A Comparative Study of the Effect of Labetalol and Remifentanil on Pain Control After Bariatric Surgery.

Background: Finding the optimal combination of anesthetics to maintain hemodynamic stability during surgery can be challenging. Traditionally, strong opioid analgesics such as fentanyl and its newer analogs have been used. However, the use of narcotics is associated with certain side effects. Objectives: This study compares the effects of labetalol and remifentanil in pain control after bariatric surgery in Hazrat Rasool Akram Hospital. Methods: This randomized, double-blind clinical trial was conducted on 48 laparoscopic bariatric surgery patients. The participants were randomly divided into two groups receiving remifentanil or labetalol. Postoperative pain was measured in the recovery unit using the numerical rating scale (NRS). This score was recorded upon entering recovery, and 30 minutes, 60 minutes, and 120 minutes after surgery for each patient. Also, the duration of anesthesia, the duration of the operation, the recovery time, the dose of the administered opioids, the volume of intravenous fluids, and the dose of administered propofol were recorded for each patient. Nausea and vomiting after the operation were also recorded as outcomes. Results: There were no significant differences between the two groups regarding the mean duration of surgery and anesthesia, dose of the administered anesthetics, recovery period, nausea and vomiting, and the dose of analgesics after the operation. The mean pain intensity during the given period and also the trend of pain intensity changes between the two groups demonstrated no statistically significant differences (P = 0.112). During the operation, 9 subjects (37.5%) in the labetalol group and 16 (66.7%) in the remifentanil group needed more analgesics (rescue drug); in this regard, a significant difference was observed between the two groups (P = 0.043). Conclusions: Based on the study's findings, there were no significant differences between labetalol and remifentanil in post and perioperative pain control. However, rescue drugs needed to maintain hemodynamic stability during laparoscopic surgery were significantly lower in patients who received labetalol than remifentanil. Postoperative complications were also comparable between labetalol and remifentanil.

Nano-architecture of MOF (ZIF-67)-based Co3O4 NPs@N-doped porous carbon polyhedral nanocomposites for oxidative degradation of antibiotic sulfamethoxazole from wastewater.

Co3O4 NPs in N-doped porous carbon (Co3O4 NPs@N-PC) materials were prepared by one-pot pyrolysis of a ZIF-67 powder under N2 atmosphere and followed by oxidation under air atmosphere (200 °C) toward promotion catalytic activity and activation of peroxymonosulfate (PMS) to degradation sulfamethoxazole (SMZ). 2-methylimidazole was used as a nitrogen source and a competitive ligand for the synthesis of Co3O4 NPs@N-PC, which in addition to affecting nucleation and growth of the crystal, promotes the production of active Co-N sites. Co3O4 NPs@N-PC nano-architecture has high specific surface areas (250 m2 g-1) and is a non-toxic, effective and stable PMS activator. The effect of operating parameters including SMZ concentration, catalyst dosage, temperature and pH in the presence of Co3O4 NPs@N-PC was investigated. The Co3O4 NPs@N-PC composite showed superior performance in activating PMS over a wide range of pH (2-10) and different temperatures so that complete degradation of SMZ (50 µM, 100 mL) was achieved within 15 min. The role of Co2+/Co3+ redox system in the mechanism before and after PMS activation was determined using XPS analysis. Surface-generated radicals led to the degradation of SMZ, in which the SMZ degradation rate attained 0.21 min-1 with the mineralization of 36.8%. The feasible degradation mechanism of SMZ was studied in the presence of different scavengers and it was revealed that the degradation reaction proceeds from the radical/non-radical pathway and in this process most of the SO4- and OH radicals are dominant. The recoverability and reuse of Co3O4 NPs@N-PC were evaluated to confirm its stability and potential for SMZ degradation and it was observed that the catalyst maintains its catalytic power for at least 5 cycles.

Utility of Biogenic Iron and Its Bimetallic Nanocomposites for Biomedical Applications: A Review.

Nanotechnology mainly deals with the production and application of compounds with dimensions in nanoscale. Given their dimensions, these materials have considerable surface/volume ratios, and hence, specific characteristics. Nowadays, environmentally friendly procedures are being proposed for fabrication of Fe nanoparticles because a large amount of poisonous chemicals and unfavorable conditions are needed to prepare them. This work includes an inclusive overview on the economical and green procedures for the preparation of such nanoparticles (flower, fruits, tea, carbohydrates, and leaves). Pure and bimetallic iron nanoparticles, for instance, offer a high bandwidth and excitation binding energy and are applicable in different areas ranging from antibacterial, anticancer, and bioimaging agents to drug delivery systems. Preparation of nano-sized particles, such as those of Fe, requires the application of high quantities of toxic materials and harsh conditions, and naturally, there is a tendency to develop more facile and even green pathways (Sultana, Journal of Materials Science & Technology, 2013, 29, 795-800; Bushra et al., Journal of hazardous materials, 2014, 264, 481-489; Khan et al., Ind. Eng. Chem. Res., 2015, 54, 76-82). This article tends to provide an overview on the reports describing green and biological methods for the synthesis of Fe nanoparticles. The present review mainly highlights selenium nanoparticles in the biomedical domain. Specifically, this review will present detailed information on drug delivery, bioimaging, antibacterial, and anticancer activity. It will also focus on procedures for their green synthesis methods and properties that make them potential candidates for various biomedical applications. Finally, we provide a detailed future outlook.

Nano-architectural design of TiO2 for high performance photocatalytic degradation of organic pollutant: A review.

In the past several decades, significant efforts have been paid toward photocatalytic degradation of organic pollutants in environmental research. During the past years, titanium dioxide nano-architectures (TiO2 NAs) have been widely used in water purification applications with photocatalytic degradation processes under Uv/Vis light illumination. Photocatalysis process with nano-architectural design of TiO2 is viewed as an efficient procedure for directly channeling solar energy into water treatment reactions. The considerable band-gap values and the subsequent short life time of photo-generated charge carriers are showed among the limitations of this approach. One of these effective efforts is the using of oxidation processes with advance semiconductor photocatalyst NAs for degradation the organic pollutants under UV/Vis irradiation. Among them, nano-architectural design of TiO2 photocatalyst (such as Janus, yolk-shell (Y@S), hollow microspheres (HMSs) and nano-belt) is an effective way to improve oxidation processes for increasing photocatalytic activity in water treatment applications. In the light of the above issues, this study tends to provide a critical overview of the used strategies for preparing TiO2 photocatalysts with desirable physicochemical properties like enhanced absorption of light, low density, high surface area, photo-stability, and charge-carrier behavior. Among the various nanoarchitectural design of TiO2, the Y@S and HMSs have created a great appeal given their considerable large surface area, low density, homogeneous catalytic environment, favorable light harvesting properties, and enhanced molecular diffusion kinetics of the particles. In this review was summarized the developments that have been made for nano-architectural design of TiO2 photocatalyst. Additional focus is placed on the realization of interfacial charge and the possibility of achieving charge carriers separation for these NAs as electron migration is the extremely important factor for increasing the photocatalytic activity.

Adsorption of Cationic Dyes on a Magnetic 3D Spongin Scaffold with Nano-Sized Fe3O4 Cores.

The renewable, proteinaceous, marine biopolymer spongin is yet the focus of modern research. The preparation of a magnetic three-dimensional (3D) spongin scaffold with nano-sized Fe3O4 cores is reported here for the first time. The formation of this magnetic spongin-Fe3O4 composite was characterized by X-ray diffraction (XRD), thermogravimetric analysis (TGA), differential thermal analysis (DTA) (TGA-DTA), vibrating sample magnetometer (VSM), Fourier-transform infrared spectroscopy (FTIR), and zeta potential analyses. Field emission scanning electron microscopy (FE-SEM) confirmed the formation of well-dispersed spherical nanoparticles tightly bound to the spongin scaffold. The magnetic spongin-Fe3O4 composite showed significant removal efficiency for two cationic dyes (i.e., crystal violet (CV) and methylene blue (MB)). Adsorption experiments revealed that the prepared material is a fast, high-capacity (77 mg/g), yet selective adsorbent for MB. This behavior was attributed to the creation of strong electrostatic interactions between the spongin-Fe3O4 and MB or CV, which was reflected by adsorption mechanism evaluations. The adsorption of MB and CV was found to be a function of pH, with maximum removal performance being observed over a wide pH range (pH = 5.5-11). In this work, we combined Fe3O4 nanoparticles and spongin scaffold properties into one unique composite, named magnetic spongin scaffold, in our attempt to create a sustainable absorbent for organic wastewater treatment. The appropriative mechanism of adsorption of the cationic dyes on a magnetic 3D spongin scaffold is proposed. Removal of organic dyes and other contaminants is essential to ensure healthy water and prevent various diseases. On the other hand, in many cases, dyes are used as models to demonstrate the adsorption properties of nanostructures. Due to the good absorption properties of magnetic spongin, it can be proposed as a green and uncomplicated adsorbent for the removal of different organic contaminants and, furthermore, as a carrier in drug delivery applications.

Heterojunction of N/B/RGO and g-C3N4 anchored magnetic ZnFe2O4@ZnO for promoting UV/Vis-induced photo-catalysis and in vitro toxicity studies.

To promote the low photocatalytic efficiency caused by the recombination of electron/hole pairs and widen the photo-response wavelength window, ZnFe2O4@ZnO-N/B/RGO and ZnFe2O4@ZnO-C3N4 ternary heterojunction nanophotocatalysts were designed and successfully prepared through a sol-gel technique. In comparison to bare ZnFe2O4 and ZnO, the ZnFe2O4-ZnO@N/B/RGO and ZnFe2O4@ZnO-C3N4 ternary products showed highly improved photocatalytic properties in the degradation of methyl orange (MO) under ultra-violet (UV) and visible light irradiation. Various physicochemical properties of the photocatalysts were evaluated through field emission scanning electron microscopy (FESEM), energy-dispersive X-ray (EDX) analysis, X-ray diffraction (XRD), UV-visible diffuse reflectance spectroscopy (DRS), Fourier transform infrared spectroscopy (FT-IR), and vibrating sample magnetometer (VSM) techniques. The observations indicated that the ternary heterojuncted ZnFe2O4@ZnO-N/B/RGO absorbs lower energy visible light wavelengths, which is an enhancement in the photocatalytic properties of ZnFe2O4@ZnO loaded on reduced graphene oxide (RGO) nanosheets and graphite-like carbon nitride (g-C3N4). This gives the catalyst photo-Fenton degradation properties.

A noble electrochemical sensor based on TiO2@CuO-N-rGO and poly (L-cysteine) nanocomposite applicable for trace analysis of flunitrazepam.

Flunitrazepam or date rape medication with trade name of Rohypnol belongs to the benzodiazepines branch that is used as a sedative, anesthetic, anticonvulsant, muscle relaxant, and antianxiety drug. It is known as "drug of aggression" because of its very strong and long-lasting effects on the central nervous system. The sedative influence of flunitrazepam drug increases with alcohol drinking, which causes mental and motor disorders and causes the victim to become silent. Due to its criminals use, its accurate measurement is crucial. In this work, a novel electrochemical sensor based on TiO2@CuO-N doped rGO, TiO2@CuO-N-rGO, nano-composite and poly (L-cysteine), poly (L-Cys), is presented for trace analysis of flunitrazepam in aqueous solution. At first, TiO2@CuO-N-rGO nano-composite was synthesized by the sol-gel method and characterized by Raman spectroscopy, Fourier transform infrared, field emission scanning electron microscope, and X-ray diffraction analysis. Then, the suspension of the TiO2@CuO-N-rGO nano-composite was drop casted on the surface of the glassy carbon electrode (GCE/TiO2@CuO-N-rGO). After that, electro-polymerization of l-cysteine on the GCE/TiO2@CuO-N-rGO surface was performed by cyclic voltammetry (CV) method. The electrochemical characteristics of the GCE/TiO2@CuO-N-rGO/poly (L-Cys) surface were evaluated in the solution of ferri/ferrocyanide by electrochemical impedance spectroscopy (EIS) and CV techniques. The increase in current, change in oxidation peak potential, and the appearance of two reduction peaks indicated higher electron transfer rate with well-performed electrochemical process of flunitrazepam at the modified electrode surface compared to the bare GCE. These improvements originate from the synergistic effect of TiO2@CuO-N-rGO nano-composite and poly (L-Cys). Finally, a linear relationship was resulted between the oxidation peak current and the concentration of flunitrazepam in the wide concentration range of 1 nM to 50 µM with a detection limit of 0.3 nM.

Electrochemical determination of the antipsychotic medication clozapine by a carbon paste electrode modified with a nanostructure prepared from titania nanoparticles and copper oxide.

A nanostructure was prepared from titania nanoparticles and copper oxide (TiO2NP@CuO) and used to modify a carbon paste electrode (CPE). The modified CPE is shown to enable sensitive voltammetric determination of the drug clozapine (CLZ). The sensor was characterized by various techniques and some key parameters were optimized. Under the optimum conditions and at a working potential of 0.6 V (vs. Ag/AgCl), the modified CPE has two linear response ranges, one from 30 pmol L-1 to 4 nmol L-1 of CLZ, the other from 4 nmol L-1 to 10 µmol L-1. The detection limit is as low as 9 pM. The transfer coefficient (α) and catalytic rate constant (kcat) were calculated and the reliability of the sensor was estimated for CLZ sensing in real samples where it gave satisfactory results. Graphical abstract Applicability of the TiO2NP@CuO nanostructures in fabrication of an efficient clozapine (CLZ) sensor based on the use of a carbon paste electrode.

The Correlation between Different Risk Factors of Hepatitis C and Different Genotypes.

BACKGROUND: Hepatitis C infection is one of the health problems in the world. Several known risk factors are responsible in transmission of this infection. We are going to study the prevalence of these risk factors for different genotypes of hepatitis C and if possible, specify probable relations between each risk factor and transmission of each genotype. MATERIALS AND METHODS: This is a cross-sectional study done on 270 people who had positive anti-hepatitis C virus (HCV) antibody and HCV RNA. Demographic specificity and possible risk factors were collected using a questionnaire, and statistical analysis was done by SPSS software (version 20). Chi-square test used to estimate the prevalence and relation between each qualitative risk factor and HCV genotype transmitted. Analysis of variance was used for studying the prevalence and relation between quantitative risk factors and HCV genotypes. RESULTS: The sample size was 270 persons. Of these, 217 (80.4%) were men and 185 (68.5%) were infected with genotype Type III. Most people were in age range of 31-40 years old 92 (34%). Single people were 126 (46.7%) and 169 (62.6%) were high school and university graduated. Tattooing as a risk factor had a meaningful relation with hepatitis C genotype (P < 0.001). CONCLUSIONS: According to the findings, most people in central provinces of Iran with hepatitis C are carrying genotype III, with most prevalent risk factors such as intravenous drug use and unsafe sexual activity. Besides, tattooing had a significant association with hepatitis C genotype, so that in these groups of people, genotype I was more frequent isolated virus.

Screening and evaluation of chronic and occult Hepatitis B in chemo - radiotherapy patients with cancer.

BACKGROUND: Hepatitis B virus infection (HBV) and its complications is one of the most serious problems of the health system in many parts of the world. In the present study, we will assess chronic and occult HBV and isolated anti-Hepatitis B core antigen whose screening and evaluation is not routine in different populations. MATERIALS AND METHODS: This descriptive analytical study was conducted on 213 patients undergoing chemotherapy - radiotherapy referred to the hematology - oncology clinics of Isfahan, Iran in 2012. In order to determine the serum levels of hepatitis B surface antigen (HbSAg), Hepatitis B Antigen and Antibody (HBCAb), aspartate aminotransferase (AST), alanine transaminase (ALT) and Alkaline phosphatase (ALK.P), venous blood samples were obtained. If the HBCAb sample was positive, another sample of the serum was sent to the laboratory to perform polymerase chain reaction and to determine viral load. RESULTS: The mean age of the patients was 47.7 ± 9 years, with an age range of 27 -73 years; 98 (46%) and 115 (54%) cases were male and female, respectively, with mean age of 51.9 ± 8.3 and 44.1 ± 8.1 years, and there was no significant difference (P < 0.001). The mean level of liver enzymes including AST, ALT and ALK.P were 34.2 ± 36.02, 38.9 ± 47.1 and 252.1 ± 234.7, respectively. Two cases were HbSAg positive (0.9%) and six cases were HBCAb positive (2.8%) and HbSAg negative. Three cases had a high viral load at the rate of starting treatment among positive anti-HBC patients. CONCLUSION: Because occult hepatitis is investigated less commonly in routine studies, it seems that screening and evaluating its prevalence is useful in the management of patients.

Immunocompromised patients: Review of the most common infections happened in 446 hospitalized patients.

BACKGROUND: Immunodeficiency is a heterogenous group of diseases affecting different components of the immune system. Patterns of infection, etiology and organ involvement are not similar in this risky population. This study was conducted to determine the prevalence of congenital and acquiring immunodeficiencies and also recognizing the most common infections and affected organs. MATERIALS AND METHODS: In a retrospective, cross-sectional survey, during 2006-2012, we reviewed all hospital records with any kind of immunodeficiency admitted in, all departments of university referral hospital, Isfahan, Iran. RESULTS: VARIOUS IMMUNODEFICIENCIES, SORTED BY PREVALENCE, WERE AS BELOW: Primary immunodeficiency diseases (PIDs) 122 (27.4%), lymphohematogenous malignancy (LHM) 105 (23.5%), solid cancer 56 (12.6%), human immunodeficiency virus/acquired immunodeficiency syndrome 64 (14.5%), non-cytotoxic immunosuppresion 94 (21%), and splenectomy 5 (1.2%). Common sources of infection were blood, lungs and buccal cavity. CONCLUSION: The most frequent type of immunodeficiency was PIDs and LHM. Infection continues to be a major problem in all variety of immunodeficiency.

Thoracic computerized tomographic (CT) findings in 2009 influenza A (H1N1) virus infection in Isfahan, Iran.

BACKGROUND: Pandemic 2009 H1N1 influenza A virus arrived at Isfahan in August 2009. The virus is still circulating in the world. The abnormal thoracic computerized tomographic (CT) scan findings vary widely among the studies of 2009 H1N1 influenza. We evaluated the thoracic CT findings in patients with 2009 H1N1 virus infection to describe findings compared to previously reported findings, and to suggest patterns that may be suggestive for 2009 influenza A (H1N1) in an appropriate clinical setting. METHODS: Retrospectively, the archive of all patients with a diagnosis of 2009 H1N1 influenza A were reviewed, in Al-Zahra Hospital in Isfahan, central Iran, between September 23(rd) 2009 to February 20(th) 2010. Out of 216 patients with confirmed 2009 influenza A (H1N1) virus, 26 cases with abnormal CT were enrolled in the study. Radiologic findings were characterized by the type and pattern of opacities and zonal distribution. RESULTS: Patchy infiltration (34.6%), lobar consolidation (30.8%), and interstitial infiltration (26.9%) with airbronchogram (38.5%) were the predominant findings in our patients. Bilateral distribution was seen in 80.8% of the patients. Only one patient (3.8%) showed ground-glass opacity, predominant radiographic finding in the previous reports and severe acute respiratory syndrome (SARS). CONCLUSIONS: The most common thoracic CT findings in pandemic H1N1 were patchy infiltration, lobar consolidation, and interstitial infiltration with airbronchogram and bilateral distribution. While these findings can be associated with other infections; they may be suggestive to 2009 influenza A (H1N1) in the appropriate clinical setting. Various radiographic patterns can be seen in thoracic CT scans of the influenza patients. Imaging findings are nonspecific.

Clinical features of novel 2009 influenza A (H1N1) infection in Isfahan, Iran.

BACKGROUND: During August 2009, novel H1N1 influenza virus began causing illness in Isfahan. Since rates of hospitalization and mortality due to the disease have varied widely in different countries, we described the clinical, radiologic, and demographic features of H1N1 hospitalized patients in a hospital in Isfahan. METHODS: This cross-sectional study was conducted in Alzahra Hospital during September 2009 to February 2010. Totally, 216 patients with confirmed, probable, or suspected cases of 2009 influenza A (H1N1) were admitted. RESULTS: Most patients were women (50.5%). Mean age of patients was 26.6 ± 19.5 years. The most common complains on admission were respiratory symptoms (91.6%, n= 198), fever (88.4%, n = 191), myalgia (65.7%, n = 142). In addition, 120 patients (56%) had at least one underlying medical disorder. Thirty-six patients (16.7%) died. Mortality was higher in children under 5 years old (10/36, 10%) and female cases (63.9% of died patients). Predicting variables affecting mortality were intensive care unit (ICU) admission and procalcitonin (PCT) > 0.5. Antiviral treatment was prescribed for 200 (92.5%) of the 216 patients. CONCLUSIONS: Based on the findings of the present study, novel H1N1 influenza is highly prevalent among the youth. Moreover, it causes a relatively high morbidity rate. Therefore, people need to be encouraged to have vaccination against 2009 H1N1. Early diagnosis and treatment is related to less admission and shorter duration of hospitalization.

Evaluating the frequency of postoperative Fever in patients with coronary artery bypass surgey.

BACKGROUND: Nowadays, coronary artery bypass graft (CABG) is a frequent surgery in treatment of coronary artery disease. According to high expense of this surgery and its important role in patients' quality of life, high survival rate of patients and success of surgery are necessary. The aim of this study was the evaluation of fever incidence (febrile events) due to incidence of pneumonia, wound infection, bacteremia, urinary tract infection and inflammatory response without infection after CABG. METHODS: In an intergrades descriptive-analytical study, 107 patients who underwent coronary artery bypass graft (CABG) were enrolled in the study. The patients then were examined by the febrile events and also their characteristics including age, sex, duration of surgery, underlying diseases, and frequency distribution of antibiotics consumptions in pre-surgical and postsurgical periods, and incidence of infectious syndromes. RESULTS: Frequency distribution of febrile events after CABG was 29.9 percent. The most common administered antibiotic before the surgery was cephalothin (Keflin) and then, cefazolin. The most common administered antibiotic after the surgery was cephalothin (Keflin) and cephalexin (47.7%) and then, cephalothin-gentamicin-cephalexin (31.8%). The average age of patients without febrile syndrome was 60.53 years and in those with febrile syndrome was 59.31 years. In terms of gender, 74.8% of the patients were males. So that 32.5% of males and 22.2% of females had fever. The incidence time of fever in most cases was in the postoperative fourth day. In terms of underlying diseases, 13 percent of them had hypertension and hyperlipidemia, 14 percent had only hypertension, 11.2 percent had only hyperlipidemia and 6.5 percent had diabetes. CONCLUSION: This study showed that the prevalence of fever in patients undergoing CABG was 29.9 percent and the most common cause of fever was sternal infections. There was a significant correlation between administered antibiotics in preoperative and postoperative periods and febrile syndrome.

Crimean-Congo hemorrhagic fever among health care workers in Iran: a seroprevalence study in two endemic regions.

Crimean-Congo hemorrhagic fever (CCHF) has repeatedly caused nosocomial outbreaks among hospital staff. In the summer of 2003, we studied the seroprevalence of anti-CCHF IgG among health care workers who had come in contact with Crimean-Congo hemorrhagic fever patients from three referral hospitals in endemic regions of Iran. A total of 223 eligible staff were examined. Whereas 5 of 129 (3.87%) exposed health care workers tested positive, none of the 94 in the unexposed group did (P=0.075). Seropositivity was more frequent among those whose intact skin had come in contact with nonsanguineous body fluids (9.52%) and those who had had percutaneous contacts (7.14%). Health care workers exposed to Crimean-Congo hemorrhagic fever patients, those who live in Systan-Baluchestan province, and older health care workers were more prone to seropositivity. Where introduction of high-risk modes of contact cannot be confined, we propose that health care workers take all the protective measures when handling Crimean-Congo hemorrhagic fever patients, particularly their blood and other body fluids.