Risk factors contributing to the incidence and mortality of acute childhood poisoning in emergency department patients in Iran: a hospital-based case-control study / 한국역학회지

OBJECTIVES@#Since poisoning is one of the most important preventable factors contributing to the hospitalization and death of children who present to emergency departments, this study was carried out to investigate the risk factors contributing to the incidence and mortality of acute childhood poisoning.@*METHODS@#This hospital-based case-control study included 243 cases and 489 controls, drawn from daily admissions to the emergency departments of the included hospitals according to the inclusion and exclusion criteria.@*RESULTS@#Gastrointestinal poisoning was the most common poisoning type, found in 87.7% of subjects, and medications were the most common cause of poisoning (49.8%). Multiple logistic regression analysis showed that a history of poisoning (odds ratio [OR], 10.44; 95% confidence interval [CI], 5.58 to 19.51; p<0.001) and the availability of poisonous substances (OR, 8.88; 95% CI, 5.41 to 14.56; p<0.001) were among the most important predictors of childhood poisoning. Respiratory poisoning (OR, 6.72; 95% CI, 1.40 to 32.07; p<0.05) and the presence of addiction in the family (OR, 4.54; 95% CI, 1.10 to 18.68; p<0.05) were the most important predictors of mortality among children with poisoning.@*CONCLUSIONS@#Addiction and the presence of physical or psychological disorders in family members, a history of poisoning, and the availability of poisonous substances were significantly associated with the incidence of childhood poisoning and resultant mortality.

Risk factors contributing to the incidence and mortality of acute childhood poisoning in emergency department patients in Iran: a hospital-based case-control study / 한국역학회지

OBJECTIVES: Since poisoning is one of the most important preventable factors contributing to the hospitalization and death of children who present to emergency departments, this study was carried out to investigate the risk factors contributing to the incidence and mortality of acute childhood poisoning. METHODS: This hospital-based case-control study included 243 cases and 489 controls, drawn from daily admissions to the emergency departments of the included hospitals according to the inclusion and exclusion criteria. RESULTS: Gastrointestinal poisoning was the most common poisoning type, found in 87.7% of subjects, and medications were the most common cause of poisoning (49.8%). Multiple logistic regression analysis showed that a history of poisoning (odds ratio [OR], 10.44; 95% confidence interval [CI], 5.58 to 19.51; p<0.001) and the availability of poisonous substances (OR, 8.88; 95% CI, 5.41 to 14.56; p<0.001) were among the most important predictors of childhood poisoning. Respiratory poisoning (OR, 6.72; 95% CI, 1.40 to 32.07; p<0.05) and the presence of addiction in the family (OR, 4.54; 95% CI, 1.10 to 18.68; p<0.05) were the most important predictors of mortality among children with poisoning. CONCLUSIONS: Addiction and the presence of physical or psychological disorders in family members, a history of poisoning, and the availability of poisonous substances were significantly associated with the incidence of childhood poisoning and resultant mortality.

Risk factors contributing to the incidence and mortality of acute childhood poisoning in emergency department patients in Iran: a hospital-based case-control study / 한국역학회지

OBJECTIVES: Since poisoning is one of the most important preventable factors contributing to the hospitalization and death of children who present to emergency departments, this study was carried out to investigate the risk factors contributing to the incidence and mortality of acute childhood poisoning.METHODS: This hospital-based case-control study included 243 cases and 489 controls, drawn from daily admissions to the emergency departments of the included hospitals according to the inclusion and exclusion criteria.RESULTS: Gastrointestinal poisoning was the most common poisoning type, found in 87.7% of subjects, and medications were the most common cause of poisoning (49.8%). Multiple logistic regression analysis showed that a history of poisoning (odds ratio [OR], 10.44; 95% confidence interval [CI], 5.58 to 19.51; p<0.001) and the availability of poisonous substances (OR, 8.88; 95% CI, 5.41 to 14.56; p<0.001) were among the most important predictors of childhood poisoning. Respiratory poisoning (OR, 6.72; 95% CI, 1.40 to 32.07; p<0.05) and the presence of addiction in the family (OR, 4.54; 95% CI, 1.10 to 18.68; p<0.05) were the most important predictors of mortality among children with poisoning.CONCLUSIONS: Addiction and the presence of physical or psychological disorders in family members, a history of poisoning, and the availability of poisonous substances were significantly associated with the incidence of childhood poisoning and resultant mortality.

< The> effectiveness of mindfulness-based cognitive therapy on psychological symptoms and quality of life in systemic lupus erythematosus patients: a randomized controlled trial

Objectives: This study was conducted to determine the efficacy of mindfulness-based cognitive therapy [MBCT] on psychological symptoms and quality of life [QoL] in patients with systemic lupus erythematosus [SLE]

Methods: We conducted a randomized single-blind clinical trial in patients with SLE referred from the Imam Ali Clinic in Shahrekord, southwest Iran. The patients [46 in total in two groups of 23 each] were randomly assigned into the experimental and control groups. Both groups underwent routine medical care, and the experimental group underwent eight group sessions of MBCT in addition to routine care. The patient's QoL was assessed using the General Health Questionnaire-28 and 36-Item Short Form Health Survey before, after, and six months after intervention [follow-up]

Results: A significant difference was seen in psychological symptoms and QoL between MBCT and control groups immediately after the intervention and at follow-up [p /= 0.050]

Conclusions: MBCT contributed to decreased psychological symptoms and improved QoL in patients with SLE with a stable effect on psychological symptoms and psychological components of QoL, but an unstable effect on physical components

Clinical trial of subcutaneous steroid injection in patients with migraine disorder

Background: Neurologic literature on therapeutic effect of subcutaneous corticosteroids in patients with migrainous chronic daily headache is scarce. The aim of this research is to assess the therapeutic effects of this management in such patients

Methods: Consecutive patients with migrainous chronic daily headache enrolled a prospective before-after therapeutic study during 2010-2013. Methylprednisolone 40 mg was divided into four subcutaneous injection doses. Two injections were administered in the right and left suboccipital area [exactly at retromastoid cervicocranial junction] and the other two injections in the lower medial frontal area [exactly at medial right and left eyebrows]. A daily headache diary was filled out by the patients before and one month after the intervention. The severity of pain was classified based on a pain intensity instrument using numeric rating scale from 0-10 point scale. Paired t-test and Chi-square test were used for statistical analysis

Results: 504 patients [378 females, 126 males] with migrainous chronic daily headache were enrolled in the study. Dramatic, significant, moderate, mild, or no improvements respectively constituted 28.6%, 33.3%, 23.8%, and 14.3% of the post treatment courses. Therapeutic effect of intervention on mean pain scores was significant; t=7.38, df=20, P=0.000. Two cases developed subcutaneous fat atrophy in frontal injection site and three cases experienced syncope during injection

Conclusion: Subcutaneous corticosteroids could be used as an adjunct therapy in patients with migrainous chronic daily headache

Effect of a school-based nutrition education program on the nutritional status of primary school children

Background and Objectives: Regarding the high prevalence of unhealthy food habits among Iranian children, we aimed to assess the effect of a school-based nutrition education program on nutritional status of primary school students in Shiraz

Materials and Methods: This randomized educational controlled trial was carried out on 221 primary school age children selected by cluster sampling in the elementary schools of Shiraz-Iran. The intervention consisted of 6 nutrition education sessions carried out through one year for children, using active learning methods. Mothers' education was carried out in person in both lecture and question-answer sessions also via sending text messages and pamphlets. Weight, height and waist circumference [WC] of children were measured before and after the intervention. Also a 168-item food frequency questionnaire was completed. Two separate nutrition knowledge questionnaires were filled up by children and their mothers. Data were analyzed using SPSS version 16

Results: 171 children [83 in the case and 88 in the control group] aged 9.5-10.5 years, completed the study. Anthropometric and nutritional knowledge of the participants in both the intervention and control groups was significantly increased. Weight, height, WC and nutritional knowledge increased significantly more in the intervention group compared to the controls. Consumption of fruits and vegetables decreased in the intervention group while plain sugar and fast foods intake increased among the controls. There were no significant differences between the changes in the intake of any of the food groups in the two groups

Conclusions: In conclusion, the designed nutrition education program could increase students' nutritional knowledge, and lead to a non-significant change towards reducing the consumption of unhealthy foods such as fast foods, sweets and salty snacks

level of awareness of rehabilitation professionals employed in rehabilitation academic centers regarding Tele-rehabilitation technology

Objective: The aim of this research was to assess the level of awareness of rehabilitation professionals employed in academic rehabilitation centers in Tehran with reference to Tele-rehabilitation technology

Methods: In this study, a descriptive cross-sectional research method was used. The research was implemented by using a researcher-designed questionnaire which was developed by the integration and cultural adaptation of different tools collected in the field of tele-health implementation feasibility. The content and face validity of the questionnaire was determined and approved by Lawsche's method. The reliability of the questionnaire was assessed by test-retest correlation coefficient determinations. After considering the inclusion and exclusion criteria, informed consent was obtained, and the questionnaires were distributed among the study sample, which comprised of 141 rehabilitation professionals

Results: The findings show that a desirable level of awareness does not exist among rehabilitation professionals with regards to this technology. Based upon the results, only 8% of the participants had basic knowledge of this technology required in case of implementation

Discussion: Since rehabilitation professionals' awareness and knowledge can be a major key to a better implementation and application of this technology, it seems that there is a need for some developmental and training programs, such as informative educational workshops and seminars, to help them improve their level of knowledge and awareness

effect of Saccharomyces strain and fermentation conditions on quality prameters of non-alcoholic beer

In this study, the effect of several species of fermenting yeast and fermentation conditions [periodic aeration and temperature] on quality parameters of non-alcoholic beer is assessed. Yeast starters with different inoculation percent were added separately into wort with determined gravity. Wort was fermented for 48 h in different temperatures under aerobic condition or periodic aeration [every 12 h]. Growth rate, wort gravity and ethanol content were analyzed for 48 hours [12-h interval]. Also, 6 trained panelists were asked for sensory evaluation of final product. The highest growth rate and the highest ethanol content were found in treatments with 4×10[7] cfu/ml inoculation fermented at 24[degree sign]C under periodic aeration and in those fermented under anaerobic conditions, respectively. The highest gravity was observed for treatments with 10[7] cfu/ml inoculation, periodic aeration and fermentation at 4[degree sign]C. The lowest growth rate and ethanol content were observed in treatments with 10[7] cfu/ml, fermented at 4[degree sign]C under anaerobic condition and those fermented under periodic aeration, respectively. In treatments with 4×10[7] cfu/ml inoculation, anaerobic condition and fermentation at 4[degree sign]C, the lowest gravity was observed. In addition, among yeasts, Saccharomyces cerevisiae and Saccharomyces rouxii showed the highest and the lowest growth rate, ethanol content and wort gravity, respectively. Additionally, treatments containing Saccharomyces cerevisiae resulted in non-alcoholic beer with more satisfactory flavor attributes

effect of Saccharomyces strain and fermentation conditions on quality prameters of non-alcoholic beer

In this study, the effect of several species of fermenting yeast and fermentation conditions [periodic aeration and temperature] on quality parameters of non-alcoholic beer is assessed. Yeast starters with different inoculation percent were added separately into wort with determined gravity. Wort was fermented for 48 h in different temperatures under aerobic condition or periodic aeration [every 12 h]. Growth rate, wort gravity and ethanol content were analyzed for 48 hours [12-h interval]. Also, 6 trained panelists were asked for sensory evaluation of final product. The highest growth rate and the highest ethanol content were found in treatments with 4×10[7] cfu/ml inoculation fermented at 24[degree sign] under periodic aeration and in those fermented under anaerobic conditions, respectively. The highest gravity was observed for treatments with 10[7] cfu/ml inoculation, periodic aeration and fermentation at 4[degree sign]. The lowest growth rate and ethanol content were observed in treatments with 10[7] cfu/ml, fermented at 4[degree sign] under anaerobic condition and those fermented under periodic aeration, respectively. In treatments with 4×10[7] cfu/ml inoculation, anaerobic condition and fermentation at 4[degree sign], the lowest gravity was observed. In addition, among yeasts, Saccharomyces cerevisiae and Saccharomyces rouxii showed the highest and the lowest growth rate, ethanol content and wort gravity, respectively. Additionally, treatments containing Saccharomyces cerevisiae resulted in non-alcoholic beer with more satisfactory flavor attributes

Genetic Diversity of Echinococcus granulosus in Center of Iran

Hydatid cyst caused by Echinococcus granulosus is one of the most important parasitic diseases around the world and many countries in Asia, including Iran, are involved with this infection. This disease can cause high mortality in humans as well as economic losses in livestock. To date, several molecular methods have been used to determine the genetic diversity of E. granulosus. So far, identification of E. granulosus using real-time PCR fluorescence-based quantitative assays has not been studied worldwide, also in Iran. Therefore, the aim of this study was to investigate the genetic diversity of E. granulosus from center of Iran using real-time PCR method. A total of 71 hydatid cysts were collected from infected sheep, goat, and cattle slaughtered in Isfahan, Iran during 2013. DNA was extracted from protoscolices and/or germinal layers from each individual cyst and used as template to amplify the mitochondrial cytochrome c oxidase subunit 1 gene (cox1) (420 bp). Five cattle isolates out of 71 isolates were sterile and excluded from further investigation. Overall, of 66 isolates, partial sequences of the cox1 gene of E. granulosus indicated the presence of genotypes G1 in 49 isolates (74.2%), G3 in 15 isolates (22.7%), and G6 in 2 isolates (3.0%) in infected intermediate hosts. Sixteen sequences of G1 genotype had microgenetic variants, and they were compared to the original sequence of cox1. However, isolates identified as G3 and G6 genotypes were completely consistent with original sequences. G1 genotype in livestock was the dominant genotype in Isfahan region, Iran.

Mid-term follow-up of drug-eluting stenting for in-stent restenosis: bare-metal stents versus drug-eluting stents

Despite major advances in percutaneous coronary intervention [PCI], in-stent restenosis [ISR] remains a therapeutic challenge. We sought to compare the mid-term clinical outcomes after treatment with repeat drug-eluting stent [DES] implantation [[DES sandwich] technique] with DES placement in the bare-metal stent [DES-in-BMS] in a [real world] setting. We retrospectively identified and analyzed clinical and angiographic data on 194 patients previously treated with the DES who underwent repeat PCI for ISR with a DES or a BMS. ISR was defined, by visual assessment, as a luminal stenosis greater than 50% within the stent or within 5 mm of its edges. We recorded the occurrence of major adverse cardiac events [MACE], defined as cardiac death, non-fatal myocardial infarction, and the need for target vessel revascularization [TVR]. Of the 194 study participants, 130 were men [67.0%] and the mean +/- SD of age was 5 7.0 +/- 10.4 years, ranging from 37 to 80 years. In-hospital events [death and Q-wave myocardial infarction] occurred at a similar frequency in both groups. Outcomes at twelve months were also similar between the groups with cumulative clinical MACE at one-year follow-up of 9.6% and 11.3% in the DES-in-BMS and the DES-in-DES groups, respectively [p value = 0.702]. Although not significant, there was a trend toward a higher TVR rate in the intra-DES ISR group as compared to the intra-BMS ISR group [0.9% BMS vs. 5.2% DES; pvalue = 0.16]. Our study suggests that the outcome of the patients presenting with ISR did not seem to be different between the two groups of DES-in-DES and DES-in-BMS at one-year follow-up, except for a trend toward more frequent TVR in the DES-in-DES group. Repeat DES implantation for DES restenosis could be feasible and safe with a relatively low incidence of MACE at mid-term follow-up

Evaluation of Ca-independent alpha-amylase production by Bacillus sp. KR-8104 in submerged and solid state fermentation systems

This study investigates the production of crude Caindependent and low pH active alpha-amylase by Bacillus sp. KR-8104 in submerged fermentation [SmF] and solid-state fermentation [SSF] systems. Different parameters were evaluated in each system using "one factor at a time" approach to improve the production of enzyme. The results showed that in the SmF the maximum enzyme production was achieved in culture medium that contained dextrin as a carbon source, as well as yeast extract and meat extract as nitrogen sources incubated at 37§C and 180 rpm for 48 h. While SSF of Bacillus sp. KR-8104 using wheat bran [WB] as a substrate showed that using tap water or distilled water as a moisturizing agent, a substrate-water ratio of 1:1.5 [w/v] and incubation at 37§C for 48 h gave the maximum alpha-amylase production. From different extraction medium examined in this study 0.1% [v/v] aqueous mixture of Tween 20 and distilled water illustrated maximum results [100 U/g]

Proposed model for integrating health and social welfare system in Iran [a comparative study]

This study was performed to recognize the structure, covering criteria and basic duties of the ministry of welfare and social security in Iran and some selected countries and to choose an appropriate structure for Iran. This study is a comparative- explorative study and performed to draw a model for Iran health and welfare system according to health, medicare, welfare and social security system in the selective country on the basis of structural concentration. The results of this study showed some differences and some similarities in the structure of welfare and social security in target communities. Similarities: in most countries the basics of duties for reaching goals were the same. The structure was simple, brief and the planning was centralized and the performance was non-centralized. The whole structure of ministry of welfare and social security management was non-centralized. Differences: there were two different methods for analysis of welfare and social security; coverage method and occupational method. In most countries there was a strong bond between the health and treatment, and welfare and social security organizations. Changing the structure of the Ministry of Health, and Ministry of Welfare and Social Security; and combining these two Ministries into the Ministry of Health and Social Security can lead to more coordination in strategic planning; reduction in tasks overlap, redoing, treatment costs and social damages; and appropriate allocation of resources and increasing social welfare