Is There a Relationship between the Types and Severity of Acute Traumatic Brain Injuries in Children and Adolescents and the Incidence of Cardiac Arrhythmias?

Background: Traumatic Brain Injury (TBI) in children is one of the most common causes of death and disability in children. Cardiac arrhythmias can be cited as one of the main factors influencing the mortality and morbidity of these children. The purpose of this study was to investigate the frequency and types of cardiac arrhythmias in children with TBI in the Intensive Care Unit (ICU) of Bahonar Hospital in Kerman. Methods: This study is a cross-sectional descriptive-analytical study examining patients under 18 years of age who were admitted to the ICU with TBI during 2018-2019 for cardiac arrhythmias. Data were collected using a checklist, including demographic characteristics and other variables in the patient’s file. Finally, the data were analyzed using SPSS version 22. Results: Forty-six of the 240 traumatized patients admitted to the ICU developed cardiac arrhythmias, the most common of which was sinus tachycardia. The incidence of arrhythmias was significantly higher in patients with subarachnoid hemorrhage (SAH), cerebral contusion, and intracerebral hemorrhage (ICH) than in those with other brain lesions. Most bradycardia was seen in mixed lesions. Dangerous arrhythmias, such as bradycardia and ventricular tachycardia (VT), were also significantly more common in the severe trauma group. Conclusion: It seems that in children with a head injury, the incidence of cardiac arrhythmias is significantly associated with the Glasgow Coma Scale (GCS) and some lesions due to brain trauma such as SAH, ICH, and brain contusion

Blood Lead Level in Opiate Addicts Hospitalized in the Intensive Care Unit of a Trauma Referral Center in Kerman, Iran

Background: Opium is the most commonly-used narcotic in Iran and some Asian countries. There are many reports of lead poisoning in opium users. Lead poisoning encompasses a wide range of symptoms the incidence and severity of which depend on the concentration and duration of contact with lead. The present study compares blood levels of lead in two groups of non-addicted patients and opiate addicts admitted to the intensive care unit (ICU) of a trauma referral hospital in Kerman, Iran. Methods:Two groups of about 30 patients were compared. The first group was the patients who were known as opium addict according to the Diagnostic and Statistical Manual of Mental Disorders-4th Edition (DSM-IV) and the second group was the patients who had no history of opium abuse. Patients' data were collected through a questionnaire. After determining the blood lead concentration by atomic absorption spectrophotometry (AAS) with graphite furnace, the data were analyzed by statistical tests. Findings: Blood lead levels (BLLs) in both addicted and non-addicted groups showed a significant difference (P < 0.050), but there was no meaningful relationship between blood lead concentration and other factors such as age, gender, type of opium, method of consumption, amount of use, and duration of dependence. Conclusion: Many of opium-addicted ICU patients in Kerman had a high BLL due to opium pollution that can be harmful for these patients

Prohibition of the extradition and deportation offenders at the procedure of the European court of human rights whit considering the European convention of human rights

The oldest topics in international law are the deportation and extradition. After raised the new issues of human rights in the field of international law and to transform human statusininternational relations inpractice the issue ofdeportationand extradition are sometimes in conflict with European human rights concepteuropean court ofhuman rightsasalegal element of the europeanconvention onhuman rightsinitspractice tojudge the votesabout thesome oftheseconflicts. Based on, thepresent article influence of human rightsstatedin theEuropean conventionof human rightson theissue ofdeportationandextradition in the practice of the statesparties tothe convention has been studied according to the European court ofhuman rightsvote

Platelet Count and MPV, Routinely Measured but Ignored Parameters Used in Conjunction with the Diagnosis of Acute Coronary Syndrome: Single Study Center in Iranian Population, 2010

Background: Myocardial infarction is the major cause of morbidity and mortality in industrialized countries. Platelet count and the mean platelet volume (MPV), a simple and reliable indicator of platelet size which correlates with platelet activation, might associate with troponin in acute chest pain. Methods: We analyzed MPV of 851 patients who were admitted to Rasoul-e-Akram Hospital with acute chest pain during the year 2010. Two blood samples were taken from each patient within 4 hours of their arrival for routine hematology, including platelet count and MPV, and cardiac troponin T. Also, electrocardiograms of the patients were recorded. Association of MPV and platelet count with troponin was observed. Results: The patients in troponin positive group, who had also ischemic electrocardiographic changes, had higher MPV values than non- acute coronary syndrome (ACS) patients with normal cardiac troponin T levels (9.9 vs 9.5 fl with p< 0.001). In troponin negative group, the mean of platelet count was higher than that in the positive group (221683 vs 198814/μl with p< 0.001). Conclusion: MPV and platelet count are inexpensive laboratory tests which can be measured in association with other laboratory biomarkers in patients presenting with acute chest pain. This could help to lower hospitalization rates and also avoid misdiagnosis and having complications of patients with ACS

Does MRI have added value in ultrasound-detected BIRADS-3 breast masses in candidates for assisted reproductive therapy?

Background: Ultrasound-detected breast lesions with probably benign features are a great challenge for clinicians, especially in breasts with dense composition. We aimed to investigate the finding of two radiologic modalities on these lesions. Methods: This retrospective cross-sectional study recruited patients including (1) candidates of assisted reproductive therapy (ART), (2) patients with prior high-risk lesions, and (3) the “suspected” BIRADS-3 masses referring to masses that US BIRADS-3 was not compatible with the clinical breast exam. The degree of agreement in diagnosing BIRADS-3 lesions between two modalities of magnetic resonance imaging (MRI) and ultrasonography (US), and comparison of the lesions in US and MRI were the study variables. Results: A total number of 123 lesions in 67 patients with a median age of 38 (IQR: 11, range: 17–67). In the examination by MRI, 107 (87.0 %) lesions were BIRADS-3 indicating the agreement level between these two modalities. The median size of the lesions in US was 9 mm (IQR: 5, range: 3–43) and 9 mm (IQR: 10, range: 4–46) in MRI. The measured size of the lesions between the two modalities was highly correlated (Spearman correlation coefficient: 0.889, P-value < 0.001). MRI evaluation revealed two cases of deep lesions which were missed in the US imaging. Conclusions: This study found relatively high agreement values between US and MRI in detecting BIRADS-3 breast lesions in candidates for ART or patients with prior high-risk lesions. Also, MRI could downgrade about one-tenth of the cases to a lower BIRADS level and resolved the need for closer follow-up

Integration of Cognitive Skills as a Cross-Cutting Theme Into the Undergraduate Medical Curriculum at Tehran University of Medical Sciences

Nowadays, improvement of thinking skills of students is one of the universally supported aims in the majority of medical schools. This study aims to design longitudinal theme of reasoning, problem-solving and decision-making into the undergraduate medical curriculum at Tehran University of Medical Sciences (TUMS). A participatory approach was applied to design the curriculum during 2009-2011. The project was conducted by the contribution of representatives of both basic and clinical faculty members, students and graduates at Tehran University of Medical Sciences. The first step toward integrating cognitive skills into the curriculum was to assemble a taskforce of different faculty and students, including a wide variety of fields with multidisciplinary expertise using nonprobability sampling and the snowball method. Several meetings with the contribution of experts and some medical students were held to generate the draft of expected outcomes. Subsequently, the taskforce also determined what content would fit best into each phase of the program and what teaching and assessment methods would be more appropriate for each outcome. After a pilot curriculum with a small group of second-year medical students, we implemented this program for all first-year students since 2011 at TUMS. Based on findings, the teaching of four areas, including scientific and critical thinking skills (Basic sciences), problem-solving and reasoning (Pathophysiology), evidence-based medicine (Clerkship), and clinical decision-making (Internship) were considered in the form of a longitudinal theme. The results of this study could be utilized as a useful pattern for integration of psycho-social subjects into the medical curriculum

Flavonoids as detoxifying and pro-survival agents: What's new?

The role of flavonoids in the survival machinery of cells has come in the spotlight due to the recent evidence of their effect on the relationship mitochondria-ER stress-proteasome, including the intracellular mechanisms of autophagy and apoptosis. Numerous experimental animal investigations and even human clinical studies have highlighted the major role of these natural compounds in the economy of life and their deep relationship with autotrophic organisms in the evolutionary space. Their role as anti-oxidant and oxidative stress preventive molecules has to date been investigated extensively in the literature. Despite this great amount of promising evidence, many concerns, however, remain, most of which dealing with biochemistry, bioavailability, pharmacokinetics, and interaction of flavonoids with gut microbiome, issues that make difficult any good attempt to introduce these molecules in the human healthcare systems as possible, encouraging therapeutic substances. This review tries to address and elucidate these items