Efficacy of virtual reality exposure therapy and eye movement desensitization and reprocessing therapy on symptoms of acrophobia and anxiety sensitivity in adolescent girls: A randomized controlled trial.

Background: Acrophobia is a specific phobia characterized by a severe fear of heights. The purpose of the present study was to investigate the efficacy of two therapies that may ameliorate symptoms of acrophobia and anxiety sensitivity, i.e., virtual reality exposure therapy (VRET) and eye movement desensitization and reprocessing (EMDR) therapy with a Waiting List Control Condition (WLCC). Methods: We applied a three-armed randomized controlled pre-post-test design with 45 female adolescent students. Students who met DSM-5 criteria for acrophobia were randomly assigned to either VRET (N = 15; Mage = 17.26; SD = 1.32), EMDR (N = 15; Mage = 17.15; SD = 1.57), or a WLCC (N = 15; Mage = 17.50; SD = 1.26). The study groups were evaluated one week before the intervention and one week after the last intervention session regarding symptoms of acrophobia (Severity Measure for Acrophobia) and anxiety sensitivity (Anxiety Sensitivity Index). Results: The data showed that both the application of VRET and EMDR therapy were associated with significantly reduced symptoms of acrophobia (d = 1.03 for VRET and d = 1.08 for EMDR) and anxiety sensitivity (d = 1.15 for VRET and d = 1.13 for EMDR) in comparison to the Waiting List. Limitations: The sample consisted only of adolescent women. Due to the recognizable differences between the two interventions, the therapists and the participants were not blind to the conditions. Conclusion: The results suggest that both VRET and EMDR are interventions that can significantly improve symptoms of acrophobia and anxiety sensitivity in female adolescents. Clinical Trial Registration: https://www.irct.ir/trial/57391, identifier: IRCT20210213050343N1.

The Efficacy of Kohl (Surma) and Erythromycin in Treatment of Blepharitis: An Open-Label Clinical Trial.

INTRODUCTION: Blepharitis is a common and chronic form of eyelid inflammation. Blepharitis treatment aims to decrease symptoms through antibacterial effects. One of the most common treatments of eyelid diseases in traditional medicine is using kohl. This clinical trial aimed to investigate its efficacy as a complementary treatment in staphylococcal blepharitis through an open-label clinical trial. MATERIALS AND METHODS: Thirty patients were randomized to receive kohl in one eye contralateral and erythromycin ointment in another eye for 90 days. At baseline and after 90 days of treatment, symptoms, clinical signs, and side effects of treatments were recorded. Statistical analysis was carried out using SPSS software, version 19. RESULTS: Despite randomization, there was a significant difference between the intervention and control eyes in the baseline mean clinical score (intervention eye: 9.86 (2.95) and control eye: 4.30 (2.81), P < 0.001). The degree of reduction of related signs and symptoms in the eyes treated with kohl was significantly higher than that in the control group: (5.2 vs. 2.20, P < 0.001) for symptoms and (7.40 vs. 2.46, P < 0.001) for clinical signs. Cohen's d statistic for mean difference of sign and symptom was 2.4 and 1.75, respectively, indicating a very strong effect. CONCLUSION: The present study results demonstrated a significant improvement in blepharitis-related signs and symptoms. The degree of improvement in the eyes treated with kohl was much higher than that in the control eyes.

Natural thymol-based ternary deep eutectic solvents: Application in air-bubble assisted-dispersive liquid-liquid microextraction for the analysis of tetracyclines in water.

Four new thymol-based ternary deep eutectic solvents were prepared and evaluated as the extractive phase in air-bubbles assisted dispersive liquid-liquid microextraction for extraction of tetracycline, doxycycline, and oxytetracycline from the water before high-performance liquid chromatography. The maximum extraction efficiencies were obtained using 400 µL of [choline chloride]:[thymol]:[nonanoic acid] in the molar ratio of 1:2:2 at pH = 5. The solvent was characterized by FTIR and NMR spectroscopy. The hydrophobicity of the deep eutectic solvent and its effect on the pH of water samples after mixing was also studied. Besides, the extraction efficiency of the ternary deep eutectic solvent was compared with that of two binary thymol-based deep eutectic solvents, including [choline chloride]:[thymol] and [thymol]:[nonanoic acid] at the same conditions. Under optimal conditions, limits of detection and quantification were 1.2-8.0 and 3.8-26.6 µg/L, respectively. The linear ranges were 18.2-500 µg/L for oxytetracycline, 26.6-500 µg/L for tetracycline, and 3.8-500 µg/L for doxycycline with the determination coefficients > 0.9912. Intra- and inter-day relative standard deviations were 1.2-3.8 and 7.7-11.2%, respectively. The developed method was applied to the analysis of tetracyclines in unspiked and spiked environmental water samples, and the obtained recoveries were 74.5-95.4% with relative standard deviations of 1.2-4.0%.

Hyphenated dispersive solid- and liquid-phase microextraction technique based on a hydrophobic deep eutectic solvent: application for trace analysis of pesticides in fruit juices.

BACKGROUND: Pesticides are extensively used worldwide to control plant pathogens and prevent agricultural product damage. However, they can pollute the environment and endanger human health. So far, a variety of sample preparation methods have been developed for the analysis of pesticide residues. RESULTS: A hyphenated solid-liquid microextraction method based on a new adsorbent of magnetic graphene oxide functionalized by (3-glycidyloxypropyl)trimethoxysilane and a deep eutectic solvent (choline chloride/4-chlorophenol (1:2)) was developed for extraction/preconcentration of trace levels of pesticides. The sorbent was characterized using scanning electron microscopy, Fourier transform infrared spectroscopy, and vibrating sample magnetometry. In-syringe magnetic dispersive solid-phase extraction in tandem with dispersive liquid-liquid microextraction followed by gas chromatography was applied for the analysis of the selected pesticides. The main parameters governing sample preparation efficiency, including adsorbent dosage, desorption conditions, pH, extraction time, deep eutectic solvent volume, and salt concentration, were investigated. The linear ranges were 0.024-500 µg L-1 with 0.9971-0.9999 linearity factor (R2 ). The limits of detection and quantification were 0.006-0.038 and 0.024-0.126 µg L-1 , respectively. The relative standard deviations were 0.5-4.2% for intra-day analysis and 2.7-4.6% for inter-day analysis. Enrichment factors were in the range 210-540. CONCLUSIONS: The method was successfully applied for the determination of malathion, heptachlor epoxide, endrin, dichlorodiphenyltrichloroethane, azinphos ethyl, cypermethrin, and deltamethrin in fruit juice samples (apple, pineapple, cherry, peach, and red and green grape juices) and the recoveries were within the range 71-115%. © 2020 Society of Chemical Industry.

The effect of ginger supplementation on IL2, TNFα, and IL1ß cytokines gene expression levels in patients with active rheumatoid arthritis: A randomized controlled trial.

Background: Rheumatoid arthritis (RA) is a chronic autoimmune and inflammatory disease that affects the joints and consequently leads to the destruction of cartilage and bone lesions. Traditionally, ginger has been consumed in treatment of osteoarthritis, joint and muscle pain, neurological diseases, and inflammation of gums, tooth pain, asthma, stroke, diabetes, and constipation. The aim of this study was to determine the effect of ginger on some immunological and inflammatory markers in patients with rheumatoid arthritis. Methods: In this study, which was performed during 2013-2016, 66 patients with active rheumatoid arthritis who referred to the rheumatology clinic at Shariati hospital were en-rolled. Patients were randomly divided into 2 groups: one group consumed 1.5 gr ginger per day, and the other group took roasted wheat flour (placebo), respectively. To determine the effect of confounding factors on the findings of the study, questionnaires for nutrient intake, physical activity, and medication were filled, and BMI was measured. For each participant, at the beginning and end of the study, Serum hs-CRP and mRNA levels of IL-1ß, IL-2 and TNF-α were determined by ELISA and Quantitative Real Time PCR, respectively. Statistical analysis was performed using SPSS software. Significance level was set at p<0.05. Results: Results of the study showed ginger powder supplementation caused a significant decline in CRP (p=0.050) and IL-1ß mRNA level (p=0.021). TNFα mRNA levels reduced in ginger group compared to placebo groupalthough the difference was not significant between the 2 groups (p=0.093). Ginger had no effects on IL2 gene expression. Conclusion: This study showed that ginger reduces inflammatory factors hs-CRP and IL-1ß gene expression in patients with active RA and it seems that ginger can improve the inflam-mation in the patients.

Therapeutic Effect of Adding Magnesium Sulfate in Treatment of Organophosphorus Poisoning.

BACKGROUND: In recent years, the prevalence of poisoning has increased dramatically due to population growth and access to drugs and toxins. Today poisoning is one of the important reasons for visiting hospitals. AIM: The present study aimed to investigate the effect of magnesium sulfate on organophosphorous toxicity. METHODS: Patients who had inclusion criteria in the study were randomly assigned to one of two groups (control group or case group) by an emergency medicine specialist. Patients' data including age, sex, ECG, vital signs, arterial oxygen saturation were recorded for patients. Patients in the case group (40 subjects) received 2 mg magnesium sulfate 50%, while the control group (40 subjects) received 100 cc normal saline (as placebo) as an intravenous infusion. RESULTS: The distribution of gender in the two groups of patients was the same. Also, the mean age, Stature and weight of patients were similar in both groups. In the group receiving magnesium sulfate, diastolic blood pressure was lower when compared with another group, at 0 and 2 hours after intervention. Moreover, the mean of systolic blood pressure in both groups was determined to be the same at all hours. Furthermore, the heart rate in the group receiving sulfate was lower as compared to the control group for 8 hours, 16 and 24 hours after intervention. CONCLUSION: The use of magnesium sulfate in organophosphate poisoning reduces therapeutic costs an average hospital length of stay and mortality compared to those who did not receive magnesium sulfate.

The Effect of Pre-Discharge Training on the Quality of Life of Burn Patients.

Introduction: Many physical, psychological, social and economic complications have been reported after discharge, which have a negative impact on the quality of life of burn patients. The present research examines the effect of pre-discharge training program on the life quality of patients with burns. Methods: This is a pre and post-experimental study with control group that was conducted in 2015 in teaching hospital Sina. The control group received the typical instructions upon being discharged from hospital while the experimental group received in-person training in the form of question-answer, pamphlets and a researcher-made instruction booklet. The patients' life quality was evaluated when they were being discharged, a month and then three months after they were discharged. Results: The result showed that the quality of life has a significant statistical difference across the three time points. And these differences are compared using Bonferroni's adjustment multiple comparisons indicating that pre-discharge training affects the quality of life scores and this effect continues over time. Conclusion: The results show that the pre-discharge training has significantly improved the life quality among the burns patients. The improvement of life quality is also correlated with the quantitative variable of total body surface area percent (TBSA %). Thus, planning and designing in-discharge training programs based on the existing context, combined with training packages focusing on the patients' needs could be a very significant step in more successful implementation of the follow-up programs on the burn patients and improving their quality of life.

Effect of Honey on Diarrhea and Fecal Microbiotain in Critically Ill Tube-Fed Patients: A Single Center Randomized Controlled Study.

BACKGROUND: In patients admitted to the Intensive Care Unit (ICU), Enteral Nutrition (EN) is the first choice for feeding support, however, it is often complicated by gastrointestinal side effects, such as diarrhea. There are no studies that have specifically evaluated effect of a prebiotic, which prevents diarrhea during enteral nutrition. OBJECTIVE: This study aimed at evaluating the effect of honey in enteral diet during occurrence of diarrhea and fecal microbiotain in critically ill patients. MATERIALS AND METHODS: In this double-blind, randomized controlled single-center study, 32 patients were randomly selected to receive a high protein kitchen enteral diet and the study group had honey as 10% of its carbohydrate intake. Quantitative analyses of bifidobacterium and Lactobacillus species of fecal samples were assessed by Real-Time Polymerase Chain Reaction (PCR) on days 0 and 7. RESULTS: Patients in the honey group showed an insignificant increase in the frequency of bifidobacterium DNA by study day 7 in comparison with the control group. In the honey group, there was a considerable reduction in diarrhea (P = 0.09). A significant difference was found in length of Intensive Care Unit (ICU) stay (P = 0.001) and Sequential Organ Failure Assessment (SOFA) score (P = 0.04) in favor of the honey group. CONCLUSIONS: Enteral nutrition with honey might reduce the length of stay at the ICU and development of organ failure in critically ill patients. It seems that honey helps reduce the incidence of diarrhea.

A supportive-educational intervention for heart failure patients in iran: the effect on self-care behaviours.

Background. Chronic heart failure is a major health and social problem. The promotion of self-care behaviours can potentially assist patients to effectively manage this chronic condition and prevent worsening of the disease. Formal personalized educational interventions that provide support and take into consideration the cultural context are needed. Objective. The objective of this research was to evaluate the effect of a supportive-educational intervention on self-care behaviours of heart failure patients in Iran. Methods. This research was a prospective, randomized trial of a supportive-educational intervention. Eighty heart failure patients were randomly assigned to receive the supportive-educational intervention or usual care. The intervention consisted of a one-hour, nurse-led, in-person education session and postdischarge followup by telephone over three months. Data were collected at baseline, one, two, and three months. Results. The control and intervention groups did not differ in self-care scores at baseline (P > 0.05). Each of the self-care scores was significantly higher in the intervention group than the control group at 1, 2, and 3 months (P < 0.001). There were significant differences in self-care behaviours over the three months, among participants in the intervention group. Conclusion. This study provides support for the effectiveness of a supportive-educational intervention to increase self-care behaviours among Iranian patients suffering from chronic heart failure.

Cow's milk allergy in multiple sclerosis patients.

BACKGROUND: Exposure to some environmental agent such as different nutrition and contact with allergens may have a role in developing multiple sclerosis (MS). The present study was aimed to evaluate the cow's milk allergy (CMA) in MS patients compared to healthy controls. MATERIALS AND METHODS: Between March 2012 and July 2012, 48 MS patients were selected and compared with 48 healthy subjectsto assess the frequency of CMA in MS patients compared to healthy control. Cow's milk specific immunoglobin E (IgE) was determined by Immuno CAP. Sex and the frequency of CMA were compared between study groups by Chi-square test. RESULTS: Total of 96 subjects were assessed (22% male and 78% female). The mean age of the study subjects was 30.8 ± 6.6 years. Mean age of case and control groups was 30.7 (±6.9) versus 30.9 ± 6.3, respectively (P value = 0.83). There were no detection of cow's milk specific IgE in serum of MS patients and healthy subjects. CONCLUSION: There was no difference between MS and healthy subjects regarding CMA.

Fish and egg specific immunoglobin e in multiple sclerosis patients.

BACKGROUND: The effect of nutrition in the course of multiple sclerosis (MS) is a topic of great interest. The present study was aimed to evaluate the immunoglobin E (IgE) against egg and fish in MS patients compared to healthy controls. METHODS: Between March 2012 and July 2012, 48 MS patients were selected and compared with 48 healthy subjects to assess the frequency of IgE against egg and fish in MS patients compared to healthy control. Fish and Egg specific IgE was determined by Immuno CAP. Sex and the frequency of specific IgE were compared between study groups by Chi-square test. RESULTS: Total of 96 subjects was assessed (22% male and 78% female). The mean age of the study subjects was 30.8 ± 6.6 years. Mean age of case and control groups was 30.7 (±6.9) versus 30.9 ± 6.3, respectively (P = 0.83). There were no detection of egg and fish specific IgE in serum of MS patients and healthy subjects. CONCLUSIONS: IgE allergy against fish and egg may be very unlikely to affect MS course.

Self-Care Behaviors among Patients with Heart Failure in Iran.

INTRODUCTION: Recovery from heart failure and dealing with its effects is significantly influenced by patient's self-care. In order to maximize the effects of behavioral interventions and for educational planning, it is essential to know how much experience and information do patients with heart failure have about their disease and self-care behaviors. The present study aimed to identify self-care behaviors in patients with heart failure. METHODS: Eighty heart failure patients hospitalized in Shahid Madani Training Center in Tabriz, Iran, participated in this study. Data collection was done through Self-Care of Heart Failure Index (SCHFI) that contained 22 questions in three sections including self-care behaviors, self-care management and confidence in performing self-care behaviors. RESULTS: The patient's self-care behaviors in three behavioral sub categories of maintaining, managing and confidence were low. The most repeated self-care behavior in the participating patients was taking medication and visiting the doctor. CONCLUSION: The results of the study showed low levels of self-care behaviors in patients with heart failure, which notes the need for patient empowerment. It is necessary to develop appropriate strategies in this regard by the authorities.

Transient expression assay of Agamma-588 (A/G) mutations in the K562 cell line.

BACKGROUND: In the previous study, we have shown that the presence of A allele at position -588 in Agamma-globin gene was highly frequent and closely associated with fetal hemoglobin elevation among beta-thalassemia intermedia patients. Therefore, we decided to investigate whether this allele (A allele at -588) could result in an increase in Agamma-globin gene expression to ameliorate the severity of the disease in thalassemia patients. METHODS: Three constructs containing mu locus control region, Agamma-globin and beta-globin genes were designed and employed in the transient expression assay. The difference among constructs was in the promoter region of Agamma-globin gene (A and G alleles at -588). A construct with T to C base substitution at -175 of Agamma-globin, created by site-directed mutagenesis, was selected as positive control. The K562 cell line was transfected with the above constructs. Subsequently, the expression of Agamma-globin gene was determined by quantitative real-time reverse transcription-PCR. RESULTS: There was not a significant increase in the expression of Agamma-globin gene in the construct containing A allele comparing the one with G allele at -588. CONCLUSIONS: -588 (A>G) mutation does not play a major role in regulation of Agamma-globin gene, suggesting that other factors may be involved.