FEBRILE SEIZURE: RECURRENCE AND RISK FACTORS

Background:Febrile Convulsion is the most common convulsive disorder in children, occurring in 2 to 4% of the pediatric population and recurring in 30- 50% of cases. Considering the varying recurrence rates reported, this study was conducted at the pediatric ward of the Shaheed Beheshti General Hospital, between 2000-2001 to determine the frequency of recurrence and related risk factors in children presenting with their first episode of febrile convulsionMaterials & Methods:A two-year cohort study was performed on 50 children presenting with the first attack of febrile convulsion. Patient demographic data including age, sex, type and duration of seizure, family history of febrile seizure or epilepsy and the interval between fever onset and occurrence of seizure were recorded in questionnaires. Those patients, for whom prophylactic medication was not administered, were followed at three-month intervals for up to one year. Findings were statistically analyzed using Fisher's exact test.Results:Recurrence was observed in twelve children (24%) out of the fifty, being most common in patients aged less than one year (54.4%). Recurrence rates among children with a positive family history of febrile convulsion, presence of complex febrile seizure and positive family history of epilepsy were 42.1%, 42.8% and 25% respectively. From among those children with a "less than one hour" interval between fever onset and occurrence of seizure, recurrence occurred in 43-7% of  cases, while in those with a "more than one hour interval", 14.7% experienced recurrence.Conclusion:Recurrence rates are increased by certain factors including age-below one year-, positive family history of febrile convulsion, and a "less than one hour" interval between time of fever onset and seizure occurrence.Keywords:Febrile Seizure, Recurrence, Risk Factor

Incidence of Neonatal Birth Injuries and Related Factors in Kashan, Iran

Background: Birth injuries are defined as the impairment of neonatal body function due to adverse events that occur at birth and can be avoidable or inevitable. Despite exact prenatal care, birth trauma usually occurs, particularly in long and difficult labor or fetal malpresentations. Objectives: This study aimed to investigate the incidence of birth injuries and their related factors in Kashan, Iran, during 2012-2013. Patients and Methods: In this cross-sectional study, all live-born neonates in the hospitals of Kashan City were assessed prospectively by a checklist included demographic variables (maternal age, weight, and nationality), reproductive and labor variables (prenatal care, parity, gestational age, premature rupture of membrane (PROM), fetal heart rate (FHR) pattern, duration of PROM, induction of labor, fundal pressure, shoulder dystocia, fetal presentation, duration of second stage, type of delivery, and delivery attendance), and neonatal variables (sex, birth weight, height, head circumference, Apgar score, and neonatal trauma). Birth trauma was diagnosed based on pediatrician or resident examination and in some cases confirmed by paraclinic methods. Statistical analyses were performed by chi-square, student’s t-test, and multiple logistic regression analyses using SPSS version 17. P ≤ 0.05 was considered statistically significant. Results: In this study, the incidence of birth trauma was 2.2%. Incidence of trauma was 3.6% in vaginal deliveries and 1.2% in cesarean sections (P < 0.0001). The most common trauma was cephalohematoma (57.2%) and then asphyxia (16.8%). In multiple logistic regression analyses, decreased fetal heart rate (FHR), fundal pressure, shoulder dystocia, vaginal delivery, male sex, neonatal weight, delivery by resident, induction of labor, and delivery in a teaching hospital were predictors of birth trauma. Conclusions: Overall, incidence of birth trauma in Kashan City was lower in comparison with most studies. Considering existing risk factors, further monitoring on labor, and delivery management in teaching hospitals are recommended to prevent birth injuries. In addition, careful supervision on students and residents' training should be applied in teaching hospitals

An integrated approach to study the impact of fractures distribution on the Ilam-Sarvak carbonate reservoirs: a case study from the Strait of Hormuz, the Persian Gulf

Most of the Iranian hydrocarbon reservoirs in the Persian Gulf Basin and the Zagros Fold-Thrust Belt are composed of fractured carbonate rocks. In this regard, determining the spatial distribution of fractures has been a challenging issue. In this study, an integrated approach was applied for understanding the impact of fractures spatial distribution on the Ilam-Sarvak (Cenomanian to Santonian) carbonate reservoir rocks. For this purpose, seismic interpretation techniques along with geomechanical and geostatistical modeling were employed to characterize fractures at different scales. Initially, the relationship between fractures origin and the normal faults was investigated by conducting an in-situ stress analysis. Afterwards, the velocity deviation log (VDL) and fracture intensity log (FIL) were derived as fracture attributes from the interpretation of Formation Micro Imager (FMI) and conventional well logs. A 3D model of VDL and FIL was achieved by using a sequential Gaussian simulation (SGS) method. In order to achieve a more realistic and accurate model of the factures distribution, variations of the shear-wave velocity and geomechanical properties (Young's modulus and Poisson's ratio) were estimated by applying the advanced seismic interpretation techniques in the normal faults domain. The results show that the intensity of fractures increases once they are introduced to the normal faults, especially in the central part of the study area around well#2. Such a fractured zone is verified by fracture density log derived from FMI logs of the mentioned well. Obviously, there is a close-knit relationship between the fracture system and the normal faults. Eventually, secondary porosity caused by features was determined though identification of Hydraulic Flow Units (HFUs). Based on the porosity and permeability data, seven HFUs were determined for the Ilam-Sarvak reservoirs. The very high values of Log FZI indicate the possible presence of fractures. Overall, the fractures contributed to enhance the secondary porosity of the reservoir rocks though increasing matrix permeability. To sum up, the fractures system plays a critical role in controlling reservoir properties especially in the hanging-wall of normal faults where the majority of the macro and micro fractures are distributed

Markdown Budgets for Retail Buyers: Help or Hindrance?

For many retailers, markdown decisions are taken by retail buyers whose compensation is based on sales revenue so their objective is to maximize it through the season. This implies that the buyers' objectives are not perfectly aligned with the overall profitability the firm. Many retailers set markdown budgets prior to the season to control margin erosion and increase profitability. Markdown budget constrains the buyers on the amount of discounts that they can apply on a given inventory of merchandise and sets a limit on the dollar value of markdowns for the season. While markdown budgets may be useful in preventing excessive discounts, they can have a detrimental effect on the buyers' ability to respond to poor market and remove distressed inventory. We investigate the effectiveness of this practice in aligning the incentives of buyers with that of the firm, and provide guidance on how these budgets should be established ahead of time. We consider a firm with a fixed inventory of a seasonable item, and a single chance to mark the price down. The retailer knows only the demand distribution at the beginning of the season, but the market information is revealed during the season to the buyer. We first characterize the buyer's markdown policy and understand the circumstances under which this can be different from the retailer's markdown policy. We use our model to determine the optimal markdown budget and quantify its effectiveness considering different factors such as the level of demand uncertainty, initial markup, and market's responsiveness to markdowns. © 2017 Production and Operations Management Societ

Utjecaj glutaraldehida na svojstva želatinskih filmova

In this work gelatin film was prepared from cow\u27s bone. In order to increase mechanical stability of the prepared transparent film as well as decrease its swelling, glutaraldehyde (GTA) was used. Different mass fractions of GTA were utilized. It was observed that at w = 0.18 % of GTA the load at break of the film is &#948;= 53.7 N and the solubility decreased. The solubility of the film was measured as a dependant parameter of the swelling behavior. In this case it was decreased from 389 % to 156 % at 5 min for gelatin films without GTA and with 0.18 % GTA, respectively. FTIR spectroscopy results showed a peak for crosslinked gelatin at &#944; = 1650 cm-1. It means the crosslinking between gelatin and GTA has taken place. SEM micrographs confirm the porosity has decreased by increasing the GTA fraction, which is an indication of higher strength.U ovom je radu pripremljen želatinski film od kravlje kosti. Da bi se povećala mehanička stabilnost pripremljenog transparentnog filma kao i smanjilo njegovo bubrenje, upotrijebljen je glutaraldehid (GTA). Upotrijebljeni su različiti maseni udjeli mase GTA. Uočeno je da kod 0,18 % GTA prekidna sila filma iznosi 53,7 N i da se povećala topljivost. Topljivost filma izmjerena je kao parametar ovisan o ponašanju pri bubrenju. U ovom slučaju smanjio se s 389 % na 156 % kod 5 minuta za želatinske filmove bez GTA odn. s 0,18 % GTA. Rezultati spektroskopije FTIR pokazali su maksimum za umreženu želatinu kod 1650 cm-1. To znači da je došlo do umrežavanja između želatine i GTA. Mikroskopske slike SEM potvrđuju da se poroznost smanjila povećanjem dijela GTA, što je pokazatelj veće čvrstoće

Do Infants Using Baby Walkers Suffer Developmental Delays in Acquisition of Motor Skills?

AbstractObjectiveDevelopment is a complex process, completed over a specific period of time, through the maturation of the nervous system. It is affected by genetic, ethnic, nutritional, social, and economic factors; one of the environmental factors affecting the acquisition of motor skills in infants is the use of baby walkers. Since this device is very commonly used for infants in our country, we conducted this study to evaluate its effects on the acquisition of motor skills in this age group of children.Materials &amp; MethodsThis longitudinal study was conducted in 2005 on 300 infants referring to the Primary Health Care Centers of Kashan district in 1384; the infants were divided into two groups of 150 babies each, with the case group using baby walkers, while the other 150, the controls, did not. All babies were followed for two years, and the ages for acquisition of motor skills were documented during face-to face or telephone interviews with the parents. Data were analyzed using the T-test and the Chi Square test.ResultsOf the study population, 175 babies (58.33%) were male. The mean age of acquisition of motor skills including rolling, crawling, moving on hands and feet, sitting without and with help, standing and walking dependently and independently were found to be delayed in infants using baby walkers, a difference between the two groups of walker users and non- walker users that was statistically significant (P&lt;0.001).ConclusionConsidering the adverse effects that walkers have on the acquisition of motor skills in infants, as demonstrated by the results of this study, we do not recommend the use of baby walkers in infants

Comparison of the frequency and complications of inappropriate antidiuretic hormone secretion in patients with septic and aseptic meningitis

Objective Due to the high prevalence of syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH). This study was carried out to evaluate the prevalence and relevant parameters of SIADH in children with septic and aseptic memingitis hospitalized at Kashan Shahid Beheshti Hospital between 1996 and 2006. Materials & Methods This descriptive study was conducted on 230 patients with meningitis hospitalized in the pediatric wards of Kashan Shahid Beheshti Hospital between 1996 and 2006. Relevant information (age, gender, type of meningitis, serum sodium and potassium, urine specific gravity (USG), blood sugar, blood urea nitrogen, serum creatinin, hydration condition) was collected from patients' records. Datawas analyzed using Mann-Whitney and K2 tests. Results Out of 230 patients with meningitis, 33 had incomplete records and only 197 patients were recruited for this study. Sixty eight cases (34.5) suffered from SIADH. It was more frequent among 1-2 year old children. According to this research, SIADH was diagnosed in 57 of the 121 patients with hyponatremia, 58.7 of the 167 patients with USG > 1.004, 74 of the 93 patients with serum osmolity < 280 mOs/L and 100 of the patients with BUN < 10 mg. Conclusion Due to the high prevalence of SIADH in septic and aseptic meningitis and its complication, it is recommended to restrict fluid therapy and monitor serum sodium, urine specific gravity and other diagnostic tests for SIADH

The effects of arm movement on reaction time in patients with latent and active upper trapezius myofascial trigger point

Background: Myofascial pain syndrome is a significant source of mechanical pain. The aim of this study was to investigate the effects of arm movement on reaction time in females with latent and active upper trapezius myofascial trigger point. Methods: In this interventional study, a convenience sample of fifteen women with one active MTP, fifteen women with one latent MTP in the upper trapezius, and fifteen normal healthy women were participated. Participants were asked to stand for 10 seconds in an erect standing position. Muscle reaction times were recorded including anterior deltoid (AD), cervical paraspinal (CP) lumbar paraspinal (LP), both of upper trapezius (UT), sternocleidomastoid (SCM) and medial head of gastrocnemius (GcM). Participants were asked to flex their arms in response to a sound stimulus preceded by a warning sound stimulus. Data were analyzed using one-way ANOVA Test. Results: There was significant differences in motor time and reaction time between active and control groups (p<0.05) except for GcM. There was no significant difference in motor time between active and passive groups except for UT without MTP and SCM (p<0.05). Also, there were no significant differences in motor times between latent MTP and control groups. Furthermore, there was no significant difference in premotor times between the three groups. Conclusion: The present study shows that patients with active MTP need more time to react to stimulus, but patients with latent MTP are similar to healthy subjects in the reaction time. Patients with active MTP had less compatibility with environmental stimulations, and they responded to a specific stimulation with variability in Surface Electromyography (SEMG)