The Prevalence of Clubfoot in the Neonates who were Referred to the Emergency Department of Mofid Children Hospital

ObjectiveClub-foot is one of the most prevalent congenital anomalies of the lowerextremities. Since there is no epidemiologic study on the prevalence of thisdisease in Iran, we decided to assess it in a sample population in Tehran.Materials and MethodsWe assessed all neonates who were referred to the emergency department ofmofid children hospital between October 2007 and November 2008, due to apaediatric emergency problem. None of the patients had chief complaints oflower extremity deformity.ResultsDuring this time period (13 months), we could examine 682 neonates. Noneof the parents of these neonates had complaints regarding anomaly of lowerextremities of their neonates at the time of the emergency referral. Of them, 371(54%) were female and 311 (46%) were male. The age of the mother at the timeof pregnancy was 35 yr in 86 (13%) neonates. There was a previous historyof clubfoot in the siblings of one of the neonates who was under orthopaedictreatment.Among all these neonates, we found two cases of clubfoot (0.3%), with bilateralinvolvement. In one of these cases, the older sibling also had clubfoot.ConclusionThe incidence of clubfoot has been reported between 0.39 and 6 cases in 1000live birth in the literature. In the present study, we found a prevalence of 0.3 forclubfoot in every 1000 neonates.Keywords: Clubfoot; prevalence; congenital; talipesequinovarus.  

Detection of extensively drug-resistant and hypervirulent Klebsiella pneumoniae ST15, ST147, ST377 and ST442 in Iran

In this study, we focused on the emergence of extensively drug-resistant (XDR), pandrug-resistant (PDR), and hypervirulent Klebsiella pneumoniae (hvKP) in Iran. During 2018 to 2020 a total of 52 K. pneumoniae isolates were collected from different clinical specimens. The hvKP isolates were identified by PCR amplification of virulence and capsular serotype-specific genes. Hypermucoviscous K. pneumoniae (hmKP) were identified by string test. Carbapenem-resistant hvKP (CR-hvKP), multidrug-resistant hvKP (MDR-hvKP), extensively drug-resistant hvKP (XDR-hvKP), and pandrug-resistant hvKP (PDR-hvKP) were determined by disc diffusion method, Carba-NP test and PCR method. XDR-hvKP isolates were typed by multilocus sequence typing (MLST). Among all K. pneumoniae isolates 14 (26.9%) were identified as hvKP and 78.6% (11/14) of them were hmKP however, none of the classic K. pneumoniae (cKP) isolates were hmKP. The predominant capsular serotype of hvKP was K2 (42.85%) followed by K1 (35.71%). The prevalence of MDR-hvKP, XDR-hvKP and PDR-hvKP isolates were 6 (42.9%), 5 (35.7%) and 1 (7.1%), respectively. ESBL production was found in 85.7% of hvKP isolates and most of them carried bla(TEM) gene (78.6%) and 6 isolates (42.9%) were CR-hvKP. Among hvKP isolates, 1 (7.1%), 2 (14.3%), 3 (21.4%), 8 (28.6%), and 11 (78.6%) carried bla(NDM-6), bla(OXA-48), bla(CTX-M), bla(SHV), and bla(TEM) genes, respectively. According to MLST analysis, 2, 1, 1, and 1 XDR-hvKP isolates belonged to ST15, ST377, ST442, and ST147, respectively. The occurrence of such isolates is deeply concerning due to the combination of hypervirulence and extensively drug-resistance or pandrug-resistance

Developing criteria for Cesarean Section using the RAND appropriateness method

<p>Abstract</p> <p>Background</p> <p>Cesarean section rates are increasing worldwide, and a rapid increase has been observed in Iran. Disagreement exists between clinicians about when to use cesarean section. We aimed to identify the appropriateness criteria for the use of cesarean section in Iran.</p> <p>Method</p> <p>A consensus development study using a modified version of the RAND Appropriateness Method (RAM). We generated scenarios from valid clinical guidelines and expert opinions. A panel of experts participated in consensus development: first round via mail (12 members), second round face-to-face (9 members). We followed the RAM recommendations for the development of the scenario lists, rating scales, and statistical analyses.</p> <p>Results</p> <p>294 scenarios relevant to cesarean section were identified. 191 scenarios were considered appropriate, of which 125 scenarios were agreed upon. The panel found cesarean inappropriate for 21% of scenarios, and 'equivocal' for 14% of scenarios.</p> <p>Conclusion</p> <p>RAM is useful for identifying stakeholder views in settings with limited resources. The participants' views on appropriateness of certain indications differed with available evidence. A large number of scenarios without agreement may partly explain why it has been difficult to curb the growth in cesarean section rate.</p

Defining Novel Molecular Events in Leiomyosarcoma

Leiomyosarcoma (LMS) is a smooth muscle neoplasm and a common histological subtype of soft tissue sarcoma (STS). LMS primarily arises in the retroperitoneum and abdominal cavity, the extremities, and the uterine wall. Current treatment outcomes are poor; consequently, personalized medicine informed by the molecular basis of the disease is needed. Here, YAF2-PRICKLE1 and ESR1-CCDC92, two novel fusion transcripts, were discovered in an LMS cell line and were detected as rare events in the tumor from which that cell line was derived. Furthermore, unbiased cluster analysis indicated that abdominal and extremity LMS transcriptomes group distinctly from uterine LMS transcriptomes, suggesting potential molecular subtypes and supporting the notion that uterine LMS is biologically distinct from abdominal and extremity LMS. Lastly, decreased FOXO4 expression correlated with increased smooth muscle differentiation in LMS. Collectively, these preliminary findings present avenues for future investigations which may facilitate diagnostic and therapeutic innovations for this disease.M.Sc

Stability, physicochemical, rheological and sensory properties of beverage containing encapsulated jujube extract with sodium alginate stabilized by sodium alginate and Gellan gum

Functional beverages are expanding in the world and since fruits are valuable food sources and are known as sources of antioxidant and phenolic compounds, their extracts and juices in these beverages can be used in different forms. The aim was to protect jujube extract by encapsulating it in the beads to enrich the beverage with phenolic compounds. On the other, gellan and alginate are known as stabilizers and suspend the particles in beverages and make fluid gel and trap particles in their structures. Gellan and sodium alginate were used to suspend alginate beads in antioxidant beverages. Four groups of samples were prepared with 0.15% and 0.3% sodium alginate concentrations and 0.05% and 0.31% gellan concentrations. The results showed that bead suspension were observed appropriately in C (0.3% alginate, 0.05% gellan gum) and D treatments (0.3% alginate, 1% gellan gum). The best sensory properties (overall acceptability= 4) were observed in C treatment (0.3% alginate, 0.05% gellan gum). On the first day of the assay, the highest pH was related to D treatment (3.83) and the lowest was related B treatment (3.57). Increasing of gellan and alginate into the beverage changed the viscosity behavior which led to show highest viscosity (417 cp in D beverage, 30 rpm) and inhibited the beads sedimentation (C and D beverages)

Decreased carO gene expression and OXA-type carbapenemases among extensively drug-resistant Acinetobacter baumannii strains isolated from burn patients in Tehran, Iran

A major challenge in the treatment of infections has been the rise of extensively drug resistance (XDR) and multidrug resistance (MDR) in Acinetobacter baumannii. The goals of this study were to determine the pattern of antimicrobial susceptibility, bla(OXA) and carO genes among burn-isolated A. baumannii strains. In this study, 100 A. baumannii strains were isolated from burn patients and their susceptibilities to different antibiotics were determined using disc diffusion testing and broth microdilution. Presence of carO gene and OXA-type carbapenemase genes was tested by PCR and sequencing. SDS-PAGE was done to survey CarO porin and the expression level of carO gene was evaluated by Real-Time PCR. A high rate of resistance to meropenem (98%), imipenem (98%) and doripenem (98%) was detected. All tested A. baumannii strains were susceptible to colistin. The results indicated that 84.9% were XDR and 97.9% of strains were MDR. In addition, all strains bore bla(OXA-51) like and bla(OXA-23) like and carO genes. Nonetheless, bla(OXA-58) like and bla(OXA-24) like genes were harbored by 0 percent and 76 percent of strains, respectively. The relative expression levels of the carO gene ranged from 0.06 to 35.01 fold lower than that of carbapenem-susceptible A. baumannii ATCC19606 and SDS - PAGE analysis of the outer membrane protein showed that all 100 isolates produced CarO. The results of current study revealed prevalence of bla(OXA) genes and changes in carO gene expression in carbapenem resistant A.baumannii

Some Factors Affecting Consumption of Fruit and Vegetable by Elderly People in Tehran

Objectives: This study was done to assess the some factors which influence on fruit and vegetable consumption among Iranian's elderly. Methods and Materials: This study was a cross sectional study which was done on 400 elderly people through a two stages sampling method. 10 elderly centers were selected from all of elderly centers in Tehran. During second stage, a systematic random sampling method was used. Data was collected using multi sectional questionnaire (Knowledge, perceived benefits and barriers, stage of readiness, daily servings of fruit and vegetable in meals, social support). One-way analysis of variance and regression analysis were used to analysis the data. Results: Fruit and vegetable intake among participations was 1.75&plusmn;1.12 servings/ day. There was no difference between men and women regarding the fruit and vegetable consumption (P>0.05). Our findings showed economic problems were the major barrier for fruit and vegetable intake and accessibility to sellers was the major farilitator. Regression analysis indicated that, a higher fruit and vegetable consumption was significantly associated with higher knowledge, safe life style, self efficacy and lower perceived barriers. Elderly people in more advanced stages of change of attitudes and health knowledge and safe life style were more likely to consume suitable amounts of fruits and vegetables in their diets. Conclusion: There are several factors which effect on fruit and vegetable consumption in Iranian's elderlies' diet. Identifying these factors could help health educators to design effective interventions

Experience of individuals with unconsummated marriage in Iran: A qualitative content analysis

Background: Sex is one of the important aspects of marriage and a way of expressing intimacy. Unconsummated marriage is a common problem whose prevalence is about 1.5% in Iran and can significantly influence marital life. Objective: This study aimed to assess the unconsummated marriage in a qualitative mode to offer new and beneficial solutions resulting from a better understanding. Materials and Methods: In this qualitative study, conventional content analysis was used. Data collection and analysis were done from April 2013 to April 2014 with 11 women and 5 men participating, who were referred to the sexual disorders clinic of Tehran Psychiatric Institute and Rasool Akram hospital of Tehran, Iran. The researchers examined the files of people referred to these clinics with the diagnosis of unconsummated marriage. Our tool for data collection was a semi-structured interview. 2 experienced faculty psychiatrists recorded all the information based on standards for reporting qualitative research guidelines. Data were analyzed using qualitative technique and coding. Guba and Lincoln criteria was used for data validity. Results: The codes of the participants' experiences were classified into 6 main categories, which include self-concept, intrapersonal factors, partner's problem, preparedness for sex, emotional relationship between couples, and the effects of unconsummated marriage on the participant's life. Conclusion: Significant experiences among women included excessive anxiety toward the society and their spouses, and among men were weakness and guilt. Being unable to have sex negatively affected their view of life and caused great harm to their self-perception. Participants personality traits and their self-concept, and attitude toward their partners were important issues