maryam saeedi

Hirschsprung's disease is a major cause of functional intestinal obstruction, mainly affecting the distal region of the large intestine. Risk factors for this disease include a family history of the disease, being male, and the presence of other conditions such as cardiac or chromosomal abnormalities.

Infants admitted to Children's Medical Center Hospital, Tehran university of medical science between April 2017 to April 2021 with a diagnosis of Hirschsprung's disease were included in this study. Demographic information, clinical and radiological findings, and complications were recorded on customized forms.

In this study, 29 neonates were included. The clinical manifestations of Hirschsprung in this study were failure to defecation in the first two days of birth, abdominal distention, and bilious vomiting. The most common complaint at the time of visit was constipation and vomiting, and the most common clinical finding at the time of hospitalization was abdominal distension. The most common radiological manifestation in the simple X-ray of affected neonates was the dilation of the intestinal loops and in the barium enema transitional zone. In the delayed X-ray, the delay in emptying the barium was observed. in neonate with Hirschsprung's disease Heart disease was a common comorbidity (27.2%). The most common heart disease was Atrial Septal Defect (ASD). The most histological involvement was in the rectal and rectosigmoid areas. The most common complication of Hirschsprung in the follow-up of neonates until at least 6 months of age was poor weight gain, constipation and fecal incontinence. We had three deaths, one case with Small intestine, one case with heart disease and one case with multiple anomalies.

The results of this study are consistent with previous research showing that genetic variations do not have a major impact on the clinical presentation of newborns with Hirschsprung's disease. While diagnostic methods like x-ray and contrast enema can be useful, biopsy is the most reliable way to confirm a diagnosis of Hirschsprung's disease. Physicians should consider performing a biopsy when evaluating a suspected case of this condition.

The global COVID-19 crisis has profoundly affected populations worldwide. While it is widely accepted that older individuals are at greater risk of severe illness, data indicate that in newborns and infants, the disease is generally not fatal.

This cross-sectional study aimed to examine the roles of laboratory tests and clinical symptoms in determining the severity of COVID-19 infection in infants younger than three months.

This study included all infants less than three months old with positive PCR tests for COVID-19 admitted to the Children's Medical Center between October 2020 and March 2022. We analyzed the association between disease severity and clinical symptoms, as well as laboratory findings.

Sixty-four neonates and infants under three months of age with COVID-19 participated in the study. Our findings suggest that lower birth weight and gestational age are associated with increased disease severity. Infants with underlying medical conditions were found to have a higher risk of reaching stage IIb or greater severity. Among laboratory and clinical findings, only white blood cell (WBC) count and cough symptoms showed a significant correlation with disease severity.

Clinical evaluations, along with factors such as birth weight, gestational age, and underlying conditions, appear more effective in guiding decision-making for COVID-19 severity in infants. Further studies are necessary to explore the influence of these factors on COVID-19 severity in this age group.

 Perfusion index is a dependable indicator for assessing the perfusion status of newborns. A low perfusion index indicates compromised hemodynamic function. The study aims to investigate perfusion index in asymptomatic newborns aged 35 to 41 weeks who did not require medical support.

 Healthy neonates born in four major maternity hospitals of Tehran University from 2019 to 2021 were selected. To ensure consistency and reliability in data collection, a detailed manual was developed and distributed, along with comprehensive training sessions for all personnel involved.

 A total of 994 newborns entered the study. Among them, echocardiography was adversely affected in 218 neonates due to abnormal screening pulse oximetry. Of these 218 neonates, 53 were found to have abnormal echocardiography results. The median perfusion index value in healthy neonates was 1.6%, and the median oxygen saturation was 97%. A percentile perfusion index curve was developed for healthy neonates to establish a normal reference range.

 Developing a percentile perfusion index curve specific to healthy neonates provides a useful reference range for healthcare providers to assess perfusion status in this population, but further research is needed to confirm its accuracy.

There has been significant interest in using Cotoneaster for treating jaundice or elevated bilirubin levels in newborns, and it has, in many cases, replaced phototherapy in herbal medicine. However, using these compounds to treat hyperbilirubinemia can lead to complications in neonates, potentially resulting in morbidity and even death.

This study examined the side effects of Cotoneaster consumption in jaundiced neonates admitted to the Children’s Medical Center between 2021 and 2022.

We conducted a cross-sectional study involving healthy neonates who consumed Cotoneaster following treatment for neonatal jaundice and subsequently experienced complications. The data were recorded using pre-prepared questionnaire forms.

The most common complications following Cotoneaster derivatives were exaggerated hyperbilirubinemia, dehydration, and poor feeding.

Given the sensitivity of neonates, the treatment of jaundice in babies should be approached with caution and supported by extensive studies. The use of herbal medicines in neonates remains questionable due to associated complications.

While catheter lengths are determined based on guidelines, regional studies should be considered to ensure optimal catheter placement.

This study aimed to compare the incidence of tip malposition and the amount of catheter retraction required to achieve appropriate placement in peripherally inserted central catheters (PICC) inserted in the head and neck, upper extremities, and lower extremities to determine the optimal catheter placement site.

This cross-sectional study was conducted in the Children's Medical Center NICU between 2020 and 2021. After the initial calculation of catheter insertion length based on guidelines, PICC placement was performed by two skilled nurses. The catheter position was then confirmed, and the amount of catheter retraction was compared for each group.

A total of 368 neonates were included in the study. The results showed a statistically significant higher incidence of catheter tip malposition in the upper extremity group (P-value = 0.004). The minimum amount of catheter retraction required to achieve proper placement was 1 cm.

This study suggests that the formula for calculating the length of the catheter in the upper extremities should be adjusted. However, further studies are needed to confirm this.

Incivility in nursing education is a complex concept that is not exactly defined in nursing. The purpose of this study was to clarify the concept of incivility in nursing education in the Iranian cultural context.

Concept analysis was performed based on hybrid model in three steps. In the theoretical phase, a review of studies was conducted from 2000 to 2020. During the fieldwork, 7 nursing faculty members and 9 nursing students were interviewed. The third phase included the comparison of the themes that were extracted from the two previous phases.

From the 1250 titles, 45 articles were analyzed. Review of literature showed that incivility has several attributes: unconventional communication, irresponsible and disrespectful behavior. The fieldwork phase added unmanaged behavior and being contrary to academic goal.

Defining the concept of incivility in nursing education refers to an unconventional, disrespectful, unmanaged behavior that is contrary to the academic goal of nursing education and results from individual differences, stress, improper application of technology, and inappropriate role models which, by creating an unsafe learning condition leads to harming the individual, organization and profession. Here, this study provides a comprehensive understanding of the incivility in nursing education that can be used in instrumentation, model building, and development of theory.

E-learning is a type of learning that is conducted using various electronic tools, such as mobile phones, and it offers advantages such as access at any time and place, reduced training costs, and flexibility. The present study aims to design, implement, and evaluate a mobile-based application for educating on the topic of home-based nursing care for common chronic diseases.

 The present study employed a developmental-applied research design with a software design approach, which was carried out in three stages: In the first stage, based on the curriculum of home-based nursing care, the necessary data elements for designing a mobile-based application were determined. Then, a researcher-made content validation checklist was sent to five members of the nursing faculty to validate the content. In the second stage, the mobile-based application for educating of home-based nursing care was designed on the Android platform. In the third stage, for usability evaluation, the application was installed on the mobile phones of 30 nursing students. After two weeks, a standard usability and user satisfaction questionnaire was applied for evaluation.

Educational content for home-based nursing education provided in the mobile application for chronic disease such as diabetes, hypertension, heart attack, stroke, chronic respiratory disease, spinal cord injury and cancer. The results of the usability evaluation of the application showed that the overall mean score of the usability questionnaire from the perspective of the nursing students was 7.40 ± 1.42 out of 9, which was a desirable category.  

The use of mobile-based applications can transform theoretical knowledge into practical exercises among nursing students and serve as suitable educational tools for improving their learning. The findings highlight the potential of mobile-based applications in enhancing nursing education, particularly in the context of home-based care.

 The power of narratives is such that they can immerse readers in their world and transform them. Narratives can transport readers to various places and times. With this in mind, the current study sought to compare the ability to maintain effort and interest over the long term, as well as resilience, across different levels of engagement with a success narrative.

 This comparative study involved the selection of 200 middle school students (2019) from both girls' and boys' schools in the first district of Rasht, utilizing a convenience sampling method. Initially, they were provided with five short stories on success for study. Following their reading of the stories, students completed the Transportation Scale - Short Form (Appel et al., 2015), the Short Grit Scale (Duckworth & Quinn, 2009), and the Connor-Davidson Resilience Scale (Connor & Davidson, 2003). The Transportation Scale - Short Form (Appell et al., 2015) was employed to measure students' levels of engagement with the narrative on success. Finally, the data were analyzed using multivariate analysis of variance with the SPSS24 software.

 The findings revealed a significant difference between the two groups in terms of their ability to maintain effort and interest in long-term goals as well as resilience (P < 0.01). Participants in the high-level narrative transportation group demonstrated greater capacity for sustaining effort and interest in long-term goals (29.52) and resilience (67.05) (P<0.01).

 Drawing from the obtained results, one could posit that storytelling serves as a distinct form of motivation and catalyst for success, prompting students to engage deeply with narratives and be impacted by their substance, consequently fostering heightened motivation and emotional enrichment.

Altered concentrations of cerebrospinal fluid (CSF) and blood amino acids may be related to epilepsy or the severity of the seizure. In the present study, we assessed the concentrations of amino acids in CSF and plasma in neonates with refractory seizures.

In this prospective cohort study, 27 neonates aged 1 to 56 days with refractory seizures were included. Blood and CSF samples were collected from each neonate within 24 hours after receiving 2nd antiseizure medications. All plasma and CSF samples were sent to the laboratory to measure amino acid concentrations. The associations between CSF and plasma amino acid levels with different variables were evaluated.

Except for leucine (P=0.15) and isoleucine (P=0.07), the levels of all amino acids were significantly higher in plasma than CSF. Significant associations were observed between types of seizure and plasma citrulline (P=0.008) and leucine concentrations (P=0.04). The mean of CSF glutamic acid was also statistically different among neonates with different EEG results (P=0.02).

Our findings indicate that several plasma and CSF amino acids could be candidate biomarkers for neonatal refractory seizures. Further studies with larger sample size are to confirm our findings.

Coronavirus-2019 (COVID-19) spreads rapidly worldwide and causes severe acute respiratory syndrome. The current study aims to evaluate the relationship between the whole-brain functional connections in a resting state and cognitive impairments in patients with COVID-19 compared to the healthy control group.

Resting-state functional magnetic resonance imaging (rs-fMRI) and Montreal cognitive assessment (MoCA) data were obtained from 29 patients of the acute stage of COVID-19 on the third day of admission and 20 healthy controls. Cross-correlation of the mean resting-state signals was determined in the voxels of 23 independent components (IC) of brain neural circuits. To assess cognitive function and neuropsychological status, MoCA was performed on all participants. The relationship between rs-fMRI information, neuropsychological status, and paraclinical data was analyzed.

The COVID-19 group got a lower mean MoCA score and showed a significant reduction in the functional connectivity of the IC14 (P<0.001) and IC38 (P<0.001) regions compared to the controls. The increase in functional connectivity was observed in the COVID-19 group compared to the controls at baseline in the default mode network (DMN) IC00 (P<0.001) and dorsal attention network (DAN) IC08 (P<0.001) regions. Furthermore, the alternation of functional connectivity in the mentioned ICs was significantly correlated with the mean MoCA scores and inflammatory parameters, i.e. erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP).

Functional connectivity abnormalities in four brain neural circuits are associated with cognitive impairment and increased inflammatory markers in patients with COVID-19.

 Sepsis is the leading cause of death in newborns, particularly in underdeveloped countries. Early diagnosis and appropriate treatment are critical in reducing neonatal mortality. Since blood culture results are often unavailable for 48 - 72 hours, other hematologic findings may provide useful information for early diagnosis.

 We examined the relationship between neonatal sepsis and blood indices in order to achieve early diagnosis.

 In this hospital-based retrospective multiple-event case-control study, we allocated the neonates into three groups: Culture-positive sepsis, culture-negative sepsis, and neonates without sepsis. We compared the lab data within these three groups.

 The study included 319 neonates: 209 cases of culture-positive sepsis, 65 cases of culture-negative sepsis, and 45 cases without neonatal sepsis. Pearson's test demonstrated a significant correlation between thrombocytopenia, positive C-reactive protein (CRP), and high cell distribution width with culture-positive sepsis (P = 0.000), indicating a statistical difference between the three groups. The mean CRP and eosinophil levels were higher in the culture-positive group with fungal sepsis.

 In septic neonates with high CRP levels, particularly in conjunction with eosinophilia, fungal coverage should be considered.

The COVID-19 pandemic has created a growing concern about domestic violence worldwide. Therefore, this study aimed to evaluate the general prevalence of all types of violence and the related effective factors during the COVID-19 outbreak among women living in Saveh, Iran.

This cross-sectional descriptive study was conducted in 2021 on 423 married women referred to health centers in Saveh who were selected using the cluster method. A demographic information questionnaire and a researcher-made domestic violence questionnaire were used to collect data. Descriptive statistical methods and statistical tests were used to analyze the data and examine the correlation between the intensity (score) of violence with the demographic variables of the samples and their spouses. Data analysis was done using SPSS version 22 statistical software. A significance level of less than 0.05 was considered significant.

Most of the participants (59.6%) were exposed to domestic violence. The mean±standard deviation of the overall domestic violence score was as much as 7.47±12.37. The most common type of domestic violence among the studied women was psychological violence. There was a direct and significant relationship between the overall score of domestic violence, the age of the samples and their spouses, and the duration of their marriage (P<0.01). The average overall score of domestic violence was significantly higher in samples who had children, were not pregnant, had drug and alcohol-addicted spouses, were renters, had a decrease in income during the COVID-19 outbreak, and had unemployed spouses (P <0.05).

Based on the results, the prevalence of domestic violence during the COVID-19 pandemic was moderate, but its severity was low. Due to the psychological effects of the COVID-19 disease on society people, the increase in the incidence of violent behavior is especially evident in vulnerable families such as low-income families and tenants and women whose spouses are unemployed and abuse substances. Therefore, identifying and supporting vulnerable families for their education and empowerment can reduce the incidence of domestic violence.

Seizure is a common sign in neonates hospitalized in the neonatal intensive care units (NICU) that may lead to morbidity and mortality. Most neonatal seizures are subclinical. Conventional EEG (cEEG) is the gold standard for detecting and monitoring seizures but is not widely available. Amplitude-integrated electroencephalography (aEEG) has been used for over a decade to evaluate infants with seizures. In this study, we tried to determine the efficacy of aEEG as
a widely available diagnostic tool in diagnosing seizures.

All cases with seizures or suspicious seizures were admitted to the NICU of the Children’s Medical Center for one year. cEEG and aEEG were performed for these infants. aEEG was recorded for at least six hours with a description of the tracing. Clinical information, outcomes, and questionnaires (patient information) were recorded in detail. The obtained data were analyzed with the SPSS version 24 software.

Eleven out of twenty-five aEEG recordings were abnormal; other patients showed normal aEEGs. The most common clinical and neurological manifestations were seizure (68%) and hypotonia (28%); the mortality rate was 12%. No significant correlation was observed between aEEG findings and gender, age, familial relation, outcome, ultrasound result, type of seizure, and underlying disease.

Job satisfaction among healthcare workers is a vital challenge for health care organizations. Pre-hospital emergency workers are one of the key and important careers in health care environments who are responsible for providing quality services to patients. Increasing job satisfaction of this spectrum can improve the quality of services received by patients and improve patient satisfaction with medical services. One of the variables that may be related to job satisfaction and performance is job content. The present study was designed with the aim of investigating the relationship between job content and job satisfaction and performance of pre-hospital emergency operatives in Saveh city.

This cross-sectional descriptive research was conducted on 77 pre-hospital emergency staff of Saveh Medical Emergency Management Center in 1402. The samples were included in the study based on the entry criteria and by census. The data collection tools included demographic information questionnaires and job content, job satisfaction and job performance questionnaires. SPSS software version 23 was used for statistical data analysis.

The results of the research showed that the mean and standard deviation of job content, satisfaction and job performance scores in the research units were 93.58±5.19, 64.27±5.7 and 66.9±3.28 respectively. Also, the results of the research showed that there is no significant correlation between job content and job performance and job satisfaction, but there is a positive and significant correlation between job satisfaction and job performance, so that job performance increases with increasing job satisfaction.

According to the results of this research, there is a positive relationship between satisfaction and job performance. Therefore, to improve the job performance of pre-hospital emergency workers, measures should be taken to increase their job satisfaction. Increasing job satisfaction also increases the individual's creativity and productivity and increases work motivation and reduces absenteeism. Increasing job satisfaction can improve the quality of services received by patients and improve patient satisfaction with medical services.

 The use of herbal drugs for treating neonatal jaundice is a common practice in many societies despite the potential complications. However, little is known about the individuals or groups who typically recommend the use of these drugs for affected neonates.

 This study aims to investigate the main recommendations of herbal drugs for treating neonatal jaundice.

 The format of the present cross-sectional study was designed and implemented based on interviews with parents of infants who have infantile jaundice who used herbal drugs for their neonates during 2019 and 2022 and were admitted to the Children’s Medical Center of Tehran, Iran. Along with baseline data, the socioeconomic situation of families was also evaluated.

 Regarding the role of people in recommending the use of herbal drugs, in 52.1% of cases, the main recommenders to use this substance to treat infant jaundice were the patient's relatives, while the role of parents in recommending the consumption of this compound was 25.5%. Also, 6.4% of the neighbors of the patients’ family were the main recommenders to use herbal drugs for the affected neonates. Interestingly, 4.3% of doctors and 11.7% of pharmacists had the leading role in recommending the use of herbal drugs to treat infant jaundice. Parents who recommended using herbal drugs for their neonates were more likely to be smokers and less affluent.

 Relatives, parents, grandparents, and even neighbors play a significant role in recommending the use of herbal drugs in the treatment and control of neonatal jaundice. The role of doctors and pharmacists in recommending the use of this compound in the treatment of jaundice, especially considering the potential side effects, should not be underestimated.

The present study was conducted with the aim of investigating the relationship between vitamin D deficiency and the serum levels of calcium, magnesium and phosphorus.

  In this descriptive sectional study, infants who were admitted to the neonatal and NICU of Tehran Children's Medical Center Hospital with any diagnosis during 2018-2020 with vitamin D deficiency or insufficiency were included in the study. Serum levels of calcium, magnesium and phosphorus, and their relationship with vitamin D deficiency were recorded and investigated.

  Among 400 included infants, 197 neonates (49.3%) had vitamin D deficiency and 203 (50.7%) had vitamin D insufficiency. The average serum level of vitamin D in studied infants was 11.477±3.55 ng/ml. There was no statistically significant relationship between the serum level of vitamin D in newborns and the serum levels of magnesium and phosphorus (P value = 0.118 and P value = 0.511), but there was a statistically significant relationship between the serum level of vitamin D and the serum level of calcium (P=0.0001). There was no statistically significant relationship between the level of serum vitamin D in newborns with the age and the gestational age of the newborn (P = 0.132 and P = 0.651). Still, a direct and significant statistical relationship was observed with the newborn's weight (P = 0.049). The average length of hospitalization in the examined infants was 16.39 ± 16.36 days. Pearson’s correlation coefficient indicated the presence of an inverse and significant correlation between the level of serum vitamin D in infants and the duration of hospitalization (P=0.036). In such a way with the reduction of vitamin D serum level, the time of hospitalization increased.

  This study showed a statistically significant relationship between low vitamin D serum levels with calcium serum levels. 

Practical Implications: 

 In infants with low weight or hypocalcemia, there is a possibility of vitamin D deficiency. Vitamin D check is recommended to start treatment earlier and decrease the duration of hospitalization and other complications.

 Most cases of newborn hyperbilirubinemia are physiologic; however, excessive unconjugated bilirubin is a potential neurotoxin. Phototherapy treats moderate to severe hyperbilirubinemia. If phototherapy increases immunoglobulin G (IgG) clearance, there is a chance of humoral immune disorders.

 The purpose of the study was to investigate the effect of phototherapy on the level of IgG in neonates.

 This study investigated 40 full-term newborns with hyperbilirubinemia. Blood samples were taken before and 72 hours after phototherapy. The IgG level was measured by calorimetry tests.

 Phototherapy resulted in a decrease in IgG levels. The IgG level significantly decreased from 833.135 to 720.185 mg/dL. Before phototherapy, 12.5% of the population had low IgG levels; however, 32.5% had low IgG levels after the treatment.

 According to the results of the study, intensive phototherapy caused a reduction in IgG levels. Since there was no significant decrease in IgG levels in neonates who received conventional phototherapy, it can be concluded that this treatment is safe in terms of IgG levels.

One of the essential tasks of pre-hospital emergency workers is to document and complete the mission form using electronic and paper forms. The current study was designed with the aim of determining the level of satisfaction of pre-hospital emergency operatives in using electronic registration and reporting forms.

This descriptive cross-sectional study was conducted on 88 operatives of pre-hospital emergency room in Saveh city in 1402-1401. The samples were included in the study based on the inclusion criteria and by census. The data collection tool included a demographic information questionnaire and a researcher-made satisfaction questionnaire of electronic registration and reporting forms. Data were analyzed using descriptive and inferential statistics and SPSS version 23 software.

The mean and standard deviation of the total satisfaction score of the samples with the electronic registration and reporting forms (Asayar program) were 81.12 and 12.46, respectively, which were significantly (p<0.001) higher than the average. Among the dimensions of the questionnaire, the speed of recording information, ease of use, and comprehensiveness respectively received the highest satisfaction scores. The satisfaction of employees in the access dimension was lower than in other dimensions.

The level of satisfaction of pre-hospital emergency operatives with electronic registration and reporting forms (Asayar program) has been optimal.

Immune dysregulation happens after exposure to corona virus disease-2019 (COVID-19) and affects many organs. It is confirmed with a positive COVID-19 test history, fever, and the involvement of 2 or more organs, but it is hard to diagnose in neonates.

There were 2 Persian neonates admitted to the Neonatal Intensive Care Unit or neonatal ward of the Children’s Medical Center, Tehran, Iran, with sepsis in this case presentation. The trunk and extremities were affected by macular rashes in both cases. COVID-19 tests in both cases were negative, but both of their mothers were affected by COVID-19 before delivery. In both cases, systemic and macular rashes responded to corticosteroids.

Macular rash can present multisystem inflammatory disease in neonates. Neonates with a positive history of COVID- 19 in parents or relatives should be considered for this syndrome.

 Ichthyosis is an epidermal disruption that increases insensible water loss. Hypernatremic dehydration is a consequence of skin disruption. This study reviewed the treatment of hypernatremic dehydration in patients with ichthyosis comparing to patients with intact skin.

 We studied five neonates with hypernatremia, including three ichthyosis cases and two normal-skin neonates. This case-series study showed that the sodium correction rate is slower in infants with ichthyosis than in infants with normal skin. The first and second neonates needed less sodium than fluid intake than normal skin infants, although fluid requirement was lower in the third ichthyosis infant than in others due to less skin disruption in this infant.

 Fluid therapy in hypernatremic dehydration in ichthyosis patients is different from neonates with intact skin because of excessive insensible water loss in these patients. It may be needed to give more fluid and less sodium depending on the degree of skin disruption, which may not be determined by physical examination.

 Patent ductus arteriosus (PDA) is a disease presenting on the first days of birth, associated with unpleasant complications such as exaggerated respiratory distress and increased mortality, requiring prompt treatment.

 This study evaluated the relationship between perfusion index and the recovery of patients diagnosed with PDA.

 In this cross-sectional study, 22 neonates with PDA (as the case group) and 22 healthy neonates (as the control group) were selected. The difference in perfusion index (PI) before and after arterial duct closing was determined, and also the relationship between pre-ductal and post-ductal PI in the case and control groups was evaluated. Data were analyzed by SPSS version 21.

 The results showed a significant difference in the mean scores of pre-ductal and post-ductal PI before and after arterial duct closure (P = 0.004). Also, pre-ductal and post-ductal PI scores were significantly lower in the case group than in the control group (P < 0.001)

 According to our findings, PI in infants with PDA is low at presentation and increases after treatment. Therefore, PI can be used as an indicator to evaluate response to treatment during follow-up, particularly when repeated echocardiography is not accessible.

The aim of this study was to evaluate the effectiveness of cognitive-behavioral therapy on difficulties in emotional regulation and cognitive flexibility in patients with obsessive-compulsive disorder. The research method was quasi-experimental pre-test-post-test with a control group. In this study, 30 patients with obsessive-compulsive disorder syndrome were assigned to psychology clinics in Rasht in 2021 as a research sample in two experimental and control groups. Groups were assessed with questionnaires Padua obsessive-compulsive disorder by Sanavio (1988), Gratz & Roemer (2004) difficulties in emotional regulation, and Dennis & Vander Wal (2010) cognitive flexibility. After 10 sessions of 90 minutes of cognitive-behavioral therapy for the experimental group, participants again answered the research questionnaire. Findings showed that cognitive-behavioral therapy significantly reduces the difficulties in emotion regulation (rejection of emotional responses, difficulty in performing purposeful behavior, difficulty in controlling impulse, lack of emotional awareness, limited strategies, lack of Emotional state) and increased cognitive flexibility (P<0.001). Due to the problems that patients with obsessive-compulsive disorder have in emotional and cognitive dimensions, it is necessary to pay more attention to these cases in the treatment process.

Manyaspects of the severe acute respiratorysyndrome coronavirus 2 (SARSCoV2)pandemicin 2019 have been unclear, especially in newborns, and reports of neonatal diseases are usually associated with perinatal infection.

The purpose of this study was to evaluate clinical and para-clinical manifestations in newborns that contracted the infection after birth.

This observational research was conducted from October 2020 to March 2022 to examine postnatal SARSCoV2 infection in infants admitted to the NICU or neonatal ward at the Children’s Medical Center in Tehran, Iran. Inclusion in the study was open to neonates who had positive RT-PCR results postnatally.

In total, 55 newborns were confirmed to have postnatal SARSCOV2. Fever was the most frequently observed symptom, with 35 (61%). Necrotizing enterocolitis was seen in 18% of neonates, and 30% of them were preterm. Neutropenia was seen in 34% of cases, with five cases having severe neutropenia. All neonates had a normal platelet count. Twenty percent of patients showed C - reactive protein higher than 6 mg/L. Two newborns had co-existing bacterial urinary tract infections. Our neonates didn’t require antiviral, anticoagulant, or corticosteroid medications, and they recovered while receiving only supportive care. Everyone in the group of newborns was discharged without complications, and there were no deaths.

The high rate of fever, high C- reactive protein, and neutropenia in SARSCoV2 neonates suggests that more observational research is needed to compare these symptoms to bacterial sepsis to avoid the overuse of antibiotics in these patients.

After the Ministry of the health of Iran officially announced widespread of COVID-19 on 19 February 2020, our attention focused on novel coronavirus. In our case, a2-day- old neonate shows symptoms of sepsis. The main presentation was hypothermia and desaturation. The mother was COVID-19 positive with an active cough. The PCR of the neonate was negative. We don’t claim that the neonate is affected by COVID-19, but this may be an atypical form of sepsis in neonates with positive mothers following COVID-19. A2-day- old female neonate with a gestational age of 40 weeks and a birth weight of 2370 grams was born via the cesarean route from a mother who was a 34-year-old primigravida woman without any history of disease during pregnancy. Two days before delivery, the mother had malaise and dry cough. She was diagnosed as a COVID-19 positive case based on RT-PCR after delivery. On the second day after birth, the parents brought the baby to the emergency room of the children’s medical center hospital with complaints of poor feeding, poor sucking and decreased urination. Physical examination revealed the following signs; hypothermia; T=36℃, diminished primitive reflexes, hypotonia, and oxygen desaturation until 85% without respiratory distress that increased to 98% with oxy hood. We admitted and treated her early-onset sepsis and discharged in excellent condition.Early-onset sepsis as defined is a clinical state that is transferred from mother. The presentations in our case maybe a new form of clinical sepsis following a mother with COVID-19. We don’t claim that our case is COVID-19 positive but in neonates with affected mother’s insidious symptoms should be in concern.

The COVID-19 pandemic has created the most health challenge in the recent years. Understanding the symptoms is important in the recognition of severity of disease and identification of its palliative factors. Spiritual health is known an important factor in reducing distress of patients, this study was designed to determine the relationship between spiritual health and symptoms of COVID-19 patients during the pandemic.

Data were collected using a cross-sectional design to select COVID-19 patients of a special hospital in Qom. Convenience sampling was carried out during the May– June 2020. Participants were asked to fill out the demographic questionnaire. The spiritual health and symptoms of patients were measured using the Paloutzain and Ellison Spiritual Health and the Edmonton Symptom Assessment Scales respectively. Pearson’s correlation coefficient, t-test and ANOVA was conducted to data analysis.

The findings demonstrated that most of the participants had high-average levels of spiritual health 70.14 (2.96) and average levels of symptoms 60.79(21.07). Spiritual health were negatively correlated with lack of Well-being (r= -.131, p < .05) and Anxious symptoms (r=-.115, p < .05). Religious health was correlated with Anxious symptoms (r= -.109, p < .05) and Drowsy (r= -.114, p < .05) and lack of Well-being (r= -.115, p < .05).

This research confirmed the relationship of Spiritual health with some symptoms. Single patients and older adults had higher levels of symptoms and their management is a priority during the pandemic.