Shahid Madani Hospital Research Articles

Trauma factors among adult and geriatric blunt trauma patients

BackgroundTrauma is known as a third leading cause of mortality among all-aged patients. ObjectiveThe aim of this study is to investigate pre-trauma physiological factors and trauma-related factors that can increase the risk of mortality among the adult and geriatric patients. MethodIn this longitudinal data analysis study, 500 non-penetrating adult trauma patients who were referred to (Shahid Madani Hospital) from January 2019–December 2019 were enrolled. Information such as age, sex, occupation, place of residence, hospitalization and surgical history, underlying illnesses, medications (such as antihypertensive drugs, etc.), lab findings (complete blood cell and creatinine levels) were recorded in the form of a questionnaire. The patients were divided in group A (aged 65 and above) and group B (aged below 65 years). The data obtained was analyzed statistically using SPSSv18. ResultThe mean age of all patients under study was 51.6 years. Among all participants, 68% (341) were male and 32% (159) were female. Regarding the cause of trauma, group A had significantly greater incidence (p-value = 0.001). The two groups were also significantly different in terms of the region of the injury (p-value = 0.014). Furthermore, underlying diseases were also statistically significant among the two groups (p-value = 0.0093). There was a significant difference between the two groups in terms of smoking and drugs (p-value = 0.01 and 0.001, respectively). Finally, the mortality rate in patients older than 65 years old (4.3%) was significantly higher than those in patients under the age of 65 years (2.9%) (p-value = 0.0001). ConclusionThe results of this study showed that among the trauma patients aged below 65 years and those aged 65 years and above, underlying illness, mortality rate, usage of drugs, cause of trauma, type of injury, vital signs, white blood cell count and platelet count, hemoglobin and serum creatinine vary significantly.

Is carotid artery stenting without protection safe? - A single center experience: case series

Background: Carotid artery stenosis is one of the main causes of ischemic stroke in Iranian population. Carotid artery stenting (CAS) is a method with for treating carotid artery disease, in order to prevent stroke. Dispersion of the embolus is a significant risk for carotid angioplasty which can be prevented by using protective devices. But studies have shown that the use of these protective devices is not safe and can have side effects such as vascular spasm and dissection. Method: 36 patients who underwent unprotected carotid artery angioplasty from April 2018 to August 2019 in Shahid Madani hospital retrospectively entered this study. Hospital records were studied for data collection. Patients were followed by phone interviews. Major adverse cardiovascular and cerebral events (MACCE) was defined as a composite of the occurrence of stroke, MI, bleeding, and all-cause mortality in the long term. Mean duration of our follow-up was 6 months. Results: During in-hospital course, an 82 years old woman with a history of CVA, hypertension, diabetes and a significant stenosis in her contralateral ICA, had an episode of stroke which was fatal. Also, there was a 46 years old woman without any risk factors, who had developed intracranial hemorrhage (ICH). 22 patients were followed. No MI, stroke, or death occurred in any of the patients. There were only 2 cases of bleeding. Conclusion: Carotid artery stenting without protection may be is a safe method of carotid revascularization. Further prospective studies and clinical trials are needed.

Clinical Manifestations and Therapeutic Findings of the Children with Glucose-6-Phosphate Dehydrogenase Deficiency Presenting Favism.

Favism is characterized as acute anemia, due to Glucose-6-phosphate dehydrogenase (G6PD) deficiency as a result of fava beans intake. It is associated with paleness, jaundice, and hemoglobinuria. In this study, signs, symptoms and therapeutic findings of the patients with hemolysis due to G6PD deficiency were investigated in Shahid Madani Hospital of Khorramabad, Lorestan. This is a single-center cross-sectional descriptive study that was conducted on all children with G6PD deficiency-induced hemolysis. 308 children (64.3% male and 35.7% female) were included in this study. The most common complaint was jaundice (82.5%) and the most common cause of hemolysis was the intake of fava bean (85.7%). 68% of the children were treated with hydration/fluid therapy. Blood transfusion was conducted in 36.36% of the cases and the mean of blood administered was 18.9 cc/kg. In this study, hydration therapy was performed in most of the children presenting favism. Also, the incorrect calculation of the amount of blood needed for transfusion increased the frequency of blood transfusions and prolonged hospitalization time.

Evaluation of colonoscopy data for colorectal polyps and associated histopathological findings

BackgroundAdenomas of colon and rectal are frequent colonoscopically found benign lesions. The aim of this study is to evaluate the incidence of polyps among patients referred for colonoscopy and associated histopathological findings. MethodsIn this retrospective study, patients referred for colonoscopy at Shahid Madani Hospital from were enrolled. The records of the patients were evaluated for demographic data, polyp status along with size and location and type and histopathological findings of the polyps. The data obtained were statistically analyzed using SPSSv22. ResultsAmong 1600 patients who underwent colonoscopy, 260 were positive with polyps. The main symptom among these patients was lower gastrointestinal bleeding 44.2%. The average size of the polyps was 5.68 ± 2.66 and the incidence was significantly greatest among the age group of 51–65 years, p < 0.01. The commonest sites polyps were sigmoid and descending colon, 28.6% and 23.2%, respectively. Adenomatous polyps were the most frequent type, 58.3%. The morphology and pathology of the polyps were significantly associated with each other, p < 0.01. ConclusionOur study evaluates the retrospective data for polyp findings among colonoscopy patients. Early diagnosis of polyps can provide better therapeutic outcomes.

Evaluation of platelet count, erythrocyte sedimentation rate and C-reactive protein levels in paediatric patients with inflammatory and infectious disease.

Inflammatory and infectious diseases are the major causes of morbidity and mortality. The identification of markers for the assessment of disease activity and response to treatment can improve long-term prognosis. The aim of this study was to evaluate platelet count, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) among children with inflammatory and infectious disease. This cross-sectional study was conducted in the paediatric immunology and infectious units of Shahid Madani Hospital of Khorramabad. One hundred fifty children, half boys and half girls, with diagnoses of infectious and inflammatory diseases were included in the study. Platelet count, ESR and CRP were measured at the time of hospitalization and thereafter (recovery phase). A questionnaire including demographic information, diagnosis and paraclinical data was completed. At the time of hospitalization, all 150 children had abnormal ESR, 110 (73.3%) had abnormal CRP and 12 (92%) had alterations in platelet count. At the time of discharge, one patient (0.7%) had normal ESR, 132 (88%) had normal CRP and 140 patients (93.3%) had normal platelet count. At the time of discharge, we found a significant difference between the levels of CRP and platelets in girls. This study showed that CRP level is useful during treatment follow-up. Changes in platelet count are likely to be more prevalent in girls.

Genetic associations and serum paraoxonase levels with atherosclerosis in western Iranian patients.

The oxidative modification of low-density lipoprotein (LDL) in the arterial wall plays a pivotal role in the initiation and progression of atherosclerosis which is a complex and progressive disorder. Paraoxonase1 (PON1), which is required for lipid metabolism, is believed to protect LDL from oxidation. The relationship between PON1 gene Leusin55Methionin (L55M) and Glutamine192Arginine (Q192R) polymorphisms in western Iranians with atherosclerosis and its association with enzyme activity and oxidized low-density lipoprotein (oxLDL) were examined in the present study. In this study, blood specimens were collected from 145 healthy individuals and 154 patients with atherosclerosis proven by angiography referred to Shahid Madani Hospital, Khorramabad, Iran. Genomic deoxy ribonucleic acid (DNA) was extracted from whole blood. For all the subjects, restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR) was carried out for the detection of L55M and Q192R polymorphisms. PON1 enzyme activity and the level of oxLDL were also evaluated. There was a 3.114-fold increase in the risk of developing atherosclerosis in the subjects presenting the PON1L55M, MM genotype compared to those with the LL genotype (OR 3.114; 95% CI 1.412-6.870). PON1Q192R polymorphism in the PON1 gene was not associated with atherosclerosis. Patients with atherosclerosis had significantly higher oxLDL and reduced PON1 enzyme activity (P < 0.05) compared to the controls. There was no association between the type of genotype, enzyme activity, and oxLDL level. It has been concluded that PON1L55M polymorphism and MM genotype are associated with an increased risk of coronary artery disease (CAD) in Iranian patients with atherosclerosis. We did not find any relationship between PON1Q192R polymorphism and atherosclerosis.

A comparison of the effectiveness of reality therapy and existential therapy on the psychological well-being of women with breast cancer

هدف از پژوهش حاضر، مقایسه‌ اثربخشی واقعیت درمانی و درمان وجودی بر بهزیستی روانشناختی زنان مبتلا به سرطان سینه بود. روش پژوهش، به روش نیمه آزمایشی همراه با پیش‌آزمون و پس‌آزمون با گروه کنترل و گمارش تصادفی انجام گرفت. جامعه آماری مطالعه، شامل زنان مبتلا به سرطان سینه شهرستان خوی در نه ماهه اول سال 1397 بود. افراد نمونه در مرحله نخست به صورت نمونه‌گیری هدفمند از بیمارستان شهید مدنی خوی که تحت عمل و شیمی درمانی قرار گرفته‌ بودند، انتخاب شدند و پس از تکمیل مقیاس‌ بهزیستی روانشناختی به صورت تصادفی در دو گروه کنترل (12نفر) و آزمایش (12 نفر) گمارده شدند. داده‌های حاصل با آزمون تحلیل کواریانس تجزیه و تحلیل شد. نتایج حاصل از این پژوهش نشان داد که تفاوت معناداری بین دو روش درمان (واقعیت درمانی و درمان وجودی) در پس‌آزمون ابعادی از قبیل استقلال، پذیرش خود، تسلط محیطی، رابطه‌ی مثبت با دیگران، بعد داشتن هدف در زندگی و رشد شخصی (05/0 P > ) وجود ندارد. بنابراین، نتیجه گرفته می‌شود، هر دو روش واقعیت درمانی و درمان وجودی برای افزایش بهزیستی روانشناختی تاثیر یکسانی داشته و می‌توانند مکمل هم مورد استفاده قرار گیرند.AbstractThe purpose of this study was to compare the effectiveness of reality therapy and existential therapy on the psychological well-being of women with breast cancer. The research method was quasi-experimental with pre-test and post-test with control group and random assignment. The statistical population of the study included women with breast cancer in Khoy city in the first nine months 2018. The subjects were selected by purposeful sampling from the Khoy Shahid Madani Hospital undergoing surgery and chemotherapy. After completing the psychological well-being scale with random assignment in control (n = 12) and experimental (n = 12) groups. They were assigned. The data were analyzed by analysis of covariance. The results showed that there was no significant difference between the two treatment modalities (reality therapy and existential therapy) in post-test dimensions such as Independence, self acceptance, environmental mastery, positive relationship with others, goal pursuit in life, and personal growth (P> 0.05). Thus, it is concluded that both reality therapy and existential therapy have the same effect on enhancing psychological well-being and can be used as a complement.Key words: Reality therapy, Existential therapy, Psychological well-being, Breast Cancer, Women.

The association of mean platelet volume to lymphocyte ratio and noreflow in patients with myocardial infarction undergoing primary percutaneous coronary intervention

Introduction: The acute coronary events are one of the most common problems which are accounted to higher mortality and morbidity rate around the world. The underlying mechanism is related to occlusion, and the best therapy is to reopen the affected vessels. Many factors can influence the outcomes of percutaneous coronary intervention (PCI). Methods: This cross-sectional study was conducted on 845 cases with acute myocardial infarction (AMI) undergoing PCI for evaluation of the "No-Reflow" phenomenon who were referred to Shahid Madani hospital in 2018. All demographic, laboratory and angiographic studies were evaluated. The obtained data were recorded and analyzed by SPSS 21. Results: Among 845 patients with STEMI, the incidence of angiographic no-reflow was 28% (n = 245). The older cases with co-morbid diseases and cardiac-related risk factors were considered as vulnerable to no-reflow after PCI. The other parameters were partially decisive factors for the prediction of no-reflow and mortality rate, such as higher MPV and MPV to lymphocyte ratio. Conclusion: The coronary artery involvement is a troublesome event because of the established heart risk factors, and sometimes treating it with PCI could be complicated due to no-reflow. The simple predictors (i.e., MPV to lymphocyte ratio) could help us reduce morbidity and mortality.

Evaluating the Usefulness of Lab-Based Test for the Diagnosis of Pneumonia in Children.

ObjectiveThe aim of this study is to determine the distribution of the results of routine laboratory tests for the diagnosis of pneumonia in children in Khorramabad.MethodsThis is a cross-sectional study and was performed on 650 children with pneumonia who were referred to Shahid Madani Hospital. From patients’ test results, the following data were recorded: whether the results were normal or not, age, sex, serotype, history of diabetes mellitus, and the presence of urinary and digestive tract symptoms.ResultsThere was no difference in the prevalence of pneumonia, gender-wise, whereas 40% of the patients were under 2 years. In addition, 53.7% of the patients were presented with leukocytosis. From the blood test, blood urea nitrogen, creatinine, sodium, and potassium were normal in most of the patients. Stool examination, urine analysis, urine culture, erythrocyte sedimentation rate, C-reactive protein, and blood sugar were also normal in these patients.ConclusionChildren under the age of 2 years are more susceptible to lung infections. Findings from blood tests such as leukocytosis are useful for making initial diagnosis other than computed tomography scan. Other lab tests might not give any useful results. In addition, a closer examination of the urinary system and digestive tract involvement is recommended, prior to urine or stool analysis.

A comparative study of hsa-miR-15 gene expression changes in myocardial infarction patients with healthy individuals in Shahid Madani Hospital of Tabriz

Background: miRNA is one of those biomarkers that have different types. Hsa-miR-15 is one of the molecules, which expressed in the heart tissue. MiRNAs are small non-coding RNA that regulates complex cardiac signaling and transcription pathways in cardiac during different condition. The aim of this study was to compare hsa-miR-15 gene expression changes in myocardial infarction patients with healthy individuals. Methods: In this case-control study, which was included 88 patients with myocardial infarction and 19 healthy individuals who had been referred to the Shahid Madani hospital of Tabriz. After total RNA extraction and cDNA synthesis, the hsa-miR-15 gene expression changes were assessed using Real-time PCR method. For data analysis, we have used independent t-test. Results: The hsa-miR-15 gene expression changes increased in the patients with myocardial infarction compared to healthy individuals. The level of hsa-miR-15 gene expression was shown a statistically significant difference between groups (p &gt;0/05). Conclusion: The hsa-miR-15gene expression increased in the patient with myocardial infarction and may be used as a biomarker in early diagnosis of myocardial infarction.

Spiritual Health in the Patients with Gastrointestinal Cancers and Its Relation with General Health

Introduction: Today, issues related to meaning and spirituality are accepted as essential parts of chronic diseases’ experience as they may seriously affect people's attitude towards their ego, illness and future. The present study was conducted to investigate the spiritual health of the patients with gastrointestinal cancers and its association with general health. Methods: This cross-sectional study was conducted on 128 patients with gastrointestinal cancer ≤54 years with knowledge of their disease type at Imam Reza Hospital and Shahid Madani Hospital in Tabriz, Iran. Samples were selected using the simple sampling method. The spiritual status of the patients was evaluated using the Paloutzian &amp; Ellison (1982) questionnaire &amp; General Health Questionnaire (GHQ-28) and the checklist designed by the researchers, containing demographic characteristics. Data analysis, including the descriptive analytic statistics, independent t-test, correlation coefficient and Pearson correlation coefficient and regression model were done using SPSS V16 software. Results: Regarding Pearson correlation coefficient, there was a significant association between general health and spiritual well-being (p=0.003, r=0.71). Also, there was a direct and significant association between spiritual health in the religious section (p=0.01, r=0.51) and spiritual well-being in the existential (p=0.001, r=0.68) with general health. Conclusion: Based on the results of this study, it could be concluded that most cancer patients have high spiritual health, this makes the patient more adaptable to their illness.

Comparison of in-Hospital Outcome after Percutaneous Coronary Intervention Between Patients with Anterior Myocardial Infarction and Those With or Without Ramus Intermedius

Introduction: Primary percutaneous coronary intervention (PPCI) is used for the treatment of ST segment elevation myocardial infarction (STEMI). Anterior STEMI is associated with adverse outcomes, and it is possible that the presence of ramus intermedius (RI) would inversely affect the outcome. This research involved the evaluation of the influence of RI presence on clinical outcomes in patients with anterior STEMI and culprit lesion in the left anterior descending artery (LAD). Matherials and Methods: This study was conducted on 105 patients with acute anterior STEMI undergoing PPCI in Shahid Madani Hospital, Tabriz, Iran, from April 2016 to March 2018. The recorded data included the patients’ demographic and baseline data, angiographic features, presence of RI, the occurrence of heart failure (HF), cardiogenic shock, and in-hospital and one-year mortality. All data were analyzed, using SPSS software (version 23; SPSS Inc., Chicago, IL). Chi-square test, Fischer’s exact test, independent t-test, or Mann-Whitney U test were employed to compare data between the two groups. A p-value ​less than 0.05 were considered statistically significant. Results: In this research, RI was present in 53 patients (50.5%). The RI presence was mostly detected in male patines than in their female counterparts (88.7% vs. 69.2%; P=0.01). In addition, those with RI presence had a lower rate of single-vessel disease (60.4% vs. 80.8%; P=0.01) and higher proximal LAD involvement (71.7% vs. 32.7%; P<0.001). After the intervention, ST segment decreased more than 50% and was significantly higher in patients with RI, compared to those without it (52.8% vs. 25.5%; P=0.004). Furthermore, there were no significant differences between the groups regarding cardiac enzymes, ejection fraction, HF, cardiogenic shock, and in-hospital and one-year mortality rates. Conclusion: The presence of RI was associated with more proximal LAD lesions and less frequent single-vessel disease. However, RI did not seem to influence in-hospital and one-year outcomes.

Mortality Rate and its Determinants in Traumatized Elderly in Patients of karaj Shahid Madani Hospital

Mortality Rate and its Determinants in Traumatized Elderly in Patients of karaj Shahid Madani Hospital

The Effect of Interval Training on Oxidative Stress Indices Among Women in Preterm Labor Underwent Coronary Artery Bypass Graft

Objectives: Oxidative stress indices are one of the factors that cause and exacerbate cardiovascular diseases in postpartum women, which can be changed with interval training. Therefore, the current study aimed at investigating the effect of interval training on oxidative stress indices among women in preterm labor undergoing the coronary artery bypass graft (CABG). Materials and Methods: This randomized clinical trial was conducted on 21 participants (the sample size was determined based on a similar study) from December 2018 to May 2019 at Shahid Madani hospital of Tabriz, Iran. After the random allocation of subjects to the training (n=11) and control (n=10) groups, demographic information was collected and their physical activity level was assessed using the Kaiser physical activity survey before and after the intervention. In addition, the levels of oxidative stress indices were measured 24 hours before and after the intervention using the blood sample. The participants completed an eight-week invention including 24 one-hour sessions according to the available protocol. Finally, data were analyzed by means of statistical tests such as the Shapiro-Wilk, Leven, and Student’s t-test at a significant level of &lt;0.05. Results: The effect of the aerobic exercise program on body weight loss, as well as body mass index (BMI) and body fat percentage changes was significant in the training group (P=0.011, P=0.004, and P=0.001, respectively). Based on the results, the serum and urine levels of 8-hydroxy-2-deoxyguanosine reduced significantly after the completion of the intervention (P=0.002 and P=0.001, respectively) in the training group. Conclusions: In general, aerobic exercise after CABG decreased the fat percentile, BMI, and oxidative stress indices in the subjects. Thus, these trainings could reduce oxidative stress indices by increasing tissue metabolism and oxygen consumption.

Reducing errors during surgery using an improved Healthcare Failure Mode and Effect Analysis model

Background/Aims Prospective risk management is a necessary measure when managing and providing the right response to a healthcare system error. This article provides an improved model of the Healthcare Failure Mode and Effect Analysis model, which aims to reduce errors in the operating room and improve on the major defects found in the Healthcare Failure Mode and Effect Analysis model. Methods The improved model presented in this descriptive mixed-methods article was examined in 2015 on selective processes in total knee replacement in Shahid Madani Hospital's operating rooms in Karaj, Iran. Data were collected through clinical observations, individual and group interviews, and collaborative conversations with the study team. Results A total of 8 activities and 15 modes of failure were identified in 5 selection processes in total knee replacement surgery. The identified modes of failure were given scores. Ultimately, 15 potential causes and 17 measures were proposed for 12 failures. The failure of the ‘unmanaged nurse or the anaesthesia technician in the operating rooms’ had the highest priority, and ‘chest leads’ and a ‘blood pressure cuff placed in the incorrect position’ had the lowest priority. Conclusion The improved model better reported the risk priorities of failures in 9 out of 12 modes. It was also able to resolve major defects in the Healthcare Failure Mode and Effect Analysis model and produce more reliable results.

Study of angiotensin-converting enzyme insertion/deletion polymorphism, enzyme activity and oxidized low density lipoprotein in Western Iranians with atherosclerosis: a case-control study

BackgroundIt has been indicated that Angiotensin-Converting Enzyme Insertion/Deletion (ACE I/D) polymorphism (rs4646994) could be regarded as a genetic factor that raises the risk of CAD through its impact on the activity of Angiotensin-Converting Enzyme (ACE) and angiotensin II level. The present study seeks to examine the relationship between ACE I/D polymorphism with the risk of atherosclerosis. Moreover, its potential effects on ACE activity and oxLDL level are investigated.MethodsIn this study, 145 healthy individuals and 154 patients (143 males and 156 females) were selected among the subjects referred to Shahid Madani Hospital. Atherosclerosis was determined in all subjects with gold standard angiography. Blood samples were collected, used to isolate white blood cells (WBC) and serum separation. The DNA was extracted and the polymorphism was determined by polymerase chain reaction (PCR). The enzyme activity was measured using high-performance liquid chromatography (HPLC).ResultsThis study indicated that patients with atherosclerosis had higher levels of oxidized Low-Density Lipoprotein (oxLDL) and ACE activity (P < 0.05) as compared to controls. Although we found a significant association between ACE I/D polymorphism genotype and the allele with atherosclerosis in the male group, there were no association when the entire patient group was compared to the entire control group.ConclusionOur study revealed the ACE I/D polymorphism of the ACE gene may not be an independent risk factor in the development of atherosclerosis and evaluation of ACE activity level is more important in evaluating the risk of disease. The researchers found no relation between ACE I/D polymorphism and atherosclerosis and also between types of genotype, ACE activity, and OxLDL level.

Reliability of Platelet Indices for Diagnosing Pulmonary Embolism; a Brief Report.

Introduction:Early diagnosis of pulmonary thromboembolism (PTE) is crucial in clinical medicine. Many para-clinical measurements are used to diagnose PTE.Objective:The present study was conducted to evaluate platelet indices in terms of diagnosing PTE.Methods:The present case-control study was conducted between May 2015 to July 2016 with 173 patients suspected of PTE in the emergency wards of Shahid Madani Hospital and Imam Reza Hospital affiliated to Tabriz University of Medical Sciences, Iran. The patients’ platelet indices were checked upon admission and they were evaluated in terms of diagnosing PTE. Platelet indices included mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PL-CR). PTE was diagnosed in 125 out of the 173 patients. Platelet indices were also compared between two groups.Results:No statistically significant differences were observed between the two groups in term of demographic variables (p>0.05). MPV was found to be 10.38±8.59 in the case group and 9.46±1.11 in the controls (p>0.05). PDW was also found to be 12.86±5.57 in the case group and 12.32±2.48 in the controls (p>0.05). Moreover, PL-CR was found to be 22.59±7.32 in the case group and 21.97±8.16 in the controls (p>0.05).Conclusion:According to the obtained results, platelet indices do not increase in PTE. They cannot be therefore used to diagnose PTE in suspected patients.

The Lowering of Bilirubin Levels in Full-Term Newborns by the Effect of Combined Massage Therapy and Phototherapy Practice.

Various therapeutic treatments have been prescribed for decreasing the bilirubin level. Massage therapy is one of the neonate treatments for jaundice. The aim of this study is to investigate the effects of combined massage therapy and phototherapy on neonatal jaundice. This study was performed at Shahid Madani Hospital in the city of Khorramabad in 2016, where 83 healthy full-term infants were enrolled. They were selected through convenience sampling and then were randomly assigned to the intervention and control groups. The control group (n = 43) received phototherapy, whereas infants in the intervention group (n = 40) received 4 days of massage and phototherapy. The serum bilirubin level, frequency of stooling and amount of urination, duration of hospitalization, and feeding frequency were analyzed using SPSS by descriptive and analytical statistics (mixed regression models). Baseline levels of bilirubin were similar between the two groups (p > 0.05). The bilirubin level was measured as 13.4 ± 0.7 mg/dL in the intervention group on day 1. It stood at 14.4 ± 1.5 mg/dL in the control group, which was not statistically significantly different. However, the mean bilirubin level was decreased on day 4 of hospitalization to 7.4 ± 0.56 mg/dL and 9.0 ± 2.3 mg/dL, showing a significant difference decrease in the intervention and control group (p < 0.05), respectively. Intervention had a significant role in decreasing the bilirubin level, amount of urination, and duration of hospitalization of full-term infants suffering from hyperbilirubinemia.

Pentalogy of Cantrell in Full Term Neonate

Pentalogy of Cantrell (PC) is an uncommon congenital disorder characterized by severe defects in the chest and abdomen, including abdominal visceral prolapsed via umbilical cord (omphalocele), defect in the lower part of the sternum, defect in the front of the diaphragm, defects in the anterior part of the pericardium, and the ectopiacordis. Here, we report a 2-hour-old girl, weighing 3,500 g, who was referred to Shahid Madani Hospital in Khorramabad due to the large omphalocele on her chest with pulsating mass above it. The baby was the first child of a 24-year-old mother who was born with an uncomplicated vaginal delivery. Very rare cases of PC are born as a term new-born.

The Relationship between Moral Sensitivity in Decision and its Dimensions with Demographic Characteristics of Nurses in Shahid Madani Hospital of Khorramabad in 2017

The Relationship between Moral Sensitivity in Decision and its Dimensions with Demographic Characteristics of Nurses in Shahid Madani Hospital of Khorramabad in 2017