symptoms. Also, the majority of patients were in the abnormal range in terms of Monocyte (89.3%), PTT (84.7%), Lymphocyte (83.6%), Neutrophil (80.4%), and LDH (74.5%). Pulmonary involvement was present in 12.5% of children. Finally, four children (1.5%) died. Conclusion: Severity of lung involvement and the outcome of the covid-19 disease (admission to the ICU and death) among children were at a low level, and in fact, it shows the better condition of children than adults in relation to this disease

A randomized clinical trial on the effect of honey in the acute gastroenteritis

Acute gastroenteritis is one of the hygienic challenges of the 21st century and one of the 6 major causes of death in children and adults in developed and developing countries. With respect to prevalence of this illness in Iran, the purpose of this study is to investigate the effectiveness of honey in treating diarrhea in Kashan, Iran. In this randomized clinical trial study, the participants were chosen from the children who were admitted to pediatric clinics. 150 children who met the criteria were divided into 3 groups. After a systematic treatment process and writing down the details, the first group received honey added to ORS (dissolved in ORS), the second group received honey separate from ORS and the control group received ORS with no honey. All the patients were under the close watch of the researchers until complete recovery. Then the data were analyzed with statistical tests and SPSS18 software. In general, among the 150 children who were studied there were 80 boys with the average age of 33.19 months and 70 girls with the average age of 29.84 months. The average diarrhea period from the beginning of treatment until complete recovery was 4.68 days for the first group, 3.725 for the second group and 5.60 for the control group. Thus there was a significant difference between the groups that received honey and the control group (p=0.001). The average number of bowel movements from the beginning of treatment until complete recovery was 4.22 for the first group, 3.50 for the second group and 4.90 for the control group. There was a significant difference in this respect (p<0.001). Generally, with regard to the findings of this study prescription of honey for diarrhea can reduce the number of bowel movements and diarrhea period. Similar studies could be done about other diseases to further investigate the effectiveness of honey in treating other health problems, not necessarily as a substitute treatment, but a supplementary treatment

The relationship between the length of umbilical cord and neonatal outcomes

Maternal outcomes and prenatal outcomes depend on the mutual reactions between maternal and fetal and environmental factors. One of the influential cases in this field is the funis length. A descriptive analytic study was conducted on 300 pregnant women, who had been admitted in labor section. After placenta expulsion, the length of the funis, placental and birth weight were measured. Gestational age was determined according to maternal LMP and sonography of pregnancy. Meconial amniotic fluid was determined through labor examination in the amniotomy. The result revealed meaningful differences between neonatal height, placental and neonatal weight. No relationship was revealed between the length of funis and the sex of neonate, the situation of Amniotic fluid, and the first minute Apgar score. Considering the deficient that may be available in this study, it is recommended that a study be done in this fiend in other regions of the country and in other countries, in employed women, and in larger samples so that we can achieve comparative or new results in this regard

The effect of listening to Vaghe\'a Surah and its translation on the state and trait anxiety before general surgeries: a Randomized Controlled Clinical Trial

Background and Objectives: Patients experience moderate to high level of anxiety before general surgery. There are differences in studies on the effect of listening Quran to decrease anxiety in general surgery patients. The purpose of this study was to evaluate the effects of Vaghe'a Surah and its translation on the state - trait anxiety before general surgeries. Methods: In this randomized controlled trial study, 60 patients who met the inclusion criteria were randomly allocated to the experiment and control groups. In the experiment group, Fifth researcher read Vaghe'a Surah and its translation for patients during 30 minutes in one day before surgery, whereas in the control group, patients had 30 minutes of rest in bed. The level of anxiety was measured before and after intervention and 30 minutes before surgery in two groups and was analyzed using Chi-Square, t-tests and repeated measure ANOVA. Results: In the experimental group, mean scores of state anxiety decreased from 43.3&plusmn;3.1 to 29.8&plusmn;2.1 following intervention (p=0.03). However, mean scores did not significantly change in the control group (p=0.5). Conclusion: The findings of the study demonstrated that the listening to Vaghe'a Surah and its translation can reduce anxiety before surgery. &nbsp

Evaluating inappropriate patient stay and its reasons based on the appropriateness evaluation protocol

Background: Hospital beds are among valuable resources for care delivery. Therefore, optimum use of them is crucial for increasing the efficiency of health-care services and controlling health-care costs. Objective: This study intended to evaluate inappropriate patient stay (IPS) in hospital settings and its reasons based on the appropriateness evaluation protocol. Methods: This cross-sectional study was conducted on 335 patients hospitalized in a tertiary care university hospital. Data were gathered prospectively by 13 hospital nurses during a 6-month period. IPS rate was evaluated using a checklist, the 27 criteria of which were related to medical services, nursing/life support services, and patient's conditions. Moreover, a 12-item checklist was used to determine physician-, hospital-, and patient/family-related factors behind inappropriate hospital stay. Results: In total, 121 of 1925 (6.3) hospitalization days of 335 patients were determined to be inappropriate. Neurosurgery and gynecology wards had the highest and the lowest inappropriate hospital stay rates (22.5 vs. 0), respectively. The main reasons behind inappropriate hospital stay were hospital-related factors (33.1), physician-related factors (29.1), and patient-related factors (21.3). Conclusion: A wide variety of physician-, hospital-, and patient/family-related factors contribute to IPS. Given the multifactorial causes of IPS, reducing its rate necessitates multidisciplinary approaches

Evaluation of an auditory brainstem response in icteric neonates

Background: Neonatal hyperbilirubinemia is a common and preventable cause of sensory-neural hearing impairment, which can cause difficulties in the development of speech and communication. This study was conducted to detect the toxic effect of hyperbilirubinemia on the brain stem and auditory tract in neonates with icterus admitted to Shahid Beheshti Hospital in Kashan, Iran. Materials and Methods: This cross-sectional study was conducted on 98 neonates with increased indirect bilirubin admitted to Shahid Beheshti Hospital in Kashan during 2014-2015. The patients were referred to Matini Hospital for the assessment of the auditory brainstem response (ABR); wave latency and interpeak intervals of the waves were also evaluated. According to the serum bilirubin level, the neonates were allocated into two groups; one group had a serum bilirubin level of 13-20 mg/d and another group had a bilirubin level more than 20 mg/d. Results: From 98 neonates, 26 (26.5%) had a bilirubin level more than 20 mg/d and 72 (73.5%) had a bilirubin level of 13-20 mg/d. Also, 46.1% of the neonates in the first group (bilirubin< 20 mg/d) and 2.8% of the neonates in the second group (bilirubin 13-20 mg/d) had abnormal ABR (P<0.0001). There was a significant difference between the mean latency time of III and V waves and the interpeak intervals of I-III, I-V, and III-V waves in neonates of the two groups (P<0.05). Conclusion: An increased indirect bilirubin level (>20 mg/d) can cause an auditory processing disorder in neonates. So, performing ABR for screening and early detection of bilirubin toxicity can be recommended as a necessary audiologic intervention in all cases of severe neonatal hyperbilirubinemia