Background: Neuro-Behcet’s disease (NBD) is similar to multiple sclerosis (MS) in multiple aspects. This study was conducted to investigate the sensitivity, specificity, accuracy, positive and negative predictive values for the 2005 revised McDonald MRI criteria for the diagnosis of MS and NBD. Methods: This study enrolled 28 consecutive patients with a diagnosis of NBD and 48 patients with a diagnosis of clinically definite MS, who were referred to the Nemazee Hospital, Shiraz University of Medical Sciences, between March 2009 and March 2010. Brain and spinal cord magnetic resonance imaging (MRI) were obtained. Two Radiologists, blinded to clinical diagnosis, reviewed the MRI. We investigated the sensitivity, specificity, accuracy, and positive and negative predictive values of the 2005 revision of the McDonald criteria for dissemination in space for the diagnosis of MS and NBD. Results: There were a total of 10 men and 38 women with a mean age of 32.76±7.5 years, with a diagnosis of MS, and 18 men and 10 women with a mean age of 26.8±5.9 years with a diagnosis of parenchymal NBD. The interobserver agreement for the diagnosis of MS using the 2005 revision of the McDonald criteria for dissemination in space with the use of the Cohen kappa scores was 0.82. The sensitivity, specificity, accuracy, and positive and negative predictive values were 80%, 61%, 71.5%, 77% and 64%, respectively. Conclusion: The accuracy and specificity of the McDonald criteria for dissemination in space for the differentiation of MS and NBD are not optimal.

BACKGROUND: Anesthesia today has strived to decrease labor pain in a tolerable and controllable fashion. Intrathecal midazolam has been introduced as an adjunct to analgesics. The study was planned to assess the efficacy, safety and duration of analgesia produced by intrathecal midazolam adjunct to sufentanil in decreasing labor pain. METHODS: In a randomized clinical trial 80 parturient included in the study. The two groups were matched for age, cervical dilation, gravid, gestational age, and other demographic characteristics. Combination of sufentanil and midazolam administered intrathecally to experimental group and compared to sufentanil group. Time to reach maximum block, and pain score was measured and recorded. RESULTS: Groups were matched for age and weight and other demographic characteristic. No significant adverse effect was seen in both groups including decrease in Apgar score. Duration of analgesia was 92.0 +/- 12.7 in sufentanil group and 185.2 +/- 15.2 minutes in midazolam and sufentanil group which was significantly different (P = 0.002). Numeric rating scale score was significantly lower in midazolam group compare to sufentanil group at 120 min (P = 0.01), 150 min (P = 0.0014), and 180 min (P = 0.001). CONCLUSIONS: Intrathecal midazolam as an adjunct to opioid could significantly enhance analgesia in labor pain with no significant adverse effect. Intrathecal injection of midazolam is an appropriate alternative to parenteral or epidural analgesia in small hospital settings.
Analgesia ; Analgesia, Epidural ; Analgesics ; Anesthesia ; Apgar Score ; Female ; Gestational Age ; Injections, Spinal ; Labor Pain* ; Midazolam* ; Pregnancy ; Sufentanil*

BACKGROUND: Workers in slaughterhouses are exposed to a wide range of biological contaminants, such as bacteria and fungi, due to their working environment. This study aimed to assess the prevalence of respiratory disorders among workers in slaughterhouses. METHODS: This study was conducted on 81 workers in slaughterhouses and 81 healthy office workers as a reference group. The American Thoracic Society standard respiratory symptoms questionnaire was used to determine the prevalence of respiratory disorders. Besides, lung function tests were conducted using a calibrated spirometer at the beginning (preshift) and at the end (postshift) of the 1st working day. Single-stage Anderson sampler was used to measure the concentration of bioaerosols in different parts of slaughterhouses. RESULTS: The prevalence of respiratory disorders, such as cough, productive cough, breathlessness, phlegm, and wheezing, was 3.17, 4.02, 3.07, 4.66, and 3.94 times, respectively, higher among workers in slaughterhouses compared with the reference group. CONCLUSION: The prevalence of respiratory disorders was significantly higher among workers in slaughterhouses. Thus, the significant reduction in the percentage predicted lung function among workers in slaughterhouses might be associated with exposure to bioaerosols in their work environment.
Abattoirs* ; Bacteria ; Cough ; Dyspnea ; Fungi ; Lung ; Prevalence ; Respiratory Function Tests ; Respiratory Sounds

PURPOSE: The present study aimed to determine the relationship between serum 25-hydroxyvitamin D (25(OH)D) level and Urinary tract infections (UTIs) in children. METHODS: In this case-control study, 70 children with UTI (case group) were compared with 70 healthy children (control group) in terms of serum 25(OH)D levels. The children were between 1 month and 12 years of age. Serum 25(OH)D levels were measured using enzyme-linked immunosorbent assay (ELISA). The results were analyzed and compared between both groups. RESULTS: Among 70 children with UTI (case group), 5 children (7.2%) were male and 65 (92.8%) were female. Among the healthy children (control group), 9 (12.8%) and 61 children (87.2%) were male and female, respectively (P=0.39). The mean±standard deviation of age in the case and control groups were 53.2±35.6 and 36.1±60.2 months, respectively (P=0.24). The mean level of serum 25(OH)D in the case group was significantly higher than that of the control group (20.4±8.6 ng/mL vs. 16.9±7.4 ng/mL, P=0.01). CONCLUSION: This study showed that there was a relationship between serum 25(OH)D levels and UTI in children. It seems that 25(OH)D plays a role in the pathogenesis of UTI.
Case-Control Studies ; Child* ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Male ; Urinary Tract Infections* ; Urinary Tract* ; Vitamin D* ; Vitamins*

The present study aimed to determine the relationship between the level of air pollutants and the rate of ischemic stroke (IS) admissions to hospitals. In this retrospective cross-sectional study, stroke admissions (January-March 2012 and 2013) to an emergency department and air pollution and meteorological data were gathered. The relationship between air pollutant levels and hospital admission rates were evaluated using the generalize additive model. In all 379 patients with IS were referred to the hospital (52.5% male; mean age 68.2+/-13.3 years). Both transient (p<0.001) and long-term (p<0.001) rises in CO level increases the risk of IS. Increased weekly (p<0.001) and monthly (p<0.001) average O3 levels amplifies this risk, while a transient increase in NO2 (p<0.001) and SO2 (p<0.001) levels has the same effect. Long-term changes in PM(10) (p<0.001) and PM(2.5) (p<0.001) also increase the risk of IS. The findings showed that the level of air pollutants directly correlates with the number of stroke admissions to the emergency department.
Air Pollutants ; Air Pollution ; Cross-Sectional Studies ; Emergency Service, Hospital ; Humans ; Male ; Patient Admission ; Retrospective Studies ; Stroke

Objective: To determine some bio-ecological aspects of malaria vectors in Jask County, where is targeted for malaria elimination in the national program. Methods: Mosquitoes were collected monthly during 2013-2014 using different collection methods. Subsequently, ELISA test was used to detect the human blood index of mosquitoes. The susceptibility status of Anopheles stephensi was evaluated against the diagnostic dosages of seven WHO recommended insecticides. Results: A total of 3. 650 female and 4. 736 Anopheles larvae were collected including Anopheles stephensi, Anopheles culicifacies s.l., Anopheles dthali, Anopheles fluviatilis s.l., Anopheles moghulensis and Anopheles turkhodi species. Anopheles stephensi was the dominant collected species on human baits and indoors with high rate of unfed and gravid specimens in internal and external window traps. Human blood index was calculated as 14.3% for this species. It was also found to be resistant to DDT and Dieldrin. Conclusions: The collected species had a wide range of habitats, and resting behaviors. With regarding to the presence of most important malaria vectors in Jask, control of the disease may be so complicated; as based on the weather condition it can be transmitted during the whole year, expect for cold months. With this strong potential of transmission, existing population movements in the area may lead to imported cases of malaria and local outbreak(s). So, more specific studies on malaria vectors in high risk areas of Jask County are recommended.

Objective: To evaluate the susceptibility of Anopheles stephensi (An. stephensi) Liston, the main malaria vector in southern Iran, to WHO recommended insecticides. Methods: Larvae of An. stephensi were collected from three different larval habitats in both urban and rural area of Bandar Abbas city and one rural area in Rudan county southern Iran. WHO standard method was used for evaluation of adult and larval mosquito susceptibility. Bendiocarb, permethrin, lambda-cyhalothrin, deltamethrin as insecticide and temephos and chlorpyriphos as larvicide were used at the diagnostic dosages recommended by WHO. Results: Findings of this study showed all larval populations of An. stephensi were completely susceptible to temephos and candidate for resistance to chlorpyriphos. Adult mosquitoes in rural areas of Bandar Abbas city were resistant to pyrethroid and carbamate insecticides. Conclusion: Comparison of the results of this survey with previous studies indicates that the resistance to pyrethroids and carbamates in this malaria endemic region is increasing. Wide use of pesticides in agriculture is certainly effective in increasing resistance. The inter-sectoral coordination and collaboration in health and agriculture seem to be necessary to manage insecticide resistance in malaria vectors.