Changes in MCP-1, HGF, and IGF-1 expression in endometrial stromal cells, PBMCs, and PFMCs of endometriotic women following 1,25(OH)2D3 treatment.

1,25(OH)2D3 has anti-inflammatory and growth inhibitory effects. Our study explored the effect of 1,25(OH)2D3 treatment on the expression of monocyte chemotactic protein-1 (MCP-1), hepatocyte growth factor (HGF), and insulin-like growth factor-1 (IGF-1) by peripheral blood mononuclear cells (PBMCs), peritoneal fluid mononuclear cells (PFMCs), endometrial stromal cells (ESCs), and its effect on the proliferation of PBMCs and PFMCs of patients with endometriosis compared with controls. PBMCs, PFMCs, and ESCs were obtained from 10 endometriosis patients and 10 non-endometriotic individuals. After treating cells with 0.1 µM of 1,25(OH)2D3 for 6, 24, and 48 h, the gene and protein expression of mentioned factors were evaluated by real-time PCR and ELISA methods, respectively. 1,25(OH)2D3 treatment significantly reduced the protein expression of MCP-1, HGF, and IGF-1 in PBMCs and PFMCs of endometriotic patients at 48 h (p < 0.05-<0.01). Also, this treatment significantly reduced MCP-1, HGF, and IGF-1 gene and/or protein expression in EESCs and EuESCs at 24 and 48 h (p < 0.05-<0.01). 1,25(OH)2D3 treatment also reduced the proliferation of PBMCs and PFMCs of endometriotic patients compared with controls (p < 0.01). 1,25(OH)2D3 can be considered as a potentially effective agent in the prevention and treatment of endometriosis along with other therapies.

The Relationship of Death Anxiety With Quality of Life and Social Support in Hemodialysis Patients.

This study aimed to determine the relationship of death anxiety with quality of life and social support in hemodialysis patients. This cross-sectional research was conducted on 226 patients with chronic renal failure. The results indicated that the means and standard deviations of MSPSS, QoL, and death anxiety of patients were 57.4 ± 10.1, 28.8 ± 5.9, and 42.5 ± 4.1, respectively. A significant negative correlation was found between QoL scores and death anxiety in hemodialysis patients (p = 0.007, r = -0.179). However, there was no statistically significant relationship between MSPSS scores and patients' death anxiety. The total score of patients' death anxiety decreased with increasing the total QoL score (p < 0.001, b = -0.18). Different variables that can affect death anxiety and QoL should be identified in the patient examination process. Also, the health care system should consider necessary planning to increase the QoL and reduce death anxiety.

Hantavirus infection in Iranian patients suspected to viral hemorrhagic fever.

BACKGROUND: Hantaviruses are a group of emerging pathogens causing hemorrhagic fever with renal syndrome and Hantavirus cardiopulmonary syndrome in human. This study was conducted to investigate Hantavirus infection among Iranian viral hemorrhagic fever suspected patients. METHODS: From April 2014 to June 2016, 113 cases from 25 different provinces of Iran were analyzed for Hantavirus infection by IgM/IgG ELISA and pan-Hantavirus RT-PCR tests. RESULTS: Although, viral genome was detected in none of the subjects, IgM and IgG antibodies were detected in 19 and 4 cases, respectively. Differentiation of the anti-Hantavirus antibodies according to virus species by EUROLINE Anti-Hantavirus Profile Kit revealed three Puumala virus IgM positive, one Hantaan virus IgM positive, one Hantaan virus IgM borderline, and two Puumala virus IgG borderline cases. CONCLUSIONS: This study demonstrates the circulation of Hantaviruses in Iran and calls for further investigations of these life-threatening viruses in the country.

Imported cases of Chikungunya virus in Iran.

BACKGROUND: Chikungunya virus (CHIKV) is a widespread mosquito-borne virus representing a serious challenge to public health. The largest outbreak in the Middle-East was recorded in 2016-2017 in Pakistan. Sistan and Baluchistan Province of Iran shares a wide border with Pakistan; accordingly, introduction of CHIKV from Pakistan to Iran seems to be probable. The current study is aimed at investigating CHIKV infection in Sistan and Baluchistan Province. METHODS: Between April 2017 and June 2018, a total of 159 serum samples of CHIK suspected cases from 10 cities of Sistan and Baluchistan Province were tested by molecular and serological assays. Samples obtained up to 4 days after onset of illness were tested by real time PCR (n = 8). Samples collected 5-10 days after disease onset were subjected to ELISA, as well as real time PCR tests (n = 72). Samples obtained after the 10th day of disease onset were tested by only ELISA (n = 79). Phylogenetic analysis of real time PCR positive samples was carried out by sequencing of a 1014-bp region of Envelope 1 gene (E1 gene). Chi-square and independent t tests were used to evaluate the association between variables and CHIKV infection. RESULTS: In total, 40 (25.1%) out of 159 samples tested positive either by real time PCR or ELISA tests.Out of 151 samples serologically analyzed, 19 (12.6%) and 28 (18.6%) cases were positive for anti-CHIKV IgM and anti-CHIKV IgG antibodies, respectively. Of 80 samples tested by real time PCR, CHIKV RNA was detected in 11 (13.7%) sera, all of them had recent travel history to Pakistan. Additionally, phylogenetic analysis of 5 samples indicated their similarity with recent isolates of Pakistan outbreak 2016-2017 belonging to Indian Ocean sub-lineage of ECSA genotype. A significant correlation between abroad travel history and CHIKV infection was observed (P < 0.001). The most common clinical symptoms included fever, arthralgia/arthritis, myalgia, headache, and chill. CONCLUSIONS: These results present substantial evidence of CHIKV introduction to Iran from Pakistan and emphasize the need for the enhancement of surveillance system and preventive measures.

Resveratrol reduces the expression of insulin-like growth factor-1 and hepatocyte growth factor in stromal cells of women with endometriosis compared with nonendometriotic women.

Resveratrol, a phytoalexin polyphenol, has antiproliferative, antiangiogenic, anti-inflammatory, and antioxidant properties. The present study has assessed the effect of resveratrol treatment on the expression of insulin-like growth factor-1 (IGF-1) and hepatocyte growth factor (HGF) in endometrial stromal cells (ESCs) from women with and without endometriosis. Endometrial tissues were obtained from 40 endometriotic patients and 15 nonendometriotic control women. After the enzymatic digestion, 13 eutopic ESCs (EuESCs), 8 ectopic ESCs (EESCs), and 11 control ESCs (CESCs) were treated with resveratrol (100 µM) for 6, 24, and 48 hr. The gene and protein expressions of IGF-1 and HGF were measured using real-time polymerase chain reaction and enzyme-linked immunosorbent assay methods, respectively. Results showed that resveratrol treatment decreased significantly the gene expression of IGF-1 and HGF in EuESCs, EESCs, and CESCs (p < 0.05). The effect of resveratrol treatment on the reduction of IGF-1 gene expression was statistically more noticeable in EESCs compared with CESCs (p < 0.05). Also, in the case of HGF gene expression, the reducing effect of resveratrol treatment was statistically more considerable in EESCs compared with EuESCs and CESCs (p < 0.05 and p < 0.01, respectively). The IGF-1 and HGF protein production decreased significantly in EuESCs and EESCs (p < 0.05) but not in CESCs. These findings suggest that resveratrol treatment could reduce the expression of IGF-1 and HGF in ESCs especially in EESCs, which play a pivotal role in disease progression.

Barriers to nurses reporting errors and adverse events.

AIM: this study aimed to assess nurses' views about major barriers to reporting errors and adverse events in intensive care units. METHOD: a descriptive analytical study was used to examine barriers to reporting such events. A questionnaire was completed by 251 nurses across seven hospitals in Iran to elicit information about their views on reporting errors and adverse events. RESULTS: the study identified three main areas that prevented the reporting of incidents-fear of the consequences after reporting an error, procedural barriers and management barriers. CONCLUSION: the most important approach to overcoming barriers that prevent nurses reporting adverse events would be to develop an atmosphere within which all nurses can report errors and the reasons that led to their occurrence honestly and without fear.

Crimean-Congo hemorrhagic fever among children in Iran.

Crimean-Congo hemorrhagic fever (CCHF) is a viral zoonotic disease which is endemic in Iran. The etiological agent of CCHF is an RNA virus belonging to the genus Nairovirus of the family Bunyaviridae. CCHF virus (CCHFV) can be transmitted to humans through bites from infected ticks and direct contact with infected blood or tissues. Although the disease has been observed in different age groups, the rate of disease is lower in children and elderly. This study was designed to characterize CCHFV-infected children in Iran. Between 2000 and 2016, a total of 908 CCHF suspected cases (in children less than 19 years old) were evaluated for CCHFV infection by CCHF IgM ELISA and RT-PCR. CCHFV infection was observed in 161 (17.73%) of subjects. Most CCHF positive children were male (70.8%) and >15 years of age (65.8%). Contact with livestock was the main risk factor (35.4%). Sistan and Baluchestan provinces had the highest frequency within the infected cohort (68.3%). The overall mortality rate was 11.8%. This study also revealed a significant reduction in CCHF-fatality rates in Iranian children when compared to earlier studies in Iran. Having contact with livestock was the major risk factor and CCHF was more common in male children of an older age.

Ru-Ni nanoparticles electrodeposited on rGO/Ni foam as a binder-free, stable and high-performance anode catalyst for direct hydrazine fuel cell.

Bimetallic Ru-Ni nanoparticles was synthesized on the reduced graphene oxide decorated Ni foam (Ru-Ni/rGO/NF) by electroplating method to be utilized as the anode electrocatalyst for direct hydrazine-hydrogen peroxide fuel cells (DHzHPFCs). The synthesized electrocatalysts were characterized by X-ray diffraction, Field emission scanning electron microscopy, Fourier transform infrared spectroscopy, and Raman spectroscopy. The electrochemical properties of catalysts towards hydrazine oxidation reaction in an alkaline medium were evaluated by cyclic voltammetry, chronoamperometry, and electrochemical impedance spectroscopy. In the case of Ru1-Ni3/rGO/NF electrocatalyst, Ru1-Ni3 provided active sites due to low activation energy (22.24 kJ mol-1) for hydrazine oxidation reaction and reduced graphene oxide facilitated charge transfer by increasing electroactive surface area (EASA = 677.5 cm2) with the small charge transfer resistance (0.1 Ω cm2). The CV curves showed that hydrazine oxidation on the synthesized electrocatalysts was a first-order reaction in low concentrations of N2H4 and the number of exchanged electrons was 3.0. In the single cell of the of direct hydrazine-hydrogen peroxide fuel cell, the maximum power density value of Ru1-Ni3/rGO/NF electrocatalyst was 206 mW cm-2 and the open circuit voltage was 1.73 V at 55 °C. These results proved that the Ru1-Ni3/rGO/NF is a promising candidate for using as the free-binder anode electrocatalyst in the future application of direct hydrazine-hydrogen peroxide fuel cells due to its excellent structural stability, ease of synthesis, low cost, and high catalytic performance.

Respiratory Support and Clinical Outcomes in Critically Ill Patients with COVID-19 in Intensive Care Unit: A Retrospective Study.

Background: Appropriate respiratory support is crucial for improving the clinical outcomes of critically ill patients infected with the SARS-CoV-2 virus. This study aimed to investigate the different modalities of respiratory support and clinical outcomes in patients with COVID-19 in intensive care units (ICUs). Materials and Methods: In a retrospective study, we enrolled 290 critically ill COVID-19 patients who were admitted to the ICUs of four hospitals in Mazandaran, northern Iran. Data were extracted from the medical records of all included patients, from December 2019 to July 2021. Patients' demographic data, symptoms, laboratory findings, comorbidities, treatment, and clinical outcomes were collected. Results: 46.55% of patients died. Patients with ≥2 comorbidities had significantly increased odds of death (OR=5.88, 95%CI: 1.97-17.52, P=0.001) as compared with patients with no comorbidities. Respiratory support methods such as face mask (survived=37, deceased=18, P=0.022), a non-rebreather mask (survived=39, deceased=12, P<0.001), and synchronized intermittent mandatory ventilation (SIMV) (survived=103, deceased=110, P=0.004) were associated with in-hospital mortality. Duration of respiratory support in nasal cannula (survived=3, deceased=2, P<0.001), face mask (survived=3, deceased=2, P<0.001), a non-rebreather mask (survived=3, deceased=2, P=0.033), mechanical ventilation (survived=5, deceased=6, P<0.019), continuous positive airway pressure (CPAP) (survived=3, deceased=2, P<0.017), and SIMV (survived=4, deceased=5, P=0.001) methods were associated with higher in-hospital mortality. Conclusion: Special attention should be paid to COVID-19 patients with more than two comorbidities. As a specific point of interest, SIMV may increase the in-hospital mortality rate of critically ill patients with COVID-19 connected to mechanical ventilation and be associated with adverse outcomes.

Does intraoperative ciprofloxacin-soaked gelfoam have adverse effects on graft success rate? A randomized, double-blind controlled trial.

OBJECTIVES: The aim of this study was to evaluate whether intraoperative ciprofloxacin-soaked gelfoam is safe in tympanoplasty or not. METHOD: In this randomized, double-blind controlled clinical study, we included 100 patients between 18 and 60 years old, having perforation ≥50% of the tympanic membrane and dry ear for at least 2 months who were a candidate for underlay tympanoplasty via postauricular approach. We used ciprofloxacin soaked gelfoam in the case group and betamethasone soaked gelfoam in the control group for packing the middle ear cavity and external auditory canal during their operation. The graft success rate and tympanogram after 6 months follow-up period was considered as the primary outcome. Also, we evaluated the postoperative hearing results 6 months after the surgery as the secondary outcomes. RESULTS: Postoperative microscopic otoscopy showed a graft success rate of 100% (44/44) and 97.7% (42/43) in the case and control groups, respectively. The level of improvement between the two groups was not significant for air-bone gap (ciprofloxacin: 9.01 ± 7.89 dB, betamethasone 5.31 ± 10.53 dB, P = .160), and speech reception thresholds (SRT; ciprofloxacin: 10.23 ± 8.62 dB, betamethasone 7.33 ± 12.60 dB, P = .260). 93.2% of all the ears in the case group and 81.4% of those in the control group achieved postoperative air-bone gap within 20 dB, but the difference between them was not significant (P = .118). CONCLUSIONS: We found that the application of ciprofloxacin impregnated gelfoam in the middle ear, and the external auditory canal had no adverse effect on the graft success rate in tympanoplasty. LEVELS OF EVIDENCE: 1b.

Vitamin D deficiency as a risk factor for endometriosis in Iranian women.

PURPOSE: Vitamin D (Vit D), as an immunomodulator, has been hypothesized to play a critical role in the pathogenesis of endometriosis. Thus, in this study, we evaluated whether there is an association between 25-hydroxyvitamin D [25(OH)D] and susceptibility to endometriosis in Iranian women. METHODS: Women at reproductive age, including 56 healthy women and 54 patients with endometriosis, were enrolled in the study. Serum levels of 25(OH)D, calcium, parathyroid hormone (PTH), and peritoneal fluid (PF) levels of 25(OH)D were assessed. RESULTS: The serum and PF levels of 25(OH)D in the patients with endometriosis were significantly lower than the control group (P = 0.001 and P = 0.03, respectively). Subjects with serum levels of 25(OH)D lower than 20 ng/mL had a 2.7 times higher risk of endometriosis than people with 25(OH)D serum levels higher than 20 ng/mL (non-deficient) (OR = 2.7, 95 % confidence interval: 1.24-5.80, P = 0.01). The serum levels of calcium and PTH were significantly lower and higher in patients with endometriosis compared with controls, respectively (P < 0.001, P = 0.02, respectively). Also, the serum levels of 25(OH)D were lower in stages I-II endometriosis than stage III-IV; however, no significant difference was observed. CONCLUSION: Our findings showed that people with Vit D deficiency are at higher risk of endometriosis.

The Correlation between Head of Bed Angle and Intra-Abdominal Pressure of Intubated Patients; a Pre-Post Clinical Trial.

INTRODUCTION: The recommended position for measuring Intra-Abdominal Pressure (IAP) is the supine position. However, patients put in this position are prone to Ventilator-associated pneumonia. This study was done to evaluate the relationship between bed head angle and IAP measurements of intubated patients in the intensive care unit. METHODS: In this clinical trial, seventy-six critically ill patients under mechanical ventilation were enrolled. IAP measurement was performed every 8 hours for 24 hours using the KORN method in three different degrees of the head of bed (HOB) elevation (0 ° , 15 ° , and 30 ° ). Bland-Altman analysis was performed to identify the bias and limits of agreement among the three HOBs. According to World Society of the Abdominal Compartment Syndrome (WSACS), we can consider two IAP techniques equivalent if a bias of <1 mmHg and limits of agreement of - 4 to +4 were found between them. Data were analyzed using SPSS statistical software (v. 19), and the significance level was considered as 0.05. RESULTS: The prevalence of intra-abdominal hypertension was 18.42%. Mean ± standard deviation (SD) of IAP were 8.44 ± 4.02 mmHg for HOB angle 0°, 9.58 ± 4.52 for HOB angle 15 ° , and 11.10 ± 4.73 for HOB angle 30o (p = 0.0001). The IAP measurement bias between HOB angle 0°and HOB angle 15° was 1.13 mmHg. This bias was 2.66 mmHg between HOB angle 0° and HOB angle 30°. CONCLUSION: Elevation of HOB angle from 0 to 30 degree significantly increases IAP. It seems that the measurement of IAP at HOB angle 15° was more reliable than 30°.

Association Between Vitamin D Receptor (VDR) and Vitamin D Binding Protein (VDBP) Genes Polymorphisms to Endometriosis Susceptibility in Iranian Women.

Endometriosis is a chronic inflammatory disease that has been reported to be associated with immune system dysfunction. On the other hand, the effect of Vitamin D as an immune modulator and its relation with several autoimmune and inflammatory diseases has been previously investigated. Moreover, several studies have reported the polymorphisms of VDR and VDBP genes can change the functions of these molecules. Therefore, these polymorphisms may be influential on endometriosis pathogenesis. In this study, we aimed at evaluating the association between VDR gene (FokI (F/f), BsmI (B/b), ApaI (A/a), TaqI (T/t)), and VDBP gene (GC*1S, GC*1F, and GC*2) polymorphisms with endometriosis in Iranian women population. This case-control study was performed on 120 women with endometriosis and 110 healthy women. ARMS-PCR and PCR-RFLP methods were used to inspect polymorphisms in VDR and VDBP genes, respectively. Based on the results, there was no statistically significant difference between the cases with endometriosis and control subjects in terms of genotypes and allele frequencies of VDR and VDBP gene polymorphisms. These data suggest that VDR and VDBP gene polymorphisms may have no role in endometriosis susceptibility in Iranian women.

Corrigendum to 'How Iran responded to expanding need for laboratory services for COVID-19?'

[This corrects the article DOI: 10.1016/j.hlpt.2021.100506.].

How Iran responded to expanding need for laboratory services for COVID-19?

After the emergence of SARS-CoV-2 in early 2020 in Iran, the rapid response team of Pasteur Institute of Iran was the first lab starting detection and report of suspected human samples. This article is a short summery of all actions from the preparedness for detecting the first cases of COVID-19, expanding the nationwide laboratory service, choosing the suitable laboratory tests and other challenges in laboratory detection during SARS-CoV-2 pandemic in Iran.

Molecular Assay on Detection of Crimean Congo Hemorrhagic Fever (CCHF) Virus in Ixodid Ticks Collected from Livestock in Slaughterhouse from South of Iran.

BACKGROUND: Ticks are vectors of a wide variety of pathogens that can be transmitted to humans, and tick-borne diseases are a significant public health issue worldwide. The present study was carried out on the hard tick infestation of livestock transported to Rafsanjan slaughter house in the southeast of Iran. METHODS: A cross-sectional survey was carried out biweekly from April to September 2016 to determine tick infestation of the meat-producing animals. All the livestock included in our study were thoroughly inspected for the presence of hard ticks on different parts of their bodies. RESULTS: A total of 258 hard ticks were collected from the body of livestock hosts. The ticks that were sampled were classified into two genera and five species: Hyalomma marginatum, Hy. anatolicum, Hy. asiaticum, Hy. dromedarii, and Rhipicephalus sanguineus. Hyalomma dromedarii was the most abundant species in the study area. More than 50 percent of the sampled ticks were collected from the body of camels brought to the slaughter house however molecular analysis showed no Crimean Congo Hemorrhagic Fever (CCHF) virus infection in tick specimens. The Sex ratio of the sampled hard ticks shows that female tick infestation was more common among the study livestock. CONCLUSION: Due to the crucial role of hard ticks in the transmission of different pathogens to humans, additional investigations are necessary to determine the risk of consumption of infested meat-producing animals in the study area.

Assessment of Care and its Associated Factors in Traumatic Patients in North of Iran.

OBJECTIVE: To determine the status of pre-hospital emergency care and its associated factors in traumatic patients. METHODS: In across-sectional study, 577 traumatic patients who were transferred to Poursina hospital by EMS (Emergency Medical Services) personnel were selected by simple random sampling method. Pre-hospital emergency services were observed. Then the mean of taken measures scores for each domain was determined in percent and evaluated in terms of associated factors (age, working experience of staff and number of missions per day) and compared using Spearman's test. RESULTS: Out of 577 patients, 454 were men (78.7%) and 123 women (21.3%). Their mean age was 35.1 years old. Accident (82.7%) was the most common mechanism of injury. Most vehicles involved in the accident were light -weight cars (48.5%) and motorcycles (32.2%). A significant relationship was found between age, general domain (p=0.039) and hemodynamic (p=0.019) as well as between work experience and general domain (p=0.018). CONCLUSION: Given that pre-hospital emergency services provided in most of the domains are relatively far from world standard, results of this research can provide information for managers to improve strategic planning on care and medical services, appropriation of budget, knowledge of personnel and necessary equipment.

Synthesis and antimicrobial evaluation of some 2,5 disubstituted 1,3,4-oxadiazole derivatives.

1,3,4-oxadiazoles are interesting compounds because of their valuable biological effects such as cytotoxic, antibacterial, antifungal, and anti-tubercular activities. Ethyl mandelate was treated with hydrazine hydrate to yield the corresponding acylhydrazide. Some of the 2,5 disubstituted 1,3,4-oxadiazole derivatives were prepared from acylhydrazide using three different procedures. In the first procedure, acylhydrazide was reacted with nitro or chloro aroyle chloride to afford a diacylhydrazide which was cyclized to 2,5-disubstituted 1,3,4-oxadiazole in the presence of phosphoryl chloride as dehydrating agent. In the second procedure, furan-oxadiazole derivative was directly prepared from carboxylic acid and acylhydrazide in one step. In the third procedure, acyl hydrazide was condensed with 5-nitrofuraldehyde to yield 5-nitrofuran-2-yl) methylene)-2-phenyl acetohydrazide intermediate which was cyclized to form the nitrofuran-oxadiazole derivative by acetic anhydride as dehydrating agent. The structures of these compounds have been elucidated by spectral IR and 1H-NMR analysis. All the newly synthesized compounds were screened for their antibacterial and antifungal activities. Compounds F3 and F4 showed remarkable antibacterial activities against Staphylococcus aureus and Escherichia coli bacteria.

Traditional effects of medicinal plants in the treatment of respiratory diseases and disorders: an ethnobotanical study in the Urmia.

OBJECTIVE: To identify, present and review the respiratoty medicinal plants which used by Urmian herbalists. METHODS: The list of traditional healers of West Azarbaijan Province was prepared and data were obtained by direct observation, interviews and the questionnaires After that, herbarium samples were collected from the desired area and deposited in herbarium unit of the Faculty of Agriculture, Urmia University, Urmia, Iran. RESULTS: Our results demonstrated that 20 medicinal plants from 10 plant families are used to treat respiratory disorders. Also, the most plant part that used for treating of respiratory disorders was seed (27%) and the most traditional form prescribed by herbalists was boiled (54%). Forty three percentage of Urmia herbalists have used herbs for the treatment of cough. CONCLUSIONS: People in this area have a strong belief that plants have a positive impact in the treatment of respiratory disorders and they have used medicinal plants since ancient times to treat these disorders. Our study revealed the importance of herbal medicines and traditional medicine in this area as medicinal resource for drug discovery in future.