Prevalence and extension of the anterior loop of the mental nerve in different populations and CBCT imaging settings: A systematic review and meta-analysis

Purpose@#This study aimed to identify the prevalence and extension of the anterior loop (AL) of the mental nerve in different populations and according to different cone-beam computed tomography (CBCT) imaging settings. @*Materials and Methods@#Medline/PubMed, Embase, Scopus, Web of Science, and ProQuest were searched. The main inclusion criterion was ALs evaluated in CBCT images. The quality of studies was assessed with the Joanna Briggs Institute risk of bias checklist. Subgroup analyses were conducted for sex, side, continent, voxel size, field of view, and type of CBCT-reconstruction images with a random-effects model. @*Results@#Sixty-three studies with 13,743 participants (27,075 hemimandibles) were included. An AL was found in 40.6% (95% CI: 32.8%-48.9%, P<0.05) of participants and 36.0% (95% CI: 27.5%-45.5%, P<0.05) of hemimandibles, in 34.9% (95% CI: 25.1%-46.2%, P<0.05) of males and 34.5% (95% CI: 23.5%-47.4%, P<0.05) of females. The average length of ALs was 2.39 mm (95% CI: 2.07-2.70 mm, P<0.05). Their extension was 2.13 mm (95% CI: 1.54-2.73 mm, P<0.05) in males and 1.85 mm (95% CI: 1.35-2.36 mm, P<0.05) in females. Significant differences were observed regarding the prevalence and length of ALs among continents and for its measured length on different CBCT-reconstruction images, but not between other subgroups. @*Conclusion@#AL was a relatively common finding. The voxel size and fields of view of CBCT devices were adequate for assessing AL; however, a 2-mm safety margin from anatomical structures (such as the AL) could be recommended to be considered when using CBCT imaging.

Microsporidiosis in Iran: A systematic review and meta-analysis

Objective To examine all evidence about Microsporidia infection in vertebrate/invertebrate hosts and Iranian populations distributed in different regions of the country. Methods All published articles up to December 2015, including descriptive and cross-sectional studies related to the prevalence and genotyping of Microsporidia infection in Iran, was considered in this systematic review. The meta-analysis was done using the random-effects model and Stats Direct statistical software. MEGA 5.05 software and maximum likelihood algorithm with Kimura 2-parameter model were used for phylogenetic analysis. Results Of the 1152 investigated studies, 33 eligible studies reported a prevalence of Microsporidia infection in vertebrate and invertebrate hosts. According to this systematic review, the overall prevalence rate of Microsporidia infection in immunocompromised patients in Iran was 8.18%. Furthermore, the overall prevalence rate of Microsporidia infection in immunocompromised patients with chronic diarrhoea, patients with non-diarrhoea, gastroenteritis, and patients with CD4 (<200 cells/μL) was 15.4%, 4.1%, 0.5%, and 12.9% respectively. The highest prevalence rate of human and animal Microsporidia was estimated in Kerman (29%) and Khuzestan (26.5%). The overall prevalence rate of Microsporidia infection in honeybees using the random-effects model was 40%. Furthermore, the highest prevalence rate of nosemosis was described in East Azerbaijan (48.2%). The most Microsporidia isolates from immunocompromised patients and pigeons in Iran belonged to genotypes D (n = 16; 50%) and E (n = 6; 20.6%) of Enterocytozoon bieneusi. Conclusions This study may be the first systematic review and meta-analysis that provides a broad outlook on the prevalence of microsporidiosis in Iran. It is necessary to investigate Microsporidia infection in vertebrate and invertebrate hosts and environmental resources in Iran.

Microsporidiosis in Iran: A systematic review and meta-analysis

OBJECTIVE@#To examine all evidence about Microsporidia infection in vertebrate/invertebrate hosts and Iranian populations distributed in different regions of the country.@*METHODS@#All published articles up to December 2015, including descriptive and cross-sectional studies related to the prevalence and genotyping of Microsporidia infection in Iran, was considered in this systematic review. The meta-analysis was done using the random-effects model and Stats Direct statistical software. MEGA 5.05 software and maximum likelihood algorithm with Kimura 2-parameter model were used for phylogenetic analysis.@*RESULTS@#Of the 1152 investigated studies, 33 eligible studies reported a prevalence of Microsporidia infection in vertebrate and invertebrate hosts. According to this systematic review, the overall prevalence rate of Microsporidia infection in immunocompromised patients in Iran was 8.18%. Furthermore, the overall prevalence rate of Microsporidia infection in immunocompromised patients with chronic diarrhoea, patients with non-diarrhoea, gastroenteritis, and patients with CD4 (<200 cells/μL) was 15.4%, 4.1%, 0.5%, and 12.9% respectively. The highest prevalence rate of human and animal Microsporidia was estimated in Kerman (29%) and Khuzestan (26.5%). The overall prevalence rate of Microsporidia infection in honeybees using the random-effects model was 40%. Furthermore, the highest prevalence rate of nosemosis was described in East Azerbaijan (48.2%). The most Microsporidia isolates from immunocompromised patients and pigeons in Iran belonged to genotypes D (n = 16; 50%) and E (n = 6; 20.6%) of Enterocytozoon bieneusi.@*CONCLUSIONS@#This study may be the first systematic review and meta-analysis that provides a broad outlook on the prevalence of microsporidiosis in Iran. It is necessary to investigate Microsporidia infection in vertebrate and invertebrate hosts and environmental resources in Iran.

[Determine effect of weight loss on serum level of inflammatory cytokines IL-1beta, IL-6, CRP andTNF-alpha in obese patients with fatty liver disease]

Background: Obesity results in a chronic inflammatory state leading to long term adverse effects. The aim of this study is to evaluate effect of low calorie diet and weight loss on serum level of inflammatory markers in patients with fatty liver disease in Iranian population

Methods: In a clinical trial, 40 patients with fatty liver disease in Gastro-hepathology clinic of Tabriz Imam Reza hospital were introduced to receive a low calorie diet. Serum level of proinflammatory factors [IL-1, IL-6, TNF-alpha and Hs-CRP] were measured and compared before and after an 8 week trial of diet

Results: The mean age of the patients was 45.36+/-10.51 years [range: 23-70]. Nine [22.5%] patients were male and 41 [77.5%] was females. The mean value of weight and body mass index of participants decreased significantly after 8 weeks [a mean decrease of 6.47+/- 3.40 percent in weight]. Weight loss in men was significantly more than women. The mean level of IL-1, IL-6, TNF-alpha and Hs-CRP was significantly decreased after weight loss in both men and women. There was no correlation between amount of weight loss with degree of decrease in inflammatory markers. Decrease of TNF-alpha was significantly more in younger patients

Conclusion: Weight loss with low calorie diet can decrease the level of IL-1, IL-6, TNF-alpha and Hs-CRP of patients with fatty liver during 8 weeks independent from gender and degree of weight loss

systematic review and meta-analysis on the treatment of liver hydatid cyst: comparing laparoscopic and open surgeries

Background and Study Aims: There is an academic debate regarding surgical interventions for liver hydatid cystdisease. The purpose of the current systematic review and meta-analysis study was to analyse the pros and cons of open surgery and laparoscopic techniques, considering the outcomes of liver hydatid cysts

Methods: Descriptive Boolean queries were used to search PubMed and Scopus for articles published between January 2000 and December 2016 to evaluate the outcomes of liver hydatid cyst in terms of mortality, post-operative complications, cure rate and recurrences. The data related to the four outcomes of liver hydatid cyst were extracted, assessed and then used as their corresponding effect sizes in the meta-analysis process

Results: Six studies totally consisting of 1028 patients [open surgery group = 816 [+7 converted to lap] and laparoscopic group = 212] were analysed. In this meta-analysis study, random effects models of outcomes [i.e. post-operative complications, mortalities, recurrences and cure rate] of the two procedures were OR = 0.852, LL = 0.469, UL = 1.546, Z = -0.526, p = 0.599 [for post-operative complications]; OR = 0.849, LL = 0.141, UL = 5.105, Z = -0.179, p = 0.858 [for mortality]; OR = 0.903, LL = 0.166, UL = 4.906, Z = -0.119, p = 0.906 [for recurrence]; and OR = 0.459, LL = 0.129, UL = 1.637, Z = -1.201, p = 0.230 [for cure rate]. Meta-analysis and illustrated forest plots showed that there are no superiorities between the two approaches. The results of heterogeneity tests of the above mentioned outcomes were Q = 8.083, df = 5, p = 0.152, I[2] = 38.142% for post-operative complications; Q = 0.127, df = 2, p = 0.938, I[2] = 0% for mortality; Q = 4.984, df = 2, p = 0.083, I[2] = 59.874% for recurrence; and Q = 10.639, df = 5, p = 0.059, I[2] = 53.001% for cure rate. The results of regression tests based on Egger's, smoothed variance based on Egger [SVE] and smoothed variance based on Thomson [SVT] showed that the p values are not significant, and there are neither significant statistical differences nor publication bias between the outcomes of the two treatment procedures

Conclusion: The results show no promising trends towards advantages of open versus laparoscopic surgeries in the treatment of liver hydatid cyst. However, informative measurement values for comparing these surgeries could be derived for complications, recurrence, mortality and cure rates. Furthermore, all three tests, namely Egger's, SVE and SVT regression models, were used to assess publication bias and showed no evidence for the existence of publication bias

Effect of anger patterns and depression on serum IgA and NK cell frequency

Background: there are conflicting findings about relationship between depression and anger with immunological parameters

Objective: to investigate the relationship between anger patterns and immune system in depressed patients

Methods: thirty-five patients with major depressive disorder were selected according to DSM-IV criteria. The Hamilton Depression Scale and Spielberger Anger questionnaires were used to determine severity of depression and "anger expression pattern", respectively. The control group without a previous history of mental illness was also selected. In the group of patients with moderate depression, serum IgA levels and NK cell percentage were measured

Results: mean differences of all types of "anger expression pattern", including; "state-trait anger", "anger expression out", "anger expression in", "anger control out" and "anger control in", between study and control groups, were statistically significant [p<0.05]. Difference in mean serum levels of IgA in either group was not significant [p=0.9], but the mean difference was significant in terms of NK-cell percentage in both groups [p=0.04]. There was no significant relationship between IgA levels and percentage of NK-cell with all types of "anger expression pattern" in both groups. Only in the control group, IgA had significant correlation with Anger control out [p=0.04]

Conclusion: moderately depressed patients versus control group had higher Spielberger scores in all types of anger expression pattern except anger controlout and anger control-in. We found no evidence supporting the relationship between" anger expression pattern" and IgA levels and NK cell percentage; however, it seems that depression itself causes reduced number of NK cells and increased IgA levels

[Cassette chromosome mec typing of methicillin-resistant staphylococcus aureus isolates collected from Sina and Imam Reza Hospitals of Tabriz]

Backgrounds and Objectives: Methicillin-resistant Staphylococcus aureus is a cause of nosocomial infections leading to high mortality. Since these strains have become prevalent in the world, it is necessary to identify and type them

Materials and Methods: This cross-sectional study was conducted to study a total of 1475 specimens collected from patients of Imam Reza and Sina hospitals of Tabriz in 2012-2013. Using phenotypic tests such as Gram stain, catalase, coagulase, DNase and mannitol fermentation 169 isolates of Staphylococcus aureus and by utilizing methicillin-resistance test 100 MRSA isolates were identified. SCCmec typing was performed by multiplex PCR method and the results were analyzed using chi-square tests using SPSS-18 software

Results: Disc agar diffusion test using cefoxitin disc [30 microg] showed methicillin resistance in 59% of our isolates. mecA and femB genes were identified in all of the MRSA isolates using PCR method. Frequency of SCCmec types and sub-types were as follow: SCCmecIII [77%], SCCmecI [5%], SCCmecIVa [1%], SCCmecIVc [1%], mixed isolates SCCmecIVc-III [1%] and Non typeable isolates [15%]. Non typeable isolates recovered in two groups [10% without any band and 5% of multi-bands III-I]. In this study, 82% of isolates were HA-MRSA, 3% were CA-MRSA and 15% were Non-typeable

Conclusion: In our S. aureus isolates, the prevalence of methicillin resistance was 59%. The most frequent SCCmec type was SCCmecIII [77%]. Our results demonstrated the spread of HA-MRSA isolates in the community and propagating CA-MRSA isolates in the studied hospitals

Gender Differences in Clinical Presentations of Cystic Fibrosis Patients in Azeri Turkish Population / 결핵및호흡기질환

BACKGROUND: Cystic fibrosis (CF) is an autosomal recessive disorder with several clinical presentations. This study was undertaken in the Azeri Turkish population in Iran, to investigate gender differences in the age at onset and diagnosis, age of death, and duration of illness of CF. METHODS: The data of 331 CF patients from 2001 to 2015 was surveyed. Parameters including age, sex, ΔF508 mutation, age at onset, age at diagnosis, age of death and clinical presentations were evaluated for both sexes, using descriptive analysis. The association of gender with these variables was studied using logistic regression, chi-square test and Mann-Whitney U test by SPSS version 18. Odds ratio with a confidence interval of 95% and p≤0.05 was considered statistically significant. RESULTS: The study included 191 males (57.7%) and 140 females (42.3%), all showing statistically significant difference (p<0.001). Age duration differed between genders. Male and female patients were further under 9 and 4 years, respectively. The occurrence of ΔF508 mutation was 0.51 times more in females than in males. Age, diagnosis and sex were closely associated: males were diagnosed at a significantly later age than females (p=0.05). While this compression performed based on clinical presentations, males with respiratory disease had a later median age at diagnosis than females at lifespan (p=0.001). The risk of infertility in males was approximately two times greater than in females (p=0.02). CONCLUSION: These findings indicate gender differences in CF patients. Future studies are needed to establish other differences and evaluate the causes for the gender variations.

Effect of intravenous injection of erythropoietin on hospitalization period in patients with acute spinal cord trauma

Background and Aim: spinal cord injury [SCI] has a very long history, and its cases form a large proportion of patients admitted to trauma centers in Iran. Studies show that repair after spinal cord injury can be done. In fact, many pharmaceutical agents, such as erythropoietin [EPO], are applied to reduce secondary injury following the initial disorder and to maintain the nerve tissue

Methods and Materials/Patients: in this clinical trial, 60 patients with acute spinal cord injury classified as A to C according to Frankel classification grading system were selected and matched with regard to the Frankel classes, the cervical and dorsal levels and then divided into two groups A and B [each containing 30 patients]. Group A, in addition to receive conventional treatment, took EPO and was evaluated in terms of hospitalization period outcomes [mean length of stay, lower extremity thrombosis, intubation, bedsores] and was compared with group B [receiving conventional medicines, such as methylprednisolone]

Results: of the 60 patients, 15 patients were female and 45 were male, with the age range of 19-72 years. The mean length of stay in the case and control group was 10.6+/-6.52 and 13.8+/-10.37 days, respectively. Six patients died during hospitalization, including three patients in the case group and three patients in the control group. 12 patients were intubated during this period, including five patients in the case group and seven patients in the control group. Of the 29 patients with bedsores, 14 patients were in the case group and 15 patients were in the control group. None of the patients had lower extremity venous thrombosis during hospitalization

Conclusion: no significant difference was found between the case and control group in the hospital stay length, intubation, bedsores and lower extremities venous thrombosis

Correlation between major depressive disorder and circulating natural killer cells

Background: major depressive disorder is a mental disorder characterized by a pervasive and persistent low mood that is accompanied by low self-esteem and loss of interest or pleasure in normally enjoyable activities. Depression is associated with multiple immunological disorders. Aim of the present study was to determine correlation between percentage of circulating NK cells and major depressive disorder

Materials and Methods: patients older than 18 years with the desire to participate were enrolled in this study. For depression evaluation, we used the Hamilton Depression Rating Scale and for determination of percentage of NK cells in peripheral blood, flow cytometry method was used

Results: our results showed that in patients with major depressive disorder, numbers of circulating NK cells have significantly reduced

Conclusion: according to our findings, depression is associated with "immune suppression". NK cells are important in early phase of immunological surveillance versus viral infections and tumors. Indeed, depressive patients are susceptible to cancers and infections

Intercontinental comparison of caustic ingestion in children / 소아과

PURPOSE: To investigate the caustic ingestion in children among different continents according to demographic characteristics (core purpose), main symptoms, common caustic agents, signs and symptoms, management, treatment and complications. METHODS: This systematic review was performed by searching the databases Science Direct, ProQuest, Google Scholar, and PubMed, electronically and manually. We included studies that were published from 1980 to 2013, at University of Medical Sciences of Tabriz, Iran. A strategic search was performed with keywords including caustic, corrosive, ingestion and children, and was limited to articles in English and Persian. Statistical analysis was performed by SPSS ver. 18. RESULTS: Of 63 selected articles of caustic ingestion with 9,888 samples, the proportion of Africa was 3 articles (4.8%) and 95 samples (1%), America 9 articles (14.3%) and 305 sample (3%), Asia 29 articles (46%) and 2,780 samples (28.1%), Europe 17 articles (27%) and 3,002 samples (30.4%), and Oceania 5 articles (7.9%) and 3,706 samples (37.5%). The average age was in the Africa 3.07+/-2.02 years, America 3.17+/-1.83 years, Asia 3.34+/-1.58 years, Europe 3.58+/-2.09 years and Oceania 3.52+/-2.02 years. Sex distribution was in Africa 76 males (0.91%) and 19 females (0.23%), America 49 males (0.58%) and 41 females (0.49%), Asia 1,575 males (18.76%) and 1,087 females (12.95%), Europe 1,018 males (12.13%) and 823 females (9.8%), and Oceania 1,918 males (22.85%) and 1,788 females (21.3%). Statistical analysis of the data indicated higher consumption in Europe and Oceania in the boys with higher average age of years. CONCLUSION: The comparison of caustic ingestion indicated that the cause substances of caustic ingestion in children are different among continents, therefore prevention strategy and different treatment guidelines among continents will be needed.

Preventive analgesia with intravenous paracetamol for post-cesarean section pain control

Effective pain therapy after cesarean section is essential for parturient comfort and to allow early ambulation to facilitate care of her infant. This study evaluated the analgesic effect of preventive 1gr intravenous paracetamol on postoperative pain and analgesic consumption during the 24 hours after cesarean section. One-hundred American Society of Anesthesiologists [ASA] 1 or 2 status parturient scheduled for elective cesarean section under spinal anesthesia. Patients received 1gr iv paracetamol into 100 ml normal saline [study group; n=50] or normal saline alone [placebo group; n=50] 20 minutes before the end of operation. Pain scores were lower in the study group in the Post anesthesia care unit [PACU] [p<0.001] and up to 4h after operation [p<0.001]. Cumulative analgesic consumption was lower in the study group [p<0.001]. Preventive administration of 1gr iv paracetamol reduces the intensity of pain in the PACU and until 4h after operation and analgesic consumption following cesarean section

Prevalence and causes of cesarean section in Iran: systematic review and meta-analysis

Unfortunately, the prevalence of cesarean section has increased in recent years. Whereas awareness of the prevalence and causes is inevitable for planning and effective interventions, so aim of this study has designed and conducted for reviewing of systematic Prevalence and caesarean causes in Iran. In this meta-analysis, the required information have been collected using several keywords which are Cesarean section rate, Cesarean section prevalence, delivery, childhood, childbirth, relative causes, relative frequency, Iran and their Persian equivalents have been collected from databases such as CINAHL, Science Direct, PubMed, Magiran, SID, Iranmedex. Finally, we found 706 related articles and selected 34 articles among them for studying of cesarean Prevalence. We used CMA software with random model for Meta-Analysis. The prevalence of Cesarean was estimated48%. Using content analysis, Factors influencing the incidence of cesarean section were divided to 3 categories including social and demographic factors, obstetric-medical causes and non-obstetric-medical causes. Maternal education and grand multiparity in the field of demographic and social factors, previous cesarean in the field of obstetric-medical causes and fear of normal-vaginal delivery [NVD] and doctor's suggestion in the field of non-obstetric-medical causes were major causes of Cesarean. According to the high prevalence of caesarean section and it upward development, it seems to be essential designing and implementing of programs and interventions effectiveness including providing of Possibility of painless childbirth and education and psychological interventions, increasing of quality of natural delivery services, proper culture and prohibiting of doctors from Personal opinions and profit

[Evidence-based care in Iran: a systematic review]

Background and Aim: Evidence-based care is defined as combining research findings with caring skills. The current study aimed at a systematic review of obstructions, facilitators, awareness, knowledge, function, perception, and results of interventions in evidence-based care in Iran

Materials and Methods: In the present survey different data base searching methods and manual search were applied using the key words of "evidence-based", "evidence-based medical", "evidence-based nursing", "evidence-based practice", "evidence-based care", "evidence-based activity", "evidence-based education", "applying research results", "research application", and their combinations with the key words of "obstructions", "facilitators", "awareness", "knowledge"," function", "perception", and" Iran" and their English synonyms in data bases of PubMed, Medlib, Magiran, SID, CINAHL, Google Scholar, and Iranmedex to collect articles

Results: Out of 819 articles, finally 25 articls were used for this study. The most important barriers of evidence-based practice were lack of facilities, lack of time, and lack of expertise in research methods. The rate of familiarity with evidence-based practice specific terms was low [44.22%]. Reference books were considered as the most important information sources. Awareness, knowledge, function, and usage of evidence-based practice was low [<50%]. Main concepts of evidence-based practice from providers' point of views were scientific and professional care, patient-oriented and considering service quality. Interventional studies had a positive effect on the improvement of evidence-based practice

Conclusion: Weak knowledge, weak attitude, and time shortage are among the most significant barriers of evidence-based care in Iran. These problems require more accurate planning and more favorable policies on the part of medical science authorities

Comparison outcome of surfactant administration via tracheal catheterization during spontaneous breathing with insure

Surfactant administration via thin endotracheal catheter [Tec] seems to be less invasive than InSurE method. We analyzed data obtained from multicenter hospitals. This multi center randomized clinical trial study was conducted concomitant within NICU of three university hospitals of Tabriz, Isfahan and Mashhad for a period of 20 months on neonates with gestational age of 27-32 weeks. All infants received nCPAP before administration of surfactant. If we required fio2> 30%to maintain spo2 >85% then surfactant was administered. A 5f vascular catheter was placed through 1 to 2 cm below the vocal cords and surfactant was administrated slowly. Mean gestational age in TEC was 29.6 weeks and in InSurE was the same. Mean weight in TEC was 1339 grams and in InSurE was 1304 gram. Surfactant was administered to 66preterm via TEC method and to 70 infant via InSurE. Mortality in TEC group was significantly lower than InSurE. P<0.01RR=0.56, CI, 95[0.42-0.76]. NEC reduced in TEC. CPAP duration decreased in two centers, p<.05 but increased in another center. Fio2 decreased rapidly and HCO3 increased 2 hours after surfactant P<0.03 in TEC. The average mean of Oxygen supplementation, BPD, Mechanical ventilation between two groups was not statistically significant. TEC method was effective in treating RDS. Mortality was significantly decreased in TEC group. As TEC procedure is a new method of surfactant administration and there are few studies about it, so it is too early to be certain about all aspects of this procedure

Association between helicobacter pylori, cagA, and vacA status and clinical presentation in Iranian children

Seroprevalence of H. pylori infection in Iran exceeds 65% of pediatric population. In this study, we intended to find association between the virulence genes [cagA and vacA] and clinical presentations. H. pylori isolates were achieved from the gastric mucosa of children. In each case, the gastric biopsy specimens were cultured and the organisms identified. Detection of different genotypes was carried out by PCR method. A total of 106 biopsy specimens were cultured and 33 H. pylori isolates obtained. Among these 33 H. pylori strains 24 [73%] were cog/1-positive. Genotypes of vacA slm2, slml, s2m2, and s2ml were 45.5%, 30.3%, 21.2%, and 3%, respectively. Most female patients were infected with genotype slm2. The vacA-ml strains were significantly more common in patients with nodular gastritis. There were no statistical differences between the vacA and cagA genotypes and clinical outcomes. The frequency of cagA genotype was high. In this study, nodular gastritis was a common finding and was rather significantly associated with ml allele of vacA

Propofol for laryngeal mask airway insertion in children: effect of two different doses

To compare two different doses of propofol for laryngeal mask airway [LMA] insertion in children undergoing out-patient surgeries. Insertion of LMA just after anesthesia induction is facilitated using propofol. However, the optimal dose of this drug not determined yet as heavy doses may lead to severe complications, whereas lower doses may not be quite as effective. In a double-blind randomized clinical trial, 120 children undergoing out-patient surgeries were recruited to receive intravenous propofol at a dose of either 2.5 mg/kg [group 1] or 3.5 mg/kg [group 2] for induction. Intravenous midazolam [0.03 mg/kg] and fentanyl [1 microg/kg] were used as pre-medication in all patients and anesthesia induction was initiated using lidocaine [1 mg/kg] prior to propofol administration. Hemodynamic changes, probable complications, quality of the established airway and number of attempts for LMA insertion were compared between two groups. There were no differences in systolic and diastolic blood pressure, heart rate, peripheral oxygen saturation and intraoperative complications between the groups [P>0.05]. LMA insertion was successful at the first attempt in 55 [93.2%] and 54 [91.5%] cases in group 1 and group 2, respectively [P>0.05]. The efficiency of the established airways was adequate in all the patients of both groups. It seems that propofol doses of 2.5 and 3.5 mg/kg are equally effective for LMA insertion following intravenous midazolam, fentanyl, and lidocaine

Quality of life in cardiovascular patients in Iran and factors affecting it: a systematic review

Cardiovascular diseases are always one of the major causes of mortality in the world affecting all aspects of patients' lives. Therefore, this study was conducted to summarize and provide a clear view of quality of life in these patients in Iran through a systematic review on the results of previously conducted studies. In a systematic review, required information was collected by searching keywords of Iran, quality of life, heart failure, cardiac, heart, and their Persian equivalents in databases of Science Direct, Pubmed, IRAN doc, SID, Medlib and Magiran. The selected time period for searching articles was since 2000 to 2012. Inclusion criteria were: releasing of article during 2000 to 2012, articles reporting patients' quality of life in any domains of heart diseases, and articles published in Persian and English. Extracted results first were summarized in Extraction Table, and then analyzed manually. Finally 18 of 1592 found articles were included in the study. A total of 3,797 cardiac patients' quality of life was measured using six different tools, the most important one of which was SF36 questionnaire. Among eight dimensions of SF36 questionnaire, the highest mean was for social role functioning with average score of 58.37 and the lowest for physical limitation [physical role functioning] with score of 42.95. Overall, mean of eight dimensions was 53.19. Among 4 general domains of quality of life, physical activity had the lowest average of 43.63 and average of general dimensions of quality of life was 47.65. The most important factors affecting quality of life were sex, age, education, marital status, occupational status, suffering duration, number of hospitalizations etc. The results of the studies showed relatively low quality of life of cardiovascular patients in general. Therefore, according to the introduced effective factors in this study, it is necessary to consider regular programs for improving quality of life in these patients and providing suitable and qualitative services

Early versus late trophic feeding in very low birth weight preterm infants

Improved survival of preterm infants, beneficial effects of trophic feeding and limited data on timing management of enteral feeding for very low birth weight preterm infants requires more researches to determine the exact starting time and increased volumes. This study aims to compare early [<48h] versus late [>72h] trophic feeding with respect to important neonatal outcomes. In a cohort study from September 2007 to October 2008, a total of 170 preterm infants [1000-1500 gram, 26-31 weeks] consisting of 125 who received trophic feeding enterally within the first 48 hours of birth [early grou] and 45 fed enterally after 72 hours [late grou], without major congenital birth defects and severe asphyxia entered the study. Bolus feeding was started in both groups at 1-2 cc/kg every 4-6 hours of human milk or preterm infant formula and advanced 1-2 cc/kg/day if tolerated along with parenteral nutrition. Feeding intolerance, possibility of necrotizing entrocolitis [NES], episodes of sepsis, body weight, length of NICU stay, and duration of parenteral nutrition were assessed serially. There were no statistically significant differences in the clinical and maternal characteristics of infants in the two groups. The time to gain birth weight [13.75 +/- 5.21 vs 20.53 +/- 6.31 [P<0.001]], duration of parenteral nutrition [9.26 +/- 4.572 days vs 14.11 +/- 6.415 days [P<0.001]], hospital stay [12.14 +/- 8.612 vs 21.11 +/- 1.156 [P<0.001]] were significantly shorter in early compared to late feeding group; none of the two groups experienced a high incidence of late onset sepsis [P=0.73]. There was 1 case of confirmed NEC in every group. The benefits of early trophic feeding shown by this study strongly support its use for the preterm infants without adding to complications

Perinatal outcome in relation to mode of delivery in Meconium-Stained Neonates

Meconium-stained amniotic fluid [MSAF] occurs in 7-22% of term pregnancies. It is less common before 38 weeks and more common after 40 weeks of pregnancy and associates with increased perinatal mortality and morbidity. The aim of this study was to determine if the perinatal outcome is affected by mode of delivery in meconium-stained amniotic fluid. Five hundred meconium stained neonates born at Alzahra Hospital were studied from 2008 to 2010. All pregnancies were at 36-42 weeks, single fetus, cephalic presentation and normal fetal heart rate pattern. Umbilical cord arterial blood gasses were analyzed immediately after delivery. Perinatal outcome was compared in normal vaginal delivery [NVD] and cesarean section [CS] groups. From 500 meconium-stained neonates 73 were born through [NVD] and 427 by CS. Two groups were not significantly different for the maternal age, gestational age and meconium concentration. Although the mean PH was in normal range [PH>7.2] and mean 1st min and 5th min Apgar scores were higher than 8 in two groups, mask ventilation, intubation and suctioning, respiratory distress and admition in NICU were significantly higher in NVD group. Serious complications like MAS and asphyxia were not statistically different between groups. According to the results of this study it is advisable that cesarean section be limited in MSAF to abnormal fetal heart rate pattern and PH<7.2