[ effect of tranexamic acid on pregnancy outcome and vaginal post-parturition hemodynamics]

Tranexamic acid, as an anti-fibrinolytic agent, has been shown to reduce bleeding, but its use has been limited in the scope of vaginal delivery. The purpose of this study was to examine the effect of tranexamic acid on pregnancy outcome and vaginal post-parturition hemodynamics. In a randomized, double-blind clinical trial, 200 primgravida pregnants were divided into the two groups [case and control]. The case group received IV tranexamic acid immediately post-parturition and the control group IV glucose 5%. Hemoglobin [Hb] on admission and 24 hours post-parturition were measured and Hb level drop more than 10% was considered as postpartum hemorrhage. The Hb status was evaluated through measuring blood pressure and heart rate. The pregnancy outcome measures [e.g. changes in Hb level, need for the additional uterotonic drugs, blood transfusion and surgery] were evaluated. There was a significant difference between the two groups in Hb level drop within the first 24 hours post-parturition. Moreover, no severe bleeding, blood transfusion and misoprostol administration were reported in the case group, but 4 cases in the control group. Tranexamic acid administration can effectively reduce post-partum bleeding and therefore prevent a further decrease in maternal Hb levels

[Effect of a cardiac rehabilitation program on clinical and paraclinical findings of patients with ischemic heart disease]

Ischemic heart disease [IHD] is predicted to be the most common cause of death worldwide by 2020. Cardiac rehabilitation [CR] as a secondary preventive measure can reduce the cardiac risk factors, mortality and morbidity, and improve the quality of life in such patients. This study aimed to investigate the effect of an 8-week CR program on clinical and paraclinical findings of patients with IHD. This clinical trial was performed on IHD patients referred to Kashan Shahid Beheshti hospital. Patients were allocated the two groups [rehabilitation and control]. The rehabilitation group received an 8-week rehabilitation program; the clinical and paraclinical evaluations were performed before and after the program. This study showed that body weight, BMI, HDL, TG, FBS, resting heart rate and the systolic and diastolic blood pressure, quality of life, exercise capacity, maximal oxygen uptake during exercise and the numbers of recurrent hospitalization were significantly improved in the rehabilitation group [P<0.001]. The rehabilitation program had no effect on the platelet count, frequency and duration of chest pain, total cholesterol, and LDL. Using an 8-week cardiac rehabilitation program can be beneficial in the management of IHD patients and ultimately can reduce the risk factors of the heart diseases, improve the quality of life and reduce the risk of disease exacerbation

[Predictive value of plasma interleukin-6 level in the diagnosis of early neonatal sepsis]

Neonatal sepsis is one of the common causes of neonatal mortality and morbidity. This study was aimed to evaluate the plasma interleukin-6 [IL-6] level as an early marker of neonatal sepsis. This study was conducted on 142 term neonates admitted to the neonatal intensive care unit of Kashan Shahid Beheshti hospital during 2010-11. The plasma IL-6 level of cases was determined using the electrochemiluminescence method. Ten icteric neonates with no signs or symptoms of sepsis were treated with phototherapy. Bactec blood culture was performed in 132 cases of suspected sepsis. Ten cases had positive blood culture and 122 negative blood culture with symptoms of sepsis. Then the levels of IL-6, in10 positive blood culture, 10 negative blood culture and another 10 cases with no symptoms of sepsis, were compared using Kruskal-Wallis test. Seventy-four cases were male and 68 were female. The incidence of neonatal sepsis was 7%. The most common bacterial agents were group B Streptococcus and Staphylococcus epidermidis. Tachypnea [35.9%] was the most common sign among the admitted neonates. The mean IL-6 level in the first [suspected sepsis with a positive blood culture], the second [suspected sepsis with a negative blood culture] and the control group [icteric neonates] were 1545.65, 14.79 and 11.04 micro g/dl, respectively [P=0.001]. The plasma IL-6 level can be a good predictor of early neonatal sepsis

[Frequency of metabolic syndrome and type 2 diabetes among the obese children and adolescents in Kashan during 2009-11]

An increase in the prevalence of metabolic syndrome [MetS] and type 2 diabetes [T2D] among the obese children is associated with such complications as the early cardiovascular diseases. This study was undertaken to evaluate the frequency of MetS and T2D among the obese children and adolescents in Kashan. This cross-sectional study was carried out on 450 obese children aged 4-18 years in Kashan. Demographic data were recorded for each case and the 12-hour fasting blood samples were collected to determine the total cholesterol, HDL, triglyceride, and plasma glucose levels. MetS was defined as the presence of at least three of the following five criteria: [1] BMI?95th percentile for age and gender, [2] triglyceride level>95th percentile for age and gender, [3] HDL level<5th percentile for age and gender, [4] impaired fasting glucose?100 mg/dL, and [5] systolic or diastolic blood pressure?95th percentile for age and height. Among 450 children, 227 [50.4%] cases were male and 223 [49.6%] female. The mean age of children was 10.3 +/- 3.18 years. One hundred fifty-four cases [34.22%] had MetS and 7 cases [1.3%] met 5 criteria for MetS. Moreover, three cases [0.7%] had T2D. Significantly high frequency of the metabolic syndrome in obese children and adolescents in this city can signal a wide range of adverse health effects

[Evaluation of plasma beta-2-microglobulin level in hemodialysis patients with carpal tunnel syndrome]

In dialysis patients, insufficient exertion of amyloid particles can cause beta-2-microglobulin [beta 2M] to deposit in periarticular structures and consequently complications like carpal tunnel syndrome. This study was conducted to evaluate the plasma beta 2M level in hemodialysis patients with carpal tunnel syndrome in Kashan. This cross-sectional study was performed on 60 hemodialysis patients, with more than 10 years history of hemodialysis with low flux membrane through an AV fistula, referred to dialysis center in Kashan. Samples of venous blood [5cc] were taken from each patient to measure the beta 2M level using the ELISA method. The carpal tunnel syndrome establishment was made through EMG/NCV under the supervision of a neurologist. The mean age of participants was 59.3 +/- 13.2 years. A total of 44 subjects [73.3%] had been diagnosed with carpal tunnel syndrome. There was a significant difference in plasma beta 2M level in hemodialysis patients with and without carpal tunnel syndrome [52.2 +/- 6.2 and 44.8 +/- 6.1, respectively; P=0.002]. There is a significant relation between beta 2M level and the incidence of carpal tunnel syndrome in hemodialysis patients. Thus, performing serial beta-2 microglobulin measurement is recommended in these patients

[Antibiotic resistance pattern of Vibrio cholerae strains isolated from the stool of cholerae patients in Kashan during 1998-2009]

Cholera is an acute diarrhoeal disease that can cause severe dehydration and death within the hours of its onset. Considering the importance of the disease, this study was carried out to assess the antibiotic resistance pattern of Vibrio cholerae [V. cholerae] strains isolated from the stool of cholerae patients in Kashan during 1998-2009. This cross-sectional study was carried out on stool specimens obtained from acute diarrhea cases referred to health care centers in Kashan. The samples were identified according to the guidelines established by the National Committee for Clinical Laboratory Standards [NCCLS] and then the biotype and serotype of V. cholerae isolates were identified using the enzymatic method. Finally, antibiotic sensitivity testing was performed using the Kirby-Bauer disk diffusion method. Resistance to all antibiotics except erythromycin was seen in all isolates of V. cholerae [58 isolates]. The highest antibiotic resistance rate was seen for ampicillin [31%] and the lowest ones for doxycycline, ciprofloxacin and tetracycline [7.1%], respectively. Moreover, among different V. cholerae serotypes, the lowest and highest levels of antibiotic resistance were seen for Inaba and Ogawa serotypes, respectively. There was no significant difference in resistance pattern between the different age and gender groups. According to the results of this study, an increased antibiotic resistance in V. cholerae has been observed which can result in the emergence of multidrug resistance and therapeutic complications

[Serum ferritin level in febrile children with and without seizures]

Background: Although febrile seizure is the most common cause of convulsion in childhood and strongly age-dependent, its incidence is rare before 9 months and after 5 years. Moreover, iron deficiency in these ages may have a detrimental effect on neurological and intellectual functioning. This study was designed to determine the serum ferritin level in febrile children with and without seizures

Materials and Methods: This case-control study was performed on 80 children [6 months to 5 years] referred to Kashan Shahid Beheshti hospital from January until June 2010. They were divided into two equal case and control groups [children with febrile seizures and febrile children without seizure, respectively]. Children with the CNS disorder, developmental delay, renal failure, and shigellotic gastroenteritis were excluded. Ferritin, Hb, MCV and MCH values between the two groups were compared

Results: The mean serum feritin levels were 97.6 +/- 90.6 ng/ml for cases and 109.2 +/- 106.2 ng/ml for controls [P=0.351]. The mean corpuscular hemoglobin was 11.17 +/- 0.881 g/dl in the case group and 11.04 +/- 0.963 g/dl in the control one [P=0.534]. Moreover, the mean MCV in the febrile seizure and fever groups were 73.71 +/- 4.16 fl and 71.86 +/- 4.42 fl, respectively [P=0.049]. Also, the mean MCH in the febrile seizure and fever groups were 24.80 +/- 1.64 pg and 23.83 +/- 2.16 pg, respectively [P=0.033]

Conclusion: No relationship between the serum ferritin level and febrile seizure is seen in both groups