[Effect of intravenous vitamin C on sleep quality in hemodialysis patients]

Poor sleep quality is common among hemodialysis patients and can potentially predict morbidity, mortality and quality of life in these patients. On the other hand, hemodialysis patients are encountered with vitamin C deficiency. The purpose of this study was to determine the effect of intravenous vitamin C on sleep quality in hemodialysis patients. In this double blind randomized clinical trial, 60 qualified hemodialysis patients were gone under investigation in Sari a city located in North of Iran during 2010. Patients randomly allocated in two equal intervention and control groups. The main measured outcome was the Pittsburg sleep quality index [PSQI] which consists of seven components. At the end of each hemodialysis session, Intervention group received vitamin C vial [500mg/5cc] intravenously, three times a week for 8 weeks and control group received normal saline in a same way. Data were collected at pretreatment and after two months of treatment. Data were analyzed by Independent t test, Paired t test, Wilcoxon and Chi-Square tests. The result indicated that the sleep quality improves significantly in vitamin C group but not in control group [P<0.001]. Vitamin C caused significant improvement in subjective sleep quality, sleep latency, habitual sleep efficiency and sleep disturbances in intervention group [p<0.05]. Also, Global PSQI score of intervention group had a greater improvement than control group. Moreover vitamin C caused significant improvement in subjective sleep quality, sleep latency, habitual sleep efficiency and sleep disturbances in intervention group after treatment [p< 0.05]. This study showed that intravenous vitamin C can effectively improve sleep quality in hemodialysis patients

[Evaluation of clinical manifestations and therapeutic and diagnostic progression of dyspepsia in children referred to Boo-Ali Hospital of Sari in 2005-2006]

Chronic abdominal pain is a common clinical problem in children. Apleys reported the incidence of 10-15% of chronic abdominal pain in school age children, but recent studies reported 20% of that type of pain. The aim of this study was determining the spectrum of clinical manifestations of dyspeptic children and to identify the relation between some clinical symptoms, organic or functional dyspepsia, and long term follow up of functional type. This descriptive case series study was done on 232 children between 4 and 18 years of age complaining about chronic abdominal pain chiefly who had referred to pediatric gastroenterology department of Boo-Ali Hospital of sari in 2005-2006. A checklist composed of patient demographic criteria and pain characteristics was prepared. Physical exam and laboratory tests such as AST, ALT, U/A, U/C, S/E, ESR, CBC were performed for all patients. If there were any alarming signs of organic abdominal pain-persistence or recurrence of symptoms and severe disability despite the use of H-blockers-upper GI endoscopies was indicated. Recorded data were analyzed by SPSS software and Chi- square tests. 102 of 232 patients had dyspepsia; 59 were girls [9.2y/o], and 43 were boys [7.5y/o]. 65 out of 102 patients had dominant abdominal pain and the rest had flatulence, vomiting and early fullness. 64 of them went under UGI endoscopies. 28 of 64 had mucosal erosion. Because the functional or organic abdominal pain has not unique diagnostic criteria, and the data about pathological change in children are fewer than that of adults we recommend the clinical findings and biochemical change of mucosa for differential diagnosis in children

Comparing the accuracy of doppler resistance index of the renal artery with DSMA scintigraphy in children with febrile UTI and prediction of VUR and acute pyelonephritis

UTI is one of the most common bacterial infections in pediatrics. Febrile urinary tract infection can produce severe renal complications when unrecognized or untreated. Acute pyelonephritis [APN] and reflux are two synergistic factors in the destruction of kidneys of children. There are no certain specific diagnostic laboratory tests and clinical symptoms for diagnosis of UTI. There are several diagnostic methods for APN and reflux in pediatrics, including ultrasonography IVP, VCUG, CT, Doppler and DMSA scintigraphy. Most of these methods are associated with the danger of exposure to radiation. In this study, we assessed and compared the accuracy of renal artery resistive index [RI] in doppler ultrosonography with DMSA scan and vcug to the diagnosis of APN and reflux in pediatrics patients. In this diagnostic study, we assessed 72 kidneys from 36 children [28 girls and 8 boys, age 19 days to 27/19 months] with febrile UTI admitted in Booalisina Hospital of Sari in 2005 to 2006. All patients underwent cysto-renal ultrasonography and Doppler ultrasonography. They Also underwent VCUG and DMSA scan to rule out vesicoureteral reflux and APN respectively. The data recorded in separate questionnaires and were analyzed using spss- statistical software. The results concluded that DMSA was positive in 34.7% of children with febrile and confirmed clinical impression, while Doppler sonography was positive in 33.3% of cases. The specificity and sensitivity of Doppler sonography were 64% and 83%, while the positive predictive value and negative predictive value were 66.7% and 81.3% respectively. According to the results of this study, Doppler RI>0.7 in pediatrics with febrile UTI and clinically suspected APN are in need of careful antibiothic therapy and must be controlled by DMSA scan DMSA is not necessary in children with Doppler RI<0.7 and they must be treated for possible cystourethral infection. Thus, there is a significant relationship between increased RI and the severity of renal involvement. Considering, that 83% sensitivity and 81.3% predictive value of Doppler RI measurement to diagnosis of APN and scaring, it is concluded that Doppler index [RI] measurement to rule out of APN is valuable

[Comparison of the effectiveness of weekly and daily iron supplementation in pregnant women in rural health centers of Mazandaran province, 1383]

Iron deficiency and its related anemia is a common Iranian pregnant women problem. This study evaluated the efficacy of daily and weekly ferrous sulfate supplementation in pregnant women. 150 pregnant women enrolled into this randomized controlled field trial. They were received 50 mg elemental iron daily in control group and 100 mg elemental iron weekly in other group for 12 weeks duration. Serum ferritin and serum hemoglobin was measured at the start and immediately after 12 weeks of the study. Collected data were analyzed with SPSS10 software. After 12 weeks of Iron supplementation, no significant differences were observed in serum hemoglobin [gr/dl] and serum ferritin [g/dl] levels in daily and weekly groups [p>0.05]. Also the frequency of anemia after 12 weeks in two groups was not significantly different [p>0.05]. According to the results and tendency of pregnant women to the weekly regime and less consumption of ferrous sulfate pills in this group, weekly regime is reccomended for suplementation

effect of simultaneous administration of zinc sulfate and ferrous sulfate in the treatment of anemic pregnant women

Iron deficiency and its resulting anemia is a common problem among Iranian pregnant women. In spite of iron supplementation program, yet, this problem has not resolved in many parts of the country. Zinc deficiency also is very common in Iran. This study evaluated the efficiency of concomitant zinc and iron therapy in the treatment of anemic pregnant Iranian women. A total of 118 anemic women were registered in this randomized controlled trial. Both groups received 100 mg elemental iron daily. The intervention group received an additional dose of 15mg zinc every day for a period of 12 weeks while the control group received placebo. Serum hemoglobin was measured at the beginig of study, after 12 weeks of treatment and at the end of 8 weeks follow-up. Collected data were analyzed with%95 significance level by ANOVA test for comparing baseline characteristics in the two groups and t-test was applied to assess hemoglobin changes in the intervention group. After 12 weeks of therapy, desirable response was obtained in 78.35% and 93.1% [CI=95%] of anemic women in control and intervention group, respectively which showed a significant difference [P<001]. this study clearly demonstrated the efficacy of this inexpensive and simple intervention in the treatment of anemia and prevention of its recurrence in anemic pregnant women