COMPARISON OF SERUM VITAMIN A LEVELS BETWEEN NEONATES WITH CONGENITAL HEART DISEASE AND CONTROLS

Objective: Prevention of congenital heart disease (CHD) has been hampered by a lack of information about the known modifiable risk factors for abnormalities in cardiac development. Vitamin A plays an important role in the periods of rapid cellular growth and differentiation, especially during pregnancy. Assuming a link between Vitamin A levels and congenital malformations, hypothetical different levels of Vitamin A were evaluated in neonates with and without CHD, in this study.Methods: In a case–control study that was conducted in 2015 in Mashhad/Iran, serum levels of Vitamin A in 30 neonates with CHD were compared to 30 healthy controls. The cases were diagnosed by echocardiography and recruited by convenience sampling. Demographic and laboratory data including age, sex, and serum Vitamin A level in each group were collected. Data analysis was done in SPSS V 20 software, and descriptive statistics, t-test, and analysis of covariance were used.Results: The mean age in cases was 11±3.4 days and in controls was 12.5±4.8 days. A total of 18 patients (60%) were male. In CHD patients, 10 cases (33.3%) had cyanotic heart disease, and 20 cases (66.7%) had non-cyanotic heart disease. The mean serum Vitamin A values in subjects (11.54±9.56 μg/dL) and controls (21.84±14.3 μg/dL) were significantly different, (p<0.05) and in case group was lower than the normal range.Conclusion: There was a significant difference in serum Vitamin A values in subjects and controls. Therefore, awareness of people about the importance of this vitamin in preventing CHD in children seems necessary

Investigation of Cancer Risk Factors in the Lifestyle of Medical Students at Mashhad University of Medical Sciences

Introduction: Every year, over 10 million new cases of cancer are diagnosed worldwide. Cancers tend to be closely associated with lifestyle.This study aimed to investigate the lifestyle-related cancer risk factors in the medical students of Mashhad University of Medical Sciences. Materials and Methods: This descriptive cross-sectional study was performed on 270 students of Mashhad University of Medical Sciences in Iran, who were selected through convenience sampling. Data collection was performed using a lifestyle risk factor questionnaire, which was provided to students online. Data were analyzed with the statistical analysis software SPSS-21 by using descriptive statistics, Chi-square, and Mann-Whitney tests at the 0.05 significance level. Results: All participants were in the age range of 22-25 years old. About 28% of the participants were male and 72% were female. Men showed higher awareness of cancer warning signs than women (p=0.046). Women were more active in taking protection measures against chemical substances than men (p=0.042). Men were in significantly better condition in terms of the use of hormones than women (p=0.048). Married people were also more active in taking protection measures against chemical substances than single people (p=0.042). Conclusion: Compared to other lifestyle risk factors for cancer, the surveyed medical students had particularly poor “eating habits” and “solar radiation exposure”. About half of the surveyed students had a high level of exposure to sunlight. Therefore, it is highly recommended to implement a program to raise students’ awareness of cancer risk factors and promote healthy lifestyles in this population

The Effects of Botulinum Toxin Type A on Reducing Sialorrhea in Children with Cerebral Palsy: A Self-Controlled Clinical Trial

Background: Cerebral palsy stands as the main cause of mobility disability in childhood, and the accompanying sialorrhea exacerbates health and psychological issues for both the child and the family. We aimed to assess the effect of botulinum toxin type A on reducing sialorrhea in children with cerebral palsy.Methods: This self-controlled clinical trial was executed among children afflicted with cerebral palsy. The Teacher Drooling Scale was used as the data collection tool. The intervention involved the administration of botulinum toxin A, with a dosage ranging from 30 to 50 units in each parotid gland, skillfully guided by a radiologist using ultrasound. Sialorrhea scores were compared before and after the injection.Results: Our study included 21 children with cerebral palsy and sialorrhea. After the two post-injection weeks, a noteworthy drop was observed in the sialorrhea score (4.10±0.831) compared to the pre-injection score (4.71±0.463). The sialorrhea score until the ninth month after injection (1.121±3.43) was still significantly lower than the score before injection.Conclusion: The injection of botulinum toxin A emerges as a potent medication, significantly curtailing the drooling among patients with cerebral palsy. This finding can be used to prevent aspiration pneumonia and reduce social and psychological complications in this population

Evaluation of physicians' skills in breaking bad news to cancer patients

Background: Delivering bad news to patients is one of the most difficult tasks of physicians that play a big role in the process of treatment and cooperation of patients. The objective of this study is to evaluate the ability and skills of physicians in delivery bad news to cancer patients. Methods: This study is a cross-sectional study performed on 70 specialist physicians in two hospitals of Mashhad in 2016. Data were collected by Persian questionnaire of SPIKES included 16 questions and were analyzed by SPSS software. Results: In this study, among the questionnaire items, the most prevalent item was not giving the bad news by phone (100%) and the least prevalent item was putting the hand on the shoulder (24.3%). This study showed that 81.4% of doctors agreed on giving the bad news in private, 72.9% agreed on giving relative hope to patients and 67.1% agreed on evaluating patients knowledge of his/her disease when giving bad news. Conclusion: The results of this study show that the ability of physicians in giving bad news is not enough in some aspects. Therefore, holding educational courses during physicians' education and after graduation are recommended to increase patients' trust and decreasing worries and inconvenience of physicians in difficult situations of delivering bad news

Neonatal meningitis caused by streptococcus pneumonia in Iran

Meningitis, pneumonia, and sepsis in newborns and young infants (age < 60 days) are the main causes of childhood mortality in developing countries. Even though streptococcus pneumonia is the most commonly detected microorganism in pediatric bacterial meningitis, it is rare in newborn infants. The following article reports a case of pneumococcal meningitis that was detected early in a newborn infant in 2013. A female baby was born by vaginal delivery with a birth weight of 2900 grams. She was symptomatic (poor feeding) from her first day of life, but she was admitted with a toxic status (dehydrated, lethargic, cyanotic, hypo tone, hypo reflex) to our referral center on her third day life. Her blood culture showed no growth of any organism and her urine culture was also negative, but the Cerebrospinal fluid (CSF) culture showed growth of streptococcus pneumonia. The maternal sepsis workup was normal. Despite all therapeutic management, unfortunately, the patient died on her fourth day after admission

Mothers' preferences toward breaking bad news about their children cancer

Background: The responsibility of breaking bad news (BBN) to patients is one of the most difficult tasks of a medical profession. Aim: The current study aimed to investigate the preferences of mothers of children with cancer about BBN. Materials and Methods: In this cross-sectional study was conducted in Mashhad during years of 2016, 62 mothers of children with cancer at Dr-Sheikh hospital were recruited by convenience sampling and completed a questionnaire including demographic data and 20 questions about the mothers' preferences to BBN. Data displayed as percent by SPSS V20 software. Results: Mothers preferred that BBN conducted by their child's doctor (93.5%), with an emotional and compassionate way (83.9%), and in a private setting (90.3%). Be told completely about the process of diagnosis (98.4%), meet people with similar conditions (83.9%), receive psychological (85.5%), and religious (79%) support after getting bad news, being in touch with a close relative (82.3%) and applying another term-like malignancy instead of cancer (95.5%). Conclusion: We tried providing helpful information for developing national guidelines about how to breaking news in Iran, by doing this study

The data on health locus of control and its relationship with quality of life in HIV-positive patients

Locus of control is a concept defined based on social learning theory, and focuses on individuals' beliefs regarding factors that influence their health status. Health Locus of Control (HLC) and its relationship with Quality of Life (QOL) in HIV positive patients in local population were studied. This was a cross-sectional study on 80 HIV-positive patients. Multidimensional Health Locus of Control (MHLC) Scale and Medical Outcome Study Short-Form Health Survey (MOS-SF-36) used to measure patients' HLC and QOL, respectively. Internal, external, and chance HLC mean ± SD scores were 30.31±3.87, 24.17±5.03, and 32.01±4.49, respectively. Positive correlation was found between internal HLC scores and both physical (p <0.001, r = 0.53) and mental quality of life (p <0.001, r = 0.48). Multiple regression analysis showed that internal HLC was the only significant predictor of quality of life. HIV-positive patients who believe their health is mostly influenced by individual's actions and behaviors (internal HLC) showed a higher quality of life. These findings suggest that modifying health locus of control beliefs, hypothetically could influence patients' quality of life. Keywords: HIV, Health locus of control, Quality of life, Medicin

Smoking during Pregnancy and Maternal and Neonatal Complications in Mashhad, Suburbs, and Subsidiary Villages: A Population-based Cross-Sectional Study

Background: Smoking is very important during pregnancy because of severe fetal and maternal complications. No community-based studies have been conducted on pregnant women in Iran. This study aimed to investigate the prevalence of smoking during pregnancy, as well as maternal and neonatal complications in Mashhad, Iran, during 2017.Methods: This cross-sectional study reviewed the information of 1140 and 92,225 smoking and non-smoking pregnant women during pregnancy, respectively, and 3-5 days after delivery using Sina Electronic Health Record System in Mashhad, Iran, during 2017. All data were extracted, encoded, and entered into SPSS software (version 16).Results: Out of the total of 93,365 pregnant women with a mean age of 22.36 years, the prevalence of smoking during pregnancy was significantly higher among those who live in the city (i.e., Mashhad), compared to individuals living in the suburbs or villages. The mean rates of stillbirth, prematurity, very-low-birth-weight, and low-birth-weight were higher in smoking pregnant mothers, compared to non-smoking ones (p <0.0001). The prevalence of smoking among literate and employed pregnant mothers was significantly higher than illiterate and unemployed pregnant women (p <0.0001). The mean birth weight of newborns of smoking mothers (1528gr) was less than the half mean of the birth weight (3180gr) of newborns of non-smoking mothers (p <0.0001).Conclusion: The prevalence of smoking in mothers living in Mashhad, Iran, was 1.2%, which is less than the global average. The results of this study showed that smoking during pregnancy has many maternal and fetal complications

Cluster analytical approach to Lifestyle characteristics: A population based study in Shiraz, Iran

Introduction: A limited number of risky behaviors cause most morbidity and mortality. The aim of this study was to determine the possible clustering of lifestyle behaviors, including transportation behaviors, diet, physical activity, and smoking in Shiraz, Iran. Methods: There were 776 representative Shirazi adults who participated in this cross-sectional study. The questionnaires were completed via person-to-person interviews. The datasets were searched for any clustering patterns. Cluster analysis was used for statistical analysis, and the data were analyzed using SPSS version 11.5. Results: Three distinct clusters were identified. Cluster 1 was named "Healthy," and it included non-smokers, safe drivers, appropriate or acceptable fruit, vegetable, and fast-food consumers, and physically-active people. Cluster 2, "Moderately Healthy," was relatively risky drivers who had appropriate behaviors on the rest of the health-related behaviors. Cluster 3, "Unhealthy," was smokers, risky drivers, inappropriate or unacceptable fruit, vegetable & fast-food consumers, and a sedentary lifestyle. Conclusions: It was obvious that health-related behaviors were clustered together and unhealthy behaviors were not established in isolatio

Evaluating the effect of oral clarithromycin on acute cutaneous leishmaniasis lesions compared with systemic glucantime

Background and aim It is widely accepted that the high prevalence of leishmaniasis, demands the search for a tolerable effective treatment with the least side effects. This study aimed to evaluate the effect of treatment with clarithromycin on regression of lesions. Materials and methods This study was performed on 20 patients with leishmaniasis referred to dermatology clinic in 2017–2018. They were divided into two groups of intervention (500 mg oral clarithromycin twice a day) and control (20 mg/kg/day systematic glucantime). Induration size of lesions was recorded. Results We had 20 patients with acute cutaneous leishmaniasis (CL) with 45 lesions in the control group and 49 lesions in the intervention group. In the control group, the mean number of lesions was 3 ± 2.8 and 5 ± 4.3 in each person in the control and intervention group (p=.63). The mean size of the largest diameter of lesions’ induration at the beginning of the treatment was 19.81 ± 13 and 15.47 ± 15.6 mm in control and intervention group (p=.3) which changed to 1.59 and 0 respectively in three months after the treatment (p=.001). Conclusions We concluded oral clarithromycin had therapeutic effects on acute CL similar to systematic glucantime and could be considered as a safe and effective treatment option