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Abstract Background Community-acquired pneumonia (CAP) is a major global health threat for children, causing numerous hospitalizations and deaths. CAP is a leading cause of mortality in children under five and results in millions of hospital admissions each year. Identifying reliable prognostic markers is crucial. Mean platelet volume (MPV) and red blood cell distribution width coefficient of variation (RDW_CV) are accessible and cost-effective options for prognosis assessment. This study investigates MPV and RDW_CV as prognostic markers in children with CAP. Methods This cross-sectional study included 150 children aged 1–15 years diagnosed with CAP upon initial examination and admitted to the hospital. CAP diagnosis was based on clinical symptoms, physical examination, and/or radiographic findings, with hospitalization criteria set for CAP in children. CAP severity was assessed using the Clinical Respiratory Score, categorizing patients into mild, moderate, and severe groups. MPV and RDW_CV were compared among these groups. Results Among the patients, 71 (47.3%) were girls, and 79 (52.7%) were boys. The average hospitalization duration was 6.24 ± 3.82 days, with a median of 5 days. Disease severity distribution was 58 (38.7%) mild, 54 (36.0%) moderate, and 38 (25.3%) severe. Both RDW_CV and MPV were higher in severe cases and in children hospitalized for more than 10 days (P

Background: The APGAR scoring system, including conventional, expanded, and combined Apgar scores, has been used to evaluate the condition of the newborn in the first minutes of birth. Umbilical cord arterial blood gas analysis (UCABGA) is another method. We compared the combined Apgar score with UCABGA in predicting short-term outcomes in neonates. Methods: A prospective cohort study was conducted on 363 live births. Neonates with major congenital anomalies, congenital cyanotic heart disease, congenital metabolic disorders, and those who transferred to other hospitals were excluded. Admission, discharge, demographic data, and Apgar scores were recorded in a pre-designed form. After delivery, the umbilical cord was double-clamped, and an arterial blood sample was taken from the clamped part. Statistical analyses were done using SPSS version 22 statistical software, and the receiver operating characteristic (ROC) curve was used to analyze the correlations between variables. Results: Out of 350 Neonates (204 male and 146 female) with a mean gestational age of 33.37±4.12 weeks, 263 (75.1%) neonates were admitted, and 34 neonates (9.7%) died. Retinopathy of prematurity(ROP) and Intraventricular hemorrhage (IVH) were recognized in 42 (12%) and 54 (15.4%) neonates, respectively, and 37 ( 10.6%) neonates ventilated mechanically. ROC curves show higher sensitivity and Specificity of 5th minute Combined Apgar score than PH and base deficit in predicting short-term outcomes except for IVH. Conclusion: The Combined Apgar score at minute 5 is a better predictor than UCABGA in predicting Death, need for admission, retinopathy of prematurity, and need for mechanical ventilation. None are good predictors for IVH.

Abstract Background Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common disorders in school-aged children. Learning disorder (LD) is also one of the most important psychiatric disorders in children, which can often be associated with ADHD. In this study, we sought to compare self-esteem and quality of life in 8 to 12-year-old children with attention deficit/hyperactivity disorder with and without co-occurring learning disorders in order to emphasize the importance of attention and diagnosis in children with ADHD. Method Among the 8- to 12-year-old outpatients referred to the child and adolescent psychiatry clinic of Omid Babol Clinic, 120 children aged 8 to 12 years with attention deficit/hyperactivity disorder whose disease was diagnosed by a child and adolescent psychiatry subspecialist. Among the tools used to collect information was the Colorado Learning Difficulties Questionnaire by Wilcott et al. (CLDQ), five-scale self-esteem test of Pepe et al. (1989) for children and quality-of-life questionnaire for 8–12-year-old children (PedsQL). Results This study investigated self-esteem and quality of life in children with ADHD (n = 120, 51.7% boys). Children with ADHD and learning disabilities reported significantly lower self-esteem and quality of life compared to those with ADHD alone. Conclusion Considering the relatively high probability of co-occurrence of ADHD and learning disorders, if one of them is diagnosed in a child, it is possible to look for other disorders in the child in order to avoid the more severe negative effects that this co-occurrence can have on the child by diagnosing it as soon as possible.

Background. Cardiotoxicity caused by fluoropyrimidines is an uncommon but potentially fatal complication. Its frequency has been 1.6 to 19% in previous studies. But there are no accurate statistics in Iran. The aim of this study was to determine the rate of cardiac complications of 5-fluorouracil (5-FU) infusion. Methods. This prospective study was conducted in patients with gastrointestinal cancers who underwent chemotherapy with regimens containing 24-hour infusion of 5-FU at Rohani Hospital of Babol. Patients with a history of radiation therapy to the chest or epigastrium or suffering from COVID-19 disease in the last 6 weeks were excluded from the study. Each patient was examined in 2 cycles of chemotherapy. In case of complications, cardiac examinations including examination, electrocardiogram, echocardiography and if necessary, coronary angiography were done. Data analysis was done with SPSS 26 software using descriptive indices and Fisher exact test (significance≤0.05). Results. In sixty one patients, 122 courses of chemotherapy were evaluated. Underlying cancer was colorectal cancer in 32 patients, stomach cancer in people. Eight patients (13.11%) had cardiac complication, in eleven chemotherapy cycles, included 7 cases of chest pain and one case of each of complications of myocardial infarction, pulmonary edema and pericarditis. Four out of 8 patients suffered from complications only in the first round, one only in the second round and three patients in both rounds of chemotherapy (P=0.004).The incidence rate of complications in patients without a history of heart disease was 8.7% and in patients with a history of heart disease 26.7%(P=0.073), in non-smokers 10% and in smokers 30%(P=0.084). It was 10.6% in non-diabetic patients and 21.4% in diabetic patients (P=0.294). Conclusion. Cardiac complications are common in 24-hour injection of 5-fluorouracil. A patient who has a heart complication once, might have a higher probability of having a complication in the next cycles. Practical Implications. Due to the high prevalence of cardiac complications of 24-hour floururacil infusion, especially in patients with a history of heart disease, careful cardiac monitoring during hospitalization is recommended.

Introduction: Ultrasound is performed to check the growth of endometrial cells outside the uterus and the pathology is performed to confirm endometriosis. A combination of diagnostic methods is important for summarizing and starting treatment of endometriosis. The present study was performed with aim to investigate and compare clinical and ultrasound diagnoses in patients with histopathological diagnoses of endometriosis. Methods: This retrospective study was conducted in 2010-2021 on 140 women aged 18-65 years old suffering from endometriosis referred to Ayatollah Rouhani Hospital in Babol city. Confirmation of endometriosis was done based on tissue pathology and then comparing clinical history with ultrasound findings. The data collection tools were the patients' files and the researcher made checklist. Collected data included clinical manifestations, presence or absence of pain during menstruation, abdominal pain, pain during intercourse, pelvic pain, abnormal menstrual bleeding, backache, pain during defecation, and dysuria. Data were analyzed by SPSS software (version 22) and chi-square and independent t-tests. P

Background: It has been pronounced that everolimus-eluting stent (EES) had lower charge of goal-lesion revascularization and stent thrombosis as compared with sirolimus-eluting stents (SES).The goal of this observation was to compare the efficacy and protection of EES with SES in primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). Methods: In this retrospective study, a total of 404 patients with coronary artery stenosis who underwent angioplasty of one or more coronary arteries were included in the study. Of these, 202 were treated with SES and the others with EES. The data were collected by a questionnaire through which the annual incidence of coronary stent complications including the occurrence of stent thrombosis (confirmed by re-angiography), the occurrence of acute coronary syndrome leading to hospitalization, the occurrence of vascular myocardial infarction related to the stenting vessel, the need for re-angiography and angioplasty and finally the incidence of cardiac mortality were evaluated. Results: This study showed that the odds ratio of EES thrombosis to SES stent in the unadjusted model is 1.01 (0.06-16.34) and in the adjusted model for confounding variables was equal to 0.80 (0.04-13.35) which in both models, these values were not statistically significant. Conclusion: The findings of the present study indicate that there is no statistically significant difference between the outcomes in the two groups treated with SES and EES release stents.

Background: Various factors, most notably the stone's features, determine the selection of an appropriate method to extract common bile duct (CBD) stones during endoscopic retrograde cholangiopancreatography. In this study, the efficacy and safety of endoscopic sphincterotomy with balloon dilation (ESBD) versus endoscopic sphincterotomy (EST) for CBD stone extraction with a diameter of 10 to 15 millimeters were compared. Methods: This retrospective cross-sectional study included 154 patients referred to the Rouhani Hospital in Babol, Iran, with CBD stones. Consensus sampling was used. Each individual's demographic information and findings from the procedure were entered into the SPSS software (v. 26). A level of less than 0.05 was considered statistically significant. Results: A total of 154 patients were included in the study, of which 81 (52.6%) were in the EST, and 73 (47.4%) were in the ESBD group. Complete stones removal rate was higher in the ESBD versus the EST group (79.5% versus 46.9%, P

Background: Pleural effusion is the accumulation of fluid in the pleural cavities resulting from an imbalance of fluid production and reabsorption. Early detection of the cause of pleural effusion leads to early treatment and reduces effects on the patient. The most important step in pleural effusion diagnosis is to determine its nature and to determine whether it is transudate or exudate. CRP(C-reactive protein) is an acute-phase protein that is synthesized by hepatocytes during inflammatory states, the highly sensitive type of CRP is more sensitive than the standard CRP test and measures lower levels. It may help differentiate the nature of pleural effusion. The aim of this research was to evaluate the hs-CRP diagnostic value in differentiating the nature of the pleural effusion Methods: In this descriptive-analytical cross-sectional study, in Rohani hospital of Babol from March 2017 to February 2019, 75 pleural effusion patients, undergoing thoracentesis, the hs-CRP level was measured in their pleural fluid and were compared based on Light´s criteria in two groups of transudates and exudates. Using the ROC curve, the appropriate cut-off point was determined for hs-CRP to differentiate the nature of pleural effusion. Results: Out of 75 patients, 45 patients were in the exudative pleural effusion group and 30 patients in the transudative group. The mean of hs-CRP in the exudate group was 18.27±10.74 mg/L and in the transudative group 2.98±2.15 mg/L (p˂0.001). The cut-off point for hs-CRP of pleural fluid was calculated to be 5.94 mg / L, which has a sensitivity of 88.9% and a specificity of 93.3%. This marker was also studied in exudative subgroups, and there was a significant difference between pleural hs-CRP levels in two groups of pleural effusion due to malignancy and Parapneumonic effusion (p=0.011). Conclusion: The pleural fluid hs-CRP can be used as a useful marker for differentiating the nature of pleural effusion and differentiating the pleural effusion of transudate and exudate.

Background and Objective: The emergency department in medical education, as one of the fundamental terms, plays a vital role. Assessing the quality of education in the emergency department in terms of clinical skills plays a key role in the improvement of educational systems in this field. The aim of this study is to determine the self-assessment of medical interns regarding the education in the emergency department. Methods: This study was conducted as a descriptive-cross-sectional study on 100 interns of Babol University of Medical Sciences. In this study, satisfaction with emergency department education in terms of "acquiring clinical skills in managing emergency patients","acquiring clinical skills in performing primary therapeutic interventions" and "quality of emergency department education" was examined. Finally, the collected data were analyzed using SPSS26 software. Findings: The average age of the participants was 25.54 ± 1.42 years. The results showed that in the field of emergency skills, the highest dissatisfaction of students was related to dealing with environmental emergencies, in the field of core skills, establishing airway management, and overall quality of emergency in creating motivation for study and research. Also, indices related to dealing with consciousness disorders, dealing with shortness of breath, and dealing with high blood pressure in the field of core skills were significantly correlated with age and/or gender. In the field of core skills, most of the indices were statistically correlated with age or gender. Conclusion: According to the findings, the need for planning and taking specific measures in the field of some clinical skills in the emergency department to increase the satisfaction of specified interns is emphasized.

Abstract Background Nowadays, it is generally assumed that non-pharmacologic pain relief in preterm infants is an important measure to consider. Research findings suggest that familiar odors have soothing effects for neonates. The aim of this study was to compare the effect of maternal breast milk odor (MBMO) with that of another mother’s breast milk odor (BMO) on the behavioral responses to pain caused by hepatitis B (HB) vaccine injection in preterm infants. Methods This single-blind randomized clinical trial was performed over the period between February 2019 and March 2020 in the neonatal intensive care unit of Babol Rouhani Hospital, Iran. Ninety preterm infants, who were supposed to receive their HB vaccine, were randomly assigned into three groups: MBMO (A), another mother’s BMO (B), and control with distilled water(C). Oxygen saturation (SaO2), blood pressure (BP) and heart rate (HR) were recorded for all participants through electronic monitoring. In addition, premature infant pain profiles (PIPP) were determined through video recording for all three groups during intervention. The chi-square, ANOVA and ANCOVA were used for analyzing the data, and P 0.05). After the intervention, however, the means for heart rate in groups A, B, and C were 146 ± 14.3, 153 ± 17.5 and 155 ± 17.7, respectively (P = 0.012). Moreover, the means for PIPP scores in groups A, B and C were 6.6 ± 1.3, 10 ± 2, and 11.4 ± 1.9, respectively (P 0.05). Conclusions The results indicate that stimulation with MBMO is effective in reducing pain in preterm infants; therefore, it can be postulated that this technique can be considered in less invasive procedures such as needling. Trial registration IRCT, IRCT20190220042771N1 . Registered 18 May 2019- Retrospectively registered,

The Occupational burnout is considered as one of the most important problems that have numerous adverse effects on nurses' job. Various personal, psychological and social factors are effective in occupational burnout. Therefore, the goal of this study was to find out the relationship between emotional intelligence and job stress with occupational burnout of nurses working in public hospitals of Kerman. This descriptive-analytical and cross-sectional study, was conducted on 300 nurses working in Kerman hospitals who selected randomly by stratified method. Organizational and demographic questionnaire and occupational burnout, emotional intelligence and job stress questionnaires have used. Structural and confirmatory factor analysis models were used to measure the model of the study. Emotional intelligence and job stress affect occupational burnout. In addition, there were meaningful and negative relationships between emotional intelligence and job stress (P

Abstract Background Premenstrual Syndrome (PMS) is a common public health issue affecting many women of reproductive age worldwide. This study has been designed to investigate of computer-based stress inoculation training (SIT) counseling approach on anxiety, depression, and stress of university students with PMS. Methods A randomized trial study with two parallel arms was done from 30 October 2022 to 21 June 2023 on 100 university students aged 18 to 38 at Babol University of Medical Sciences. The participants were randomly divided into two groups intervention and control. The data collection tools included questionnaires on demographic-fertility characteristics, the Premenstrual Symptoms Screening Tool (PSST), the Hospital Anxiety and Depression Scale (HADS), the Perceived Stress Scale (PSS-14), the Sheehan Disability Scale (SDS) and Riff’s Psychological Well-being Scale (RPWS). The data were assessed using chi-square, t-student, ANOVA repeated measure, and linear regression tests. A significance level of P

سابقه و هدف: هوش معنوی ظرفیتی است که می‌تواند موجب افزایش انطباق‌پذیری فرد در زندگی شود. هدف پژوهش حاضر طراحی پرسش‌نامۀ هوش معنوی مبتنی بر آموزه­های قرآنی و تعیین ویژگی‌های روان‌سنجی آن بود. روش کار: این پژوهش از نوع مطالعات آزمون­سازی و همبستگی است. جامعۀ آماری پژوهش دانشجویان دانشگاه علوم پزشکی بابل بود که با استفاده از روش نمونه‌گیری دردسترس 276 نفر از آنان انتخاب شدند و هم‌زمان پرسش‌نامه­های هوش معنوی مبتنی بر آموزه­های قرآنی، سلامت عمومی، سلامت معنوی و هوش معنوی را تکمیل کردند. بررسی روایی این پرسش‌نامه‌ها از طریق ارزیابی روایی محتوایی، روایی صوری، روایی سازه با استفاده از تحلیل عاملی و روایی و روایی همگرا و روایی هم‌زمان با استفاده از آزمون همبستگی پیرسون صورت گرفت. برای تعیین پایایی پرسش‌نامه نیز از آلفای کرونباخ و پایایی بازآزمایی استفاده شد. در این پژوهش همۀ موارد اخلاقی رعایت شده است و مؤلفان مقاله تضاد منافعی گزارش نکرده‌اند. یافته‌ها: نتایج نشان داد که روایی محتوایی و صوری پرسش‌نامۀ هوش معنوی مبتنی بر آموزه­های قرآنی پذیرفتنی است. با استفاده از تحلیل عامل اکتشافی دو عامل پنهان در پرسش‌نامه یافت شد و تحلیل عاملی تأییدی مؤید روایی سازۀ آن بود. همبستگی معنادار بین نمرات این پرسش‌نامه و پرسش‌نامۀ هوش معنوی گویای روایی هم‌زمان و همبستگی معنادار بین دو خرده‌مقیاس و نمرۀ کل پرسش‌نامه گویای روایی همگرای آن بود. آلفای کرونباخ و پایایی بازآزمایی پرسش‌نامه نیز مطلوب بود. نتیجه‌گیری: با توجه به نتایج حاصل از روایی و پایایی پرسش‌نامۀ هوش معنوی مبتنی بر آموزه­های قرآنی می‌توان گفت این پرسش‌نامه ابزاری پایا و روا برای بررسی هوش معنوی بر اساس آموزه­های قرآنی است و قابلیت استفاده در جامعۀ ایرانی دارد.