Emergency Department Patient Satisfaction Assessment using Modified Servqual Model; a Cross-sectional Study.

INTRODUCTION: The quality of medical services and attention paid to patients in medical centers have been concerning for healthcare providers. OBJECTIVE: The present study was designed to identify factors affecting patient satisfaction with medical service in the emergency department (ED). METHOD: This was a cross-sectional study conducted in spring 2016 in Imam Khomeini Hospital, Jiroft, Iran. Patients aged more than 18 years presenting to the ED with a minimum stay of 24 hours were included. Unwillingness to take part, incomplete questionnaires, or unavailability for an interview were considered the exclusion criteria. Data were collected using a 24-item researcher-made questionnaire based on Servqual quality measuring tool with five components of tangibles, reliability, responsiveness, assurance, and empathy. RESULTS: The present study recruited 373 patients with the mean age of 41.7±21.8 years (minimum 18 and maximum 79 years), of whom, 67.1% were men. Mean scores indicate the level of patient satisfaction with the hospital service ranging from relatively satisfied to totally satisfied. The components ranking in improving patient satisfaction were as follows: tangibles 4.59, assurance 2.77, reliability 2.74, responsiveness 2.57, and empathy 2.33. CONCLUSION: Of the components assessing the patient satisfaction, tangibles were the most effective component and empathy was the least effective one.

Photo-catalytic, anti-bacterial, and anti-cancer properties of phyto-mediated synthesis of silver nanoparticles from Artemisia tournefortiana Rchb extract.

Metal nanoparticles have largely been investigated due to their potential medicinal activities. This study demonstrates the biological properties of green-synthesized silver nanoparticles (AgNPs) by using Artemisia tournefortiana Rchb ethanol extract. Instrumentations such as ultraviolet-visible spectra analysis, high-resolution transmission electron microscopy, scanning electron microscopy, energy-dispersive X-ray analysis, X-ray diffraction, and Fourier transform infrared spectroscopy were used to reveal the synthesized AgNPs. Microscopic results showed that the particles were mostly spherical in shape, having an average diameter of 22.89±14.82nm. The antibacterial activity of the phyto-fabricated AgNPs was investigated by the determination of minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). The in vitro cytotoxicity effect was investigated against normal human embryonic kidney (HEK293) cells and human colon adenocarcinoma cancer (HT29) cells. The apoptotic cells were identified by annexin V/PI FITC staining, and morphological assessment. The expressions of Bax and Bcl2 were evaluated by quantitative real time PCR method. The phyto-synthesized AgNPs have shown increased cell apoptosis and demonstrated dose-dependent cytotoxicity in HT29 cancer cells. Moreover, the photocatalytic activity of the phyto-synthesized AgNPs was evaluated by degradation of Coomassie Brilliant Blue G-250 under UV light exposure and these fabricated Ag nanoparticles demonstrated efficacy in degrading the dye within 60min. Overall, the present results highlighted the antibacterial and anticancer properties of fabricated AgNPs, suggesting that phyto-synthesized silver nanoparticles could possess potent anti-pathogenic bacteria and anti-colon cancer activities.

Antioxidant, antibacterial and anticancer properties of phyto-synthesised Artemisia quttensis Podlech extract mediated AgNPs.

The focus of this study is on a rapid and cost-effective approach for the synthesis of silver nanoparticles (AgNPs) using Artemisia quttensis Podlech aerial parts extract and assessment of their antioxidant, antibacterial and anticancer activities. The prepared AgNPs were determined by ultraviolet-visible spectroscopy, X-ray diffraction, Fourier transform infra-red spectroscopy, transmission electron microscopy, scanning electron microscopy, energy-dispersive spectroscopy, and dynamic light scattering and zeta-potential analysis. The AgNPs and A. quttensis extract were evaluated for their antiradical scavenging activity by 2, 2-diphenyl, 1-picryl hydrazyl assay and anticancer activity against colon cancer (human colorectal adenocarcinoma cell line 29) compared with normal human embryonic kidney (HEK293) cells. Also, the prepared AgNPs were studied for its antibacterial activity. The AgNPs revealed a higher antioxidant activity compared with A. quttensis extract alone. The phyto-synthesised AgNPs and A. quttensis extract showed a dose-response cytotoxicity effect against HT29 and HEK293 cells. As evidenced by Annexin V/propidium iodide staining, the number of apoptotic HT29 cells was significantly enhanced, following treatment with AgNPs as compared with untreated cells. Besides, the antibacterial property of the AgNPs indicated a significant effect against the selected pathogenic bacteria. These present obtained results show the potential applications of phyto-synthesised AgNPs using A. quttensis aerial parts extract.

Novel imatinib-loaded silver nanoparticles for enhanced apoptosis of human breast cancer MCF-7 cells.

In the current study, in vitro biological feature of imatinib-loaded silver nanoparticles (IMAB-AgNPs) on human breast cancer cell line was investigated. The formation of synthesized silver nanoparticles (AgNPs) was characterized by UV-Visible spectroscopy, EDS, TEM imaging, SEM, FTIR, DLS and Zeta potentiometer. The developed IMAB-AgNPs with maximum percentage of loading efficiency was demonstrated in the average of 130 nm and mostly spherical. Additionally, in vitro drug release study showed a slow and continuous release of imatinib over a period of 80 h. We demonstrated that the synthesized IMAB-AgNPs exhibited a dose-dependent cytotoxicity against MCF-7 cell line. Then, real-time PCR method was also applied for the investigation of Bax and Bcl-2 gene expression in the cells. Comparing IMAB-AgNPs to AgNPs and Imatinib revealed the ability of IMAB-AgNPs to up-regulating Bax/Bcl-2 ratio. An induction of apoptosis was evidenced by Annexin-V/PI detection assay. Based on the current obtained data, the IMAB-AgNPs can exhibit inhibitory effect on viability through up regulation of apoptosis in MCF-7 cancer cells, which provides influencing evidence for the green synthesized AgNPs as a promising sustained drug delivery system.

Chemical composition, antioxidant, antibacterial and cytotoxic effects of Artemisia marschalliana Sprengel extract.

The present study was to investigate the gas chromatography/mass spectrometry (GC/MS), in vitro antioxidant, antibacterial and anticancer activity of the ethanolic extract from aerial parts of Artemisia marschalliana Sprengel against human gastric carcinoma (AGS) and L929 cell lines. Phytochemical analysis of A. marschalliana Sprengel extract showed 22 major components and the most dominant compounds were trans-phytol (29.22%), α-Linolenic acid (13.47%) and n-Hexadecanoic acid (9.28%). In addition, the antioxidant and anticancer activity of A. marschalliana Sprengel extract were evaluated using 1,1-diphenyl-2-picrylhydrazyl (DPPH) and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) methods, respectively. Antibacterial activity against selected pathogenic bacteria was also determined. According to the present obtained results, it seems that this plant has potential uses for pharmaceutical industries and further studies of pharmaceutical importance were suggested to be performed on A. marschalliana Sprengel.

Phytosynthesis of silver nanoparticles using Artemisia marschalliana Sprengel aerial part extract and assessment of their antioxidant, anticancer, and antibacterial properties.

A rapid phytosynthesis of silver nanoparticles (AgNPs) using an extract from the aerial parts of Artemisia marschalliana Sprengel was investigated in this study. The synthesized AgNPs using A. marschalliana extract was analyzed by UV-visible spectroscopy, X-ray diffraction, and Fourier transform infrared spectroscopy and further characterized by transmission electron microscopy, scanning electron microscopy, zeta potential, and energy-dispersive spectroscopy. Characteristic absorption bands of AgNPs were found near 430 nm in the UV-vis spectrum. Energy-dispersive spectroscopy analysis of AgNPs in the energy range 2-4 keV confirmed the silver signal due to surface plasmon resonance. Scanning electron microscopy and transmission electron microscopy results revealed that the AgNPs were mostly spherical with an average size ranging from 5 nm to 50 nm. The zeta potential value of -31 mV confirmed the stability of the AgNPs. AgNPs produced using the aqueous A. marschalliana extract might serve as a potent in vitro antioxidant, as revealed by 2,2-diphenyl-1-picryl hydrazyl assay. The present study demonstrates the anticancer properties of phytosynthesized AgNPs against human gastric carcinoma AGS cells. AgNPs exerted a dose-dependent inhibitory effect on the viability of cells. Real-time polymerase chain reaction was used for the investigation of Bax and Bcl-2 gene expression in cancer and normal cell lines. Our findings show that the mRNA levels of pro-apoptotic Bax gene expression were significantly upregulated, while the expression of anti-apoptotic Bcl-2 was declined in cells treated with AgNPs compared to normal cells. In addition, flow cytometric analysis showed that the number of early and late apoptotic AGS cells was significantly enhanced following treatment with AgNPs as compared to untreated cells. In addition, the AgNPs showed strong antibacterial properties against tested pathogenic bacteria such as Staphylococcus aureus, Bacillus cereus, Acinetobacter baumannii, and Pseudomonas aeruginosa. Based on the obtained data, we suggest that phytosynthesized AgNPs are good alternatives in the treatment of diseases because of the presence of bioactive agents.