Reviews in Clinical Medicine
Volume:11 Issue: 1, Winter 2024

Congenital heart disease (CHD) is a common condition, affecting 8 in 1,000 live births, and is not limited to pediatric cases anymore due to advancements in medical techniques. Thus, the enhancement of chronic disorders and the development of the comorbidities become noticeable and evaluation on the cardiovascular risk factors in patients is necessity.

A systematic review of English and Persian literature was done by using electronic search in databases of Scopus, PubMed, Science Direct, Up-to-date, and ProQuest from 2000 to 2021. The study was focused on the all article types with the theme of the risk factors on congenital heart disease in adults. Initially, 200 papers were extracted and evaluated by the research team in terms of inclusion criteria; and at last 74 papers were selected. The association between adults with congenital heart disease and risk of cardiovascular disease by conducting a narrative was evaluated.

out of six groups of risk factors which were recognized for adults with congenital heart disease, the level of physical activity is highly impressive. The findings showed that while women were less active and more likely to be obese, male patients had a greater prevalence of smoking and high blood pressure. Although age is discussable specifically based on the other medical factors, sex was not individually determined for the self-effective risk factor.

Cardiovascular risk factors remained the noticeable leading obsession across time in the world. Alarmingly, the increasing rate of adult CHDs require best healthcare investments.

Mycobacterium tuberculosis is still one of the most dangerous human pathogens. Identification of the relationships between different clinical strains has remained a high priority for epidemiology research.

In this study, we used MLSA (Multilocus sequence analysis) to generate a highly robust phylogeny of M. tuberculosis. MLSA, based on single nucleotide polymorphism (SNP) was performed on five genes fragments from the Rpsl (302 bp), MprA (559 bp), LipR (322 bp), KatG (488 bp) and Fgd1 (266 bp), in order to identify polymorphic nucleotide sites, and the discriminatory power of each locus for all genes was measured with Hunter‐Gaston Index (HGI).

In this study, a sequence type (ST) number was assigned to each unique allelic profile, and 9 sequence types were identified from 20 strains, these imply that there is a high diversity of strains in this area.

Our results showed that the presence of high genetic diversity among clinical isolates of M. tuberculosis in Northeast of Iran. There is no evidence for recent transmission. Keywords: Mycobacterium tuberculosis, Multi-locus sequence analysis; Molecular epidemiology; Tuberculosis; KatG; Rpsl1. IntroductionMycobacterium tuberculosis (M. tuberculosis), the causative agents of tuberculosis (TB), is one of the most successful human pathogens, infecting nearly one-third of the people all around the world, causing over 9 million new cases and 1.7 million deaths each year [1-2]. Identification of the relationships between different clinical strains of M. tuberculosis has great significance to the public health [3].

to compare the refractive error measurements achieved through three distinct techniques: retinoscopy, subjective method, and the subjective fogging method.

Participants included 223 young adults aged 18 to 36 years (mean age: 25.63±5.31). The refractive error of one eye was measured under three different accommodation control conditions: subjective refraction, fogging subjective refraction and retinoscopy.

Data were collected for 223 young adults. The average Spherical value obtained by the retinoscopy method was 0.21 and the average cylinder was -0.76. These values were -0.01 and -0.75, respectively, in the subjective with fog method The Spherical value and cylinder obtained by the regular subjective method were -0.13 and -0.74 D, respectively; The mean spherical equivalent with subjective refraction method was more minus than fogging subjective refraction and retinoscopy provided the most plus results. the difference in spherical and spherical equivalent value between three methods was significant (p- value< 0.001) but the difference in cylindrical value between three groups was not significant (p- value> 0.05). According to the Intraclass Correlation Coefficient analysis, the agreement between three methods for measuring sphere (ICC= 0.99), cylinder (ICC= 0.95) and spherical equivalent (ICC= 0.99) was good.

The results showed that retinoscopy and fogging subjective refraction were the most similar methods, with a small mean difference. However, the comparison between retinoscopy and subjective refraction had wider limits of agreement than retinoscopy and fogging subjective refraction. 

Hydatid cyst, a common ailment affecting both humans and animals, has the potential to develop in various anatomical locations, with the liver and lungs being the primary sites of occurrence. Individuals in endemic regions, particularly those involved in livestock farming, face an increased risk of exposure to this parasitic disease. The cysts can concurrently manifest in multiple areas of the body, highlighting the intricate nature of their presentation. Despite often being asymptomatic, early detection of hydatid cysts is crucial for effective intervention. Diagnostic tools such as ultrasound, CT scans, and serological tests play a pivotal role in identifying these cysts, even without overt symptoms. The insidious progression of hydatid cysts allows them to persist asymptomatically over prolonged periods, posing a latent threat. However, the rupture of these cysts, whether spontaneous or triggered by external factors, can result in severe consequences, potentially leading to fatality. This study reports a compelling case involving a 41-year-old woman investigating the causes of infertility. Through comprehensive examinations, multiple hydatid cysts were serendipitously discovered in her liver, spleen, and kidneys. This case underscores the diverse anatomical locations these cysts can occupy and emphasizes the significance of vigilant diagnostic approaches, even in individuals initially presenting with unrelated concerns such as infertility.

Obstructive sleep apnea causes various psychological and physical complications, reduces productivity, and increases vehicle accidents. This study investigated the association of obstructive sleep apnea with the level of physical activity. In this cross-sectional study, people who referred to a specialized occupational medicine clinic were enrolled by simple random method. After applying the entry criteria, participants completed package including demographic and occupational data, the IPAQ International Activity Questionnaire, the ESS daily sleepiness assessment and the STOP-BANG (SB) questionnaire. Fasting blood glucose and lipid profiles were measured and divided into two groups according to the score of SB questionnaire. Totally 126 participants were enrolled and the mean age was 36.85 ± 9.88 years. There were 65 subjects(52%) high risk to obstructive sleep apnea and 61 non- cases (48%). The group with SB score less than 3 was significantly more frequent. Glucose, triglyceride and LDL levels were significantly higher in obstructive sleep group (p<0.05). Participants with low physical activity had significantly higher chance of obstructive apnea (OR = 9.6, 95% CI 1.1–78.8berr In addition, rotational shift decreased the odds of obstructive sleep apnea to 0.17 and Individuals with ESS more than 10 carried higher odds of obstructive sleep apnea. There was a significant relationship between the severity of obstructive sleep apnea and physical activity. Exercise and daily activities in people who are prone to disease as well as patients with a disease can help to prevent and improve apnea and its subsequent complications.

type 1 diabetes is one of the most chronic diseases of childhood. The therapeutic recommendation for this condition is quite complex and needs changes in lifestyle. Recently the role of gut microbiota has received attention as a possible mechanism in the pathogenesis and control of the disease. One hundred thirty Children aged 6-18 years old with newly diagnosed diabetes type one participate in the trial. They are randomly assigned to the intervention or control group. The patients will receive a six month course of probiotics or placebo besides their conventional treatment with insulin and they will be followed for at least one year. Participants are followed at 3 month intervals for one year. At each visit anthropometrical data, glycemic control and total dose of insulin required to keep the optimal glycemic control is evaluated and registered. There is evidence that alterations in gut microbiota is seen in children with diabetes. In this study we aim to evaluate the effect of probiotic administration on the duration of honeymoon period in pediatrics with type one diabetes and their glycemic control and insulin requirements.

This article briefly describes effective factors, the process to access health services, the success of the national and international indices, problems - challenges, concerns and worries about the health of children and system services. Then study the root causes and then paid attention to global and national experience to provide solutions in the form of national sector reform program.

Research in statistical reports from confirmed sites about Iran children health situation analysis Research in several findings of Iran statistical investigation &surveys (Iran Ministry of health and medical education)

Factors affecting the health are: social and economic factors 50%, access to health services 25%, biological and genetic factors 15% and physical factors 10%. If the development programs in this country will not proceed in a smooth and stable way, the present acceleration of all existing programs will deteriorate.The Census 2016 showed that all provinces were experiencing the positive growth rate. According to the same census provinces like Hamedan, Ardebil, Kermanshah, Kurdistan, Zanjan, Gilan, Lorestan, east and central Azerbaijan, with the population proportion of 23% of total population of Iran had the population growth rate of less than 1% . Life expectancy at birth, during the two decades with the 5.3 year increase, has reached to 72.5 years..According to child health information in Iran, health development is achieved during several recent years by PHC program and trend of child mortality and morbidity decreased significantly by health care programs for this vulnerable ages.

Coronavirus disease 2019 (COVID-19) is a rapidly growing health concern claiming over 6 million lives as of April 2022. Some evidence revealed that pregnancy increases the risk of severe illness with Coronavirus infection. COVID-19 also complicates the pregnancy results such as the number of cesarean deliveries and premature births. Mitral stenosis is a structural heart disease that endangers the patient and their newborn, accompanied by serious morbidity and mortality. The present patient, 40 years old gravida 2 para 1 at 37 weeks presented to the emergency department with progressive dyspnea following fever and malaise for a week. SARS-CoV-2 testing was positive ergo appropriate treatment was administered. CT scan showed severe COVID-19 pneumonia with a severity index of 23. Due to respiratory distress, the patient was readily admitted to the intensive care unit. The patient was supported with non-invasive ventilation. Nevertheless, NIV was insufficient with signs of respiratory fatigue so the patient was intubated. Despite the subsidence of fever and stable clinical condition patient remained tachycardic which promoted us to perform echocardiography revealing severe mitral stenosis. This report contains our experience and suggestions regarding this rare concurrence. The paucity of data is significant regarding the management of concurrent structural heart disease and COVID-19 in pregnancy. It should be emphasized that the importance of maintaining routine care and screening during the pandemic; which can be catastrophic if missed.