ABSTRACT
Objectives: Perinatal asphyxia [PA] is very significant in perinatal medicine due to the involvement of the central nervous system. This study was conducted to investigate the biochemical, clinical, and paraclinical changes associated with Phenobarbital administration in neonates with PA
Methods: In this prospective, case-control study, 30 neonates with PA in two groups of 15 each [case and control] were investigated. The case group received 20 mg/kg intravenous phenobarbital within six hours of birth, and the control group did not receive phenobarbital. Serum concentrations of nitric oxide [NO] were measured at enrollment and one week after birth in the two groups. Clinical, electroencephalography, and magnetic resonance imaging findings of the two groups were compared
Results: At enrollment, the two groups did not differ in clinical severity, seizure incidence, or NO concentration. After one week, NO concentration was significantly lower in the case group [p < 0.050], but there was no significant difference in other variables between the two groups
Conclusions: Early administration of phenobarbital in term neonates with PA could protect them against encephalopathy
ABSTRACT
Background: Health equity is a main principle of all healthcare systems in the world. Family Physician [FP] program, as a health sector reform [HSR] in Iran, was executed to reduce households' health care cost and to achieve health equity in 2004. Meanwhile, catastrophic health expenditure is known as an accepted indicator in HSR evaluation. In this context, after determining and comparing socioeconomic status [SES] among different periods, we made an attempt to evaluate households' health financial protection in different quintiles after implementation of FP program
Methods: The current cross-sectional study was based on the data obtained from Household Income and Expenditure Survey in 2004 and 2011. The health expenditures, catastrophic health expenditure [CHE], and SES were determined by this data during these years. Descriptive analyses and comparisons using Chi-squared test were carried out via SPSS, version 20
Results: A total of 1716 households were included in the survey during 2004 and 2011. The highest proportion of households was related to quintiles very poor and poor with respect to each year. Moreover, it was observed that SES in 2011 had the worse situation compared to that in 2004; this situation was worse in urban areas. In the present study, CHE is related to poorer quintiles, and in rural areas no household was faced with CHE in 2011
Conclusions: Implementation of FP program in rural areas with more primary care has prevented hospitalization. This was considerable for poorer quintiles and has led to financial protection for rural households
ABSTRACT
Understanding the possible role of visfatin in the pathogenesis of beta-thalassemia major [BTM] and its relationship with markers of endothelial function could help us to provide more effective therapeutic approaches for treatment of patients with BTM and its related complications. The aim of current study was to compare serum level of visfatin between patients with BTM and control group and determine its correlation with markers of endothelial function, intracellular adhesion molecule [ICAM] and vascular adhesion molecule [VCAM]. In this case-control study, patients with BTM receiving regular blood transfusion aged 10-20 years and a group of healthy subjects were enrolled. Selected subjects examined clinically and venous blood samples obtained for visfatin, ICAM, VCAM, cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol and ferritin measurements. Mean [standard deviation] of studied laboratory measurements compared in two studied groups and the relation between visfatin and ICAM, VCAM, ferrittin, body mass index determined. In this study 31 patients with BTM and 30 healthy controls studied. Mean of visfatin was significantly higher in patients with BTM than control group [133.9 +/- 60.1 vs. 43.3 +/- 27.9, P < 0.001]. The higher level of visfatin among patients with BTM indicated the possible inflammatory role of this adipocytokine in BTM. It seems that for understanding the underlying mechanisms and its relation with vascular inflammatory markers and endothelial function further studies with larger sample size is needed
Subject(s)
Humans , Male , Female , Nicotinamide Phosphoribosyltransferase/blood , Cell Adhesion Molecules , Vascular Cell Adhesion Molecule-1 , Inflammation , Case-Control StudiesABSTRACT
BACKGROUND: Although a marked proportion of thalassemic patients acquire Torque teno virus (TTV) through blood transfusion, its clinical importance is unclear. This study was designed to investigate the clinical importance of TTV infection in thalassemic patients with and without hepatitis C virus (HCV) co-infection in Iran. METHODS: In this case-control study, 107 thalassemic patients on chronic transfusion and 107 healthy individuals were selected. According to HCV and TTV infection status (detected by semi-nested PCR), patients were categorized into 4 groups: TTV and HCV negative, TTV positive, HCV positive, and TTV and HCV positive. Blood ferritin, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels in these 4 groups were assessed. RESULTS: Approximately half of the thalassemic patients (50.5%) and 27.1% of controls had TTV infection. Thalassemic patients had a greater chance of TTV infection compared to the control group with a sex-adjusted OR of 4.13 (95% CI=2.28-8.13). The increased levels of ALT, AST, and ferritin in the TTV and HCV-infected group were not significantly different from those in the TTV and HCV negative group. Co-infection with TTV and HCV did not significantly increase ALT, AST, and ferritin levels compared to infection with TTV alone. CONCLUSION: Although common in thalassemic patients, TTV infection appears to have a negligible role in increasing the severity of liver disease, even when co-infection with HCV occurs.