Adjunctive Local Application of Lidocaine during Scleral Buckling under General Anesthesia

Purpose: To evaluate the effect of local lidocaine application on the incidence of the oculocardiac reflex (OCR) during scleral buckling (SB) for rhegmatogenous retinal detachment (RRD) under general anesthesia. Methods: In a randomized clinical trial, eyes with RRD scheduled for SB under general anesthesia were randomized to adjunctive local application of 1 ml lidocaine 2% versus normal saline to the muscles after conjunctival opening. Surgical stimulation was initiated 5 minutes afterwards. Additionally, 100 mg of lidocaine 2% was added to 50 ml of normal saline in the treatment group which was used for irrigation during surgery; control eyes were irrigated with normal saline. The incidence of the OCR, rate of postoperative nausea/vomiting (PONV), total intravenous (IV) analgesic dose, duration of surgery, and period of hospitalization were compared between the study groups. Results: Thirty eyes of 30 patients including 22 (73.3%) male and 8 (26.7%) subjects with mean age of 49.4΁16.3 years were operated. OCR and PONV occurred less frequently, and total intravenous analgesic dose was significantly lower in the lidocaine group (P < 0.05 for all comparisons). However, no significant difference was noted between the study groups in terms of duration of surgery and period of hospitalization. Conclusion: Adjunctive local application of lidocaine during SB under GA for RRD decreases the rate of OCR and PONV, reduces the intravenous analgesic dose, but does not affect the duration of surgery or hospitalization

Antibacterial Effects of Chitosan, Formocresol and CMCP as Pulpectomy Medicament on Enterococcus ‎faecalis, Staphylococcus aureus and Streptococcus ‎mutans

Introduction: During pulpectomy of primary teeth, cytotoxic medicaments such as formocresol or camphor mono-chlorophenol (CMCP) are used as medicaments. For the first time it is theorized that chitosan can substitute these traditional materials used in pulpectomy of infectious primary teeth. Methods and Materials: This preliminary in vitro study consisted of two separate phases (n=75), each of which assessed the antibacterial effects of chitosan versus formocresol and CMCP and positive/negative controls (n=15) on three bacteria types [Enterococcus ‎faecalis, Staphylococcus aureus, Streptococcus ‎mutans, (n=5 per subgroup)]. Phases 1 and 2 concerned respectively with 1- and 7-day effects of these materials. Bacteria were cultured and injected into sterilized canals and colonies were counted. Medicaments were applied and colonies were re-counted after 1 day of treatment (phase 1). Specimens were re-sterilized and re-randomized, and used for phase 2, in which the same procedures were performed for a 7-day period. Effects of agents on bacteria were analyzed statistically (Kruskal-Wallis α=0.05 and Mann-Whitney α=0.017). Results: Treatments reduced bacterial count either after 1 or 7 days (P=0.000). Their effects on different bacteria types were not significant either after 1 or 7 days (P&gt;0.48). Antibacterial efficacies of treatments (indicated by colony reduction) were significantly different, after 7 days (P=0.045). Antibacterial efficacy of chitosan was similar to that of formocresol or CMCP, in both phases [either after 1 or 7 days of treatment (P&gt;0.017). Formocresol and CMCP had similar efficacies in either phase (P&gt;0.017). Conclusions: This preliminary study confirmed the appropriate antibacterial efficacy of chitosan as a medicament in pulpectomy of infectious primary teeth.Keywords: Antibacterial Agents; Camphor Mono-Chlorophenol; Chitosan; CMCP; Enterococcus ‎faecalis; Formocresol; Medicament; Pulpectomy; Staphylococcus aureus; Streptococcus ‎mutan

Risk perception related to COVID-19 among the Iranian general population : an application of the extended parallel process model

Background The novel coronavirus disease 2019 (COVID-19) has emerged as a major global public health challenge. This study aimed to investigate on how people perceive the COVID-19 outbreak using the components of the Extended Parallel Process Model (EPPM) and to find out how this might contribute to possible behavioral responses to the prevention and control of the disease. Methods This cross-sectional study was conducted in Iran during March and April 2020. Participants were recruited via online applications using a number of platforms such as Telegram, WhatsApp, and Instagram asking people to take part in the study. To collect data an electronic self-designed questionnaire based on the EPPM was used in order to measure the risk perception (efficacy, defensive responses, perceived treat) related to the COVID-19. Descriptive statistics, chi-square, t-test and analysis of variance (ANOVA), were used to explore the data. Results A total of 3727 individuals with a mean age (SD) of 37.0 (11.1) years participated in the study. The results revealed significant differences in efficacy, defensive responses and perceived treat among different population groups particularly among those aged 60 and over. Women had significantly higher scores than men on some aspects such as self-efficacy, reactance, and avoidance but men had higher perceived susceptibility scores compared to women. Overall 56.4% of participants were engaged in danger control (preventive behavior) while the remaining 43.6% were engaged in fear control (non-preventive behavior) process. Conclusion More than half of all participants motivated by danger control. This indicated that more than half of participants had high perceived efficacy (i.e., self-efficacy and response efficacy). Self-efficacy scores were significantly higher among participants who were older, female, single, lived in rural areas, and had good economic status. The results suggest that socioeconomic and demographic factors are the main determinants of the COVID-19 risk perception. Indeed, targeted interventions are essential for controlling the pandemic

Expiratory and inspiratory cries detection using different signals' decomposition techniques

This paper addresses the problem of automatic cry signal segmentation for the purposes of infant cry analysis. The main goal is to automatically detect expiratory and inspiratory phases from recorded cry signals. The approach used in this paper is made up of three stages: signal decomposition, features extraction, and classification. In the first stage, short-time Fourier transform, empirical mode decomposition (EMD), and wavelet packet transform have been considered. In the second stage, various set of features have been extracted, and in the third stage, two supervised learning methods, Gaussian mixture models and hidden Markov models, with four and five states, have been discussed as well. The main goal of this work is to investigate the EMD performance and to compare it with the other standard decomposition techniques. A combination of two and three intrinsic mode functions (IMFs) that resulted from EMD has been used to represent cry signal. The performance of nine different segmentation systems has been evaluated. The experiments for each system have been repeated several times with different training and testing datasets, randomly chosen using a 10-fold cross-validation procedure. The lowest global classification error rates of around 8.9% and 11.06% have been achieved using a Gaussian mixture models classifier and a hidden Markov models classifier, respectively. Among all IMF combinations, the winner combination is IMF3+IMF4+IMF5

Distribution of genes encoding resistance to macrolides, lincosamides, and streptogramins among methicillin-resistant Staphylococcus aureus strains isolated from burn patients

The increasing resistance to macrolide, lincosamide, and streptogramin B agents among methicillin-resistant Staphylococcus aureus (MRSA) is a worldwide problem for the health community. This study aimed to investigate the prevalence of ermA, ermB, ermC, and msrA in MRSA strains isolated from burn patients in Ahvaz, southwest of Iran. A total of 76 isolates of S. aureus were collected from January to May 2017 from Taleghani Burn Hospital in Ahvaz. Among 76 S. aureus strains collected, 60 (78.9%) isolates were MRSA. The antimicrobial susceptibility testing for MRSA showed extreme high resistance rate to clarithromycin (100%) and azithromycin (100%), followed by erythromycin (98.3%). The PCR assay revealed that the frequency rates of msrA, ermA, and ermC genes were 23 (38.3%), 28 (46.7%), and 22 (36.7%), respectively. In addition, none of the MRSA isolates had the ermB gene. Because of the high prevalence of macrolide and lincosamide resistance found in MRSA isolates from infections of burn patients in Ahvaz, southwest of Iran, it is recommended that local periodic survey be performed for controlling the dissemination of antimicrobial resistance

Correlation of Midkine Serum Level with Pro- and Anti-Inflamatory Cytokines in Multiple Sclerosis

Background: Midkine (MK) is a heparin-binding growth factor with promoting effects in inflammatory responses through enhancing leukocytes migration. Objective: To study the correlation between MK serum levels and concentration of inflammatory cytokines in Multiple Sclerosis (MS) patients. Methods: We evaluated the MK level and its relationship with inflammatory cytokines (IL-17 and IL-23) and anti-inflammatory ones (IL-10 and TGF-beta) in multiple sclerosis (MS) patients. The serum concentrations of MK and cytokines were assessed by ELISA in 32 MS patients in comparison with 32 healthy subjects. Results: Our data showed that the MK concentration in MS patients is lower than healthy controls (341.15 +/- 40.71 Pg/ml vs. 620.15 +/- 98.61 Pg/ml, respectively, p= 0.015). We also observed a significant decrease in IL-10, IL-23, and TGF-beta cytokine levels in MS patients. There was a significant correlation between MK and IL-23 concentrations in our study (r = + 0.829, p <= 0.001). Conclusion: These results confirm a role for MK in inflammatory reactions in MS

Spatio-temporal mapping of breast and prostate cancers in South Iran from 2014 to 2017

Background The most common gender-specific malignancies are cancers of the breast and the prostate. In developing countries, cancer screening of all at risk is impractical because of healthcare resource limitations. Thus, determining high-risk areas might be an important first screening step. This study explores incidence patterns of potential high-risk clusters of breast and prostate cancers in southern Iran. Methods This cross-sectional study was conducted in the province of Kerman, South Iran. Patient data were aggregated at the county and district levels calculating the incidence rate per 100,000 people both for cancers of the breast and the prostate. We used the natural-break classification with five classes to produce descriptive maps. A spatial clustering analysis (Anselin Local Moran’s I) was used to identify potential clusters and outliers in the pattern of these cancers from 2014 to 2017. Results There were 1350 breast cancer patients (including, 42 male cases) and 478 prostate cancer patients in the province of Kerman, Iran during the study period. After 45 years of age, the number of men with diagnosed prostate cancer increased similarly to that of breast cancer for women after 25 years of age. The age-standardised incidence rate of breast cancer for women showed an increase from 29.93 to 32.27 cases per 100,000 people and that of prostate cancer from 13.93 to 15.47 cases per 100,000 during 2014–2017. Cluster analysis at the county level identified high-high clusters of breast cancer in the north-western part of the province for all years studied, but the analysis at the district level showed high-high clusters for only two of the years. With regard to prostate cancer, cluster analysis at the county and district levels identified high-high clusters in this area of the province for two of the study years. Conclusions North-western Kerman had a significantly higher incidence rate of both breast and prostate cancer than the average, which should help in designing tailored screening and surveillance systems. Furthermore, this study generates new hypotheses regarding the potential relationship between increased incidence of cancers in certain geographical areas and environmental risk factors.This study received funding from Kerman University of Medical Sciences (number = 97000230). The funder provided the cost of geocoding and cleaning the data

The urgent need for integrated science to fight COVID-19 pandemic and beyond

The COVID-19 pandemic has become the leading societal concern. The pandemic has shown that the public health concern is not only a medical problem, but also afects society as a whole; so, it has also become the leading scientifc concern. We discuss in this treatise the importance of bringing the world’s scientists together to fnd efective solu‑ tions for controlling the pandemic. By applying novel research frameworks, interdisciplinary collaboration promises to manage the pandemic’s consequences and prevent recurrences of similar pandemics

Global burden of chronic respiratory diseases and risk factors, 1990–2019: an update from the Global Burden of Disease Study 2019

Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6–4.3) with a prevalence of 454.6 million cases (417.4–499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4–225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9–3.6) deaths. With 262.4 million (224.1–309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries