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Objective: To evaluate different doses of ivermectin in adult patients with mild COVID-19 and to evaluate the effect of ivermectin on mortality and clinical consequences. Methods: A randomized, double-blind, placebo-controlled, multicenter clinical trial was performed at five hospitals. A total of 180 mild hospitalized patients with COVID-19 confirmed by PCR or chest image tests were enrolled and allocated to six arms including hydroxychloroquine 200 mg twice per day, placebo plus hydroxychloroquine 200 mg twice per day, single dose ivermectin (200 μg/kg), three low interval doses of ivermectin (200, 200, 200 μg/kg), single dose ivermectin (400 μg/kg), and three high interval doses of ivermectin (400, 200, 200 μg/kg). The primary endpoint of this trial was all-cause of mortality or clinical recovery. The radiographic findings, hospitalization and low O
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PURPOSE: The present study aimed to determine the relationship between serum 25-hydroxyvitamin D (25(OH)D) level and Urinary tract infections (UTIs) in children. METHODS: In this case-control study, 70 children with UTI (case group) were compared with 70 healthy children (control group) in terms of serum 25(OH)D levels. The children were between 1 month and 12 years of age. Serum 25(OH)D levels were measured using enzyme-linked immunosorbent assay (ELISA). The results were analyzed and compared between both groups. RESULTS: Among 70 children with UTI (case group), 5 children (7.2%) were male and 65 (92.8%) were female. Among the healthy children (control group), 9 (12.8%) and 61 children (87.2%) were male and female, respectively (P=0.39). The mean±standard deviation of age in the case and control groups were 53.2±35.6 and 36.1±60.2 months, respectively (P=0.24). The mean level of serum 25(OH)D in the case group was significantly higher than that of the control group (20.4±8.6 ng/mL vs. 16.9±7.4 ng/mL, P=0.01). CONCLUSION: This study showed that there was a relationship between serum 25(OH)D levels and UTI in children. It seems that 25(OH)D plays a role in the pathogenesis of UTI.
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Child , Female , Humans , Male , Case-Control Studies , Enzyme-Linked Immunosorbent Assay , Urinary Tract Infections , Urinary Tract , Vitamin D , VitaminsABSTRACT
Background: The prevalence of metabolic syndrome (MetSyn) is increasing worldwide. The aim of this study was to determine the prevalence of MetSyn and insulin resistance (IR) in children and adolescents in Qazvin, Iran. Methods: A cross-sectional study was conducted in 338 children and adolescents aged 10–18 years old who were selected by a multistage cluster random sampling method. We performed standardised measurements of variables including waist circumference (WC), blood pressure, plasma glucose level, total cholesterol, high-density lipoprotein cholesterol (HDL), triglycerides, and insulin. MetSyn was defined according to the International Diabetes Federation criteria. IR was estimated by the homeostatic model assessment. Results: Of the 338 total subjects, 172 were female. The overall prevalence of MetSyn and IR were 3.4% and 18.2%, respectively. There was no sex difference for the prevalence of MetSyn. A total of 185 subjects (56.4%) had one or two components of MetSyn. The most common component was low HDL levels in both sexes, which was followed by high WC in females and high fasting plasma glucose levels in males. Conclusion: The lack of a standard definition of MetSyn in children and adolescents combined with the geographical and socioeconomic differences make it difficult to compare the results from different studies. Modification of lifestyle habits is an important strategy in preventing MetSyn and IR.
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Background: Sleep problems are one of the main health issues raised by families. Therefore, we aimed to evaluate the sleep problems of pre-school children in Iran. Methods: Five hundred and seventy-nine children aged 3–6 years were randomly recruited from 15 kindergartens in the city of Qazvin in Iran. The Iranian version of BEARS (Bedtime problems, Excessive daytime sleepiness, Awakenings during the night, Regularity and duration of sleep and Snoring) and the Children’s Sleep Habits questionnaire (CSHQ) were completed by interviewers. Data analysis was performed using SPSS version 19. The data were analysed with a Student’s t-test, chi-square and Fisher’s exact tests. A P value 0.05). Conclusion: The children had sleep-related problems, including a late bedtime, delayed sleep onset, daytime sleepiness, midnight awakening, sleep-disordered breathing, and snoring. Sharing a room was very common among the Iranian children.
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PURPOSE: Febrile seizures are induced by fever and are the most common type of seizures in children. Although numerous studies have been performed on febrile seizures, their pathophysiology remains unclear. Recent studies have shown that cytokines may play a role in the pathogenesis of febrile seizures. The present study was conducted to identify potential links between serum interleukin-1beta (IL-1beta), tumor necrosis factor-alpha (TNF-alpha), and febrile seizures. METHODS: Ninety-two patients with simple or complex febrile seizures (46 patients per seizure type), and 46 controls with comparable age, sex, and severity of temperature were enrolled. RESULTS: The median concentrations of serum IL-1beta in the simple, complex febrile seizure, and control groups were 0.05, 0.1, and 0.67 pg/mL, respectively (P=0.001). Moreover, the median concentrations of TNF-alpha in the simple, complex febrile seizure, and control groups were 2.5, 1, and 61.5 pg/mL, respectively (P=0.001). Furthermore, there were significant differences between the case groups in serum IL-1beta and TNF-alpha levels (P<0.05). CONCLUSION: Unlike previous studies, our study does not support the hypothesis that increased IL-1beta and TNF-alpha production is involved in the pathogenesis of febrile seizures.
Subject(s)
Child , Humans , Cytokines , Fever , Interleukin-1beta , Seizures , Seizures, Febrile , Tumor Necrosis Factor-alphaABSTRACT
It is known that neuropeptide Y which is widely distributed throughout the central nervous system is able to prevent seizures in animals. There are limited studies about the role of neuropeptide Y in febrile seizures. This study was conducted to evaluate the association between plasma neuropeptide Y level and febrile seizures in children. Seventy six patients with typical and atypical febrile seizures [each group 38 patients] and 38 sex and age matched control subjects were enrolled. The mean plasma levels of neuropeptide Y in typical and atypical febrile seizures were 90.60 +/- 28.01 and 97.34 +/- 41.27 pmol/l respectively. This value in control group was 88.94 +/- 32.66 pmol/l. There was no significant differences between groups regarding plasma neuropeptide Y level [P=0.532]. Also, there was no significant difference in comparison with case groups [P=0.40]. This study revealed that there is no association between plasma neuropeptide Y and febrile seizures
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Cutaneous leishmaniasis [CL] is a major health problem in many parts of Iran, although diagnosis of CL especially in the endemic area is easy, but treatment and management of the disease is a global dilemma. Diagnosis of CL in non-endemic area is not as simple as in endemic foci. In this study, the status and the proportions of CL induced by Leishmania major and L. tropica among CL suspected patients referred to the Center for Research and Training in Skin Diseases and Leprosy, [CRTSDL] during 2008 to 2011 are described. CL patients with suspected lesions were clinically examined. History of trip to zoonotic CL and/or anthroponotic CL endemic areas and the characteristics of their lesion[s] were recorded. Diagnosis of the lesion was done using direct smear microscopy, culture and conventional polymerase chain reaction [PCR]. A total of 404 [M=256, F=148] patients with 776 lesions were recruited and parasitologically examined. The results showed that 255 of the patients with 613 lesions; patients with lesion[s] induced by L. major=147 [M=63, 43%, F=84, 57%] and lesion[s] induced by L. tropica=108 [M=35, 32%, F=73, 68%]. History of travel to endemic area was not always correlated with isolated Leishmania species. Although travel history to endemic area is an important factor to be considered for diagnosis, but parasitological confirmation is necessary initiation of treatment
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The control of postoperative pain is important in children, and poor pain control leads to organ dysfunction and behavioral problems. We compared the analgesic effects of suppository acetaminophen, bupivacaine wound infiltration, and caudal block with bupivacaine on postoperative pain in pediatric inguinal herniorrhaphy. In this double-blinded, randomized controlled clinical trial, 90 children of American Society of Anesthesiologists [ASA] grade I-II, aged between 3 months and 7 years, and scheduled for elective unilateral inguinal herniorrhaphy under general anesthesia were assigned to three equal groups. Patients in the first group received 20 mg/kg of suppository acetaminophen. In the second group, 2 mg/kg of 0.5% bupivacaine was infiltrated in the incisional site, and in the third group, a caudal block was performed with 0.75 mL/kg of 0.25% bupivacaine. The Face, Legs, Activity, Cry, Consolability [FLACC] pain scale was applied 30 minutes after operation. Thereafter, the FLACC score was obtained every hour during the next 6 hours. If the FLACC score was 4 or over, we administered 0.5 mg/kg of intravenous meperidine. The data was transferred to SPSS-10 software and analyzed statistically with chi-square and analysis of variance tests. P < 0.05 was considered significant. The mean analgesic duration in the acetaminophen, bupivacaine infiltration, and caudal block groups was 4.07, 5.40, and 5.37 hours, respectively. Significant differences were not observed between the bupivacaine infiltration and caudal block groups [P = 0.9], but the differences between the bupivacaine infiltration and acetaminophen groups [P = 0.034] and the caudal block and acetaminophen groups [P = 0.039] were significant. With regard to meperidine administration, significant differences were not observed between the bupivacaine infiltration and caudal block groups [P = 0.848], but significant differences were observed between these two groups and the acetaminophen group [P < 0.05]. Patients in the bupivacaine infiltration and caudal block groups had less postoperative pain than those in the acetaminophen group and received lower amount of meperidine. We concluded that in children, bupivacaine infiltration and caudal block with bupivacaine produce better analgesia than suppository acetaminophen. It seems that bupivacaine infiltration is better than caudal block because of its simplicity, lower incidence of complications, and failure rate
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This study was performed to determine the sensitivity and specificity of qualitative hCG testing of vaginal washings for diagnosis of preterm premature rupture of membranes [PPROM]. A total of 92 singleton pregnant women at 20 - 37 weeks of gestation were placed in two equal groups of documented rupture of membranes and intact membranes as control. Confirmatory tests included pooling of amniotic fluid in the vaginal vault with positive ferning test. Patients with vaginal bleeding and obvious fetal anomaly were excluded. After cleaning the vagina with a sterile tampon and irrigation with 5 ml sterile saline, fluids were collected from the posterior vaginal fornix. Samples were tested by a pregnancy test strip with sensitivity of 25 mIU/ml. Data were collected and analyzed using t-test, Mann-Whitney, Chisquared, Fisher's exact tests. The groups had similar demographic characteristics. The hCG test was positive in 38 [83%] of the ruptured membranes group and in 4 [8%] of the control group. Sensitivity, specificity, positive predictive value, and negative predictive value were shown to be 83%, 91%, 90%, and 84%, respectively. The qualitative determination of hCG in vaginal washings proved a simple, rapid, noninvasive, and reliable test in the diagnosis of PPROM.
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Febrile seizures are the most common cause of seizure in children. Identification of risk factors is very important. This study was conducted to determine the association between the serum copper level and simple febrile seizure in children. In this study, 30 children with simple febrile seizures [case group] were compared with 30 children with febrile illness without seizures [control group] regarding serum copper level. This study was conducted in Qazvin children's hospital [Qazvin, Iran]. The mean serum copper levels in the case and control groups were 141.41 +/- 30.90 and 129.43 +/- 18.97 mcg/dl, respectively. This difference was not significant statistically. This study revealed that there is no association between serum copper levels and febrile seizures. It seems that copper deficiency is not a risk factor for febrile seizures in children
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Clofibrate is a glucuronosyl transferase inducer that has been proposed to increase the elimination of bilirubin in neonates with hyperbilirubinemia. This study was conducted to determine the therapeutic effect of clofibrate in term neonates with non-hemolytic jaundice. This study was conducted on 52 newborns with pathologic unconjugated jaundice in Qazvin children hospital. Newborns divided randomly in two groups. Case group treated with clofibrate and intensive phototherapy, while control group treated only with intensive phototherapy. Serum bilirubin level was measured before and 6, 12, 24 and 48 hours after treatment. Results were compared and analyzed. The mean serum level of bilirubin before treatment in the case and control groups were 20.78 +/- 2.38 and 20.52 +/- 2.44 mg/dl, respectively [P=0.69]. The mean serum level of bilirubin in 6, 12, 24 and 48 hours after treatment in the case group were 18.20 +/- 2.20, 14.70 +/- 2.06, 10.72 +/- 2.40 and 8.90 +/- 0.83 mg/dl, respectively. These values in control group were 18.26 +/- 2.42, 15.36 +/- 2.59, 12.29 +/- 2.28 and 10.23 +/- 1.50 mg/dl, respectively. There was significant difference between two groups regarding mean serum level of bilirubin 24 hours [P=0.019] and 48 hours after treatment [P=0.005]. In conclusion, clofibrate was effective in reducing neonatal jaundice and its effect appeared 24 hours after treatment
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Humans , Female , Male , Infant , Hyperbilirubinemia, Neonatal/drug therapy , Glucuronosyltransferase , Bilirubin , Jaundice, Neonatal , Single-Blind MethodABSTRACT
Cutaneous leishmaniasis [CL] is endemic in Iran, where it is one of the most important health problems. Both anthroponotic CL [ACL] caused by L. tropica and zoonnotic CL [ZCL] caused by L. major are reported. Antimoniate derivatives as the standard therapy for CL need multiple injections and are not easy to tolerate for the patients. This study was conducted in Mashhad to compare the efficacy of weekly versus twice a week intralesional injections of meglumine antimoniate [MA] in the treatment of ACL. This randomized controlled trial was performed during 2006 to 2008 in Mashhad, Iran. Using computerized sequence of random numbers, participants were randomly allocated in the two arms of the study: one receiving weekly and the other receiving twice-a-week intralesional injections of MA. The lesion size, induration and healing rate were assessed, recorded and compared. Healing was defined as complete re-epithelialisation and disappearance of duration. A total of 252 suspected CL patients with 372 lesions were screened. 82 parasitologically proven cases with 121 lesions caused by L. tropica were included and 74 patients with 113 lesions completed the study. At 12[th] week after initiation of treatment, complete healing was observed in 38 out of 44 lesions [86.4%] in the group which received weekly intralesional MA injection. The median time-to-heal in this group was 36 days [95% confidence interval [CI]: 32.0-39.9]. Complete healing was recorded in 60 out of 69 lesions [86.9%] in the group which received twice a week intralesional injections of MA with a median time-to-heal of 25 days [95% CI:20.9-29.1]. While no significant difference was observed between the two groups in terms of complete healing rate [P=0.999], time-to-heal was significantly different between the 2 groups [P=0.003]. It seems that the effectiveness of twice-weekly intralesional injections of MA is similar to once-weekly regimen while the former regimen causes more rapid healing of lesions
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Who has declared that protected of people against medical expenditures is as one of the three important objectives of the health system. The criticized of the economic situation urges the policy makers and academician area to pay more attention to this issue. This study was conducted to estimate the patient's out of pocket for medical expenditure in Qazvin province in per income decentiles in 2009. This was a descriptive -analytic study performed on 384 urban households in Qazvin in 2009. The data were collected through interviews which used questionnaire consists of 25 stems. The data were analyzed by descriptive statistical index. The average of out of pocket money in patients was 59/7% of total medical expenditures. The highest percent [67/5%] belongs to first income level and fifth income decentile has lowest percent [45/5%]. Total average oop divided by total household income which was%7/3, that the highest percent belongs to the first income decentile [lowest income] 19%, and tenth income decentile has the lowest percent [3.6%].Despite coverage of general insurance, results of this study reveals that OOP percentage of studied urban households is relatively was high [59/7%] and lower income decentiles [first decentile], OOP consists of substantial percent of household's income [19%]
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There are some reports in which a condition of zinc deficiency and its associated outcomes with a change in concentration of serum copper among the thalassemic patients has been highlighted. The aim of this prospective study was to determine the serum zinc and copper levels in children with beta-thalassemia major. In this cross sectional study all children under 12 years affected by beta thalassemia major [40 patients] were evaluated for serum zinc and copper levels in Qazvin thalassemia center [Qazvin, Iran] in 2007. Serum measurements for zinc and copper were performed by atomic absorption spectrophotometer. The mean concentrations of serum zinc and copper levels were 67.35 +/- 20.38 and 152.42 +/- 24.17 micro g/dl respectively. Twenty-six [65%] of thalassemic patients had zinc concentration under 70 micro g/dl [hypozincemia]. None of the thalassemic children had copper deficiency. No significant correlation between serum zinc level with age, weight, height, body mass index, duration of blood transfusion, desferrioxamine dose and ferritin level was observed in thalassemic patients [P=0.3]. This study revealed that hypozincemia is common in thalassemic patients, but in contrast, there is no copper deficiency. Further evaluation in this regard is recommended
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Humans , Male , Female , Zinc/blood , Copper/blood , Child , Prospective Studies , Cross-Sectional StudiesABSTRACT
Treatment of cutaneous leishmaniasis, especially when caused by L. tropica, is challenging. Meglumine antimoniate [Glucantime[R]] is used as the standard treatment, but multiple injectiond are necessary. The objective of this study was to compare the efficacy of weekly intralesional injections with twice weekly injections of Glucantime for the treatment of anthroponotic cutaneous leishmaniasis [ACL]. This randomized open clinical trial was conducted, in Bam, Kerman province, Iran. 96 eligible patients according to inclusion and exclusion criteria who were willing to participate were included. The included patients were randomly assigned into two groups, one group treated with weekly intralesional injections of Glucantime[R] and the other group treated with intralesional Glucantime[R] twice a week. Type and size of each lesion [induration, ulcer and scar] were recorded weekly. Complete healing was defined as complete re-epithelialization and absence of induration in all lesions and was considered as the primary outcome measure. A total of 48 patients completed the study; complete cure was seen in 24 of 27 [89%] patients who received weekly intralesional MA with a mean duration of healing equals to 70 +/- 10 days. Complete cure was seen in 24 of 31 [77%] patients who received intralesional MA twice a week, the mean duration of healing in the latter group was 58 +/- 5 days. There was no significant difference between the two groups [P=0.23]. It seems that the efficacy of intralesional injections of Glucantime[R] once a week is similar to efficacy of twice a week Glucantime[R] injections
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Aggressive periodontitis characterized by a rapid rate of periodontal disease progression in the absence of large quantity of bacterial plaque and or calculus present, affects otherwise healthy individuals less than 30 years old. The purpose of this study was to determine the prevalence of aggressive periodontitis among high school students in Qazvin, Iran. 780 students attending high school in Qazvin, Iran during 2004-2005 were randomly selected. Probing depths on 6 sites of permanent incisors and first molars were measured in each individual. Those presenting with pocket depths >4.5 mm in more than one tooth were asked to participate in the next phase of the study, in which bitewing and pen apical radiographs were taken. Individuals with radiographic evidence of bone loss received full clinical and radiographic examinations. The prevalence of aggressive periodontitis was determined. Fisher's exact test was used to determine significant 4 differences between gender groups. Data analysis was done utilizing SPSS Version 13. Of the 780 patients examined initially, 39 individuals had probing depths >4.5mm. Thirty four of these individuals presented for further examination which led to the diagnosis of localized aggressive periodontitis in 6 individuals [0.77%], 4 girls [0.86%] and 2 boys [0.63%]. No significant difference between boys and girls were found. We found no cases of generalized aggressive periodontitis. The results of this study revealed that 0.77% of the population studied was diagnosed with localized aggressive periodontitis. This figure is similar to those reported for European and North American populations