Comparison of safety and effectiveness of antiretroviral therapy regimens among pregnant women living with HIV at preconception or during pregnancy: a systematic review and network meta-analysis of randomized trials.

BACKGROUND: Mother-to-child transmission is the primary cause of HIV cases among children. Antiretroviral therapy (ART) plays a critical role in preventing mother-to-child transmission and reducing HIV progression, morbidity, and mortality among mothers. However, after more than two decades of ART during pregnancy, the comparative effectiveness and safety of ART medications during pregnancy are unclear, and existing evidence is contradictory. This study aimed to assess the effectiveness and safety of different ART regimens among pregnant women living with HIV at preconception or during pregnancy. METHODS: We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Web of Science. We included randomized trials that enrolled pregnant women living with HIV and randomized them to receive ART for at least four weeks. Pairs of reviewers independently completed screening for eligible studies, extracted data, and assessed the risk of bias using the Cochrane risk of bias tool. Our outcomes of interest included low birth weight, stillbirth, preterm birth, mother-to-child transmission of HIV, neonatal death, and congenital anomalies. Network meta-analysis was performed using a random-effects frequentist model, and the certainty of evidence was evaluated using the GRADE approach. RESULTS: We found 14 eligible randomized trials enrolling 9,561 pregnant women. The median duration of ART uptake ranged from 6.0 to 17.4 weeks. No treatment was statistically better than a placebo in reducing the rate of neonatal mortality, stillbirth, congenital defects, preterm birth, or low birth weight deliveries. Compared to placebo, zidovudine (ZDV)/lamivudine (3TC) and ZDV monotherapy likely reduce mother-to-child transmission (odds ratio (OR): 0.13; 95% CI: 0.05 to 0.31, high-certainty; and OR: 0.50; 95% CI: 0.33 to 0.74, moderate-certainty). Moderate-certainty evidence suggested that ZDV/3TC was associated with decreased odds of stillbirth (OR: 0.47; 95% CI: 0.09 to 2.60). CONCLUSIONS: Our analysis provides high- to moderate-certainty evidence that ZDV/3TC and ZDV are more effective in reducing the odds of mother-to-child transmission, with ZDV/3TC also demonstrating decreased odds of stillbirth. Notably, our findings suggest an elevated odds of stillbirth and preterm birth associated with all other ART regimens.

Deep eutectic solvent-based ferrofluid for highly efficient preconcentration and determination of metronidazole by vortex-assisted liquid-phase microextraction under experimental design optimization.

To determine metronidazole in water samples, we developed an environmentally friendly, efficient, and straightforward ferrofluid-based liquid-liquid microextraction sample pretreatment technique. It is coupled with a high-performance liquid chromatography-ultraviolet analytical technique known for its sensitivity, speed, and precision. The magnetic separation of metronidazole-containing ferrofluid from the matrix was effortlessly achieved through the application of an external magnetic field, eliminating the need for centrifugation. Response surface optimization was employed to systematically determine the key experimental parameters influencing extraction efficiency, including pH, NaCl concentration, ferrofluid volume, and vortex duration. With a low detection limit (0.116 ng mL-1), a broad linear range between 0.5 and 700 ng mL-1 was achieved at optimal conditions. Additionally, acceptable spiking recoveries (94.3-97.3 %) and RSD values (≤3.7 %) for intra- and inter-day precision were attained in water samples. In conclusion, the effectiveness of the vortex and ferrofluid combination, along with the convenience of collection and elimination of the need for centrifugation, bestows a highly valuable technique for determining metronidazole in water samples.

Prevalence of acquired and transmitted HIV drug resistance in Iran: a systematic review and meta-analysis.

BACKGROUND: There is no systematic review on the prevalence of HIV drug resistance (HIVDR) in Iran. We aimed to estimate the prevalence of HIVDR among people living with HIV (PLHIV) in Iran. We assessed HIVDR prevalence in antiretroviral therapy (ART) naïve PLHIV (i.e., those without a history of ART) and PLHIV receiving ART. METHOD: We systematically searched Scopus, PubMed, Web of Science, Embase, Iranian databases (Iranian Medical Research Information System, Magiran, and Scientific Information Database), the references of studies, and Google Scholar until March 2023. A random-effects model was used to calculate a point estimate and 95% confidence interval (95% CI) for the prevalence of HIVDR in PLHIV. RESULTS: Among 461 potential publications, 22 studies were included in the meta-analysis. The pooled prevalence of acquired HIVDR in PLHIV receiving ART was 34% (95% CI: 19, 50) for nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), 27% (95% CI: 15, 41) for non-nucleoside reverse transcriptase inhibitors (NNRTIs), and 9% (95% CI: 3, 18) for protease inhibitors (PIs). The pooled prevalence of acquired HIVDR in treatment failure PLHIV was 50% (95% CI: 31, 69) for NRTIs, 49% (95% CI: 29, 69) for NNRTIs, 11% (95% CI: 2, 24) for PIs, and 1% (95% CI: 0, 4) for integrase inhibitors (INIs). The pooled prevalence of transmitted HIVDR in ART-naïve people was 3% (95% CI; 1, 6) for NRTIs, 5% (95% CI: 2, 9) for NNRTIs, and 0 for PIs and INIs. CONCLUSION: The prevalence of HIVDR was relatively high in both ART-naïve PLHIV and those receiving ART. Without universal pretreatment HIVDR testing and more frequent routine HIV viral load testing among PLHIV who are on ART, the HIVDR prevalence might increase in PLHIV in Iran.

Magnetic nanofluid based on hydrophobic deep eutectic solvent for efficient and rapid enrichment and subsequent determination of cinnamic acid in juice samples: Vortex-assisted liquid-phase microextraction.

A quick, environmentally friendly and easy approach for the determination of cinnamic acid in juice samples based on the creation and usage of a novel magnetic nanofluid (mixture of hydrophobic deep eutectic solvent and magnetic nanoparticles) has been reported. Response surface methodology was applied to justify the contribution of the efficient factors including pH, nanofluid volume, ionic strength and vortex time. Cinnamic acid concentrations were monitored and quantified based on their HPLC peak representing linear correlations under the best operational circumstances showing linearity between 3 and 550 ng mL-1. The LOD, LOQ, and enrichment factor for cinnamic acid were 0.8 ng mL-1, 2.7 ng mL-1 and 57.2, respectively. The proposed method was used for enrichment and subsequent determination of cinnamic acid from juice samples which suggests a potential alternative approach for cinnamic acid analysis in complicated food samples.

Complementary and alternative medicine application in cancer patients in Iran.

PURPOSE: Nowadays, complementary and alternative medicine (CAM) is used by cancer patients all over the world. The aim of this study was to investigate the prevalence of CAM use in patients with cancer in Iran. METHODS: This descriptive-analytical study was conducted on 320 cancer patients in Arak. For gathering information, a researcher-made questionnaire was used. This questionnaire was consisted of two parts: demographic and clinical information; and patient's attitude toward using complementary and alternative medicine treatments and their effectiveness, as well as how much they used different kinds of these treatments. The data were analyzed using SPSS software version 16. RESULTS: Our findings showed that average age of participants was 55.11 ± 15.58. Most of them had leukemia (25.9%) and underwent chemotherapy (55%), and 141 (44.3%) of individuals were using CAM. Majority of patients (73.2%) were using CAM to improve physical conditions, 61.4% were using it simultaneously with conventional medical treatments, and 25% to reduce pain. Participants have reported visiting holy places, yoga, prayer therapy, and using medicinal plants and special diets, respectively. CONCLUSION: Considering the high number of patients using CAM treatments, proper planning and implementation to educate professional members of health team, especially doctors and nurses about CAM treatments is essential. The most important CAM treatments to be educated are spiritual therapies, yoga, medicinal plants, and diet therapy. Moreover, support and education about using these kinds of treatment should be considered in the supportive care program for patients with cancer.

Magnetic nanofluid based on green deep eutectic solvent for enrichment and determination of chloramphenicol in milk and chicken samples by high-performance liquid chromatography-ultraviolet: Optimization of microextraction.

In this work, magnetic nanofluid based on a deep eutectic solvent that constricts through a simple and easy route, and subsequently applied for the preconcentration and microextraction of chloramphenicol (CAP) as a hazardous drug from milk and chicken samples via syringe-to-syringe microextraction prior to its determination by high-performance liquid chromatography-ultraviolet (HPLC-UV). In addition, the optimum conditions of effective factors were searched by the central composite design (CCD), and subsequently, at their optimum value, the figures of merit were evaluated. Also, the suggested method illustrated a low limit of detection (0.2 ng mL-1), a low limit of quantitation (0.67 ng mL-1), and a good linear range with an R2 of 0.996. The CAP relative recoveries in milk and chicken samples were 90.3%-95.1%, with relative standard deviations lower than 4.2%. The current enhancement technique is simple, easy, and rapid, which makes it suitable for quantification of CAP by HPLC-UV at trace levels in complicated materials with reliable and reproducible results.

Survey of antibacterial activity and release kinetics of gold-decorated magnetic nanoparticles of Fe0 conjugated with sulfamethoxazole against Escherichia coli and Staphylococcus aureus.

Drug delivery of antibiotics with magnetic nanoparticles improved by coating metals such as gold and silver has recently been studied. This work describe a simple method to synthesize modified magnetic nanoparticles which have high ability to modify the customary formulation of antibiotics such as sulfamethoxazole (SMX) and pursuant study of adsorption-desorption (release) of this drug. These synthesized nanoparticles were characterized by different methods, including field emission scanning electron microscopy, energy dispersive X-ray spectroscopy and mapping, Fourier-transform infrared spectroscopy, X-ray diffraction, vibrating-sample magnetometry, thermogravimetric analysis and zeta potential test. Present assay showed a well correlation with the introduced carrier for the drug. Also the hypothesis were proved by some adsorption isotherm models and drug kinetics studies of carriers with different drug release kinetics models. This study confirmed the adsorption isotherm models and kinetics of drug sorbate are Temkin and Pseudo-First-Order Lagergren models, respectively; the kinetics of drug release from this carrier is based on Zero-Order model. The values of MIC in antibacterial test for pure SMX and SMX conjugated nanoparticles against Escherichia coli were calculated to be 14 and 2.5 µg/mL, respectively, and these values against Staphylococcus aureus were 24 and 1.25 µg/mL, respectively.

Silver-coated magnetic nanoparticles as an efficient delivery system for the antibiotics trimethoprim and sulfamethoxazole against E. Coli and S. aureus: release kinetics and antimicrobial activity.

Trimethoprim and sulfamethoxazole are prescribed for a broad spectrum of bacteria. However, the use of these medicines is restricted due to the risk of microbial resistance in the body. Nanotechnology is a strategy for overcoming this problem by helping develop novel drug delivery systems. This study aims to assess the ability of Fe3O4/Ag and Fe3O4@SiO2/Ag nanoparticles to improve efficiency of the traditional formulation of trimethoprim and sulfamethoxazole. Fe3O4/Ag and Fe3O4@SiO2/Ag were found to have sphere-like morphologies with average sizes of 33.2 and 35.1 nm, respectively. The values of the zeta potential for the pure sulfamethoxazole and trimethoprim were -30.6 and -10.0 mV, respectively, which increased to zero or even larger positive values after being conjugated with the NPs. The study of the release kinetics showed that 64.7% of the medicines were released from the carriers within 40 days. The values of MIC for sulfamethoxazole, trimethoprim, Fe3O4/Ag/sulfamethoxazole, Fe3O4/Ag/trimethoprim, Fe3O4@SiO2/Ag/sulfamethoxazole, and Fe3O4@SiO2/Ag/trimethoprim against Escherichia coli were calculated to be 12, 9, 4, 4, 4, and 4 µg/mL, respectively. Besides, the relevant values against Staphylococcus aureus were measured to be 12, 9, 4, 4, 3, and 2 µg/mL, respectively. The use of synthesized nanomaterials for the delivery of these antibiotics leads to smaller doses compared to their traditional forms.

Effect of chitosan coating containing Nepeta pogonosperma extract on shelf life of chicken fillets during chilled storage.

Chicken meat is highly susceptible to microbial and chemical spoilage due to its high moisture and protein content. The use of edible coatings contains herbal extracts with antioxidant and antibacterial properties that help to extend the shelf life of meat products. In this study, the effect of chitosan coating (2%) and Nepeta pogonosperma extract (NPe) (0.2% and 0.6%) and their combination on chemical properties (pH, peroxide value (PV), thiobarbituric acid index (TBARS), total volatile basic nitrogen (TVB-N)) and microbial (aerobic mesophilic and psychrotrophic microorganisms, lactic acid bacteria, Enterobacteriaceae and Pseudomonas sp.) of chicken fillets were studied over a 12-day refrigerated storage period compared to the control sample. The results of NPe DPPH radical scavenging activity (DRSA) showed that IC50 and total phenolic contents values were 94.65 µg/ml and 113.53 mg GAE/g extract, respectively. Statistical results showed that the rate of increase in pH, PV, TBARS, and TVB-N of all coated treatments were lower than control. Microbial analysis results showed a decrease in the growth of different bacteria in chitosan-treated combined with NPe compared to the control sample during chilled storage. Chicken fillets coated with chitosan and 0.6% NPe displayed a longer shelf life compared to other samples.

Self-care and related factors in patients with type II diabetes in Iran.

PURPOSE: To assess Self-care and related factors in patients with type II diabetes in Iran. METHODS: This descriptive cross-sectional study was performed on 100 patients with type II diabetes who were referred to specialized diabetes centers related to Arak University of Medical Sciences in Iran. Data collection was done using a researcher-made questionnaire. The questionnaire consisted of three parts (the first part was demographic information, the second part was self-care behaviors such as diet, exercise, control, treatment, and prevention of complications over the past seven days, and the third part was factors influencing patients' self-care behaviors). The inclusion criteria were; patients 18-80 years of age with a diagnosis of type 2 diabetes, at least one year passed of diabetes diagnosis, no chronic diseases other than those related to diabetes, had awareness of the diagnosis, had no hearing and speech impairments, and no mental illnesses. The exclusion criteria was the patient's failure to answer all questions of the questionnaire. Data analysis was performed using SPSS software version 16, and using descriptive statistics and Pearson test, independent t-test, one-way analysis of variance and Spearman test. RESULTS: The mean score of self-care in patients was 84.41 ± 11.75 and at the intermediate level. Spearman correlation coefficient test results showed a significant relationship between self-care behavior and gender (p = 0.001), and insurance type (p = 0.035). Also, men had higher average self-care compared to women (p = 0.001). The highest average score of self-care was in Adherence to medication and the lowest score was in exercise and physical activity. CONCLUSION: Due to the low self-care score in exercise and physical activity and the lack of periodic renal examinations, planning and educational interventions in all aspects of self-care, especially in terms of sports and physical activity, and periodic renal examinations are essential.

Willingness to utilize supervised injection facilities among people who inject drugs in Iran: Findings from 2020 national HIV bio-behavioral surveillance survey.

BACKGROUND: Supervised injection facilities (SIFs) have not yet been integrated into Iran's harm reduction programs. This study aimed to report the extent to which people who inject drugs (PWID) in Iran are willing to use SIFs. METHODS: Participants were recruited from 11 major cities using respondent-driven sampling. Willingness to use SIFs was defined as a three-level categorical variable: low, moderate, or high. RESULTS: Of 2,490 PWID, 52.8% and 23.8% reported high and moderate willingness to use SIFs, respectively. PWID with a history of homelessness (relative-risk ratio (RRR): 2.22, 95% CI: 1.76-2.80), incarceration (1.86 [1.48-2.35]), hepatitis C infection (1.49 [1.13-1.97]), and non-fatal overdose (2.30 [1.69-3.13]) were more likely to be willing to utilize SIFs. Willingness to use SIFs was also higher among PWID who reported recent public injecting (2.24 [1.70-2.97]), daily injection (1.82 [1.35-2.45]), stimulants injection (2.39 [1.41-4.07]), syringe sharing (3.09 [1.23-7.74]), harm reduction services utilization (2.80 [2.13-3.68]), and food insecurity (8.28 [5.43-12.63]). CONCLUSION: The majority of PWID in Iran expressed willingness to use SIFs, in particular, those who were involved in higher-risk injection practices, dealing with structural risks, and had experienced drug-related harms. SIFs represent critical opportunities to deliver comprehensive harm reduction services to improve the health and well-being of PWID in Iran.

Interventional treatments for chronic, axial or radicular, non-cancer, spinal pain: a protocol for a systematic review and network meta-analysis of randomised trials.

INTRODUCTION: Chronic, non-cancer, axial or radicular spinal pain is a common condition associated with considerable socioeconomic burden. Clinicians frequently offer patients various interventional procedures for the treatment of chronic spine pain; however, the comparative effectiveness and safety of available procedures remains uncertain. METHODS: We will conduct a systematic review of randomised controlled trials that explores the effectiveness and harms of interventional procedures for the management of axial or radicular, chronic, non-cancer, spine pain. We will identify eligible studies through a systematic search of Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials and Web of Science from inception without language restrictions. Eligible trials will: (1) enrol primarily adult patients (≥18 years old) with axial or radicular, chronic, non-cancer, spine pain, (2) randomise patients to different, currently available, interventional procedures or to an interventional procedure and a placebo/sham procedure or usual care, and (3) measure outcomes at least 1 month after randomisation.Pairs of reviewers will independently screen articles identified through searches and extract information and assess risk of bias of eligible trials. We will use a modified Cochrane instrument to evaluate risk of bias. We will use frequentist random-effects network meta-analyses to assess the relative effects of interventional procedures, and five a priori hypotheses to explore between studies subgroup effects. We will use the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty in evidence for each outcome, including direct, indirect and network estimates. ETHICS AND DISSEMINATION: No research ethics approval is required for this systematic review, as no confidential patient data will be used. We will disseminate our findings through publication in a peer-reviewed journal and conference presentations, and our review will support development of a BMJ Rapid Recommendations providing contextualised clinical guidance based on this body of evidence. PROSPERO REGISTRATION NUMBER: CRD42020170667.

Highly selective magnetic dual template molecularly imprinted polymer for simultaneous enrichment of sulfadiazine and sulfathiazole from milk samples based on syringe-to-syringe magnetic solid-phase microextraction.

Antibiotics, such as sulfadiazine and sulfathiazole, are widely used in veterinary applications which can result in remains in edible animal products. Therefore, there is an immense need for a reliable, selective, sensitive, and simple analytical technique for monitoring the concentration of sulfadiazine (SDZ) and sulfathiazole (STZ) in edible animal products. In this regard, we developed a magnetic dual template molecularly imprinted polymer (MMIP) to determine the SDZ and STZ in milk samples. For the sensitive and selective extraction and determination of target analytes, MMIPs have been combined with the syringe-to-syringe magnetic solid-phase microextraction (SS-MSPME) method. In addition, we used central composite design (CCD) for the extraction of SDZ and STZ. With optimum conditions, an efficient, rapid, and convenient technique for the preconcentration and determination of SDZ and STZ in milk samples by SS-MSPME coupling with HPLC-UV was developed. Using our combined approach, the limits of detection are 0.9 and 1.3 ng mL-1 for SDZ and STZ, respectively, along with good linearity and determination coefficients higher than 0.98. Our method demonstrates a practical approach for the deduction of antibiotics in milk samples with high recoveries and selectivity.

Magnetic dual-template molecularly imprinted polymer based on syringe-to-syringe magnetic solid-phase microextraction for selective enrichment of p-Coumaric acid and ferulic acid from pomegranate, grape, and orange samples.

Magnetic dual-template molecularly imprinted polymer (Fe3O4@SiO2-MDMIP) was prepared to enrich and determine both p-Coumaric acid (p-CA) and ferulic acid (FA) based on syringe-to-syringe magnetic solid-phase microextraction (SS-MSPME). The obtained MDMIP was characterized and recognized, and then its adsorbing performance was studied. Based on the results, the Fe3O4@SiO2-MDMIP indicated selective recognition towards p-CA and FA with large adsorption capacity. The optimization of MDMIP-SS-MSPME conditions (pH, Fe3O4@SiO2-MDMIP mass, NaCl concentration, number of cycle, and elution volume) were conducted using the central composite design (CCD). Under the optimum conditions, an effectual and a convenient method was established to determine p-CA and FA in pomegranate, grapes, and orange samples based on SS-MSPME coupling with high-performance liquid chromatography-ultraviolet (HPLC-UV). Our developed method showed the limit of detection (LOD) of 0.08 ng mL-1 for p-CA and 0.07 ng mL-1 for FA. The method also indicated good linearity with R2 > 0.99 and good recoveries of 85.12-94.96% with RSDs ≤ 5.58% spiked at three various concentration levels in pomegranate, grapes, and orange samples.

A ferrofluidic hydrophobic deep eutectic solvent for the extraction of doxycycline from urine, blood plasma and milk samples prior to its determination by high-performance liquid chromatography-ultraviolet.

The ferrofluid phase was prepared according to mixing magnetic nanoparticle and the hydrophobic deep eutectic solvent as a green microextraction solvent. This new composite was applied for vortex-assisted dispersive liquid-liquid microextraction (VA-HDES-ferrofluid-DLLME) of doxycycline (DOC) residual extraction and determined through high-performance liquid chromatography-ultraviolet (HPLC-UV). The characterization of magnetic nanoparticle was investigated by XRD, TEM and FESEM. The dependency of DOC microextraction to main variables and their interaction and find optimum points were undertaken using response surface methodology with either central composite design (CCD). Thus, the optimum pH, ionic strength, ferrofluid volume and vortex time for DOC extraction are determined to be 3.0, 4%w/v, 150 µL and 7 min, respectively. According to this condition, linear response is found to be greater than 10-400 ng mL-1, with a correlation coefficient of 0.983. The detection and quantification limits are 3.6 and 8.5 ng mL-1, while the repeatability and reproducibility as precision criteria (RSD%) are 3.74% and 4.15%, respectively. The DOC recoveries in all of the urine, blood plasma and milk samples are between 86.70 and 97.48%, with RSD% lower than 5.72%.

Synthesis and application of Ce-doped TiO2 nanoparticles loaded on activated carbon for ultrasound-assisted adsorption of Basic Red 46 dye.

Ce was doped on TiO2 nanoparticles (NPs), and this association was loaded on activated carbon (Ce-TiO2-NPs-AC). The characterization was completed by FE-SEM, TEM, and XRD, and finally these NPs were used for the ultrasonic-assisted adsorption of Basic Red 46 (BR 46) from aqueous solution. An experimental model suggested by the central composite design (CCD)-as a branch of response surface methodology (RSM)-provides insight into the influence of variables, such as BR 46 concentration, pH, adsorbent mass, and sonication time, on BR 46 removal. Experimental results revealed that setting conditions at 25 mg L-1 of BR 46, pH 5.0, 0.02 g of Ce-TiO2-NPs-AC and 4 min sonication resulted in a high coefficient of determination (R2 > 0.99) and low probability values. The difference in the values is likely due to the accumulation of more than 99% of BR 46, while equilibrium data described by Langmuir isotherm model with a high adsorption capacity of 58.61 mg g-1 and adsorption process were successfully correlated with pseudo-second-order kinetics model.

The Effect of Aloe Vera Clinical Trials on Prevention and Healing of Skin Wound: A Systematic Review.

BACKGROUND: Aloe vera is an herbaceous and perennial plant that belongs to the Liliaceae family and used for many medicinal purposes. The present study aimed to systematically review clinical trials regarding the effect of Aloe vera on the prevention and healing of skin wounds. METHODS: To identify all related published studies, we searched SID, IRANDOC, Google Scholar, PubMed, MEDLINE, Scopus, Cochrane Library, and ScienceDirect databases in both the English and Persian languages from 1990 to 2016. The keywords used were Aloe vera, wound healing, and prevention. All clinical trials using Aloe vera gel, cream, or derivatives that included a control group with placebo or comparison with other treatments were included in the study. The PRISMA checklist (2009) was used to conduct the review. RESULTS: In total, 23 trials that met the inclusion criteria were studied. The results of the studies showed that Aloe vera has been used to prevent skin ulcers and to treat burn wounds, postoperative wounds, cracked nipples, genital herpes, psoriasis, and chronic wounds including pressure ulcers. CONCLUSION: Considering the properties of Aloe vera and its compounds, it can be used to retain skin moisture and integrity and to prevent ulcers. It seems that the application of Aloe vera, as a complementary treatment along with current methods, can improve wound healing and promote the health of society.

The effect of Aloe Vera gel on prevention of pressure ulcers in patients hospitalized in the orthopedic wards: a randomized triple-blind clinical trial.

BACKGROUND: One of the most common orthopedic problems is the incidence of pressure ulcer followed by immobility. This study aimed to investigate the effect of Aloe Vera gel on the prevention of pressure ulcer in patients hospitalized in the orthopedic ward. METHOD: This study is a randomized, triple-blind clinical trial which was done on 80 purposefully selected patients in orthopedic ward in Arak town, Iran, 2016. Patients were randomly assigned into two intervention and control groups based on blocking sampling method. In each group the routine daily cares to prevent bed sores were performed by nurses. In the intervention group in addition to routine nursing care to prevent bed sores, twice a day (hours of 9 and 21) pure Aloe Vera gel on the areas of hip, sacrum and heel were rubbed, but in the control group placebo (gel of water and starch) were used. Then sacral, hip and heel of both groups on days 3, 7 and 10 for of signs of pressure ulcers was evaluated. RESULTS: The mean age of patients in the control group was (42.34 ± 12.19) and in the intervention group Was (41.71 ± 11.50) years, respectively. In the intervention group 1 patient afflicted with sore of hip and two people with sacral pressure ulcer. In the control group 3 patients affiliated with sore of hip, 8 people with sacral pressure ulcer, and 1 person had pressure sore of heel. Analysis of the data showed that both groups had statistically significant differences in the incidence of pressure ulcers (P = 0.047). This means that Aloe Vera gel could prevent the occurrence of pressure ulcers in the intervention group. CONCLUSION: Due to the effect of Aloe Vera gel to prevent a rise in temperature, non-blanchable redness, swelling and pain of the skin of regions under study in hospitalized patients in the orthopedic ward, applying of it toward the prevention of pressure ulcers in patients at risk of pressure ulcer development is recommended. TRIAL REGISTRATION: This study was registered in Iranian Registry of Clinical. Trials in 07/09/2016 with the IRCT ID: IRCT2016051027825N1 .

Optimization of process parameters for determination of trace Hazardous dyes from industrial wastewaters based on nanostructures materials under ultrasound energy.

In this study, ultrasound-assisted dispersive solid phase micro-extraction based on nanosorbent namely silver-zinc oxide nanoparticles loaded on activated carbon (Ag-ZnO-NP-AC) combined with derivative spectrophotometry method for the simultaneous pre-concentration and determination of Methyl Green (MG) and Rose Bengal (RB) dyes in water and industrial wastewater. Characterized sorbent by field emission scanning electron microscopy (FESEM), energy-dispersive X-ray spectroscopy (EDX), particle-size distribution (PSD), Fourier transform infrared spectroscopy (FTIR), X-ray powder diffraction (XRD) and Transmission electron microscopy (TEM) analysis with superior adsorption capacity was applied in ultrasound assisted dispersive-solid-phase micro-extraction (UA-DSPME) methodology. pH, sorbent mass, ultrasonication time, and eluent volume influence and contribution on response correspond to simultaneous pre-concentration and determination of MG and RB were optimized by response surface methodology (RSM) and results were compared with the experimental values. Under the optimal conditions (UA-DSPME), the enrichment factors (EFs) were 93.89 and 97.33 for the MG and RB dyes, respectively. The limits of detection were 2.14 and 2.73ngmL-1 and the limit of quantification were 7.15 and 9.09ngmL-1 for MG and RB, respectively. The analytes can be determined over 10-2000ngmL-1 with recoveries between 90.8% to 97.7% and RSDs less than 3.6%. The developed method due to simplicity and rapidity is able successful for repeatable and accurate monitoring of under study analytes from complicated matrices.

Comparison between dispersive solid-phase and dispersive liquid-liquid microextraction combined with spectrophotometric determination of malachite green in water samples based on ultrasound-assisted and preconcentration under multi-variable experimental design optimization.

The ultrasound-assisted dispersive solid-phase microextraction (USA-DSPME) and the ultrasound-assisted dispersive liquid-liquid microextraction (USA-DLLME) developed for as an ultra preconcentration and/or technique for the determination of malachite green (MG) in water samples. Central composite design based on analysis of variance and desirability function guide finding best operational conditions and represent dependency of response to variables viz. volume of extraction, eluent and disperser solvent, pH, adsorbent mass and ultrasonication time has significant influence on methods efficiency. Optimum conditions was set for USA-DSPME as: 1mg CNTs/Zn:ZnO@Ni2P-NCs; 4min sonication time and 130µL eluent at pH 6.0. Meanwhile optimum point for USA-DLLME conditions were fixed at pH 6.0; 4min sonication time and 130, 650µL and 10mL of extraction solvent (CHCl3), disperser solvent (ethanol) and sample volume, respectively. Under the above specified best operational conditions, the enrichment factors for the USA-DSPME and USA-DLLME were 88.89 and 147.30, respectively. The methods has linear response in the range of 20.0 to 4000.0ngmL-1 with the correlation coefficients (r) between 0.9980 to 0.9995, while its reasonable detection limits viz. 1.386 to 2.348ngmL-1 and good relative standard deviations varied from 1.1% to 2.8% (n=10) candidate this method for successful monitoring of analyte from various media. The relative recoveries of the MG dye from water samples at spiking level of 500ngmL-1 were in the range between 94.50% and 98.86%. The proposed methods has been successfully applied to the analysis of the MG dye in water samples, and a satisfactory result was obtained.