Nurses' bereavement experiences of a deceased colleague due to COVID-19: A phenomenological study

AIM

Healthcare workers have little time to mourn due to the intensification of the COVID-19 pandemic. Although grief is a normal part of life and death, the circumstances surrounding the death can affect the grieving process. So far, the nurses' experience in mourn for a deceased colleague in the COVID-19 pandemic has not been determined. Identifying these experiences can provide opportunities to formulate appropriate strategies to functionally adapt to death and promote mental health and well-being during this crisis. This study aimed to understand the nurses' experiences in mourning for a deceased colleague due to COVID-19.

DESIGN

This was an interpretive phenomenological study.

METHOD

Participants included 10 nurses with the bereavement experience following the death of a colleague due to COVID-19, who were selected through purposive sampling, and the data were collected through in-depth and semi-structured interviews and analysed using Diekelmann et al.'s (1989) approach.

RESULTS

The nurses' bereavement experiences were in the form of eight themes: disbelief and amazement, acceptance with grief, lasting sadness, unsung laments, bringing back memories, impulse to leave the service, a professional myth and holy death. For nurses, mourning for the death of a colleague due to COVID-19 is like a lasting sadness that begins with disbelief and amazement and changes to acceptance with sadness. From the fellow nurses' point of view, this type of death was perceived as a holy death, which along with countless unsung laments and memories brought to us the association of a professional legend, and that such a fate would be inevitable for us as well, it was a push to leave the service.

PUBLIC CONTRIBUTION

Crisis managers and policymakers need to add protocols and training programs for resilience skills and healthy mourning.

Investigation of the effects of hydrophobic surfaces on thermohydraulic characteristics and entropy generation of hybrid nanofluids with magnetic properties in a micro-heat sink under a magnetic field

The cooling process of the devices is a big challenge in the electronic industry, and most of the process units (graphical are central) experience defects under harsh temperature conditions, so dissipating generated heat under various working conditions should seriously be studied. This study investigates the magnetohydrodynamics of hybrid-ferro nanofluids in the presence of hydrophobic surfaces in a micro-heat sink. To scrutinize this study, a Finite Volume Method (FVM is applied. The ferro nanofluid includes water as base fluid and Multiwall Carbon Nanotubes (MWCNTs) and Fe3O4 as nano-additives, which are used in three concentrations (0, 1 and 3%). The other parameters such as Reynold number (5-120), Hartmann number (magnitude of the magnetic field from 0 to 6) and hydrophobicity of surfaces are considered to be scrutinized for their impacts on heat transfer and hydraulic variables as well as entropy generation ones. The outcomes indicate that increasing the level of hydrophobicity in surfaces leads to improve heat exchange and reduces the pressure drop simultaneously. Likewise, it decreases the frictional and thermal types of entropy generations. Intensifying the magnitude of the magnetic field enhances the heat exchange as much as the pressure drop. In the same result, it can decrease the thermal term in entropy generation equations for the fluid, but it increases the frictional one and adds a new term named magnetic entropy generation. Incrementing Reynolds number improves the convection heat transfer parameters although it intensifies the pressure drop in the length of the channel. Also, the thermal and frictional kinds of entropy generation decrease and increase with increasing the flow rate (Reynold number).

A Comparative Study on the Effect of Intrathecal Bupivacaine vs. Ropivacaine on Maternal and Neonatal Outcomes After Cesarean Section: A Systematic Review and Meta-analysis

Context

The type of anesthesia in cesarean section can affect the mother and baby. This study aimed to determine the comparative effect of intrathecal hyperbaric bupivacaine vs. hyperbaric ropivacaine on maternal and neonatal outcomes after cesarean section.

Evidence Acquisition

PubMed, Web of Science, Embase, Google Scholar, IranDoc, MagIran, and Scopus databases were searched from 1 September 2022 to 1 November 2022. Eighteen clinical trials with 1542 patients were included in the analysis.

Results

There was no statistically significant difference in hypotension, bradycardia, and Apgar score between the 2 groups (P > 0.05). The risk of nausea (relative risk (RR), 1.526; 95% CI, 1.175 - 1.981; P = 0.001) and vomiting (RR, 1.542; 95% CI, 1.048 - 2.268; P = 0.02) caused by bupivacaine was 0.53% and 0.54% higher than that of ropivacaine. The incidence of shivering (RR, 2.24; 95% CI, 1.480 - 3.39; P = 0.00) was 2.24 times higher in the bupivacaine group than in the ropivacaine group. The average onset time of sensory block (standardized mean difference (SMD), -0.550; 95% CI, -1.054 to -0.045; P = 0.032) and motor block (SMD, -0.812; 95% CI, -1.254 to -0.371; P = 0.000) was significantly lower in the bupivacaine group than in the ropivacaine group.

Conclusions

Despite the fact that ropivacaine and bupivacaine are effective in cesarean section, ropivacaine is more favorable because of less hemodynamic changes, less duration of sensory and motor block, and fewer side effects, which are effective in patient recovery.

Factors affecting decision-making for knee arthroplasty in patients with osteoarthritis

OBJECTIVE

Identifying factors affecting decision-making for knee arthroplasty in patients with knee osteoarthritis is critically important for pain relief, improving in knee function and reaching an optimal outcome. When decision-making is hurried or delayed, surgery may not occur in time, which complicates the surgery and increases its complications. This study was conducted to investigate the factors influencing decision-making for knee arthroplasty.

METHODS

This study is a qualitative study and inductive content analysis method. This study enrolled 22 patients undergoing knee arthroplasty selected through purposive sampling. Data were collected through semi-structured in-depth interviews and analyzed using inductive content analysis.

RESULTS

Data analysis yielded three categories: hope to return to normal life, encouragement and recommendations, and trust and assurance.

CONCLUSION

To make better treatment-related decisions and achieve better outcomes based on the patient's values and wishes, it is necessary for the treatment team to increase its interactions and establish stronger communication with patients to make their expectations more realistic and help them understand the risks. They should also make efforts to increase patients' knowledge about the advantages and disadvantages of surgery and clarify what is important to them in decision-making.

Size-dependent molecular interaction of nontraditional 2D antibiotics withStaphylococcus aureus

The application of nanomaterials for their antibacterial properties is the subject of many studies due to antibiotic resistance of pathogen bacteria and the necessity of omitting them from food and water resources. Graphene oxide (GO) is one of the most popular candidates for antibacterial application. However, the optimum condition for such an effect is not yet clear for practical purposes. To shed light on how GO and bacteria interaction depends on size, a wide range of GO flake sizes from hundreds of µm²going down to nano-scale as low as 10 N m²was produced. In anin-vitrosystematic study to inhibitStaphylococcus aureusgrowth, the correlation between GO flake size, thickness, functional group density, and antibacterial activity was investigated. The GO suspension with the average size of 0.05 µm², in the order of the size of the bacteria itself, had the best bacteriostatic effect onS. aureuswith the minimum inhibitory concentration value of 8 μg ml^-1, well within the acceptable range for practical use. The bacteriostatic effect was measured to be a 76.2% reduction of the colony count over 2 h of incubation and the mechanism of action was the wrapping and isolation of cells from the growth environment. Furthermore,in-vivoanimal studies revealed that 16 μg ml^-1of the optimum GO has efficient antibacterial performance against the methicillin-resistant strains of the bacteria with an enhanced wound healing rate and tensiometrial parameters which is important for realized targets.

The contributing factors of resistance or sensitivity to epigenetic drugs in the treatment of AML

Drug resistance is the drug-effectiveness reduction in treatment and is a serious problem in oncology and infections. In oncology, drug resistance is a complicated process resulting from enhancing the function of a pump that transports drugs out of tumor cells, or acquiring mutations in drug target. Surprisingly, most drugs are very effective in the early stages, but the response to the drug wears off over time and resistance eventually develops. Drug resistance is caused by genetic and epigenetic changes that affect cancer cells and the tumor environment. The study of inherited changes in the phenotype without changes in the DNA sequence is called epigenetics. Because of reversible changes in epigenetics, they are an attractive target for therapy. Some of these epigenetic drugs are effective in treating cancers like acute myeloid leukemia (AML), which is characterized by the accumulation and proliferation of immature hematopoietic cells in the blood and bone marrow. In this article, we outlined the various contributing factors involved in resistance or sensitivity to epigenetic drugs in the treatment of AML.

Anti-oxidative and anti-hyperglycemic properties of Agastache foeniculum essential oil and oily fraction in hyperglycemia-stimulated and lipopolysaccharide-stimulated macrophage cells: In vitro and in silico studies

ETHNOPHARMACOLOGICAL RELEVANCE

Hyperglycemia (HG) and lipopolysaccharide (LPS) often promote superoxide accumulation, which may increase oxidative stress. Reducing superoxide production in hyperglycemia and the inflammatory condition is an emerging way to reduce protein and lipid oxidation and diabetes complication.

AIM OF STUDY

To examine the effect of Agastache foeniculum essential oil (AFEO) and oil fraction (AFoil) on HG- and LPS-stimulated oxidative stress, the pathogenicity of AFEO and AFoil on oxidative stress was assessed.

METHODS

The stimulatory effects of AFEO and AFoil on the activity and expression of NADH oxide (NOX), catalase (CAT), superoxide dismutase (SOD), and the expression of nuclear respiratory factor 2 (NRF2) and nuclear factor-kappa B (NF-kB) in the stimulated macrophage cell line, J774.A1, was studied. The interaction patterns of AFEO and AFoil components with NOX, SOD, CAT, NRF2, and NF-kB proteins were also deduced using molecular docking.

RESULTS

Estragole was the main ingredient in AFEO (97%). Linolenic acid (32.10%), estragole (16.22%), palmitic acid (12.62%), linoleic acid (12.04%), and oleic acid (8.73%) were the major chemical components of the AFoil. NOX activation was stimulated in macrophage cells by HG and LPS. At 20 μg/mL, AFEO and AFoil decreased NOX activity while increased SOD and CAT activities in stimulated macrophages. AFoil with estragole and omega-3 fatty acids was better than AFEO with estragole in anti-hyperglycemic and anti-oxidative activity. According to molecular docking research, estragole, linoleic acid, and linolenic acid bind to different hydrophobic pockets of NOX, SOD, CAT, NFR2, and NF-kB using hydrogen bonds, van der Waals bonds, pi-alkyl, and pi-anion interactions, with different binding energies.

CONCLUSION

AFEO and AFoil showed antioxidant and anti-diabetic activity. The mechanisms in lowering oxidative stress markers depended on down-regulating superoxide-producing enzymes and up-regulating superoxide-removing enzymes at gene and protein levels. The AFoil emulsion can be used to reduce the detrimental impacts of hyperglycemia and oxidative stress.

Psychometric properties of the Persian version of the quality of recovery-15 questionnaire

Background

Recovery after surgery is a complex process since it depends on many factors, such as the patient’s sex, age, surgery type, and presence of other diseases. This study aimed to translate and evaluate the psychometric properties of the Persian version of the quality of recovery-15 (QoR-15) questionnaire in Iranian patients undergoing surgery.

Methods

The Persian version of the QoR-15 questionnaire was developed after translating and culturally validating the instrument. Content validity was assessed with a sample of clinicians (n = 15) and face validity was assessed in a sample of patients (n = 15) undergoing elective surgery. The final questionnaire was completed by 450 patients (n = 450) 24 h after surgery. Construct validity was assessed using exploratory factor analysis in patients (N = 250). Convergence and divergent validity were also assessed. Internal consistency was assessed using Cronbach's alpha and construct reliability was also assessed. Test–retest reliability was assessed on a randomly selected sub sample of 50 patients. Finally, the questionnaire was completed by a further sample of 200 patients 24 h after surgery and construct validity was assessed using confirmatory factor analysis.

Results

According to Lawshe, all items received at least an acceptable ratio for content validity ratio (CVR). Item content validity index (I-CVI) of each item was greater than 0.79. Construct validity indicated good fit statistics in the five components of CFA, and CFI was > 0.93. The reliability of the QoR-15 questionnaire was acceptable based on Cronbach’s alpha score (> 0.001), test–retest reliability value (0.81), and CR (> 0.7).

Conclusion

The Persian version of the QoR-15 questionnaire was equivalent to the original one regarding both conceptual and linguistic aspects. This study also confirmed the validity and reliability of the Persian version of the QoR-15 questionnaire. Therefore, the Persian version of the QoR-15 questionnaire can be a suitable and brief instrument to assess the recovery quality in Iranian patients undergoing surgery.

Overcoming fear of movement resulting from knee replacement; strategies used by patients: An interview study

BACKGROUND AND AIMS

Fear of movement is among the main concerns of patients following knee replacement surgery and a determining factor in the success of surgery. The strategies adopted by patients to overcome this fear have not yet been identified, but once pin pointed, these strategies can be strengthened and modified through intervention. The aim of the present study was to explore the personal strategies adopted by patients following knee replacement to overcome fear of movement.

MATERIALS AND METHODS

Interviews were conducted with 15 patients who had undergone knee replacement, selected by purposive sampling. Data were collected through in-depth semi-structured interviews and analyzed using inductive content analysis.

RESULTS

The patients' strategies as depicted in their narratives were classified into three categories: 1) Movement based on awareness; 2) Movement based on support; and 3) Movement based on hope. These three categories are described in eight subcategories and show what strategies the patients used to overcome their fear of movement.

CONCLUSION

These findings can help to increase awareness about strategies to overcome fear of movement in patients following knee replacement and to develop and support tailored treatment strategies with the aim of reducing such fear of movement and increasing physical activity among the patients.

Clarifying the concept of the four-season symphony (I SEA) in nursing practice: A Wilson's approach to concept analysis

Acquired knowledge provides one with intuitive rationality as a means of achieving a goal. Spiritual, ethical and esthetic competencies are also required for acquiring intuitive rationality. Nurses pay less attention to intuitive rationality, think only with their brain rather than observe with their heart and therefore deprive themselves of proper, immediate and comprehensive cognition of their environment. An initiative to harmonize sensory receptors in charge of thinking, speaking, and acting in nurses is required for establishing a symphonic intellectual, spiritual, ethical, and aesthetic (I SEA) nursing practice. The present research was conducted to clarify the concept of four-season symphony of I SEA in nursing practice. The present study was conducted by employing Wilson's method of concept analysis and searching databases including Google Scholar, ScienceDirect, Scopus, PubMed, SID, and Magiran using symphony, rationality, intellectuality, spirituality, ethics, aesthetic, and nursing practice as keywords. According to the integrated concept of the four-season symphony in nursing care, nursing practice refers to performing the symphonic action of four seasons of I SEA in orderly and smart thinking, speaking and acting in looking, listening, speaking, heartfelt sympathy and using the hands for caregiving and steps for accompanying patients. This symphony provides an opportunity for the emergence of perfect nurses of four seasons and helps with individual and organizational symphonic improvements in nursing care and nurses. According to this perspective, nurses should always ask themselves whether their thought, speech, and action are intellectual, spiritual, ethical and aesthetic.

Deep PUF: A Highly Reliable DRAM PUF-Based Authentication for IoT Networks Using Deep Convolutional Neural Networks

Traditional authentication techniques, such as cryptographic solutions, are vulnerable to various attacks occurring on session keys and data. Physical unclonable functions (PUFs) such as dynamic random access memory (DRAM)-based PUFs are introduced as promising security blocks to enable cryptography and authentication services. However, PUFs are often sensitive to internal and external noises, which cause reliability issues. The requirement of additional robustness and reliability leads to the involvement of error-reduction methods such as error correction codes (ECCs) and pre-selection schemes that cause considerable extra overheads. In this paper, we propose deep PUF: a deep convolutional neural network (CNN)-based scheme using the latency-based DRAM PUFs without the need for any additional error correction technique. The proposed framework provides a higher number of challenge-response pairs (CRPs) by eliminating the pre-selection and filtering mechanisms. The entire complexity of device identification is moved to the server side that enables the authentication of resource-constrained nodes. The experimental results from a 1Gb DDR3 show that the responses under varying conditions can be classified with at least a 94.9% accuracy rate by using CNN. After applying the proposed authentication steps to the classification results, we show that the probability of identification error can be drastically reduced, which leads to a highly reliable authentication.

Exploring the Lived Experience of Missed Nursing Care in Postgraduate Nursing Students in Iran

BACKGROUND

Missed care is a global phenomenon, which can include many clinical conditions that threaten the patients' safety in all countries and cultures, and also indicates the quality of nursing care. The nursing students' awareness and understanding of missed nursing care is of great importance. The current study aims to explore the lived experience of postgraduate nursing students in missed care.

METHODS

The current qualitative study was performed based on the interpretive phenomenological approach in Tehran, Iran, in February to December 2019. A total of 10 master's degree nursing students were selected through purposive sampling. A total of 10 semi-structured individual interviews were used to collect the data. The trail version of MAXQDA-10 software was used for coding. All interviews were recorded and codified, and the main themes were extracted from them using Dicklemann et al.'s (1989) analytical method.

RESULTS

Two main themes, five sub-themes, and 31 meaning units were obtained. The main themes included: "unfulfilled care" and "living in limbo".

CONCLUSION

Missed care, as unfulfilled care, is accompanied with living in limbo for nursing students, and this condition is influenced by organizational and personal factors. It seems that managers can prevent missed nursing care by supervising nursing care, reducing the nurses' workload, creating a sense of commitment to work, and enforcing ethical issues among nurses.

Serial interval and time-varying reproduction number estimation for COVID-19 in western Iran

There is no report on the serial interval (SI) of coronavirus disease 2019 (COVID-19) in Iran, the present report aims to estimate the SI and time-varying R of COVID-19 in western Iran. In this study, there were 1477 confirmed, probable and suspected cases of severe acute respiratory syndrome coronavirus 2 for Kermanshah from 22 February to 9 April. The close contacts of the confirmed cases were identified using telephone follow up of patients and their contacts. The SI distribution was used as an alternative. We fitted different models using the clinical onset dates of patients with their close contact (infector–infectee). Also, we applied a ‘serial interval from sample’ approach as a Bayesian methodology for estimating reproduction number. From 22 February to 29 March, 247 COVID-19 cases were confirmed by RT-PCR. Close contact between 21 patients (21 infector–infectee pairs), including 12 primary cases and 21 secondary cases, was confirmed. The mean and standard deviation of the SI were estimated as 5.71 and 3.89 days. The R varied from 0.79 to 1.88 for a 7-day time-lapse and ranged from 0.92 to 1.64 for a 14-day time-lapse on raw data. Also, the R varied from 0.83 to 1.84 for 7-day time-lapse and from 0.95 to 1.54 for a 14-day time-lapse using moving average data, respectively. It can be concluded that the low reproduction number for COVID-19 in Kermanshah province is an indication of the effectiveness of preventive and interventive programmes such as quarantine and isolation. Consequently, continuing these preventive measures is highly recommended.

Access Matting Reduces Mixedgrass Prairie Soil and Vegetation Responses to Industrial Disturbance

Substantial interest exists in understanding the role of low-disturbance construction methods in mitigating industrial impacts to native grassland soils and vegetation. We assessed soil and vegetation responses to conventional high-disturbance sod-stripping and revegetation on sandy soils, and the alternative practice of low-disturbance access matting to provide a temporary work surface on sandy and loamy soils. Treatments were associated with high-voltage transmission tower construction during 2014 within the Mixedgrass Prairie. High-disturbance sites were hydroseeded in May of 2015, while low-disturbance sites recovered naturally. We assessed soil physical (bulk density, water infiltration) and chemical properties (organic matter, pH, and electrical conductivity) after construction and herbage biomass for three growing seasons. Sod-stripping led to 53% greater soil bulk density and 51% less organic matter than nondisturbed controls, while water infiltration increased by 32% in these high-sand (>80%) soils. In contrast, access matting led to minimal soil property changes regardless of the texture. While total herbage biomass was unaffected by all construction treatments, sod-stripping reduced grass biomass by 80% during the first growing season, which coincided with a 119% increase in forb mass. Root biomass (0-15 cm) also declined 77% with sod-stripping. Vegetation biomass on sites with access matting remained largely unaffected by the disturbance. Overall, low-disturbance construction methods using access matting were more effective than sod-stripping in mitigating the negative impacts of industrial development on Mixedgrass soil properties, as well as vegetation biomass, and are recommended as a best management practice during industrial disturbance.

The prevalence of kidney scarring due to urinary tract infection in Iranian children: a systematic review and meta-analysis

INTRODUCTION

Urinary tract infection is one of the most common diseases in childhood, and can lead to severe complications such as renal scarring in case of lack of diagnosis and timely treatment.

OBJECTIVE

The aim of this study was to investigate the prevalence of kidney scarring caused by urinary tract infection in Iranian children by meta-analysis.

STUDY DESIGN

English -language databases including Science Direct, PubMed, Scopus, Web of Science, and Springer, and Persian -language sites including SID, Magiran, Iranmedex, and Medlib, and the Google Scholar search engine were searched by in March 2018 using MeSH keywords. The heterogeneity of studies was studied using the I2 index. Data were analyzed using STATA software, version 15.1.

RESULTS

In 18 studies, the prevalence of kidney scarring from urinary tract infections in Iranian children was 31% (95% confidence intervalCI: 22%-39%), (which was 14% in girls and 23% in boys. Also, the prevalence of kidney scar in children with urinary reflux was 47% and in children without urinary reflux was 12%. The most common symptom of the renal scar was fever in 61%, followed by urinary reflux in 45% (unilateral in 42% and bilateral in 30%). Also, the prevalence of mild, moderate, and severe reflux, respectively, was 31%, 27%, and 13%. Meta-regression also showed that the prevalence of kidney scar due to urinary tract infections had no significant relationship with the number of samples and years of research (P > 0.05).

DISCUSSION AND CONCLUSION

About one-third of Iranian children suffering from urinary tract infections had kidney scarring, so that the prevalence is lower in girls than in boys. Also, the prevalence of renal scarring in children with urinary reflux is about four times higher than that in children without urinary reflux.

The ESC ACCA EAPCI EORP acute coronary syndrome ST-elevation myocardial infarction registry

Aims 

The Acute Cardiac Care Association (ACCA)–European Association of Percutaneous Coronary Intervention (EAPCI) Registry on ST-elevation myocardial infarction (STEMI) of the EurObservational programme (EORP) of the European Society of Cardiology (ESC) registry aimed to determine the current state of the use of reperfusion therapy in ESC member and ESC affiliated countries and the adherence to ESC STEMI guidelines in patients with STEMI.

Methods and results 

Between 1 January 2015 and 31 March 2018, a total of 11 462 patients admitted with an initial diagnosis of STEMI according to the 2012 ESC STEMI guidelines were enrolled. Individual patient data were collected across 196 centres and 29 countries. Among the centres, there were 136 percutaneous coronary intervention centres and 91 with cardiac surgery on-site. The majority of centres (129/196) were part of a STEMI network. The main objective of this study was to describe the demographic, clinical, and angiographic characteristics of patients with STEMI. Other objectives include to assess management patterns and in particular the current use of reperfusion therapies and to evaluate how recommendations of most recent STEMI European guidelines regarding reperfusion therapies and adjunctive pharmacological and non-pharmacological treatments are adopted in clinical practice and how their application can impact on patients’ outcomes. Patients will be followed for 1 year after admission.

Conclusion 

The ESC ACCA-EAPCI EORP ACS STEMI registry is an international registry of care and outcomes of patients hospitalized with STEMI. It will provide insights into the contemporary patient profile, management patterns, and 1-year outcome of patients with STEMI.

Facile Synthesis of Silver-salicylic acid (modified)/TiO2-nanotube/Ti plates for UV-light Promoted Dye Degradation

Abstract. Salicylic acid (mod)-Ag/TiO2NTs/Ti photocatalyst plates were prepared using chemical modification process of TiO2-nanotubes/Ti plates with salicylic acid and silver nanoparticles. Morphology studies exhibit that esterification between salicylic acid and -OH groups on TiO2 surface as well as deposition of Ag has been led to formation of uniform deposits on the walls of TiO2-nanotubes/Ti plates. The photocatalytic activity of the plates was tested on the degradation of Methylene Orange (MO) dye. The activity tests showed that the photodegradation efficiency for salicylic acid(mod)-Ag/TiO2NTs/Ti is higher than for Ag/TiO2NTs/Ti, salicylic acid(mod)/TiO2NTs/Ti and TiO2NTs/Ti plates, showing the integration the photocatalytic advantages of both Ag-TiO2 and salicylic acid-Mod-TiO2 composites. The modified plates can eliminate 96.6% of MO under UV light irradiation after 1 h, while can be recycled 4 times with 72.9% degradation ratio. Improved surface adsorption of MO, fast charge separation and slow electron-hole recombination are the main factors being responsible for the increase the photocatalytic activity of salicylic acid (mod)-Ag/TiO2-nanotubes/Ti plate. Resumen. Se prepararon placas de fotocatalizador de ácido salicílico (mod)-Ag/TiO2NTs/Ti, utilizando un proceso de modificación química de placas de nanotubos/TiO2-TiO2, con ácido salicílico y nanopartículas de plata. Los estudios morfológicos muestran que la esterificación entre el ácido salicílico y los grupos -OH en la superficie de TiO2, así como la deposición de Ag, ha llevado a la formación de depósitos uniformes en las paredes de las placas de nanotubos de TiO2/ Ti. La actividad fotocatalítica de las placas se probó en la degradación del colorante naranja de metileno (MO). Las pruebas de actividad mostraron que la eficiencia de fotodegradación para el ácido salicílico (mod)-Ag /TiO2NTs/Ti es mayor que para las placas Ag/TiO2NTs/Ti, ácido salicílico (mod)/TiO2NTs/Ti y TiO2NTs/Ti, mostrando la integración de las ventajas fotocatalíticas de los compuestos de Ag-TiO2 y ácido salicílico-Mod-TiO2. Las placas modificadas pueden eliminar el 96.6% del MO bajo la irradiación con luz UV después de 1 h, mientras que pueden reciclarse 4 veces con una relación de degradación del 72.9%. La mejora de la adsorción superficial de MO, la rápida separación de la carga y la lenta recombinación del hueco de electrones son los principales factores responsables del aumento de la actividad fotocatalítica del ácido salicílico (mod)-Ag/TiO2-nanotubos/placa de Ti.

Mesoporous MgO/PPG hybrid nanofibers: synthesis, optimization, characterization and heavy metal removal property

In this research, mesoporous magnesium oxide/poly(propylene glycol) (MgO/PPG) hybrid nanofibers were synthesized as a new adsorbent for the removal of heavy metal ions from solutions.

An Evaluation of Acupressure on the Sanyinjiao (SP6) and Hugo (LI4) Points on the Pain Severity and Length of Labor: A Systematic Review and Meta-analysis Study

Background:

In this study, the effects of SP6 and LI4 acupressure on the pain severity and length of labor are examined.

Materials and Methods:

This systematic review and meta-analysis study was performed on articles published in 2004–2015. The articles, published in the English and Farsi languages, related to the effects of acupressure on the SP6 and LI4 points on the length and pain severity of labor. Data were collected by searching medical databases, including PubMed, ISI, MagIran, Google Scholar, Iran Medex, SID, Irandoc, and EMBASE, for relevant material.

Results:

Women who received SP6 acupressure experienced less pain immediately after the intervention [−0.56, 95% confidence interval (CI): −0.77, −0.36] than women in the touch group and exhibited decrease in the length of labor (−0.99, 95% CI: −1.39, −0.39), the active phase (0.95, 95% CI: −1.30, −0.61), and the second stage of labor (−0.39, 95% CI: −0.74, −0.03). Women who received LI4 acupressure experienced less pain immediately after the intervention (−0.94, 95%, CI: −1.36, −0.53) than women in the touch group and exhibited shorter active phase (−0.91, 95%, CI: −1.18, −0.63) and second stage of labor (−0.55, 95%, CI: −0.95, −0.15) lengths.

Conclusions:

The use of SP6 and LI4 acupressure shows promise as a method for managing the length and pain severity of labor, but further study is required to establish its effectiveness along with other pharmacological and nonpharmacological methods.

Association of the CYP17 MSP AI (T-34C) and CYP19 codon 39 (Trp/Arg) polymorphisms with susceptibility to acne vulgaris

The aim of this study was to detect the association of the cytochrome P450 (CYP) 17 T-34C and CYP19 T<C polymorphisms with the risk of acne vulgaris (AV). The study enrolled 198 patients with AV (mild, moderate and severe) and 195 unrelated age-matched healthy controls from western Iran who had Kurdish ethnic background. The presence of the CYP17 TC genotype significantly increased the risk of mild, moderate and severe AV by 2.68, 2.28 and 2.94 times, respectively, while the presence of the CYP19 TC genotype significantly elevated the risk of overall AV and mild AV by 2.1 and 3.2 times, respectively. There was a synergy between the CYP 17 TC and CYP19 TT genotypes, which increased the risk of AV by 2.45-fold (P < 0.001). To our knowledge, this is the first study showing that the CYP17 T-34C and CYP19 T<C variants and their synergy are associated with susceptibility to AV in an Iranian population.

Trend of Suicide in Kermanshah during 11 years (2004 to 2014), Iran

Suicide is one of the most important health problems which has dedicated a significant part of the energy and health care costs to itself. The present study carried out to investigate trend of suicide in Kermanshah province during 2004-2014. This is an analytical (cross sectional) study in which all cases died by suicide and documented in forensics of Kermanshah during 2004 – 2014 were investigated. For evaluating the trend for suicide, Poisson regression model was used and to calculate suicide rate, census data from 2006 and 2011 as well as Organization for Civil Registration were obtained. During the 11 years of study, 2799 people died in Kermanshah province by suicide; among which 1681 (60.1%) were men and 1118 (39.9%) were women. The average annual mortality rate was 15.77 per 100,000; that is, 12.81 women and 18.62 men per every 100,000 populations. The highest number of deaths caused by suicide was witnessed among the age group 20-24 by 24.91 per 100,000. The most common method of suicide death was self-immolation among women with 47.8% and hanging in men with 48.1%. Over these years, suicide by hanging was rising with almost constant rate; however, self-immolation was rising until the end of 2008 that it started to decrease. Although the deaths by suicide in west of Iran is lower compared to other countries; it is higher in this region than other parts of the country. Considering the suicide trend and young population of Iran, the overall rate of deaths by suicide will substantially increase in Iran in case no plan and appropriate strategy are provided.Journal of Medical and Biomedical Sciences (2017) 6(2), 17- 24

The Effect of Sevoflurane Plus Propofol on Pain and Complications after Laminectomy: A Randomized Double Blind Clinical Trial

INTRODUCTION

Pain is one of the most important reasons for the patients concern after surgery. The perfect sedative should have properties like rapid onset, least pain and adverse effects.

AIM

To assess the effect of sevoflurane plus propofol on postoperative pain, haemodynamic stability and complication after lumbar disc surgery.

MATERIALS AND METHODS

This was a randomized double- blind clinical trial. A total of 75 patients scheduled for elective lumbar disc surgery with simple random sampling design received sevoflurane (n=25, induced with Thiopentone and maintained with sevoflurane), propofol (n=25, induced and maintained with propofol) and sevoflurane plus propofol (n=25, induced with propofol and maintained with sevoflurane). Visual Analog Scale (VAS) was used to determine the intensity of postoperative pain. Complications after surgery and haemodynamic changes during surgery were recorded.

RESULTS

The mean pain intensity and morphine consumption in the sevoflurane plus propofol group was lower compared to the propofol and sevoflurane groups at different intervals (p<0.001). The prevalence of shivering, nausea and vomiting in the sevoflurane plus propofol group was 24%, 28%, 28% respectively vs sevoflurane group 32%, 60%, 48% respectively and propofol group 32%, 16%, 12% respectively with p-value > 0.05, <0.001, <0.05 respectively. The mean blood pressure and heart rate were significantly lower in the sevoflurane plus propofol group compared to the propofol and sevoflurane groups (p<0.001).

CONCLUSION

According to the effect on pain and complications after lumbar disc surgery sevoflurane plus propofol can be regarded as safe and alternative drug in general anaesthesia for these patients.

Demographic and clinical characteristics of the children with aminoacidopathy in Isfahan Province, Central Iran in 2007-2015

CONTEXT

Aminoacidopathies refer to defects in protein synthesis pathways which result in a range of biochemical disorders and clinical presentations. The enzyme defects in intermediate metabolic pathways lead to accumulation of one or more amino acids or metabolites. Despite higher prevalence rates, screening infants for inherited metabolic disorders is not run in many Middle East countries.

AIM

This research is part of a larger study of inherited metabolic disorders to characterize and measure the prevalence of aminoacidopathies.

SETTINGS AND DESIGN

Cross-sectional study in the population aged 0-17 years old in Isfahan province of Iran, 2007-2015.

SUBJECTS AND METHODS

Demographic characteristics, history of disease, development of clinical condition and socioeconomic status were obtained from interviews as well as patient records of pediatric tertiary referral hospitals and metabolic disorders centers.

STATISTICAL ANALYSIS USED

SPSS qualitative and quantitative analysis.

RESULTS

The incidence rate of aminoacidopathies was derived to be 9/100,000 live births. The frequency of consanguineous marriages in this group of the patients was 89.2%. Of the patients with aminoacidopathies, 76.6% required hospitalization with tyrosinemia having the highest rate overall (>10 times). The most prevalent symptoms in this group of patients were developmental disorders and convulsions while half presented with growth disorders during follow-up. Of the 35.5% patients, who died at various ages, one-third was in the maple syrup urine disease subgroup.

CONCLUSION

Although metabolic disorders are identified as rare diseases, they are more prevalent in the studied population of Isfahan.

Comparing Gabapentin and Celecoxib in Pain Management and Complications After Laminectomy: A Randomized Double-Blind Clinical Trial

BACKGROUND

Complications and postoperative pain are major care problems that can affect the quality of health care plan.

OBJECTIVES

According to the use of multimodal therapy the current study aimed to compare the efficacy of gabapentin and celecoxib in pain management and complications after laminectomy at Ilam University of Medical Sciences, Ilam, Iran, in 2015.

PATIENTS AND METHODS

In this randomized double-blind clinical trial, 114 patients scheduled for elective laminectomy with simple random sampling design received gabapentin (n = 38, 900 mg/day), celecoxib (n = 38, 600 mg/day) and placebo (n = 38, capsule contain starch). Visual analog scale (VAS) was used to determine the intensity of pain. Complications after surgery, anxiety scores before surgery and patient's satisfaction 24 hours after the surgery were recorded.

RESULTS

The mean pain intensity in the gabapentin group was lower compared to those of the placebo and celecoxib groups respectively at different time durations (P < 0.001). The means of morphine consumption were 11.9 mg, 22.8 mg and 30.1 mg in the gabapentin, celecoxib and placebo groups, respectively (P < 0.001). The prevalence of shivering, nausea, vomiting and pruritus were 10.5%, 12.8%, 10.3% and 18.4% in the gabapentin group vs 31.5%, 29.8%, 32.4% and 28.9% in the celecoxib group and 42.1%, 44.7%, 39.5% and 44.7% in the placebo group (P < 0.001). The mean anxiety score in the gabapentin group was 2.4 vs those of the celecoxib group 3 and placebo group 3.6 (P < 0.001). The frequencies of drowsiness were 42.1%, 13.2% and 5.3% in the gabapentin, celecoxib and placebo groups, respectively (P < 0.001). In the gabapentin group, patient satisfaction was significantly higher compared to those of the placebo and celecoxib groups (P < 0.05).

CONCLUSIONS

According to the effect of gabapentin on pain management, complications after laminectomy and increased patients satisfaction, it can be regarded as an alter native in multimodal analgesia.

Demographic and obstetric factors affecting women's sexual functioning during pregnancy

BACKGROUND

Sexual desire and frequency of sexual relationships during pregnancy remains challenging. This study aimed to assess factors that affect women's sexual functioning during pregnancy.

METHODS

This was a cross sectional study carried out at prenatal care clinics of public health services in Iran. An author-designed structured questionnaire including items on socio-demographic characteristics, obstetric history, the current pregnancy, and women's sexual functioning during pregnancy was used to collect data. The generalized linear model was performed in order to find out factors that affect women's sexual functioning during pregnancy.

RESULTS

In all, 518 pregnant women participated in the study. The mean age of participants was 26.4 years (SD = 4.7). Overall 309 women (59.7%) scored less than mean on sexual functioning. The results obtained from generalized linear model demonstrated that that lower education, unwanted pregnancy, earlier stage of pregnancy, older age, and longer duration of marriage were the most important factors contributing to disturbed sexual functioning among couples.

CONCLUSION

The findings suggest that sexual function during pregnancy might be disturbed due to several factors. Indeed issues on sexual relationship should be included as part of prenatal care and reproductive health programs for every woman.

The effect of cinnamon on menstrual bleeding and systemic symptoms with primary dysmenorrhea

Background:

Primary dysmenorrhea with interferes in daily activities can have adverse effects on quality of life of women.

Objectives:

Regarding the use of herbal medicine, the aim of this study was to assess the effect of cinnamon on primary dysmenorrhea in a sample of Iranian female college students from Ilam University of Medical Sciences (west of Iran) during 2013-2014.

Patients and Methods:

In a randomized double-blind trial, 76 female student received placebo (n = 38, capsules containing starch, three times a day (TDS)) or cinnamon (n = 38, capsules containing 420 mg cinnamon, TDS) in 24 hours. Visual analogue scale (VAS) was used to determine the severity of pain and nausea. Vomiting and menstrual bleeding were assessed by counting the number of saturated pads. The parameters were recorded in the group during the first 72 hours of the cycle.

Results:

The mean amount of menstrual bleeding in the cinnamon group was significantly lower than the placebo group (P < 0.05 and P < 0.001, respectively). The mean pain severity score in the cinnamon group was less than the placebo group at various intervals (4.1 ± 0.5 vs. 6.1 ± 0.4 at 24 hours, 3.2 ± 0.6 vs. 6.1 ± 0.4 at 48 hours, and 1.8 ± 0.4 vs. 4.0 ± 0.3 at 72 hours, respectively) (P < 0.001). The mean severity of nausea and the frequencies of vomiting significantly decreased in the cinnamon group compared with the placebo group at various intervals (P < 0.001, P < 0.05).

Conclusions:

Regarding the significant effect of cinnamon on reduction of pain, menstrual bleeding, nausea and vomiting with primary dysmenorrhea without side effects, it can be regarded as a safe and effective treatment for dysmenorrhea in young women.

Acupressure and anxiety in cancer patients

Background:

Anxiety has negative effects on mental and physical performance, quality of life, duration of hospitalization, and even on the treatment of patients with cancer.

Objectives:

Today acupressure is widely used to treat anxiety. Thus, the present study aimed to investigate the effects of acupressure on anxiety in patients with cancer.

Patients and Methods:

A double-blind randomized clinical trial was conducted on 85 patients hospitalized with 3 groups including acupressure group (n = 27), sham group (n = 28), and control group (n = 30) in the hematologic ward of Shahid Beheshti Hospital of Hamadan, Iran, in 2013. The sampling permuted-block randomization with triple block was used. The anxiety of the patients in the experimental, sham, and control groups were measured with Spielberger’s State-Trait Anxiety Inventory (STAI). Then, real acupressure was performed in the experimental group and fake acupressure in the sham group, and only routine care was provided for the control group. Anxiety of the patients was also assessed at 5 and 10 days after the intervention. Statistical analysis of the data was performed by SPSS software using repeated measures analysis of variance (ANOVA) and post hoc least significant difference (LSD) test.

Results:

According to the findings, the mean level of anxiety before the intervention between groups were matched (P > 0.05). Acupressure had a significant influence on the anxiety in the experimental group at 5 (45.30 ± 7.14) and 10 days (43.48 ± 6.82) after the intervention (P < 0.05). However, it did not have a significant impact on their covert anxiety (45.48 ± 7.92 at 5^th day vs 45.63 ± 8.08 at 10th day, P > 0.05). No significant differences were observed in the fake points regarding overt and covert anxiety of patients in the sham group (overt anxiety; 47.57 ± 7.85 at 5^th day vs. 46.71 ± 7.32 at 10^th day, P > 0.05) (covert anxiety; 47.96 ± 6.33 at 5^th day vs. 46.89 ± 6.94 at 10^th day, P > 0.05). Moreover, the routine care provided for the control group did not have any effect on the overt and covert anxiety of the patients (P > 0.05).

Conclusions:

Acupressure is recommended as a complementary therapy to reduce anxiety in patients with cancer because of its low cost, safety, and simplicity.

Association of body weight and female sexual dysfunction: a case control study

Background:

Obesity is rapidly increasing worldwide with negative effects on women’s health, psychosocial factors and quality of life. Female sexual dysfunction (FSD) is a major public health problem that is worrying for many women physically, emotionally and socially.

Objectives:

The purpose of this study was to investigate the association of body weight with FSD and sexual satisfaction, in Ilam, western Iran, in 2010 to 2011.

Patients and Methods:

This was a case-control study on 120 women aged 18–50 years [64 with FSD (case), 64 without FSD (control)] married, from Ilam-IR, who were interviewed as per the Iranian version of Female Sexual Function Index (FSFI). Body mass index (BMI) and waist-to-hip ratio (WHR) were recorded by researchers. The subjects were randomly selected from primary health centers.

Results:

FSFI score was significantly lower in overweight women (P < 0.05). FSFI strongly correlated with body mass index (BMI) (r = -0.68, P < 0.001) and waist-to-hip ratio (r = -0.29, P < 0.05) in women with FSD. Of sexual function parameters, there was a strong and inverse correlation between BMI and arousal (r = -0.71, P < 0.001), lubrication (r = -0.61, P < 0.001), orgasm (r = -0.52, P < 0.001) and satisfaction (r = -0.54, P < 0.001), while pain (r = -0.12, P > 0.05) and desire (r = -0.17, P > 0.05) did not correlate with BMI. There was an association between BMI and extreme satisfaction (r = -0.28, P < 0.05). Extreme physical pleasure (r = -0.19, P > 0.05) and extreme emotional satisfaction (r = -0.16, P > 0.05) were not correlated with BMI.

Conclusions:

Overweight and obesity negative affect sexuality in women with sexual dysfunction. A systematic evaluation of sexual function to disclose a cause and effect relationship between obesity and FSD is suggested.

ACL reconstruction using bone-patella tendon-bone autograft: press-fit technique vs. interference screw fixation

PURPOSE

The gold standard in ACL reconstructions has been the bone-patellar tendon-bone autograft fixed with interference screws. This prospective, randomized clinical trial aimed to compare two methods of fixation for BPTB grafts: press-fit fixation vs. interference screw, over a 12-month follow-up interval.

METHODS

158 patients with an average age of 29.8 years, between 2011 and 2012, were treated for torn ACL. 82 patients underwent reconstruction with BPTB autograft with a press fit fixation technique, and in 76 cases an interference screw was used. At the time of final follow-up, 71 patients in press-fit group and 65 patients in interference screw group were evaluated in terms of return to pre-injury activity level, pain, knee stability, range of motion, IKDC score and complications.

RESULTS

At 12-month follow-up, 59 (83 %) and 55 (85 %) in press-fit and screw group, respectively had good-to-excellent IKDC score (p > 0.05). The mean laxity assessed using a KT-1000 arthrometer improved to 2.7 and 2.5 mm in press-fit and screw group, respectively. Regarding Lachman and pivot shift test, there was a statistically significant improvement in the integrity of the ACL in both the groups, but no significant differences was noted between groups. There were no significant differences in terms of femur circumference difference, effusion, knee range of motion, pain and complications.

CONCLUSIONS

The press-fit technique is an efficient procedure. Its outcome was comparable with the interference screw group. Furthermore it has unlimited bone-to-bone healing, no need for removal of hardware, ease for revision and cost effectiveness.

Coupling of solvent-based de-emulsification dispersive liquid-liquid microextraction with high performance liquid chromatography for simultaneous simple and rapid trace monitoring of 2,4-dichlorophenoxyacetic acid and 2-methyl-4-chlorophenoxyacetic acid

A simple, rapid, and efficient sample pretreatment technique, based on solvent-based de-emulsification dispersive liquid-liquid microextraction (SD-DLLME), followed by high performance liquid chromatography (HPLC) has been developed for simultaneous preconcentration and trace detection of 2,4-dichlorophenoxyacetic acid (2,4-D) and 2-methyl-4-chlorophenoxyacetic acid (MCPA) in water and urine samples. Some parameters such as acidity of solution, the amount of salt, type, and volume of extraction solvents, type of disperser/de-emulsifier solvent, and its volume were investigated and optimized. Under optimum extraction conditions, the limits of detections (LODs) of this method for MCPA and 2,4-D were 0.2 and 0.6 μg L(-1) (based on 3S(b)/m) in water and 0.4 and 1.6 μg L(-1) in urine, respectively. Furthermore, dynamic linear range of this method for MCPA and 2,4-D was 1-300 and 2-400 μg L(-1), repectively. Finally, the applicability of the proposed method was evaluated by extraction and determination of the herbicides in urine and different water samples.

Treatment of intertrochanteric fractures in elderly highrisk patients: dynamic hip screw vs. external fixation

INTRODUCTION

Although the use of a dynamic hip screw (DHS) is considered to be the preferred treatment for intertrochanteric fractures, the external fixation device could produce clinical outcomes comparable to the outcomes obtained with conventional treatment. Furthermore, because external fixation is minimally invasive, we expected a lower rate of morbidity. Therefore, we compared the two treatments in a clinical trial of elderly patients with intertrochanteric fracture.

METHODS

60 elderly high-risk patients with an average age of 78 years were treated for intertrochanteric fracture, resulting from a low energy trauma. Patients were randomly divided in two groups regarding to treatment. In Group A the patients were treated with DHS, while in Group B were treated with external fixator.

RESULTS

The fixator was well accepted and no patient had significant difficulties while sitting or lying. The average intraoperative time was 73 min in Group A and 15 min in Group B (p<0.05). 27 patients of Group A need blood transfusion postoperatively and none in Group B (p<0.05). The mean duration of hospitalization in Group A and Group B was 8.4 and 2.2 days, respectively (p<0.05). 9 of patients Group B had pin-track infection grade 2 that all were treated by oral antibiotics. There were no differences in comorbidities, quality of reduction, screw cut out, bed sore and HHS between the two groups.

CONCLUSION

Treatment with external fixator is an effective treatment for intertrochanteric fractures in elderly highrisk patients. The advantages include quick and simple application, minimal blood loss, less radiation exposure, adequate fixation, pain reduction, early discharge from hospital, low costs and favourable functional outcomes.

Study of operated primary and secondary (recurrence) hydatidosis in hospitals of Kermanshah, west of Islamic Republic of Iran

Cystic echinococcosis, caused by the larval stage of Echinoccocus granulosus, is a global public health threat. The aim of this study was to determine the demographic and clinical characteristics of cases of primary and secondary hydatid cyst in the west of the Islamic Republic of Iran. A retrospective record review was made in 7 public and private hospitals in Kermanshah from 2004 to 2009. Of 526 files of suspected cases analysed, 291 cases of hydatid cyst had been operated upon and confirmed. Of the patients, 51.5% were females, 57.7% lived in urban and suburban areas and the largest age group (17.5%) was 31-40 years. The major organs involved were liver (64.9%) and lung (26.8%) and 18 cases (6.2%) were confirmed as secondary hydatidosis. Most patients (79.4%) had been treated with albendazole. Kermanshah province should be considered an endemic region for human hydatid cyst disease; greater efforts in prevention are needed.