The first febrile seizure; predisposing factors and recurrence rate

  Objective Febrile seizure is the most common worrisome neurologic disorder in children in terms of parental point of view. The purpose of this study was to answer distressing parents’ questions about the prevalence and possibility of febrile seizure recurrence. Materials & Methods 140 patients who were admitted due to the first febrile seizure in the six months (March up to September) of the year 2015 were enrolled to this study. Exclusion criteria include central nervous system infection, non-confirmed febrile seizure and lack of parental acceptance for long-term inclusion in this study. All children were followed in terms of second febrile seizure during one year follow-up from the time of first febrile seizure. (3 sentences were deleted). Results Recurrence of febrile seizure was 25.7 % during one-year follow-up. Significant risk factors for recurrence include: age less than one year old, male gender, seizure with low level of fever, family history of epilepsy, family history of febrile seizure, complex febrile seizure (focal and repeated in 24 hours), seizure duration more than 15 minutes and parental indifference to the onset of fever in their children before seizure occurrence. Although duration of fever before seizure, failure to thrive, positive history of admission in neonatal period, dystocia atbirth delivery and children with day care staying were associated with greater febrile seizure recurrence; but, they did not have significant relationship with recurrence rate. Prophylaxis with benzodiazepine reduced the recurrence rate. Conclusion Chance of febrile seizure recurrence in one-year follow-up increased in presence of risk factors expressed in finding part. parental indifference to the onset of fever in their children that is starting before seizure was a considerable risk factor in terms of recurrence prevalence. We recommended to emphasis on parental education about this new finding as a risk factor for febrile seizure in order to prevent its future recurrence

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The Effect of Patient Education through Social Media on the COVID-19-Related Anxiety in Patients with Diabetes: A Single-Blind Clinical Trial

Background and Objective: The COVID-19 pandemic has increased the level of anxiety in patients with diabetes and educating patients in this field can be an appropriate method to reduce their level of anxiety. The present study aimed to determine the effect of patient education through social media on the COVID-19-related anxiety in patients with diabetes. Materials and Methods: The present single-blind clinical trial was conducted at the teaching hospitals of Zanjan, Iran in 2022.  A total of 113 diabetic patients were selected using convenience sampling and then divided into two groups of experimental (n = 58) and control (n = 55) by simple random allocation. Data were collected using a demographic questionnaire and Corona Disease Anxiety Scale (CDAS). Training related to COVID-19 was provided to the intervention group at a two-week interval, while the control group only received routine care. Data were entered into SPSS software (version 26) and then analyzed using descriptive and inferential statistics. Results: Patients in both groups were homogeneous in terms of demographic and clinical characteristics (P >0.05). A statistically significant difference was observed between the mean scores of anxiety in the intervention group at two measurement points before and after the intervention (P 0.05). Conclusion: Educational intervention through social media slightly reduces COVID-19-related anxiety in patients with diabetes. Therefore, social media is suggested as a convenient and accessible method to educate patients on Covid-19

Evaluation of Cyproheptadine Hydrochloride Effects on Weight Gain in Underweight Children with Anorexia; A Randomized Clinical Trial

Background: Cyproheptadine hydrochloride is an antihistaminic drug. Appetite stimulation is one of its secondary effects that can be of advantage in some diseases. In this study we investigated the effect of Cyproheptadine hydrochloride on weight gain in underweight children with anorexia at age group 2 to10 years old. Materials and Methods: In this randomized clinical trial, we selected 2-10 year-old underweight children with anorexia who referred to Ayatollah Mousavi Hospital in Zanjan (Iran), during 2015. One hundred and thirty-six children were allocated at random in two groups. The Cyproheptadine - treated children group were given the drug orally; 0.1 mg/kg/dose three times per day for 8 weeks, while patients in placebo group received placebo with the same dose. After two months, weight gain was compared with the previous values in both groups. Results: In this study, 86 patients (63.2%) were female. The average increase in weight in the cyproheptadine - treated group was significantly higher than in the placebo group (1.08 ± 0.67 kg and 0.22 ± 0.46 kg, respectively) (p=0.005). The average increase height in the Cyproheptadine -treated group was significantly higher than in the placebo group (1.60 ± 0.97 cm, and 0.86 ± 0.85 cm, respectively) (p=0.005). According to the parents of both groups, anorexia in the Cyproheptadine -treated group improved in 100%, and in the placebo group in 52.7%. This difference was statistically significant (p=0.005). No any side effects of Cyproheptadine hydrochloride were observed. Conclusion: According to the finding of our study, there were no serious side effects of Cyproheptadine hydrochloride. Therefore considering the acceptable safety of Cyproheptadine hydrochloride for inducing growth in underweight children, we propose its administration with the aforementioned dose

Possible ameliorating effects of Glycyrrhiza Glabra (Licorice) on the sperm parameters in rats under high fat diet

Objectives. Adverse effects of obesity, which is caused by an imbalance between the energy intake and expenditure, on the male reproductive system have been reported. Considering the anti-obesity effect of Glycyrrhiza Glabra (GC), we conducted this study to elucidate whether it can ameliorate the sperm parameters