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Background: Low birth weight neonates have low energy reserves; thus, postpartum feeding is required to meet their ongoing nutritional requirements. Total parenteral nutrition (TPN) provides critical nutrients for the metabolism and development of neonates; however, few studies have investigated the effect of TPN on the early growth patterns of neonates. The present study examined the effects of TPN on preterm neonate anthropometric characteristics using two commonly used TPN calorie introduction techniques. Methods: This randomized clinical trial studied preterm neonates with birth weights of less than 1500 g. Calories were initiated at a rate of 3 g/kg for lipids and 3.5 g/kg for amino acids in the intervention group. In the control group, the amino acid solution was begun at 1 g/kg/day and the lipid solution at 0.5 g/kg/day, and both were increased daily by 1 g/kg to a maximum of 3.5 and 3 g/kg/day for amino acids and lipids, respectively. In this group, all neonates reached full calorie intake at 3 to 5 days of age. The trend of change in the anthropometric parameters was evaluated and compared. Results: Although both groups showed an increase in neonatal weight, length and head circumference, no statistically significant difference was observed between them. Both groups had similar lengths of hospital stay. Conclusion: Based on the findings of the present study, TPN feeding done using two approaches to amino acid and lipid administration had no significant influence on hospital stay, TPN duration, or growth indices in preterm neonates weighing less than 1500 g.

Key Clinical Message In this case report, total knee arthroplasty was performed in a patient with pigmented villonodular synovitis. During surgery, severe black discoloration of the articular cartilage and menisci was observed in the patient. According to literatures, this is the first case report of severe articular cartilage pigmentation in a patient with pigmented villonodular synovitis.

Background and aim: During the last two decades, with the introduction of nanotechnology, a more promising perspective for cancer treatment appeared, and many research was conducted in nanomedicine. Based on the findings of studies, nanoparticles improve bioavailability, overcome biophysical and biochemical barriers, and reduce cytotoxicity. This study aims to evaluate the survival rate and clinical outcome of nanodrug administration for lung cancer treatment.Material and methods: In this study, international databases such as PubMed, Scopus, Science Direct, ISI, Web of Knowledge, and Embase were reviewed to select articles related to the purpose of this study from January 2012 to July 2022. Effect size with 95% confidence interval (CI) with fixed effect modal and inverse-variance done. STATA.V16 software was used for data analysis.Results: In the initial review, the abstracts of 183 studies were reviewed, two authors reviewed the full text of 34 studies, and finally, seven studies were selected. Overall survival rate and Progression-Free survival rate between nab-paclitaxel plus carboplatin compared solvent-based paclitaxel plus cisplatin in lung cancer patients was 88% (HR: 95% CI, 0.51 to 1.25; p=0.00) and 77% (HR: 95% CI, 0.37 to 1.17; p=0.00), respectively.Conclusions: Based on the findings of the present meta-analysis, nab-paclitaxel administration can prolong the progression-free survival rate; improve the objective response rate, and increase the overall survival rate.

Background and Objectives: Placement of skin heat probe for continuous monitoring of infant body temperature is one of the main components of neonatal care. Therefore, managing the body temperature of newborns under radiation warmers requires a lot of attention from nurses to prevent unwanted complications. The aim of this study was to determine the appropriate connection point of skin probe for temperature control in premature infants under radiant heating admitted to neonatal intensive care units in Hamadan in 2020. Materials and Methods: In this cross-sectional descriptive study, 140 infants aged 34 to 37 weeks admitted to neonatal intensive care units in Hamadan in 2020 who met the inclusion criteria were included in the study by available methods. The incubator temperature was set at 37 degrees and it was the same for all infants. For each infant, the probe was attached to the forehead, chest between the ribs, right axillar, arms adjacent to the nipple, right armpit, back of the legs, and upper thigh, respectively. The baby's temperature displayed on the digital warmer screen was recorded two minutes later. A researcher-made checklist was used to record the data and the data were analyzed using t-test and Paired t-test. Results: The correlation between left and right axillary was highest, meaning that the best location for the incubator thermometer probe, after the left axillary is the right axillary (r = 0.91, P = 0.001). Conclusions: The most suitable place for connecting skin probe for temperature control after left axillary, is the right axillary.

Introduction: To prevent the adverse effects of fetal malnutrition (FM), its management and early diagnosis by reliable tools are essential. The present study aimed to identify the rate of malnutrition in a referral maternity center in Iran using different systems for evaluating the nutritional status and determining a better index for FM. Methods: This cross-sectional study was performed on the neonates born in the maternity ward of Hajar Hospital in Shahrekord, Iran in 2020. FM was evaluated based on different parameters, including the CANSCORE index, body mass index (BMI), Ponderal index, and mid-arm circumference/head circumference (MAC/HC) index. After recording the measurements, birth weight and height were plotted on the intrauterine growth chart, and the infants were classified into groups of appropriate for gestational age (AGA), small for gestational age (SGA), and large for gestational age (LGA). Results: Based on the fetal growth status index, 14.7% of the neonates were in the AGA group, and 95.3% were in the LGA group. Malnourishment was detected in 40.5% of the neonates based on the CANSCORE index, 8.3% based on the MAC/HC index, 6.9% based on the BMI, and 5.2% based on the Ponderal index. In addition, the CANSCORE index had a significant positive correlation with all the growth indices (except the MAC/HC index), and the Ponderal index was also significantly correlated with all the growth indices except height. Conclusion: According to the results, the CANSCORE index could show growth status and FM more accurately compared to other anthropometric parameters that may underestimate FM. Furthermore, BMI is a highly sensitive indicator, and infants malnourished in terms of BMI should be examined based on the CANSCORE index to accurately identify FM.

Background: Invasive mechanical ventilation in infants suffering from respiratory distress syndrome (RDS) is associated with some complications, such as chronic lung disease, and therefore, the tendency to use non-invasive methods is increasing. The present study aimed to compare the effect of non-invasive continuous positive airway pressure (CPAP) and a combination of high-frequency oscillation ventilation (HFOV) and CPAP in the treatment of RDS in infants.Methods: In this clinical trial, 37 infants suffering from RDS admitted to the Neonatal Intensive Care Unit of Hajar Hospital in Shahrekord were randomly assigned to two groups treated with CPAP alone and CPAP plus HFOV. The baseline information, including gestational age, time of birth, weight, gender, duration of hospitalization, duration of oxygenation and CPAP, the time of transition to oral feeding, and hemodynamic parameters, were recorded. The obtained data were analyzed in Stata software.Results: The mean scores of the length of hospitalization, the time to start and complete oral feeding, as well as the duration of CPAP and oxygenation, were higher in the CPAP group, as compared to those in the HPA+CPAP group; nonetheless, the differences were significant only for the duration of oxygenation (P

Skin is the body's first defense line against environmental pathogens. However, open skin wounds can interfere with the normal function of the skin and the entry of opportunistic bacteria into the body. Recently, the development of nano-dressing containing green antibiotics has been received much attention around the world. In this study, the essential oil of Citrus sinensis (CSEO) was used as an antibacterial agent. The ingredients of CSEO were identified by GC-MS analysis with five major components of Limonene (61.83%), trans-p-2, 8-Menthadien-1-ol (4.95%), Trans-Limonene oxide (2.29 %), Cis- Limonene oxide (2.58 %), and trans-Carveol (2.90%). Nanogel of CSEO was prepared by the addition of a gelling agent (carbomer 940 2%) to its optimum nanoemulsion with a particle size of 125 ± 4 nm. Also, electrospun nanofibers of polycaprolactone with a mean diameter of 186 ± 36 nm were prepared. Characterization of the nanofibers, including SEM, ATR-FTIR, and contact-angle measurement, were carried out. After that, the nanogel was impregnated on the surface of the nanofibers, NGelNFs. Interestingly, NGelNFs completely inhibited the growth (~ 0%) of four important human bacteria strains, including Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumonia. The prepared prototype, NGelNFs, can be used as a potent antibacterial agent. Furthermore, this work introduced an effective and new method for the preparation of green antibacterial agents as well as antibiotic-free wound dressings.

The faults and fractures are known as two of the most important parameters in earthquake occurrence. During the construction in urban areas, faults and fractures may be covered in depth and thus are not visible at the ground surface. In this context, non-invasive geophysical prospecting methods (microtremor and geoelectrical methods) and borehole data were used to detect subsurface geological structures (hidden faults) in a suburb of Shiraz in Iran. The horizontal to vertical spectral ratio (HVSR) method was used to obtain the dynamic parameters (predominant frequency and resonance amplitude) of the soil, to detect hidden faults. The results show that the abrupt changes in the sediment thickness and predominant frequencies at a specific direction (NW-SE) can be related to the displacement of a nearly vertical fault with NW-SE trend. In addition, the electrical resistivity method using continuous resistivity profiling (CRP) and Schlumberger arrays was employed to detect a hidden fault and the results were compared with previous data. The obtained results of both arrays illustrate the presence of a nearly vertical fault with NW-SE trend in the region. Comparison of all results shows that the detected faults by both methods are consistent with each other. Therefore, it can be conclusive that combination of the two methods is a useful and reliable approach to study and detect hidden faults. Keywords: Microtremor, Horizontal to vertical spectral ratio (HVSR), Electrical resistivity, Sediment thickness, Hidden faults

Background: The cornerstone of the treatment of respiratory distress syndrome (RDS) is respiratory support and surfactant replacement therapy. The administration of surfactant through a thin intratracheal catheter is one of the methods used to reduce one of the standard technique complications of a surfactant injection (Intubation-Surfactant-Extubation method [INSURE]). The aim of this study was to compare the effectiveness of this method on the treatment of RDS in neonates with one of the INSURE technique. Methods: In this double blind clinical trial, 104 neonates with RDS were randomly allocated to two groups, one group received surfactant via an endotracheal tube (INSURE) and the other received surfactant without intubation (SWI) via a thin intratracheal catheter. Subsequently the outcomes of the two groups were compared. Results: The incidence of hypoxemia during surfactant administration was significantly lower in the SWI group (11.5%) than in the INSURE group (28.8% , P< 0.05). no significant difference was observed in the need for intubation and mechanical ventilation during the first 72 hours of life, the duration of mechanical ventilation, the need for nasal continuous positive airway pressure (NCPAP), the need for oxygen, the incidence of bronchopulmonary dysplasia, intraventricular hemorrhage, pulmonary hemorrhage ,and death in the two groups. Conclusion: Administration of surfactant through a thin intratracheal catheter is a safe and easy technique. This method is as effective as the INSURE method in improving the outcomes of RDS treatment.

Background: The door-to-needle-time (DNT) is considered a standard time for scheduling thrombolysis for acute ST-segment elevation of myocardial infarction and this time can be reduced by minimizing the delay in starting thrombolytic treatment once the patient has reached to the hospital. This study was carried out on a sample of Iranian patients with acute myocardial infarction to determine the DNT in those after changing schedule of thrombolysis during 8 years from emergency to coronary care unit (CCU). Methods: A descriptive cross-sectional study was carried out on all consecutive patients with a confirmed diagnosis of acute myocardial infarction admitted to the emergency ward of Ekbatan Hospital in Hamadan, Iran, within 2011 and had an indication of fibrinolytic therapy, which 47 patients were finally indicated to receive streptokinase in the part of CCU. Results: The mean time interval between arrival at the hospital and electrocardiogram (ECG) assessment was 6.30 min, taking ECG and patient′s admission was 21.6 min and transferring the patient from admission to CCU ward was 31.9. The time between transferring the patients to CCU ward and fibrinolytic administration order and the time between its ordering and infusion was 31.2 min and 14.0 min respectively. In sum, the DNT was estimated 84.48 ± 53.00 min ranged 30-325 min that was significantly more than standard DNT (P

Background: The cornerstone of the treatment of respiratory distress syndrome (RDS) is respiratory support and surfactant replacement therapy. The administration of surfactant through a thin intratracheal catheter is one of the methods used to reduce one of the standard technique complications of a surfactant injection (Intubation-Surfactant- Extubation method [INSURE]). The aim of this study was to compare the effectiveness of this method on the treatment of RDS in neonates with one of the INSURE technique. Methods: In this double blind clinical trial, 104 neonates with RDS were randomly allocated to two groups, one group received surfactant via an endotracheal tube (INSURE) and the other received surfactant without intubation (SWI) via a thin intratracheal catheter. Subsequently the outcomes of the two groups were compared. Results: The incidence of hypoxemia during surfactant administration was significantly lower in the SWI group (11.5%) than in the INSURE group (28.8% , P< 0.05). no significant difference was observed in the need for intubation and mechanical ventilation during the first 72 hours of life, the duration of mechanical ventilation, the need for nasal continuous positive airway pressure (NCPAP), the need for oxygen, the incidence of bronchopulmonary dysplasia, intraventricular hemorrhage, pulmonary hemorrhage ,and death in the two groups. Conclusion: Administration of surfactant through a thin intratracheal catheter is a safe and easy technique. This method is as effective as the INSURE method in improving the outcomes of RDS treatment. [ABSTRACT FROM AUTHOR]