Hypercalciuria and febrile convulsion in children under 5 years old / 소아과

PURPOSE: The association between hypercalciuria and febrile convulsion is controversial. The present study aimed to investigate the statistical association between hypercalciuria and childhood febrile convulsions. METHODS: Overall, 160 children aged 6 months to 5 years, including 80 children with febrile convulsion and 80 febrile children without convulsion (comparison group), were recruited. All laboratory tests, including 24-hour urine calcium, were undertaken in an academic clinical laboratory. RESULTS: Forty-five children of the febrile convulsion group (60%) and 30 of the comparison group (40%) had hypercalciuria. There was a significant difference between the 2 groups (P=0.02). CONCLUSION: Our results indicated that there is a statistical association between convulsion and hypercalciuria in children. Since we found this association with a cross-sectional assessment, further studies, especially prospective and controlled designs, are needed.

Echocardiographic evaluation of cardiovascular complications after birth asphyxia in term neonates

Objectives: After birth asphyxia, a variety of hemodynamic disorders may be noted in the neonatal intensive care unit; these require appropriate recognition and management. The present study was designed to demonstrate the prevalence of heart complications amongst asphyxiated newborns

Methods: Through a cohort study, 29 asphyxiated term neonates were followed since birth until amelioration of pulmonary hypertension and compared with 31 well born neonates. Both groups were evaluated for their heart anatomy and hemodynamic with meticulous assessment through echocardiography. This study was conducted in Besat Medical Center since August 2010 until February 2012

Results: Hemodynamic and anatomic disorders including myocardial dysfunction, pulmonary hypertension and patent arterial duct [PDA] were strongly associated with birth asphyxia [P< 0.05]

Conclusion: Birth asphyxia was associated with systolic and diastolic dysfunction and pulmonary hypertension which demands precise evaluation, early recognition and appropriate management

Role of cervical IL-6 and IL-8 levels in preterm labor in nulliparous pregnant women

Premature birth is a cause of prenatal mortality and covers 60-80% of deaths caused by the congenital defects. Despite eye-catching developments in medical sciences, premature birth statistics are still high and impose hefty costs on the society. Laboratory indexes such as IL-6 and IL-8 are used to predict the preterm delivery. In this study, the role of IL-6 and IL-8 of cervix in women with preterm labor and term delivery were compared. This case-control study was performed on 89 patients, 60 patients in control group and 29 patients in the study group, who had symptoms of preterm labor. Endocervical swab samples were collected from all patients in order to study IL-6 and IL 8 levels using ELISA technique. SPSS-15 statistical software was used for the analysis of data. T-test was used to assess different qualitative variables. 78 patients [87.63%] and 11 patients [12.35%] had term and premature deliveries, respectively. The two groups had not significant difference in terms of weight and size. A significant statistical difference only in cervix IL-8 was observed between the two term and preterm groups after comparison of the mean variables. Cervico-vaginal level of IL-8 in premature deliveries is higher than term deliveries and it can be used to predict premature delivery

[Prescription writing ability of young doctors and medical interns in Kurdistan province, Iran]

Background and Objective: Evaluation of prescriptions of doctors and particularly medical interns is an essential method for obtaining information about prescribing patterns and drug consumption. The present study aimed to assess the ability of prescription writing of medical interns and young doctors for common illnesses

Methods: In this cross-sectional study, the ability of prescription writing of medical interns and recently graduated doctors was evaluated via objective structured clinical examination [OSCE] on ten common diseases in Sanandaj Medical School, Iran, in 2010

Results: The average number of medicine for each prescription was 2.1 and the average score of participants in all stations was 62%. From the correct prescriptions 81.5% had appropriate medicine and 34.4% accurate dosage, and 21.3% with precise course of treatment. 24.1% had administered wrong drugs for patients. Half of the cases determined the correct treatment period. In terms of related factors the score of girls was better than boys [P = 0.03]. However, there was no relationship between their ability and age, marital status, average mark of interns, or their medical exam score in pre-internship examination [r = 0.1]

Conclusion: Prescription writing ability of participants was relatively acceptable, but important issues such as drug dosage, frequency of consumption and course of treatment, which are essential in disease treatment, should be improved. Therefore, it is necessary to review medical education programs and curriculums

status of diabetes control in Kurdistan province, west of Iran

Based on some estimation more than two million peoples in Iran are affected by Type 2 diabetes. The present study was designed to evaluate the status of diabetes control among Type 2 diabetes patients in Kurdistan, west of Iran and its associated factors. In our cross sectional study conducted in 2010, 411 Type 2 diabetes patients were randomly recruited from Sanandaj, Capital of Kurdistan. Chi square test was used in univariate analysis to address the association between HgAlc and FBS status and other variables. The significant results from Univariate analysis were entered in multivariate analysis and multinomial logistic regression model. In 38% of patients, FBS was in normal range [70-130] and in 47% HgA1c was <7% which is normal range for HgA1c. In univariate analysis, FBS level was associated with educational levels [P=0.001], referral style [P=0.001], referral time [P=0.009], and insulin injection [P=0.016]. In addition, HgA1c had a relationship with sex [P=0.023], age [P=0.035], education [P=0.001], referral style [P=0.001], and insulin injection [P=0.008]. After using multinomial logistic regression for significant results of univariate analysis, it was found that FBS was significantly associated with referral style. In addition HgA1c was significantly associated with referral style and Insulin injection. Although some of patients were under the coverage of specialized cares, but their diabetes were not properly controlled

Risk factors for acquisition of ventilator-associated pneumonia in adult intensive care units

Objective: Ventilator Associated Pneumonia [VAP] has an imperative place amongst nosocomial infections leading to increase morbidity and mortality rates. The present study aimed to determine risk factors for acquisition of ventilator- associated pneumonia in an intensive care unit [ICU]

Methods: A nested case-control study was carried out from September 2007 to June 2008. All 183 patients hospitalized at the adult ICU ward in Be'sat Hospital, Sanandaj city western Iran over a 48 hour period were included. Bacteriologic diagnosis and antibiotic susceptibility patterns were performed based on Edward and Ewing's methods and CLSI system guidelines

Results: Of the 149 samples which were taken from endotracheal tubes of 183 patients, 48 cases were diagnosed for VAP with an incidence rate of 26.2%. Mean duration of hospitalization was 23.4+/-10.2 days. The maximum and minimum antibiotic resistance for the gram negative bacteria was 93.3% for Cefalotin and 50% for Amikacin. The main risk factors for acquisition of ventilator- associated pneumonia were mechanical ventilation [Adjusted OR: 1.55, 95% CI: 1.37-1.74], history of antibiotic consumption [AOR: 8.92, CI: 1.16- 66.66] and fever [AOR: 3.11, CI: 1.22- 7.93]

Conclusions: VAP is significantly related to ICU hospitalization, mechanical ventilation and history of antibiotics consumption. Cefalotin and Amikacin showed the highest and lowest antibiotic resistance against gram negative bacteria respectively

Landmine victims in Iran Kurdistan; demographic features and accident characteristics

Iranian civilians living in border areas are still victims of un-neutralized war mines from the eight years war between Iraq and Iran. This cross-sectional study was aimed to determine demographic characteristics and features associated with the land mine injuries using data from a representative group of victims. Overall, 300 civilian mine victims in Kurdistan Province western Iran between 1991 to 2005 were randomly recruited. The documentary data for those who lost their lives was gathered from the archives of local police, Red Crescent and War-disabled [Janbazan] Organization. Other survived mine-injured victims were interviewed for data collection using a validated check list. SPSS was used for all analyses. Overall, 17.7% of victims [n=53] were killed immediately after explosion and 82.3% [n=247] were injured. Of those who survived, 40% [n=99] had an amputation surgery of lower limb in particular. Majority of victims were either farmers or shepherd. Amongst risk factors investigated, victims' job and age were significantly correlated with mine accidents in Kurdistan province after adjusting for other factors including gender, education level and socioeconomic status [Adjusted OR=2.1, 95% CI, 1.1-3.2, p < 0.01 and AOR=1.7, 95% CI, 1.1-2.5, p=0.04 respectively]. Young civilians living in border areas between Iran and Iraq with certain jobs are still affected by un-neutralized war mines despite the valuable mine clearance activities in the area. Concerted efforts are required to avoid and minimize the adverse effects of mine explosions in border areas in west of the country and in Kurdistan in particular

Epidemiology of metabolic syndrome among women of reproductive age in Abhar city in western Iran

Metabolic syndrome is a set of metabolic disorders highly related with cardiovascular diseases and has high expansion among population. The present study aimed to assess the prevalence and characteristics of the metabolic syndrome amongst women of reproductive age. A cross sectional study was conducted using a systematic randomized sampling method. Overall, 406 women of reproductive age living in Abhar city western Iran was recruited. Data was analyzed using T-test, Fisher exact test and chi-square. The prevalence rate of metabolic syndrome was 28.1%. This figure increased as the mean age and body mass index [BMI] of women increased. The common metabolic disorder was HDL < 50 [98.2%]. Majority of cases with metabolic syndrome were either overweight or obese [53.5%].The most expansion of metabolic syndrome was observed in the age range of between 45 to 49 years [70.6%]. There was a significance relationship between having metabolic syndrome and patients' level of education and profession [p<0.01]. Obesity and old reproductive age are the main risk factors associated with metabolic syndrome. Increased prevalence of metabolic syndrome in this part of the world is going to be a major public heath concern which indicates the necessity of applications for preventive programs based on national and international guidelines