scholarly journals Changes in Opioid Poisoning Pattern in Children: A Retrospective Study in Rasht, Iran

2021 ◽  
Vol 15 (3) ◽  
pp. 151-156
Author(s):  
Manijeh Tabrizi ◽  
◽  
Sima Sarabi ◽  
Morteza Rahbar Taramsari ◽  
Adel Baghersalimi ◽  
...  

Background: Poisoning comprises about 7% of accidents in children under 5-year-old and 2% of all pediatric deaths in developing countries. To warn against and prevent future potential poisoning with opioid substances, this comparative study was conducted on pediatric cases referred to the 17th Shahrivar Hospital in Rasht, Iran, in 2006 and 2018. Methods: In this retrospective, cross-sectional study, all hospitalized pediatric cases diagnosed with opioid poisoning in 2006 and 2018 were investigated systematically. The demographic data, such as age, gender, city or village of residence, the poisoning substances involved, and the clinical outcomes were extracted from the medical records and entered on an appropriately-designed form. The data analysis was performed, using SPSS software, version 21. Results: Fifty pediatric cases were examined with a mean age of 44.38±3.8 months old. Among these cases, 14 children had been poisoned, 13 of whom with opium and one with morphine in 2006; while in 2018, 36 children had been poisoned with methadone and only one with opium. Conclusion: Comparing years 2006 with 2018, a considerable increase in pediatric opioid poisoning cases was observed with a tendency toward methadone being the substance involved. The occurrences might be due to unsafe access of unaware children to this drug, especially after the initiation of methadone maintenance treatment for opiate addicts, who were mainly the parents or relatives living in the same household.

Author(s):  
Amirhossein Orandi ◽  
Seyed Mohammad Mireskandari ◽  
Shahram Samadi ◽  
Negar Eftekhar ◽  
Mostafa Mohammadi ◽  
...  

Background: Establishing and maintaining a secure airway using a cuffed endotracheal tube (ETT) is an important step in management of intubated patients. Out-of-range ETT cuff pressure is associated with various complications which could lengthen the hospital stay. The aim of this cross-sectional study was to evaluate ETT cuff pressure in intubated patients in the emergency department (ED), operating rooms (ORs), and Intensive Care Units (ICUs) of Imam Khomeini Hospital Complex (IKHC), Tehran, Iran. Methods: The ETT cuff pressure of 153 patients was measured using a standard manometer. Demographic data and duration of intubation were recorded. The data were analysed using the SPSS software version 16. P values less than 0.05 were considered significant. Results: The ETT cuff pressure exceeded the recommended range in 125 out of 153 patients (81.7%). The mean cuff pressure (67.29 cmH2O) was significantly higher than the recommended range (p<0.001). The cuff pressure was higher in patients in the ORs compared to patients in the ED and ICU (OR=8.46, p<0.001). Conclusion: Intubation in the OR can be considered a risk factor for higher-than-normal ETT cuff pressure and subsequent complications. The ETT cuff pressure monitoring by means of a manometer is recommended.


2020 ◽  
Vol 6 (2) ◽  
pp. 68-72
Author(s):  
Payman Asadi ◽  
Vahid Monsef Kasmaei ◽  
Seyyed Mahdi Zia Ziabari ◽  
Shiva Bakian ◽  
Amir Noyani

Objective: Emergency medical services (EMS) is a critical component of health care system and the forefront of stroke care. The prominent role of EMS in stroke care is timely and accurate diagnosis of acute ischemic stroke and transfer of the patients to stroke centers. The present study aimed to assess the "awareness" and "attitude" of EMS personnel concerning prehospital stroke care based on American Stroke Association (ASA) guideline in Rasht town. Methods: This was an analytical cross-sectional study. The participants, consisted of all EMS personnel (n=115) in Rasht town in 2012, entered the study based on census method. Awareness and attitude of EMS personnel toward prehospital stroke care were assessed using a questionnaire based on ASA guideline. The questionnaire had two sections. The first part contained demographic data and the second part had multiple choice items (Likert-type scale response anchors) to assess awareness and attitude of the personnel. The questionnaires were filled out by the personnel. The collected data were analyzed using descriptive and inferential statistics using SPSS software version 20. P value less than 5% was considered significant. Results: Ninety people participated in this study. The average of age and working experience of participants were 36.84 ± 8.02 and 11.36 ± 5.71, respectively. Most of the participants had bachelor degree (n=33, 36.7%) and majored in medical emergency (n=43, 47.8%). Most of them were contract employees (47.8%). Mean scores of awareness and attitude of the personnel were 26.68 (the total number of score = 51) and 32.56 (the total number of score = 80), respectively. Conclusion: Findings revealed poor awareness and attitude of EMS personnel toward prehospital stroke care based on ASA guideline in Rasht Town. We recommended retraining courses to promote awareness of EMS personnel.


2021 ◽  
Vol 20 (3) ◽  
pp. 256-261
Author(s):  
Javad Tafaroji ◽  
◽  
Hosein Heydari ◽  
Sajad Rezvan ◽  
Enayatollah Noori ◽  
...  

Background and Objectives: Neutropenia is the absolute count of neutrophils less than 1500 per cubic millimeter. Because the early detection of the cause of neutropenia and appropriate measures to reduce its mortality and financial costs are important, this study was conducted to investigate the relationship between the cause of neutropenia and the severity of neutropenia with clinical and laboratory findings to take appropriate measures. Subjects and Methods This study was a cross-sectional descriptive-analytical study. In this study, 111 patients with neutropenia were studied in Hazrat Masoumeh Hospital in Qom City, Iran, by a census method in 3 years from 2014 to 2016. Necessary information was obtained from the patients' medical records through a questionnaire. Data were analyzed by SPSS software. Results The study findings showed relationships between the cause of the disease and variables of age (P= 0.007), the severity of neutropenia (P<0.001), disease outcome (P<0.001), length of hospital stay (P<0.001), Hb (P<0.001), and WBC (P<0.001). The causes of neutropenia in the studied patients were viral (54.1%), sepsis (24.3%), malignancy (10.8%), anemia (4.5%), idiopathic (3.6%) and ITP (2.7%). Conclusion The present study showed a significant relationship between demographic and laboratory findings with the cause and severity of the disease. Therefore, considering these factors at the beginning of hospitalization can play a crucial role in promoting proper management in the treatment of patients with neutropenia.


2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Talaei

Aim:Psychiatric disorders are from prevalent outcomes of chronic diseases such as diabetes mellitus. In spite of focused attention of prior researchers on psychiatric distresses of diabetes type2, there were not enough researches about psychopathology of diabetes type1. The aim of this study was to compare psychopathology of diabetes type1 with type2, and assess its relationship to demographic factors.Method:In this cross-sectional study, all of type1 and type2 diabetic patients who have medical records in "Khorasan Center of Diabetes Researches" matched about age and gender, then assessed their psychopathologies by using SCL-90-R questionnaire. Finally, 66 diabetic patients (33 with type1 and 33 with type2) completed the questionnaires and results processed by SPSS software.Results:The most prevalent pathology in SCL-90-R items was related to paranoid ideations (69.7%) and less prevalent item was phobic anxiety (33.3%). Prevalence of psychopathology in diabetic patients was 56.1%, in type1 diabetics more than type2 (66.7%, 45.5%), and in men more than women (63.3%, 50%). Independent t-test did not demonstrate a significant correlation between psychopathology and type of diabetes (P=0.156), but obsessive-compulsive symptoms and hostility in diabetes type1 have seen more than type2 (P< 0.05). ANOVA only could demonstrate relationship of education (P=0.006) and frequency of complications (P=0.011) to psychopathology.Conclusion:Great prevalence of psychiatric disorders in diabetic patients, need more attention for early diagnosis and treatment.


2021 ◽  
Vol 23 (4) ◽  
pp. 294-300
Author(s):  
Renata Somavilla ◽  
Pablo Zanetti ◽  
Shaiana Carmo ◽  
Lilian Rigo

AbstractThe objective was to investigate the experience of dental caries and associated factors from the children’s and adolescents’ medical records who visited the Children's Dental Clinic of a College of southern Brazil. A cross-sectional study was carried out by analyzing 262 medical records. For data collection, information on demographic data, oral hygiene, food, breastfeeding and oral clinical data were used to investigate. A multivariate analysis was used to estimate the odds ratios (OR) and their 95% confidence intervals, by the exposure variables in a Binary Logistic Regression model (p-value< 0.05). Of the sample, 86.3% had some teeth with experience of dental caries, with only 13.7% free of caries. The average dental caries was 5.3 ± 3.1 in children between 6 and 8 years and 2.0 ± 1.9 between 9 and 12 years. There was a statistically significant association between age and dental caries, with the largest age group being a protective factor for dental caries (OR 0.30; 95%CI 0.17-0.53). Children who were breastfed naturally had a protective factor for caries (OR 0.29; 95%CI 0.10-0.88). The experience of dental caries in children was high, especially in primary teeth, with a higher average of decayed teeth. Breastfeeding and age were a protective factor for dental caries. Keywords: Dental Caries. Breast Feeding. Candy. Oral Hygiene. Diet, Cariogenic. ResumoO objetivo foi investigar a experiência de cárie dentária e fatores associados em prontuários de crianças e adolescentes que procuraram o Ambulatório de Odontologia Infantil de uma Faculdade do Sul do Brasil. Realizou-se um estudo transversal por meio da análise de 262 prontuários. Para a coleta de dados, foram utilizadas informações sobre dados demográficos, higiene bucal, alimentação, aleitamento materno e dados clínicos bucais para investigação. Uma análise multivariada foi utilizada para estimar os odds ratios (OR) e seus intervalos de confiança de 95%, pelas variáveis de exposição em um modelo de Regressão Logística Binária (p-valor <0,05). Da amostra, 86,3% tinham alguns dentes com histórico de cárie dentária, e apenas 13,7% livre de cárie. A média de cárie dentária foi de 5,3 ± 3,1 em crianças entre 6 e 8 anos e 2,0 ± 1,9 entre 9 e 12 anos. Houve associação estatisticamente significativa entre idade e cárie dentária, sendo a maior faixa etária fator de proteção para cárie dentária (OR 0,30; IC95% 0,17-0,53). Crianças amamentadas naturalmente apresentaram fator de proteção para cárie (OR 0,29; IC95% 0,10-0,88). O histórico de cárie dentária em crianças foi elevado, principalmente nos dentes decíduos, com maior média de dentes cariados. O aleitamento materno e a idade foram fatores de proteção para cárie dentária. Palavras-chave: Cárie Dentária. Aleitamento Materno. Doces. Higiene Bucal. Dieta Cariogênica


2016 ◽  
Vol 86 (5-6) ◽  
pp. 242-248 ◽  
Author(s):  
Genc Burazeri ◽  
Jolanda Hyska ◽  
Iris Mone ◽  
Enver Roshi

Abstract.Aim: To assess the association of breakfast skipping with overweight and obesity among children in Albania, a post-communist country in the Western Balkans, which is undergoing a long and difficult political and socioeconomic transition towards a market-oriented economy. Methods: A nationwide cross-sectional study was carried out in Albania in 2013 including a representative sample of 5810 children aged 7.0 – 9.9 years (49.5% girls aged 8.4 ± 0.6 years and 51.5% boys aged 8.5 ± 0.6 years; overall response rate: 97%). Children were measured for height and weight, and body mass index (BMI) calculated. Cut-off BMI values of the World Health Organization (WHO) and the International Obesity Task Force (IOTF) were used to define overweight and obesity in children. Demographic data were also collected. Results: Upon adjustment for age, sex, and place of residence, breakfast skipping was positively related to obesity (WHO criteria: OR = 1.5, 95% CI = 1.3–1.9; IOTF criteria: OR = 1.9, 95% CI = 1.4–2.5), but not overweight (OR = 1.1, 95% CI = 0.9–1.3 and OR = 1.1, 95% CI = 0.9–1.4, respectively). Furthermore, breakfast skipping was associated with a higher BMI (multivariable-adjusted OR = 1.05, 95% CI = 1.02–1.07). Conclusions: Our findings point to a strong and consistent positive relationship between breakfast skipping and obesity, but not overweight, among children in this transitional southeastern European population. Future studies in Albania and other transitional settings should prospectively examine the causal role of breakfast skipping in the development of overweight and obesity.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Huailiang Wu ◽  
Weiwei Sun ◽  
Hanqing Chen ◽  
Yanxin Wu ◽  
Wenjing Ding ◽  
...  

Abstract Background Pregnant women experience physical, physiological, and mental changes. Health-related quality of life (HRQoL) is a relevant indicator of psychological and physical behaviours, changing over the course of pregnancy. This study aims to assess HRQoL of pregnant women during different stages of pregnancy. Methods This cross-sectional study was performed using the The EuroQoL Group’s five-dimension five-level questionnaire (EQ-5D-5L) to assess the HRQoL of pregnant women, and demographic data were collected. This study was conducted in a regional university hospital in Guangzhou, China. Results A total of 908 pregnant women were included in this study. Pregnant women in the early 2nd trimester had the highest HRQoL. The HRQoL of pregnant women rose from the 1st trimester to the early 2nd trimester, and dropped to the bottom at the late 3rd trimester due to some physical and mental changes. Reports of pain/discomfort problem were the most common (46.0%) while self-care were the least concern. More than 10% of pregnant women in the 1st trimester had health-related problems in at least one dimension of whole five dimensions. In the whole sample, the EuroQoL Group’s visual analog scale (EQ-VAS) was 87.86 ± 9.16. Across the gestational stages, the HRQoL remained stable during the pregnancy but the highest value was observed in the 1st trimester (89.65 ± 10.13) while the lowest was in the late 3rd trimester (87.28 ± 9.13). Conclusions During pregnancy, HRQoL were associated with gestational trimesters in a certain degree. HRQoL was the highest in the early 2nd trimester and then decreased to the lowest in the late 3rd trimester due to a series of physical and psychological changes. Therefore, obstetric doctors and medical institutions should give more attention and care to pregnant women in the late 3rd trimester.


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e045892
Author(s):  
Solomon Feleke ◽  
Gudina Egata ◽  
Firehiwot Mesfin ◽  
Gizachew Yilak ◽  
Abebaw Molla

ObjectiveThe study aimed to assess the prevalence of stunting, wasting, underweight and associated factors in orphaned children under 5 years old.DesignA cross-sectional study.SettingGambella City, Ethiopia.ParticipantsA sample of 419 under 5 orphaned children included in the study. Eligible households with orphans had selected using a systematic random sampling method. The lottery method was used when more than one eligible study participants live in the household. An OR with 95% CI was performed to measure the strength of association between each dependent variable and independent variables. Variables with p<0.05 were declared statistically significant.Primary outcomeThe main outcome of this study was the prevalence of undernutrition among orphaned under 5 and its associated factors.ResultsPrevalence of stunting, wasting and underweight in orphan children under 5 were 12.2%, 37.8% and 21.7%, respectively. The prevalnce of wasting peaks among age group of 36–47 months (42.5%), whereas underweight peaks in 48–59 months (27.7%). Food insecurity, wealth index, family size, vitamin A supplementation, diarrhoea, fever 2 weeks before the survey, children under 5 and parents’ death were associated with undernutrition.ConclusionThe prevalence of stunting, wasting and underweight among orphan children under 5 was significantly high. Multisectoral collaborative efforts towards access to health services, improving income-generating activities, micronutrient supplementation and social support and protection targeting orphan and vulnerable populations have to be built up.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 508.2-509
Author(s):  
K. Maatallah ◽  
H. Boussaa ◽  
H. Riahi ◽  
H. Ferjani ◽  
M. Habechi ◽  
...  

Background:Foot disease is a common problem in rheumatoid arthritis (RA). Therapeutic decisions are often based on clinical examination (CE) alone, which can be adversely affected by factors such as deformity, obesity, and peripheral edema. Ultrasonography (US) has previously been shown to be more sensitive than CE for detecting synovitis and tenosynovitis in RA forefeet, but few data exist for the hindfoot and ankle.Objectives:The aim of this study was to compare CE and US for the detection of hindfoot and ankle synovitis and tenosynovitis in patients with established RA.Methods:We conducted a cross-sectional study including patients with RA (ACR/EULAR 2010). Demographic data and disease parameters were collected. CE was performed by a rheumatologist for the presence or absence of tenderness, swelling, and mobility restriction of both ankles. The following tendons were examined for tenosynovitis: tibialis anterior (TA) and posterior (TP), fibularis longus (FL), and brevis (FB) (assessed together). In a second time, US examination of the tibiotalar, talonavicular, and subtalar joints and the same tendons as CE was performed by a blinded radiologist experienced in musculoskeletal imaging using a Philips HD11 device with a high-frequency linear transducer. The presence or absence of synovitis and tenosynovitis was recorded, and the composite synovitis score (power doppler / grayscale ultrasound (PDUS)) was measured for each joint. The US score of each patient was defined by the sum of the composite scores of the joints studied (0-30). A p-value <0.05 was considered significant.Results:Sixty-two feet were examined in 31 RA patients (25 women and six men) with a mean age of 54.8±10.8 years old [32-70]. The mean disease duration was 8.5±7.2 years [1-37]. Rheumatoid Factor (RF) and Anti-Citrullinated Peptides Antibodies (ACPA) were positive in 61.3% and 83.8% of cases. The mean DAS28 ESR was 3.8±1.5 [0.6-7].Clinical examination of ankles revealed tenderness in 57.4% of cases, swelling in 38.8% of cases, and restriction in the range of motion in 11.1% of cases. TA tenosynovitis was noted in 14.8% of cases, TP tenosynovitis in 22.2% of cases, and FL and FB tenosynovitis in 31.5% of cases.US showed tibiotalar synovitis in 59.3% of cases, talonavicular synovitis in 64.8% of cases, and subtalar synovitis in 46.3% of cases. TA tenosynovitis was noted in 5.6% of cases, TP tenosynovitis in 22.2% of cases, and FB and FL tenosynovitis in 25% and 11.1% of cases respectively.An association was found between clinical tenderness and US synovitis of the tibiotalar joint (p=0.013) and the talonavicular joint (p=0.027). No association was noted between clinical swelling and US synovitis in these joints.No association was noted between clinical and US tenosynovitis of TA (p=0.279), TP (p=0.436), FB (p=0.495) and FL (p=0.315).Conclusion:Clinical examination of RA ankles may be challenging and needs to be coupled with US, which is more sensitive and accurate in the detection of synovitis and tenosynovitis.Disclosure of Interests:None declared


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