Causes of Trauma in Pregnant Women Referred to Shabih-Khani Maternity Hospital in Kashan

Background: Trauma occurs in 7% of pregnancies and is a major cause of morbidity and mortality in the mother and fetus. Objectives: The present study was conducted in Kashan in 2009–2010 to evaluate the causes of trauma in pregnancy. Patients and Methods: This descriptive study analyzed data from 32 pregnant women with trauma who were referred to the maternity hospital from 2009 to 2010. Data included age, gestational age, mother’s occupation, cause of trauma, maternal-fetal complications, gravidity, and parity. The diagnosis of maternal and fetal complications was based on clinical examinations by a gynecologist and results of blood tests, urine analysis tests, and sonography. Data were analyzed as frequency distributions. Results: the causes of trauma included falling (9 cases (28.1%)), abdominal trauma (8 cases ( 25%)), spousal feud (3 cases (9.4%)), motorcycle accident (2 cases (6.25%)), car accident (2 cases (6.25%)), falling from a motorcycle (2 cases (6.25%)), falling or fainting resulting in head trauma (1 case (3.1%)), pain from crossing over a bump in the car (1 cases (3.1%)), and unspecified causes (4 cases (12.55%)). The causes of traumas occurred between 5 and 40 weeks of gestation. In 17.2% of the cases, trauma occurred prior to 20 weeks of gestation. However, there was no significant relationship between the cause of trauma and maternal age or gestational age. Vaginal bleeding and retroplacental clots were reported in 2 (6.25%) cases and 1 (3.1%) case, respectively. Conclusions: Nearly half of the women presenting with trauma had experienced spousal feud or domestic violence; therefore, it is necessary to recognize spousal abuse and provide adequate support to traumatized pregnant women

Predictors of happiness among Iranian nurses

Abstract Objectives This study aimed to assess happiness and its predictors among a group of Iranian hospital nurses. Methods This cross-sectional study was done in 2016 on 620 hospital nurses who worked in five teaching hospitals affiliated to Kashan University of Medical Sciences, Kashan, Iran. Nurses were recruited through the census method. Data collection instruments were a researcher-made demographic and occupational characteristics questionnaire, the Oxford Happiness Inventory, and the Minnesota Job Satisfaction Questionnaire. Data analysis was done through stepwise multiple linear regression analysis. Results Among 620 recruited nurses, 422 returned their questionnaires completely filled. The mean of their happiness was 123.4 ± 18.4 in the possible score range of 29–174. The significant predictors of happiness were satisfaction with mental health, monthly salary, satisfaction with salary, quality of life, current hospital ward, the length of working in the current ward, work shift, age, job satisfaction, and satisfaction with physicians' conduct and performance. These variables explained 50.3% of the total variance of happiness. Satisfaction with mental health had the greatest proportion in explaining the variance of happiness. Conclusion Nurses in teaching hospitals in Kashan, Iran, have moderate happiness. Their happiness is affected by different factors, particularly by satisfaction with their mental health. Health policy-makers and authorities, in developing workforce-related plans and programs, need to pay special attention to nurses' happiness and its contributing factors. Keywords Happiness Iran Job satisfaction Mental health Nurses Personal satisfaction Surveys and questionnaire

Psychometric evaluation of Shah version of modified Barthel index in elderly people residing in Kashan Golabchi nursing home

Background: The rehabilitation interventions have an important role in the promotion of elderly health level especially who are residing in nursing homes. This study was designed to evaluate the reliability and validity of the Shah version of modified barthel index (MBI) in older people residing in Kashan Golabchi nursing home. Materials and Methods: The Shah version of MBI was translated from English to Persian through forward-backward translation method. Sampling was performed using census method in Kashan Golabchi nursing home during 2006-7 (n=100). The questionnaires were completed through interview, observation and inter-rater agreement coefficient was assessed. Reliability was determined via internal consistency and validity was determined via concurrent validity, exploratory factor analysis and known-groups approach. Results: Inter-rater reliability coefficient (Kappa) for every item was more than 0.6 Inter-rater reliability in the total MBI was 0.998. The questionnaire reliability coefficient (internal consistency) was 0.96-0.99 and item-total correlation confirmed its reliability too. Its concurrent validity with Persian original barthel index was confirmed (r=0.993, P<0.0001) and the known-groups approach revealed its validity (P<0.0001). The results of factor analysis signified its monofactoriality with Eigen value of 8.268 and the mentioned factor could explain the 82.68% of the total variance. Conclusion: The Persian Shah version of MBI for evaluation of disability in elderly people residing in Golabchi nursing home is a valid and reliable tool

A comparative study on the effect of multiple and/or demand-based breast feeding on the newborn growth

History and Objectives: Considering the significance of newborn growth, its prognosis, the absence of enough information and the controversies regarding the effect of feeding intervals on the growth process, this comparative study was carried out to evaluate the effect of demand-based and multiple feeding on the newborn growth in Shabihkhani hospital in Kashan from 1996 to 1997. Materials and Methods: The clinical trial, sequential sampling and quasi-experimental strategy of this research was carried out on 45 newborns in demand-based feeding group (Control) and 40 newborns in multiple-feeding group (Case). The groups were similar regarding age, occupation, education, multiparous state, number of children, kind of pregnancy, interval between labors, father’s age, education and occupation, number of children, home area, home status, monthly income, gender, time of first feeding and birth-time weight, height and head perimeter. Birth-time weight, height and head perimeter and the same parameters at days 14 and 28 postpartum were measured and statistical t-test was used for data analysis. Results: Eight cases of the demand-based group and 14 cases from the multiple-feeding group were excluded from the study for illnesses, incomplete information, supplementary nutrition, not on time refers, inappropriate follow-up and/or mismatch of nutritional style with considered criteria. In total, the research was carried out on 63 cases (Control (n=32) and case (n=31) groups). During the first 14 days, the weight changes were 399.7±113 and 613.9±194.1 in control group and case group respectively. In other words, case group showed a 53% increase in comparison with control group (P<0.001). In addition, changes of head perimeter and height were also greater in case group, but did not reach to significant level. Conclusion: Multiple-feeding method can clearly affect the physical growth of newborns. It is recommended to perform a research study to evaluate the long-term effect of this feeding pattern on growth and other related parameters

Association between the maternal BMI and infants' growth during the first 4 months

Background: Low-weighed mothers’ attitude towards the lack of their milk for breast feeding is one the most important causes of unsuccessful breast feeding. Meanwhile, prior investigators have raised controversies regarding the association between maternal BMI and infant’s growth. Thus, the present study was carried out on low- and moderate- weighed mothers and their infants to determine the association between the maternal BMI and infants’ growth during the first 4 months in Kashan in 1376-77. Materials and methods: This cohort study was conducted on infants of low weighed mothers (BMI<19.8 as the case group) and infants of normal weighed mothers (19.8 Results: The study population included 75 cases and 75 controls with the mean birth weight of 3257.27±421 and 3286.2±455 gr. Their mean age was 5362.8±606.4 and 5497.8±621.27 gr after 2 months and 6793.2±682.4 and 7004±762.4 gr after 4 months, respectively (NS). We have not found any significant association in height, head and arm circumference between the two groups. Conclusion: Low weight of mothers does not have any influence on physical infant’s growth. Further studies with bigger sample size and greater duration (the first 2 years) is strongly recommended

Effect of injection of Atropine-Promethazine on the duration of active phase of labor

History and Objectives: Due to importance of reducing the duration of the active phase of labor and controversies about effect of injection of Atropine-Promethazine combination on the duration of the active phase of labor, this study was performed on multiparous women referring to Shaheed Dr. Shabihkhani maternity hospital in Kashan in the second half of 1374 to evaluate the effects of injection of Atropine-Promethazine on the duration of active phase of labor. Materials and Methods: A single-blinded clinical trial was performed on 2 experimental and control groups with intramuscular injection of 0.5mg Atropine and 25mg Promethazine and 2 milliliter distilled water respectively at the beginning of the active phase of labor. Onset of the active phase was characterized by 3 centimeters dilation and 50% effacement. The previous delivery was normal in all samples and rupture of amniotic sac occurred after the onset of the active phase of labor. Women with history of abortion, hypertension, diabetes cardiac disease twin pregnancy, abnormal fetal presentation and pelvic stricture were excluded from the study. Then duration of the active phase, i.e. the time from 3 centimeters to 10 centimeters dilation, was evaluated by repeated vaginal examinations and recorded. Results: 200 multiparous women aged 18-35 years were studied. They were para 2 to para 4. Experimental and control groups each contained 100 patients that were age and para-matched. The duration of active phase of labor was 190±100 and 149±81 minutes in the experimental and control groups respectively. Injection of Atropine and Promethazine combination reduces the duration of the active phase of labor by 23.7% (P<0.001). Conclusion: Considering the effect of Atropine-Promethazine combination in reducing the duration of the active phase of labor, its administration is recommended during labor

Prevalence of depression and its contributing factors among Kashan medical university students

History and Objectives: Depression is a debilitating factor in life. Its frequency is estimated to be around 15-20. It's prevalence among students groups were reported from 10 to 64. Depression may lead to suicide, drug dependence, low self confidence and may lead to low school performance among students and it will have adverse effect directly and indirectly on the society as a whole. The present study was carried out in order to determine the prevalence of depression among university students in Kashan in 1996-1997. Materials and Methods: A descriptive study was carried out on 310 subjects. Individuals were selected on random basis. A short version of Beck standard questionnaire was given to each student. Personal records were collected. Results: From 307 individuals, the prevalence was 35.8. Depression was most prevalent among health and hygiene students (42.3) and the medical students had the lowest prevalence (28.4). Depression was not related to gender and residency of students. Conclusion: Due to relative high prevalence of depression among students, preventive measures ought to be designed in order to reduce stressful situations

The impact of postpartum depression on quality of life in women after child's birth

Background: Postpartum depression (PPD) is a common problem after child's birth and may influence the quality of life (QOL). Investigation of postpartum QOL and depression can be useful for better care for mothers and improvement of their well-being. Objectives: The objective of this study was to assess the life quality in mothers with and without PPD. Patients and Methods: In a prospective study, women who had experienced child's birth with and without PPD were recruited in Kashan-Iran. PPD was measured using the Edinburgh Postnatal Depression Scale (EPDS) and QOL was measured by SF-36 questionnaire. Data collection was conducted at two assessment points: second month (n = 321) and fourth month (n = 300) postpartum. Based on EPDS, a score of 13 or more was defined as PPD. Mean scores of SF-36 questionnaire were compared between women with and without PPD at two assessment points and within each group from the first to the second assessments. Moreover, correlation between scores of EPDS and scores of life quality dimensions were evaluated. Data were analyzed by using the Student's t-test, Mann-Whitney U-test, ANOVA, Kruskal-Wallis, Chi-square test, Pair t test, Wilcoxon, Pearson and Spearman Correlation Coefficient. Results: Differences in seven out of eight mean scores of QOL dimensions (except role-physical) between depressed and non-depressed women at the first and the second assessments were significant. Results of changes in mean scores of QOL dimensions from the first to the second assessments in each group showed that non-depressed women scored higher in all of eight dimensions with significant differences in two dimensions (bodily pain and role-emotional as well as mental health component). In depressed women, scores of life quality decreased in some of QOL dimensions but differences were not significant. There were significant negative correlations between EPDS scores and scores of seven out of eight SF-36 sub-scales (except role-physical) in addition to physical and mental health components at two assessments. The highest correlation was found between EPDS scores and emotional well-being and total scores of SF-36 dimension at the first and the second assessments (r = -o.489, r = -0.381), respectively. Conclusions: The findings demonstrated that postpartum depression leads to a lower life quality at second and fourth months postpartum. Integration of PPD screening into routine postnatal care is recommended. © 2013, Iranian Red Crescent Medical Journal; Published by Kowsar Corp