The effect of increasing blood flow rate on dialysis adequacy in hemodialysis patients

Background and aim: One of the morbidity and mortality determinants of the dialysis patients is inadequacy of dialysis. Increasing the dialysis efficacy improves patient’s prognosis. The aim of this study was to assess the effect of increasing blood flow on the adequacy of dialysis in dialysis department of Ekbatan hospital of Hamadan. Methods: This before-after desigh study was performed on 42 patients. First, data was collected about the following parameters: patient’s weight before and after hemodialysis, ultrafiltration, urea before and after hemodialysis, the time of dialysis, percentage of filter clearance and speed of dialysate. Then the patient was attached to the dialysis machine and a sample of blood was taken. The pumpage of dialysis machine in the first session was put on 200 ml/min and in the second session on 250 ml/min. During the hemodialysis, the hemodynamic status and vital signs of patient’s were controlled. When hemodialysis finished a blood sample was taken from the artery set, in a section before dialyzer (4 blood sample for each patients), weight was controlled again and the sample was sent to a laboratory for urea control. Then the efficiency of dialysis was determined. Descriptive and analytical statistics were used for analysis of the data. Results: Results showed the mean KT/V (K=Clearance dialyzer T= Time V=Volume of distribation of urea) of patients whose pumping cycle were 200 ml/min, had 0.943±0.335 and URR (Urea Reduction Ratio) 53.3±13.5 wereas mean KT/V patients with 250 pumping cycle had 1.195±0.45 and URR 60.17±10.47. Paired t-test with %95 confidence interval showed that there was a significant difference in dialysis efficiency between the two groups (p<0.05). Conclusion: Our data suggests that increasing blood flow rate by 25% of previous flow rate is effective in achieving higher dialysis adequacy in hemodialysis patients

High prevalence of goiter in schoolchildren in Isfahan; zinc deficiency does not play a role

Wstęp: Dane dotyczące znaczenia niedoboru cynku w etiologii wola endemicznego są niejednoznaczne. Celem niniejszego badania było ustalenie związku między stężeniem cynku w surowicy a występowaniem wola u dzieci w wieku szkolnym w Isfahanie. Materiał i metody: Badanie przeprowadzono w 2005 roku. Włączono do niego 2331 dzieci, u których oceniono palpacyjnie wielkość tarczycy. U części dzieci oznaczono stężenie jodu w moczu (UIC, urinary iodine concentration) i stężenie cynku w surowicy. Wyniki: Obecność wola stwierdzono u 32,9% dzieci. Średnie UIC wynosiło 195,5 &#956;g/l. Stężenie cynku w osoczu oznaczono u 94 dzieci z wolem i 326 dzieci, u których nie stwierdzono wola. Średnie stężenie cynku w osoczu &#177; odchylenie standardowe wynosiło 100,81 &#177; 22,33 &#956;g/dl u dzieci z wolem i 96,00 &#177; 25,79 &#956;g/dl u dzieci bez wola (p = 0,08). Częstość niedoboru cynku (stężenie cynku w surowicy &#8804; 65 &#956;g/dl) nie różniła się istotnie w grupie dzieci z wolem i bez wola (6,4% v. 8,0%, p = 0,61). Wnioski: Częstość występowania wola u dzieci w wieku szkolnym w Isfahanie jest nadal duża. Wydaje się, że niedobór cynku nie ma wpływu na znaczną liczebność przypadków wola w tym regionie. Wskazane są dalsze badania mające na celu identyfikację czynników zwiększających częstość występowania wola w Isfahanie. (Endokrynol Pol 2010; 61 (3): 287-290)Introduction: There are controversial data about the role of zinc deficiency in the aetiology of endemic goiter. The aim of the present study was to determine the association between zinc status and goiter in schoolchildren of Isfahan. Material and methods: This study was performed in 2005. Two thousand three hundred and thirty-one schoolchildren were enrolled, and thyroid size was determined by inspection and palpation. Urinary iodine concentration (UIC) and serum zinc level were measured in a group of those children. Results: The prevalence of goiter was 32.9%. The median UIC was 195.5 &#956;g/L. Serum zinc was measured in 94 goitrous and 326 nongoitrous children. The mean &#177; standard deviation of serum zinc in goitrous and non-goitrous children was 100.81 &#177; 22.33 and 96.00 &#177; 25.79 &#956;g/dL, respectively (P = 0.08). The prevalence of zinc deficiency (serum zinc &#8804; 65 &#956;g/dL) in goitrous and non-goitrous children did not differ significantly (6.4 % v. 8.0%, P = 0.61). Conclusions: The prevalence of goiter is still high in Isfahan schoolchildren. It seems that zinc status is not involved in the high prevalence of goiter in this region. The role of other possible goitrogens should be investigated in Isfahan. (Pol J Endocrinol 2010; 61 (3): 287&#8211;290

Association between Serum Ferritin and Goitre in Iranian School Children

Despite long-standing supplementation of iodine in Iran, the prevalence of goitre among general people remains high in some regions. The study investigated the role of iron status in the aetiology of goitre in school children in Isfahan, Iran. Two thousand three hundred and thirty-one school children were selected by multi-stage random sampling. Thyroid size was estimated by inspection and palpation. Urinary iodine concentration (UIC) and serum ferritin (SF) were measured. Overall, 32.9% of the children had goitre. The median UIC was 195.5 μg/L. The mean±SD of SF in the goitrous and non-goitrous children was 47.65±42.51 and 44.55±37.07 μg/L respectively (p=0.52). The prevalence of iron deficiency in goitrous and non-goitrous children was 9.6% and 3.1% respectively (p=0.007). Goitre is still prevalent in school children of Isfahan. However, their median UIC was well in the accepted range. Iron deficiency is associated with goitre in a small group of goitrous children. The role of goitrogens should also be investigated in this region

The Impacts of Low-Level Laser Therapy – A Complementary Treatment in the Management of Side Effects After Implant Surgery

Introduction: One of the most important medical applications of laser is low-level laser therapy (LLLT). In this method, laser radiation penetrates easily into the target tissue. The aim of this study was to investigate whether LLLT can reduce the side effects of advanced implant surgery.Methods: In this triple-blind clinical trial, 30 patients aged 25 to 65 years were selected for implant insertion and divided into two groups. In the laser group, immediately after the surgery, 72 hours and 1 week after the surgery, the surgical site was irradiated with an 830 nm laser. The dose required for the laser therapy was 5 J/cm2. The degree of pain, facial swelling and wound healing were analyzed using statistical methods.Results: Our results showed that at 12, 24, 48, and 72 hours after the surgery, the pain level was reduced in the laser group compared with the placebo group (P &lt; 0.05). Swelling of the face was also significantly reduced 7 days after surgery in the laser group (P &lt; 0.05). The investigation on the recovery conditions of the surgical site showed that on the 3rd, 7th and 14th days after the surgery, higher levels of wound healing have been achieved (P &lt; 0.05).Conclusion: Our results suggest that laser, as a complementary therapy; can be used to reduce the severity and duration of pain. Also, laser can reduce facial swelling and accelerate wound healing

The Combined Effects of a Methacrylate Powder Dressing (Altrazeal Powder) and Photobiomodulation Therapy on the Healing of a Severe Diabetic Foot Ulcer in a Diabetic Patient: A Case Report

Weakened wound healing is a popular, severe complication of patients with diabetes that poses a risk for foot infection and amputation. In recent years, researchers have been searching to find new treatments for treating diabetic foot ulcer.&nbsp; In this case report for the first time, we applied photobiomodulation therapy and Altrazeal powder together to treat and expedite tissue repair in a severe case of diabetic foot ulcer in a 47-year-old woman who suffered from type 1 diabetes.&nbsp; &nbsp;We observed along with progress of combination therapy, the ulcer area was significantly reduced, and the wound healed within 16 weeks. Also, dermatitis and purulent secretion were treated, and pain was reduced. This reported case study, indicated the beneficial impact of the combination of photobiomodulation therapy and Altrazeal powder for the healing of a severe of diabetic foot ulcer in a patient with type one diabetes. Combined application of photobiomodulation therapy plus Altrazeal powder demonstrated an additive effect. Further clinical trials in clinical setting in is suggested to validate the results further. In addition, more studies in preclinical models are suggested to find mechanism of action of the combination therapy

Vitamin D status of 6- to 7-year-old children living in Isfahan, Iran

Wstęp: Witamina D ma podstawowe znaczenie dla utrzymania dobrego zdrowia. O niedoborach witaminy D donoszą autorzy z wielu krajów, również tych o dużym stopniu nasłonecznienia. Niniejsze badanie przeprowadzono w celu dokonania oceny stężenia witaminy D u zdrowych dzieci w wieku 6-7 lat, zamieszkałych w Isfahanie, Iran. Materiał i metody: Do badania włączono 513 zdrowych dzieci. Zmierzono u nich stężenie PTH i 25-hydroksywitaminy D (25-OHD) w surowicy. Określono spożycie witaminy D w diecie, czas ekspozycji na słońce w ciągu doby i odsetek powierzchni ciała wystawionej na działanie słońca. Przyjęto, że stężenia 25-OHD wynoszące < 20 ng/ml i 10 ng/ml odpowiadają odpowiednio łagodnemu i ciężkiemu niedoborowi witaminy D. Do ustalenia lokalnych punktów odcięcia dla niedoborów witaminy D użyto krzywych ROC. Wyniki: U 3% dzieci stężenie witaminy 25-OHD wynosiło < 20 ng/ml, a u 26% wynosiło < 33 ng/ml (lokalny punkt odcięcia dla niedoboru witaminy D). Czas ekspozycji na słońce i dzienne spożycie witaminy D w diecie miały istotny wpływ na stężenie witaminy D w surowicy. Wnioski: W omawianym badaniu wykazano częste występowanie niedoboru witaminy D u dzieci zamieszkałych w Isfahanie. Wydłużenie czasu ekspozycji na słońce i zwiększenie dziennego spożycia witaminy D w diecie może zapobiec niedoborom witaminy D u tych dzieci. (Endokrynol Pol 2010; 61 (4): 377-382)Introduction: Vitamin D is essential for the maintenance of good health, and vitamin D deficiency has been reported from many countries, including those with a lot of sunshine. This study was conducted to evaluate the vitamin D status in healthy 6- to 7-year-old children in Isfahan, Iran. Material and methods: Five hundred and thirteen healthy children were enrolled. Serum PTH and 25-hydroxyvitamin D (25-OHD) were measured. Dietary vitamin D intake, duration of daily sunlight exposure, and percentage of exposed body surface area were determined. 25-OHD levels < 20 ng/mL and < 10 ng/mL were defined as mild and severe vitamin D deficiency, respectively. The ROC curve was utilized to obtain a local cut-off point of vitamin D deficiency. Results: 25-OHD was < 20 ng/mL in 3% and < 33 ng/mL (local cut-off point of vitamin D deficiency) in 26% of subjects. Duration of sunlight exposure and daily intake of vitamin D had significant effects on serum level of vitamin D. Conclusions: A high prevalence of vitamin D deficiency in Isfahan children was observed in this study. Improvements in duration of sunlight exposure and daily intake of vitamin D can prevent vitamin D deficiency in these children. (Pol J Endocrinol 2010; 61 (4): 377-382

Association between Serum Ferritin and Goitre in Iranian School Children

Despite long-standing supplementation of iodine in Iran, the prevalence of goitre among general people remains high in some regions. The study investigated the role of iron status in the aetiology of goitre in school children in Isfahan, Iran. Two thousand three hundred and thirty-one school children were selected by multi-stage random sampling. Thyroid size was estimated by inspection and palpation. Urinary iodine concentration (UIC) and serum ferritin (SF) were measured. Overall, 32.9% of the children had goitre. The median UIC was 195.5 \u3bcg/L. The mean\ub1SD of SF in the goitrous and non-goitrous children was 47.65\ub142.51 and 44.55\ub137.07 \u3bcg/L respectively (p=0.52). The prevalence of iron deficiency in goitrous and non-goitrous children was 9.6% and 3.1% respectively (p=0.007). Goitre is still prevalent in school children of Isfahan. However, their median UIC was well in the accepted range. Iron deficiency is associated with goitre in a small group of goitrous children. The role of goitrogens should also be investigated in this region

The relationship of air pollution and surrogate markers of endothelial dysfunction in a population-based sample of children

<p>Abstract</p> <p>Background</p> <p>This study aimed to assess the relationship of air pollution and plasma surrogate markers of endothelial dysfunction in the pediatric age group.</p> <p>Methods</p> <p>This cross-sectional study was conducted in 2009-2010 among 125 participants aged 10-18 years. They were randomly selected from different areas of Isfahan city, the second large and air-polluted city in Iran. The association of air pollutants' levels with serum thrombomodulin (TM) and tissue factor (TF) was determined after adjustment for age, gender, anthropometric measures, dietary and physical activity habits.</p> <p>Results</p> <p>Data of 118 participants was complete and was analyzed. The mean age was 12.79 (2.35) years. The mean pollution standards index (PSI) value was at moderate level, the mean particular matter measuring up to 10 μm (PM₁₀) was more than twice the normal level. Multiple linear regression analysis showed that TF had significant relationship with all air pollutants except than carbon monoxide, and TM had significant inverse relationship with ozone. The odds ratio of elevated TF was significantly higher in the upper vs. the lowest quartiles of PM₁₀, ozone and PSI. The corresponding figures were in opposite direction for TM.</p> <p>Conclusions</p> <p>The relationship of air pollutants with endothelial dysfunction and pro-coagulant state can be an important factor in the development of atherosclerosis from early life. This finding should be confirmed in future longitudinal studies. Concerns about the harmful effects of air pollution on children's health should be considered a top priority for public health policy; it should be underscored in primordial and primary prevention of chronic diseases.</p

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Mapping development and health effects of cooking with solid fuels in low-income and middle-income countries, 2000-18 : a geospatial modelling study

Background More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels.Methods We did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km x 5 km resolution in 98 LMICs based on 2.1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution.Findings Although primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure in LMICs, and rising ambient air pollution is undermining potential gains from reductions in the prevalence of solid-fuel use for cooking in many countries. We estimated that, in 2018, 205000 (95% uncertainty interval 147000-257000) children younger than 5 years died from lower respiratory tract infections that could be attributed to household air pollution.Interpretation Efforts to accelerate the adoption of clean cooking fuels need to be substantially increased and recalibrated to account for subnational inequalities, because there are substantial opportunities to improve air quality and avert child mortality associated with household air pollution. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.Peer reviewe