The relationship between nut consumption and blood pressure in an Iranian adult population: Isfahan Healthy Heart Program

BACKGROUND AND AIMS

Few studies outside of Western countries have evaluated the relationship between consumption of nuts and blood pressure (BP). This study aimed to investigate the relationship between nut consumption and blood pressure in an Iranian adult population.

METHODS AND RESULTS

We performed a cross-sectional investigation among 9660 randomly selected Iranian adults, sampled to represent three large Iranian regions, using data collected in the Isfahan Healthy Heart Program in 2007. The frequency of nut consumption was assessed by a food frequency questionnaire. Systolic and diastolic BPs (SBP and DBP) were measured in duplicate by trained personnel using a standard protocol. Multiple linear and logistic regressions were applied to assess the relationship between nut intake and BP levels and the presence of hypertension as SBP ≥ 140 mmHg, and/or a DBP ≥ 90 mmHg and/or current use of at least one type of anti-hypertensive medication. Those with nut consumption ≥4 times/week showed less mean of BPs and hypertension prevalence, compared to those who consumed nuts <1 times/week (p < 0.001). Compared to no consumption, consuming nuts ≥4 times/week was associated with a 34% lower prevalence of hypertension (multivariate odds ratio (OR) = 0.66; confidence interval (CI) = 0.51-0.87; p for trend = 0.009).

CONCLUSIONS

More frequent nut consumption is associated with lower BP and lower risk of hypertension among Iranian adults.

Evaluation of orchidopexy with or without opening the external oblique fascia in children with superficial inguinal undescended testis

INTRODUCTION

Orchidopexy is one of the most common pediatric surgeries. In general, the operation for truly undescended testis (UDT) includes opening of the external oblique fascia. The most common location of the testis in UDT is adjacent to the external inguinal canal (superficial inguinal type). Using a new method we performed orchidopexy without opening the fascia. In this clinical trial we compared the outcome after a classic procedure with that obtained using our method.

METHODS AND PATIENTS

This clinical controlled trial was undertaken in the Al Zahra hospital between 2008 and 2010. Patients were randomized into either into the closed technique group (group A, n=52) or the open group (group B, n=52). The incidence of short-term and long-term complications was recorded with a specific questionnaire at the time of surgery and at follow-up visits. Data were analyzed with the SPSS 15.0 software using chi-square and t-tests.

RESULTS

104 patients were included in this study. The incidence of short-term complications (surgical site hematoma, surgical wound infection, scrotal hematoma) and long-term complications (testicular atrophy) did not differ significantly between the 2 groups. Procedure duration in group A was significantly shorter than in group B (p=0.001). Medial thigh sensory loss was more common in group B (p=0.05).

CONCLUSION

When investigating the surgical management of undescended testes, our study found differences in medial thigh sensory loss rate and procedure duration between the open and closed techniques. Operative treatment of UDT without opening the external oblique fascia is highly recommended.

Duplication of cervical oesophagus: a case report and review of literatures

Foregut duplication is commonly found in the posterior mediastinum. 10-20% of these anomalies are associated with oesophageal duplication. It can occur in all parts of oesophageal length. Although duplication of cervical oesophagus has been previously reported, but a majority of them were found in thoracic oesophagus. Infants with oesophageal duplication usually manifested by respiratory distress or asymptomatic thoracic mass, casually, detected in X-ray. A 7-month-old infant weighing about 7.5 kg, with the signboard of respiratory distress, fever and nutritional intolerance was admitted to our hospital. Physical examination showed dehydration, stridor, tachypnoea, intercostal retraction and neck stiffness. Plain chest radiogram showed dubious cystic mass in the distal neck. Cervical and chest computed tomography scan showed neck cystic lesion disseminated to posterior mediastinum, probably propagated to the respiratory system. Cystic lesion connected to oesophagus was partially resected, oesophagus was repaired and remaining mucous of a cyst was removed, then gastrostomy tube was applied. Although cervical oesophageal duplication cysts are rare, but they must be considered as one of the differential diagnoses of cervical mass with respiratory distress in infants.

Perineal mesh rectopexy with sterile talc in children with rectal prolapse

BACKGROUND

With such a wide variety of treatment options available for rectal prolapse and a variable success rate, the optimal treatment for this condition in children is still debated. In this study, we evaluated a technique of perineal mesh rectopexy with a sterile talc-soaked mesh and compared the success rates and complications of this method with those of abdominal rectopexy.

METHODS AND MATERIALS

To examine the effect of therapeutic interventions, a randomized control trial (children were randomized into the case group or the control group) was carried out. In the control group, children were operated on by abdominal posterior mesh rectopexy. In the case group, a 30-cm sterile asbestos-free talc-soaked mesh was placed in the presacral space in a spiral fashion with the end exiting from the perineal incision. From 5 (th) day after surgery onward, the mesh was gradually extracted (10 cm per day) and completely removed by the 7 (th) postoperative day. On postoperative assessment, the duration of hospitalization, the postoperative complications and the success rates after surgery were compared. Patients were followed up for one year.

RESULTS

In this study we evaluated 120 children. Mean age of the patients was 5.1±0.081 years in the case group and 4.91±0.59 years in the control group (p=NS). 34 patients in the case group were male vs. 41 patients in the control group. Results indicated that there was no statistically significant difference in postoperative complications between groups. The infection rate was 1.6% in the case group and 6.6% in the control group (p=NS).There was a higher resolution of constipation in the perineal rectopexy group (68.4% in the control group and 96.8% in the case group; p=0.002). The duration of hospitalization was 6.34±0.28 days in the case group and 6.68±0.31 days in the control group (p=NS).

CONCLUSION

Our findings suggest that perineal mesh rectopexy with sterile talc can be an alternative approach to abdominal surgery and offers an acceptable outcome with a low rate of complications.