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Breastfeeding Status and Effective Factors in 21 - 27 Months Iranian Infants  [PDF]
Fatemeh Nayeri, Mamak Shariat, Hosein Dalili, Farima Raji, Akram Karimi
Open Journal of Pediatrics (OJPed) , 2015, DOI: 10.4236/ojped.2015.52024
Abstract: The aim of this study was to assess the Breastfeeding status among children aged 21 - 27 moths. A cross sectional study was carried out in South Health Center (Tehran-Iran) in 2010. Four hundred 21 - 27 month breastfed infants entered the study. This study compared some variables in 2 groups; weaning before and after 22 months. The level of significance was considered P < 0.05. Mean breastfeeding duration and median (either exclusive or combined) were 19.66 ± 6.40 and 22 months. Among all reasons were cited by mothers, some reasons like insufficient breast milk supply (77.9%), infant restless (77.1%), and Mother’s reluctance (75.6%) were the most common causes of exclusive breastfeeding cessation. A significant relation was seen between breastfeeding duration and gestational age or birth trauma (P Value = 0.031, P Value = 0.04). Breastfeeding training and First mother-infant skin to skin contact had significant roles on breastfeeding duration (P Value < 0.05, P Value = 0.001, respectively). It seems lots of public health efforts and policy are needed to improve breastfeeding rate in our country.
Neonatal Urinary Tract Infection: Clinical Response to Empirical Therapy Versus In Vitro Susceptibility at Bahrami Children’s Hospital- Neonatal Ward: 2001-2010
Peymaneh Alizadeh Taheri,Behdad Navabi,Mamak Shariat
Acta Medica Iranica , 2012,
Abstract: Urinary tract infection (UTI) is a neonatal life threatening infection which is usually treated with ampicillin plus an aminoglycoside or a third-generation cephalosporin. Recently, growing number of Escherchia coli species resistant to ampicillin and aminoglycosides have raised concerns regarding the necessity to change the empirical therapy. This motivates us to determine neonatal UTI clinical response to the used empirical antibiotics. This study was designed as a Case Series. All neonates admitted to Bahrami Children Hospital, Tehran, Iran, during 2001- 2010 with a diagnosis of UTI surveyed by simple non-random sampling. Totally, 97 cases (including 83 (85.6%) term, 8 (8.2%) post-term and 6 (6.2%) preterm neonates) with a mean age of 15.85 ± 7.05 days at admission ,average weight of 3195.57 ± 553g at birth and 3276.29 ± 599.182 g at admission were studied. Ampicillin resistance in 93 cases (95.9%), gentamicin resistance in 51 cases (52.6%) and trimethoprim- sulfamethoxazole resistance in 44 cases (45.4%) were the leading resistances in this study. Escherichia coli was the dominant organism in 76.3% (74 patients) of study population which was resistant to ampicillin in 95.9% (71 cases). Despite the observed resistant to initial empirical regimen antibiotics (especially ampicillin), 81.4% of patients responded to empirical therapy. However, we believe till conductance of more detailed studies regarding the relationship between empirical therapy and antibiogram concordance, physicians take ampicillin-resistant E coli infection issue into accounts from the first steps of management of critically ill neonates.
Prevalence of Maternal Vitamin D Deficiency in Neonates with Delayed Hypocalcaemia
Nassrin Khalesi,Seyed Mohsen Bahaeddini,Mamak Shariat
Acta Medica Iranica , 2012,
Abstract: Maternal vitamin D deficiency is one of the major risk factors for neonatal vitamin D deficiency followed by neonatal hypocalcaemia. The aim of this study is to determine the relationship between delayed neonatal hypocalcaemia and maternal vitamin D deficiency. This is a descriptive cross-sectional study. Target population of this study included all term and preterm neonates with delayed hypocalcaemia (after the first 72 hours of birth) admitted to Ali-Asghar Hospital. The sample size was 100 neonates included in the study. Demographic, clinical and paraclinical data including Ca, P, PTH and level of maternal and neonatal vitamin D were recorded according to patients records. 67 neonates (67%) were term and 33(33%) were preterm neonates. The mean of serum calcium in neonates was 6.49± 0.68mg/dL (in the range of 4.3-7.8 mg/dL). 85% of neonates and 74% of mothers had vitamin D deficiency. 100% of neonates born to mothers with vitamin D deficiency were hypocalcaemia. A statistically significant difference was seen between the mean values of serum Ca (6.67 in term vs. 6.12 in preterm neonates) and vitamin D in term and preterm neonates was 16.34 vs. 20.18 (P= 0.0001 and P=0.01 respectively). Also, a significant correlation was seen between maternal and neonatal level of vitamin D (P=0.0001, r=0.789). With regard to the socio-cultural status in Iran besides women's clothing style and nutritional deficiencies before and during pregnancy, health authorities and policy makers are responsible to focus their serious attention on hypocalcaemia and hypovitaminosis D in neonates.
Comparison of Tension-free Vaginal Tape Versus Transobturator Tape in Women with Stress Urinary Incontinence
Zinat Ghanbari,Bahareh Hajibaratali,Mamak Shariat
Journal of Family and Reproductive Health , 2007,
Abstract: Objective: This study compared the Tension-free vaginal tape (TVT) and Transobturator tape (TOT) procedures for surgical treatment of stress urinary incontinence in women."nMaterials and methods: This prospective non randomized clinical trial was conducted in Vali-e-asr hospital from March 2001 to March 2005. A total of 71 patients with clinical and urodynamic diagnosis of Stress urinary incontinence (SUI) were enrolled in the study. Patients were divided into two groups and underwent TVT or TOT procedures. Mean operation time, cure rate, post operative urinary retention, bleeding and infection were compared between two groups. SPSS software was used for statistical analysis. Chi square and fisher exact test calculated the effects of the nominal variables. Mean difference of quantitative variables were compared by student's T- test. P ≤0.05 was considered statistically significant. "nResults: There was no significant difference in mean time of operation and peri-operative complications among groups. Urinary retention was 13.8% (n=5) in the TVT group versus 2.8% (n=1) in TOT group (NS). The rates of cure (91.6% vs 91.4%), improvement (5.6% vs 8.6%) and failure (2.8% vs 0) were similar for the TVT and TOT groups. The rate of hemorrhagic complications was 5.5% in TVT and 2.8% in TOT group (NS)."nConclusion: TOT appears to be equally efficient to TVT for surgical treatment of stress urinary incontinence after 30 months follow-up.
Low grade Endometrial Stromal Sarcoma of uterine corpus, a clinico-pathological and survey study in 14 cases
Tahereh Ashraf-Ganjoei, Nadereh Behtash, Mamak Shariat, Asamosadat Mosavi
World Journal of Surgical Oncology , 2006, DOI: 10.1186/1477-7819-4-50
Abstract: Fourteen patients with histologically proven ESS were included in the analysis. Endometrial stromal sarcoma is characterized by proliferations composed of cells with Endometrial stromal cell differentiation. Low-grade endometrial stromal sarcoma has an infiltrating margin and typically show extensive worm-like vessel invasion.The median age was 44.35 ± 6 years. The most common presenting symptom was vaginal bleeding, occurring in twelve patients (86%). Diagnosis was made through Fractional dilatation and curettage in four patients (28.5%). Eight patients had a total abdominal hysterectomy and salpingo-ophorectomy (57%). Radiotherapy as adjuvant therapy was administered to four patients (28.5%). The median follow-up time was 45.6 months (range 24–84). The median overall survival of the 14 patients was 45.35 ± 21 months (range 20–83). Three of 14 patients demonstrated a recurrence of disease at 9, 72, and 96 months respectively. The recurrent diseases were treated with surgery, chemotherapy, and radiotherapy. No patient died of the disease. Clinico-pathological parameters did not significantly differ between patients with and without recurrence, but patients with no myometrial invasion and low mitotic count <= 5/HPF showed longer disease-free survival.Five-year survival rate was 93%. Survival probabilities were calculated by the product limit method of Kaplan and Meier that showed, patients with no myometrial invasion and low mitotic count <= 5/HPF have longer disease-free survival, but P value was not significant.Endometrial Stromal Sarcomas (ESSs) are very rare malignant tumors that constitute approximately 10% of all uterine sarcomas but only around 0.2% of all uterine malignancies [1]. The annual incidence of ESS is 1–2 per million women accounting for 400 to 700 new cases each year in Europe [2].ESS can be mistaken for leiomyoma. Its clinical recognition may be difficult, and the diagnosis is often made postoperatively after histological examination [3,4]. The ty
Trans- Obturator Tape (TOT) efficacy in management of stress urinary incontinence and the impact on quality of life: a study in 54 patients
Zinat Ghanbari,Shirin Goodarzi,Mamak Shariat,Zahra Moshtaghi
Tehran University Medical Journal , 2010,
Abstract: "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Stress urinary incontinence is a major confounding factor which impairs health quality in women. Some procedures cannot resolve it's impact on life quality. This study aims to assess a less common and newly method; use of transobturator tension- free vaginal tapes (TOT) in regard to short- term and long-term morbidity and impact on patient's quality of life (QOL)."n"nMethods: Fifty four patients diagnosed with urinary stress incontinence, underwent a transobturator tension free vaginal tape procedure with or whitout prolapse surgery. Pre and post operative quality of life assessed with Incontinence- specific Quality of Life questionnaire (I-QOL), and objective and subjective cure rate according to patients signs and symptoms before operation, early and late surgical complications like hemorrhage, Injury and/ or perforation of bladder, intestine, urethra and infection were mentioned. "n"nResults: The overall intraoperative and early post-operative complication rates were 5.5% and 3.7%, respectively. No case of hematoma, bladder or bowel injury was seen. I-QOL scores were significantly higher after surgery. The mean I-QOL score were 23.6 and 64 before and after surgery respectively (p<0.0001). This improvement was independent of the concomitant pelvic floor repair surgery, menopause, underlying diseases, number of parity, body mass index (BMI) and age. The global rate of objective cure was 94.4% (p<0.0001). The majority of women were satisfied with the outcome. (subjective cure was 90.7%- p<0.001)."n"nConclusions: This study demonstrates that the TOT approach in the treatment of stress urinary incontinence is a safe and effective procedure which promotes health quality of life.
Cabergoline versus Coasting in the Prevention of Ovarian Hyperstimulation Syndrome and Assisted Reproductive Technologies Outcome in High Risk Patients
Farnaz Sohrabvand,Soheila Ansaripour,Maryam Bagheri,Mamak Shariat
International Journal of Fertility & Sterility , 2009,
Abstract: Background: Coasting is the most common method used in the prevention of ovarian hyperstimulationsyndrome (OHSS) acting through vascular endothelial growth factor (VEGF) reduction. However,the pregnancy rate is reported to fall with coasting when it takes more than three days. Recently lowdosecabergoline, a selective D2 dopamine receptor agonist has been proven to selectively reducevascular permeability without affecting angiogenesis and seems to be able to decrease the rate ofOHSS without affecting pregnancy rate.Materials and Methods: This clinical trial was performed on 60 women in assisted reproductivetechnologies (ART) cycles at risk of OHSS, having at least 20 follicles in their ovaries (mostly≤14mm) and a serum estradiol level ≥3000pg/mL. Patients were divided into two equal groups. Ingroup A, oral cabergoline 0.5 mg/day was given for seven days after hCG administration; whilein group B gonadotropin administration was halted until serum estradiol levels reached less than3000pg/mL before hCG administration. The main outcome measurements compared were rates ofpregnancy and severity of OHSS.Results: Total number of oocytes, metaphase II oocytes, fertilization and clinical pregnancy rateswere higher in group A (p<0.05). Severe OHSS was not found in either group. Moderate OHSS wasseen in one subject in the cabergoline group versus seven in the coasting group.Conclusion: Cabergoline seems to be a safe drug for prevention of moderate-severe OHSS.
Study of Positive and Negative Consequences of Using GnRH Antagonist in Intrauterine Insemination Cycles
Shirin Ghazizadeh,Elham Pourmatroud,Mamak Shariat,Masomeh Masomi
International Journal of Fertility & Sterility , 2009,
Abstract: Background: To assess the usefulness of premature luteinization hormone (LH) surge preventionin an intrauterine insemination (IUI) cycle by GnRH antagonist administration.Materials and Methods: Sixty patients with unexplained or mild male infertility or minimalto mild endometriosis were enrolled in this prospective randomized controlled trial. There weretwenty patients in group A (with GnRH antagonist) and 40 patients in group B (without GnRHantagonist).In all of the participants, clomiphene citrate and human menopausal gonadotropin (CC+HMG) wereused for ovarian stimulation. When at least one follicle with ≥ 16 mm diameter was seen, LH surgewas checked by a urinary LH kit. In patients with negative results, human chorionic gonadotropinwas continued in both groups, but in group A 0.25 mg Ganirelix SQ was administered for two days,,then in both groups human chorionic gonadotropin (HCG) was injected on the third day and IUIwas done 36-40 hours later. Ongoing pregnancy was the primary outcome.Results: Baseline characters and clinical parameters were similar in both groups with the exceptionof ≥14 mm follicles which were higher in group A (p value= 0.003). The pregnancy rate in bothgroups was not significantly different, although it was higher in group B (10% in group A and 15%in group B).Conclusion: At least in CC+HMG stimulated cycles for IUI, the occurrence of premature LHsurge could have a useful rule and GnRH antagonist administration could be an inappropriateintervention.
Comparison of Two Embryo Scoring Systems for Prediction of Outcome in Assisted Reproductive Techniques Cycles
Farnaz Sohrabvand,Mamak Shariat,Navid Fotoohi Ghiam,Mahdi Hashemi
Acta Medica Iranica , 2011,
Abstract: Cumulative embryo score (CES) is one of the many embryo scoring methods which have been developed to help clinicians to transfer high quality embryos and predict pregnancy rate in assisted reproductive techniques (ART) cycles. Regarding the existing difference in CES calculation this study was done to compare two methods in order to determine the more practical and preferable one. In a retrospective, cross sectional descriptive analytical study, a total of 508 ART cycles in infertile patients treated from November 2002 until March 2004, were evaluated using two methods of CES calculation in embryonic scoring to predict ART outcome. According to one method, CES was obtained by adding the individual scores of all transferred embryos. Whereas in the other reference method, CES was calculated by the sum of each embryo score multiplied by its number of blastomeres on the day of transfer. The mean score of transferred embryos (MSTE) was referred to CES divided by the total number of embryos transferred in either method. A total of 109 clinical pregnancies (pregnancy rate 21.5%) including 96 singletons, 10 twins and triplets occurred in the 508 ART cycles. The pregnancy rate was strongly correlated to CES & MSTE. According to one method, CES was 12.6±6.4 in pregnant versus 9.2±5.8 in non-pregnant group (P<0.0001). According to the other one, in the pregnant group CES was 86.7±48 versus 68.7±55 in the non-pregnant group (P<0.002). Both methods showed a significant difference. Regarding MSTE, using the first method, in the pregnant group it was 3±0.6 versus 2.8±0.7 in the non-pregnant group (P<0.011) whereas with the other approach it was 21.3±8.6 in the pregnant group versus 19.9±9.07 in non-pregnant (P<0.152) showing that the first method can also predict pregnancy outcome with MSTE. Considering that both MSTE and CES in the first method can significantly predict outcome in ART cycles, it seems this method is preferable and more useful in practice. Moreover, sometimes due to continuous division, on the third post oocyte retrieval day the blastomere number cannot be counted precisely which can be misleading if taken into account according to the method introduced by Steer.
Relationship Between Helicobacter Pylori Infection and Serum Ferritin Level in Primary School Children in Tehran-Iran
Ali Zamani,Mamak Shariat,Zohreh Oloomi Yazdi,Shahla Bahremand
Acta Medica Iranica , 2011,
Abstract: Iron deficiency can cause cognitive and functional learning disorders in children. Some studies have reported a relationship between low serum ferritin levels in patients with anemia and Helicobacter pylori (H. pylori) infection. Therefore, we aimed to determine the relationship between these two common diseases. This descriptive analytical cross-sectional study was performed to assess serum ferritin levels and H. pylori antibody titers (IgG) among 6-12 year old healthy primary school children in Tehran during the academic year 2005-2006. Specimen collection was done by cluster and randomization methods (multistage sampling). Personal information and laboratory results were compiled in questionnaires and data were analyzed by descriptive and analytical statistics via SPSS software. 165 primary school children (43% boys, 57% girls) with mean age 9.2 ± 1.5 years were enrolled in the study. H. pylori IgG antibody titer was positive in 26% of cases with mean values of 0.79 ± 0.42 units in boys and 0.75 ± 0.39 units in girls, which showed a significant statistical difference (P=0.004). H. pylori infection was more common among children of large families or those with low economic status (P=0.002). 29% of children had low serum ferritin levels. Out of the children with low serum ferritin levels, 71% and 28% had negative and positive anti H. pylori antibody titers (IgG levels), respectively. Also, 296 children (25%) with normal ferritin levels had H. pylori infection. We did not find a significant relationship between H. pylori infection and low serum ferritin levels or iron deficiency anemia.
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