Genetic variation of Giardia lamblia isolates from food-handlers in Kashan, Central Iran

<p><strong><em>Background:</em></strong> Based on genotyping study of human isolates of <em>Giardia lamblia</em>; humans are mainly infected by two assemblages A and B. The present study was carried out to determine the sub-assemblages of <em>G. lamblia</em> isolated from food handlers referred to Kashan health centers, central Iran, 2015.</p><p><strong><em>Methods:</em></strong> In this cross-sectional<strong> </strong>study,<strong> </strong>3653 stool samples collected from food-handlers that annually refer to health center for getting a health certification and examined microscopically for <em>G. lamblia</em> cyst. Totally, 44 isolates were selected from 47 <em>Giardia</em> positive samples. Cysts were partially purified by the sucrose density gradient method. After freeze-thaw cycles, genomic DNA was extracted using QIAamp Stool Mini kit. A single step PCR-RFLP method was used to amplify a 458bp fragment at the glutamate dehydrogenase <em>(gdh</em>) locus, restriction enzymes <em>BspLI </em>and <em>RsaI</em> were used for distinguish between genotypes A and B and their subgroups.</p><p><strong><em>Results:</em></strong> Of 44 isolates, 24(54.5%) were sub-assemblage AII, 9(20.5%) group B including 7(15.9%) BIII and 2(4.6%) BIV sub-assemblage and 11(25%) isolates showed a mixed pattern of AII and B. Sub-assemblage AI was not detected in this study.</p><strong><em>Conclusion:</em></strong> The higher rate of sub-assemblage AII demonstrated an anthroponotic origin of the infection so infected food-handlers could directly transmit this protozoan to consumers via contaminated food and water. For finding of pattern of transmission and distribution of <em>Giardia</em> assemblages and sub-assemblage, more studies in human and animal population in different regions are necessary

Survey of hydatid cyst surgeries in hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences during 2004 to 2014

Background: Hydatidosis is one of the most important zoonotic diseases with global distribution. Due to the prevalence of the disease in country, the study aimed to determine the clinical and laboratory findings in patients with hydatidosis admitted to surgical departments of educational hospitals, Imam Khomeini and Golestan, in Ahvaz city during 2004-2014. Materials and Methods: Data of the patients including demographic characteristics, and clinical and laboratory findings were recorded in a prepared form and analyzed using descriptive statistics and Chi-square tests by the SPSS software. Results: From a total of all patients, 49 (55.7) and 39 patients (44.3) were females and males respectively; 25 patients were resident in rural areas and 62 in urban areas. The mean age of the patients was 30.6&plusmn;2 years. Also, the maximum and minimum percentages of the disease were observed in the age group 20-29 and 80-89, respectively. Recurrence was observed in 9 patients. The highest prevalence of the hydatid cyst was in the right lobe of the liver (26.1). Among the methods of imaging, sonography and MRI had the highest and lowest use in the diagnosis of the disease, respectively. Conclusion: Findings of this study show that the most common organs affected are the liver and the younger age group and suburbs are more prone to hydatidosis. Due to the chronicity of the disease and the late diagnosis during the visit, screening for endemic areas and high-risk persons is recommended

Chitosan-titanium dioxide-glucantime nanoassemblies effects on promastigote and amastigote of Leishmania major

The purpose of the present study was to design nanoassemblies of chitosan-titanium dioxide (TiO2) nanoparticles (NPs) loaded with glucantime for using their synergistic effects and enhancing the toxic effects of glucantime on Leishmania parasites. The nanoassemblies were prepared by electrostatic interactions and optimized by a response surface central composite design. The effects of glucantime, chitosan and TiO2 NPs amounts were studied on the particle size, zeta potential, loading efficiency, and release efficiency of drug from nanoassemblies. The conjugation of TiO2/chitosan-glucantime was verified by UV spectroscopy and changes in surface charge of NPs. The anti-promastigots effect of glucantime loaded in TiO2/chitosan nanoassemblies was studied by tripan blue dye test and their anti-amastigotes effect by counting the average number of parasites per infected J774 macrophages in 100 cells. The optimized formulation obtained by using 12.5 mg glucantime, 25 mg chitosan and 6 mg TiO2 NPs. Although TiO2 NPs alone were effective more than negative control in reduction of promastigots and amastigotes but they didn't show significant difference compared with free glucantime (p > 0.05). However, at the concentration of 50 μg/mL and after 72 h exposure nanoassemblies decreased the proliferation of L. major promastigotes and amastigotes 13 and 4-fold, respectively compared with glucantime alone. © 2017 Elsevier B.V

The relationship between emotional intelligence and communication skills in healthcare staff

Introduction: Emotional intelligence (EI), also known as Emotional Quotient, is defined as an individual�s alertness on his or her own emotions, together by an alertness of the emotions in other people and the capacity to manage them and act appropriately. Objectives: The purpose of this study was to investigate the relationship between the EI (Emotional Intelligence) and communication skills of healthcare staff working at ambulatory clinics in Shiraz. Methods: 108 healthcare staff was selected using simple random sampling. To assess the EI, a valid and reliable Persian version of Goleman�s questionnaire was used. To assess the communication skills, a questionnaire was designed based on previous questionnaires. For each healthcare staff, five patients were selected randomly to complete the questionnaires. Results: The total score of the EI was 76.49±2.83 out of 112. The mean total score of the communication skills was 96.80±11.63 out of 120. There was a significant relationship between the total score of EI and communication skills. The R2 coeffcient was 0.74. There was also a significant relationship between EI dimensions and the total score of communication skills (P < 0.001). Conclusion: Having a higher level of EI leads to better communication with patients and better health outcomes. © 2018, Author(s)

Using Team-Based Learning to Teach Evidence-Based Medicine to First-Year Residents

Team-based learning (TBL) is a well-established instructional strategy that provides students with the chance to apply conceptual knowledge through a series of actions, including pre-class, individual, team class activity, and immediate feedback. The purpose of the present study was to introduce a course of teaching the evidence-based medicine (EBM) to all first-year medical residents in different disciplines at Shiraz Medical School in Iran country using the TBL instructional strategy. The sample included 86 medical residents at Shiraz Medical School. This study had a quasi-experimental design and was conducted in 12 sessions of evidence-based medicine (EBM) based on team-based learning (TBL) strategy. The obtained data were analyzed using SPSS software. In all sections, the results of Individual Readiness Assurance Tests (IRATs) and Group Readiness Assurance Tests (GRATs) were added and calculated. Cronbach's alpha test was implemented to evaluate the reliability of the questionnaires. For the descriptive analysis of data, descriptive statistics were used. ANOVA and T-test were used for analytic analysis. There was a significant difference in answering the questions between individual (3.73 ± 2.33) and group (4.71 ± 2.29) stages. Residents gained higher average grades on working in the team (P-value < 0.02). Results of residents' response about satisfaction questionnaire are shown that the best scores belong to group activities in TBL. The results of this study showed that TBL could be used as an effective method for residents' education in different disciplines. © 2019 Mandana Akbarinejad Mousavi et al., published by Sciendo 2019

Lethal effects of gold nanoparticles on protoscolices of hydatid cyst: in vitro study

Recurrence of hydatidosis may results from cyst fluid spillage during surgery. To inactivate the cyst content, different scolicidal agents have been introduced. Nevertheless, novel and more effective treatments are needed due to the associated complications. In the current study, we examined the scolicidal effects of gold nanoparticles on Echinococcus granulosus protoscoleces. Hydatid cysts of sheep liver were collected in this study. The cyst fluid containing protoscoleces was aspirated aseptically. The protoscoleces were exposed to gold nanoparticles at different concentrations (250, 500, 1000, 2000, and 4000 μg/mL). Eosin staining method was applied to determine the viability of protoscoleces at 5, 10, 20, 30, and 60 min. Moreover, cytotoxicity analysis, scanning electron microscopy (SEM) of ultrastructural changes, DNA fragmentation, were performed, and protoscoleces were studied following treatment. The significant scolicidal effects of gold nanoparticles were observed at all concentrations compared to the control group. A total of 4000 μg/mL of gold nanoparticles could destroy 76 of protoscoleces in 60 min. Cytotoxic effects of gold nanoparticle on J774 macrophage cell line, in minimum and maximum concentration (500 and 4000 μg/mL), were 1 and 11, respectively. After treatment of protoscoleces with gold nanoparticles in different times and concentrations, considerable alteration in size, ultrastructure changes in tegument and shape of sucker, as well as DNA fragmentation of parasite were seen. Based on the results, gold nanoparticles could exert scolicidal effects on hydatid cyst protoscoleces; therefore, they can be applied in hydatid cyst treatment. © 2018, Springer-Verlag London Ltd., part of Springer Nature

Effect of Peer Assisted Learning (PAL) education on knowledge, attitude and behavior related to prevention and control of diabetes

Objectives: The present study aimed to compare the effect of Peer Assisted Learning (PAL) method and routine lecture on knowledge, attitudes, and behaviors of participants in the prevention of diabetes. Results: The results showed that one month after the intervention and the implementation of the educational program, the mean scores of the two groups in terms of knowledge, attitude, and behavior increased significantly. © 2019 The Author(s)

Chitosan-titanium dioxide-glucantime nanoassemblies effects on promastigote and amastigote of Leishmania major

The purpose of the present study was to design nanoassemblies of chitosan-titanium dioxide (TiO2) nanoparticles (NPs) loaded with glucantime for using their synergistic effects and enhancing the toxic effects of glucantime on Leishmania parasites. The nanoassemblies were prepared by electrostatic interactions and optimized by a response surface central composite design. The effects of glucantime, chitosan and TiO2 NPs amounts were studied on the particle size, zeta potential, loading efficiency, and release efficiency of drug from nanoassemblies. The conjugation of TiO2/chitosan-glucantime was verified by UV spectroscopy and changes in surface charge of NPs. The anti-promastigots effect of glucantime loaded in TiO2/chitosan nanoassemblies was studied by tripan blue dye test and their anti-amastigotes effect by counting the average number of parasites per infected J774 macrophages in 100 cells. The optimized formulation obtained by using 12.5 mg glucantime, 25 mg chitosan and 6 mg TiO2 NPs. Although TiO2 NPs alone were effective more than negative control in reduction of promastigots and amastigotes but they didn't show significant difference compared with free glucantime (p &gt; 0.05). However, at the concentration of 50 μg/mL and after 72 h exposure nanoassemblies decreased the proliferation of L. major promastigotes and amastigotes 13 and 4-fold, respectively compared with glucantime alone. © 2017 Elsevier B.V

The global, regional, and national burden of colorectal cancer and its attributable risk factors in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Background Data about the global, regional, and country-specific variations in the levels and trends of colorectal cancer are required to understand the impact of this disease and the trends in its burden to help policy makers allocate resources. Here we provide a status report on the incidence, mortality, and disability caused by colorectal cancer in 195 countries and territories between 1990 and 2017. Methods Vital registration, sample vital registration, verbal autopsy, and cancer registry data were used to generate incidence, death, and disability-adjusted life-year (DALY) estimates of colorectal cancer at the global, regional, and national levels. We also determined the association between development levels and colorectal cancer age-standardised DALY rates, and calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. All of the estimates are reported as counts and age-standardised rates per 100 000 person-years, with some estimates also presented by sex and 5-year age groups. Findings In 2017, there were 1·8 million (95% UI 1·8–1·9) incident cases of colorectal cancer globally, with an agestandardised incidence rate of 23·2 (22·7–23·7) per 100 000 person-years that increased by 9·5% (4·5–13·5) between 1990 and 2017. Globally, colorectal cancer accounted for 896 000 (876 300–915 700) deaths in 2017, with an agestandardised death rate of 11·5 (11·3–11·8) per 100 000 person-years, which decreased between 1990 and 2017 (–13·5% [–18·4 to –10·0]). Colorectal cancer was also responsible for 19·0 million (18·5–19·5) DALYs globally in 2017, with an age-standardised rate of 235·7 (229·7–242·0) DALYs per 100 000 person-years, which decreased between 1990 and 2017 (–14·5% [–20·4 to –10·3]). Slovakia, the Netherlands, and New Zealand had the highest age-standardised incidence rates in 2017. Greenland, Hungary, and Slovakia had the highest age-standardised death rates in 2017. Numbers of incident cases and deaths were higher among males than females up to the ages of 80–84 years, with the highest rates observed in the oldest age group (≥95 years) for both sexes in 2017. There was a non-linear association between the Socio-demographic Index and the Healthcare Access and Quality Index and age-standardised DALY rates. In 2017, the three largest contributors to DALYs at the global level, for both sexes, were diet low in calcium (20·5% [12·9–28·9]), alcohol use (15·2% [12·1–18·3]), and diet low in milk (14·3% [5·1–24·8]). Interpretation There is substantial global variation in the burden of colorectal cancer. Although the overall colorectal cancer age-standardised death rate has been decreasing at the global level, the increasing age-standardised incidence rate in most countries poses a major public health challenge across the world. The results of this study could be useful for policy makers to carry out cost-effective interventions and to reduce exposure to modifiable risk factors, particularly in countries with high incidence or increasing burde