ABSTRACT
Objectives: To determine the epidemiological aspect of mucormycosis, the nature of malignancies complicated by mucormycosis, the initial site of involvement and the subsequent outcome
Methods: This was a cross-sectional study which was performed by reviewing the medical records of 95 patients with leukemia complicated with biopsy-proven mucormycosis admitted to the educational hospitals affiliated with Shiraz University of Medical Sciences over a 21-year period. We recorded demographic information including age and sex and disease characteristics such as type of leukemia, site of involvement, paraclinical findings at the time of admission and the outcome of the patients. The incidence of mucormycosis in leukemia was determined by identifying the number of leukemia patients diagnosed within the last 17 years
Results: The male to female ratio was 2.39:1 in of 95 patients studied. The overall incidence rate of mucormycosis was 4.27 per 100 leukemic patients in last 17 years which showed a decreasing trend from 2001 to 2011. The most frequent type of leukemia was acute myelogenous leukemia [AML] which was found in 58 patients [61.5%]. The most common site of initial tumor involvement was sinonasal [90.16%]. The mortality rate was about 54%, compared to the mortality rate of about 43.24% in patients with best prognosis of AML
Conclusion: The incidence of mucormycosis in leukemia showed a decreasing trend in our country and its recent incidence is comparable to that of other regions. The best preventive method against this lethal infection is to modify and control the environment which reduces the risk of exposure to air-born fungal spores
ABSTRACT
Objectives: To determine the prevalence and predisposing factors of mucormycosis in patients with diabetes mellitus [DM] in a Shiraz referral centers
Methods: This retrospective case control study, reviewed the medical records of 162 patients with pathologically confirmed diagnosis of mucormycosis hospitalized in two major Shiraz University hospitals during the last 21 years. For each diabetic patient, two patients with diabetic ketoacidosis [DKA] matched for age, sex and the date of admission was selected as control group. Age, type of diabetes mellitus [DM] and duration of involvement as well as paraclinical findings were compared between cases and controls
Results: There were 162 patients with murormycosis of which 30 [18.5%] had DM as predisposing factor
Diabetes was the second common predisposing disease next to leukemia. There were 19 [63.3%] women and 11 [36.7%] men among the patients. The overall mortality rate was 53.33% mortality rate. The mean age of the patients was 45.3 +/- 17.6 years. The mean duration of diabetes in case and control groups were 5.75 +/- 5.43 and 7.2 +/- 7.85 years respectively, without any statistical significance between them [p=0.063]. Blood sugar in patients was lower than control group [p=0.012]. Serum bicarbonate level in case group was higher than in control group [p<0.001]. Arterial pH in control group was more acidic than case group [p<0.001]. Insulin; dependent DM was significantly more prevalent in control group compared to case group [73.4% vs. 36.6%; p=0.002]
Conclusion: Our study showed that the number of hospitalized patients with mucormycosis over the last 7 years has been decreased which is due to better control of infection in diabetics. In addition to hyperglycemia and acidosis, several other unknown factors like immune defects may predispose diabetics to this fungal infection
ABSTRACT
The induction and regulation of broodiness is of the most important role of prolactin in avian species. The promoter region of the prolactin gene is an appropriate model for studying tissue-specific and hormonally-regulated activation of gene transcription. In this study, the association between prolactin promoter region alleles and egg production in Fars native chickens was investigated. In total, 100 laying hens, randomly selected from the flock of the Breeding Center for Fars Native Chicken, were genotyped for two single nucleotide polymorphisms [C-2161G and C-2402T], one 24-bp insertion-deletion at the site -358. The observed genotypic frequencies in the C-2161G site were CC [0.437], CG [0.435] and GG [0.101]. Two alleles were found for the SNP of C-2402T with frequency of 0.34 for T and 0.66 for C. The 24-bp insertion-deletion at the site -358 was shown to be polymorph in the studied sample, with the observed genotyping frequency of 0.417 in II, 0.457 in ID and 0.126 in DD. Significant relationship was found between the SNP[s] and insertion-deletion genotypes with egg production [P<0.01]
ABSTRACT
Laparoscopic cholecystectomy is associated with shorter hospital stay and less pain in comparison to open surgery. The aim of this study was to evaluate the effect of intraperitoneal hydrocortisone on pain relief following laparoscopic cholecystectomy. Sixty two patients were enrolled in a double-blind, randomized clinical trial. Patients randomly received intraperitoneal instillation of either 250 ml normal saline [n=31] or 100 mg hydrocortisone in 250 ml normal saline [n=31] before insufflation of CO[2] into the peritoneum. Abdominal and shoulder pain were evaluated using VAS after surgery and at 6, 12, and 24 hours postoperatively. The patients were also followed for postoperative analgesic requirements, nausea and vomiting, and return of bowel function. Sixty patients completed the study. Patients in the hydrocortisone group had significantly lower abdominal and shoulder pain scores [10.95 vs 12.95; P<0.01]. The patients were similar regarding analgesic requirements in the recovery room. However, those in the hydrocortisone group required less meperidine than the saline group [151.66 [ +/- 49.9] mg vs 61.66 [ +/- 38.69] mg; P=0.00]. The patients were similar with respect to return of bowel function, nausea and vomiting. No adverse reaction was observed in either group. Intraperitoneal administration of hydrocortisone can significantly decrease pain and analgesic requirements after laparoscopic cholecystectomy with no adverse effects
Subject(s)
Humans , Female , Male , Hydrocortisone , Injections, Intraperitoneal , Pain, Postoperative/therapy , Hydrocortisone/administration & dosageABSTRACT
Introduction and Objective: cow's milk allergy has been considered as a cause of infantile colic. Many physicians change the diet of these infants to a cow's milk free diet. In this study, we evaluated the role of cow's milk allergy in infantile colic in breast fed infants
Materials and Methods: this single blind clinical trial was done in infants between three weeks and three months old with infantile colic who were referred to a subspecialty clinic in Shiraz-Iran from September 2003 to February 2004. Only exclusively breast fed infants were selected. For other infants who were formula fed, only a questionnaire was filled out, stool exam was performed and they were then excluded from the study. Skin prick tests with cow's milk and stool exams [for occult blood] were performed for these infants, and the correct technique of breast feeding was taught to their mothers. Then, the infants were divided to case and control groups randomly. In the case group, the mothers were advised not to consume cow's milk and other dairy products for two weeks. But in the control group, no change in the diet of the mothers was recommended. Furthermore, 50 healthy infants without symptoms of colic were included in the study as the second control group. Their mothers were asked about the type of feeding and stool exams were done for them. Finally, the data were analyzed using chi-square test
Results: from all 270 examined infants, colic was confirmed in 169 cases. Among them, 153 infants were breast fed exclusively. 114 cases in this group allowed the skin prick test to be done. The test was positive in only 3 infants [2.6%]. From these 114 infants, only 77 infants completed the study. 35 infants were in the case group and 42 infants were in the control group. Infants with colic whose mothers did not take dairy products, did not improve significantly in comparison with the control group. Prevalence of formula feeding was significantly higher in colicky infants in comparison with non-colicky infants [24% and 2% respectively]. Prevalence of occult blood in the stools of colicky infants was significantly higher in colicky infants than non-colicky infants [24% and zero respectively]
Conclusion: due to the unresponsiveness of infants to the elimination of cow's milk, it can be concluded that cow's milk allergy is not a common cause of infantile colic. Therefore, it is not advised to eliminate the dairy products from the diet of nursing mothers. Also, it is not necessary to perform skin prick tests as a routine test in these infants. The high prevalence of occult blood in the stools of infants suffering from colic is a new finding. Evaluation of its cause will be helpful in determining the etiology of infantile colic