Nelaton catheter assisted versus standard nasogastric tube insertion: a randomized, clinical trial.

It is sometimes difficult to insert a nasogastric tube in an anaesthetized patient. We evaluated the benefit of reinforcing the distal portion of the nasogastric tube with a Nelaton catheter: 8 and 10 French Nelaton catheters were inserted into 16 and 18 French nasogastric tubes respectively through the first proximal holes of tubes up to their tips. The patients anaesthetized were randomly allocated into either the control or the Nelaton groups, and nasogastric tube was inserted as deeply as the catheter length, then the catheter was withdrawn and the tube was inserted farther to reach the stomach. Eighty patients (40 in each group) were included in this study. The success rate of nasogastric tube insertion was 90% in the Nelaton group and 57% in the control group (P = 0.001). The mean insertion time was 80 (SD 43) and 92 (SD 35) seconds in the Nelaton and the control groups respectively.

The effect of probiotics on childhood constipation: a randomized controlled double blind clinical trial.

Background. Inconsistent data exist about the role of probiotics in the treatment of constipated children. The aim of this study was to investigate the effectiveness of probiotics in childhood constipation. Materials and Methods. In this placebo controlled trial, fifty-six children aged 4-12 years with constipation received randomly lactulose plus Protexin or lactulose plus placebo daily for four weeks. Stool frequency and consistency, abdominal pain, fecal incontinence, and weight gain were studied at the beginning, after the first week, and at the end of the 4th week in both groups. Results. Forty-eight patients completed the study. At the end of the fourth week, the frequency and consistency of defecation improved significantly (P = 0.042 and P = 0.049, resp.). At the end of the first week, fecal incontinence and abdominal pain improved significantly in intervention group (P = 0.030 and P = 0.017, resp.) but, at the end of the fourth week, this difference was not significant (P = 0.125 and P = 0.161, resp.). A significant weight gain was observed at the end of the 1st week in the treatment group. Conclusion. This study showed that probiotics had a positive role in increasing the frequency and improving the consistency at the end of 4th week.

Augmenting the expression of NKp44 molecule and the natural killer activity in peripheral blood mononuclear cells from patients with malignant colorectal carcinoma.

OBJECTIVE: NKp44 and NKG2D are of the main NK activating receptors involved in recognition and killing of tumors. Here we studied the stimulatory effects of PHA and/or K562 cell line on induction of NKp44 and NKG2D expression and the NK activity of PBMCs from patients with colorectal carcinoma (CRC). MATERIALS AND METHODS: Peripheral blood samples were collected from 10 patients with CRC. The peripheral blood mononuclear cells (PBMCs) from each patient received a single stimulation with PHA or double stimulation with PHA and irradiated K562 cell line (iK562). The expression of CD56, NKG2D and NKp44 were detected by flowcytometry. The NK activity of PBMCs against a colorectal carcinoma cell line named as SW742 was determined with 51Cr-release assay. RESULTS: Double stimulation of PBMCs with PHA+iK562 significantly augmented the number CD56(+) cells compared to PHA alone and non-stimulated PBMCs (P<0.000, P<0.0000; respectively). A single stimulation of PBMCs with PHA resulted in an enhancement in NKG2D and NKp44 expression from 16.6±3.3% (for non-stimulated PBMCs) to 42±5.6% and 48.1±3.8% respectively (p<0.05). Double stimulation of PBMCs augmented the NKp44 expression significantly in comparison with single stimulation with PHA (73.6±12%, p<0.05). Double stimulation of PBMCs significantly enhanced the NK activity against SW742 target cells compared to single stimulation with PHA (p<0.05). DISCUSSION AND CONCLUSION: Our results demonstrated that the mitogen and iK562 exposure to PBMCs can significantly improve NK activity which is co-related to the higher expression of NKp44 and NKG2D. These data may help to improve cancer immunotherapy protocols.

Nelaton catheter assisted versus standard nasogastric tube insertion: a randomized, clinical trial

It is sometimes difficult to insert a nasogastric tube in an anaesthetized patient. We evaluated the benefit of reinforcing the distal portion of the nasogastric tube with a Nelaton catheter: 8 and 10 French Nelaton catheters were inserted into 16 and 18 French nasogastric tubes respectively through the first proximal holes of tubes up to their tips. The patients anaesthetized were randomly allocated into either the control or the Nelaton groups, and nasogastric tube was inserted as deeply as the catheter length, then the catheter was withdrawn and the tube was inserted farther to reach the stomach. Eighty patients [40 in each group] were included in this study. The success rate of nasogastric tube insertion was 90% in the Nelaton group and 57% in the control group [P = 0.001]. The mean insertion time was 80 [SD 43] and 92 [SD 35] seconds in the Nelaton and the control groups respectively

Nasal polyposis in patients with asthma and allergic rhinitis.

OBJECTIVE: This study aimed to determine the prevalence of nasal polyps in patients with allergic rhinitis and with asthma, and also to assess the impact of this condition on these disorders. STUDY DESIGN: Cross-sectional study. METHODS: The presence of nasal polyps was assessed by rhinoscopy and endoscopic examination. RESULTS: Nasal polyps were detected in 60 out of 250 patients (24 per cent) with documented asthma or allergic rhinitis. There was a statistically significant correlation between asthma severity and nasal polyposis prevalence (p = 0.007), but not between allergic rhinitis severity and nasal polyposis prevalence (p = 0.081). The prevalence of nasal polyps increased significantly with increasing patient age and rhinitis or asthma duration. CONCLUSION: The prevalence of nasal polyps in patients with allergic rhinitis or asthma was higher than previously reported. Given this high prevalence of nasal polyposis, nasal examination and concomitant treatment of this disorder are recommended.

Serum level of anti-hepatitis B surface antigen 6-8 years after hepatitis B vaccination at birth.

The duration of protection after hepatitis B vaccination in children is unknown. We determined the serum level of antibody to hepatitis B surface antigen (anti-HBsAg) in 273 randomly selected 7-9-year-old schoolchildren from Zanjan City, Islamic Republic of Iran, who had been fully vaccinated against hepatitis B starting at birth. Titres < or = 10 mlU/mL were considered unprotective. Just over half of the children (52%) had titres < or = 10 mlU/mL with no difference between the sexes, while 81 (29.7%) had no anti-HBsAg (0 mlU/mL). Three of the children had antibodies to hepatitis B core protein. More studies are needed to determine the necessity for or timing of booster doses.

Breast-feeding patterns and factors determining exclusive breast-feeding.

INTRODUCTION: Breast-feeding is a major determinant of infants' health and survival. The aim of this study was to examine breast-feeding patterns and the role of some factors on exclusive breast-feeding. METHODS: The study was done at the Health Centre of Community Oriented Medical Education of Zanjan City, Iran. Mothers of 650 infants younger than one year of age were interviewed directly by healthcare providers. The necessary information was recorded on pre-structured questionnaires, and the feeding patterns of all infants were determined. RESULTS: The rate of breast-feeding was greater than 92 percent during the first year of life. Exclusive breast-feeding rate in the first five days of life was 82 percent, but it declined to 44 percent at the first month. The chance of exclusive breast-feeding was higher in infants who were on demand feeding (odds ratio [OR] 2.6), breastfed more than eight times per day (OR 2.23), and their birth weight ranged from 2.5 to 4 kg (OR 2.16). This chance was less among infants exposed to pacifiers (OR 2.62) and with the numbers of deliveries equal to or more than three (OR 2.25). CONCLUSION: The rates of breast-feeding initiation and its duration at six and 12 months were higher than the national goal. The rate of exclusive breast-feeding was nearly 44 percent. It seems necessary to elucidate the role of other factors, such as socioeconomic status, on exclusive breast-feeding.

Cutoff point of waist circumference for the diagnosis of metabolic syndrome in an Iranian population.

BACKGROUND: Proposed cutoffs for waist circumference (WC) in western populations may be not appropriate for Asian populations. The published data among Iranians are insufficient to address this issue. This study was designed to identify cutoffs for WC that confer increased risk of metabolic syndrome in Iranian adults living in Zanjan, a province located in the west of Tehran. MATERIALS AND METHODS: Data of a cross-sectional sample of 3277 Iranian adults aged more than 20 years were analyzed. In the original study individual body weight, height, WC, and blood pressure were assessed and fasting plasma glucose, triglycerides, total cholesterol, low- and high-density lipoprotein cholesterol were measured. After excluding WC, existence of two or more of the remaining four risk factors of the modified NCEP III criteria for metabolic syndrome were defined as multiple risk factors. Receiver operating characteristic (ROC) analysis was used to find out the optimal cutoff values of WC to predict metabolic syndrome. RESULTS: The cutoff level yielding the maximal sensitivity and specificity for predicting the presence of metabolic syndrome (multiple risk factors) was 87 cm in men and 82 cm in women. Cutoffs corresponding to body mass index (BMI) 25 and 30 kg/m(2) to predict metabolic syndrome were 84 and 97 cm in men and 78 and 91 cm in women, respectively. CONCLUSIONS: Lower cutoffs for WC should be considered in the identification of Iranian population at high risk of metabolic syndrome.

Serum level of anti-hepatitis B surface antigen 6-8 years after hepatitis B vaccination at birth

The duration of protection after hepatitis B vaccination in children is unknown. We determined the serum level of antibody to hepatitis B surface antigen [anti-HBsAg] in 273 randomly selected 7-9-year-old schoolchildren from Zanjan City, Islamic Republic of Iran, who had been fully vaccinated against hepatitis B starting at birth. Titres </= 10 mIU/mL were considered unprotective. Just over half of the children [52%] had titres </= 10 mIU/mL with no difference between the sexes, while 81 [29.7%] had no anti-HBsAg [0 mIU/mL]. Three of the children had antibodies to hepatitis B core protein. More studies are needed to determine the necessity for or timing of booster doses