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Effect of a synbiotic on functional abdominal pain in childhood
Get PDFBackground: One of the common functional gastrointestinal disorders in children is functional abdominal pain (FAP). The aim of the present study was to determine whether the administration of a synbiotic composed of fructo-oligosaccharides (FOS) and the seven types of beneficial bacteria is useful in FAP of childhood. Methods: In this placebo-controlled, double-blind trial, 4-15-year-old children who met the Rome III criteria for FAP were randomly divided to receive either synbiotic or placebo twice daily for 4 weeks. Primary outcome was at least 50 reduction in the number of pain episodes, and secondary outcomes were a decline of at least two scales in the pain duration and intensity based on Wong-Baker scale. Response to therapy was decrease of pain frequency/intensity. Results: A total of 67 children completed the trial (35 with synbiotic). Response rate was higher with synbiotic than placebo after four weeks (53.1 vs 11.4; p<0.001), and synbiotic had significant superiority to placebo to relieve the duration (4.56±9.12 vs12±18.59, min/day, P=0.04), frequency (0.31±0.53vs 1.17±0.7, episode/Wk., P<.001) and intensity (2.38±2.29 vs 5.49±1.83, p<0.001) of abdominal pain. Conclusion: Synbiotic compared to placebo significantly decreased the intensity, frequency and duration of FAP in children
Asynchronous Bilateral Testicular Cancer in A Patient with Bilateral Undescended Testicle: A Case Report
Get PDFBACKGROUND AND OBJECTIVE: Testicular cancer is almost the only common genitourinary tract cancer at a young age. One of the risk factors for testicular tumors is undescended testicles. If testicular fixation is corrected in the normal position, the probability of testicular cancer decreases in the undescended testicle before puberty, but it does not disappear, and the patient should be examined for a long time. The purpose of this case report is to introduce a patient who, despite undergoing orchidopexy, has developed asynchronous bilateral testicular cancer, which shows the importance of long-term follow-up in people with a history of undescended testicles.
CASE REPORT: The patient was a 54-year-old man with a history of congenital bilateral undescended testicles, infertile, and orchidopexy surgery in childhood and a history of classic seminoma in the left testicle four years ago. Again, in periodic follow-ups and examination of the right testicle, a mass in the right testicle was touched, which showed malignant changes in the ultrasound. Serum levels of testicular markers were normal. According to the sonographic findings, examinations and patient records, the patient underwent radical right testicular orchidectomy. Classic seminoma was reported in the results of right testicle pathology, and in further examinations, no evidence of metastasis was seen. The patient is currently undergoing follow-up and postoperative chemotherapy.
CONCLUSION: According to the results of this case reported in patients with intangible testicles, especially bilateral, long-term follow-up is necessary for asynchronous bilateral testicular cancer
Umbilical cord serum procalcitonin, as an early diagnostic marker of early neonatal sepsis
Get PDFBackground and Objective: The prognosis of early neonatal sepsis is significantly associated with rapid diagnosis and appropriate antibiotic therapy. Since blood culture has been reported positive in less than 16 of neonatal sepsis cases, various biochemical markers have been evaluated. This study was performed to evaluate the umbilical cord blood procalcitonin (PCT) as an early diagnostic marker of early neonatal sepsis. Methods: This cross-sectional study included 100 neonates in two groups of case and control. The case group consisted of three separate groups, including proven, suspected and clinical sepsis groups. The PCT level of umbilical cord blood was measured by immunoluminoassay method, and PCT 0.5-2ng/ml, 2-10 ng/ml and >10ng/ml were considered weakly positive, positive and strongly positive, respectively. Sepsis screening tests and a culture taken from blood or other sterile fluids were studied in the case group. Findings: The PCT mean was 1.39±1.52 and 0.17±0.05ng/ml in the case (sepsis) and control groups, respectively. Finally, the PCT level was significantly higher in all cases in the proven sepsis group than in other sepsis groups. Conclusion: The result of this study showed that the mean value of PCT level in umbilical cord blood was higher in the sepsis group, and it was higher in the proven sepsis group than in the other two groups of sepsis
Attention-deficit/hyperactivity disorder in children with constipation and fecal incontinence
Get PDFBackground and Objective: There is some evidence of a relationship between attention-deficit/hyperactivity disorder (ADHD) and functional defecation disorders (FDDs), both of which are common in childhood. The aim of the study was to investigate the frequency of ADHD in children with fecal incontinence (FI) and functional constipation (FC). Methods: This cross-sectional study was conducted on 99 children aged 4-14 years who met the Rome IV criteria to diagnose pediatric chronic FC with FI from January to May 2020. The ADHD was then assessed by the child and adolescent psychiatrist via clinical visits, DSM-5 and Conners Rating Scale (CRS). Pearson’s Chi-Square test and Mann-Whitney’s test were used to compare children with and without ADHD. A P value <0.05 was considered statistically significant. Findings: According to DM-V and clinical visits, about 24 (24.2) children with FC and FI were diagnosed with ADHD. Moreover, six and one of their relatives had anxiety/depression and schizophrenia, respectively. Children with ADHD were significantly male (83, p= 0.009), older (p= 0.003), heavier (p= 0.005), first born (79, P < 0.001) and premature (37, P=0.01) with older mothers (p=0.01). Conclusion: This study showed that there was a high prevalence of ADHD in children with FC and FI. Therefore, screening of suspected children is recommended
Effect of antenatal steroid before elective cesarean section on prevention of respiratory morbidities of full-term neonates
Get PDFBackground and Objective: Elective cesarean section (ECS) increases neonatal respiratory complications like transient tachypnea of the newborn (TTN) and respiratory distress syndrome (RDS). This pilot study examined the effect of antenatal steroids on the prevention of respiratory problems in full-term neonates born via ECS.
Methods: This experimental study was carried out on full-term neonates (39-42 weeks) born by ECS to the mothers admitted to Babol Clinic Hospital, northern, Iran in 2016. The intervention group received betamethasone (12 mg, intramuscular, once a day) for 2 days before ECS plus conventional care, but the control group received only conventional care. The rate of respiratory complication and the admission rate of the newborn ward and neonatal intensive care unit (NICU) were compared between two groups.
Findings: Overall, 200 full-term neonates (100 neonates in the experimental group and 100 neonates in the control group) were enrolled. Nine neonates (9%) in the experimental group and 8 neonates (8%) in the control group had TTN (P=0. 64), and one (1%) neonate in the experimental group and one neonate (1%) in the control group had RDS (P=1).
Conclusion: Antenatal corticosteroid administration to the mothers before ECS with gestational ages of 39-42 weeks does not reduce the incidence of respiratory complications. Thus, further studies are needed to determined its effects in gestational age group more than 39 weeks
Analgesic Effect of Duloxetine Compared to Nortryptiline in Patients with painful Neuropathy: A Randomized, Double-Blind, Placebo-Controlled Trial
Get PDFBackground:  Diabetic neuropathic pain (DNP) is a common complication of diabetes and has a profound effect on patients quality of life. Therefore. The purpose of the present study was to compare the analgesic effects of duloxetine and nortryptiline in the management of patients with diabetic neuropathy. Methods: This was a randomized, double-blind, parallel-group, placebo-controlled trial in subjects with a proven diagnosis of DM and suffered from neuropathic pain. Patients were recruited in this study from 20 February 2016 (first patient, first visit) to 22 June 2017 (last patient, last visit), including 5 weeks follow-up. A diagnosis of DNP was based on history, clinical examination, Nerve conduction velocity and Diabetic neuropathy symptom score (more than one point). Results: Both drugs reduced pain when compared with placebo. A significant VAS reduction from 6.4 at baseline to 3.75 at endpoint was observed in the duloxetine group. However, there was no significant difference in the efficacy between nortriptyline and duloxetine based on patientchr('39')s visual analogue scale (VAS) (p>0.05). No clinically significant changes or serious adverse events were found among treatment groups including changes in vital signs, laboratory assessments, physical examination or electrocardiograms. The decrease in the mean pain intensity was significantly greater in the duloxetine and nortriptyline group compared to the placebo group both in the primary analysis and in the by-visit analysis (p<0.003) Conclusions: The present study demonstrates the safety and effectiveness of both duloxetine and nortriptyline in the management of DNP
An epidemiological study of poisoning cases in Babol (northern Iran) from 2015 to 2018
Get PDFBackground: Poisoning is a major public health problem that constitutes a significant share of the global burden of disease. Previous studies conducted in this area indicated the importance of such epidemiological studies. The most critical impact of these studies is their effect on changing current regulations and, therefore, decreasing poisoning cases. We aimed to evaluate all poisoning cases with regard to the patients’ demographics and the involved intoxicants. Methods: The present study was conducted to investigate all poisoning cases who were admitted during a three-year period. Causes of poisoning, hospitalization, management procedures and outcome of the cases were surveyed.  A total of 1448 patients referred to Shahid Beheshti Hospital (Babol, Iran) from 2015 to 2018. Results: More than half of the patients were females (51.7), and the majority of poisoning cases were seen in patients aged between 15 to 25 years (34.2). It was found that suicide made a large part of poisoning cases (65.6), and females tend to attempt suicide more than males (64.3 vs. 35.7, respectively). Also, regular drugs followed by club drugs were the most abundant toxic agents (52.1 and 23.3, respectively). Aluminum phosphide (AlP) was the most lethal intoxicant in our study, accounting for 68.2 of all deaths. Conclusions: According to the results, it is concluded that the existing regulations for drug control and suicide prevention have not been efficient enough and further actions yet to be made to reduce the consequences of drug- and non-drug-related toxicities
Class I integrons among multidrug resistant Enterobacter spp. isolates from hospitalized patients in Babol, North of Iran
Get PDFBackground: Multidrug resistance (MDR) in Enterobacter spp. has created therapeutic challenges all over the world. The present study was conducted for evaluating the prevalence of class I integron, determining the gene cassettes and antimicrobial resistance profile of Enterobacter spp. isolates from clinical samples in Babol, North of Iran. Methods: During a 13-month period, 30 Enterobacter spp. isolates were collected from Ayatollah Rouhani Hospital, Babol, Iran. Various types of antimicrobial agents were used to determine the resistance pattern. Class I integron and associated gene cassettes were detected by PCR assay. Results: The resistance rates to AP, CPM, CTX, TM, NI, IMI, AK, CIP and GM antimicrobials were 100, 93.3, 33.3, 33.3, 30, 20, 20, 20 and 13.3, respectively. The distribution results of int genes showed that 63.3 of isolates carried the intI genes. Also, the prevalence of aadB, dfrA1, blaOXA30 and blaPSE1 genes were estimated at 36.6, 33.3, 6.6 and 0, respectively. Conclusion: Our results showed that class I integrons have a widespread distribution among the Enterobacter spp. isolates and have clinical relevance to MDR isolates. The results confirmed the necessity for uninterrupted monitoring to prevent distribution of multidrug resistance among Enterobacter spp. strains in Ira
The Relationship between Maternal Mental Health and the Development of Infants Under One Year of Age
Get PDFBACKGROUND AND OBJECTIVE: Maternal mental health is one of the factors affecting the development of the child, especially in the early years of life. Since lack of attention to development of infants and the following complications may lead to irreparable consequences, this study was performed to investigate the relationship between maternal mental health and the development of infants under one year of age.
METHODS: This cross-sectional study was performed on 200 mothers with infants aged 12 months who referred to Babol health centers in 2018. The required data were collected using demographic questionnaire, Goldberg General Health Questionnaire (GHQ-28) (score 21 and below means health and 22 and above means disorder) and the Spielberger State-Trait Anxiety Inventory (STAI) (scores between 20-34 are minimum, 35-45 mild, 46-54 average and greater than or equal to 57 are defined as severe).
FINDINGS: The mean age of mothers in this study was 29.8±5.13 years. 29% of mothers had symptoms of mental disorder. The mean score of maternal general health was 19.20±11.89 and the mean score of the depression component was 2.45±3.62. In Spielberger State-Trait Anxiety Inventory, there was a difference in infant weight index between growth percentiles of 15-50% and 50-85% at birth (p=0.015). However, no significant difference was observed with the growth process. Goldberg General Health Questionnaire (GHQ-28) did not show a significant relationship with infants' weight, height and head circumference at the end of one year. All infants had a normal growth pattern in all three indices of weight, height and head circumference.
CONCLUSION: The results showed that there is a relationship between maternal mental health and infant birth weight. But in the growth process, there is no relationship between infants' growth indicators and mothers' mental health
Intermittent right upper extremity ischemia in a patient with simultaneous aberrant right subclavian artery and patent foramen ovale: A case report
Get PDFBackground: Upper extremity intermittent ischemia due to non-aneurysmal, not occluded aberrant right subclavian artery (ARSA) is rare. Case presentation: We describe a 30-year-old male who suffered from PFO and non-aneurysmal, not occluded ARSA, and presented by intermittent right upper extremity ischemia. He was treated by right carotid subclavian transposition for ARSA and antiplatelet medication for PFO. Conclusion: Authors assume that intermittent limb ischemia can occur secondary to anatomical changes in a patient without aneurysmal degeneration or occluded ARSA and the existence of pure PFO without any evidence of venous thrombosis is not enough to prove the paradoxical emboli scenario