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In this research, the synthesis of novel derivatives of spiroisatins in high yields was investigated. These new compounds were synthesized using a multicomponent reaction (MCR) of isatin, malononitrile, acetophenone derivatives, diethyl oxalate, primary amines, and Et3N in aqueous media. Under similar conditions, spiropyrroloisatins were prepared using MCRs of synthesized spiroistins. The antioxidant activity of newly synthesized spiroisatins is due to having an NH group which was evaluated by two procedures. Also, the antimicrobial activity of newly generated spiroisatins was evaluated by a disk distribution process utilizing two kinds of Gram‐negative bacteria and Gram‐positive bacteria and bacterial growth was stopped using these compounds. The advantages of this method are short reaction times, high yields of products, and the easy separation of catalyst and product using simple procedures. [ABSTRACT FROM AUTHOR]

Background: Studies show that leaving the hospital with personal consent is increasing. This phenomenon has unpleasant and sometimes irreversible consequences. This study aims to investigate the causes and consequences of leaving the hospital with the personal consent of patients referred to the emergency department of hospitals affiliated with Qom University of Medical Sciences in 2021. Materials and Methods: In this descriptive-analytical study, 345 patients were selected who, with personal consent, left the emergency department of selected hospitals affiliated with Qom University of Medical Sciences in 2021. The study data were collected via a questionnaire and a checklist. The questionnaire comprised demographic variables, patientrelated factors, personnel-related factors, and hospital-related factors. The checklist of the consequences included questions about leaving the hospital with personal consent. The data were analyzed using descriptive and inferential statistics in SPSS software, version 20. Results: Of 345 patients included in the study, 55.9% were male and the mean age of patients was 47.1 years. The most important reasons for leaving the hospital with personal consent were as follows: personal reasons (22.9%), fear of continuing treatment (11.9%), preference to continue the treatment in other medical centers (9.3%), the suggestion of other hospital staff (35.1%), not having the desired doctor (27%), nurses' suggestion (19.4%), lack of care (20.4%), and inadequate hospital space and facilities (14.0%). The consequences of leaving the hospital with personal consent in this study included re-admission and hospitalization (10.3%), mortality (3.4%), heart disease (0.87%), and mental disorders (0.57%). Conclusion: After identifying the reasons for leaving the hospital with personal consent and highlighting the irreparable human and financial consequences, these causes should be eliminated to prevent irreparable and unfortunate consequences. Such causes include personal reasons, fear of continuing the treatment, and lack of care. Fixing the causes requires proper planning and effective actions. [ABSTRACT FROM AUTHOR]

Introduction: Enteral nutrition is a type of feeding for patients who are not conscious or cannot feed orally. In addition to Blendrized solutions, many commercially powders are also available for enteral feeding. Since the supply of calories is the most important issue in patients with enteral nutrition, it is very important to have enough information about the calories and macronutrients of both types of enteral nutrition solutions. Method: Two 200 cc samples of Blendrized formula (1800 kcal) and two 200 cc samples of 4 different types of commercially powders were prepared and kept in standard conditions. One series of samples was sent to the pharmaceutical research center laboratory for caloric measurement and the second series of samples was sent to the accredited food laboratory to measure macronutrients. Results: calories of commercially powders were 3.83 kcal on average and 3.930 kcal in the case of formula. High-protein powder had the highest calorie (3.93). No significant difference was observed regarding macronutrients of standard powders (CHO, PRO, and FAT). All three macronutrients were more in high-protein powder. CHO and FAT of the formula were lower than the standard powders, but the amount of PRO was similar to them. Conclusion: standard commercial powders do not have significant differences in terms of calories and macronutrients. High protein powder is better for patients with muscle wasting. Blenderized formula also provides well the calories needed by patients and can be used for patients hospitalized in non-ICU units. [ABSTRACT FROM AUTHOR]

Context: In some studies, Fresh Frozen Plasma (FFP) transfusion in severely ill patients was accompanied with an increase in the risk of nosocomial infection. However, there are no comprehensive data in terms of FFP transfusion and its relationship with nosocomial infection in heart surgery. Hence, the present systematic review and meta-analysis aimed to investigate the relationship between FFP transfusion and nosocomial infection risk in the patients undergoing cardiac surgery. Evidence Acquisition: Study selection: The present study included all the studies, which probed into nosocomial infection after FFP transfusion in patients with cardiac surgery. Data sources: Medline, Web of Science, Embase, Central, and Scopus electronic databases were searched to the end of March 2019. Results: Finally, five articles and three abstracts that studied nosocomial infection were entered into the present systematic review. FFP increased the rate of nosocomial infection in cardiac surgery in one article, but this was not the case in the remaining four articles. The three abstracts also reported that FFP increased the rate of nosocomial infection in cardiac surgery. Conclusion: The studies indicated that the benefit of FFP administration outweighed the probable risk of infection. Indeed, none of the studies indicated a strong relationship between FFP transfusion and infection rate after cardiac surgery. [ABSTRACT FROM AUTHOR]

Background: Intensive care units (ICUs) provides intensive treatment medicine to avoid complications such as malnutrition, infection and even death. As very little is currently known about the nutritional practices in Iranian ICUs, this study attempted to assess the various aspects of current nutrition support practices in Intensive Care Units of imam Reza hospital. Method: We conducted a cross-sectional study on 50 critically ill patients at 9 ICUs from January to May 2023. Data were collected through interview with supervisors of ICUs, medical record reviews and direct observation of patients during feeding. Results: Our study showed that requests and answers for nutrition counseling in this hospital are recorded in the HIS system (Hospital Information System). Nutrition counseling should be organized in the first 24 hours of the patients' hospitalization in the ICU and 60% of patients received diet counselling. The evaluation form of the patients' specialized condition is also completed by nutritionists along with nutritional counseling in the HIS system. Monitoring of nutritional status, energy and protein intake were recorded in 5 days in any of the participating ICUs. Commercial enteral feeding powders are used in the ICU units of this hospital. In the case of patients who have intolerance to commercial powder, blenderized formula is used. Conclusions: Our findings demonstrated that the quality of nutritional care was approximately appropriate in ICUs of this hospital but monitoring of nutritional tolerance and anthropometric status of patients after nutrition counseling along over time is necessary. [ABSTRACT FROM AUTHOR]

Hiccups that last more than 48 hours are known as persistent hiccups. A 38-year-old man presented to the emergency with a 3-day history of persistent hiccups, and after partial treatment and normal test results, he was discharged from the emergency. After 22 hrs, he was brought to the emergency again with a complaint of stuttering and was admitted with a chance of stroke. A 50% stenosis development in the right carotid artery was reported, and the MRI results were normal. After 20 hrs of admission, the patient's stutter was thoroughly treated, and he was discharged with the diagnosis of TIA. Persistent hiccups can be a precursor to a stroke. [ABSTRACT FROM AUTHOR]