The Prevalence of Iron Deficiency Anemia among High School Students in Iran: A Systematic Review

Introduction: Iron is one of the most important elements forming the body and an essential metal for many biological processes in mammals. According to studies, anemia can cause numerous side effects in the body. Because of the effectiveness of iron in myelinated nerves, this illness can cause hearing loss and vision problems as well, and in students, it can even cause academic failure and learning problems and intensify behavioral disorders. Therefore, to collect the statistics of the prevalence of the disorder in order to inform parents, the present study was conducted to assess the prevalence of iron deficiency anemia in high school students in Iran using meta-analysis method.Method: This study was continued in review form using the key words anemia, iron deficiency anemia, and anemia prevalence with a review of the articles in Pubmed, Iranmedex databases and Scientific Information Database of SID in related topics with 89 articles. Time domain for searching articles and related books and was mainly from 1991 onwards.Results: Studies on the prevalence of iron deficiency anemia in high school students show different results. Recent statistics based on published articles at home and abroad show the prevalence of iron deficiency anemia equal to 10.6%, (with a 95% confidence interval: 9.7 to 11.5) until 2014.Conclusion: The disease can cause hearing and vision disorders in adolescents. Moreover, it can cause academic failure and learning problems and intensify behavioral disorders in students.  Given that children's health is an indicator of health planning of family for them, attention to the factors preventing iron deficiency anemia and its treatment is essential for students. Following this study, it is suggested that by correcting diet as the first step of prevention of catching this diseases, we take a step towards preventing it

A Study of Carotid Arterial Intima-Media Thickness (IMT) Changes based on Clinical and Para-Clinical Indexes in Patients with Type 2 Diabetes

 Background & objectives: Ultrasonography as a non-invasive, inexpensive and generally available method has been used to measure of the intima-media thickness (IMT) of carotid arteries changes and finding its relationship with cardiovascular risk factors and vascular diseases. The aim of this study was to investigate the carotid arterial wall thickness (IMT) changes based on clinical and para-clinical indexes in patients with type 2 diabetes mellitus (DM). Methods: In this descriptive-analytical study, 100 patients with type 2 DM were randomly selected from all patients admitted to diabetes clinics and were considered in terms of clinical and paraclinical indexes of systemic atherosclerosis. Both types of IMT (TA and TB) were measured by ultrasonography in six locations of the carotid system. The intensity of these two values was calculated compared with the normal IMT and also, its relationship with clinical and para clinical indexes were determined. The results were statistically analyzed using SPSS software version 19.  Results: In this study, more than 80% of patients had IMT upper than normal. There was a significant difference between the severe increase of IMT and effective variables such as sex, smoking, physical inactivity, dyslipidemia and poor blood glucose control. Conclusions: This study showed that the DM and factors such as sex, smoking, physical inactivity had a significant effect on the increasing IMT compared to the normal range

Efficacy and safety of decompressive craniectomy in acute ischemic stroke patients treated with intravenous thrombolysis

Abstract Introduction The optimal timing for decompressive hemicraniectomy (DHC) after intravenous thrombolysis (IVT) remains unclear. This study in patients with acute ischemic stroke treated with IVT aimed to assess the safety of DHC and patient outcome. Methods Data was extracted from the Tabriz stroke registry from June 2011 up to September 2020. In all, 881 patients were treated with IVT. Among these, 23 patients underwent DH. Six patients were excluded due to symptomatic intracranial hemorrhage (parenchymal hematoma type 2 based on SITS-MOST definition) after IVT, but other types of bleeding after venous thrombolysis, including HI1, HI2, and PH1 were not excluded; so the remaining 17 patients were enrolled in the study. Functional Outcome was defined as the proportion of patients who achieved mRS score of 2–3 (moderate disability), 4–5 (severe disability), or 6 (mortality) at 90 days after stroke. mRSwas assess by trained neurologist at the hospital clinic with direct interview Safety outcome was assessed by comparison of two scans just prior to and after craniectomy. Any new hemorrhage or worsening of previous hemorrhage was reported. Parenchymal hematoma type 2, based on ECASS II definition, was considered as major surgical complication. This study was approved by the local ethics committee of the Tabriz University of Medical Sciences (Ethics Code: IR.TBZMED.REC.1398.420). Results At the three-month mRS follow up, six patients (35%) had moderate and five (29%) had severe disability. The outcome of death was observed in six patients (35%).Nine of 15 patients (60%) underwent surgery in the first 48 hours after onset of symptoms. No patient over 60 years of age survived to the three-month follow up; 67% of those who were under60 years and underwent DH in the first 48 hours had favorable outcome. Hemorrhagic complication was seen in 64% of patients but none was major. Conclusion Results of this study showed that the rate of major bleeding and outcome of acute ischemic stroke patients who underwent DHC after IVT is comparable with the reported data in the literature and intentionally waiting for the fibrinolytic effects of IVT to disappear may not outweigh the benefits of DHC. Although the findings of the study should be interpreted with caution and larger studies are needed to confirm the results

Antibiotic use during the first 6 months of COVID-19 pandemic in Iran : a large-scale multi-centre study

WHAT IS KNOWN AND OBJECTIVE: Although antibiotics are ineffective against viral infections, epidemiological studies have revealed that the COVID‐19 pandemic resulted in the overuse of antibiotics and disruption of antimicrobial stewardship programmes. We investigated the pattern of antibiotic use during the first 6 months of the COVID‐19 pandemic in Iran. METHODS: A multi‐centre retrospective study was designed to investigate the use of 16 broad‐spectrum antibiotics in 12 medical centres. The rate of antibiotic use was calculated and reported based on the Defined Daily Dose (DDD) per 100 hospital bed‐days. The bacterial co‐infection rate was also reported. RESULTS AND DISCUSSION: Totally, 43,791 hospitalized COVID‐19 patients were recruited in this study. It was found that 121.6 DDD of antibiotics were used per 100 hospital bed‐days, which estimated that each patient received approximately 1.21 DDDs of antibiotics every day. However, the bacterial co‐infections were detected only in 14.4% of the cases. A direct correlation was observed between the rate of antibiotic use and mortality (r[142] = 0.237, p = 0.004). The rate of antibiotic consumption was not significantly different between the ICU and non‐ICU settings (p = 0.15). WHAT IS NEW AND CONCLUSION: In this study, widespread antibiotic use was detected in the absence of the confirmed bacterial coinfection in COVID‐19 patients. This over‐consumption of broad‐spectrum antibiotics may be associated with increased mortality in hospitalized COVID‐19 patients, which can be an alarming finding