Comparison of maternal characteristics in low birth weight and normal birth weight infants

Low birth weight is a key determinant in the risk of morbidity and mortality in the neonatal period and during childhood. This unmatched case–control study in Hamadan, Islamic Republic of Iran, compared the characteristics of mothers of low- and normal-birth-weight infants. Maternal sociodemographic data, pregnancy history, anthropometric data and cord plasma zinc level were collected from 134 mothers of low-birth-weight infants and 134 mothers of normal infants at the time of delivery. Significant differences in maternal characteristics namely gravida, parity, body mass index, maternal weight gain during pregnancy and plasma cord blood zinc were found between low- and normal-birth-weight infants. There were no significant differences in maternal age, maternal education, maternal occupation, family income, previous abortion, previous preterm labour, birth interval, type of clinic and place of residence between the 2 groups.

[Evaluation of patients with common variable immunodeficiency and detection of IL-2 as a cell-mediated immune index]

Common variable immunodeficiency [CVID] is the most prevalent primary immunodeficiencies characterized by impaired antibody responses, defect in T-cell proliferation and secretion of cytokines, especially IL-2. This study aimed to evaluate the function of cellular immune system in CVID patients based on Il-2 level, as a cell-mediated immune index, as well as the clinical and paraclinical evaluation of such patients. This case-control study was conducted on 20 CVID and 10 healthy participants referred to the Immunology and Allergy Department at Children Medical Center in Kashan. The clinical and paraclinical findings of the patients were collected using the questionnaire. The peripheral blood mononuclear cells were cultured with PHA in both groups and then the supernatants were collected for quantification of IL-2 secretion using the ELISA method. CVID was seen in 85% of the cases hospitalized with infection. The most common infection was respiratory tract infection; the opportunistic infections and autoimmunity were seen in 5-10% and 40% of the cases, respectively. Delayed-type hypersensitivity response was negative in 65% of the patients. Moreover, IL-2 level was zero in15 patients and lower than that of the control group in 5 patients [P<0.05]. All patients showed deficiency in T-cell function with decreased IL-2 production. The manifestations of this deficiency are a high incidence of autoimmunity, granulomatosis, bronchiectasis and recurrent infections in the patients in spite of monthly IVIG injections

[ correlation between neonatal phototherapy and risk of childhood asthma in children referred to pediatric clinic of Kashan Shahid Beheshti hospital during 2009-10]

Asthma is the most common chronic disease in childhood. Several factors have been considered as the disease risk factors. The neonatal phototherapy has recently been recognized as the main childhood risk factor. The aim of this study was to evaluate the relationship between the neonatal phototherapy and childhood asthma. This analytical case-control study was conducted on the asthmatic children with a history of neonatal icterus as the case group and those with no history of neonatal icterus as the control group with similar characteristics [age, gender, type of delivery and birth weight]. Twenty-eight out of 200 subjects in the case and 34 in the control group had the inclusion criteria. Phototherapy and its duration were compared in the case and control groups. Data were analyzed using chi-square and t-test. Twenty-six [92.8%] subjects in the case group and 20 [58.8%] subjects in the control group had a past history of phototherapy [P=0.002]. The mean number of days for neonatal phototherapy in the case and control groups was 4.9 and 3.2, respectively [P=0.001]. This study shows that neonatal phototherapy, as well as its duration, is an effective factor affecting childhood asthma. So, the phototherapy must be avoided except in rare situations with the least duration

[ physiological parameters in preterm infant in kangaroo and traditional methods]

Kangaroo method is a revolutionary way of taking a good care of infants, especially preterm infants. The studies have well demonstrated the positive effects of kangaroo method on physiological parameters of preterm infants. Skin to skin contacts can have effects on increasing the rate of oxygen saturation, decreasing the risk of hypothermia, stabilizing the heart rate, breath and sleep patterns. A cross over clinical trail was utilized to expose the infants and their mothers to both traditional and kangaroo methods. Sixty infants were selected through simple random allocation and divided into two groups. The infants in first group were removed from the incubator by kangaroo method which followed by the traditional method, for breastfeeding and the second groups vice versa. The infant's physiological parameters were measured at different times. The study demonstrated that the second group infants had different mean heart rate at 5th, 30th minutes, before removing from incubator and also five minutes after returning back [P=0.001, P=0.02, P=0.03]. It was also revealed that other physiological parameters [Breathing, oxygen saturation and temperature] didn't have any differences between groups. Mothers mostly preferred the kangaroo method to traditional way, especially those who had experienced infertility. All statistics were computed by the SPSS software [version 14]. Kangaroo and traditional method showed the same effect on physiological parameters. However, since the mothers preferred Kangaroo method, the researchers recommend it as a substitute for current nursing care methods

[ comparison of the effect of chlorhexidine gluconate 2% and alcohol ethylic 70% in prevention of phlebitis]

Over 80% of hospitalized patients receive IV therapy through peripheral catheters during a hospital stay. This technique of therapy has numerous complications such as phlebitis which can affect the patient's health state. The prevalence of phlebitis in Iran is higher than other countries. So, according to high prevalence of phlebitis and insufficient researches about chlorhexidine gluconate solution as a selective disinfectant for prevention of phlebitis, research in this subject seems necessary. This research is a clinical trial study which was done on hospitalized patients in Tabriz Imam Khomeini hospital in internal wards. For this aim collectively 60 patients were studied in chlorhexidine gluconate 2% and Alcohol ethylic [Ethanol] 70%.The Samples were selected through available sampling and divided in two groups randomly. Data collecting tool was observing checklist which includes two sections: demographic characteristics and standard scale of phlebitis signs and symptoms. This research showed that incidence of phlebitis in chlorhexidine group was 36.7% and in Alcohol ethylic group was 53.3% which there was no significant differences between both groups [p>0.05]. Although there were no significant differences between using of two solutions on prevention of phlebitis, but incidence, signs and symptoms of phlebitis in chlorhexidine group was lower than Alcohol ethylic group. So, it is suggested as a selected solution for disinfecting of catheter insertion site.

[Perinatal care regionalization and geographical distribution model in the Islamic Republic of Iran]

During the past decade, neonatal mortality rate in Iran has not decreased satisfactorily. Regionalization of perinatal care services is a potential solution to improve the access of those in need to the best quality care within economic and administrative constraints. This study aims to develop a framework for optimized and efficient distribution of perinatal care services at different levels of care provision. We utilized small area analysis in an iterative process to divide the country into service areas of Perinatal Care Regions [PCRs], to distribute three levels of perinatal services and hospital beds in PCRs, to minimize patients' traveling distances, and to fit the facilities to the needs while incurring minimum changes to the current administrative borders and available infra-structure. We divided the country into 33 PCRs. A total of 1256 level-III [Neonatal Intensive Care Unit] beds and 3768 level-II neonatal beds were required in the country and distributed to the districts. One level-Ill district was designated as the center for each PCR. Sixty one districts were identified as level-III and 104 as level-II. Level-I and Ib districts were allocated to the nearest next level districts. Our proposed model decreased the average distance of districts from the center from 125 to 109 km. The average distance and the distance weighted by population of the districts from the PCR center also reduced to 79 and 42 km, respectively. Our model reduced the distance between levels of care provision and balanced the care facilities with population needs at the district level Implementing this model requires resources. It may encounter some resistance in practice. Such resistance should be tackled with setting regulations, monitoring, training, advocacy, and appropriate incentives. A sustainable national regionalization model should be developed centrally, and customized to the specific needs and circumstances of each region

Relationship between quality of life and social support in hemodialysis patients in Imam Khomeini and Sina educational hospitals of Tabriz university of medical sciences

The main treatment of chronic renal failure is kidney transplantation. But unfortunetly patients should be treated by dialysis, until being transplantated. In spite of therapetics effects of hemodialysis, these patients are faced with various physical and psychological stressful factors which leads to decreasing quality of life. There have been done a few research on social support of hemodialysis patients in the world, and their quality of life in Asian countries, specialy in Iran, so in this research beside of determining quality of life and social support of hemodialysis patients we are going to measure their relationship with each other. For this purpose, all hemodialysis patients who had interance criterias and were hospitalized in hemodialysis wards of Tabriz Medical Sciences University hospitals; were selected and data were collected by interviewing and completing questionnaire including three parts of demographic, quality of life, and social support. The results indicate that quality of life in 56.1%, and social support in 50.6% of hemodialysis patients were desirable, and there is a direct and significant relationship between these two variables [p< 0.001, r = 0.4]. In quality of life subsecter, social dimension in 88% of patients was desirable, while physical dimension [57/3%] and psychological dimension [53%] in most of the patients were undesirable. In social support subsecters, emotional support [57.3%] was the bigest amount, while it was 14% of total variance of quality of life. The effects of instrumental support, and informational support on quality of life were not statistically meaningful. Nearly half of the mentioned patients had not desirable quality of life and social support, and regarding to positive relationship between these two concepts specially important effects of supports in emotional subsector, it is suggested that health care planner and managers in addition of increasing instrumental and informational support should take care of emotional support in such groups for improving quality of life in hemodialysis patients