Search

Background: It is necessary to determine the knowledge, attitudes, and practices (KAP) of the coronavirus disease 2019 (COVID-19) epidemic for good management and intervention. Objectives: The current study aimed to evaluate the KAP of the public population regarding COVID-19 in the southeastern region of Iran. Methods: A self-constructed questionnaire based on the literature was developed. The items were asked from the participants via a telephone interview in Zahedan, Iran, during September and October 2020. This study evaluated the association of demographic and socioeconomic information using KAP scales. The data were analyzed using SPSS software (version 20.00). A significance level of 0.05 was considered for the study. Results: A total of 524 participants accepted to have an interview via telephone in the study. About 17% and 10.10% of the participants had poor and excellent knowledge, respectively. Moreover, 72.9% and 66.6% of the respondents had good knowledge and attitude, respectively. The practice was good in 42.4%of the participants. Overall, 73.3% of the subjects had good KAP. Gender had a significant association with attitude toward COVID-19 (X² = 18.85; P < 0.001). Place of living did not have any significant association with all scales and overall KAP. Marital status had a significant association with attitude (X² = 15.89; P = 0.003), practice (X² = 9.60; P = 0.048), and KAP (X² = 18.64; P < 0.001) of COVID-19. Education had a significant association with attitude (X² = 19.58; P = 0.012), practice (X² = 20.26; P < 0.001), and KAP (X² = 28.98; P < 0.001) regarding COVID-19. Occupation had a significant association with knowledge (X² = 26.94; P < 0.001), practice (X² = 15.65; P = 0.017), and KAP (X² = 22.29; P < 0.001) regarding COVID-19. Conclusions: The majority of the participants had great knowledge, a positive state of attitude, and acceptable practice. Although the findings are reasonable, it is recommended that the public should proceed to reinforce knowledge, attitude, and practice regarding COVID-19 [ABSTRACT FROM AUTHOR]

Background: Epilepsy, febrile convulsion, and breath-holding spells are neurological diseases affecting the heart. Objectives: This study aimed to evaluate electrocardiography alterations in children with epilepsy, febrile convulsion, and breath-holding spells compared to controls. Methods: This case-control study was conducted on 360 children aged 0.5 - 5 years in Zahedan, Iran. The children with epilepsy, febrile convulsion, and breath-holding spells were diagnosed by a single neurologist based on the standard definition. Electrocardiography was also performed by a pediatric cardiologist. The data were analyzed using the SPSS 20.0 software, and P < 0.05 was considered statistically significant. Results: Among the participants, 160 (44.4%) were female. Females also comprised 45.6%, 42.2%, 38.9%, and 51.1% of the participants in the epilepsy, febrile convulsion, breath-holding spells, and control groups, respectively. QTd was different in the epilepsy group compared to the controls and patients with breath-holding spells (P < 0.001). Additionally, QTc was significantly different in the epilepsy group in comparison to the controls (P < 0.001) and patients with breath-holding spells (P = 0.020), in the controls compared to the patients with febrile convulsion (P < 0.001), and in the controls in comparison to the patients with breath-holding spells (P < 0.001). QTcd was also different in the epilepsy group compared to the controls (P < 0.001), patients with breath-holding spells (P < 0.001), and those with febrile convulsion (P = 0.006) as well as in the controls in comparison with the patients with febrile convulsion and breath-holding spells (P < 0.001). Finally, QT was different in the patients with breath-holding spells compared to those with epilepsy (P = 0.005), in the patients with breath-holding spells in comparison with the controls (P = 0.002), and in the patients with breath-holding spells compared to those with febrile convulsion (P < 0.001). Conclusions: The present study findings indicated that QT dispersion was different in the epilepsy group compared to the patients with breath-holding spells, corrected QT was different in the epilepsy group compared with the patients with breath-holding spells, QTc dispersion was different in the epilepsy group in comparison with the patients with breath-holding spells and febrile convulsion, and QT was different in the patients with breath-holding spells compared to those with epilepsy and febrile convulsion. [ABSTRACT FROM AUTHOR]

Background: Celiac disease (CD) is an autoimmune mediated gluten sensitive enteropathy and cardiac involvement in CD children is frequent. Objectives: This study aimed to investigate cardiac involvements in patients with celiac disease by using Doppler Tissue Echocardiography and conventional echocardiography to identify myocardial dysfunctions in celiac patients compared to healthy individuals. Patients and Methods: This case-control and approved study was performed on 120 children with celiac disease and 60 healthy children aged 1- 18 years old in a single center. Patients with valvular disease, rhythm abnormality, CHD, malignancy, systemic inflammatory diseases, diabetes mellitus, renal insufficiency, chronic obstructive pulmonary disease and hypertension were excluded from the study. The participants underwent echocardiography. Data were analyzed through SPSS 17 using Student's t-test and Mann-Whitney U. A P value of < 0.05 was considered as significant. Results: Out of 120 patients with celiac, 55.83% were females and for the control group it was 43.33%. The participants in the case and control groups were matched for sex and age. Weight and height showed significant differences between the groups. Right ejection time had significant mean differences of 245.30 ± 24.60 and 253 ± 22.66 for the case and control groups respectively with the t = -2.03 and P = 0.044. Similar trends were observed for the left myocardial performance index by DTE with a mean of 0.79 ± 0.12 and 0.72 ± 0.12 for the case and control groups, respectively (t-3.32, P = 0.001). QT and heart rate by ECG and ET, IRT and MPI by DTE had significant differences in the case and control groups. LA in diastole and LVM and Peak A velocity had significant differences in both groups. ET, ICT, and IRT revealed significant differences in the case and control groups. Conclusions: Consistent with many study's results, we reached the conclusion that Doppler Tissue Echocardiography and Conventional Echocardiography are good determination methods of systolic and diastolic myocardial functions in patients with celiac disease. Between these two methods, the present study confirmed the importance and strong power for Doppler Tissue Echocardiography. [ABSTRACT FROM AUTHOR]

Background: Cardiac dysfunction is one of the major causes of morbidity and mortality in thalassemia patients. This study aimed to compare the effect of Brain Natriuretic Peptides (BNP) and Calcitonin Gene-Related Peptide (CGRP) with echocardiographic findings in early diagnosis of cardiac disease in major thalassemia patients. Materials and Methods: This study was performed on 80 patients among 500 major thalassemia patients and 80 healthy people. Those with metabolic, endocrine disorder, hypertension, heart failure, and valvular disease excluded from the study. These two groups were matched based on age and sex. Essential heart findings were analyzed using Mylab 60. After blood sampling, levels of CGRP and BNP were measured by use of ELISA kit from extracted plasma. Mann-Whitney test, independent t-test, and Pearson correlation were used to analyze data and P< 0.05 was considered significant. Results: The results showed that mean age of all participants was 17.581± 5.344 years when distributed between case and control as 18.21 ± 5.14 and 16.95 ± 5.49 respectively without significant difference. Means of weight, length, hemoglobin, systolic and diastolic pressure were lower in patients group. The majority of echocardiography findings of left and right heart were higher in case group. The average of CGRP and BNP level were more in case group (p<0.05). A positive correlation was observed between BNP (R=0.229, P=0.041) and right MPI. There was also correlation between PEP(R=0.0238,P=0.035) , PEP/ET(P=0.005) of right heart and peak A velocity of left heart (R=0.245,P=0.03) with CGRP. Conclusion: Findings of this survey showed that systolic and diastolic function of left heart would be changed in patients with major beta thalassemia. Therefore, monitoring BNP and CGRP in symptom free thalassemia patients as well as serial echocardiography is recommended. [ABSTRACT FROM AUTHOR]

Background: Survivors of childhood malignancy are at risk of long-term late effects. One of the most commonly involved systems in this effect is endocrine system. Appropriate timely recognition and treatment of late complications including endocrine complication is essential for the continuing health and improvement in quality of life in cancer survivors. Objectives: Therefore, this study has been conducted to investigate the aforementioned complications resulting from the treatment of the common malignancies in children in Iran. Patients and Methods: We performed a cross sectional study for evaluation of endocrine complication in cancer survivors who had finished their cancer treatment and come for followed up in oncology clinic of children medical center. Results: Demographic data, treatment modality, and endocrine late effect recorded and analyzed. There were 96 survivors with median age of 13.8 - 5.8 years (range 3 - 31 years). The median follow up time was 2.7 years (range 1 - 10 years). Hyperinsulinemia was the most common late effect. Other complication was dyslipidemia, overweight, obesity, osteopenia, hypothyroidism, diabetes mellitus and osteoporosis respectively. Conclusions: Our study has demonstrated a significant prevalence of endocrine complication after childhood cancer therapy and a long term follow-up program for survivors of childhood cancer is therefore needed. [ABSTRACT FROM AUTHOR]

Background: Infantile-onset Pompe disease is a rare genetic and lethal disorder which is caused by the lack of acid alpha-glucosidase activity (GAA). The aim of our study was to identify the demographic and clinical characteristics, and natural history of these patients. Materials and Methods: In this retrospective study, clinical file of 15 patients diagnosed with infantile-onset Pompe disease whose symptoms started before the age of 12 months were studied. Diagnosis was based on clinical history, physical examination and diagnostic parameters in chest X-ray, echocardiogram, electrocardiogram and biochemical tests after rule out the other metabolic and neuromuscular disorders. Results: Sixty percent of the patients were male and 40% were female. The mean age at the onset of symptoms was 78 days (range: 3-150 days). Most frequent clinical and paraclinical symptoms were cardiomegaly, hypotonia, hyporeflexia, macroglossia, failure to thrive, hepatomegaly, and feeding problems, respectively. The mean age at the time of death was 5.96 months (range: 4-8 months), and all patients died before one year of age. Muscle enzymes including AST, ALT, LDH, and CPK were elevated in all patients. Due to the lack of availability, enzyme replacement therapy was not possible for any patient. Conclusion: The study showed that despite the supportive measures and no specific treatment, the clinical course is not significantly different with similar studies and the overall prognosis of this form of disease is very poor and disappointing. [ABSTRACT FROM AUTHOR]

Lithophagia is a type of pica that might be resulted from Iron Deficiency Anemia (IDA)which is the frequent presenting signs of Celiac Disease (CD). A 5-year-old child with a two year history of the lithophagia with a, refractory IDA, abdominal distention and constipation. The child did not grow well and had failure to thrive. With suspicion to CD, TTg IgA level was measured and due to an incearse of TTg IgA level the patients were undergone esophagogastrodeudonoscpy and jejunal biopsy. The biopsy showed severe villous atrophy and an increase in limphoplasma cells. Biopsy confirmed diagnosis of CD and glutten free diet was initiated Anally. Six months after diagnosis and commencing the gluten free diet, the lithophagia and constipation in patient eradicated completely. IDA and failure to thrive were improved and the level of TTg IgA was reached to the normal. The case demonstrated the relationship between lithophagia and CD in anemia. Therefore, in the same cases such as our case should be considered CD as the most important causes of lithophagia. [ABSTRACT FROM AUTHOR]

Objective: Prediction of survival and mortality rates in costly environments such as the intensive care unit (ICU) is of great importance for the assessment of new treatments, resource consumption control, and improvement of quality control. This study aimed to determine the ability to predict mortality and discharge rate of patients using the FOUR score in the pediatric ICU (PICU) of Ali Ibn Abitalib Hospital, Zahedan and compare the results with those of Glasgow Coma Scale (GCS). Methods: This prospective study was conducted on 200 patients admitted to the PICU. Convenience purposive sampling was used. Research data was collected using the Full Outline of Unresponsiveness (FOUR) score and GCS using questionnaires. Obtained data was analyzed with SPSS 16 using descriptive statistics and correlation analyses. Findings: Of the 200 children admitted to the PICU, 71.5% and 28.5% were discharged and died, respectively. The inter-rater reliability for the FOUR score was good to excellent (weighted κ: eye, 0.72; respiration, 0.82; brainstem, 0.74; motor, 0.78), In terms of mortality and discharge prediction, logistic regression analyses (FOUR score = OR: 0.13; 95% CI: 0.06–0.29; P<0.001; GCS=OR: 2.49; 95% CI: 1.44–4.32; P<0.001) showed that the FOUR score is a good predictor for in-hospital mortality. Conclusion: Results indicated that the FOUR score is more capable than GCS in predicting the mortality and discharge of patients admitted to the PICU. [ABSTRACT FROM AUTHOR]

Background: Patients suffering from major beta thalassemia need frequent blood transfusions and, if not treated well, would be at risk of heart dysfunction. This study was performed to determine the diagnostic value of electrocardiography versus echocardiography in measuring the left ventricular mass index in these patients. Methods: Between July 2010 and June 2011, 82 asymptomatic patients over 10 years of age with major thalassemia (42 men with a mean age of 17.65 ± 3.39 years and 40 women with a mean age of 16.9 ± 3.38 years) were enrolled in this study. For all the patients, standard electrocardiography (to measure R in aVL and S in V3 and calculate left ventricular mass index by electrocardiography) and echocardiography (to measure interventricular septum diameter in diastole, left ventricular posterior wall diameter in diastole, and left ventricular diameter in diastole in order to calculate left ventricular mass index by echocardiography) were performed, at least one week after transfusion. The calculated left ventricular mass indices were thereafter compared between the two methods (electrocardiography and echocardiography). Results: Sensitivity, specificity, positive predictive value, and negative predictive value in the two techniques in determining the left ventricular mass index were 67%, 25%, 89%, and 7% in the females, 65%, 33%, 92%, and 6% in the males, and 67%, 14%, 89%, and 3% in the total population, respectively. Furthermore, this study demonstrated that the average left ventricular mass index by echocardiography and electrocardiography was 104.86 ± 21.65 gr/m2 and 91.69 ± 12.03 gr/m2, respectively. Echocardiography was much more accurate than electrocardiography in determining the left ventricular mass index (p value = 0.0001). Conclusion: The findings of this study demonstrated that echocardiography was more accurate and more reliable than electrocardiography in determining the left ventricular mass index in major thalassemia patients. [ABSTRACT FROM AUTHOR]

Objective: Patent ductus arteriosus (PDA) is one of the most frequently seen congenital heart diseases. Its closure is recommended because of the risk of infective endocardis, as well as morbidity and mortality in the long. The aim of this study was to assess the long term results of the transcatheter closure of PDA in infants using amplatzer duct occlude (ADO). Methods: From May 2004 to September 2011, forty eight infants underwent transcatheter closure of PDA. A lateral or right anterior oblique view aortogram was done to locate PDA and to measure its size. Before discharge, repeat aortogram was performed to evaluate eventual residual shunt and to confirm the appropriate deployment of the ADO. Follow up evaluations were done with transthoracic echocardiography at discharge, 1 month, 6 months, 12 months and yearly thereafter. Findings: The mean age of patients at procedure was 9.18±2.32 (range 3 to 12) months, mean weight 6.73±1.16 (range 4.5 to 10.1) kg. The PDA occluded completely in 20 out of the 48 patients. Twenty four patients had trivial or mild shunt and two patients had moderate residual shunt which disappeared in one patient within 24 hours and other patient with moderate shunt in 1 month. One patient (age 8 months) had mild LPA stenosis. The device emobolization occurred in two patients, immediately after the procedure in one and during night in the other patient Conclusion: The long term results suggested that transcatheter closure of PDA using Amplatzer duct occluder is a safe and effective treatment in infants less than 1 year of age with minimal complications. [ABSTRACT FROM AUTHOR]

Background: Heart disease is the main cause of mortality and morbidity in patients with beta thalassemia, rendering its early diagnosis vital. We studied and compared echocardiographic findings in patients with beta thalassemia major, patients with beta thalassemia intermedia, and a control group. Methods: Eighty asymptomatic patients with thalassemia major and 22 asymptomatic cases with thalassemia intermedia (8-25 years old) were selected from those referred to Ali Asghar Hospital (Zahedan-Iran) between June 2008 and June 2009. Additionally, 80 healthy individuals within the same age and sex groups were used as controls. All the individuals underwent echocardiography, the data of which were analyzed with the Student t-test. Results: The mean value of the pre-ejection period/ejection time ratio of the left ventricle during systole, the diameter of the posterior wall of the left ventricle during diastole, the left and right isovolumic relaxation times, and the right myocardial performance index in the patients with beta thalassemia major and intermedia increased significantly compared to those of the controls, but the other parameters were similar between the two patient groups. The mean values of the left and right pre- ejection periods, left ventricular end systolic dimension, and left isovolumic contraction time in the patients with thalassemia intermedia increased significantly compared to those of the controls. In the left side, myocardial performance index, left ventricular mass index, isovolumic contraction time, and deceleration time exhibited significant changes between the patients with thalassemia major and those with thalassemia intermedia, whereas all the echocardiographic parameters of the right side were similar between these two groups. Conclusion: The results showed that the systolic and diastolic functions of the right and left sides of the heart would be impaired in patients with thalassemia major and thalassemia intermedia. Consequently, serial echocardiography is suggested in asymptomatic patients with beta thalassemia for an early diagnosis of heart dysfunction and proper treatment. [ABSTRACT FROM AUTHOR]

Familial hypercholesterolemia (FH) is an autosomal disorder that causes severe elevations in total cholesterol and low- density lipoprotein. FH is one of the primary risk factors for premature coronary artery disease in children and adults which requires early diagnosis and appropriate medical intervention. In this article, we report two cases of homozygous familial hypercholesterolemia. [ABSTRACT FROM AUTHOR]

Background: Patients suffering from major beta thalassemia need frequent blood transfusions and, if not treated well, would be at risk of heart dysfunction. This study was performed to determine the diagnostic value of electrocardiography versus echocardiography in measuring the left ventricular mass index in these patients., Methods: Between July 2010 and June 2011, 82 asymptomatic patients over 10 years of age with major thalassemia (42 men with a mean age of 17.65 ± 3.39 years and 40 women with a mean age of 16.9 ± 3.38 years) were enrolled in this study. For all the patients, standard electrocardiography (to measure R in aVL and S in V3 and calculate left ventricular mass index by electrocardiography) and echocardiography (to measure interventricular septum diameter in diastole, left ventricular posterior wall diameter in diastole, and left ventricular diameter in diastole in order to calculate left ventricular mass index by echocardiography) were performed, at least one week after transfusion. The calculated left ventricular mass indices were thereafter compared between the two methods (electrocardiography and echocardiography)., Results: Sensitivity, specificity, positive predictive value, and negative predictive value in the two techniques in determining the left ventricular mass index were 67%, 25%, 89%, and 7% in the females, 65%, 33%, 92%, and 6% in the males, and 67%, 14%, 89%, and 3% in the total population, respectively. Furthermore, this study demonstrated that the average left ventricular mass index by echocardiography and electrocardiography was 104.86 ± 21.65 gr/m2 and 91.69 ± 12.03 gr/m2, respectively. Echocardiography was much more accurate than electrocardiography in determining the left ventricular mass index (p value = 0.0001)., Conclusion: The findings of this study demonstrated that echocardiography was more accurate and more reliable than electrocardiography in determining the left ventricular mass index in major thalassemia patients.

Background: Heart disease is the main cause of mortality and morbidity in patients with beta thalassemia, rendering its early diagnosis vital. We studied and compared echocardiographic findings in patients with beta thalassemia major, patients with beta thalassemia intermedia, and a control group., Methods: Eighty asymptomatic patients with thalassemia major and 22 asymptomatic cases with thalassemia intermedia (8-25 years old) were selected from those referred to Ali Asghar Hospital (Zahedan-Iran) between June 2008 and June 2009. Additionally, 80 healthy individuals within the same age and sex groups were used as controls. All the individuals underwent echocardiography, the data of which were analyzed with the Student t-test., Results: The mean value of the pre-ejection period/ejection time ratio of the left ventricle during systole, the diameter of the posterior wall of the left ventricle during diastole, the left and right isovolumic relaxation times, and the right myocardial performance index in the patients with beta thalassemia major and intermedia increased significantly compared to those of the controls, but the other parameters were similar between the two patient groups. The mean values of the left and right pre-ejection periods, left ventricular end systolic dimension, and left isovolumic contraction time in the patients with thalassemia intermedia increased significantly compared to those of the controls. In the left side, myocardial performance index, left ventricular mass index, isovolumic contraction time, and deceleration time exhibited significant changes between the patients with thalassemia major and those with thalassemia intermedia, whereas all the echocardiographic parameters of the right side were similar between these two groups., Conclusion: The results showed that the systolic and diastolic functions of the right and left sides of the heart would be impaired in patients with thalassemia major and thalassemia intermedia. Consequently, serial echocardiography is suggested in asymptomatic patients with beta thalassemia for an early diagnosis of heart dysfunction and proper treatment.