Evaluation of urinary tract infections following

زمینه و هدف: عفونت ادراری یک مشکل شایع و جدی در نوزادان است. مطالعات نشان داده اند که زردی می تواند یک علامت زودرس عفونت ادراری باشد. هدف از این مطالعه بررسی شیوع عفونت ادراری در نوزادان مبتلا به زردی، سن بروز، شدت زردی، علایم و عوارض هیپربیلی روبینمی غیر مستقیم ناشی از عفونت ادراری در این نوزادان می باشد. روش بررسی: در این مطالعه توصیفی- تحلیلی در سالهای 1382 الی 1388، کلیه نوزادان مراجعه کننده به بیمارستان قائم مشهد بعلت زردی بدون علامت از نظر عفونت ادراری بررسی شدند. از نوزادان مورد مطالعه آزمایش بیلی روبین مستقیم و غیر مستقیم، کامل ادرار و کشت ادرار و سایر آزمایشات لازم انجام گردید. در اغلب نوزادان با عفونت ادراری سونوگرافی کلیه ها انجام گردید. اطلاعات مربوط به حاملگی، زایمان و حوادث پس از تولد ثبت شد. داده ها با استفاده از تست دقیق فیشر، کای دو و t دانشجویی مورد تجزیه و تحلیل قرار گرفت. یافته ها: از 1487 نوزاد دچار زردی ، 1061 نوزاد از نظر عفونت ادراری بررسی گردیدند که 74 مورد (97/6) عفونت گزارش گردید. سن بروز زردی، سن مراجعه و سن بهبودی نوزادان دچار عفونت ادراری بطور قابل ملاحظه ای دیرتر از نوزادان فاقد عفونت بود (05/0

Evaluation of acute renal failure in neonates bedridden in Neonatal Intensive Care Unite (NICU) in Ghaem hospital

چکیده: زمینه و هدف: نارسایی حاد کلیه بصورت یک کاهش ناگهانی شدید در GFR (Glomerular Filtration Rate) تعریف شده است و در بخش نوزادان شایع می باشد. این مطالعه با هدف بررسی انسیدانس، اتیولوژی، شیوه افتراق انواع نارسایی کلیه در نوزادان انجام شد. روش بررسی: در یک مطالعه توصیفی، 750 نوزاد بستری شده در بخش مراقبت های ویژه نوزادان بیمارستان قائم(عج) مشهد، از دی ماه 1384 تا دی ماه 1385، با تشخیص نارسایی کلیوی و بر اساس سونوگرافی و پاسخ به مایع درمانی به دو گروه رنال و پره نال تقسیم بندی شدند. این نوزادان از نظر ریسک فاکتورهای پره ناتال، پری ناتال، پست ناتال ریسک فاکتورهای مادری و محیطی و اندکس های مختلف سرمی و ادراری بررسی و داده ها به کمک آمار توصیفی تحلیل شدند. یافته ها: از 750 بیمار پذیرش شده 38 نوزاد (5) تشخیص نارسایی کلیوی داشتند، که 29 نفر (4/76) نارسایی پره رنال و 9 نفر (6/23) نارسایی رنال داشتند. فاکتورهای مستعد کننده همراه با نارسایی کلیوی شامل آسفیکسی (42)، سندرم غشا هیالن مامبران ((RDS (7/26)، سپسیس (13)، دهیدراتاسیون شدید (13) و بیماری مادرزادی قلبی (2/5) بودند. نتیجه گیری: نارسایی حاد کلیه یک علت مهم مرگ در نوزادان می باشد. شناسایی فاکتورهای مستعد کننده مثل نارس بودن، آسفیکسی، RDS، ونتیلاسیون و کنترل دقیق وضعیت کلیه های نوزادان در این شرایط ضروری است. پیش آگهی نوع پره رنال در صورت مایع درمانی مناسب، خوب بوده ولی در نوع رنال پیش آگهی وابسته به بیمار زمینه‌ای می باشد و مرگ و میر بالاست

Effect of peppermint on pediatrics’ pain under endoscopic examination of the large bowel

Introduction: Colonoscopy is a painful and invasive technique for patients especially for pediatrics. Peppermint has analgesic effect. Therefore, we wish to look at the effect of peppermint essence on the patients&rsquo; satisfaction and pain after colonoscopy. Methods: This clinical trial study was performed on 100 patient&rsquo;s candidate for colonoscopy. Patients were randomly divided into two groups. Control group received no drug. Case group was administrated supermint essence thirty minutes before colonoscopy. A valid questionnaire was filled during the colonoscopy for patient&rsquo;s satisfaction and pain evaluation. Results: The mean value of abdominal pain was 0.527&plusmn;2.500 in control group and 1.625&plusmn;0.491 in case group after treatment (p&lt;0.05). Degree of satisfaction was 8 and 17.6 percent in control and case groups, respectively. Mean value of satisfaction in control group was 1.833&plusmn;0.389 that was significantly different from case group (2.607&plusmn;0.566) (p&lt;0.05). Duration of colonoscopy in control group was significantly higher than the one in case group (p&lt;0.05). Conclusion: Our findings showed that peppermint essence causes an increasing in satisfaction as well as a reduction in pain in patients under the colonoscopy.</p

Assessment of check dams’ role in flood hazard mapping in a semi-arid environment

This study aimed to examine flood hazard zoning and assess the role of check dams as effective hydraulic structures in reducing flood hazards. To this end, factors associated with topographic, hydrologic and human characteristics were used to develop indices for flood mapping and assessment. These indices and their components were weighed for flood hazard zoning using two methods: (i) a multi-criterion decision-making model in fuzzy logic and (ii) entropy weight. After preparing the flood hazard map by using the above indices and methods, the characteristics of the change‐point were used to assess the role of the check dams in reducing flood risk. The method was used in the Ilanlu catchment, located in the northwest of Hamadan province, Iran, where it is prone to frequent flood events. The results showed that the area of ‘very low’, ‘low’ and ‘moderate’ flood hazard zones increased from about 2.2% to 7.3%, 8.6% to 19.6% and 22.7% to 31.2% after the construction of check dams, respectively. Moreover, the area of ‘high’ and ‘very high’ flood hazard zones decreased from 39.8% to 29.6%, and 26.7% to 12.2%, respectively

Avoiding cardiopulmonary bypass in extracardiac cavopulmonary connection: Does it really matter?

ObjectivesWe examined the effect of avoiding cardiopulmonary bypass on the early outcome variables after fenestrated extracardiac total cavopulmonary connection.MethodsBetween May 2001 and January 2009, 102 patients with univentricular heart physiology underwent fenestrated extracardiac total cavopulmonary connection. Patients were divided into one of 2 groups: the cardiopulmonary bypass (n = 48) group and the no cardiopulmonary bypass (n = 54) group. In both groups there were patients with primary and staged fenestrated extracardiac total cavopulmonary connection. Duration of mechanical ventilation, pleural effusion, hemodynamic status, incidence of arrhythmia, and mortality were compared between the 2 groups.ResultsBoth groups were matched, except for more cases of tricuspid atresia in the no cardiopulmonary bypass group (P = .014) compared with other diagnostic morphologies and higher preoperative hemoglobin levels in the no cardiopulmonary bypass group (P = .01). Avoiding cardiopulmonary bypass did not reveal any significant effect on postoperative outcomes. A cardiopulmonary bypass time of more than 120 minutes caused not only a meaningful increase in the mean of mechanical ventilation duration (35 ± 9.6 vs 13 ± 2.1 hours, P = .026) but also increased the incidence of mechanical ventilation for more than 12 hours (P = .04). Bypass time of more than 120 minutes did not have influence on any other postoperative variables.ConclusionAvoiding cardiopulmonary bypass in fenestrated extracardiac total cavopulmonary connection had no direct effect on the early outcome variables

Influenza: A Unique Disease

Dear Editor-in-Chief, Influenza, commonly known as the flu, is an infectious disease caused by an influenza virus (1). Symptoms can be mild to severe (2). The most common symptoms include: high fever, runny nose, sore throat, muscle pains, headache, coughing, sneezing, and feeling tired (1). Three of the four types of influenza viruses affect people, Type A, Type B, and Type C (3, 4). Type D has not been known to infect people, but is believed to have the potential to do so (4, 5). Usually, the virus is spread through the air from coughs or sneezes (1). Influenza spreads around the world in yearly outbreaks, resulting in about three to five million cases of severe illness and about 250,000 to 500,000 deaths (1). About 20% of unvaccinated children, and 10% of unvaccinated adults are infected each year (6). In the northern and southern parts of the world, outbreaks occur mainly in the winter, while around the Equator, outbreaks may occur at any time of the year (1). Death occurs mostly in the young, the old, and those with other health problems (1). Larger outbreaks known as pandemics are less frequent (3). In the 20th century, three influenza pandemics occurred: Spanish influenzain 1918 (~50 million deaths), Asian influenza in 1957 (two million deaths), and Hong Kong influenza in 1968 (one million deaths) (7). The World Health Organization (WHO) declared an outbreak of a new type of influenza A (H1N1) to be a pandemic in June 2009 (8)

Expression of Endothelial Nitric Oxide Synthase in Testicular Cells of Men with Obstructive Azoospermia; a Case-Control Study

Introduction: Obstructive azoospermia is one of the causes of post-testicular infertility in men and previous studies have reported inconsistent levels of endothelial nitric oxide synthase (eNOS) enzyme in these patients. Accordingly, the present study aimed to provide further evidence on the expression of eNOS enzyme in patients with azoospermia. Materials and Methods: In this case-control study, 10 patients, who were diagnosed with azoospermia and were referred to the infertility center for treatment or diagnosis, and 7 healthy fertile men were recruited. An informed written consent was obtained from included subjects and they underwent testicular biopsies. Samples were assessed via immunohistochemical methods to determine their levels of eNOS expression. Results: Both leydig and sertoli cells were found to express eNOS, while this enzyme was not expressed in normal germinal cells. The only significant difference between the two groups was the level of eNOS expression in sertoli cells which was found to be higher in patients with obstructive azoospermia compared to the control group (P&lt;0.001). Conclusion: According to the results of this study, sertoli cells and their interactions with germinal cells of seminiferous tubule might play an important role in sperm quality and a subsequent successful fertilization

Early Risk stratification for Arrhythmic death in Patients with ST-Elevation Myocardial Infarction

BACKGROUND: Sudden cardiac death is a leading cause of death in patients with ST-elevation myocardial infarction (MI). According to high cost of modern therapeutic modalities it is of paramount importance to define protocols for risk stratification of post-MI patients before considering expensive devices such as implantable cardioverter-defibrillator. METHODS: One hundred and thirty seven patients with acute ST-elevation MI were selected and underwent echocardiographic study, holter monitoring and signal-averaged electrocardiography (SAECG). Then, the patients were followed for 12 ±3 months. RESULTS: During follow-up, 13 deaths (9.5%) occurred; nine cases happened as sudden cardiac death (6.6%). The effect of ejection fraction (EF) less than 40% on occurrence of arrhythmic events was significant (P<0.001). Sensitivity and positive predictive value of EF<40% was 100% and 76.95% respectively. Although with lesser sensitivity and predictive power than EF<40%, abnormal heart rate variability (HRV) and SAECG had also significant effects on occurrence of sudden death (P=0.02 and P=0.003 respectively). Nonsustained ventricular tachycardia was not significantly related to risk of sudden death in this study (P=0.20). CONCLUSION: This study indicated that EF less than 40% is the most powerful predictor of sudden cardiac death in post MI patients. Abnormal HRV and SAECG are also important predictors and can be added to EF for better risk stratification

Curriculum Development in Pediatric Education: A Systematic Review ‏

Training of Pediatric residents is a dynamic process which should be changed as the nature and epidemiology of pediatric diseases change. We aimed to determine the educational needs of Pediatric residents. Materials and Methods: In this systematic review after choosing appropriate keywords and their combinations,, an extensive search was done in databases of Medline, EMBASE, ProQuest and Ovid, Web of Science, Cochrane Library, Scopus, and CINAHL as well as Persian databases, such as Magiran, Medlib, and SID, using equivalent keywords in Persian, to find related articles to Pediatric education, until October 2018. The full text of the articles was studied by two reviewer and their main findings were extracted and categorized. Quality of studies was evaluated using STROBE statement. Results: Data from nine studies were entered in this study. According to the findings, the necessity of changing Pediatric resident curriculum seems to be necessary in accordance with the conditions of the community. So, subspecialties for Pediatric resident training should be considered; these items include: cardiology, development, hematology and oncology, endocrinology, infectious diseases, respirology, palliative care of neurology, emergency, neonatology, gastroenterology, nephrology, gynecology, child psychiatry, behavioral psychology, surgical specialties, orthopedics and adolescents, dermatology, ophthalmology, and otolaryngology.Conclusion: Pediatric residents need sufficient, specific training to enable them to competently investigate and manage of children complaints. So, Pediatric resident curriculum should be developed to be in according to Pediatric educational needs, and also to support the learner’s personal development by contributing to enhancing their self-respect and confidence, motivation and aspirations