Effect of Silybum Marianum on Reduction of Chemotherapy-Induced Peripheral Neurotoxicity with Cisplatin.

Background: Chemotherapy-induced peripheral neurotoxicity (CIPN) is one of the major complications of chemotherapy regimens commonly used in the treatment of solid and hematologic cancers. Given the high incidence of CIPN in antitumor therapies in patients and limited studies on antioxidants, this study was aimed to investigate the effect of Silybum marianum (SM) on cisplatin-induced peripheral neuropathy. Materials and Methods: This double-blind randomized clinical trial study was performed on 60 cancer patients treated with cisplatin chemotherapy at Seyyed-o-Shohada Hospital of Isfahan during 2019-2020. The patients were divided into two parallel groups as intervention (treated by SM) and placebo, and DN4 (Douleur neuropathique 4 questions) and CIPNAT (chemotherapy-induced peripheral neuropathy assessment tool) were completed for patients in the before and after intervention groups and compared between the two groups. Results: The mean of DN4 score in the before and after study in the intervention group was in 1.76 ± 1.24 and 2.07 ± 2.03, respectively (P = 0.38), and in the control group was 1.41 ± 1.28 ± 3.11 ± 2.86, respectively (P = 0.012). The mean CIPNAT score in the intervention groups was 5.93 ± 3.65 and 4.20 ± 3.23 (P = 0.01), and in the control group was 4.20 ± 4.22 and 4.16 ± 4.03 (P = 0.39). Conclusion: Based on our data, SM is an effective agent in reducing peripheral neuropathy. The use of SM was associated with decreased scores of peripheral neuropathy and was helpful in patients undergoing chemotherapy with cisplatin.

The Prevalence of Depression and Anxiety and Its Association with Sleep Quality in the First-Year Medical Science Students.

Methods: A total number of 471 freshmen students (NUMS) participated in the study, pinpointing that the data are collected in 2019 and 2020. In line with measuring depression, anxiety, and sleep quality, the Persian Beck Depression Inventory-II, Beck Anxiety Inventory, and Pittsburgh Sleep Quality Index were employed. The associations between depression and anxiety with sleep quality were assessed by using the multiple logistic regression model. All statistical analyses were conducted in STATA14, and the significant level was set at P < 0.05. Results: The prevalence of depression, anxiety, and poor sleep quality in the study population was 21.4%, 31.9%, and 28%, respectively. Analytical analyses indicated that after adjusting for studied covariates, the odds of poor sleep quality in individuals with depression were 3.5 times higher compared to the counter group (P < 0.001). Moreover, the odds of poor sleep quality in individuals with anxiety were 2.1 times higher compared to the counter group (P < 0.001). Conclusion: Noticeable proportion of freshmen students suffer from depression and anxiety; in line with such a critical issue, our study found that depression and anxiety had a statistical association with sleep quality in study population. From this respect, it seems that providing essential interventions and psychological counseling services could be constructive for the freshmen medical students.

Sleep duration and quality are associated with health-related quality of life in adults aged 60 years and older.

BACKGROUND: The current study aimed to determine the association between sleep duration and quality with health-related quality of life (HRQoL) among the Iranian older persons. METHODS: This study was conducted on a representative sample of 3452 Iranian older people (≥ 60 years) who participated in the Iranian Longitudinal Study on Ageing (IRLSA) launched in Neyshabur (Razavi Khorasan province, northeastern Iran). The Persian versions of 12-Item Short Form Survey (SF-12) and Pittsburgh Sleep Quality Index (PSQI) were utilized to measure the level of HRQoL and the level of sleep duration and quality, respectively. Multiple linear regression model was performed to analyze the data and clarify the independent association of sleep duration and quality with HRQoL. RESULTS: More than half of the study population (52.4%) suffered from poor sleep quality. 57.3% and 3.9% of individuals were short sleepers (< 7 h) and long sleepers (equal or more than 9 h), respectively. The total score of HRQoL was achieved 65.87 ± 20.55. After adjusting the covariates, the results indicated that short sleep duration was negatively associated with HRQoL (P < 0.05), whereas no significant associations were found between long sleep duration and HRQoL (P > 0.05). Interestingly, the results of multiple linear regression model revealed a significant negative association between poor sleep quality and HRQoL (P < 0.001). CONCLUSION: The current study confirmed that short sleep duration and poor sleep quality were independently associated with lower HRQoL in the older persons. Therefore, interventional courses should be planned to enrich sleep-related healthcare and general HRQoL in the older persons.

Impact of polystyrene microplastics on the growth and photosynthetic efficiency of diatom Chaetoceros neogracile.

The increasing prevalence of microplastic pollution in aquatic environments has raised concerns about its impact on marine life. Among the different types of microplastics, polystyrene microplastics (PSMPs) are one of the most commonly detected in aquatic systems. Chaetoceros neogracile (diatom) is an essential part of the marine food web and plays a critical role in nutrient cycling. This study aimed to monitor the ecotoxicological impact of PSMPs on diatoms and observe enzymatic interactions through molecular docking simulations. Results showed that diatom growth decreased with increasing concentrations and exposure time to PSMPs, and the lowest photosynthetic efficiency (Fv/Fm) value was observed after 72 and 96 h of exposure to 200 mg L-1 of PSMPs. High concentrations of PSMPs led to a decrease in chlorophyll a content (up to 64.4%) and protein content (up to 35.5%). Molecular docking simulations revealed potential interactions between PSMPs and the extrinsic protein in photosystem II protein of diatoms, suggesting a strong affinity between the two. These findings indicate a detrimental effect of PSMPs on the growth and photosynthetic efficiency of diatoms and highlight the need for further research on the impact of microplastics on marine microbial processes.

An innovative machine learning based on feed-forward artificial neural network and equilibrium optimization for predicting solar irradiance.

As is known, having a reliable analysis of energy sources is an important task toward sustainable development. Solar energy is one of the most advantageous types of renewable energy. Compared to fossil fuels, it is cleaner, freely available, and can be directly exploited for electricity. Therefore, this study is concerned with suggesting novel hybrid models for improving the forecast of Solar Irradiance (IS). First, a predictive model, namely Feed-Forward Artificial Neural Network (FFANN) forms the non-linear contribution between the IS and dominant meteorological and temporal parameters (including humidity, temperature, pressure, cloud coverage, speed and direction of wind, month, day, and hour). Then, this framework is optimized using several metaheuristic algorithms to create hybrid models for predicting the IS. According to the accuracy assessments, metaheuristic algorithms attained satisfying training for the FFANN by using 80% of the data. Moreover, applying the trained models to the remaining 20% proved their high proficiency in forecasting the IS in unseen environmental circumstances. A comparison among the optimizers revealed that Equilibrium Optimization (EO) could achieve a higher accuracy than Wind-Driven Optimization (WDO), Optics Inspired Optimization (OIO), and Social Spider Algorithm (SOSA). In another phase of this study, Principal Component Analysis (PCA) is applied to identify the most contributive meteorological and temporal factors. The PCA results can be used to optimize the problem dimension, as well as to suggest effective real-world measures for improving solar energy production. Lastly, the EO-based solution is yielded in the form of an explicit formula for a more convenient estimation of the IS.

Effects of purified anthocyanins supplementation on serum concentration of inflammatory mediators: A systematic review and dose-response meta-analysis on randomized clinical trials.

Anthocyanins, due to their antioxidant effects, are candidates to reduce inflammation and the risk of inflammatory diseases. Therefore, through conducting a systematic review and meta-analysis, we tried to find the effect of purified anthocyanins on serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). Databases including, ISI Web of Science, Scopus, ClinicalTrials.gov, PubMed, and Cochrane Library were searched up to June 2023. The meta-analysis was done by calculating mean differences and their standard deviations. Calculating the statistical heterogeneity of intervention effects was performed through I-squared statistics and Cochran's Q test. The pooled estimate showed a significant decrease in serum levels of CRP, TNF-α, and IL-6 (weighted mean difference (WMD) = -0.12 mg/L, 95% confidence interval (CI) = -0.21 to -0.02, p = 0.013; WMD = -1.37 pg/mL, 95% CI = -1.79 to -0.96; p < 0.001; WMD = -1.43 pg/mL, 95% CI = -1.87 to -1.00; p < 0.001, respectively). Subgroup analysis results revealed purified anthocyanins significantly decreased serum levels of CRP among participants with serum levels of CRP≥1.52 mg/L, at-risk/unhealthy status, and in trials with intervention duration ≥84 days, anthocyanins dose ≥320 mg/day, and sample size ≥85 subjects. Regarding TNF-α and IL-6, out results showed that there was a significant effect of purified anthocyanins on serum levels of TNF-α and IL-6 in most subgroups. The results of our study indicated that purified anthocyanins significantly decreased serum levels of CRP, TNF-α, and IL-6. However, further high-quality studies are needed to firmly establish the efficacy of purified anthocyanins.

The Effect of Parenteral Selenium Therapy on Serum Concentration of Inflammatory Mediators: a Systematic Review and Dose-Response Meta-Analysis of Randomized Clinical Trials.

Selenium can protect against inflammation through its incorporation in selenoenzymes; therefore, in this study, we assessed the effect of parenteral selenium on C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) through a systematic review and meta-analysis on randomized controlled trials (RCTs). A systematic search was performed in the databases, including PubMed, Scopus, Cochrane, clinicaltrials.gov, and ISI Web of Science, up to October 2022, with no limitation in study location or publication time. We calculated the effect size by the mean change from baseline in serum concentration of selected inflammatory mediators and their standard deviations. DerSimonian and Laird random effects model was used to estimate the heterogeneity and summary of the overall effects. Included studies in this systematic review and meta-analysis were 10 and 8 RCTs, respectively. Our results revealed parenteral selenium significantly decreased serum IL-6 (Weighted Mean Difference (WMD) = -3.85 pg/ml; 95% confidence interval (CI) = -7.37, -0.34 pg/ml; p = 0.032) but did not significantly change serum levels of CRP (WMD = 4.58 mg/L; 95% CI = -6.11, 15.27 mg/L; P = 0.401) compared to the comparison groups. According to our results, parenteral selenium supplementation might reduce serum levels of inflammatory mediators.

Is poor sleep quality associated with lipid profile in elderly population? Finding from Iranian Longitudinal Study on Ageing.

BACKGROUND: Abnormal lipid profile as one of reversible cardiovascular disease risk factors might be affected by poor sleep quality. AIM: This study aimed to assess the association between poor sleep quality and serum concentration of lipid profile in Iranian elderly population. METHODS: The study was performed on a representative sample of 3452 Iranian older people (≥60 years) who contributed in the Iranian Longitudinal Study on Ageing (IRLSA). Sleep quality was measured through the validated Persian version of Pittsburgh Sleep Quality Index (PSQI). Fasting blood samples were collected from the participants to measure plasma levels lipid profile. We used multiple linear regression model to evaluate the independent association of poor sleep quality with lipid profile. RESULTS: The mean age of participants was 68.0±6.7 years and 52.5% of them were male. In total, 52.4% of study population reported poor sleep quality (PSQI>5). Mean serum concentration of triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) was 143.2±74.2 mg/dl, 195.6±43.2 mg/dl, 112.9±31.0 mg/dl, and 57.3±12.4 mg/dl, respectively. Poor sleep quality was significantly associated with serum levels of TG (ß=17.85; P=0.006), LDL-C (ß=5.45; P=0.039) and HDL-C (ß=-2.13; P=0.039) after adjusting for studied covariates. CONCLUSION: Our study illustrates that poor sleep quality is a risk factor for poorer lipid profile. Therefore, early behavioral or pharmacological interventions that improve sleep quality are necessary to modify lipid profile in elderly population.

Quantitative Photoacoustic Tomography Using Iteratively Refined Wavefield Reconstruction Inversion: A Simulation Study.

The ultimate goal of photoacoustic tomography is to accurately map the absorption coefficient throughout the imaged tissue. Most studies either assume that acoustic properties of biological tissues such as speed of sound (SOS) and acoustic attenuation are homogeneous or fluence is uniform throughout the entire tissue. These assumptions reduce the accuracy of estimations of derived absorption coefficients (DeACs). Our quantitative photoacoustic tomography (qPAT) method estimates DeACs using iteratively refined wavefield reconstruction inversion (IR-WRI) which incorporates the alternating direction method of multipliers to solve the cycle skipping challenge associated with full wave inversion algorithms. Our method compensates for SOS inhomogeneity, fluence decay, and acoustic attenuation. We evaluate the performance of our method on a neonatal head digital phantom.

The role of cholesterol 25-hydroxylase in viral infections: Mechanisms and implications.

Viral infections pose significant threats to human health, causing various diseases with varying severity. The intricate interactions between viruses and host cells determine the outcome of infection, including viral replication, immune responses, and disease progression. Cholesterol 25-hydroxylase (CH25H) is an enzyme that catalyzes the conversion of cholesterol to 25-hydroxycholesterol (25HC), a potent antiviral molecule. In recent years, increasing evidence has highlighted the critical involvement of CH25H in modulating immune responses and influencing viral infections. Notably, the review discusses the implications of CH25H in viral pathogenesis and the development of therapeutic strategies. It examines the interplay between CH25H and viral immune evasion mechanisms, highlighting the potential of viral antagonism of CH25H to enhance viral replication and pathogenesis. Furthermore, it explores the therapeutic potential of targeting CH25H or modulating its downstream signaling pathways as a strategy to control viral infections and enhance antiviral immune responses. This comprehensive review demonstrates the crucial role of CH25H in viral infections, shedding light on its mechanisms of action in viral entry, replication, and immune modulation. Understanding the complex interplay between CH25H and viral infections may pave the way for novel therapeutic approaches and the development of antiviral strategies aimed at exploiting the antiviral properties of CH25H and enhancing host immune responses against viral pathogens. In the current review, we tried to provide an overview of the antiviral activity and importance of CH25H in viral pathogenesis.

Is a spot urine sample a good substitution to estimate 24-h urinary sodium excretion in a population ≥ 50 years old? A validation study.

PURPOSE: A variety of prediction equations have been able to estimate 24-h urinary sodium excretion from spot urine samples; however, Iranians over the age of 50 have not been compared and verified. Using spot urine samples as a substitute for 24-h urine samples to estimate 24-h urine sodium excretion among the population age 50 and older are the purpose of this study. METHODS: A 24-h urinary sodium excretion was studied by well-known Kawasaki, INTERSALT, Tanaka, and World Health Organization/Pan American Health Organization (WHO/PAHO) formulas. On 360 individuals, the mean bias, agreements between estimated and measured values, correlation, absolute and relative differences, and misclassification rates were evaluated for four equations. RESULTS: As a result, the mean urinary sodium excretion for a 24-h period was 136.3 ± 52.21 mmol/24-h, which corresponds to a calculated intake of 9.1 ± 3.8 g of salt per day. According to the WHO/PAHO formula, the mean bias between measured values and estimated 24-h urinary sodium excretion is - 21.6 mg/day (95% confidence interval (CI) - 144.8, 101.6 mg/day), which is the smallest difference compared with the other three formulas. The lowest rate of individual misclassification of salt intake was 40% for WHO/PAHO, especially for those who consumed less than 9 g/day, while Kawasaki had the lowest misclassification rate at higher levels of salt intake. CONCLUSION: As a result of our research, the WHO/PAHO equations accurately predict 24-h urinary sodium excretion among Iranians aged ≥ 50 more than other equations, both at the population level and at the individual level. However, further study is needed in regard to different ages in Iran.

A systematic review and dose-response meta-analysis of the effect of selenium supplementation on serum concentration of C-reactive protein.

BACKGROUND: Despite conducting new studies on the potential effect of selenium in reducing inflammation; results held contradictory weights and turns into an intriguing area of research. Concerns have been raised on this matter on hand to reach conclusive/consistent results. Therefore, this study seeks to address this scientific gap by assessing randomized controlled trials (RCTs) investigating the effect of selenium intake on C-reactive protein (CRP). METHOD AND MATERIALS: To find all the relevant English-language RCTs, databases including SCOPUS, Web of Science, Clinical Trials.gov, PubMed, and Cochrane Library were searched with no time limit (up to June 2022). Based on the mean changes for both comparison and intervention groups, the effect sizes were calculated. Further, DerSimonian and Laird random-effects model was performed to determine the summary of overall effects and their heterogeneity. RESULTS: Fifteen studies were selected for systematic review and thirteen studies were known to be eligible for meta-analysis. Meta-analysis results indicated a significant effect in serum CRP concentrations compared to the control group (weighted mean difference (WMD)= -0.22 mg/L 95 % confidence interval (CI): - 0.39, - 0.04; p = 0.014). CONCLUSION: In conclusion, our study confirms the downward effect of selenium on the serum concentration of CRP. On a wider level, further research is also needed to assess the selenium effect on other inflammatory mediators.

Household Food Insecurity and Associated Factors among Iranian Patients with Esophageal and Gastric Cancers.

Background: Household food insecurity (HFI) which has still been one of the major global public health issues is related to adverse health outcomes in individuals. Therefore, this study aimed to determine the prevalence of HFI and its associated factors in Iranian patients with esophageal and gastric cancers. Methods: The data of this cross-sectional study was obtained from 315 patients with esophageal and gastric cancers who were selected from a gastrointestinal cancer-based cohort study conducted in Firoozgar hospital, in Tehran. Food insecurity (FI) was measured using the Iranian version of the HFI questionnaire that was completed by a trained interviewer. The multivariable logistic regression model was used to determine the independent association of each factor with HFI. A P value lower than 0.05 was considered statistically significant. Results: The mean±SD of participants' age was 63.2±12.6 years and 65.4% were men. Most of the patients (75.8%) suffered from gastric cancer and 24.2% from esophageal cancer. The overall prevalence of FI among participants' households was 35.2%. There was an independent significant association between wealth index (WI) and HFI after the use of the multivariable logistic regression model, in such a way that the odds of FI in the poorest, poor, moderate, and rich patients' households were respectively, 6.41, 5.05, 2.74 and 2.04 times higher compared with the richest households. Conclusion: More than a third of participants' households struggled with FI, which was found to have a higher prevalence in loweconomic households. Therefore, health policymakers should intervene in food-insecure households by developing, establishing, and implementing strategies and control programs to improve affordable food access.

Coagulopathy and thromboembolic events a pathogenic mechanism of COVID-19 associated with mortality: An updated review.

During 2019, the SARS-CoV-2 emerged from China, and during months, COVID-19 spread in many countries around the world. The expanding data about pathogenesis of this virus could elucidate the exact mechanism by which COVID-19 caused death in humans. One of the pathogenic mechanisms of this disease is coagulation. Coagulation disorders that affect both venous and arterial systems occur in patients with COVID-19. The possible mechanism involved in the coagulation could be excessive inflammation induced by SARS-CoV-2. However, it is not yet clear well how SARS-CoV-2 promotes coagulopathy. However, some factors, such as pulmonary endothelial cell damage and some anticoagulant system disorders, are assumed to have an important role. In this study, we assessed conducted studies about COVID-19-induced coagulopathy to obtain clearer vision of the wide range of manifestations and possible pathogenesis mechanisms.

Quality of life of patients treated with opium tincture or methadone: A randomized controlled trial.

OBJECTIVE: Quality of life (QoL) is an increasingly recognized patient-centered treatment outcome in individuals with opioid use disorder. There is a gap in literature on the impact of opium tincture (OT) on patients' QoL compared to standard treatment options such as methadone. This study aimed to compare the QoL of participants with opioid use disorder receiving OAT using OT or methadone and identify the factors associated with their QoL during treatment. METHODS: The opium trial was a multicenter non-inferiority randomized clinical trial in four private OAT outpatient clinics in Iran. The study assigned patients to either OT (10 mg/ml) or methadone sirup (5 mg/ml) for a follow-up of 85 days. QoL was assessed using the brief version of the World Health Organization Quality of Life instrument (WHOQOL- BREF). RESULTS: A total of 83 participants, 35 (42.2%) in the OT arm and 48 (57.8%) in the methadone arm, completed the WHOQOL-BREF in full and were included in the primary analysis. The mean score of patients' QoL showed improvement compared to baseline, but differences were not statistically significant between OT and methadone arms (p = 0.786). Improvements were mainly observed within the first 30 days of receiving treatment. Being married and lower psychological distress were associated with an improved QoL. Within the social relationships domain, male gender showed significantly higher QoL compared to females. CONCLUSION: OT shows promise as an OAT medication, comparable to methadone in improving patients' QoL. There is a need to incorporate psychosocial interventions to further sustain and improve the QoL in this population. Identifying other social determinants of health which affect QoL and the cultural adaptation of assessments for individuals from various ethnocultural backgrounds are critical areas of inquiry.

An origami-based colorimetric sensor for detection of hydrogen peroxide and glucose using sericin capped silver nanoparticles.

The hydrogen peroxide (H2O2) measurement is considered highly important in industrial wastewater quality assessment, environmental protection, and disease detection. Here, a simple high-performance paper-based sensor is proposed for rapid and in situ detection of H2O2. To this end, 3,3',5,5'-tetramethylbenzidine is embedded in the sensor to act as a color indicator, whose reaction with hydrogen peroxide is catalyzed by a silver nanozyme modified by sericin. The result of the reaction clarified by the appearance of blue color in the sensor detection zone is received by a portable scanner, while also calculating its intensity by image analysis software. This method is sensitive to hydrogen peroxide in the concentration range of 0.5‒240 mg/dL, providing a detection limit of 0.15 mg/dL. The ability of the sensor to determine glucose is also evaluated by adding a layer containing glucose oxidase enzyme to the sensor structure. A desirable response is obtained in the range of 1.0‒160 mg/dL, together with a detection limit of 0.37 mg/dL. Accordingly, the proposed sensor shows satisfactory results compared to clinical methods for monitoring the amount of glucose in biological samples such as serum and saliva.

Relationship of sleep duration and sleep quality with health-related quality of life in patients on hemodialysis in Neyshabur.

Background: As a public health priority, health-related quality of life (HRQoL) is associated with some factors like sleep disorders. Taking this into consideration, this study aimed at investigating the relationship between sleep duration and sleep quality with HRQoL in patients on hemodialysis. Methods: This cross-sectional study was carried out among 176 patients on hemodialysis who were admitted to the dialysis ward of 22 Bahman hospital and a private renal clinic in Neyshabur (a city in North-East of Iran) in 2021. Sleep duration and quality were measured using an Iranian version of Pittsburgh Sleep Quality Index (PSQI) and HRQoL was evaluated with the Iranian version of a 12-Item Short Form Survey (SF-12). To analyze the data and examine the independent association of sleep duration and quality with HRQoL, multiple linear regression model was performed. Results: The mean age of the participants was 51.6 ± 16.4 and 63.6% were male. Moreover, 55.1% and 5.7% of subjects reported a sleep duration shorter than 7 h and equal to or more than 9 h, respectively, and the value prevalence of poor sleep quality was reported as 78.2%. Furthermore, the reported overall score of HRQoL was 57.6 ± 17.9. According to the adjusted models, poor sleep quality was negatively associated with the total HRQoL score (B = -14.5, P < 0.001). Shedding light on sleep duration and Physical Component Summary (PCS), the result indicated that insufficient sleep duration (<7 h) had a borderline negative association with PCS (B = -5.96, p = 0.049). Conclusions: Sleep duration and quality have important effects on HRQoL in patients on hemodialysis. Therefore, in line with improving sleep quality and HRQoL among these patients, essential interventions should be planned and performed.

Bacterial spectrum and antimicrobial resistance pattern in cancer patients with febrile neutropenia.

BACKGROUND: Bloodstream infections are serious complications in neutropenic cancer patients. There has been a universal pickup in multidrug resistant (MDR) strains. For individuals who are at high risk for infections caused by MDR bacteria, a novel de-escalation strategy has been developed. Determine the bacterial spectrum and antibiotic resistance pattern in febrile neutropenic cancer patients was the goal of this investigation. MATERIALS AND METHODS: From 2019 to 2020, 60 cancer patients with febrile neutropenia who were sent to Isfahan's Omid Hospital were included in this retrospective analysis. Experiments were done on the antimicrobial susceptibility of isolated bacterial infections. RESULTS: The patients' average age was 43.35±15.59 years. Ninety-one percent (55/61) of the 60 patients had hematologic malignancies, and 8.3 percent (5/61) had solid tumors. The majority of the germs were gram-negative bacteria (66.7 percent). E. coli was the pathogen that was isolated the most frequently (26.7%), followed by Klebsiella (16.7 percent). In addition, the most prevalent identified Gram-positive bacteria was Staphylococcus epidermidis (21.7 percent). Third-generation cephalosporin (ESBL-E) resistance was present in 50% of E. coli, along with 50% resistance to cotrimoxazole, ciprofloxacin, and piperacillin, 31% resistance to amikacin, and 20% resistance to meropenem (CRE). They had an 80% sensitivity to amikacin and a 70% sensitivity to ciprofloxacin. Ten percent of our patients had antibiotic resistance in the antibiogram (XDR). CONCLUSION: In summary, most bacterial infections were resistant to different medications. The emergence and spread of Gram-negative bacteria that are resistant to antibiotics can be stopped by prudent antibiotic use.

Effect of soy isoflavones on C-reactive protein in chronic inflammatory disorders.

New evidence suggests that soy products might reduce chronic systemic inflammation. Therefore, we aimed to summarize the effect of soy isoflavones on serum concentration of C-reactive protein (CRP) among participants with chronic inflammatory disorders by conducting this study. Cochrane Library, Scopus, ISI Web of Science, clinicaltrials.gov, and PubMed were searched to identify randomized clinical trials (RCTs) published up to December 2020. The effect size was calculated by the mean change from baseline in concentrations of CRP and its standard deviation for both intervention and comparison groups. DerSimonian and Laird random-effects model was used when the heterogeneity test was statistically significant. In total, thirteen RCTs involving 1213 participants and ten RCTs involving 1052 participants were eligible for our systematic review and meta-analysis respectively. Study duration ranged from 4 to 96 weeks and soy isoflavones dose varied from 33 to 132 mg/day. Overall effect size indicated a non-significant effect on serum concentration of CRP following soy isoflavones intake (weighted mean differences (WMD)=-0.15 mg/L, 95% confidence interval (CI): -0.54, 0.23; p=0.430). Subgroup analysis revealed that soy isoflavones significantly reduced serum concentration of CRP in studies among participants with age >57 years and baseline CRP levels >3.75 mg/L. The present study proposed that soy isoflavones could not significantly reduce serum CRP levels. It seems more RCTs on participants with age more than 57 years and higher levels of CRP is necessary.

Opium tincture versus methadone for opioid agonist treatment: a randomized controlled trial.

AIM: To test if opium tincture (OT) was non-inferior to methadone in retaining participants in opioid agonist treatment (OAT). DESIGN: A Phase III, multi-centre, parallel-group, non-inferiority, double-blind randomized controlled trial with an allocation ratio of 1:1. Participants were provided treatment and followed for a period of 85 days. SETTING: Four OAT clinics in Iran. PARTICIPANTS: Two hundred and four participants with opioid use disorder [mean age (standard deviation) = 37.4 (9.3); female 11.3%] recruited between July 2017 and January 2018. INTERVENTIONS: Participants were assigned to either OT (102) or methadone (102) using a patient-centred flexible dosing strategy. MEASUREMENTS: Treatment retention over 85 days was the primary outcome. Self-reported opioid use outside treatment and occurrence of adverse events (AEs) were the secondary outcomes. FINDINGS: Remaining in treatment at the end of the follow-up were 68.6% in the methadone arm and 59.8% in the OT arm. The relative retention rate of methadone to OT was 1.15 (0.97, 1.36) in both intent-to-treat and per-protocol analyses; non-inferiority was not supported statistically, as the upper bound of the confidence interval exceeded our pre-specified non-inferiority margin (1.25). Opioid use outside treatment was reported by 30.3% of OT (n = 152) and 49.4% of methadone (n = 168) patients, a difference in proportions of -19%: 90% confidence interval (-28%, -10%). The total count of AEs in the OT arm (22 among nine individuals) was significantly higher (P = 0.04) than that in the methadone arm (three among two individuals). Nausea was the most common side effect. CONCLUSION: While this study could not conclude the non-inferiority of opium tincture (OT) to methadone for retaining patients in opioid agonist treatment, OT retained 60% of participants to end of follow-up (85 days) and was superior to methadone in reducing self-reported opioid use outside treatment.