Esophageal atresia: our experiences in a university hospital

Introduction and aim Esophageal atresia is a relatively common congenital malformation occurring one in 2500–3000 live births. The aim of this study was to determine the frequency, type of anomaly, and mortality and to detect the associated anomaly in patients with esophageal atresia.Patients and methods All neonates with diagnosis of esophageal atresia who were referred to pediatric surgery ward of Imam Khomeini Hospital were included in this study. Duration of this study was 10 years from 20 March 1997 to 20 March 2006. For comparison, duration of the study was divided into two periods (1997–2001 and 2002–2006). Sex, mortality rate, associated anomalies, type of atresia, mortality, performing thoracostomy or gastrostomy, and packed cell infusion were studied. Gross classification was used for typing of anomaly. Analysis was performed using the Pearson v2-test and analysis of variance using SPSS.Results In this study, 198 (male = 100, female = 98) neonates were included. The most frequent type of atresia was type C (93.4%). Overall mortality rate was 50%. Mortality during the first period was 54.43% and during the second period was 47.05% (P = 0.384). The mean age at the second surgery was significantly higher in type D patients compared with others. The rate of gastrostomy was significantly higher during the first period (89.87%) compared with the second period of study (79.27%) (P = 0.002). The rate of cervical esophagostomy was decreased from 8.86 to 4.23% (P = 0.228).Conclusion Mortality rate has decreased in our hospitals. The rate of gastrostomy decreased during the second period of study. The age at the first surgery was significantly higher in type D classification patients.Keywords: esophageal atresia, gastrostomy, morbidity, mortality, thoracostomy, tracheoesophageal fistula, VACTERL syndrom

Epidemiology of neonatal congenital hypothyroidism during 2011-2017

Introduction: Neonatal hypothyroidism is a condition of treatable thyroid deficiency that can lead to severe retardation if not diagnosed on time or inappropriately treated. The present study is an epidemiologic study of neonatal congenital hypothyroidism in Lordegan during 2012-2018. Materials and Methods: This descriptive-analytical study was performed to evaluate the epidemiological characteristics of congenital hypothyroidism. The data were entered into SPSS version 20 software and analyzed by statistical tests, Chi square, ANOVA, T-Test, Pearson Correlation and Spearman Correlation at 0.05 Level. Results: The analysis of 7-years data showed that from the screening of 39332 newborns, 335 were identified as definitive patients, 159 males, 176 females, 275 rural (82.1%) and 169 neonates with a history of family marriage (50.4%). There was a significant relationship between neonatal birth weight and congenital hypothyroidism (P = 0.000). There was a significant relationship between type of delivery and hypothyroidism (P = 0.000). In the treated children, there was a direct relationship between the age of onset of treatment and their TSH level, which was statistically significant (P = 0.013). Conclusion: Due to the high prevalence of congenital hypothyroidism in Lordegan, it is necessary to study further the factors affecting the incidence of congenital hypothyroidism as well as educate pregnant women and timely screening for this disease. keywords: Congenital Hypothyroidism, Epidemiology, Neonata

Risk factors for thyroid cancer in women in chaharmahal and bakhtiari province

Introduction: Thyroid cancer is the most common type of endocrine cancer, which accounts for 1 of all cancers. This type of cancer has the highest mortality rate of all endocrine cancers. The aim of this study was to determine the risk factors for thyroid cancer in women in Chaharmahal and Bakhtiari province. Methods: The present study was a retrospective and case-control study in which 115 thyroid cancer patients and 230 controls were matched in women of Chaharmahal and Bakhtiari province. Data were collected using a questionnaire and interviewed by the researcher. To analyze the data, Chi-square and logistic regression tests with odds ratio with 95 confidence were performed using SPSS v.22 software. Results: The results showed that the two groups of case and control in terms of physical activity, history of thyroid cancer in second degree relatives, history of smoking and history of ocp pill use had no significant relationship with thyroid cancer (p>0.05). But there is a significant relationship between the history of thyroid cancer in first degree relatives, history of organ photography, history of chemotherapy or radiotherapy, history of thyroid disease, history of levothyroxine, low income, fast food consumption and red meat consumption They had thyroid cancer (p<0.05). Conclusion: Low income, consumption of fast food, consumption of red meat, history of thyroid cancer in first degree relatives, history of organ photography, history of chemotherapy or radiotherapy, history of thyroid disease, history of levothyroxine from The most important predictor of thyroid cancer in this study was that it can be considered by educational and health planners to prevent this cancer and take appropriate intervention measures

RESULTS OF POSTERIOR MYECTOMY FOR THE TREATMENT OF CHILDREN WITH CHRONIC CONSTIPATION

Background and Objectives - The aim of this study was to evaluate the result of posterior myectomy in children with chronic constipation who underwent to this surgery. Methods - Forty eight children with chronic constipation who did not respond to diet, laxative, or enema were included. Children with abnormal barium enema showing transitional zone were excluded. Children with documented metabolic disease diabetes, and hypothyroidism were also excluded. All patients underwent posterior myectomy. Children were followed during 1 year after surgery regarding frequency of fecal evacuation, fecal consistency, straining during defecation, and diameter of feces. Data was analyzed using SPSS version 13.0 (Chicago, IL, USA). Results - Of 48 cases that underwent surgery, 21 were male and 27 were female. Age range was 1.5 to 11 years old. Mean duration of constipation before surgery was 22.79±17.08 (range 6-48 months). Mean duration of medical treatment was 14.90±10.31 (range= 6-48 months). Fecal consistency, feces diameter, number of bowel movements and straining during defecation were compared before and after surgery. The results were statistically significant ( P <0.001). Of all cases, 52% continued treatment of constipation after surgery for 1 year. Ganglion cells were absent in 32 cases. Ganglion cells were present in seven children. Proximal ganglion cell was found in nine cases Treatment response was not different between cases according to status of ganglion cell in biopsy. Conclusion - Fecal consistency, feces diameter, number of bowel movements, and straining for defecation were improved after posterior myectomy. Another study with more sample is required for better evaluation of treatment

Voltage control of critical and non-critical loads in distribution networks with electric spring

The electric spring (ES) is a novel voltage compensator which is series with a noncritical load to regulate the critical load voltage. The voltage fluctuation is caused by wind speed fluctuation, load fluctuation, and generator tripping. In busbar voltage drop situation, the electric spring decreases the voltage of non-critical load in order to support the critical load (busbar) voltage. All the non-critical loads couldn’t work under any voltage (for example 0.5pu). In this paper, a control strategy founded on active and reactive power compensations has been proposed for voltage control of critical loads on a reference value while it controls the voltage of non-critical loads between an acceptable boundary. The proposed controller has two voltage control loops which adjusts active and reactive power of the electric spring. The experimental results from the case study show that the ES with the proposed control strategy can effectively mitigate double voltage control of both critical and non-critical loads while dynamically managing the demand response of the system at the same time.fi=vertaisarvioitu|en=peerReviewed

Rabies: A Comprehensive Review of Traditional Persian Medicine Literature

Persian scholars greatly influenced the advancement of medical sciences during the Middle Ages. As a review of the books surviving from that time shows, infectious diseases was one main field of interest for these scientists. Among this group of health problems, rabies was specifically described by Persian physicians, particularly by Avicenna (980 – 1037 A.D.) in his famous “Canon of Medicine.”The current study aimed to examine these physicians’ brilliant views and innovations on the manifestations, diagnosis, and management of rabies, a subject not comprehensively assessed until now

Evaluation of treatment outcomes for Tuberculosis patients during 10 years

Background and purpose: Tuberculosis is one of the most common infectious diseases in the world that can affect various organs including the lungs. Currently it is one of the major causes of death and disability, especially in developing countries. The aim of this study is to analyze the outcome of treatment for tuberculosis patients in Chaharmahal & Bakhtiari province during the years 2007-2017. Materials and Methods: This is a descriptive-analytic study of historical cohort. Data on type of treatment, outcome of treatment, demographic and epidemiological characteristics were collected by referring to patients' health records through Health Department. Data were analyzed by SPSS v.20 using chi-square, Kruskal-Wallis and logistic regression tests at the 0.05 level. Results: The number of patients was 342 who were studied during 11 years from 2007-2017. 51.2% were female and 48.8% were male. The mean age of the patients was 49.79 +/- 21.66 years. 1.2% of patients were infected with HIV. The outcome of treatment for a total of 342 patients with tuberculosis, 304 ( 88.9%) were successfully treated and eventually recovered. Of the 38 patients who had unsuccessful treatment, 22 died during the course of treatment and 16 patients had treatment failure and absenteeism. The highest treatment failure, absenteeism, and death were seen in the age group 65 and older. There was a significant relationship between age (p <0.0001), gender (p = 0.01), history of imprisonment (p <0.0001) and type of disease (p <0.0001) with treatment outcome. Conclusion: To achieve desirable outcome of treatment, comprehensive support, supply of drugs needed for TB control, need to improve DOTS strategy and planning for timely screening and identification of patients especially in high risk groups. Keywords:Treatment Outcome; Tuberculosis; Epidemiology; Chaharmahal & Bakhtiar