Tinnitus in Avicenna’s Canon of Medicine

Tinnitus is the sensation of hearing continuous or intermittent sounds, when there is no external or mechanical source

Psychometric Properties of the Dichotomous Thinking in Eating Disorders Scale (DTEDS)

Introduction: The Dichotomous Thinking in Eating Disorders Scale (DTEDS) is a short, self- assessment of the presence of a rigid, “black-and-white” cognitive thinking style. This study aimed to examine the psychometric properties of Dichotomous Thinking in eating disorders in Iran.Methods: For this purpose, a sample of 362 women with nutritional problems referring to health centers, nutrition clinics, and beauty institutes of Shiraz (2019-2020) were selected by convenience sampling method and Eating Attitudes Scale. In this descriptive and cross-sectional study, participants responded to the Persian version of Dichotomous Thinking Eating Disorders and Positive and Negative Perfectionism Scales. Finally, based on the data collected, exploratory and confirmatory factor analysis, convergent and divergent validity were employed to determine the construct validity. Moreover, the reliability of the questionnaire was assessed via internal consistency (Cronbach alpha).Results: factor analysis supported the original two-factor model of the questionnaire, and fit indices indicated a good model fit. The questionnaire's convergent and divergent validity and internal consistency were also adequate. For two factors, Cronbach’s alpha ranges from 0.74 to 0.88, suggesting satisfactory reliability of the Persian version of the DTEDS.Conclusion: The Persian version of the DTEDS has adequate validity and reliability in Iranian society and is a good self-report for research and clinical settings

EFFECTS OF SELF-REGULATED-ASSESSMENT LEARNING STRATEGIES AS LEARNING AND INTERACTING WITH FAMILIES ON SCHOOL ACHIEVEMENT AND SELF-CONCEPT MATH GIRLS STUDENTS IN THIRD GRADE

Abstract The Main objective Determining the effect of training of self-regulation strategies, assessment as learning and interacting with the families on self-concept and students' academic achievement in mathematics and comparing the effectiveness of these methods with each other. The study sample consisted of all female students of third grade in the middle schools of Arak city in academic year of 2011-2012, including 171 classes accounting for over 5094 students enrolled in this city. In this study, four subjects groups (three experimental groups and one control group) were needed. Since the selected sample in each group included 31-38 subjects, and the total sample consisted of 137 female students in the third grade of middle school, the current study is considered as a semiexperimental study. Analysis of data showed that the training of assessment components as learning can increase the self-concept and academic achievement in math in female students in the third grade of middles school. Based on collected data analysis on the second research hypothesis, suggesting "training self-regulation strategies increases the self-concept and academic achievement in mathematics of female students", the second research hypothesis was also confirmed. As a conclusion, assessment as learning can have a great impact on academic achievement and self-concept of the students. In fact, this type of assessment has gone far beyond the assessment for learning, since the assessment for learning is an educational tool that not only monitors the students' learning and control to, but also increases the evaluation of learning

A Case-Control Study of Comparison of Plasma Levels of Matrix Metalloproteinase-9 in Inhaled Opium Addicts and Clinically Healthy Persons

cancer invasion and lymphatic metastasis. Smoking has been reported to increase the metalloproteinase level, but the role of opium consumption in metalloproteinase level has not yet been examined. The current research intended to examine the impacts of opium consumption on the serum levels of metalloproteinase.Methods: This case-control research was conducted in Kerman (in the southeast of Iran), after getting medical approve by the ethics committee. Case group of 33 non-smokers with no active inflammatory diseases who had the experience of inhaled opium and its derivatives were compared with a control group of 40 non-smokers with no active inflammatory disease and no experience of inhaled opium and its derivatives. Student’s t-test, mean, and chi-square test were employed to determine the correlation between the variables.Findings: No statistically meaningful variation was detected in plasma metalloproteinase concentration between the case and control groups (P = 0.160). Also, there was no significant relation between the plasma metalloproteinase concentration and urinary morphine in case groups (P = 0.410), but a statistically significant correlation was found between gender and metalloproteinase in both the case and control groups (P = 0.003)

Relationship among noise exposure, sensitivity, and noise annoyance with job satisfaction and job stress in a textile industry

The purpose of this study was to investigate the relationship among noise exposure, sensitivity, and noise annoyance with job satisfaction and job stress among the workers of a textile industry. In this study, Weinstein’s Noise Sensitivity Scale, Noise Annoyance Questionnaire (recommended based on ISO 15666-2003), Health and Safety Executive (HSE) Job Stress Questionnaire, and Job Satisfaction Scale were used to determine the degree of noise sensitivity, noise annoyance, occupational stress, and job satisfaction, respectively. The results showed that there was a significant difference in the mean of job satisfaction, job stress, noise sensitivity, and noise annoyance between case and control groups. The results of multivariate analysis of covariance showed that noise exposure, noise sensitivity, and noise annoyance can justify 0.09, 0.19, and 0.06 of the variance of job stress, respectively. These variables also could justify 0.09, 0.12, and 0.05 of the variance of job satisfaction, respectively. Noise sensitivity had the greatest effect on increasing the occupational stress and job satisfaction

Adjunctive Glucocorticoid Therapy in Patients with Septic Shock.

Background Whether hydrocortisone reduces mortality among patients with septic shock is unclear. Methods We randomly assigned patients with septic shock who were undergoing mechanical ventilation to receive hydrocortisone (at a dose of 200 mg per day) or placebo for 7 days or until death or discharge from the intensive care unit (ICU), whichever came first. The primary outcome was death from any cause at 90 days. Results From March 2013 through April 2017, a total of 3800 patients underwent randomization. Status with respect to the primary outcome was ascertained in 3658 patients (1832 of whom had been assigned to the hydrocortisone group and 1826 to the placebo group). At 90 days, 511 patients (27.9%) in the hydrocortisone group and 526 (28.8%) in the placebo group had died (odds ratio, 0.95; 95% confidence interval [CI], 0.82 to 1.10; P=0.50). The effect of the trial regimen was similar in six prespecified subgroups. Patients who had been assigned to receive hydrocortisone had faster resolution of shock than those assigned to the placebo group (median duration, 3 days [interquartile range, 2 to 5] vs. 4 days [interquartile range, 2 to 9]; hazard ratio, 1.32; 95% CI, 1.23 to 1.41; P<0.001). Patients in the hydrocortisone group had a shorter duration of the initial episode of mechanical ventilation than those in the placebo group (median, 6 days [interquartile range, 3 to 18] vs. 7 days [interquartile range, 3 to 24]; hazard ratio, 1.13; 95% CI, 1.05 to 1.22; P<0.001), but taking into account episodes of recurrence of ventilation, there were no significant differences in the number of days alive and free from mechanical ventilation. Fewer patients in the hydrocortisone group than in the placebo group received a blood transfusion (37.0% vs. 41.7%; odds ratio, 0.82; 95% CI, 0.72 to 0.94; P=0.004). There were no significant between-group differences with respect to mortality at 28 days, the rate of recurrence of shock, the number of days alive and out of the ICU, the number of days alive and out of the hospital, the recurrence of mechanical ventilation, the rate of renal-replacement therapy, and the incidence of new-onset bacteremia or fungemia. Conclusions Among patients with septic shock undergoing mechanical ventilation, a continuous infusion of hydrocortisone did not result in lower 90-day mortality than placebo. (Funded by the National Health and Medical Research Council of Australia and others; ADRENAL ClinicalTrials.gov number, NCT01448109 .)

Association of NFKB1 gene polymorphism (rs28362491) with cardiometabolic risk factor in patients undergoing coronary angiography

Introduction: Genetic and environmental factors are involved in the pathogenesis of cardiovascular diseases (CVDs). The aim of the study was to investigate between the genotype of the NFKB1 gene and the cardiometabolic risk factor in patients undergoing coronary angiography. Methods: This cross-sectional study was conducted on 462 adults (male and women) aged between 35 and 75 years who referred to Afshar Hospital for coronary angiography in 2021- 2022. The polymerase chain reaction restriction fragment length polymorphism method was used to detect the genotype of rs28362491. Biochemical parameters were measured using commercial kits. Gensini and Syntax scores were calculated using the angiography result to assess the extent of coronary artery stenosis. We used multivariate logistic regression analysis to examine the relationship between genotype variants and cardiometabolic risk factors. Results: There was no association between variant genotypes and abnormally levels of serum alanine aminotransferase (ALT) (P value=0.51), aspartate aminotransferase (AST) (P value=0.99), triglyceride (TG) (P value=0.48), total cholesterol (P value=0.79), low density lipoprotein-cholestero (LDL-C) (P value=0.31), high-density lipoprotein-cholesterol (HDL-C) (P value=0.53), fast blood sugar (FBS) (P value=0.39), systolic blood pressure (P value=0.14), diastolic blood pressure (P value=0.64), Gensini score (P value=0.48) and syntax score (P value=0.74) in the crude model even after adjustment for confounding factors. Conclusion: We found no association between the ATTG polymorphism and cardiometabolic risk factors in patients who had coronary angiography. Further investigations are needed to assess the association between variants of 28362491 and cardiometabolic markers

Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries

Background: To better understand the epidemiology and patterns of tracheostomy practice for patients with acute respiratory distress syndrome (ARDS), we investigated the current usage of tracheostomy in patients with ARDS recruited into the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG-SAFE) study. Methods: This is a secondary analysis of LUNG-SAFE, an international, multicenter, prospective cohort study of patients receiving invasive or noninvasive ventilation in 50 countries spanning 5 continents. The study was carried out over 4 weeks consecutively in the winter of 2014, and 459 ICUs participated. We evaluated the clinical characteristics, management and outcomes of patients that received tracheostomy, in the cohort of patients that developed ARDS on day 1-2 of acute hypoxemic respiratory failure, and in a subsequent propensity-matched cohort. Results: Of the 2377 patients with ARDS that fulfilled the inclusion criteria, 309 (13.0%) underwent tracheostomy during their ICU stay. Patients from high-income European countries (n = 198/1263) more frequently underwent tracheostomy compared to patients from non-European high-income countries (n = 63/649) or patients from middle-income countries (n = 48/465). Only 86/309 (27.8%) underwent tracheostomy on or before day 7, while the median timing of tracheostomy was 14 (Q1-Q3, 7-21) days after onset of ARDS. In the subsample matched by propensity score, ICU and hospital stay were longer in patients with tracheostomy. While patients with tracheostomy had the highest survival probability, there was no difference in 60-day or 90-day mortality in either the patient subgroup that survived for at least 5 days in ICU, or in the propensity-matched subsample. Conclusions: Most patients that receive tracheostomy do so after the first week of critical illness. Tracheostomy may prolong patient survival but does not reduce 60-day or 90-day mortality

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

The Epidemiology of Parotid Tumors at the Ear, Nose and Throat Department of Shafa Educational Hospital, Kerman, Iran

Background: Neoplasms of the parotid glands are rare and constitute 3-4% of all head and neck tumors. The aim of this study was to determine the epidemiology of parotid surgeries at the ear, nose, and throat (ENT) department of Shafa Hospital, Kerman, Iran. Methods: In a cross-sectional study from March 2006 until March 2011, all patients who had had parotidectomy at Shafa Hospital (n = 47) were included. Their tumor type, pathology, age, gender, type of surgery, and early surgery complications were evaluated. Results: The mean age of the patients was 40.1 years and 20 of them (42.6%) were male. Seven cases (14.9%) had malignant tumors and 37 (78.7%) had benign tumors. Total and subtotal parotidectomy were performed for 21.3% and 78.7% of the patients, respectively. Early complications of surgery were detected in eight cases (17.0%), i.e. four cases (8.5%) had facial paralysis, three patients (6.4%) had hematoma, and one individual (2.1%) had an infection. Malignancy was not significantly related with either age or gender. Conclusion: The prevalence of benign and malignant tumors and complications of surgery in this center was similar to other national and international studies. Systematic data collection and appropriate databases should be established to increase accuracy and reduce errors in similar research. Keywords: Parotid, Tumor, Benign, Malignant, Surgical complicatio