Workshop-based training of pre-hospital emergency technicians for acute psychiatric patients:benefits and drawbacks

Background: Pre-hospital emergency technicians are crucial in managing patients with acute psychiatric symptoms. They must quickly assess the condition, make a primary diagnosis, and refer the patient to the appropriate treatment center. Insufficient skills in these situations can cause serious harm. Educating technicians on dealing with these patients may enhance their knowledge and skills; however, we do not know the extent and longevity of this improvement and which areas are affected. This study investigates the impact of training on pre-hospital emergency technicians’ knowledge and skills. Methods: This quasi-experimental study involved pre-hospital emergency technicians in Robat Karim and Nasim Shahr counties from December 2022 to January 2022. The technicians received workshops on interacting with psychiatric patients. The training topics included the basic principles of coping with a psychiatric patient. They also covered a step-by-step approach to dealing with an aggressive patient, dealing with a patient threatening suicide, managing agitation, managing a patient suffering from panic attacks, and finally dealing with a delirious patient. A pre-test assessed their baseline knowledge and skills, followed by a post-test after training and another test three months later. The test results were analyzed. Results: This study involved forty male participants ranging in age from 25 to 44 and with work experience ranging from five to twenty years. As a result of training in dealing with acute psychiatric patients, technicians developed significant skills and knowledge immediately after training, and these improvements remained significant three months after training. Nevertheless, the correct answers decreased during the three-month follow-up compared to the pre-test. Education was less effective at managing panic, delirium, and agitation. Conclusion: In conclusion, technicians’ knowledge and skills can be effectively enhanced through training; however, the impact diminishes with time. Theories and practical methods, periodic repetition, and real-world internships are the best ways to maximize training effectiveness.</p

Detection of Sea, Seb, Sec, Seq genes in staphylococcus aureus isolated from nasal carriers in Tehran province, Iran; by multiplex PCR

Staphylococcus(S.) aureus  produces different extra-cellular protein toxins and virulence factors. One of the most important extra-cellular proteins is an enterotoxin which causes staphylococcal food poisoning (SFP) due to their enterotoxins. Different methods have been used to detect this toxin, each of which has advantages and disadvantages. DNA amplification methods, however, can show the presence of enterotoxigenic strains of S. aureus before the expression of enterotoxins on the basis of specific gene sequences. In this study, 150 S. aureus strains isolated from nasal carriers were confirmed by biochemical testing. PCR was used to amplify the staphylococcal enterotoxin A, B, C and Q genes, as well as the staphylococcal nuclease gene.  Among the 150 healthy human isolates from the nasal carrier, 95 were confirmed as S. aureus.  Only 58.9% of the isolates were diagnosed as sea, b, c, q positive. There were 24 (25.3%) isolates associated with the sea gene, 15.8% isolates associated with the seb gene, 9.5% of the isolates were associated with the sec gene, and 8.4% of the isolates associated with the seq gene. Of these isolates, 41% might be possessing additional se genes but they were not see (178 bp) and sed (319 bp) genes.  The nuc gene, which encodes thermo nuclease, was used as a target DNA to identify S. aureus. Additionally, one of these enterotoxigenic isolates carried more than one toxin gene

Up-regulated Th17 cell function is associated with increased peptic ulcer disease in Helicobacter pylori-infection

Background: During Helicobacter pylori (H. pylori) infection CD4+ T cells in the gastric lamina propria are hyporesponsive and polarized by Th1/Th17 cell responses controlled by Treg cells. The objective of this study was to determine the number of Th17 cells in gastric mucosa of patients with gastritis and peptic ulcer and determined the relationship between main virulence factor of H. pylori and Th17 cells. Methods and materials: A total of 89 H. pylori-infected gastritis patients, 63 H. pylori-infected peptic ulcer patients and 48 H. pylori-negative non-ulcer dysplasia patients were enrolled in this study. The number of Th17 was determined by immunohistochemistry. IL-8 and IL-17A expressions were determined by real-time polymerase chain reaction (qPCR). Also, the grade of chronic and active inflammation was investigated for involvement according to the density of neutrophils and mononuclear in gastric mucosal crypts, from one to all crypts. Results: The number of Th17 cells and the expression of IL-8 and IL-17A in infected patients were significantly higher than uninfected subjects. The number of Th17 cells and the expression of IL-8 and IL-17A in infected patients with peptic ulcer were significantly higher than patients with gastritis. Additionally, the numbers of Th17 cells as well as the expression of IL-8 and IL-17A were positively correlated with the degree of H. pylori density in infected patients with peptic ulcer, while this correlation was negative in infected patients with gastritis. The numbers of Th17 cells as well as the expression of IL-8 and IL-17A were positively correlated with the degree of chronic inflammation. Conclusion: The predominant Th17 cell responses may play a role in the pathogenesis of peptic ulcers disease in infected patients

First line in psychiatric emergency: Pre-hospital emergency protocol for mental disorders in Iran

Introduction: This article is a report of designing a rapid and effective guide for paramedics who take care of patients in a pre-hospital setting to answer developing demands. Methods: The relevant literature was reviewed, and the topics were extracted. Then, the extracted items were discussed in an expert panel. Finally, items were discussed in a meeting including emergency technicians and emergency technical assistants to identify implementation problems. Results: Important topics for managing psychiatric patients were categorized at three levels: 1) Patient safety and security issues, 2) Patient status assessment and diagnosis, and 3) Patient management (medical, behavioral management, and referral to a treatment center). Discussion: This protocol can be a solution to improve emergency technician training. Such summarized protocols can be used for rapid review immediately before exposing a patient with an acute psychiatric condition. Due to specific cultural and different access to medicines in Iran, some issues are different. © 2020 The Author(s)

Original Article Expression levels of microRNA machinery components Drosha, Dicer and DGCR8 in human (AGS, HepG2, and KEYSE-30) cancer cell lines

Abstract: MicroRNAs (miRNAs) have recently been shown to play fundamental roles in diverse cellular processes and linked to variety of cancers. Dicer and Drosha are two major enzymes in the miRNA maturation process. DGCR8 is the assistant of Drosha in the microprocessor complex. In this study, we evaluated the mRNA expression profiles of major miRNA processing machinery Drosha, Dicer, and DGCR8 in human gastrointestinal (AGS, KYSE30 and HepG2) cancer cell lines. Materials and Methods: The cells were cultured and harvested, and total cellular RNA was isolated from cells. Then, first-strand cDNA was synthesized from the RNA of cells. Afterward, Quantitative analysis was performed by real-time RT-PCR using the PowerSYBR Green PCR Master Mix. Results: Expression levels of Drosha in AGS and HepG2 cells were higher than the controls, whereas, Drosha&apos;s expression level in KYSE-30 cell line was lower. The Dicer expression levels in AGS and HepG2 cells were higher, while, its expression level in KYSE-30 cell was lower. The DGCR8 expression levels in all three cell lines were significantly higher than the control samples. Conclusion: Expression levels of the two most important enzymes of the miRNA machinery, Drosha and Dicer, and microprocessor complex component, DGCR8 were noticeably dysregulated when compared to healthy controls

Prevalence and Correlates of Hepatitis C Infection among Male Injection Drug Users in Detention, Tehran, Iran

For the benefit of planning for the future care and treatment of people infected with hepatitis C virus (HCV) and to help guide prevention and control programs, data are needed on HCV seroprevalence and associated risk factors. We conducted a cross-sectional sero-behavioral survey of injection drug users (IDU) detained for mandatory rehabilitation during a police sweep of Tehran, Iran, in early 2006. During the study period, a consecutive sample comprising 454 of 499 (91.0%) men arrested and determined to be IDU by urine test and physical examination consented to a face-to-face interview and blood collection for HCV antibody testing. Overall, HCV prevalence was 80.0% (95% confidence interval (CI) 76.2–83.6). Factors independently associated with HCV infection included history of incarceration (adjusted OR 4.35, 95% CI 1.88–10.08), age of first injection ≤25 years (OR 2.72, 95% CI 1.09–6.82), and history of tattooing (OR 2.33, 95% CI 1.05–5.17). HCV prevalence in this population of IDU upon intake to jail was extremely high and possibly approaching saturation. Findings support that incarceration is contributing to the increased spread of HCV infection in Iran and calls for urgent increased availability of HCV treatment, long-term preparation for the care of complications of chronic infection, and rapid scale-up of programs for the primary prevention of parenterally transmitted infections among drug users

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

The need to be prepared all police forces to perform basic rescue measures in case of emergency

Police officers play an essential role in maintaining public safety and health. They are often the first people to arrive at the scene of various incidents. One of the things that officers should pay special attention to is incidents that cause serious personal injury. Given that officers may encounter scenes that require immediate action during an emergency, it is critical to have the appropriate knowledge and training. This knowledge and training will help them to take correct and basic actions to save the lives of injured people in the face of emergency incidents. These measures can be very critical before performing additional diagnostic and therapeutic measures. Also, sometimes it is considered as the first step necessary for the success of advanced measures, and it can also prevent the aggravation of injuries and the development of complications. In addition, officers can play an important role in providing medical care to injured people when rescue forces are unable to enter the scene due to special circumstances. They can take the necessary first steps to prevent the injuries from worsening and ensure the survival of the injured person. Currently, officers in many cases serve as first responders for the units they serve. This role is very vital and sensitive because these people have to make important decisions in stressful and high-pressure situations that may cause life or death [1]. A recent study found that in more than 80 percent of cases, police agencies responded to medical emergencies involving injured individuals, and approximately 50 percent of these groups provided some form of patient care at the scene. This shows that officers, in addition to their main duties, also pay attention to humanity and the importance of preserving people's health and lives [2]. Also, a more recent survey shows that 40 percent of officers in two major operational units have attended to the medical affairs of their colleagues before the arrival of emergency services. This shows that police officers can provide first aid and support in emergencies by knowing exactly the situations and immediate needs of people [3]

Performance of UN Security Council in Public Health Protection during Covid-19 Pandemic, Stressing the Resolution 2532 (2020)

Aims: The Covid-19 outbreak and pandemic imposed such a challenge on the international community that it involved not only all countries but also international institutions and organizations. Meanwhile, it became evident that governments and international organizations were not prepared to cope with this unknown virus due to a lack of multi-dimensional recognition and knowledge about the virus. Consequently, the health and hygiene status of the whole world faced a turbulent and insecure situation. This situation was to the extent that some organizations, such as the UN and its specialized bodies and agencies, including the WHO and even the Security Council, considered the prevailing conditions as woeful, deleterious and even a threat to the international peace and security. Thus, these organizations sought to adopt appropriate policies to protect human lives and confront the threats caused by the Covid-19 outbreak and pandemic. Ultimately, the Security Council issued Resolution 2532 (2020), calling for an immediate ceasefire of any armed conflict in the involved countries. Conclusion: Although the covid-19 pandemic was announced as a threat to international peace and security under Resolution 2532 (2020), the role and position of the Security Council regarding its cooperation with countries in conflict will provide the chance to replace challenges with opportunities and enhance international peace and security. Achieving this goal requires consensus on international cooperation between all governments, especially the permanent members of the Security Council, with priority being given to the international community’s interests that will make the Covid-19 outbreak prevention possible by taking appropriate measures