The effect of combination therapy with intravitreal bevacizumab and topical timolol-dorzolamide eye drops on diabetic macular edema: a double-blind randomized controlled trial.

BACKGROUND: The mainstay of treatment in diabetic macular edema (DME) is intravitreal administration of anti-vascular endothelial growth factors (anti-VEGFs). Aqueous depressants may enhance the effects of anti-VEGF agents by prolonging their clearance via aqueous outflow. PURPOSE: To compare the anatomical and functional outcomes of treatment with intravitreal bevacizumab (IVB) and topical timolol-dorzolamide versus IVB alone. METHOD: In this randomized placebo-controlled clinical trial, patients with center-involving DME (ci-DME) and best corrected visual acuity (BCVA) of 20/30 or less were enrolled and randomly allocated to two treatment arms. One group received three monthly IVB injections and timolol-dorzolamide eye drops twice a day (IVB + TD group); the other group received three monthly IVB injections and artificial tear drops as placebo (IVB group). Patients underwent ophthalmic evaluations and macular optical coherence tomography scans at baseline and 1 month after the third injection. RESULT: Forty-six eyes from 46 patients with ci-DME were recruited. There was no intergroup difference regarding age, gender distribution, diabetic retinopathy stage, glycemic indices, BCVA, central macular thickness (CMT), or intraocular pressure at baseline. BCVA was significantly improved in the IVB + TD group (0.46 ± 0.18 to 0.36 ± 0.18 logarithm of the minimum angle of resolution [logMAR], p = 0.002), in contrast to IVB group (0.40 ± 0.17 to 0.35 ± 0.22 logMAR, p = 0.113). Similarly, the IVB + TD group showed a significant reduction in CMT (p < 0.001), unlike the IVB group (p = 0.086); and the CMT change in the former was greater than in the latter (- 0.57 ± 57.67 vs. - 25.52 ± 68.02 µm, p = 0.033). CONCLUSION: Our findings support the short-term effectiveness of topical timolol-dorzolamide as adjunctive therapy to IVB injections in managing center-involving DME in terms of anatomical and visual outcomes. TRIAL REGISTRATION: Clinicaltrials.gov NCT05083689 (October 19, 2021).

Epidemiology of adolescent idiopathic scoliosis in Isfahan, Iran: A school-based study during 2014-2015.

BACKGROUND: Scoliosis is a three-dimensional deformity of the spine with lateral curvature in addition to the rotation of vertebral bodies. The aim of the present study was to determine the prevalence of adolescent idiopathic scoliosis (AIS) in our society and its demographic-related factors. MATERIALS AND METHODS: This was a cross-sectional study that took place from November 2014 to March 2015 in Isfahan, Iran. During the period of study, 24 schools were randomly chosen from six zones by a simple random sampling method. In each school, about 120 students were randomly selected and evaluated. Anterior forward bending test and scoliometry were done in all students and suspicious ones referred to Alzahra spine clinic for further evaluation. The diagnosis of AIS was based on radiographic finding and Cobb angle more than 10°. Data about age, sex, height, body mass index, hand dominancy, and type of schoolbag were recorded. RESULTS: A total number of 3018 children were evaluated and 19 were diagnosed with AIS that showed the prevalence of 0.62%. None of the study variables had a significant relation with the presence of AIS. The cutoff point for the detection of AIS with scoliometry was calculated as 3.5, with a sensitivity of 73.7% and specificity of 86.7%. CONCLUSION: The prevalence of AIS in our area was 0.62%, which was lower than previous reports and did not have a relation with demographic factors; however, screening surveys identify a significant number of children with AIS who could benefit from preventive treatment.

A case-control study of risk factors for hepatitis B infection: A regional report among Isfahanian adults.

BACKGROUND: Hepatitis B is one of the major causes of mortality among viral diseases. To reduce morbidity rate and increase knowledge of people about potential risk factors, the aim of this study was to determine the prevalence of hepatitis B among the general population and the risk factors associated with hepatitis B virus (HBV) infection in Isfahan, Iran. MATERIALS AND METHODS: In a case-control study, 314 HBV-infected patients and 557 healthy participants were recruited. Data on demographics, immunization history, medical history, family medical history, life history, therapeutic factors, and behavioral risk factors were collected through a standard checklist. Chi-square and logistic regression were used for univariate and multivariable analyses. RESULTS: Our results showed that among sociodemographic variables, higher age, being male, lower economic status, and lower educational attainments increased the risk of affecting by HBV (odds ratio [OR] >1, P < 0.001); furthermore, Iranian and no immigrant people showed higher significant risk of being affected by HBV. Multivariable logistic regression showed among medical, blood, and behavioral risk factors, family history of hepatitis (OR: 10.56; 95% confidence interval [CI]: 4.56-24.86), dental treatment history (OR: 4.30; 95% CI: 1.41-13.10), and hospitalization (OR: 2.94; 95% CI: 1.72-5.00). CONCLUSION: Our results demonstrated that there are still several risk factors for hepatitis B surface antigen infection among the Iranian adult population. Immunization programs should continue and focus on high-risk adults, and interventions should be directed toward to reduce risk factors associated with hepatitis B.

Assessment of hepatitis C risk factors in center of Iran: A case-control study.

BACKGROUND: Hepatitis C virus (HCV) infections remain as one of the major public health problems worldwide. The current study aimed at investigating the potential risk factors of HCV+ in a sample of Iranian patients. MATERIALS AND METHODS: In a case-control study, 436 HCV-infected patients and 531 age-matched HCV antibody negative controls were recruited in a central region of Iran. Sociodemographic characteristics, blood and therapeutic factors, underlying diseases, and behavioral risk factors were evaluated through a standard checklist and compared between two study groups. RESULTS: Although among studied potential risk factors, many of them were significantly associated with infected with HCV; however, in multivariable logistic regression model in the presence of other variables being male gender (odds ratio [OR]: 4.1; 95% confidence interval [CI]: 2.2-7.8), illiterate or less educated (OR: 62.64; 95% CI: 5.94-660.35), having history of intravenous (IV) drug addiction (OR: 33.0; 95% CI: 5.43-250.0), and tattooing (OR: 14.29; 95% CI: 1.82-90.91) increased risk of infection with HCV. CONCLUSION: In total, the current case-control study documented that socioecomical factors including economical state, marital status, education, and ethnicity and also other expected factors such as hospitalization, imprisonment, dialysis, tattooing, needle sharing, IV drug abuse, and extramarital sexual relationship represent an important source of HCV infection among adults in a central region of Iran. Thus, we suggest further considerations for prevention of HCV infection as most of related factors are preventable by close considerations.

Nature's coatings: Sodium alginate as a novel coating in safeguarding plants from frost damages.

Frost damage remains a significant challenge for agricultural practices worldwide, leading to substantial economic losses and food insecurity. Practically, traditional methods for frost management have proven ineffective and come with several drawbacks, such as energy consumption and limited efficacy. Hence, proposing an anti-freezing coating can be an innovative idea. The potential of sodium alginate (SA) to construct anti-freezing hydrogels has been explored in several sciences. SA hydrogels can form protective films around plants as a barrier against freezing temperatures and ice crystals on the plant's surface. Sodium alginate exhibits excellent water retention, enhancing plant hydration during freezing conditions. This coating can provide insulation, effectively shielding the plant from frost damage. The advantages of SA as a coating material, such as its biocompatibility, biodegradability, and non-toxic nature, are highlighted. Therefore, the proposed use of SA as an innovative coating material holds promise for safeguarding plants from frost damage. Following SA potential and frost's huge damage, the present review provides a comprehensive overview of the recent developments in SA-based anti-freezing hydrogels, their applications, and their potential in agriculture as anti-freezing coatings. However, further research and field trials are necessary to optimize the application methods and understand the long-term effects on productivity.

Nano/micro-cellulose-based materials as remarkable sorbents for the remediation of agricultural resources from chemical pollutants.

Overusing pesticides, fertilizers, and synthetic dyes has significantly increased their presence in various parts of the environment. The transportation of these pollutants into agricultural soil and water through rivers, soils, and groundwater has seriously threatened human and ecosystem health. Applying techniques and materials to clean up agricultural sources from pesticides, heavy metals (HMs), and synthetic dyes (SDs) is one of the major challenges in this century. The sorption technique offers a viable solution to remediate these chemical pollutants (CHPs). Cellulose-based materials have become popular in nano and micro scales because they are widely available, safe to use, biodegradable, and have a significant ability to absorb substances. Nanoscale cellulose-based materials exhibit greater capacity in absorbing pollutants compared to their microscale counterparts because they possess a larger surface area. Many available hydroxyl groups (-OH) and chemical and physical modifications enable the incorporation of CHPs on to cellulose-based materials. Following this potential, this review aims to comprehensively summarize recent advancements in the field of nano- and micro-cellulose-based materials as effective adsorbents for CHPs, given the abundance of cellulosic waste materials from agricultural residues. The recent developments pertaining to the enhancement of the sorption capacity of cellulose-based materials against pesticides, HMs, and SDs, are deliberated.

Searching the Staphylococcal Toxic Shock Syndrome Toxin -1 in Septic Children with negative Cultures: A Comparative Study in Tehran, Iran.

BACKGROUND: Bacteria induced sepsis is common in infants and children. Staphylococcus aureus produces numerous exotoxins, like staphylococcal Toxic shock syndrome toxin (TSST- 1), which stimulate the immune system by T cell activation and inflammation in various organs. Recent studies suggest that staphylococcal toxins, generally named super antigens (SAgs), may also have a significant role in the pathogenesis of some pediatric disorders especially in the clinical presentation of sepsis and septic shock. This study was carried out in order to compare staphylococcal TSST- 1 (SAgs) in children with sepsis symptoms (and septic shock) with negative blood culture versus a control group. MATERIALS AND METHODS: This cross-sectional study was conducted during 2 years (2014 -2016) in two referral hospitals (Rasoul Akram and Bahrami hospitals) in Tehran, Iran. We selected 44 children) mean age of 4 years) who were admitted in pediatrics and PICUs wards with sepsis symptoms- /+septic shock. Forty-five children (mean age of 3.9 years) were selected as a control group. All cases with blood samples were examined for TSST-1 (SAgs) by polymerase chain reaction (PCR) method in both case and control groups and results were compared. Data were analyzed by SPSS-16software. Chi-square or Fisher test was used to compare the variables. P-value < 0.05 was considered as a valuable tool. RESULTS: Positive blood cultures with other bacteria, Streptococcus pneumonia, Haemophilus influenzae, Pseudomonas aeruginosa, Escherichia coli, were detected in 5 cases with negative TSST-1 in blood samples. S.aureus isolated from blood culture was detected in 2 cases with positive TSST- 1.Positive TSST-1 (SAgs) was detected in 6 cases (14%) with negative blood culture for S.aureus; it was significantly higher in cases (14% vs. 2%; P value = 0.05). CONCLUSION: This study indicates the probable role of TSST-1(SAgs) in the progression of sepsis (and septic shock) in toxic children with negative blood culture for S.aureus. Anti-staphylococcal treatment is immediately required, especially in toxic children with related clinical presentations, even in cases with negative blood cultures. Indeed, the clinical use against SAgs suppressants of downstream cell-destructive events might be helpful.

Shortcomings in dealing with psychological effects of natural disasters in iran.

BACKGROUND: Natural disasters result in numerous economic, social, psychological and cultural consequences. Of them, psychological consequences of disasters will affect the lives of people long after the critical conditions finish. Thus, concerning the importance of psychological support in disasters, this study has identified problems and weaknesses in dealing with the psychological effects of the disasters occurred in Iran. METHODS: This qualitative study was carried out using semi-structured in-depth interviews and focus groups. Sample volume consisted of 26 experts in the field of disaster management. Content analysis was used to analyze data. RESULTS: Nine major problems were identified as weaknesses in handling the psychological effects of the disaster. These weaknesses include: rescuers' unfamiliarity with the basic principles of psychosocial support, shortage of relevant experts and inadequate training, paying no attention to the needs of specific groups, weaknesses in organizational communications, discontinuation of psychological support after disaster, unfamiliarity with native language and culture of the disaster area, little attention paid by media to psychological principles in broadcasting news, people's long-term dependence on governmental aid. CONCLUSIONS: Disaster management has various aspects; in Iran, less attention has been paid to psychological support in disasters. Increasing education at all levels, establishing responsible structures and programming seem necessary in dealing with the psychological effects of disasters.