Effect of zinc supplementation in children with asthma: a randomized, placebo-controlled trial in northern Islamic Republic of Iran

There are conflicting reports about the benefits of zinc supplements in childhood asthma. This study examined the effect of zinc supplementation in children with asthma attending an outpatient clinic in Sari, Islamic Republic of Iran. In a randomized, double-blind, placebo-controlled clinical trial over 8 weeks, 284 children on inhaled steroids were allocated to receive zinc supplements [50 mg/day] [n = 144] or placebo [n = 140]. Cases and controls had low initial serum zinc concentrations [61.8 [SD 7.3] microg/dL and 60.9 [SD 4.3] microg/dL]. After treatment, mean serum zinc level in the case group was significantly higher [129 [SD 20.4] microg/dL] than in the controls [63 [SD 8.6] microg/dL]. There were no significant differences in IgE levels before and after treatment. The case group showed significant improvements in clinical symptoms such as cough, wheezing and dyspnoea and in all spirometry parameters [FVC, FEV1 and FEV1/FVC]

Clinical efficacy and safety of polyethylene glycol 3350 versus liquid paraffin in the treatment of pediatric functional constipation

Functional constipation is prevalent in children. Recently polyethylene glycol has been introduced as an effective and safe drug to treat chronic constipation. There are only a few clinical trials on comparison of PEG and liquid paraffin in childhood constipation. The purpose of this study was to evaluate clinical efficacy and safety of PEG 3350 solution and liquid paraffin in the treatment of children with functional constipation in Sari Toba clinic during the period of 2008-2009. Children with a history of functional constipation were subjects of this study. One hundred and sixty children of 2-12 years old with functional constipation were randomized in two PEG and paraffin treatment groups. Patients received either 1.0-1.5 g/kg/day PEG 3350 or 1.0-1.5 ml/kg/day liquid paraffin for 4 months. Clinical efficacy was evaluated by stool and encopresis frequency/week and overall treatment success rate was compared in two groups. Results and major conclusion: Compared with the baseline, defecation frequency/ week increased significantly and encopresis frequency meaningfully decreased in two groups during the period of the study. Patients using PEG 3350 had more success rate [mean: 95.3% +/- 3.7] compared with the patients in paraffin group [mean: 87.2% +/- 7.1] [p=0.087]. Administration of PEG 3350 were associated with less adverse events than liquid paraffin. In conclusion in treatment of pediatric functional constipation, regarding clinical efficacy and safety, PEG 3350 were at least as effective as liquid paraffin and but less adverse drug events

study of hospital bavage solution and calorie and protein in take. For patients needs from the special care unit at Imam Khomeini hospital, Sari, Iran during 2005-2006

Malnutrition is a major problem within intensive care units [ICU] affecting the outcome of patients. In Imam Khomeini Hospital, patients were fed with gavage solutions prepared in the kitchen of hospitals, however, its' nutritional value has not been studied at present time. The aim of this study was to analyze the gavage solution and to compare the calculated nutritional demand with the provided values. The amount of carbohydrate, lipid and protein of gavage solution has been determined with Leen ion, Gerber and Kejeldal methods, respectively. In this study, 30 patients with at least 5 days in the ICU were included. Daily metabolic needs were calculated with Harris-Benedict equation and then, calculated calorie and protein values were compared with the provided values. The carbohydrate, lipid, protein and energy contents of gavage solutions were 0.035 +/- 0.002 g/ml, 0.0225 +/- 0.017 g/ml, 0.012 +/- 0.002 g/ml, and 0.39 +/- 0.164 Kcal/ml. The calorie and protein provided by the hospital solution, in comparison to the standard enteral solutions, were 32.5% and 16% respectively. Total energy expenditure [TEE] at the time of admission to ICU was 2302 +/- 633 Kcal/ per day. During week 1, 2, and 3, TEE was 2301 +/- 634, 2283 +/- 661 and 2228 +/- 790 respectively. Maximum provided energy was 632 +/- 600 Kcal/ per day. Maximum protein was provided in week 3 and equal to 22.9% of patient's needs. The gavage solution provided by hospitals can not meet the calorie and protein needs of patients. It is necessary to prepare solutions with enough contents of carbohydrate, lipid and protein or to provide them with standard enteral nutritional solutions

[Clozapine induced oculogyric crisis, a case report]

Oculogyric crisis which is a dystonic reaction commonly caused by typical antipsychotics treatment of acute dystonias, rarely occurs with atypical antipsychotics like clozapine. The aim of this report was to describe a rare case of clozapine-induced oculogyric crisis successfully treated with biperiden. The patient was a 42-year-old woman with a 19-year history of schizophrenia treated with high-potency typical antipsychotics, risperidone and lithium augmentation with appropriate doses and duration. Because of poor response to prior medications, she was prescribed clozapine started with 25 mg/d and gradually titrated up to 150 mg/d. She has experienced two episodes of oculogyric crisis treated successfully with biperiden. Although low affinity of clozapine for blocking D2 dopaminergic receptors and its anticholinergic activity may explain the significantly lower incidence of dystonic reactions, they may happen in some patients and could be suppressed with biperiden. should consider dystonic reaction as a possible clozapine adverse effect and on the basis of this report, clozapine-induced oculogyric crisis may be treated successfully with biperiden

Causes of burns and their outcomes in patients hospitalized in the burn division of Zare hospital 2006-2007

It has been reported that the cause of burn is an important factor in the determination of prognosis and outcome. Due to different results of various centers, we conducted this study to determine the relationship between cause of burn and outcomes including rate of infection, costs and mortality in Zare Hospital. This prospective study, has been preformed on 113 patients from September 2006 to April 2007. The inclusion criteria were ages more than 10 years old and partial thickness or full thickness burn. Based on the clinical situation of patients, appropriate samples, such as swab, tissue biopsy, urine, blood and sputum were obtained. The relationship between cause of burns and different variables, including demographic data, infections, costs and mortality have been assessed by Chi-square test. Flame injury was the most common type of burn [53.2% cases]. Burn percent and days stayed in the hospital were 30.6 +/- 21.2% and 21.6 +/- 11.9 days, respectively. These variables were significantly higher in the patients with flame injury. The mean antibiotics and total cost of patients were 9834102 +/- 11818945 and 24301863 +/- 18872089 Rials. Electricity was the cause of burns in 11.5% of patients. The overall mortality was 29.3%. However, it was significantly different in patients with various causes of burns. Inappropriate outcomes in patients with flame injury were much severe and more common than other causes. There was a relationship between the cause of burn and demographic and psychosocial variables such as sex, marital status, residency, educational state, suicide intent and past medical history of patients