Letter to Editor: Tokophobia in Iranian women during the COVID-19 pandemic

This is a Letter to the Editor and does not have an abstract. Please download the PDF or view the article HTML

Drug Calculation Cards and Medication Errors in the Neonatal Intensive Care Units

Introduction: Medication administration errors are the most common medication errors. One of the most important causes of medication administration errors is a mistake in calculating the dose of medication by nurses. This study was conducted to evaluate the effects of using the Drug Calculation Cards on the amount and type of medication administration errors in the Neonatal Intensive Care Units (NICUs). Methods: This quasi-experimental study was conducted with one-group before-after design to examine the effects of using the Drug Calculation Cards on the amount and type of medication administration errors. Eligible NICU nurses in selected centers affiliated to Qazvin University of Medical Sciences were registered (n = 33) in the study within three months. Then, before intervention data were collected using “medication administration errors reporting” questionnaire. Three months later the intervention (drug calculation card) was done and the same medication administration errors reporting questionnaire was dispersed. The data were entered to the SPSS version 14 and was analyzed using descriptive statistics. Results: The mean medication administration error during the three months before and three months after the intervention were 12.41 ± 14.48 and 9.62 ± 12.72, respectively, which had a statistically significant difference (P = 0.004). Conclusions: Using the Drug Calculation Cards by nurses i

Creatinine Phosphokinase (CPK) Elevation in the Coexistence of Wilson's Disease and Autoimmune Hepatitis with Atypical Presentation: A Diagnostic Dilemma

Background: Wilson's disease (WD) is a genetic disorder with various clinical presentations due to excessive accumulation of copper in the liver and other organs. It can present as acute/chronic hepatitis, liver failure, extrahepatic and neuromuscular manifestations. Autoimmune hepatitis (AIH) is a necroinflammatory disease of the liver, which affects a lot of people particularly the children population. AIH has a broad clinical presentation that is similar to WD. Coexistence of WD with elevated creatinine phosphokinase (CPK) and AIH, may be a diagnostic dilemma. Case Report: We presented a 6 years old boy with dysarthria, aggressive behavior, weak attention, concentration and weight loss with abnormal physical examination. Laboratory, histochemical, genomic studies, muscle/liver biopsy and atomic absorption test confirmed the diagnosis of both WD and AIH in the boy. Conclusion Although CPK and liver enzyme elevation is a rare presentation of chronic hepatitis with dominant feature of WD and AIH; however, simultaneous therapy with immunosuppressive drugs and Penicillamine may have superior benefit with a significant response

Evaluation of Clarithromycin and Metronidazole Resistance of Helicobacter Pylori Infection in Symptomatic Iranian Children

Helicobacter Pylori (H. pylori) as a gram-negative bacterium is the most common infection of the gastrointestinal tract, and worldwide it affects the children over three years of age. H. pylori could cause gastrointestinal and extra-intestinal manifestations. Antibiotic resistance can happen primarily and occurs during treatment. We aimed to evaluate the resistance gene of H. pylori obtained from gastric biopsy by polymerase chain reaction (PCR) method in Iranian children over 3 years old. Materials and Methods This study was a cross-sectional to evaluate the resistance gene of H. pylori obtained from gastric biopsy by polymerase chain reaction method for metronidazole and clarithromycin in children over three years old referring to the Mofid Children's Medical Center in Tehran, Iran. Results: Finally, data from seventy-nine samples included (mean age=10.7 years and male gender = 60.8%). Beta Globulin (BG) gene were detectable in 75 (94.93%) specimens of 79 (100%). Seventeen out of 75 specimens showed positive results for molecular detection of H. pylori. The results of RFLP-PCR technique showed that mutation of RdxA gene in seven of 17 (41.1%) for Metronidazole resistance and one case of 17 (5.8%) mutation of 23Y RNA gene that leads to clarithromycin resistance. Conclusion: Regarding the results of our study, it is better to check microbial resistance by culture and antibiogram for the antibiotic regimen of the first and second line of H. pylori treatment in children

Letter to Editor: Tokophobia in Iranian Women During the COVID-19 Pandemic

This is a Letter to the Editor and does not have an abstract. Please download the PDF or view the article HTML

Clinical Assessment of Nursing Care Regarding Prevention of Ventilator-associated Pneumonia in Neonates

Background: Ventilator-associated pneumonia (VAP) is the second common nosocomial infection in NICUs leading to some complications. Nurses are one of the main resources in health care that directly influence neonatal health care. Responsibility of most of preventive strategies related to VAP complications lies with nurses; therefore, nursing care should be assessed until the nurses show standard level of performance in hospitals. The aim of this cross-sectional study, conducted within 2015-2016, was to assess nursing care regarding VAP prevention in neonatal intensive care units (NICUs) in selected hospitals affiliated to Shahid Beheshti University of Medical Sciences.Methods: In this descriptive cross-sectional study, 100 observations of nursing care regarding VAP were selected by convenience method in NICUs of Mahdiyeh, Mofid, and Imam Hossein hospitals affiliated to Shahid Beheshti University of Medical Sciences within 2015-2016. The data collection tools included demographic information questionnaire and a developed checklist related to VAP prevention. The observations were assessed and documented with two sampling methods, including time and event sampling. The data were analyzed in SPSS software (version 16).Results: According to the results of the current study, the rate of compliance of nursing care with the standards for prevention of VAP in neonates under mechanical ventilation in NICU with developed standards was estimated at 62.81 percent.Conclusion: Authorities should pay more attention to nursing cares especially incompetent cares explained in this study to increase the health of hospitalized neonates, decrease complications, length of stay, and costs. Moreover, future research is needed to investigate the reasons of this incompetency

Evaluation of Psychometric Properties of NutriCHEQ in Iranian Toddlers.

BackgroundAlthough poor dietary habits have a great effect on the health status of children, especially in toddlers, a few questionnaires exist for the assessment of dietary imbalances. This study aims to assess the validity and reliability of the NutriCHEQ in Iranian healthy toddlers.MethodsIn this cross-sectional study, first, the NutriCHEQ was translated to Persian and culturally adapted by the forward-backward translation technique. In order to assess the face validity, we used a cognitive interviewing technique of 25 parents/caretakers of healthy toddlers. In the next step, experts assessed content validity, respectively. One item was removed during the content validity process. Then, a blueprint of NutriCHEQ was distributed among 156 parents/caretakers of healthy toddlers in different focal points in Tehran for assessing construct validity by nonlinear principal components analysis. In addition, the anthropometric indices checklist and Food Frequency Questionnaire (FFQ) were filled out for toddlers. Then, construct validity was assessed. The Varimax rotation ran for two sections separately. The four-factor structure was confirmed.ResultsThe model showed a good fit, and all the extracted variance of four factors were satisfactory (F1 = 20.77; F2 = 22.30; F3 = 14.75; and F4 = 13.71). All of the extracted items of the NutriCHEQ in two parts showed 71.53% cumulative variance. For criterion-related validity, there was a statistically significant positive correlation between the NutriCHEQ and Z-score (rho = 0.632, P < 0.001). The Bland-Altman result indicates 95% limits of agreement between the NutriCHEQ questionnaire and Z-score.ConclusionsTherefore, we concluded that NutriCHEQ is a valid, reliable, and convenient instrument to identify the Iranian toddlers' nutritional status. Therefore, it can be used for research and clinical settings

Diagnostic challenges in the early onset of inflammatory bowel disease: A case report

Inflammatory bowel disease (IBD) with very early onset manifestations (younger than six years of age) is an essential pediatric gastrointestinal disease that encompasses a group of diverse and rare genetic defects. It may be associated with chronicity, premalignant nature, and high morbidity and mortality during childhood. Because of overlapping phenotypes, the definitive diagnosis based on conventional strategies is frequently a challenge. However, many patients with different molecular pathologies are treated with the same therapeutic strategy. In this context, it is essential to define a more reliable method to provide an opportunity for a rapid and accurate diagnosis. Here we report a novel homozygous exonic variant in a patient with an IBD-like lesion in the colon during the infancy period. A 7 months old boy who was born of a consanguineous marriage developed gastrointestinal disorders early in life. After complete diagnostic workups, this case underwent conventional therapy of IBD for five months; but clinical remission was not achieved. We identified a novel homozygous mutation (c.684C > T p(=)) in exon 7 of IL-12RB1 gene that in silico studies indicated its significance in the splicing process. At the 14th month of age, this case died. Our finding reveals the importance of genetic screening as an early diagnostic tool in the identification of the underlying causes of IBD with very early onset manifestations, particularly infantile ( < 2 years of age) IBD. This strategy makes an opportunity in prompt diagnosis and targeted therapy