Effect of Probiotics on Infantile Colic in Breast-Fed Infants: A Randomized Single-Blind Clinical Trial

Aim: This study examined the impact of probiotics on children's colic in breast-fed infants. Methods: This study was a randomized single-blind clinical trial. 100 infants were referred to pediatric gastroenterology clinic of Avicenna diagnosed by gastroenterologist of children who suffered from infantile colic and they were qualified after justifying parents and obtaining written consent. (IRCT registration number: IRCT2016082829573N1). Results: Results showed that there was a statistically significant difference in terms of crying time (p = 0.000) and the arrival and departure of the group. (p = 0.000). Conclusion: The outcomes indicated that using probiotics could reduce colic in infants and improve the quality of life in this grou

Earthquake risk assessment using an integrated Fuzzy Analytic Hierarchy Process with Artificial Neural Networks based on GIS: A case study of Sanandaj in Iran

Earthquakes are natural phenomena, which induce natural hazard that seriously threatens urban areas, despite significant advances in retrofitting urban buildings and enhancing the knowledge and ability of experts in natural disaster control. Iran is one of the most seismically active countries in the world. The purpose of this study was to evaluate and analyze the extent of earthquake vulnerability in relation to demographic, environmental, and physical criteria. An earthquake risk assessment (ERA) map was created by using a Fuzzy-Analytic Hierarchy Process coupled with an Artificial Neural Networks (FAHP-ANN) model generating five vulnerability classes. Combining the application of a FAHP-ANN with a geographic information system (GIS) enabled to assign weights to the layers of the earthquake vulnerability criteria. The model was applied to Sanandaj City in Iran, located in the seismically active Sanandaj-Sirjan zone which is frequently affected by devastating earthquakes. The Multilayer Perceptron (MLP) model was implemented in the IDRISI software and 250 points were validated for grades 0 and 1. The validation process revealed that the proposed model can produce an earthquake probability map with an accuracy of 95%. A comparison of the results attained by using a FAHP, AHP and MLP model shows that the hybrid FAHP-ANN model proved flexible and reliable when generating the ERA map. The FAHP-ANN model accurately identified the highest earthquake vulnerability in densely populated areas with dilapidated building infrastructure. The findings of this study are useful for decision makers with a scientific basis to develop earthquake risk management strategies

Determination of celiac disease frequency in type 1 diabetes mellitus children in the Pediatric Endocrinology Clinic of Sari, Mazandaran

Background: Diabetes mellitus, type 1 (T1DM) and celiac disease (CD) are both immune-mediated. The mean rate of clinical overlap is 8%. The aim of this study was to discover the frequency of CD in children with type 1 diabetes in Mazandaran province. Methods: This retrospective descriptive study was performed in the pediatric endocrinology referral center, in Sari from 2012 to 2014. We screened all individuals aged between six months and 18 years with diabetes diagnosis after ketoacidosis, positive anti-GAD 65 antibodies, and insulin therapy. Patients with a positive tissue Transglutaminase Immunoglobulin A (tTG-IgA) antibodies test underwent endoscopic biopsy. Categorical data were tested using chi-square and quantitative data with independent sample T-test in SPSS. Date reported with 95% confidence interval. P<0.05 was considered statically significant. Results: Of the 119 children enrolled, six cases (5%) were positive for tTG-IgA antibodies and all of them were boys (P=0.013). Histopathologically, CD was confirmed in 5 persons (4.2%). The mean age of seropositive patients was 10.3±3.3 years. History of DKA was mostly negative (83.3%) in them. The mean breastfeeding duration was 21±3.2 months, and only one had started formula after 12 months of birth. Conclusions: The results of the current study showed that the frequency of CD in T1DM children in north of Iran was similar to that other countries but lower than that in previous reports of Iran. The periodic screening test for CD in this high-risk group is necessary to diagnose the asymptomatic disease and prevent its complications

Detection of Nocardia, Streptomyces and Rhodococcus from bronchoalveolar lavage specimens of patients with HIV by Multiplex PCR Assay

Background: Nocardia, Streptomyces and Rhodococcus are life threatening opportunistic pathogens under immunodeficiency conditions, particularly among patients infected with HIV. Rapid and accurate detection of these infections can improve immune health quality, patient management and appropriate treatment. The aim of this study was to design a novel multiplex-PCR assay for rapid diagnosis of these three organisms directly from bronchoalveolar lavage (BAL) specimens of patients infected with HIV.Methods: The genus specific primers were designed for directdetection of Nocardia, Streptomyces and Rhodococcus in a single tube multiplex PCR. This PCR specifically amplified the target genes from pure cultures. It subsequently was applied on BAL specimens of 29 HIV positive patients that had previously been culture negative for actinomycete bacteria, of which Nocardia, Streptomyces and Rhodococcus are members.Results: Of 29 respiratory clinical specimens, there were positive for Nocardia spp. and one was positive for Streptomyces spp using the multiplex PCR assay. The sequencing of the PCR products identified the species as Nocardia cyriacigeorgica (n=2), Nocardia farcinica and Streptomyces albus.Conclusion: This novel multiplex PCR assay yielded reliable results for accurate identification of Nocardia, Streptomyces and Rhodococcus from BAL while the results of bacterial culture were negative.

Effects of anthropogenic activities on the heavy metal levels in the clams and sediments in a tropical river

The present study aimed to assess the effects of anthropogenic activities on the heavy metal levels in the Langat River by transplantation of Corbicula javanica. In addition, potential ecological risk indexes (PERI) of heavy metals in the surface sediments of the river were also investigated. The correlation analysis revealed that eight metals (As, Co, Cr, Fe, Mn, Ni, Pb and Zn) in total soft tissue (TST) while five metals (As, Cd, Cr, Fe and Mn) in shell have positively and significantly correlation with respective metal concentration in sediment, indicating the clams is a good biomonitor of the metal levels. Based on clustering patterns, the discharge of dam impoundment, agricultural activities and urban domestic waste were identified as three major contributors of the metals in Pangsun, Semenyih and Dusun Tua, and Kajang, respectively. Various geochemical indexes for a single metal pollutant (geoaccumulation index (I geo), enrichment factors (EF), contamination factor (C f) and ecological risk (Er)) all agreed that Cd, Co, Cr, Cu, Fe, Mn, Ni and Zn are not likely to cause adverse effect to the river ecosystem, but As and Pb could pose a potential ecological risk to the river ecosystem. All indexes (degree of contamination (C d), combined pollution index (CPI) and PERI) showed that overall metal concentrations in the tropical river are still within safe limit. River metal pollution was investigated. Anthropogenic activities were contributors of the metal pollution. Geochemical indexes showed that metals are within the safe limit

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Mapping child growth failure across low- and middle-income countries

Child growth failure (CGF), manifested as stunting, wasting, and underweight, is associated with high 5 mortality and increased risks of cognitive, physical, and metabolic impairments. Children in low- and middle-income countries (LMICs) face the highest levels of CGF globally. Here we illustrate national and subnational variation of under-5 CGF indicators across LMICs, providing 2000–2017 annual estimates mapped at a high spatial resolution and aggregated to policy-relevant administrative units and national levels. Despite remarkable declines over the study period, many LMICs remain far from the World Health 10 Organization’s ambitious Global Nutrition Targets to reduce stunting by 40% and wasting to less than 5% by 2025. Large disparities in prevalence and rates of progress exist across regions, countries, and within countries; our maps identify areas where high prevalence persists even within nations otherwise succeeding in reducing overall CGF prevalence. By highlighting where subnational disparities exist and the highest-need populations reside, these geospatial estimates can support policy-makers in planning locally 15 tailored interventions and efficient directing of resources to accelerate progress in reducing CGF and its health implications

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic