Post-infectious Transverse Myelitis Secondary to Hand, Foot, and Mouth Disease in a Pregnant Daycare Worker.

Transverse myelitis (TM) is a rare inflammatory disorder of the spinal cord that infections, vaccines, and autoimmune processes can cause or may have no discernible cause. About half of the cases are caused by an infection, usually a viral respiratory infection, flu-like illness, or sometimes a gastrointestinal infection. Although coxsackieviruses and enteroviruses are known to cause TM, it is more commonly associated with respiratory symptoms or systemic signs than a rash. In this case, we present a pregnant daycare worker who had a case of longitudinally extensive TM after an episode of hand, foot, and mouth disease (HFMD), which only showed the typical rash without fever or systemic signs.

Comparison of the Effects of 12 Weeks of 3 Types of Resistance Training (Traditional, Circular and Interval) on Pro-Inflammatory Markers in Nonathletic Men with Obesity.

Objective: The primary aim of this study was to compare the effects of 12 weeks of 3 resistance training methods (traditional, circular and interval) compared with no exercise on the plasma levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in nonathletic men with obesity. Materials and Methods: The study sample included 44 nonathletic men with obesity who were randomly assigned to one of four groups: traditional, circular, and interval resistance training or a control group. IL-6 and TNF-α cytokines were analyzed using commercial ELISA kits. Results: The results of mixed-design ANOVA with repeated measures showed that there was significant correspondence between the type of training used and time on TNF-α (F(1,40) = 2212.35; P = .001; estimates (ES) = 0.98) and IL-6 (F(1,40) = 2423.69; P = .001; ES = 0.98) levels. Results indicated that there was a significant difference between the resistance training groups and the control group in both TNF-α (F(3, 40) = 11.39; P = .001; ES = 0.46) and IL-6 (F(3, 40) = 4.65; P = .007; ES = 0.25) levels. Conclusion: All types of resistance training decreased biomarker outcomes compared with the control group. However, interval resistance training showed a significant difference from circular resistance training in IL-6 level, while there was no significant difference between the effects of the 3 types of resistance training on TNF-α levels.

Increased atherosclerotic plaque in AOC3 knock-out in ApoE-/- mice and characterization of AOC3 in atherosclerotic human coronary arteries.

Introduction: Amine oxidase copper containing 3 (AOC3) displays adhesion between leukocytes and endothelial cells and enzymatic functions. Given its controversial role in atherogenesis, we proposed to investigate the involvement of AOC3 in the formation of atherosclerotic plaques in ApoE-/-AOC3-/- mice and human coronary arteries. Methods: Lesions, contractile markers, and AOC3 were studied in aortic tissues from 15- and 25-week-old mice and different stages of human coronary atherosclerotic arteries by immunohistochemistry (IHC) and/or western blot. Human VSMCs, treated or not with LJP1586, an AOC3 inhibitor, were used to measure differentiation markers by qPCR. AOC3 co-localization with specific cell markers was studied by using confocal microscopy in mice and human samples. Results: At 15 weeks old, the absence of AOC3 was associated with increased lesion size, α-SMA, and CD3 staining in the plaque independently of a cholesterol modification. At 25 weeks old, advanced plaques were larger with equivalent staining for α-SMA while CD3 increased in the media from ApoE-/-AOC3-/- mice. At both ages, the macrophage content of the lesion was not modified. Contractile markers decreased whereas MCP-1 appeared augmented only in the 15-week-old ApoE-/-AOC3. AOC3 is mainly expressed by mice and human VSMC is slightly expressed by endothelium but not by macrophages. Conclusion: AOC3 knock-out increased atherosclerotic plaques at an early stage related to a VSMC dedifferentiation associated with a higher T cells recruitment in plaques explained by the MCP-1 augmentation. This suggests that AOC3 may have an important role in atherosclerosis independent of its canonical inflammatory effect. The dual role of AOC3 impacts therapeutic strategies using pharmacological regulators of SSAO activity.

Changes in the Level of Asprosin as a Novel Adipocytokine after Different Types of Resistance Training.

Obesity is at epidemic proportions in the world. Evidence supports increased physical activity and exercise are efficacious in controlling obesity, in part due to altering select adipocytokine levels. The present study aimed to compare the effect of 12 weeks of three resistance training methods (traditional, circular and interval) on the levels of the adipocytokine asprosin and body composition in sedentary men with obesity. Forty-four sedentary men with obesity, who were randomly divided into the 4 equal groups: traditional, circular, and interval resistance training as well as a control group. Results showed that there was a significant interaction between the type of training used and time on asprosin levels (F (1,40)= 13353.03, P= 0.001, ES= 0.99). All types of resistance training decreased asprosin levels and improved body composition parameters in comparison to the control group (F (3, 40) = 34.60, P = 0.001, ES= 0.77). Interval resistance training had the greatest effect on reducing asprosin levels and improving body composition related outcomes (body mass: P=0.001, ES=0.633, body mass index: P=0.001, ES=0.632, percent body fat: P=0.001, ES=0.647, waist to hip ratio: P=0.001, ES=0.786). The results of the present study support the benefits of resistance training as a non-pharmacological approach in reducing asprosin levels and improving body composition in individuals with obesity.

Development of a National Roadmap for Electronic Prescribing Implementation.

BACKGROUND: In July 2015, Iran Food and Drug Administration convened a multi-stakeholder workgroup (workgroup) to help develop recommendations for electronic prescribing implementation in Iran. OBJECTIVES: In general, the consensus of the workgroup was to focus on solutions that incrementally reduce the burden on patients, providers, and payers, and require minimal rework by using national standards that have already been used for Health Information Interchange. We used a road mapping method which includes a number of systematic steps and is adapted from the standard scientific method. Medical Informatics Experts Developed protocols for Scoping Reviews, Systematic reviews and Health Technology Assessment study and then collected evidence from peer-reviewed scholarly journal publications and gray literature. Health Insurance companies representatives and Electronic Prescribing pilot studies executives were asked to report their experiences in the case of e-prescribing. RESULTS: After five meetings, by comparing and contrasting the national and international evidence, the recommendations were finalized in expert panels. In this paper, we report recommendations from this roadmap.

Comparing the Impact of Topical Application of Human Milk and Chlorhexidine on Cord Separation Time in Newborns.

OBJECTIVES: The best umbilical cord care after birth is a controversial issue. Aim of this research was to compare the effect of topical application of human milk and chlorhexidin on cord separation time in newborns. METHODS: One hundred seventy four neonates attending from hospitals affiliated to Kashan University of Medical Sciences were included. Newborns from birth were randomized to two groups. In group mother's milk, mother will rub her own milk to cord stump two times a day. chlorhexidin (group 2) were applied to the umbilical stump every 12 hours. The time to umbilical cord separation and any discomfort such as infection, hemorrhage, and discharge and odor were documented. Data was analyzed by SPSS software. Independent Samples t-Test, χ(2), Fisher were used in this study. RESULTS: Results showed a significant statistical difference between cord separation time in two groups and the mean cord separation time in the human milk group (7.15±2.15days) was shorter than the chlorhexidin group (13.28±6.79 days). In addition, a significant correlation was found between Signs of infection (discharge, redness, swelling and odor) in both groups. CONCLUSIONS: Topical application of breast milk on umbilical cord care leads to quick cord separation time and can be used as easy, cheep, non injury methods for umbilical cord care.

Comparing the Effects of Two Feeding Methods on Metabolic Bone Disease in Newborns with Very Low Birth Weights.

INTRODUCTION: Bone metabolic disease is an important issue in newborns with very low birth weight. The 80 percent of the transport of calcium (Ca) and phosphor (P) from mother to fetus takes place in the third trimester of pregnancy. This transport process is impaired with the preterm delivery of the newborn. On the other side, breast milk and formula are not competent resources to supply sufficient amounts of Ca and P to meet the requirements of the preterm newborn, thereby a greater reduction in the storage of these minerals. The current study has been done with the purpose of comparing the effects of two feeding methods on the indices of metabolic bone disease in newborns with very low birth weights (VLBW). MATERIALS & METHODS: The study design was cohort and the study was done on a total of 58 newborns with very low birth weights in Kashan Shahid Beheshti Hospital. The newborns were divided into two groups with 29 placed in the group of alternate feeding on preterm formula (preNan) and the other 29 placed in the group of breast milk and preterm formula (preNan). Eventually, the indices of bone metabolic disease were measured in both groups and were statistically analyzed. RESULTS: The difference between the mean serum levels of Ca in different weeks and also between the two groups were significant (p=0.001). However, the changes in mean serum level of P in the two groups were not significant (P=0.151). The comparison of serum levels of alkaline phosphatase between the two groups indicated that their difference was significant and that they had been influenced by the feeding method (P=0.001). The serum level of bicarbonate, when compared between the two groups, was found to make a significant difference (P=0.001). The difference between the two feeding methods in precipitating rickets and osteopenia was not significant. CONCLUSION: According to the findings of current study, feeding on preterm formula (preNan) is associated with better and more desirable results, though the occurrence of rickets in the two groups had no significant difference.

The Etiology and Clinical Evaluations of Neonatal Seizures in Kashan, IRAN.

OBJECTIVE: Detection of seizure, its etiology, and clinical types is important for guiding therapy. This study was designed to evaluate the etiology and clinical evaluations of neonatal seizures in Kashan, Iran. MATERIALS AND METHODS: The data of 100 hospitalized neonates with a complaint of seizures in Kashan City, from January 2006 to January 2011 were evaluated. The pediatric neurologist made the final diagnosis. The gestational age, neonate admission age, type of delivery, and laboratory and radiological investigations were reviewed from the medical records. The relation of seizure etiology and other variables were compared using the Chi-square test. All the statistical analyses were performed using SPSS (ver 11.5). RESULTS: A total of 100 neonates were hospitalized with a diagnosis of seizures. The overall incidence rate of seizures was 2.6 per 1,000 live births. A total of 59% of seizures happened in the first three days of life. The etiologies of seizures were hypoxicischemic encephalopathy (HIE) (36%), hyponatremia (12%), hypoglycemia (11%), intracranial hemorrhage (11%), infections (10%), hypocalcemia (8%), metabolic disorders (7%), the structural anomalies (5%), and hypomagnesaemia (4%). In 23% of neonates, no specific etiology was found and 23% had multiple etiologies. In 45% of neonates, the EEG was not recorded. The type of the seizures were focal-clonic (26%), tonic (25%), multifocal clonic (34%), subtle (11%), and myoclonic (4%). The types of the seizure were unrelated to the paraclinical findings. CONCLUSION: Neonatal seizures are common and HIE was the main cause of seizures in this study. The clinical evaluation of neonatal seizures needs improvement.

Incidence of Neonatal Birth Injuries and Related Factors in Kashan, Iran.

BACKGROUND: Birth injuries are defined as the impairment of neonatal body function due to adverse events that occur at birth and can be avoidable or inevitable. Despite exact prenatal care, birth trauma usually occurs, particularly in long and difficult labor or fetal malpresentations. OBJECTIVES: This study aimed to investigate the incidence of birth injuries and their related factors in Kashan, Iran, during 2012-2013. PATIENTS AND METHODS: In this cross-sectional study, all live-born neonates in the hospitals of Kashan City were assessed prospectively by a checklist included demographic variables (maternal age, weight, and nationality), reproductive and labor variables (prenatal care, parity, gestational age, premature rupture of membrane (PROM), fetal heart rate (FHR) pattern, duration of PROM, induction of labor, fundal pressure, shoulder dystocia, fetal presentation, duration of second stage, type of delivery, and delivery attendance), and neonatal variables (sex, birth weight, height, head circumference, Apgar score, and neonatal trauma). Birth trauma was diagnosed based on pediatrician or resident examination and in some cases confirmed by paraclinic methods. Statistical analyses were performed by chi-square, student's t-test, and multiple logistic regression analyses using SPSS version 17. P ≤ 0.05 was considered statistically significant. RESULTS: In this study, the incidence of birth trauma was 2.2%. Incidence of trauma was 3.6% in vaginal deliveries and 1.2% in cesarean sections (P < 0.0001). The most common trauma was cephalohematoma (57.2%) and then asphyxia (16.8%). In multiple logistic regression analyses, decreased fetal heart rate (FHR), fundal pressure, shoulder dystocia, vaginal delivery, male sex, neonatal weight, delivery by resident, induction of labor, and delivery in a teaching hospital were predictors of birth trauma. CONCLUSIONS: Overall, incidence of birth trauma in Kashan City was lower in comparison with most studies. Considering existing risk factors, further monitoring on labor, and delivery management in teaching hospitals are recommended to prevent birth injuries. In addition, careful supervision on students and residents' training should be applied in teaching hospitals.

Perforated acute appendicitis in a pre-term neonate.

Acute appendicitis is a common occurrence in childhood, but this diagnosis is considered rarely in differential diagnosis of acute abdomen in the neonatal period because its occurrence is very rare in neonates. We report a 20-day- old afghan female baby that was admitted to neonatal intensive care unit, because of irritability and abdominal distension. Complete ultrasound of abdomen and pelvis was normal. In plain Radiographs of chest and abdomen with the exception of Air-filled stomach and intestine, there was no abnormality. Due to the lack of improvement and severe abdominal distension, she was transmitted to the operating room and Surgical exploration revealed perforated appendix. Appendicitis should be considered in the differential diagnosis for a neonate with abdominal distension and bilious vomiting and needs strong clinical suspicion.

Risk factors for neural tube defects: a study at university-affiliated hospitals in Tehran.

BACKGROUND: Neural tube defects have a complex and imperfectly understood etiology involving both genetic and environmental factors. In this case-control study, we tried to determine the association of known risk factors for neural tube defects in patients referred to university-affiliated hospitals with neurosurgical services in the city of Tehran. METHODS: Risk factors were assessed in-person through interviews with infants' mothers. We found 192 neural tube defect cases. One hundred and ninety-three apparently normal babies were randomly selected from the same hospitals to serve as control cases. RESULTS: Maternal age of less than 18 years (P = 0.02), female sex of the child (P = 0.01), birth in spring and summer seasons (P = 0.001), history of not using folic acid (P = 0.001), less than 5 prenatal visits (P = 0.001), and poverty (P = 0.02) were the most important risk factors for neural tube defects. Logistic regression analysis of these risk factors confirmed these correlations. A negative history of consuming folic acid had the most significant statistical correlation with these malformations. CONCLUSION: Poor quality diets were an important environmental risk factor in this study.