Background: Considering the psycho-social model of diseases, the aim of this study was to evaluate the effect of psychiatric intervention on the pregnancy rate of infertile couples.
Methods: In a randomized clinical trial, 638 infertile patients referred to a university infertility clinic were evaluated. Among them, 140 couples with different levels of depression in at least one of the spouses were included in this substudy. These couples were divided randomly into two groups. The patients in the case group received 6-8 sessions of psychotherapy before starting infertility treatment and were given fluoxetine 20-60 mg per day during the same period. The control group did not receive any intervention. Three questionnaires including the Beck Depression Inventory (BDI), Holmes-Rahe stress scale and a socio-demographic questionnaire were applied for all patients. The clinical pregnancy rates of the two groups, based on sonographic detection of the gestational sac six weeks after LMP, were compared. The data were analyzed by paired-T test, T-test, χ2 and the logistic regression method.
Results: The pregnancy rate was 47.1% in the case group and 7.1% in the control group. The pregnancy rate was significantly related to the duration and cause of infertility and the level of stress in both groups (p< 0.001). The pregnancy rate was shown to be higher in couples in which the male has a secondary level of education (p< 0.001).
Conclusions: Psychiatric interventions greatly improve pregnancy rates, and it is therefore crucial to mandate psychiatric counseling in all fertility centers in order to diagnose and treat infertile patients with psychiatric disorders and help couples deal with stress.
Background: Pain associated with IV injection of propofol is seen in 28 to 90% of patients. A number of techniques have been tried to minimize propofol-induced pain, with variable results. We compared the efficacy of pretreatment with ephedrine and lidocaine for the prevention of propofol-induced pain.
Methods: One hundred and twenty adult patients, ASA physical status I-II, undergoing elective surgery were randomly assigned into six groups (20 each). Normal saline group received normal saline, lidocaine group received lidocaine 2% (40 mg), and ephedrine (E 30) group received 30 µg/kg ephedrine, ephedrine (E 70) group received 70 µg/kg ephedrine, ephedrine (E 100) group received 100 µg/kg ephedrine, ephedrine (E 150) group received 150 µg/kg ephedrine. All pretreatment drugs were made in two mL. Pain was assessed by a 100-point scale of visual analogue (VAS) (0= no pain, 100= the most severe pain) and (VRS) verbal rating scale at the time of propofol injection. Noninvasive mean arterial blood pressure (MAP) and HR were recorded before induction, just before intubation, and 1, 2, and 3 min after intubation, respectively.
Results: The mean of pain scorel during propofol injection was significantly more in Normal Saline group compared to lidocaine and ephedrine (E30, E70, E100, E150) groups but there was no significant difference between lidocaine and ephedrine (E30, E70, E100, E150) groups (80.9vs 59.6 and 56.2, 51.05, 52.8, 57.45) Kruskal- wallis P=0.009. The incidence of pain was also significantly more in Normal Saline group compared to lidocaine group and ephedrine's groups but there was no significant difference between lidocaine and different dose levels of ephedrine. A small dose of ephedrine (30 and 70 µg/kg) could prevent propofol induced pain before intubation and did not produce significant hemodynamic changes compared with the other groups after intubation.
Conclusions: Pretreatment with ephedrine (specially low dose) effectively attenuated pain intensity, and frequency with propofol injection without undesired complications.
Results: A total of 1,029 cases were reviewed. 60% were boys. The highest incidence of diarrhea (75.5%) was observed at 12-24 months and the lowest rate of diarrhea was under 6 months (11.5%). The frequency of diarrhea was lower in winter than in other seasons. Only 31.49% of children received proper and rational treatment with antibiotics. The most commonly used antibiotics in hospitalized patients were ceftriaxone (94.5%) and before hospitalization was cefixime (39.5%). Based on the results of this study, it was found that 66.13% of children younger than 5 years with acute diarrhea had appropriate treatment. 31.94% of patients had inappropriate antibiotic therapy.
Conclusion: In most cases of acute diarrhea in children, no evidence of bacterial or parasitic infection was found. However, a high percentage of patients received antibiotics without laboratory evidence (stool testing). |
Results: The results revealed that red cell distribution width (RDW), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and mean corpuscular volume (MCV) in CBC features have the highest AUC with values of 85.29, 80.96, 79.94 and 79.70, respectively. Then, blood oxygen saturation level (SPO2) in vital features has a higher AUC with a value of 79.28. Moreover, combinations of features in the CBC group have the highest AUC with a value of 95.57. Then, coagulation and vital signs groups have the highest AUC with values of 85.20 and 83.84, respectively. Finally, triple combinations of features in CBC, vital signs, and coagulation groups have the highest AUC with the value of 96.54.
Conclusion: Our proposed system can be used as an assistant acceptable tool for triage of COVID-19 patients to determine which patient will have a higher risk for hospitalization and intensive care in medical environments. |
Case Presentation: A 14-month-old female infant with Covid-19, in November 2019 with prolonged fever lasting for 12 days, weakness and lethargy was admitted to Sanandaj Social Security Hospital, in November 2019. The infant did not have any history of illness, drug or allergy and had received vaccination according to the country's protocol. Later she was transferred to Besat Hospital in Sanandaj due to persistent fever and elevated liver enzymes. The patient had severe leukocytosis and hepatosplenomegaly in the second center. During the diagnostic measures for the patient and the rule out of other possible causes through imaging and laboratory investigations and also the evaluation of relevant criteria, HLH was suggested and treated with antibiotics (ceftriaxone, meropenem), IVIg, dexamethasone and pantoprazole. After that the fever decreased, then oral prednisolone was prescribed and a follow-up was recommended. She was discharged in good general condition.
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