Effects of perioperative vitamin E and zinc co-supplementation on systemic inflammation and length of stay following coronary artery bypass graft surgery: a randomized controlled trial.

OBJECTIVES: Coronary artery bypass graft (CABG) surgery has been reported to be associated with lower postoperative plasma antioxidant and zinc levels. We hypothesized that perioperative supplementation of vitamin E and zinc might improve short-term postoperative outcomes. METHODS: In this placebo-controlled double-blind, randomized study, patients undergoing CABG performed with cardiopulmonary bypass were recruited. The intervention group received zinc and vitamin E supplementation (1200 IU vitamin E and 120 mg elemental zinc) the day before surgery, followed by postoperative daily supplementation of 30 mg zinc and 200 IU vitamin E from the 2nd day after surgery to 3 weeks. The control group received placebos. Length of stay (LOS) in the intensive care unit and hospital, sequential organ failure assessment score on 3rd day after surgery, and plasma inflammatory markers on days 3 and 21 post-surgery were evaluated. RESULTS: Seventy-eight patients completed the study (40 in the intervention group and 38 in the placebo group). The hospital LOS was significantly shorter (p < 0.05) in the intervention group. Postoperative changes in plasma albumin levels were not different between the two groups. The plasma zinc level was higher (p < 0.0001), but plasma C-reactive protein (p = 0.01), pentraxin 3 (p < 0.0001), interferon γ (p < 0.05), malondialdehyde (p < 0.05), and aspartate aminotransferase (p < 0.01) were lower in the intervention group compared to the placebo group. CONCLUSIONS: Perioperative vitamin E and zinc supplementation significantly reduced hospital LOS and the inflammatory response in CABG surgery patients. In these patients, the optimal combination and dose of micronutrients need further study but could include zinc and vitamin E. CLINICAL TRIAL REGISTRY: This trial was registered at ClinicalTrials.gov website (NCT05402826).

Antibiofilm and cytotoxic potential of extracellular biosynthesized gold nanoparticles using actinobacteria Amycolatopsis sp. KMN.

This study intends to biosynthesize gold nanoparticles (AuNPs) using Amycolatopsis sp. KMN and to investigate its potential antibiofilm, cytotoxic and antioxidant activities. The physicochemical characterization of biosynthesize AuNPs was identified by UV-Visible, energy-dispersive X-ray, and Fourier transform infrared spectroscopy, as well as high-resolution transmission electron microscopy, X-ray diffraction, zeta potential, and dynamic light scattering methods. Crystal violet assay and scanning electron microscopy showed that the AuNPs with a particle size of 44.4 nm have a strong antibiofilm activity (at 750 µg/ml concentration) against bacteria strains viz Staphylococcus aureus ATCC 29213, Escherichia coli ATCC 25922, and Pseudomonas aeruginosa ATCC 27853. The result also demonstrated strong cytotoxic activity against two cell lines, MCF-7 and HT-29. The MTT test result displayed that over a period of 48 hr, the IC50 of AuNPs was 600 and 300 µg/ml for MCF-7 and HT-29 cell lines, respectively. The IC50 of AuNPs against DPPH was 46.87 µg/ml. This is the first report that examines Amycolatopsis sp. strain KMN-mediated synthesis of AuNPs is rapid and in situ with antibiofilm and cytotoxicity activities. Moreover, it has the potential for an effective antibiofilm and cytotoxic activity that could be used in future therapeutic applications.

Low-dose gamma irradiation and pectin biodegradable nanocomposite coating containing curcumin nanoparticles and ajowan (Carum copticum) essential oil nanoemulsion for storage of chilled lamb loins.

The current investigation assessed the effect of pectin (PE) biodegradable nanocomposite coating containing curcumin nanoparticles (CNP) and ajowan (Carum copticum) essential oil nanoemulsion (ANE) combined with low-dose gamma irradiation on microbial, physiochemical, and sensorial qualities of lamb loins during refrigeration conditions. Active coating combined with gamma irradiation reduced the count number of mesophilic and psychrotrophic bacteria, lactic acid bacteria, Enterobacteriaceae; and minimized lipid and protein oxidation changes, total volatile basic nitrogen content, met-myoglobin formation, and color deterioration in the loin samples. The increased shelf-life of lamb loins up to 25 days compared with 5 days assigned for the control group can be associated with the application of ionizing radiation and edible PE coating containing CNP and ANE, which might be due to the synergistic or additive effects of treatments. Overall, as an effective preservation technique, a combination of PE + CNP + ANE and irradiation can be recommended for prolonging the shelf-life of lamb loins during refrigerated storage.

Antibacterial Activity of Prunus Scoparia Root Methanol Extract against Most Common Burn Wound Pathogens.

BACKGROUND: Burn wound infection and sepsis are serious medical conditions requiring prompt intervention. Plants are a good natural source for the development of novel, safe, and cost-effective antibacterial agents. The objective of the present study was to assess the antibacterial potential of aqueous, chloroform, and methanol extracts of the Prunus scoparia (P. scoparia) root against the most common burn wound pathogens. METHODS: The present experimental study was conducted at Shiraz University of Medical Sciences (Shiraz, Iran) during 2018-2019. The antibacterial activity of the total plant extract was assayed using the broth microdilution method. Fractionation was performed using a separation funnel and solvents with different polarities. Broth microdilution and agar well diffusion assays were performed to determine the antibacterial potential of the obtained fractions. Quantitative and qualitative phytochemical analyses were performed to confirm the presence of secondary metabolites in both the total extract and the fractions. RESULTS: Methanolic extract of P. scoparia root exhibited antibacterial activity against all tested bacterial strains, especially against Methicillin-resistant Staphylococcus aureus (MRSA) isolates. This extract, compared to the aqueous and chloroformic extracts, exhibited the presence of active antibacterial compounds. The quantitative and qualitative results of phytochemical screening showed that phenols and flavonoids were the main antibacterial compounds in the methanolic extract of the plant. CONCLUSION: For the first time, we demonstrated the antibacterial activity of the P. scoparia root against MRSA isolates and other common burn wound pathogens.

Predictors of Quality of Life in Patients with Heart Disease.

Individuals with heart disease have been found to have more negative psychological and physical effects that impact their quality of life (QoL) than the general population. Spiritual well-being is considered a protective factor associated with QoL in people with heart disease. Therefore, the current research seeks to evaluate whether sociodemographic factors and spiritual well-being predict QoL among patients with heart disease. A total of 500 patients who were selected through a convenient sampling method from an Iranian hospital participated in this descriptive-correlational study. Data were collected using the McGill QoL Questionnaire, the Spiritual Well-being Scale, and demographic variables. The data analysis included descriptive and inferential statistics powered by SPSS (v. 23). Following multivariate analyses, findings revealed that those participants with their main source of income derived from family or a government pension and with College or intermediate educational levels were more likely to have higher QoL. Those participants with average or poor socioeconomic status reported higher QoL than those who were more affluent. Furthermore, younger patients (- 0.2, 95% CI - 0.3 to - 0.003, p = 0.016) and those with higher social support (0.7, 95% CI 0.2 to 1.3, p = 0.006) and spiritual well-being (0.2, 95% CI 0.1 to 0.3, p < 0.001) had significantly better QoL. In the current study, spiritual well-being and social support led to reduced negative psychological sequelae and improved QoL in cardiac patients.

Spiritual well-being and moral distress among Iranian nurses.

BACKGROUND: Moral distress is increasingly recognized as a problem affecting healthcare professionals, especially nurses. If not addressed, it may create job dissatisfaction, withdrawal from the moral dimensions of patient care, or even encourage one to leave the profession. Spiritual well-being is a concept which is considered when dealing with problems and stress relating to a variety of issues. OBJECTIVE: This research aimed to examine the relationship between spiritual well-being and moral distress among a sample of Iranian nurses and also to study the determinant factors of moral distress and spiritual well-being in nurses. RESEARCH DESIGN: A cross-sectional, correlational design was employed to collect data from 193 nurses using the Spiritual Well-Being Scale and the Moral Distress Scale-Revised. ETHICAL CONSIDERATIONS: This study was approved by the Regional Committee of Medical Research Ethics. The ethical principles of voluntary participation, anonymity, and confidentiality were considered. FINDINGS: Mean scores of spiritual well-being and moral distress were 94.73 ± 15.89 and 109.56 ± 58.70, respectively. There was no significant correlation between spiritual well-being and moral distress (r = -.053, p = .462). Marital status and job satisfaction were found to be independent predictors of spiritual well-being. However, gender and educational levels were found to be independent predictors for moral distress. Age, working in rotation shifts, and a tendency to leave the current job also became significant after adjusting other factors for moral distress. DISCUSSION AND CONCLUSION: This study could not support the relationship between spiritual well-being and moral distress. However, the results showed that moral distress is related to many elements including individual ideals and differences as well as organizational factors. Informing nurses about moral distress and its consequences, establishing periodic consultations, and making some organizational arrangement may play an important role in the identification and management of moral distress and spiritual well-being.

Exploring the Relationship Between Spiritual Well-Being and Death Anxiety in Survivors of Acute Myocardial Infarction: Moderating Role of Sex, Marital Status and Social Support.

Previous empirical studies have shown that both spiritual well-being (SWB) and death anxiety (DA) significantly affect the mental health of patients with acute diseases. In this regard, our paper contributes to the extant literature by scrutinizing the conditional relationship between SWB and DA as well as the various mechanisms underpinning such a relationship in patients with acute myocardial infraction (AMI). A descriptive, correlational methodology was utilized. Our main sample consisted of 300 patients with acute myocardial infraction who were hospitalized in a specialized medical institution in Iran throughout a two-month period (i.e. August-October 2015). Patients completed Spiritual Well-Being Scale (SWBS) and Templer's Death Anxiety Scale (TDAS). Even though our study showed that the relationship between SWB and DA in patients with AMI is non-significant, we found that (1) single patients with higher SWB have lower DA, (2) single patients with higher SWB as well as social support have significantly lower DA, and (3) for single men/men without social support, there is a negative relationship between SWB and DA. The relationship between SWB and DA is influenced by factors such as sex, marital status and social support. In addition, the specific nature of this relationship (i.e. strength and sign) is dependent upon the sociodemographic characteristics of patients as well as other contextual influences. Result revealed that although relationship between SWB and DA is non-significant, this is influenced by factors such as sex and social support. In addition, the specific nature of this relationship (i.e. strength and sign) is dependent upon the sociodemographic characteristics of patients as well as other contextual influences.

The Factor Structure of the Spiritual Well-Being Scale in Veterans Experienced Chemical Weapon Exposure.

This study aimed to determine the factor structure of the spiritual well-being among a sample of the Iranian veterans. In this methodological research, 211 male veterans of Iran-Iraq warfare completed the Paloutzian and Ellison spiritual well-being scale. Maximum likelihood (ML) with oblique rotation was used to assess domain structure of the spiritual well-being. The construct validity of the scale was assessed using confirmatory factor analysis (CFA), convergent validity, and discriminant validity. Reliability was evaluated with Cronbach's alpha, Theta (θ), and McDonald Omega (Ω) coefficients, intra-class correlation coefficient (ICC), and construct reliability (CR). Results of ML and CFA suggested three factors which were labeled "relationship with God," "belief in fate and destiny," and "life optimism." The ICC, coefficients of the internal consistency, and CR were >.7 for the factors of the scale. Convergent validity and discriminant validity did not fulfill the requirements. The Persian version of spiritual well-being scale demonstrated suitable validity and reliability among the veterans of Iran-Iraq warfare.

Relationship Between Spiritual Well-Being and Hope in Patients with Cardiovascular Disease.

Spirituality and hope have been identified as important constructs in health research, since both are thought to enhance a person's ability to cope with the consequences of serious illness. The aim of this study was to examine the relationship between spiritual well-being and hope in patients with cardiovascular disease. Using descriptive, correlational methodology, the investigator gathered data on a convenience sample of 500 patients with cardiovascular disease who were hospitalized in a medical institution in Iran. The study was conducted over a four-month period. Participants completed a demographic questionnaire, the Spiritual Well-Being Scale (SWBS) and the Herth Hope Index (HHI). The mean score on the SWBS and HHI was 86.21 (SD 12.46) and 34.80 (SD 5.05), respectively. Multivariate predictors for spiritual well-being were female gender (p = 0.047), religiosity (p = 0.018), and hope (p < 0.001). Significant predictors of hope were marital status (p < 0.001), educational status (p < 0.001), economic status (p < 0.001), and spiritual well-being (p < 0.001). Findings suggest that multiple factors may impact spiritual well-being and hope. Therefore, this study has implications for those providing care to patients with cardiovascular disease.

Effect of acupressure on pain in Iranian leukemia patients: A randomized controlled trial study.

Nonpharmacological methods of pain relief such as acupressure are becoming increasingly popular worldwide. Practitioners often claim that such methods are highly effective and less invasive than analgesic drugs, but available empirical evidence is largely inconclusive. This study aimed to test the hypothesis that, postacupressure intervention, the amount of pain experienced by sampled leukemia patients, who received acupressure in addition to standard care, will reduce substantially compared to patients who received only routine treatment. This controlled trial was undertaken with hospitalized leukemia patients between February and June 2015. Our primary sample consisted of 100 participants who were randomly allocated to 2 groups. One (intervention) group underwent 12 acupressure sessions in addition to standard treatment while the control group received no intervention apart from being given the standard treatment for leukemia. The visual analogue scale was used to measure the levels of pain experienced. No significant differences were found between the 2 groups across 12 interventions. However, each group reported significantly different pain level changes before and after each intervention, suggested that the acupressure method was effective in reducing pain in the short term. Nurses are able to apply this complementary therapy alongside other procedures to manage these patients' pain. It is recommended that further studies be conducted to better understand the specific conditions under which acupressure can provide effective pain relief.

Psychometric Properties of the Persian Version of Spiritual Well-Being Scale in Patients with Acute Myocardial Infarction.

The purpose of this study was to assess the psychometric properties of the Persian version of Spiritual Well-Being Scale (SWBS) in patients with acute myocardial infarction. A multisite, cross-sectional survey was employed to determine the instrument's reliability (Cronbach's α and construct reliability) and validity (face, content, and construct). Using systematic sampling of adult outpatients at primary care clinic sites in the Qazvin City, Iran (N = 300), it was found that the Cronbach's alpha and construct reliability of both factors associated with the SWBS were above 0.7. The construct validity of the scale was determined using exploratory factor analysis. The findings supported two factors: relation with God and relation with life. Further investigation through confirmatory factor analysis (eigenvalues of greater than one) confirmed a third factor construct associated with the SWBS. A total of 50.65 % of the variance were explained by these three factors. The overall findings of the study demonstrated that the SWBS is a valid and reliable instrument that has potential utility in future research and clinical practice settings.

SYSTEMIC ORAL ANTIBIOTICS AS A PROPHYLACTIC MEASURE TO PREVENT ENDOPHTHALMITIS IN PATIENTS WITH OPEN GLOBE INJURIES IN COMPARISON WITH INTRAVENOUS ANTIBIOTICS.

PURPOSE: To compare the use of systemic oral and intravenous antibiotics as a prophylactic measure to prevent endophthalmitis in patients with open globe injuries. METHODS: This prospective study was conducted on 1,255 consecutive patients with open globe injuries due to sharp or blunt trauma in a hospital setting in Tehran, Iran from January, 2011 to May, 2013. The patients were randomly divided into two groups and either received intravenous or oral systemic antibiotics as a measure to prevent endophthalmitis. The patients who developed endophthalmitis were followed for 1 year. RESULTS: In the first group, 12 patients (1.8%) developed endophthalmitis until postoperative Day 3 and 2 more patients (0.3%) developed endophthalmitis until the end of Week 1. These numbers in group receiving oral antibiotics were 8 (1.3%), 5 (0.8%), and 13 patients, respectively, showing no statistically significant difference between the 2 groups. There was also no statistically significant difference in the visual acuity of patients developing endophthalmitis in these 2 groups 1 year postoperatively. CONCLUSION: No statistically significant difference in the occurrence of postoperative endophthalmitis or the visual acuity 1 year after operation among patients with open globe injuries receiving intravenous or oral systemic antibiotics as a prophylactic measure was observed.

Is bowel preparation necessary before kidney-ureter-bladder radiography and intravenous urography?

PURPOSE: To assess whether bowel preparation prior to kidney-ureter-bladder (KUB) radiography and intravenous urography (IVU) are of value in improving visualization of the urinary system. MATERIALS AND METHODS: A total of 186 patients participated in this study. Thirty-nine patients with chronic constipation based on Rome III criteria and 147 patients with normal bowel habits were included. All the patients were randomly divided into two groups. Patients in group 1 received castor oil before imaging and had to eat or drink nothing after midnight. Patients in group 2 were allowed to eat and drink before the examination and received no bowel preparation. Kidney-ureter-bladder radiographies were obtained in all the patients and IVUs were indicated in 77 patients. To assess the image quality, radiographic images were divided into 5 anatomical regions and each region was scored from 0 to 3 based on obscurity of the images by the bowel gas or fecal residue. RESULTS: Mean total score for visualization of the urinary system on plain and contrast images did not differ significantly between the two groups (P = .253). However, patients with chronic constipation who received bowel preparation revealed a significantly better visualization score on plain images (P = .001). CONCLUSION: Bowel preparation prior to KUB and IVU does not improve the quality of the images in patients with normal bowel habits. However, a significantly better visualization of KUB was noted among patients with chronic constipation who had received bowel preparation.

Antinociceptive and Anti-inflammatory Effects of Pistacia vera LeafExtract in Mice.

Pistacia vera L., a member of Anacardiaceae family, has been used for sedation and analgesia in traditional medicine. In this study, the antinociceptive and anti-inflammatory effects as well as acute toxicity of the aqueous and ethanolic extracts of P. vera leaves were investigated in mice. The antinociceptive activity was studied using hot plate and writhing tests. The effect of the extracts against acute inflammation was determined using xylene-induced ear edema and the activity of the extracts, against chronic inflammation, was assessed using the cotton pellet test. The LD50 values of the infusion and maceration extracts were 0.8 g/Kg and 0.79 g/Kg, respectively. The aqueous and ethanolic maceration extracts of the P. vera leaves at the doses of 0.4 g/Kg and 0.5 g/Kg (IP), respectively, showed antinociceptive effects. The pretreatment of naloxone (2 mg/Kg, SC) inhibited the activities of extracts in hot plate test, but naloxone at the same dose could not inhibit the antinociceptive activity in writhing test. The extracts also showed anti-inflammatory effects in acute and chronic anti-inflammatory tests. The ethanolic extract was as effective as diclofenac in both inflammatory tests. The aqueous and ethanolic extracts of P. vera leaves demonstrated central and peripheral antinociceptive activities dose-dependently and the central effect may be mediated by opioid system. The extracts also demonstrated anti-inflammatory effects against acute and chronic inflammation.

Long-term outcome of trans urethral prostatectomy in benign prostatic hyperplasia patients with and without diabetes mellitus.

OBJECTIVE: To compare the different aspects of the postoperative outcomes in diabetics and nondiabetics of transurethral prostatectomy in patients with benign prostatic hyperplasia. METHODS: From December 2000 to December 2003, a total of 138 men with BPH, who were candidates for transurethral resection of the prostate (TURP), were selected for this study, of these 20 were diabetics. The International Prostate Symptom Score (I-PSS) and the erectile function were assessed preoperatively and during an average follow-up period of 63 months postoperatively. Comorbid conditions and all surgical complications during the follow-up were recorded. RESULTS: No significant differences were detected between the baseline IPSS and the prostate volume in diabetic and nondiabetic patients. Both groups showed significant reductions in IPSS, and greater reductions were detected in nondiabetic patients 6 months after their operations that were not statistically significant (23.5 +/- 8.0 versus 20.9 +/- 7.6 respectively, p = 0.169). There were no significant differences in the perioperative complications. The incidence of a second TURP was higher in diabetics (25% vs. 7.8%, p = 0.033). Although not statistically significant, a higher incidence of postoperative erectile dysfunction (ED) in diabetic patients (37.5% vs. 11.5%, p = 0.073) was observed. CONCLUSION: TURP is a beneficial and safe procedure in diabetic patients with BPH and is not associated with a higher incidence of perioperative or postoperative complications except for the possible postoperative ED and the retreatment rate that seems to be higher.

Erectile dysfunction after prostatectomy: an evaluation of the risk factors.

OBJECTIVE: The occurrence of erectile dysfunction (ED) in patients who have undergone prostatectomy has been assessed in the previous studies; however, its rate and risk factors vary in different studies. This study was conducted to assess the possible risk factors for ED after prostatectomy. MATERIAL AND METHODS: In total, 246 men with benign prostatic hyperplasia (BPH) who were candidates for either open prostatectomy or transurethral resection of the prostate (TURP) were admitted in this study during a period of 3 years between December 2000 and December 2003. Cardiac risk index was assessed before the operation using American Heart Association guidelines and erectile function was assessed both preoperatively and 6 months after surgery. Patients with moderate to severe ED according to the five-item version of the International Index of Erectile Function were considered as ED afflicted. In this study, the prevalence of preoperative ED, the incidence of postoperative ED, and those conditions that could lead to an increase in the incidence of postoperative ED in either procedure were determined. RESULTS: The mean age of the patients was 63.7+/-9.7 years. The prevalence rates of preoperative ED were 24.6% and 25.9% in TURP and open prostatectomy groups, respectively. Among patients with no or mild ED preoperatively, 12.5% showed moderate to severe ED postoperatively (13.4% in TURP group vs 11.25% in open prostatectomy group). CONCLUSIONS: The incidence rate of postoperative ED after prostatectomy was 12.5%. Risk factors for its appearance included hypertension, diabetes mellitus, higher transfusion rates, higher cardiac risk index and an older age.