Frequency of Cutaneous Manifestations in Diabetic Patients in Endocrinology Clinic of Babol University of Medical Sciences

BACKGROUND AND OBJECTIVE: Diabetes is the most common endocrine disorder in the world. Understanding the cutaneous manifestations associated with diabetes can help in choosing the appropriate treatment approach in these patients. The aim of this study was to evaluate the frequency of cutaneous manifestations in diabetic patients referred to the endocrinology clinic of Babol University of Medical Sciences. METHODS: The present cross-sectional study was performed on 300 patients with diabetes referred to Rouhani Hospital in Babol in 2019. Age, gender, BMI, type and duration of diabetes, and patients’ diabetes control status (HbA1C) were recorded and patients were thoroughly examined by a dermatologist and divided into two groups of below and above 50 years. In terms of cutaneous manifestations, they were divided into two groups; with cutaneous manifestations and without cutaneous manifestations. FINDINGS: 293 patients (97.76%) had type 2 diabetes. The mean age of patients was 55±12 years and the mean duration of diabetes was 9.73±1.20 years. In this study, 130 patients (43%) had cutaneous lesions, of which 76 patients (58.5%) were female. Pruritus, acrochordon, cherry angioma, diabetic dermatopathy, fungal skin infections with frequencies of 25.7%, 21%, 14.3%, 6% and 5.7% were the most common skin disorders, respectively. 68 patients (69.4%) had skin manifestations and had diabetes for more than 10 years. There was a significant difference between the two groups of with and without cutaneous manifestations, gender and duration of diabetes (p<0.001). There was no significant difference between the mean age, BMI and HbA1C in the two groups (p=0.07, p=0.09 and p=0.11, respectively). CONCLUSION: The results of the study showed that pruritus and acrochordon are the most common cutaneous manifestations and long-term diabetes and female gender are the most important risk factors for cutaneous manifestations

Optimal and Robust Switching Control Strategies: Theory, and Applications in Traffic Management

Macroscopic modeling, predictive and robust control and route guidance for large-scale freeway and urban traffic networks are the main focus of this thesis. In order to increase the efficiency of our control strategies, we propose several mathematical and optimization techniques. Moreover, in the second part of the thesis, based on the hybrid nature of our traffic models, we develop robust switching control schemes for switched nonlinear systems and for our urban traffic control application.Delft Center for Systems and ControlMechanical, Maritime and Materials Engineerin

Maternal hematocrit status and pregnancy outcome

Background&Objective: The present study was designed to investigate the outcome of pregnancy and delivery in pregnant Iranian women with low and high hematocrit. Materials&Methods: In a cohort control study, 609 pregnant women attending Yahyanejad Hospital for antenatal care and delivery from Dec 2001 to Dec 2003 were randomly selected. Women with hemoglobinopathies such as thalassemia were excluded from the study. Maternal characteristics including hematocrit values were recorded at the first antenatal care and 3 cc.blood was sent to the laboratory for CBC. The main outcome measures included birth weight, gestation at delivery, Apgar scone, mode of delivery,the admitted NICU and perinatal death. X2, T-test, Anova and logistic regression models were also applied to analyze the data. Results: Anemia (hematocrit40%) did not increase the risk of low birth weight or preterm delivery. The risk of low Apgar score, operative deliveries and admitted NICU was significantly increased in women with high and low hematocrit adjusting for maternal age, parity, weight gain, inter pregnancy, father and mother education and other confounding factors. Conclusion: Low and high maternal hematocrit in the first trimester can contribute to the adverse pregnancy outcomes, thus pregnant women with abnormal hematocrit are at high risk factor and necessary awareness should be given to them on how to prevent complication and adverse outcome by special clinical care

Comparison of the Effect of Massage with Coconut Oil and Sunflower Oil on the Growth of Premature Infants

BACKGROUND AND OBJECTIVE: Prematurity and low birth weight are one of the major health problems and the most common causes of infant mortality. Infant massage is potentially beneficial for physiological and psychological health. The present study was conducted to compare the effect of massage with coconut oil and sunflower oil on the growth of premature infants. METHODS: This clinical trial was performed on 100 premature infants admitted to the neonatal intensive care unit of Amirkola Children's Hospital in 2018 in four groups of 25 infants. Infants of the intervention groups with one cc of sunflower oil and coconut oil and the oil-free massage group were massaged for 15 minutes three times a day for seven days with the help of a research assistant, and the control group received only routine care. The weight, height, and head circumference of infants were collected using a personal profile questionnaire and compared in four groups at the beginning and end of the intervention. FINDINGS: Comparison of mean weight and head circumference changes at the end of the first week between coconut oil massage group (0.134±0.334 cm, 6.81±3.04 g), sunflower oil massage group (0.239±1.172 cm, 6.35±2.69 g), oil-free massage group (1.061±1.534 cm, 2.95±2.65), and control group (0.663±1.174 cm, 3.52±4.38 g) showed significant difference (p<0.05). Comparison of mean height changes in different groups (0.413±0.739, 0.448±0.747, 0.458±0.693, 0.429±0.611 cm, respectively) did not show any significant difference. CONCLUSION: The results of the study showed that oil massage is recommended as it increases the rate of changes in weight gain and head circumference in premature infants

MHD Natural Convection and Entropy Generation of Variable Properties Nanofluid in a Triangular Enclosure

Natural convection heat transfer has many applications in different fields of industry; such as cooling industries, electronic transformer devices and ventilation equipment; due to simple process, economic advantage, low noise and renewed retrieval. Recently, heat transfer of nanofluids have been considered because of higher thermal conductivity coefficient compared with those of ordinary fluids. In this study; natural convection and entropy generation in a triangular enclosure filled by Al2O3 –water nanofluid affected by magnetic field considering Brownian motion is investigated numerically. Two inclined walls are maintained at constant cold temperature (Tc) while the bottom wall is kept at constant high temperature (Th) with (Th>Tc). In order to investigate natural convection, a computer program (FORTRAN language) based on finite volume method and SIMPLER algorithm has been used. Analyses is performed for volume fraction of nanoparticles 0, 0.02, 0.04, Hartmann number 0, 50,100, Rayleigh numbers 103,104,105 and angle of inclined walls 450. In investigated angles and Rayleigh numbers; average Nusselt number is increased by enhancement of volume fraction of nanoparticles in a fixed Hartmann number. It is also observed that total entropy generation variations by increasing volume fraction of nanoparticles is similar to that of Nusselt number. By the results; effect of friction is always insignificant on generated entropy. It is observed that natural convection of nanofluid is decreased by enhancement of Hartmann number and its behavior is close to thermal conduction. It is also concluded that average Nusselt number and total generated entropy are decreased

Barriers to Use of Non-pharmacological Pain Management Methods in Neonatal Intensive Care Unit

BACKGROUND AND OBJECTIVE: Many activities and interventions performed in neonatal intensive care unit (NICU) cause pain. Recurrent and untreated pain can lead to severe and harmful complications for neonates. Provision of pain management solutions is one of the duties of nurses. This study aimed to evaluate the barriers to use of non-pharmacological pain management methods in NICU from perspective of nurses. METHODS: This cross-sectional study was conducted on all nurses (N=57) working in NICU of hospital affiliated to Babol University of Medical Sciences, Babol, Iran selected by census method. Data were evaluated using a researcher-made questionnaire consisting of three parts and a three-point Likert scale. Barriers and suggested solutions were evaluated in the questionnaire, and the obtainable scores of the questionnaire related to the items of barriers and problems in application of non-pharmacological pain management methods and solutions were 17-51 and 12-36, respectively. FINDINGS: According to the opinions of nurses, the most important barriers to the application of non-pharmacological pain management methods were shortage of personnel in each work shift (2.0±54.6), shortage of time and heavy workload (2.0±40.6), unawareness of pain complications (2.0±40.6) and long working hours and fatigue (2.0±35.6), respectively. Among the most important strategies mentioned by nurses were regularizing non-pharmacological pain management methods (2.0±63.6), regular holding of training classes (2.0±58.5), using matrons as tutors (2.0±53.6) and increasing the number of nurses in each shift or each ward (2.0±44.5). CONCLUSION: According to the results of this study, inadequate nursing staff and insufficient knowledge about pain complications were the most important causes for lack of application of pain management methods for neonate

Improvement of Hypothermia Control and Management Methods in Term ‎Newborns after Training on Neonatal Hypothermia with the Help of Clinical ‎Audit

BACKGROUND AND OBJECTIVE: Maintenance of temperature at normal range by supplying heat and reducing its loss is an important part of neonatal care. This study aimed to investigate the effectiveness of in-service training for nurses on maintaining normal body temperature and eliminating heat stress and to compare the care practices to the current standards in term new-borns, before and after training on neonatal hypothermia care in hospitals affiliated to Babol University of Medical Sciences, in 2014. METHODS: This descriptive-intervention study was performed on 98 newborns to evaluate the nursing care provided for prevention of neonatal hypothermia in the operating rooms, maternity and neonatal wards, and NICUs before and one month after training on neonatal hypothermia care. The data were obtained using a self-regulated checklist, which was designed according to the relevant standards of care for prevention of hypothermia. The checklists were scored based on the number of provided nursing care practices. The intervention included speech, educational posters, leaflets, and slides. FINDINGS: The mean scores of nursing care before and after the intervention were 4.6&plusmn;1.1 and 7.0&plusmn;1.4 (out of 10), respectively, in the delivery rooms the respective mean sores were 8.4&plusmn;1.4, and 11.1&plusmn;0.7 (out of 13), for the operating rooms they were respectively 5.9&plusmn;1.8, and 7.3&plusmn;0.8 (out of 11), and in the NICUs they were 8.0&plusmn;1.5, and 9.8&plusmn;2.0, respectively (out of 14 p=0.0001). The prevalence of mild hypothermia at birth in the operating and delivery rooms was 38.1% and 21.5% before and after training, respectively. CONCLUSION: The highest level of care for the preservation of warm chain was provided in operating rooms and the lowest level of care was observed in delivery rooms. To prevent hyperthermia, health policy-makers are recommended to focus more attention on maintaining temperature in and providing facilities for this purpos

Assessment of Bone Density in Children 6 to 14 Years Old with Asthma Treated with Fluticasone

BACKGROUND AND OBJECTIVE: Corticosteroid therapy is one of the main treatments for asthma and considering the effects of corticosteroid on bone mineral density, the present study was conducted to analyze the bone mineral density in children with asthma treated with inhaled corticosteroids. METHODS: This cross-sectional study was conducted among 62 children 6 to 14 years old with moderate or severe asthma admitted to Amirkola Children's Hospital, whose disease have lasted for at least one year and were treated with inhaled corticosteroids. DEXA method was used to measure bone density using Hologic QDR4500 device. Based on this method, the lumbar spine and the femur neck was examined and Z-Score criteria was recorded for each patients. In addition to the above-mentioned information, the dosage, duration of consumption and duration of the disease was also recorded for each patients. FINDINGS: The mean age of children was 7.8 ± 2.1, among which 33 children (53.2%) were boys. The mean duration of asthma was 2.3 years and the mean forced expiratory volume in 1 second (FEV1) was 77.3±5.4% in patients. Osteopenia was observed in 5 patients (CI-95%=1–15, 8.1%). There was no significant difference between osteopenia and gender, duration of consumption and age. However, there was a significant difference between osteopenia and the dosage of the drug (p=0.007). CONCLUSION: Osteopenia was observed in a considerable percentage of children with asthma who were treated with fluticasone spray for more than one year, which was also affected by drug dosag