Context: Kangaroo Mother Care (KMC) is a supportive technique that beings at the neonatal period and is one of the skin-to-skin contact methods of holding neonate by mother. This method has an important role in exclusive breastfeeding and thermal care of neonates. This study aimed to investigate the application of KMC and evaluate the effect of this technique in different neonatal outcomes, particularly in Iranian neonates. Moreover, this review can be a tool for formative evaluation for this newly introduced treatment intervention in Iran. Evidence Acquisition: This review was conducted in national and international databases concerning experience with KMC on term and preterm neonates admitted in Iranian hospitals from 2006 to 2014. The measured outcomes included physiologic, psychologic, and clinical effects of this practice on newborn infants. Results: In this study, 42 Persian and English language papers were reviewed and finally 26 articles were selected. Various effects of KMC on different factors such as analgesia; physiological effects, breastfeeding, icterus, length of hospitalization, infection, psychologic effects, and weight gain were found. Conclusions:The results showed that as a simple and suitable strategy for increasing the health status of the mothers and newborns, KMC had an important role in improvement of neonatal outcomes in neonatal wards of Iranian hospitals in recent ten years. Therefore, promoting this technique in all neonatal wards of the country can promote health status of this population.
Background Many techniques have been introduced for reduction mammaplasty and are utilized in diverse rates by different surgeons according to patient needs. Each technique is evaluated based on the aesthetic result, longevity, complication rate, and preservation of the nipple-areola complex (NAC) sensation. Objectives This study introduces the new modified technique of supero-septum pedicle mammaplasty (SSPM) that makes use of both the septum and superior pedicle and is suitable for macromastia and gigantomastia cases. Methods Between 2015 and 2018, 60 women who underwent SSPM were evaluated in a prospective study after undergoing superior pedicle deepithelialization and resection of the inferior, lateral, and medial segments. In the lateral pillar, a tongue of tissue was preserved for fixation to the medial pectoral fascia through a window created in superior pedicle at the third intercostal space. Finally, a septum pedicle was sutured to the fascia and muscle at the upper border of the sixth rib somewhat medially. Patients were followed up for a minimum of 13 months. Results The mean sternal notch to nipple (SN-N) distance was 33.05 cm, and the mean NAC elevation was 10.92 cm. Breast reductions varied from 270 to 2800 g/breast. Complications included wound dehiscence (5%), wound infection (2.5%), and partial areolar necrosis (2.5%). At 6 months postoperation, the NAC sensation was significantly better compared to preoperative values (P < 0.005). Conclusion SSPM is a relatively safe method of reduction mammaplasty, even for very large breasts, that leads to good aesthetic form along with preserving circulation and sensation of the NAC.
A high incidence of thromboembolic events have been reported among thalassemia intermedia patients especially in splenectomized patients. This study has been conducted to evaluate the coagulation state of patients referred to thalassemia research center at Booali Sina Teaching Hospital, Sari, Iran. This descriptive-cross sectional study was performed in 2007. Sixty thalassemia intermedia patients aged older than 10 years were enrolled. After recording demographic and therapeutic data of the participants, the plasma levels of Coagulant factors were measured. Obtained Data were analyzed using SPSS 13 software and t-test and chi-square tests. Of 60 studied patients, 62% were female. The mean age of the patients was 26.6 +/- 9.3 years. ASA tablet were used in 53.3%. None of the patients have experienced thromboembolic events. Decrease in protein C has been observed in 60%. Antithrombin III was decreased in 42% and protein S declined in 10% of the patients. Mutation in factor V leiden was seen in 3%. Splenectomy performed in 53.3% and there was no significant relation between low level of protein C and protein S, antithrombin III and presence of factor V Leiden with splenectomy (p > 0.05). Regarding to the high incidence of low levels of protein C, protein S and antithrombin III among thalassemia intermedia patients, there is an increased risk of thromboembolic events in the patients.
Ileocecal valve atresia is a very rare anomaly with only a few cases reported in the literature. The conventional therapy includes ileocecal resection and ileocolic anastomosis. Here, we present a patient with inborn ileocecal valve atresia in whom we successfully preserved the ileocecal valve and the terminal ileum through opening a valve and tapering the ileum in one operation.
Psoriasis is an inherited chronic inflammatory papulosquamous disorder with a variable clinical spectrum affecting about 0.5% to 2% of children and adolescence. In spite of all performed researches around the world for seeking better treatments with fewer adverse effects to control the disease, there is still no cure for psoriasis. Treatment of psoriasis in children is very conservative and many therapies used for adults may not be appropriate for children due to possible long-term or delayed adverse effects. A wide range of therapeutic options are existed including; topical therapy, phototherapy, chemotherapy, systemic therapies and biologic therapies. Here in, because of the lack of data in this specific field of dermatology, we decided to review the current therapies of childhood psoriasis.
The Nose is one of the most challenging facial parts to reconstruct. Its asymmetries, defects, or disharmonies are easily noticeable. The complex contours, highlights, shadows, and special shape of its subunits makes nasal reconstruction more difficult in panfacial burn than that of nonburned ones. This retrospective study conducted at Zare Hospital. Twenty-five panfacial burn cases with nasal defect were studied from 2010 to 2019. Profile photos were manipulated by Photoshop. Based on the difference between the burn-related shortened nasal length and the expected photoshopped one, severity of the short nose was detected, and strategy of the surgery determined. Ten out of 25 cases with normal nasal length and projection, or mild short nose with minimal alar rim, tip and/or columellar defect underwent nasal reconstruction with skin and/or composite graft. Nine patients with normal nasal length or mild to moderate short nose but moderate to severe alar defect underwent reconstruction with turndown flap plus skin and/or composite graft. Pre-expanded forehead flap (n=1) and delayed scarred or skin grafted forehead flap (n=5) were used for six patients with severe short nose defect. There are several procedural alternatives for reconstruction of burn-related mild to moderate nasal deformity. For severe and deep pan facial burn, delayed forehead flap seems safe with acceptable color and texture harmony. Our designed algorithm could potentially improve selection of proper nasal reconstruction techniques and assist novice surgeons.
Context: Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection is an emerging human disease that has been reported from the Arabian Peninsula and Middle East countries since 2012. Although zoonotic transmission was postulated, virological and serological finding suggest that the dromedary camels act as the potential reservoirs of MERS-CoV infection to humans. As October 2014, a totally 855 confirmed cases with 333 related deaths were reported to WHO. All cases occurred in or epidemiologically linked to affected countries. The virus ability to induce a pandemic attack is limited. The clinical presentations vary and range from asymptomatic infection to severe respiratory disease and death. However, most severe disease occurs in elderly and in those with underlying conditions. Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV infection is health care facilities and in the community. The WHO encourages all member states to perform surveillance of patients with acute severe respiratory infection and to carefully monitor any unusual patterns. This paper aims to review the current key characteristics of MERS-CoV infection in human and update the WHO recommendations about this illness.
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