Incidence of cleft lip and palate in Gorgan - Northern Iran: An epidemiological study

Objective: Cleft lip with or without cleft palate is the most common orofacial congenital anomaly among live births. This study was carried out to determine the incidence rate of oral clefting in Gorgan, Northern Iran during 2004-2009. Methods: This descriptive hospital-based study was performed on 35,009 live newborns in Dezyani Hospital in Gorgan, Northern Iran during 2004-2009. All newborns were screened for oral clefts. Data including birth date, gender, type of oral clefts, parents' consanguinity, parental ethnicity and presence of other congenital anomalies were recorded for analysis. Result: The overall incidence rate of oral clefts during this 6-year period was 1.05 per 1000, or 1 per 946 live births. The incidence of cleft lip and isolated cleft palate was 0.08 and 0.37 per 1,000 live births, respectively. The ratio for different cleft types was 1:7:4 (CL: CLP: CP). The incidence of oral clefting was 1.2 per 1,000 male births and 0.86 per 1,000 female births (RR=1.40; 95% CI: 0.73-2.71). According to parental ethnicity, the incidence of oral clefting was 0.7, 1.7 and 1.26 per 1,000 in Native Fars, Turkman and Sistani, respectively. The relative risk for oral clefting in Turkman to native Fars group was 2.56 (p<0.02). In this study, 56.7% of clefts were CL+P, 8.1% were CL and 35.1% of cases were CP. CP was more common among girls (54%) than among boys (46%) but CL was more common among boys. Conclusion: The results showed that the incidence of oral clefts in the study population as being 1.05 per 1,000 live births, which has increased from 0.97 per 1,000 live births reported in an earlier study in this area. © OMSB, 2012

Tessier number 30 clefts with congenital heart defects

Introduction: Midline cleft of mandible, classified as Tessier 30 clefts is extremely rare, with less than 100 reported cases in the latest studies. Variations in severity and associated malformations have been reported before. Case Presentation: In this report, we present the first documented Iranian case of Tessier 30 with median cleft of lower lip and bifid tongue concomitant with congenital heart defects. Conclusions: We explain embryologic origin, differential diagnosis, other associated anomalies and its treatment by reviewing literature. © 2015, Iranian Red Crescent Medical Journal

The role of IL-6 for predicting neonatal sepsis: A systematic review and meta-analysis

Objective: Neonatal sepsis (NS) is a common and life-threatening disorder in infants. Previous studies showed that interleukin-6 (IL-6) may be a valid non-invasive and rapid method for diagnosis of NS. We conducted this review to assess the validity of IL-6 for predicting NS. Methods: This was a systematic review with meta-analysis. Embase, Medline and Web of Science databases were searched between January 1990 and December 2009. The search terms used were "cytokine", "neonate", "sepsis" and "interleukin-6". We used standard methods recommended for meta analyses of diagnostic test evaluations. The analysis was based on a summary ROC (SROC) curve. Meta-regression analysis was used to assess the effects of some confounding factors on the results of meta-analysis. Potential presence of publication bias was tested using funnel plots and the Egger test. Findings: Meta-analysis was performed on 13 publications including 353 infants with sepsis and 691 control infants. The pooled sensitivity and specificity of IL-6 was 0.79 and 0.84, respectively. The maximum joint sensitivity and specificity (i.e., the Q value) in SROC curve was 0.82 and the area under curve (AUC) was 0.89 (95% CI: 0.84-0.94). Meta-regression analysis showed that the diagnostic accuracy of IL-6 was not affected by confounding variables. The evaluation of publication bias showed that the Egger test was not significant (P=0.07). Conclusion: IL-6 seems to be a valid marker for predicting NS. It may be considered for early diagnosis of sepsis in neonatal care units. © 2011 by Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, All rights reserved

Prevalence and pattern of congenital heart disease among neonates in Gorgan, Northern Iran (2007-2008)

Objective: Congenital heart disease (CHD) is the most common congenital anomaly newborns. The aim of this longitudinal, hospital-based study was to evaluate the prevalence and pattern of CHD among Iranian newborns in Gorgan, Northern Iran. Methods: 11739 live births in Dezyani hospital in Gorgan were screened for CHD, 2007 through 2008. Clinical examination, echocardiography, color Doppler and cardio catheterization were used as diagnostic tools. Clinical and demographic factors, namely sex, type of CHD and associated anomalies of diagnosed cases were recorded in a pre-designed questionnaire for analysis. Findings: The overall prevalence rate of CHD was 8.6 per 1000 live births. This was 9.96 per 1000 male births and 7.34 per 1000 female births. It was 4.5 and 13.19 per 1000 in 2007 and 2008, respectively. ASD was the commonest lesion (2.64 per 1000), followed by VSD+ASD (1.28 per 1000) and PDA (1.28 per 1000). The rate of ASD in male and female was 3.02 and 2.26 per 1000 respectively. Parents of 40 (39.6%) babies were related. 39 (38.6%) couples were first cousins. Conclusion: This study showed that the prevalence of CHD among live births in Gorgan is lower than reported in the studies for Middle East and European countries. © 2011 by Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, All rights reserved

Birth prevalence of oral clefting in northern Iran

Objective: To explore the prevalence of oral clefting in northern Iran. Setting: In the Dezyani hospital 37,951 live births from 1998 through 2003 were screened for oral clefts. Clinical and demographic factors of diagnosed cases, including birth date, ethnicity, type of oral cleft, parental consanguinity, and coexisting anomalies, were recorded for analysis. Results: The overall prevalence of oral clefting was 0.97 per 1000 live births. The prevalence of cleft lip with or without cleft palate and isolated cleft palate was 0.60 and 0.37 per 1000, respectively. The prevalence of oral clefting was 1.08 per 1000 male births and 0.86 per 1000 female births. With respect to parental ethnicity, the prevalence of oral clefting was 0.86, 0.88, and 1.47 per 1000 in Fars, Turkman, and Sistani, respectively. Conclusions: The prevalence of oral cleft among live births in the Dezyani hospital is similar to that reported in the previous studies for Iran and whites

Neuropsychiatric manifestations of COVID-19 can be clustered in three distinct symptom categories

Several studies have reported clinical manifestations of the new coronavirus disease. However, few studies have systematically evaluated the neuropsychiatric complications of COVID-19. We reviewed the medical records of 201 patients with confirmed COVID-19 (52 outpatients and 149 inpatients) that were treated in a large referral center in Tehran, Iran from March 2019 to May 2020. We used clustering approach to categorize clinical symptoms. One hundred and fifty-one patients showed at least one neuropsychiatric symptom. Limb force reductions, headache followed by anosmia, hypogeusia were among the most common neuropsychiatric symptoms in COVID-19 patients. Hierarchical clustering analysis showed that neuropsychiatric symptoms group together in three distinct groups: anosmia and hypogeusia; dizziness, headache, and limb force reduction; photophobia, mental state change, hallucination, vision and speech problem, seizure, stroke, and balance disturbance. Three non-neuropsychiatric cluster of symptoms included diarrhea and nausea; cough and dyspnea; and fever and weakness. Neuropsychiatric presentations are very prevalent and heterogeneous in patients with coronavirus 2 infection and these heterogeneous presentations may be originating from different underlying mechanisms. Anosmia and hypogeusia seem to be distinct from more general constitutional-like and more specific neuropsychiatric symptoms. Skeletal muscular manifestations might be a constitutional or a neuropsychiatric symptom. © 2020, The Author(s)

Iranian and American Moral Judgments for Everyday Dilemmas Are Mostly Similar

Moral judgment is a complex cognitive process that partly depends upon social and individual cultural values. There have been various efforts to categorize different aspects of moral judgment, but most studies depend upon rare dilemmas. We recruited 25 subjects from Tehran, Iran, to rate 150 everyday moral scenarios developed by Knutson et al. Using exploratory factor analysis (EFA), we observed that the same moral dimensions (except socialness dimension) were driven by the same moral cognitive factors (norm violation, intention, and social affect) in Iranian vs. American studies. However, there were minor differences in the factor loadings between the two cultures. Furthermore, based on the EFA results, we developed a short form of the questionnaire by removing eleven of the fifteen scenarios from each of the ten categories. These results could be used in further studies to better understand the similarities and differences in moral judgment in everyday interactions across different cultures. © Copyright © 2021 Yazdanpanah, Soltani, Mirfazeli, Shariat, Jahanbakhshi, GhaffariHosseini, Alavi, Hosseinpour, Javadnia and Grafman

Incidence and pattern of congenital malformations in Gorgan-north of Iran

Congenital malformations are emerged as a common cause of fetal death and one of the most important causes of prenatal mortality and morbidity. This study was done to determine the incidence and pattern of congenital malformations in a referral hospital in Gorgan, North of Iran. This cross-sectional study was done on 6204 live birth in Dezyani hospital in Gorgan, North of Iran during a 12-month period from January 1st to December 31st of 2007. Gender, type of congenital malformations according to International Classification of Diseases (ICD-10) and maternal ethnicity were recorded. Data for each newborn was filled in a questionnaire. Data analyzed by using SPSS software version 16 and �2 test. The overall incidence of congenital malformations among newborns was 17.7 per 1000 live births. The incidence of congenital malformations was 22.4 per 1000 in males (RR = 1.68 Q95%: 1.14-2.48) and 13.06 per 1000 in females. Anomalies of the central nervous system had the highest incidence (7.3 per 1000) followed by congenital heart defects (5.2 per 1000) and musculoskeletal system (3.7 per 1000) births. According to ethnicity the incidence rate of congenital malformations was 16.5,17.2 and 20 per 1000 live births in native Fars, Turkman (RR = 1.04 CI95%:65-1.67) and Sistani (RR = 1.2 CI95%: 0.78-1.85) groups, respectively. This study showed that the incidence rate of congenital malformations is increased from 10.1 -17.7 per 1000 live birth in Northern Iran during an 8 years period

Associated malformations in newborns with imperforate anus in Gorgan, Iran (2006-10)

Background and Objective: Imperforate anus is a common anorectal malformation, which is associated with other anomalies. This study was done to determine the associated malformations in newborns with imperforate anus in northern Iran. Methods: This descriptive study was carried out on 40 hospitalized newborns (24 boys and 16 girls) with imperforate anus in Taleghani teaching hospital in Gorgan, northern Iran during 2006-10. Results: From 40 newborns with imperforate anus, 23 newborns (57.5%) had associated anomalies. The commonest associated anomalies was genitourinary (65.2%) followed by heart (47.8%), gastrointestinal (13%) and musculoskeletal anomalies (8.7%). Conclusion: Associated anomalies in newborns with imperforate anus in northern Iran have a high prevalence in comparison with other reports

Risk factors of neural tube defects in northern Iran

Background: Neural tube defects (NTDs) including spina bifida and anencephaly are the second most common birth defects with 2.8 per 1000 births in northern Iran. Objectives: This study was conducted to determine the risk factors of neural tube defects in Gorgan, north of Iran. Patients and Methods: This hospital-based, case-control study was carried out on all NTD-affected pregnancies (n = 59) during February 2007 - August 2010, and 160 healthy pregnancies were selected via convenient sampling method in three hospitals in Gorgan, north of Iran. Risk factors including maternal body mass index (BMI), season of birth, gender of the newborn, mother's age, ethnicity, consanguineous marriage, folic acid consumption, nutrition, habitat, and education, were assessed through interviews with mothers. Univariate and multivariate logistic regression analyses were used to estimate the risks by odds ratios (ORs) and 95 confidence intervals. Results: The multivariate analysis showed that maternal BMI (normal/underweight OR: 0.23, overweight/underweight OR: 0.15, obese/underweight OR: 0.13) and maternal ethnicity (Fars/Sistani OR: 3.49) and maternal nutrition (good/poor OR: 0.46) were significantly correlated with NTDs in the newborns. Conclusions: This study showed that maternal ethnicity, insufficient nutrition, and BMI, were the main risk factors of NTDs in northern Iran. © 2014, Iranian Red Crescent Medical Journal