Effect of Multi-sensory Stimulation on Neuromuscular Development of Premature Infants

Background: preterm birth is considered as a risk factor for developmental disabilities, which can lead to long-term effects on the nervous system of children.Objectives: The aim of this study was to determine the effect of multi-sensory stimulation on neurodevelopment of premature infants.Materials & Methods: In this two-group double-blind clinical trial conducted from June to August 2016 in Iran, 80 preterm infants were randomly divided into two groups. The Intervention group received multisensory stimulation for 12 min per session, 5 sessions per wk along with routine NICU care the control group received ward's routine care. Neuromuscular Maturity each infant was assessed by New Ballard Score.Results: The intervention group showed higher Neuromuscular Maturity compared to the control group. The Posture, Arm Recoil, Popliteal angle and Heel to ear were statistically significant between the groups.Conclusions: The results shows that Multi-sensory stimulation can have beneficial effects on the development of neuromuscular in premature infants.Keyword: Multisensory stimulation. Neurodevelopmen. premature infant

Clinicopathological Study of 307 Patients with Lichen Planus Actinicus and Pigmentosus Referred to Razi Skin Hospital from 2016 to 2021

Introduction: The two less-known subtypes of lichen planus (LP) are lichen planus actinicus (LPA) and lichen planus pigmentosus (LPP), with the highest prevalence in the Middle East. Objectives: We aimed to evaluate the clinicopathological profile of these patients. Methods: 307 cases including 184 LPA and 123 LPP patients were recruited from the registered pathology reports of Razi Skin Hospital of Tehran from April 2016 to March 2021. The clinical features and pathological reports were extracted and analyzed. Results: Among 307 patients, 117 (63.9%) in the LPA group and 88 (71.5%) in the LPP group were women. Duration of disease ranged from 1 month to 20 years and 1 month to 12 years in the LPA and LPP groups, respectively. Face (159 patients), limbs (68), and neck (23) were the most frequent sites of involvement in LPA patients, whereas face (60 patients), limbs (47), and trunk (42) were more commonly involved in the LPP patients. Pruritus and oral mucosal lesions were found with similar frequency in both groups. Pathological evaluation showed vacuolar degeneration of basal layer (100%), lymphocytes infiltration (97.3%), and melanin incontinence (58.2%) as the most frequent findings in LPA and vacuolar degeneration of basal layer (100%), lymphocytes infiltration (100%), and melanin incontinence (52/8%) as the most frequent findings in LPP cases.Conclusion: LPA and LPP were both more prevalent among women.  Face was the most common site of involvement in both LPA and LPP. Vacuolar degeneration, lymphocyte infiltration, melanin incontinence, and hyperkeratosis were more common histological findings in this study

Clinicoepidemiological Features of 82 Cases of Bullous Pemphigoid in Tehran, Iran

Bullous Pemphigoid is a chronic immunobullous disease, characterized by subepidermal bulla on the skin and mucosa. The purpose of the present study was to investigate the clinicoepidemiological features of bullous pemphigoid in Iranian patients. In this retrospective descriptive study, we reviewed 82 bullous pemphigoid patients within 2014-2016. The mean age of the patients was 67.13 years (range between 25 and 97) including 32(39.1%) males and 50(60.9%) females. Mucosal involvement was positive in 33(40.2%) of the patients, and oral mucosa was most commonly involved. Head and neck area were involved in 43 (52.4%) of the patients. Clinical and epidemiological characteristics of bullous pemphigoid are different in different regions of the world

Leikkauspotilaan lämpötilan ylläpitäminen leikkausosastolla

Opinnäytetyön tarkoituksena oli kartoittaa leikkauspotilaan lämpötilan ylläpitämistä ja laatia sairaanhoitajaopiskelijoille oppimateriaalin. Tavoitteena oli edistää oppimateriaalin kautta sairaanhoitajaopiskelijoiden tietoutta ja osaamista leikkauspotilaan lämpötilan ylläpitämisen keinoista ja tärkeydestä. Opinnäytetyöllä haettiin vastauksia hypotermian ja hypertemian syihin ja seurauksiin sekä myös lämpötilan mittaamismenetelmiin ja lämpötilan ylläpitämiskeinoihin. Opinnäytetyö toteutettiin kirjallisuuskatsauksena (n=30) ja aineistoa on analysoitu sisällön analyysiä käyttäen. Opinnäytetyön tulososiosta laadittiin PowerPoint- tietopaketti ja siihen liittyen tietotestin sairaanhoitajaopiskelijoille, jotta he voivat testata omaa osaamistaan. Opinnäytetyön toimeksiantajana toimii Turun ammattikorkeakoulu. Merkittävimmistä hypotermian aiheuttajista ovat yleisanestesia ja laajat puudutukset. Näiden lisäksi hypotermian riskiä lisää muun muassa sukupuoli, ikä, leikkauksen kesto, verenvuoto, suonensisäisesti annettavien nesteiden määrä ja lämpötila sekä potilaan laaja-alainen paljastaminen. Hypotermia lisää leikkaushaavainfektion ja sydäntapahtumien riskiä, vaikuttaa munuaisten toimintaan negatiivisesti, nostaa potilaan tarvetta verensiirrolle, aiheuttaa postoperatiivista lihasvärinää ja pidentää sairaalassaoloa lisäten sairaalakustannuksia. Hypertermian aiheuttajina ovat mikrobit, ei-infektiiviset sairaudet ja voimakas fyysinen rasitus. Se hidastaa sydämen minuuttitilavuutta, lisää hapenkulutusta ja nostaa seerumi laktaattipitoisuutta. Tässä työssä ei ole käsitelty maligni eli pahanlaatuista hypertermiaa. Lämpötilaa voidaan mitata leikkauspotilailta keuhkovaltimokatetrin avulla, virtsarakkokatetrin avulla, peräaukon, kainalon, suunontelon, korvan ja otsan kautta. Potilaan lämpötilaa voidaan ylläpitää sekä passiivisilla että aktiivisilla lämmittämismenetelmillä. Passiivisia menetelmiä ovat puuvillapeitto, avaruuslakana, leikkausliinat ja ympäristön lämpötilan nostaminen. Aktiivisia menetelmiä taas ovat erilaiset lämpöpuhallinpeitteet, lämpöpatjat, itselämpiävät peitot ja suonensisäisesti annettavien nesteiden lämmitys. Tehokkain tapa ylläpitää potilaan lämpöä on käyttää useaa lämmitysmenetelmää samanaikaisesti sekä suosia myös esilämmitystä.The purpose of this thesis was to map out surgical patient body temperature maintenance and to create a learning material for nursing students. The aim of this thesis was to improve nursing students knowledge on the importance and ways of maintaining body temperature of surgical patient through learning material. In this thesis answers were find out on the causes and effects of hypothermia and hyperthermia, as well as methods for measuring and maintaining temperature. This thesis was carried out using the literature review method (n=30) and the materials were analyzed using content analysis. From the result of the thesis PowerPoint learning material and with-it knowledge test were created for nursing student so that they could test their owns skills. This thesis was commissioned by Turku University of Applied Sciences. One of the most significant causes of hypothermia is general anesthesia and partial anesthesia. In addition to this the risk of hypothermia is increased by gender, age, duration of surgery, bleeding, volume and temperature of intravenous fluids and extensive of patient exposure. Hypothermia increases the risk of surgical wound infection and cardiac problems, affects negatively on renal function, increases the patient need for blood transfusion, causes post-operative muscles tremors and prolong hospital stays which increases hospital costs. Hyperthermia is caused by microbes, non-infectious diseases and intense physical exertion. It slows cardiac output, increases oxygen consumption and raises serum lactate levels. In this thesis malignant hyperthermia was not included. Core temperature is measured in surgical patient using a pulmonary artery catheter, a bladder catheter, through the rectum, axillary, oral, ear and forehead. The patient temperature can be maintained by both passive and active warming methods. Passive methods include cotton blankets, space blankets, surgical drapes and by raising the ambient temperature. Active methods include various forced air warming blankets, warming mattresses, self-warming blankets, and by warming intravenous fluids. The most effective way to warm surgical patient is by using several heating methods at the same time. Prewarming is also preferred

Developing a Conceptual Model of Green Supply Chain Antecedents and Consequences using Qualitative Qualification Approach

The purpose of this study is to develop a conceptual model and classify the antecedents and consequences of the green supply chain in the parts industry. The study method is qualitative content analysis and the main tool for data collection is semi-structured interviews. Data analysis was performed using a combination of directional and summary content analysis techniques. The identified factors include 29 open codes that were inserted in the form of seven main categories and at the end, using Max Kyoda software, classification and conceptual model were drawn. Reliability using kappa coefficient was equal to 0.960, which is at the level of excellent agreement. The results show that the 7 components identified in the antecedents and consequences of the green supply chain in the component manufacturing industry include; Supplier and green purchase, green design and packaging, green production, green distribution and marketing, environmental management, education and research, reverse logistics. The components of education and research and reverse logistics have emerged as new components in this research. Today, in a competitive environment, global organizations have realized that improving environmental performance can set them apart from their competitor

Psoriasiform mycosis fungoides: a rare form of the disease with review of the literature

Background: Mycosis fungoides (MF) typically presents as erythematous scaly patches or plaques that may progress to cutaneous tumors. Although MF may be presented like other dermatoses, initial presentation as psoriasiform plaques simulating psoriasis is rare. Differentiating MF from psoriasis is important because systemic therapies used for psoriasis can worsen MF. We describe a case of psoriasiform MF and we also review the clinicopathological features of similar cases in the literature.Case: A 46-year-old woman was referred to our clinic with a history of psoriasiform plaques for 13 years. She had multiple, generalized, indurated plaques with thick psoriasiform scales that were unresponsive to topical treatments. The histopathology showed marked psoriasiform epidermal hyperplasia with epidermotropic atypical lymphocytes compatible with MF. Immunohistochemical (IHC) staining showed that atypical lymphocytes were positive for CD3, CD4, CD8, and CD5. Of note, upper dermal and intraepidermal large atypical lymphocytes were CD30 positive. The review of similar psoriasiform MF cases revealed that they had all been treated as psoriasis for many years and finally diagnosed as MF especially after deterioration induced by immunosuppressive therapies.Conclusions: In presumed cases of psoriasis that are unresponsive to treatment, progressive, or ulcerative, biopsy should be considered to rule out MF, particularly before starting a potent immunosuppressive agent

Psoriasiform mycosis fungoides: a rare form of the disease with review of the literature

Background: Mycosis fungoides (MF) typically presents as erythematous scaly patches or plaques that may progress to cutaneous tumors. Although MF may be presented like other dermatoses, initial presentation as psoriasiform plaques simulating psoriasis is rare. Differentiating MF from psoriasis is important because systemic therapies used for psoriasis can worsen MF. We describe a case of psoriasiform MF and we also review the clinicopathological features of similar cases in the literature.Case: A 46-year-old woman was referred to our clinic with a history of psoriasiform plaques for 13 years. She had multiple, generalized, indurated plaques with thick psoriasiform scales that were unresponsive to topical treatments. The histopathology showed marked psoriasiform epidermal hyperplasia with epidermotropic atypical lymphocytes compatible with MF. Immunohistochemical (IHC) staining showed that atypical lymphocytes were positive for CD3, CD4, CD8, and CD5. Of note, upper dermal and intraepidermal large atypical lymphocytes were CD30 positive. The review of similar psoriasiform MF cases revealed that they had all been treated as psoriasis for many years and finally diagnosed as MF especially after deterioration induced by immunosuppressive therapies.Conclusions: In presumed cases of psoriasis that are unresponsive to treatment, progressive, or ulcerative, biopsy should be considered to rule out MF, particularly before starting a potent immunosuppressive agent

Illness perception of patients with pemphigus vulgaris

Objective: Little is known about illness perception in patients with pemphigus vulgaris (PV). We designed a cross-sectional study to clarify the beliefs about PV. Methods: A total of 100 patients with PV (45 men, 55 women) completed the Illness Perception Questionnaire-Revised to assess beliefs about seven aspects of illness perception, including chronicity, recurrence, consequences, self and medicine role in controlling illness, coherence, and emotional representation. The relationship between illness perception and clinical and demographic variables was evaluated. Results: Patients viewed PV as a chronic and cyclical disease with important impression on their life and emotions. Patients had a good understanding of the disease and supposed an acceptable role for themselves and medical treatment. Interestingly, the clinical subtype and severity of the disease did not influence any aspect of illness perception, but some differences on the basis of demographic data were demonstrated. Conclusion: Our patients had a relatively good understanding of their illness and a correct perception about chronicity and the cyclical identity of illness. The patients believed that their life and emotions had been strongly influenced by the disease but were hopeful for a cure. Because correction of misconceptions about a disease may improve treatment outcomes, an assessment of patients' illness perception may be useful to try and modify perception

Identification of a novel mutation in the ST14 gene in an Iranian family with ichthyosis and hypotrichosis

Inherited ichthyosis is a heterogeneous group of rare cutaneous disorders characterized by hyperkeratosis and scaly skin. So far, only a few genetic studies on ichthyosis have been performed in Iran. Herein, we reported a family with two cases of ichthyosis and hypotrichosis that were investigated by whole exome sequencing. Targeted data analysis identified a novel nonsense variant c.1243C>T (p.Gln415Ter) located at exon 11 of the ST14 gene in the proband. Sanger sequencing showed co-segregation of this mutation with the disease in this family. Further studies are needed to develop knowledge about the spectrum of changes in this gene and their effects on protein function and disease phenotype