Risk factors for stunting and wasting at age six, twelve and twenty-four months for squatter children of Karachi, Pakistan

Objective: A high proportion of stunting and wasting in children under-five has been reported from developing countries. This paper presents the nutritional status of a two year cohort of urban squatter children in Karachi, Pakistan and assesses risk factors for wasting and stunting at the reference ages of six, twelve and twenty-four months.Methods: A birth cohort of 738 children were visited at specific intervals by trained nurses to collect information on anthropometric measurements, feeding practices and intercurrent illnesses. Socioeconomic and demographic information included water and sanitation facilities, availability of electricity, type of house construction material and average monthly income. Information about the mother\u27s reproductive history was also obtained.Results: At two years the proportion of stunting and wasting was 41.8% and 10.6% respectively. Intrauterine growth retarded children had a higher risk of stunting and wasting at all reference ages as compared to children who were appropriate for gestational age. In the logistic regression models, intrauterine growth retardation was the only significant risk factor that remained in all models at each reference age.CONCLUSION: The consistent association of IUGR for stunting and wasting adds to the growing body of evidence that by improving maternal health we will ultimately break the vicious cycle of malnourishment and improve the health and well-being of future generations. We suggest interventions to improve the nutritional status of Pakistani urban children living in squatter settlements focused on mothers and children

Frequency and determinants of vaginal infection in postpartum period: a cross sectional survey from low socioeconomic settlements, Karachi, Pakistan

Objective: To determine the frequency and factors associated with perceived vaginal infections among married women in their postpartum period. Methods: A cross-sectional study was conducted from July 2000 to October 2000 in five squatter settlements of Karachi, Pakistan. These squatter settlements were selected on the basis of an existing surveillance system run by female community health workers for maternal and child healthcare which identified women who had delivered 42-56 days prior to the date of interview. Vaginal infection was considered present when a mother perceived foul smelling vaginal discharge during the postpartum period. Mothers were interviewed to gain insight into socioeconomic and demographic variables, materials used to staunch lochia, duration of labour, personal and perineal hygiene and past obstetric history. Results: A total of 525 women were interviewed. The estimated prevalence of perceived vaginal infection was 5.1%. Factors associated with perceived vaginal infections included, delivery conducted by a non-medical personnel (AOR 3.5, CI 1.3-9.5) and use of unhygienic cloth or cotton for staunch of lochia (AOR 2.7, CI 1.1-6.2). Conclusion: Among women who reported perceived vaginal infection, a higher proportion were delivered by non-medical personnel, and used unhygienic material (cloth or cotton) for staunch of lochia as compared to women who did not perceive vaginal infection. We recommend deliveries to be conducted by trained personnel and provision of health education for persons who conduct delivery and women to use hygienic material for staunch of lochia during post partum period (JPMA 56:99;2006)

Blood pressure alterations in burn patients with septic shock under hydrocortisone treatment

Background and Objectives: Hydrocortisone is widely used in septic shock cases resistant to fluid and vasopressor therapy. It may result in increased blood pressure and survival. However the efficacy is no established among patients with severe burn and septic shock. Accordingly it was assessed in this study. Materials and Methods: The patients older than 14 years of age with resistant septic shock were enrolled during one-year period. The hydrocortisone was prescribed 100 mg three times per day and the alterations in systolic and diastolic blood pressures were recorded. Results: Twenty-nine patients were enrolled including 19 men and 10 women. The mean age was 37 ± 19 years and the mean burn surface area was 60 ± 20. Fourteen patients had positive blood culture. The most common isolated microorganism were Pseudomonas aeuroginosa in 34.6(10 cases), and then Acinetobacter in 13.8(4 cases). The infection was from wound in 79 and the remaining 21 had pneumonia. Twenty-one patients had good response to hydrocortisone and the increase in systolic and diastolic blood pressures was significant; but the mortality rate was similar. Conclusion: Treatment with hydrocortisone would result in increase in systolic and diastolic blood pressure in burn patients with resistant septic shock. © 2015, Tehran University of Medical Science. All rights reserved

Xanthomicrol is the main cytotoxic component of Dracocephalum kotschyii and a potential anti-cancer agent

Spinal-Z, a methanolic mixture of dried powdered seeds of Peganum harmala Linn. and leaf of Dracocephalum kotschyii Boiss. is an Iranian ethno-medical remedy. It has been used for the treatment of various types of cancer for many years. To evaluate the use of Spinal-Z in treatment of cancer, we examined its effects against a panel of malignant cell lines and tumors induced in mice. The in vitro antiproliferative activities of Spinal-Z, the seed extract of P. harmala and the leaf extract of D. kotschyii were determined using the MTT assay. The concentration of the agent required to inhibit cell growth by 50 (IC50) was estimated. In addition, the anti-tumor activities of the remedy and its constituents were investigated. Viability of cells treated with Spinal-Z and its components decreased in a dose dependent manner. Spinal-Z and its components showed cytotoxic effects against all cell lines tested. The leaf extract of D. kotschyii showed a greater preferential cytotoxic effect than the seed extract of P. harmala and Spinal-Z, on all cell lines tested. Harmine showed cytotoxicity against HL60 and K562 cell lines. This could explain the cytotoxic effect of P. harmala on these cells. The leaf extract of D. kotschyii was able to inhibit tumor proliferation in mice. The active ingredient in the leaf extract of D. kotschyii appears to be a flavone identified as xanthomicrol. Xanthomicrol was able to inhibit proliferation of a number of malignant cells. The cytotoxic effects of xanthomicrol were more selective towards malignant cells than doxorubicin. © 2005 Elsevier Ltd. All rights reserved

Variability in gene cassette patterns of class 1 and 2 integrons associated with multi drug resistance patterns in Staphylococcus aureus clinical isolates in Tehran-Iran

Background: To investigate antibiotic resistance, the occurrence and distribution of class 1 and 2 integrons in multidrug- resistant Staphylococcus aureus isolates from hospitals in Tehran, Iran. The isolates were examined for susceptibility to antimicrobial agents. The mecA gene, class 1 and 2 integrons were detected by PCR. Integrase positive strains were further analysed for the presence of resistance gene cassettes using specific primers and were sequenced. Results: Among 139S.aureus isolates, 109 (78.4 ) and 112 (80.5 ) strains were considered as multidrug resistant and mecA positive, respectively. Class 1 integrons and internal variable regions were found in 72.6 (101/139) and 97 (98/101) and class 2 integrons and variable regions also in 35.2 (49/139) and 65.3 (32/49) of S.aureus clinical isolates, respectively. Twelve distinct cassette arrays were found, containing genes encoding resistance to β-lactams, aminoglycosides, streptothricin, trimethoprim, chloramphenicol,a putative glucose dehydrogenase precursor and a protein with unknown function. Gene cassette arrays aadB, aadA2 and dhfrA1-sat2-aadA1 were common in S.aureus isolates. We detected a completely new gene cassettes which contained aadB, oxa2, aacA4, orfD-aacA4-catB8, aadB-catB3, orfD-aacA4 and aadB-aadA1-cmlA6 of class 1 and dhfrA1-sat2-aadA1, dhfrA11, dhfrA1-sat2 of class 2 integrons. Conclusions: This is the first study to report carriage of class 1 and 2 integrons and associated gene cassettes among in S.aureus isolates from Iran. © 2015 Mostafa et al

Optimizing psma radioligand therapy for patients with metastatic castration-resistant prostate cancer. A systematic review and meta-analysis

The aim of the review was to evaluate patient and treatment characteristics for patients with metastatic castration-resistant prostate cancer (mCRPC) treated with PSMA radioligand therapy (PRLT) associated with above-average outcome. The systematic review and meta-analysis followed recommendations by the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA). We searched for publications in PubMed, Embase, and ClinicalTrials.gov up to 31 September 2020. Thirty-six publications and four duplicates reported 2346 patients. Nearly two-thirds of the patients had bone metastases. Median overall survival (OS) was 16 months. Asymptomatic patients and patients with only lymph node metastases lived longer than symptomatic patients and patients with more extensive metastases. Patients treated with an intensified schedule of177Lu PRLT lived longer than those treated with a conventional schedule. Half of the patients obtained a PSA decline ≥ 50% and these patients lived longer than those with less PSA decline. Approximately 10% of the patients developed hematologic toxicity with anemia grade 3 as the most severe adverse effect. Characteristics for patients, cancer, restaging, and PRLT predict above average overall survival following treatment with PRLT

Carbapenem resistance in gram-negative bacilli isolates in an iranian 1000-bed tertiary hospital

Objective: Carbapenems are beta-lactamase antibiotics, presently considered as most potent agents for treatment of infections caused by Gram-negative bacilli. The aim of this study was to determine resistance of Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumonniae as prevalent nosocomial agents to commonly used antibiotics including carbapenems such as imipenem and meropenem. Methodology: A total of 202 gram-negative bacilli including K.pneumoniae, P aeruginosa and A.baumannii isolated from hospitalized patients in Milad hospital of Tehran were subject for susceptibility testing. Susceptibility testing was performed by disk diffusion and MIC methods as recommended by Clinical Laboratory Standards Institute (CLSI) Results: All isolates of K. pneumonia were susceptible to imipenem and meropenem. Resistance in non-fermenting gram-negative bacilli (NFGB) was prevalent. P.aeruginosa isolates exhibited 7.5 and 40.2 resistance to imipenem and meropenem respectively. The majority isolates of Acinetobacter baumannii were multi-drug resistant and resistance of this organism to imipenem and meropenem was 27.7 and 38.5 respectively. Conclusions: Our study revealed that in spite of resistance of K.pneumoniae to commonly used antibiotics, all isolates were susceptible to imipenem and meropeem. More than 80 isolates of A .bammanni were resistant to commonly used antibiotics. About 40.2 isolates of P.aeruginosa and (38.5) isolates of A.baumannii were resistant to meropenem respectively

Prevalence, risk factors, and epidemiology of food-borne botulism in Iran

Background: Botulism is a severe neuroparalytic disease caused by toxins produced by several Clostridium species. This work presents the surveillance results of botulism in Iran, with the distribution of the cases by regions and by vehicle of transmission. Methods: We describe the findings of the Centers for Disease Control and Prevention (CDC) surveillance on 2037 suspected cases of food-borne botulism during 2007�2017. Results: A total of 252 (12.3) cases were confirmed to food-borne botulism. The mean annual incidence per 100,000 Iranian Natives was 7.1 cases for male individuals and 3.3 cases for female individuals. All botulism events were confirmed to be foodborne. The most commonly implicated food was home-prepared traditional processed fish product, followed by the consumption of commercially canned products and non-pasteurized dairy products. Forty-eight (19) fatal botulism were reported which, the case-fatality rate declined from 4.5 to 0.7 during the study period. Conclusion: Laboratory-based diagnosis of botulism is an imperative procedure to elucidate cases, particularly food-borne botulism, to identify toxins in food and confirm clinical diagnosis, helping sanitary control measures. In addition, educational materials related to botulism prevention should be disseminated to different communities. © 2020 Atlantis Press

Additive and interactive associations of Environmental and Sociodemographic Factors With the Genotypes of Three Glutathione S-Transferase Genes in Relation to the Blood arsenic Concentrations of Children in Jamaica

Arsenic (As) is a metalloid that has been classified as a xenobiotic with toxic effects on human beings, especially on children. Since the soil in Jamaica contains As, dietary intake is considered the main source of As exposure in Jamaicans. In addition, glutathione S-transferase (GST) genes, includin

The Practice Of Art in Pediatric Nursing

Giriş: Hastaneye yatmanın çocuğun gelişimi üzerine olumsuz etkileri vardır. Çocuk için hastane korkutan, rahatsız eden ve hoş olmayan yaşantıları içerir. Travmatize olan çocuk, normalde yapabildiği günlük pek çok işini yerine getiremez, sözel iletişim kurmakta zorlanır. Sözsüz ifade ise ancak sanat gibi bir yöntemle açığa çıkarılabilir. Sanat arzu edilen sonuca ulaşmak için bilgi ve becerinin kullanılmasıdır. Hemşirelikte sanat, hastaların gereksinimleri ve kaygılarını anlamak, hastaların yeterliliğini artıran amaçlar ve uygulamalar geliştirmek, hastaların durumunu iyileştirmek için kullanılır. Çocuk hemşireliği, primer hemşirelik, aile merkezli bakım ve atravmatik bakım bileşenlerinden oluşur. Çocuk hemşireliğinde sanat uygulamaları değerlendirirken bu bileşenler üzerinden değerlendirilmelidir. Bu derlemede, hemşireliğin sanatsal boyutu ile, çocuk hemşireliğinde sanatın yeri ve çocuk sağlığı uygulamaları için önemi tartışılmış, sanat içerikli araştırmaların çocuk sağlığı açısından yararları ortaya konmaya çalışılmıştır.  Introduction: Entering a hospital has negative effects on the development of child. Hospital includes fear, disturbia and bad experiences for a child. The child who is tramvatic can not do many daily activities which normaly can be performed and has the difficulty of doing verbal communication Non-verbal communication can only be come out with a princible like art. Art is the usage of information and skill in order to arrive a result which is desired. Art in the nursing is understanding the needs of patents and fears, improving the sufficiency of patients and developing principles are used in order to do good fort he patients. Childhood nursing is composed of primer nursing, family-based maintenance and traummatic maintenance. While art practises is evaluated, it must be evaluated from this comporents in this collection the artistic valve of nursing and the place of art in the childhood nursing and child-health practises are debated, the benefits of art based inquires are put forwar