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Background: The aim of this study was to evaluate reinfection and fungal infections among 785 patients with COVID-19 disease admitted to Baqiyatallah Hospital in Northeastern Iran after the onset of the COVID-19 epidemic. Materials & Methods: In this descriptive-analytic study (20 February–21 July 2020), reinfection and fungal infections among 785 patients were investigated using epidemiological questionnaire, clinical trials, Real-time PCR and CT scan (chest computed tomography) from the hospital HIS (hospital's information system) and collected samples. Results: Reinfection and one oral candidiasis were diagnosed in one 68-year-old man and one 47-year-old man 63 and 42 days after the initial infection, respectively. Conclusion: The research results showed that exposure to COVID-19 may not establish long-term protective immunity to all patients.

This study sought to identify Iranian preschool children’s (N = 318) knowledge of genital and non-genital body parts. Assessment consisted of children naming selected external body parts in drawing...

BackgroundManagement of analgesia and hemodynamic status is essential for orthopedic surgery patients. This study aimed to determine the effect of intrathecal (bupivacaine + magnesium sulfate) versus (pethidine + magnesium sulfate) and sole pethidine on the hemodynamic status and onset and duration of sensory/motor block in patients with lower limb fractures.MethodsThis double-blind randomized clinical trial was done between October 2020 and August 2021 in the Gorgan 5thAzar, Hospital, northeastern Iran and included 120 patients undergoing orthopedic surgery with spinal anesthesia and divided them in four groups of A: bupivacaine (10 mg), B: (pethidine 1 mg / kg), C: (bupivacaine 10 mg + magnesium sulfate 100 mg), and D: (pethidine 1 ‌mg / kg + magnesium sulfate 100 mg). The recorded parameters were hemodynamic parameters, time of onset, and duration of sensory/motor block.ResultsThere were no clinically significant differences in hemodynamic parameters between the groups. The onset of sensory block (P = 0.235), the onset of motor block (P = 0.097), and the duration of motor block (P = 0.135) were not statistically different between the groups; however, there was a significant difference in the duration of sensory block between the groups (P = 0.035). Magnesium sulfate increased the duration of motor block in the pethidine group C (80.93 ± 30.28) and decreased it in the bupivacaine group D (75.23 ± 38.56).ConclusionsThe intrathecal drugs used in the study did not cause any specific side effects. Therefore, these drugs can be used interchangeably. Magnesium sulfate, in combination with bupivacaine reduced the duration of sensory/motor block. While in the pethidine group, it acted as suitable analgesia by increasing the duration of sensory block. Therefore, magnesium can be considered a suitable additive for intrathecal pethidine.Trial registration: Iran clinical trial register: (IRCT20170413033408N3) Registration date: 2020-06-11

The clinical benefits of rituximab in systemic sclerosis (SSc) are still contentious. The present meta-analysis aimed to systematically assess rituximab’s safety and efficacy profile in SSc patients. A systematic online query was performed in PubMed, Scopus, Web of Science, and Embase. The studies on the application of rituximab for patients with SSc were reviewed comprehensively for over two years. In terms of efficacy profile, mRSS, MS, LVEF, sPAP, FVC, DLCO, TLC, FEV, DAS, severity activity, HAQ-DI and SF36 were assessed for organ involvement and quality of life. The level of biological and immunological markers was also evaluated in SSc patients treated with RTX. In total, 24 studies met the criteria. Although they did not have a high quality, they were free from heterogeneity and publication bias. The pooled results revealed a long-term improvement in mRSS and MS. HAQ-DI was improved to 0.78 after 12 months, and DAS was significantly reduced to 0.33, 0.23, and 0.24 following 6, 12, and 24 months of treatment, respectively (p = 0.00 for both parameters). The rest of the parameters remained stable over time in patients with SSc. The pooled analysis of these patients demonstrated that the induction of death, cancer, infection, and infusion were 9, 5, 18 and 10%, respectively. Based on the pooled results of this meta-analysis, rituximab improves skin score and disease indices and stabilizes organ involvement in SSc patients. Rituximab seems to possess reasonable safety, similar to previous data from other autoimmune diseases.

Background and objectives: Leishmaniasis is a tropical disease caused by protozoan parasites from the genus Leishmania. In this study, we aimed at investigating the in vitro anti-leishmanial effect of essential oils of Rosmarinus officinalis, Mentha pulegium, Foeniculum vulgare, Lippia citriodora and Pelargonium graveolens. Methods: The essential oils were prepared from freshly dried and powdered plants with steam-distilled water. Iranian strain of Leishmania promastigotes was cultured in RPMI medium and the inhibitory effects of different concentrations (25, 32, 62.5, 125, 250, 500 and 1000 μg/ml) of the essential oils were investigated at 24, 48 and 72 hours. The number of live parasites before and after treatment with the essential oils was counted by trypan blue 10% staining and using neobar lam. Results: The essential oils significantly decreased the number of promastigotes in a dose-dependent manner (P

Purpose Antifungal resistance and virulence properties of Candida albicans (C. albicans) are growing health problems worldwide. The present study aims to investigate the effect of Zinc Oxide (ZnO) nanoparticles and Nystatin on SAP1-3 genes expression in C. albicans isolates of females with Vulvovaginal Candidiasis (VVC) isolated from Sayad Shirazi Obstetrics and Gynecology Hospital in Northeastern Iran during 2017-2018. Patients and Methods In this descriptive-analytic study, vaginal samples were collected from 280 VVC women. 196 (70%) of C. albicans isolates were identified by phenotypic and ITS genotypic methods. Susceptibility to Fluconazole C. albicans isolates was determined by the disk diffusion method. Detection of ERG11 gene was done by RT-PCR technique. Results It was revealed that PCR amplified the ERG11 gene in all of the Fluconazole-resistant isolates. Real-time PCR was used to survey the effects of 3±1.7µg/mL concentrations of ZnO nanoparticles and Nystatin on expression of SAP1-3 genes before and after treatment. 186 (95%) susceptible C. albicans and 10 (5%) Fluconazole-resistant C. albicans isolates from VVC were exposed to sub-minimum inhibitory concentrations (Sub-MIC) of ZnO-np (range=0.02-12 μg/mL). Sub-MIC concentration was used for each strain, which reduced the expression of SAP1-3 genes to 1.8 MIC in the vaginal swabs. The observed reduction in gene expression was significant for both ZnO nanoparticles and Nystatin (P=0.01 and P=0.07, respectively). Conclusion ZnO as antifungal agent can well reduce the growth and gene expression of SAP1-3 in the pathogenesis of VVC.

One of the most important causes of marital dissatisfaction is the lack of life skills. This study aimed to compare the effects of training self-awareness and problem-solving skills on marital satisfaction of married women.This study was a randomized field trial conducted in Gorgan since October 2019 to September 2020. A total of 105 married women were allocated to one of two interventions or a control group based on triplex block randomization. Data collection tools were the Persian version of the self-awareness questionnaire, problem-solving questionnaire and Four ENRICH Couple Scales. The participants completed the questionnaires before (T1), immediately (T2), and one month after the intervention completion (T3). The first intervention group received self-awareness skills training and the second received problem-solving skills training one session per week for four weeks. The control group did not receive any training. Data were analyzed using One-way ANOVA, Kruskal-Wallis, Chi-square, Fishers exact test, exact test, repeated measure ANOVA, and Bonferroni test, using SPSS 16. A P value0.05 was considered significant.The mean score of ENRICH Scales in the three groups, immediately and one month after the intervention, were not statistically significant (P0.05). However, in the problem-solving group, the scale of marital satisfaction was significantly different at T2 and T3 (31.40±4.55, 33±5.21, P=0.008). In the self-awareness training group at T1 and T3, the mean of the conflict resolution scale (32.60±63.28, 33.94±5.74, P=0.03) was significantly different.The results showed that problem-solving skills training was more effective in increasing the score of marital satisfaction compared to self-awareness skills training.

Background and objectives: Promoting and influencing the formation of professional behavior is one of the most challenging issues in education. The purpose of this study was to compare effects of context-based learning (CBL) and cooperative learning on professional behavior and critical thinking of anesthesiology students. Methods: This was a semi-experimental study that was conducted on 42 third and fifth semester anesthesiology students who were divided into a CBL group (n=21) and a collaborative learning group (n=21). Data were collected before the intervention and one week and a month after the intervention using a questionnaire designed by Goze et al. and the Ricketts' Critical Thinking Disposition Inventory. The collected data were analyzed with SPSS (version 16) using the generalized estimation equation method, the Chi-square test, independent T-test and the Mann–Whitney U test. A p-value of less than 0.05 was considered statistically significant. Results: After the intervention, the mean score of professional behavior and critical thinking did not differ significantly between the two groups (P>0.05), but time had a significant impact on the mean score of professional behavior and critical thinking of the students (P

BACKGROUND Pancreatic cancer is considered as the most deadly tumor among gastrointestinal cancers because of its poor prognosis. The frequently deregulated pathway in the cancer cell is associated with an increased expression of various genes, including the synthesis of fatty acids. We aimed to evaluate the level of serum fatty acid synthase (FASN) as a diagnostic marker for early diagnosis of pancreatic cancer. METHODS Serum FASN levels were measured by ELISA in 92 patients with pancreatic adenocarcinomas and in 92 healthy controls. Logistic regression analysis was used to identify independent predictors of certain diagnostic categories. RESULTS Serum FASN levels were significantly higher in patients with pancreatic cancer than in healthy controls (1.35 [0.98-2.3] ng/mL vs 1.04 [0.19-1.34] ng/mL, p < 0.001) and in smokers compared to non-smokers (1.41 [0.79-2.52] ng/mL vs 1.07 [0.21-1.74] ng/mL, p < 0.001). FASN levels and smoking were associated with increased risk of PC (1.54 [1.1- 2.14] ng/mL, p = 0.011 and 5.69 [2.68-12.09] ng/mL, p < 0.001, respectively). CONCLUSION Elevated serum FASN levels in patients with pancreatic cancer indicate the need for the production of large numbers of lipids for the survival and proliferation of human cancer cells and the diagnostic value of FASN as a new diagnostic biomarker.

Background: The aim of this study was to evaluate respiratory problems via pulmonary function testing in cement transport workers at Incheh Borun border in northeast of Iran in 2016. Methods: The study was conducted on 358 male workers. All subjects were evaluated for respiratory symptoms via pulmonary function testing and completion of the American Thoracic Society questionnaire. Results: Mean age of workers was 34.8±12.87 yr (age range 16-79 yr). Mean duration of employment was 6.1±4.36 yr. Most workers (75.4%) were illiterate or had elementary education. In addition, 56 (15.6%) subjects were smokers. Only three individuals (0.3%) had obstructive pattern. There was a significant relationship between age of workers and frequency of respiratory problems (P

Background: Tranexamic acid and vitamin C are potent antifibrinolytic and oxidative stress agents that reduce blood loss and transfusion blood in cardiopulmonary bypass (CPB). Objectives: The aim of this study was to evaluate the efficacy of tranexamic acid (TA) and tranexamic acid combined with vitamin C (TXC) on drainage volume (blood loss) and atrial fibrillation (AF) in patients undergoing cardiac bypass surgery in Gorgan, Shafa hospital, Iran. Methods: This study is a double-blind randomized clinical trial. A sample size of 120 candidates of cardiac bypass surgery were included in this prospective study. Patients were randomly assigned to treatments in two groups. In both groups, 50 mg/kg tranexamic acid was administered intravenously directly before sternotomy: group A (N = 58) patients received tranexamic acid (TA) only and group B (N = 62) tranexamic acid with vitamin C (TXC) half an hour before surgery and 2 g vitamin C with 100 mL 0.9% saline were injected. Subsequently, during 4 days after surgery, 1000 mg of vitamin C and 100 cc 0.9% saline was infused every day. Intraoperative and postoperative blood loss (volume of blood in the drain) and atrial fibrillation complications were recorded for 24 hours after the operation. Results: The patients who received vitamin C had less bleeding during operation and in the early hours post-operation. Patients in (TA) group had mean drainage of 34.41 milliliter more than patients in (TXC) group (P < 0.001). Chi-square test showed that arrhythmia (AF) condition was the same in the two groups during 14 times of study (four times during operation and ten times up to 24 hours after the operation), and AF arrhythmia in the two groups was less than 5%. Conclusions: In this study tranexamic acid with vitamin C have a positive effect on the amount of drainage (blood loss) and there was no significant difference in the incidence of AF between two groups.

Purpose Antifungal resistance and virulence properties of Candida albicans (C. albicans) are growing health problems worldwide. The present study aims to investigate the effect of Zinc Oxide (ZnO) nanoparticles and Nystatin on SAP1-3 genes expression in C. albicans isolates of females with Vulvovaginal Candidiasis (VVC) isolated from Sayad Shirazi Obstetrics and Gynecology Hospital in Northeastern Iran during 2017–2018. Patients and Methods In this descriptive-analytic study, vaginal samples were collected from 280 VVC women. 196 (70%) of C. albicans isolates were identified by phenotypic and ITS genotypic methods. Susceptibility to Fluconazole C. albicans isolates was determined by the disk diffusion method. Detection of ERG11 gene was done by RT-PCR technique. Results It was revealed that PCR amplified the ERG11 gene in all of the Fluconazole-resistant isolates. Real-time PCR was used to survey the effects of 3±1.7µg/mL concentrations of ZnO nanoparticles and Nystatin on expression of SAP1-3 genes before and after treatment. 186 (95%) susceptible C. albicans and 10 (5%) Fluconazole-resistant C. albicans isolates from VVC were exposed to sub-minimum inhibitory concentrations (Sub-MIC) of ZnO-np (range=0.02–12 μg/mL). Sub-MIC concentration was used for each strain, which reduced the expression of SAP1-3 genes to 1.8 MIC in the vaginal swabs. The observed reduction in gene expression was significant for both ZnO nanoparticles and Nystatin (P=0.01 and P=0.07, respectively). Conclusion ZnO as antifungal agent can well reduce the growth and gene expression of SAP1-3 in the pathogenesis of VVC.

Background: Leishmaniasis occurs with an incidence of 0.5–1.5 million new cases annually, and is also endemic in 88 countries across the world. Aim: Presently, we aimed to investigate the status of Cutaneous Leishmaniasis (CL) in Golestan Province in North of Iran. Methods: A retrospective survey was conducted on existed data of 6873 patients with CL who attended to Health Centers in Golestan Province during 2010 to 2017 years. Data were collected using patient sheets and online registry form of CL. Descriptive statistical methods such as mean and standard deviation, and Chi-square test were employed to report and analyze results. p-Value

Malnutrition is a major health problem in hospitalized pediatric patients. It is reported that the number of malnourished pediatric patients varies between 21% and 80% according to the level of the country's development. It is essential that patients who are malnourished or at risk for malnutrition be identified as soon as they are admitted to the hospital. A recent study applied 3 nutritional risk …