Exploring the relationship between contextual factors and health-promoting lifestyle profile (HPLP) among medical students: A cross-sectional study.

Background and Aims: The present study was conducted with the aim of investigating the relationship between health-promoting lifestyle profile (HPLP) among medical students and contextual factors such as gender, age, field of study, academic level, marital status, history of physical and mental illnesses, and smoking. Methods: The present research was conducted in a cross-sectional method in 2021 on 500 students of Shiraz University of Medical Students. An e-questionnaire link was sent to them via email. The research tool was the HPLP questionnaire consisting of 52 questions in six domains in a 4-point Likert scale. Data were analyzed using SPSS software version 24 with one-sample t-test, independent t-test, analysis of variance, and Tukey's post hoc test. Results: A total of 500 students fully answered the questions completely. All components of a healthy lifestyle-except for exercise-obtained a score higher than the cut-off point. The component of Self-Actualization (spiritual growth) (3.035 ± 0.68) had the highest score, while the lowest score was related to exercise and physical activity (2.126 ± 0.60). Married individuals had a better average health score compared to singles (p = 0.047). The average health score did not have a significant relationship with gender, but significantly related to age, field of study (p < 0.001), history of mental illnesses (p < 0.001) and Smoking (p < 0.001). Conclusion: It seems that university officials should pay more attention to the health domain of students' lifestyles, such as nutrition, the development of exercise and physical activities, and the management of stress and mental health. Additionally, providing necessary awareness and considering training courses, as well as developing sports and recreational facilities, can be effective in creating a better environment for the growth and development of students and ensuring their well-being.

Integrated approaches for heavy metal-contaminated soil remediation: harnessing the potential of Paulownia elongata S. Y. Hu, Oscillatoria sp., arbuscular mycorrhizal fungi (Glomus mosseae and Glomus intraradices), and iron nanoparticles.

In recent years, researchers have extensively investigated the remediation of heavy metal-contaminated soil using plants, microorganisms, and iron nanoparticles. The objective of this study was to investigate and compare the individual and simultaneous effects of Paulownia elongata S. Y. Hu, cyanobacteria (Oscillatoria sp.), arbuscular mycorrhizal fungi (AMF) including Glomus mosseae and Glomus intraradices, and zero-valent iron nanoparticles (nZVI) on the remediation of heavy metal-contaminated soil containing chromium (Cr VI and Cr III) and nickel (Ni). The study found significant variations in parameters such as pH (acidity), electrical conductivity (EC), nitrogen (N), phosphorus (P), potassium (K), and organic carbon (OC) among different treatments. The addition of cyanobacteria, AMF, and nZVI influenced these properties, resulting in both increases and decreases compared to the control treatment. The treatment involving a combination of cyanobacteria, AMF, and nZVI (CCAN25) exhibited the highest increase in growth parameters, such as total dry mass, root length, stem diameter, and leaf area, while other treatments showed varied effects on plant growth. Moreover, the CCAN25 treatment demonstrated the highest increase in chlorophyll a, chlorophyll b, and carotenoid levels, whereas other treatments displayed reductions in these pigments compared to the control. Moderate phytoaccumulation of Cr and Ni in P. elongata samples across all treatments was observed, as indicated by the bioconcentration factor and bioaccumulation coefficient values being less than 1.0 for both metals. The findings provide insights into the potential application of these treatments for soil remediation and plant growth enhancement in contaminated environments.

The effect of lemon inhalation aromatherapy on pain, nausea, as well as vomiting and neurovascular assessment in patients for lower extremity fracture surgery: a randomized trial.

BACKGROUND: Complementary and integrative medicine may be effective for postoperative outcomes. This study aimed to determine the effect of lemon inhalation aromatherapy on pain, nausea, and vomiting and neurovascular assessment in patients for lower extremity fracture surgery. METHODS: This is a randomized clinical trial study. Ninety patients who had undergone lower extremity fracture surgery were randomly assigned to the intervention (lemon aromatherapy) and control groups. Lemon aromatherapy was started in the morning of the surgery and extended at two-hour intervals until the end of the surgery, in the recovery room, and 16 h after surgery. Numerical pain and nausea and vomiting scales, the Rhodes Index of Nausea, Vomiting, and Retching, and the WACHS Neurovascular Observation Chart were used to assess the outcomes before and after the intervention (in the recovery room and 4, 8, 12, and 16 h post-surgery). The data were analyzed using the Wilcoxon test, ANCOVA, and Repeated Measure ANCOVA. RESULTS: A significant difference was observed between the groups in terms of the intensity of pain (P < 0.001) and nausea and vomiting (P = 0.001) during the study period. Moreover, a significant difference was found between groups as to the frequency and severity of nausea, vomiting, and retching. The amount and duration of postoperative vomiting and nausea were significantly lower in the intervention group compared to the control group. In addition, lemon inhalation aromatherapy decreased the frequency of anti-emetic drug administration in the recovery room (P = 0.04) and 16 h post-surgery (P = 0.03). CONCLUSIONS: This study indicated that aromatherapy reduced pain intensity, postoperative nausea, vomiting, and retching, as well as the incidence of anti-emetic drug administration. Therefore, using lemon inhalation aromatherapy to relieve pain and reduce nausea and vomiting is suggested for lower extremity fracture patients who have undergone surgery. TRIAL REGISTRATION: This study was registered in the Iranian Registry of Clinical Trail (Number = 57,331, IRCT20130616013690N10, approved 24/07/2021) ( https://www.irct.ir/trial/57331 ).

ZnO nanoparticles efficiently enhance drought tolerance in Dracocephalum kotschyi through altering physiological, biochemical and elemental contents.

Using nanofertilizers in certain concentrations can be a novel method to alleviate drought stress effects in plants as a global climate problem. We aimed to determine the impacts of zinc nanoparticles (ZnO-N) and zinc sulfate (ZnSO4) fertilizers on the improvement of drought tolerance in Dracocephalum kotschyi as a medicinal-ornamental plant. Plants were treated with three doses of ZnO-N and ZnSO4 (0, 10, and 20 mg/l) under two levels of drought stress [50% and 100% field capacity (FC)]. Relative water content (RWC), electrolyte conductivity (EC), chlorophyll, sugar, proline, protein, superoxide dismutase (SOD), polyphenol oxidase (PPO) and, guaiacol peroxidase (GPO) were measured. Moreover, the concentration of some elements interacting with Zn was reported using the SEM-EDX method. Results indicated that foliar fertilization of D. kotschyi under drought stress with ZnO-N decreased EC, while ZnSO4 application was less effective. Moreover, sugar and proline content as well as activity of SOD and GPO (and to some extent PPO) in treated plants by 50% FC, increased under the influence of ZnO-N. ZnSO4 application could increase chlorophyll and protein content and PPO activity in this plant under drought stress. Based on the results, ZnO-N and then ZnSO4 improved the drought tolerance of D. kotschyi through their positive effects on physiological and biochemical attributes changing the concentration of Zn, P, Cu, and Fe. Accordingly, due to the increased sugar and proline content and also antioxidant enzyme activity (SOD, GPO, and to some extent PPO) on enhancing drought tolerance in this plant, ZnO-N fertilization is advisable.

Effects of nutrition education via a mobile-based game on nutritional knowledge, dietary habits and anthropometric indices in preschool children: A study protocol.

Preschool age is a great time to learn a healthy lifestyle, for behavior therapy. Mobile health procedures are inexpensive, reliable, and accessible. This project has two phases. The KidFood mobile game and two nutrition knowledge questionnaires were designed during the first phase. In the second phase, a six-month, parallel, blinded, randomized controlled trial will perform on 120 Iranian children aged 5 to 6 years. Before and after nutritional education via KidFood, the dietary habits, the nutritional knowledge of parents and children, and the anthropometric indices of children will be evaluated.

Surviving surgery; succumbing to pharmacotherapy: A case report underscoring the importance of PRN order clarification for patient safety.

"Pro re nata" (PRN) or "as needed" medicine administration and usage is a relatively neglected area in medication management (pharmacotherapy/pharmaceutical care) which contributes to error-prone use of medications and is unsafe for patients. In this case, we report the incident of diclofenac toxicity in a 51-year-old woman due to a prescription of 100 mg diclofenac suppositories PRN, or as needed, for postoperative pain control without explanation of the maximum daily dose (150 mg daily), which led to arbitrary consumption of 3 g of diclofenac over 5 days (600 mg daily) by the patient, and subsequent development of metabolic acidosis, acute kidney injury, and sudden cardiac arrest. The implementation of practical guidelines and training programs for health care workers to appropriately prescribe, dispense, and administer PRN medicines are necessary, and should at least include providing clarification for their indication, dose and frequency, as well as any cautionary instructions to ensure safe and effective use of such medicines.

The effect of video-based multimedia training on knowledge, attitude, and performance in breast self-examination.

BACKGROUND/OBJECTIVES: Breast neoplasm is one of the most common cancers in Iranian women due to the late diagnosis. Awareness of breast neoplasm and using Breast Self-Examination (BSE) assist in the early detection and treatment of cancer. This study examined the effectiveness of video-based multimedia training versus face-to-face training in awareness of breast neoplasm and BSE and possible factors affecting their effectiveness. METHODS: This research was a pre-test, a post-test experimental study comparing the knowledge, attitude, and performance of women about BSE across two training intervention groups (face-to-face versus video-based multimedia). The study was conducted at Shiraz University of Medical Sciences (SUMS), and 100 women between 20 to 60 years old were allocated to each intervention group via multi-stage cluster sampling (n:110). Three valid and reliable researcher-made questioners were used. Data were analyzed using SPSS 24 with independent t-test, paired t-test, and ANOVA. RESULTS: Both video-based multimedia and face-to-face training methods significantly increased the participant's knowledge, attitude, and skills about breast self-examination (P < 0.001). In the sub-categories, the results showed that the face-to-face training improved negligence and forgetfulness in applying BSE (P = 0.03) and correcting or modifying the previous knowledge around the issue (P = 0.02). The effect of the video-based method on participants with university education was more than on non-university (P = 0.04). CONCLUSION: Incorporating video-based multimedia training in awareness of breast neoplasm and breast self-examination provides an easy, flexible, and affordable way for detection, particularly considering crisis restrictions. This can be of particular attention in more populated, developing/low-income countries and rural and remote areas to enhance equitable access to training and facilitation diagnosis and treatment if applicable.

Chitosan nanoparticles improve physiological and biochemical responses of Salvia abrotanoides (Kar.) under drought stress.

BACKGROUND: The use of organic nanoparticles to improve drought resistance and water demand characteristics in plants seems to be a promising eco-friendly strategy for water resource management in arid and semi-arid areas. This study aimed to investigate the effect of chitosan nanoparticles (CNPs) (0, 30, 60 and 90 ppm) on some physiological, biochemical, and anatomical responses of Salvia abrotanoides under multiple irrigation regimes (30% (severe), 50% (medium) and 100% (control) field capacity). RESULTS: The results showed that drought stress decreases almost all biochemical parameters. However, foliar application of CNPs mitigated the effects caused by drought stress. This elicitor decreased electrolyte conductivity (35%), but improved relative water content (12.65%), total chlorophyll (63%), carotenoids (68%), phenol (23.1%), flavonoid (36.4%), soluble sugar (58%), proline (49%), protein (45.2%) in S. abrotanoides plants compared to the control (CNPs = 0). Furthermore, the activity of antioxidant enzymes superoxide dismutase (86%), polyphenol oxidase (72.8%), and guaiacol peroxidase (75.7%) were enhanced after CNPs treatment to reduce the effects of water deficit. Also, the CNPs led to an increase in stomatal density (5.2 and 6.6%) while decreasing stomatal aperture size (50 and 25%) and semi-closed stomata (26 and 53%) in leaves. CONCLUSION: The findings show that CNPs not only can considerably reduce water requirement of S. abrotanoides but also are able to enhance the drought tolerance ability of this plant particularly in drought-prone areas.

The quality of reporting general safety parameters and immune-related adverse events in clinical trials of FDA-approved immune checkpoint inhibitors.

BACKGROUND: While immune-checkpoint inhibitors (ICIs) have transformed the field of oncology for advanced-stage cancers, they can lead to serious immune toxicities. Several systematic reviews have evaluated the risk of immune-related adverse events (irAEs); however, most have focused on published articles without evaluating trial registries. The objective of this methodological review was to compare the quality of reporting of safety information and in particular, serious irAEs (irSAEs), in both publications and ClinicalTrials.gov for all current FDA-approved ICIs. METHODS: PubMed was searched to retrieve all published phase III randomized controlled trials (RCTs) evaluating ICIs. For each eligible trial, we searched for corresponding registration on ClinicalTrials.gov and extracted relevant safety data from both the publication and results posted on registry. We then compared the quality of reporting and the value of safety data between both sources. RESULTS: Of 42 eligible published trials, 34 had results posted on ClinicalTrials.gov . Considerable variability was noted in the reporting of safety in both sources. SAEs were reported for all trial results in ClinicalTrials.gov compared to 23.5% of publications. An overall incidence for irAEs and irSAEs was reported in 58.8 and 8.8% of publications respectively, compared to 11.8 and 5.9% in registry results. Comparing the value of specific irSAEs was not possible between the two sources in 32/34 trials either due to different reporting formats (61.8%) or data not being reported in one or both sources (32.4%). From the 2 studies with compatible irSAE format, only 1 had matching data in both sources. CONCLUSIONS: The reporting of irAEs / irSAEs varies considerably in publications and registries, which outlines the importance of standardizing the terminologies and methodologies for reporting safety information relevant to ICIs.

Medication Errors Associated With Adverse Drug Reactions in Iran (2015-2017): A P-Method Approach.

Medication errors are the second most common cause of adverse patient safety incidents and the single most common preventable cause of adverse events in medical practice. Given the high human fatalities and financial burden of medication errors for healthcare systems worldwide, reducing their occurrence is a global priority. Therefore, appropriate policies to reduce medication errors, using national data and valid statistics are required. The primary objective of this study was to provide a national 'characteristic profile' of medication error-associated adverse drug reactions (ADRs), which are also known as preventable ADRs (pADRs). A retrospective study of pADR reports submitted to the national pharmacovigilance center (PCV) within Iran's Food and Drug Administration was conducted over a 2-year period (2015-2017). Preventability Method (P-Method), which is a standardized tool developed and recommended by the World Health Organization (WHO), was used for preventability assessment. The results of the analyses revealed that while the number of pADRs increased from year one to two (601 to 630), their proportion out of all ADRs per year decreased (7.32% to 6.44%). The percentage of pADRs was higher in females (61.01%) and adults (83.27%), and the highest number of reports were received by nurses (71.57%). Having 'a documented hypersensitivity to an administered drug or drug class' was the most common preventable factor in both years (61.23% and 54.29% respectively), and 'anti-infectives used systemically' were the medication class which primarily contributed to both serious (53.29%) and non-serious pADRs (39.19%). The specific characteristics of medication errors associated with ADRs from this study, especially the preventable criteria which led to their occurrence, can help devise more specific preventative policies.

Does Opium Dependency Affect the Pattern of Involvement in Laryngeal Cancer?

INTRODUCTION: Laryngeal cancer is the second most common cancer involving the respiratory tract, second only to lung cancer. Previous studies have shown opium dependency to be a possible risk factor for laryngeal cancer. Opium consumption is a major problem in some parts of the world. The aim of this study was to investigate the effect of opium consumption on the pattern of involvement in laryngeal cancer. METHODS AND MATERIALS: In this analytical cross-sectional study, 44 patients diagnosed with laryngeal cancer (41 male and three female) were studied. Data were collected using a questionnaire, physical examination, and paraclinical studies. Patients were defined as opium dependent based on the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) criteria and duration of opium consumption. RESULTS: Patients were categorized into two groups: opium-dependent (32.6%) and non-opium-dependent (67.4%) patients. The average age of the patients was 58.5±3.2 years in the opium-dependent group and 60.7±2.8 years in the non-opium-dependent group (P=non-significant). An analysis of the pattern of involvement in each group showed glottis involvement in 56%, subglottis involvement in 8%, supraglottis involvement in 32%, and hypopharyngeal involvement in 4% of the opium-dependent group compared with glottis involvement in 55.9%, subglottis involvement in 11.8%, supraglottis involvement in 32.4%, and hypopharyngeal involvement in none of the non-opium-dependent group (P=non-significant). CONCLUSION: There was a poor correlation between opium dependency and pattern of involvement in laryngeal cancer. Opium dependency did not lead to the development of laryngeal cancer at a younger age, based on our study.

ABCB1-C3435T polymorphism and breast cancer risk: a case-control study and a meta-analysis.

PURPOSE: To investigate the association of ABCB1-C3435T transition with breast cancer risk which was followed by a meta-analysis. METHODS: In a case-control study we collected blood samples from 290 women (including 150 breast cancer patients and 140 healthy controls). ABCB1-C3435T genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. A meta-analysis was performed for a total of 13 eligible studies involving 5,835 cases and 8,178 controls. RESULTS: The results of case-control study revealed a significant association between T allele (OR=1.770, 95%CI=1.236-2.535, p=0.002), CT genotype (OR=1.661, 95%CI=1.017-2.713, p=0.042), and TT genotype (OR=3.399, 95%CI=1.409-8.197, p=0.006) with breast cancer risk. Data from meta-analysis revealed a significant association between ABCB1-C3435T polymorphism and breast cancer risk in allelic (OR=1.243, 95%CI=1.079-1.432, p=0.003), co-dominant (OR=1.349, 95%CI=1.042-1.746, p=0.023), dominant (OR=1.204, 95%CI=1.019-1.422, p=0.029), and recessive (OR=1.226, 95%CI=1.011-1.488, p=0.039) models. CONCLUSIONS: The results suggest that the ABCB1-C3435T gene polymorphism might be a genetic risk factor and a potential biomarker for breast cancer.