Improvement in Essential Oil Quantity and Quality of Thyme (Thymus vulgaris L.) by Integrative Application of Chitosan Nanoparticles and Arbuscular Mycorrhizal Fungi under Water Stress Conditions.

Water stress is one of the critical abiotic stresses and limiting factors in the productivity of plants, especially in arid and semi-arid regions. In recent years, the application of bio-fertilizer and stress-modulating nanoparticles (NPs) is known as one of the eco-friendly strategies for improving plants quantity and quality under stressful conditions. In order to achieve the desirable essential oil (EO) quality and quantity of thyme in water deficit conditions, a 2-year field experiment was carried out as a split plot based on the randomized complete block design (RCBD), with 12 treatments and three replications. The treatments included different irrigation levels, containing irrigation at 80% field capacity (FC80) as no stress, 60% FC as moderate water stress (FC60) and 40% FC as severe water stress (FC40), as well as four different fertilizer sources, including non-application of fertilizer (control), application of arbuscular mycorrhizal fungi (AMF), chitosan NPs (CHT) and co-application of AMF+CHT NPs. The results demonstrated that the dry yield of thyme decreased by 13% and 40.3% under FC60 and FC40 water stress conditions. However, co-application of AMF+CHT NPs enhanced the dry yield of thyme by 21.7% in comparison to the control (non-application of fertilizer). The maximum EO content (2.03%) and EO yield (10.04 g 7 g m-2) of thyme were obtained under moderate water stress (FC60) fertilized with AMF+CHT NPs. Co-application of AMF+CHT NPs enhanced the EO content and EO yield of thyme by 17.1% and 42.7%, respectively. Based on the GC-MS and GC-FID analysis, 38 constituents were identified in the thyme EO, with the major constituents being thymol (35.64-41.31%), p-cymene (16.35-19.38%), γ-terpinene (12.61-13.98%) and carvacrol (2.78-3.93%) respectively. The highest content of thymol and γ-terpinene was obtained under moderate water stress (FC60) fertilized with AMF+CHT NPs. In addition, the highest content of p-cymene and carvacrol was observed in the severe water stress (FC40) fertilized with AMF+CHT NPs. The present research suggests that the co-application of AMF+CHT NPs represents a sustainable and eco-friendly strategy for improving the EO quantity and quality of thyme under water stress conditions.

Effectiveness of implementing of an infection control link nurse program to improve compliance with standard precautions and hand hygiene among nurses: a quasi-experimental study.

BACKGROUND: Standard precautions (SPs) including hand hygiene are considered fundamental protective measures to manage health care-associated infections (HCAIs) and to reduce occupational health hazards. The purpose of this research was to examine the effectiveness of an infection control link nurse (ICLN) program on compliance with SPs and hand hygiene among nurses. METHODS: A quasi-experimental study with a pretest-post-test design was conducted with participating of 154 clinical nurses who worked in different wards of a tertiary referral teaching hospital in Iran. The intervention group (n = 77) had 16 infection control link nurses nominated. The control group (n = 77) received only the standard multimodal approach used in the hospital. Pre- and post-test assessment of compliance with standard precautions and hand hygiene compliance was performed via the Compliance with Standard Precautions Scale (CSPS) and the World Health Organization observational hand hygiene form. Two independent sample t-tests were used to examine differences between Compliance with Standard Precautions and hand hygiene Compliance among nurses in intervention and control group. Multiple linear regression analysis was used to assess the effect size. RESULTS: After developing and implementing the infection control link nurse program, no statistically significant improvement was found in the Compliance with Standard Precautions (ß = 5.18; 95% CI= -0.3-10.65, p = 0.064). An improvement in hand hygiene compliance was observed among nurses in the intervention group that improved statistically significant from 18.80% before the program to 37.32% 6 months after the program (ß = 20.82; 95% CI 16.40-25.25, p < 0.001). CONCLUSIONS: Given the continuing level of interest that exists in improving health care workers' hand hygiene practices, the findings of this study provide significant practical implications for hospitals seeking to improve compliance with hand hygiene among nurses, showing the effectiveness of using infection control link nurse program. Further research is needed to assess effectiveness of using infection control link nurse program to improve compliance with standard precautions.

Challenges and prerequisites of risk management program in the operating rooms of Iranian hospitals: A qualitative study.

BACKGROUND: The World Health Organization (WHO) considers a safe operating room as one of the necessities of hospitals that support patients. Achieving safety in surgical operations in all countries of the world is the basic goal of healthcare centers and organizations; hence, the present study investigated the challenges and prerequisites for the implementation of an active risk management program in the operating rooms of Iranian hospitals. MATERIALS AND METHODS: This qualitative-phenomenological study was conducted in 2022. Data were collected using semi-structured interviews, targeted sampling, and the participation of 20 experts (health policy and management experts and academic officials and faculty members of universities) and executive staff (nurses and operating room technicians, doctors and surgical specialists, and officials of surgical departments) and were analyzed using the framework analysis method. RESULTS: In the resulting qualitative study, the challenges and prerequisites for active risk management in the operating room from the point of view of experts and executive staff were divided into three sub-themes. These three themes include managerial challenges and prerequisites, organizational resources (financial resources, human resources, equipment, and facilities), and cultural issues. CONCLUSION: Considering managerial prerequisites, organizational resources (financial, human, equipment, and facilities), cultural issues, and removing challenges, an active risk management program in the operating room can be implemented correctly. With the correct implementation of this program, injuries in the operating room for personnel and patients will be greatly reduced, and the satisfaction of beneficiaries and the productivity of the hospital will be greatly increased.

A sensitive determination of morphine in plasma using AuNPs@UiO-66/PVA hydrogel as an advanced optical scaffold.

In this study, a novel turn-on fluorescence nanoprobe structure has been developed by in situ synthesis and embedding of gold nanoparticles (AuNPs) and Zr-based metal-organic frameworks (MOFs), UiO-66, in polyvinyl alcohol (PVA) hydrogel for sensitive quantification of morphine in human plasma samples. A three-dimensional network of PVA hydrogel was formed by simultaneously penetrating UiO-66 and gold ions in the hydrogel frame and reducing to AuNPs without adding any reducing agent. The morphology and characterization of this new PVA-based nanocomposite hydrogel were studied by transmission electron microscopy, dynamic light scattering instrument, energy-dispersive X-ray spectroscopy, and Fourier transform infrared spectroscopy. Based on weakened fluorescent intensity resulting from AuNPs binding with Zr node in UiO-66 within PVA matrix, AuNPs@UiO-66 part of the nanocomposite has been employed as a fluorescent sensing probe for selective detection of morphine. The subsequent turn-on of the biocompatible nanoprobe is dependent on the strong binding of morphine with AuNPs on the surface of the UiO-66 frameworks. This platform illustrates a linear calibration curve in the range from 0.02 to 2.0 µg mL-1 with a detection limit of 0.016 µg mL-1. The relative intra- and inter-day standard deviations of the nanoprobe for determinations of morphine were 0.84% and 0.69% (n = 5), respectively. It is particularly proper for precise morphine assay in complex samples like human plasma with good recoveries and acceptable results. Due to its portable, robust, and instrument-free characteristics, it is estimated to display superb prospective for on-site clinical monitoring.

Co-Application of TiO2 Nanoparticles and Arbuscular Mycorrhizal Fungi Improves Essential Oil Quantity and Quality of Sage (Salvia officinalis L.) in Drought Stress Conditions.

Drought stress is known as a major yield-limiting factor in crop production that threatens food security worldwide. Arbuscular mycorrhizal fungi (AMF) and titanium dioxide (TiO2) have shown to alleviate the effects of drought stress on plants, but information regarding their co-addition to minimize the effects of drought stress on plants is scant. Here, a two-year field experiment was conducted in 2019 and 2020 to evaluate the influence of different irrigation regimes and fertilizer sources on the EO quantity and quality of sage (Salvia officinalis L.). The experiment was laid out as a split plot arranged in a randomized complete block design with three replicates. The irrigation treatments were 25, 50, and 75% maximum allowable depletion (MAD) percentage of the soil available water as non-stress (MAD25), moderate (MAD50), and severe (MAD75) water stress, respectively. Subplots were four fertilizer sources including no-fertilizer control, TiO2 nanoparticles (100 mg L-1), AMF inoculation, and co-addition of TiO2 and AMF (TiO2 + AMF). Moderate and severe drought stress decreased sage dry matter yield (DMY) by 30 and 65%, respectively. In contrast, application of TiO2 + AMF increased DMY and water use efficiency (WUE) by 35 and 35%, respectively, compared to the unfertilized treatment. The highest EO content (1.483%), yield (2.52 g m-2), and cis-thujone (35.84%, main EO constituent of sage) was obtained in MAD50 fertilized with TiO2 + AMF. In addition, the net income index increased by 44, 47, and 76% with application of TiO2 nanoparticles, AMF, and co-addition of TiO2 + AMF, respectively. Overall, the integrative application of the biofertilizer and nanoparticles (TiO2 + AMF) can be recommended as a sustainable strategy for increasing net income and improving EO productivity and quality of sage plants in drought stress conditions. Future policy discussions should focus on incentivizing growers for replacing synthetic fertilizers with proven nano and biofertilizers to reduce environmental footprints and enhance the sustainability of sage production, especially in drought conditions.

A cross-sectional multicenter linkage study of hospital admissions and mortality due to methanol poisoning in Iranian adults during the COVID-19 pandemic.

A methanol poisoning outbreak occurred in Iran during the initial months of coronavirus disease 2019 (COVID-19) pandemic. We aimed to evaluate the epidemiology of the outbreak in terms of hospitalizations and deaths. A cross-sectional linkage study was conducted based on the hospitalization data collected from thirteen referral toxicology centers throughout Iran as well as mortality data obtained from the Iranian Legal Medicine Organization (LMO). Patient data were extracted for all cases aged > 19 years with toxic alcohol poisoning during the study period from February until June 2020. A total of 795 patients were hospitalized due to methanol poisoning, of whom 84 died. Median [interquartile ratio; IQR] age was 32 [26, 40] years (range 19-91 years). Patients had generally ingested alcohol for recreational motives (653, 82.1%) while 3.1% (n = 25) had consumed alcohol-based hand sanitizers to prevent or cure COVID-19 infection. Age was significantly lower in survivors than in non-survivors (P < 0.001) and in patients without sequelae vs. with sequelae (P = 0.026). Twenty non-survivors presented with a Glasgow Coma Scale (GCS) score > 8, six of whom were completely alert on presentation to the emergency departments. The time from alcohol ingestion to hospital admission was not significantly different between provinces. In East Azerbaijan province, where hemodialysis was started within on average 60 min of admission, the rate of sequelae was 11.4% (compared to 19.6% average of other provinces)-equivalent to a reduction of the odds of sequelae by 2.1 times [95% CI 1.2, 3.7; p = 0.009]. Older patients were more prone to fatal outcome and sequelae, including visual disturbances. Early arrival at the hospital can facilitate timely diagnosis and treatment and may reduce long-term morbidity from methanol poisoning. Our data thus suggest the importance of raising public awareness of the risks and early symptoms of methanol intoxication.

Endoscopic, laboratory, and clinical findings and outcomes of caustic ingestion in adults; a retrospective study.

Aim: Compared to the prevalence and complications, there is still limited evidence in this regard. Background: With an incidence rate of 200,000 cases annually and the induction of numerous complications, caustic ingestion imposes a significant burden on the healthcare system. Apart from being fatal in some cases, this injury affects its victims' quality of life as it is followed by many gastrointestinal problems. This injury mainly occurs accidentally among children, whereas in adults, it often occurs with suicidal intentions. Despite recent advances in internal medicine, gastroenterology, and toxicology, this type of injury remains a debilitating and, in some cases, fatal disorder for its victims. Methods: This study retrospectively evaluated the clinical, laboratory, and endoscopic findings of 150 patients admitted to a referral center of toxicology and forensic medicine and assessed factors associated with each type of injury. Results: The findings indicated a mortality rate as high as 7.3% in this population. Age, pH, and previous medical conditions were associated with more complications. Higher degrees of injury were also significantly associated with higher mortality. No significant difference was observed between types of corrosive substances. Conclusion: It seems that the most effective intervention for controlling caustic ingestion injuries would be psychiatric support, primary healthcare, and household education.

Optimizing Antioxidant Activity and Phytochemical Properties of Peppermint (Mentha piperita L.) by Integrative Application of Biofertilizer and Stress-Modulating Nanoparticles under Drought Stress Conditions.

Drought stress (DS) negatively affects plant growth, productivity, and quality in semi-arid and arid regions. Nowadays, application of biofertilizers and stress-modulating nanoparticles (NPs) improves plant performance under stressful conditions. The study evaluated the impacts of arbuscular mycorrhizal fungi (Myco-Root) and TiO2 NPs on the nutrient uptake, dry yield, essential oil (EO) productivity, and EO quality of peppermint (Mentha piperita L.) under different irrigation regimes. The treatments included three irrigation regimes containing irrigation after 20% (I20, well-watered), 40% (I40, mild DS), and 60% (I60, severe DS) maximum allowable depletion (MAD) percentage of the soil's available water as well as four fertilizer sources contain no fertilization (control), Myco-Root biofertilizer, TiO2 NPs, and an integrative application of Myco-Root + TiO2 NPs. The results demonstrated that the highest (195.72 g m-2) and the lowest dry yield (78.76 g m-2) of peppermint was obtained in well-watered conditions with integrative application of Myco-Root + TiO2 NPs and severe drought stress (I60) without fertilization, respectively. The dry yield of peppermint was reduced by 27.7 and 53.4% in mild (I40) and severe drought stress (I60), respectively. The maximum EO content (1.49%) and EO yield (2.30 g m-2) was recorded in mild drought stress (I40) treated with Myco-Root + TiO2 NPs. Based on the GC-MS and GC-FID analysis, 29 constituents were identified in peppermint EO, with the major constituents being menthol (38.99-52%), menthone (12.72-20.13%), 1,8-cineole (6.55-7.84%), and neo-menthol (3.14-4.52%), respectively. The maximum content of menthol, 1,8-cineole, and neo-menthol was obtained under mild drought stress (I40) fertilized with Myco-Root + TiO2 NPs. The results indicate that the integrative application of Myco-Root + TiO2 NPs could be used as an alternative method of using chemical fertilizers in sustainable agricultural systems for improving the EO quantity and quality of peppermint grown under drought stress conditions.

Plasma Concentration of Taurine Changes following Acetaminophen Overdose in Male Patients during Hospitalization.

Changes in plasma concentration of taurine during hospitalization of acetaminophen poisoned patients have not been studied. Hepatotoxicity is a common consequence of acetaminophen overdose that may lead to acute liver failure. Numerous biomarkers for drug-induced liver injury have been explored. All biomarkers are usually obtainable 48 h following acetaminophen overdose. We have already introduced taurine as a non-specific early biomarker of acetaminophen overdose. This study aimed to follow up changes in plasma concentration of taurine during the first three days of acetaminophen overdose. Sixty-four male patients suffering from acetaminophen overdose were selected for the study. Four blood samples were taken from the patients every 12 h. Sixty blood samples were also taken from sixty healthy humans. The plasma concentration of taurine in both groups was analyzed an already developed HPLC method. Analysis of regression showed a significant correlation between means of plasma concentrations of taurine and acetaminophen, aspartate aminotransferase, Alanine aminotransferase, glutathione peroxidase, and prothrombin time during hospitalization. The high plasma concentration of taurine, 6 h or more after acetaminophen overdose, could be a useful early indicator of liver damage.

A Rapid Mercury Droplet Electrode Polarography Method for Determination of Blood Lead Level in Lead Poisoned People.

BACKGROUND: Lead is a hazardous heavy metal, which causes many problems in the human body. Unfortunately, recent reports showed that smugglers and opium sellers add lead to drugs during the production procedure in order to increase its weight and cost. PURPOSE: The aim of this study was development of a rapid and accurate method for measurement of blood lead levels (BLL) in the oral and inhaled opiate abuser people. METHODS: BLL in samples obtained from the oral and inhaled opium addicted patients referring to Sina Hospital in Tabriz, Iran, during 2017 was compared with healthy control group (N=15). The wet digestion method was used to prepare whole blood and Mercury Droplet Electrode Polarography (MDEP) method was utilized for measurement of the lead content of digested samples. RESULTS: Results showed that there were significant differences between the BLL of samples obtained from oral (17.12±74.61 µg/dL, p<0.0003) and inhaled (19.33±2.257 µg/dL, p<0.0001) opium addicted groups in comparison with healthy control group (4.669±0.3367 µg/dL). CONCLUSION: Based on the results of this study it was observed that BLL in opium addicted people needs to be measured as soon as possible. Furthermore, screening of blood lead concentrations in opium-addicted people with a rapid and accurate MDEP method is very necessary and important.

Development of family-based follow-up care system for patients with burn in Iran: Participatory action research.

Aim: After the discharge of patients with burns, quality of life, psychological and social adjustment, performance and their follow-up are ambiguous. Therefore, we decided to improve the status of family-based care programmes in patients with the burn. Design: Participatory action research. Methods: The participatory action research was conducted between the Faculty of Nursing, Sina Hospital's managers and multidisciplinary burn teams from 2017-2018. The procedure for data collection included focus group meetings with key informants, interviews, observation, and questionnaire. Qualitative data were analysed using the qualitative content analysis and qualitative data were analysed by SPSSv.24. Results: The study, comprised of four phases, started in May 2017 and completed in 9 months. The results of quantitative showed that quality of life has a statistically significant difference before and after the action. The qualitative data resulted were grouped into 3 categories and 28 subcategories and were analysed in the SWOT Matrix. All the multidisciplinary burn teams together with the managers as a team working of the care providers and the academic researcher resulted in enablers the changes in providing health education and services as well as improving the quality of life of patients and their families.

Comparison of Two Naloxone Regimens in Opioid-dependent Methadoneoverdosed Patients: A Clinical Trial Study.

BACKGROUND: Methadone toxicity is one of the major causes of death in opioiddependent individuals. OBJECTIVE: We aimed to compare two different protocols of naloxone administration in terms of reversal of overdose signs and symptoms and frequency of complications in opioid-dependent methadone-intoxicated patients. METHOD: One-hundred opioid-dependent patients with signs/symptoms of methadone overdose were included. The patients were consecutively assigned into Tintinalli (group 1) or Goldfrank regimen protocol (group 2) of naloxone administration. Group 1 received naloxone with the dose 0.1 mg given every two to three minutes while group 2 received naloxone with the initial dose of 0.04 mg increasing to 0.4, 2, and 10 mg every two to three minutes to reverse respiratory depression. They were then compared regarding reversal of toxicity and risk of development of complications. RESULTS: The time to reversal of the overdose signs/symptoms was significantly less in Goldfrank regimen protocol (P<0.001). Frequency of withdrawal syndrome and recurrence of respiratory depression were not significantly different between the two groups. Aspiration pneumonia and intubation were more frequent in group 2, as well. CONCLUSION: It seems that gradual titration of naloxone by Tintinalli protocol can reduce major complications compared to the Goldfrank regimen. However, this protocol was not perfect in opioid-dependent methadone-overdosed patients, either, since it could induce complications, as well. We may need new protocols in overdosed opioid-dependent patients.

A review of aluminium phosphide poisoning and a flowchart to treat it.

The use of pesticides such as aluminium phosphide (AlP) has increased in the recent years and improved the quantity and quality of agricultural products in a number of developing countries. The downside is that AlP causes severe chronic and acute health effects that have reached major proportions in countries such as India, Iran, Bangladesh, and Jordan. Nearly 300,000 people die due to pesticide poisoning in the world every year. Poisoning with AlP accounts for many of these deaths. Unfortunately, at the same time, there is no standard treatment for it. The aim of this article is to give a brief review of AlP poisoning and propose a treatment flowchart based on the knowledge gained so far. For this purpose we reviewed all articles on the management of AlP poisoning published from 2000 till now. Using a modified Delphi design, we have designed a handy flowchart that could be used as a guide for AlP poisoning management of patients in emergency centres.

The Protocol of Choice for Treatment of Snake Bite.

The aim of the current study is to compare three different methods of treatment of snake bite to determine the most efficient one. To unify the protocol of snake bite treatment in our center, we retrospectively reviewed files of the snake-bitten patients who had been referred to us between 2010 and 2014. They were contacted for follow-up using phone calls. Demographic and on-arrival characteristics, protocol used for treatment (WHO/Haddad/GF), and outcome/complications were evaluated. Patients were entered into one of the protocol groups and compared. Of a total of 63 patients, 56 (89%) were males. Five, 19, and 28 patients were managed by Haddad, WHO, or GF protocols, respectively. Eleven patients had fallen into both GF and WHO protocols and were excluded. Serum sickness was significantly more common when WHO protocol was used while 100% of the compartment syndromes and 71% of deformities had been reported after GF protocol. The most important complications were considered to be deformity, compartment syndrome, and amputation and were more frequent after the use of WHO and GF protocols (23.1% versus 76.9%; none in Haddad; P = NS). Haddad protocol seems to be the best for treatment of snake-bitten patients in our region. However, this cannot be strictly concluded because of the limited sample size and nonsignificant P values.

The effects of milk thistle on hepatic fibrosis due to methotrexate in rat.

BACKGROUND: Extracts of milk thistle (MT), Silybum marianum, have been used as medical remedies since the time of ancient Greece. Methotrexate is a potentially hepatotxic drug. OBJECTIVES: To clarify the hepatoprotective effects of MT on methotrexate. MATERIALS AND METHODS: From January 2010 to April 2010, 30 male rats were recruited into three 10-rat subgroups in Tabriz University of Medical Sciences. Normal saline was injected intraperitoneally in the first group (A; the controls); intraperitoneal methotrexate plus oral MT extract were administered to the second group (B) and intraperitoneal methotrexate alone was given to the third group (C). Pre- and post-interventional measuring of serum parameters were carried out every 15 days. After six weeks, the rats were decapitated and histopathological evaluation of liver was done. RESULTS: Serum liver enzymes (AST, ALT), alkaline phosphatase, total and direct bilirubin, creatinine and BUN were measured on days 0, 15, 30, 45. They were significantly higher in the group C, comparing with other two groups. Serum albumin was the least in group C animals as well. There were no significant differences between groups A and B. The mean±SD fibrosis score using semi-quantitative scoring system (SSS) was 1.25±0.46, 1.40±0.52 and 6.70±0.82, in groups A, B and C, respectively (p<0.001). CONCLUSIONS: MT extract can effectively prevent methotrexate-induced liver dysfunction and fibrosis in rats.

Effect of pulse therapy with glucocorticoid and cyclophosphamide in lung fibrosis due to paraquat poisoning in rats.

OBJECTIVE: To evaluate the effectiveness of cyclophosphamide and methylprednisolone pulse therapy in the prevention of pulmonary fibrosis due to paraquat poisoning in rats. METHODS: This study was carried out in Sina Hospital, Tabriz, Iran, between February and August 2009. Acute poisoning in rats was induced by intraperitoneal injection of Paraquat (15 mg/kg). We planned 2 separate treatment groups (10 rats each), pulse therapy with methylprednisolone (26.5 mg/kg) and cyclophosphamide (15 mg/kg) intraperitoneally for 3 days (PQ+P) and treatment with conventional anti-oxidant drugs including vitamin A, vitamin E, and N-acetylcysteine (PQ+Vit). Prevention of pulmonary fibrosis was evaluated on the fifteenth day. A semi-quantitative determination of lung fibrosis was carried out (Ashcroft staging criteria) on the lung sections and results compared with the paraquat control group (PQ). RESULTS: The mean score of fibrosis in the PQ was 4.60+/-1.20, in PQ+P was 2.93+/-0.72, and for PQ+Vit groups was 4.25+/-1.08. The score of fibrosis in the PQ+P was significantly lower than the PQ group (p=0.011), while there was no significant difference in the average score of lung fibrosis between the PQ and PQ+Vit groups. CONCLUSION: Pulse therapy with cyclophosphamide and methylprednisolone significantly prevented pulmonary fibrosis. Therefore, we recommend it along with conventional therapies in the treatment of acute paraquat poisoning.