Archives of Iranian Medicine
Volume:24 Issue: 8, Aug 2021

Pain control methods after cesarean section may interfere with infant breast-feeding. The aim of this study was to evaluate the effect of pethidine on breast feeding of infants born via cesarean section with spinal anesthesia.

In this randomized double-blind clinical trial, we evaluated 116 infants born via cesarean section in Gerash Amiralmomenin hospital (Southern Iran) in 2017. The subjects were selected through purposive sampling and randomly by permuted block randomization and assigned to intervention and control groups. The test group received 100 mg of pethidine as intravenous infusion and the control group received only routine cares. Infants’ breast feeding behavior in both groups was recorded within 48 hours of hospitalization, using the standard tool for rapid assessment of infant feeding behavior, which consists of 4 main components of breastfeeding, including readiness to feed, rooting, latching, and sucking with a score range of 0 to 3 for each component evaluated at 1, 6, 12, 24, 36, and 48 hours postnatally. Data were analyzed using independent t tests and chi-square test.

The highest score of breast-feeding behavior pertained to sucking reflexes in the control group and the lowest score to breast feeding readiness in the pethidine group. Readiness for feeding in the control group (2.09±0.53) was significantly higher than the pethidine group (1.81±0.61) (95% CI: 0.0552, 0.5092 and P=0.015). Sucking reflex (95% CI: -0.1461, 0.2208 and P=0.687), latching (95% CI: -0.3012, 0.0345 and P=0.118) and rooting reflexes (95% CI: -0.1685, 0.2342 and P=0.747) were almost equal in the control group (2.54±0.49, 2.52±0.38, 2.5±0.48, respectively) and pethidine groups (2.51±0.43, 2.65±0.45, 2.46±0.53, respectively). The total score of feeding behavior in the control group (9.66±1.04) was higher than that of the pethidine group (9.44 ±.69) (95% CI: -0.2032, 0.6412 and P=0.306). There was no significant difference between the infants’ feeding frequency (95% CI: -0.269, 1.930 and P=0.137) and duration of feeding (95% CI: -3.2067, 0.4597 and P=0.14).

Evaluation of infants in the first 48 hours after birth showed that those babies whose mothers received pethidine were less willing to start breast-feeding. However, other components of breast-feeding behaviors were similar.

End-stage renal disease (ESRD) is a condition in which bone turnover and metabolism is impaired; thus, osteoporosis and low bone density are subsequently inevitable. We aimed to determine bone mineral density (BMD) and biochemical markers, and associated factors in hemodialysis (HD) patients.

Patients aged 30-70 years undergoing HD between 2015 to 2019 were enrolled in this cross-sectional study. BMD measured by dual energy x-ray absorptiometry (DEXA) and biochemical laboratory tests were assessed in 200 patients undergoing HD. Statistical analysis was based on t test, Pearson, regression and Mann-Whitney tests using SPSS 16.

Two hundred patients were investigated. Sixty percent of the patients were female. Mean ± SD of participants’ age was 58.6 (±11.63) years and mean ± SD for duration of HD was 45.69 (± 43.76) months. Osteoporosis was found in 48% (n=96) and low bone density in 36% (n=76) of our patients. General osteoporosis was more frequent in those undergoing HD for more than 3 years, although not significantly (P=0.093, odds ratio [OR]=0.37). However, regional osteoporosis in hip and femoral neck, but not spine vertebrae, were significantly higher after three years of HD (P=0.036, OR=0.27; P=0.042, OR=0.27; and P=0.344, OR=0.56, respectively). Increased body mass index (BMI) correlated negatively with osteoporosis (P=0.050).

With increasing age and duration of HD, BMD decreases. Higher BMI was associated with higher bone mass density. Bone density assessment seems to be necessary in patients undergoing HD.

Due to their self-renewal and differentiation ability, the mesenchymal stem cells (MSCs) have been studied extensively. However, the MSCs lifespan is restricted; they undergo several divisions in vitro that cause several alternations in cellular features and relatively lessens their application. Thus, this study was aimed to assess the effect of platelet-derived microparticles (PMPs), a valuable source of proteins, microRNAs (miRNAs), and growth factors, on the expression of hTERT, c-MYC, p16, p53, and p21 as the most important aging and cell longevity genes alongside with population doubling time (PDT) of PMP-treated cells in comparison to a control group.

Umbilical cord MSCs (UC-MSCs) were used in this study, whereby they reached a confluency of 30%. MSCs were treated by PMPs (50 µg/mL), and then, PDT was determined for both groups. Quantitative expression of hTERT, c-MYC, p16, p53, and p21 was examined through quantitative real-time PCR at various intervals (i.e. after five and thirty days as well as freezingthawing process).

Our results demonstrated that the treated group had a shorter PDT in comparison to the control group (P<0.050). The real-Time PCR data also indicated that PMPs were able to remarkably up-regulate hTERT and c-MYC genes expression while down-regulating the expression of p16, p21, and p53 genes (P<0.050), especially following five days of treatment.

According to these data, it appears that PMPs are a safe and effective candidate for prolonging the lifespan of UCMSCs; however, further investigations are needed to corroborate this finding.

Appendix tumors are rare tumors found in the gastrointestinal tract, observed at a rate of about 0.2%–0.3%. Our aim in this study was to present the clinicopathological classification, treatment and long-term prognosis of patients with low grade appendiceal mucinous neoplasm (LAMN)

Patients who underwent surgery in the Erciyes University Department of (Kayseri, Turkey), Department of General Surgery between December 2010 and December 2018, and who had LAMN as a result of pathology were included in our study. Demographic data, clinical and pathological features of the disease, their treatment and follow-up results after treatment were reviewed retrospectively.

We included 24 patients in the study. Of these patients, 10 (41.6%) were male. The mean age distribution was 56.4 ± 20.3 (21–91) years. Appendectomy was performed in 14 patients, and additional organ resections were performed in 8 patients. The most common symptom at the time of presentation was abdominal pain (79.1%; 95% CI, 58.3–91.7). The most common preliminary diagnosis in the preoperative period was acute appendicitis (50%; 95% CI, 29.2–70.8). Mean postoperative hospitalization time was 7.4 ± 7.96 (2–31) days. On pathological examination, appendectomy resection margins were positive in two patients. The mean (median) postoperative follow-up was 31.25 ± 23.9 (27) (1–90) months. One-year survival was 91.6%, and 5-year survival was 83.3%. Recurrence was detected in three patients during the follow-up period.

If appendix mucinous neoplasia (AMN) is suspected in patients undergoing surgery with an initial diagnosis of acute or plastron appendicitis, care should be taken to remove the lesion without perforation. Pseudomyxoma peritonei, which may develop as a result of perforation, is associated with recurrence and decreased survival.

Angiopoietin-2 (Angpt2) is associated with the progression of coronary artery disease (CAD). This research aimed to investigate the possible association between single nucleotide polymorphisms (SNPs) of ANGPT2 and CAD.

This research was performed in a hospital from the eastern region of China. From February 2019 to June 2019, 222 patients with CAD were newly diagnosed and 403 healthy controls were confirmed by physical examinations. The distribution frequency of five SNPs of the ANGPT2 (rs11137037, rs2442598, rs12674822, rs1823375, and rs734701) in all participants was analyzed by real-time polymerase chain reaction (PCR) with SNP locus-specific probes.

Our data showed that the participants with the TT genotype of rs2442598 were at reduced risk of CAD compared with wild-types (adjusted odds ratio [AOR] = 0.511, 95% CI: 0.283–0.923). The participants with the AC and AC+CC genotypes of rs11137037 were at greater risk of CAD compared to wild-types (AOR = 1.754, 95% CI: 1.140-2.699; AOR = 1.731, 95% CI: 1.165–2.573, respectively). In addition, carriers of the GG+TT genotypes of rs12674822, showed more significant high-density lipoprotein than those of GG genotype, in addition, carriers of the GG+TT genotypes of rs12674822, showed more significant high-density lipoprotein than those of GG genotype (P=0.037).

These findings, as well as analysis of the haplotype, clearly indicate that ANGPT2 SNPs were highly correlated with susceptibility to CAD among the Han Chinese population.

Primary osseous sarcomas of the mobile spine are rare bony tumors. Ewing sarcoma, chondrosarcoma, chordoma and osteosarcoma constitute the majority of primary bone sarcomas of the spine; however, other rare sarcoma tumors may also affect the spine. In order to perform an epidemiological study of theses tumors, national registries may help to evaluate data for populations with similar characteristics.

A population-based study was designed based on data from the Iran National Cancer Registry (INCR). All morphology codes (M-Code) of primary osseous sarcomas of the mobile spine (C-code 41.2) were derived and analyzed.

Among 186 patients with primary osseous sarcomas of the mobile spine, 67.2% were men and 32.8% were women. The median (IQR) age was 37.0 (20.0–59.0) years and the age-standardized incidence rate (ASIR) was 0.37 per million. The majority of cases of Ewing sarcoma (29.5%) were observed in the age group 20–25 years. Among male patients with chondrosarcoma, the median age was 39.0 (30.0–50.0), while females showed a median age of 56.0 (50.0–59.0). The median age of patients with chordoma was 54.0 (47.0–63.0) years. The crude incidence rate of mobile spine osteosarcoma was 0.04 per million.

Ewing sarcoma was the most frequent primary osseous sarcoma of the mobile spine. A male predilection was observed among all major sarcomas of the mobile spine. Ewing sarcoma in Iran affects the mobile spine in slightly older ages compared to other studies. Myxoid chondrosarcoma is the most frequent subtype of the mobile spine chondrosarcoma. Chordoma affects male in older ages compared to females. In contrast with other studies which showed a bimodal distribution of osteosarcoma of the spine including young adult and older age groups, 86% of cases in Iran were in the age group of 10–40 years

This study was designed and conducted to investigate the spatial distribution of permanent and temporary congenital hyperthyroidism (PCH and TCH) in Isfahan.

This study was conducted on neonates who were born from March 21, 2006 to March 20, 2011 and had undergone the congenital hypothyroidism (CH) screening program in counties affiliated to the Isfahan University of Medical Sciences. CH was diagnosed in 958 patients who treated with levothyroxine. The incidence rates of permanent and temporary congenital hypothyroidism in Isfahan province were calculated and their distribution was shown on the map. The space maps were drawn using the ArcGIS software version 9.3.

Based on the data obtained from the screening program, the average incidence of congenital hypothyroidism in the province during the period of 2006–2011 was 2.40 infants per 1000 live births (including both PCH and TCH). The most common occurrence was in Ardestan County (10:1000) and the lowest overall incidence was observed in the Fereydounshahr county (1.39:1000). The incidence of PCH in the counties of Ardestan and Golpayegan had the highest rate in all years of study; and the greatest number of TCH cases in the five years were observed in Nain, Natanz, Khansar and Chadegan counties.

Adding the time dimension and performing spatial-temporal analysis is suggested because of the following items: high prevalence of CH in Isfahan province, the important role of this disease in mental retardation and neuropsychiatric disorder, the necessity of conducting future medical researches to find possible factors of CH etiology in Isfahan province, as well as necessity of performing spatial analysis with advanced statistical methods.

Given the overwhelming mental health consequences of infectious epidemics, timely identification and treatment of people with mental health problems is essential. In this narrative review, screening instruments and procedures for identification of mental health problems at the time of epidemic crises are reviewed and the results are discussed in the context of our experience in the recent COVID-19 epidemic in Iran.

Forty studies were retrieved from searches in several databases which used screening procedures for identification of mental health conditions during infectious epidemics.

Studies were performed on three groups of health care workers, at-risk general population, and patients with confirmed/ suspected infection, using a wide range of instruments. Most have used screening instruments for the purpose of prevalence estimation and only 5 have included it as a health intervention while none has investigated its effectiveness.

The evidence base for screening at the time of epidemics is weak. If it is used to identify the needs and enhance help seeking, the screening instruments should have adequate psychometric properties; moreover, their integration in the available services is strongly recommended. Original studies are needed to investigate the usefulness of mental health screening programs in crises such as the COVID-19 epidemic.