The effect of supermint oral drop (peppermint essence) on the patients’ pain and their satisfaction after colonoscopy

زمینه و هدف: کولونوسکپی روشی تهاجمی است که برای بیمار به ویژه کودکان ناراحت کننده و دردناک است. هدف از تحقیق حاضر بررسی میزان تأثیر تجویز قطره خوراکی سوپرمینت (اسانس نعناع) بر درد و رضایتمندی بیمار پس از عمل کولونوسکوپی بوده است. روش بررسی: در این مطالعه کارآزمایی بالینی، 101 بیمار کاندید عمل کولونوسکوپی به روش در دسترس انتخاب و به طور تصادفی به دو گروه تقسیم شدند. به گروه شاهد(50 نفر) دارویی تجویز نشد. به گروه مورد (51 نفر)، 20 قطره خوراکی سوپرمینت 30 دقیقه قبل از کولونوسکوپی خورانده شد. پس از عمل کولونوسکوپی با استفاده از پرسشنامه استاندارد میزان درد و رضایتمندی بیمار بررسی شد. داده ها توسط آزمون توصیفی و تحلیلی (t-test) مورد تجزیه و تحلیل قرار گرفت. یافته ها: میانگین میزان دردهای شکمی در گروه شاهد 527/0±500/2 و در گروه مورد 491/0± 625/1 از نمره 10 بود (05/0

Mathematical Modeling for Nanofluids Simulation: A Review of the Latest Works

Exploiting nanofluids in thermal systems is growing day by day. Nanofluids having ultrafine solid particles promise new working fluids for application in energy devices. Many studies have been conducted on thermophysical properties as well as heat and fluid flow characteristics of nanofluids in various systems to discover their advantages compared to conventional working fluids. The main aim of this study is to present the latest developments and progress in the mathematical modeling of nanofluids flow. For this purpose, a comprehensive review of different nanofluid computational fluid dynamics (CFD) approaches is carried out. This study provides detailed information about the commonly used formulations as well as techniques for mathematical modeling of nanofluids. In addition, advantages and disadvantages of each method are rendered to find the most appropriate approach, which can give valid results

HLADQ2 and HLADQ8 Alleles Are Associated with Celiac Disease in Children

Background: Celiac disease is the permanent intolerance to dietary gluten, the major protein component of wheat. The role of human leukocyte antigen (HLA) DQ2 heterodimer (DQA1*0501-DQB1*0201) in presenting gluten peptides to effectors T cells in celiac disease (CD) has been well documented. Epidemiological studies of the disease in Iran are not available. This study was aimed to investigate the frequency of HLADQ2 and HLADQ8 in children with celiac disease in Mashhad city. Methods: This case-control study was conducted on 25 celiac patients and 25 matched healthy controls for HLA typing of DQ2/DQ8. CD diagnosis was reached in 25 subjects, according to the revised criteria of the European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition criteria (NASPGHAN). Sensitivity, specificity, and negative and positive predictive values were calculated. Results: Mean age was 134.06±30.48 months in case and control groups, with no statistical difference between the two groups. 48% of cases and controls were male, and 52 % were female. HLA-DQ2/8 was positive with 80% (CI 95%:64-95), sensitivity was 80% (CI 95%:58-92), specificity 48% (CI 95%:28-68), NPV 70.58% (CI 95%:44-88), PPV 61(CI 95%:42.2-76.5) and accuracy was 64%. Conclusion: A positive association was found between HLA DQ2/8 and Iranian celiac disease. As negative and predictive values were high, HLA typing may be considered a beneficial test for diagnosis confirmation

Food-dependent exercise-induced anaphylaxis due to wheat in a young woman

Food Dependent Exercise-Induced Allergy is a rare condition. However, the occurrence of anaphylaxis is increasing especially in young people. The diagnosis of anaphylaxis is based on clinical criteria and can be supported by laboratory tests such as serum tryptase and positive skin test results for specific IgE to potential triggering allergens. Anaphylaxis prevention needs strict avoidance of confirmed relevant allergen. Food-exercise challenge test may be an acceptable method for diagnosis of Food Dependent Exercise-Induced Allergy and dietary elimination of food is recommended to manage it. In this study, a 32 year-old woman visited the allergy clinic with a history of several episodes of hives since 11 years ago and 3 life-threatening attacks of anaphylaxis during the previous 6 months. The onsets of majority of these attacks were due to physical activity after breakfast. On Blood RAST test, the panel of common food Allergens was used and she had positive test only to wheat flour. On skin prick tests for common food allergens she showed a 6 millimeter wheal with 14 mm flare to Wheat Extract. The rest of allergens were negative. The patient was diagnosed as wheat-dependent exercise-induced, and all foods containing wheat were omitted from her diet. In this report we emphasized on the importance of careful history taking in anaphylaxis diagnosis

Utility of Modeling End-Stage Liver Disease in Children with Chronic Liver Disease

Abstract Introduction: Chronic liver diseases consist of wide spectrum disorders that may be complicated by cirrhosis and therefore need to transplantation. The pediatric end-stage liver disease (PELD) score and model of endstage liver disease (MELD) score has been used as predictors of mortality chronic liver diseases listed for liver transplantation. The aim of this study is evaluation of relation between PELD\MELD score and evidence of cirrhosis in children with choronic liver disease. Materials and Method: This cross-sectional study conducted on 106 patients of chronic liver disease referred to Ghaem haspital, Mashhad university of medical science, Iran during 24 months period (2010)(2011)(2012)(2013). PELD and MELD score were calculated for all patients. Clincal and patholoogical findings of cirrhosis were recorded. Results: Mean age of patients was 68/3 ± 41.8 months. Mean PELD\MELD score was -1/59± 9/64. There was significant correlation between PELD\MELD score and clinical icter, spelenomegaly, evidence of hepatopulminary syndrome, esophageal varices, evidence of cirrhosis in tissue specimences. Conclusion: PELD\MELD score appear to be benefit for detection of cirrhotic children among paients with choronic liver disease

Presentation of DNA Methyltransferase 3 Beta Mutation with Immune Deficiency and Dilation of Aorta and Esophagus

Background: Immunodeficiency, Centromeric region instability, and Facial anomalies syndrome (ICF) is a rare autosomal recessive disorder with Centromeric instability as a hallmark. Method: In this case report, we describe an Iranian 6-year-old male who was diagnosed with ICF syndrome. He had a history of recurrent infections, hydrocephalus report in pregnancy, failure to thrive, facial anomalies, global developmental delay, and umbilical hernia. Results: The investigation showed esophageal dilatation in barium swallow, ascending aortic dilatation in echocardiography and cutis laxa in skin biopsy. In laboratory data, impaired antibody function was observed. Finally, to find the probable causative genetic variant, a whole exome sequencing was performed. The data analysis using bioinformatics tools revealed c.1592G>A mutation in the exon 15 of DNMT3B. With respect to the diagnosis of ICF syndrome, our patient was treated with intravenous immunoglobulin (IVIG). Conclusion: It is necessary to perform periodic neurologic and ophthalmologic examinations. Echocardiography must be done annually. In addition, the possibility of HSCT should be evaluate

Assessment of the Blood Lead Level in Children with Unexplained Failure to Thrive (FTT) admitted to Pediatrics Emergency Ward of Ghaem Hospital, Mashhad, Iran

BackgroundLead is a strong and stable toxin, harmful especially to children, pregnant women, and the elderly. Nearly 27% of children aged under 5 years suffer from failure to thrive (FTT). Due to the probable harmful effects of lead poisoning on children’s growth, in this study we aimed to assess the blood lead level in children with unexplained failure to thrive.MethodsThis analytic cross-sectional study was performed on 200 children under 2 years of age who were referred to Ghaem hospital, a referral hospital in Mashhad city-Iran. The participants were divided into two equal groups, one with unexplained FTT (group A), and children with normal weight (group B). Baseline characteristics were obtained by a research-made questionnaire. Blood samples were taken by the hospital nurses who were blind to the study groups. Blood lead level was measured by atomic absorption spectrophotometric method (Perkin Elmer 3030). ResultsThe mean ± standard deviation (SD) of blood lead level in FTT group and control group were 7.3±3.32 µg/dL and 6.37±5.93 µg/dL, respectively. Blood lead level was significantly higher in FTT group than control group (P=0.001). Baseline Charactistics (such as hgender, parental educational level, gestational age, and socio-economic status of the family) were not significantly different between the two groups (P>0.05).ConclusionThe results of our study revealed that blood lead level was higher in children with FTT. So Lead poisoning may be a potential cause of unexplained FTT. So, measuring blood lead level can be useful in diagnostic workup of patients with FTT

Gastrointestinal symptoms of patients with autism spectrum disorder

Background: Concern about possible GI dysfunction in ASD is intensified by high rates of feeding concerns and consequent medical sequelae in ASD. Etiological factors contributing to the pattern and prevalence of atypical intake in ASD remain elusive, but may involve pathophysiological processes in the GI tract. In this study, we evaluated the gastrointestinal symptoms of patients with autism spectrum disorder in Mashhad, Iran.Methods: This is a cross-sectional study performed during September 2015 and April 2018 on patients referred to pediatric gastrointestinal clinics of Ghaem and Noor Hedayat centers by definite diagnosis of autism spectrum disorder (ASD). All subjects were interviewed to answer some questions about the gastrointestinal manifestations like constipation, chronic abdominal pain, diarrhea, recurrent vomiting, gastro-esophageal reflux, nausea, and agitation. For each patient a checklist was completed including demographic, history and physical examination variables.Results: During the period of study, 46 definite ASD patients were enrolled in the study. The mean age of the participants was 7.72± 2.80 years (range: 2-16). Most of the patients were male (37, 80.4%). Diarrhea (occasional or chronic) was seen in six patients (13%) and constipation in 21 patients (45.7%).  There was no significant difference between the gastrointestinal symptoms and gender or age of the patients (P>0.05). An important finding in physical examination was tooth decay, which was found in 21 patients (45.7%).Conclusion: GI symptoms, with the high prevalence in ASD patients, should be considered as major problems; and preventive strategies must be taken for resolving them. Constipation was the most prevalent symptom, which can be related to the nature of the disease or other mechanisms

The Impact of Silymarin on the Symptom Severity in Pediatric Patients with Inflammatory Bowel Disease: A Randomized Clinical Trial

Background: Inflammatory Bowel Disease (IBD) is a multifactorial disease, posing significant challenges to public health. The aim of this study is to determine the effect of silymarin on the symptom severity in pediatric patients with IBD.Methods & Materials: This randomized clinical trial was conducted on children aged 5-18 diagnosed with IBD referred to the GI clinic at Akbar Children's Hospital in Mashhad. Those who met the inclusion criteria were randomly allocated into either the intervention or placebo group, each group consisting of 20 participants. In the intervention group, silymarin was administered three times daily in divided doses for three months. The control group received a placebo. To assess the efficacy of silymarin, PUCAI and PCDAI were evaluated for all patients at three different time points: before the intervention, during the first visit, and after the intervention. Data were analyzed utilizing the SPSS version 25, with a significance level set at p 0.05). However, a statistically significant difference was observed in the disease activity index score between the two groups during the second, and third evaluations (p<0.05)

Lessons learnt from basin management in Iran and the world (case study Helmand, Danube and Colorado basins)

In recent years, river flow into Sistan dam changed because of construction of dams and expansion of irrigation areas in the upper Helmand basin. Planning for construction of more dams and heightening of Kajaki dam in Helmand basin shall intensify the severity of water shortage of Sistan dam and Hamun Lake. Sistan dam located at downstream of Helmand river on Sistan branch of the Helmand river, power shifts in Afghanistan and expansion of irrigation areas in upstream basins and absence of an integrated authority/management in the basin are the major problems. Political nature of international protocols for management of the basin is another problem for water resource management in the region. Above mentioned issues forced the local water authorities to solve the problems using natural and man-made reservoirs and interlink canals, called Chah-Nimeh dams. This study focused on comparison of Helmand, Danube and Colorado river basins to find possible acts in Helmand basin