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Background: Baricitinib, commonly used for autoimmune diseases, is typically administered orally, which can lead to systemic adverse effects. A topical formulation could potentially offer localized therapeutic effects while minimizing these side effects. Objectives: This study focuses on developing a lipid-based topical formulation of baricitinib (BCT-OS) for treating psoriasis. Methods: The optimized formulation was then assessed for physical, chemical, and biopharmaceutical characterization. Furthermore, the anti-inflammatory efficacy of the formulation was tested in a model of psoriasis induced by imiquimod in mice, and its tolerance was determined by the evaluation of biomechanical skin properties and an inflammation test model induced by xylol in mice. Results: BCT-OS presented appropriate characteristics for skin administration in terms of pH, rheology, extensibility, and stability. The formulation also demonstrated a notable reduction in skin inflammation in the mouse model, and high tolerability without affecting the skin integrity. Conclusions: BCT-OS shows promise as an alternative treatment for psoriasis, offering localized therapeutic benefits with a potentially improved safety profile compared to systemic administration.

Topical ocular drug delivery faces several challenges due to the eye’s unique anatomy and physiology. Physiological barriers, tear turnover, and blinking hinder the penetration of drugs through the ocular mucosa. In this context, nanoparticles offer several advantages over traditional eye drops. Notably, they can improve drug solubility and bioavailability, allow for controlled and sustained drug release, and can be designed to specifically target ocular tissues, thus minimizing systemic exposure. This study successfully designed and optimized PLGA and PCL nanoparticles for delivering baricitinib (BTB) to the eye using a factorial design, specifically a three-factor at five-levels central rotatable composite 23+ star design. The nanoparticles were small in size so that they would not cause discomfort when applied to the eye. They exhibited low polydispersity, had a negative surface charge, and showed high entrapment efficiency in most of the optimized formulations. The Challenge Test assessed the microbiological safety of the nanoparticle formulations. An ex vivo permeation study through porcine cornea demonstrated that the nanoparticles enhanced the permeability coefficient of the drug more than 15-fold compared to a plain solution, resulting in drug retention in the tissue and providing a depot effect. Finally, the in vitro ocular tolerance studies showed no signs of irritancy, which was further confirmed by HET-CAM testing.

Objective Phonological Mean Length of Utterance (PMLU), a quantitative measure for assessing phonological skills, is a diagnostic and clinical criterion in phonological development. Moreover, it is an indicator showing the efficacy of the intervention. The PMLU is a word level measure that can be calculated on the child’s transcribed speech sample (transcription). To calculate PMLU, all consonants and vowels of the child’s produced words, and target words (standard production of words in native adults) are individually scored. The proportion of Whole-Word Proximity (PWP), another phonological quantitative measure, includes the ratio of the produced PMLU to the targeted word PMLU. PWP indirectly reflects the intelligibility of speech. Since languages are distinctive in syllabic and phonological structures, PMLU should be studied as a language-specific measure. PMLU has specifically been designed to assess phonological skills in spontaneous speech. Spontaneous speech sampling methods are advantageous since they consider the effect of morphological and syntactic skills, length, and complexity of words, and they could show the normal development of word complexity. This study was conducted to determine PMLU and PWP in 48 to 60 months old Persian-speaking children with Isfahani accents and to compare them in story generation and conversation sampling methods. The potential sensitivity of PMLU to growth was also examined. Materials & Methods This is an observational and cross-sectional study that was conducted for one year in 2016 in Isfahan City, Iran. A total of 100 children (51 boys and 49 girls) aged 48-60 months participated in story generation sampling, and 67 children (32 boys and 35 girls) participated in conversation sampling. The participants were selected from 261 kindergartens under the supervision of the Welfare Organization of Isfahan Province using the convenience sampling method. After completing the consent form and considering the inclusion criteria, conversation and story-generation samples were collected. Audio samplings were done in the same room using the same software (Clear Record Litev. 2.1). Raters transcribed the first 50 words of the recorded speech samples. Finally, we used the formula to calculate the target PMLU and child PMLU based on the normal production of an adult who speaks Persian with an Isfahani accent and the child’s production, respectively. To evaluate inter-rater reliability, raters randomly transcribed 20% of all samples to recalculate values. Participants’ story generation and conversation scores were entered into SPSS16 separately. The Kolmogorov-Smirnov test was used to examine the data distribution. Based on the data distribution, paired t-test and Wilcoxon test were used to compare measurements, and the Pearson and Spearman tests were used to investigate the associations. Results Child PMLU, target PMLU, and PWP measures of the story generation method were 8.794, 8.811, 0.998, and those of the conversation method were 9.068, 9.093, and 0.998, respectively. Correlation test results showed significant relationship between age and PWP in story generation (r=0.308) and conversation (r=0.313). Comparing child PMLU in story generation and conversation showed a significant relationship between child PMLU in both sampling methods (P=0.000). The result of the target PMLU comparison in two methods of story generation and conversation (P=0.000) was significant. PWP did not significantly differ between the two sampling methods (P=0.973). The inter-rater reliability was calculated at 0.70. Conclusion This study can be used as a basis for quantitative studies in the field of children’s phonological assessment using Persian whole words. However, longitudinal studies in different age groups with a high level of evidence in this field can convince therapists to use whole-word measures in clinics.

Background: Surgery is a stressful event that can be accompanied by a great deal of fear and anxiety, especially in emergency situations. Objectives: This study aimed to determine the level of fear of hospitalization and associated anxiety and factors in the candidates of emergency surgery referring to the hospitals affiliated with Zanjan University of Medical Sciences. Methods: This descriptive cross-sectional study was performed on 304 patients admitted to the emergency department and their family members, referring to the hospitals affiliated with Zanjan University of Medical Sciences in 2020. The patients were recruited by convenience sampling. Data collection tools included a questionnaire for demographic information and disease specifications, the hospitalization fear questionnaire (Slobodan M. Jankovic), and the Visual Analogue Scale (10-point) to assess pain and anxiety in the emergency departments. For data analysis, independent t-test, analysis of variance (followed by the LSD post hoc test), Pearson correlation, and stepwise multiple regression were used by SPSS 22. Results: The results showed that a higher number of the patients (61.4%) experienced anxiety rather than hospitalization fear (23.2%). The pain had a negative correlation with patients’ and their companions’ fear of hospitalization and a positive correlation with their level of anxiety. Also, the anxiety of the patient's companion increased with the prolongation of the waiting time. The companion’s hospitalization fear and anxiety significantly correlated with the patient’s level of anxiety (P

Atopic dermatitis (AD) is a chronic autoimmune inflammatory skin disorder which causes a significant clinical problem due to its prevalence. The ongoing treatment for AD is aimed at improving the patient’s quality of life. Additionally, glucocorticoids or immunosuppressants are being used in systemic therapy. Baricitinib (BNB) is a reversible Janus-associated kinase (JAK)-inhibitor; JAK is an important kinase involved in different immune responses. We aimed at developing and evaluating new topical liposomal formulations loaded with BNB for the treatment of flare ups. Three liposomal formulations were elaborated using POPC (1-palmitoyl-2-oleoyl-glycero-3-phosphocholine), CHOL (Cholesterol) and CER (Ceramide) in different proportions: (i) POPC, (ii) POPC:CHOL (8:2, mol/mol) and (iii) POPC:CHOL:CER (3.6:2.4:4.0 mol/mol/mol). They were physiochemically characterized over time. In addition, an in vitro release study, ex vivo permeation and retention studies in altered human skin (AHS) were also performed. Histological analysis was used to study the tolerance of the formulations on the skin. Lastly, the HET-CAM test was also performed to evaluate the irritancy capacity of the formulations, and the modified Draize test was performed to evaluate the erythema and edema capacity of the formulations on the altered skin. All liposomes showed good physicochemical properties and were stable for at least one month. POPC:CHOL:CER had the highest flux and permeation, and the retention in the skin was equal to that of POPC:CHOL. The formulations exhibited no harmful or irritating effects, and the histological examination revealed no changes in structure. The three liposomes have shown promising results for the aim of the study.

Background: Renal failure is a chronic disease getting more prevalent nowadays. Objectives: Since caring for the patients is expected to result in family functioning disorders, this study was done in Zanjan Province in 2019 to determine the extent of the hemodialysis patients’ family function. Methods: This is a descriptive study. 199 patients undergoing hemodialysis treatment were selected through the stratified random sampling method. Data collection tools included demographic information questionnaire and McMaster Family Functioning Questionnaire. The data were analyzed by KolmogorovSmirnov test, descriptive statistics, independent t-test and Pearson correlation coefficient in the SPSS software version 25. Results: About half of the participants were male (52.3%), married (76.4%), the family caretaker (56.3%) and urban dwellers (70.4%), having insufficient income per month (75.4%). 52.7% of the patients under study were more than 60 years old. The age group 20-29 (six percent) had the lowest frequency in the population of the hemodialysis patients under study. Furthermore, 15.1% of the participants had no health insurance coverage and there was no social support system backing 67.3% of the participants. All dimensions of family functioning, under this study, fell within the normal range. The mean scores of family functioning dimensions were lower in terms of problem solving dimension than in other dimensions (The problem solving dimension score equaled 1.88 within the range of 0–4) and families functioned better in this respect. Furthermore, the results proved significant statistical relationship between number of family members, sufficient family income, and the distance from the hemodialysis centers and being covered by the social support system on the one hand and some dimensions of family functioning on the other hand (p

The low water solubility of baricitinib (BCT) limits the development of new formulations for the topical delivery of the drug. The aims of this study were to assess the solubility of BCT in different solvents, including Transcutol, a biocompatible permeation enhancer that is miscible in water, to evaluate the drug uptake in human skin and porcine tissues (sclera, cornea, oral, sublingual, and vaginal), and to subsequently extract the drug from the tissues so as to determine the drug recovery using in vitro techniques. Analytical methods were developed and validated for the quantification of BCT in Transcutol using absorption and fluorescence spectroscopies, which are complementary to each other and permit the detection of the drug across a broad range of concentrations. Results show that Transcutol permits an increased drug solubility, and that BCT is able to penetrate the tissues studied. The solutions of BCT in Transcutol were stable for at least one week. Hence, Transcutol may be a suitable solvent for further development of topical formulations.

Sjögren’s syndrome is a chronic systemic autoimmune disease affecting from 0.2 to 3% of the general population. The current treatment for Sjögren’s syndrome is aimed at controlling symptoms such as dry eyes and xerostomia. Systemic therapy with glucocorticoids or immunosuppressants is also used. Baricitinib is an immunosuppressant drug, specifically a Janus kinases 1 and 2 selective inhibitor. We propose ocular liposomal formulations loaded with baricitinib for the management of Sjögren’s syndrome. The novelty of the work relies on the fact that, for the first time, baricitinib is intended to be used for topical delivery. Two liposomal formulations were prepared with different lipids: (i) L-α-phosphatidylcholine (Lα-PC) and (ii) a combination of lipids 1-palmitoyl-2-oleoyl-phosphatidylethanolamine: s1-Palmitoyl-2-oleoyl-sn-glycerol-3-phosphoglycerol (3:1, mol/mol) (POPE:POPG), and they were physicochemically characterized. The in vitro drug release and the ex vivo permeation through corneal and scleral tissues were also assessed. Finally, the tolerance of the formulations on the ocular tissues was evaluated by the HET-CAM technique, as well as through the histological analysis of the cornea and sclera and the cornea transparency. Both liposomes resulted in small, spherical shapes, with suitable physicochemical properties for the ocular administration. Lα-PC led to higher flux, permeation, and retention in the sclera, whereas POPE:POPG led to higher flux and permeation in the cornea. The formulations showed no irritant effects on the chorioallantoic membrane. Additionally, the liposomes did not affect the cornea transparency when they were applied, and the histological analysis did not reveal any structural alteration.

Background: Multidrug resistance is a serious problem in the treatment of urinary tract infections. Integrons are ancient structures that contain determinants of a site-specific recombination system to capture genes encoding antimicrobial resistance. The aim of this study was to determine the prevalence of multidrug resistant Klebsiella isolates in clinical specimens. In addition, the existence of integrons in resistant isolates was assessed by amplification of integrase genes. Methods: Susceptibility of 100 Klebsiella isolates was determined to 19 antibiotics by the Kirby-Bauer disc diffusion method and integron classes were detected. Then the multi-drug resistance association with the existence of the integrase gene was calculated by chi-squre and fisher exact tests. Results: According to antibiogram results, 54 isolates were multidrug resistant. By amplification of intergrase gene it was revealed that 27% of the isolates harbor integrons. Also by PCR-RFLP it was revealed that all of them were class 1. The existence of integrons was confirmed in 25 of our multidrug resistant isolates, indicating the frequency rate is high and integrons may be partly responsible for multidrug resistant. Conclusion: Multidrug resistance suggests that strategy for treatment of patients with Klebsiella infections needs to be revised. The possibility of transmission of resistance genes by integrons would be decreased by treatment of patients with the appropriate antibiotics.

Aim of the study: We aimed to study the relationship of sexual assault with self-concept and the general health of the victims referred to forensics in Ahvaz city (Iran). Material and methods : It was a cross-sectional descriptive and analytical study that was designed by two groups as case and control which has done on 128 subjects. Sixty-four rape victims who were referred to the forensic center, considered as case group and in control group, 64 people who were being referred to health clinics in Ahvaz city. The data were collected through Rogers’s standard self-concept and general health questionnaires. Questionnaires were filled in self-completion way. Data had entered and analyzed by using SPSS software (version 22). A level of significance was less than 0.05. Results: The average score of self-concept in the case group was 14.97 ±4.78 and in control group was 6.08 ±2.9. Average score of general health of the case and control groups, respectively, were 51.09 ±18.07 and 16.92 ±12.79. A significant statistical difference between the average score of self-concept, social functioning, physical and general health components in the groups was observed. Conclusions : More negative self-concept and vulnerable general health was observed in the rape victims group than in the control group. Providing counseling and health services and family and social support of these victims can be effective in their general health promotion

This study investigates the method of extracting cellulose from hazelnut green shell (which is almost used as a plant fertilizer) doped with gelatin/nano silver to create nano fiber composite. Cellulose was obtained with a Soxhlet extractor, and using electrospinning method, nano fiber was obtained. Different percentage of gelatin and nano silver was used, and sample morphology was investigated by scanning electron microscope and energy dispersive X-ray. Furthermore, the bactericidal property of samples was analyzed against Bacillus cereus and Shigella, and the results showed an excellent bactericidal property against both Gram-positive and Gram-negative bacteria. Furthermore, the samples’ ultraviolet (UV) protection factor was measured, the UV-blocking property of specimens was investigated, and the resulting outcomes indicate good prevention of UV. On the other hand, anti-inflammatory property of the samples was analyzed by Winter method, and the results illustrated that cellulose/gelatin/nano silver has the ability to reduce edema; therefore, the produced nano composite has anti-inflammatory property. Furthermore, hydrophilicity efficiency and tensile strength of samples were investigated.

Research aims on natural fibers using nano materials according to health studies. In this research, cork powder was used as a raw natural and ecofriendly material which was doped with nano strontium titanate. The composite was extruded by twin screw extruder to obtain composite fibers. The strength of the composites produced was investigated and the results revealed that all samples containing cork with nano particles have better strength, which can be used in textile industry. On the other hand, the composite UV protection was studied and the result showed the final composite has excellent protection against UV transmission which is so important in today’s world. Also, water uptake was investigated and the SEM images proved the distribution of nano particles and cavity forms of cork after extrusion.