Ahmadreza Dehpour, PharmD, PhD
Vol 58, No 10 (2020)
The antiepileptic Valproic acid (VPA) changes the oxidative/ anti-oxidative balance that results in oxidative stress and maybe an increased risk of cardiac dysfunction. The aim of this study was to investigate the effect of VPA on ventricular function in epileptic children. We designed a study to evaluate ventricular function in epileptic children who had received VPA for at least one year. All subjects were evaluated using standard echocardiography, pulsed wave Doppler (PWD), and tissue Doppler imaging (TDI). This study consisted of 60 patients with epilepsy (mean age 10.30±3.21 years) and 60 healthy subjects in the control group (mean age 10.28±3.18 years). The duration of antiepilepsy medication ranged from 1.4 to 10 years, and the dose of VPA was 5-30 mg/kg. The ejection fraction and fractional shortening (P=0.841 and 0.064, respectively) were not significantly different between the two groups. The present study reports subclinical right and left ventricular systolic and diastolic dysfunction along with longitudinal ventricular motion disorder. It is recommended the evaluation of subclinical cardiac dysfunction in children treated by VPA.
Spinal anesthesia (SA) may impair thermoregulatory control, which may result in shivering, which is a potentially harassing complication. The aim of the current study was to evaluate the prophylactic effects of intravenous ketamine on the prevention of shivering in patients who underwent elective cesarean section (CSs) under SA. In this double-blind, randomized placebo controlled trial, a total of 90 parturients under SA using hyperbaric bupivacaine 12.5 mg were allocated in two groups to receive ketamine 0.3 mg/kg or 0.9% saline following delivery. After induction of SA, patients were observed for the incidence and intensity of shivering using a four-point scale. Shivering was observed in 24 patients (53.3%) in the saline group and 15 patients (33.3%) in the ketamine group. Median (quartiles 1 and 3) of the intensity of shivering was 1 (0-2) and 0 (0-2) in saline and ketamine groups, respectively. Time from spinal anesthesia to the beginning of shivering was 33.1±11.7 min in saline versus 41.6±20.7 min in the ketamine group. The incidence of nausea, vomiting, hypotension, and bradycardia was not different between the groups. A significantly higher incidence of nystagmus and sedation was observed in the ketamine group when compared with the saline group administration of low dose i.v. Ketamine (0.3 mg/kg) was effective in lowering shivering intensity during CSS under spinal anesthesia, though side effects such as nystagmus and sedation may restrict its effectiveness.
We aimed to determine the bone mineral status in patients with spondyloarthritis (SA), and to assess the impact of parameters associated with bone loss on bone mineral density (BMD). Seventy-five patients (62 men) with SA fulfilling the modified New York criteria were included in a cross-sectional study during one year. BMD was assessed in all patients using dual-energy X-ray absorptiometry. The patient’s average age was 36.8 years. Sixty-five patients (86.6%) had bone loss. The lumbar spine was the site most affected by osteoporosis (37%). Bone loss was significantly associated with low BMI, peripheral joint involvement, active disease (high ASDASESR and BASDAI), vitamin D insufficiency, elevated erythrocyte sedimentation rate (ESR) and c-reactive protein, as well as high BASRI, high BASMI, and with the use of csDMARDs or anti-TNF alpha therapy. The disease activity, biologic inflammation, low vitamin D level, peripheral joint involvement, and structural damage were the major factors that induce bone loss in SA patients. Multivariate analysis showed that only high ESR level (AOR 19.9, 95% CI) and peripheral arthritis (AOR 14.5, 95% IC) were independent risk factors of bone loss. Our study shows that bone loss was a multifactorial complication of SA.
Osteoporosis is defined as a reduction in bone density up to 2.5 standard deviations less than the maximum mean bone density in humans. It is estimated that 50% to 80% of the differences in the bone mass of the individuals are related to their genetic and heredity. The prevalence of osteoporosis is 6% in Iran, in which it is more than Japanese and less than in the United States. In this cross-sectional descriptive-analytical study, patients with a history of recurrent kidney stones (those who had referred to the stone clinic more than one time) undergoing bone density measurement using the DEXA method to determine the presence or absence of osteoporosis (Reduction of bone density up to 2.5 standard deviations less than the maximum mean bone density) were enrolled. Exclusion criteria were patients with metabolic diseases, corticosteroid intake, renal failure, hyperparathyroidism, and age >60 years. According to the results of this study, there were 61 patients with a history of recurrent kidney stones, which 34 of them (55.74%) were male and 27 (44.26%) were female; the mean age was 42.41±9.8 years (ranging from 18 to 60 years). Evaluation of frequency distribution of patients showed that 18% of patients had osteoporosis. In this study, 52.5% of patients were without osteoporosis and osteopenia. It should be noted that 29.5% of patients had only osteopenia. The frequency distribution of osteoporosis in patients with a history of recurrent kidney stones by gender showed that four males (36.4%) and seven females (63.6%) had osteoporosis. There was no significant relationship between gender and osteoporosis in patients with a history of recurrent kidney stones (P=0.153). There was also no significant relationship between gender and osteopenia in these patients (P=0.380). There was no significant relationship between age and osteoporosis in patients with a history of recurrent kidney stones (P=0.203). There was no significant relationship between BMI and osteoporosis in patients with a history of recurrent kidney stones (P=0.344). There was no significant relationship between osteoporosis with age and BMI in patients with a history of recurrent kidney stones, and the highest percentage of osteoporosis was in the spine region, which consisted of 8.2% of all patients. There was no significant relationship between osteopenia with gender and BMI in patients with a history of recurrent kidney stones, but there was a significant relationship between age and osteopenia in patients with recurrent kidney stones.
Multiple sclerosis (MS) is defined as an inflammatory, progressive, and autoimmune disease in the central nervous system, recognized by its subsequent demyelination and neurodegeneration. Cognitive disorders are among the most severe problems in patients with MS, affecting their personal and professional life. This study is aimed to evaluate memory and visual learning, visual processing speed, and spatial perception in MS patients based on age, gender, and level of education. This cross-sectional study was carried out on 42 MS patients (based on McDonald’s criteria). The level of disability in patients was assessed using EDSS, and cognitive performance was evaluated by the use of judgment of line orientation (JLO), symbol digit modalities test (SDMT), and revised brief visuospatial memory test (BVMT-R). In this study, patients were within the age range of 20-51 years, 73.8% of which were female, and 61.9% had academic degrees. According to the classes of independent variables (gender, education level), no significant difference was observed in the mean scores of dependent variables (JLO, SDMT, and BVMR-T scores) (P>0.05). In addition, age as a confounding variable had no impact (P>0.05). In addition, gender and level of education had no significant interaction (P>0.05). According to the results of the study, age, gender, and education level had no significant effect on memory and visual learning, visual processing speed, and spatial perception
The suicide rate among the Iranian population has increased over the past few decades. Descriptive information about this public health challenge could inform health policymakers to prioritize prevention strategies. We described the last updated data from the Iranian forensic medicine between 2016 and 2018. We obtained the data on the fatal suicide cases from the national suicide registry of the Iranian Forensic Medicine Organization (FMO), validated by death certificates and harmonized for epidemiologic studies. This study included 9,021 nationally registered suicide deaths from March 21, 2016, to March 20, 2018. A descriptive statistical approach was used to present the findings. Of 9,021 registered suicide deaths with age range between 10 to 94 years [median=31], 44.6% [n=4,015] was in the category of ≤ 29, 48.0% [n=4,328] between 30 to 59, and 7.4% (n=666) in the category of ≥ 60 years old. The percentage of fatal suicide was obviously higher in men (71.2%, n=6,424). Hanging was the most common method of suicide, both among men (57.7%, n=3706) and women (37.6%, n=976). The frequency of fatal suicide was significantly higher in married than single cases (52.6% vs. 42.9%). Overall, at the national level, the most common suicide method was hanging (51.9%), followed by self-poisoning (25.8%) and self-immolation (6.8%). We found evidence of age- and gender differences in suicide mortality across the country. Men, people in younger age groups, and married couples could be considered as the target population for preventive interventions in Iran.
Acute leukemia (AL) is a group of malignant hemopathies characterized by monoclonal intramedullary proliferation of abnormal hematopoietic cells, the maturation process of which is blocked at the "Blast" stage. In these pathologies, an abnormal cell clone proliferates. By its character of anarchy, of nonresponse to normal regulators of cell proliferation and its invasive character, this clone assumes all the characters of malignancy. The diagnosis of ALL can no longer be based solely on morphological and cytochemical characteristics, but must include the elements of the immunological phenotype of leukemic cells. Currently, a classification, based on immunophenotypic and cytogenetic data as well as on molecular biology data, is necessary for the determination of the optimal treatment. The objective of this work is to reach a descriptive approach of the acute leukemia in the region of Annaba, in the east of Algeria. Description of the epidemiological, clinical and cytological characteristics of the cases of acute leukemia collected in the Hematology Laboratory of Dorban Hospital over a period of 6 years. - Analysis of the results of our study and their comparison with those published in the literature, with a reminder of the epidemiological and diagnostic data. The retrospective study was conducted in the division of the hematology hospital of Sidi Ammar-Annaba, during the period from January 2018 to July 2019. This study was based on data from 50 patients. During our study period, the results show that 50 cases of acute leukemia confirmed by the myelogram were notified. The annual average is 12.3 cases. The collection data were made in Annaba at the CHU-Dorban, we noted a variety of clinical signs and a variety of symptoms represented mainly by fever (100%), anemia (100%), hemorrhagic syndromes (30 , 6%) and splenomegaly (80.6%). For the myelogram. Acute lymphoblastic leukemia (ALL) was predominant with 25 cases. In conclusion we can say that. Acute leukemia in adults in eastern Algeria can be expressed by a variety of symptoms and hematological disorders, in addition to a series of associated conditions.
The subcutaneous or hypodermic tissue is the innermost layer of the skin, which is essential for adipose tissue. The dermal attachment to the epidermis is a basal layer composed of collagen. This basal layer performs four different functions and acts as a scaffold for soft tissue organization. It is citing for regeneration that has selective permeability for serum filtration. Also, it is a barrier between different cell types, and cite where the epithelium subcutaneous to the cells. Untreated, bedsores can lead to serious complications, one of which is cellulite, a potentially life-threatening bacterial infection. As the bedsore wound spreads to the joints and bones, it may cause bone and joint infections that can damage the cartilage, tissue, and reduce joint function. The bacteria can then enter the bloodstream through wounds, leading to shock and life-threatening conditions. Stage II wounds can heal in one to six weeks, but wounds that lead to stage three or four may last several months or may never heal, especially in children with health problems. The purpose of this study was to design bio-based wounds with gelatin, Gum Arabic, and polyurethane. The wounds were made with different bio composite specimens. The procedure is gelatin, and gum Arabic was combined with certain percentages. The temperature of mixing and solubilization was set at 50°C. After complete fabrication of the material and complete dissolution of the samples in the solvent without any agglomeration, the samples were placed in a low-temperature freezer at -70°C and were placed in a freeze dryer. After the drying process is completed and the pores are ready on the wound heal sample, in the next stages, several tests are carried out to check the suitability of the produced wounds. The SEM analysis was performed on bio-based wounds in which the results showed the suitability and porosity of these wound dress were suitable. The presence of proper porosity and moisture level for wound healing and non-acidity, as well as the use of bed wound healing, have been distinguished from other conventional wound healing products in the market and research domain.
Cry as the only way of communication of babies with the surrounding environment can be happened for many reasons such as diseases, suffocation, hunger, cold and heat feeling, pain and etc. So, the analyzing and detection of its source is very important for parents and health care providers. So the present study designed with the aim to test the performance of neural networks in the identification of the source of babies crying. Present study combines the genetic algorithm and artificial neural network with (Linear Predictive Coding) LPC and MFCC (Mel-Frequency Cepstral Coefficients) to classify the babies crying. The results of this study indicate the superiority of the proposed method compared to the other previous methods. This method could achieve the highest accuracy in the classification of newborns crying among the previous studies. Developing methods for classification audio signal analysis are promising and can be effectively applied in different areas such as babies crying.
Postpartum depression (PPD) is a mood disorder that can affect women after childbirth, and this disorder can strike fathers as well as mothers. The study reports a 28-year-old man who attempted suicide three times following his wife's delivery and newborn baby boy. The psychiatric assessment showed that the man revealed major depression following childbirth. So effective mental disorders screening and health care services must be provided for fathers as well as mothers and children.