Search

Introduction: Research has shown that neural feedback creates a kind of two-way communication between mind and body that changes abnormal cognitive processes to normal cognitive processes. Therefore, the aim of this study was to evaluate the effectiveness of neural feedback on executive functions, behavioral problems and clinical symptoms of attention deficit / hyperactivity disorder. Methods: The research is quasi-experimental design with pre-test post-test and three-month follow-up with experimental and control groups. The statistical population of this study included all children aged 9 to 12 years in Hamedan in 2009-2010. Purposeful sampling method was used and the samples were matched in terms of level of intelligence and type of disorder. Each participant in the experimental group received 24 sessions of neural feedback twice a week. Participants were assessed using the Swanson, Nolan, and Pelham-IV Questionnaire -Fourth Edition to assess the clinical symptoms of ADHD, Coolidge Neuropsychological Inventory to assess executive function, and Rutter Children's Behavioral Problems Questionnaire. Multivariate analysis of variance (MANOVA) was used to test the research hypotheses. Results: The results showed that there was a significant difference between the experimental group and the control group in all post-test variables of executive functions, behavioral problems and clinical symptoms and their components (P ≤ 0.05). Conclusion: According to the results, it seems that neural feedback is an effective intervention for the treatment of these variables. [ABSTRACT FROM AUTHOR]

This study assesses the impact of religiosity on delirium severity and patient outcomes among Shi'a Muslim intensive care unit (ICU) patients. We conducted a prospective observational cohort study in 21 ICUs from 6 Iranian academic medical centers. Delirium was assessed using the Confusion Assessment Method for the ICU (CAM-ICU) tool. Eligible patients were intubated, receiving mechanical ventilation (MV) for ≥ 48 h. Illness severity was assessed using Acute Physiology and Chronic Health Evaluation II (APACHE II) scores. A total of 4200 patients were enrolled. Patient religiosity was categorized as more (40.6%), moderate (42.3%), or less (17.1%) based on responses to patient and surrogate questionnaires. The findings suggest that lower pre-illness religiosity may be associated with greater delirium severity, MV duration, and ICU and hospital LOS. The lower mortality in the less religiosity group may be related in part to a greater proportion of female patients, but it remains unclear whether and to what extent greater religiosity impacted treatment decisions by patients and families. Further investigation is needed to validate and clarify the mechanism of the mortality findings. [ABSTRACT FROM AUTHOR]

This paper investigates the shear rate influence on asphaltene aggregation in heptane-toluene mixture through experiments and theoretical modeling at constant temperature and pressure. The experiments were performed within a Couette apparatus at different shear rates (129.14 – 1142.39 s−1). The size distributions of asphaltene aggregates in time were measured. In all tests, the average diameter of asphaltene aggregates initially increases up to a maximum and then decreases to a steady-state value. The existence of steady state size is believed to occur when the rates of aggregation and fragmentation become equal. A fractal population balance model was used and the aggregation kernel was assumed to be a linear combination of orthokinetic and perikinetic kernels. The Particle Swarm Optimization (PSO) algorithm was employed for estimating the model parameters including orthokinetic and perikinetic collision efficiencies, and , respectively, fractal dimension, , and breakage coefficient,. The results showed that the fractal dimension, the collision efficiency of orthokinetic mechanism and breakup rate coefficient increase with increasing of shear rate. However, the value of perikinetic collision efficiency decreases with the increase in shear rate. Totally, the effect of fluid shear on fragmentation was found to be higher than that on aggregation of asphaltene particles.GRAPHICAL ABSTRACT [ABSTRACT FROM AUTHOR]

Introduction: Recently, treatment of children with severe-to-profound sensorineural hearing loss (SNHL) has been influenced by diagnostic improvements and technological treatment advances, specifically new cochlear implant prospects. Multiple handicaps children and children with syndromes and conditions resulting disabilities, such as dual sensory loss, cerebral palsy, somatic abnormalities, and autistic spectrum disorder, are now not routinely precluded from receiving a cochlear implant. The primary aim of this study was to determine the effects of dysmorphic feature on cochlear implant outcome. Materials and Methods: In this cohort study, we evaluated 336 cochlear implanted children from 2007 to 2009. The case group consists of 53 patients (15/7%) with dysmorphic features and control group consisted at 53 patients with normal features and without behavioral and developmental disorders. All patients received auditory and speech rehabilitation and we evaluated their speech and auditory outcome. One year after cochlear implantation, the patient was assessed by categories of auditory perception (CAP) and speech intelligibility rating (SIR) tests. Results: We included 106 out of 336 cochlear implanted children, with the mean age of 30.42 ± 12.16 (maximum 48 months), 52 cases (49.1%) were girls and 54 (50.9%) were boys. There was a significant difference in SIR between case and control groups (3.26 ± 0.98) versus (4.06 ± 0.94) (P < 0.001), and a significant difference in CAP (4.09 ± 1.26) versus (5.43 ± 1.23) as well (P < 0.001). Conclusion: In this study, the prevalence of dysmorphic feature in children with severe-to-profound SNHL is 15.7%. One year after cochlear implant SIR and categories of auditory perception in these patients are significantly lower than children without dysmorphic feature, but cochlear implant will help these children. [ABSTRACT FROM AUTHOR]

One of the rare complications of brucellosis is neurobrucellosis. There have been numerous reports showing clinical forms of brucellosis affecting CNS, such as cranial nerve involvement, myelitis, vascular disease, radiculoneuritis, meningitis, meningoencephalitis, and demyelinating disease. In this case report, we introduce a 2.5 yr old girl with unilateral abducens nerve palsy referred to Baghiyatallah Hospital Outpatient Clinic, Tehran, Iran in June 2015. [ABSTRACT FROM AUTHOR]

Background: Approximately 60% of term and 80% of premature infants are hospitalized for hyperbilirubinemia in the first week of life. Hyperbilirubinemia is the most common cause of infant hospitalization and readmission. Due to the high frequency of hyperbilirubinemia in infants and the high costs of treatment, it is necessary to find a way to decrease hospitalization duration. Objectives: The aim of this study is to assess the adjunctive effect of probiotics on decreasing hospitalization time for infants with hyperbilirubinemia. Methods: In this randomized, controlled clinical trial, 92 term infants with hyperbilirubinemia who met the inclusion criteria were randomly assigned to either the probiotic or control group. Patients in both groups underwent common phototherapy. Once a day, those in the probiotic group were also given half of a capsule of Prokid probiotic, while those in the control group received half of a placebo capsule. The duration of phototherapy and hospitalization, the blood groups of mothers and infants, and each patient’s bilirubin levels before and after phototherapy, direct Coombs test results, and levels of hemoglobin, G6PD, and reticulocytes were recorded. Results: Data from 92 patients with a mean age of 5.25 ± 2.35 days underwent analysis. The control group had 47 (51.1%) patients with a mean age of 5.19 ±2 .51 days and the probiotic group had 45 (48.9%) patients with a mean age of 5.31 ± 2.19 days (P = 0.81). The 92 patients had a mean bilirubin level of 16.70 ± 3.07 mg/dL, with a mean of 16.42 ± 3.53 mg/dL in the control group and 17.00 ± 2.49 mg/dL in the probiotic group (P = 0.37). The duration of hospitalization averaged 3.34 ± 0.70 days overall, with an average of 3.55 ± 0.74 days for the control group and 3.13 ± 0.70 days for the probiotic group. The probiotic group had a significantly lower hospitalization stay in comparison to the control group (P = 0.004). Conclusions: Our findings suggest that probiotics may be beneficial as an adjunct treatment for infants with hyperbilirubinemia by reducing the duration of hospitalization. [ABSTRACT FROM AUTHOR]

Background: Hypoglycemia is one of the most common neonatal disorders, associated with severe complications. There has been a great deal of controversy regarding the definition and screening of hypoglycemia. Therefore, in this study, we aimed to determine a cut-off value for blood glucose level in glucometer readings. Methods: This cross-sectional study was conducted on 238 newborns at risk of hypoglycemia, admitted to Baqiyatallah Hospital of Tehran, Iran in 2012; the subjects were selected via simple sampling. After obtaining informed consents from the newborns' parents, 1 cc blood samples were sent to the laboratory for measuring the blood glucose level. Moreover, venous blood samples, as well as heel-stick blood samples, were obtained for glucometer measurements. Blood glucose measurements were used to determine the cut-off value by the receiver operating characteristic (ROC) curve and make comparisons with the diagnostic criteria for hypoglycemia in the literature. Results: A total of 238 infants with the mean weight of 2869±821.9 g were enrolled in this study. The mean (±SD) blood glucose levels were 65.1±22.9, 82.9±24.7, and 84.4±24.8 mg/dl, based on the standard laboratory method, glucometer reading of venous blood samples, and glucometer reading of heel-stick capillary blood samples, respectively. The optimal cut-off point for hypoglycemia was determined as 65 mg/dl, using glucometer-based assessment of heel-stick blood samples. Conclusion: The significant difference in blood glucose levels measured by the laboratory method and outpatient glucometer readings highlights the importance of a cut-off value for rapid assessment and control of blood glucose and timely detection of hypoglycemia. In fact, the cut-off value introduced in the present study could facilitate such measurements. [ABSTRACT FROM AUTHOR]

Background: Iran has extended borders with high-TB burden countries (Afghanistan and Pakistan) and immigrations of these populations influences TB distribution in the region and threatens the control strategies. The aim of this study was to evaluate the extent of recent TB transmission among Iranian and Afghan cases. Materials and Methods: Spoligotyping and 15-locus variable number tandem repeat (VNTR) typing were applied to genotype 102 MTB isolates (2009 to 2010). Phylogenetic relationships were analysed by two methods: a cluster-graph method and a minimum spanning tree (MST) method. Furthermore, evaluation of recent TB transmission was assessed with three indices including, RT In, RTIn-1 and TMI. Results: Using molecular typing, 35 different spoligotypes were detected among the studied isolates. Seventy seven cases (75.4%) were distributed into 10 clusters and the remaining 25 (24.5%) isolates had a unique pattern. The cluster sizes also ranged from 2 to 21 isolates. The most frequent spoligotype in our populations belong to Haarlem (n=30, 29.4%) followed by CAS (n= 29, 28.4%) and Beijing (n=16, 15.6%) lineages. The used indices give the following values: RT In = 0.75, RTIn-1 = 0.65 and TMI = 0.24. Conclusion: The low rate of TB transmission in our findings (24%) showed that the mode of TB transmission in Iran is mostly associated with reactivation of a previous TB infection and that recently a transmitted disease has a minor role. However, the increasing incidence of the intra-community transmission in recent years highlights the need for establishing new strategies for control of TB. [ABSTRACT FROM AUTHOR]

Background: Toxoplasma gondii, is a mandatory intracellular protozoa, that many people worldwide are infected with. In children, the infection enters central nervous system and leads to inflammation of the gray matter. Autism, is a complex developmental disorder, altering social communication, with unknown origin. Neuropathological changes in autism are the same as those occurred in brain toxoplasmosis. The objective of this survey was to evaluate positive serology of toxoplasma gondii, in autistic children. Methods: This case-control study was done on 3-12 years old children, referring to the neurology and psychiatry sub-special clinics of Baqiyatallah hospital and also autistic children of Omid-e Asr and Navid-e Asr general rehabilitation centers in Tehran, Iran. 40 autistic children were placed in the case group and 40 children, suffering from no neuropsychiatric disease or other ones, were placed in the control group. A folder, containing demographic data, type of the disorder, onset of diagnosis and child characteristics at birth, such as time of birth (preterm/ term) fulfilled for each child. Sampling was done with 5 ml blood, for determining IgM and IgG antibody levels against toxoplasma gondii, using ELISA method. Data analyzed by the software SPSS ver. 17 and descriptive and analytic analysis were done, using central and dispersion indexes and also chi-Square test. Results: The autistic group contained 34 boys and 6 girls (85 and 15 percent respectively), with the average age of 6 (±2.71) years old [minimum of 2.33 and maximum of 12]. The average age at the time of diagnosis was 4.01 (±1.87) years old. 87. The non-autistic group contained 17 boys and 23 girls (42.5 and 57.5 percent respectively), with the average age of 5.67 (±3.09) years old [minimum of two and maximum of 12]. IgM and IgG serology of all autistic children were negative, while in non-autistic group, 2.5 percent (1 child) were positive and 97.5 percent (39 ones) were negative. There were no statistically significant difference among these two groups according to the serology results. (P=0.31). Conclusion: There was no statistically significant difference in comparing positive serology of toxoplasmosis, between the two groups. However, to obtain a perfect result, a larger sample size are required. [ABSTRACT FROM AUTHOR]

Background: Congenital hypothyroidism (CHT) is one of the most common congenital endocrinal disorders. The prevalence of CHT is estimated about 1 in 3,000 newborns. The prevalence, etiology and associated disorders of abnormal thyroid screening tests are reported in different ranges. In this study, we assessed the pre-term newborns for CHT and associated factors that influence thyroid function. Methods: One hundred newborns with the gestational age fewer than 35 weeks were investigated. Baseline serum thyroid stimulating hormone (TSH) and free thyroxin (FT4) levels were measured during the first 5 days of life and were repeated during the first 5 weeks. We analyzed the effects of demographic factors and the presence of respiratory distress syndrome on the alteration of thyroid function tests during the first 5 weeks of life. Results: The mean gestational age (GA) at delivery was 32.35±1.97 (range 28 to 35) weeks. CHT was observed in 13(13%) preterm infants. GA was the only factor which affect the FT4 changes over the two weeks follow-up (P < 0.001, b: -2.783, Power: 70.2%) although the differences between baseline and followup amount of TSH were not significantly influenced by GA (P = 0.062, power: 46%). However, the adjusted TSH and FT4 serum level changes during follow-up were significantly different between two groups (between CHT and normal, P = 0.006, 0.000, respectively). Conclusions: It seems that thyroid function tests should be repeated in preterm infants, especially for patients with lower gestational age, to confirm the diagnosis of CHT. Also, CHT should be considered among the newborns that are affected by RDS. [ABSTRACT FROM AUTHOR]

Background: Hearing impairment (HI) is one of the most common congenital disorders in neonates and is considered as a severe and obscure handicap. The best early diagnostic method for HI in newborns is universal newborn hearing screening (UNHS). This method has been implemented since a few years ago in Iran. In this study, we introduced the findings of hearing screening in a hospital in Tehran (Iran). Methods: This cross-sectional study was conducted on all newborns (n = 3818) in Najmieh Hospital (Tehran, Iran) during 2006-07. Newborns were screened using the Transient-Evoked Otoacoustic Emission (TEOAE) test at the first 48 hours after birth. The results were documented as "pass" (desirable) or "refer" (undesirable). Neonates with undesirable results were re-screened during the next 2-4 weeks. If the responses in both sessions (test and retest) were not desirable, the infants were referred for a final diagnosis with Auditory Brainstem Response (ABR) test before three months of age. They were then referred to an otolaryngologist for more evaluations. Findings: From 3818 neonates screened, 90% had a pass response and 10% were referred for retest at 2-4 months of age. Of those who were referred, only 11 (3.6%) infants had an undesirable response again. Among these, nine infants referred for ABR and only 3 subjects showed sensory-neural hearing loss as the final diagnosis. One of them did not have any risk factors of HI. Conclusion: In order to minimize false negative and positive results, suspected cases are suggested to be reevaluated during the 2nd to 4th weeks after birth. In addition, high risk infants should be tested by ABR. Since one third of the children with HI in this study did not have any risk factors for HI, we recommend careful hearing screening for all neonates even those without any risk factors. [ABSTRACT FROM AUTHOR]

Epilepsy is an important disease with a cumulative incidence of 3% all over the life and more than half of them are started from childhood. In this study we surveyed magnetic resonance imaging (MRI) findings in epileptic children and its relation with clinical and demographic findings in order to find better diagnostic and treatment modalities for these children in the future. In this cross sectional study, we investigated consecutively all 1 to 15-year-old epileptic children who referred to the pediatric neurology outpatient clinic from 2004 to 2010. Two hundred children were enrolled for investigation. There were 85 (42.5%) girls and 115 (57.7%) boys, aged 1 to 15-year-old (7.7±4). 196 (98%) of the children had abnormal electroencephalography (EEG). Abnormal MRI was seen in 57 (28.5%) patients and consisted of brain atrophy (10%), increasing white matter signal intensity in T2-weighted images (8%), benign cysts (5%), brain tumors (4%) and vascular abnormalities (1.5%). Abnormal MRI findings had significant relation with abnormal EEG, age, positive family history for epilepsy, dysmorphic appearance, and abnormal physical exam. Considering 98% EEG abnormalities in these epileptic children, benign nature of MRI findings in most of our cases, the high price of MRI and the small minority of patients who benefit from active intervention as a result of MRI, we suggest to use EEG for confirmation of epilepsy and perform MRI for patient with abnormal physical exams, focal neurologic deficits or focal EEG abnormalities. [ABSTRACT FROM AUTHOR]

Background: Bovine tuberculosis is a chronic bacterial disease of cattle that occasionally affects human. A unique mutation at position 169 (C→G) in Mycobacterium bovis differentiates it from Mycobacterium tuberculosis. For the first time, PCR-RFLP method was used in this study to separate the two organisms. Methods: In this study, 98 tuberculosis patients were assessed using microscopic evaluations, culture and antibiogram. Then, nucleotide changes in position 169 were investigated using Allele-specific PCR and PCR-RFLP methods. Finally, the results were compared with spoligotyping results . Findings: Antibiogram revealed 28 subjects (28.57%) to be resistant and 54 (55.1%) to be sensitive to pyrazinamide while and 16 cases (16.23%) showed no growth. Of 28 resistant patients, 3 (3.1%) were diagnosed with M. Bovis using the classical methods. Using molecular methods, 95 (96.93%) out of 98 subjects were diagnosed with M. tuberculosis and 3 (3.06%) with M. bovis. Allele-specific PCR and PCR-RFLP matched with spoligotyping results. Conclusion: Our result showed the incidence of M. bovis infection to be higher in Iranian population (3.1%) than other studied cases (0.5-1%). In addition, we showed that Allele-specific PCR is the method of choice because it is faster and cheaper than PCR-RFLP. However, PCR-RFLP could be a proper alternative to prevent probable mismatches in Allele-specific PCR. [ABSTRACT FROM AUTHOR]

In this study, we investigated the changes of the serum levels of thyroid hormones including Thyroxine (T4), Triiodothyronine (T3), T3 resin uptake and Thyroid stimulating hormone (TSH) in epileptic children during treatment with anti-epileptic drugs (AEDs) including carbamazepine (CBZ), primidone (PRM), phenobarbital and valproic acid (VPA). Materials and Methods This study consisted of four case-series comparisons, was conducted on 115 epileptic children (37 girls and 78 boys with an age range between 2 months and 15 years, mean: 62.06 ± 44.97 months). These children were divided into 4 groups who took either phenobarbital (n=29), PRM (n=28), CBZ (n=29), or VPA (n=29) for 3 months. Thyroid hormone levels (T3, T3 resin uptake, T4 and TSH) were measured at the beginning and three months after starting the study. Results At first, all patients were euthyroid and there were no clinical or laboratory findings suggestive of hypothyroidism. Regarding thyroid hormones before and after the administration of phenobarbital, carbamazepine, valproic acid and primidone, there were no significant changes in serum T3, T4, T3 resin uptake and TSH levels. Conclusion Our findings showed that short term therapy with phenobarbital, carbamazepine, valproic acid and primidone had no effect on thyroid function tests. [ABSTRACT FROM AUTHOR]

Objective Febrile seizure is the most common convulsive disorder in childhood. The role of iron in metabolism of neurotransmitters and carrying oxygen to the brain suggests the possibility of a relationship between iron deficiency anemia and febrile seizures. The aim of this study was to investigate the relationship between iron deficiency anemia and febrile seizures. Materials & Methods This case - control study was performed on 132 cases and 88 controls, aged 9 months to 5 years, from July 2007 to June 2009 in Baqyiatallah Hospital. Patients were selected using simple random sampling. The case group included children with first febrile seizure (core temperature over 38.5°C during seizure) without a central nervous system infection or an acute brain insult. The control group included children suffering from a febrile illness without seizure. Iron deficiency anemia was defined with one of these laboratory indexes: 1) Hemoglobin (Hb) <10.5mg/dl 2) Plasma ferritin <12ng/dl 3) Mean corpuscular volume (MCV) <70 fl. The data collected from patients were analyzed with SPSS.13 software. Results Low plasma ferritin was found in 35 cases (26.5%) compared to 26 controls (29.5%), low Hb level was found in 4 cases (3%) compared to 6 controls (6.8%) and low MCV was found in 5 cases (3.8%) compared to 6 controls (6.8%). There was no significant difference in plasma ferritin , Hb level and MCV indices between the two group. Conclusion Considering the above-mentioned results, there is no relationship between iron deficiency anemia and febrile seizures. [ABSTRACT FROM AUTHOR]

Sleep problems are common in childhood, but there are limited studies regarding that in Iranian children and awareness of the sleep problems and their complication in Iranian parents. We arranged this study in which parents of children attending for a sick visit or routine growth control to assess whether sleep problems are under-reported at general pediatric visits. In a cross - a sectional study from April 2010 to April 2011 in 301 children aged 2-14 years old attending to pediatric clinics were enrolled. To investigate the general orientation of parents about their child sleep problem we asked them a global question at first regarding sleep of their child. After that, the Persian version of BEARS questionnaire was completed by them. Only 30 (9.9%) parents reported sleep problems in their children in response to primary global question but by collecting the data from BEARS questionnaire it was revealed 45.18% (136/301) of children had one or more of sleep disorders at all. As mentioned 136 (45.18%) children had slept problems of which the most frequent complaint (15.28%) was related to bedtime problems. The second complaint (11.96%) was awakening during the night children. A significant association between sleep problems and child gender was not found. Co-sleeping with parents was found in 55.48% of all children in this study. Despite the high prevalence and adverse effects of sleep disorders, the present study suggests that parents underreport sleep problems at consultation. We suggest children should be assessed for sleep disorders in monitoring and health screening visits. [ABSTRACT FROM AUTHOR]