Neonatal Seizures: Etiology and Frequency

ObjectiveThe aim of the present study was to evaluate the etiology and frequency of neonatal seizure in hospitalized neonates.Materials and MethodsIn this descriptive, cross-sectional study, we evaluated 1295 neonates with seizures admitted to neonatal and NICU wards in our center. Data was collected on age, sex, birth weight, serum levels of calcium, glucose, and sodium, CT scan findings, history of maternal opium abuse, blood and cerebrospinal fluid culture, and analyzed using SPSS 13.ResultsOf a total of 1295 patients, 34 (2.62%) had seizure. Mean age was 14.03 ± 10.05 days (range, 1 to 29 days); twenty-five (73.5%) neonates were boys and 9 (26.5%) were girls. Of 34 neonates with neonatal seizures, 12 (35.3%), 11 (32.4%), 9 (26.5%), 7 (20.6%), and 3 (8.8%) had hypocalcemia, asphyxia, hypoglycemia, intracranial hemorrhage, and hypernatremia, respectively.Maternal addiction, meningitis, and sepsis were found in 3 (8.8%), 1 (2.9%) and 1 (2.9%) of neonates, respectively.ConclusionThe incidence rate of neonatal seizure in the neonates in our NICU and neonatal ward was 2.62%. Common causes of seizure in this study included hypocalcemia, asphyxia, hypoglycemia, intracranial hemorrhage, and hypernatremia. Maternal ddiction, meningitis and sepsis had the lowest prevalence

Erratum: Comparison of purgative manna drop and phototherapy with phototherapy treatment of neonatal jaundice: A randomized double-blind clinical trial (Osong Public Health and Research Perspectives (2019) 10:3 (152-157) DOI: 10.24171/j.phrp.2019.10.3.06)

The Name and affiliation of the third author, Neda Rahimi, Pediatric Department, Hamadan University of Medical Sciences, Hamadan, Iran, were incorrect. The corrected name and affiliation are as follows: Neda Rahimian, Department of Internal Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran The authors apologize for the error. © 2020 Korea Centers for Disease Control and Prevention. All rights reserved

CPOE in Iran-A viable prospect?. Physicians' opinions on using CPOE in an Iranian teaching hospital

Background: In recent years, the theory that on-line clinical decision support systems can improve patients' safety among hospitalised individuals has gained greater acceptance. However, the feasibility of implementing such a system in a middle or low-income country has rarely been studied. Understanding the current prescription process and a proper needs assessment of prescribers can act as the key to successful implementation. Objectives: The aim of this study was to explore physicians' opinions on the current prescription process, and the expected benefits and perceived obstacles to employ Computerised Physician Order Entry in an Iranian teaching hospital. Methods: Initially, the interview guideline was developed through focus group discussions with eight experts. Then semi-structured interviews were held with 19 prescribers. After verbatim transcription, inductive thematic analysis was performed on empirical data. Forty hours of on-looker observations were performed in different wards to explore the current prescription process. Results: The current prescription process was identified as a physician-centred, top-down, model, where prescribers were found to mostly rely on their memories as well as being overconfident. Some errors may occur during different paper-based registrations, transcriptions and transfers. Physician opinions on Computerised Physician Order Entry were categorised into expected benefits and perceived obstacles. Confidentiality issues, reduction of medication errors and educational benefits were identified as three themes in the expected benefits category. High cost, social and cultural barriers, data entry time and problems with technical support emerged as four themes in the perceived obstacles category. Conclusions: The current prescription process has a high possibility of medication errors. Although there are different barriers confronting the implementation and continuation of Computerised Physician Order Entry in Iranian hospitals, physicians have a willingness to use them if these systems provide significant benefits. A pilot study in a limited setting and a comprehensive analysis of health outcomes and economic indicators should be performed, to assess the merits of introducing Computerised Physician Order Entry with decision support capabilities in Iran. © 2008 Elsevier Ireland Ltd. All rights reserved

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

BACKGROUND: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). INTERPRETATION: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden

Low birth weight causes survey in neonates

Background: Neonatal mortality rate is one of the main health problems which is affected by prenatal status, maternal, fetal and perinatal conditions. Low birth weight (LBW) is one of the main causes of neonatal and infantile mortality. The aim of this study is an evaluation of the LBW causes in neonates. Methods: This descriptive cross sectional study was done on 1500 neonates, born in Fatemieh Hospital, Hamedan, 2004. Data such as birth weight, sex, maternal age, gestational age, birth interval, history of abortion, prenatal care, maternal occupation, level of education, systemic and underlying diseases, history of infections and smoking were extracted from medical records. Data were statistically analyzed by SPSS ver.13 using chi-square, t-test and fisher's exact test. Findings: 19.1% of neonates were LBW newborns. Mean values for maternal age, gestational age, maternal weight and height, and the interval between births of LBW neonates were significantly lower compared with normal birth weight neonates. The number of siblings of LBW neonates was more than normal birth weight neonates. Maternal infections and systemic diseases, occupation, the presence and absence of prenatal care in LBW neonates, showed no significant differences with normal birth weight newborns. Smoking and history of abortion in the mothers of LBW neonates were more than those of normal birth weight neonates. Maternal educational level of LBW neonates was lower than mothers of normal birth weight neonates. The most common maternal infection was vaginitis and the most common maternal systemic disease was hypertension. Conclusions: The results revealed a correlation between LBW in neonates with maternal age, gestational age, maternal weight and height. There was also a correlation with the interval between pregnancies, number of siblings, maternal smoking, previous abortion and level of mothers' education

Evaluation of the incidence and pattern of early childhood dental caries and effective factors on 2-6 year old children in Hamedan in 2006

Background: Prolonged bottle and breast feeding may result in Early Childhood Caries (ECC). The clinical appearance of teeth in ECC in the children is typical and follow a definitive pattern. The goal of this study was to investigate the prevalence of ECC and its dependent factors in Hamadan Kindergarten's children in 2006. Materials and Methods: In this cross-sectional descriptive study, ECC data were collected using questionnaires from 414 children with age range of 2-6 years by a dentist. The relationship between early childhood caries and bottle or breast feeding, period of feeding, use of sweetening materials, frequency of feeding at night, and first time brushing were recorded. Data were analyzed with T-test and Chi- square test. Results : The prevalence of ECC was 31.7. The most affected teeth were left maxillary incisors (28.01) and least affected left lower canine (0). There was a meaningful correlation between breast feeding and ECC. There was no correlation between ECC and age, sex, first time brushing, feeding period, use of sweetening materials, bottle feeding and feeding at night. Conclusion: The prevalence of ECC was high in the studied population and there was a relationship between breast feeding and it's duration with ECC

The micromechanical nature of stresses in triphasic granular media with interfaces

International audienceThe total stress tensor as the average stress within a triphasic granular medium is formally derived from micromechanics where internal forces associated with the solid phase, the two immiscible fluid phases and the associated three interfaces are explicitly accounted for. It is demonstrated that for rigid solid particles, the contributions of all local solid-fluid surface tensions to the total stress are eventually zero. The present work gives the total stress expression as a function of a solid-phase specific stress tensor and a fluid mixture stress contribution that is related to the material's microstructure. A generally non-spherical fluid mixture stress is obtained in contrast to an averaged hydrostatic fluid pressure usually associated with standard thermodynamics. The tensorial nature of this fluid mixture stress contribution is highlighted through numerical experiments pertaining to an idealized granular material in the pendular regime at low wetting saturations. Numerical simulations providing full access to microstruc-tural information are conducted using the Discrete Element Method (DEM), which describes internal forces using resultant forces that clearly deviate from the distributed nature of internal forces in triphasic granular media, e.g., fluid pressures. Nevertheless, this micro-scale representation is demonstrated to be indeed valid for macro-scale stress description in the pendular regime