Ali Asghar Hospital Research Articles

The investigation of the characteristics of inflammatory factors and cardiac enzymes in children with Covid-19 hospitalized with the initial manifestation of fever without other symptoms hazrat Ali-Asghar Hospital in Tehran in 2018-2019.

The prevalence of asymptomatic fever among children is high and may be confused with fever caused by corona. The purpose of this study is to investigate the characteristics of inflammatory factors and cardiac enzymes in children with Covid-19 hospitalized with the initial manifestation of fever without other symptoms. In this descriptive-analytical cross-sectional study, all 200 children with positive Covid-19 were hospitalized in Hazrat Ali-Asghar Hospital in Tehran between 2018 and 2019. For gathering data, clinical records and demographic information of patients were noted in the made-researcher's checklist and the collected data were analyzed using SPSS software version 24. It was found that the relationship between the degrees of fever of the patients with the number of platelets was also inverse and significant. In addition, there was a significant relationship between the degree of fever of the patients and the LDH number, ALT number and segment and lymphocyte percentage of the patients. In addition, it was found that the passing time of fever has a significant relationship with ALT and ESR in such a way that with the passage of time, there is a higher probability of seeing an increase in ESR, but in the case of ALT, it increases in a shorter period of time and decreases more after the passage of time. According to the results of the present study, in case of suspected to Covid and fever in patients, along with other tests, AST, ALT, D-dimer, and CKMB can be used to diagnose Covid, in such a way that in Covid, AST is probably normal and mentioned other tests can be higher than normal.

Epidemiological, Demographic, and Clinical Characteristics of Von Willebrand Disease Patients in Zahedan City, Iran: A Descriptive Study.

Background:Von Willebrand disease (VWD) is one of the most common coagulative diseases, so identifying the effective factors in preventing this complication is essential. The study aimed to evaluate the frequency of demographic and epidemiological findings in VWD patients referred to a hospital in Zahedan, Iran. Materials and Methods: This study was performed on 76 patients with VWD referred to Hazrat Ali-Asghar Hospital in Zahedan City, Sistan, and Baluchestan province. After obtaining consent from the patients, the demographic information and clinical symptoms of the disease were recorded. All statistical analyses were performed using SPSS 22.0 software. All descriptive data were expressed as mean ±SD and percent (%) depending on the continuous and dichotomous variables. A P-value ≤0.05 was considered significant statistically. Results:The present study results showed that the highest age group of VWD patients at the time of disease diagnosis was in the age group 1-5 years (47.3%), and most patients had type III VWD (80.3%). It was also found that 67.1% of patients had a positive family history and their parents' consanguineous marriage (77.6%). The most common complaints were epistaxis (88.15%), cutaneous bleeding (78.94%), and oral cavity bleeding (61.84%), respectively. Conclusion: Due to the high prevalence of VWD in consanguineous marriages and an increase in adverse complications and symptoms in VWD patients, proper diagnosis and screening at an early age, especially in people with family history, is essential. Efforts are needed to develop national registries and widely provide the required and available basic services for diagnosis and treatment.

The Effects of Foot Reflexology and Simple Foot Massage on Fatigue and Pain in Children With Leukemia: A Randomized Control Trial

Background and Purpose: Chemotherapy is one of the main options in treating childhood cancers. Fatigue and pain are common symptoms of cancer and one of the major complications experienced during chemotherapy. This study aimed to determine the effect of foot reflexology and simple foot massage on fatigue and pain in children with leukemia. Materials and Methods: This randomized clinical trial was performed on 99 children with leukemia aged 4-14 years, undergoing chemotherapy in the oncology departments of Hazrat Ali Asghar Hospital and Children’s Medical Center, Tehran City, Iran, in 2019. The sampling was sequential, and participants were assigned into three groups by block randomization: Foot reflexology, simple foot massage, and control group. The foot reflexology and simple foot massage were performed for 5 consecutive days. Participants were asked to report the intensity of pain and fatigue over the past 48 hours using the pain visual and child fatigue scales. Statistical analysis was conducted with SPSS software, version 22. Quantitative variables were reported as the Mean±SD. The chi-square test, analysis of variance, and repeated measures tests were used for data analysis. Results: Demographic characteristics in three groups were not significantly different except for gender (P=0.011). There was no significant difference in pain (P=0.67) and fatigue (P=0.45) before the intervention. The Mean±SD pain scores on the third day in foot reflexology, simple foot massage, and control group were 4.4±1.9, 5.2±1.79, and 6.3±1.76, respectively (P<0.001). The Mean±SD pain scores on the fifth day in foot reflexology, simple foot massage, and control group were 2.7±1.4, 3.9±1.83, and 6.7±1.5, respectively (P<0.001). The Mean±SD fatigue scores on the third day in foot reflexology, simple foot massage, and control group were 2.36±0.55, 2.95±0.6, and 3.65±0.32, respectively (P<0.0001). The Mean±SD fatigue scores on the fifth day in foot reflexology, simple foot massage, and control group were 2.14±0.42, 2.67±0.73, and 4.12±0.16, respectively (P<0.0001). Conclusion: Our results showed that foot reflexology and simple foot massage can decrease pain and fatigue in children with leukemia. Performing foot reflexology could be recommended as a complementary intervention to reduce pain and fatigue in children with leukemia.

Comparison of Antiphospholipid Antibody Levels in Children with and Without COVID-19

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to the recent pandemic. According to published reports, respiratory symptoms, such as pneumonia and inflammatory conditions, are common in this disease. Objectives: The current study aimed to investigate the level of antiphospholipid (aPL) antibodies in children with and without coronavirus disease 2019 (COVID-19). Methods: This descriptive-analytic cross-sectional study was conducted on patients under 16 years of age with and without COVID-19 admitted to Ali Asghar Hospital between December 2021 and February 2022. Patient information was collected by the researcher in a checklist. The checklist included demographic information, clinical findings, and information on laboratory and ultrasound results. Results: In this study, 99 patients were evaluated in three groups: control (without COVID-19), moderate, and severe. The means (standard deviation [SD]) of C-reactive protein (CRP) and D-dimer were significantly higher in the severe group. The Pearson correlation coefficient test was used to examine the relationship between aPL and anticardiolipin (aCL) antibodies with laboratory results. The only significant and direct relationship was observed between aCL antibody and D-dimer. Conclusions: Increased CRP and D-dimer in children with COVID-19 are associated with the severe form of this serious disease. However, there was no significant association between the severity of the disease and the levels of aCL and aPL antibodies and anti-beta 2-glycoprotein I antibodies (aβ2GPI) in children.

Prevalence of Failure to Thrive and Associated Risk Factors in In-patients Under 5 Years of Age

Background: Failure to thrive (FTT) is defined as delaying or stopping a child’s growth and mightlead to more serious complications, such as reduced learning ability, mental or physical disability, and mortality. Objectives: The present study aimed to assess the prevalence of growth retardation in children under 5 years of age and its risk factors. Methods: This cross-sectional study was conducted on all 2038 children admitted to Ali Ebne Abitalib and Ali Asghar hospitals in Zahedan, Iran, in 2016. The samples entered the study based on census sampling, and the children’s height, weight, and other growth indices were measured. The children with confirmed growth retardation were recognized as the case group. Other children were regarded as controls. The parents’ characteristics were recorded in a list provided for this purpose. Data analysis was performed with SPSS software (version 20) using logistic regression with an error level of 0.05. Results: Of all children, 52.6% were male. The mean age of the total patients was 17.6 ± 4.14 months. The prevalence of children with growth failure was 747 patients (36.6%). In this study, the prevalence of short stature was significantly associated with factors such as parental height, low household level of education, high patients’ birth order, dry feeding, low birth weight, place of residence, and presence of background disease (P < 0.05). Nevertheless, the prevalence of short stature was not significantly associated with gender, age, polygamy status, age of complementary feeding, and gestational age (P > 0.05). Conclusions: The present study concluded that the prevalence of FTT was high due to socioeconomic factors in the studied society. Parental short stature, education, nutrition, low birth weight, and residence in rural areas were the most significant factors.

Effect of a Play-based Intervention on the Anxiety of Mothers of Premature Babies Admitted to the Neonatal Intensive Care Unit: A Randomized Controlled Clinical Trial

Objective The present study aims to examine the effect of a play-based intervention on the anxiety of mothers of premature babies admitted to the neonatal intensive care unit (NICU). Materials & Methods This is a non-blinded randomized controlled clinical trial. The participants were recruited from among the mothers of premature babies (<37 weeks) admitted to the NICU of Hazrat-e Ali Asghar Hospital and divided into two groups of intervention (n=20) and control (n=20) using the block randomization method. They were 20-35 years old with at least a high school diploma. Their babies had stable physiological conditions with no physical disorders or specific diseases. The anxiety of mothers was measured by Spielberger’s State-Trait anxiety inventory (STAI) before study and two days after discharge. The intervention group received the play-based program for their babies at least once a day, for at least 5 days until discharge. The control group received routine hospital care. Results Independent t-test results showed no significant difference in the scores of STAI and its domains between the two groups before and after the intervention. However, mean difference of pre- and post-scores of total STAI and state anxiety domain was significant in two groups (P<0.05), but it was not significant in terms of trait anxiety (P>0.05). The ANCOVA results showed that the effect size of intervention on state anxiety (P=0.001) and total anxiety score (P=0.004) was 27% and 20%, respectively. Conclusion The play-based intervention, can reduce the anxiety of mothers of premature babies admitted to the NICU and consequently affect the growth of children and mental health of family and society.

Demographic and Clinical Profiles Including Comorbidities in Hospitalized Patients Under 18 Years of Age with COVID-19

Objectives: This study was aimed to evaluate the various demographic and clinical characteristics in hospitalized children with COVID-19 as well as their comorbidities. Methods: This cross-sectional study evaluated a total of 809 hospitalized COVID-19 patients under 18 years of age in the referral university based Ali-Asghar Hospital in 2020. Demographic and clinical characteristics of patients were extracted from the archived records and data analysis was performed using SPSS software version 26. Results: The mean age of patients was 4.1 years and the higher percentage of patients (57%) were male. The most common symptoms of COVID-19 in children were fever, cough, and diarrhea. As well, the most common symptoms in 22.1% of patients admitted to the intensive care unit (ICU) were gastrointestinal (GI) symptoms (79%), fever (62.6%), and respiratory distress (53.6%), respectively. The majority of patients were in the age group less than one year (52%) and mortality rate was 6.3% in total and 10% in children with underlying disease. Besides, the mortality rate of intubated cases was 13 times higher. Conclusion: The findings of present study showed that COVID-19 in children was associated with various clinicopathological manifestations. Underlying disease including respiratory distress, cancer, and kidney disease as well as GI symptoms might be guided predicting the hospitalized cases in ICU. Newborns less than one year of age are exposed to severe COVID-19 infection which is associated with higher mortality rate and it should be given special attention in the early diagnosis and management of the COVID-19 disease.

Assessment of Laboratory and Clinical Data in COVID-19 Patients Treated by Convalescent Plasma

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) has affected over 200 million individuals worldwide, and finding a treatment to control and eradicate the disease is considered a critical issue. Different drugs and therapies have been used since the beginning of the pandemic; however, effective infection control has not been achieved. Convalescent plasma (CP) that contains immune factors (neutralizing antibodies and inflammatory) can be an effective way to treat some infections, as it was previously used to control the pandemic. Objectives: The present study aimed to assess the effect of CP infusion on some clinical indicators of coronavirus disease 2019 (COVID-19). Methods: This study investigated the effects of CP treatment on some clinical factors, such as C-reactive protein (CRP), lactate dehydrogenase (LDH), erythrocyte sedimentation rate (ESR), and D-dimer among 125 patients in two groups, including a CP-treated group and a non-treated control group, in Ali-Asghar Hospital of Shiraz, Iran. Results: Mortality rate analysis between CP-treated and control groups showed a 31% reduction (53% and 84% mortality in CP-treated and non-treated control groups, respectively). In addition, the clinical factor analysis of CP-treated patients showed a significant change in D-dimer on the seventh day (P = 0.036) and oxygen saturation (SpO2) (P = 0.00), lymphocyte count (P = 0.00), platelet (P = 0.005), and ESR (P = 0.007) between the first and fourth days of treatment. Moreover, CP-treated patients were separated into two age groups. It was observed that on the fourth day, the rate of SpO2 and lymphocyte count were significantly different in patients under 50 years compared to patients ≥ 50 years (P = 0.004 and P = 0.011, respectively); a similar finding was shown for lymphocyte count on the seventh day after CP infusion (P = 0.012). The results also revealed a significant difference between males and females in lymphocyte count after CP treatment on the fourth and seventh days (P = 0.006 and P = 0.042, respectively). Conclusions: The results demonstrated the potential impact of CP infusion on the laboratory data of COVID-19-infected patients. Accordingly, this method could have a practical effect on reducing and even suppressing inflammation, infection, and mortality rate among these patients. However, further studies are needed to obtain more accurate results.

Co-Infection Rates between SARS-CoV-2 and RSV in Oropharyngeal, Nasopharyngeal Aspirate and Saliva Samples of COVID-19 Patients, Shiraz, South of Iran.

Determining the prevalence of respiratory viruses' coinfection with coronavirus disease 2019 (COVID-19) is essential to defining its true clinical influence. This study aimed to evaluate co-infection rates between severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) and respiratory syncytial virus (RSV) in infected patients in Shiraz, south of Iran. In a cross-sectional descriptive study, oropharyngeal, nasopharyngeal aspirate (NPA), and saliva samples of 50 COVID-19 patients who were referred to Ali-Asghar hospital (Shiraz, Iran) from March to August 2020, were collected. A control group consisted of age and sex-matched healthy participants. The nasopharyngeal and oropharyngeal aspirates were collected by sterile swabs. All cases were hospitalized, and all SARS-CoV-2 patients had a fever and respiratory symptoms. The samples were packed in a vial with 1 mL of transport medium and transported to the Valfagre specialty laboratory, where they were tested for RSV using a real-time polymerase chain reaction (PCR). 100 nasopharyngeal/oropharyngeal aspirates and saliva samples including 50 healthy controls (24 females, 26 males) and 50 COVID-19 patients' samples (27 males and 23 females) were studied. There was no significant difference regarding age as well as gender between both groups (p> 0.05). None of the healthy subjects was infected with RSV; however, 5(10%) patients from COVID-19 group were infected with the RSV virus. Chi-square test did not show a significant difference between RSV infection in COVID-19 patients and healthy subjects. The outcome of present research showed that concurrent RSV with COVID 19 infection might be seen in hospitalized patients in Shiraz Southwest of Iran. For more reliable findings, further research on bigger populations, including more pathogens in several places around the country, and considering the severity of symptoms is required.

The Effect of L-Arginine Oral Supplementation on the Improvement of Cardiovascular Function and Pulmonary Artery Pressure in Patients with Major and Intermedia β-Thalassemia.

Thalassemia is the most common inherited anemia in worldwide. Heart failure is the most common cause of mortality and morbidity in patients with major and intermedia β-thalassemia. This study aimed to evaluate the effect of oral administration of L-arginine on the improvement of systolic Pulmonary Artery Pressure (PAP) and cardiac function in patients with major and intermedia β-thalassemia. This randomized clinical trial was done on 88 patients with β-thalassemia admitted to Ali Asghar Hospital, Tehran, Iran between 2020 and 2021. Echocardiography was performed for all the patients before the intervention. Afterwards, the patients were randomly divided into two groups of placebo and L-arginine. The patients underwent echocardiography after eight weeks and were compared with respect to the results. The mean blood transfusion interval was 20.21 d in the placebo group and 17.14 d in the L-arginine group (P=0.082). The results revealed no significant difference between the two groups regarding the mean levels of Hemoglobin (Hb) and ferritin, frequency of splenectomy. However, the mean PAP significantly decreased from 32.88 to 26.02 in the L-arginine group (P=0.009), but did not change in the placebo group. Nonetheless, no significant change was observed in the mean Ejection Fraction (EF) before and after L-arginine administration. L-arginine administration prevented the increase of PAP and was effective in preventing cardiovascular disorders including increased systolic PAP in patients with major and intermedia B-thalassemia. However, the results have to be confirmed in further studies with larger sample sizes.

Evaluation of factors related to depression in peritoneal dialysis patients: a multicenter cross-sectional study

BackgroundEnd-stage renal disease (ESRD) is serious global public health challenge in many developing countries. Treatment of ESRD is carried out through renal replacement therapy like peritoneal dialysis (PD). Depression is the most common mood disorder which has a strong impact on the quality of life in patients with ESRD. Little is known about the prevalence and risk factors of depression in peritoneal dialysis patients.Method and materialsA multicenter cross-sectional study was conducted on 164 adult ESRD patients undergoing peritoneal dialysis for at least three months who referred to the peritoneal dialysis centers of Al-Zahra, Noor & Ali Asghar hospitals, Isfahan, Iran from May to August 2019. Beck Depression Inventory Second Edition questionnaire was used to measure the symptoms of depression and its severity.Results43.5% of patients had some levels of depression. Assessing the association of depression with demographic and PD-related factors showed that there was no significant difference regarding age, BMI, dialysis adequacy and residual kidney function, dialysis frequency, type of dialysis solution used, disease duration, and age at the start of dialysis. Ordinal logistics regression analysis showed significant association between depression severity categories and gender (OR = 0.397, CI: 0.160–0.985, p = 0.046), marital status (OR = 2.983, CI: 1.180–7.541, p = 0.021), having a separate room for dialysis (OR = 2.511, CI: 1.108–5.692, p = 0.027).ConclusionAs our findings have revealed 43.5% of our participants suffered from mild-to-severe depression, we suggest careful attention and routine evaluation for depression in PD patients, especially women and single patients and those who have low socioeconomic status.

The Effect of Benson Relaxation Technique on Anxiety and Quality of Life in Patients with Thalassemia Major: A Clinical Trial.

Thalassemia major is the most common chronic blood disease in the world, especially in Asia and Iran, and it gives rise to anxiety and reduces quality of life [QOL] in patients. The purpose of this study was to determine the effect of Benson relaxation technique on anxiety and QOL in patients with thalassemia major. This semi-experimental clinical trial study was conducted on 140 patients with thalassemia major in two intervention groups [n = 70] and control group [n = 70] in Ali Asghar Hospital, Zahedan.The data were collected using a demographic information form, the Spielberger State-Trait Anxiety Inventory [STAI], and the World Health Organization Quality of Life-BREF [WHOQOL-BREF] and self-report checklist. The control group received routine care, whereas the intervention group, we first completed the questionnaires; then, Benson relaxation technique was taught to each patient in three one-hour sessions in the presence of a family member for three consecutive days. Finally, they were asked to practice this technique twice a day for 12weeks. The questionnaires were completed again one and three months after the intervention. Data analysis showed no significant difference between the mean scores of anxiety and QOL and its dimensions in the two groups at baseline [P > 0.001]. One and three months after the relaxation technique, however, the intervention group experienced a statistically significant difference in the mean scores of anxiety and QOL and its dimensions [P < 0.001]. The results confirmed that Benson Relaxation Technique reduces anxiety and improves the QOL of patients with thalassemia major. Clinical Trials Registration: IRCT20200926048842N2.

First molecular detection of SARS-CoV-2 virus in cockroaches.

Coronavirus is one of the main pathogens that primarily targets the human respiratory system. There are several ways to transmit this virus, such as direct contact or droplets spread by coughing or sneezing, and direct contact with fomites and surfaces is another way. This cross-sectional study was conducted in Shiraz, southern Iran, in 2021. 5 locations, including 3 hospitals and 2 dormitories, were selected for the survey. The cockroaches were collected from selected locations and transferred to the Laboratory of Medical Entomology at Shiraz University of Medical Sciences. All specimens were identified morphologically. The external and gastrointestinal washouts of collected samples with sterile phosphate-buffered saline separately were used for molecular analysis. An RT-qPCR assay, which suggests the possible insect‑borne transmission, was used. External and gastrointestinal washout of B. germanica from Dastgheyb Dormitory and P. americana from Ali-Asghar Hospital were positive for contamination with the SARS-CoV-2. Cockroaches spread the virus in the environment and contaminate human food and various surfaces of buildings. Their role will be more important in crowded places such as hotels, lodging houses, restaurants, and hospitals; vector control programs should be carried out with more accuracy in such places.

Effectiveness of Pelvic Ultrasonography in the Diagnosis of Central Precocious Puberty and Its Differentiation from Similar Conditions

Background: Differentiation of patients with central precocious puberty (CPP) from healthy individuals and patients with CPP-like conditions [isolated premature thelarche (IPT) and isolated premature adrenarche (IPA)] is important for selecting an appropriate treatment. The gonadotropin-releasing hormone stimulation test is used as the gold standard for differentiating CPP from other conditions. Despite its high specificity, this test has disadvantages, such as low sensitivity, time-consuming sampling, and need for multiple blood samples. Objectives: This study aimed to investigate the use of pelvic ultrasonography (US) and its parameters in distinguishing CPP patients from those with similar conditions and healthy individuals. Patients and Methods: In this case-control study, a total of 183 patients, who were referred to the endocrinology department of Ali Asghar Hospital in Tehran, Iran for the evaluation of CPP, were recruited cconsecutively from 2015 to 2019. All the participants were Iranians and classified based on the clinical and laboratory findings. Pelvic US parameters were evaluated in all groups. One-way analysis of variance (ANOVA) was used to compare the mean values of continuous variables between the groups. Moreover, a post-hoc test was performed for pairwise comparisons between the groups if the result of ANOVA test was statistically significant. Finally, the receiver-operating characteristic (ROC) curve analysis was performed to determine the best cutoff points for US parameters. Results: Of 183 children, 62 were allocated to the control group (33.87%), 93 to the CPP group (50.81%), 16 to the IPT group (8.74%), and 12 to the IPA group (6.55%). The results showed no significant difference between the groups regarding chronological age and body mass index, while the bone age (107.76 ± 19.81 months) (P &lt; 0.001) and height (129.53 ± 8.97 cm) were significantly higher in the CPP group compared to the other groups (P = 0.003). All US parameters were significantly different between the CPP and control groups. There were also significant differences between CPP patients and those with IPT and IPA in terms of all parameters, except for the cervical anteroposterior diameter and ovarian volume. The best parameters for differentiating CPP from other conditions were the uterine volume (cutoff value, 1.40; 75.27% sensitivity; 75.56% specificity), uterine transverse diameter (cutoff value, 13.5 mm; 72.04% sensitivity; 71.11% specificity), and fundus/cervix (F/C) ratio (cutoff value, 0.98; 78.49% sensitivity; 70% specificity). Conclusion: The pelvic US parameters can improve the diagnosis of CPP and play an auxiliary role in distinguishing the treatment needed. Based on the findings, the best diagnostic parameter and its cutoff value can vary depending on ethnicity and type of study.

The Effect of Family-Centered Intervention on Key Indicators of Diabetes Management and Control in Patients with Type-2 Diabetes.

This study is to determine the effect of the family-centered intervention (FCIS) on the key indicators of diabetes management and Control control in patients with type-2 diabetes. The present study is a quiz- experimental study with a randomized control group. Participants were 64 patients with type-2 diabetes visiting Ali Asghar Hospital of Isfahan in 2018. The eligible patients were assigned to either the intervention group or the control group (i.e., patient-center care) through block randomization. FCIS were implemented in 4 two-hour sessions as home visits while the patients and their caregivers were present. Data were collected twice-i.e. before the intervention and 12 weeks after it- and were analyzed, by running a t-test (α = 0.05), using SPSS-21. The mean ± SD age of participants was 50.4 ± 8.5. There was no significant difference between the two groups in the mean weight, serum levels of FBS and A1C, physical activity, energy intake, and BMI before intervention. But, a significant improvement in the mean values of these variables in the intervention group after the intervention, compared with the control group was indicated (P < 0.05). This study suggests that FCIS are more effective than patient-center care in the management and control of type-2 diabetes. Therefore, it is recommended that the family be considered in educational interventions.

The Effect of the Family-Centered Empowerment Model on Family Functioning in Type 1 Diabetic Children: A Quasi-experimental Study

Background: The family-centered empowerment model seems to be effective in empowering the patient and engaging family members in identifying the patient’s care needs and cooperating with the patient to control diabetes and its complications. Objectives: The present study aimed to evaluate the effect of the family-centered empowerment model on family functioning in children with type 1 diabetes. Methods: This quasi-experimental study was conducted on 80 primary caregivers of children with type 1 diabetes admitted to the diabetes clinic of Hazrat Ali Asghar (AS) Hospital in Zahedan, southeast Iran, in 2021. The diabetic children were selected using convenience sampling, and then the participants were equally classified by the random block method and were assigned to 2 groups (intervention and control groups). The data were collected using the family assessment device (FAD) and a demographic information form. Repeated measures analysis of variance (ANOVA) was used to assess the effectiveness of the training intervention by modifying the effect of some quantitative variables. The significance level in this study was set at 0.05 (P = 0.05) using SPSS version 26. Results: The mean age of the children was 8.95 ± 2.18 years in the intervention group and 9.10 ± 1.97 years in the control group (P = 0.75). The mean family functioning scores were not significantly different between the intervention and control groups before the intervention. However, the 2 groups showed a significant difference in terms of family functioning scores one and a half and 3 months after the intervention (P &lt; 0.001). Conclusions: Teaching family members about disease control can be very useful because there is a strong connection between the family and the health status of its members. People, especially those with chronic diseases, are dependent on their family members, and even their attitudes are affected by the family.

The Prevalence and Risk Factors for Urinary Tract Infection in Kidney Transplant Recipients in the First Year After Transplantation

Background: End-stage renal disease (ESRD) needs replacement therapy and most often, kidney transplantation is the best therapeutic option. Urinary tract infection (UTI) is one of the most important complications after renal transplantation that affects transplantation outcomes. Objectives: This study aimed to define the incidence rate, UTI risk factors among kidney transplant recipients, and causative organism of UTI and their antibiotic susceptibility. Methods: In this cross-sectional study, we collected clinical, demographic, and laboratory data from 268 transplant recipients in Ali-Asghar Hospital from 2011 - 2018. Data collected from patients were analyzed with SPSS software version 25. Results: According to the results, 50 (18.7%) had UTI in the first year after renal transplantation. Female gender and underlying cause of renal failure were predisposing factors for UTI. The most common causative organism was Escherichia coli (58.4%). The antibiotic susceptibility results showed nitrofurantoin and meropenem as the most effective antibiotics for E. coli. Conclusions: The UTI was more common in women and patients with analgesic nephropathy and lupus nephritis. The most common causative organism was E. coli and meropenem and nitrofurantoin were the most effective drug choices.

Results of Port-A-Cath Implantation: A Cross-Sectional Study about a Single Tertiary Cancer Center Experience.

Background: Identifying possible complications accompanying central venous catheterization may improve the results. The current study was conducted to clarify the complication rate among port-a-cath implantation in children referred to Ali-Asghar hospital from 2011 to 2015. This study was designed to determine complication rates among the pediatric population who underwent port-a-cath implantation for chemotherapy. Methods: The current observational study reviewed the medical documents of children who were referred to Ali-Asghar hospital from 2011 to 2015. Factors such as underlying disease, demographic characteristics, complications and their management were considered. We analyzed the results of this study using multivariate logistic regression. Results: A total number of 100 patients met the eligibility criteria. In Thirty-two cases, chemoport catheters were removed due to complication management or termination of adjuvant chemotherapeutic treatment. Fifty-one boys and forty-nine girls enrolled in the study. The mean duration of catheter preservation defined per patient was 693 days ±1 year SD. 14 catheters were removed followed by planned treatment termination, while 18 catheters were complicated due to port dysfunction, infection, skin necrosis, and extravasation, hematoma in order of decreasing. Conclusion: Chemo port utilization is mandatory in pediatric patients with cancers demanding adjuvant treatment. The possible complications would be managed by a variety of protocols. Respecting anti-septic principles by trained personnel will prevent the majority of associated complications.

Evaluation of the prevalence and clinical and laboratory features of acute viral myositis in children with influenza referred to the emergency department of Ali Asghar Tehran Hospital in 2019 and 2020.

ABSTRACTIntroduction:Influenza-related viral myositis is observed mostly in children with influenza, and the disease is more common in influenza type B. The aim of the present study was to evaluate the prevalence, and clinical and laboratory features of acute viral myositis in children with influenza in 2019 and 2020.Methods:This retrospective cross-sectional study was performed in Ali Asghar Hospital, from December 2019 to February 2020. Children aged 2–14 years with symptoms of acute onset of fever, along with the symptoms of influenza with or without muscle pain who referred to the emergency department of Hazrat Ali Asghar Children’s Hospital, were included in the study. The data were collected and analyzed by Statistical Package for the Social Sciences (SPSS) version 22.Results:Out of the 105 participants in this study, 62 (59%) were male and the rest were female. The average age of the patients was 5.34 years (SD = 2.63). Clinical signs of lower limb pain, myalgia, lameness, weakness, and lethargy were significantly more common in patients with myositis (P-value < 0.05). In-vitro examination demonstrated that creatine phosphokinase (CPK), aspartate aminotransferase (AST), and aAlanine aminotransferease (ALT) levels were significantly higher in patients with myositis.Conclusion:Based on the present results, the clinical symptoms in patients are quite clear, and based on the symptoms, it is possible to diagnose and treat myositis without relying on laboratory findings; due to the self-limitation of this complication and lack of the need for complex treatments in case of early diagnosis, physicians can diagnose and treat many cases, depending on the clinical symptoms and the accuracy of the examination.

Co-segregation of variant NSUN2 Lue198Arg among Iranian family with intellectual disability: a case report

BackgroundIntellectual disability is characterized by impairments in adaptive behavior and cognitive functioning manifested during the developmental period. Since disabilities are heterogeneous, variant analysis can help us confirm and accurately diagnose children with intellectual disabilities. Some papers reported that bi-allelic variants of the NSUN2 gene caused a group of neurological disorders, including non-syndromic autosomal recessive intellectual disability (NS-ARID), Dubowitz syndrome, and familial restrictive cardiomyopathy 1 (RCM1). We report on a consanguineous family with three siblings diagnosed with intellectual disability.Case presentationThe 7-year-old female was referred to Ali-Asghar hospital, Zahedan, Iran, with clinical manifestations comprising moderate intellectual disability, ptosis, long face, and short stature. Chromosome banding, metabolic testing, and magnetic resonance imaging examinations revealed no abnormalities. Accordingly, other affected siblings born of the same parents were considered. Whole-exome sequencing (WES) was conducted on the sufferer to consider NS-ARID variants. Findings identified a variant with uncertain significance (NM_017755.6: c.593 T > G) in the NSUN2 gene in the proband. This variant was confirmed through Sanger sequencing of the affected and unaffected family members. Besides, the computational results showed that the L198R exchange could change the interaction between wild-type and other residues in the protein. The affected patients with NS-ARID had similar clinical characteristics and genetic abnormalities.ConclusionTaken together, we described the variant in three Iranian siblings; further expanding of the other variants involved in the disease will be evident by using high-throughput sequencing technologies.