A 7-year study on the prevalence of congenital hypothyroidism in northern Iran.

BACKGROUND: Congenital hypothyroidism (CH) is one of the most common congenital endocrine disorders.The present study determined the prevalence and demographic characteristics of congenital hypothyroidism in the north of Iran. OBJECTIVE: To determine the prevalence of congenital hypothyroidism based on transient and permanent types with demographic characteristics in Mazandaran province in northern Iran. METHODS: This retrospective descriptive survey analyzed the medical records of children with primary diagnosis of CH in health centers in all cities of Mazandaran Province between June 2009 and March 2016. To compare the study groups (CH type) in terms of quantitative and qualitative variables, the t-test and Chi-square test were used, respectively using the SPSS22. P-value <0.05 was considered as significant. RESULTS: Of 269,088 infants screened during the study period, 548 infants with primary congenital hypothyroidism were identified (a prevalence of 1 per 491 births) and congenital hypothyroidism was definitively diagnosed in 389 children (a prevalence of 1 per 453 births); of them, 169 had permanent CH (a prevalence of 1 per 1043 births) and 220 had transient CH (a prevalence of 1 per 801 births). The female to male ratio in the permanent congenital hypothyroidism group was higher than that in the transient congenital hypothyroidism group (p=0.08). The family relationship between mother and father was stronger in the permanent congenital hypothyroidism group than in the transient congenital hypothyroidism group (p=0.03). CONCLUSION: These findings show that congenital hypothyroidism is more prevalent in the north of Iran than in other areas of Iran; the prevalence of transient CH is particularly higher than permanent CH.

Prevalence of Enterobius vermicularis amongst kindergartens and preschool children in Mazandaran Province, North of Iran.

Enterobiasis (oxyuriasis) is probably the most common helminth, which infects humans. Amongst different age groups, prevalence of Enterobius vermicularis in children is high compared to adults. Oxyuriasis is one of the most significant parasitic diseases of children. This nematode in children can result in loss of appetite, insomnia, grinding of the teeth, restlessness, endometritis, abdominal cramps, diarrhea and etc. Due to important complications of this parasite, the objective of the current study was to determine the prevalence of enterobiasis in kindergarten and preschool children of Amol, Mazandaran Province, North of Iran. A total number of 462 children from 32 kindergartens of Amol were examined for the prevalence of E. vermicularis infection, 2013. Adhesive cello-tape anal swab method was trained to parents for sampling. In addition, a questionnaire was designed and filled out to collect demographic information for each individual. Data were analyzed using Chi square test and multivariate logistic regression for each risk factor. The overall prevalence of E. vermicularis infection was 7.1 % (33). Although infection with E. vermicularis in girls 7.9 % was higher compared to boys 6.3 %, there was no significant difference between gender and age (p > 0.05) whereas binary logistic regression showed significant difference between enterobiasis and age (p < 0.05). The findings indicated that the prevalence of E. vermicularis in kindergarten and preschool children is relatively high and still is an important health problem and should not be underestimated due to being highly contagious infection. Therefore, educational programs and mass treatment should be carried out in order to reduce infection incidence in this area and regular parasitological test and attention to personal hygiene in kindergarten and preschool is of great importance.

Massage as adjuvant therapy in the management of post-cesarean pain and anxiety: A randomized clinical trial.

OBJECTIVE: The present study was conducted to determine the effect of massage on post-cesarean pain and anxiety. METHODS: The present single-blind clinical trial was conducted on 156 primiparous women undergone elective cesarean section. The participants were randomly divided into three groups, including a hand and foot massage group, a foot massage group and a control group (n = 52 per group). The patients' intensity of pain, vital signs and anxiety level were measured before, immediately after and 90 min after the massage. RESULTS: A significant reduction was observed in the intensity of pain immediately and 90 min after massage (P < 0.001). Moreover, changes in some of the physiological parameters, including blood pressure and respiration rate, were significant after massage (P < 0.001); however, this change was not significant for pulse rate. A significant reduction was also observed in the level of anxiety (P < 0.001) and a significant increase in the frequency of breastfeeding (P < 0.001) after massage. CONCLUSION: As an effective nursing intervention presenting no side-effects, hand and foot massage can be helpful in the management of postoperative pain and stress.

High Seroprevalence of Toxoplasma gondii Antibody in HIV/AIDS Individuals from North of Iran.

BACKGROUND: Toxoplasmosis in immunocompetent people is generally asymptomatic but in immunocompromised patients including HIV/AIDS, cancer patients, and organ transplant recipients, etc. it can lead to serious pathological problems. The objective of current study was to determine the seroprevalence of T. gondii IgG and IgM antibodies in HIV/AIDS patients using ELISA technique in Mazandaran Province, northern Iran. METHODS: Overall, 82 serum samples (61 males and 21 females) were collected from HIV/AIDS patients in Mazandaran Provinces, in 2013. Sera were surveyed employing ELISA assay. Data were analyzed using Chi-Square or Fisher exact test. In addition, before sampling a questionnaire was filled out for each subject. RESULTS: Overall seroprevalence of examined sera was 96.3% for IgG antibody but none of the sera shown IgM antibody against T. gondii. The seroprevalence of toxoplasmosis in males and females was 96.7% and 95.2%, respectively. An antibody titer of >1 IU/ml was considered as positive. Furthermore, none of the included variables statistically was significant. CONCLUSIONS: Seroprevalence of chronic (latent) toxoplasmosis in HIV/AIDS patients in Mazandaran Province is high compared to toxoplasmosis in general population. Consequently, the risk of acquiring Toxoplasma encephalitis in examined seropositive HIV/AIDS patients of Toxoplasma is high.

A comparison of the "hands-off" and "hands-on" methods to reduce perineal lacerations: a randomised clinical trial.

OBJECTIVE: The objective of the current study was to compare the "Hands-off" and "Hands-on" methods to reduce perineal lacerations. METHOD: We conducted a randomized controlled trial to compare the effectiveness of two techniques for perineum protection during spontaneous delivery. Study participants included 600 nulliparous expectant mothers, who were divided equally between the "hands off" and "hands on" groups (n_300 per group). FINDINGS: A total of 147 (49 %) women in the "Hands-on" and 143 women (47.7 %) in the "Hand -off" groups encountered perineal trauma (p = 0.74). In the "Hands-on" group, 8 women (2.7 %) experienced a third degree trauma compared with (0.3 %) that in the "Hands-off" method (p = 0.1). Episiotomy was performed on 38 women (12.7 %) from the "Hands-on" and 17 (5.7 %) women from the "Hands-off" (p = 0.003) groups. In addition, 28 women (9.3 %) from the "Hands-on" group and 47 women (15.7 %) from the "Hands-off" group experienced periurethral tears (p = 0.01) that did not need mending. CONCLUSION: Application of the "Hands-off" method for vaginal delivery has a positive effect on the mother's health because of the reduction of Episiotomy and third degree tearing. Therefore, we conclude that the "Hands-off" method offers a safer alternative for perineal control during labor.

The effectiveness of diclofenac gel and eutectic mixture of local anesthetic cream on vein puncture pain severity with vein catheter in patient undergoing cesarean section: A randomized, double-blind, placebo-controlled trial.

AIM: This study was aimed to explore the effect of applying diclofenac gel and a eutectic mixture of local anesthetic (EMLA) cream on vein puncture pain severity with vein catheter in the patients undergoing cesarean section. MATERIALS AND METHODS: The sample comprised 90 women undergoing elective cesarean section that referred to Imam Ali Hospital's maternity section in Amol city (Northern Iran). Data collection tools included visual analog scale for pain severity and a checklist for short term possible side-effects of diclofenac gel, EMLA cream and Vaseline ointment as placebo. RESULTS: The pain of vein puncture with diclofenac gel and EMLA cream was significantly lower than that with the Vaseline ointment (P = 0.001). Similarly, there was a significant difference between using diclofenac gel and EMLA cream in catheter insertion pain severity (P = 0.006). In addition, there was no short term possible side-effect with using diclofenac gel and Vaseline ointment, but a short term side-effect (blanching) was detected in 20% of subjects with EMLA cream. CONCLUSION: Compared to Vaseline cream, EMLA cream and diclofenac gel application significantly reduces the pain severity associated with vein catheter insertion. Use of diclofenac gel is preferred compared with EMLA cream, because of economics, more efficiency purpose, and no side-effects.