Maternal anemia during pregnancy and infant low birth weight: a systematic review and meta-analysis

Background: infant low birth weight is one of the major problems in different societies. Different reports have provided different results regarding the relationship between maternal anemia and infant low birth weight in different months of pregnancy

Objective: the aim of this study was to determine the relationship between maternal anemia during pregnancy and infant low birth weight

Materials and Methods: this systematic review was conducted using related keywords in national [Sid, Iran.doc, Iran medex and Magiran] and international [PubMed, Science Direct, Cochrane, Medline, Web of Science, Scopus, Springer, Embase, Google scholar] databases. Relative risks and confidence intervals were extracted from each study. The results were combined using random-effects model for meta-analysis. The I[2] index was also used to measure heterogeneity between the studies

Results: overall, 17 studies with a total sample size of 245407 entered the final meta-analysis and demonstrated that the relative risk for maternal anemia in the first, second and third trimester of pregnancy were 1.26 [95% CI: 1.03-1.55], 0.97 [95% CI: 0.57-1.65], and 1.21 [95% CI: 0.84-1.76], respectively. The relationship between maternal anemia and infant low birth weight in the first trimester of pregnancy was significant

Conclusion: maternal anemia, especially during the first trimester of pregnancy, can be considered as a risk factor for pregnancy outcomes. Therefore, one needs to take the necessary steps to cure this disease in order to reduce the incidence of infant low birth weight

Clinical and histological presentation of helicobacter pylori and gluten related gastroenteropathy

Celiac disease has been reported to be associated with gastric abnormalities. The aim of this study was to assess the relationship between the prevalence of celiac disease and Helicobacter pylori infection in an Iranian population of 250 patients. Biopsies were taken from the gastric antrum and duodenum. Morphology and histology were evaluated using the updated Sydney system and modified Marsh criteria, respectively. To simplify the interpretation of gastric lesions we classified gastritis in macroscopic and microscopic stages. Serology for anti-tissue transglutaminase antibody was performed to determine the presence of celiac disease. Among 250 patients, 232 [93%] had histological evidence of Helicobacter pylori infection. Histological abnormalities [Marsh I to IIIc] were present in 24 [10%]. Of 24 patients, 20 [83%] with histological abnormalities were infected with Helicobacter pylori. Of 250 patients, 25 [10%] had a positive anti-tissue transglutaminase antibody. Of 25 anti-tissue transglutaminase antibody positive patients, 9 [3.6%] had microscopic and macroscopic enteritis [Marsh I to IIIc]. Clinical presentation of celiac disease was not distinguishable from cases infected with Helicobacter pylori. Histology, even in patients with positive serology, was non-specific and unhelpful. We found a high prevalence of Helicobacter pylori infection and chronic gastritis, but neither was associated with celiac disease, in agreement with studies in Western populations

Measurement of apelin in patients with lone AF

Atrial fibrillation is one of the most common arrhythmias and it is a risk factor for stroke, heart failure, morbidity and mortality. Apelin is a protein with multiple effects on cardiovascular system such as, endothelium-dependent vasodilation, positive inotropy, declining ventricular preload and afterload and increases cardiac contractility. Plasma level of apelin which is a good guiding for evaluation of the severity and treatment of heart failure can be a good prognostic factor in lone AF. In this case-control study, 26 patients with lone AF without any other important disease and 27, age and gender matched controls from 30 to 70 years old were evaluated. Measurement of apelin in serum was performed by ELISA method. There were 26 patients aged 30 to 70 years from both genders and 27 controls. The level of apelin in patients group under 60 years old was 1.88+1.07 ng/ml and in controls group was 1.29+ 0.50 ng/ml and for older than 60 years old, 1.007+ 0.56 ng/ml and 1.41+ 0.93 ng/ml, respectively. Data of this study showed no reduction of apelin in lone AF group under 60 years old, but there is significant reduction in patients older than 60 years old. There is no relationship between sex and apelin level

Surface electromyography of neck, face and head muscles during alternating compression effect in brushing teeth with Miswak [a tree twig]

To assess the surface electromyography of neck [sternocleidomastoid, splenius capitis and trapezeius], face [masseter] and head [temporalis] muscles during brushing teeth with Miswak [a tree-twig used for cleansing the teeth] as a novel physical agent that may play a vital role in neck, face and head muscles exercise. Surface electromyography [sEMG] has been used to examine the neuromuscular activity of neck, face and head muscles under different teeth brushing circumstances of three healthy persons. EMG showed rhythmic muscular activity of sternocleidomastoid, splenius capitis, trapeze ius and continuous muscular activity of temporalis and masseter muscles of both sides from the force and movement of shoulder joint exerted by the user during brushing teeth with Miswak. Most likely brushing with Miswak would play an imperative role as a new physical agent by putting forth intermittent compression effect on neck, face and head muscles exercise. This study is also a direction for future research on utilization of Miswak as a physical agent or a physical device in rehabilitation programs in order to accomplish pericranial muscles exercise that might be advantageous for chronic neck pain, headache due to muscle contraction [tension-type headache] and torticollis

Bacteriology and sensitivity patterns of acute adult bacterial meningitis: a seven-year overview

Bacterial meningitis is a potentially fatal infection and its rapid diagnosis has an important role in the prognosis of the disease. The objective of this study was to determine the microscopic, bacteriologic and clinical characteristics of adult bacterial meningitis in Chaharmahal province of Iran over a period of seven years. Materials and Thirty-one patients with bacterial meningitis in Shahrekord Kashani Hospital were observed in a period of seven years [Oct. 1993 - Sept. 2000]. The clinical findings, type of bacteria isolated from cerebrospinal fluid [CSF] samples, CSF leucocyte counts, CSF cultures and the antibiotic sensitivity profile of the common bacterial isolates were evaluated. The annual incidence of the disease was about 0.64 per 100,000 inhabitants. Neck stiffness and impairment of consciousness were seen only in a half of Behnam Zamanzad, Hedayatollah Shirzadeh, Mohammad Reza Naficy Department of Microbiology and Immunology, Shahrekord University of Medical Sciences, Shahrekord, Iran the cases. In 50% of patients, the CSF leucocyte counts were 1000-10,000/mm3, while in 26% of the cases the count was below 500/mm3. Eighty-three% of CSF cultures were reported positive. Steptococcus pneumoniae [58%], Neisseria meningitidis [19%] and Gram negative enteric bacilli [6%] were the most common isolates. Gram's stain of sedimented CSF helped in the presumptive identification of the causative bacteria in 80% of the cases. Fifty% of the pneumococcal isolates were resistant to penicillin and 13% were resistant to chloramphenicol. Conclusions: A combination of CSF culture and microscopic examination is highly specific for early diagnosis of bacterial meningitis, and performing an antibacterial sensitivity test is recommended before any antibiotic therapy

comparative study of bolus administration and continuous infusion of ranitidine on gastric PH with intragastric PH-probe

The high mortality rate associated with significant bleeding from stress ulceration has promoted efforts to prevent this complication in critically ill patients. Gastric pH is a key factor in the pathogenesis of stress ulceration and maintaining a pH of 4 or greater reduces the risk for development of the gastric ulceration. Our aim was to compare effects of intravenous bolus administration and continuous intravenous infusion of ranitidine on gastric pH in critically ill patients at the intensive care unit [ICU]. Twenty patients who met the inclusion criteria were entered this prospective, randomized, cross over study. A total of 1500 gastric pH measurement was obtained for each phase of the study. Continuous infusion of ranitidine maintained a gastric pH greater than 4 over a longer period than that of bolus administration [22.1 hrs vs. 14.2 hrs, respectively; P<0.001]. The pH-monitoring device which was made locally, was comparable to a standard international device. This study showed that continuous infusion of ranitidine was more effective than administration of an equivalent dose of the drug by bolus in maintaining the appropriate gastric pH required for the prevention of stress ulceration

Anti-HCV antibody among iranian IV drug users: is it a serious problem?

Hepatitis C virus [HCV] is transmitted mainly via sexual contacts and blood [or its products'] transfusion. Transmission of this virus by contaminated needles used by IV drug users has raised great concern. In the present survey, the rate of HCV infection among a group of IV drug users was investigated and some important risk factors of the virus transmission were determined. A total of 402 male IV drug users from Ghasr Prison in Tehran, Iran, entered the study [1995]. At the stage of blood sampling, a questionnaire including demographic data; history of blood transfusion, tattooing and cupping [or Hejamat, the traditional way of phlebotomy in Iran] was also filled for every enrolled prisoner. HCV 3.0 ELISA and RIBA II were used to detect the HCV antibody and antigen in blood sera, respectively. Data were analyzed using Chi-square and Fisher's exact tests. HCV antibody was found in the sera of 182 of 402 cases [45.3%]. Seventy-three of 182 [40.1%] HCV antibody-positive persons had a history of tattooing. All cases with a history of cupping were antibody positive. There was a statistically significant relationship between antibody positivity and having a history of tattooing/cupping [p< 0.005]. Other risk factors did not seem to have a significant relationship with HCV antibody positivity. Similar to the findings of many developed and developing countries, a high rate of hepatitis C infection is present among Iranian IV drug users. We believe that tattooing and cupping are two important risk factors associated with HCV infection in IV drug users in Iran