The prevalence of self-medication of antibiotics has been revealed in various studies. The main aim of this work is to investigate the frequency of self-medication in children under 6 years and the ...factors affecting it.
This is a population-based cross-sectional study conducted in the Arak metropolitan in the center of Iran from January 2019 to January 2020. We used stratified random sampling to determine recruitment criteria. As 1754 households were invited to the study that 1483 were approved to participate. Children's data were obtained by the interview with their mothers. In order to define self-medication consumption of antibiotics, it was adapted between annually maternal self-reported consumption of antibiotics among their children and history of received antibiotics registered in insurance services during the same time period. Logistic regression models were exploited to obtain odds ratios and 95% confidence intervals.
Mean age of mothers was 31.8 years (SD = 5.4), 52.1% of the children were boys. Annually self-medication of antibiotic consumption was estimated 61.6% (n = 914). Based on the logistic regression analysis, in the adjusted analysis, girls were associated with self-medication consumption of antibiotics lower than boys' children (p = 0.016). Older mothers were lower self-medication consumption of antibiotics than youngers (p = 0.001). Moreover, the permanent job of fathers was associated with lower self-medication consumption of antibiotics than temporarily and unemployment (p = .001). The odds of self-medication consumption of antibiotics were increasing with the increase in age of children (OR: 1.21, CI95%: 1.12, 1.31 and p = 0.001). The increase in parity has been a significant association with the self-medication consumption of antibiotics (OR: 1.64, CI95%: 1.38, 1.95and p = 0.001).
Results of this study show that some factors such as children's age, gender, mother's age, father's occupational status, and parity are the determinants that significantly impact the self-medication prevalence.
Gross total resection of skull base meningioma is so challenging due to its relevant high morbidity. Gamma knife radiosurgery is concerned by providing a favorable therapeutic option in the ...management of SBM. This study aims to evaluate the neurological outcome after GKRS as an adjuvant or primary treatment for SBM according to their locations.
This retrospective cross-sectional study consisted of 108 patients with SBM who underwent GKRS as an adjuvant or primary treatment. We found 40 patients with cavernous sinus meningioma (CSM), 36 patients with petroclival meningioma (PCM), and 22 patients with cerebellopontine angle meningioma (CPM). 81.1% of whom were female (n = 90) with a median age of 52.68 years. The mean tumor volume was 4.5 cm3 and the mean marginal dose was 13 Gy.
Tumor control was achieved in 96.4 % of patients at a median follow-up of 38.4 months. Over all 17 of 108 patients (15.6%) report improvement in their neurological symptoms. Patients with CPM demonstrated lower rates of neurological symptoms improvement compared to patients with PCM and CSM. Deterioration of neurological symptoms after GKRS developed in 11 patients (10.1%) which was more reported by patients with CSM than the others. The most improvement in cranial nerve deficit was in CN Ⅵ, Ⅴ, VIII among patients with CSM, PCM, and CPM respectively.
GKRS is acceptable as a primary or adjuvant treatment for SBM by providing an appreciable rate of improvement in neurological symptoms.
Background: One of the challenges in medicine has been the exaggerated use of antibiotics. The purpose of this study was to investigate the prevalence of antibiotic usage in children in Arak, Iran ...(2019-2020) to determine the factors related to antibiotic prescription and consumption in children. Methods: This was a population based, cross-sectional study conducted in Arak, the capital city of Markazi Province, Iran. Stratified random sampling was applied to recruit children who were up to five years old, and registered in the healthcare system between Jan. 2019 and Jan. 2020. A response rate of 85% was obtained from the subjects’ parents. Face-to-face interviews were used to collect the data from the children’s mothers. Univariate and adjusted linear regression analyses were applied to assess the determinants of antibiotic consumption in these children. Results: A total of 1483 children were enrolled in the study; most of them were boys with the mean age of 2.1±1.5 years old. The annual prevalence of antibiotic consumption in Arak was found to be 62.4% for at least one antibiotic. The most consumed antibiotic was azithromycin (24.2%). Among antibiotic groups, the most consumed group was macrolides (26.9%). Upon multiple logistic regression analyses, a lower consumption rate was observed among the younger children with older mothers, and children whose fathers had permanent jobs than other children groups. A higher consumption rate was observed among families with higher parity. Conclusion: The annual prevalence of antibiotic consumption in this study was very high, with the most consumed drug being azithromycin. We recommend that the use of antibiotics be reconsidered by drawing future healthcare policies, aiming at reducing the heavy antibiotics consumption in children.
Bacterial meningoencephalitis is a serious infection affecting the brain and its surrounding membranes. While imaging studies play a crucial role in diagnosing this condition, the typical ...radiological findings are well-documented. However, this case report describes an unusual imaging presentation that deviates from the expected patterns, emphasizing the need for awareness of such variations.
A 7-year-old female with no prior medical history was referred to our hospital with fever, seizure, and loss of Consciousness. She had mild flu a week before admission. The duration of seizure episodes were 2-3 min, with tonic-clonic uncontrollable jerky movements. Brudzinski and Kernig signs were positive and plantar reflex was upward bilaterally in the physical examination. The computed tomography (CT) scan showed brain ventriculomegaly/hydrocephalus, and MRI findings indicated multiple foci located at cerebellum, basal ganglia, and thalamus alongside intensely restricted diffusion of the layering debris, suggesting pyogenic ventriculitis. Cerebrospinal fluid (CSF) analysis showed severe hypoglycorrhachia, despite non-significant increase of protein. The patient was undergone antibiotic therapy with ceftriaxone, vancomycin and rifampin, resulting in normalization of CSF values.
This case report highlights the importance of recognizing and interpreting unusual imaging presentations of bacterial meningoencephalitis in paediatric patients. It emphasizes the need for a comprehensive diagnostic approach, including clinical evaluation, laboratory tests, and imaging studies, to ensure accurate diagnosis and appropriate management of this potentially life-threatening condition. Further research and awareness of atypical imaging findings are warranted to enhance our understanding and improve patient outcomes.
Sleeve gastrectomy (SG) is a popular surgery for morbid obesity because of minimal complications, while somewhere uncommon micronutrient deficiencies occur that make problems. One of these rare ...complications is dry beriberi (BB).
A 20-year-old girl with obesity that a few months after SG had non-specific symptoms like nausea, vomiting, debilitating weakness, burning, and tingling in her feet, which led to more tests and imaging and confused the physicians. During the next two months, she had a 40 kg weight loss. The critical test that helped diagnosis was Electromyography and Nerve Conduction Velocity (EMG/NCV), which showed subacute axonal sensory-motor polyneuropathy and decreased level of vitamin B1, proved the patient's diagnosis was dray BB.
SG may contribute to vitamin and trace elements deficiency development. One of the micronutrients that deficiencies can disturb the patient is vitamin B1 deficiency. Vitamin B1 deficiencies could be demonstrated with peripheral polyneuropathy, beriberi, or Wernicke-Korsakoff syndrome. Based on decreased vitamin B1 and EMG/NCV results, the diagnosis had been dry beriberi corrected with supplement therapy.
Thiamine deficiency should be suspected in all patients with vomiting, neurological symptoms, and rapid weight loss post-bariatric surgery (BS), even after restrictive surgery. Especially when a patient reports substantial weight loss and vomiting in short order. Hopefully, this case report will make any patient hospitalized with similar conditions evaluated for beriberi and again multivitamin supplementation therapy after SG is emphasized.
•Rapid weight loss after sleeve gastrectomy may cause thiamine deficiency.•Restrictive surgeries like sleeve gastrectomy may induce thiamine deficiency.•Multi vitamin supplementation therapy after sleeve gastrectomy is mandatory.
Background Children show milder symptoms of COVID-19 with lower mortality rates. The manifestation of COVID-19 in the pediatric population is an understudied topic. Our aim was to investigate the ...clinical and para-clinical manifestations of SARS-CoV-2 in children in the Central province of Iran. Materials and Methods We investigated the clinical and para-clinical manifestations of children referred to all hospitals in the Central Province of Iran from March 2019 to June 2020. Results We surveyed 96 pediatric patients hospitalized in hospitals in the Central Province of Iran. The average age of the patients was 110 months. 53% of patients (51 people) were male. The analysis did not show a significant relationship between the laboratory results and the gender of the patients. Conclusion Male and female pediatric patients had the same condition in terms of clinical manifestations, laboratory results and antibiotic use.
BACKGROUND: Ectopic pregnancy (EP) is the leading cause of maternal death in the first trimester of pregnancy. There are many variables which can predispose EP. The aim of this study was to evaluate ...the possible association between individual’s response to given medical treatment and predicting factors of ectopic pregnancy among pregnant women. METHODS: In this cross-sectional study, 277 patients with ectopic pregnancy who were admitted to obstetrics and gynecology ward of Besat hospital, Sanandaj, Iran, were evaluated. The necessary information was obtained from all women diagnosed with EP during 2008 to 2013. Patients who received any medication before study or those who could not use methotrexate (MTX) were excluded from study. RESULTS: In this study, 205 (74.1%) patients responded to the medical therapy. There was a significant association between successful response to the treatment and beta human chorionic gonadotropin (β-hCG) serum level less than 5000 mIU/ml, pregnancy sac size less than 4 cm and lack of fetal heart rate (FHR) in transvaginal sonography (TVS). CONCLUSION: In conclusion, it was found that β-hCG serum level, pregnancy sac size and presence of FHR play a key role in predicting the response to the medical treatment in women with ectopic pregnancy, and might be helpful in selecting appropriate therapeutic scheme.
BackgroundBacterial meningoencephalitis is a serious infection affecting the brain and its surrounding membranes. While imaging studies play a crucial role in diagnosing this condition, the typical ...radiological findings are well-documented. However, this case report describes an unusual imaging presentation that deviates from the expected patterns, emphasizing the need for awareness of such variations.Case presentationA 7-year-old female with no prior medical history was referred to our hospital with fever, seizure, and loss of Consciousness. She had mild flu a week before admission. The duration of seizure episodes were 2-3 min, with tonic-clonic uncontrollable jerky movements. Brudzinski and Kernig signs were positive and plantar reflex was upward bilaterally in the physical examination. The computed tomography (CT) scan showed brain ventriculomegaly/hydrocephalus, and MRI findings indicated multiple foci located at cerebellum, basal ganglia, and thalamus alongside intensely restricted diffusion of the layering debris, suggesting pyogenic ventriculitis. Cerebrospinal fluid (CSF) analysis showed severe hypoglycorrhachia, despite non-significant increase of protein. The patient was undergone antibiotic therapy with ceftriaxone, vancomycin and rifampin, resulting in normalization of CSF values.ConclusionThis case report highlights the importance of recognizing and interpreting unusual imaging presentations of bacterial meningoencephalitis in paediatric patients. It emphasizes the need for a comprehensive diagnostic approach, including clinical evaluation, laboratory tests, and imaging studies, to ensure accurate diagnosis and appropriate management of this potentially life-threatening condition. Further research and awareness of atypical imaging findings are warranted to enhance our understanding and improve patient outcomes.
