Real-time impact of COVID-19 pandemic on cutaneous leishmaniasis case finding and strategic planning, preventive interventions, control and epidemiology in a region with a high burden of cutaneous leishmaniasis and COVID-19: A cross-sectional descriptive study based on registry data in Ilam-Iran

Background and Aims

Cutaneous leishmaniasis (CL) is a severe parasitic disease affecting people, mostly in underdeveloped nations. As a zoonotic infection yearly incidence of CL depends on several parameters such as demographic, epidemiological, and environmental factors as well as prevention and control measures. The sudden outbreak of pandemics such as SARS-Corona-Virus-2 pandemic, can probably affect the incidence or reporting of other diseases, especially infectious diseases, in various ways such as pressure on health systems, providing sanitary services and its components, lockdowns and changes in people's living habits.

Aim

This study aimed to evaluate the COVID-19 impact on the incidence and other epidemiological aspects as well as control measures of CL in Ilam Province-Iran.

Methods

Required data was extracted from the CL registration system in Ilam from 2014 to 2021 to demonstrate the trend of CL incidence before and after COVID-19 pandemic.

Results

Based on our results, a declining pattern of CL incidence was observed, accompanied by the advent and intensification of the viral pandemic in Iran and Ilam province. Although, this decreasing pattern was not integral in all areas, and even increase in CL detection was emphasized in some regions.

Conclusion

It may be inferred that the COVID-19 pandemic may disrupt treatment programs of CL cases, rodent nest destruction, and fighting vector insects.

Intelligent modeling of hydrogen sulfide solubility in various types of single and multicomponent solvents

This study aims to study the solubility of acid gas, i.e., hydrogen sulfide (H₂S) in different solvents. Three intelligent approaches, including Multilayer Perceptron (MLP), Gaussian Process Regression (GPR) and Radial Basis Function (RBF) were used to construct reliable models based on an extensive databank comprising 5148 measured samples from 54 published sources. The analyzed data cover 95 single and multicomponent solvents such as amines, ionic liquids, electrolytes, organics, etc., in broad pressure and temperature ranges. The proposed models require just three simple input variables, i.e., pressure, temperature and the equivalent molecular weight of solvent to determine the solubility. A competitive examination of the novel models implied that the GPR-based one gives the most appropriate estimations with excellent AARE, R² and RRMSE values of 4.73%, 99.75% and 4.83%, respectively for the tested data. The mentioned intelligent model also performed well in describing the physical behaviors of H₂S solubility at various operating conditions. Furthermore, analyzing the William's plot for the GPR-based model affirmed the high reliability of the analyzed databank, as the outlying data points comprise just 2.04% of entire data. In contrast to the literature models, the newly presented approaches proved to be applicable for different types of single and multicomponent H₂S absorbers with AAREs less than 7%. Eventually, a sensitivity analysis based on the GPR model reflected the fact that the solvent equivalent molecular weight is the most influential factor in controlling H₂S solubility.

P-303 Supplementing IVM medium with mesenchymal stem cell-conditioned medium, L-carnitine, and Repaglinide to improve maturation and developmental competence of oocytes derived from normal and endometriosis mice

Study question

Does supplementing in vitro maturation (IVM) medium with bone marrow mesenchymal stem cell-conditioned medium (BMSC-CM), L-carnitine (LC), and Repaglinide (RG) enhance the developmental competence of oocytes derived from endometriosis-induced mice?

Summary answer

L-carnitine and BMSC-CM supplementation improved maturation and fertilization, and developmental competence of oocytes following IVF by modulating nitro-oxidative stress and accelerating nuclear maturation of oocytes.

What is known already

Endometriosis (EMS) is a detrimental condition of the female reproductive system affecting up to 15% of women of reproductive age. Oocytes retrieved from EMS-affected ovaries are more likely to fail IVM and to show altered morphology and lower cytoplasmic mitochondrial content. Mesenchymal stem cells (MSCs) secrete various types of cytokines, growth factors, bioactive factors, and tissue regenerative components into mesenchymal stem cell-conditioned medium. L-carnitine is an antioxidant playing an important role in cell metabolism and is crucial for fatty acid metabolism. Repaglinide (RG) is an anti-hyperglycemic medication that induces insulin secretion by attaching to β cells of the pancreas.

Study design, size, duration

To induce EMS, two groups of mice were used. The first group, as donor mice, were intraperitoneally injected with estradiol-17β depot for one week. Then, they were sacrificed on day 14, and their uterine horns were removed. The suspension including tissue fragments from uterine horns was injected intraperitoneally to the recipient mice group. To ensure the induction of EMS, ovaries of some mice in both normal and EMS groups were analyzed by histological examination.

Participants/materials, setting, methods

Adult female NMRI mice (6-8 weeks old) were divided into two normal and EMS-induced mice. Oocytes obtained from normal and EMS-induced mice were cultured in the IVM medium supplemented with RG, LC, and BMSC-CM for 24 hours. Subsequently, IVM, IVF, embryo development rates, blastocyst cell numbers were assessed. Moreover, the levels of reactive oxygen species (ROS), nitric oxide (NO), and total antioxidant capacity (TAC) of the IVM medium were evaluated.

Main results and the role of chance

Microscopic studies of ovarian tissue samples showed that folliculogenesis, quality of follicles, and oocyte quality reduced in the EMS-induced group. The IVM results represent that 0.3 mg/ml and 0.6 mg/ml of LC, and 25% and 50% of BMSC-CM enhanced the percentage of MII oocytes significantly. Indeed, the highest IVM rate in both the normal and EMS-induced mice was observed in the BMSC-CM 50% group. More importantly, 0.3 and 0.6 mg/ml of LC, and 25% and 50% of BMSC-CM treatments showed a dramatic decrease in ROS and NO levels and a significant enhancement in TAC levels compared to the control group. Our results also indicated that there was a substantial improvement in terms of IVF, cleavage, and blastocyst rates in all treatment groups compared to the control group. The highest blastocyst formation rate was obtained in 50% of the BMSC-CM group. In normal groups, there was a dramatic increase in the mean of total cell number and TE cells in 1µM RG, 0.3 and 0.6 mg/ml LC, 25% and 50% BMSC-CM. In EMS-induced groups, except for the 1M RG group, all treatment groups exhibited a significant difference in the mean total cell population and TE cells compared to the control group.

Limitations, reasons for caution

Due to limited laboratory facilities, the levels of growth factors, pro-inflammatory cytokines, anti-apoptotic, and antioxidants were not measured in the IVM medium. We, therefore, do not know which of the constituents of the BMSC-CM, in particular, had promoter effects on the oocyte maturation, fertilization, and developmental competence of IVF embryos.

Wider implications of the findings

These approaches may outline the clinical applications of LC and BMSC-CM in the assisted reproductive technology (ART) setting and pave the way to improve the maturation culture. Also, these findings can advance the efficiency of fertility outcomes in endometriosis-related infertile couples.

Trial registration number

N/A

O-185 Cryopreservation of Human Spermatozoa: Utilization of L-Proline as a Novel Additive to Improve Sperm Quality Following Freezing-Thawing Process

Study question

Does supplementation of human sperm freezing media with L-Proline improve sperm quality and DNA Integrity following the freezing-thawing process?

Summary answer

The inclusion of L-proline as a novel additive to human sperm cryopreservation media improves sperm parameters and DNA integrity via mitigating oxidative stress.

What is known already

Sperm cryopreservation is an essential aspect of assisted reproductive technique (ART) and male fertility preservation. Although frozen-thawed semen has great practical benefits for reproduction, it is widely reported that the cryopreservation process induces physical and chemical detrimental changes in sperm functions. Indeed, freezing induces nitro-oxidative stress, lipid peroxidation, DNA fragmentation, and apoptosis. L-proline plays versatile roles in osmotic protection and oxidative stress, cell signaling, programmed cell death, and nutrient adaptation. This multifunctional amino acid is a natural osmoprotectant and the protective effect of L-proline against freezing-thawing-induced damages in stallion and donkey spermatozoa have been reported.

Study design, size, duration

Thirty normozoospermic semen samples were collected by masturbation after 3–5 days of sexual abstinence from men who were referred to the IVF clinic of Kermanshah Motazedi Hospital from December 2020 to June 2021. Each prepared semen sample was aliquoted to 4. In aliquots 1 to 4, experimental concentrations of L-proline (0, 1, 2, and 4 mmol/L), were included in the freezing medium.

Participants/materials, setting, methods

30 normozoospermic, healthy, non-smoker men were enrolled. Sperm parameters (progressive motility, viability, and morphology) were assessed. Sperm chromatin quality was measured by Aniline blue (AB), Toluidine blue (TB), and Chromomycin A3 (CMA3) staining. DNA integrity was evaluated by the Sperm chromatin dispersion (SCD) test. Furthermore, the levels of reactive oxygen species (ROS), lipid peroxidation (LPO), and total antioxidant capacity (TAC) were determined in sperm freezing media. All assessments were conducted before cryopreservation and after thawing.

Main results and the role of chance

Our findings showed that sperm progressive motility and viability were significantly higher in the 4 mmol/L L-proline treated groups compared to the control groups (p = 0.003, p = 0.0200) respectively. The percentage of normal morphology was improved in L-Proline-treated groups. However, this improvement was not considerable (p > 0.5). Moreover, the level of ROS production significantly diminished in the 4 mmol/L L-proline group compared to the control group (p < 0.001). Besides, the level of TAC was significantly enhanced in the 4 mmol/L L-proline group by comparison to the control group (p < 0.001). Furthermore, the results of AB and TB tests demonstrated that chromatin packaging after supplementation with 4 mmol/L L-proline significantly improved compared to the control group (p < .0001). In this regard, there was a significant improvement between the 4 mmol/L   L-proline group and the control group in terms of CMA3 evaluation (p < .0001). Also, there was a difference between the 4 mmol/L L-proline group and the control group in reducing the level of fragmented DNA. Although 4 mmol/L of Praline could diminish the SCD level compared to the control group, this amelioration was not statically significant (p = 0.053).

Limitations, reasons for caution

We were not able to perform further studies to verify the effects of L-proline on mitochondrial activity and membrane potential, and sperm apoptosis as well as to confirm the efficiency and safety of L-proline in terms of more indicators such as the in vitro embryonic development and live birth rate.

Wider implications of the findings

These findings can draw attention to the potential role of L-proline as a novel additive and antioxidant to human freezing medium in preserving sperm quality and protecting spermatozoa against ROS attack during sperm cryopreservation in infertility clinics.

Trial registration number

N/A

In vitro maturation medium supplementation: utilization of repaglinide, L-carnitine, and mesenchymal stem cell-conditioned medium to improve developmental competence of oocytes derived from endometriosis mouse models

Endometriosis (EMS) is one of the most prevalent causes for female infertility. Herein, we investigated the effect of the repaglinide (RG), L-carnitine (LC), and bone marrow mesenchymal stem cell-conditioned medium (BMSC-CM) supplementation during in vitro maturation (IVM) on the quality, maturation, and fertilization rates, as well as embryonic quality and development of oocytes derived from normal and EMS mouse model. Immature oocytes were collected from two groups of normal and EMS-induced female NMRI mice at 6-8 weeks of age. Oocytes were cultured in IVM medium unsupplemented (control group), or supplemented with 1 M RG, 0.3 and 0.6 mg/mL LC, and 25 and 50% BMSC-CM. After 24 h of oocyte incubation, IVM rate and antioxidant status were assessed. Subsequently, the rates of fertilization, cleavage, blastulation, and embryonic development were assessed. Our results demonstrated that supplementation of IVM medium with LC and BMSC-CM, especially 50% BMSC-CM, significantly enhanced IVM and fertilization rates, and markedly improved blastocyst development and total blastocyst cell numbers in EMS-induced mice compared to the control group (53.28±0.24 vs 18.09±0.10%). Additionally, LC and BMSC-CM were able to significantly modulate EMS-induced nitro-oxidative stress by boosting total antioxidant capacity (TAC) and mitigating nitric oxide (NO) levels. Collectively, LC and BMSC-CM supplementation improved oocyte quality and IVM rates, pre-implantation developmental competence of oocytes after in vitro fertilization, and enhanced total blastocyst cell numbers probably by attenuating nitro-oxidative stress and accelerating nuclear maturation of oocytes. These outcomes may provide novel approaches to refining the IVM conditions that can advance the efficiency of assisted reproductive technologies in infertile couples.

The application of the loop-mediated isothermal amplification method for rapid detection of methicillin-resistant Staphylococcus aureus

Methicillin-resistant Staphylococcus aureus (MRSA) is an important problem associated with significant mortality and morbidity and well known as a predominant bacterial pathogen. The aim of this study was to identify MRSA strains. In this study (June 2018 to June 2019) isolates of S. aureus were obtained from patients referred to teaching hospitals of Ahvaz, Iran. All isolates were confirmed by conventional microbiological methods. In following, antimicrobial susceptibility testing (AST), MRSA screening, PCR detection of MRSA and LAMP assay were performed. Out of a total of 156 staphylococcal isolates, 126 isolates were identified as MRSA. Seventy-two (57.1%) MRSA isolates were recovered from wound. All MRSA isolates were sensitive to vancomycin, linezolid, teicoplanin, quinupristin-dalfopristin, and tigecycline. The results of LAMP showed 100% agreement with PCR. Sensitivity and specificity of the LAMP assays for the mecA genes were 100% and 100%, respectively. The LAMP assay is a rapid and simple method for the identifications of MRSA. Because of its performance without the need for specific instrumentation, this method can be easily employed in medical centers for the detection of mecA.

Moderate overfeeding of different sources of metabolizable energy and protein. II: Effects on inflammatory status of sheep in late pregnancy and growth trajectory of the offspring

Our objective was to evaluate the effects of moderate overfeeding of different sources of metabolizable energy (ME) and protein (MP) on inflammatory status of sheep in late gestation and short-term growth performance of the offspring. A total of 32 healthy pregnant Zell ewes (2.5 ± 1 years old, 42.19 ± 1.65 kg body weight [BW]) were selected 7 weeks before lambing. After receiving a ten-day adaptation diet, eight ewes were randomly allocated to each of the four treatments including: 1) The adaptation diet that fulfills ME and MP requirements, according to the National Research Council's (NRC, 2007) recommendations for late pregnant ewes (CON); 2) A diet with 10% higher levels of ME than CON, using corn grain for extra ME (HEC); 3) A diet with 10% higher level of ME compared to CON, using flaxseed for additional ME (HEF); and 4) A diet with a 10% higher level of MP than CON, using a rumen-protected lysin and methionine supplement (RP-Lys & Met) to supply extra MP (PRO). After lambing, ewes continued their dietary treatments until 30 days postpartum; however, the content of ingredients were proportionally increased to meet the recommended levels of energy and protein for lactating ewes (NRC, 2007). Blood samples from the ewes were taken on days -21, -14, and -7 before parturition. Colostrum yield and components were determined, and lamb's BW and milk intake (MI) were measured weekly until 28 days of age. Other growth performance indexes were computed accordingly. Blood samples from the offspring were taken on days 15 and 30 of life. The data was analyzed using SAS software (SAS Institute Inc., 9.4). Compared with the CON, HEF-fed ewes were the only group that had lower levels of oxidative stress and blood inflammatory markers at -7 d before parturition (P < 0.05). Concentrations of aminotransferases in CON-fed ewes were greater than other groups in late gestation (P ≤ 0.05). Offspring of HEF- and PRO-fed ewes had higher birth BW than lambs of the CON-fed group (3.71 and 4.11 vs. 3.01 ± 0.24, Kg for HEF, PRO, and CON, respectively). Except for week 2, lambs of CON-fed ewes had lower BW gain compared with the other offspring (P < 0.01). Lambs of PRO-fed ewes had greater levels of plasma immunoglobulin G (IgG, days 15 and 30 of life; P < 0.05) and MI (from week 2; P < 0.001) than other groups. In conclusion, regardless of the source, moderate overfeeding of ME/MP was more beneficial for the immune status of late pregnant dams and the offspring's performance than non-overfed ones.

P–061 Protective effect of melatonin against bleomycin, etoposide, and cisplatin (BEP) chemotherapy-induced testicular toxicity in Wistar rats: A biochemical, immunohistochemical and apoptotic genes based evidence

Study question

Does exogenous melatonin (MLT) attenuate BEP-induced damage in testicular cells and spermatogenesis in a dose-dependent manner?

Summary answer

Melatonin protected the testes against BEP-induced testis damage through ameliorating nitro-oxidative stress, apoptosis, and inflammation. However, there was no significant difference between melatonin-treated groups.

What is known already

Recently, the prevalence of testicular cancer (TC), accounting for the most common cancer among young people of reproductive age (15–40 years), has risen internationally. BEP chemotherapy has increased the 5-year survival rate of TC patients at all stages of testicular germ cell tumors to 90–95%. However, BEP creates a high incidence of male infertility and even long-term genotoxic effects, which emerges as a critical health issue. Melatonin is a well-known potent antioxidant with widespread clinical applications that recently has been giving increasing attention to its role in male sub/infertility.

Study design, size, duration

60 Adult male Wistar rats were randomly assigned to six groups (n = 10/group). Group 1, 3, and 4 were injected with vehicle, 10 and 20 mg/kg of melatonin, respectively. Other groups received one cycle of bleomycin, etoposide, and cisplatin for a total of 3 weeks with or without melatonin. Melatonin administration started daily one week before BEP initiation continued on days 2, 9, and 16; and one week after the completion of the BEP cycle.

Participants/materials, setting, methods

Bodyweight, testes weight, Sperm parameters (count, motility, viability, and morphology), testosterone hormone level, testicular histopathology, stereological parameters, testicular level of malondialdehyde (MDA), nitric oxide (NO), and total antioxidant capacity (TAC), the expression of Bcl–2, Bax, Caspase–3, p53, and TNF-α (Real-time PCR and immunohistochemistry) were evaluated at the end of the study (day 35).

Main results and the role of chance

Our findings showed that melatonin restores the BEP-induced reduction in the body and testes weight (P&lt;.05). the evaluation of quantitative analysis of the testes stereological procedures, QRT-PCR examination and immunohistochemical (IHC) staining revealed that melatonin reverses the BEP-induced impaired spermatogenesis (P&lt;.05). Furthermore, melatonin rectifies BEP-induced disturbance on sperm count, motility, viability, and morphology. The testosterone level in the BEP-treated group was decreased significantly by comparison with the control group (P&lt;.01). By contrast, co-administration of 10 and 20 mg/kg of melatonin could enhance the serum testosterone level significantly (P&lt;.05). Moreover, melatonin enhanced the antioxidant status of the testis by elevating TAC and ameliorating MDA and NO levels. More notably, QRT-PCR examination indicated that melatonin therapy suppressed BEP-induced apoptosis by modulating apoptosis-associated genes such as Bcl–2, Bax, Caspase–3, p53 in the testis (P&lt;.01). Besides, Co-administration of 10 and 20 mg/kg of melatonin with BEP regimen decreased significantly the population of p53 (54.21 ±6.18% and 51.83±8.45, respectively) and TNF-α positive cells (42.91±9.92% and 33.57±2.97, respectively) by comparison to the BEP group. Also, melatonin with low and high doses could enhance the expression of Bcl–2 protein in spermatogenic cells line (59.19±10.18%, 63.08±5.23, respectively) compared to the BEP-treated group.

Limitations, reasons for caution

Owing to limited laboratory facilities we were not able to perform further studies to verify the mechanism of melatonin in the specific targets by using transfection technique and transgenic.

Wider implications of the findings: These findings can draw attention to the clinical application of melatonin and also suggest that melatonin may be an attractive agent for attenuating chemotherapy-associated male sub/infertility. This indolamine also may shorten the fertility recovery period in patients undergoing chemotherapy with the BEP regimen.

Trial registration number

N/A

Investigating the anti-inflammatory effects of high molecular weight secretions from Limosilactobacillus reuteri PTCC 1655 on LPS-stimulated PMA-differentiated THP-1 cells

AIMS

This study was done to investigate the anti-inflammatory effects of high molecular weight secretions from Limosilactobacillus reuteri PTCC 1655 probiotic bacteria on lipopolysaccharide (LPS)-stimulated phorbol 12-myristate 13-acetate (PMA)-differentiated THP-1 cells.

METHODS AND RESULTS

After culturing the bacterium, the crude cell-free supernatant was fractionated on the basis of molecular weights using ultrafiltration. Also, a heat-killed and sonicated fraction was obtained from the biomass of the bacterial culture. All fractions were used to measure their anti-inflammatory effects on PMA-differentiated THP-1 cells following LPS stimulation by quantifying various cellular markers of inflammation. The results demonstrated that various L. reuteri PTCC 1655-derived fractions, especially the >100 kDa supernatant fraction decreased some of the inflammatory cytokines and mediators, including tumour necrosis factor-α, interleukin-1, nitric oxide, cyclooxygenase-2, matrix metalloproteinase-9 and interleukin-6, which are critical for the pathogenesis of some inflammatory diseases.

CONCLUSION

It is concluded that the L. reuteri PTCC 1655-derived high molecular weight fractions significantly reduce inflammation and therefore could be appropriate candidates for future medical studies.

SIGNIFICANCE AND IMPACT OF THE STUDY

Providing new insights about the significance of L. reuteri PTCC 1655-derived extracts and their potential to modulate inflammation.

Moderate over-feeding of different sources of metabolizable energy and protein improved gestational insulin resistance markers and maternal metabolic status of sheep around lambing

The objective of this study was to determine the effect of moderate over-nutrition of energy (using flaxseed as a source of n-3 fatty acids) and protein (using rumen-protected lysine and methionine) around parturition on prepartal insulin resistance (IR) and periparturient metabolic status and performance of ewes. For this purpose, 32 apparently healthy ewes (2.5 ± 1 years old, 42.19 ± 1.65 kg body weight (BW)) were randomly selected out of 200 pregnant Zell ewes on d 50 before the expected lambing. After receiving a ten-day adaptation diet, eight ewes were randomly allocated to one of the following four dietary treatments: 1) the adaptation diet that meets the metabolizable energy (ME) and protein (MP) requirements of ewes during late pregnancy as recommended by National Research Council = NRC (2007) (Control = CON). 2) A diet with 10% higher levels of ME than NRC (2007) recommendations using corn grain as a source of extra ME (HEC). 3) A diet with 10% higher levels of ME compared to NRC (2007) recommendations using flaxseed for additional ME (HEF). 4) A diet with a 10% higher level of MP than NRC (2007) recommendations using rumen-protected lysine and methionine as a source of extra MP (PRO). While the dietary treatments did not affect animals' dry matter intake (DMI), the CON ewes lost more BW starting from d 10 to d 30 relative to parturition compared to others (P < 0.05). Milk protein and fat yield (g/d) were significantly higher for PRO and HEF compared to HEC and CON ewes (P < 0.05). Moderately over-fed ewes with MP and ME had an improved insulin sensitivity (IS) compared to CON ones. The source of additional ME also impacted IR indices because HEC showed an enhancement in IS than HEF animals (P < 0.05). A lower IS in CON ewes was parallel with higher concentrations of plasma urea at prepartum (P < 0.01), lower levels of plasma cholesterol, triglyceride (P < 0.01) and glucose post-partum (P < 0.05), and a tendency for higher levels of beta-hydroxybutyrate (BHB) and non-esterified fatty acids (NEFA) in CON ewes during both pre- and post-partum periods. There were negative correlations between plasma urea, BHB, and NEFA with IR markers on d 7 prepartum in line with these results. Comparing data, we could not find a significant change in metabolic status among ewes fed with either PRO or HEF/HEC. In conclusion, the inclusion of 10% extra MP and ME could improve late gestation maternal IS and the metabolic status of dams around lambing.

Evaluating the frequency of carbapenem and aminoglycoside resistance genes among clinical isolates of Acinetobacter baumannii from Ahvaz, south-west Iran

Acinetobacter baumannii is one of the most important opportunistic challenging pathogens as a result of its ability to acquire resistance to broad range of antibiotics and cause a variety of severe nosocomial infections. We investigated the frequency of the aminoglycoside-modifying enzymes (AMEs) and oxacillinase genes among clinical isolates of A. baumannii collected from hospitalized patients in Imam Khomeini Hospital, Ahvaz city, Iran. This prospective cross-sectional study was performed on 80 clinical isolates of A. baumannii collected from patients referred to Imam Khomeini Hospital in Ahvaz, Iran. Initial identification of isolates as A. baumannii was performed using conventional bacteriologic tests, and final confirmation was carried out by PCR of bla_OXA-51-like gene and multiplex PCR of gyrB locus. MICs of different classes of antibiotics against these strains was measured by using VITEK 2 system. After extraction of genomic DNA, two groups of multidrug-resistant A. baumannii genes including AME (aadA1, aadB, aphA6 and aacC1) and oxacillinases (bla_OXA-23-like, bla_OXA-24-like, bla_OXA-51-like, bla_OXA-58-like and bla_OXA-143-like) were detected. According to antibiotic susceptibility testing, among 80 A. baumannii strains, 75 isolates (91.25%) were multidrug resistant. The results showed that colistin and tigecycline, with respective sensitivity rates of 97.5% (78/80) and 56.25% (45/80), had the highest effects. The presence of bla_OXA-51-like and gyrB genes was confirmed in all strains. Furthermore, bla_OXA-23-like and bla_OXA-24-like genes were found in 68.75% (55/80) and 20% (16/80) of isolates respectively, while no isolate harbored the bla_OXA-143-like gene. The frequency of genes encoding the AMEs including aadA1, aacC1, aphA6 and aadB were 11.25% (9/80), 16.25% (13/80), 22.5% (18/80) and 30% (24/80) respectively. Our findings indicate that the presence of the aadB and aphA6 is correlated with high resistance against amikacin and gentamicin. We found a very high resistance rate against most of the antimicrobial agents usually prescribed for severe infections caused by A. baumannii. Therefore, because of rapid emergence of resistance even for colistin or tigecycline, monotherapy should be avoided. These results show the importance of providing antibiotics correctly in intensive care units and following antibiotic stewardship protocols as the only effective strategies to attempt to control antibiotic resistance in healthcare settings.

The effect of eye movement desensitization and reprocessing on the fear of hypoglycemia in type 2 diabetic patients: a randomized clinical trial

Background

The fear of hypoglycemia leads to psychological symptoms in patients with diabetes type 2. In this research, the effects of EDMR on the fear of hypoglycemia in patients with diabetes type 2 were examined.

Methods

A clinical trial study was carried out with participation of 72 patients who had diabetes type 2 in Velayat Hospital. The participants were randomly assigned into control and intervention groups. The intervention group received EMDR. The required information was gleaned using a questionnaire of fear of hypoglycemia, intensity of hypoglycemia, and demographics filled out before the intervention, and 1 month and 3 months after it. The data were analyzed using descriptive statistics on SPSS Version 23. For comparison of fear of hypoglycemia in intervention and control groups, repeated measure ANOVA and Cohen d test were used.

Results

The mean age of the participants in the intervention group was 43.17 ± 10.55 and in the control group was 45.86 ± 13.6. In this study, without considering the potential disruptors in the incorrect model, the intervention caused a reduction of 15 points 1 month after the completion of the intervention and a reduction of 17 points 3 month after the completion of the intervention on the scale of fear of hypoglycemia; but post-correction of potential disruptors, intervention caused a reduction of 19.5 scores 1 month after the completion and a reduction of 20.3 scores 3 months after the intervention .

Conclusions

The EMDR can be used as a non-pharmaceutical treatment method to treat and alleviate the fear of hypoglycemia in type 2 diabetes patients.

Trial registration

Iranian Registry of Clinical Trials: IRCT20181201041813N1, 2019/11/13.

Chlorhexidine alcohol versus povidone-iodine: The comparative study of skin disinfectants at the blood transfusion centers of Iran

OBJECTIVES

The skin disinfection in the blood donor's arm is a key step to minimize the risk of microbial contamination at blood donation sessions. Current study aimed to compare the efficacy of 2% chlorhexidine gluconate in 70% isopropyl alcohol (CHG/IPA) with povidone-Iodine (PI) at blood transfusion centers (BTCs) of Iran.

MATERIAL AND METHODS

Blood donors were selected to evaluate three commercial CHG/IPA disinfectants (N=300), prior the application at BTCs, and to compare the rate of positive skin cultures between CHG/IPA and PI in 31 BTCs (N=8578). The rate of positivity for PI over a 5-year period was also investigated. After application of a two-step disinfection procedure, the biochemical characteristics were checked in accordance with the conventional bacteriological methods. The Z-test analysis was used to compare the deviation between the positive microbial culture ratios.

RESULT

No donors had a positive culture after disinfection during the evaluation study. There was no difference in the rate of positivity between PI and CHG/IPA after disinfection (P>0.05). The rate of positivity for PI from 2012 to 2017 showed a decreasing trend. The rate of positivity was significantly higher in winter rather than summer (P<0.05).

CONCLUSION

The disinfection efficacy of CHG/IPA was equivalent to that of PI. The 5-year monitoring of PI at BTCs showed that the improvement in the rate of positive skin cultures possibly due to effectiveness of correcting actions.

Clinical and metabolic response to vitamin D plus probiotic in schizophrenia patients

BACKGROUND

This study determined the effects of a novel combination of vitamin D and probiotic on metabolic and clinical symptoms in chronic schizophrenia.

METHODS

This trial was conducted among 60 patients with chronic schizophrenia to receive either 50,000 IU vitamin D3 every 2 weeks plus 8 × 10⁹ CFU/day probiotic (n = 30) or placebo (n = 30) for 12 weeks.

RESULTS

Vitamin D and probiotic co-supplementation was associated with a significant improvement in the general (- 3.1 ± 4.7 vs. + 0.3 ± 3.9, P = 0.004) and total PANSS scores (- 7.4 ± 8.7 vs. -1.9 ± 7.5, P = 0.01). Vitamin D and probiotic co-supplementation also significantly increased total antioxidant capacity (+ 51.1 ± 129.7 vs. -20.7 ± 53.3 mmol/L, P = 0.007), and significantly decreased malondialdehyde (- 0.3 ± 0.9 vs. + 0.2 ± 0.4 μmol/L, P = 0.01) and high sensitivity C-reactive protein levels (- 2.3 ± 3.0 vs. -0.3 ± 0.8 mg/L, P = 0.001) compared with the placebo. Moreover, taking vitamin D plus probiotic significantly reduced fasting plasma glucose (- 7.0 ± 9.9 vs. -0.2 ± 9.9 mg/dL, P = 0.01), insulin concentrations (- 2.7 ± 2.3 vs. + 0.4 ± 2.0 μIU/mL, P < 0.001), homeostasis model of assessment-estimated insulin resistance (- 0.8 ± 0.7 vs. + 0.1 ± 0.7, P < 0.001), triglycerides (- 7.8 ± 25.2 vs. + 10.1 ± 30.8 mg/dL, P = 0.01) and total cholesterol levels (- 4.9 ± 15.0 vs. + 5.9 ± 19.5 mg/dL, P = 0.04) and total-/HDL-cholesterol ratio (- 0.1 ± 0.6 vs. + 0.3 ± 0.8, P = 0.04).

CONCLUSION

Probiotic and vitamin D for 12 weeks to chronic schizophrenia had beneficial effects on the general and total PANSS score, and metabolic profiles.

TRIAL REGISTRATION

This study was retrospectively registered in the Iranian website ( www.irct.ir ) for clinical trials registration ( http://www.irct.ir : IRCT2017072333551N2). 07-31-2017 2.

Detection of acute Toxoplasma gondii infection in pregnant women by IgG avidity and PCR analysis

During pregnancy, Toxoplasma gondii can be transmitted from mother to foetus and trigger a primary infection that may be symptomatic. It is important to distinguish between recently acquired and past infections to ensure proper treatment to minimize irreversible foetal injury. We used PCR of the B1 gene to evaluate the accuracy of T. gondii IgG antibody avidity testing in discriminating recent from past infection. In a cross-sectional study, T. gondii IgG and IgM antibodies were detected by enzyme linked fluorescence assay (ELFA) in 2120 serum samples from pregnant women referred to Karaj medical laboratories, February 2013 through March 2015 with 40 samples found positive. IgM-positive samples were evaluated by IgG avidity testing and PCR to amplify the B1 gene. Avidity studies indicated 20 samples with high IgG avidity, 15 with low IgG avidity, and five showing borderline values. The B1 gene was amplified in the borderline samples, with nine of the 15 showing low avidity. The B1 gene was not amplified in the high avidity sera. Our findings suggest that IgG avidity alone may not be sufficient to discriminate recent from past T. gondii infection and should not be used as the sole confirmatory test in pregnant women with IgG and IgM T. gondii antibodies. IgG avidity testing in combination with PCR may be more reliable for distinguishing between high- and low-risk infection and decrease the frequency of unnecessary treatment of pregnant women.

Exposure to Visible Light Emitted from Smartphones and Tablets Increases the Proliferation of Staphylococcus aureus: Can this be Linked to Acne?

BACKGROUND

Due to rapid advances in modern technologies such as telecommunication technology, the world has witnessed an exponential growth in the use of digital handheld devices (e.g. smartphones and tablets). This drastic growth has resulted in increased global concerns about the safety of these devices. Smartphones, tablets, laptops, and other digital screens emit high levels of short-wavelength visible light (i.e. blue color region in the visible light spectrum).

MATERIAL AND METHODS

At a dark environment, Staphylococcus aureus bacteria were exposed to the light emitted from common tablets/smartphones. The control samples were exposed to the same intensity of light generated by a conventional incandescent light bulb. The growth rate of bacteria was examined by measuring the optical density (OD) at 625 nm by using a spectrophotometer before the light exposure and after 30 to 330 minutes of light exposure.

RESULTS

The growth rates of bacteria in both smartphone and tablet groups were higher than that of the control group and the maximum smartphone/control and tablet/control growth ratios were observed in samples exposed to digital screens' light for 300 min (ratios of 3.71 and 3.95, respectively).

CONCLUSION

To the best of our knowledge, this is the first study that investigates the effect of exposure to light emitted from digital screens on the proliferation of Staphylococcus aureus and its association with acne pathogenesis. Our findings show that exposure to short-wavelength visible light emitted from smartphones and tablets can increase the proliferation of Staphylococcus aureus.

Evaluation of the Effect of Radiofrequency Radiation Emitted From Wi-Fi Router and Mobile Phone Simulator on the Antibacterial Susceptibility of Pathogenic Bacteria Listeria monocytogenes and Escherichia coli

Mobile phones and Wi-Fi radiofrequency radiation are among the main sources of the exposure of the general population to radiofrequency electromagnetic fields (RF-EMF). Previous studies have shown that exposure of microorganisms to RF-EMFs can be associated with a wide spectrum of changes ranged from the modified bacterial growth to the alterations of the pattern of antibiotic resistance. Our laboratory at the nonionizing department of the Ionizing and Non-ionizing Radiation Protection Research Center has performed experiments on the health effects of exposure to animal models and humans to different sources of electromagnetic fields such as cellular phones, mobile base stations, mobile phone jammers, laptop computers, radars, dentistry cavitrons, magnetic resonance imaging, and Helmholtz coils. On the other hand, we have previously studied different aspects of the challenging issue of the ionizing or nonionizing radiation-induced alterations in the susceptibility of microorganisms to antibiotics. In this study, we assessed if the exposure to 900 MHz GSM mobile phone radiation and 2.4 GHz radiofrequency radiation emitted from common Wi-Fi routers alters the susceptibility of microorganisms to different antibiotics. The pure cultures of Listeria monocytogenes and Escherichia coli were exposed to RF-EMFs generated either by a GSM 900 MHz mobile phone simulator and a common 2.4 GHz Wi-Fi router. It is also shown that exposure to RF-EMFs within a narrow level of irradiation (an exposure window) makes microorganisms resistant to antibiotics. This adaptive phenomenon and its potential threats to human health should be further investigated in future experiments. Altogether, the findings of this study showed that exposure to Wi-Fi and RF simulator radiation can significantly alter the inhibition zone diameters and growth rate for L monocytogenes and E coli. These findings may have implications for the management of serious infectious diseases.

A label-free, PCR-free and signal-on electrochemical DNA biosensor for Leishmania major based on gold nanoleaves

Detection of leishmaniasis is important in clinical diagnoses. In the present study, identification of Leishmania parasites was performed by a label-free, PCR-free and signal-on ultrasensitive electrochemical DNA biosensor. Gold nanoleaves were firstly electrodeposited by an electrodeposition method using spermidine as a shape directing agent. The biosensor was fabricated by immobilization of a Leishmania major specific DNA probe onto gold nanoleaves, and methylene blue was employed as a marker. Hybridization of the complementary single stranded DNA sequence with the biosensor under the selected conditions was then investigated. The biosensor could detect a synthetic DNA target in a range of 1.0×10^-10 to 1.0×10^-19molL^-1 with a limit of detection of 1.8×10^-20molL^-1, and genomic DNA in a range of 0.5-20ngμL^-1 with a limit of detection of 0.07ngμL^-1. The biosensor could distinguish Leishmania major from a non-complementary-sequence oligonucleotide and the tropica species with a high selectivity. The biosensor was applicable to detect Leishmania major in patient samples.

Progression-free and overall survival in ovarian cancer patients treated with CVac, a mucin 1 dendritic cell therapy in a randomized phase 2 trial

Background

CAN-003 was a randomized, open-label, Phase 2 trial evaluating the safety, efficacy and immune outcomes of CVac, a mucin 1 targeted-dendritic cell (DC) treatment as a maintenance therapy to patients with epithelial ovarian cancer (EOC).

Methods

Patients (n = 56) in first (CR1) or second clinical remission (CR2) were randomized (1:1) to standard of care (SOC) observation or CVac maintenance treatment. Ten doses were administered over 56 weeks. Both groups were followed for progression-free survival (PFS) and overall survival (OS).

Results

Fifty-six patients were randomized: 27 to SOC and 29 to CVac. Therapy was safe with only seven patients with Grade 3–4 treatment-emergent adverse events. A variable but measurable mucin 1 T cell-specific response was induced in all CVac-treated and some standard of care (SOC) patients. Progression free survival (PFS) was not significantly longer in the treated group compared to SOC group (13 vs. 9 months, p = 0.36, hazard ratio [HR] = 0.73). Analysis by remission status showed in the CR1 subgroup a median PFS of 18 months (SOC) vs. 13 months (CVac); p = 0.69 (HR = 1.18; CI 0.52–2.71). However CR2 patients showed a longer median PFS in the CVac-treated group (median PFS not yet reached, >13 vs. 5 months; p = 0.04, HR = 0.32 CI). OS for CR2 patients at 42 months of follow-up showed a difference of 26 months for SOC vs. > 42 months for CVac-treated (as median OS had not been reached; HR = 0.17 (CI 0.02–1.4) with a p = 0.07).

Conclusions

CVac, a mucin 1-dendritic cell maintenance treatment was safe and well tolerated in ovarian cancer patients. A variable but observed CVac-derived, mucin 1-specific T cell response was measured. Notably, CR2 patients showed an improved PFS and lengthened OS. Further studies in CR2 ovarian cancer patients are warranted (NCT01068509).

Trial registration

NCT01068509. Study Initiation Date (first patient screened): 20 July 2010. Study Completion Date (last patient observation): 20 August 2013, the last patient observation for progression-free survival; 29 April 2015, the last patient was documented regarding overall survival.

Prevalence of beta lactamase producing species of pseudomonas and acinetobacter in pediatric burn patients

Burn wound infection is a major cause of morbidity and mortality in burn victims. Pseudomonas and Acinetobacter species are among the most common organisms complicating burn wounds. Presence of extended spectrum ß-lactamase (ESBL) and metallo-ß-lactamase (MBL) genes plays an important role in spreading ß-lactam resistant strains of these organisms and is a serious condition in the treatment of the affected patients. As a result, we aimed to determine the prevalence of SHV, TEM, PER and VIM ß-lactamases in Pseudomonas and Acinetobacter species isolates from burn wound swabs of children with burn injury. In this descriptive observational study, 107 Pseudomonas and Acinetobacter isolates collected from burn patients were subjected to PCR assay. Using PCR method and DNA sequencing, the existence of SHV-, TEM-, PER- and VIM-type ß-lactamase encoding genes were determined. Out of the 107 Pseudomonas and Acinetobacter isolates, 66 (77.6%) were ESBL positive, 26.2% were positive for SHV gene, 37.4% were positive for TEM gene, 14% were positive for PER gene and 15.9% of them harbored VIM gene. More than half of the Pseudomonas and Acinetobacter strains in our pediatric burn unit harbor ß-lactamase encoding genes that make them resistant to a wide range of ß-lactam antibiotics. Consequently, it is suggested to choose an appropriate antibiotic regimen based on the antibiogram pattern of the strains.

Orientational ordering of confined hard rods: the effect of shape anisotropy on surface ordering and capillary nematization

We examine the ordering properties of rectangular hard rods with length L and diameter D at a single planar wall and between two parallel hard walls using the second virial density-functional theory. The theory is implemented in the three-state Zwanzig approximation, where only three mutually perpendicular directions are allowed for the orientations of hard rods. The effect of varying shape anisotropy is examined at L/D=10,15,and20. In contact with a single hard wall, the density profiles show planar ordering, damped oscillatory behavior, and a wall-induced surface ordering transition below the coexisting isotropic density of a bulk isotropic-nematic (I-N) phase transition. Upon approaching the coexisting isotropic density, the thickness of the nematic film diverges logarithmically, i.e., the nematic wetting is complete for any shape anisotropy. In the case of confinement between two parallel hard walls, it is found that the continuous surface ordering transition depends strongly on the distance between confining walls H for H<L, while it depends weakly on H for H>L. The minimal density at which a surface ordering transition can be realized is located at around H∼2D for all studied shape anisotropies due to the strong interference effect between the two hard walls. The first-order I-N phase transition of the bulk system becomes a surface ordered isotropic I_{B} to capillary nematic N_{B} phase transition in the slit pore. This first-order I_{B}-N_{B} transition weakens with decreasing pore width and terminates in a critical point for all studied shape anisotropies.

Klebsiella pneumonia, a Microorganism that Approves the Non-linear Responses to Antibiotics and Window Theory after Exposure to Wi-Fi 2.4 GHz Electromagnetic Radiofrequency Radiation

BACKGROUND

Drug resistance is widely believed to be an increasingly serious threat to global public health. We have previously reported that short term exposure of microorganisms to diagnostic ultrasound waves could significantly alter their sensitivity to antibiotics. In our previous studies, Klebsiella pneumoniae showed major differences in the sensitivity to antibiotics in exposed and non-exposed samples. This study was aimed at investigating the alteration of antibiotic resistance of Klebsiella pneumonia, after exposure to Wi-Fi 2.4 GHz electromagnetic radiofrequency radiation.

MATERIALS AND METHODS

In this in vitro study, three replicate agar plates were used for each test. The antibiotic susceptibility test was carried out using disc diffusion method on Mueller Hinton agar plates and the inhibition zones in both control and exposed groups were measured. A common Wi-Fi router was used in this study as the radiofrequency exposure source. Irradiated samples were exposed to Wi-Fi radiofrequency radiation for 3, 4.5 and 8 hours.

RESULTS

Statistically significant variations of sensitivity to antibiotics were found for all studied antibiotics after 4.5 hours of RF exposure, compared to non-exposed bacteria. Interestingly, the mean diameters of the inhibition zones after 3 hours of exposure were less than those exposed for 4.5 hours. Following this rise in the sensitivity to antibiotics, a fall was observed in the bacteria exposed for 8 hours for all studied antibiotics.

CONCLUSION

The findings of this study show a statistically significant rise in the sensitivity of Klebsiella pneumoniae to different antibiotics after 4.5 hours of exposure to 2.4 GHz Wi-Fi radiation, followed by a fall after 8 hours of exposure. These observations can be interpreted by the concept of non-linearity in the responses of Klebsiella pneumoniae to different antibiotics after exposure to electromagnetic radiofrequency radiation. As in this study a minimum level of effect was needed for the induction of adaptive response, these results also confirm the validity of the so-called "window theory".

Bacterial contamination of different components of the waterpipe

SETTING

Waterpipe smoking is an emerging topic in tobacco research that may have unrecognised health hazards.

OBJECTIVE

To determine whether waterpipes are a source of bacterial contamination.

METHODS

A total of 15 restaurants and waterpipe cafés were randomly selected from the list of locations serving waterpipe tobacco in Kerman city, Iran. Different parts of the waterpipe devices were sampled, including the disposable mouthpiece, the mouthpiece of the hose and the water in the bowl of the waterpipe. The samples were smeared onto bacterial culture media, including eosin methylene blue, blood agar and MacConkey agar growth media, and incubated at 37°C. After 24-48 h, they were examined for colony growth.

RESULTS

Of 285 samples from different parts of the waterpipes, 236 (82.8%) showed positive cultures; the rate of contamination ranged from 69% in the fixed mouthpiece to 96% in bowl water. Coagulase-negative staphylococci (32.9%), Streptococcus spp (26.9%), Neisseria spp (13.7%) and Escherichia coli (9.4%) were the most frequent contaminants.

CONCLUSION

Waterpipes are frequently contaminated with microorganisms. This study revealed potential microbial hazards in waterpipes that may contribute to respiratory tract colonisation.

Chorionic morphine, naltrexone and pentoxifylline effect on hypophyso-gonadal hormones of male rats

BACKGROUND

Knowledge about harmful effects of morphine on hormone secretion seems to be necessary. The aim of the present study was to evaluate the effect of pentoxifylline on side effects derived by morphine on hypophyso-gonadal hormones of male rats.

METHODS

32 male rats were divided into the 4 groups of OSS: control (received 40 g Sucrose/l drinking water and intraperitoneal injection of 1 l/kg normal saline), OMS: morphine group (received 0.4 mg/l + 40 g Sucrose/l in drinking water and intraperitoneal injection of 1 l/kg normal saline), NMS: morphine+naltrexane group (received 0.4 mg/l + 40 g Sucrose/l in drinking water and IP injection dose of 10 mg/kg/ml/day Naltrexane) and PMS: morphine + pentoxifylline group (received 0.4 mg/dl + 40 g Sucrose/l in drinking water and IP injection dose of 12 mg/kg/ml/day Pentoxifylline) for 56 days, respectively.

RESULTS

Serum levels of testosterone, LH, FSH hormones were measured. Pentoxifylline increased serum levels of testosterone, LH, FSH hormones compared to control, morphine and morphine-naltrexane groups.

CONCLUSION

Pentoxifylline has a significant efficacy for increasing serum levels of sexual hormones. Considering that Pentoxifylline is safe and cheap, with easy application, we suggest for the usage of this drug for improving semen parameter's quality before performing ART for the treatment of morphine addicts (Fig. 1, Ref. 31).

The prevalence of anemia in the patients who survived and died due to myocardial infarction (MI)

Introduction & Objective: Ischemia heart disease (IHD) is the most often met reason for losses in different communities. The most common reason of IHD is Atherosclerosis, and various etiologic factors such as high blood pressure, diabetes, smoking, and hyperlipidemia are involved in its development. Anemia is also considered another resulting reason of loss and morbidity in patients via IHD. Accordingly, the current paper aimed to determine the prevalence of anemia in patients who survived and died of myocardial infarction. Materials and Methods: The present research is of a case-control type, and the subjects were the patients with myocardial infarction admitted to Heart Ward of Hamadan Ekbatan Hospital within one year (2012-2013). The patients were divided into two categories of demised and survived after myocardial infarction, and in each 160-subject group, the prevalence of anemia with hemoglobin levels was investigated. Moreover, the demographic characteristics, ejection fraction, and patients' underlying medical conditions were also taken into account. The data obtained were analyzed by SPSS 15 software and chi-square test. Results: Of the 320 patients studied, 61 patients (19.1%) had anemia and 51 (83.6%) patients who were anemic had died. 31.7% of the deceased patients after MI were weak, while 6.3% of the survived patients after MI were anemic. Also, in all age and sex groups, anemia in the former patient group was higher than in the sustained group. The predominance of anemia was clearly greater in the women than in the men (P < 0.05). Conclusion: Based on the findings, there is a statistically clear variation in the prevalence of anemia in the former patient group after MI than in the group who survived after MI.

Enhanced performance of dye-sensitized solar cells based on TiO2 nanotube membranes using an optimized annealing profile

Free standing TiO₂ nanotube membranes are transferred onto FTO slides in front-side illuminated dye-sensitized solar cells (DSSCs). The electronic properties of the tubes and, as a result, the efficiency of the DSSCs can be considerably improved by ramped annealing.

Morphine-induced conditioned place preference and the alterations of p-ERK, p-CREB and c-fos levels in hypothalamus and hippocampus: the effects of physical stress

The hypothalamus and hippocampus are important areas involved in stress responses and reward processing. In addition, ERK/CREB pathway plays a critical role in the control of cellular responses to stress and reward. In the current study, effects of acute and subchronic stress on the alteration of p-ERK, p-CREB and c-fos levels in the hypothalamus and hippocampus of saline- or morphine-treated animals during morphine-induced conditioned place preference (CPP) procedure were investigated. Male Wistar rats were divided into two saline- and morphine-treated supergroups. Each supergroup includes of control, acute stress and subchronic stress groups. In all of groups, the CPP procedure was done, afterward the alternation of p-ERK/ERK ratio, p-CREB/CREB ratio and c-fos level in the hypothalamus and hippocampus were estimated by Western blot analysis. The results indicated that in saline- or morphine-treated animals, p-ERK/ERK ratio, p-CREB/CREB ratio and c-fos level increased after application of acute and subchronic stress (except for p-ERK/ERK ratio in morphine-control group). Our findings revealed that in saline- or morphine-treated animals, acute and subcronic stress increased the p-ERK/ERK ratio, p-CREB/CREB ratio and c-fos level in the hypothalamus and hippocampus and this enhancement in morphine-treated animals, was more considerable than that in saline-treated animals.

Radon exhalation rate and natural radionuclide content in building materials of high background areas of Ramsar, Iran

Radon exhalation rates from building materials used in high background radiation areas (HBRA) of Ramsar were measured using an active radon gas analyzer with an emanation container. Radon exhalation rates from these samples varied from below the lower detection limit up to 384 Bq.m(-2) h(-1). The (226)Ra, (232)Th and (40)K contents were also measured using a high resolution HPGe gamma- ray spectrometer system. The activity concentration of (226)Ra, (232)Th and (40)K content varied from below the minimum detection limit up to 86,400 Bq kg(-1), 187 Bq kg(-1) and 1350 Bq kg(-1), respectively. The linear correlation coefficient between radon exhalation rate and radium concentration was 0.90. The result of this survey shows that radon exhalation rate and radium content in some local stones used as basements are extremely high and these samples are main sources of indoor radon emanation as well as external gamma radiation from uranium series.

Association between troponin T and ICU mortality, a changing trend

Background

Initially elevated levels of troponin predict adverse outcomes in patients admitted to the intensive care unit (ICU). No research team has investigated the changes in concentration of cardiac troponin T (cTnT) during ICU stay and their association with patient outcome.

Objective

We investigated whether the change in cTnT levels during ICU stay could predict outcomes (death or survival).

Methods

In this cohort study, all patients admitted to the medical ICU (10 beds) from January to July 2008 were enrolled. Troponin levels were evaluated within the first 24 hours of ICU admission and on the fourth, seventh and 10th days after admission.

Results

The study population (135 patients) had a mean age of 60.9 ± 21.5 years. The outcome was significantly different with regard to normal or elevated cTnT concentrations on the first and seventh days of follow up (p = 0.03 and 0.023, respectively). This difference was non-significant for cTnT levels on the fourth and 10th days after admission (p = 0.69 and 0.78, respectively). The change in cTnT levels was not significantly different between the deceased and discharged patients (p = 0.4).

Conclusion

Changes in cTnT levels during ICU stay did not show a significant trend (power: 0.26). Patients whose cTnT levels were increased on the first and seventh days of ICU stay had a worse survival, which could be associated with cardiac events on admission or at specific times during the stay in ICU.

Seroepidemiology of crimean congo hemorrhagic Fever in slaughterhouse workers in north eastern iran

BACKGROUND

Crimean Congo Hemorrhagic Fever (CCHF) is an acute febrile haemorrhagic disease. This study was conducted to ascertain the infection status amongst slaughterhouse workers in Iran's north-eastern provinces (Razavi and northern and southern Khorasan), so that analysis of the results could help clarification of the epidemiology of this disease in the aforementioned provinces and eastern regions of Iran.

METHODS

In this cross-sectional study, conducted in 2004 and 2005, 108 slaughterhouse workers from 24 cities of the three previously mentioned provinces were randomly entered into the study. An IgG specific ELISA test was carried out on the participants' serum samples.

RESULTS

Sixteen out of 108 (14.8%) participants under study were shown to have IgG against CCHF. The highest rate of infection was seen in Razavi Khorasan and southern Khorasan at 17.5% and 16.7%, respectively.

CONCLUSION

The study showed a relatively high frequency of this disease amongst slaughterhouse workers in these provinces. Taking into account the small number of reported cases from these provinces, it would seem that more focus is required on primary diagnosis and on referral of suspected patients.