Tehran University Medical Journal

Background: Premature infants undergo a lot of stressors during treatment procedures in the neonatal intensive care units which causes significant physiological changes in these neonates. Multi-sensory stimulation is a broad category of interventions designed to improve the evolutionary and physiological outcomes of premature infants hospitalized in the neonatal intensive care unit to minimize stress in this environment. So, the study aimed to evaluate the effect of multi-sensory stimulation on physiological parameters in preterm infants.
Methods: This double-blind clinical trial conducted in the neonatal intensive care unit of Shahid Motahari Hospital in Jahrom from April to December 2016. In this study, 80 preterm infants with a gestational age of 34 to 36 weeks were selected by non-probability sampling method and were randomly divided into two groups of multi-sensory stimulation and control. Neonates in the intervention group received a multi-sensory stimulation program for 60 minute. The multi-sensory stimulation program was included a combination of auditory, tactile, motor and visual stimulation. The preterm infants in the control group received only usual care. The data collecting tool was a questionnaire and checklist for physiological parameters of preterm infants.
Results: The results showed that the two groups were homogeneous in terms of fetal age, birth weight, the height of birth, first and fifth minute Apgar score of birth. The results showed that there was no significant difference between the mean of physiological indexes in the two groups before the intervention. Statistical tests showed that there was a decreasing trend in the average of all physiological indices during the intervention (first and second half during the intervention) (P<0.001), However, these changes were not significant in the control group (P<0.05). Also, analysis of variance (ANOVA) with repeated measures showed that there was a significant difference between changes in physiological variables between the two groups at different stages of evaluation (P<0.001).
Conclusion: Multi-sensory stimulation leads to a decrease in heart rate and respiratory rate and the stability of blood pressure in preterm infants.

Background: Psoriasis is a chronic and recurrent inflammatory disease that involves skin, joints and different organ systems. It is associated with Multiple morbidities such as cardiovascular disorders, diabetes, hypertension, hyperlipidemia and chronic kidney disease (CKD). Due to the high importance of the association between psoriasis and CKD which results in major side effects the aim of this study was to evaluation of CKD and associated factors in Psoriasis patients at Razi Hospital, Tehran, Iran.
Methods: This retrospective study was conducted as a cross-sectional descriptive and analytical study to evaluate the frequency of CKD and associated factors in psoriatic patients admitted to the Razi Hospital whose last time of admission was from June 2018 to January 2019. According to the K/DOQI guideline, CKD is defined as the GFR<60 mL/min/1.73 m² during at least a period of three months. GFR was calculated based on the MDRD formula. The sample size was equal to 265. The hospital documents of inpatients who have been admitted to Razi Hospital wards or follow-up clinics during 2017-2019 were used for collecting information and data. This information has been extracted based on the initial checklist for data collection. Collected data has been analyzed and performed by using SPSS 25 software.
Results: The study found that 18 (6.8%) of psoriasis patients had CKD. Patients were in the age range of 3.5-92 years, the majority of them were in the age range of 18.65–79.7 years. 171 (64.5%) patients were male and 94 (35.5%) were female. 41 (15.5%) patients had diabetes, 94 (35.5%) had hyperlipidemia and 41 (15.5%) had hypertension. History of NSAID, Methotrexate, Cyclosporine, Acitretin, Infliximab, and Adalimumab medication use among 9 (3.4%), 205 (77.4%), 56 (21.1%), 147 (55.5%), 30 (11.3%), and 28 (10.6%) patients were observed, respectively. Also, 54 (20.4%) had a history of phototherapy. 217 (81.9%) of the psoriatic patients had CPP (Chronic Plaque Psoriasis) and 48 (18.1%) had PP (pustular Psoriasis) and finally, 21 (7.9%) of the patients had psoriatic arthritis.

Conclusion: The prevalence of CKD was shown to increase by age. The other correlated factors are diabetes, hypertension, and hyperlipidemia. On the other hand, there was not found any significant correlation between drugs (NSAIDs, Methotrexate, Cyclosporine, Acitretin, Infliximab, Adalimumab) and CKD prevalence. There was also no significant correlation between phototherapy, psoriasis type and psoriatic arthritis, duration of psoriasis and CKD prevalence.