Reviews in Clinical Medicine
Volume:9 Issue: 3, Summer 2022

Low birth weight (LBW) is a challenging multifaceted public health problem as it associated with infant mortality. LBW affects newborns’ survival and is a global concern especially for developing countries. It is the most common health indicator for assessing neonates’ health conditions. In terms of short and long term consequences, LBW plays an important role in inferring infant and childhood morbidities such as mental retardation, learning disabilities, inhibited growth and cognitive delays and so on. To estimate the prevalence of LBW babies and determine the socio-demographic factors associated with LBW. A community-based cross-sectional study was carried out among postnatal mothers with singleton live born baby in a rural area of North Karnataka, India from January 2016 to December 2016. Based on the sample size, data was collected from 337 participants. The study Participants comprised of postnatal mothers with single live born baby. Weight of the newborn was recorded. Chi square test was used to find the association. The prevalence of LBW was found to be 21.1%. A number of factors like teenage pregnancy, occupation, type of family, etc. were found to be significantly associated with low birth weight. Although the prevalence of LBW is lower than some of the studies done earlier in other parts of the country, but it are still more than national average of 18.6%. Thus there is a need to encourage the utilization of health services to ensure 100% antenatal care (ANC) registration and institutional deliveries.

A correlation cannot be established between clinical findings and hematoma thickness in Chronic Subdural Hematoma cases. The effects of hematoma on intracranial structures can be evaluated as a grading criterion. This study aims to establish a grading system by establishing a correlation between the compression effects of hematoma and clinical conditions in Chronic Subdural Hematoma cases. The radiological and clinical findings of the cases diagnosed with Chronic Subdural Hematoma were recorded. Headache, dizziness, focal neurological deficit, and reduction in Glasgow Coma Scale scores were recorded as clinical criteria. Radiologically, a 4-grade grading system was prepared. Hematoma without compression effect, dural compression and sulcus effacement, parenchymal compression, and midline shift of more than 5 mm were used in the grading system, respectively. The clinical symptoms and signs within each grade were recorded. Computed Tomography examinations and clinical findings of 414 cases were recorded. It has been noted that as the grade increases, the clinical symptoms and signs increase along with the increase in hematoma thickness. However, it has been noted that an absolute correlation cannot always be established between hematoma thickness and clinical symptoms. The grading system is instructive in showing the effects of hematoma on intracranial structures rather than hematoma thickness in Chronic Subdural Hematoma cases. Complete drainage of hematoma is rare in surgically treated cases. Clinical improvement is associated with optimal intracranial dynamics rather than hematoma thickness. The grading system is instructive regarding clinical and radiological follow-up of the cases.

This study was aimed to evaluate the prognosis of patients with severe burns by measuring the plasma base excess and serum lactate levels and comparing it with the ABSI scoring system as an important indicator in the resuscitation of burn patients. This prospective cohort study was performed on all patients hospitalized in the burn ward of the hospital. The demographic data and ABSI scoring of all patients were recorded. Patients' clinical information and routine tests, gasometry (for measuring plasma base excess) and serum lactate levels were measured at the time of admission, 12 hours, and 24 hours after admission. A total of 311 burning patients were evaluated in this study. Mann-Whitney test showed a significant difference in the mean plasma BE1 (at the time of admission) and BE2 (24 hours after admission) between the patients who were discharged and the patients who died (P <0.001). The results indicated a difference in the process of lactate changes between two groups of patients in terms of intensity of ABSI(P <0.001). The multivariate logistic regression with the entry of BE and lactate at the time of admission and ABSI as predictive variables indicated a significant BE and ABSI. The results of this study confirmed that the plasma base excess can be used as a valuable tool in the monitoring of burn patients' resuscitation along with clinical criteria. On the other hand, the ABSI scoring system is still a valuable tool to predict the deaths of burn patients.

This study was conducted to determine the relationship between sex role and women's childbearing motivation. In this study 841 married female participants lived in urban society of Mashhad were recruited based on a multistage sampling from a variety of settings. Data was gathered using Childbearing Questionnaire (CBQ) and brief form of Bem sex role questionnaire. Analyzed using Pearson correlation coefficient, multiple regression test and independent t-test. Feminine sex role was in significant relationship with positive childbearing motivation (p=.001). Masculine sex role have no relationship with both childbearing motivations. ANOVA showed a difference between the motivations in four groups of participants divided based on sex role scores. LSD test shows that positive motivation in android (p=.013) and masculine (p=.012) groups were significantly less than feminine group. Negative childbearing motivations in feminine group was less than in UN-differentiate group (p=.014). Multiple regression analysis show that positive motivation was in relationship with the feminine sex role and reverse relationship with marriage age. Reproductive health policy makers and family planning counselors can apply study findings in order to plan perfect programs to direct proper fertility behaviors in the society.

An imbalance has been reported in the oxidant-antioxidant system of infants with febrile convulsion. This study aimed to compare serum vitamin C levels between febrile children with or without seizures. This multicenter case-control study was conducted on febrile infants and children who were referred to the pediatric emergency wards of Mashhad University of Medical Science. The subjects were equally divided into two febrile groups of case (with seizure) and control (without seizures). Visible Spectrophotometer was used to determine the total vitamin C level. In total, 100 febrile children were included in this study. Based on the results, there was no statistically significant difference between the two groups in terms of age, gender, and family history of febrile convulsion (FC) (P>0.05). The mean vitamin C levels in the case and control groups were 42.73±7.2 and 78.59±11.1 µg/l, respectively. There was a significant difference between the groups regarding the vitamin C level (P<0.001). Regression analysis revealed that age (P=0.74), gender (P=0.66), and family history of febrile convulsion (P=0.52) had not any correlation with vitamin C levels. On the other hand, the vitamin C levels was associated with FC (P=0.001). The serum levels of vitamin C in the children with febrile seizure were lower than those in the control group. Thus, the reduced vitamin C levels can be considered as a predisposing factor for FC.

Child abuse and neglect is a public health challenge with lifelong consequences for survivors. Physicians’ knowledge regarding child abuse and neglect is essential for diagnosis, treatment, and timely referral to legal authorities. This study aimed to determine pediatric residents’ and pediatricians’ knowledge and attitude regarding child abuse and neglect. In this cross-sectional study, pediatric residents› and pediatricians› knowledge and attitude regarding child abuse and neglect were measured using a standard questionnaire with confirmed validity and reliability. In this questionnaire, knowledge score ranged from 0 to 17, and attitude score ranged from 10 to 50. After collecting the questionnaires and calculating the scores, the information was entered into the SPSS software (version 22), and statistical analysis was performed. A total of 80 participants, including 38 pediatric residents and 42 pediatricians, participated in this research. Among them, 71.3% were female, and 28.8% were male. The mean score of knowledge and attitude in all participants was 14.05 ± 1.88 out of 17 and 41.39 ± 4.36 out of 50, respectively. The mean score in the pediatric residents and pediatricians was 13.42 ± 2.02.  and 14.62 ± 1.57 for knowledge and 40.66 ± 4.32 and 42.05 ± 4.35 for attitude, respectively. Regarding knowledge, 19 participants (23.8%) had a good score, 35 (43.8%) had a moderate score, and 26 (32.5%) had a poor score (p=0.24). There was a significant difference in terms of knowledge score among four academic groups (first-year resident, second-year resident, third-year resident, and pediatrician) (p=0.031), as the score wassignificantly higher in pediatricians than in residents (p=0.004). However, no significant difference was observed for attitude score (p=0.056). In general, and regarding all participants, no significant relationship was observed between attitude score and knowledge score (p=0.059). Most pediatric residents and pediatricians participating in the present study had moderate knowledge and attitude toward child abuse and neglect, and less than a quarter of the participants had good knowledge in this regard. Also, the pediatricians had significantly higher knowledge scores than the pediatric residents. These results emphasize the importance of more education for pediatric residents regarding child abuse and neglect and continuing education programs for pediatricians.

Oral lichen planus treatment offers favorable clinical results over time due to its widespread prevalence. However, to date, there is still no theoretical agreement on the cause of this disease. Therefore, the present study aimed to investigate the frequency of human papillomavirus (HPV) DNA in oral lichen planus (OLP) tissue samples by the polymerase chain reaction (PCR) method.This retrospective study was carried out from 1387 to 1398 on 40 OLP samples (24non-erosive-atrophic and 16 erosive-atrophic forms) in the Oral Pathology Department of Mashhad Dental School. Polymerase chain reaction (PCR) was undertaken to identify HPV-DNA. Subsequently, the samples for HPV-DNA underwent PCR analysis again with the specific primers. The data were analyzed statistically by chi-square and independent t-test test regarding the significance levelof lower than 0.05. The population consisted of 29 women (72.5%) and 11 men (27.5%) with an average age of 49.48± 2.78 years. Human papillomavirus DNA in none of the studied samples (in none of the groups) was detected by PCR. Gender distribution in the studied groups was not significantly different from each other, as the groups did not differ significantly in average age. No HPV-positive samples were observed in oral lichen planus samples based on the recent findings in the current study of the Iranian population. Nevertheless, the patients› demographic data were not meaningfully associated. More sample sizes with a control group and a complete medical history should be recruited in further studies. Using complementary methods to approve the PCR method can help further studies to demonstrate accurate results.

The formation of the massive deletion of genes called “black holes,” which are detrimental to a pathogenic lifestyle, provides a bacterial evolutionary route that permits a pathogen to augment virulence and host-adaptability. For example, cadaverine substrate has inhibitory effects on the enterotoxin activity of the Shigella species. Therefore, the encoding gene of the lysine decarboxylase enzyme (CadA gene) as an anti-virulence gene is deleted from the genome of the Shigella. This and other similar cases in bacteria can be used for antitoxin therapy. Hence, identification of the role of black holes in the pathogenic evolution of bacteria output could possibly lead to novel treatments of infectious diseases in human beings. Here, we reviewed different types of pathoadaptation mutations among pathogens. Cases of black holes among the important human bacterial pathogens included Shigella, Rickettsiae, Mycobacterium leprae, Burkholderia, Bordetella, and Chlamydia. We found that the most prevalent pathoadaptive pathway among bacteria was the gene inactivation or deletion route.