Tanaffos Respiration Journal
Volume:19 Issue: 1, Winter 2020

Respiratory infectious disease is considered as one of the most serious problems among children in developing countries. The importance of zinc in the improvement of respiratory disease has been indicated. However, there are some unanswered questions and uncertainty. This systematic review aimed at assessing the therapeutic benefits of zinc supplementation on respiratory infections of Iranian children.

Databases, such as PubMed, Scopus, Embase, Magiran, and IranDoc, were searched for randomized controlled trials published from January 1998 to December 2017 on Zinc supplementation for the treatment or improvement of acute respiratory disease among Iranian children, during March 2018. Studies were screened according to the PICO framework, and irrelevant studies were excluded.

A total of 5 studies conducted on 522 children were included in this review. Except for one study, others had indicated the beneficial effect of zinc supplement on improving signs and symptoms of respiratory infectious disease and earlier discharge from the hospital.

Although studies on the efficacy of zinc on respiratory infectious disease of children in Iran have not widely considered and more studies should be conducted, all published articles (except for one of them) had indicated the effectiveness of zinc supplementation on respiratory infections among children. Other criteria, such as age, gender, birth weight, diet, and type of respiratory infections, should be considered during zinc therapy. Controlling these confounding variables and measuring the level of blood zinc are necessary to understand how much zinc should be prescribed for respiratory treatment of children.

The use of mobile-based software for the self-management of patients with asthma improves the quality of life, reduces healthcare costs, provides effective health care interventions in asthma, and supports the patients in self-management. The current study was performed to identify the features of mobile-based self-management software for patients with asthma (MSSPA).

The present review study was performed in 2018. Four databases including PubMed, Scopus, Emerald, and Google Scholar were screened by the combination of selected keywords. Data were collected using a data extraction form. Data were analyzed using the content analysis method. Results were abstracted and reported based on the study objectives.

Of the 297 articles retrieved during the first round of search, 24 were selected; 15 of which were the original articles (62.5%). As the most important applications of MSSPA, it could be used as a tool to support patients in selfmanagement, provide them with educational information, and self-observation. Also, 75% of the studies (n=18) emphasized the effectiveness of MSSPA. Identification of the required field of the software was the most important requirement in using MSSPA. Nevertheless, some of the studies reported the low quality and compatibility of some designed apps compared with those of the available information systems.

Identification of MSSPA features and considering them in new versions can promote the quality of MSSPA. However, according to the results of the study, in addition to identifying the software features, more attention should be paid to the users’ needs in software design.

Postoperative pulmonary complications (PPC) are important problems that prolong hospital stays by increasing morbidity and mortality of patients. Early identification of risky cases through preoperative evaluation is important for reducing the complications that may be seen in patients postoperatively. The aim of this study is to calculate, evaluate and compare the risk indices for PPC in patients who will undergo elective abdominal surgery.

One hundred twenty-four patients who were hospitalized for elective abdominal surgery were included in this prospective observational study. American Society of Anesthesiologists (ASA), Epstein and Shapiro scores, respiratory failure index (RFI), pneumonia risk indexes (PI) and scores were calculated preoperatively. Patients were re-evaluated at the 48th postoperative hour, and one-week follow-up was performed. The patients with PPCs are recorded.

The mean PPC rate was 36.8%. Based on this, pleural effusion was observed in 18.5%, prolonged mechanical ventilation in 8.9%, atelectasis in 9.7%, and respiratory failure in 5.7%, bronchospasm in 4.0%, and pneumonia in 3.2% of patients. An increased risk in PPC was determined if ASA were above 3 (odds ratio, [OR], 7.06; <0.001), PI scores were above 3 (OR, 6.67; <0.001), RFI score were above 4 (OR, 6.30, p:0.001) and Shapiro score above 2 (OR, 20.01; <0.001), respectively.

The Shapiro index is the strongest predictor of pulmonary complications, whereas the PI is the strongest predictor of morbidity risk. However, RFI and the PI are equally valuable for predicting respiratory complications and may prove to be useful in abdominal surgeries for preoperative assessment.

Sleep complaints are common problems in the general population and insomnia and sleep disorders place significant economic and social burdens on the community. Postmenopausal women are 2.6 to 3.5 times more likely to develop obstructive sleep apnea (OSA) compared to non-menopausal women. In this study, we evaluated sleep disorders and mental health in postmenopausal women.

This study was a descriptive cross-sectional study and the samples were selected from postmenopausal women above 50 years who had participated in a survey entitled, "Evaluation of Sleep Disorders among Adults in Tehran" in 2017. Cluster sampling method was applied with proportional allocation. A total of 4021 samples were collected, 2075 of which belonged to women. In addition, 174 out of 2075 samples were related to postmenopausal women over the age of 50. The data were analyzed using the statistical package IBM SPSS version 22.0. P-values less than 0.05 were considered significant.

In this study, 118 (67.8%) women had insomnia for less than three months, and 23 (13.2%) women had insomnia for more than three months. The prevalence of STOPBANG parameters in this group of postmenopausal women was 37% and significantly related to Body mass index (BMI) and neck circumference at P < 0.001 and 0.006, respectively. There was no significant relationship between social dysfunction and insomnia. However, anxiety in General Health Questionnaire (GHQ) was significantly associated with insomnia, sleepiness, sadness, and irritability.

Our results indicate that the impact of insomnia symptoms, OSA comorbidity and mental disorders could extend far beyond. The use of urgent health care and quality of life issues is essential for long-term mental and physical well-being; if there is no treatment in the menopause population, there will be serious mental and physical complications.

Asthma is a common condition in which the patient requires selfmanagement and teaching programs that lead to reduced prevalence and mortality. The main aim of this study was to improve the management knowledge of the disease through the use of educational tools, pamphlets and face-to-face lecture, concurrent with evaluating and comparing its effectiveness in response to treatment.

In this study, 82 asthmatic patients were enrolled. Training necessary to control the disease and use of drugs were provided to patients in one group by pamphlets (39 patients) and the other by face-to-face education (43 patients). After a month, Disease control examination and Asthma Control Test (ACT) scores were evaluated and compared.

The mean age of participants was 39.12±14.25 years. There was no significant difference between the two groups in age, gender and education (P> 0.05) and no significant difference in asthma control between the two groups before the intervention (P = 0.065). The overall asthma control score in the pamphlet was increased from 15.43±4.99 at baseline to 20.58±4.47 in the assessment after one month education (P <0.001) and in face-to-face training an overall score was increased from 13.27±5.39 to 21.95±2.77 (P <0.001). After one month education, asthma control score was increased 5.23 ± 6.88 in pamphlets group and 8.9 ± 6.32 in face-to-face group (P = 0.014).

Evaluation of both educational methods showed face-to-face training is more efficient.

The main purpose of this study was to describe the demographic and clinical features of cryptic disseminated TB; it was also aimed to shed light on diagnostic test, procedure results, organ involvement, and outcomes of cryptic disseminated TB in patients with confirmed disseminated TB.

We performed a secondary post hoc analysis of collected data from our previous study entitled “Disseminated Tuberculosis among Adult Patients Admitted to Hamad General Hospital, Qatar: A FiveYear Hospital-Based Study” with modified objectives. This study included patients admitted from January 1, 2006 to December 31, 2010.

Twenty-three patients were recruited with non-miliary patterns on chest x-ray. Their mean age was 34.4±12.6 years and 15 (65.6%) were males. The mean duration of illness was 46.13±48.4 days and the most common presenting symptom was fever in 20 patients (87%), while 3 (13%) patients had underlying medical conditions with diabetes mellitus 2 (8.7%), being the most common. Bronchoalveolar lavage (BAL) and bronchial wash (BW) fluids were Acid-fast bacilli (AFB) positive in 1/4 (25%) of the cases and culture-positive for Mycobacterium tuberculosis (M. tuberculosis) in 4/4 (100%) of all the cases. Two patients (8.7%) had positive sputum smear, while 18 (78.3%) patients had positive culture for M. tuberculosis. All except one patient completed their treatment in Qatar. One patient died one month after the start of antituberculous treatment.

Cryptic disseminated TB should be suspected when a patient from TB-endemic countries develops unexplained fever and cough despite normal or non-miliary pattern chest radiograph. Moreover, respiratory specimen cultures should be obtained from these patients, regardless of the symptoms presented and the initial site of the involved organ.

The number of bariatric surgeries has increased in recent years, and major attempts have been made to find the best surgical procedure. Laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB) are the most common bariatric surgery procedures. This study aimed to investigate the effects of these two procedures on improving sleep quality, daytime sleepiness, and obstructive sleep apnea.

This case-control study was performed on two groups of patients (n=60 per group). The case group included obese candidates for LSG or RYGB, and the control group consisted of obese patients without any surgical interventions. The sleep quality, obstructive sleep apnea (OSA) risk, and daytime sleepiness were examined, using the Pittsburgh Sleep Quality Index (PSQI), Stop-Bang questionnaire, and Epworth Sleepiness Scale (ESS), respectively. The results were recorded before and six months after the intervention and compared between the two groups.

There was no significant difference in the mean scores of ESS, PSQI, and Stop-Bang questionnaire between the two groups before the intervention (P>0.05). However, the mean scores of PSQI and its dimensions, ESS, and StopBang questionnaire significantly improved in patients undergoing surgery (P<0.05). The results of linear regression analysis also showed significant improvements in the ESS, PQSI and Stop-Bang scores in the intervention group. Body mass index (BMI) reduction improved the scores of PSQI, ESS, and StopBang questionnaire in patients, with impact factors of 0.032, 0.700, and 0.025, respectively (P<0.05).

LSG and RYGB surgeries significantly improved the patients’ sleep quality, decreased daytime sleepiness, and reduced the risk of OSA. Overall, BMI reduction and lack of OSA can significantly affect sleep quality.

Percutaneous tracheostomy is an elective method that is increasingly being taken up in the intensive care unit alongside the patient's bed. In many centers, bronchoscopy is used, but the necessity of using bronchoscopy in percutaneous tracheostomy has not yet been determined. Discontinuing use of bronchoscopy can potentially reduce the cost and increase the efficiency of percutaneous tracheostomy. Therefore, in this study, we performed a percutaneous dilatational tracheostomy without using fiberoptic bronchoscopy.

This study was performed as a descriptive epidemiological survey among 70 patients in Shahid Rajaei Hospital of Qazvin in 2015 and 2016. The results were assessed in the patients.

In this study, pneumothorax, trauma, major and minor bleeding, cuff leak and change to surgical procedures as well as accidental extubation were not seen. However, subcutaneous emphysema, mal-position and hypoxia each were seen in one patient (1.4%).

Totally the results demonstrated that percutaneous dilatation tracheostomy without fiberoptic bronchoscopic guidance is useful and safe.

Melatonin as an antioxidant agent can have an effective role in lung development. In this study, the effect of melatonin administration on lung injury in the neonate mice was assessed.

Lung injury was induced by two injections of 15 mg/kg methylazoxymethanol (MAM) on gestational day 15 (E15). Pregnant BALB/c mice were randomly divided into five groups: Control (CO), Melatonin (MEL), Luzindole (Luz), MAM, and MAM+MEL. Melatonin and luzindole were intra-peritoneally injected at a dose of 10 mg/kg (from E15 until delivery). Histopathological changes including: hemorrhage, neutrophils infiltration and fibrosis in the neonate lung were studied by hematoxylin and eosin (H&E) and Masson’s Trichrome staining. Alveolarization and alveolar wall thickness were measured.

In histological examination, hemorrhage, neutrophils infiltration and fibrosis were seen in the MAM and Luz groups; however, these injuries were attenuated in the MAM plus melatonin group. Significant reduction of alveolarization was recorded in the MAM and Luz groups compared to the control group, while the alveolar wall thickness was significantly increased in these groups compared to control group.

Administration of exogenous melatonin in pregnant mice could have a protective effect on the pulmonary development of neonates and could decrease lung injury in neonate mice.

Extra-nasal types of Extra-nodal natural killer cell lymphoma (ENKL) have been known with poorer prognoses than nasal type with the worst responses to treatment. The current work introduces a case of ENKL with GI involvement with no nasal manifestations. We report a 56-year male farmer with fever, productive cough, dyspnea, anorexia, vomiting and chill in addition to malaise and cachexia of three months duration referred to a hospital with acute abdominal pain, and was diagnosed as peritonitis due to perforated terminal ileum ulcer before experiencing surgery as a case of acute abdomen. The pathologic study of the relevant biopsy showed “ulceration and necrosis with dense fibrinoleukocytic exudation and granulation tissue formation. CT scan determined a bilateral mass like haziness which was more likely to be metastatic. The review of the previous pathologic specimens raised Natural Killer/T cell Lymphoma (NKTL), the reason for which we focused on the patient’s sinuses and nasal area as well as nasopharynx. There was no finding in examination and endoscopy of sinuses. Pathology also found malignant high grade non-Hodgkin T cell lymphoma in specimens obtained from debridement of ulcer at terminal ileum. It also showed that most of the tumor cells were positive for CD3, CD56, CD8, and LCA but negative for CD19, CD20 and AE1/AE3. Positive reactions for CD30 were shown by some cells. CD56, CD3, and CD8 were expressed by neoplastic cells and CD30 were positive in few cells. Proliferative activity (Ki67 index) was high (60-70%). This was the main base to diagnose an extra-nodal extra-nasal NK/T cell lymphoma. In conclusion, Intestinal changes at middle age, especially in men with nonspecific clinical manifestations is highly advised to be studied pathologically and genetically for T cell types like CD30 positive T cells which are usually engaged in ENKTL.