Iranian Red Crescent Medical Journal
Year:2015 | Volume:17 | Issue:7|Papers Count:8

Background: Urbanization and diet change have increased the prevalence of Vitamin D deficiency. Unfortunately, none of the suggested treatments is widely accepted.Objectives: Therefore, we evaluated the most used and suggested protocol for treating Vitamin D deficiency in Percutaneous coronary intervention (PCI) candidate patients referred to our hospital in a short-term clinical trial.Patients and Methods: All patients with coronary artery disease, referred to our hospital and candidates for PCI (drug eluted stents) were included. Deficient patients were randomly assigned to treatment (Vitamin D3 pearls of 50, 000 IU; one per week for 10 weeks then one pearl every month for maintenance) and non-treatment groups. Vitamin D was measured after nine months.Results: After initial evaluation, 116 cases were found to be deficient, and were divided into two equal groups of 58. No significant difference was found between the normal, treated and non-treated groups regarding age and gender. Thirty-two out of 58 (55.1%) subjects were vitamin D deficient and reached normal levels by taking supplements and seven out of 58 (12%) were deficient and reached normal levels without taking supplements, with the difference being significant (P<0.001).Conclusions: The used protocol is not enough for treating Vitamin D deficiency. Furthermore, the protocol should be revised according to baseline Vitamin D classification.

Background: One of the limiting factors for early hospital discharge in preterm infants is their inability to feed sufficiently to obtain consistent weight gain. Therefore, feeding difficulty is one of the most significant issues with which a preterm infant is faced.Objectives: The purpose of this study was to examine the effect of oral sensory motor stimulation on feeding performance, length of hospital stay, and weight gain in preterm infants at 30 - 32 weeks of gestational age.Patients and Methods: Premature infants (n=20) were randomly assigned to experimental and control groups. The experimental group received oral sensory motor stimulation of the oral structures (15 minutes / day) for 10 successive days, while these stimulations were not offered to the control group. Days elapsed to achieve oral feeding, length of hospital stay, and weight gain in the two groups were assessed.Results: Transition to oral feeding was acquired significantly earlier in the infants in the experimental group than in the controls: 13 and 26 days, respectively (P<0.001). Likewise, the length of hospitalization was significantly shorter in the experimental group than in the control group: 32 days and 38 days, correspondingly (P<0.05). The two groups showed no significant difference in terms of weight gain in the first, second, third, and fourth weeks of birth: first week: 100 vs.110; second week: 99 vs.111; third week: 120 vs.135; and fourth week: 129 vs.140.Conclusions: The present research revealed that the number of days to reach oral feeding in our preterm babies was decreased by oral motor stimulation, which in turn conferred earlier hospital discharge.

Background: Pertussis or "whooping cough" is an acute, communicable infection of the respiratory tract caused by the Gram-negative bacterium Bordetella pertussis. It has been recorded in history of medicine that the first pertussis epidemic was reported in 1578 by a French scientist, Guillaume de Baillou, in Paris. Furthermore, the causative agent was first isolated in 1906 by Jules Jean Baptiste Vincent Bordet and his brother-in-law Octave Gengou. However, it seems that earlier reports can be found in history of medicine.Objectives: The aim of this study as to analyze the first Report of Epidemic Pertussis by Bahaodowle Razi From the 15th Century Anno Domini Materials and Methods: We investigated a copy (Persian lithograph) of the book named "a summary of experiences in medicine", written by Bahaoddin-bin-Ghasem-Bahaoddin Razi (well known as Bahaodowle Razi) in 1502 to find the earliest existing report of epidemic pertussis in the history.Results: Bahaodowle Razi, a Persian physician from the 15th century Anno Domini (AD), reported two epidemics in Harat and one in Rey (inold Persia) for the first time, one century before Baillou. He named it as Sorfe-ie-Am (meaning public cough). Those occurred during his lifetime. Explaining about his observations and experiences about this epidemic, Bahaodowle Razi elaborated on prognosis, symptoms, etiology and predisposing factors of pertussis.Conclusions: This document shows that Bahaodowle Razi’s report was the first report of epidemic pertussis in the medical history.

Introduction: Spontaneous pneumocephalus without any pathological condition is very rare. We described a patient with spontaneous pneumocephalus probably arising from the relatively enlarged air-filling sphenoid sinus.Case Presentation: A 51-year-old woman admitted Imam Reza Hospital, Mashhad, Iran with a sudden onset of severe headache and nausea without any neurological deficit. Brain computed tomography (CT) scan was performed to role out any pathology in the brain. Brain CT revealed large ethmoidal and sphenoid sinuses and disseminated intracranial pneumocephalus. A Cerebrospinal Fluid (CSF) examination was performed to rule out meningitis. Further evaluation confirmed a small defect in the sphenoid sinus. She has no recurrent headache or other symptoms after about six-month follow-up.Conclusions: An extremely rare condition, a spontaneous intracranial pneumocephalus with skull base defect origin could be considered as a possible diagnosis in patients with sudden and severe headache. We can safely conclude that medical treatment and close follow-up is an effective mode of therapy in this patient.

Introduction: Traumatic lumbar spondylolisthesis is rare disease and in the literature, different surgical approaches, including anterior, posterior, or combined approaches (posterior and anterior) are used to treat the lesion.Case Presentation: We treated a case of traumatic lumbosacral spondylolisthesis using posterior approach and the patient showed a satisfactory outcome. At the final follow-up, he was completely asymptomatic, and radiographic images revealed normal lumbar alignment and a solid interbody fusion.Conclusions: Traumatic lumbosacral spondylolisthesis can be treated using posterior approach alone to obtain reduction, decompression, and solid fusion.

Background: Some Iranian pilgrims are referred to Iran because of catching a new disease or exacerbation of their disease during the Hajj ceremony. These diseases need prolonged and specialized treatments. Investigation of the reasons led to their return to Iran is useful and effective in policy-making and planning of preventive health services.Objectives: This study aimed to investigate the causes of referring Iranian patients to Iran during Hajj in 2010.Patients and Methods: In this cross-sectional study, all Iranian pilgrim cases in Hajj (2012) who referred to Iran were studied, and data analysis was performed. Demographic data and the causes of return to Iran during and after Hajj rituals were analyzed.Results: A total of 106 cases were referred Iran during Hajj 2012. Psychiatric problems, with 26.4% allocated the highest rate of return to Iran during Hajj days, and significant difference was observed in the reasons before and after performing Hajj rituals (P=0.001).Conclusions: Psychiatric, neurological, gastrointestinal, and respiratory diseases are the most frequent reasons of referring patients to Iran. More accuracy in screening and care of patients are recommended before Hajj in order to prevent references to Iran and its complications.

Background: Hepcidin is a key regulator of iron absorption in humans. It is mainly affected by hypoxia and iron stores.Objectives: The current study aimed to determine the correlation between serum hepcidin and ferritin levels in patients with Thalassemia Major (TM) and Thalassemia Intermedia (TI).Patients and Methods: The current cross-sectional study investigated 88 randomly selected patients with Thalassemia, 48 TM and 40 TI, registered at the Thalassemia Clinic of Shiraz University of Medical Sciences, a referral center for Thalassemia in Southern Iran in 2013. All patients with TI were receiving Hydroxyurea (HU) 10 - 15 mg/kg/day for at least 10 years. The serum hepcidin, ferritin levels, hemoglobin (Hb) and nucleated Red Blood Cell (RBC) of the two groups were measured.Results: No statistically significant correlation was observed between serum hepcidin and ferritin levels in any of the two groups of patients with TM (rs=0.02, P=0.892) or TI (rs=0.055, P=0.734). The median Interquartile Range (IQR) for serum hepcidin and ferritin levels were significantly higher in TM compared to TI group, (hepcidin: 87.6 (43.9) vs.51.8 (23.4), P<0.001; ferritin: 2208 (3761) vs.465 (632), P<0.001).Conclusions: There was insignificant correlation between serum hepcidin and ferritin levels in the two groups of patients with TM and TI. It seems that regulation of hepcidin in patients with Thalassemia is more affected by erythropoeitic activity than iron stores. Also, hepcidin levels were significantly higher in patients with TM than TI, possibly due to higher erythropoeitic activity in TI. In TI, it seems that low dose HU increases Hb levels and leads to transfusion-independence, but it is not high enough to suppress bone marrow activity and ineffective erythropoiesis. Consequently, serum hepcidin level decreases.

Background: Unprecedented growth of fatalities due to traffic accidents in the recent years has raised great concerns and efforts of authorities in order to identify and control the causes of these accidents.Objectives: In the present study, the contribution of psychological, social, demographic, environmental and behavioral factors on traffic accidents was studied for young boys in Tehran, emphasizing the importance of psychosocial factors.Patients and Methods: The design of the present study was quantitative (correlational) in which a sample population including 253 boys from Tehran (Iran) with an age range of 18 to 24 who had been referred to insurance institutions, hospitals, correctional facilities as well as prisons, were selected using stratified cluster sampling during the year 2013.The subjects completed the following questionnaires: demographic, general health, lifestyle, Manchester Driving Behavior Questionnaire (MDBQ), young parenting, and NEO-Five Factor Inventory (NEO-FFI). For data analysis, descriptive statistics, correlation coefficient, and inferential statistics including simultaneous regression, stepwise regression, and structural equations modeling were used.Results: The findings indicated that in the psychosocial model of driving behavior (including lapses, mistakes, and intentional violations) and accidents, psychological factors, depression (P<0.02), personality trait of conscientiousness (P<0.02), failure schema due to the parenting style of mother (P=0.001), and perception of police commands (P<0.002), played an important role in predicting driving behavior. Among social factors, perception of police regulations (P=0.003), had an important effect on violations and mistakes. Among environmental and behavioral factors, major factors such as driving age (P=0.001), drug and alcohol use (P=0.001), having driver’s license (P=0.013), records of imprisonment or committing a crime (P=0.012) were also able to predict occurrence of accidents.Conclusions: As the results of this study show, different factors contribute to different driving behaviors and accidents. The broad scope of these factors links accidents to other social issues and damages.