The relationship of hyperlipidemia with maternal and neonatal outcomes in pregnancy: A cross-sectional study

Background: Concentrations of plasma lipids levels during pregnancy clearly increases. According to some studies, dyslipidemia is effective in the incidence of preeclampsia and insulin resistance. Objective: This study aimed to examine the relationship between hyperlipidemia and maternal and neonatal outcomes in pregnant women. Materials and Methods: This is a cross-sectional study which was conducted on two groups of pregnant women with hyperlipidemia and normal ones to assess maternal and neonatal outcomes. Maternal data including gestational age, mother’s age, body mass index, and maternal weight gain during pregnancy, gestational diabetes mellitus, preeclampsia, cholestasis, and delivery method. Also, birth weight and Apgar score were gathered as the neonatal outcomes. Results: The results showed that the prevalence of abnormal lipid parameters increased with increasing gestational age. In pregnant women with dyslipidemia in combination with increased triglyceride, cholesterol and Low-density lipoprotein, and decreased High-density lipoprotein, the incidence rates of gestational diabetes (p < 0.001), preeclampsia (p < 0.001), cholestasis (p = 0.041), fetal growth retardation (p < 0.001), and macrosomia (p < 0.001) were statistically higher. Conclusion: Dyslipidemia was associated with some adverse effects of pregnancy and harmful fetal outcomes. Therefore, it seems that adding laboratory assessment of lipid profiles before and during pregnancy can be effective in early diagnosis of dyslipidemia. Key words: Dyslipidemias, Gestational diabetes, Preeclampsia, Fetal macrosomia

Anxiety in patients under electrophysiological interventions and related factors

زمینه و هدف: مداخلات الکتروفیزیولوژیک یکی از جدیدترین روش‌های تشخیص و درمان دیس‌ریتمی‌ها هستند که می‌توانند همانند دیگر روش‌های تهاجمی موجب اضطراب بیماران گردند. اضطراب از این جهت حائز اهمیت است که می تواند باعث کاهش اثربخشی مداخله گردد؛ لذا این مطالعه با هدف بررسی میزان اضطراب بیماران تحت مداخلات تشخیصی و درمانی الکتروفیزیولوژیک و شناسایی عوامل فردی و بالینی مرتبط با آن صورت گرفته است. روش بررسی: در این مطالعه توصیفی- تحلیلی که به صورت مقطعی انجام شد، 72 نفر از بیماران در انتظار مداخلات تشخیصی و درمانی الکتروفیزیولوژیک بستری در بیمارستان دکتر حشمت شهر رشت به روش تدریجی از اردیبهشت تا مرداد ماه سال 1392 انتخاب و وارد مطالعه شدند. داده های پژوهش با استفاده از ابزاری 2 بخشی شامل پرسشنامه اطلاعات فردی– بالینی و ابزار اضطراب و افسردگی بیمارستانی (فقط بخش اضطراب این ابزار) به روش مصاحبه و مشاهده یافته های ثبت شده در پرونده در محدوده زمانی 5-3 ساعت قبل از مداخله الکتروفیزیولوژی گردآوری شدند. یافته ها: بین میانگین نمره اضطراب نمونه ها با جنسیت ارتباط معناداری وجود داشت و میانگین اضطراب در زنان به طور معناداری بیش از مردان بود (001/0≥P). همبستگی معکوس معناداری نیز بین میانگین نمره اضطراب نمونه ها با سن آنان (03/0>P و 255/0-=r) به دست آمد؛ بدین ترتیب که نمرات اضطراب نمونه ها با افزایش سن آنان کاهش می یافت. نتیجه گیری: بر اساس نتایج این مطالعه پرستاران باید کنترل اضطراب را در بیماران زن و در سنین جوان تر با دقت بیشتری مورد توجه قرار دهند تا بتوان با کنترل اضطراب این افراد، به اثر بخشی بیشتر مداخلات الکتروفیزیولوژیک دست یافت

Kidney disease improving global outcome for predicting acute kidney injury in traumatic brain injury patients

AbstractAimTo determine the incidence of acute kidney injury (AKI) based on Kidney Disease Improving Global Outcome (KDIGO) criteria in patients with severe traumatic brain injury and to study AKI in relation to risk factors and outcomes.MethodThis trial was a descriptive analytic study on 83 patients with severe traumatic brain injury admitted to Poursina Hospital (Rasht, Iran). The incidence of AKI was determined based on KDIGO criteria over a 12-month period. The correlation of mortality rates, multi-organ failure (MOF), and neurologic outcome to AKI were studied.ResultsOf 83 eligible patients who entered the study, 25.3% (N=21) developed AKI based on KDIGO criteria. Glasgow Outcome Scale on admission was the only risk factor significantly associated with the incidence of AKI (p=0.001). Mortality rates (62% vs. 22.6%, p=0.002) and the occurrence of MOF were significantly higher in patients who developed AKI (23.8% vs. 0% MOF based on Sequential Organ Failure Assessment, p<0.0001; 19% vs. 0% MOF based on Multiple Organ Dysfunction score, p<0.0001). Poor neurologic outcome was observed in 95% and 92% of patients with and without AKI, respectively (p=0.674).ConclusionThe incidence of AKI among patients with severe traumatic brain injury is striking. The association of Glasgow Outcome Scale with AKI helps to identify patients at a higher risk of developing AKI. Significant rates of mortality and MOF among patients with severe traumatic brain injury and AKI, necessitates consideration of renoprotective measures from the early days of hospital admission

Rotator cuff repair with or without proximal end detachment for long head of the biceps tendon tenodesis

Background Rotator cuff tears cause pathologies of the long head of the biceps tendon (LHBT). One of the surgical treatments for such a tear is LHBT tenodesis to the humerus. This study aims to compare simultaneous rotator cuff repair and LHBT tenodesis with or without detachment of the proximal end of the LHBT (PELHBT) from its site of adhesion to the glenoid. Methods This retrospective study involved patients affected by LHBT pathology with rotator cuff tear. The patients were divided into two groups, with or without PELHBT detachment from the glenoid. Therapeutic outcomes were investigated by evaluation of patient satisfaction, pain based on visual analog scale, shoulder function based on Constant score and simple shoulder test, and biceps muscle strength based on the manual muscle testing grading system before surgery, at 6 months, and at the final visit after surgery. Results Groups 1 and 2 comprised 23 and 26 patients, respectively, who showed no significant differences in demographic characteristics (p>0.05). Shoulder function, biceps muscle strength, pain, and satisfaction rate improved over time (p0.05). No post-surgical complication was found in either group. Conclusions There was no difference in final outcomes of tenodesis with or without detachment of the PELHBT from the supraglenoid tubercle. Such tendon detachment is not necessary

Can indirect magnetic resonance arthrography be a good alternative to magnetic resonance imaging in diagnosing glenoid labrum lesions?: a prospective study

Background This study was designed to evaluate and compare the diagnostic value of magnetic resonance imaging (MRI) and indirect magnetic resonance arthrography (I-MRA) imaging with those of arthroscopy and each other. Methods This descriptive-analytical study was conducted in 2020. All patients who tested positive for labrum lesions during that year were included in the study. The patients underwent conservative treatment for 6 weeks. In the event of no response to conservative treatment, MRI and I-MRA imaging were conducted, and the patients underwent arthroscopy to determine their ultimate diagnosis and treatment plan. Imaging results were assessed at a 1-week interval by an experienced musculoskeletal radiologist. Image interpretation results and arthroscopy were recorded in the data collection form. Results Overall, 35 patients comprised the study. Based on the kappa coefficient, the results indicate that the results of both imaging methods are in agreement with the arthroscopic findings, but the I-MRA consensus rate is higher than that of MRI (0.612±0.157 and 0.749±0.101 vs. 0.449±0.160 and 0.603±0.113). The sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of MRI in detecting labrum tears were77.77%, 75.00%, 91.30%, 50.00%, and 77.14%, respectively, and those of I-MRA were 88.88%, 75.00%, 92.30%, 66.66%, and 85.71%. Conclusions Here, I-MRA showed higher diagnostic value than MRI for labral tears. Therefore, it is recommended that I-MRA be used instead of MRI if there is an indication for potential labrum lesions

Diagnostic Methods of Metabolic Syndrome in Children

We aimed to define Metabolic Syndrome (METs) from different viewpoints to determine the most appropriate method that could be used for early METs' diagnosis in general population and treat them immediately. This study was an analytic cross-sectional study which was conducted on 725, twelve year-old-girls and boys from Rasht city in Iran. METs was defined based on 7 different methods. Data were reported by descriptive statistics (number, percent, mean, and standard deviation) and analyzed by Cohen's kappa coefficient correlation and chi-square in SPSS version 19. The highest and lowest percentages of METs were obtained by DE Ferranti (17.5%) and viner et al., (0.8%) methods, respectively. Results showed that viner et al., had the highest degree of agreement with NCEP ATPIII and the lowest with DE Ferranti. Furthermore, De Ferranti showed the highest degree of agreement with NHANESIII and the lowest with Viner et al., According to results, the identification of the cut off points of obesity could help to promote public health care

An Unusual Presentation of Neuronal Ceroid Lipofuscinosis With CLN6 Mutation

Background: Neuronal ceroid lipofuscinoses (NCL) is a rare progressive neurodegenerative disorder caused by more than 530 mutations of at least 13 different genes (CLN 1-14). NCL is a part of the lysosomal disease characterized by the presence of neuronal and extraneural autofluorescent lipopigment accumulations that leads to motor and mental deterioration, developmental regression, seizure, vision loss, and premature death. NCL is classified into four main groups based on the different clinical manifestations and age of presentation. In this study, we aimed to report an unusual presentation of NCL with CLN6 mutation without retina involvement. Case Presentation: We reported a 10-year-old boy with mixed types of seizures, developmental delay, cognitive problems, unsteady gait, and speech disorders. Although after a thorough assessment, CLN6 mutation was diagnosed, he had all symptoms of this mutation, except the visual impairment. Conclusion: According to recent NCL case reports from Asia, full familiarity with its presentation by pediatricians and neurologists is obligatory. Children with developmental regression or refractory seizures, who also have visual or other neurological symptoms such as ataxia and other cerebellar symptoms, even at older ages, should be evaluated for NCL. Attention to ophthalmological examinations and neurological signs and confirming the diagnosis by biopsy or genetic analysis is desirable to prevent missed diagnosis

Predictors of intention to quit smoking among hospital male personnel

Smoking is the most preventable cause of premature death in the world and its disadvantages impose heavy financial burden on the health system. Among the behavioral models of health education, the most applicable one in smoking cessation is Transtheoretical Model (TTM). This study aimed to detect the predictors of smoking cessation among hospital male personnel. The participants were 200 current and former smokers Personnel working at four hospitals. The instruments included decisional balance scale, self-efficacy scale, processes of change scale (behavioral and experiential), and stages of change which were completed by self-report. Descriptive statistics analysis showed that 66.5% of participants were located in the earlier stages of change. Bivariate spearman correlations showed that self-efficacy, processes of change and decisional balance were significantly correlated with the stage of change. Besides, ordinal regression revealed that experiential processes of change, self-efficacy and behavioral processes were the strongest predictors for the change stages of smoke cessation. The current study revealed that the readiness to quit smoking is significantly predicted by the mechanisms of self-efficacy and the process of change such as environment reevaluation, stimulus control and counter conditioning, which can lead to positive progress in the change stages of smoke cessation. The findings of this study showed that using TTM for smoking cessation would be very effective in improving readiness to quit smoking among hospitals personnel

Predictive factors of job satisfaction among nurses in therapeutic-educational centers of Guilan University of Medical Science

Introduction and Aims: Continuous controlling is a useful instrument to facilitate organization progress and development, so that neglect to this crucial matter leads to job burnout and lower quality services. This study was done to explore predictors of job satisfaction among nurses employed in hospitals affiliated to Guilan University of Medical Sciences.Materials and Methods: In this cross-sectional descriptive study, 309 nurses of eight educational centers in Guilan University of Medical Sciences in 2010 were selected by stratified sampling and were investigated by a two part questionnaire including demographic information and Index of Work Satisfaction (IWS). Data were analyzed using descriptive and inferential statistics tests (Pearson, Chi-square and Multivariate Linear Regression Model) at P<0/05 with SPSS v16.Results: The overall nurses’ job satisfaction was found to be at moderate level 163/69. The highest satisfaction score was specified to the element of task requirement followed by autonomy and low level of satisfaction was due to two components including interaction and payment. We considered variables in a multivariate linear regression analysis, the main determinants of total job satisfaction were employment status (P<0/05), family income (P<0/03) and the number of children (P<0/007).Conclusion: As satisfied employees play a crucial role in organization’s success, improving and reinforcing job factors related to nurses’ satisfaction in job environment, using a comprehensive program by organization managers and planners seems necessary.* Corresponding Author: Rasht, Guilan University of Medical Sciences, Faculty of Nursing and Midwifery.Email: [email protected]

Comparison of Wound Repair Outcomes of Chromic Catgut versus Vicryl Sutures for Episiotomy Repair: A clinical trial

AbstractBackground and Aim:A large number of postpartum women suffer from short and long-term complications of episiotomy.The aim of this study was to compare Chromic Catgut and Vicryl Sutures wound healing inpostpartum women.Materials and Methods:This study was a randomized clinical trial. The sample was 102 pregnant women who wererandomly divided into two groups. The episiotomy wound repaired by Chromic Catgut and Vicrylrespectively. 4-6 weeks after delivery both groups were evaluated for wound healing. Woundhealing was evaluated using the scale (REEDA). The reeda scale consisted of 5 items includingredness, edema, ecchymosis, discharge, approximation. The data was analyzed by t-test and Mann-WhitneyEu test.Results:The results showed that the two groups had no significant difference in terms of age, gestationalage, parity, duration of the second stage of delivery, the time between the delivery and repair ofepisiotomy, length of episiotomy repair and education. Reeda scale average score was lower invicryl sutured wounds (p&lt;0.05). The mean scores of redness, edema, ecchymosis and dischargewere also significantly lower in vicryl group. The approximation scores had not significantdifference between the two groups.Conclusions:According to the results of this study it seems that vicry sutures had better outcomes in healing ofepisiotomy wounds.Keywords:Episiotomy; Vicryl; Catgut; Wound Healin