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Retinopathy of prematurity progression and its related factors: A cohort study in preterm infant in northern Iran
Get PDFBackground and Objective: Retinopathy of Prematurity (ROP) is a vasoproliferative retinal disease in premature infants, causing lifetime visual impairment and blindness at an early age. The aim of this study was to investigate the impact of oxygen profile in the progression of ROP.
Methods: This prospective cohort study (from 2010 to 2020) was applied in the Ophthalmology center of Ayatollah Rouhani Hospital in Babol (Babol University of Medical Sciences, Babol, Iran) included 828 infants (<37 weeks of gestation with a birth weight <2500 g). Moreover, the oxygen profile of infants (with/without ROP) was collected from their history profile in terms of arterial blood gas.
Findings: The duration of oxygen therapy was significantly higher in ROP patients (9.19±14.33 days), compared to control (3.16±4.35 days), (P=0.002). The minimum level of PO2 was significantly lower in ROP infants (51.71±44.81 mmHg) compared to controls (92.75±65.45 mmHg, P<0.001). Furthermore, patient with zone 1 involvement had higher PO2 level than the patient with zone 2 involvement (P=0.029). The ventilation requirement was more frequent in ROP patients (39.27%) compared to controls (19.24%, P<0.001). Also, the CPAP requirement was more frequent in ROP patients (48.51%) compared to controls (32.95%, P<0.001).
Conclusion: Our results have indicated that the duration of oxygen therapy and the minimum and maximum level of PO2 are indicators of ROP occurrence
Evaluation of Head Position Using Craniovertebral Angle in Two Sitting and Standing Positions in the Elderly
Get PDFBACKGROUND AND OBJECTIVE: Abnormal head posture can lead to pain, physical limitations, falls and fractures that have a negative impact on people's quality of life. Since head orientation in sagittal view varies according to different body postures, this study was conducted to investigate the effect of two standing and sitting postures on sagittal view.
METHODS: This observational study was performed on 70 elderly people referred to Elderly Health Center of Babol University of Medical Sciences. In order to measure the craniovertebral angle to determine the direction of the head in the sagittal view, participants were photographed in both standing and sitting positions. After initial evaluation, participants were divided into two groups of head posture (forward head posture and normal head posture) based on craniovertebral angle, with an angle of less than 51° as abnormal head posture.
FINDINGS: The mean age of the subjects was 67.9±3.8. The size of the craniovertebral angle in sitting position (52±8.3) was greater than in standing position (48.1±6.5) (P<0.0001). In addition, two subgroups of forward head posture and normal posture showed increased craniovertebral angle in sitting position (forward head posture: 48.3±7.2, normal: 59.6±4.6) comapred to standing position (forward head posture: 43.7±6.5, normal: 56.9±4.2) (P<0.003, P<0.0001, respectively).
CONCLUSION: According to the results, the craniovertebral angle increases in sitting position compared to the standing position
Comparison of ertapenem non-susceptibility with 2-mercaptopropionic acid phenotypic tests in predicting NDM-1 and IMP-1 production in clinical isolates of Escherichia coli
Get PDFBackground: A routine phenotypic test has not been recommended for detection of metallo-β-lactamases (MBLs) producing Enterobacteriaceae species such as Escherichia coli. The current study was conducted to compare the 2-Mercaptopropionic acid (2-MPA) phenotypic method and ertapenem non-susceptibility test with polymerase chain reaction in predicting the production of MBLs in clinical isolates of E. coli. Methods: Antimicrobial susceptibility test for beta-lactam antibiotics were performed by disk diffusion method. All isolates which showed inhibition zones of ≤ 22 mm for CAZ and ≤ 27 mm for CTX were considered potential MBLs producing isolates. The production of MBLs was confirmed using 2-MPA compound. Also, susceptibility to ertapenem was evaluated in all isolates. Conventional PCR was performed to detect blaIMP-1 and/or blaNDM-1 genes in all potential MBLs producing E. coli isolates. Results: Of 259, 138 (53.3) isolates were potential MBLs producing bacteria. One hundred and fifteen out of 138 (83.3) isolates were susceptible to ertapenem. MBLs production was confirmed in 75/138 (54.4) isolates by 2-MPA phenotypic method.  The blaNDM-1 or/and blaIMP-1 genes were found in 30/75(40) and 39/115(33.9) isolates which were confirmed by 2-MPA and were susceptible to ertapenem, respectively. The Sensitivity of 2-MPA method and ertapenem non-susceptibility test compared with PCR were 65.2 and 15.2, and the specificity was 52.1 versus 82.6, respectively. Conclusion: This study demonstrated that the 2-MPA phenotypic method does not have acceptable sensitivity and specificity in comparison with PCR, but its results are more reliable for the detection of MBL producing E. coli isolates compared with non-susceptibility to ertapenem
Hospital diet for COVID-19, an acute respiratory infectious disease: An evidence-based Protocol of a Clinical Trial
Get PDFBackground: COVID-19 caused a global pandemic problem. No confident management is introduced for it yet. This study aimed to propose a dietary protocol for hospitalized patients with the diagnosis of acute respiratory infectious disease caused by COVID-19 based on Persian Medicine. Methods: This study was conducted in three phases. In the first phase, any diseases that could be matched with the clinical features of infection with COVID-19 were searched in selected PM references. In the second phase, medicinal herbs and foods that were available and could be used in the hospital diet were extracted and summarized. In the third phase, the new documentation of these pharmaceutical and food items was conducted. Results: The signs and symptoms of infectious respiratory disease caused by COVID-19 can be categorized in the field of Zato al-rieh that can mainly be matched with pneumonia. Based on the described criteria, some nutrients and medicinal materia medica have been introduced for acute respiratory infection including Cydonia oblonga, Honey, Citrus sinensis, Malus domestica, Citrus medica, Crocus sativus, Raisin, Rosa Damas Cena, D.Carota, Camellia Sinensis, Anethum graveolens dhi, Punica granatum, Petroselinum Crispum, Coriandrum sativum, Urtica dioica, Allium sativum, Sesamum indicum Conclusion: Most materia medica has documents in current articles including anti-cough suppressants, antiviral properties, anti-bacterial, anti-inflammatory, antioxidant, immunomodulatory etc. A protocol of hospital diet for patients with infectious respiratory syndrome caused by COVID-19 has been introduced in this manuscript
Phenotypic and Genotypic Detection of Metallo-Beta-Lactamases in Carbapenem Resistant Acinetobacter baumannii
Get PDFBackground: Carbapenem resistance in Acinetobacter baumannii has become a major concern for treating physicians. The aim of this study was to investigate the prevalence of metallo β-lactamase (MBL) genes (bla VIM , and blaIMP) among isolated multidrug-resistant A. baumannii . Methods: Fifty non-repetitive carbapenem-resistant A. baumannii isolates were collected. Antibiotic susceptibility was performed by disk diffusion method. MICs were determined by E test method. The resistant strains were tested for the production of carbapenemases by the Modified Hodge Test (MHT) followed by EDTA-disk synergy test was performed for metallo-β-lactamases (MBL) phenotypic detection. Detection of bla VIM , and blaIMP was performed by PCR followed by sequencing. Results: All isolates had a multidrug resistant profile, and were all resistant to all antibiotics including the carbapenems but remained susceptible to colistin. Among these isolates, Carbapenemase production was confirmed by the Modified Hodge test for 42 (84) isolates. Phenotypic method showed the production of MBL in 15 (30) isolates. PCR techniques revealed that out of 50 isolates, 13 (26) were positive for blaVIM and all were negative for blaIMP. Conclusion: Our study concludes that the high prevalence of carbapenem resistant Acinetobacter species with MBL production is one of the main concerns in our country and this situation needs strict infection control measures
Frequency and causes of failure in exclusive breast feeding in Babol, northern Iran: a cross sectional study
Get PDFIntroduction: The reasons for the failure of exclusive breastfeeding (EBF) in the world are different and it changes over time. The aim of this study was to determine the frequency and causes of failure of EBF in infants in Babol, North of Iran.
Method: This cross-sectional study was performed on infants referred to the health care centers affiliated by Babol University of Medical Sciences for 6-month age vaccination. Inclusion criteria were parental satisfaction, 6-month infant and lack of infant’s congenital anomalies. Mother and infant’s demographic information and breastfeeding outcomes were completed by mother’s self-declaration. A 4-option question was asked of the mother regarding infant nutrition including breastfeeding only, formula feeding only, relative formula feeding and relative breastfeeding. Descriptive and analytical indicators were used for data analysis.
Results: Totally, 371 infants with the mean birth weight of 3265.82±514.19 g were entered into the current study. Most of them (72.2%) used at least one of the following cases: pacifier, bottle, sugar water or complementary feeding during the first 6 months of life. According to these results, the rate of failure in EBF was 72.2%. Based on the 4-option question on exclusive breastfeeding, 63.6% of infants had exclusively breastfed. Regression analysis was shown that the maternal age (p=0.012) and gestational age at birth (p=0.039) were predictors of EBF discontinuation.
Conclusion: In the present study, the rate of failure in EFB was 72.2%. The most common cause of failure in EBF was the uses of pacifier, bottle and sugar water which was occurred due to the lack of awareness of mothers. Moreover, the maternal age and gestational age at birth were effective factors of EBF. The EBF can be improved by planning in educating and supporting mothers, especially in cases where there is preterm delivery
Evaluation of Colonoscopy Screening Results in the First-Degree Relatives of Patients with Familial Colorectal Cancer X-Type
Get PDFBACKGROUND AND OBJECTIVE: Colorectal cancer is one of the growing cancers in Iran and one of the few preventable cancers in the World Health Organization. One of the most important ways to early diagnose this malignancy and its underlying lesions (polyps) and subsequently to prevent it is screening. Colorectal cancer is one of the growing cancers in Iran and one of the few preventable cancers in the World Health Organization. One of the most important ways of early detection of this malignancy and its underlying lesions (polyps) and consequently its prevention is screening. Different protocols have been developed for the diagnosis of first degree relatives of known hereditary cases such as HNPCC and FAP, but the diagnosis plan for first degree relatives has not been defined as a group of familial colorectal cancers without known mutations (type X colorectal cancer). The purpose of this study was to evaluate the results of colonoscopy screening in first-degree relatives of these patients.
METHODS: This cross-sectional study was performed on the families of patients with suspected Lynch syndrome who had no deficiency in the expression of repair proteins. Data were collected from the medical records system of colorectal cancer patients who had been enrolled in the system for prevention and early detection of colorectal cancer at Shahid Beheshti University of Medical Sciences Research Center from 1387 to 1397.
FINDINGS: The results of colonoscopy revealed that 18 out of 77 subjects had 23% polyps or tumors in their colon, out of which 55% were polyps and the rest were adenomas. About 60% of polyps were in the rectum and sigmoid and the rest in the colon and cecum. Also, 4 patients in this screening showed tumors in their colon, all of which were newly diagnosed, and 2 patients in this screening were diagnosed with inflammatory bowel disease.
CONCLUSION: According to the results of this study, in the case of colon polyps, the families of these patients appear to be at high risk like those of Lynch syndrome families and need regular colonoscopy care
Comparison of the Effect of Massage with Coconut Oil and Sunflower Oil on the Growth of Premature Infants
Get PDFBACKGROUND AND OBJECTIVE: Prematurity and low birth weight are one of the major health problems and the most common causes of infant mortality. Infant massage is potentially beneficial for physiological and psychological health. The present study was conducted to compare the effect of massage with coconut oil and sunflower oil on the growth of premature infants.
METHODS: This clinical trial was performed on 100 premature infants admitted to the neonatal intensive care unit of Amirkola Children's Hospital in 2018 in four groups of 25 infants. Infants of the intervention groups with one cc of sunflower oil and coconut oil and the oil-free massage group were massaged for 15 minutes three times a day for seven days with the help of a research assistant, and the control group received only routine care. The weight, height, and head circumference of infants were collected using a personal profile questionnaire and compared in four groups at the beginning and end of the intervention.
FINDINGS: Comparison of mean weight and head circumference changes at the end of the first week between coconut oil massage group (0.134±0.334 cm, 6.81±3.04 g), sunflower oil massage group (0.239±1.172 cm, 6.35±2.69 g), oil-free massage group (1.061±1.534 cm, 2.95±2.65), and control group (0.663±1.174 cm, 3.52±4.38 g) showed significant difference (p<0.05). Comparison of mean height changes in different groups (0.413±0.739, 0.448±0.747, 0.458±0.693, 0.429±0.611 cm, respectively) did not show any significant difference.
CONCLUSION: The results of the study showed that oil massage is recommended as it increases the rate of changes in weight gain and head circumference in premature infants
Comparison of the push-out bond strength between root mineral trioxide aggregate( MTA) and calcium-enriched mixture (CEM) cement
Get PDFIntroduction: Root mineral trioxide aggregate (MTA) is a type of MTA that has been introduced in the Iranian market. There have been few studies on this substance. This study compared the push-out bond strength of Root MTA and CEM cement, which were both Iranian products.
Materials & Methods: This in vitro study was performed on 20 extracted maxillary incisors. Samples were divided in two groups. The canals of the first group were filled with Root MTA and the second group by CEM cement. In order to investigate the push-out bond strength, the device applied a force in the direction parallel to the longitudinal axis of the sample so that the desired materials would fail. Each sample was classified into one of three types of failureincluding adhesive (failure in the material and dentin interface), cohesive (failure in the material itself) or a combination of both.
Results: There was no significant difference between the mean pressure on teeth for the two groups (P>0.05). There was no significant difference between the frequencies of different types of failure between the two groups (P>0.05). Cohesive failure in the CEM group was twice as high as in the MTA group (P>0.05).
Conclusion: There was not any significant difference between the push-out bond strength of CEM cement and Root MTA cement. These findings demonstrated that Root MTA material showed a satisfactory result in the bond strength test compared to CEM material, and could be used as an alternative to CEM cement
Acute Pancreatitis as A Complication of Typhoid Fever: A Case Report
Get PDFBACKGROUND AND OBJECTIVE: Typhoid fever could have a wide range of complications. Pancreatitis is a rare complication in children with typhoid fever. The aim of this case report is to describe a case of typhoid fever presented with acute pancreatitis (AP).
CASE REPORT: A 13-year-old girl with fever and abdominal pain around the umbilical region lasting one week was referred to the Amirkola Children’s Hospital. She had recurrent non-bloody, non-biliary vomiting and watery diarrhea while she had dysentery during admission. She had drunk spring water in a recent trip. The stool culture was positive for Salmonella Typhi. The Widal test results were first: TO:1.80, TH:1.80 and after one week: TO:1.320, TH:1.320. Hydrotherapy along with treatment with cefotaxime (50mg/kg for 14 days) recovered the patient from dysentery, nausea and fever. After one week, she complained of periumbilical abdominal pain, vomiting and tenderness of epigastric region. Lipase level was elevated to 500 U/L and her pain became worse. Spiral abdominopelvic CT scan showed normal liver, spleen, gallbladder and bile ducts. However, the pancreas tail was hypodense and larger than normal. The pancreatitis was treated by hydration and intravenous pantoprazole. After two weeks of admission, she was discharged with remission, and the lab tests and ultrasound examination were normal within a 4-week follow-up.
CONCLUSION: According to this case report the pancreatitis should be considered in children with typhoid fever and persistent abdominal pain