Involuntary and Persistent Environmental Noise Influences Health and Hearing in Beirut, Lebanon

Objective. This study was conducted to assess the effects of involuntary and persistent noise exposure on health and hearing among Lebanese adults in Beirut, Lebanon, where people are exposed to noise from construction sites, power generators, honking cars, and motorcycles. Methods. Using a descriptive and exploratory design with mixed methods, participants were surveyed, interviewed, and tested for hearing while street noise levels were measured near their residents and work places. Results. Self-reports of 83 Lebanese adult, who lived and worked in Beirut, helped identify common patterns in experiences such as irritability, anger, headaches, and sleep disturbances due to noise annoyance. Of those tested, 30% suffered from high-frequency hearing impairment. Our results showed that environmental sound dB had increased by 12% and sound intensity by 400% above the maximum standard level when compared to the WHO report of 1999. Conclusion. Environmental noise contributes to premature hearing loss and potentiates systemic diseases among Lebanese

Hashimoto Encephalopathy with an Unusual Presentation of Status Epilepticus Seizures: A Case Report

A 33 yr old man, previously diagnosed with hypothyroidism, presented with decreased level of consciousness and generalized tonic-clonic (GTC) seizure to Namazi hospital, Shiraz, Iran, during April 2015. The patient later referred with another episode of seizure like attack for which he received phenytoin, carbamazepine and levothyroxine and was discharged. During his last admission, the patient was admitted with chief complaints of decreased consciousness and four GTC attacks. On admission, the patients had aphasia, ataxia, loss of verbal communication, eye contact and complete loss of obedience. Thyroid function tests showed low levels of T3 and T4 with high levels of thyroid stimulating hormone. Other blood tests were all either normal or slightly abnormal. Lumbar puncture and CSF analysis had a high titer of Anti-TPO antibodies. With high suspicion of Hashimoto encephalopathy, pulsed methyl prednisolone (10 mg) was administered, however the patient showed little improvement. Therefore, plasmaphresis was started, to which the patient showed dramatic response

The Iranian Parents of Premature Infants in NICU Experience Stigma of Shame

ntroduction: To explore experiences of Iranian parents with a hospitalized premature infant in Neonatal Intensive Care Unit (NICU) and examine socio-cultural factors associated with having a less than perfect infant. Methods: Purposely selected 21 participants in this study were 6 fathers, 7 mothers, 5 nurses and 3 physicians specialized in neonatology. Semi-structured in-depth interviews using inductive approach and content analysis helped obtain and analyze data by open encoding for classification and theme abstraction. Results: Findings revealed that parents of hospitalized NICU infants in Iran experienced: job and income loss; shattered confidence in parental role; challenges to family dynamics; shame as a social stigma; loss of control; overwhelmed with uncertainties; and stress induced physical and emotional problems. Conclusion: Unique and outstanding finding of this study was the social stigma of shame for parents of an NICU infant which directly explained the socio-cultural aspect of Iranian society where families place great importance on having a healthy and strong infant. Having a premature infant with anomalies is viewed as a family flaw. Physicians and nurses must focus more on communication with parents and fulfill an important role to educate, assure and comfort parents. Establishing support system for parents of NICU infants seem urgently needed to improve parentinfant bonding

The experiences of parents with infants in Neonatal Intensive Care Unit

Background: In recent years significant medical science advances have been made in the field midwifery and infant care. The premature, low birth weight and ill infants are admitted to the technologically advanced NICU for care and they often require long‑term stay. This study addresses parental experiences with the infant care in NICU, explores their concerns regarding nursing supports for parents and offers nurses’ perspectives on performing duties. Materials and Methods: A qualitative inductive content analysis method was applied in 2011 that included a purposely selected group of parents, nurses and physicians from neonatal unit at the Medical Science University of Isfahan. Participants were surveyed and interviewed according to the institutional ethics committee approval and signed informed consents. Results: The content analysis identified two main categories: 1) the definition of stress, which consisted of misgivings, nervous pressure, imbalance, separation and 2) the parents’ reaction to stress, which revealed emotional, psychotic and behavioral reactions as subcategories. Discussion: The medical team awareness of NICU parent experiences is essential to the quality of care. Recognizing the type of parents’ reaction to the whole process by the healthcare team seems essential to the optimum outcome

An Exploration of the Viewpoints of Parents and Nurses on Care Provision in Neonatal Intensive Care Units

Background: Infants are regarded as a vulnerable group in need of nursing care, particularly during NICU admission. Parents of these infants often experience emotional, psychological and physical upheavals. Therefore, nurses can be of great help to the parents and facilitate a healthy transition from this period. Improper communication with parents, who seek information on their infant's condition, intensifies their stress, fear and misunderstanding. In fact, inadequate communication with healthcare providers and lack of family support are major issues for the parents of NICU-admitted infants. Methods: In this qualitative study, via content analysis, we objectively selected and collected data from parents, physicians and nurses, residing in Isfahan, Iran in 2012. Data saturation was reached after conducting 25 in-depth, semi-structured interviews. Results: Based on the findings, five major categories were extracted: 1) care provision in NICUs; 2) diagnostic difficulties; 3) NICU admission process; 4) challenges of hospitalization; and 5) maintenance of infant viability. Conclusion: Nurses' proper response to parents' questions about the infant's condition reduced stress among parents. Based on the findings, training is essential to healthy family dynamics and infant's well-being, particularly for younger parents who support their infants at home. Also, regular updates on infant's condition could help reduce parents' stress and discomfort

The image of nursing, as perceived by Iranian male nurses

The stereotypical public image of nursing is a major concern for male nurses around the world. In this study, we explored how Iranian male nurses perceived the public view of nurses, and their perceptions of themselves. A qualitative descriptive design and content analysis were used to obtain data from 18 purposely-selected male hospital nurses with a baccalaureate nursing degree in Tabriz, Iran. Semistructured interviews were conducted and analyzed. Two main themes emerged: (i) the outsider's view of nursing, which referred to the participants' perceptions of their public image; and (ii) the insider's view, which related to the male nurses' perceptions of themselves. Results included personal transition into a positive professional self-image through the educational process, and continued public perception of nursing as a female profession ill-suited for a man. Strategies to improve the insider's and outsider's views of nursing are listed to help recruit and retain more Iranian male nurses

A semi-analytical approach for the response of nonlinear conservative systems

This work applies Parameter expanding method (PEM) as a powerful analytical technique in order to obtain the exact solution of nonlinear problems in the classical dynamics. Lagrange method is employed to derive the governing equations. The nonlinear governing equations are solved analytically by means of He’s Parameter expanding method. It is demonstrated that one term in series expansion is sufficient to generate a highly accurate solution, which is valid for the whole domain of the solution and system response. Comparison of the obtained solutions with the numerical ones indicates that this method is an effective and convenient tool for solving these types of problems

Development of a new DNA extraction protocol for PFGE typing of Mycobacterium tuberculosis complex.

A modified pulsed-field gel electrophoresis (PFGE) protocol was developed and applied to clinical isolates of Mycobacterium tuberculosis complex to reduce the cost of using lyticase. This protocol reduces the expense of PFGE typing of Mycobacterium tuberculosis complex as it removes the use of lyticase during the spheroplast formation from these bacteri

Increased Expression of Transforming Growth Factor-beta and Receptors in Primary Human Airway Fibroblasts from Chemical Inhalation Patients

The widespread use of sulfur mustard (SM) as a chemical warfare agent in the past century has proved its long-lasting toxic effects. Despite a lot of research over the past decades on Iranian veterans, there are still major gaps in the SM literature. Transforming growth factor (TGF-beta), a cytokine that affects many different cell processes, has an important role in the lungs of patients with some of chronic airway diseases, especially with respect to airway remodeling in mustard lung. Primary airway fibroblasts from epibronchial biopsies were cultured, and gene expression of TGF-beta 1, TGF-beta 2, TbR-I and TbR-II in fibroblasts of SM injured patients and controls were investigated. Expression of TGF-beta s and receptors was measured by RT-PCR. Protein level of TGF-beta 1 was surveyed by western blot. Our findings revealed that expression levels of TGF-beta 1, TGF-beta 2, TbR-I and TbR-II were upregulated in the airway fibroblasts of SM exposed patients in comparison with control samples. TGF-beta 1 expression was shown to be markedly increased in primary lung fibroblasts of chemically injured patients. Our novel data, suggested that over-expression of TGF-beta molecule and receptors in primary airway fibroblasts of mustard gas injured patients may be involved in progression of airway remodeling of these patients

Screening and comparative characterization of microorganisms from Iranian soil samples showing ω-transaminase activity toward a plethora of substrates

In this study, soil microorganisms from Iran were screened for ω-transaminase (ω-TA) activity based on growth on minimal media containing (rac)-α-methylbenzylamine (rac-α-MBA) as a sole nitrogen source. Then, for the selection of strains with high enzyme activity, a colorimetric o-xylylendiamine assay was conducted. The most promising strains were identified by 16S rDNA sequencing. Five microorganisms showing high ω-TA activity were subjected to determine optimal conditions for ω-TA activity, including pH, temperature, co-solvent, and the specificity of the ω-TA toward different amine donors and acceptors. Among the five screened microorganisms, Bacillus halotolerans turned out to be the most promising strain: Its cell-free extract showed a highly versatile amino donor spectrum toward aliphatic, aromatic chiral amines and a broad range of pH activity. Transaminase activity also exhibited excellent solvent tolerance, with maximum turnover in the presence of 30% (v/v) DMS