مجله دانشکده پزشکی اصفهان
پیاپی 625 (هفته اول امرداد 1400)

Valproic acid is prescribed in many clinical cases. Decreased level of consciousness is one of the most prominent symptoms of valproic acid poisoning. The aim of this study was to investigate the relationship between the level of consciousness and other symptoms of poisoning and therapeutic outcome in patients poisoned with oral valproic acid.

This study was performed as a cross-sectional study using the information of patients with valproic acid poisoning admitted to Khorshid hospital in Isfahan, Iran, during the years 2018 and 2019. The data about demographic characteristics and patients’ signs and symptoms were collected from hospital records by using a checklist, and were analyzed.

Data of 243 patients poisoned with valproic acid were analyzed. At the time of admission, 194 patients (79.8%) were alert, and respiratory status was normal in 237 cases (97.5%). Sodium levels in 218 patients (92.8%) and potassium levels in 212 cases (91%) were normal. Analysis of venous blood gases showed metabolic acidosis in 45 cases (19.2%). In these patients, respiratory status showed a significant relationship with the level of consciousness (P < 0.001), and the level of consciousness had a significant relationship with therapeutic outcome (aspiration pneumonia) (P < 0.001).

The results of this study showed that most of the patients poisoned with valproic acid had benign disorders, and would have complete recovery with treatment. In cases of acute poisoning and decreased level of deep consciousness, it is important to pay attention to the patients’ respiratory status, and the necessary measures should be taken to prevent aspiration as a therapeutic consequence.

Infant is a vulnerable creature whose death is affected by embryonic period and also by factors during and after delivery. The first step in reducing neonatal mortality is to identify the causes. The aim of this study was to investigate the causes of neonatal mortality in Ghaem hospital, Mashhad, Iran.

The present study was a case-control study in which the case group included 448 deceased infants admitted to the neonatal intensive care unit (NICU) of Ghaem hospital during the years 2012-2017, and the control group included 448 infants admitted to the same ward during the same period and after treatment. The data were completed by a trained researcher through the study of neonatal records. All analyzes were performed with SPSS software at a significance level of less than 0.050.

Among the neonates admitted to NICU, 53.7% were boys and 46.3% were girls with a mean age of 16.80 ± 6.06 days. Logistic regression model showed that the first minute Apgar score of less than 6 [Odds ratio (OR = 2.91)], asphyxia (OR = 2.64), sepsis (OR = 2.41), and respiratory distress syndrome (OR = 8.13) increased the chance of neonatal death. The variable of age of the baby reduced the chance of the baby dying. The variables of neonatal sex and type of delivery did not show a significant relationship.

According to the results of this study, asphyxia, sepsis, respiratory distress syndrome, low Apgar score, and low birth weight were the most common causes of neonatal death.

Considering the possible role of CharcoL leyden Crystal (CLC) gene in olfactory reduction, this study was performed to determine the relationship between olfactory reduction and middle turbine eosonophilia in patients with chronic sinusitis.

In a cross-sectional study, 45 patients with chronic rhinosinusitis who referred to Alzahra and Ayatollah Kashani hospitals of Isfahan, Iran, during the years 2019-2020 were selected, and a biopsy of the middle turbine was performed, and the expression of CLC gene was examined using real time polymerase chain reaction (PCR) test. Patients' olfactory status was assessed with methanol test questionnaires (CCCLC) and Sino-nasal outcome test-22 (SNOT-22), and the relationship between CLC gene expression and olfactory power was evaluated.

The mean olfactory score of the subjects was 4.73 ± 1.27, which was 5.58 ± 0.81 and 3.58 ± 77 in the negative and positive CLC subjects, respectively, and the CLC negative subjects had a higher olfactory level (P < 0.001). The mean score of SNOT-22 in all patients was 83.49 ± 14.88 and in the two groups of CLC negative and positive was 77.58 ± 15.43 and 91.58 ± 9.54, respectively, and the difference between the two groups was significant (P = 0.001).

The findings of the present study show that there is a significant relationship between CLC gene expression and decreased sense of smell in patients with chronic rhinosinusitis, and the sense of smell is lower in CLC positive patients.