Investigating the Prevalence of Delirium as a Psychiatry Disorder in Patients Undergoing Hip Joint Surgery

Background: Delirium is a severe organic disorder in the brain and a type of disorder in the cognitive state associated with reduced attention and cognition. This study aimed to investigate the prevalence of delirium in patients undergoing hip joint surgery.Methods: In cross sectional study, the patient's demographic profile form and a checklist of intervening factors designed which were used to measure the prevalence of delirium. The researcher checked the delirium status of the patients on the day before the surgery, 6, 12, 24, and 48 hours after the surgery, and at the time of discharge. Ethical criteria in the research included obtaining informed consent of patients, keeping patients confidential, notifying the delirium status patients to the attending physician for further actions, and not imposing costs on patients. The data were analyzed using Spss software version 16 and descriptive and analytical tests.Results: Result showed, the overall prevalence of delirium in patients was equal to 58 (46.4), and 92 (73.6) of patients without a spouse, 112 (89.6) of patients with poor economic status, 63 (50.4) of smoking patients, 14 (11.2) with a history of drug use, 54 (43.2) with a history of hospitalization in the ICU. Also, the mean (SD) age of the patients was 75.44 (8.43).Conclusions: According to the findings, the prevalence of delirium in patients with hip joint surgery was high, that is why it is necessary to carry out preventive interventions to reduce delirium in these patients. ASEAN Journal of Psychiatry, Vol. 24 (1) January, 2023; 1-6

No sign of Rotavirus co-infection in COVID-19 patients with gastrointestinal symptoms

Background and aims The main goal of the present study is to investigate the incidence of Rotavirus co-infection in COVID-19 patients. Methods and Results Fecal samples of COVID-19 patients with gastrointestinal symptoms which had positive PCR-were collected from Abadan's hospital, Iran during the period December 2020 to January 2021. Samples were analyzed by RT-PCR to determine the presence of Rotavirus. Finally, the total samples size of 37 were included in this study. The mean age of patients was 48.22 years. Abdominal pain alone was detected in 48.65 of the patients. At least one gastrointestinal symptom was detected in all of the patients. Diarrhea and fever were seen in 13.51 and 59.46 of patients, respectively. Nausea and vomiting were seen in 5.41 of the patients. RT-PCR showed no infection of Rotavirus among the patients. Conclusion Gastrointestinal symptoms related to COVID-19 are common. More studies is need among these patients groups for investigate co-infection with other fecal viral shedding carries, due to a worse prognosis and its association with disease severity

Novel Information Regarding the Treatment of Helicobacter pylori Infection: A Systematic Review and Meta-analysis of Randomized Clinical Trials

OBJECTIVE: Helicobacter pylori infects at least 50 of the world's human population. The current study aimed to assess and compare the efficacy of triple versus quadruple therapy. METHODS: Randomized clinical trials (RCTs) consisting of triple and quadruple therapy were identified through electronic and manual searches in the national and international online databases (IsI, Magiran, Embase, PubMed, and Scopus). The random-effects model was applied to pool analysis. Funnel plots and the Egger test were used to examine publication bias. RESULTS: After a detailed review of the selected articles, 79 RCTs were included in the meta-analysis; it was based on using triple and quadruple therapy as the first and second-line treatment. The results showed that quadruple therapy in the first-line treatment had a higher eradication rate than triple therapy. Overall, the eradication rate with triple therapy was 74 (95 CI, 71-77) for intention-to-treat (ITT) analysis and 80 (95 CI, 77-82) for per-protocol (PP) analysis. Generally, the eradication rate with quadruple therapy was 82 (95 CI, 78.0-86.0) for ITT analysis and 85 (95 CI, 82.0-89.0) for PP analysis. The analysis also revealed that quadruple therapy was more effective for 7 or 10 days. CONCLUSION: The current study results demonstrated that quadruple therapy has better effectiveness than triple therapy as the first-line treatment; however, in the second-line treatment, the effectiveness of quadruple and triple regimens is almost similar. The effectiveness of quadruple therapy in the Asian population was found to be slightly higher than that of triple therapy, while this difference was considerably higher in the European population

Circular RNAs and tuberculosis infection

Tuberculosis (TB) is a deadly infectious disease caused by Mycobacterium tuberculosis (Mtb) that affects the im-mune system chronically. Therefore, effective control and treatment of tuberculosis requires rapid and accurate diagnostic strategies. Tuberculosis has always been a global burden on health, social and economic systems due to the lack of standard curative and diagnostic (bio)markers. Accordingly, the management and monitoring of patients with active TB at the primary care level may be possible through new, rapid and cost-effective non -sputum-based diagnostic procedures. Biomarkers can help diagnose various diseases, including circular RNA (circRNA), which has recently been introduced as an endogenous, abundant and stable RNA in the cytoplasm with unique tissue specificity. There are frequent reports of circRNA involvement in many pathological and physiological processes in human beings. Recent studies have highlighted the presence of circRNAs in serum and their role as promising biomarkers in the diagnosis of the disease, potentially due to the continuous, stable, closed covalent circular structures and lack of easy degradation by nucleases. The purpose of this review article is to scrutinize the behavior of circulating plasma RNAs in relation to the pathogenesis and diagnosis of tuberculosis

The Relationship between Clinical Competence and Ethical Reasoning and Factors Affecting it in Nurses Working in Therapeutic Educational Centers of Ilam

Clinical competence means a person's ability to use techniques on time, to communicate effectively with others, and to benefit from the knowledge and clinical reasoning ability when responding to different clinical situations in such a way that a person can use these skills at all times. The aim of the study is the relationship between clinical competence and ethical reasoning and the factors affecting it in nurses working in therapeutic educational centers of Ilam. Methods: In this descriptive-analytical study, 110 nurses working in three therapeutic educational centers in Ilam city were randomly selected. Demographic information forms, standard nursing clinical competence questionnaire (NCCQ), and nursing dilemma test (NDT) were used to collect data. The results also showed a positive and significant relationship between age, level of education, years of work experience, employment status, and occupational role with clinical competence and ethical reasoning (P<0.05). On the other hand, there was an inverse and significant relationship between the workplace and clinical competence and ethical reasoning (P<0.05). Data analysis was carried out using Descriptive statistics (frequency, percentage, mean and standard deviation) and analytical tests (Pearson correlation tests and analysis of variance) in SPSS. P-value< 0.05 was considered as the significance level. Using the results of the present study, nursing education planners and managers can periodically organize workshops on nursing ethics and nursing problems in hospitals and universities. Moreover, clinical competence and ethical reasoning should be taken into account when training nursing personnel in university classrooms and in-service courses

Assessment of genetic markers for multilocus sequence typing (MLST) of Fasciola isolates from Iran

Background Several markers have been described to characterise the population structure and genetic diversity of Fasciola species (Fasciola hepatica (F. hepatica) and Fasciola gigantica (F. gigantica). However, sequence analysis of a single genomic locus cannot provide sufficient resolution for the genetic diversity of the Fasciola parasite whose genomes are similar to 1.3 GB in size. Objectives To gain a better understanding of the gene diversity of Fasciola isolates from western Iran and to identify the most informative markers as candidates for epidemiological studies, five housekeeping genes were evaluated using a multilocus sequence typing (MLST) approach. Methods MLST analysis was developed based on five genes (ND1, Pepck, Pold, Cyt b and HSP70) after genomic DNA extraction, amplification and sequencing. Nucleotide diversity and phylogeny analysis were conducted on both concatenated MLST loci and each individual locus. A median joining haplotype network was created to examine the haplotypes relationship among Fasciola isolates. Results Thirty-three Fasciola isolates (19 F. hepatica and 14 F. gigantica) were included in the study. A total of 2971 bp was analysed for each isolate and 31 sequence types (STs) were identified among the 33 isolates (19 for F. hepatica and 14 for F. gigantica isolates). The STs produced 44 and 42 polymorphic sites and 17 and 14 haplotypes for F. hepatica and F. gigantica, respectively. Haplotype diversity was 0.982 +/- 0.026 and 1.000 +/- 0.027 and nucleotide diversity was 0.00200 and 0.00353 +/- 0.00088 for F. hepatica and F. gigantica, respectively. There was a high degree of genetic diversity with a Simpson's index of diversity of 0.98 and 1 for F. hepatica and F. gigantica, respectively. While HSP70 and Pold haplotypes from Fasciola species were separated by one to three mutational steps, the haplotype networks of ND1 and Cyt b were more complex and numerous mutational steps were found, likely due to recombination. Conclusions Although HSP70 and Pold genes from F. gigantica were invariant over the entire region of sequence coverage, MLST was useful for investigating the phylogenetic relationship of Fasciola species. The present study also provided insight into markers more suitable for phylogenetic studies and the genetic structure of Fasciola parasites

Antimicrobial resistance and biofilm formation capacity among Acinetobacter baumannii strains isolated from patients with burns and ventilator-associated pneumonia

BackgroundAcinetobacter baumannii is a pathogen responsible for nosocomial infections, especially in patients with burns and ventilator-associated pneumonia (VAP). The aims of this study was to compare the biofilm formation capacity, antimicrobial resistance patterns and molecular typing based on PFGE (Pulsed-Field Gel Electrophoresis) in A. baumannii isolated from burn and VAP patients. Materials and MethodsA total of 50 A. baumannii isolates were obtained from burn and VAP patients. In this study, we assessed antimicrobial susceptibility, biofilm formation capacity, PFGE fingerprinting, and the distribution of biofilm-related genes (csuD, csuE, ptk, ataA, and ompA). ResultsOverall, 74 of the strains were multidrug resistant (MDR), and 26 were extensively drug-resistant (XDR). Regarding biofilm formation capacity, 52, 36, and 12 of the isolates were strong, moderate, and weak biofilm producers. Strong biofilm formation capacity significantly correlated with XDR phenotype (12/13, 92.3). All the isolates harbored at least one biofilm-related gene. The most prevalent gene was csuD (98), followed by ptk (90), ataA (88), ompA (86), and csuE (86). Harboring all the biofilm-related genes was significantly associated with XDR phenotype. Finally, PFGE clustering revealed 6 clusters, among which cluster No. 2 showed a significant correlation with strong biofilm formation and XDR phenotype. ConclusionOur findings revealed the variable distribution of biofilm-related genes among MDR and XDR A. baumannii isolates from burn and VAP patients. A significant correlation was found between strong biofilm formation capacity and XDR phenotype. Finally, our results suggested that XDR phenotype was predominant among strong-biofilm producer A. baumannii in our region

Amoxicillin-docosahexaenoic acid encapsulated chitosan-alginate nanoparticles as a delivery system with enhanced biocidal activities against Helicobacter pylori and improved ulcer healing

Encapsulation of amoxicillin (AMX) for drug delivery against Helicobacter pylori infection and aspirin-induced ulcers in rat's stomachs was performed using docosahexaenoic acid (DHA)-loaded chitosan/alginate (CA) nanoparticles (NPs) developed by ionotropic gelation method. The physicochemical analyses of the composite NPs were performed by scanning electron microscopy, Fourier transform infrared spectroscopy, zeta potential, X-ray diffraction, and atomic force microscopy. The encapsulation efficiency of AMX was increased to 76 by incorporating DHA, which resulted in a reduction in the particle size. The formed CA-DHA-AMX NPs effectively adhered to the bacteria and rat gastric mucosa. Their antibacterial properties were more potent than those of the single AMX and CA-DHA NPs as demonstrated by the in vivo assay. The composite NPs attained higher mucoadhesive potential during food intake than during fasting (p = 0.029). At 10 and 20 mg/kg AMX, the CA-AMX-DHA showed more potent activities against H. pylori than the CA-AMX, CA-DHA, and single AMX. The in vivo study showed that the effective dose of AMX was lower when DHA was included, indicating better drug delivery and stability of the encapsulated AMX. Both mucosal thickening and ulcer index were significantly higher in the groups receiving CA-DHA-AMX than in the groups receiving CA-AMX and single AMX. The presence of DHA declines the pro-inflammatory cytokines including IL-1 beta, IL-6, and IL-17A. The synergistic effects of AMX and the CA-DHA formulation increased the biocidal activities against H. pylori infection and improved ulcer healing properties

Efficient sonocatalytic degradation of orange II dye and real textile wastewater using peroxymonosulfate activated with a novel heterogeneous TiO2–FeZn bimetallic nanocatalyst

TiO2–FeZn nanocatalyst combined with sonolysis were used to activate peroxymonosulfate (PMS) as a highly efficient advanced oxidation process (US/TiO2–FeZn/PMS) for the decoloration of orange II dye (OII) and real textile wastewater. The characterization of the as-synthesized NPs was performed by SEM, FTIR, EDX and XRD analyses. Optimal experimental conditions of operational parameters were obtained: pH = 3, 15 mg/L initial OII concentration, 0.2 g/L PMS, 0.7 g/L nanocatalyst dosing, and 300 W ultrasonic power. The decolorization was observed to increase with increasing the dose of nanocatalyst and the ultrasonic power, and with decreasing pH (under acidic conditions). Under optimal experimental conditions, decolorization and COD removal of textile wastewater were 99.9 and 74.6, respectively, at 40 min. The TiO2–FeZn/PMS/US as a novel process exhibited a higher removal of OII (95) than TiO2 NPs/PMS/US process (54). The OII removal efficiency by the different processes decreased in the following order: TiO2–FeZn/US/PMS &gt; TiO2–FeZn/PMS &gt; TiO2–FeZn/US &gt; TiO2 /US/PMS &gt; US/PMS &gt; TiO2–FeZn &gt; PMS &gt; US. The recyclability study revealed that the process could be reused up to three consecutive cycles. The current US/nanocatalyst/PMS system was concluded to be an efficient, reusable and stable nanocatalyst for the oxidation of textile dyes. © 2023, Iranian Chemical Society

An Investigation into the Surface Dose Using Eclipse Treatment Planning System and Film Dosimetry for Treatment of Breast Cancer

Purpose: Accurate knowledge about surface dose distribution is a critical issue in skin irradiation. This study was conducted to investigate the surface dose using the Eclipse Treatment Planning System (TPS) calculation and GAF chromic film measurement for breast cancer treatment. Materials and Methods: An inhomogeneous chest phantom was used in the present study. Irradiations were done with a 6 MV energy beam of a linear accelerator (Varian 2100C/D). TPS calculations and film measurements were compared for surface dose estimations. Results: The average difference between film measurements and TPS calculations was 7.1. Surface doses were lower in TPS calculations in comparison with film measurements. Conclusion: TPS plays a significant role in radiotherapy. However, they have many errors in measuring surface doses. Because of the inaccuracy of the majority of treatment planning systems in calculating the surface dose, the need for practical measurements is essential. Copyright © 2023 Tehran University of Medical Sciences