Microwave-Assisted Combustion Synthesis of ZnO:Eu Nanoparticles: Effect of Fuel Types.

Nanoparticles of Europium oxide doped with Zinc oxide were synthesized via microwave-assisted combustion method. Citric acid as a simultaneous fuel and chelating agent and glycine as a fuel and mixture of these fuels were sleeted. X-Ray diffraction patterns (XRD) indicated the formation of ZnO structure with a few amount of Eu2O3 phase. Fourier transformation infra red (FTIR) spectra reveal the increase of ZnO4 bonds with glycine content of fuels mixture. Scanning electron microscope (SEM) images showed the conversion of nanosphere to spongy-like structure with respect to change of fuel mixtures from citric to glycine. From transmission electron microscopy (TEM) nanoparticles of a mean size 30 nm are observed Green fluorescence emission of different samples was due to activation of self activated center of ZnO structure through transition of electron from Eu3+ to Vzn sites.

Retraction: High-performance sono/nano-catalytic system: CTSN/Fe3O4-Cu nanocomposite, a promising heterogeneous catalyst for the synthesis of N-arylimidazoles.

[This retracts the article DOI: 10.1039/C9RA08062G.].

Delivering Primary Health Care (PHC) Services for Controlling NCDs During the COVID-19 Pandemic: A Scoping Review.

Non-communicable diseases (NCDs) are the leading cause of death worldwide. NCDs also increase mortality from COVID-19 and primary health care (PHC) services are an important component in the prevention and control of long-term NCDs. The main goal of the present study was to review primary healthcare services for the NCDs patients via primary healthcare network during COVID-19 pandemic. In this scoping review, Search engines including PubMed, Scopus, and Science-direct up to 1st February 2022 were searched to identify studies regarding primary care services for NCDs patients via primary health care during COVID-19 pandemic. A total of 42 studies met the inclusion criteria and were included in our analysis. 24 studies were about the status and changes of primary health services for NCDs patients in PHC settings, while 18 studies focused on adaptive strategies used during COVID-19 in different countries including United States, Canada, United Kingdom, Portugal, Georgia, South Africa, Thailand, Mexico, India, Kenya, Guatemala and Saudi Arabia. These strategies included remote monitoring, follow up, consultation, empowerment and educational services as well as home visiting Disruption of NCDs services in PHC during the COVID-19 pandemic was observed in different countries, which highlights the urgency of attention of researchers and policy-makers to development of appropriate and adaptive policies to improve PHC service coverage and its quality during the pandemics.

S1 Transforaminal Epidural Anesthesia in Percutaneous Transforaminal Endoscopic Discectomy: A Case-Series Study.

Background: Percutaneous transforaminal endoscopic discectomy (PTED) has become popular over the years due to its safety and low invasiveness. This surgery can be performed with different anesthesia techniques; however, the extent to which the surgeon and patient are satisfied with the analgesia is debatable. Objectives: This study investigated the efficiency of the S1 transforaminal epidural block. Methods: This retrospective study was conducted on 60 patients with L4 - L5 lumbar disc herniation who underwent PTED under the S1 transforaminal epidural block. All patients had clinical symptoms associated with unilateral radiculopathy and were candidates for surgery. Percutaneous transforaminal endoscopy and S1 epidural block were performed by a surgeon for all patients. Results: Of the 60 evaluated cases, 61.7% and 38.3% were female and male, respectively, with a mean age of 42.98 ± 10.79 years. The mean pain score before surgery was 7.83 ± 0.69, which decreased to 2.58 ± 0.65 during surgery and 0.50 ± 0.50 48 hours after surgery (P < 0.001). The mean duration of operation in these patients was 58.58 ± 16.95 minutes, and the mean onset time was 10.08 ± 3.12 minutes. Moreover, the mean bleeding was 124.17 ± 25.20 cc. Conclusions: The PTED with S1 epidural anesthesia is a simple, safe, and effective method that causes good analgesia during the operation and cooperates well with the surgeon in neurological monitoring due to patient consciousness.

Recent advances on biomedical applications of pectin-containing biomaterials.

There is a growing demand for biomaterials developing with novel properties for biomedical applications hence, hydrogels with 3D crosslinked polymeric structures obtained from natural polymers have been deeply inspected in this field. Pectin a unique biopolymer found in the cell walls of fruits and vegetables is extensively used in the pharmaceutical, food, and textile industries due to its ability to form a thick gel-like solution. Considering biocompatibility, biodegradability, easy gelling capability, and facile manipulation of pectin-based biomaterials; they have been thoroughly investigated for various potential biomedical applications including drug delivery, wound healing, tissue engineering, creation of implantable devices, and skin-care products.

A comparative study of the status of supportive-palliative care provision in Iran and selected countries: Strengths and weaknesses.

BACKGROUND: Terminally, illnesses such as cancer, AIDS, dementia, and advanced heart disease will require special supportive and palliative care, although a few numbers of these patients are provided with these services. The aim of the present study was to perform a comparative study of supportive-palliative care provision in selected countries. MATERIALS AND METHODS: This research was a descriptive comparative study that its research population was the frameworks of palliative and supportive care provision in Egypt, Turkey, America, Australia, Canada, the Netherlands, and China. These frameworks were compared across six dimensions of service receivers, financing, providers, service provider centers, type of services provided, and training. Data collection tool has included the checklist and information sources, documents, evidence, articles, books, and journals collected through the Internet and organizations related to the health information of selected countries and by the library search. Data were investigated and analyzed using the data collection tool and checklists. FINDINGS: The findings showed that the developed countries having decentralized trusteeship structure had a more favorable status in palliative and supportive care provision. The type of services provided was a combination of mental, psychological, social, spiritual, financial, and physical and communication services. Provider centers included hospital, the elderly, and cancer and charity centers. CONCLUSION: Regarding the investigation and recognition of the status of supportive-palliative care provision, it was observed that the provision of these services was a concern of the selected countries, but they did not have a defined model or pattern to provide these services. Therefore, it is suggested that each country takes a step to redesign and define frameworks and structures in the evolution of supportive-palliative cares in accordance with the particular conditions, indigenous culture, religion, and other effective cases of that country and pays special attention to the role and position of supportive-palliative cares.

Investigating the challenges and barriers of palliative care delivery in Iran and the World: A systematic review study.

Palliative care and terminal patients care centers have an important role in improving the physical and psychological state of the patient and their families and increasing their satisfaction and care providers. A literature search of online databases (PubMed, Scopus, Web of science, Cochrane library, and Google Scholar) was searched from January 1, 2000, to the end of April 2019, by using the appropriate English keywords. Furthermore, IranMedex, Barkat, and Magiran databases were searched for the Persian articles. We used Standards for Reporting Qualitative Research checklist to evaluate the articles quality. From 1328 articles, 166 were reviewed in depth with 13 satisfying our inclusion criteria. The findings of this study revealed a wide range of barriers and challenges to palliative care delivery. The identified barriers were: Cultural, social and organizational barriers, lack of resources, equipment and financing, attitudes and cultures, barriers related to the patient and the patient's family, related barriers providers, time and money, education, communication challenges, policies, insurance problems, safety, and crisis management. The results of the studies showed that there are various barriers and challenges such as economic, cultural, social, organizational, and communication related to palliative care. Given the identified barriers and challenges, it is suggested that to improve the delivery of palliative care, the health system policy-makers and planners consider a resource-appropriate and culturally appropriate framework for palliative care delivery.

Cross-cultural adaptation and validation of the Persian version of the painDETECT questionnaire.

OBJECTIVE: The purpose of this study was to translate and cross-culturally adapt the painDETECT questionnaire into the Persian language and assess the clinometric properties of the translated version (P-PDQ). METHODS: This is a single-center prospective observational study. After forward and backward translations, consensus was achieved by the expert panel on the pre-final version. Semantic equivalence of this version was assessed and necessary modifications were made accordingly to achieve the final version (P-PDQ). One hundred and fifty chronic pain patients were sub-classified into neuropathic pain (NeP (n = 82)) or non-NeP (n = 68) groups by two pain specialists. P-PDQ was then administered to 50 patients twice with an interval of 5-7 days to assess relative reliability. Chronbach's α and intraclass correlation coefficient (ICC) were calculated to evaluate internal consistency and test-retest reliability of the P-PDQ, respectively. Criterion validity was assessed as the correlation of the P-PDQ and the validated Persian version of the self-report Leeds Assessment of Neuropathic Symptoms and Signs (P-sLANSS). RESULTS: Chronbach's α and ICC of the P-PDQ were 0.76 and 0.97, respectively. The P-PDQ scores were significantly correlated with those of P-sLANSS (ρ = 0.87, p < .01). The mean overall score of P-PDQ was significantly higher in the NeP group (p < .01) which reflects discriminant validity. Sensitivity, specificity, positive and negative predicting values and Youden index were 74.70%, 98.51%, 78.04%, 98.48%, and 0.73, respectively at the cutoff value ≤17. CONCLUSION: The P-PDQ is a reliable and valid tool to distinguish neuropathic component in chronic pain cases.

Association of Serum Minerals, Vitamin D, Total Protein, and Inflammatory Mediators and Severity of Low Back Pain.

BACKGROUND: Low back pain (LBP) is a multifactorial disorder with multiple etiologies, which are not fully understood. In this study, we aimed to evaluate the relationship between serum levels of minerals, total protein, vitamin D (vit D), and inflammatory mediators with LBP and its severity. MATERIALS AND METHODS: This case-control study was derived from the study nested in the Fasa Cohort Study. Overall, 148 individuals with LBP were compared with 150 individuals without LBP. Blood samples were evaluated for serum protein, iron (Fe), aluminum (Al), copper (Cu), phosphorus, vit D, IL-1B, IL-6, high-sensitive C-reactive protein (HS-CRP), and TNF-alpha. Severity of pain was measured with the McGill and Oswestry questionnaires. RESULTS: The mean age of participants in the case and control groups was 49.2 ± 6.1 and 47.57 ± 5.85 years, respectively. In the case group, 61 patients (48.8%) were male. The mean serum levels of Fe, Al, vit D, Cu, IL-1B, IL-6, HS-CRP, and TNF-alpha were significantly different between case and control groups (P≤0.05). However, there were no significant differences between studied groups in the term of sex and serum phosphorus (P>0.05). Regarding pain severity, age was correlated with McGill score (r=0.18), body mass index with Oswestry (r=0.21), Fe with McGill (r=-0.15) and Oswestry (r=-0.13), protein with McGill (r=0.32) and Oswestry (r=-0.32), Al with McGill (r=0.56) and Oswestry (r=0.45), IL-1B with McGill (r=0.19) and Oswestry (r=0.13), TNF-alpha with McGill (r=0.34) and Oswestry (r=0.26), IL-6 with Oswestry (r=0.13), HS-CRP with McGill (r=0.60) and Oswestry (r=0.46), and vit D was correlated with McGill (r=0.21) and Oswestry scores (r=0.17). Higher Fe (odds ratio [OR]: 0.99), protein (OR: 0.47), Al (OR: 0.11), and vit D levels (OR: 0.97) were protective against LBP (P<0.001). Higher IL-1B (OR: 1.01), TNF-alpha (OR: 1.03), and HS-CRP (OR: 1.0003) presented as risk factors for LBP (P<0.001). CONCLUSION: Our study revealed except phosphorous, all the serum levels minerals and inflammatory markers was significantly different in LBP patients compared to healthy individuals. Also, in the LBP patients, serum levels of Fe, total protein, Al, and vit D aside to inflammatory mediators (i.e., IL-1B, TNF-alpha, and HS-CRP) shows a marked association with severity of LBP.

Recent advances in the application of mesoporous silica-based nanomaterials for bone tissue engineering.

Silica nanomaterials (SNMs) and their composites have recently been investigated as scaffolds for bone tissue engineering. SNM scaffolds possess the ability to encourage bone cell growth and also allow the simultaneous delivery of biologically active biomolecules that are encapsulated in the mesopores. Their high mechanical strength, low cytotoxicity, ability to stimulate both the proliferation and osteogenic differentiation of progenitor cells make the SNMs appropriate scaffolds. Their physiochemical properties facilitate the cell spreading process, allow easy access to nutrients and help the cell-cell communication process during bone tissue engineering. The ability to deliver small biomolecules, such as dexamethasone, different growth factors, vitamins and mineral ions depends on the morphology, porosity, and crystallinity of SNMs and their composites with other polymeric materials. In this review, the abilities of SNMs to perform as suitable scaffolds for bone tissue engineering are comprehensively discussed.

Metal-based nanoparticles for bone tissue engineering.

Tissue is vital to the organization of multicellular organisms, because it creates the different organs and provides the main scaffold for body shape. The quest for effective methods to allow tissue regeneration and create scaffolds for new tissue growth has intensified in recent years. Tissue engineering has recently used some promising alternatives to existing conventional scaffold materials, many of which have been derived from nanotechnology. One important example of these is metal nanoparticles. The purpose of this review is to cover novel tissue engineering methods, paying special attention to those based on the use of metal-based nanoparticles. The unique physiochemical properties of metal nanoparticles, such as antibacterial effects, shape memory phenomenon, low cytotoxicity, stimulation of the proliferation process, good mechanical and tensile strength, acceptable biocompatibility, significant osteogenic potential, and ability to regulate cell growth pathways, suggest that they can perform as novel types of scaffolds for bone tissue engineering. The basic principles of various nanoparticle-based composites and scaffolds are discussed in this review. The merits and demerits of these particles are critically discussed, and their importance in bone tissue engineering is highlighted.

High-performance sono/nano-catalytic system: CTSN/Fe3O4-Cu nanocomposite, a promising heterogeneous catalyst for the synthesis of N-arylimidazoles.

Herein, a promising heterogeneous nanoscale catalytic system constructed of chitosan (CTSN, as a polymeric basis), iron oxide nanoparticles (Fe3O4 NPs, as the magnetic agent), and copper oxide nanoparticles (CuO NPs, as the main catalytic active site) is presented. Firstly, a convenient synthetic route for preparation of this novel nanocatalyst (CTSN/Fe3O4-Cu) is presented. Further, the synergistic catalytic effect between the novel-designed catalyst and ultrasound waves (USW) in N-arylation coupling reactions of the imidazole derivatives (using various aryl halides) is precisely discussed. Concisely, high reaction yields (98%) have been obtained in short reaction time (10 min) through applying a partial amount (0.01 g) of this nanocatalyst. As the main reason for high catalytic activity of CTSN/Fe3O4-Cu, nanosized cluster-shaped morphology, which provides a wide surface active area, can be expressed. However, as the most distinguished properties of CTSN/Fe3O4-Cu catalytic system, high convenience in separation and excellent reusability could be mentioned. CTSN/Fe3O4-Cu nanocomposite can be easily recovered by using an external magnet and reused at least for eight times with no significant decline in the catalytic activity. Structural characterizations of this novel system have been done by various analytical methods and the obtained results have been well interpreted in the context.

The Results of Treating Failed Back Surgery Syndrome by Adhesiolysis: Comparing the One- and Three-Day Protocols.

BACKGROUND: The optimal treatment of failed back surgery syndrome (FBSS) is controversial. Limited studies have demonstrated the satisfactory outcomes of percutaneous adhesiolysis in FBSS, which can be performed as a 1 day or 3 days procedure. In the current randomized clinical trial, we compared the clinical and functional outcomes of these 2 techniques. METHODS: In this study, 60 patients with FBSS were randomly assigned into 2 equal groups: 1 day group and 3 days group. Before and at 4 and 12 weeks after the procedure, pain intensity was measured using visual analogue scale (VAS). The Oswestry disability index (ODI) was also completed. Pain reduction of 50% or more was defined as treatment success. RESULTS: Significant pain relief and ODI improvement were obtained in the 2 groups with adhesiolysis (P < 0.001). However, pain intensity remained the same before and at 4 and 12 weeks after adhesiolysis. ODI score was significantly lower in 1 day group in the 1 month visit (P < 0.001). Treatment was successful in 76.7% and 83.3% of the patients in 1 day and 3 days groups, respectively (P = 0.519). CONCLUSIONS: Adhesiolysis is an effective treatment for pain relief and functional improvement in FBSS. The results of 1 day and 3 days procedures are comparable. Based on these findings, the authors recommend using 1 day technique, which can potentially decrease the patients' discomfort, hospital stay, and cost of treatment.

A Comparison of the Sociodemographic and Clinical Characteristics of Patients Referring to a Pain Clinic with Subacute and Chronic Pain.

OBJECTIVES: The aim of the present study was to assess and compare the sociodemographic characteristics and clinical features of patients referring to a university hospital's pain clinic with chronic ( ≥ 12 weeks) and subacute pain ( < 12 weeks). METHODS: In this cross-sectional study, 426 patients were included. Demographic variables including education level, marital and employment status, and risk factors such as obesity, diabetes mellitus, hypertension, cigarette smoking, and opium addiction were recorded. Also, sites of pain, pain quality and associated symptoms, and pain severity were assessed using a numerical rating scale. Each one of these variables was compared between the chronic and subacute pain groups. RESULTS: Of the 426 studied patients, 292 (69%) had chronic pain and 134 (31%) reported subacute pain. Patients with chronic pain were older and had higher body mass indices. Additionally, self-employment was less frequent among the chronic pain group. The patients with chronic pain had a higher prevalence of addiction. The most commonly reported site of pain in all patients was the lower back (62.4%), followed by pain in the leg and foot (39.9%), knee (24.4%), and hip (18.8%). There were no statistically significant differences in pain sites between the two groups, except for knee pain, which was more common among the chronic pain group. The patients with chronic pain had a higher incidence of obscure and persistent pain, while those with subacute pain experienced more night pain. CONCLUSIONS: About one-third of the patients referring to the pain clinic had subacute pain. The patients with chronic pain were older and more obese, had a higher prevalence of addiction, had more cases of knee pain, and reported more instances of obscure and persistent pain than those with subacute pain.

Intravenous Paracetamol Versus Patient-Controlled Analgesia With Morphine for the Pain Management Following Diagnostic Knee Arthroscopy in Trauma Patients: A Randomized Clinical Trial.

BACKGROUND: Most patients undergoing outpatient surgeries have the unpleasant experience of high level pain after surgery. Compared with open surgeries, arthroscopic procedures are less painful; however, inadequate pain management could be associated with significant concerns. Opioids alone or in combination with local anesthetics are frequently used for diminishing postoperative pain using intravenous or epidural infusion pumps. Despite morphine various disadvantages, it is commonly used for controlling pain after surgery. OBJECTIVES: The aim of this study was to compare intravenous paracetamol and patient-controlled analgesia (PCA) with morphine for the pain management following diagnostic knee arthroscopy in trauma patients. PATIENTS AND METHODS: Sixty trauma patients who were scheduled to undergo knee arthroscopy were randomly divided into two groups. Patients immediately received intravenous infusion of 1 g paracetamol within 15 minutes after surgery and every 6 hours to 24 hours in the paracetamol group. The patient-controlled analgesia group received morphine through PCA infusion pump at 2 mL/h base rate and 1mL bolus every 15 minutes. Pain level, nausea and vomiting, and sedation were measured and recorded during entering the recovery, 15 and 30 minutes after entering the recovery, 2, 6, and 24 hours after starting morphine pump infusion in the morphine and paracetamol in the paracetamol groups. RESULTS: There was no significant difference regarding the pain level at different times after entering the recovery between the two groups. No one from the paracetamol group developed drug complications. However, 22.3% in the PCA morphine suffered from postoperative nausea; there was a statistically significant difference regarding the sedation level, nausea, and vomiting at various times between the two groups. CONCLUSIONS: Intravenous administration of paracetamol immediately after knee arthroscopy improved postoperative pain, decreased analgesic administration, maintained stable hemodynamic parameters, had no complications related to opiates, no nausea and vomiting, and increased patient satisfaction and comfort in comparison to PCA with morphine.

Comparison of Transforaminal and Parasagittal Epidural Steroid Injections in Patients With Radicular Low Back Pain.

BACKGROUND: Epidural steroid injection (ESI), including transforaminal (TF) epidural injections and interlaminar (IL) epidural steroid injections are commonly performed procedures for the management of lumbosacral radicular pain. Parasagittal interlaminar (PIL) approach could enable higher ventral epidural spread, with fewer complications than TF. OBJECTIVES: This study aims to compare the effectiveness of PIL and TF ESI in relieving the pain and disability of patients with lumbosacral pain. PATIENTS AND METHODS: This prospective study enrolled 64 patients, aged between 18 to 75 years, with a diagnosis of low back pain and unilateral lumbosacral radicular pain. The patients were randomized to receive fluoroscopically guided epidural injection, through either the PIL or TF approach. Patients were evaluated for effective pain relief [numerical rating scale (NRS) < 3] by 0 - 10 numeric rating scale (NRS) and functional improvement by the Oswestry Disability Index (ODI). RESULTS: Effective pain relief [numeric rating scale (NRS) < 3] was observed in 77.3% (95% CI: 67‒90.5%) of patients in PIL group and 74.2% (95% CI: 62.4 - 89.4%) of patients in the TF group (P = 0.34), at 4 weeks. Mean NRS score was not significantly different between the PIL group compared to the TF group, at 4 weeks (P = 0.19). Number of patients with improved disability (measured by ODI < 20%) was not significantly different in PIL group (78% of cases) compared to the TF group (76% of cases), at 4 weeks (P = 0.21). There were no adverse effects observed in any of our patients. CONCLUSIONS: The PIL epidural injection is as effective as TF epidural injection in improving pain and functional status, in patients with chronic lumbosacral low back pain, due to disc degeneration.

Acute respiratory failure as a rare complication of celiac plexus block in a patient with adenocarcinoma of the ampulla of vater.

Celiac and splanchnic plexus blocks are considered as terminal approaches for pain control in end stage pancreatic cancer. It may be done temporarily (using local anesthetics) or as a permanent act (using alcohol and/or phenol). Like every other interventional procedure, celiac plexus block has its own potential complications and hazards among them pneumothorax and ARDS are very rare. In this case report we present an end stage patient with adenocarcinoma of ampulla of Vater with involvement of both abdomen and thorax who presented with severe intractable abdominal pain. Bilateral celiac plexus block in this patient resulted in left side pneumothorax and subsequent development of ARDS. We discuss the rare complications of celiac plexus block as well.