Comparison of Misoprostol and Evening Primrose Oil on Cervical Preparation Before Gynecological Surgery.

This study aimed to evaluate the efficacy and safety of evening primrose oil (EPO) for cervical ripening before gynecologic procedures and compare it to misoprostol. In this study, 40 hysteroscopy and dilation and curettage candidates were enrolled. Patients were randomly assigned to receive either 2000 mg of vaginal EPO (n = 20) or 200 µg of vaginal misoprostol (n = 20) 2 hours before the expected procedure. The measured outcomes were the size of the Hegar dilator that passed through the cervix effortlessly, uterine cervicovaginal complications, and drug-related side effects. The two groups were not significantly different in age, number of gravity, parity, type of delivery, and menopausal status (P > .05). The mean ± SD size of the first dilator was 5.25 ± 1.55 in the misoprostol group and 7.30 ± 1.08 in the EPO group (P < .001). The pain complaint in the EPO group was significantly lower (P = .027), but the two groups were not significantly different in terms of other complications. No cases of uterine or cervical rupture were seen in either group. The present study showed that 2000 mg of vaginal EPO was significantly more effective for cervical ripening than 200 µg of vaginal misoprostol before gynecological surgery. Therefore, it is recommended to use EPO as an alternative to misoprostol.

Effect of chamomile oil on the intensity of nonspecific low back pain in prehospital emergency technicians.

INTRODUCTION: Low back pain (LBP) are prevalent in prehospital emergency (PE) technicians. This study aimed to investigate effect of chamomile oil on the intensity of LBP in PE technicians. METHODS: In this three-blind randomized clinical trial study, 90 PE technicians with LBP were randomly assigned to three groups: intervention, placebo and control. Intervention and placebo used 1.5 cc oil of chamomile and paraffin respectively, in lumbar region, three times a day for three weeks. Control group did not receive any intervention. Pain intensity and its interference with daily activities were measured by brief pain inventory (BPI), before intervention and end of first, second, and third weeks. RESULTS: Intervention group showed a significant drop in pain intensity and pain interference with daily activities at end of first, second, and third week (p < 0.001). At the end of first and second weeks, the mean pain reduction in intervention was significantly higher than that in placebo and control (p < 0.001), but at end of third week, there was no significant difference between three groups in this respect (p > 0.05). CONCLUSION: Topical chamomile oil application can reduce the intensity of LBP in PE technicians and its impact on their daily activities for a period of two weeks.

Optimized cocktail of 90Y/177Lu for radionuclide therapy of neuroendocrine tumors of various sizes: a simulation study.

BACKGROUND AND OBJECTIVES: There is significant interest and potential in the treatment of neuroendocrine tumors via peptide receptor radionuclide therapy (PRRT) using one or both of 90Y and 177Lu-labeled peptides. Given the presence of different tumor sizes in patients and differing radionuclide dose delivery properties, the present study aims to use Monte Carlo simulations to estimate S-values to spherical tumors of various sizes with 90Y and 177Lu separately and in combination. The goal is to determine ratios of 90Y to 177Lu that result in the largest absorbed doses per decay of the radionuclides and the most suitable dose profiles to treat tumors of specific sizes. MATERIAL AND METHODS: Particle transfer calculations and simulations were performed using the Monte Carlo GATE simulation software. Spherical tumors of different sizes, ranging from 0.5 to 20 mm in radius, were designed. Activities of 177Lu and 90Y, individually and in combination, were homogeneously placed within the total volume of the tumors. We determined the S-values to the tumors, and to the external volume outside of the tumors (cross-dose) which was used to approximate background tissue. The dose profiles were obtained for each of the different tumor sizes, and the uniformity of dose within each tumor was calculated. RESULTS: For all tumor sizes, the self-dose and cross-dose per decay from 90Y were higher than that from 177Lu. We observed that 177Lu had the most uniform dose distribution within tumors with radii less than 5 mm. For tumors greater than 5 mm in radius, a ratio of 25% 90Y to 75% 177Lu resulted in the most uniform doses. When the ratio of 177Lu to 90Y was smaller, the uniformity improved more with increasing tumor size. The cross-dose stayed approximately constant for tumors larger than 15 mm for all ratios of 177Lu to 90Y. Finally, as the size of the tumor increased, differences in the S-values between different ratios of 177Lu to 90Y decreased. CONCLUSION: Our work showed that to achieve a more uniform dose distribution within the tumor, 177Lu alone is more effective for small tumors. For medium and large tumors, a ratio of 90Y to 177Lu with more or less 177Lu, respectively, is recommended.

Bond strength and microleakage of different types of cements in stainless steel crown of primary molar teeth.

BACKGROUND: The margin of crown is a significant area for plaque accumulations. Therefore, the ability of the cement to seal the margin is very important. The aim of the present study was to evaluate the bond (retentive) strength, microleakage, and failure mode of four different types of cements in stainless steel crown (SSC) of primary molar teeth. MATERIALS AND METHODS: In this experimental study, eighty extracted primary molar teeth were divided into two groups of forty teeth to test the microleakage and bond strength. The crowns were cemented according to the manufacturer guidelines with four cement types including self-cure glass ionomer, resin-modified glass ionomer, polycarboxylate, and resin cements. Stereomicroscope and universal testing machine were used to measure the microleakage and bond strength, respectively. For calculating the surface area of crowns, three-dimensional scanning was used. Furthermore, the failure mode was examined after the bond strength test. The cements surfaces and the tooth-cement interfaces were evaluated using scanning electron microscopy (SEM). The obtained values were analyzed using SPSS-23 software through Shapiro-Wilk and one-way analysis of variance tests. Means, standard deviations, medians, and interquartile ranges were calculated. P < 0.05 was considered as statistically significant in all analyses. RESULTS: Significant differences between microleakage (P = 0.001) and failure mode (P = 0.041) of the four types of cements were obtained. However, the mean bond strengths of the four groups did not differ significantly (P = 0.124). The obtained SEM images confirmed the results of bond strength and microleakage. CONCLUSION: Resin cement and resin-modified glass ionomer, respectively, showed superior properties and are recommended for use in SSCs of primary molar teeth.

Evaluation of Dosimetric Parameters for Tumor Therapy with 177Lu and 90Y Radionuclides in Gate Monte Carlo Code.

BACKGROUND: 90Y and 177Lu are two well-known radionuclides used in radionuclide therapy to treat neuroendocrine tumors. OBJECTIVE: This current study aims to evaluate, compare and optimize tumor therapy with 90Y and 177Lu for different volumes of the tumor using the criterion of self-absorbed dose, cross-absorbed dose, absorbed dose profile, absorbed dose uniformity, and dose-volume histogram (DVH) curve using Gate Monte Carlo simulation code. MATERIAL AND METHODS: In our analytical study, Gate Monte Carlo simulation code has been used to model tumors and simulate particle transport. Spherical tumors were modeled from radius 0.5 to 20 mm. Tumors were uniformly designed from water (soft tissue reagent). The full energy spectrum of each radionuclide of 177Lu and 90Y was used in the total volume of tumors with isotropic radiation, homogeneously. Self-absorbed dose, cross-absorbed dose, absorbed dose profile, absorbed dose uniformity, and DVH curve parameters were evaluated. RESULTS: The absorbed dose for 90Y is higher than 177Lu in all tumors (p-value <5%). The uniformity of the absorbed dose for 177Lu is much greater than 90Y. As the tumor size increases, the DVH graph improves for 90Y. CONCLUSION: Based on self-absorbed dose, cross-absorbed dose, absorbed dose uniformity, and DVH diagram, 177Lu and 90Y are appropriate for smaller and larger tumors, respectively. Next, we can evaluate the appropriate cocktail of these radionuclides, in terms of the type of composition, for the treatment of tumors with a specific size.

Retinoblastoma presentation, treatment and outcome in a large referral centre in Tehran: a 10-year retrospective analysis.

BACKGROUND/OBJECTIVES: Early diagnosis, care and treatment of retinoblastoma is a challengeable issue for Iranian health system. This study was designed and conducted in a referral multidisciplinary centre in the capital city of Iran to evaluate management, care, prognosis and survival rates of paediatric patients with retinoblastoma. METHODS: In this retrospective study, a total number of 309 patients younger than 15 years, diagnosed with retinoblastoma, who referred for diagnosis and treatment to MAHAK's Pediatric Cancer Treatment and Research Center (MPCTRC) from 2007 to 2017 were evaluated. All data were analyzed via SPSS version 22 software in regard of parametric and non-parametric data. Survival rates were analyzed using the Kaplan-Meyer method. RESULTS: The mean age of patients was 20 months and the majority of patients (77%) had leukocoria as a common clinical symptom at the time of diagnosis. Primary treatment methods were systemic chemotherapy (94%), laser (35%) and primary enucleation (28%). Relapses occurred in nearly 42% of cases, and the median time from diagnosis to the first relapse was 9 months. At the time analyzing the data, 11% of patients died. Patients' 5-year OS and RFS rates were 79.6% and 41.5%, respectively. CONCLUSION: Comparing results with other conducted studies identifies that the recurrence rate was high in our considered patients. Also, OS and RFS rates in our study were not as considerable as other reports. Screening methods, updating protocols and follow-up of patients may lead to improvements in survival rates of patients with retinoblastoma.

Incidence and Factors Contributing to Low Back Pain in the Nonobstetrical Patients Operated Under Spinal Anesthesia: A Prospective 1-Year Follow-Up Study.

PURPOSE: To determine the incidence and factors contributing to postspinal anesthesia (SPA) low back pain (LBP) in patients undergoing nonobstetrical surgeries. DESIGN: A prospective 1-year follow-up study. METHODS: Patients having nonobstetrical surgery using SPA were included. The patients were followed up through phone calls and interviews every postoperative day for the first week, weekly for a month, and then monthly for a year after SPA. Patients' duration of LBP, duration of surgery, and need for LBP treatment were recorded. FINDINGS: Of 410 patients, 5.8% (24 patients) experienced LBP. The incidence of LBP did not have a significant correlation with the recorded variables (P > .05). There was a negative significant correlation between duration of LBP and duration of surgery (r = -0.5096; P = .001). Of the 24 patients experiencing LBP, 16.7% (four patients) experienced it for less than 1 day, 66.7% (16 patients) 1 to 7 days, 16.7% (four patients) more than 7 days, and only one patient (4.2%) for up to 17 days. Special LBP treatment was not needed in any of the patients. CONCLUSIONS: The incidence of LBP was very low, and those patients undergoing nonobstetrical surgery and receiving SPA did not experience persistent LBP.

Diagnostic value of saline infusion sonohysterography for detecting endometrial focal lesion.

INTRODUCTION: Different diagnostic tools are available to evaluate endometrial focal lesion such as hysteroscopy, sonohystrography and transvaginal ultrasound. The present study aimed to determine the diagnostic value of saline infusion sonohystrography (SIS) in diagnosis of intrauterine lesions in women with Abnormal Uterine Bleeding (AUB). METHODS: This cross-sectional study recruited 100 married women with chief complain of AUB referred to gynecologic clinics at the Amir Al-Momenin hospital, Semnan, Iran from March 2014 to February 2016. All participants were in the reproductive age and post-menopausal period that showed abnormal endometrial thickness or endometrial focal lesions through transvaginal ultrasound. Participants underwent SIS, hysteroscopy plus focal lesion resection and endometrial biopsy in order. The gold standard was the histopathology of endometrial specimen reported by pathologist. RESULTS: Mean±SD age of women was 41.2±11.3 years. To diagnose the overall focal lesions, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the SIS were 79.6, 89.1, 89.6, and 78.8% respectively. These figures were 75.0, 87.5, 82.5 and 81.7%, respectively to diagnose polyps. The SIS sensitivity, specificity, PPV and NPV values to diagnose the myomas were 60.0, 97.8, 75.0, and 95.7% respectively. CONCLUSION: Findings show that, SIS probably is a proper method for detecting endometrial focal lesion including polyps and myomas. Future studies may help to define further advantages of this procedure.

Concentration and Prevalence of Aflatoxin M1 in Human Breast Milk in Iran: Systematic Review, Meta-Analysis, and Carcinogenic Risk Assessment: A Review.

This meta-analysis was designed to review the published reports regarding the concentration and/or prevalence of aflatoxin M1 (AFM1) in human breast milk in Iran. The carcinogenic risk for Iranian infants consuming this milk was estimated with the hazard index. The PubMed and Scopus databases and the Scientific Information Database were screened for relevant studies between 1995 and 2017, and 11 of the 112 collected studies were included in the systematic review and meta-analysis. The mean (95% confidence interval) concentration of AFM1 was 5.85 ng/L (4.54 to 7.15 ng/L), which was lower than the European Union standard (25 ng/L). The mean prevalence of AFM1 in breast milk in Iran was 42% (11 to 77%). The estimated daily intakes for male and female infants were 0.02 to 5.57 ng/kg and 0.02 to 3.68 ng/kg of body weight per day, respectively. The rank order of estimated daily intake for both male and female infants according to age was 1 week > 1 month > 6 months > 12 months. The hazard index for all age groups of infants in all provinces in Iran was less than 1. Therefore, infants in Iran were not considered at carcinogenic risk from AFM1 in human breast milk.

Fluoride in Iranian Drinking Water Resources: a Systematic Review, Meta-analysis and Non-carcinogenic Risk Assessment.

A systematic review, meta-analysis, and non-carcinogenic risk considering fluoride content of drinking water resources of 31 provinces of Iran among some international databases such as Science Direct, Scopus, PubMed, and national databases including SID and Irandoc (2011 to July 2017) were conducted. In this context, 10 articles (40 studies) with 1706 samples were included in meta-analyses and risk assessment studies. The pooled concentration of fluoride in the cold, mild, and warm weather provinces were calculated as 0.39 mg/L (95% CI 0.32-0.48 mg/L), 0.52 (95% CI 0.43-0.61 mg/L), and 0.75 (95% CI 0.56-0.94 mg/L), respectively. The pooled concentration of fluoride in Iranian drinking water resources was 0.51 (95% CI 0.45-0.57 mg/L). The minimum and maximum concentrations of fluoride content were related to Kermanshah (0.19 mg/L) and Kerman (1.13 mg/L) provinces, respectively. The HQ of fluoride in the children and adults were 0.462 and 0.077, respectively as children are more vulnerable than adults. The HQ for children and adults was lower than 1 value. Therefore, there is no considerable non-carcinogenic risk for consumers due to drinking water in Iran. Although the non-carcinogenic of fluoride in drinking water was not significant, fluoride entry from other sources, such as food or inhalation, could endanger the health of the residents of Kerman and Bushehr provinces.

Evaluation of the Protective Effect of Cystone Against Cisplatin-induced Nephrotoxicity in Patients with Cancer: A Pilot Study.

INTRODUCTION: Cisplatin is a widely used anti-cancer drug that is commonly administered for the treatment of various cancers. However, nephrotoxicity is the most important side effect of this drug which limits its use. This study aimed to investigate the protective effect of Cystone against nephrotoxicity induced by Cisplatin in patients with cancer. METHODS: This pilot clinical trial study was conducted on 43 cancer patients treated with Cisplatin (75 mg/m2 for a period of six months). The subjects were divided into treatment group (receiving Cystone, two per 8 hours; n = 21) and control group (n = 22). The two groups were compared with each other in terms of demographic and laboratory variables. RESULTS: In the intervention group receiving Cystone, serum creatinine-based GFR level (P = 0.453) and 24-hour urine creatinine-based GFR level (P = 0.397) did not change significantly during the studied period, but in the control group, serum creatinine-based GFR level (P = 0.013) and 24-hour urine creatinine-based GFR level (P = 0.016) significantly changed. Serum creatinine-based GFR level increased by 2.3 units in the intervention group and 10.5 units in the control group (P = 0.005) in the six months of the study. At the end of the sixth month, 24-hour urine creatinine-based GFR level increased by 2.2 units in the intervention group and 0.8 unit in the control group (P = 0.008). CONCLUSIONS: The use of Cystone resulted in more stable kidney function indices in the intervention group, as compared with the control group. Therefore, Cystone seems to have a protective effect against nephrotoxicity induced by Cisplatin in cancer patients.

Treatment challenges and outcomes for pediatric intracranial ependymoma at a single institution in Iran.

BACKGROUND: The scarcity of information on pediatric ependymoma in Iran motivated this study. Our main objectives were to determine outcomes, identify clinical management challenges at a nongovernment hospital in Iran, and devise guidelines for improving care. PROCEDURE: A retrospective chart review was performed for pediatric patients with ependymoma who were younger than 15 years and treated at MPCTRC between 2007 and 2015. Records included patient demographics, treatment regimens used, duration of follow-up, and outcomes. Clinical outcomes [ie, 3-year overall survival (OS) and progression-free survival (PFS)] were determined based on the age at diagnosis (younger or older than 3 years) by using the Kaplan-Meier method. RESULTS: In total, 73 eligible patients were enrolled; 20 patients were in the younger group, and 53 were in the older group. The majority (91.8%, n = 67) of patients underwent initial gross-total or partial surgical resection, and 6 (8.2%) had a biopsy. Twenty-one patients experienced ependymoma recurrence. The median time to relapse was 1 year. The median duration of follow-up and PFS were 25 and 17 months, respectively. The 3-year OS and PFS were 61% and 59.5%, respectively. At the time of this project, 27 patients had died, and 35 were alive with no evidence of disease. CONCLUSION: Our study demonstrated inferior outcomes of Iranian children with ependymoma. To improve our care for these children, a paradigm shift must occur that includes radiation therapy as standard of care, second-look surgery, a multidisciplinary team approach, and potentially twinning initiatives.

Agreement of histopathological findings of uterine curettage and hysterectomy specimens in women with abnormal uterine bleeding.

OBJECTIVES: To examined the diagnostic value of  dilatation and curettage (D and C) in patients with abnormal uterine bleeding (AUB) by conducting a histopathological examination of endometrial tissues by D and C and hysterectomy. Methods: In this retrospective study, the medical records of 163 women who had been hospitalized  in the Obstetrics and Gynecology Ward, Amir-al-Momenin Hospital, Semnan, Iran between 2010 and 2015 for diagnostic curettage due to  AUB and who had undergone hysterectomy were investigated. The patients' characteristics and histopathologic results of curettage and hysterectomy were extracted, and sensitivity and specificity and positive and negative predictive values of curettage were calculated. Results: The mean ± standard deviation age of the patients was 49.8±7.8 years. The sensitivity values of D and C in the diagnosis of endometrial pathologies was 49.1%, specificity 84.5%, positive 60.5%, and negative predictive 77.5%. The sensitivities of D and C in the diagnosis of various endometrial hyperplasia was 62.5%, disordered proliferative endometrium 36.8%, and endometrial cancer 83.3%. Of 6 patients with endometrial polyps on performing hysterectomy, no patient was diagnosed by curettage. Conclusions: Dilatation and curettage has acceptable sensitivity in the diagnosis of endometrial cancer, low sensitivity in the diagnosis of endometrial hyperplasia, and very low sensitivity in the diagnosis of disordered proliferative endometrium and endometrial polyps.

Effects of hydrogen peroxide mouthwash on preventing ventilator-associated pneumonia in patients admitted to the intensive care unit

Abstract Aims The aim of the study was to determine the effect of hydrogen peroxide (HP) mouthwash on the incidence of ventilator associated pneumonia (VAP) in patients admitted to the intensive care unit (ICU). Methods This was a randomized clinical trial conducted on 68 patients. The intervention group used 3% HP as mouthwash and the control group used mouthwashes with 0.9% normal saline (NS) twice a day. Data were collected using a questionnaire and the Modified Clinical Pulmonary Infection Score (MCPIS). MCPIS includes five items, body temperature: white blood cell count, pulmonary secretions, the ratio of pressure of arterial oxygen (PaO2) to fraction of inspired oxygen (FiO2), and the chest X-ray. Each of these items scored 0–2. Scores ≥6 were considered as VAP signs. The SPSS-20 software was employed to analyze the data. Results In total, 14.7% patients of the HP group and 38.2% patients of the NS group contracted VAP. The risk of VAP in the NS group was 2.60 times greater than that in the HP group (RR = 2.60, 95% CI: 1.04–6.49, p = 0.0279). The mean ± SD MCPIS was calculated as 3.91 ± 1.35 in the HP group and 4.65 ± 1.55 in the NS group, a difference statistically significant (p = 0.042). There were no significant differences in the risk factors for VAP between the two groups. Conclusion HP mouthwash was found more effective than NS in reducing VAP. HP mouthwash can therefore be used in routine nursing care for reducing VAP.

Retinal Toxicity in Patients Treated With Hydroxychloroquine: A Cross-Sectional Study.

Hydroxychloroquine (HCQ) is an antimalarial medication that can also be used to treat autoimmune diseases. However, it can produce irreversible changes to the retina that lead to visual impairment. The aim of this study was to determine the proportion of patients treated with HCQ who develop retinal toxicity and the risk factors for the development of HCQ-induced retinal toxicity among Iranian patients. The is a cross-sectional clinical study of 59 patients who were treated with HCQ during 2014-2015. A questionnaire was used to collect data on the following demographic and clinical factors: age, gender, type of rheumatic disease, history of cataract surgery, daily and cumulative HCQ dose, and duration of HCQ use. Retinal toxicity was diagnosed on the basis of the automated perimetry results of the central 10° of vision and spectral domain optical coherence tomography. The associations between the demographic and clinical factors and retinal toxicity were assessed, and P < 0.05 was considered statistically significant. Retinal toxicity was detected in 18 (30.5%) of the patients, and 5 (8.5 %) developed color vision impairments. There was no association between retinal toxicity and sex (P = 0.514), history of cataract surgery (P = 0.479), type of rheumatic disease (P = 0.539), or daily HCQ dose (P = 0.062). However, there was a significant positive association between retinal toxicity and age (P = 0.006), cumulative HCQ dose (P = 0.002), and duration of HCQ use (P < 0.001). In conclusion, the risk factors for retinal toxicity after HCQ treatment were advanced age, use of a higher cumulative HCQ dose, and a longer duration of treatment.

Effects of cigarette smoking on morphological features of platelets in healthy men.

OBJECTIVES: To assess the effects of cigarette smoking on thrombocytopoiesis and some platelet morphological parameters in healthy male smokers. METHODS: In this cross-sectional study, 542 consecutive healthy men (aged 20 to 88 years), referred to the laboratory of Fatemieh Hospital, Semnan, Iran, between November 2011 and November 2012 for checking up were enrolled. The subjects were divided into 2 groups of smokers (n=258 with frequency of 10 or more cigarette per day with more than 12 months duration of smoking) and non-smokers (n=284). The blood samples were extracted to examine values of platelet indices using an ABX Micros 60 cell counter. RESULTS: Comparing platelet indices across smokers and non-smokers showed that the mean platelet count was statistically significantly higher in adult smokers than in nonsmokers (264.1 ± 81.2/µl versus 247.7 ± 83.9/µl, p=0.021), while the mean plateletcrit value was contrarily lower in the adult smokers (18.0 ± 12.0% versus 25.0 ± 10.0%, p less than 0.001). Other platelet indicators were not discrepant between the smokers and non-smokers. CONCLUSION: Cigarette smoking in healthy individuals results in significant and considerable effects on platelet morphological indices. The mean platelet count is significantly increased, and plateletcrit values are reduced, compared with non-smoking status.

The effect of topical application of lavender essential oil on the intensity of pain caused by the insertion of dialysis needles in hemodialysis patients: A randomized clinical trial.

BACKGROUND: Patients undergoing hemodialysis experience constant fear and anxiety due to the pain of the insertion of dialysis needles, which might lead to certain physiological and psychological complications for them in the long term. It is therefore essential to control their pain through a simple, safe method. OBJECTIVE: The present study was conducted to determine the effect of the topical application of lavender essential oil on the intensity of pain during the insertion of dialysis needles in hemodialysis patients. DESIGN: This open crossover study was conducted on 34 hemodialysis patients with arteriovenous fistula (AVF) admitted to the dialysis unit of one of the hospitals of Semnan University of Medical Sciences in 2013. The intensity of pain was measured in all the patients in three different states during the insertion of arterial needles for hemodialysis: (1) The topical application of 100% lavender essential oil, (2) no intervention, (3) placebo (with water). MAIN OUTCOME MEASURES: Pain intensity was measured in this study through the numeric rating scale (NRS) of pain. RESULTS: The findings showed that the mean±SD of pain intensity was 2.91±1.69 with the topical application of lavender, 4.59±2.02 in the no intervention state and 4.18±1.66 with the placebo state. Statistical tests showed a significant difference between the patients' intensity of pain in the three different states (p=0.001). CONCLUSION: Based on the findings of the study, the topical application of lavender decreases moderate intensities of pain during the insertion of dialysis needles. Accordingly, lavender oil may be an option to reduce pain by insertion of hemodialysis needles.

Cigarette smoking and risk of pressure ulcer in adult intensive care unit patients.

The objective of this study was to assess relationship between smoking, some other risk factors and ulcers development in intensive care unit. This prospective cohort study was performed in two university-affiliated hospitals. The sample consisted of adult male patients who were admitted to medical-surgical intensive care units. All eligible patients were grouped according to their cigarette smoking status as smoker and non-smoker. The final sample included 160 smokers and 192 non-smokers. Pressure ulcer occurred in 62 smoker patients and 28 of non-smoker who showed significant difference. Also number of pack-year of cigarettes smoking showed significant association with ulcer development. Ulcer stage was significantly different between the two groups. Besides of smoking, age, length of stay, faecal incontinency, diabetes mellitus, anaemia and trauma were significantly associated with pressure ulcers. Our study showed significant association between smoking and development of pressure ulcers.

Factors associated with cord blood IgE levels.

BACKGROUND: The cord blood IgE level is thought to be a predictor of allergic disorders in childhood. It is not well understood how this marker is influenced by the fetal environment, such as maternal, paternal, placenta, and fetal characteristics. OBJECTIVE: We aimed to investigate the association between cord blood IgE levels and various genetic and environmental factors. METHODS: This was a cross-sectional study including a total of 181 neonates and their mothers. A questionnaire asking about demographic data, delivery characteristics, maternal past medical history and information on exposure to known environmental allergens was distributed to pregnant women. Blood samples from them and neonatal cord blood samples were taken at the same time for IgE assay. RESULTS: By univariate analysis we found an association between cord blood IgE levels and higher number of previous pregnancies, delivery season, type of delivery, history of allergy during pregnancy, but not the type of allergic disease and history of allergic disease before pregnancy, were associated with elevated cord blood IgElevels. The maternal blood level of IgE was correlated with its level in cord blood. By multivariate analysis, the number of previous pregnancies, the type and season of delivery and a history of allergy during pregnancy and maternal age and blood IgE levels were variables which had a significant association with cord blood IgE levels. CONCLUSION: Among the evaluated factors, the presence of any kind of allergic disorder in the mother or her family and elevated maternal blood IgE level are associated with the cord blood IgE of the child. Maternal age and smoking, neonatal gender, type of delivery, season of birth and parity are probable predictors.

Cigarette smoking and nephrolitiasis in adult individuals.

BACKGROUND: Nephrolithiasis is a widespread multifactorial disorder. Constitutional, environmental and genetic factors play a role in stone formation. Although important advances have been made in understanding the pathophysiology of stone formation, none of the many theories have given a satisfactory explanation of this process. OBJECTIVES: The objective of study was to evaluate the probable relationship between cigarette smoking and nephrolitiasis in adult men. PATIENTS AND METHODS: A total of 102 cases diagnosed with nepholithiasis and 121 age-matched healthy controls were recruited from June 2010 to September 2011. Smoking status and resultant data was obtained from both groups. RESULTS: Twenty seven (26.5%) of the patients with stones and eighteen (14.9%) of the control group were current cigarette smokers. Our findings showed that smoking significantly increases the risk of nepholithiasis (OR = 2.06, 95% CI: 1.06-4.01, P = 0.034). There was no significant difference in the number of cigarettes smoked (P = 0.830) and years of smoking (P = 0.536) between subjects with and without stones (P = 0.536). CONCLUSIONS: This study suggests that cigarette smoking might be an independent risk factor for the development of nephrolithiasis.