Effectiveness of prophylaxis treatment in the acute febrile stage of febrile seizure in children under five years old

Abstract Objectives In children suffering from febrile seizure, the likelihood of recurrence seems to be high in the early hours following the first episodes in the absence of proper interventions. The present study was aimed  at assessing and comparing the outcomes of different preventive interventions in the acute stage after febrile seizure in children. Materials & Methods This randomized clinical trial study was performed between September 2015 and September 2016. We enrolled patients aged between 6 and 60 months suffered from febrile seizure and referred to the PediatricEmergency Department at Besat Hospital in Hamadan. The eligible patients were randomly assigned to the following four receive one of the following groups: group 1 (not receiving any anti-seizure drugs), group 2 (receiving a single dose of phenobarbital) on admission, group 3 (receiving a single dose of phenobarbital on admission continued until the fever is resolved), and group 4 (receiving diazepam until the disappearance offever). Results The study population consisted of 248 children. The recurrence rate of seizure in the acute stage was 4.84%. Also, the impact of diazepam and phenobarbital (either as a single dose or as continuous) on the prevention of febrile seizure recurrence in the acute stage has been established. None of the patients had febrile status epilepticus. Conclusion Controlling seizures without prescribing anti-seizure drugs increases the risk for the recurrence of febrile seizure in the acute stage. Different drug regimens for controlling seizure, including diazepam and phenobarbital (as stat or maintenance), may play a similar role in preventing the occurrence of febrile seizur

Does Dietary Intake by Tehranian Adults Align with the 2005 Dietary Guidelines for Americans? Observations from the Tehran Lipid and Glucose Study

The aim of this study was to compare dietary intakes by Tehranian adults with recent dietary guidelines for the Americans. The study made a cross-sectional assessment of the dietary patterns of Tehranian adults using a validated food-frequency questionnaire. It included 2,510 subjects (1,121 men and 1,389 women) aged 19-70 years. They were the participants of the third follow-up survey of the Tehran Lipid and Glucose Study (2005-2008). The dietary patterns were assessed using the latest World Health Organization (WHO)'s nutritional goals and Dietary Guidelines for the Americans Adherence Index (DGAI) 2005. The mean [standard deviation (SD)] DGAI score for this population was 8.31 (1.9). Participants in the highest quartile category of DGAI were more likely to be female, older, non-smoking, and physically active than those in the lowest quartile category (p<0.001). Percentage of participants meeting the DGA recommendations waslow, especially for starchy vegetables (2.3%), orange vegetables (16.2%), lean meat (9.2%), grains (12.0%), and legumes (6.4%). Over-consumption of grains was observed in almost half of the participants while approximately 20% of the subjects over-consumed milk and meat groups. Intakes of most nutrients examined were significantly associated with the DGAI 2005 score (p<0.001), except for vitamin E, vitamin B12, and vitamin D. The least adherence with the WHO goals was observed with n-3 PUFAs, sodium, fruit, and vegetable intakes. The results revealed that the dietary patterns of most Tehranian adults did not comply with the 2005 DGA and nutritional goals of WHO/Food and Agriculture Organization

Program to reduce empowerment barriers hindering mothers to contribute to speech skills of hearing-impaired children with cochlear implant

Background and aims: Given the importance of reducing barriers hindering the empowerment of mothers from contributing to the rehabilitation of hearing-impaired children with cochlear implants, the present study points to the direction of designing, adopting, and assessing a program that would lessen such barriers. Methods: In this randomized controlled trial (RCT), participants were consecutively selected from individuals referring to speech-therapy centers serving hearing-impaired children in the Town of Shiraz (Iran). Intervention and control groups were established using randomized block selection (35 individuals per group). The parent-based intervention was adopted in 6 training sessions, each session lasting 80 minutes. A researcher-made questionnaire was employed to investigate empowerment barriers, while children’s speech skill was assessed using the Newsha scale. Results: Data collected from 35 intervention and 33 control group members were examined. Evaluation of primary and interactional effects of "time" and "group" shows time to have a meaningful effect on "parental discord" and "empowerment barrier" variables (P<0.001). Time-group interaction also proved significant regarding effects on "difficulty working with hearing-impaired child" and "parents’ false beliefs". Compared to the control group, the intervention group shows significant improvement across all variables at studied different time periods. Not to forget the immediate effects of time and group on the "speech skill" variable, which also proved significant (P=0.001). Conclusion: The results denote the effectiveness of the parent-based intervention on mothers’ empowerment and speech improvement in children with impaired hearing

Dietary differences between elderly Iranians living in Sweden and Iran a cross-sectional comparative study

<p>Abstract</p> <p>Background</p> <p>During the last decades, global migration has increased and many immigrant groups have a higher prevalence than the native born population of several cardiovascular disease risk factors, including poor dietary habits. However, it is uncertain if dietary habits in immigrant populations reflect dietary habits in their country of origin or if the current diet is a consequence of the migration and possible change of dietary habits. The aim of this study was to examine possible dietary differences between elderly Iranians living in Stockholm, Sweden with elderly Iranians living in Tehran, Iran, taking into account sex, age, marital status, and education.</p> <p>Methods</p> <p>Dietary intakes were assessed by semi - quantitative food frequency questionnaire in a cross-sectional study of 121 Iranians living in Stockholm and 52 Iranians living in Tehran, aged 60-80. Differences in dietary habits between the two groups was analysed by bootstrapped regression analyses with 1000 replications.</p> <p>Results</p> <p>Iranians living in Sweden had significantly higher intake of protein, total fat, fiber than Iranians living in Iran, but lower consumption of carbohydrates. The observed differences in intake of macronutrients were reflected in consumed amount of all food items, which were higher among Iranians living in Iran with the exception of bread and grain consumption which was lower.</p> <p>Conclusions</p> <p>There are general differences in dietary habits between Iranians living in Iran and Iranians living in Sweden. Parts of observed differences in dietary habits may reflect a favourable adoption process to the Swedish dietary habits after migration. Meanwhile other differences are point of concern in light of the high prevalence of overweight, among Iranians living in Sweden and can have unfavourable impact in particular in the context of cardiovascular health.</p

Prevalence and Correlates of Psychiatric Disorders in a National Survey of Iranian Children and Adolescents

Objective: Considering the impact of rapid sociocultural, political, and economical changes on societies and families, population-based surveys of mental disorders in different communities are needed to describe the magnitude of mental health problems and their disabling effects at the individual, familial, and societal levels. Method: A population-based cross sectional survey (IRCAP project) of 30 532 children and adolescents between 6 and 18 years was conducted in all provinces of Iran using a multistage cluster sampling method. Data were collected by 250 clinical psychologists trained to use the validated Persian version of the semi-structured diagnostic interview Kiddie-Schedule for Affective Disorders and Schizophrenia-PL (K-SADS-PL). Results: In this national epidemiological survey, 6209 out of 30 532 (22.31%) were diagnosed with at least one psychiatric disorder. The anxiety disorders (14.13%) and behavioral disorders (8.3%) had the highest prevalence, while eating disorders (0.13%) and psychotic symptoms (0.26%) had the lowest. The prevalence of psychiatric disorders was significantly lower in girls (OR = 0.85; 95% CI: 0.80-0.90), in those living in the rural area (OR = 0.80; 95% CI: 0.73-0.87), in those aged 15-18 years (OR = 0.92; 95% CI: 0.86-0.99), as well as that was significantly higher in those who had a parent suffering from mental disorders (OR = 1.96; 95% CI: 1.63-2.36 for mother and OR = 1.33; 95% CI: 1.07-1.66 for father) or physical illness (OR = 1.26; 95% CI: 1.17-1.35 for mother and OR = 1.19; 95% CI: 1.10-1.28 for father). Conclusion: About one fifth of Iranian children and adolescents suffer from at least one psychiatric disorder. Therefore, we should give a greater priority to promoting mental health and public health, provide more accessible services and trainings, and reduce barriers to accessing existing services

Serum Zinc level in Children with Febrile Seizure: A Case – Control Study

AbstractObjectiveFebrile seizure (FS) is the most common seizure disorder in children. FS is a genetic age-limited seizure disorder that occurs only with febrile illness. Nowadays, we know that genetic factors play a major role in occurrence of FS, but some trace elements (for example: zinc) may have important role in occurrence of FS. In this study, we investigate serum level of zinc in patients with FS and in febrile children without seizure as control group.  Materials &amp; MethodsIn this case-control prospective study 41 patients with first febrile seizure (FS) (simple &amp; complex) as case group and 41 febrile children without seizure as age, sex matched control group admitted in Besat hospital in Hamadan between January 2013 to January 2014 were enrolled. Ages of children were 6 months to 5 years. Serum zinc levels were measured by atomic absorption spectrophotometery method in these groups.ResultsThe mean serum zinc level was 70.41±20.46 mcg/dl and 92.73±17.62 mcg/dl in the case group and the control group, respectively (P = 0.001). In fact, serum zinc level in children with FS was significantly lower than that of control group.ConclusionAlthough based on results of this study, we found lower serum zinc level in children with febrile seizure, but we can't recommend zinc administration for prevention of FS and we need further fundamental basic studies in futures.  

Carbapenemase-producing Klebsiella pneumoniae strains among clinical specimens in Kashan (2014-2015)

Background: Resistance among the Enterobacteriaceae family especially in Klebsiella genus as one important leading cause of nosocomial infection, is one of the most important health challenges all over the world. Klebsiella pneumoniae carbapenemase (KPC)-producing bacteria are among the most prevalent &beta;-lactamases in Klebsiella strains. Our aim was to study KPC-producing Klebsiella strains in clinical samples in Kashan. Materials and Methods: In this cross-sectional study Klebsiella isolates (n=181) were recovered from clinical samples during September to July 2015. After identification of Klebsiella isolates by biochemical tests, the susceptibility pattern of recovered Klebsiella from clinical isolates to 17 antibiotics were studied by disk diffusion method. Using PCR assay blaKPC gene in Klebsiella isolates were studied. Statistical analyses of data were performed by Chi square test and (P&lt;0.05) was considered statistically significant. Results: Forty eight out of 181 Klebsiella samples were multidrug resistant and the most resistant was seen to Ampicillin and Cephalotin. Among the Klebsiella isolates, 21(11.6) carried blaKPC gene which most of them were recovered in ICU ward from urinary and respiratory specimens. Conclusions: Our study showed that in Klebsiella strains isolated from patients, especially hospitalized patients in Kashan, resistance to carbapenems is seen with presence of blaKPC gene. Due to the ability of gene to spread by mobile genetic elements the finding is alarming in treatment of Klebsiella infections

Associations of Pre-Defined Dietary Patterns with Obesity Associated Phenotypes in Tehranian Adolescents

Obesity has become a public health problem in adolescents and could be a risk factor for both short-term and long-term health consequences. This study aimed to evaluate the relationship of Dietary Guidelines for Americans Adherence Index (DGAI), Healthy Eating Index-2005 (HEI-2005) and Healthy Eating Index-2010 (HEI-2010) with risk of obesity associated phenotypes in Tehranian adolescents. This cross-sectional study was conducted within the framework of the Tehran Lipid and Glucose Study, on 722 adolescents, aged 10–19 years. Usual dietary intakes were assessed by a food frequency questionnaire, and diet quality scores were obtained based on DGAI, HEI-2005 and HEI-2010. General obesity and cardio metabolic risk factors were defined according to the Centers of Disease Control and Prevention and de’Ferranti cut-offs, respectively. After adjusting for age, sex, energy intake and physical activity, compared to those in the lowest quartile, participants in the highest quartile of HEI-2010 had lower risk of general obesity (OR: 0.62; 95% CI: 0.38–0.93; Ptrend = 0.03) and central obesity (OR: 0.63; 95% CI: 0.44–0.95; Ptrend = 0.04). No association was observed between different types of obesity and scores of other diet quality indices. In conclusions, considering the role of HEI-2010 in decreasing the risk of obesity, these findings suggest that HEI-2010 may be useful for assessing diet-related progress in obesity prevention efforts

Acrylamide content of collected food products from tehran’s market: a risk assessment study

Acrylamide concentration in food products collected from the Tehran market was investigated by the aid of a dispersive liquid-liquid microextraction (DLLME) system coupled with gas chromatography-mass spectrometry (GC-MS). Also, the dietary exposure distribution and related potential risk for acrylamide ingestion were estimated by the Monte Carlo simulation (MCS). The highest and lowest mean concentration of acrylamide was detected in coffee and roasted nuts samples as 549 and 133 μg/kg, respectively. The mean acrylamide dietary exposure values for children (3–10 years), adolescents (11–17 years), adults (18–60 years), and seniors (61–96 years) were estimated to be 1.81, 1.02, 0.61, and 0.53 μg/kg body weight (BW)/day, respectively. In all age groups, except children, the estimated exposure in men and boys was higher than that in women and girls. Bread, despite containing low acrylamide content groups (157 μg/kg while compared with other, except roasted nuts), showed with the highest contribution rate in all age groups due to its high consumption rate. The estimated incremental lifetime cancer risk (ILCR) for all age groups was noted as greater than 10−4 indicating serious risk to the population. Moreover, the margin of exposure (MOE) values based on carcinogenicity showed health concern to all age groups (< 10,000). Regarding the non-carcinogenic risk, the target hazard quotient (THQ) was lower than 1, and MOE based on neurotoxicity was higher than 125 (safety thresholds), which represented negligible and ignorable risk in all age groups except in a small group of children and adolescents27305583057