BackgroundDespite the decreasing rate of under nutrition children in recent years overall, the negative affect in growth and development make it as a main concern in the world. Applying an available and appropriate supplementary food is a major approach in treating children with Moderate Acute Malnutrition (MAM).ObjectiveTo compare the effectiveness of a new supplementary blended flour (containing chickpea, rice, wheat and barley, named Shadameen) in combination with multivitamin/mineral supplement and nutritional counseling versus multivitamin/mineral supplement and nutritional counseling alone, in the treatment of children with MAM.MethodsThis randomized controlled trial study was conducted at Heshmatiyeh Hospital in Sabzevar city in Iran, from January 2016 to December 2016. Seventy infants, aged 9 to 24 months with MAM who were referred from urban health centers to the hospital clinic were included. They were randomly assigned to receive, for about 3 months, either multivitamin / mineral supplement and nutritional counseling alone or in combination with an extra supplementary blended food. We analyzed weight, length, weight for length Z score (WLZ), weight for age Z score (WAZ) and length for weight Z score (LAZ), along with recovery rate and adverse events among the two groups. The data were analyzed using SPSS version 16. We used statistics, Chi-square, independent t-test, and Fisher’s exact test for the analyses of primary and secondary outcomes.ResultsThe food supplementation infant’s mean weight and WLZ and WAZ were greater compared with the other group (0.81±0.29 gr and 0.55±0.33 gr, p=0.002), (0.36±0.36 and 0.02±0.52, p=0.003), (0.40±0.33 and 0.09±0.37, p=0.001). The recovery rate in the food supplemented group was significantly higher than the other group (68.4%, 31.6%, p=0.001). No adverse reactions were observed. There were no significant differences in LAZ at the end of the study between the two groups (p=0.53).ConclusionThis study showed that Shadameen in combination with multivitamin/mineral and counselling therapy can be more effective in decreasing the wasting rate of children with MAM than vitamin/mineral and counseling therapy alone.Trial registrationThe trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2015040921670N1.FundingThis study was financially supported by the vice chancellor for research office, Mashhad University of Medical Sciences.
PurposeShoulder dislocation is a common joint dislocation managed by the emergency physicians in the emergency departments. Pre- and post-reduction radiographic examinations have long been the standard practice to confirm the presence of dislocation and the successful reduction. However, shoulder ultrasonography has recently been proposed as an alternative to the radiographic examination. This study aimed to assess the accuracy of ultrasonography in evaluating proper reduction of the dislocated joint.MethodsThis was a prospective observational study. All patients with confirmed anterior shoulder dislocation were examined by both ultrasonography and radiography after the attempt for reduction of the dislocated joint. The examiners were blinded to the result of the other imaging modality. Results of the two methods were then compared.ResultsOverall, 108 patients with confirmed anterior shoulder dislocation were enrolled in the study. Ninety-one (84.3%) of the patients were males. Mean age of the participants was (30.11 ± 11.41) years. The majority of the patients had a recurrent dislocation. Bedside ultrasonography showed a sensitivity of 53.8% (95% CI: 29.1%–76.8%) and a specificity of 100% (95% CI: 96.1%–100%) in detecting inadequate reductions. The results of ultrasonography had a statistically significant agreement with the results of radiography (Kappa = 0.672, p < 0.001).ConclusionThe results suggest that the sensitivity of post-reduction ultrasound is not sufficient for it to serve as a substitute for radiography.
Introduction: Consumption of vegetable products is increasing commonly in the world because they are recognized as an important source of nutrients, vitamins, and fiber for humans. Salads are among the most widely used foods that are also known as the most contaminated foods in restaurants. This study was conducted to determine the microbial contamination of salad-preparing tables and salad-serving dishes. Materials and Methods: This study was conducted at 39 restaurants in Mashhad City in Iran during 2017. In this regard, 78 samples were determined from the salad preparing tables and serving dishes. Samples were tested for cleanliness status using Adenosine Triphosphate (ATP)-bioluminescence method as a rapid test. Results: According to the ATP bioluminescence device, 43.6% of the assessed dishes were clean, 38.5 % were dirty, and 17.9 % were not adequately clean. According to the results of ATP bioluminescence device for tables, 23.1 % of the tested tables passed the test, 15.4 % were classified in the caution status, and 61.5% failed. Conclusion: The ATP method has been widely used, especially in the food industry, as a rapid method for measuring general levels of cleanliness. However, this method is not a reliable replacement for measuring the microbial contamination. The ATP bioluminescence should not be used as a substitute for quantitation of microbial load.
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