Evaluating risk factors for protein-energy malnutrition in children under the age of six years: a case-control study from Iran

Introduction: Protein-energy malnutrition is one of the most important public health problems in Iran. It not only accounts for more than half of child mortality but can also produce somatic and mental impairment in survivors. The main aim of this study was to identify risk factors for protein-energy malnutrition in children under 6 years of age in Namin city. Methods: This was a population-based, multicenter case-control study. Seventy-six children with malnutrition and 76 children without malnutrition were randomly recruited for case and control groups. The prevalence of risk factors in the two groups was compared. Data were gathered from a health center database and interviews with mothers and health workers. The Wilcoxon signed-rank test and logistic regression were used for data analysis. Results: Female gender, poverty, short maternal height, and use of unhygienic latrines in the home were significantly associated with childhood malnutrition (P , 0.05). Conclusion: The results of this study indicate four main factors (poverty, small maternal height, female gender, and absence of hygienic latrines in the home) as underlying factors in malnutrition of children under the age of 6 years

The impact of bismuth adding to rabeprazole, amoxicillin and clarithromycin on eradication rate of Helicobacter pylori

Background: High prevalence of Helicobacter pylori infection and induction of resistance as a result of consumption of antibiotics necessitates an ongoing effort for evaluation of new regimen to overcome this phenomenon.  Intensive efforts are being made to identify such an optimal regimen, but there are many obstacles hindering the achievement of this goal. This study aimed to investigate the impact of adding bismuth to rabeprazole, amoxicillin and clarithromycin on rate of H. pylori eradication.Methods: In this randomized clinical trial, 60 patients with dyspepsia and positive gastric biopsy for H. pylori in endoscopy were recruited. The first group (A) received rabiprazole for 6 weeks, amoxicillin and clarithromycin for 2 weeks either with bismuth for 2 weeks and the second group (B) received rabiprazole for 6 weeks, amoxicillin and clarithromycin for 2 weeks either without bismuth. Four weeks after the treatment, the compliance and eradication were evaluated using stool antigen of helicobacter. The patients who could complete the therapeutic regimen were assigned for analysis.Results: H. pylori eradication rates were 70% and 56.6% in two groups A and B (with and without Bismuth), respectively and the difference was significant. There is a significant relationship between the studied groups and the results of fecal antigen of H. pylori.Conclusions: The bismuth had a significant effect on the success of eradication rate of H. pylori and its impact adding to the treatment regimen containing clarithromycin was effective on eradication success rate

Depression in mothers of children with thalassemia or blood malignancies: a study from Iran

BACKGROUND: Several studies have found that parents of children with chronic diseases or disabilities have higher depression scores than control parents. Mothers usually take on the considerable part of the extra care and support that these children need and thus are at markedly increased risks of suffering from psychological distress and depression. The main aim of the present study was to investigate if mothers of children with thalassemia or blood malignancies have higher scores of depression compared with a group of control mothers. METHODS AND MATERIALS: In this cross – sectional study, 294 mothers were recruited in three groups and assessed using the Beck Depression Inventory (BDI): mothers of children with thalassemia, mothers of children with blood malignancies and a control group. SPSS version 11.5 with chi square, ANOVA, linear and logistic regression were used for statistical analysis. RESULTS: The only variable bearing a statistically significant relationship with the depression score of mothers was the child's disease: for thalassemia with OR of 2.17 (95% CI = 1.16–4.0, P = 0.015), for blood malignancies with OR of 2.71 (95% CI = 1.48–4.99, P = 0.001). DISCUSSION AND CONCLUSION: The results of this study can contribute to the development of a screening program for decreasing depression burden and promoting quality of life for mothers of children with thalassemia or blood malignancies

Economic evaluation of dialysis and comprehensive conservative care for chronic kidney disease using the ICECAP-O and EQ-5D-5L; a comparison of evaluation instruments

AbstractBackgroundChronic Kidney Disease (CKD) patients often require long-term care, and while Hemodialysis (HD) is the standard treatment, Comprehensive Conservative Care (CCC) is gaining popularity as an alternative. Economic evaluations comparing their cost-effectiveness are crucial. This study aims to perform a cost-utility analysis comparing HD and CCC using the EQ-5D-5L and ICECAP-O instruments to assessing healthcare interventions in CKD patients.MethodsThis short-term economic evaluation involved 183 participants (105 HD, 76 CCC) and collected data on demographics, comorbidities, laboratory results, treatment costs, and HRQoL measured by ICECAP-O and EQ-5D-5L. Incremental Cost-Effectiveness Ratios (ICERs) and Net Monetary Benefit (NMB) were calculated separately for each instrument, and Probabilistic Sensitivity Analysis (PSA) assessed uncertainty.ResultsCCC demonstrated significantly lower costs (mean difference $8,544.52) compared to HD. Both EQ-5D-5L and ICECAP-O indicated higher Quality-Adjusted Life Years (QALYs) for both groups, but the difference was not statistically significant (p > 0.05). CCC dominated HD in terms of HRQoL measures, with ICERs of -$141,742.67 (EQ-5D-5L) and -$4,272.26 (ICECAP-O). NMB was positive for CCC and negative for HD, highlighting its economic feasibility.ConclusionCCC proves a preferable and more cost-effective treatment option than HD for CKD patients aged 65 and above, regardless of the quality-of-life measure used for QALY calculations. Both EQ-5D-5L and ICECAP-O showed similar results in cost-utility analysis

Comparative study of the efficacy of Remifentanil for controlling labor pain when used both alone and in combination with Dexamethasone

  Aims and background: Labor pain is often severe. Unrelieved labor pain can have an adverse effect on the physiologic status of the women in labor. Accurate measurement and appropriate management of pain is a significant problem for attending medical and nursing personnel. There are several options for controlling labor pain. Each method has its own risks and benefits, with variations in effectiveness, availability and acceptability. The purpose of this study was to compare the effectiveness of remifentanil when used with and without dexamethasone in women undergoing a normal vaginal delivery. Materials and methods: In this study 90 pregnant women were selected from the pregnant women referred to Alavi Hospital. Group A received Remifentanil with Dexamethasone and Group B received Remifentanil alone. The pain scores based on VAS  were measured before the intervention and 30, 60, and 120 minutes after the intervention. Finally, the data were analyzed by SPSS. Findings:  Pain severity according to the VAS score was significantly lower in patients that received remifentanil with dexamethasone 30, 60 and 120 min after the intervention compared to the other group.  Analysis of the pooled risk differences showed that nausea, vomiting and headache were significantly higher in remifentanil alone users. There wasn’t a significant difference in FHR or Apgar in the 1st and 5th minute between the two groups. Conclusion:  The use of remifentanil with dexamethasone has more of a beneficial effect for many parturient women compared to remifentanil

Empathy, Burnout and Quality of Life among Medical Students of Ardabil University of Medical Sciences

Background & objectives: Even though clinical empathy is one of the clinical competencies of medical students and there is a high emphasis on teaching and learning, it decreases during medical education. This study investigated the relationship between burnout, quality of life and clinical empathy in medical students. Methods: this exploratory cross-sectional study used the Jefferson empathy questionnaire, WHO quality of life questionnaire and burnout inventory. All three questionnaires are standard, and their validity and reliability have been confirmed in various studies in Iran. The research population was the Ardabil University of Medical Sciences internship medical students, for which the census sampling method was used. Various statistical tests, such as Pearson and spearman correlation, Chi-square, etc., were used for data analysis. Results: Out of 130 students, 128 (98.4%) completed all of the questionnaires. Data analysis showed that 98% of students suffered from moderate burnout and 2% of them had severe burnout. About 44% of students were satisfied or very satisfied with their health status and 33% of students were dissatisfied or very dissatisfied. The mean score of clinical empathy in students was 79.46±9.82. Data analysis showed a statistically significant inverse relationship between quality of life and burnout (p=0.0001). Conclusions: Considering that the situation of students was not very favorable in terms of all three variables, non-curricular programs seem to be essential for improving student adaptation mechanisms to the job-related situations in medical students and promoting clinical empathy

Sodium Intake, Dietary Knowledge, and Illness Perceptions of Controlled and Uncontrolled Rural Hypertensive Patients

Introduction and Objectives. Nutritional knowledge of the patients is important in dietary adherence. This study aimed to determine the relationship between illness perceptions and nutritional knowledge with the amounts of sodium intake among rural hypertensive patients. Methods. In a cross-sectional study, 671 hypertensive patients were selected in a multistage random sampling from the rural areas of Ardabil city, Iran, in 2013. Data were collected using a questionnaire consisting of four sections and were analyzed using Pearson correlation and multiple linear regressions by SPSS-18. Results. The mean of sodium intake in the uncontrolled hypertensive patients was 3599±258 mg/day and significantly greater than controlled group (2654±540 mg/day) (P<0.001). Knowledge and illness perceptions could predict 47.2% of the variation in sodium intake of uncontrolled group. A significant negative relationship was found between knowledge and illness perceptions of uncontrolled hypertensive patients with dietary sodium intake (r=-0.66, P<0.001 and r=-0.65, P<0.001, resp.). Conclusion. Considering the fact that patients’ nutritional knowledge and illness perceptions could highly predict their sodium intake, the importance of paying more attention to improve patients’ information and perceptions about hypertension is undeniable, especially among the uncontrolled hypertensive patients

Epidemiological Study of Adult Patients with Acute Abdomen Referred to Fatemi Ardabil Hospital from 2020 to 2021

Introduction: The prevalence and causes of acute abdomen can be different in various regions and races. Knowing the epidemiology of the disease can prevent unnecessary surgeries and unwanted complications caused by surgery. The present study was conducted with the aim of epidemiological investigation of adult patients with acute abdomen referred to Fatemi Ardabil Hospital from 2020 to 2021. Methods: A cross-sectional descriptive study was conducted during a year with a statistical population of 1031 patients referred to the Emergency Department of Fatemi Ardabil Hospital with abdominal pain. The sampling method was easy non-probability sampling. The information of these patients was collected through a preliminary questionnaire and analyzed using SPSS 16 software. Results: In this study, the number of 535 participants were male and 496 were female. 53.5% of patients had non-bilious vomiting، 67.6% had normal abdominal function، 53% had anorexia، 16.2% had abdominal distension and 14.3% had fever. 20.1% had pain in the right lower quadrant، 16.1% no tenderness، 15.6% rebound tenderness، 5.4% guarding، 5.8% psoas sign and 16.3% Murphy sign. 27% of abdominal pain was related to appendicitis، 20% to cholecystitis، 15.3% to intestinal obstruction and the lowest number of cases were related to metastasis and ectopic pregnancy with 0.3%. Conclusion: The best tools available for examining and managing abdominal pain are clinical examination and a comprehensive history

Data_Sheet_1_Effect of saffron supplementation on oxidative stress markers (MDA, TAC, TOS, GPx, SOD, and pro-oxidant/antioxidant balance): An updated systematic review and meta-analysis of randomized placebo-controlled trials.pdf

IntroductionThis study aimed to perform an updated systematic review and meta-analysis to evaluate the effectiveness of saffron supplementation on oxidative stress markers [malondialdehyde (MDA), total antioxidant capacity (TAC), total oxidant status (TOS), glutathione peroxidase (GPx), superoxide dismutase (SOD), and prooxidant/antioxidant balance (PAB)] in randomized controlled trials (RCTs).MethodsWe searched PubMed/Medline, Web of Science, Scopus, Cochrane CENTRAL, and Google Scholar until December 2022. Trial studies investigating the effects of oral saffron supplements on MDA, TAC, TOS, GPx, SOD, and PAB concentrations were included in the study. To analyze the results, mean differences (SMD) and 95% confidence intervals (CI) were pooled using a random effects model. Heterogeneity was assessed using the Cochrane Q and I2 values. Sixteen cases were included in the meta-analysis (468 and 466 subjects in the saffron and control groups, respectively).ResultsIt was found that saffron consumption caused a significant decrease in MDA (SMD: −0.322; 95% CI: −0.53, −0.16; I2 = 32.58%) and TOS (SMD: −0.654; 95% CI: −1.08, −0.23; I2 = 68%) levels as well as a significant increase in TAC (SMD: 0.302; 95% CI: 0.13, 0.47; I2 = 10.12%) and GPx (SMD: 0.447; 95% CI: 0.10, 0.80; I2 = 35%). Subgroup analysis demonstrated a significant reduction in MDA levels in studies with a saffron dosage of >30 mg/day, age of DiscussionIn summary, the results showed that saffron has beneficial effects on oxidative stress markers.</p