Environmental Fate Modelling of Lead Contamination in Water and Sediments of Hawizeh Marshes

Background: This study aimed to determine the maximum concentration of lead in the water and sediments of Hawizeh Swamp during 2020-2021.Methods: The ECOFATE model was employed to calculate ecological risk parameters (RQ) along with total dissolved solids (TDS), total suspended solids (TSS), and total organic carbon (TOC) at four stations during summer and winter. Using the framework of environmental fate model of ECOFATE, comprehensive data on hydrological sections, input chemical quantities, chemical characteristics, and ecosystem attributes were measured.Results: The findings indicated that lead concentrations were at the highest level in both sediment and water samples of the wetland across three-dimensional space during summer and winter. TSS, TOC and TDS values were estimated, of which the TDS was used to measure ecological risk due to its higher values.Conclusion: The RQ values of lead indicated high and medium risk within the sedimentary and aquatic environments of the wetland ecosystem, respectively. Statistical calculations further revealed that this wetland was at risk of environmental pollution, posing potential hazards to humans through the food chain. The increase in the biological pollution of this wetland is due to the increase in the population and urban sewage. Therefore, it is imperative to raise public awareness regarding the significance of the wetland and advocate for its regular monitoring

An Assessment of m-Health Effect on Covid-19 Management Using PLS Modeling Approach

Introduction: The aim of the present study was to investigate the different roles of m-Health in pandemic management using the Partial Least Square (PLS) modeling technique. Owing to the limited existing literature regarding theorizing and the lack of the default model in predicting the role of m-Health in pandemic management, this method was used for exploratory modeling. Material and Methods: The PLS model was performed with smart-PLS software for the following steps: estimating weight ratios, considering weight ratios as input, estimating parameters, model-fitting and testing hypotheses. In addition, Factor scores in regression equations were used to estimate structural parameters. PLS algorithm, Cronbach's alpha, and Composite Reliability were used for the measurement and reliability evaluation model Goodness-of-fit. In addition, the R2 index was used to evaluate the model adequacy. Bootstrapping was used for significant coefficients. The Goodness-of-fit of the model was examined via the Standardized Root Mean Square Residual (SRMR) criterion. Results: It is determined the measurement models goodness-of-fit which the alpha values were as follows: diagnosis construct=0.786, follow-up=0.772, treatment=0.796, health care providers=0.704 and education=0.839 with more than 0.7 for all measures for Composite Reliability, the structural model measures such as R2 were higher than 0.6 for all areas and the overall model goodness-of-fit was -0.007 for SRMR, the five hypotheses developed in the model were confirmed according standardized coefficients more than 1.96 for all paths. Furthermore, the proposed model concerning the positive and significant role of m-Health in diagnosis, treatment and follow-up, education and health providers during the pandemic era was approved. Conclusion: The results of the present study can be used as a theoretical basis in developing models related to the role of m-Health in pandemic management. Also, health policymakers and practitioners could use the results to manage current and post-coronary conditions and to promote services based on various m-Health apps

Knowledge and attitude of general dentists regarding common emergencies in dental offices: A cross-sectional study in Shiraz, Iran

Background: Medical emergencies are likely to occur in dental offices due to the use of anesthetics, anxiety, and systemic complications of the patient. Since such emergencies are life threatening in many cases, preparedness of the dentist is highly required. Aims: This study was carried out to evaluate the dentists' knowledge and attitude regarding diagnosis and treatment of medical emergencies in dental offices in Shiraz, Iran. Methods: This cross-sectional study was performed on 150 general dentists in Shiraz with at least 5 years since graduation in 2015. They were asked to complete a validated questionnaire including the dentists' demographic information and inquiries about their performance and knowledge in emergency situations. Statistical Analysis Used: Independent t-test, one-way ANOVA, and Pearson's correlation coefficient were used in this study. Results: According to the inclusion criteria, 105 dentists participated in the study. The mean knowledge and attitude of the dentists was estimated 4.98 (±1.50) out of 10. No significant correlation was detected between age, sex, number of patients per day, and working hours with the knowledge of managing an emergency situation (P > 0.05). Out of the number of studied dentists, 49% had attended training workshops and 90% called for re-attending a workshop. The knowledge score of those who had participated in workshops was significantly higher than those who had not (P = 0.016). Conclusion: The results of this study revealed that the dentists' knowledge about emergency situations was average while the knowledge was higher in those who had attended emergency workshops. Thus, retraining courses and workshops must be considered more often for graduated dentists

Evaluation of Endocrine Complications in Beta-Thalassemia Intermedia Patients: A Cross Sectional Multi-Center Study

60th Annual Meeting of the American-Society-of-Hematology (ASH) -- DEC 01-04, 2018 -- San Diego, CAWOS: 000454837606312…Amer Soc Hemato

Perinatal complications associated with preterm deliveries at 24 to 33 weeks and 6 days gestation (2011- 2012): A hospital-based retrospective study

Background: Morbidity and mortality of preterm babies are important issues in perinatal medicine. In developed countries, preterm delivery is the cause of about 70% of mortality and 75% of morbidity in the neonatal period, respectively. Objective: The aim of this study was to determine the risk factors for preterm labor and the outcomes, in terms of perinatal mortality and morbidity at the time of discharge home, among preterm infants at less than 34 weeks gestation. Materials and Methods: A retrospective study was conducted and all infants with a gestational age of 24 to 33 weeks and 6 days who were born from November 1st, 2011 to March 31, 2012 were enrolled in this study. Results: From 1185 preterm infants were born during this period, 475 (40.08%) infants with less than 34 weeks gestational age were included in the study. Our study showed the major obstetrical risk factors for preterm labor were as follows: preeclampsia (21%), premature rupture of membranes (20.3%), abruption of placenta (10%), and idiopathic cases (48.7%). The neonatal mortality rate in less than 34 weeks was 9.05%. Significant perinatal morbidity causesd in less than 34 weeks were as follows: sepsis (46.94%), respiratory distress syndrome (41.47%), patent ductus arteriosus (21.47%), retinopathy of prematurity (3.57%), necrotizing entrocolitis (1.68%), intra-ventricular hemorrhage (9%), and broncho-pulmonary dysplasia (0.84%). Conclusion: Preterm birth is associated with adverse perinatal outcome. This situation needs to be improved by directing appropriately increased resources for improving prenatal health services and providing advanced neonatal car

Conservative management in young patients with borderline and malignant ovarian tumors: outcomes and pregnancies

Background: Recent studies have showed conservative management in selective patients with borderline and malignant ovarian tumors is safe; therefore this management is considered in patients with ovarian tumor who desire to preserve fertility. Objective: This study has been performed to evaluate the clinical outcome and fertility in patients with ovarian tumors who were treated conservatively. Materials and Methods: All patients who were treated conservatively (preservation of uterus and at least one ovary) or were on follow-up and had recurrence were evaluated in Vali-e-Asr Hospital during 2000-2004. Results: Among 410 patients with ovarian tumors, 60 were treated conservatively. Age range was 13-34 years. Twenty-six of patients (43.3%) were desired pregnancy and 34 (56%) patients did not. Three (5%) patients had history of infertility. Histological types of tumors were as follows; 15(25%) borderline tumors, 10(16.7%) epithelial tumors, 26(43.3%) germ cell tumors, and 9(15%) sex cord tumors. Range of follow-up time was 12-48 months. Seven term pregnancies in 6 patients had been occurred, 1 in epithelial group, 2 in germ cell group, 1 in sex cord group and 3 in borderline group. Nine patients had recurrence and 2 patients expired, including one patient with serous cyst carcinoma (Stage IIIC).This patient had refused radical surgery and referred to our center with recurrence. Another patient had immature teratoma (Stage IIIC). Conclusion: Conservative surgical management in young patients with stage I (grade 1, 2) of epithelial ovarian tumor and sex cord-stromal tumor and in patients with borderline and germ cell ovarian tumors could be performed in order to preserve fertility

The effects of two vitamin D regimens on ulcerative colitis activity index, quality of life and oxidant/anti-oxidant status

Abstract Background The optimum dosage for vitamin D supplementation has not yet been elucidated in patients with Ulcerative colitis (UC). The aim of this study was to investigate the effects of two vitamin D regimens in UC patients with vitamin D deficiency. Methods In this double blind randomized clinical trial, 50 patients with mild to moderate UC, who met inclusion criteria, received either 1000 or 2000 IU/day of vitamin D (as low dose or high dose group, respectively) for 12 weeks. Serum 25-hydroxy vitamin D (25-OHD) level, total antioxidant capacity (TAC), and Total Oxidant Status (TOS), the inflammatory bowel disease questionnaire − 9 (IBDQ-9) score and the Simple Clinical Colitis Activity Index Questionnaire (SCCAI) score were assessed before and after intervention. Results At the end of study, serum 25-OHD levels significantly increased in the high dose group (P < 0.001) and the increase was significantly more than low dose group (6.7 ± 3.8 ng/mL in the high dose group versus 0.2 ± 0.5 ng/mL in the low dose group) (P < 0.001). Serum TOS concentration decreased significantly (− 0.37 ± 0.26) only in the high dose group (P value = 0.023). There was no statistically significant change in serum TAC between two groups during the study. IBDQ-9 mean score significantly increased in high dose group compared to the low dose group (P value = 0.001) and SCCAI score in both groups reduced (− 2.58 ± 2.16 and − 0.9 ± 0.3 in high dose and low dose respectively), while this reduction was significant only in the high dose group (P value ≥0.001). Conclusion Our results indicate that 2000 IU daily dose of vitamin D can increase serum 25-OHD concentration, and quality of life, while it reduces disease activity in UC patients with vitamin D deficiency. We recommend assessment of the vitamin D status in all patients with UC because they may benefit from vitamin D therapy

Potential Effect of L-Carnitine on the Prevention of Myocardial Injury after Coronary Artery Bypass Graft Surgery

Background: L-carnitine has been demonstrated to confer cardiac protection against ischemia reperfusion injury in animals. This study evaluates the effects of L-carnitine administration on cardiac biomarkers after coronary artery bypass graft (CABG) surgery. Methods: One hundred thirty-four patients undergoing elective CABG surgery, without a history of myocardial ischemia or previous L-carnitine treatment, were enrolled and randomly assigned to an L-carnitine group ([n = 67], 3000 mg/d, started 2 days preoperatively and continued for 2 days after surgery) or a control group (n = 67). CK-MB (creatine kinase, muscle- brain subunits) and troponin T (TnT) levels were assessed in all the patients before surgery as baseline levels and at 8 and 24 hours postoperatively. Results: Our study included 134 patients (99 [73.8%] males) at a mean ± SD age of 59.94 ± 8.61 years who were candidates for CABG and randomized them into control or L-carnitine groups. The baseline demographic characteristics, including age (60.01 ± 9.23 in the L-carnitine group vs. 59.88 ± 7.98 in the control group) and sex (54 [80.6%] in the L-carnitine group vs. 45 [67.2%] in the control group) did not show any significant differences (p value=0.93 and 0.08, respectively). Patients in the L-carnitine group had lower levels of CK-MB (mean ± SD, 25.06 ± 20.29 in the L-carnitine group vs. 24.26 ± 14.61 in the control group), but the difference was not significant (p value = 0.28). TnT levels also showed no significant differences between the two groups (399.50 ± 378.91 in the L-carnitine group vs. 391.48 ± 222.02 in the control group; p value = 0.34). Conclusion: In this population of intermediate- to high-risk patients undergoing CABG surgery, L-carnitine did not reduce CK-MB and TnT levels

Dietary acid load and cirrhosis-related mortality: a prospective cohort study

Abstract As a global health concern, cirrhosis contributes significantly to morbidity and mortality. This prospective cohort study aimed to investigate the association between dietary acid load (DAL) and cirrhosis-related mortality. Present study was conducted on 121 patients with newly diagnosed cirrhosis who were followed up for 48 months. Anthropometric measures, nutritional status and dietary intakes were assessed and DAL was estimated based on potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores. Crude and multivariable-adjusted hazard ratios (HR) with 95% confidence intervals (CI) were estimated using Cox proportional hazard analyses. Participants in the high PRAL and NEAP scores had significantly higher intakes of grains and lower intakes of fruits and vegetables. Also, the intake of dairy products and legumes, nuts and seeds decreased significantly with increasing NEAP score. After adjustment of all the confounders, the risk of mortality in the second and third tertiles of PRAL was 5.9 times and 10.97 higher than those in the first tertile, respectively (P trend: 0.006). Similarly, comparing the risk of mortality in the second and third tertiles with the first tertile of NEAP showed a 4.46-fold and 12.3-fold increased risk, respectively (P trend: 0.010). Our findings suggested that DAL was significantly associated with cirrhosis-related mortality and highlight the need for further research to understand the underlying mechanisms and establish optimal DAL levels in cirrhotic patients

Evaluating the Potential Effect of Melatonin on the post-Cardiac Surgery Sleep Disorder

Background: Postoperative neurological injuries, including cognitive dysfunction, sleep disorder, delirium, and anxiety, are the important consequences of coronary artery bypass graft surgery (CABG). Evidence has shown that postoperative sleep disturbance is partly due to disturbed melatonin secretion in the perioperative period. The aim of this study was to evaluate the effect of melatonin on postoperative sleep disorder in patients undergoing CABG. Method: One hundred forty-five elective CABG patients participated in a randomized double-blind study during the preoperative period. The patients were randomized to receive either 3 mg of melatonin or 10 mg of Oxazepam one hour before sleep time. Each group received the medication from 3 days before surgery until the time of discharge. Sleep quality was evaluated using the Groningen Sleep Quality Score (GSQS), and the incidence of delirium was evaluated by nursing records. Sleep quality and anxiety scores were compared before and after surgery through the Wilcoxon signed-rank test. The analysis of covariance (ANCOVA) and independent t-test were used to compare the sleep and anxiety scores between the groups. P values ≤ 0.05 were considered statistically significant. Results: Totally, 137 patients at a mean age of 60 years completed the study (76% male). The analysis of the data showed that sleep was significantly disturbed after surgery in both groups. The patients in the Oxazepam group demonstrated significantly higher disturbance in their mean postoperative GSQS score than did their counterparts in the melatonin group (p value < 0.001). A smaller proportion of the participants experienced delirium in the melatonin group (0.06%) than in the Oxazepam group (0.12%); however, this difference was not statistically significant. Conclusion: The result of the present study revealed that melatonin improved sleep in post-cardiac surgery patients more than what was observed with Oxazepam. Therefore, melatonin may be considered an effective alternative for Benzodiazepines in the management of postoperative sleep disorder