Comparison of the effects of vid-cast and lecture-based training courses on burn knowledge among medical interns at the Motahari burn hospital

Background: A training course on burn infection and care is one of the courses that medical students take during their internship. This training course has not yet been taught through e-learning in medical schools in Iran. Therefore, this study aimed to compare the effects of two methods: traditional lecturing and employing a vid-cast with interactive electronic content, on the knowledge of interns in a training course on burns. Methods: This quasi-experimental study with a pre-post non-equivalent group design was conducted among medical interns taking burn rotation training courses at the Motahari burn hospital, affiliated with the Iran University of Medical Sciences. The two groups were given a pre-test at the beginning of the course. One group was given in-person lectures, and the other was given the same content in the form of a vid-cast with interactive electronic files. At the end of the rotation course, a post-test was administered on the planned content, and scores of both groups were compared. Results: The pre-test mean scores in the lecture group before and after the training intervention were 8 and 14.2, respectively; this difference was significant (P<0.001). The difference between the pre-test and post-test mean scores in the vid-cast group was also significant (P<0.001).The mean of post-test scores in the lecture group was 14.92 and 17.24 in the e-learning group; this difference was also significant (P<0.001). Conclusion: Post-test scores in the e-learning group were higher with a significant statistical difference, suggesting that the e-learning outperformed their counterparts in the traditional lecture model. It is recommended that e-learning be used either as a supplementary or the main method of training in burn infection and care for interns

Histological Survey of the Effect of Granulocyte-colony-stimulating Factor(G-CSF) on Bacterial Translocation and Wound Healing in Burned Mice

Background: Burn wound is an important cause of morbidity and mortality worldwide. Improving the host's immune system and removing the infection can be effective in healing wounds caused by burns. Granulocyte-colony-stimulating factor (G-CSF) stimulates both the bone marrow to produce granulocytes and the function of neutrophil precursors. The aim of this study was to examine the effect of G-CSF on removing infection and healing wound. Materials and Methods: A burn model was used to induce burns in 18 adult Balb/c mice, and their wounds were infected by Acinetobacter baumannii strains. Burned mice were divided into two groups (control and G-CSF) and treated daily by subcutaneous injections of normal saline (0.1 mL) and G-CSF (10 μg/kg). The wound healing process was evaluated by the morphological and histological assessments. Results: In morphological assay, the mean size of the wounds in the 3rd and 7th days of the treatment was significantly lower in the G-CSF treated group compared to the control group. Some of the histological parameters were evaluated, including the level of inflammation, re-epithelialization, angiogenesis, collagen deposition, the amount of granulation tissue, and fibroblast maturation. The results showed that inflammation was reduced in the G-CSF-treated group, and re-epithelialization and collagen deposition were increased insignificantly compared to the normal saline-treated group. Furthermore, bacterial translocation was reduced significantly in the G-CSF-treated group. Conclusion: G-CSF enhances wound closure and helps in wound healing by improving the immune system. It has also an anti-inflammatory role and reduces bacterial translocation

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

Epidemiology of tuberculosis in Lorestan, 2008-2009

Background : Tuberculosis is known as one of the main causes of mortality worldwide. 1.7 milliard people worldwide are infected with TB germs, there are 8 million new cases of TB annually, and three million deaths occur due to the disease in developing countries. Materials and Methods: This study included all the cases who had referred to all the health centers of Lorestan province with positive samples for acid-fast bacilli, or with symptoms consistent with TB, who had been treated for tuberculosis by physicians during 2008-2009. Results: Out of 198 cases of TB in the province in 2009, 107 (54 %) and 91 (46 %) cases were male and female respectively. 109(55%) cases of smear-positive pulmonary tuberculosis, 32(16%) cases of smear-negative pulmonary tuberculosis and 45(22/7%) cases of extra pulmonary tuberculosis, and 7(3/5%) cases of TB recurrence have been reported during this year. In 2008, 149 cases of TB have been reported, with an incidence of 8.4 per 100 thousand, out of them 79 (54%) and 70 (46%) cases were male and female respectively. 68(45/6%) cases of smear-positive pulmonary tuberculosis, 35(23/5%) cases of smear-negative pulmonary tuberculosis, and 35 (23/5%)cases of extra pulmonary tuberculosis have been reported. Conclusion: Considering the relatively high prevalence of tuberculosis in the province, reported cases of treatment failure and drug-resistant tuberculosis, it seems it is very important to diagnose the disease in the patients accurately and monitor drug consumption precisely

Measuring the amount of serum albumin in burn patients and the relationship between the burned area and length of hospital stay

Background: Albumin is one of the most important proteins in the body by several important functions, it is essential in the maintenance of normal plasma colloid oncotic pressure and is the primary serum binding protein responsible for the transport of various substances in the circulation including fatty acids, hormones, and drugs. Decrease in the amount of serum Albumin (Hypoalbuminemia) is a common finding in the burn patients, but its relationship with mortality is not accurately clear. Our purpose of this study was to measure the amount of Albumin serum in burn patients and find out its relationship between the burned area and length of hospital stay. Methods: This cross-sectional study was conducted on patients aged over 16 years who referred to the Motahari Hospital of September 2014 to February 2015 in the first 24 hours of their referral. The amount of Albumin was measured in two groups of discharged patients and patients who died while hospitalized, one week after hospital stay and in the time of discharge and death; and its relationship in terms of each other was determined by statistical analysis. We also assessed the relationship between burn and duration of hospital stay with the amount of Albumin on the day of patient&rsquo;s admission. Results: This study showed that the average amount of albumin in the group of discharged patients in the time of admission, one week after and during admission was significantly higher than the group of expired patients (P<0.0001). Also there was a significant relation between the burned area and the amount of albumin (P<0.0001). The more the burned area, the less the amount of Albumin. But there was no significant relationship between the amount of albumin with age and length of hospital stay. Conclusion: Measuring the level of Albumin is one of the yardsticks that can be used for prognosis of recovery or death of burn patients, and its assessment at regular intervals in burn patients is essential

Pleural and Pericardial Effusions: Rare Presentations of Brucellosis, Iran

We report a rare case of brucellosis presenting with pleural and pericardial effusions in a 35 year-old male rancher in Iran with fever and dyspnea. Such findings should prompt inclusion of brucellosis in the differential diagnosis in endemic areas

The Role of α₇ Nicotinic Acetylcholine Receptor in Modulation of Heart Rate Dynamics in Endotoxemic Rats

<div><p>Previous reports have indicated that artificial stimulation of the vagus nerve reduces systemic inflammation in experimental models of sepsis. This phenomenon is a part of a broader cholinergic anti-inflammatory pathway which activates the vagus nerve to modulate inflammation through activation of alpha7 nicotinic acetylcholine receptors (α7nACHR). Heart rate variability represents the complex interplay between autonomic nervous system and cardiac pacemaker cells. Reduced heart rate variability and increased cardiac cycle regularity is a hallmark of clinical conditions that are associated with systemic inflammation (e.g. endotoxemia and sepsis). The present study was aimed to assess the role of α7nACHR in modulation of heart rate dynamics during systemic inflammation. Systemic inflammation was induced by injection of endotoxin (lipopolysaccharide) in rats. Electrocardiogram and body temperature were recorded in conscious animals using a telemetric system. Linear and non-linear indices of heart rate variability (e.g. sample entropy and fractal-like temporal structure) were assessed. RT-PCR and immunohistochemistry studies showed that α7nACHR is expressed in rat atrium and is mainly localized at the endothelial layer. Systemic administration of an α7nACHR antagonist (methyllycaconitine) did not show a significant effect on body temperature or heart rate dynamics in naïve rats. However, α7nACHR blockade could further reduce heart rate variability and elicit a febrile response in endotoxemic rats. Pre-treatment of endotoxemic animals with an α7nACHR agonist (PHA-543613) was unable to modulate heart rate dynamics in endotoxemic rats but could prevent the effect of endotoxin on body temperature within 24 h experiment. Neither methyllycaconitine nor PHA-543613 could affect cardiac beating variability of isolated perfused hearts taken from control or endotoxemic rats. Based on our observations we suggest a tonic role for nicotinic acetylcholine receptors in modulation of heart rate dynamics during systemic inflammation.</p> </div