Association between splenectomy and pulmonary hypertension in patients with major beta- thalassemia

Background and purpose: Increased pressure in the pulmonary circulation is of the major factors causing cardiac disorders in patients with thalassemia. The aim of this study was to investigate the relationship between splenectomy and pulmonary arterial pressure in individuals with beta- thalassemia major. Materials and methods: A cross-sectional study was carried out in patients with beta-thalassemia attending Hajar Hospital Shahrekord, Iran, 2015. All patients underwent echocardiography and the hemoglobin levels, platelet count, ferritin, pressure, pulmonary arterial pressure, etc. were measured. Data analysis was done in Stata 13. Results: Among the variables measured, the average age, hemoglobin level, platelet count, nucleated RBC, lactate dehydrogenase, tricuspid regurgitation flow, pulmonary arterial pressure, right diameter, main pulmonary diameter, left ventricular end diastolic diameter, left ventricular end systolic diameter were found to be higher in patients with splenectomy, compared to those of the patients without splenectomy (P> 0.05). Significant correlation was observed between platelets, NRBC and the time of splenectomy with pulmonary artery pressure (P 0.05). Conclusion: The results showed that splenectomy could increase the susceptibility to pulmonary artery pressure in patients with beta thalassemia major or lead to the progression of pulmonary hypertension in this disease

Assessing growth parameters of children with congenital hypothyroidism subject to levothyroxine treatment compared to normal growth parameters in healthy newborns

Background and aims: Congenital hypothyroidism (CH) is one of the most common treatable physical growth disorders leading to mental retardation. Most cases of this disease can be detected through the neonatal screening program. Given the high prevalence of this disease and the implementation of screening programs in recent years in Iran, this study aimed to assess the growth indices of newborns with CH. Methods: In this retrospective cohort study, 66 newborns with CH detected in the screening program in Shahrekord were selected by a census sampling method. Overall, 125 healthy newborns were also selected as controls by the convenience sampling technique according to the inclusion and exclusion criteria. The height, weight, head circumference, and body mass index (BMI) of the samples were measured and then the mean, median, standard deviation, as well as the 3rd, 15th, 25th, 50th, 75th, 85th, and 97th percentiles in the two groups were determined and compared based on gender and age group. Results: The height, weight, head circumference, and BMI of the boys, in addition to the head circumference and BMI of the girls, were not significantly different from those of the controls (P>0.05). However, the height and weight of the girls were significantly lower compared to those in the control group, although the difference in the weight was corrected at the age of 9 months. Conclusion: In general, the growth indices of newborns with CH were lower than those of the controls. This difference was significant only for the weight and height of girls with CH. Keywords: Congenital hypothyroidism, Growth indices, Newborn Screenin

Comparison of the effect of polyethylene glycol 40 and fig syrups on the treatment of chronic functional constipation in children: A randomized clinical trial

Background and aims: None of the available constipation treatments for children are completely successful. Therefore, the present study aimed to evaluate the effect of the polyethylene glycol (PEG) solution 40 and fig syrup on the treatment of chronic constipation in children. Methods: In this double-blind clinical trial, 120 patients with chronic functional constipation were selected and divided into two groups. The first group received 5 mL of fig syrup without senna 3 times daily, and the second group took PEG 40 syrup at 1 mL/kg of body weight per day (the dose was adjustable according to the patient�s condition and need). At weeks 0, 2, 4, and 6, a checklist containing questions about children�s constipation was completed by the researcher, and the data were analyzed by SPSS version 24. Results: Changes in the frequency of abdominal pain at fourth times 0, 2, 4, and 6 weeks demonstrated statistically significant differences between the two groups (P=0.044), and it was significantly lower the in PEG group; however, the defecation was not statistically significant (P=0.902). After six weeks, the frequency of painful defecation, difficult defecation straining during defecation, and fear of defecation was significantly lower in the group given PEG syrup compared to the fig syrup-receiving group (P=0.001). Conclusion: Overall, PEG syrup was significantly effective in treating chronic functional constipation in children compared to the fig syrup

Parental Education or Household Income? Which Socioeconomic Status Indicator Can Better Reduce Body Mass Index Disparities among Latino Children?

Aim: We compared the effects of parental education and household income on children’s Body Mass Index (BMI) in Hispanic White (HW) and non-Hispanic White (NHW) families. Methods: In this cross-sectional study, we borrowed data from the Adolescent Brain Cognitive Development (ABCD) study and analyzed data of 5100 children between the ages of 9 and 10. The independent variables were parental education and household income. The primary outcome was BMI value. Ethnicity was the moderating variable. Confounders were age, sex, and family structure. Three mixed-effects regression models were used for data analysis. Results: Overall, higher parental education and household income were associated with lower BMI levels in children. While an interaction was reported between ethnicity and parental education, no relation was noted between ethnicity and household income regarding BMI. The interaction indicated weaker protective effects of high parental education on BMI in HW children than NHW children. Household income showed similar protective effects on children’s BMI in HW and NHW families. Conclusion: Parental education but not household income loses some of its protective effects on childhood BMI among HW families compared to NHW families. Distal social determinants of health may be more vulnerable to the MDRs (minorities’ diminished returns) than proximal ones. As a result, closing the income gap may be a good strategy towards closing the childhood BMI gap between highly educated HW and NHW families. Policies that raise the minimum wage and those that help HW families save money (e.g., earned income tax policies) maybe more promising strategies to eliminate the ethnic gap in BMI than increasing the education level of ethnic minority families

Parental Education or Household Income? Which Socioeconomic Status Indicator Can Better Reduce Body Mass Index Disparities among Latino Children?

Aim: We compared the effects of parental education and household income on children's body mass index (BMI) in Hispanic White (HW) and non-Hispanic White (NHW) families. Methods: In this cross-sectional study, we borrowed data from the Adolescent Brain Cognitive Development (ABCD) study and analyzed data of 5100 children between the ages of 9 and 10. The independent variables were parental education and household income. The primary outcome was BMI value. Ethnicity was the moderating variable. Confounders were age, sex, and family structure. Three mixed-effects regression models were used for data analysis. Results: Overall, higher parental education and household income were associated with lower BMI levels in children. While an interaction was found between ethnicity and parental education, no interaction was noted between ethnicity and household income regarding BMI. The interaction indicated weaker protective effects of high parental education on BMI in HW children than NHW children. Household income showed similar protective effects on children's BMI in HW and NHW families. Conclusion: Parental education but not household income loses some of its protective effects on childhood BMI among HW families compared to NHW families. Distal social determinants of health may be more vulnerable to the MDRs (minorities' diminished returns) than proximal ones. As a result, closing the income gap may be a good strategy towards closing the childhood BMI gap between highly educated HW and NHW families. Policies that raise the minimum wage and those that help HW families save money (e.g., earned income tax policies) maybe more promising strategies to eliminate the ethnic gap in BMI than increasing the education level of ethnic minority families. Keywords: body mass index (BMI); children; ethnicity; obesity; socioeconomic status

Association between Splenectomy and Pulmonary Hypertension in Patients with Major Beta- Thalassemia

Background and purpose: Increased pressure in the pulmonary circulation is of the major factors causing cardiac disorders in patients with thalassemia. The aim of this study was to investigate the relationship between splenectomy and pulmonary arterial pressure in individuals with beta- thalassemia major. Materials and methods: A cross-sectional study was carried out in patients with beta- thalassemia attending Hajar Hospital Shahrekord, Iran, 2015. All patients underwent echocardiography and the hemoglobin levels, platelet count, ferritin, pressure, pulmonary arterial pressure, etc. were measured. Data analysis was done in Stata 13. Results: Among the variables measured, the average age, hemoglobin level, platelet count, nucleated RBC, lactate dehydrogenase, tricuspid regurgitation flow, pulmonary arterial pressure, right diameter, main pulmonary diameter, left ventricular end diastolic diameter, left ventricular end systolic diameter were found to be higher in patients with splenectomy, compared to those of the patients without splenectomy (P> 0.05). Significant correlation was observed between platelets, NRBC and the time of splenectomy with pulmonary artery pressure (P 0.05). Conclusion: The results showed that splenectomy could increase the susceptibility to pulmonary artery pressure in patients with beta thalassemia major or lead to the progression of pulmonary hypertension in this disease

Assessment of Three Therapeutic Procedures in the Prevention of Diabetic Macular Oedema after Phacoemulsification through Intraocular Lens Implementation

A cataract is an ocular complication of diabetes mellitus, and the risk of developing diabetic macular oedema (DME) increases in cataract surgery. This randomized, single-blind clinical trial study was conducted on 45 eyes (39 patients) with stable diabetic retinopathy with cataract to compare the efficacy of three therapeutic procedures in the prevention of DME after phacoemulsification through intraocular lens implantation. After cataract surgery by phacoemulsification, the patients were randomly assigned into three groups. The group A received 1.25 mg of intravitreal bevacizumab, and group B received a sub-tenon injection of 40 mg triamcinolone at the end of the surgery. The group C received topical diclofenac drops every 8h for four weeks after the surgery. Results showed there was no significant difference in the demographics and clinical features, central macular thickness, and systemic condition of the three groups at the beginning of the study. There was a significant difference between the preoperative and postoperative periods (i.e., three months after surgery) in the three groups regarding mean macular thickness; however, the difference among the three groups was not significant in the post-operative periods. The DME after cataract surgery occurred in 4 eyes (26.67%) in the diclofenac group and three eyes (20.00%) in the intravitreal bevacizumab and three eyes (20.00%) in sub-tenon triamcinolone groups. According to results, the administration of these three therapeutic procedures can be beneficial in the prevention of DME in patients with cataract and diabetic retinopathy

Effect of face-to-face training and pamphlets in reducing anxiety in 7-25 years old clients referred to echocardiography

Introduction: Echocardiography is a diagnostic test in that ultrasound waves are used for producing images of the heart muscle and valves. Echocardiography provides a series of useful information about the heart and its function for treatment purpose. It is especially useful for assessing valvular heart disease. Although it has no known side effect, but similar to any other medical procedure, it is associated with stress and discomfort. Hence, trusting and eliminating patients' stress should be started from the first moment. This study review beneficial effects, method, and possible side effects of echocardiography and assess the effect of face-to-face training and pamphlets in reducing anxiety. Methods: In this clinical trial, 7-25 year children referring echocardiography center of Hajar hospital in Shahrekord was selected by convinced sampling. 90 selected subjects randomly allocated into three groups of 30 subjects (one control group and two groups) groups. Pamphlets and booklets about echocardiography and face-to-face education by a physician for 15 minutes were presented to two groups. Spielbergers anxiety questionnaire were filled before and after training. Data analysis was done by SPSS software using chi square tests, ANOVA and paired t test. Results: Obvious Anxiety prior to echocardiography, in the trained group by Pamphlets was 47/9±9/6, in the trained group by face-to-face education 48/2±11/5, And in control group 46/5±31/1 respectively. In spite of decreasing obvious and hidden anxiety after echocardiography (P0/05). Discussion: In all groups, obvious anxiety after echocardiography was significantly less than anxiety before echocardiography. Although hidden anxiety after echocardiography decreased in control group and trained group by face-to-face education, but it has not changed in the trained group by Pamphlets. anyway in the three groups was not significantly different

GGE biplot and AMMI application in the study of adaptability and grain yield stability of durum lines under dryland conditions

Introduction Durum wheat (Triticum turgidum var. durum) is grown for human consumption, mainly as pasta products, e.g., spaghetti and macaroni, couscous, bulgur, frike, flat breads, etc. Worldwide, the area annually planted to durum wheat is estimated to be around 17-18 million hectares, i.e., 8 percent of total wheat area, with a production averaging about 30 million tons annually, which is 5.5 percent of total wheat production. Although durum is grown in various regions of the world, the great bulk of durum area and production is concentrated in the Mediterranean basin and North America. Eight countries (Algeria, Canada, Italy, Morocco, Syria, Tunisia, Turkey, and USA) account for nearly two thirds (2/3) of world durum area and production. In Iran, the area under durum cultivation is about 400-500 thousands hectares with an annual production of 400-500 thousand tons, which covers about 60% of country demands. In spite of the importance of durum for Iranian rural economies, the country has not all succeeded in its research and development efforts to substantially improve durum productivity. The combinations of increasing demand for durum and durum products, as a result of demographic pressure, and relatively low durum productivity partly due to abiotic stresses (i.e. cold, terminal heat, moisture and nutrient deficiency stresses) made the country to an importer of durum. These are frequently exacerbated by biotic stresses, e.g., diseases and insects that may severely inhibit crop growth. Materials and methods The main purpose of this study was to achieve high yielding durum wheat genotypes with higher yield stability in different environmental condition, tolerance to environmental stresses such as cold damage, drought and end of season heat stress. Hence, 17 durum wheat lines were evaluated for grain yeild and morphlogical traits in Maragheh, Sararood, Qamloo, Ardabil and Shirvan agricultural research stations in 2011-14. In each location, the experiments were conducted in a randomized complete block design with three replications. Results and discussion Based on combined ANOVA, there was significant difference among the environments, genotypes and G×E. GGE-biplot models showed that the 5 environments were belonged to 3 mega-environments, and different genetopes had higher yield in each mega-environments. Sumplimentary irrigation, at sowing time and flowering growth stages, could increase grain yield of lines 30 and 70 percent in Maragheh and Qamloo locations, respectively. The increase of grain yield was 42 percent for line Rascon under suplimentary irrigation. The AMMI and GGE results also confirmed genotype 5 was the most high-yielding durum line with reasonable yield stability in cold areas (Maragheh, Qamloo and Ardabil). Also, genotype 13 was the most high yielding and stable line in Sararood. Hence, these line can be candiatted to release new durum varieties for cold and moderat rainfed areas. Complementary irrigation could increase grain yield up to 30 and 70 percent in Maragheh and Sararood, respectively. Conclusions It can be concluded that finding of new stable high-yielding durum lines, with better performances than that the existed varieies, is a great progress in durum breeding programs in cold rainfed areas. Both GGE biplot and AMMI analyses could be used in grain yield stability and adaptability under rainfed conditions and sumplementary irrigations, however, the results of GGE biploet were more applicable and can be use extensively in the study of grain yield adaptability and stability under rainfed and sumplementary irrigations conditions in durum wheat breeding programs

Comparison of the Effect of Oral Acetaminophen and Ibuprofen on Patent Ductus Arteriosus Closure in Premature Infants Referred to Hajar Hospital in Shahrekord in 2016-2017

Background and Aim: Arterial duct in term infants is closed 96 h after birth in normal conditions. In some cases, especially in preterm infants, this duct is not closed after birth, which is called patent ductus arteriosus (PDA). This disease, if left untreated, leads to depressed respiratory capacity and shunt in preterm infants. The aim of this study was to compare the effect of oral acetaminophen and ibuprofen on PDA closure in preterm infants. Materials and Methods: In this clinical trial, 50 infants with a gestational age of < 37 weeks with PDA, confirmed by echocardiography and clinical symptoms, were selected and randomly divided into two groups of 25. One group was orally given acetaminophen at 10 mg/kg body weight (BW) every 6 h for 72 h, and another group received ibuprofen at 10 mg/kg BW on the 1st day and then 5 mg/kg on the 2nd and 3rd days. Before and after the intervention, infants were examined for possible side effects using echocardiography. Results: According to the results before and after the intervention, the PDA diameter was not statistically significant difference between the two treatment groups (P = 0.328 and P = 0.602). Frequency and percentage of the closure of PDA in acetaminophen group were 23 (92%) and in the ibuprofen group 22 (88%) with no statistically significant difference (P = 1.000). The mean levels of blood urea nitrogen, creatinine, and aspartate aminotransferase were not significantly different between the two groups; however, the mean of alanine aminotransferase was higher in the acetaminophen group (P < 0.05). Urine output was normal in both groups; however, the frequency of gastrointestinal complications was higher in the ibuprofen group than in the acetaminophen group (P < 0.05). Conclusion: The results of this study indicate better or equal efficacy of acetaminophen in comparison to ibuprofen to close PDA