Early age onset familial Mediterranean fever associated with compound heterozygote M680I /M694V mutation

Familial Mediterranean fever (FMF) is an autosomal recessive genetic disorder characterized by acute episodes of fever accompanied by severe abdominal pain, pleurisy, arthritis, and skin rash. The clinicalvariability of the disease has been mainly attributed to MEFV gene allelic heterogeneity and partly to the influence of additional genetic and/or environmental factors. We present a 6-month-old boy who suffered from recurrent fever accompanied by abdominal pain and skin rashes. Molecular screening by polymerase chain reaction (PCR) and sequencing for common mutations causing FMF revealed presence of a 694V/680I compound heterozygote mutation in exon 10 of the related gene. This is thefirst report of early onset and severe phenotype FMF case associated with a 694V/680I compound heterozygote mutation

Perspectives and attitudes of breastfeeding women using herbal galactagogues during breastfeeding: a qualitative study

Some herbal galactagogues have gained reputation and recognition by the public and health professionals as alternative approaches to increase breast milk supply. This study explores the perspectives and attitudes of breastfeeding women towards the use of herbal galactagogues while breastfeeding, their experiences, and why and how they have chosen an alternative option over conventional treatments to enhance breastfeeding performance. This exploratory research was conducted through in-depth semi-structured interviews with women living in Perth, Western Australia, who were using one or more herbal galactagogues during breastfeeding. Purposeful and subsequent snowball sampling methods were employed to recruit participants. All interviews, facilitated by an interview guide, were audio-recorded, then transcribed verbatim. Thematic analysis was used to analyse qualitative data to construct themes and subthemes.The perspectives and attitudes of the 20 participants are classified under three main headings: i) use of herbal medicines during breastfeeding, ii) available herbal medicines resources, and iii) level of breastfeeding support received. Throughout the interviews, participants described how their perseverance and determination to breastfeed, as well as concerns over breastfed infants’ safety with conventional treatments, influenced their choice of therapy. A sense of self-efficacy and autonomy over their own health needs was seen as influential to their confidence level, supported self-empowerment and provided reassurance throughout the breastfeeding journey. There was also a desire for more evidence-based information and expectations of health professionals to provide credible and reliable information regarding the use of herbal medicines during breastfeeding. This study has enhanced our understanding of the perspectives and attitudes of breastfeeding women towards the use of herbal medicines, in particular galactagogues, while breastfeeding. The positive attitudes of breastfeeding women identified in this study highlight the need for further research into evaluating the safety and efficacy of commonly used herbal galactagogues, whilst the negative views on breastfeeding education should be taken into consideration when implementing or improving breastfeeding-related health policies

Prioritizing solutions to incorporate Prosthetics and Orthotics services into Iranian health benefits package: Using an analytic hierarchy process

Introduction: Health benefits package (HBP) is regarded as one of the main dimensions of health financing strategy. Even with increasing demands for prosthetics and orthotics (P&O) services to approximately 0.5% of the world’s population, only 15% of vulnerable groups have the chance to make use of such benefits. Inadequate coverage of P&O services in the HBP is accordingly one of the leading reasons for this situation in many countries, including Iran. Aims: The main objective of this study was to find and prioritize solutions in order to facilitate and promote P&O services in the Iranian HBP. Study design: A mixed-methods (qualitative-quantitative) research design was employed in this study. Methods: This study was conducted in two phases. First, semi-structured interviews were undertaken to retrieve potential solutions. Then an analytic hierarchy process (AHP) reflecting on seven criteria of acceptability, effectiveness, time, cost, feasibility, burden of disease, and fairness was performed to prioritize them. Results: In total, 26 individuals participated in semi-structured interviews and several policy solutions were proposed. Following the AHP, preventive interventions, infant-specific interventions, inpatient interventions, interventions until 6 years of age, and emergency interventions gained the highest priority to incorporate in the Iranian HBP. Conclusion: A number of policy solutions were explored and prioritized for P&O services in the Iranian HBP. Our findings provide a framework for decision- and policy-makers in Iran and other countries aiming to curb the financial burdens of P&O users, especially in vulnerable group

The Onset Time Of Lactation After Delivery

Background: As any delay in the onset of milk production and ejection in the first few days after delivery can cause breast-feeding failure, this study has been done to determine factors that may affect the onset time of lactation in vaginal and cesarean section deliveries with and without labor pain (elective). Methods: 300 partUJient mothers selected from two private and university hospitals were divided in three separate groups (each consisted of 100 cases) according to their delivery type [vaginal and cesarean section with and without pain (elective)]. Interfering factors like mothers' ornewboms' illnesses were omitted, the needed infom1ation about filling ofbreasts and milk ejection was given to mothers before partw·ition, then a questionnaire was provided and offered to them, data collected and statistical analysis cruTied out. Results: There was a meaningful difference between average time of milk-ejection in groups with different types of delivery (p= 0.00 I), but no difference was found between elective cesarean section and cesarean section with labor pain (p= 0.741 ). We found that milk-ejection time has a strong COITelation with type of delivery (r= O.SlO) and also the time of taking the neonate back to mother (r = 0.256), and this correlation is statistically meaningful (p= 0.000). Conclusion: Any kind of stress including cesarean section may postpone milk ~jection by hmmonal inhibition for a few days after delivery and this will result in newborn weight loss and fai lure of nursing by the mother. So, to support breast feeding in our country, the rate of cesarean section must be wisely diminished, vaginal delivery encouraged, and after deli very every newborn taken back to his or her mother as soon as possible for nursing

Comparison of Creatin Phosphokinase changes between newborns delivered by vaginal and cesarean section

Background: Creatin Kinase (CK) is an enzyme that participates in the usage and storage of energy cycle in tissue especially the muscles. Elevation of CK in the serum of the newborns is due to CK-MB isoenzyme, which increases in skeletal muscles of the fetus. Muscle activity has an important role in the elevation of creatin kinase level, and there is a direct relationship between muscular activity and CK level, since vaginal delivery leads to increased pressure on skeletal muscles of the newborns this study was done to determine CK changes among newborns delivered by vaginal and Cesarean section.Methods: 180 term neonates who were born in Al-Zahra hospital of Tabriz University of Medical Sciences from March to August 2005 were chosen. This selection was done in such a manner that we could divide cases into three groups of 60 neonates upon their method of delivery including vaginal, elective and urgent Cesarean Section, and every group was divided in two subgroups upon their Apgar score as being low or high each containing 30 newborns. One hour after delivery 1 milliliter blood was taken from the umbilical cord of neonates and titers of CK were analyzed by spectrophotometer method. Findings: There was a meaningful difference between the mean level of Creatin Kinase in the group of neonates with low Apgar score in comparison with high Apgar score (P=0.001). Also the mean level of CK was higher in neonates delivered via elective Cesarean (P=0.002) and this difference was meaningful in Cesarean section with labor pain (P=0.001) in comparison with vaginal delivery. As a whole there was a meaningful difference between Cesarean section and vaginal delivery (P=0.001), but no difference was found between elective and Cesarean section with labor pain (P=0.1).Conclusions: This study shows that the level of CK is higher in neonates with low Apgar score regardless of the method of delivery and probably this finding is the results of brain, cardiac and muscles hypoxia of the newborns. Also total CK is elevated in neonates born via Cesarean section (elective and urgent), this alteration may be the result of anesthesia and or mother tissue injury by surgerical procedure and that was transferred to the neonates

<i>In vitro </i>microtuberization in potato (<i>Solanum tuberosum </i>L.) cultivars

1245-1247Mechanism of microtuberization in three elite cultivars kufri badhsha (KB), kufri chandramukhi (KCM) and kufri jawahar (KJ) of potato was studied. Sprouts of all the three cultivars were used to obtain in vitro shoot cultures. MS medium supplemented with chlorocholine chloride was found to be most suitable for all the cultivars. Maximum tuberization was obtained under incubation conditions of continuous darkness at 20°±1°C. The highest number of micro-tubers per plant basis was produced under continuous darkness and KCM recorded the highest yield of micro-tubers and was found significantly superior to KJ and KB