Pitfalls in Interpreting Umbilical Cord Blood Gases and Lactate at Birth

Acid-base status in umbilical cord blood is an objective measure of the fetus’ exposure to and ability to handle hypoxia. The objective of this thesis was to clarify some of the methodological pitfalls in interpreting umbilical cord blood gases and lactate values at birth. Study I pinpoints the methodological confounding in calculating base deficit (BD) with algorithms used in different brands of blood gas analyzers and reports the consequences for diagnosing metabolic acidosis (MA) at birth. Neonatal MA rates cannot be compared between maternity units or between scientific articles where different fetal compartments (blood or extracellular fluid) and different algorithms for calculating BD have been used. Study II addresses the issue of possible diagnostic discrepancies when acid-base parameter value decimals are rounded off. A drift of a dichotomy parameter value cut-off due to decimal rounding will result in a shift in distribution of negative and positive cases in a population sample. The findings warrant a discussion on standardization of round-off rule and the number of decimals for a specific analyte result. Study III demonstrates that delayed cord blood sampling with intact pulsations affects umbilical acid-base values and hematological parameters in both vaginal and cesarean deliveries. The changes were more marked after vaginal delivery. A change towards acidemia and lactemia can be explained by the hidden acidosis phenomenon, i.e. a surge into the central circulation of peripherally trapped acid metabolites when the newborn starts to breathe. Study IV shows that clinical characteristics have a significant influence on the distribution of veno-arterial and arterio-venous gradients (Δ values) in umbilical cord blood. Validation criteria based on fixed ΔpH and ΔpCO2 values may then exclude correct samples of clinical outliers. Lactate cannot be used for validation of umbilical cord blood samples. A negative ΔpO2 value indicates delayed cord blood sampling or mix-up of samples and is the only certain validation criterion

Zeolite application to sea water for ammonia absorbtion and its effects on growth and survival of Penaeus indicus

We evaluated Zeolite efficiency in absorption of ammonia from sea water. Three phases including ammonia movement through Zeolite column, application of Zeolite powder and granule in closed containers filled with ammonia solution and dispersion of Zeolite in shrimp culture tanks were implemented in the study. For the first phase, ammonia solution in two concentrations (4.8 and 2.42mg/lit) and a water salinity of 42ppt (sea water) was passed through the Zeolite column (400g of granule Clinoptilolite) in three replications. Concentration of ammonia in outlet solution was between 0.2-5.4mg/lit in the first replication and 0.0 to 5.5, 0.0 to 2.6mg/lit in the 2nd and 3rd replication, respectively. At the second phase, volume and levels of ammonia concentration left in the closed jug of ammonia solution was different. The concentration of ammonia was measured at various time periods in four replications. The results showed that ion exchange in seawater is not a one way process, so that ammonia concentrations in the jugs with Zeolite fluctuated with time, contrary to its stable concentration in control treatments. At the third phase, Zeolite in granule and powder forms was added to culture tanks of shrimp juveniles (Penaeus indicus) weighting on average 0.2g each for 79 days of culture period and a stocking density of 16 individuals per square meter. Thus, we provided three treatments, using Zeolite granules, powder and one control. A Duncan's test of the growth and survival rate of the cultured shrimps showed no significant difference among the treatments (P>0.01)

The evaluation of occlusal relationship between the primary canines and primary molars in 3 to 5-year-old Iranian children

Aim: As to the assessment of occlusal status pertaining to primary canines and molars, the latter is less within reach as it is difficult to guide jaws towards a centric occlusion while maintaining a vintage point in both direct and indirect observation.  This study was originally intended to assess primary canine occlusion as a practical indicator in the evaluation of primary molar occlusion, which is otherwise less feasible in dental examination. Method and materials: A total of 281 healthy children (145 males and 136 females), with complete primary dentition and without erupted permanent teeth and serious caries were examined by a trained student of dentistry. Occlusal patterns of primary second molars were noted as flush terminal plane, distal step and mesial step and for primary canine as class I, class II and class III with regard to Angle’s classification. Results: Overall, Class II canine occlusion seemed to have coincided with more than half of the flush terminal molar occlusions (62%), whereas class I was largely associated with mesial step molars (61.2%). This was also found to be applied to cases undergoing unilateral assessment. (

Effects of Work-Related Stress on Work Ability Index among Iranian Workers

AbstractBackgroundWork Ability Index (WAI) is a well-known and valid self-report tool that has been widely used in various studies to identify and avoid early retirement and work-related disability. Nevertheless, very few studies have been carried out to evaluate work ability in Iran. We aimed to investigate the WAI and the effect of work-related stress on it among Iranian workers.MethodsA cross-sectional, descriptive and analytic study was carried out among 449 workers from five working sectors in three big cities of Iran. Work ability and work-related stress were measured using the Persian version of WAI and the Persian version of Health and Safety Executive Stress Indicator Tool.ResultsMore than a third of the workers surveyed (34.70%) did not have an appropriate level of work ability (WAI < 37). There was a significant correlation between subscales of work-related stress and the mean score of WAI. Furthermore, the variables of body mass index, sleep quality, exercise activity, job tenure, and three subscales of work-related stress including demands, supervisor support, and role were significant predictors of WAI.ConclusionAccording to the results of this study, the interventional programs must be focused on improving supervisors support, eliminating ambiguity and conflicts in the role of workers in their job and organization, reducing job demands, improving sleep quality, and increasing exercise activity

Understanding risk factors for musculoskeletal disorders in Iranian housewives: Development of a comprehensive health promotion behavior model

Background: Chronic musculoskeletal problems are a major source of disability, reduced productivity and poor quality of life. Prevalence of musculoskeletal disorders among Iranian housewives is particularly high. Understanding how housework causes the injuries, mobility restrictions and pain associated with musculoskeletal disorders is vital to developing health promotion behavior models to support intervention. The aim of this qualitative study was to explore the experiences of housewives with musculoskeletal disorders and, according to the risk factors identified, to develop a comprehensive behavior change framework to facilitate implementing a musculoskeletal health-promoting training intervention for women. Methods: Twenty-four in-depth interviews were conducted with Iranian housewives aged 20-65 years experiencing musculoskeletal pain over a 13-month period from September 2020 to October 2021. The conventional content analysis approach was used to interrogate the data. The transcript of each interview was considered a unit of analysis, and data analysis was performed using MAXQDA2018 software. Results: The analysis of the interview data provided 1432 meaning units. From these codes, a conceptual framework was developed. This comprehensive model is comprised of 24 subcategories, eight categories and three themes: Individual and social predictors of MSDs and their control, Risk factors for MSDs, and Prevention and treatment of MSDs. Altogether the developed conceptual framework specified the multiple risk factors for MSDs in housewives. The findings were aligned to various health promotion models, and it was seen that ecological models, especially the Theory of Triadic Influence, can be very helpful as a supportive roadmap to implementing multilateral interventions to improve the quality of life of housewives. Conclusions: This study developed an evidence based comprehensive model that identifies the individual, psychosocial, and cultural factors that influence the status of MSDs in women’s domestic work to support the development and implementation of effective ergonomic interventions to manage potentials for MSDs

Assessing the Ergonomic Status of Commonly Used Chairs in Iran’s Universities Based on Combinational Equations and Anthropometric Indices

BACKGROUND: Inappropriate design of chairs and disproportion with students’ body dimensions can influence their physical and mental health as well as their educational efficiency and concentration. OBJECTIVE: The aim of this study was to examine the ergonomic status of commonly used chairs in Iran’s universities using combinational equations and anthropometric indices. METHODS: Participants in this cross-sectional study were 166 students in Iran. Eleven anthropometric parameters of the students and nine dimensions in seven types of commonly used chairs in Iran’s universities were measured. Combinational equations were used to determine the fitness of the chairs. RESULTS: There was a major mismatch between most students’ anthropometric measurements and the dimensions of the chairs. Backrest height and seat height were the best and the worst features, respectively, according to ergonomic recommendations for chairs. The recommended measurements of seat height, seat depth, seat width, desk height, desk width, desk length, backrest width, backrest height, and desk distance were 332, 420, 436, 245, 95, 511, 426, 550, and 281 mm, respectively. CONCLUSION: None of the commonly used chairs in Iran’s universities were found to be a good fit to the students’ anthropometric dimensions. Therefore, in order to prevent inappropriate body postures, chairs designs have to reviewed, and made to fit with Iranian students’ anthropometric data. The recommended measurements obtained in this study can be used to design a suitable ergonomic chair to match with a high percentage of Iranian students

Study protocol for a randomized controlled trial to improve the quality of life of housewives with musculoskeletal disorders – a health promotion intervention based on a participatory ergonomic approach: the Housewives Ergonomic Intervention (HEI) trial

Background: A variety of household chores expose women to a variety of biomechanical and psychosocial risk factors. A result of this is many housewives with musculoskeletal disorders. Given the interactive effects of these risk factors, it is necessary to consider multiple strategies to mitigate their effects. Accordingly, the present study will investigate the impact of a health promotion training program based on a participatory ergonomic approach towards a reduction in the prevalence of musculoskeletal disorders and an improvement the quality of life of housewives. Methods: Iranian housewives aged 20-65 years currently attending a specialist health clinic due to a painful musculoskeletal complaint will be invited to join the study. Recruitment will continue until a sample of 160 women provide informed consent to participate. The study will be conducted using a mixed-methods protocol in two phases. In the first phase, psychosocial and biomechanical risk factors will be identified using a qualitative approach. In the next phase, the results from the qualitative approach will be used to develop a conceptual framework based on health promotion theories, and an intervention program based on a participatory ergonomic approach designed. Participants will be randomly allocated into one of four groups: (1) biomechanical intervention group, (2) psychosocial intervention group, (3) multidisciplinary intervention group (both biomechanical and psychosocial intervention), and (4) a control group. Data will be collected using Rapid Entire Body Assessment (REBA), Visual Analog Scale (VAS), Work Ability Score (WAS), Hospital Anxiety and Depression Scale (HADS) and the 36-item Short-Form health survey (SF-36) at baseline, and in 3-months and 6-months follow-up assessments. The impact of the three interventions on musculoskeletal disorders, work ability, stress, and quality of life will then be evaluated Discussion: The study will provide a practical approach to reducing stress, reducing musculoskeletal disorders, enhancing the ability to work, and improving the quality of life of women with musculoskeletal disorders associated with housework. If the designed interventions in the present study are effective, they will have great practical potential for generalization to all housewives