Association between response to the medical treatment and predicting factors in ectopic pregnancy

BACKGROUND: Ectopic pregnancy (EP) is the leading cause of maternal death in the first trimester of pregnancy. There are many variables which can predispose EP. The aim of this study was to evaluate the possible association between individual’s response to given medical treatment and predicting factors of ectopic pregnancy among pregnant women.METHODS: In this cross-sectional study, 277 patients with ectopic pregnancy who were admitted to obstetrics and gynecology ward of Besat hospital, Sanandaj, Iran, were evaluated. The necessary information was obtained from all women diagnosed with EP during 2008 to 2013. Patients who received any medication before study or those who could not use methotrexate (MTX) were excluded from study.RESULTS: In this study, 205 (74.1%) patients responded to the medical therapy. There was a significant association between successful response to the treatment and beta human chorionic gonadotropin (β-hCG) serum level less than 5000 mIU/ml, pregnancy sac size less than 4 cm and lack of fetal heart rate (FHR) in transvaginal sonography (TVS).CONCLUSION: In conclusion, it was found that β-hCG serum level, pregnancy sac size and presence of FHR play a key role in predicting the response to the medical treatment in women with ectopic pregnancy, and might be helpful in selecting appropriate therapeutic scheme.

Association between response to the medical treatment and predicting factors in ectopic pregnancy

BACKGROUND: Ectopic pregnancy (EP) is the leading cause of maternal death in the first trimester of pregnancy. There are many variables which can predispose EP. The aim of this study was to evaluate the possible association between individual’s response to given medical treatment and predicting factors of ectopic pregnancy among pregnant women. METHODS: In this cross-sectional study, 277 patients with ectopic pregnancy who were admitted to obstetrics and gynecology ward of Besat hospital, Sanandaj, Iran, were evaluated. The necessary information was obtained from all women diagnosed with EP during 2008 to 2013. Patients who received any medication before study or those who could not use methotrexate (MTX) were excluded from study. RESULTS: In this study, 205 (74.1%) patients responded to the medical therapy. There was a significant association between successful response to the treatment and beta human chorionic gonadotropin (β-hCG) serum level less than 5000 mIU/ml, pregnancy sac size less than 4 cm and lack of fetal heart rate (FHR) in transvaginal sonography (TVS). CONCLUSION: In conclusion, it was found that β-hCG serum level, pregnancy sac size and presence of FHR play a key role in predicting the response to the medical treatment in women with ectopic pregnancy, and might be helpful in selecting appropriate therapeutic scheme

The Relationship between Development Indices and Children’s Growth Among Under 12-Month-Old Children in Markazi Province, Iran

Background: The factors affecting children’s growth and development have been discussed in various research studies. This study evaluates the association between growth and development of under 12-month-old children in Iran.Methods: This cross-sectional study uses the Ages & Stages Questionnaire (ASQ) data and demographic characteristics in the child's health records of 15,885 Iranian children in Arak city up to March 2017. The impact of growth disorder, type of delivery, preterm birth, at birth weight/height/head circumference, gross motor, problem-solving, personal-social, communication, and fine motor on the participants’ head circumference/weight/height was assessed. Unadjusted analyses were done using independent sample t-test, Pearson correlation test and one-way analysis of variance. Multiple multivariate regression was utilized for adjusted effects. P-values less than 0.05 were considered statistically significant.Results: Head circumference was associated with growth disorder, type of delivery, and preterm birth. Children with known and unknown growth disorders had 610.19 and 160.58 grams less weight than those without any growth disorder. Gross motor and personal-social aspects of ASQ were found to be associated with weight at the age of 12-month old. Height at 12-months was affected by growth disorder, gross motor, personal-social, communication, and fine motor.Conclusion: Results of this study show that cesarean type of delivery, preterm birth, and low birth weight are the impacting factors associated with negative children growth trends and lower developmental status at the age of 12 months

Prevalence of Antibiotics Consumption in Children in Central Iran: 2019-2020

Background: One of the challenges in medicine has been the exaggerated use of antibiotics. The purpose of this study was to investigate the prevalence of antibiotic usage in children in Arak, Iran (2019-2020) to determine the factors related to antibiotic prescription and consumption in children. Methods: This was a population based, cross-sectional study conducted in Arak, the capital city of Markazi Province, Iran. Stratified random sampling was applied to recruit children who were up to five years old, and registered in the healthcare system between Jan. 2019 and Jan. 2020. A response rate of 85% was obtained from the subjects’ parents. Face-to-face interviews were used to collect the data from the children’s mothers. Univariate and adjusted linear regression analyses were applied to assess the determinants of antibiotic consumption in these children. Results: A total of 1483 children were enrolled in the study; most of them were boys with the mean age of 2.1±1.5 years old. The annual prevalence of antibiotic consumption in Arak was found to be 62.4% for at least one antibiotic. The most consumed antibiotic was azithromycin (24.2%). Among antibiotic groups, the most consumed group was macrolides (26.9%). Upon multiple logistic regression analyses, a lower consumption rate was observed among the younger children with older mothers, and children whose fathers had permanent jobs than other children groups. A higher consumption rate was observed among families with higher parity. Conclusion: The annual prevalence of antibiotic consumption in this study was very high, with the most consumed drug being azithromycin. We recommend that the use of antibiotics be reconsidered by drawing future healthcare policies, aiming at reducing the heavy antibiotics consumption in children

Neurological outcomes after gamma knife radiosurgery for symptomatic skull base meningiomas based on their locations: Single institution experience

Background and objective: Gross total resection of skull base meningioma is so challenging due to its relevant high morbidity. Gamma knife radiosurgery is concerned by providing a favorable therapeutic option in the management of SBM. This study aims to evaluate the neurological outcome after GKRS as an adjuvant or primary treatment for SBM according to their locations. Methods: This retrospective cross-sectional study consisted of 108 patients with SBM who underwent GKRS as an adjuvant or primary treatment. We found 40 patients with cavernous sinus meningioma (CSM), 36 patients with petroclival meningioma (PCM), and 22 patients with cerebellopontine angle meningioma (CPM). 81.1% of whom were female (n = 90) with a median age of 52.68 years. The mean tumor volume was 4.5 cm3 and the mean marginal dose was 13 Gy. Results: Tumor control was achieved in 96.4 % of patients at a median follow-up of 38.4 months. Over all 17 of 108 patients (15.6%) report improvement in their neurological symptoms. Patients with CPM demonstrated lower rates of neurological symptoms improvement compared to patients with PCM and CSM. Deterioration of neurological symptoms after GKRS developed in 11 patients (10.1%) which was more reported by patients with CSM than the others. The most improvement in cranial nerve deficit was in CN Ⅵ, Ⅴ, VIII among patients with CSM, PCM, and CPM respectively. Conclusion: GKRS is acceptable as a primary or adjuvant treatment for SBM by providing an appreciable rate of improvement in neurological symptoms

Prevalence and determinants of self-medication consumption of antibiotics in children in Iran: A population-based cross-sectional study, 2018-19.

IntroductionThe prevalence of self-medication of antibiotics has been revealed in various studies. The main aim of this work is to investigate the frequency of self-medication in children under 6 years and the factors affecting it.MethodsThis is a population-based cross-sectional study conducted in the Arak metropolitan in the center of Iran from January 2019 to January 2020. We used stratified random sampling to determine recruitment criteria. As 1754 households were invited to the study that 1483 were approved to participate. Children's data were obtained by the interview with their mothers. In order to define self-medication consumption of antibiotics, it was adapted between annually maternal self-reported consumption of antibiotics among their children and history of received antibiotics registered in insurance services during the same time period. Logistic regression models were exploited to obtain odds ratios and 95% confidence intervals.ResultsMean age of mothers was 31.8 years (SD = 5.4), 52.1% of the children were boys. Annually self-medication of antibiotic consumption was estimated 61.6% (n = 914). Based on the logistic regression analysis, in the adjusted analysis, girls were associated with self-medication consumption of antibiotics lower than boys' children (p = 0.016). Older mothers were lower self-medication consumption of antibiotics than youngers (p = 0.001). Moreover, the permanent job of fathers was associated with lower self-medication consumption of antibiotics than temporarily and unemployment (p = .001). The odds of self-medication consumption of antibiotics were increasing with the increase in age of children (OR: 1.21, CI95%: 1.12, 1.31 and p = 0.001). The increase in parity has been a significant association with the self-medication consumption of antibiotics (OR: 1.64, CI95%: 1.38, 1.95and p = 0.001).ConclusionResults of this study show that some factors such as children's age, gender, mother's age, father's occupational status, and parity are the determinants that significantly impact the self-medication prevalence