ARCHIVES OF IRANIAN MEDICINE
Year:2019 | Volume:22 | Issue:8|Papers Count:10

Background: In the present study, we evaluated post-natal growth and psychomotor development status of infants at 6 months of age based on their gestational age at elective cesarean sections. Methods: This is a prospective cohort study performed in 2014-2015 in Iran. The study population consisted of 6-month-old infants with gestational ages of 38– 40 weeks delivered by elective cesarean section. The subjects were divided into 3 groups: Group A (neonates with gestational age of 380/7 weeks), group B (neonates with gestational age of 390/7 weeks), and group C (neonates with gestational age of 406/7 weeks). At the infant age of 6 months, the mothers were called for follow-up visits. Growth and psychomotor status of all subjects were assessed by expert pediatricians based on the Age and Stage Questionnaires. Recorded data related to outcomes in neonatal period and 6 months later were analyzed to determine associations between groups’ variables. Results: A total of 952 subjects were found eligible for study participation. The mean birth weight, length and head circumference were significantly higher in group C compared with the other groups (P = 0. 005). Regarding growth parameters, a significant association was found between gestational age at birth and all other growth indices at 6 months of age (P = 0. 005). The mean weight at 6 months of age was higher in group B in comparison with group A (P = 0. 001) and C (P = 0. 007). Infants born at 380/7 weeks were shorter in comparison with those born at 390/7 (P = 0. 002) and 406/7 weeks (P = 0. 005). Head circumference was significantly lower in group A than group B (P = 0. 02) and C (P = 0. 05). Regarding psychomotor indices at 6 months, a significant association was found between gestational age at birth and problem-solving skills (P = 0. 003). Delays in problem-solving skills were more frequent in neonates born at 380/7 weeks compared with those born at 390/7 (P = 0. 005) or 406/7 weeks (P = 0. 003). This difference was also significant between the two groups who were born at 390/7 and 406/7 weeks (P = 0. 01). Conclusion: The results from this study demonstrated that postponing the time of planned elective cesareans beyond 39 weeks of gestation may improve infant’ s growth and psychomotor outcomes.

Background: Multiple sclerosis (MS) is a chronic and potentially progressive demyelinating disease of the central nervous system. The incidence and prevalence rate of the disease has been increasing globally, especially in females. Methods: In this cross-sectional population-based study based on Iranian MS Society data (1989-2016), we aimed to present most recent age-standardized incidence and prevalence rate of MS, female to male ratio, mean onset age, and prevalence of positive family history of MS alongside with their time trend via Joinpoint regression analysis in 27 years. Additionally, a linear regression model was used for evaluating the association of onset age with sex and family history in patients. Results: In 18, 061 registered cases: female to male ratio was generally 3. 06: 1, showing a general decreasing trend. The mean onset age of the disease was 28. 50 ± 8. 61 with a general increasing trend. 12. 52% of the cases had at least a positive any-degree family history of MS, exhibiting a weak increasing trend. The age-standardized incidence and prevalence rate was 1. 8 (95% CI: 1. 3, 7. 2) and 116 (95% CI: 96, 139) per 100 000 populations, respectively, both presenting a significant increasing trend, however, incidence rate ended in plateaued and finally decreasing trend. Finally, onset age was predicted to be lower in females and subjects with positive family history of MS. Conclusion: Tehran is among MS high-risk areas with increasing trends in prevalence and increasing followed by plateaued incidence rates indicating necessity of extra investigations of the underlying reasons and health system preparedness for further health care requirements of MS patients.

Background: Mental disorders contribute significantly to the burden of diseases in Iran. Therefore, the current study aims to assess the prevalence of psychiatric disorders and their associated factors among youth in Kermanshah province of Iran. Methods: The current study is a part of the first phase of Ravansar Cohort (a part of the PERSIAN Youth Cohort) including 2991 participants aged 15 to 34 from Ravansar district in western Iran. Enrollment and data collection for this phase were performed from end April 2015 to early April 2017. The data were gathered using structured interviews and national and international standard questionnaires. Data analysis was carried out using multinomial logistic regression and chi-square test. Results: The prevalence of any psychiatric disorder among the selected population was 31. 3%. Major depressive disorder (MDD) (21. 6%), followed by generalized anxiety disorder (GAD) (6. 4%) and dysthymia (1. 9%) were the most prevalent disorders among the study individuals. The prevalence of alcohol and opioid/stimulant use disorders was 4. 6% and 5. 1%, respectively. Moreover, there was significant relationship between location of residence (city or village) and marital status with prevalence of the disorders. Conclusion: Based on the results of the current study, it can be concluded that the prevalence of mental and psychiatric disorders among the youth in Ravansar district, western Iran is relatively high and needs specific plans and interventions to control it.

Background: Breastfeeding empowerment is a key motivational, psychological and flexible factor influencing the continuance of breastfeeding. The purpose of this mixed-methods study was to design and evaluate the empowering program for breastfeeding. Methods: We used a mixed-methods study with a sequential exploratory approach. In the qualitative phase, we explored the experiences of women about empowerment for breastfeeding using conventional content analysis. In the intervention phase, we designed and implemented a breastfeeding empowerment program based on the findings of the qualitative phase and evaluated it 2 weeks, 2 months and 4 months after childbirth. This randomized clinical trial is registered under IRCT2015081723657N1. Results: Analysis of data from the interviews in the qualitative phase yielded three main categories, namely “ adequate knowledge and skills about breastfeeding” , “ overcoming breastfeeding problems” and “ perception of family support for breastfeeding” . In the qualitative phase, after implementing the program, the mean scores of breastfeeding empowerment were significantly higher in the intervention compared to the control group at 2 weeks (mean difference=-25. 30; 95% CI =-5. 36,-15. 23), 2 months (mean difference =-21. 71; 95% CI =-31. 24,-12. 19), and 4 months (mean difference =-17. 72; 95% CI =-27. 14,-8. 30) after childbirth (P < 0. 001). In addition, exclusive breastfeeding was significantly higher in the intervention group at 2 weeks, 2 months and 4 months after childbirth (P = 0. 003, P = 0. 003, P = 0. 044, respectively). Conclusion: To empower women for breastfeeding, the mother, father and key family members should be educated using practical and visual teaching techniques during pregnancy and postpartum period. Moreover, since breastfeeding empowerment is established 2 weeks after childbirth, empowering programs should be implemented prior to this period.

Background: Mutations and polymorphisms of the GSK3β gene have been associated with several diseases including Alzheimer disease, diabetes and cancer; however, to date, no variants of this gene have been associated with colorectal cancer (CRC). This study aims to explore, for the first time, the association of the GSK3β rs334558 and rs6438552 polymorphisms with CRC. Methods: Genomic DNA from 330 CRC patients and healthy blood donors were analyzed. Identification of polymorphisms was made by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methodology. Association was calculated by the odds ratio (OR) test. Results: Patients carrying the C/T genotype for the rs334558 (T>C) polymorphism showed an increased risk for CRC (OR = 1. 71, 95% CI: 1. 05– 2. 79, P = 0. 039); this association was also observed for TNM stage and tumor location. For the rs6438552 (T>C) polymorphism, the OR analysis showed that patients carrying C/T and C/C genotypes have a decreased risk for CRC (OR = 0. 44, 95% CI: 0. 27– 0. 70, P = 0. 001 and OR = 0. 24, 95% CI: 0. 10– 0. 64, P = 0. 001, respectively); this decreased risk was also evident in the stratified analysis by TNM stage and tumor location. Haplotype analysis of these 2 loci of GSK3β (rs334558 and rs6438552) showed differential distribution. The T-T and C-C haplotype was associated with a decreased risk of CRC, while the T-C haplotype was associated with an increased risk of CRC. Conclusion: Our results denote that GSK3β gene polymorphisms play a significant role in promoting or preventing CRC. Additionally, variations in this gene are associated with the tumor site and the tumor-node-metastasis (TNM) stage in these patients.

Many genes with different inheritance modes contribute to the pathogenicity of intellectual disability (ID) making it the most known genetically heterogeneous disorder. Advanced next-generation sequencing (NGS) technologies have helped researchers identify genes underlying ID at an exponential pace. As a consanguineous country, Iran is a hotspot for discovering novel autosomal recessive intellectual disability (ARID) genes. Here, we aimed to review and compare reported ARID gene discovery both in Iran and globally, and pinpoint the research areas that need to be developed in future. We studied published articles and reviews on all known ID genes. In parallel, the gene-discovery research carried out on the Iranian population were also reviewed to determine the contribution of Iran to identifying novel ID genes. Also we tried to find supporting evidence on the causative role of novel genes identified in Iran including confirmatory functional studies and existence of more affected families. We also briefly reviewed the current therapeutic approaches under development for a subset of eligible ID cases. In total, 8% of all ID and 11. 5% of all ARID genes described so far have been identified via studies on Iranian population. Functional studies have been performed on 29% of the genes identified in Iran. More than one affected family has been reported for many of these genes, supporting their causative role in ID pathogenesis. Despite the notable contribution of Iran in gene-discovery research, further functional studies on the identified genes are required.

Hydatidosis is an important zoonotic parasite disease in several herbivorous mammals. Human cystic echinococcosis (CE) caused by infection with larval stage of Echinococcus granulosus has been frequently reported from different organs. Here, we report the first case of a urinary echinococcosis in Iran with a pain in the lower left abdominal quadrant and severe frequent urination (pollakiuria). We detected a cyst 120 × 15 mm dimensions with heterogeneous mass contain fluid in the back of the urinary bladder neck between the umbilical region and external urethral sphincter. The patient was candidate for open-abdomen surgery and cysts were resected. The isolated cysts from liver and urinary bladder were referred to pathology laboratory, and the tissue sections were stained with Tri-chrome and Hematoxylin/eosin staining methods. Microscopic examination of prepared tissue sections showed protoscoleces of E. granulosus with specific and thick laminated hyaline layer (non-cellular membrane), with covers the thin activate germinal epithelium, which revealed the diagnosis of a hydatid cyst. This rare case illustrates that CE is the necessity of considering in the differential diagnosis from cysts, abscesses, malignant and benignant tumors, especially is essential in endemic areas of CE.

The patient was a 12-year-old boy who presented with loss of consciousness and right hemiparesis four days after liver transplantation. The patient had received immunosuppressive drugs like methylprednisolone 1 g daily on the first three days of transplantation and 2 mg/ kg/d afterward, tacrolimus 4 mg daily from the second day after transplantation and mycophenolate mofetil 500 mg daily from the second day after transplantation...

Dear Editor, During the last decade, systematic review and meta-analysis (SRM) had become one of the most popular types of scientific research, particularly in medical sciences as the milestone of evidence-based medicine. Also the number of SRMs prospectively registered in the registries, e. g. PROSPERO, and those who follow the standards such as the PRISMA for providing a transparent report are increasing (Figure 1).

Dear Editor, Human development and the nature of his perception toward the surrounding world have undergone the great changes. According to the evidences found in the Burnt City (Shahr-e Sukhteh), Sistan and Baluchistan, Iran, it can be theorized that the civilization of the Burnt City has had the approximated theoretical and conceptual perception of the outside world to some extent. Theoretical perception is resulted from the surrounding world abstraction. Abstraction forms when human brain can pass the visual perception level and reach the abstract and conceptual perception. In fact, conceptualization and finding common roots among different processes in the universe is the basis for theoretical and philosophical perception of the universe.