Food-dependent exercise-induced anaphylaxis due to wheat in a young woman

Food Dependent Exercise-Induced Allergy is a rare condition. However, the occurrence of anaphylaxis is increasing especially in young people. The diagnosis of anaphylaxis is based on clinical criteria and can be supported by laboratory tests such as serum tryptase and positive skin test results for specific IgE to potential triggering allergens. Anaphylaxis prevention needs strict avoidance of confirmed relevant allergen. Food-exercise challenge test may be an acceptable method for diagnosis of Food Dependent Exercise-Induced Allergy and dietary elimination of food is recommended to manage it. In this study, a 32 year-old woman visited the allergy clinic with a history of several episodes of hives since 11 years ago and 3 life-threatening attacks of anaphylaxis during the previous 6 months. The onsets of majority of these attacks were due to physical activity after breakfast. On Blood RAST test, the panel of common food Allergens was used and she had positive test only to wheat flour. On skin prick tests for common food allergens she showed a 6 millimeter wheal with 14 mm flare to Wheat Extract. The rest of allergens were negative. The patient was diagnosed as wheat-dependent exercise-induced, and all foods containing wheat were omitted from her diet. In this report we emphasized on the importance of careful history taking in anaphylaxis diagnosis

Microbiology of Upper Respiratory Tract Pathogens in Cystic Fibrosis Patients

Cystic fibrosis (CF) is an inherited genetic disorder with chronic respiratory manifestations. The respiratory symptoms may start very early in life. The aim of this study was to evaluate the prevalence and antimicrobial susceptibility of respiratory pathogens in children with CF. In this clinical laboratory study, 100 CF patients were prospectively collected from February 2016 to March 2017. Microbiological cultures and antimicrobial susceptibility tests of the most frequently isolated upper respiratory tract bacteria were performed. According to the results of this study, Staphylococcus aureus was the most frequent microorganism 24 (24%) in CF patients followed by Pseudomonas aeruginosa 21 (21%). In children younger than one-year-old, Enterococci and Klebsiella pneumonia were the most frequently isolated pathogens. In other age groups, Staphylococcus aureus and Pseudomonas aeroginosa were most frequent. All pathogens showed more sensitivity to Ceftriaxone, Amikacin, and Ceftazidime. However, Staphylococcus aureus was most sensitive to Cefoxitin, Clindamycin, and Linezolid and Pseudomonas aeroginosa were most sensitive to Amikacin, Ceftazidime, and Ceftriaxone respectively. In conclusion, Staphylococcus aureus and Pseudomonas aeroginosa were the most frequent microorganisms in CF patients in our population. In patients younger than one-year-old, the most frequent pathogens were Enterococci and Klebsiella. All pathogens and Pseudomonas aeroginosa were sensitive to Ceftriaxone, Amikacin, and Ceftazidime but Staphylococcus aureus was most sensitive to Cefoxitin, Clindamycin, and Linezolid respectively. It seems that Ceftriaxone, Amikacin, and Ceftazidime are the most suitable antibiotics for the treatment of pulmonary infections in CF patients in our population

The effect of supermint oral drop (peppermint essence) on the patients’ pain and their satisfaction after colonoscopy

زمینه و هدف: کولونوسکپی روشی تهاجمی است که برای بیمار به ویژه کودکان ناراحت کننده و دردناک است. هدف از تحقیق حاضر بررسی میزان تأثیر تجویز قطره خوراکی سوپرمینت (اسانس نعناع) بر درد و رضایتمندی بیمار پس از عمل کولونوسکوپی بوده است. روش بررسی: در این مطالعه کارآزمایی بالینی، 101 بیمار کاندید عمل کولونوسکوپی به روش در دسترس انتخاب و به طور تصادفی به دو گروه تقسیم شدند. به گروه شاهد(50 نفر) دارویی تجویز نشد. به گروه مورد (51 نفر)، 20 قطره خوراکی سوپرمینت 30 دقیقه قبل از کولونوسکوپی خورانده شد. پس از عمل کولونوسکوپی با استفاده از پرسشنامه استاندارد میزان درد و رضایتمندی بیمار بررسی شد. داده ها توسط آزمون توصیفی و تحلیلی (t-test) مورد تجزیه و تحلیل قرار گرفت. یافته ها: میانگین میزان دردهای شکمی در گروه شاهد 527/0±500/2 و در گروه مورد 491/0± 625/1 از نمره 10 بود (05/0

A New Era of the Fresh Start

The Journal of Reviews in Clinical Medicine (RCM) is the leading journal of its type at Mashhad University of Medical Sciences covering all aspects of the natural and clinical sciences, which may be a matter of concern for the related specialists. The scope of the journal defines the RCM Publishing Group's ambition to take a considerable step forward in constructing a valuable medical resource for both authors and readers. It offers the practical and the professional support for clinicians to spread the critical and constructive analysis in a specific field through extended explanations on the topic. In other words, it pragmatically provides the readers with recent advances and discoveries by means of previously published literature or data. Furthermore, the journal expects to generate the ideas of where the researches might go in the future. The RCM Publishing Group hopes to be a gateway to the positive outlook of research in any medical discipline. In this issue, we present the wide range of researches in different fields of medicine, which describe briefly below. Acute lymphoblastic leukemia (ALL) is one of the most common pediatric disorders that affected the large number of patients. Along with the high rate of treatment success, a modified and individualized diagnostic test can significantly increase the survival rate. Therefore, cytogenetic and molecular tests might play an important role in the prognosis of ALL by detecting the special genetic polymorphism affecting drug metabolism and its subsequent effective level and toxicity. Differential diagnosis between benign and malignant brain tumors has been a dilemma for appropriate management and treatment for years. Magnetic resonance spectroscopy is now addressing the need for noninvasive methods of measuring human brain function. Chronic kidney diseases such as renal failure are considered as the devastating medical problems in different age group. The long-term appropriate medical care especially nutritional support can exert a positive effect on patients` health. Furthermore, the use of tranexamic acid in cardiac surgery and its complications such as bleeding, the use of herbal medicine in the treatment of refractive seizure in children, the different causes of coma in pediatric medicine and also peripheral nervous system destruction occurred in systemic vasculitis has been discussed. Finally, we focus on cyclooxygenase 2 (COX2) as a major overexpressing enzyme in cancers. Thus, clinicians may consider COX 2 inhibitors as one of the therapeutic agents.  The previous studies evaluated this role are reviewed in Wilms` tumor. Above all, we want to express our appreciation to all those who have submitted their manuscripts to RCM journal, all the Editorial board members and all the dedicated staffs for their loyal and precious cooperation. We look forward to attracting more specialists, residents and medical students to make RCM a really international and multicultural journal. Frankly, this has promised to be a far more difficult task than we anticipated. However, we will continue our efforts to take the first steps in this evolution more effectively

Cholelithiasis in Children: A Diagnostic and Therapeutic Approach

Context: Although cholelithiasis is not a common condition in children, recent studies have documented an increasing incidence rate, owing to the development of diagnostic tools. The prevalence of cholelithiasis in children has been reported to be 0.13% - 0.3%, whereas in obese children and adolescents, the prevalence rate has been estimated at 2% - 6.1%. In this study, we aimed to review cholelithiasis in children. The gathered results could be useful in finding a suitable method and proper clinical practice for this complication. Evidence Acquisition: For literature review, international databases, including PubMed and Google Scholar, were searched, using keyword combinations, e.g., “cholelithiasis in children”, “gallstone in children”, and “childhood cholelithiasis”, to review diagnostic and therapeutic approaches for cholelithiasis in children from 2006 to 2016. Also, some articles were retrieved through hand searching and reviewing the reference lists of papers, regardless of the date of publication. Abstracts, duplicates, and articles irrelevant to childhood cholelithiasis were excluded. Results: A total of 36 out of 93 articles were reviewed. The results showed that the prevalence of childhood cholelithiasis varies in different communities, with a global rate of 1.9%. Most cases of cholelithiasis in children were associated with underlying diseases. Hemolytic diseases, hereditary blood disorders, and cirrhosis were among the main causes of cholelithiasis in children. Cholelithiasis was detected incidentally or via diagnostic evaluations due to the presentation of symptoms. Conclusions: Although evaluation of the underlying causes of gallstone formation and appropriate diagnostic/therapeutic implications is still a challenging issue in the management of childhood cholelithiasis, in asymptomatic cases or those with gallstones of certain sizes, it is only recommended to monitor the disease or rule out the underlying causes. It should be noted that long periods of diagnostic and therapeutic approaches can impose stress and tension on families

Citation Analysis of Iranian Journal of Basic Medical Sciences in ISI Web of Knowledge, Scopus, and Google Scholar

Objective(s): Citation tracking is an important method to analyze the scientific impact of journal articles and can be done through Scopus (SC), Google Scholar (GS), or ISI web of knowledge (WOS). In the current study, we analyzed the citations to 2011-2012 articles of Iranian Journal of Basic Medical Sciences (IJBMS) in these three resources.   Material and Methods: The relevant data from SC, GS, and WOS official websites. Total number of citations, their overlap and unique citations of these three recourses were evaluated. Results: WOS and SC covered 100% and GS covered 97% of the IJBMS items. Totally, 37 articles were cited at least once in one of the studied resources. Total number of citations were 20, 30, and 59 in WOS, SC, and GS respectively. Forty citations of GS, 6 citation of SC, and 2 citations of WOS were unique. Conclusion: Every scientific resource has its own inaccuracies in providing citation analysis information. Citation analysis studies are better to be done each year to correct any inaccuracy as soon as possible. IJBMS has gained considerable scientific attention from wide range of high impact journals and through citation tracking method; this visibility can be traced more thoroughly

Probiotics in the Treatment of Acute Diarrhea in Young Children

Background: Well-controlled clinical studies in the developedworld have shown that probiotics can shorten the duration ofacute non-bacterial diarrhea. We aimed to evaluate the efficacyof a probiotic consisting of a mixture of Lactobacillus acidophilusand Bifidobacterium bifidum in the treatment of young childrenwith acute diarrhea in Mashad, IranMethods: Sixty-two hospital inpatients aged 6 to 36 monthswith acute non-bloody, non-bacterial diarrhea of a less than 2days' duration and moderate dehydration were enrolled.Thirty-two were treated with probiotic powder three timesdaily for 5 days plus the routine oral rehydration solution(study group) and the other 30 were given a placebo plus oralrehydration solution (control group).Results: Mean age at the time of admission was 14.5±7months for the study group and 13.7±6 months for controls.The mean duration of diarrhea was 3.4 days in the study groupand 4.5 days in controls (P = 0.027). Duration of hospital admissionwas 2.1±0.7 days in the probiotic group comparedwith 2.7±0.6 days in the control group (P = 0.033). Averageweight gain was 425 ± 9 and 370 ± 85 g for the study and controlgroups, respectively. Average reduction in the frequencyof diarrhea per day was 4.4 ± 1.5 times for the study groupand 3.6 ± 1.3 times for the control group.Conclusion: Lactobacillus acidophilus and Bifidobacteriumbifidum shortened the duration of diarrhea and hospital stay,and normalized stool frequency. The use of probiotics mightbe recommended for treating acute diarrhea in young children

Cleft lip and Palate: A 30-year Epidemiologic Study in North-East of Iran

Introduction: Cleft lip and palate are among the most common congenital anomalies worldwide. This study was conducted in order to explore the incidence and related factors of cleft lip and/or palate (CL/P) among live births in Mashhad, North-Eastern Iran.   Materials and Methods: In this cross-sectional study, records of 28,519 infants born between March 1982 and March 2011 at three major hospitals in Mashhad were screened for oral clefts. Clinical and demographic factors relating to diagnosed cases, including birth date, gender, birth weight, maternal age, number of pregnancies, type and side of cleft and presence of other congenital anomalies were recorded for analysis.   Results: The overall incidence of CL/P was 1.9 per 1,000 live births. Cleft lip associated with cleft palate (CLP) was the most prevalent type of cleft (50%), followed by isolated cleft lip         (35.2%) and isolated cleft palate (14.8%). A total of 92.6% of oral clefts were bilateral and 5.5% were located on the right side. In addition, clefts were found to be more common in male than female births (male/female ratio=2.3). The rate of associated congenital anomalies in CL/P newborns was 37%. No significant differences were observed in the incidence of oral clefts across three decades of study; except for CLP which was significantly more prevalent between 2002–2011 (P=0.027). There were no significant differences with regard to season of birth, associated anomalies or maternal age of affected newborns in the three time periods of the study. Furthermore, maternal age and number of pregnancies were not significantly different among the three types of cleft (P=0.43 and P=0.91, respectively). Although the mean birth weight of patients affected with isolated cleft palate was considerably lower than that of the other two types of cleft, the difference was not statistically significant (P=0.05).    Conclusion:  This study indicates a frequency of CL/P close to the findings in East Asian countries and higher than some previous reports from Iran, European and American countries. Ethnicity-related genetic factors may have a role in the conflicting results obtained from different populations

Cleft lip and Palate: A 30-year Epidemiologic Study in North-East of Iran

Introduction: Cleft lip and palate are among the most common congenital anomalies worldwide. This study was conducted in order to explore the incidence and related factors of cleft lip and/or palate (CL/P) among live births in Mashhad, North-Eastern Iran.   Materials and Methods: In this cross-sectional study, records of 28,519 infants born between March 1982 and March 2011 at three major hospitals in Mashhad were screened for oral clefts. Clinical and demographic factors relating to diagnosed cases, including birth date, gender, birth weight, maternal age, number of pregnancies, type and side of cleft and presence of other congenital anomalies were recorded for analysis.   Results: The overall incidence of CL/P was 1.9 per 1,000 live births. Cleft lip associated with cleft palate (CLP) was the most prevalent type of cleft (50%), followed by isolated cleft lip         (35.2%) and isolated cleft palate (14.8%). A total of 92.6% of oral clefts were bilateral and 5.5% were located on the right side. In addition, clefts were found to be more common in male than female births (male/female ratio=2.3). The rate of associated congenital anomalies in CL/P newborns was 37%. No significant differences were observed in the incidence of oral clefts across three decades of study; except for CLP which was significantly more prevalent between 2002–2011 (P=0.027). There were no significant differences with regard to season of birth, associated anomalies or maternal age of affected newborns in the three time periods of the study. Furthermore, maternal age and number of pregnancies were not significantly different among the three types of cleft (P=0.43 and P=0.91, respectively). Although the mean birth weight of patients affected with isolated cleft palate was considerably lower than that of the other two types of cleft, the difference was not statistically significant (P=0.05).    Conclusion:  This study indicates a frequency of CL/P close to the findings in East Asian countries and higher than some previous reports from Iran, European and American countries. Ethnicity-related genetic factors may have a role in the conflicting results obtained from different populations