ali soleimany

Because of the higher frequency of dystocic labor in nulliparous pregnant women, a supplementary test is highly important for predicting the probability of the cesarean intervention. The aim of this study was to evaluate the correlation between the amniotic fluid lactate (AFL) level and the outcome of delivery in nulliparous term pregnant women referring with the complaint of the spontaneous rupture of membranes.

Nulliparous women with term pregnancies and single cephalic presentation, presenting with the spontaneous rupture of membranes and active phase of labor, were enrolled in this study. The AFL was evaluated by a portable device. In addition, the partogram curve, labor progression, and delivery method were recorded for each patient. Finally, the association between the need for cesarean delivery and the AFL level was investigated as well.

In general, 200 nulliparous pregnant women were enrolled in this study. The mean age of women and the mean AFL were 29.12±7.54 years and 7.32±3.63 mmol/L, respectively. Among 144 patients with AFL below 10.1 mmol/L, 33 patients (22.9%) had a cesarean delivery. Further, among 56 patients with AFL above 10.1 mmol/L, 42 patients (75%) had a cesarean delivery (P<0.001). Eventually, an AFL level higher than 10.1 mmol/L in predicting the cesarean section had a sensitivity of 85.6% and a specificity of 82.7%.

Amniotic lactate levels >10.1 mmol/L in nulliparous women with single-term pregnancy can be used as a marker for predicting cesarean delivery.

Death due to coronary artery disease (CAD) is twice higher in men than women, and older men are more susceptible to the disease. Serum testosterone levels decrease with increasing age.

In this study, we aim to study the association between serum testosterone levels and Gensini scores in men.

This cross-sectional study was conducted on 60 men above 40 years who had undergone coronary angiography. Thirty of them had normal coronary vessels, and 30 had coronary artery disease. For each group, the Gensini score was calculated.

Serum testosterone levels in the CAD group and the control group were 4.04 ± 2.56 and 5.59 ± 2.20 ng/mL, respectively (P < 0.05), and free testosterone levels in the CAD patients and the control groups were 7.32 ± 5.24 and 12.91 ± 3.27 pg/mL respectively (P < 0.001). Sex hormone binding globulin (SHBG) levels in the CAD and the control groups were 28.88 ± 15.30 and 38.2 ± 19.9 nmol/mL, respectively (P = 0.04). Univariate analysis showed a significant association between Gensini score and total and free testosterone levels. The receiver operating characteristic curve (ROC) showed that the cut-off point of 7.97 had a sensitivity of 73.3% and specificity of 90% in predicting a high Gensini score (AUC = 0.799, P < 0.001).

Findings of our study demonstrated that serum free testosterone levels have a significant correlation with Gensini score and CAD severity.

Clindamycin, IVIg, and corticosteroids are widely used in medicine. In this study, we represent an unusual case of sinus bradycardia following the administration of these drugs. The patient was a 31-year-old woman who presented a complaint of vaginal bleeding at Shahid Motahhari Hospital, Urmia, Iran. Vaginal examination revealed active bleeding. Laboratory tests reported a positive HCG level. Ultrasonography was performed, and the results showed the presence of retained products of conception. The patient became a candidate for curettage. The initial pulse rate was tachycardia. Laboratory data were reported, platelet count of 16000. corticosteroids and IVIgs were started. Due to the possibility of infectious abortion, Clindamycin and Gentamicin was started. About 24 hours after curettage and 4 hours after starting clindamycin, the patient felt dizziness. Vital signs were obtained that PR: 38-40. We concluded that clindamycin and IVIg can result in severe bradycardia, even in patients with no previous cardiac history, especially when combined with corticosteroids. As a result, we recommend physicians be more cautious when administrating these medications.

Chronic constipation is a common problem in children, which may last for years and cause unpleasant effects on the patients’ and their family’s lives. Timely treatment can reduce the costs and complications. Re-admissions not only have a negative impact on the quality of life of the patients and their family but also has an adverse economic impact on the health system. Therefore, this study was conducted to determine the frequency of constipation re-admissions and some related factors in Motahari Hospital of Urmia from 2013 to 2019.

In this descriptive-analytical study, 1045 cases of constipated children were investigated from the beginning of 2013 to the end of 2019. At first, a checklist containing demographic information and clinical characteristics of all children admitted with constipation was prepared and completed, and then data were analyzed using SPSS software version 23.

Out of 1045 children with constipation, 48% were male, and 52% were female with a mean age of 5/1±2/92 years. 73.4% were urban, and 26.6% were rural residents, and 14% of the children were admitted more than once during 6 years. There was a significant relationship between age, weight, height, parental education, and place of residence with re-admissions in children with chronic constipation (p<0.05).

The findings of this study showed that the cornerstone of re-admissions due to chronic constipation in children might be multifactorial and needs complete evaluation of social, behavioral and health status of children.

Klotho allele status is associated with increased risk of cardiovascular diseases, diabetes and hypertension.

To determine if serum klotho level was lower among diabetic and hypertensive patients compared to control group. Patients and

This was a cross-sectional study of 90 participants. Thirty pure diabetic patients and 30 participants with pure hypertension were compared with the healthy control group. Multiple logistic regressions were used to examine the association between serum klotho and diabetes and hypertension. We also tested the cut off point of serum klotho to predict hypertension and diabetes by using ROC (receiver operating characteristic) curve.

The level of serum klotho was significantly lower in diabetic and hypertensive patients. Participants with higher klotho were less likely to have diabetes and hypertension [OR: 0.48, 95% CI (0.22-0.81)] even after adjustment for covariates. ROC curve for diabetes and hypertension indicated 0.8 area under the curve which was statistically significant.

This study found that serum klotho was associated with lower odds of diabetes and hypertension. Further longitudinal studies are necessary to confirm this finding.

Serum Klotho is suggested to have protective effect against cardiovascular diseases. Nitric oxide production and preventing of oxidative stress have been suggested as its possible mechanisms of action. In this study we aimed to evaluate the association between serum Klotho level and cardiovascular diseases.

According to coronary angiography results, 40 patients with normal coronary artery and 40 patients with coronary artery disease included in this study. Serum Klotho level and laboratory data were analyzed for each patient and the association between serum Klotho level and coronary artery disease was evaluated.

Our results showed that Serum Klotho level in patients with 1 vessle, 2 vessle and 3 vessel disease was 2.16± 0.2, 2.2±0.13, 1.98±0.2 mIU/L respectively. (P value=0.02) The plasma Klotho concentration was significantly lower in patients with coronary artery disease.

Serum Klotho level can be a useful marker for evaluation of patients with coronary artery disease.

Coronary artery ectasia is known as the cause of chest pain and dyspnea. Because of its variable presentations according to the genetic and environmental differences, we studied patients with pure coronary artery ectasia in north-west of Iran.

Exclusion criteria were established ectasia in one or more coronary arteries without any significant coronary artery stenosis defined as stenosis > 70%. Coronary artery angiography and demographic data of patients were evaluated.

The mean age of patients according to the type of ectasia were 54.57±8.65 in type 1, 59.95±9.62 in type 2, 58.91±12.33 in type 3, and 57.46±10.74 in type 4. Type 3 ectasia was the most common type of ectasia (30.7%). Type 1 ectasia was more common in men and type 3 ectasia was more common in women (p=0.04). There wasn’t any significant association between the type of ectasia and the prevalence of dyspnea or chest pain. Coronary artery ectasia was frequently observed in the left anterior descending artery (LAD).

The prevalence of coronary ectasia according to its types is different between men and women. There was no association between the extent of ectasia according to Markis classification and the prevalence of dyspnea and chest pain.

CAE characterized as diffuse dilatation of epicardial coronary arteries has been shown to have association with risks of death and myocardial infarction. Neutrophil count and neutrophil to lymphocyte ratio (NLR) are cost effective, available and rapidly measureable inflammatory marker. In this study we decided to investigate the association between these factors as inflammatory markers and CAE severity.

In this cross sectional study 577 patients who underwent coronary angiography between September 2016 and September 2017 were evaluated. According to angiography findings patients were divided into four groups: 1-normal coronary artery, 2-coronary artery diseased group, 3-low risk coronary artery ectasia (CAE) and 4-high risk CAE.

In CAE group 61 patients (52.1%) had one vessel involvement and defined as low risk and 56 patients (47.9%) had two or more vessel involvement and grouped as high risk CAE. NLR was non-significantly higher in CAD group following high risk CAE group. (2.61±0.51 and 2.33±0.11 respectively) absolute neutrophil count was significantly higher in CAD and high risk CAE groups.

Neutrophil count is an inflammatory marker with good association with coronary artery ectasia and coronary artery disease.

Different investigations on seasonal variations of the pulmonary thromboembolism and deep vein thrombosis (DVT) incidence have not yielded a definite conclusion. Some papers showed significant increase in incidence of thromboembolism in winter; on the other hand, others neglected that correlation. Some articles have tried to show infrastructure of these variations. Better understanding of the cornerstone of these variations can result in prevention of disease and saving lives of susceptible people. In this narrative review article, we reviewed previous articles according to the region of study and tried to find the factors affecting diverse results among different studies.