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Background and Aims: Laparoscopic cholecystectomy is one of the surgical procedures for cholecystectomy, which may be associated with difficulty and complications in people with high body mass index (BMI). In this study, we investigated the location of the portal infection following laparoscopic cholecystectomy and its association with BMI in hospitals affiliated with Babol University of Medical Sciences in 2012-2015. Materials and Methods: In this cross-sectional analytical study, all patients who underwent laparoscopic cholecystectomy surgery (n=801) were included after obtaining informed consent. Demographic (e.g., gender, age, and BMI) and clinical (e.g., type of disease, number of gallstones, port site infection, and duration of surgery) information were evaluated. Results: Most patients were female (87%), with a mean age of 43.38 ± 14.23 years. The average BMI of the patients was reported as 31.72 ± 6.86 kg/m2; most of them were in the range of 30-39.9 (44.8%), and at least a few patients had a BMI greater than or equal to 40 (12.5%). The mean BMI of patients was 31.72 ± 6.86 kg/m2. The majority of patients had chronic cholecystitis (70.2%) and colic bilirubin (18.6%). The duration of surgery was 35.18 ± 10.59 minutes. Around 2% of the patients had an infection site of the port (1.2%), the cases of umbilical epigastric (0.5%), or both sites (0.2%). The BMI of patients with port umbilical infection was 41.48±3.45 and epigastric 30.38±5.87, and patients with port umbilical infection had significantly higher BMI than patients with epigastric infection (P

Background and purpose: Preventing ventilator-associated pneumonia (VAP) as one of the most common and also the most fatal complications caused by intubation and mechanical ventilation in intensive care units (ICU) has always been emphasized in countless studies. Chlorhexidine mouthwash is commonly used as a gold standard in the control of dental plaques and prevention of VAP. Given the increasing prevalence of gram-negative infections due to resistance to commonly used antibiotics and the associated complications, this study aimed to investigate and compare the impact of tea tree oil/aloe vera herbal mouthwash, known for its antibacterial and anti-inflammatory properties, on the occurrence of ventilator-associated pneumonia. Materials and methods: This study is a double-blind randomized clinical trial. 62 intubated patients, aged from 16 to 65 and hospitalized in the intensive care units of Hazrat Waliasr Hospital in Arak City in 2023, were assigned using a simple randomization method in two interventions (tea tree oil/aloe vera mouthwash) and control groups (chlorhexidine mouthwash). Mouthwash bottles were covered before distribution. None of the patients, colleagues (nurses), and the specialist determining the final result of the study were aware of the allocation of patients in the intervention or control group. Oral care in both groups was performed by washing hands, wearing gloves, evaluating the mouth condition, adjusting the pressure of the endotracheal tube cuff (20-30 Cm.H2O), brushing with a soft toothbrush, mouthwash twice daily and open suctioning of oral and subglottic secretions. Lastly, at intervals of 3 days (to assess the incidence of early VAP) and 7 days (to assess the incidence of late VAP) after the intervention, the modified clinical pulmonary infection score (MCPIS) was calculated and a score greater than or equal to 6 was considered as a diagnosis of pneumonia. This tool has been utilized in similar studies and its validity and reliability have been confirmed. Eventually, the data was statistically analyzed using the chi-square test, independent t-test, and repeated measures test to investigate the effect of the intervention over time with SPSS version 20 software. Results: According to the results, 64.5% of the participants were male and 35.5% of them were female. There was no statistically significant difference between the two groups in terms of average age, gender, reason for admission, history of underlying diseases, invasive interventions, average number of drugs and antibiotics, type and amount of nutrition, and duration of mechanical ventilation. The incidence of early-onset pneumonia was 9.7% in the intervention group and 12.9% in the control group. Although the incidence was lower in the intervention group, there was no statistically significant difference between the two groups (P-value=0.99). The incidence of late-onset pneumonia in the intervention group was 12.9% and 16.1% in the control group. Despite of lower incidence of late-onset pneumonia in the intervention group, there was no statistically significant difference (P-value=1.00). Moreover, according to the results of Bonferroni's paired comparisons test, the difference in the average MCPIS score between 3 days and 7 days later in the intervention group was not significant and did not increase significantly (P-value=0.06), which means that in this group, the effect of the intervention can be seen at this time. Conclusion: Oral care using tea tree oil/aloe vera mouthwash or 0.2% chlorhexidine has no preference or significant advantage over each other, and both can be effective in reducing ventilator-associated pneumonia. Considering the lower incidence of early and late pneumonia in the intervention group, it is recommended to conduct studies with a larger sample size and also use accurate oral assessment tools to confirm the removal of dental plaque (plaque score) in this population of patients. (Clinical Trials Registry Number: IRCT20210104049936N1)

Background: Lipid disorder is a modifiable risk factor for diseases related to plaque formation in arteries such as heart attack, stroke, and peripheral vascular diseases. Identifying related factors and diagnosis and treatment in time reduces the incidence of non-communicable diseases (NCDs). The aim of this study was to determine factors associated with lipids based on a national survey data. Methods: Data of 16757 individuals aged 25–64 years obtained from the Iranian STEPwise approach to NCD risk factor surveillance (STEPs) performed in 2016, through multistage random sampling, were analyzed. Because of clustered, hierarchical, and skewed form of the data, factors related to total holesterol (TC), triglycerides (TG), low-density lipoprotein-cholesterol) (LDL-C), high-density lipoprotein-cholesterol) (HDL-C), TG/HDL-C, TC/HDL-C, and LDL-C/HDL-C were determined applying multilevel quantile mixed model. Parameters of the model were estimated on the basis of random effect of the province as well as urban or rural area for 10th, 25th, 50th, 75th, and 90th quantiles. Statistical analyses were performed by R software version 4.0.2. Results: Significant relationship was found between age, body mass index (BMI), waist circumference (WC), diabetes, hypertension, smoking, physical activity, education level, and marital status with TC, LDL-C, HDL-C, LDL-C, and LDL-C/HDL-C. With increasing BMI and WC, subjects had higher levels of serum lipids, especially in higher quantiles of lipid levels. Lipid levels were significantly increased among smokers and those with diabetes or hypertension. The random effects were also significant showing that there is a correlation between the level of lipids in provincial habitants as well as urban and rural areas. Conclusions: This study showed that the effect of each factor varies depending on the centiles of the lipids. Significant relationship was found between sociodemographic, behaviors, and anthropometric indices with lipid parameters.

The outbreak of a novel coronavirus disease 2019 (COVID-19) began in China in December 2019 and spread worldwide. The current review summarized clinical, radiological, and laboratory findings of patients infected with COVID‐19. Based on many studies, the main symptoms of the disease include respiratory symptoms, fever, cough, and dyspnea; there is also a wide range of biochemical, hematological, and radiological changes in the patients. The signs (or symptoms) and other variables in the early stage or the mild stage of the disease appear in a highly heterogeneous and non-specific manner. Identifying the clinical and paraclinical symptoms of COVID-19 can be effective in controlling it.

Introduction: Bacterial bloodstream diseases cause important public health problems and are considered as significant issues in morbidity and mortality in patients who are hospitalized. This study aimed to investigate the frequency of bacterial isolates from suspected septicemia and subsequent drug resistance patterns in affiliated patients to the Amir Al-Momenin Hospital of Gerash, Fars, Iran. Materials and Methods: In this hospital-based cross-sectional study, 2485 blood samples were examined in the Bacteriology Laboratory of Amir Al-Momenin Hospital of Gerash, during 2018-2019. Then, drug susceptibility tests were done for positive blood cultures. All specimens were cultivated in MacConkey agar, Blood Agar, and chocolate agar mediums. A total of 120 positive samples were obtained, and biochemical tests were used to classify bacteria to species levels. After identification, a drug susceptibility test was carried out on the Mueller-Hinton agar via 16 antibiotics based on the Clinical and Laboratory Standards Institute guidelines. Results: Of the 2485 blood culture results, 120 (4.82%) were determined as positive. The blood culture examination revealed the most common isolated as Staphylococcus epidermidis (45%, n=54 cases), Acinetobacter baumannii (10.83%, n=13 cases), Escherichia coli (10%, n=12 cases), Klebsiella pneumoniae (5.83%, n=7 cases), respectively. Additionally, among all the antibiotics tested, the highest percentage of resistance was related to cefoxitin in 48 cases (40%), cephalexin in 47 (39.1%), clindamycin in 47 (39.1%), and erythromycin in 42 (35%). Conclusions: Results revealed that most of the bacterial isolates had a high rate of resistance to the most commonly used antibiotics. Therefore, continuous antibiotic resistance pattern evaluation in different areas is necessary.