Mirhadi Mussavi | Tabriz University Of Medical Sciences (original) (raw)

Papers by Mirhadi Mussavi

Journal of Research in Medical and Dental Science, 2018

Blood culture is a procedure in NICU and gold standard procedure for diagnosis of newborn infecti... more Blood culture is a procedure in NICU and gold standard procedure for diagnosis of newborn infections and it is necessary for appropriate management of patient. The present study was aimed to investigate the performance compatibility of Tabriz medical Sciences University nurses who worked in NICU. The present cross-sectional descriptive study was conducted using convenience sampling method on 180 nurses working at Alzahra, Taleghani and Tabriz Children Hospital. The study tools included a two-part questionnaire, the first part of which focused on demographic characteristics of the infants and nurses and the service area, and the second part was a checklist of the nurses' performance in pre & post of blood culture procedure. Data analysis was performed using SPSS (ver.18) statistical software as well as descriptive and Analytical statistics. While 72.6 present of nurses …trained about blood cultures sampling workshop. The average percentage of the total performance score before an...

Iranian Journal of Neonatology IJN, 2019

Background: Blood culture is a method in neonatal intensive care unit (NICU) and a gold standard ... more Background: Blood culture is a method in neonatal intensive care unit (NICU) and a gold standard for the diagnosis of infection that is essential for proper newborn management. The aim of this study was to compare the performance of nurses in the NICUs of Tabriz University of Medical Sciences using a standard sampling method. Methods: This descriptive cross-sectional study was performed on 90 nurses working in Al-Zahra and Taleghani ג��Educational and Medical Centers, and Tabriz Children Hospital using the convenience sampling method. The study tool included a two-part questionnaire in which the first part contained demographic characteristics of the infants and nurses and the service area. The second part included a checklist of the nurses' performance before and during ג��the blood culture procedure. Data analysis was performed using SPSS statistical software (version 21), as well as descriptive and analytical statistics. Results: Most nurses did not attend training courses fo...

International Journal of Pediatrics, 2020

Background: Apgar score is a method for clinical evaluation of neonate at birth, and predicts the... more Background: Apgar score is a method for clinical evaluation of neonate at birth, and predicts their clinical conditions and physical or mental development. This score is affected by different factors during pregnancy and birth. This study aimed to investigate the relationship between some neonatal and maternal factors during pregnancy on the Apgar score. Methods: This case-control study was conducted on 234 neonates born in Ilam hospitals during 2015-2016. The case group included 81 neonates with Apgar score <7 and control group containing 153 neonates with Apgar score ≥7in minute1 as well as 48 cases and 96 controls in minute 5. Data analysis was performed using descriptive statistics, Chi-square test, Fisher's exact test and odds ratio. Results: The mean maternal weights in the case and control groups were 66.8 ± 13.5 and 67.1 ± 11.1 Kg, respectively. The mean± SD for maternal age 29 ± 5 vs. 29 ± 5.7 years, marriage age 22 ± 3 vs. 22.2 ± 4.9 years, BMI 24.5±3.2 vs. 26.1 ± 4...

Iranian Journal of Pediatrics, 2017

Background: To date there is no effective drug treatment for transient tachypnea of the newborn (... more Background: To date there is no effective drug treatment for transient tachypnea of the newborn (TTN) and respiratory support is the only means to handle this disease. This study was performed to evaluate the effect of albuterol (Salbutamol) in improvement of respiratory distress in involved neonates. Methods: We conducted a randomized, blinded, placebo-controlled clinical trial Neonates with TTN received either nebulized albuterol (30 neonates) or placebo (30 neonates), and early clinical parameters were measured during and after treatment. Results: Totally 60 neonates including 31 males and 29 females, mean gestational age of 36.9 ± 1.69 weeks, mean weight of 2703 ± 589 gr, were analyzed. Respiratory distress score was significantly decreased in treatment compared to placebo group (from 5.6 at the start to 1.7 at the end of study vs 5.6 to 3.9 respectively) and the PO2 was significantly increased in neonates receiving nebulized albuterol compared to the placebo group (from 58.5% at the start to 84.8% at the end of study vs 58.2% to 70.2% respectively). No adverse effects were observed in either group. The duration of continuous positive airway pressure (CPAP) application was significantly decreased in the treatment group compared to the placebo group (1.6 ± 0.77 vs. 3.3 ± 0.98 respectively) (P = 0.0001). Conclusions: Application of nebulized albuterol caused a considerable improvement in the respiratory distress of neonates at its primary hour of using via reduction of respiratory scores, duration and concentration of oxygen requirement, and duration of CPAP without any side effects. Therefore, this drug can be applied in the treatment of Transient Tachypnea of the Newborn appropriately.

Iranian Journal of Pediatrics, 2016

Background: Although several different types of natural surfactants are available, including Alve... more Background: Although several different types of natural surfactants are available, including Alveofact, Curosurf, and Survanta, the preferred type and the magnitude of their effects are unknown. Objectives: This study was designed to compare the effects of these three surfactants on the gas exchange and clinical outcomes of neonates with respiratory distress syndrome (RDS). Methods: This triple-blind randomized clinical trial studied all preterm neonates ≤ 37 weeks with RDS who were admitted to the neonatal intensive care unit (NICU) of Taleghani hospital (Tabriz, Iran) between 2012 and 2013. The patients were divided into three groups, each of which received one of these surfactants. The incidences of ventilator dependency, patent ductus arteriosus (PDA), broncho-pulmonary dysplasia (BPD), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH), hospital-stay length, and continuous positive airway pressure (CPAP) failure, as well as blood gas levels, were recorded as endpoint measurements and compared. Results: In total, 165 neonates of gestational age ≤ 37 weeks with RDS were examined. Neonates were allocated to three different groups randomly, including a Survanta group (n = 49), a Curosurf group (n = 62), and an Alveofact group (n = 54). The mean gestational age of the neonates was 31.6 ± 3.7 weeks, and their mean weight was 1,840 ± 790 grams. The male/female ratio was 2:1 (67% male, 33% female); 104 (63%) neonates were ≤ 32 weeks gestational age, and 61 (37%) were >32 weeks. There were no significant differences for gender or demographic characteristics among the neonates in relation to the type of applied surfactant. According to the clinical parameters (BPD, IVH, ROP, hospital-stay length, and mechanical ventilation requirement), no significant differences were observed between the groups before and after surfactant administration, but the differences between the Survanta and Alveofact groups for the incidence rates of pneumothorax (P = 0.03) and pulmonary hemorrhage (P = 0.03) were statistically significant. Conclusions: No significant differences were observed in most of the clinical variables between the three types of natural surfactant, but in neonates ≤ 32 weeks, the incidence of pneumothorax was significantly higher in the Alveofact group; in neonates > 32 weeks, the incidences of PDA, mean hospital-stay length, and mean mechanical ventilation time were also significantly higher in the same group. It thus appears that Curosurf and Survanta replacement therapies among premature neonates with RDS perform better than Alveofact replacement therapy.

Iranian journal of pediatrics, 2014

Red reflex test is an effective screening tool in the early diagnosis of neonatal eye abnormaliti... more Red reflex test is an effective screening tool in the early diagnosis of neonatal eye abnormalities. The aim of this study was to detect the sensitivity and specificity of red reflex assessment in neonates, performed by pediatricians (or other care providers) in comparison with ophthalmologists. Also association between red reflex findings and neonatal variables is evaluated. By a prospective study all neonates born from July 2011 until March 2012 in Mustafa Hospital, a general teaching hospital in Ilam city, Iran, were evaluated. Neonates were firstly investigated by pediatrician in substandard conditions at the first day of birth and several days later by ophthalmologist in standard conditions. Totally 255 neonates including 141 boys and 114 girls were investigated, 144 of whom were born by cesarean section. There was a significant relationship between method of childbirth (72.9% disorders in CS vs 56.8% in vaginal delivery (P<0.007)), duration of delivery (disorders in prolong...

Iranian journal of pediatrics, 2014

To evaluate the efficacy and safety of metoclopramide in the treatment of feeding intolerance in ... more To evaluate the efficacy and safety of metoclopramide in the treatment of feeding intolerance in preterm neonates less than 36 weeks of gestational age. A randomized, controlled, masked cross-over study. A block of 4 randomizations was used. The "drug group" received intravenous metoclopramide before feeding and placebo group received placebo at the same time. The time to full enteral feeding and suspected adverse effects of metoclopramide, length of hospital stay or incidence of NEC or septicemia were the main outcome measures. Mean (standard deviation) of weight and Apgar score among metoclopramide and placebo groups were 1638.3±321 gr, 8.9±1.4 and 1593.3±318.8 gr, 8.8±1.3 respectively. Times to full feeding were significantly shorter in the metoclopramide group than in the control group (12.9±5.6 vs 17.0±6.3; P<0.0001) and also the numbers of withheld feedings were significantly lower (P<0.0001). According to the regression analysis, lower weight and placebo group...

Iranian Journal of Pediatrics, 2015

Background: Tracheal intubation is extremely distressing, painful, and may influence heart rate a... more Background: Tracheal intubation is extremely distressing, painful, and may influence heart rate and blood pressure. Sedatives, analgesics, and muscle relaxants are not commonly used for intubation in neonates. Objectives: This study aimed to evaluate the effects of lidocaine spray as a non-intravenous drug before neonatal intubation on blood pressure, heart rate, oxygen saturation and time of intubation. Patients and Methods: In a randomized, controlled study each neonate was randomly assigned to one of the two study groups by staffs who were not involved in the infant's care. The allocation concealment was kept in an opaque sealed envelope, and the investigators, the patient care team, and the assessors were blinded to the treatment allocation. The selected setting was NICU unit of a teaching hospital in Ilam city, Iran and participants were 60 neonates with indication of tracheal intubation with gestational age >30 weeks. Patients in the treatment group received lidocaine spray and the placebo group received spray of normal saline prior to intubation. Main outcome measurements were the mean rates of blood pressure, heart rate, oxygen saturation, intubation time and lidocaine side effects were measured before and after intubation. Results: Totally 60 newborns including 31 boys and 29 girls were entered into the study (drug group n = 30; placebo group n = 30). Boy/girl ratio in treatment and placebo groups were 1.3 and 0.88, respectively. Mean age ± SD of participants was 34.1 ± 24.8 hours (treatment: 35.3 ± 25.7; placebo: 32.9 ± 24.3; P < 0.0001). Mean weight ± SD of neonates was 2012.5 ± 969 g. Application of lidocaine spray caused a significant reduction of mean intubation time among treatment group compared with placebo group (treatment: 15.03 ± 2.2 seconds; placebo: 18.3 ± 2.3 seconds; P < 0.0001). Mean blood pressure, heart rate and oxygen saturation rate, among neonates in treatment group was reduced after intubation compared with their relevant figures before intubation; however, their differences were not statistically significant except for mean oxygen saturation rate that was reduced significantly in placebo group. No side effects were observed during study. Conclusions: Though the current study revealed some promising results in the application of lidocaine spray during neonatal intubation without any considerable side effects; however, the current investigation could only be considered as a pilot study for further attempts in different locations with higher sample sizes and in different situations.

International Journal of Pediatrics, 2018

Background: Premature neonates are hospitalized until they can get full mouth feeding and this of... more Background: Premature neonates are hospitalized until they can get full mouth feeding and this often leads to increasing the hospitalization period. This study compared two neonatal care policies: early discharge of stable preterm infants with home gavage feeding and discharge when they reached to full oral feeding. Materials and Methods: By a case-control study, all stable premature neonates admitted in Alzahra teaching hospital, Tabriz, Iran, who were not able to feed orally, were divided into two groups. Study group included 48 neonates who achieved full oral feeding through oro-gastric tube and were discharged for outpatient follow-up. Control group included 50 neonates with the same feeding conditions who remained hospitalized and fed up by their mothers. Within one month, early clinical criteria were compared between both groups. Results: The mean gestational age for the control group was (30.6 +/- 2.5 weeks), study group was (30.2 +/- 1.8 weeks) and average admission weights ...

Journal of Research in Medical and Dental Science, 2018

Blood culture is a procedure in NICU and gold standard procedure for diagnosis of newborn infecti... more Blood culture is a procedure in NICU and gold standard procedure for diagnosis of newborn infections and it is necessary for appropriate management of patient. The present study was aimed to investigate the performance compatibility of Tabriz medical Sciences University nurses who worked in NICU. The present cross-sectional descriptive study was conducted using convenience sampling method on 180 nurses working at Alzahra, Taleghani and Tabriz Children Hospital. The study tools included a two-part questionnaire, the first part of which focused on demographic characteristics of the infants and nurses and the service area, and the second part was a checklist of the nurses' performance in pre & post of blood culture procedure. Data analysis was performed using SPSS (ver.18) statistical software as well as descriptive and Analytical statistics. While 72.6 present of nurses …trained about blood cultures sampling workshop. The average percentage of the total performance score before an...

Iranian Journal of Neonatology IJN, 2019

Background: Blood culture is a method in neonatal intensive care unit (NICU) and a gold standard ... more Background: Blood culture is a method in neonatal intensive care unit (NICU) and a gold standard for the diagnosis of infection that is essential for proper newborn management. The aim of this study was to compare the performance of nurses in the NICUs of Tabriz University of Medical Sciences using a standard sampling method. Methods: This descriptive cross-sectional study was performed on 90 nurses working in Al-Zahra and Taleghani ג��Educational and Medical Centers, and Tabriz Children Hospital using the convenience sampling method. The study tool included a two-part questionnaire in which the first part contained demographic characteristics of the infants and nurses and the service area. The second part included a checklist of the nurses' performance before and during ג��the blood culture procedure. Data analysis was performed using SPSS statistical software (version 21), as well as descriptive and analytical statistics. Results: Most nurses did not attend training courses fo...

International Journal of Pediatrics, 2020

Background: Apgar score is a method for clinical evaluation of neonate at birth, and predicts the... more Background: Apgar score is a method for clinical evaluation of neonate at birth, and predicts their clinical conditions and physical or mental development. This score is affected by different factors during pregnancy and birth. This study aimed to investigate the relationship between some neonatal and maternal factors during pregnancy on the Apgar score. Methods: This case-control study was conducted on 234 neonates born in Ilam hospitals during 2015-2016. The case group included 81 neonates with Apgar score <7 and control group containing 153 neonates with Apgar score ≥7in minute1 as well as 48 cases and 96 controls in minute 5. Data analysis was performed using descriptive statistics, Chi-square test, Fisher's exact test and odds ratio. Results: The mean maternal weights in the case and control groups were 66.8 ± 13.5 and 67.1 ± 11.1 Kg, respectively. The mean± SD for maternal age 29 ± 5 vs. 29 ± 5.7 years, marriage age 22 ± 3 vs. 22.2 ± 4.9 years, BMI 24.5±3.2 vs. 26.1 ± 4...

Iranian Journal of Pediatrics, 2017

Background: To date there is no effective drug treatment for transient tachypnea of the newborn (... more Background: To date there is no effective drug treatment for transient tachypnea of the newborn (TTN) and respiratory support is the only means to handle this disease. This study was performed to evaluate the effect of albuterol (Salbutamol) in improvement of respiratory distress in involved neonates. Methods: We conducted a randomized, blinded, placebo-controlled clinical trial Neonates with TTN received either nebulized albuterol (30 neonates) or placebo (30 neonates), and early clinical parameters were measured during and after treatment. Results: Totally 60 neonates including 31 males and 29 females, mean gestational age of 36.9 ± 1.69 weeks, mean weight of 2703 ± 589 gr, were analyzed. Respiratory distress score was significantly decreased in treatment compared to placebo group (from 5.6 at the start to 1.7 at the end of study vs 5.6 to 3.9 respectively) and the PO2 was significantly increased in neonates receiving nebulized albuterol compared to the placebo group (from 58.5% at the start to 84.8% at the end of study vs 58.2% to 70.2% respectively). No adverse effects were observed in either group. The duration of continuous positive airway pressure (CPAP) application was significantly decreased in the treatment group compared to the placebo group (1.6 ± 0.77 vs. 3.3 ± 0.98 respectively) (P = 0.0001). Conclusions: Application of nebulized albuterol caused a considerable improvement in the respiratory distress of neonates at its primary hour of using via reduction of respiratory scores, duration and concentration of oxygen requirement, and duration of CPAP without any side effects. Therefore, this drug can be applied in the treatment of Transient Tachypnea of the Newborn appropriately.

Iranian Journal of Pediatrics, 2016

Background: Although several different types of natural surfactants are available, including Alve... more Background: Although several different types of natural surfactants are available, including Alveofact, Curosurf, and Survanta, the preferred type and the magnitude of their effects are unknown. Objectives: This study was designed to compare the effects of these three surfactants on the gas exchange and clinical outcomes of neonates with respiratory distress syndrome (RDS). Methods: This triple-blind randomized clinical trial studied all preterm neonates ≤ 37 weeks with RDS who were admitted to the neonatal intensive care unit (NICU) of Taleghani hospital (Tabriz, Iran) between 2012 and 2013. The patients were divided into three groups, each of which received one of these surfactants. The incidences of ventilator dependency, patent ductus arteriosus (PDA), broncho-pulmonary dysplasia (BPD), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH), hospital-stay length, and continuous positive airway pressure (CPAP) failure, as well as blood gas levels, were recorded as endpoint measurements and compared. Results: In total, 165 neonates of gestational age ≤ 37 weeks with RDS were examined. Neonates were allocated to three different groups randomly, including a Survanta group (n = 49), a Curosurf group (n = 62), and an Alveofact group (n = 54). The mean gestational age of the neonates was 31.6 ± 3.7 weeks, and their mean weight was 1,840 ± 790 grams. The male/female ratio was 2:1 (67% male, 33% female); 104 (63%) neonates were ≤ 32 weeks gestational age, and 61 (37%) were >32 weeks. There were no significant differences for gender or demographic characteristics among the neonates in relation to the type of applied surfactant. According to the clinical parameters (BPD, IVH, ROP, hospital-stay length, and mechanical ventilation requirement), no significant differences were observed between the groups before and after surfactant administration, but the differences between the Survanta and Alveofact groups for the incidence rates of pneumothorax (P = 0.03) and pulmonary hemorrhage (P = 0.03) were statistically significant. Conclusions: No significant differences were observed in most of the clinical variables between the three types of natural surfactant, but in neonates ≤ 32 weeks, the incidence of pneumothorax was significantly higher in the Alveofact group; in neonates > 32 weeks, the incidences of PDA, mean hospital-stay length, and mean mechanical ventilation time were also significantly higher in the same group. It thus appears that Curosurf and Survanta replacement therapies among premature neonates with RDS perform better than Alveofact replacement therapy.

Iranian journal of pediatrics, 2014

Red reflex test is an effective screening tool in the early diagnosis of neonatal eye abnormaliti... more Red reflex test is an effective screening tool in the early diagnosis of neonatal eye abnormalities. The aim of this study was to detect the sensitivity and specificity of red reflex assessment in neonates, performed by pediatricians (or other care providers) in comparison with ophthalmologists. Also association between red reflex findings and neonatal variables is evaluated. By a prospective study all neonates born from July 2011 until March 2012 in Mustafa Hospital, a general teaching hospital in Ilam city, Iran, were evaluated. Neonates were firstly investigated by pediatrician in substandard conditions at the first day of birth and several days later by ophthalmologist in standard conditions. Totally 255 neonates including 141 boys and 114 girls were investigated, 144 of whom were born by cesarean section. There was a significant relationship between method of childbirth (72.9% disorders in CS vs 56.8% in vaginal delivery (P<0.007)), duration of delivery (disorders in prolong...

Iranian journal of pediatrics, 2014

To evaluate the efficacy and safety of metoclopramide in the treatment of feeding intolerance in ... more To evaluate the efficacy and safety of metoclopramide in the treatment of feeding intolerance in preterm neonates less than 36 weeks of gestational age. A randomized, controlled, masked cross-over study. A block of 4 randomizations was used. The "drug group" received intravenous metoclopramide before feeding and placebo group received placebo at the same time. The time to full enteral feeding and suspected adverse effects of metoclopramide, length of hospital stay or incidence of NEC or septicemia were the main outcome measures. Mean (standard deviation) of weight and Apgar score among metoclopramide and placebo groups were 1638.3±321 gr, 8.9±1.4 and 1593.3±318.8 gr, 8.8±1.3 respectively. Times to full feeding were significantly shorter in the metoclopramide group than in the control group (12.9±5.6 vs 17.0±6.3; P<0.0001) and also the numbers of withheld feedings were significantly lower (P<0.0001). According to the regression analysis, lower weight and placebo group...

Iranian Journal of Pediatrics, 2015

Background: Tracheal intubation is extremely distressing, painful, and may influence heart rate a... more Background: Tracheal intubation is extremely distressing, painful, and may influence heart rate and blood pressure. Sedatives, analgesics, and muscle relaxants are not commonly used for intubation in neonates. Objectives: This study aimed to evaluate the effects of lidocaine spray as a non-intravenous drug before neonatal intubation on blood pressure, heart rate, oxygen saturation and time of intubation. Patients and Methods: In a randomized, controlled study each neonate was randomly assigned to one of the two study groups by staffs who were not involved in the infant's care. The allocation concealment was kept in an opaque sealed envelope, and the investigators, the patient care team, and the assessors were blinded to the treatment allocation. The selected setting was NICU unit of a teaching hospital in Ilam city, Iran and participants were 60 neonates with indication of tracheal intubation with gestational age >30 weeks. Patients in the treatment group received lidocaine spray and the placebo group received spray of normal saline prior to intubation. Main outcome measurements were the mean rates of blood pressure, heart rate, oxygen saturation, intubation time and lidocaine side effects were measured before and after intubation. Results: Totally 60 newborns including 31 boys and 29 girls were entered into the study (drug group n = 30; placebo group n = 30). Boy/girl ratio in treatment and placebo groups were 1.3 and 0.88, respectively. Mean age ± SD of participants was 34.1 ± 24.8 hours (treatment: 35.3 ± 25.7; placebo: 32.9 ± 24.3; P < 0.0001). Mean weight ± SD of neonates was 2012.5 ± 969 g. Application of lidocaine spray caused a significant reduction of mean intubation time among treatment group compared with placebo group (treatment: 15.03 ± 2.2 seconds; placebo: 18.3 ± 2.3 seconds; P < 0.0001). Mean blood pressure, heart rate and oxygen saturation rate, among neonates in treatment group was reduced after intubation compared with their relevant figures before intubation; however, their differences were not statistically significant except for mean oxygen saturation rate that was reduced significantly in placebo group. No side effects were observed during study. Conclusions: Though the current study revealed some promising results in the application of lidocaine spray during neonatal intubation without any considerable side effects; however, the current investigation could only be considered as a pilot study for further attempts in different locations with higher sample sizes and in different situations.

International Journal of Pediatrics, 2018

Background: Premature neonates are hospitalized until they can get full mouth feeding and this of... more Background: Premature neonates are hospitalized until they can get full mouth feeding and this often leads to increasing the hospitalization period. This study compared two neonatal care policies: early discharge of stable preterm infants with home gavage feeding and discharge when they reached to full oral feeding. Materials and Methods: By a case-control study, all stable premature neonates admitted in Alzahra teaching hospital, Tabriz, Iran, who were not able to feed orally, were divided into two groups. Study group included 48 neonates who achieved full oral feeding through oro-gastric tube and were discharged for outpatient follow-up. Control group included 50 neonates with the same feeding conditions who remained hospitalized and fed up by their mothers. Within one month, early clinical criteria were compared between both groups. Results: The mean gestational age for the control group was (30.6 +/- 2.5 weeks), study group was (30.2 +/- 1.8 weeks) and average admission weights ...