[Evaluation of pneumothorax risk factors in mechanically ventilated neonates admitted to neonatal intensive care unit]

Pneumothorax is the most common pulmonary air leak syndrome which occurs more frequently in the neonatal period than any other time of life. Mechanical ventilation with positive pressure is one of the most common causes of this condition. The aim of this study was to evaluate pneumothorax risk factors in mechanically ventilated neonates admitted to neonatal intensive care unit [NICU] of Besat Hospital in Sanandaj This was a nested case-control study. Case group were neonates under ventilation with pneumothorax admitted to NICU between April 2012 and March 2013. Control group included neonates under ventilation without pneumothorax whose admission times followed in the immediate chronology to the case group. 31 cases and 62 controls were selected. Data collection was performed by use of medical records and ventilator memory in the last 24 hours. The data were introduced into SPSS software. Analysis of qualitative variables was performed by chi-squared and Fisher test. We used Mann Whitney U test for analysis of quantitative variables and logistic regression in order to control confounders. 61.3% of newborns with pneumothorax were male and 38.7% female. 61.3% of these neonates were born by Cesarean section and 38.7% by vaginal delivery. Their mean gestational age was 32 weeks and the mean birth weight was 1819 g. 74% of cases had pneumothorax in the right side, 13% left side and 13% bilaterally. Hyaline membrane disease [HMD] was the most common underlying disease [74.2%] in the newborns with pneumothorax. 38% of neonates under pressure controlled ventilation developed pneumothorax compared to 7.1% of neonates under synchronized intermittent mandatory ventilation [SIMV], which showed a significant difference [p=0.03]. Ventilator parameters associated with higher risk of pneumothorax were more episodes of ventilator adjustments [P<0.001], high peak inspiratory pressure [p<0.001], high positive end expiratory pressure [p=0.029] and high mean airway pressure [p<0.001]. In general pneumothorax risk factors in mechanically ventilated neonates in our investigation were similar to those of other studies. Our findings indicated that pressure controlled ventilation more episodes of ventilator adjustments, increased peak inspiratory pressure, positive end expiratory pressure and mean airway pressure are major pneumothorax risk factors in the mechanically ventilated newborns. To prevent pneumothorax, it is necessary to avoid frequent changes of ventilator adjustments and decrease in the above mentioned parameters to the levels enough to supply lung oxygenation

Effects of Zataria multiflora and Geranium pelargonium essential oils on growth-inhibiting of some toxigenic fungi

The effects of two Iranian medicinal plants including Zataria multiflora and Geranium pelargonium were evaluated on growth-inhibiting of some toxigenic fungi such as Aspergillus flavus, A. parasiticus, A. ochraceus and Fusarium verticillioides. In this study, standard Z. multiflora and G. pelargonium essential oils [EOs] were diluted in 0.01% dimethyl sulfoxide. Different dilutions of Z. multiflora [500, 1000, 2000 and 4000 ppm] and G. pelargonium EOs [1000, 2000, 4000 and 8000 ppm] along with 0.1 ml of each fungal suspension were inoculated onto sabouraud glucose agar and incubated at 25 [degree sign] C for 7 days. Zataria multiflora [>/= 2000 ppm] and G. pelargonium [>/= 8000 ppm] EOs completely inhibited all the tested fungi. Aspergillus species were more susceptible than F. verticillioides to two EOs. The EOs considerably exhibited inhibitory effects against these important toxigenic fungi and their different concentrations demonstrated various degrees of growth inhibition. This study showed inhibitory effects of Z. multiflora and G. pelargonium EOs against some toxigenic fungi including A. flavus, A. parasiticus, A. ochraceus and F. verticillioides

[ comparative study of mycoflora of Iranian and imported soybeans]

The natural occurrence of fungal contamination was evaluated in stored soybeans in different agro-ecological zones. Of 30 samples examined, fungal contaminations were positive in 25.9 percent and 74.1 percent of Iranian and imported soybeans [p<0.05]. The total fungal CFU/g counts were calculated 6.3 * 10[2] in Iranian and 18 * 10[2] in imported samples. The most frequent isolated fungi from soybeans originated from Iran and imported were Aspergillus spp. [59.7, 58.6 percent], Penicillium spp. [26.8, 27.3 percent], and Fusarium spp. [13.5, 14 percent], respectively. Soybeans with a high incidence of diverse species of fungi to need for proper surveillance and monitoring for the prevention of fungal and mycotoxin contaminations

Molecular pathology of 6 novel GJB2 allelic variants detected in familial and sporadic Iranian non syndromic hearing loss cases

Mutations of GJB2 gene encoding connexion 26 are the most common cause of hearing loss in many populations. A very wide spectrum of GJB2 gene mutations associated with hearing loss have been detected but pathogenic role has been tested only for a part of them. In this study, we have provided genetic evidence on the pathogenicity of our previously reported novel GJB2 allelic variants. The pathogenic role of GJB2 allelic variants were assessed using co segregation of each allelic variant with hearing loss in family members, absence of the allelic variants in control populations, coexistence with a second GJB2 mutation, nature of the amino acid substitution and evolutionary conservation of the appropriate amino acid. The GJB2 allelic variants including 363delC, 327delGGinsA, H16R and G200R have been co segregated with autosomal recessive non syndromic hearing loss in five families and are not found in control subjects. The G130V and K102Q were found in heterozygous state in two deaf individuals. G130V results in an exchange a residue highly conserved among all the connexins but was found with a rate of 1% in control subjects and K102Q results in an exchange a residue not conserved among all the connexins and not identified in control subjects. We conclude that, 363delC, 327delGGinsA, H16R and G200R may be pathogenic. However, the pathogenicity and inheritance of K102Q and G130V can not be assessed clearly and remains to be identified

[Intravitreal triamcinolone acetonide in chronic refractory uveitis]

To evaluate the effect of intravitreal triamcinolone acetonide injection for management of chronic refractory uveitis in terms of inflammation, visual acuity and macular thickness. This interventional case series was conducted on uveitic eyes with no remission despite proper administration of periocular and/or systemic steroids. After systemic and rheumatologic evaluations and confirmation of non-infectious nature of uveitis, 18 eyes of 10 patients underwent intravitreal injection of 4 mg triamcinolone acetonide. Changes in intraocular inflammation, bestcorrected visual acuity [BCVA], intraocular pressure [IOP] and macular thickness on optical coherence tomography were assessed during six months of follow-up. Mean BCVA increased from a baseline value of 0.81 +/- 0.29 to 0.35 +/- 0.33 LogMAR one week and to 0.17 +/- 0.07 LogMAR one month after the injection, respectively [P<0.001]. It decreased thereafter to 0.46 +/- 0.3 LogMAR at the sixth month visit, but was still significantly greater than the baseline value [P<0.001]. Mean IOP reached its maximum level one month post-injection with an increase of 7.36 +/- 0.48 mmHg compared to the baseline value, however only two eyes had IOP>22 mmHg which were successfully controlled using topical IOP-lowering medication. Mean central macular thickness decreased from 339.8 +/- 24.1 microm to its minimum value [197.18 +/- 12.7 microm] one month after the injection [P<0.001] and then increased to 203.57 +/- 9.06 microm at sixth month visit, still less than the baseline value [P< 0.001]. Intravitreal injection of triamcinolone acetonide in chronic refractory uveitis improves visual acuity and decreases central macular thickness which is sustained for at least six months. The only noticeable complication, transient IOP elevation can be controlled with topical medications

[ effect of self-care program on relief of skin complications of psoriasis]

Psoriasis is an unpredictable, chronic, cutaneous disease with recurrence period that could lead to disability and psychosis. Evidence shows that in addition to routine therapeutic procedures implementing self-care program can contribute to reduction of complications as an inexpensive method. Hence, this study was conducted with the aim of investigating the effect of self-care program on relief of the disease complications in Tehran in 2002. This quasi-experimental study [before and after] was carried out on 50 patients. Self-care program was performed in different fields [food, medicine, bathing, washing, type of clothing, temperature, …] through face to face education and role playing and the cases were investigated in terms of symptom severity [skin dryness including splitting and flaking itching and existence of new plaque] every two weeks for three months. To collect data questionnaire, self-reporting check list, observational check list with Likert scale and correlation of 92.5% were used whose validity had been confirmed through content validity. The data analysis was performed using t-test and Wilcoxon. The results showed that 64% of the studied patients were male, 54% employed, 72% married and 42% had university degrees. 34% were 11-20 years old with the mean age of 11.9. The results indicated that the mean skin splitting severity decreased from 2.34 to 0.04%, flaking from 4.48 to 0.5, itching from 2.5 to 0.54 and area of lesion from 81.77 to 27.33 after intervention [P=0.0001]. The comparison of behavior before and after intervention showed that the extent of all self-care behaviors increased significantly [P=0.001]. The research results show that implementation of self-care program reduces the severity of skin symptoms. Thus, administration of this inexpensive, accessible program in care plans of patients to lower the physical, mental, familial, and social problems of patients is recommended

[Relation of iron deficiency anemia with first febrile convulsion in 6 month to 5 year old children]

Introduction: There are form studies about possible relation between iron deficiency anemia and febrile convulsion. But these results have not shown a definite and convincing answer yet. In attention to high prevalence of anemia and febrile convulsion in children population and its importance that has a preventable nature this study aims to further survey its possible relation

Objective: This study was carried out to determine the relation of iron deficiency anemia with first febrile convulsion in 6 month to 5-year-old children admitted to Hefdah Shahrivar Hospital, in Rasht in 2006

Materials and Methods: Degree of iron sufficiency parameters including Hemoglobin [HB], Mean Cell Volume [MCV], Mean Cell Hemoglobin [MCH], Plasma Ferritin, Fe and Total Iron Binding Capacity [TIBC] were prospectively measured in 200 children with first FC [FFC] and compared with 200 controls matched regarding age and sex with febrile conditions without convulsion

Results: In our 400 participant febrile children, 233 were boys [58.2%] and 167 were girls [41.8%]. Out of 200 children who had febrile convulsion, 118 were boys [59%], and 82 were girls [41%]. In convulsion group mean HB [10.48 +/- 1.16], MCV [77.5 +/- 6.6], and MCH [25.3 +/- 2.78] were higher than control group but without any statistically significant differences. Mean Fe 58.55 +/- 35.35 [P=0.003], Ferritin 100.23 +/- 114.3 [P=0.005], TIBC 320.89 +/- 49.4 [P=0.002], were higher in convulsive group with no statistically significant differences. From 184[46%] anemic children, 96[52.1%] were without convulsion and 88 children [47.9%] had convulsion, with no statistically significant differences regarding febrile convulsion and iron anemia and with odds ratio = 1.175 shows anemia doesn't have any protection for FFC

Conclusion: We found that there was no relation between iron deficiency anemia and First Febrile Convulsion

[ comparative study between citanest and mepivacaine on high blood pressure in hypertensive patients]

Background and aim: selection the proper local anesthetic drug in dental procedures especially for patients with cardiovascular problems is very important. Recently, a lot of studies have been conducted on local anesthetic drugs such as mepivacaine, prilocain and particularly lidocaine but much attention has not been paid to homodynamic effects of prilocain associated with citanest as a vasoconstrictor that are recommended for cardiovascular patients. The aim of the present study was to compare the effects of citanest and mepivacaine on blood pressure of hypertensive patients

Materials and Methods: in this clinical study, 18 hypertensive patients [15 females. 3 males], referred to Isfahan dental faculty, with the mean age of 49.7, who needed extraction or mandibular surgery, were selected. Mepivacaine was injected in one session and citanest in later session. The injection was interior alveolar nerve block for all patients. Each patient, blood pressure and pulse rate were measured during, after 5 and 10 minutes of injection. Data were collected and analyzed by SPSS - 4 software and repeated measure analysis test

Results: average pulse rate and blood pressure [systolic and diastolic] after 5 minutes for citanest were 0.77+/-2,81, 0.36+/-1.34 and 3.3+/-0.77, respectively and after 10 minutes were 0.55+/-.3.11, 0.24+/-1.39 ant1 0.23+/-1.55, respectively. For mepivacaine after 5 minutes these lisures were in order 0.77+/-5.2, 0.5+/-0.9] and 0.12+/-.48 and after ten minutes were in order 0188+/-5.29, 0.3+/-1.03 and 0.17+/-0.54. No statistically significant difference was found between two drugsin all cases

Conclusion: The findings of this study show that two local anesthetic drugs: citanest with vase constriction and mepivacaine without vasoconstriction in cardiovascular patients affected with hypertension have equal effects in dentistry procedures

Induction of labor with use of a foley catheter and extraamniotic corticosteroids

The purpose of this study is to show the effect of extraamniotic administration of corticosteroids to shorten the times to either active labor and/or delivery. This is a double blind randomized study. 65 patients who were candidates for the termination of pregnancy between the ages of 16-45, with intact membranes and unripe cervix were randomly divided into two groups, a study group [n=34] and a control group [n=31]. In the study group, 20mg of dexamethasone was infused through a Foley catheter into the extraamniotic space and the infusion was continued with normal saline in both groups. The result of the study showed that the interval of induction to active phase of labor was 6.6 +/- 2.33 hours in the study group and 8.2 +/- 3 hours in the control group [t= 2.413, p=0.0187]. The interval of induction to delivery was 8.4 +/- 2.62 hours in the study group and 10.05 +/- 3.35 hours in the control group [t= 2.828, p=0.0063]. In conclusion, corticosteroids may have a role in shortening the interval of induction to active phase of labor and the interval of induction to delivery