فهرست مطالب parisa khoshnevis asl

The aim of asthma treatment is to reduce airway inflammation by avoiding environmental triggers and using daily anti-inflammatory medications. This study aimed to compare the effects of fluticasone propionate (FP) and budesonide (Bud) on the clinical symptoms and control of asthma in children with moderate to severe asthma. In this open-label study, children with moderate to severe asthma were randomly selected to receive either FP 250 mcg or Bud 400 mcg for 3 months. Asthma control test scores were measured in both groups monthly. The clinical symptoms, drug adherence, and rescue medication were also evaluated. A total of 50 patients with ages between 4 and 7 years old were included in the study (25 cases received Bud and 25 cases received FP). Asthma control test scores, daily and nocturnal symptoms, and cough rates were significantly improved in both groups. The average asthma control scores for the fluticasone group were 21.68±3.32 in the second month and 24.84±2.67 in the third month, whereas the budesonide group had scores of 18.52±3.32 and 22.48±4.12 during the same periods. These variances were statistically significant. Additionally, the requirement for salbutamol use was notably reduced in the fluticasone group compared to the budesonide group throughout all three months. The efficacy of fluticasone propionate in decreasing the need for rescue medication and enhancing asthma control test scores was markedly superior to that of budesonide.

 Febrile seizures are one of the most common neurological disorders in children. The aim of this study was to investigate the extent of abnormal EEG reports and its association with other risk factors of febrile seizures.

 In this prospective observational study, all patients with febrile seizure admitted into Mousavi Hospital in Zanjan, Iran, from April 2015 to March 2016 were enrolled. EEG was carried out for all patients and the clinical data were recorded in the prepared questionnaire .The statistical analysis was performed by using spss.16 software.

 One hundred seventy patients, 92 (54.1%) male and 78 (45.9%) female with the mean age of 28.57 months were evaluated. The EEG reports were normal in140 (82.4%) cases and 30 (17.6%) cases had abnormal reports including 8 cases(26.6%) of spike & sharp electric discharge, 2 cases (6.6%)of slow activity and 20 cases(66.6%) of nonspecific changes. EEG abnormalities were significantly related with male sex (P = 0.020), history of previous febrile convulsion (p< 0.001), positive family history of epilepsy and febrile seizures (p< 0.001) and complex type of febrile convulsion (p< 0.001). Longer duration of seizure (p< 0.001) and older age of patients (p< 0.033) had significant relation with abnormal EEG.

 Although EEG is not routinely performed in all patients with febrile seizure, it is recommended for male gender, age over 3 years, complex febrile seizure, previous history of seizure and family history of epilepsy or febrile seizures.

Leukemia is the most common malignancy in childhood. It accounts for about one third of children's malignancy. The most common is acute lymphoblastic leukemia (ALL), which is characterized by a majority of immature lymphatic precursors in the blood and bone marrow.

In this descriptive cross-sectional study, all patients under 16 years of age who were admitted to the pediatric ward of Ayatollah Mousavi Hospital in Zanjan between 2008 and 2017 with leukemia were included in the study. Data was obtained from patients' records and analyzed using SPSS software.

Fifty three patients less than 16 years of age were enrolled in this study. Forty six patients (86.8%) had ALL and 7 patients (13.2%) had AML. Twenty nine patients (54.7%) were male and 24 patients (45.3%) were female (45.3%). There was no significant difference in types of leukemia between girls and boys (P = 0.890). Thirty two (%60/3) of patients were under 5 years of age. In children 1-5 years old, Forty eight patients (90.6%) had ALL and 5 patients (4.9%) had AML. There was no significant difference between types of leukemia based on age groups (P = 0.076)
 

The most common type of leukemia in children is ALL, with the most prevalence in boys and younger than 5 years old children.

This study aims to evaluate the effect of symbiotic (Pedilact) on the treatment of infantile colic.

In this randomized clinical trial in Zanjan, Iran, 76 infants with infantile colic were assigned to two groups of 38 cases using block randomization. The intervention group received 5 drops of Pedilact, a symbiotic containing Lactobacillus reuteri and simethicone (20 mg twice daily), and the control group received placebo in addition to simethicone for 4 weeks. Daily crying time, number of crying attacks per day, and sleep duration were recorded on days 1, 7, 14, 21, and 28, and the results were compared.

Thirty?three infants in the intervention group and 35 infants in the control group were enrolled. There was no significant difference between the two groups in terms of age, gender, gestational age, maternal age, type of delivery, type of feeding, and weight at the beginning and the end of the study (all P > 0.05). Daily crying time in the control and intervention groups decreased from 240 and 210 min/day, respectively, to 0 min/day in both the groups. Daily crying attacks decreased from 5 and 4/ day in the control and intervention groups, respectively, to 0/day. Sleep duration in both the groups increased from 720 to 840 and 930 min/day in the control and intervention groups, respectively, but the changes were not significant (P = 0.56, P = 0.52, and P = 0.13, respectively).

We did not find a significant improvement in colic symptoms in infants receiving symbiotic compared to placebo.

Since the outbreak of COVID-19, global concern emerged inspiring scientists to dedicate more attention to this pandemic. The disease caused by a novel coronavirus requires urgent striking action to probe the disease phases and find a proper cure. In this regard, the necessity of brief and thorough explanations comes into view. In this study, we gathered useful information about the virology, pathogenesis, epidemiology, manifestations, diagnosis, and treatment with special consideration of pediatric patients. This review article helps medical caregivers to receive a quick and effective approach to deal with this disease in their practice.

Clinical reasoning as a critical and high level of clinical competency should be acquired during medical education, and medical educators should attempt to assess this ability in medical students. Nowadays, there are several ways to evaluate medical students’ clinical reasoning ability in different countries worldwide. There are some well-known clinical reasoning tests such as Key Feature (KF), Clinical Reasoning Problem (CRP), Script Concordance Test (SCT), and Comprehensive Integrative Puzzle (CIP). Each of these tests has its advantages and disadvantages. In this study, we evaluated the reliability of combination of clinical reasoning tests SCT, KF, CIP, and CRP in one national exam and the correlation between the subtest scores of these tests together with the total score of the exam.

A total of 339 high ranked medical students from 60 medical schools in Iran participated in a national exam named “Medical Olympiad”. The ninth Medical Olympiad was held in Shahid Beheshti University of Medical Sciences, Tehran, Iran, under the direct supervision of the Ministry of Health and Medical Education in summer 2017. The expert group designed a combination of four types of clinical reasoning tests to assess both analytical and non-analytical clinical reasoning. Mean scores of SCT, CRP, KF, and CIP were measured using descriptive statistics. Reliability was calculated for each test and the combination of tests using Cronbach’s alpha. Spearman’s correlation coefficient was used to evaluate the correlation between the score of each subtest and the total score. SPSS version 21 was used for data analysis and the level of significance was considered <0.05.

The reliability of the combination of tests was 0.815. The reliability of KF was 0.81 and 0.76, 0.80, and 0.92 for SCT, CRP, and CIP, respectively. The mean total score was 169.921±41.54 from 240. All correlations between each clinical reasoning test and total score were significant (P<0.001). The highest correlation (0.887) was seen between CIP score and total score.

The study showed that combining different clinical reasoning tests can be a reliable way of measuring this ability.