مجله دانشکده پزشکی اصفهان
پیاپی 536 (هفته چهارم شهریور ماه 1398)

The quality of working life of workforce is a factor in attracting qualified, tactful, and motivated people to health-care organizations. Job stress is one of the factors that affect quality of service delivery. The aim of this study was to investigate occupational stress of health-care staff working in Alzahra hospital, the largest healthcare center of Isfahan Province, Iran.

A cross sectional study was performed on 581 employees of Alzahra hospital. The subjects were sampled using quoto-random sampling method in 8 occupations including nurses (290 cases), care aides (88 cases), office workers (72 cases), operating room personnel (37 cases), anesthesia technicians (36 cases), midwives (21 cases), laboratory staff (20 cases), and radiology staff (17 cases). The Health and Safety Executive (HSE) Health Stress Questionnaire was completed by participants in self-administration. The checklist of the study, including demographic characteristics and occupational factors (job title, the place of service for employment, contract type, work history, and employee shift) was also completed and compared.

Total stress score according to HSE questionnaire was 118.1 ± 6.5, and the highest score was in demands and role subscale. The job title had a significant relationship with the total score of job stress and as well with control and role subscale (P < 0.050). The highest stress was seen among the operating room technicians, and the lowest among midwifery personnel. Overall, there was no significant difference in the overall job stress score in terms of service area of the employees, work experience, second job, and type of shift (P > 0.050); otherwise, there was a significant relationship between type of shift with role subscale (P < 0.050). There was a significant relationship between the type of contract with total stress score (P < 0.050).

The findings of this study indicate that job stress among employees of Alzahra hospital is significantly different among various job titles, which requires more attention to reduce stress in stressful jobs such as operating room technicians and nurses. Considering the relationship between shiftwork and contract type with some subscales of job stress, managers need to pay more attention to convert contracts from temporary to permanent, and preparation of staff shift schedules.

Performing Benson relaxation technique by the mother improves the labor and affects neonate. This research investigated the effect of Benson relaxation technique for mothers on infant’s umbilical arterial blood gases.

In this randomized clinical trial study, 60 eligible pregnant women were selected through convenient sampling, and randomly assigned to experimental and control groups. Data collection instruments were mother’s demographic information form and neonatal information form. Benson relaxation technique were instructed to the experimental group using videos and slide presentations, and after admitting to hospital, they were encouraged to implement the noted technique. Benson relaxation technique will not be instructed to the control group. After delivery, umbilical cord of neonate was clamped at two sites, and 0.5 ml of umbilical arterial blood was collected by a trained nurse in a syringe containing heparin (< 0.1 ml), kept in an icebox, and sent to the laboratory for testing partial pressure of oxygen (PO2</sub>) and carbon dioxide (PCO2</sub>). Statistical analysis were performed using SPSS software.

There was a statistically significant difference in terms of mean oxygen (P < 0.001) and carbon dioxide (P < 0.001) pressure in the umbilical artery between the control and intervention </em>groups; the markers of the umbilical arteries of the neonate were improved in intervention group.

 Using Benson’s relaxation technique by mothers improves neonate’s arterial blood gases; and can be recommended to the healthcare system as an effective method to improve neonatal outcomes.</div>

Based on the previous studies, stem cells have been proved to be activated within 4 weeks after myocardial infarction (MI) by growth hormone (GH). In this study, we aimed to assess the relation of 3 months of GH prescription on left ventricular ejection fraction (LVEF), and thickness of interventricular septum (IVS) and posterior left ventricle (LV) among Iranian individuals suffering from heart failure because of their first MI attack.

16 clinically stable patients with history of MI suffering from heart failure with LVEF < 40% were eligible for enrollment in this randomized clinical trial study. They were randomly assigned to groups receiving 5 mg subcutaneous GH (n = 8) or placebo (n = 8) with injections done each other day for 3 months. Cardiac outcomes including LVEF, and thickness of IVS and posterior LV were assessed at the end of the intervention.

LVEF was remarkably increased by three months started from baseline of 32 ± 3.80 percent in patients receiving GH to 43.80 ± 4.60 percent (P = 0.002). Moreover, LVEF was significantly higher in participants receiving GH (43.80 ± 4.60 percent) compared with placebo group (33.14 ± 4.84 percent) at the end of trial (P = 0.003). IVS or posterior LV wall thickness failed to prove any considerable associations in GH or placebo groups.

 Our outcomes revealed that GH administration was associated with raised LVEF function among the patients with heart failure due to MI attack.</div>

Interictal spikes not only are used to diagnose epilepsy, its syndromes, and therapeutic guidelines in patients with epilepsy, but also may be a window to understand anatomy, severity, and epilepsy outcomes better. The aim of this study was to investigate the relationship between interictal spike rate and magnetic resonance imaging (MRI) findings.

This descriptive cross-sectional study was performed on patients with refractory temporal lobe epilepsy admitted to epilepsy monitoring unit, Ayatollah Kashani hospital, Isfahan, Iran. Brain MRI (with epilepsy protocol) and all files related to long-term monitoring (LTM) of patients were studied, and then, the spike rate was calculated for each patient. Clinical information of patients as well as MRI and interictal findings were placed in separate tables designed for this purpose. Analysis of these findings consisted of two parts. In the first part, descriptive statistics (frequency and percentage), and for second part, inferential statistics (Spearman correlation coefficient and multivariate logistic regression) were used.

This study was done on 70 patients with refractory temporal lobe epilepsy, 44 men (62.9%) and 26 women (37.1%). The mean age of the participants was 29.00 ± 10.49 years (10-60). Spearman's correlation coefficient showed a significant relationship between spike rate and MRI findings (P < 0.050). The results of regression analysis showed that only two lesions of "Hippocampus and Amygdala sclerosis" and "tumor and tumor-like lesions" could predict spike rate among MRI lesions. Normal MRI could also predict the amount of spikes.

 It seems that a combination of brain MRI with physiological measurements, including interictal spike rate, can determine subtypes of refractory temporal lobe epilepsy, and can lead to better diagnosis and treatment.</div>

About 90% of newborns begin to breathe immediately after birth without any need for special action. The remaining 10% have to start breathing, require resuscitation of which only 1% require advanced resuscitation measures such as cardiac massage and the use of drugs. Therefore, in order to determine the need for neonatal resuscitation and their outcomes, this research was conducted.

In this cross-sectional study, the infants were selected using convenience sampling method in Bahar hospital in Shahroud City, Iran. Demographic and maternal obstetrical data and the information about the weight and the need for resuscitation and neonatal outcome were extracted from the profiles. Data analysis was performed using t and chi-square tests via SPSS software. The significance level for all tests was considered as (P < 0.05).

6677 newborns were enrolled in the study. The mean age of mothers was 27.20 ± 5.43 years and the average maternal education was 3.91 ± 10.17 years. The mean of neonatal weight was 3126.09 ± 484.31 grams. 2.70% of newborns required resuscitation measures such as the heating and drying. 1.30% were revived with ventilation, and 0.40% with cardiac massage. According to the chi-square test, there was a positive and significant relationship between the need for newborn resuscitation and hospitalization in the newborn intensive care unit (NICU) (P = 0.001). There was a significant negative correlation between weight gain and hospitalization (P = 0.001).

 Given the high percentage of neonatal hospitalizations in the intensive care unit, following resuscitation procedures and to reduce its complications, it is recommended that a more structured program be developed in the case of supportive and caring guidelines for both staff and mothers.</div>