Background:Birth injuries are defined as the impairment of neonatal body function due to adverse events that occur at birth and can be avoidable or inevitable. Despite exact prenatal care, birth trauma usually occurs, particularly in long and difficult labor or fetal malpresentations.Objectives:This study aimed to investigate the incidence of birth injuries and their related factors in Kashan, Iran, during 2012-2013.Patients and Methods:In this cross-sectional study, all live-born neonates in the hospitals of Kashan City were assessed prospectively by a checklist included demographic variables (maternal age, weight, and nationality), reproductive and labor variables (prenatal care, parity, gestational age, premature rupture of membrane (PROM), fetal heart rate (FHR) pattern, duration of PROM, induction of labor, fundal pressure, shoulder dystocia, fetal presentation, duration of second stage, type of delivery, and delivery attendance), and neonatal variables (sex, birth weight, height, head circumference, Apgar score, and neonatal trauma). Birth trauma was diagnosed based on pediatrician or resident examination and in some cases confirmed by paraclinic methods. Statistical analyses were performed by chi-square, student’s t-test, and multiple logistic regression analyses using SPSS version 17. P ≤ 0.05 was considered statistically significant.Results:In this study, the incidence of birth trauma was 2.2%. Incidence of trauma was 3.6% in vaginal deliveries and 1.2% in cesarean sections (P < 0.0001). The most common trauma was cephalohematoma (57.2%) and then asphyxia (16.8%). In multiple logistic regression analyses, decreased fetal heart rate (FHR), fundal pressure, shoulder dystocia, vaginal delivery, male sex, neonatal weight, delivery by resident, induction of labor, and delivery in a teaching hospital were predictors of birth trauma.Conclusions:Overall, incidence of birth trauma in Kashan City was lower in comparison with most studies. Considering existing risk factors, further monitoring on labor, and delivery management in teaching hospitals are recommended to prevent birth injuries. In addition, careful supervision on students and residents' training should be applied in teaching hospitals.

Objectives:The best umbilical cord care after birth is a controversial issue. Aim of this research was to compare the effect of topical application of human milk and chlorhexidin on cord separation time in newborns.Methods:One hundred seventy four neonates attending from hospitals affiliated to Kashan University of Medical Sciences were included. Newborns from birth were randomized to two groups. In group mother’s milk, mother will rub her own milk to cord stump two times a day. chlorhexidin (group 2) were applied to the umbilical stump every 12 hours. The time to umbilical cord separation and any discomfort such as infection, hemorrhage, and discharge and odor were documented. Data was analyzed by SPSS software. Independent Samples t-Test, χ2, Fisher were used in this study.Results:Results showed a significant statistical difference between cord separation time in two groups and the mean cord separation time in the human milk group (7.15±2.15days) was shorter than the chlorhexidin group (13.28±6.79 days). In addition, a significant correlation was found between Signs of infection (discharge, redness, swelling and odor) in both groups.Conclusions:Topical application of breast milk on umbilical cord care leads to quick cord separation time and can be used as easy, cheep, non injury methods for umbilical cord care.

Introduction:Bone metabolic disease is an important issue in newborns with very low birth weight. The 80 percent of the transport of calcium (Ca) and phosphor (P) from mother to fetus takes place in the third trimester of pregnancy. This transport process is impaired with the preterm delivery of the newborn. On the other side, breast milk and formula are not competent resources to supply sufficient amounts of Ca and P to meet the requirements of the preterm newborn, thereby a greater reduction in the storage of these minerals. The current study has been done with the purpose of comparing the effects of two feeding methods on the indices of metabolic bone disease in newborns with very low birth weights (VLBW).Materials and Methods:The study design was cohort and the study was done on a total of 58 newborns with very low birth weights in Kashan Shahid Beheshti Hospital. The newborns were divided into two groups with 29 placed in the group of alternate feeding on preterm formula (preNan) and the other 29 placed in the group of breast milk and preterm formula (preNan). Eventually, the indices of bone metabolic disease were measured in both groups and were statistically analyzed.Results:The difference between the mean serum levels of Ca in different weeks and also between the two groups were significant (p=0.001). However, the changes in mean serum level of P in the two groups were not significant (P=0.151). The comparison of serum levels of alkaline phosphatase between the two groups indicated that their difference was significant and that they had been influenced by the feeding method (P=0.001). The serum level of bicarbonate, when compared between the two groups, was found to make a significant difference (P=0.001). The difference between the two feeding methods in precipitating rickets and osteopenia was not significant.Conclusion:According to the findings of current study, feeding on preterm formula (preNan) is associated with better and more desirable results, though the occurrence of rickets in the two groups had no significant difference.

Acute appendicitis is a common occurrence in childhood, but this diagnosis is considered rarely in differential diagnosis of acute abdomen in the neonatal period because its occurrence is very rare in neonates. We report a 20-day- old afghan female baby that was admitted to neonatal intensive care unit, because of irritability and abdominal distension. Complete ultrasound of abdomen and pelvis was normal. In plain Radiographs of chest and abdomen with the exception of Air-filled stomach and intestine, there was no abnormality. Due to the lack of improvement and severe abdominal distension, she was transmitted to the operating room and Surgical exploration revealed perforated appendix. Appendicitis should be considered in the differential diagnosis for a neonate with abdominal distension and bilious vomiting and needs strong clinical suspicion.

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Background: Breast cancer is one of the most prevalent and painful cancers amongst women in the world. The purpose of this study was to investigate the effectiveness of acceptance and commitment therapy on reducing the severity of pain in women with breast cancer. Methods: This was a quasi-experimental study which was conducted on 30 women with breast cancer referring to Ilam Medical Center in 2018. Patients were randomly assigned into two groups of experimental and control groups. Participants in the pre-test stage completed the multivariate questionnaire for the West Haven-Yale. At the next stage, the experimental group participants were exposed to 8 sessions of acceptance and commitment therapy while the control group did not receive any special treatment. Both groups completed the same questionnaire again at the posttest stage. Results: In terms of severity pain, mean scores of the experimental and control groups at the pretest stage were 76.66 and 74.98, respectively. Meanwhile, mean scores of the mentioned groups at the posttest stage were 70.08 and 74.06. The mean score of the experimental group in the posttest phase was decreased after the intervention compared to the control group. Conclusions: The results of the study reveal that acceptance and commitment therapy is a suitable intervention model for reducing the severity of perceived pain in breast cancer patients.

We propose a fully automated variation of the GrabCut technique for segmenting comparatively simple images with little variation in background colour and relatively high contrast between foreground and background. The interactive trimap generation central to the original formulation of GrabCut is replaced by a tentative approximation of the background using active contours. Instead of waiting until convergence of the iterated graph cut, we terminate as soon as the Gaussian models of foreground and background are (locally) maximally separated. We demonstrate that this results in equivalent segmentation quality at significantly lower cost. A comparison with three alternative segmentation techniques, including normalised cut, indicates that the method is eminently suitable for the chosen image domain.

The effect of 6-week training with ground balance ladder on postural control and risk of falls in elderly ..