Shiraz E-Medical Journal
Year:2020 | Volume:21 | Issue:4|Papers Count:9

Dear Editor, We are glad to read the article by Fallahi et al. (1), entitled “ Pulmonary Tuberculosis Seasonality Survey in Fars Province, South of Iran” , which was published in the last issue of the journal. This well-written article aimed to find the sessional distribution pattern of pulmonary tuberculosis (TB). However, there are some concerns regarding interpretation of results. The authors reported the TB sessional distribution pattern based on diagnosis time. The timeline of TB infection starts when infectious droplets are inhaled by close contacts to infected patients...

Background: During recent decades, there has been a dramatic increase in the prevalence of asthma in children. There is low-grade quality evidence that breastfeeding and anemia are associated with a reduced risk of asthma in children up to 5 years of age. Objectives: Regarding the high prevalence of anemia and asthma in Iranian children, we aimed to evaluate the risk factors for asthma in children. Methods: The present case-control study examined 110 children (55 cases and 55 controls) aged 3 to 12, admitted to Shahroud educational hospitals from March 2017 to February 2018. The children diagnosed based on the Global Initiative for Asthma criteria, by a specialist physician, were selected as the case group and those admitted to other hospital wards for diseases (such as orthopedic and nephrology), other than respiratory problems were selected as the control group. Multivariable logistic regression was used to find asthma risk factors. P < 0. 05 was considered statistically significant. Results: Of 110 children, 63 (57. 3%) were boy and mean ( standard deviation (SD)) age of the participants was 7. 23 ( 4. 17) years and mean weight was 29. 6 ( 21. 6) kg. Most of the children (76. 4%) were fed by breast milk during infancy. Mean ( SD) Hb in the case group was 10. 4 ( 2. 5) g/dL and in the control group was 11. 5 ( 2. 3) g/dL (P = 0. 01). The prevalence of anemia was 72. 7% and 50. 9% in the case and control group, respectively (P < 0. 001). After controlling for potential confounders, breastfeeding (OR breast milk only vs. formula only = 2. 23, P = 0. 01), serum level of hemoglobin (OR = 0. 13, P = 0. 002) and ferritin (OR = 0. 32, P = 0. 04) were significantly associated with the risk of asthma. Conclusions: Our study found the role of low duration of breastfeeding and ferritin deficiency as a risk factor for development of asthma in children. This finding emphasizes that iron supplementation along with breastfeeding in childhoodmayprevent asthma and hence reduce the children’ s mortality and morbidity rates associated with asthma.

Dear Editor, We thank the authors for their interest and comments on our manuscript (1). As it was mentioned by the authors, apparently more frequent diagnosis of tuberculosis in warm seasons may be a reflection of more frequent acquisition of organism during cold seasons, which is due to crowding, low immunity and low level of vitamin D, and less diagnostic confusion with common upper respiratory tract infection (2, 3)...

Background: Thyroid function and depressive disorders have a reciprocal correlation. Objectives: This study was performed to assess the association between thyroid function and depressive symptoms in older adults. Methods: In this cohort study, all older adults (aged 60 or over) recruited in the Amirkola Health and Ageing Cohort Project (AHAP) were followed from 2011 to 2016. At a baseline examination, depressive symptoms were assessed using the geriatric depression scale (GDS). Thyroid function was evaluated with the serum levels of T3, T4, and thyroid stimulating hormone (TSH). Older adults whose GDS scores showed no depressive symptoms at the baseline were followed for five years. The t-test, ANOVA, logistic regression model, and Pearson’ s correlation coefficient were used for data analysis. Results: Totally, 1, 463 individuals completed the first phase of the study. We showed that 623 (45. 3%) persons with a mean age of 69. 6  7. 3 years had mild-to-severe depression and 840 (54. 7%) individuals had no depressive symptoms. The baseline thyroid function of the participants showed that the mean levels of T3 (0. 330), T4 (0. 312), and TSH (0. 064) had no significant difference between patients with depressivesymptomsandindividuals without these symptoms. After the baseline assessment, 571 individualswhodid not have depressive symptoms were followed for five years. The results showed that 69 (12. 1%) persons were hypothyroid and six (1. 1%) were hyperthyroid. Overt or subclinical hypo (P = 0. 103) or hyper (P = 0. 128) thyroid function had no significant difference between older adults who were depressed and non-depressed. Conclusions: A five-year follow-up of elderly people revealed no significant correlation between depressive symptoms and thyroid function in this population.

Objectives: To compare the therapeutic outcomes of proximal crescentic osteotomy (PCO) versus proximal opening wedge osteotomy (POWO). Methods: In this retrospective analytical study, 88 patients with moderate to severe unilateral hallux valgus (HV) were enrolled. HV severity and angle, intermetatarsal angle, MTPJ status, and AOFAS score were collected. Results: The AOFAS score, HV and intermetatarsal angles, and MTPJ status improved in all patients with no significant differences between the two groups. The POWO group showed significantly higher satisfaction score at the 3rd month post-operation. Conclusions: Both osteotomies demonstrated acceptable outcomes; however, short term patient satisfaction was greater in the POWO technique.

Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East respiratory syndrome (MERS-CoV) and severe acute respiratory syndrome (SARSCoV) (1). An epidemic of coronavirus disease 2019 (COVID-19) has spread rapidly since December 8, 2019 in China (2). The sudden outbreak of Corona from China to more than 30 countries has shocked the international community, and especially health policy makers around the world. For example in Iran in February 25, 2020, the Ministry of Health and Medical Education (MOHME) reported 95 confirmed cases of COVID-19 and 15 fatalities. Many social and economic issues are tied to the Corona outbreak. The Coronavirus shock was wider and stronger than severe acute respiratory syndrome (SARS), bird flu, and swine flu in previous years. This particular outbreak of Coronavirus revealed how a biological and epidemiological issue can be transformed to a social, economic and political subject...

Background: Poor sleep quality in medical students may negatively affect their professional training and deteriorate neurocognitive and academic performance. Objectives: In this study, we aim to determine the prevalence and determinants of poor sleep quality and its scales in a group of medical students in Tehran, Iran in 2017. Methods: In this cross-sectional study, Pittsburgh Sleep Quality Index (PSQI) was completed by 154 medical students in Tehran, Iran. Demographic characteristics were also gathered. Global PSQI and scales scores were calculated. Results: Median Global PSQI score was 5. Poor sleep quality was observed in 65 (42%) students. Participants scored worst in sleep duration and daytime dysfunction scales, and 84. 4% of the total participants reported some degree of daytime dysfunction. More than 90% of the participants reported no use of sleep medication. Neither of the variables sex, age, place of residence, being a freshman or having a history of sleep problems showed any significant association with sleep quality. When evaluating the scales, sleep duration problem was mostly observed in freshmen (P = 0. 02), while medication use and daytime dysfunction were more common in second-year students (P = 0. 04 and P = 0. 01, respectively). Conclusions: The prevalence of poor sleep quality was high in this group of medical students in Tehran. The problem was largely observed in sleep duration and daytime dysfunction subscales of sleep quality.

Background: Cirrhosis, as the end stage of a variety of chronic liver diseases, can affect oxygenation in patients and make them hypoxic through hepatopulmonary syndrome or portopulmonary hypertension. However, we observed that some patients referring to our center for liver transplantation had high arterial oxygen saturation. Objectives: This study was designed to investigate the presence and association of hemoglobin oversaturation in cirrhotic patients candidate for liver transplantation. Methods: In a cross-sectional study, cirrhotic patients referring to Shiraz Organ Transplantation Center were included from 2013 to 2015. The exclusion criteria were other disorders that might affect O2 saturation and other causes of liver transplantation except for cirrhosis. Also, we excluded all patients with chest X-ray abnormality. Hemoglobin saturation was measured by arterial blood gas analysis. Patients were divided into two groups, oversaturated patients (Hb sat O2  98%) as the case group and patients with Hb sat O2 < 98% as the control group. We compared the case and control groups for the cause of cirrhosis, sex, smoking status, age, spirometry, model for end-stage liver disease (MELD) score, and the place of residence’ s altitude. After univariate analysis, logistic regression models were used for multivariate analysis and adjusted for significant and near significant (P value < 0. 2) covariates. Results: Of 495 patients, 18. 6% were oversaturated. Moreover, 64. 5% of the control group patients were males versus 58. 7% of the case group. Themeanage of the control group (40. 6 14. 7) was significantly higher than that of the case group (36. 8 15. 7) in univariate analysis (P value = 0. 02). Hemoglobin oversaturation was significantly higher in patients with auto-immune hepatitis (AIH) than in patients with other causes of cirrhosis (P value = 0. 001). There was no significant difference between the case and control groups in other causes of cirrhosis or other factors. In multivariate analysis, just AIH remained statistically significant in the models (odds ratio = 2. 03; 95% confidence interval = 1. 13-3. 65; P value = 0. 01). After finding an association between AIH and oversaturation, the drugs routinely used for the treatment of AIH were compared between the case and control groups. No significant difference was found between them in using prednisone, azathioprine, and cyclosporine (P values = 0. 5, 0. 6, and 0. 6, respectively). Conclusions: Based on our research, there was an association between oversaturation in cirrhotic patients and AIH. The association was not related to the drugs used for the treatment of AIH.

Background: House flies (Musca domestica L. ) may mechanically transmit many microorganisms to humans. Objectives: To identify bacteria contaminating Musca domestica (Diptera: Muscidae) collected from animal husbandries in province of Qom, Iran in the year of 2019. Methods: In the cross-sectional study, house flies were captured by plastic water bottle fly traps and insect nets from four districts of the Qom Province and were immediately transferred to the Department of Medical Entomology, School of Public Health in sterile glass containers, individually. The bacterial isolation of the surface and gut contents of the flies were separately performed by biochemical methods. To confirm Salmonella spp. and Shigella spp., antigen-antibody agglutination reactions were carried out by specific antisera. Results: A total of 23 bacterial species were identified from 160 house fly external surfaces and/or digestive tract were isolated. The most frequently isolated bacteria from the external body and the digestive tract of 160 flies were E. coli (73. 8%) and P. aeruginosa (100%), respectively. The most frequently isolated bacteria were P. aeruginosa, Salmonella serogroupD, S. dysenteriae, E. coli, C. freundii, S. aureus, and S. epidermidis. Conclusions: House flies are important in the mechanical transmission of a different range of the pathogens. In addition, because of the geographical features of Qomand isolated pathogens, it seems that the possibility of mechanical disease transmission by the flies can be increased.