Shahid Sadoughi Hospital Research Articles

Comparison of Prescribing Pattern of Prophylactic Antibiotics with the Standard Instructions in the General Surgery Department of Hospitals

Background. Prescribing prophylactic antibiotics before surgery is one way to prevent infection at the surgical site. The aim of this study was to compare the pattern of prescribing prophylactic antibiotics with the standard instruction in the general surgery ward of Shahid Sadoughi Hospital in Yazd. Methods. A descriptive cross-sectional design was employed to conduct the study. The sample was selected through random stratified sampling method using Morgan and Krejcie sampling table. Descriptive statistical tests including frequency, frequency percentage, mean, standard deviation and Chi-square were used for the analysis of data by SPSS software version-23. Results. Out of 236 cases reviewed, 27.1% met the practice guidelines regarding the time, 39.4% regarding the type of preoperative prophylaxis and 58% with respect to the duration of the prescribed postoperative antibiotics (Up to 24 hours after surgery). Conclusion. The most important reasons for the inconsistency of prophylactic antibiotics with the standard guideline are the inappropriate timing of prophylactic antibiotics and the use of antibiotics that are not recommended in the clinical guidelines. Informing and educating the public on the content of the notification instructions, establishing a monitoring system and increasing the participation level of the hospital pharmacy in the distribution of medicine can be effective in prescribing prophylactic antibiotics.

Evaluation of age-sex relationship on BUN and Cr variables; report of four-year mortality of hospitalized patients due to acute myocardial infarction

Objectives: Blood urea nitrogen (BUN) and serum creatinine (Cr) levels are the risk factors associated with prognosis in patients with the acute coronary syndrome. This study aimed to investigate whether BUN and Cr have a predictive value in patients diagnosed with acute myocardial infarction (AMI) and their mortality.
 Methods: This descriptive-analytical study was performed retrospectively by referring to the archives of Shahid Sadoughi Hospital in Yazd, Iran. The participants were 131 patients with acute myocardial infarction whose files were accessible from 2014 until 2018. Parameters such as age, sex, type of stroke, Cr and BUN levels at the time of admission, and outcome were examined. A questionnaire was used to collect data. Data analysis was performed using SPSS software version 21, and graphs were drawn with Sigma Plot software version 12.5.
 Results: Data analysis showed no significant difference between Cr and BUN levels between men and women (P = 0˃05). The levels of both of these factors elevated with age in the patients (BUN: P ≤ 0/01), (Cr: P ≤ 0/05). In addition, both Cr (P ≤ 0/05) and BUN (P ≤ 0/001) had higher levels in the deceased patients than in the discharged ones.
 Conclusions: The results revealed that in addition to elevated Cr and BUN, which are indicators of renal function, age is a significant risk factor in predicting mortality in AMI patients.

Evaluation of diagnostic value of laboratory tests (CRP, WBC and ESR) in patients with COVID-19 in Shahid Sadoughi Hospital, Yazd

COVID-19 disease is spreading rapidly around the world and its control requires proper diagnosis of infected people. RTPCR is the primary method of laboratory diagnosis of COVID-19, but is associated with false-positive cases. Therefore, the aim of this study was to evaluate the diagnostic value of laboratory tests (CRP, WBC and ESR) in the diagnosis of COVID-19. In a cross-sectional and descriptive-analytical study, the file of 200 patients with COVID-19 admitted to Shahid Sadoughi Hospital in Yazd in 2020-2021was evaluated and the results of laboratory tests (CRP, WBC and ESR) were recorded. Considering RT-PCR and lung CT scan as the gold standard, the sensitivity and specificity of each test were determined. Data were analyzed using SPSS software. The frequency of positive findings of CT scan, RT-PCR and gold standard in the studied patients were 83.5%, 50% and 91%, respectively. The mean WBC of patients was 109 2.17 and the ESR was 43.79 mm / h. CRP test was also positive in 71.3% of patients. The sensitivity and specificity of WBC, ESR and CRP in the detection of COVID-19 were 31.5%, 62.4% and 73.1%, respectively, and their specificity was 63.6%, 22.2% and 42.1%, respectively. The frequency of CRP, WBC and ESR findings was not significantly different from the gold standard findings in the studied patients (P> 0.05). CRP test is more sensitive than ESR and WBC in diagnosing COVID-19 and can be used in screening patients.

Evaluation of the relationship between lactate dehydrogenase level and clinical status of patients with COVID-19 in terms of disease severity in patients admitted to Shahid Sadoughi Hospital in Yazd

There are many evidences suggesting that the serum lactate dehydrogenase (LDH) levels reflect the extent of various pathophysiological processes. However, the current information about dynamic change of LDH in COVID-19 pneumonia has not been well investigated. This study aimed to evaluate the relationship between LDH level and clinical status of patients with COVID-19 in terms of disease severity in patients. This study included all COVID-19 patients admitted to the wards and ICU of Shahid Sadoughi Hospital in Yazd and the sampling method in this study is census. Patients' information will be extracted from their file and entered into a predefined checklist. This information was entered into SPSS.V21 software. Of 4346 patients whose LDH test is available, 2364 (54.4%) are male and 1982 (45.6%) are female. 487 (11.2%) of patients in intensive care unit and 3859 (88.8%) were hospitalized in other wards. The mean serum LDH level was significantly different between patients admitted to the intensive care unit and other wards of the hospital (pvalue <0.001). Increased LDH serum levels were associated with poor prognosis in patients with COVID-19.

The effect of interprofessional education on interprofessional professionalism behaviors of the surgical team members

IntroductionInterprofessional professionalism (IPP) has been introduced as one of the critical sub-competencies of interprofessional collaboration. This study aimed to assess the effect of interprofessional education on the behavior of interprofessional professionalism among the surgical team in the intervention compared to the control group.MethodsThis is a quasi-experimental study. The participants were nurses in anesthetist and surgical technology and surgical residents of Shahid Sadoughi Hospital (n = 150) who were included in the study by the census. The intervention employed an interprofessional case-based learning strategy to explore themes of interprofessional professionalism. Two assessors used the Interprofessional Professionalism Assessment (IPA) tool to measure learners’ performance while observing them in practice prior to the intervention, one and three months after the intervention. Data were analyzed using descriptive tests (mean and SD) and RM-ANOVA.ResultsIn this study, the participants in the intervention (n = 78) and the control (n = 72) groups entered the study. The Baseline IPA scores of participants were reported as 1.25 (0.12) and 1.21 (0.1) in the intervention and control groups, respectively. The IPA score of the participants in the intervention group (2.59 (0.26) and 2.54 (0.24)) was higher than the control group (1.17 (0.08) and 1.12 (0.07)) after one and three months of the intervention (P = 0.0001). The effect of educational interventions was reported at the large level (Eta Square = 0.89).ConclusionInterprofessional professionalism in surgical teams has been recognized as a critical element of team-based care. The present study used an interprofessional education strategy to develop IPP behavior. All professions benefited from interprofessional education. It is suggested that all surgical team professionals participate in interprofessional education.

Evaluation of Risk Factors Related to Life Status of Patients With COVID-19 Hospitalized in Yazd

Introduction: Following the epidemic crisis and the outbreak of Coronavirus 2019 (Covid-19) in Iran and other provinces, the statistics of the patients showed that Yazd is among the top few provinces in the country in terms of the prevalence and incidence of this deadly disease. Therefore, this study aims to investigate the risk factors related to the life status of patients with coronavirus.
 Methods: In this cross-sectional analytical study, demographic, clinical, and biochemical information of 932 patients who were infected with COVID-19 from May 2018 to March 2019 and were hospitalized in Shahid Sadoughi Hospital in Yazd were examined. Information was recorded through patients’ records or telephone calls. Data analysis was performed by independent t-test, Mann-Whitney, Chi-square, and logistic regression using SPSS-22 software.
 Results: Based on the results 57.9% (N=540) of patients were male and the mean age of all patients was 53.33 (19 ± 0.15) years, and also 9.6% (N=82) of patients died. The risk of death for patients hospitalized in the intensive care unit (ICU) was 75 times higher than that of patients who were hospitalized in general wards. Also, the risk of death for patients with a history of cancer was 12 times higher than other patients. The risk factors associated with mortality were identified by multivariate logistic regression model, which included increasing age, having shortness of breath, history of cancer, hospitalization in the ICU, increased white blood cell count, and sodium deficiency.
 Conclusion: In order to reduce the mortality of patients with COVID-19, it is necessary for physicians to prioritize the treatment of elderly patients with underlying diseases, such as cancer and shortness of breath in order to improve their clinical condition.

Evaluation of Growth Indices and Nutritional Status in Children Hospitalized at the Pediatric Ward of Shahid Sadoughi Hospital in Yazd, Iran in 2020

Background: Malnutrition is one of the most important health issues especially in developing countries that can have adverse effects on physical and mental health of children, resulting in various infections. This study aims to evaluate the growth indices and nutritional status in children hospitalized at the pediatric ward of Shahid Sadoughi Hospital in Yazd, Iran in 2020.
 Methods: In this cross-sectional and descriptive-analytical study, the anthropometric indices of 100 children older than 1 month hospitalized in the pediatric ward of Shahid Sadoughi Hospital in Yazd, Iran in 2020 were determined. Children's information, including age, sex, cause of hospitalization, and duration of hospitalization were extracted from the patients' medical files and recorded in a checklist. Nutritional status was assessed using weight-for-age, weight-for-height, and height-for-age criteria.
 Results: The prevalence of malnutrition among the studied children was 40% (18% acute malnutrition and 22% chronic malnutrition). The prevalence of wasting, underweight, and stunting status were 28%, 27%, and 20%, respectively. There was no significant difference in the malnutrition frequency and also the malnutrition type based on sex, age, cause of hospitalization, and duration of hospitalization (P > 0.05); however, the type of malnutrition was significantly associated with age (P < 0.05).
 Conclusion: Considering the high prevalence of malnutrition in this study and the fact that malnutrition can lead to infections and increase the chances of hospitalization, it is recommended that all hospitalized children be evaluated and treated for malnutrition using anthropometric criteria and nutritional classifications.

Guillain-Barré syndrom in a patient with Wegener’s disease, a rare case

Peripheral neuropathy may be reversible or permanent. Hence, we would like to present a 38-years-old man without any previous medical history admitted to ShahidSadoughi Hospital in Yazd in terms of reduced force of all four limbs, shortness of breath, cough and hemoptysis. Electromyography and nerve conduction velocity study was performed after the para-clinical examinations and Guillain–Barré syndrome was considered first diagnosis. Regarding the pulmonary symptoms, sinusitis and bilateral alveolar opacities, and positive anti-neutrophil cytoplasmic antibodies, Wegener's granulomatosis was suggested as a potential diagnosis and more steps were performed. This patient has been verified to have concurrent increasing limb weakness, also known as Guillain-Barré syndrome.

Etiological Classification of Patients with Ambiguous Genitalia: A Cross-Sectional Study

Background: Disorder of sex development (DSD) is one of the most serious problems encountered at birth. DSD is a heterogeneous group of rare conditions wherein chromosomal, gonadal, or anatomical sex is atypical. The aim of this study was to define the classification and etiological distribution of patients presented with ambiguous genitalia
 Methods: This study was a cross-sectional study conducted in the department of Pediatric and Endocrinology and Surgery at Shahid Sadoughi Hospital in Yazd from March 2016 to March 2020. All patients with genital ambiguity were included in the study with the exception of five patients since they did not have a final diagnosis of ambiguous genitalia.
 Results: Out of 50 patients, thirty-one (62 %) patients were diagnosed with 46, XXDSD, fifteen (30%) patients with 46, XYDSD, while four (8%) patients with ovotesticular DSD. Congenital adrenal hyperplasia (CAH) was the common cause in 46, XXDSD with majority due to deficiency of 21 hydroxylase enzyme. Three (6%) patients with 46, XXDSD were diagnosed with genital ambiguity as part of syndrome. Out of patients with 46, XYDSD, CAH observed in two (4%) patients, severe hypospadias in nine (18%) patients and 5-alpha reductase deficiency in two (4%) patients and one (2%) patient with syndrome. Four (8%) patients were diagnosed with ovoteticular DSD.
 Conclusion: Our study revealed that 46, XXDSD was the most frequent DSD etiological diagnosis. CAH was the commonest cause in 46, XXDSD and severe hypospadias were the underlying cause of 46, XYDSD.

Risk factors, clinical, and laboratory characteristics of patients with a diagnosis of COVID-19

Objective: An outbreak of coronavirus disease 2019 (COVID-19) occurred in late 2019. A better understanding of this disease will help us in preventing and managing it. This study evaluated the risk factors and clinical and laboratory characteristics of patients admitted to Shahid Sadoughi hospital in Yazd with a diagnosis of COVID-19. Methods: This cross-sectional study was conducted on patients with the diagnosis of COVID-19 admitted to Shahid Sadoughi hospital in Yazd in May 2020, Iran. Patients’ clinical information, including their symptoms at admission, history of smoking or drug/ alcohol abuse, history of Td (tetanus, diphtheria) vaccine, radiographic/computed tomography (CT) scan findings, and blood oxygen saturation, was recorded. The patients were also asked about their previous history of diabetes, hypertension, autoimmune disorder, and cancer or history of diseases in heart, lung, liver, and thyroid. Laboratory findings, height, weight and body mass index of the patients were also recorded. Statistical analyses were performed using SPSS 21. Results: The mean age of 86 patients enrolled in the study was 61.40±17.37 years, of which 56 (65.11%) had mild pulmonary involvement and 30 (34.89%) had severe pulmonary involvement, according to CT scan results. Also, 26 (30.2%) of all patients had diabetes and about 30 (36%) had high blood pressure, but current smokers (6%) were rare. In patients with severe pulmonary involvement, the level of neutrophil, creatinine, and lactate dehydrogenase (LDH) was higher than patients with mild pulmonary involvement. Out of 56 patients with mild pulmonary involvement, 47 patients had a history of Td vaccination in the last 5 years. Only one patient in the severe group had a history of Td vaccination. Conclusion: A lower percentage of blood lymphocytes as well as higher levels of neutrophils, creatinine, and LDH were observed in patients with severe pulmonary involvement. Numerous factors, especially more prominent laboratory abnormalities, determine the severity of the disease, and a better understanding of these factors can help physicians know the severity of the disease and its prognosis. These findings help us to further clarify the characteristics of COVID-19. Also, the effect of Td vaccine should be investigated in future studies.

Evaluation of Complications of Covid-19 in Children Admitted to Shahid Sadoughi Hospital in Yazd (March 2020 - March 2021)

Introduction: The World Health Organization first reported outbreaks of COVID-19 in 2019 in Wuhan, China. Limited studies have been performed on long-term complications after the acute phase of this disease in children. This study aimed to evaluate the long-term outcomes of children who had previously been hospitalized with COVID-19. Methods: In this cross-sectional study, long-term complications in 105 children less than 18 years of age suspected of having Covid-19 disease were assessed (2020-2021). This evaluation was performed by completing a questionnaire by patients' families three months after discharge and collecting information from the patients' records at the time of hospitalization. Participants were also classified into four age groups. Finally, the data were analyzed using SPSS software version 19. P-value less than 0.05 was considered statistically significant. Results: All 105 children suspected of having COVID-19 who were hospitalized during the mentioned period were included in this study, but the families of 80 children completed the questionnaire. The most common long-term complications in the patients were mood disorders (35.2%), loss of appetite (22.9%), and fatigue (20%), respectively. It has also been found that with the increasing age of the patients, the incidence of complications has increased. Conclusion: This study results demonstrated that the most common side effects observed in trimester follow-up of children with COVID-19 are mood disorders, loss of appetite, and fatigue, respectively. Thus, post-COVID-19 complications cannot be dismissed among children and adolescents. Controlled population-based studies and further in-depth analyses are needed to confirm their impact on individuals and health care systems.

Evaluation of serum calcium levels in patients with COVID-19 in Shahid Sadoughi Hospital in Yazd

COVID-19 produced by SARS-CoV-2 is still distributing and its dangerous cases are related to electrolyte disorders such as calcium levels disturbance. The aim of current study was to investigate serum calcium levels in patients with COVID19 in Shahid Sadoughi Hospital of Yazd. In this cross-sectional study, COVID-19 patients admitted to Shahid Sadoughi Hospital in Yazd from March 2019 to March 2020 were studied. The following data were extracted from patients' records: age, sex, time elapsed from onset of symptoms to hospitalization, severity of COVID-19, serum calcium level at hospitalization, and disease outcome (recovery or death). The serum calcium level mean of patients was 8.2 ±0.7 mg/dl. Most patients had hypocalcemia. Patients who died had lower serum calcium levels than patients who recovered. Therefore, hypocalcemia is common in hospitalized COVID-19 patients and is associated with mortality.

Evaluation and prioritization of occupational safety and health risks of Shahid Sadoughi Hospital in Yazd in 2019

Introduction: Today, it is essential to pay attention to the opportunities and threats in health services, especially in hospitals, to identify and evaluate the existing risks and manage them in these centers. Hospital risk management is a program to reduce the occurrence and prevalence of preventable accidents and is of great economic, human and moral importance in the hospital environment. This study aimed to evaluate and prioritize the occupational safety and health risks of the staff of Shahid Sadoughi Hospital in Yazd in 2019
 Methods and material: : The present study is descriptive-cross-sectional. In the first step, the main risks in clinical, laboratory, facilities, radiology, and administrative departments were identified. Based on FMEA logic, three severity, probability, and vulnerability indicators were identified for each risk. Then, prioritization criteria were determined, and ANP prioritized the risks.
 Results: According to infectious disease experts with a risk of 0.86 in the clinical ward, inhalation of Barisek chemical vapor 1.17 in the laboratory, radiation of the device with a risk of 0.64 in imaging, infectious disease with a risk of 0.33 and 1.3 in order of priority The first were in the administrative and facilities department.
 Conclusion: The results showed that the hospital management should adopt special management programs to control infectious diseases with a staff health approach. Control measures should be set with priority risks. The difference in the obtained risk numbers indicated the different priorities of implementing risk management programs in each ward of Shahid Sadoughi Hospital.

Exploring the lived experiences of nurses working in the COVID-19 ward of Shahid Sadoughi Hospital, Yazd, Iran: A qualitative study

Introduction: The outbreak of COVID-19 has created a global health emergency worldwide due to its rapid transmission, which is a notable feature of the virus. This contagious disease leads to physical health problems and several psychological disorders. Nurses are at the forefront of fighting against this disease, so this study was attempted to discover the lived experiences of nurses working in the COVID-19 wards.
 Mateials and Methods: This qualitative research was performed using descriptive phenomenological approach. The participants were selected among nurses working in the COVID-19 ward of Shahid Sadoughi Hospital, Yazd, Iran. For data collection, semi-structured interviews were conducted. After conducting 20 interviews, data saturation was achieved. Then,the interviews were transcribed verbatim. For data analysis, Colaizii's seven-step method and MaxiCuda software were used.
 Results: After extracting the concepts and analyzing them, 35 categories and nine main categories were extracted.The Main categories were coping strategy and cognitive tolerance, service under pressure, psychological burden and Physical disorder, communication quality, dual challenges and symptoms of weakening and pressure, judgmental and perceptual style, enjoyable expensiveness, adaptive and reinforcing protection, detailed identity and positive sign.
 Conclusion: Nurses working in COVID-19 ward experienced unfavorable mental, emotional, and occupational conditions. They need more support and equipment to care for themselves and COVID-19 patients. This research can be used to develop supportive strategies and services for an emerging epidemic.

Comparing the Ability of FAST and CT scan in Determining Free Fluid in Stable Patients with Blunt Abdominal Trauma

Background: Blunt abdominal trauma (BAT) has a high rate of morbidity and mortality. In the past few years, focused assessment with sonography in trauma (FAST) and computerized tomography (CT) scan have been extensively utilized and studied in management of BAT. The present study aims to compare the diagnostic accuracy of FAST and CT scan in detection of free fluid in BAT patients.
 Methods: In this cross-sectional study, patients with BAT were evaluated by both FAST and CT scans in Shahid Sadoughi Hospital, Yazd, Iran, from May 2017 to February 2018. The results were compared and the sensitivity, specificity, and accuracy of FAST and CT scan were calculated. In addition, the accuracy of FASTs performed by emergency medicine residents (EMR) was compared with those procedures performed by radiology residents (RR) in detecting abdominal free fluid following blunt trauma.
 Results: In this study, 175 patients were participated and most of them were males. The commonest cause of trauma was a road traffic accident (RTA). When FAST was performed by EMRs, sensitivity was 96.3%, specificity 75%, 60% positive and 98.1% negative predictive values and 94.8% accuracy in true evaluating free fluid , and Sensitivity 97.5%, specificity 83.3%, 71.4% positive and 98.8% negative predictive values when FAST was performed by RRs.
 Conclusion: Based on this study finding, it seems that FAST is highly sensitive, specific and accurate in the initial evaluation of patients with BAT.

The Role of Social Support and Caregiver Burdens among Parents of Children with Cancer

Background: Cancer is the most common disease in the present century and the number of affected children is increasing. It can cause many problems for family caregivers. This study assessed the correlation between social support and care-giving burden among parents of children with cancer.
 Methods: This cross-sectional descriptive study was conducted by convenience sampling method on 230 parents (115 mothers and 115 fathers) referring to Oncology Clinic and Oncology Ward in Yazd Shahid Sadoughi Hospital (Iran) from March to August 2020 (Covid-19 Pandemics). Researchers asked the patients' parents to answer the questionnaires. The data were gathered by the demographic questionnaire, Care Burden Scale (CBS), and Social Support Scale and analyzed with SPSS21 using Pearson correlation coefficient, Chi-square, and Analysis of Variance (ANOVA) (P=0.05).
 Results: The mean of the care burden of parents was 52.19 2.48 and the social support of them was higher than that (78.78± 13.21). There was no significant correlation between social support and domains of general strain (P=0.90), disappointment (P=0.52), emotional involvement (P=0.53), environment (P=0.95), and isolation (P=0.40) of the care burden.
 Conclusions: There was no correlation between social support and care burden in the parents of children with cancer. Other factors may be involved in care burden of the parents. More research is needed with more samples in the future.

Attitude of medicine students toward properties of favorable professor

Today, professors play a significant role in educating students. In this study, we decided to examine the opinions of medical students about the criteria of a good professor in Shahid Sadoughi Hospital in Yazd. This study was as descriptive and cross-sectional. The data collection tool in this study was a two-part questionnaire. This questionnaire consisted of 37 items. Finally, the collected data were entered into SPSS, using statistical tests were analyzed. There was no statistically significant difference between the mean score of the questionnaire and its domains in terms of gender, age, type of university and academic year. The most important property of a good professor from the students' point was having teaching skills.

Determining the degree of compliance of Antibiotic prophylaxis before surgery with national guidelines in the gynecology ward of Shahid Sadoughi Hospital in Yazd

Proper use of antibiotic prophylaxis reduces the rate of postoperative infection, but the administration of inappropriate antibiotics increases the spread of antibiotic-resistant bacterial species as well as prolongs the hospital stay, imposes unnecessary costs, and drug reactions. The purpose of the present study was the investigation of the rate of compliance of antibiotic prophylaxis before surgery with national guidelines in the gynecology ward of Shahid Sadoughi Hospital in Yazd. The present study was a cross-sectional research that was performed in the gynecology ward of Shahid Sadoughi Hospital in Yazd, Iran. The records of 200 patients were reviewed randomly. Patients’ information was including personal information, type of surgery, type of prophylactic antibiotic, dose of antibiotic and time of administration. Finally, the compliance of antibiotic prophylaxis with national guidelines was compared and data analysis was performed using SPSS 22 software. The age mean of patients was 36.6 ±10.5 years. Out of 200 operations, 85 were hysterectomy, 65 cesarean, 30 curettage & abortion and 20 other gynecological operations. The present study showed that the highest compliance was related to the time of antibiotic administration.

Effect of Multi-Sensory Stimulation of Neonates on Stress Level of Mothers with Premature Neonate Hospitalized in Neonatal Intensive Care Unit

Background and Objective: Premature birth is an unexpected event that causes a lot of stress for parents as they are not psychologically and emotionally prepared to face it. Therefore, this study aimed to determine the effect of multi-sensory stimulation of neonates by mothers on the stress level of mothers with premature neonates hospitalized in the Neonatal Intensive Care Unit (NICU). Materials and Methods: This quasi-experimental study was performed on 80 mothers (in experimental and control groups) who were selected using the census method in the NICU of Shahid Sadoughi Hospital, in Yazd, Iran. The infants in the experimental group were stimulated twice a day from the third to the sixth day. Data were collected using demographic characteristics form and Parental Stress Scale that were completed before and after the intervention. Data were analyzed in SPSS software (version 20) through statistical tests. Results: There was no significant difference between the mean stress levels in the two study groups before intervention; however, there were significant differences in intervention and control groups post-intervention in the mean±SD score of stress (P<0.001) in areas of scenes and sounds (2.26±0.40 and 2.63±0.47), infant’s appearance and behavior (3.79±0.29 and 4.05±0.25), relationship with the infant and parental role (2.60±0.38 and 3.41±0.33), and overall stress level (4.08±0.64 and 4.88±0.31). No significant difference was observed between the mean stress level in the area of communication and personnel’s behavior (P<0.3). Conclusion: The use of multi-sensory stimulation had a significant effect on reducing the stress in mothers with premature infants admitted to NICU. Therefore, this method is recommended to be used to improve the mental status of mothers.

Clinical and Paraclinical Predictive Factors for In-hospital Mortality in Adult Patients with COVID-19: A Cross-sectional Study in Iran

Background: COVID-19, a type of coronavirus emerged in Wuhan, China in December 2019, causing an epidemic of pneumonia with unknown reasons. Objective: This study aimed to investigate the factors affecting in-hospital mortality of patients with COVID-19 hospitalized in one of the main hospitals in central Iran. Methods: This retrospective cross-sectional study (February-May 2020) was conducted on patients with a confirmed diagnosis of COVID-19 admitted to Yazd Shahid Sadoughi Hospital in Iran. The patients with uncompleted or missed medical files were excluded from the study. Data were extract-ed from the patients' medical files and then analyzed. The patients were categorized as survivors and non-survivors groups, and they were compared. Results: Total 573 patients were enrolled and 356 (62.2%) were male. The mean±SD of age was 56.29±17.53 years, and 93 (16.23%) died. All the complications were more in non-survivors. Inten-sive care unit (ICU) admission was in 20.5% of the patients, which was more in non-survivors (P<0.001). The results of multivariate logistic regression test showed that pleural effusion in lung computed tomography (CT) scan (OR=0.055, P=0.019), white blood cell (WBC) (OR=1.418, P=0.022), serum albumin (OR=0.009, P<0.001), non-invasive mechanical ventilation (OR=34.351, P<0.001), and acute respiratory distress syndrome (ARDS) (OR=66.039, P=0.003) were the predic-tive factors for in-hospital mortality. Conclusion: In-hospital mortality with COVID-19 was about 16%. Plural effusion in lung CT scan, increased WBC count, lower mount of serum albumin, non-invasive mechanical ventilation, and ARDS were obtained as the predictive factors for in-hospital mortality.