The intersection of race and gender alters the protective effects of social determinants on sustained health problems such as insomnia, physical inactivity, and BMI. Social groups particularly vary in the operant mechanisms by which SES contributes to maintaining health over time. The health effects are less universal for education than income. Race by gender groups differ more in SES determinants of BMI, insomnia, and physical inactivity than depressive symptoms and SRH.

Coronary artery fistula (CAF) is a rare congenital anomaly that can be complicated by endocarditis, myocardial infarction, or coronary aneurysms. This article reviews the clinical characteristics and surgical outcome of 10 patients with CAF in Rajae Heart Center. From 1990 to 2000, 10 patients (age, 6 months to 15 years; mean age, 8.5 years) were diagnosed with CAF by echocardiography and cardiac catheterization. Six were female and 4 were male. All patients with isolated CAF (9) were asymptomatic. One patient with associated anomaly (mitral valve prolapse with severe mitral regurgitation) had dyspnea on exertion and palpitation. Five fistulas originated from the right coronary artery-three from the left and two from the left circumflex. Drainage was to the right ventricle (7), right atrium (2), and pulmonary artery (1). The ratio of pulmonary to systemic flow ranged between 1 and 1.6. All patients had surgical ligation. In the symptomatic patient, in addition to ligation, mitral valve replacement was performed. There was no operative or late death. Follow-up evaluation (range, 1-6 years; mean, 4.2 years) showed no evidence of recurrent or residual CAF. Surgical management of CAF is a safe and effective treatment resulting in 100% survival and clousure rate.

Background and aims: None of the available constipation treatments for children are completely successful. Therefore, the present study aimed to evaluate the effect of the polyethylene glycol (PEG) solution 40% and fig syrup on the treatment of chronic constipation in children. Methods: In this double-blind clinical trial, 120 patients with chronic functional constipation were selected and divided into two groups. The first group received 5 mL of fig syrup without senna 3 times daily, and the second group took PEG 40% syrup at 1 mL/kg of body weight per day (the dose was adjustable according to the patient’s condition and need). At weeks 0, 2, 4, and 6, a checklist containing questions about children’s constipation was completed by the researcher, and the data were analyzed by SPSS version 24. Results: Changes in the frequency of abdominal pain at fourth times 0, 2, 4, and 6 weeks demonstrated statistically significant differences between the two groups (P=0.044), and it was significantly lower the in PEG group; however, the defecation was not statistically significant (P=0.902). After six weeks, the frequency of painful defecation, difficult defecation straining during defecation, and fear of defecation was significantly lower in the group given PEG syrup compared to the fig syrup-receiving group (P=0.001). Conclusion: Overall, PEG syrup was significantly effective in treating chronic functional constipation in children compared to the fig syrup.