Experiences of the mothers of infants hospitalized in the neonatal intensive care unit (NICU)

BACKGROUND

The mother-newborn relationship is more important in neonates hospitalized in the NICU than in healthy neonates. This study was conducted to explore the experiences of the mothers of infants hospitalized in the NICU.

MATERIALS AND METHODS

This qualitative study was done in 2016 by adopting a conventional content analysis approach. Thirty-five mothers in the NICUs, Imam Hossein Hospital and Fatemieh Hospital were selected. Their experiences were assessed using in-depth individual semi-structured interviews. Sampling was purposive and was continued until reaching data saturation.

RESULTS

Two hundred and nine primary codes were extracted. After removing duplicates and overlaps, 95 primary codes were categorized in 8 subcategories, 2 accessory categories and 1 main category based on their appropriateness, agreement, and similarity. The accessory categories of "mothers' worries" and "mothers' hopes" were merged into a more general, abstract category named "dual feelings about the baby".

CONCLUSIONS

The nurses' awareness of the mothers' experiences can help design interventions to promote the quality of care for mothers and infants in the critical period of the NICU admission.

Antimicrobial Photothermal Treatment of Pseudomonas Aeruginosa by a Carbon Nanoparticles-Polypyrrole Nanocomposite

BACKGROUND

Nowadays, it is needed to explore new routes to treat infectious bacterial pathogens due to prevalence of antibiotic-resistant bacteria. Antimicrobial photothermal therapy (PTT), as a new strategy, eradicates pathogenic bacteria.

OBJECTIVE

In this study, the antimicrobial effects of a carbon nanoparticles-polypyrrole nanocomposite (C-PPy) upon laser irradiation were investigated to destroy the pathogenic gram-negative Pseudomonas aeruginosa.

MATERIAL AND METHODS

In this experimental study, the bacterial cells were incubated with 50, 100 and 250 µg mL-1 concentrations of C-PPy and irradiated with a 808-nm laser at two power densities of 0.5 and 1.0 W cm-2. CFU numbers were counted for the irradiated cells, and compared to an untreated sample (kept in dark). To explore the antibacterial properties and mechanism(s) of C-PPy, temperature increment, reactive oxygen species formation, and protein and DNA leakages were evaluated. Field emission scanning electron microscopy was also employed to investigate morphological changes in the bacterial cell structures.

RESULTS

The results showed that following C-PPy attachment to the bacteria surface, irradiation of near-infrared light resulted in a significant decrement in the bacterial cell viability due to photothermal lysis. Slightly increase in protein leakage and significantly increase intracellular reactive oxygen species (ROS) were observed in the bacteria upon treating with C-PPy.

CONCLUSION

Photo-ablation strategy is a new minimally invasive and inexpensive method without overdose risk manner for combat with bacteria.

Carbon@polypyrrole nanotubes as a photosensitizer in laser phototherapy of Pseudomonas aeruginosa

Phototherapy has been offered as an alternative and promising antibacterial strategy to overcome the antibiotic resistance problem. This study evaluated the antibacterial and phototherapy effects of carbon nanotubes with a polypyrrole coating in a core@shell structure (CNTs@PPy) on Pseudomonas aeruginosa (P. aeruginosa). P. aeruginosa was treated with CNTs@PPy at different concentrations (50-500 μg mL^-1) in dark or laser light irradiation with a wavelength of 808 nm, a power density of 1000 mW cm^-2 for 20 min. Temperature increment, cell viability, formation of reactive oxygen species (ROS) and protein/nucleic acid leakage subsequent the P. aeruginosa treatment were evaluated. The results showed that near-infrared laser irradiation of CNTs@PPy caused to a temperature increment confirming the ability of powerful photokilling of P. aeruginosa in a photothermal route. On the other hand, while CNTs@PPy represented just a 30-50% P. aeruginosa killing rate in dark, laser irradiation of 250 and 500 μg mL^-1 concentrations of CNTs@PPy resulted in a ˜70% P. aeruginosa killing rate, along with significant ROS production into the medium and protein and nucleic acid leakage from P. aeruginosa. These later effects were assigned to a photodynamic route activity of CNTs@PPy upon laser irradiation. Therefore, CNTs@PPy acted as a photosensitizer in both photothermal and photodynamic therapies to present an enhanced bactericidal activity to annihilate and destroyed the gram-negative bacteria P. aeruginosa, a cause of many infectious diseases.

Assessment of narrative writing by Persian-speaking students with hearing impairments

OBJECTIVE

Previous studies have highlighted that narrative skill is critical to the development of the literacy skills by children. Children with cochlear implants (CI) and hearing aids (HA) may have problems in narrative development compared to peers with healthy hearing (HH). There is no exact data about the narrative writing ability of Persian-speaking students who are hearing-impaired. This study was undertaken to compare the microstructure and macrostructure scores for narrative writing of Persian-speaking students who are hearing-impaired and peers with HH.

DESIGN

This was a cross-sectional descriptive-analytical study.

SETTING

The subjects were recruited from elementary schools in the city of Tehran.

PARTICIPANTS

A total of 144 elementary school students were participated.

OUTCOME MEASURES

The written narratives were elicited using a wordless pictorial storybook story. Three-way ANOVA with post hoc adjusted Bonferroni test was applied to determine the main effects and interactions of grounded variables on the microstructure and macrostructure components of narrative writing.

RESULTS

No significant differences were observed in the macrostructure components of narrative writing between hearing-impaired and HH students. Factors analysis showed that the 4th grade HH students had significantly the highest scores, and the 3rd grade HA students had significantly the lowest scores in microstructure components of narrative writing.

CONCLUSION

The findings revealed that hearing-impaired students similarly to their HH peers can transmit the main idea (macrostructure) of narrative writing, but show critical difficulties when using complete grammatical elements (microstructures) to form sentences to convey the idea in the narrative.

Efficacy and safety of Cerebrolysin treatment in early recovery after acute ischemic stroke: a randomized, placebo-controlled, double-blinded, multicenter clinical trial

Background and Purpose : The aim of this study was to evaluate the efficacy, safety, and tolerability of cerebrolysin in the early recovery phase after acute ischemic stroke. Methods. This prospective, randomized, double-blinded, placebo-controlled, multicenter, parallel-group study enrolled a total of 100 patients within 18 h after the onset of stroke. The patients were treated with Cerebrolysin (30 mL over seven days followed by 10 mL until day 30) or placebo once daily over a period of four weeks. Efficacy was primarily assessed by the NIH Stroke Scale at day 30, and additional parameters included the modified Rankin Scale, the Clinical Global Impression, the Patient Global Satisfaction (PGS) and the Mini Mental State Examination (MMSE). Nonparametric statistical procedures employing the Wilcoxon-Mann-Whitney test were used for data analysis. Safety and tolerability were assessed by adverse events, vital signs, and laboratory parameters. Results.The estimated effect size on the change from baseline in the NIH Stroke Scale on day 30 indicated a medium to large superiority of cerebrolysin compared to placebo (Mann-Whitney [MW] 0.66; 95% confidence interval [CI] 0.55-0.78, P=0.005). Similar effect sizes were reported for the modified Ranking Scale (MW 0.65; 95% CI 0.54-0.76; P=0.010) and the Clinical Global Impression (MW 0.70; 95% CI 0.55-0.85; P=0.006). Effect sizes in the MMSE and PGS did not reach statistical significance. No significant group differences were seen in any of the safety parameters. Conclusions. Cerebrolysin was effective, safe, and well tolerated in the early recovery phase after acute ischemic stroke and significantly improved neurological and global function outcomes compared to placebo.

Serum level of copper in patients with coronary artery disease

Background:

Atherosclerotic disease is the most important cause of mortality in the world. Oxidation is an important pathway in the pathogenesis of coronary artery disease (CAD) through oxidation of low-density lipoprotein (LDL) and free radical formation. Copper (Cu) is an essential micronutrient for enzymes that catalyse LDL oxidation reactions. Therefore, an evaluation of Cu in the atherosclerotic disease is important.

Materials and Methods:

In this study, 334 subjects without recent cardiac event and history of collagen vascular or infectious disease were investigated. All patients divided into four groups to evaluate severity of CAD according to Syntax scoring system. All groups were matched in cardiovascular risk factors.

Results:

The serum level of Cu was significantly higher in total atherosclerotic groups than normal group (P value = 0.001) and significantly increased with severity of atherosclerosis.

Conclusion:

The finding indicated that the serum level of Cu is higher in atherosclerotic patients and it increases with severity of atherosclerosis. Therefore, it may be possible that the basic relationship exist between serum Cu level and atherosclerosis and an association between Cu level and severity of atherosclerosis.

Association between Serum Iron and the Severity of Coronary Artery Disease

BACKGROUND

Coronary Artery Disease (CAD) is the most important cause of mortality in the world. About half of cardiovascular risk factors have not been completely understood. Oxidation of LDL by oxidants such as iron plays a central role in atherogenesis. As a result, evaluation of the iron stores is important in the risk evaluation of the atherosclerotic disease.

MATERIALS AND METHODS

This cross sectional study was performed on 337 patients with chronic stable angina hospitalized in Sari heart center, Mazandaran University of Medical Sciences from February 2010 to July 2012. Coronary angiography was performed and the angiograms were evaluated by two cardiologists. Moreover, blood samples were collected after a 14-hour fast immediately before the coronary angiography in order to measure the total cholesterol, HDL- cholesterol, and glucose. The patients were divided into four groups to evaluate the severity of Coronary Artery Disease (CAD) according to Syntax scoring system.

RESULTS

The study results revealed a significant difference among the four study groups regarding the iron serum level. It was significantly higher in the sever atherosclerosis group compared to the normal (P=0.0122), mild (P=0.023), and moderate CAD groups (P<0.001).

CONCLUSIONS

The findings indicated that the serum level of iron was higher in the atherosclerotic patients and increased with the severity of CAD. Therefore, a basic relationship probably exists between the serum iron level and CAD. Further prospective and experimental studies are needed to confirm the association between the iron status and atherosclerosis.

Isolation and genetic characterization of metallo-β-lactamase and carbapenamase producing strains of Acinetobacter baumannii from patients at Tehran hospitals

BACKGROUND AND OBJECTIVE

Carbapenems are therapeutic choice against infections caused by gram-negative bacilli including strains of Acinetobacter baumannii. Resistance to these antibiotics is mediated by efflux pumps, porins, PBPs and ß-lactamases. The aim of this study was to determine the possibility of existence of MBLs, OXAs and GES-1 betalactamase genes among clinical isolates of Acinetobacter collected from Tehran hospitals.

MATERIAL AND METHODS

Two hundred and three Acinetobacter isolates were collected from patient at Tehran hospitals. The isolates were identified using biochemical tests. The susceptibility to different antibiotics was evaluated by disk diffusion method and MICs of imipenem were determined using Micro broth dilution method (CLSI). PCR was performed for detection of bla(VIM-2), bla(SPM-1), bla(IMP-2), bla(GES-1), bla(OXA-51), bla(OXA-23) betalactamase genes. Clonal relatedness was estimated by PFGE with the restriction enzyme SmaI.

RESULTS AND CONCLUSION

Of 100 isolates of imipenem resistant Acinetobacter spp. collected from Tehran hospitals in 2009 and 2010, 6 isolates produced metallo-beta-lactamases and 94 isolates produced OXA-type carbapenemase. The bla(SPM-1), bla(GES-1), bla(OXA-51), bla(OXA-23) genes were detected by PCR among 6, 2, 94 and 84 isolates of A. baumannii, respectively. The MICs of isolates to imipenem were 8-128 µg/mL. PFGE analysis of 29 bla(OXA-51) and bla(OXA-23)-positive A. baumannii isolates gave 6 different patterns. This is the first report of SPM-1 and GES-1 beta-lactamase producing A. baumannii. Production of the OXA-23, OXA-51, GES-1 and SPM-1 enzyme presents an emerging threat of carbapenem resistance among A. baumannii in Iran.

Single-dose oral fluconazole versus topical clotrimazole in patients with pityriasis versicolor: A double-blind randomized controlled trial

This study was designed to compare the therapeutic effects of topical clotrimazole and systemic fluconazole in pityriasis versicolor. A double-blind randomized controlled trial was carried out in the dermatological clinic of Gorgan, northern Iran, between April 2006 and May 2007. All consecutive patients with pityriasis versicolor were included and randomly divided into two groups. In the first group (G1), patients underwent treatment with a single dose of fluconazole capsule (400 mg) and placebo cream. In the second group (G2), patients underwent treatment with clotrimazole cream (twice daily) and placebo capsule. The course of treatment was 2 weeks. All subjects were re-evaluated 2, 4 and 12 weeks after the end of the therapeutic course. After 2 weeks, the rate of complete resolution of disease was significantly higher in G2 than G1 (49.1% vs 30%). After 4 weeks, 41 patients (81.2%) of G1 and 52 patients (94.9%) of G2 showed complete resolution. After 12 weeks, 46 patients (92%) in G1 and 45 patients (81.8%) in G2 showed complete resolution. Recurrence rate in G1 and G2 were 6% and 18.2%, respectively. No complications were seen in either group. In this study, clinical response at week 4 was greater in the clotrimazole group than the fluconazole group. Recurrence at week 12 after treatment was less with oral fluconazole than clotrimazole cream. So, for better evaluation, more studies need to be done.