Is a Single dose of Prophylactic Antibiotics Sufficient in Patients with Acute Non-Complicated Appendicitis?

Background: Acute appendicitis is one of the most common acute surgery events. Its main treatment is surgery. However medical management before and after the surgery has an important impact on the treatment. Objective: The aim of study was evaluating the outcomes of single dose and quadruple doses of prophylactic antibiotic therapy in patients with acute non-complicated appendicitis. Methods: This randomized double blind clinical trial was carried out on 294 patients in single dose (136 patients) and the quadruple doses (158 patients) groups. In single dose group, a dose of 1g Cefazolin + 500mg Metronidazole was prescribed intravenously about half an hour before surgery. The quadruple doses group received three more doses after surgery.  Two groups were followed for fever, erythema, seroma, wound infection, intra-abdominal abscess formation and readmissions within one month after discharge. Results: The mean age of patients was 31±5.14 years. 203(69%) of patients were men while 91(31%) were women. There were no significant statistical differences between groups in age, sex and body mass index (BMI) variables. No significant statistical differences were observed during surgery and hospitalization period between two groups. In the single dose group, wound infection was 8(5.9%), while it was 6(3.8%) in the quadruple doses group; hence, there were no significant statistical differences in this regard. There was no abdominal abscess in groups. There were significant statistical differences regarding erythema, seroma and antibiotics consumption costs between groups. Conclusion: A single dose of prophylactic antibiotics is sufficient in patients with acute suppurative non-complicated appendicitis

Prevalence and Correlates of Psychiatric Disorders in a National Survey of Iranian Children and Adolescents

Objective: Considering the impact of rapid sociocultural, political, and economical changes on societies and families, population-based surveys of mental disorders in different communities are needed to describe the magnitude of mental health problems and their disabling effects at the individual, familial, and societal levels. Method: A population-based cross sectional survey (IRCAP project) of 30 532 children and adolescents between 6 and 18 years was conducted in all provinces of Iran using a multistage cluster sampling method. Data were collected by 250 clinical psychologists trained to use the validated Persian version of the semi-structured diagnostic interview Kiddie-Schedule for Affective Disorders and Schizophrenia-PL (K-SADS-PL). Results: In this national epidemiological survey, 6209 out of 30 532 (22.31%) were diagnosed with at least one psychiatric disorder. The anxiety disorders (14.13%) and behavioral disorders (8.3%) had the highest prevalence, while eating disorders (0.13%) and psychotic symptoms (0.26%) had the lowest. The prevalence of psychiatric disorders was significantly lower in girls (OR = 0.85; 95% CI: 0.80-0.90), in those living in the rural area (OR = 0.80; 95% CI: 0.73-0.87), in those aged 15-18 years (OR = 0.92; 95% CI: 0.86-0.99), as well as that was significantly higher in those who had a parent suffering from mental disorders (OR = 1.96; 95% CI: 1.63-2.36 for mother and OR = 1.33; 95% CI: 1.07-1.66 for father) or physical illness (OR = 1.26; 95% CI: 1.17-1.35 for mother and OR = 1.19; 95% CI: 1.10-1.28 for father). Conclusion: About one fifth of Iranian children and adolescents suffer from at least one psychiatric disorder. Therefore, we should give a greater priority to promoting mental health and public health, provide more accessible services and trainings, and reduce barriers to accessing existing services

Antifungal effects of Allium ascalonicum, Marticaria chamomilla and Stachys lavandulifolia extracts on Candida albicans

Introduction: Due to increased risk for opportunistic fungal infections and increasing prevalence of hospital infections caused by pathogenic yeasts and fungus resistance to antifungal drugs, discovery of antifungal compounds with high efficiency is necessary. This study was aimed to evaluate and compare the antifungal activities of Allium ascalonicum, Marticaria chamomilla and Stachys lavandulifolia on Candida albians. Methods: In this study the plants extracts were prepared with macerated method using ethanol 70%. Antifungal activities of the extracts were performed according to microbroth dilution method in 96 well microdilution plates. The amount of Minimum Inhibitory Concentration (MIC) and Minimum Fungicidal Concentration (MFC) based on counting the number of fungal colonies (CFU) were evaluated for each of Allium ascalonicum, Chamomile and Stachys lavandulifolia extracts compared with the control group. Results: MIC of Allium ascalonicum, Marticaria chamomilla and Stachys lavandulifolia were respectively 0.31, 3.75 and 15.13 mg/ml and also MIC50% of Allium ascalonicum, Marticaria chamomilla and Stachys lavandulifolia were respectively 0.93, 10.59 and 41.32 mg/ml and MIC 90% of them were respectively 8.65, 16.88 and 60.55 mg/ml and their MFC were respectively 20, 20 and 65 mg/ml. Conclusion: The results indicate that all three extracts are effective, but Allium ascalonicum possesses the highest antifungal activity on Candida albicans. If clinical trials approve these findings, this plant may represent a new source of antifungal agent for control of Candida albicans

Prevalence, comorbidity and predictors of anxiety disorders among children and adolescents

Childhood anxiety may lead to serious health consequences in later life. The present study provides the prevalence, comorbidity, and predictors of anxiety disorders among children and adolescents. This was a cross-sectional national project that was implemented on 28,698 children and adolescents in Iran. Participants entered the study by multistage cluster sampling with an equal number of each gender and three age groups (6-9, 10-14, and 15-18 years) within each cluster. The tools used in this research were the demographic questionnaire and K-SADS-PL. To analyze the data logistic regression and chi-square tests were used in SPSS (ver. 16). The prevalence of anxiety disorder in children and adolescents was 13.2 in boys and 15.1 in girls. Furthermore, gender, age, place of residence and history of psychiatric hospitalization of parents could predict anxiety disorders. Anxiety disorders had comorbidity with behavioral disorders, neurodevelopmental disorders, mood disorders, psychotic disorders, substance abuse disorders, and elimination disorders. According to our findings in this study, anxiety disorders affect the performance, health and life of children and adolescents, identifying the childhood anxiety, as well as finding diseases that are associated with anxiety disorders, can help in the prevention of the disorder. Keywords: Anxiety disorder; Children and adolescents; Comorbidity; Predictors; Prevalence