An Exploration of the Viewpoints of Parents and Nurses on Care Provision in Neonatal Intensive Care Units

Background: Infants are regarded as a vulnerable group in need of nursing care, particularly during NICU admission. Parents of these infants often experience emotional, psychological and physical upheavals. Therefore, nurses can be of great help to the parents and facilitate a healthy transition from this period. Improper communication with parents, who seek information on their infant's condition, intensifies their stress, fear and misunderstanding. In fact, inadequate communication with healthcare providers and lack of family support are major issues for the parents of NICU-admitted infants. Methods: In this qualitative study, via content analysis, we objectively selected and collected data from parents, physicians and nurses, residing in Isfahan, Iran in 2012. Data saturation was reached after conducting 25 in-depth, semi-structured interviews. Results: Based on the findings, five major categories were extracted: 1) care provision in NICUs; 2) diagnostic difficulties; 3) NICU admission process; 4) challenges of hospitalization; and 5) maintenance of infant viability. Conclusion: Nurses' proper response to parents' questions about the infant's condition reduced stress among parents. Based on the findings, training is essential to healthy family dynamics and infant's well-being, particularly for younger parents who support their infants at home. Also, regular updates on infant's condition could help reduce parents' stress and discomfort

Hashimoto Encephalopathy with an Unusual Presentation of Status Epilepticus Seizures: A Case Report

A 33 yr old man, previously diagnosed with hypothyroidism, presented with decreased level of consciousness and generalized tonic-clonic (GTC) seizure to Namazi hospital, Shiraz, Iran, during April 2015. The patient later referred with another episode of seizure like attack for which he received phenytoin, carbamazepine and levothyroxine and was discharged. During his last admission, the patient was admitted with chief complaints of decreased consciousness and four GTC attacks. On admission, the patients had aphasia, ataxia, loss of verbal communication, eye contact and complete loss of obedience. Thyroid function tests showed low levels of T3 and T4 with high levels of thyroid stimulating hormone. Other blood tests were all either normal or slightly abnormal. Lumbar puncture and CSF analysis had a high titer of Anti-TPO antibodies. With high suspicion of Hashimoto encephalopathy, pulsed methyl prednisolone (10 mg) was administered, however the patient showed little improvement. Therefore, plasmaphresis was started, to which the patient showed dramatic response

The Iranian Parents of Premature Infants in NICU Experience Stigma of Shame

ntroduction: To explore experiences of Iranian parents with a hospitalized premature infant in Neonatal Intensive Care Unit (NICU) and examine socio-cultural factors associated with having a less than perfect infant. Methods: Purposely selected 21 participants in this study were 6 fathers, 7 mothers, 5 nurses and 3 physicians specialized in neonatology. Semi-structured in-depth interviews using inductive approach and content analysis helped obtain and analyze data by open encoding for classification and theme abstraction. Results: Findings revealed that parents of hospitalized NICU infants in Iran experienced: job and income loss; shattered confidence in parental role; challenges to family dynamics; shame as a social stigma; loss of control; overwhelmed with uncertainties; and stress induced physical and emotional problems. Conclusion: Unique and outstanding finding of this study was the social stigma of shame for parents of an NICU infant which directly explained the socio-cultural aspect of Iranian society where families place great importance on having a healthy and strong infant. Having a premature infant with anomalies is viewed as a family flaw. Physicians and nurses must focus more on communication with parents and fulfill an important role to educate, assure and comfort parents. Establishing support system for parents of NICU infants seem urgently needed to improve parentinfant bonding

The experiences of parents with infants in Neonatal Intensive Care Unit

Background: In recent years significant medical science advances have been made in the field midwifery and infant care. The premature, low birth weight and ill infants are admitted to the technologically advanced NICU for care and they often require long‑term stay. This study addresses parental experiences with the infant care in NICU, explores their concerns regarding nursing supports for parents and offers nurses’ perspectives on performing duties. Materials and Methods: A qualitative inductive content analysis method was applied in 2011 that included a purposely selected group of parents, nurses and physicians from neonatal unit at the Medical Science University of Isfahan. Participants were surveyed and interviewed according to the institutional ethics committee approval and signed informed consents. Results: The content analysis identified two main categories: 1) the definition of stress, which consisted of misgivings, nervous pressure, imbalance, separation and 2) the parents’ reaction to stress, which revealed emotional, psychotic and behavioral reactions as subcategories. Discussion: The medical team awareness of NICU parent experiences is essential to the quality of care. Recognizing the type of parents’ reaction to the whole process by the healthcare team seems essential to the optimum outcome

The effect of the various doses of atorvastatin on renal tubular cells; an experimental study

Recent retrospective observational studies suggest that high-potency statin therapy might increase the risk of acute kidney injury, however data on this subject is scares. Objectives: This study, was designed to investigate the renal tubular cell effect of different doses of atorvastatin to detect the possible aggravation of renal function or morphology of the kidney. Materials and Methods: In this experimental study 24 male Wistar rats were designated into 4 equal groups and treated as follows. Control group received phosphate buffer as the vehicle of atorvastatin for 7 days. Groups 1, II and III received atorvastatin at doses of 10, 50 and 150 mg/kg daily for 7 days, then on the day 8, all rats were anesthetized using ketamine and the blood samples were collected for evaluation of creatinine (Cr) and blood urea nitrogen (BUN) levels and then all rats were sacrificed, then the animals’ kidneys were dissected out and histopathological studies were performed Results: Mean (±SD) of scores of injury to renal tubular cells in control group was 4.2 ±2.2 and in groups I, II and III were 6.44 ± 4.9, 15.4± 8.5 and 25.8 ± 12.7 respectively. Group III which received 150 mg/kg/day of atorvastatin had significant renal damage in comparison to control group (P < 0.001). There was no significant difference of renal injury score between control group with groups of I and II. Conclusions: In the present study we found, atorvastatin with a dose of 150 mg/kg/day for 7 days was nephrotoxic for rats, while lower doses at 10 mg/kg/day or 50 mg/kg/day for 7 days were not accompanied by renal injury. These findings imply further attention to the administration of higher doses of atorvastatin in clinical conditions

Gravity/CFT correspondence for three dimensional Einstein gravity with a conformal scalar field

We study the three dimensional Einstein gravity conformally coupled to a scalar field. Solutions of this theory are geometries with vanishing scalar curvature. We consider solutions with a constant scalar field which corresponds to an infinite Newton's constant. There is a class of solutions with possible curvature singularities which asymptotic symmetries are given by two copies of the Virasoro algebra. We argue that the central charge of the corresponding CFT is infinite. Furthermore, we construct a family of Schwarzschild solutions which can be conformally mapped to the Martinez-Zanelli solution of Einstein's equations with a negative cosmological constant coupled to conformal scalar field.Comment: 27 pages, to appear in Nucl. Phys.

The effects of hydro-ethanolic extract of Capparis spinosa (C. spinosa) on lipopolysaccharide (LPS)-induced inflammation and cognitive impairment: Evidence from in vivo and in vitro studies

Ethnopharmacological relevance: Capparis spinose (C. spinosa) belonging to Capparaeae, originates from dry areas in the west or central Asia and Mediterranean basin. For thousands of years, C. spinosa has been reported to be used as a therapeutic traditional medicine to relieve various ailments including rheumatism, pain and inflammatory diseases. Aim of the study: There are several studies mentioning that systemic inflammation results in learning and memory impairments through the activation of microglia. The objective of this study was to investigate the effect of C. spinosa on both in vivo and in vitro models of neuroinflammation and cognitive impairment using lipopolysaccharide (LPS). Materials and methods: In vivo: 40 male rats were used in the present study. Cognitive impairment was induced using LPS (1 mg/kg/d; i.p.) for 4 weeks. Treatment with C. spinosa (100 and 300 mg/kg/d; p.o.) was performed 1 h before LPS administration. At the end of the experiment, rats were undergone for behavioral and biochemical analysis. In vitro: Primary microglia isolated from mouse was used in the present study. The cells were pretreated with C. spinosa extract (10�300 μg/ml) and then stimulated with LPS (1 μg/ml). The expression levels of inflammatory and anti-inflammatory cytokines were elucidated using Real-Time PCR and ELISA methods. Results: The escape latency in the Morris water maze test in the LPS group was significantly greater than the control group (p < 0.001), while, in extract-treated groups, it was less than the LPS group (p < 0.001). Additionally, we found that the levels of IL-1β, TNF-α, and iNOS/Arg-1 ratio was also significantly lower in extract-treated groups than the LPS group (p < 0.001). The results revealed that C. spinosa extract significantly reduced the levels of TNF-α, iNOS, COX-2, IL-1β, IL-6, NO and PGE2, and the ratios of iNOS/Arg-1 and NO/urea, following the LPS-induced inflammation in microglia (p < 0.001). Conclusions: Our finding provides evidence that C. spinosa has a neuroprotective effect, and might be considered as an effective therapeutic agent for the treatment of neurodegenerative diseases that are accompanied by microglial activation, such as AD. © 202

Effects of organic fertilizers on growth and biochemical characteristics of Fenugreek

Fenugreek (Trigonella foenum-graecum L.) is an annual herb used as organic (green) manure and has medicinal applications. Organic fertilizers are used in sustainable agriculture of vegetables. Sources of organic manure and their effects on growth and yield characteristics of plants need to be determined. Effects of vermicompost and vermiwash were determined on qualitative and quantitative factors of chemical content, development and yield of fenugreek (Trigonella foenum-gaecum L.) from May to July 2012 at Agriculture College of University Guilan. A completely randomized block design with 3 replications was used. Treatments included 7 t/ha of cow manure, vermicompost, vermiwash (obtained from 7 t/ha vermicompost); 7 t/ha of leachate vermicompost + vermiwash and a control (no fertilization). Use of organic fertilizers beneficially affected plant height, pod length, pod fresh and dry mass, 1000-seed mass, plant fresh and dry mass, internode length and percents of leaves protein and nitrogen. Use of organic fertilizers may increase yield and yield components of fenugreek and its yield efficiency.</p

Cost-effectiveness analysis of infliximab versus CinnoRA in the treatment of moderate to severe ulcerative colitis in Iranian patients

Objectives: This study was done to evaluate the cost-effectiveness of IFX versus CinnoRA for the treatment of moderate-to-severe UC patients. Conclusion: Our results demonstrated that IFX is more effective and more costly than CinnoRA, and if we ignore the predicted surgeries, CinnoRA is nearly as effective as IFX. However, these findings should be cautiously interpreted without a robust clinical trial of CinnoRA in UC patients. Since the impact of CinnoRA may have been over/underestimated