Monitoring of airborne asbestos fibers in an urban ambient air of Mashhad City, Iran: levels, spatial distribution and seasonal variations

Asbestos, as with other pollutants in the air, has adverse effects on the health of human beings and animals. Today, the relationship between presence of asbestos fibers in the air breathed by humans and developing serious diseases such as lung cancer (asbestosis) and mesothelioma has been proven. The objectives of this study were to monitor the levels of asbestos fibers in ambient air of Mashhad, Iran during 2018, and to draw its Geographic Information System (GIS) distribution map for the city. In this descriptive study, 13 sampling points in Mashhad city were chosen. Sampling of asbestos was carried out for 3 hour during summer and winter at 2018. Sampling of asbestos was performed using MCE (Mixed Cellulose Ester) membrane filters (pour size 0.45 µm; diameter: 25 mm) and cassette holder and peripheral pump. The samples were the analyzed by the phase contrast microscopy (PCM) method (NIOSH7400). Also, to investigate the type of asbestos and for more accurate counting of fibers, Scanning Electron Microscopy (SEM) analysis was utilized. Meteorological parameter were recorded through portable devices. To draw the graphs, Excel, R and Arc GIS software were used. Results showed that the mean asbestos fiber concentrations were equal to 11.40 ± 2.14 and 14.38 ± 2.52 f/L in summer and winter, respectively. The maximum level of asbestos fiber was detected in the station of Baitolmoghaddas square by 26.64 ± 2.14 and 19.3 SEM f/L in winter and summer, respectively. High concentration of asbestos fiber observed in this study can be attributed to the heavy traffic, the presence of prominent industries in the vicinity of the study area, and topographic features. The results from this research recommends that suitable controlling policies should be regulated to reduce both ambient air asbestos and its adverse health endpoints in Mashhad. © 2020, Springer Nature Switzerland AG

Development and implementation of water safety plans for groundwater resources in the southernmost city of West Azerbaijan Province, Iran

The transfer of water from the source to the consumption point is always associated with the possibility of contamination in any of its various components. To resolve this problem, the World Health Organization has considered a water safety plan. The purpose of this study is to implement water safety plan in the water supply system of Bukan city. This study was performed on Bukan’s water supply system in 2019–20 using a software to guarantee the quality of the water safety plan and the WHO and IWA guidelines. The software checklists were prepared and after confirming the validity of the translation and its facial and content validity, it was completed based on the records of the Water and Sewerage Company and interviews with experts. Out of a total of 440 points of full-application of the program and 392 points for the reviewed phases, 183.6 points were acquired and 43.7% of WSP-coordinated implementation was observed. The highest percentage of WSP-coordinated implementation (75.2%) was assigned to the validation stage with the highest point, and the support program stage had the lowest percentage of performance (1.1%). Among the major components of the water supply system, the final consumption point received the most attention from the system. Given the lifespan of the introduction and use of WSP in the world, it was expected that better results would be obtained from evaluating the implementation and progress of this approach in Bukan’s water supply system. However, the implementation rate of this program in this city compared to other cities in Iran, showed that according to the implementation time (one year), the obtained results are relatively convincing and good and the water supply system has a moderate level of safety

A multidisciplinary approach to triage patients with breast disease during the COVID-19 pandemic: Experience from a tertiary care center in the developing world

Background: The COVID-19 pandemic has created a need to prioritize care because of limitation of resources. Owing to the heterogeneity and high prevalence of breast cancers, the need to prioritize care in this vulnerable population is essential. While various medical societies have published recommendations to manage breast disease during the COVID-19 pandemic, most are focused on the Western world and do not necessarily address the challenges of a resource-limited setting.Aim: In this article, we describe our institutional approach for prioritizing care for patients presenting with breast disease.Methods and results: The breast disease management guidelines were developed and approved with the expertise of the Multidisciplinary Breast Program Leadership Committee (BPLC) of the Aga Khan University, Karachi, Pakistan. These guidelines were inspired, adapted, and modified keeping in view the needs of our resource-limited healthcare system. These recommendations are also congruent with the ethical guidelines developed by the Center of Biomedical Ethics and Culture (CBEC) at the Sindh Institute of Urology and Transplantation (SIUT), Karachi. Our institutional recommendations outline a framework to triage patients based on the urgency of care, scheduling conflicts, and tumor board recommendations, optimizing healthcare workers\u27 schedules, operating room reallocation, and protocols. We also describe the Virtual Blended Clinics , a resource-friendly means of conducting virtual clinics and a comprehensive plan for transitioning back into the post-COVID routine.Conclusion: Our institutional experience may be considered as a guide during the COVID-19 pandemic, particularly for triaging care in a resource-limited setting; however, these are not meant to be universally applicable, and individual cases must be tailored based on physicians\u27 clinical judgment to provide the best quality care

Directives in English language newspaper editorials across cultures

In opinion discourse like newspaper editorials, written arguments exhibit an interesting interplay of linguistic features and strategies to achieve the communicative purpose of persuading the audience which is worth investigating especially in cross cultural settings. The intentions of editorials are fulfilled most explicitly through the strategy of directives, where facts may be provided only to endorse editorial stance. A pragma-dialectical approach to discourse analysis assumes argument structures as speech acts which require careful analysis of text and context. In this vein, this study analysed directives in 90 English editorials, taken from two Asian (Dawn and New Straits Times) and one American newspaper (The New York Times), by looking at their form, frequency and co-text. The results indicate Dawn's stance when realizing directives as direct, NYT's stance was authoritative, whereas NST's stance was less engaging and more cautious

Approaches to the management of pediatric ovarian masses in the 21st century: Systematic review and meta-analysis

Background: Laparoscopy is increasingly being adopted for the treatment of ovarian pathologies in adults. However, its implementation for the management of pediatric ovarian masses varies and the evidence, to date, has not been comprehensively analyzed. This review aims to compare laparoscopic and open surgical management of pediatric ovarian masses.Methods: We searched PubMed, Cochrane Library and Google Scholar from the year 2000 till April 2017. Studies selected for this included those on epidemiological trends of pediatric ovarian lesions, assessing outcomes of laparoscopic management and comparison of laparoscopic and open surgical techniques for pediatric ovarian masses. A meta-analysis comparing outcomes of both modalities was performed using standard methodology.Results: A total of 44 studies met the inclusion criteria of which 15 were on histological types of ovarian lesions, 24 assessed laparoscopic management only and five compared laparoscopy with open surgery for pediatric ovarian masses. Nonneoplastic lesions were the most common ranging from 36.5% to 73.7%, with cystic lesions being the most prevalent. Neoplastic lesions ranged between 26.3% and 63.5%, with germ cell tumors being the most common, while malignancy ranged between 3.5% and 10.8%. Laparoscopic management was generally advocated for managing benign lesions with a cautious approach for suspicion of malignant lesions. In comparison to open surgery, laparoscopic surgery had shorter operating time (MD = -33.24 min, 95% CI = -34.29 to -32.19, p \u3c 0.0001), less intraop bleeding (MD = - 61.46 ml, 95% CI = -62.69 to -60.24, p \u3c 0.0001), and reduced length of hospital stay (MD = -2.78 days, 95% CI= -2.82 to -2.74, pConclusion: Limited evidence suggests that laparoscopic approach to presumptively benign ovarian masses have better outcomes when compared to open surgery with regards to operating time, blood loss and hospital stay. However, complication rates were similar between the two approaches. Studies with rigorous scientific methods are needed for a definitive recommendation, especially in resource limiting settings. However malignant lesions should still be managed with an open surgical approach to avoid upstaging of disease status