Arch Iran Med
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Diagnosis and timely treatment of neonatal jaundice and prevention of dangerous side effects of pathologic neonatal jaundice remain a serious debate. The first step in prevention of jaundice is the identification of predisposing factors. The present study aims to systematically review the maternal risk factors of neonatal hyperbilirubinemia. ⋯ The most common maternal risk factors for neonatal jaundice were prematurity, blood type incompatibilities, preeclampsia, hypertension, diabetes mellitus, vaginal bleeding, delivery problems (type of delivery, labor injuries, delivery at home, skin ecchymosis, and cephalohematoma), mothers and community cultural beliefs (use of traditional supplements), breast problems, and decrease in breastfeeding.
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With the increasing prevalence of obesity, non-alcoholic fatty liver disease (NAFLD), has become a frequent cause of chronic liver disease, often leading to cirrhosis. In recent decades, gut microbiota have been evaluated as an effective factor in NAFLD pathogenesis, causing steatohepatitis by involving the host immune system. The aim of this study is to evaluate gut microbiota dysbiosis in NAFLD/NASH patients in comparison to healthy controls. ⋯ Overall, study findings indicate a relationship between microbial composition and NAFLD. Study methods and sequencing techniques influenced these results.
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Human albumin is an expensive therapy with inappropriate use in many clinical conditions. Inappropriate use of albumin imposes a substantial economic burden on the healthcare system and society. Drug use evaluation (DUE) is one method of assessing the appropriateness of drug use which has been powered by increasing concern about the cost-effectiveness of drugs. The objective of this study is to systematically review the appropriateness of albumin utilization in Iranian hospitals. ⋯ Our findings show that inappropriate use of albumin imposes a relatively high additional cost on the society. The included studies show that the percentage of inappropriate use of albumin is relatively high in Iran and this abuse is an essential problem in Iranian hospitals. Prescription based on standard guidelines could improve rational use of albumin and lead to savings in treatment costs.
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Due to advances in surgical procedure, anesthesia techniques, blood transfusion and antibiotic therapy, the technique of cesarean section has been progressing over the time. However, cesarean section is still a risk-specific operation, with long-term and shortterm consequences for the mother and neonate. The rate of cesarean surgery is constantly growing due to both justifiable and nonjustifiable medical and non-medical reasons. ⋯ The results show that there is still a high prevalence of C-section. In Iran, the highest rate of cesarean was in Tehran province (62.1%-72.1%) and the lowest was in Sistan and Baluchestan province (12%). It appears necessary to plan for effective interventions in terms of painless vaginal delivery, improving the quality of vaginal delivery services, proper culture and education.
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Meta Analysis
Prolonged versus Intermittent Infusion of Antibiotics in Acute and Severe Infections: A Meta-analysis.
Acute and severe infections are an absolute indication for the use of intravenous broad-spectrum antibiotics. However, previous studies have found inconsistent clinical advantages of prolonged (extended [≥3-hour infusion] or continuous [24-hour fixed rate infusion]) over intermittent (6, or 8, or 12 interval hours infusion) infusion. The clinical superiority between prolonged and intermittent infusion in treating acute and severe infections thus continues to be elusive. We conducted a meta-analysis to summarize all published randomized controlled trials (RCTs), prospective and retrospective observational studies to determine whether prolonged infusion, compared to intermittent infusion, is correlated with lower mortality and better clinical outcome. ⋯ Better outcomes in hospitalized patients, especially in those who were critical ill, were reported in prolonged infusion of intravenous antibiotics compared with traditional intermittent infusion.