Acta medica Iranica
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Acta medica Iranica · Aug 2015
Restorative Effect of Vitamin D Deficiency on Knee Pain and Quadriceps Muscle Strength in Knee Osteoarthritis.
Both vitamin D deficiency and quadriceps muscle weakness are associated with knee osteoarthritis (KOA) and pain. The aim of this study was to determine the restorative effect of vitamin D deficiency on pain and quadriceps muscle strength in knee osteoarthritis. Patients with KOA aged ≥30 years, the presence of knee pain for at least one month or longer and serum 25-hydroxyvitamin (25-OHD) deficiencies were recruited in the study. ⋯ Serum 25-OHD reached to sufficient levels in all except one patient. At the end of the study period, serum 25-OHD and quadriceps muscle strength increased significantly as compared with baseline (P=0.007 and P=0.002, respectively), whereas knee pain decreased significantly based on Western Ontario and McMaster University Osteoarthritis index (P=0.001)as well as visual analogue scale scores (P=0.001). These findings indicated that correction of vitamin D deficiency in patients with KOA exerts a significant favorable effect on quadriceps muscle strength and knee pain.
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Acta medica Iranica · Jul 2015
Diagnostic value of IL-6, CRP, WBC, and absolute neutrophil count to predict serious bacterial infection in febrile infants.
Since clinical manifestations of most febrile infants younger than three months old are nonspecific, differentiation of Serious Bacterial Infection (SBI) from self-limiting viral illness is a significant challenge for pediatricians. This study was performed to assess the diagnostic value of white blood cell count (WBC), Absolute Neutrophil Count (ANC), Interleukin -6 (IL-6) and C-reactive protein (CRP) level to predict SBI in febrile infants younger than three months old who were hospitalized. This was a diagnostic test validation study. ⋯ IL-6 and CRP are more valid and better diagnostic markers for predicting SBI than WBC count and ANC. CRP level seems to be an accessible and cost-effective marker for early diagnosis of SBI. Since by no marker we can totally rule out SBI in febrile infants < three months of age, it is recommended to administer systemic antibiotics until culture results become available.
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Acta medica Iranica · Jan 2015
Randomized Controlled Trial Comparative StudyA comparison to facilitate insertion of the laryngeal mask: term of recovery and postoperative nausea and vomiting after anesthesia with propofol- atracurium and thiopental-atracurium.
Laryngeal mask is a supraglothic instrument for ventilation of patients who are under anesthesia. Insertion of laryngeal mask requires maintaining sufficient depth of anesthesia to avoid airway reflex (gagging, coughing and spasms). The present study investigated two techniques of anesthesia with propofol-atracurium and thiopental-atracurium to facilitate insertion of the laryngeal mask, term of recovery and postoperative nausea and vomiting. ⋯ Results indicated that anesthetic technique with propofol-atracurium provides better and more comfortable condition for insertion of laryngeal mask significantly (P<0.05). Hemodynamic changes during induction of anesthesia and five minutes after insertion of the laryngeal mask in first group was more than second one (P<0.05), and nausea and vomiting during recovery in propofol group was significantly lower than thiopental group (P<0.05). Using techniques of anesthesia with propofol - atracurium in inserting laryngeal mask airway in patients who have an indication for the use of this technique is better than anesthesia with thiopental -atracurium.
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Acta medica Iranica · Jan 2015
Randomized Controlled Trial Comparative StudyComparison of glyburide and insulin in women with gestational diabetes mellitus and associated perinatal outcome: a randomized clinical trial.
Insulin is currently the drug of choice in treating patients with gestational diabetes mellitus but insulin is expensive, inconvenient to store and use and probably associated with more risks of asymptomatic hypoglycemia in comparison with some oral agents. This randomized clinical trial was conducted to evaluate the efficacy and safety of glyburide in patients with gestational diabetes mellitus in comparison with insulin therapy. Pregnant women aged between 18-45 years with singleton pregnancies and in their 24-36 weeks of gestation were assessed for eligibility. ⋯ There was no statistically significant difference between the times of treatment-to-delivery in two studied groups. There were no statistically significant differences between maternal and neonatal outcomes in two studied groups. Glyburide can effectively and safely control the glycemic index in women with gestational diabetes mellitus in comparison with insulin.
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Acta medica Iranica · Jan 2015
Comparative StudyAcute Respiratory Distress Syndrome diagnosis after coronary artery bypass: comparison between diagnostic criteria and clinical picture.
Acute Respiratory Distress Syndrome (ARDS) is a potential complication of cardiac surgery, given that patients undergoing CABG frequently have hypoxemia and pulmonary dysfunction during initial hours after surgery. Thus, ARDS criteria in these patients are more likely to be positive while these criteria may not match the patient`s clinical picture. We aimed to investigate frequency of rapid onset hypoxemia in Pressure of Arterial Oxygen to Fractional Inspired Oxygen Concentration (PaO2/FiO2) less than 200 and diffuse pulmonary infiltrates as two diagnostic criteria forwards and compared these criteria with the clinical picture of the patients after Coronary Artery Bypass Graft (CABG) in this study. ⋯ Duration of intubation in patients with ARDS (14.26 ± 4.25 hours) in the first 48 hours was higher but not statistically different from the group without ARDS (11.60 ± 5.45 hours) (P.value=0.236). ARDS diagnosis based on rapid onset of hypoxemia (PaO2/FiO2≤200 mmHg) and diffuse pulmonary infiltrates and without signs or symptoms of obvious heart failure criteria in patients undergoing CABG could lead to overdiagnosis or misdiagnosis in less than 24 hours follow up. We recommend following patients for more than 24 hours and revise the current ARDS criteria for CABG patients.