Occupational exposure of health care personnel to SARS-CoV-2 particles in the intensive care unit of Tehran hospital.

The outbreak of SARS-CoV-2 (COVID-19) has attracted much attention to study its possible presence and airborne transmission. The possibility of COVID-19 airborne transmission in indoor environments is debatable. The present study examined the concentration of viral RNA-containing particles produced directly or indirectly by breathing or coughing of confirmed COVID-19 patients or by carriers without symptoms. Some studies do not accept this method of transmission (COVID-19 airborne transmission). The present study aimed to measure the possible exposure of health care personnel to SARS-CoV-2 particles that may have been suspended in the air to respond to the hypothesis of COVID-19 airborne transmission. Airborne particle sampling was performed using impingement method based on NIOSH (chapter BA) and ASHRAE. Selection of sampling sections was in line with the WHO guidelines. The samples were analyzed using RT-PCR technique. Based on the given results, airborne particles of COVID-19 may present in the air and affect the health of hospital personnel. In fact, the analysis of gene expression in ambient conditions and thereby aerosol transmission of SARS-CoV-2 through air is possible and may lead to occupational exposure of health care personnel. Furthermore, it was found that airborne emission of COVID-19 through the breathing zone of patients, particularly in ICU wards with confirmed cases of COVID-19, may be higher than in other ICU wards. Also, the demonstrated results showed that there is a possibility of reaerosolization (reintroduction) of previously airborne SARS-CoV-2 particles into the atmosphere due to health care personnel frequently walking between different wards and stations of ICU.

Comparison of Er,Cr:YSGG and diode laser effects on dentin hypersensitivity: a split-mouth randomized clinical trial.

OBJECTIVES: The aim of the present study was to compare the clinical efficacy of diode laser and Er,Cr:YSGG lasers in the treatment of dentin hypersensitivity. MATERIALS AND METHODS: Thirty-four teeth from 17 patients with dentin hypersensitivity were divided into two groups. In group D, the teeth were irradiated with diode laser beams with a wavelength of 940 nm for 1 min, and in group E, the teeth were irradiated with Er,Cr:YSGG laser beams with a wavelength of 2780 nm and a pulse width of 140-200 µs. Treatments with laser beams were carried out in 1 session. Sensitivity was assessed with air spray and a dental explorer. Pain severity was measured with the use of visual analog scale (VAS) before and after laser application. RESULTS: A decrease in dentin hypersensitivity was observed in both groups immediately, 1 week, and 1 month after laser irradiation. Statistically significant differences were found between the two groups in dentin hypersensitivity severity only 1 month after laser application. The decrease in dentin hypersensitivity by Er,Cr:YSGG laser was significantly higher than that by diode laser at this time interval. CONCLUSION: The decrease in dentin hypersensitivity after application of Er,Cr:YSGG laser was significantly higher than that after the application of diode laser at 1-month postoperative interval. CLINICAL RELEVANCE: Er,Cr:YSGG laser is a better choice than diode laser for the treatment of dentin hypersensitivity in the short term.

Life Table Parameters of Tuta absoluta (Lepidoptera: Gelechiidae) on Different Varieties of Tomato.

Tuta absoluta (Meyrick), a tomato leaf miner, is one of the destructive pests of tomatoes, which is native to South America, and has been considered as a quarantined pest for Iran since 2010 while it has quickly spread all around the country and is known as a key pest in tomato-cultured regions since 2012. In the current study, the life table parameters of T. absoluta were studied on cut leaves of three greenhouse cultivars of tomato including 'Atabay', 'Cluse', and 'Perenses'. Data were analyzed based on the age-stage, two-sex life table analysis. Results showed differences in the duration of egg, larvae, pupae, and adults. Meanwhile, the life table parameters including intrinsic rate of increase (r), finite rate of increase (λ), net reproductive rate (R0), and gross reproductive rate (GRR) were categorized increasingly based on the feeding on Cluse, Atabay, and Perenses, respectively. The findings of the current study showed that the Cluse could be nominated as an unsuitable host for tomato leaf miner among cultivars because of its negative influences on the pest's biological parameters. Moreover, these results may develop the finding and screening process of relatively resistant cultivars to be used in the management of T. absoluta.

Radial head resection versus prosthetic arthroplasty in terrible triad injury: a retrospective comparative cohort study: a retrospective comparative cohort study.

AIMS: The crucial role of the radial head in the stability of the elbow in terrible triad injury is acknowledged. This retrospective study aims to compare the results of resection of a severely comminuted radial head with or without prosthetic arthroplasty as part of the reconstruction for this injury. PATIENTS AND METHODS: The outcome of radial head resection was compared with prosthetic arthroplasty in 29 and 15 patients with terrible triad injuries, respectively. There were ten female patients (34.5%) in the resection group and six female patients (40%) in the prosthesis group. The mean age was 40.7 years (sd 13.6) in the resection group and 36 years (sd 9.4) in the prosthesis group. The mean follow-up of the patients was 24.4 months (sd 12) in the resection group and 45.8 months (sd 6.8) in the prosthesis group. Outcome measures included visual analogue scale (VAS) for pain, Mayo Elbow Performance Score (MEPS), Disabilities of Arm, Shoulder and Hand (DASH) Score, and range of movement. Postoperative radiological complications were also recorded. RESULTS: The mean ranges of extension, flexion, supination, and pronation were not significantly different between the two study groups (p = 0.75, p = 0.65, p = 0.82, and p = 0.68, respectively). The mean VAS score, DASH score, and MEPS of the two groups were also not statistically significantly different (p = 0.93, p = 0.19, and p = 0.32, respectively). At the final visit, the elbow was stable in all patients. No patient was found to have developed an Essex-Lopresti injury. Osteoarthritis grade I and II was observed in five and three patients of the resection group, respectively, and four and one patients of the arthroplasty group, respectively. CONCLUSION: The outcome of patients undergoing treatment for terrible triad injuries is similar whether the patient's radial head was excised or replaced. Cite this article: Bone Joint J 2018;100-B:1499-505.

Creatinine, blood urea nitrogen and thyroid hormone levels before and after haemodialysis.

A study was carried out on 57 patients with chronic renal failure in a hospital in Kerman city, Islamic Republic of Iran. Blood samples were taken before and after haemodialysis to measure blood urea nitrogen and serum creatinine, triiodothyronine (T3) and thyroxine (T4) levels. Findings revealed that before dialysis T4 in 11 cases and T3 in 29 cases were lower than the normal range, but after haemodialysis only 3 cases for T4 and 15 cases for T3 were lower than normal levels. The remaining cases reverted to normal state. We suggest that a feedback relationship exists between the major end catabolic products (creatinine and blood urea nitrogen) and thyroid hormone serum levels.

Prevalence of oral Candida colonization in patients with diabetes mellitus.

OBJECTIVES OF THE STUDY: We aimed to assess the prevalence of oral Candida colonization in patients with diabetes and its relationship with factors such as Candida species, serum glucose level, and the susceptibility rate of isolated yeasts to antifungals. PATIENTS: Random samples were obtained from 113 patients with type 2 diabetes, 24 patients with type 1 diabetes, and 105 healthy controls. MATERIALS AND METHODS: The samples were taken by swabbing the oral mucosa of patients with diabetes mellitus and healthy individuals. Afterwards the samples were inoculated onto CHROMagar-Candida. The growing colonies were counted, and the isolated yeasts were identified by PCR-RFLP and RapID methods. Various isolated species of Candida were also subjected to susceptibility testing of antibiotic drugs. Blood samples were taken to evaluate glycosylated hemoglobin (HbA1c). RESULTS: Although the Candida carriage rate and density were statistically higher in diabetics than healthy individuals, no direct association was found between having high Candida-burden and glycosylated hemoglobin. The most commonly isolated species in both diabetics and controls was Candida albicans. Of the tested antifungal drugs, the highest rate of resistance was found against itraconazole, followed in frequency by ketoconazole and fluconazole. CONCLUSIONS: This study identified a significant association between the poor glycemic control and the higher prevalence rates of Candida carriage and density in diabetic patients. In addition, a high prevalence of C. dubliniensis in diabetic patients was found, which might be misdiagnosed with its morphologically related species, C. albicans.

Circulating levels of interleukin-35 in patients with multiple sclerosis: evaluation of the influences of FOXP3 gene polymorphism and treatment program.

The regulatory T (Treg) cells play a major role in the control of the autoimmunity and inflammation, and IL-35 has been described as an immunosuppressive cytokine that is mainly produced by CD4(+)FOXP3(+) Treg cells. The aim of this study was to evaluate the serum levels of IL-35 and a single nucleotide polymorphism (SNP), rs3761548, in FOXP3 gene in patients with multiple sclerosis. The blood samples were collected from 140 multiple sclerosis (MS) patients (including 51 untreated and 89 treated patients) and 140 healthy subjects as a control group. The serum levels of IL-35 were measured by ELISA. The DNA was analyzed for SNP rs3761548 in FOXP3 gene using SSP-PCR. There was no significant difference between untreated MS patients and control group regarding the mean serum levels of IL-35, although this parameter was higher in untreated patients. However, the mean serum level of IL-35 in treated MS patients was significantly higher than that in the control group (P < 0.008). The mean serum levels of IL-35 in patients who were treated with interferon-ß, methylprednisolone, or with the both interferon-ß and methylprednisolone were significantly higher than that in the healthy group (P < 0.01, P < 0.01, and P < 0.2, respectively). The frequencies of AA and AC genotypes at rs3761548 in the FOXP3 gene were significantly higher in MS group as compared with healthy subjects (P < 0.05). The frequency of CC genotype at rs3761548 was significantly lower in the MS group in comparison with healthy control subjects (P < 0.001). Moreover, the frequency of A allele was significantly higher whereas the frequency of C allele was significantly lower in MS patients in comparison to healthy subjects (P < 0.001). The mean serum level of IL-35 was significantly lower in MS patients or healthy subjects with AA genotype as compared with those with CC genotype at rs3761548 in FOXP3 gene (P < 0.01 and P < 0.001, respectively). These results showed higher serum levels of IL-35 in treated MS patients representing that the benefit effects of treatment may in part performed through the upregulation of the IL-35 production. The SNP rs3761548 may influence the susceptibility to MS disease and the serum levels of IL-35.

Comparative assessment of the therapeutic effects of the topical and systemic forms of Hypericum perforatum extract on induced oral mucositis in golden hamsters.

Oral mucositis is a common and irritating complication of chemotherapy and radiotherapy for malignancies. Current treatments have failed to achieve complete remission of this complication. The St. John's wort plant (Hypericum perforatum) has long been known for its anti-inflammatory and antibacterial effects. The current study was designed to investigate the therapeutic efficacy of the topical and systemic administration of H. perforatum extract on oral mucositis. Oral mucositis was induced in 72 male golden hamsters by administration of 5-fluorouracil (60mg/kg), on days 0, 5, and 10 of the study. The cheek pouch was scratched with a sterile needle on days 1 and 2. On days 12-17, H. perforatum extract topical gel 10%, oral H. perforatum extract (300mg/kg), and gel base groups were treated and then compared with a control group. Weights and blood samples were evaluated, biopsies from buccal lesions were examined histopathologically, and tissue malondialdehyde (MDA) was measured. Both of the H. perforatum extract treatment groups saw a significant relief in oral mucositis compared to the control and base gel groups; the systemic form was superior to the topical form. H. perforatum extract, administered orally or topically, expedited the healing of chemotherapy-induced oral mucositis in hamsters.

Higher circulating levels of chemokine CCL20 in patients with multiple sclerosis: evaluation of the influences of chemokine gene polymorphism, gender, treatment and disease pattern.

Chemokines play an important role in the autoimmune diseases. The aim of this study was to investigate the levels of CCL20 and a polymorphism [-786C > T (rs6749704)] in the chemokine gene in patients with multiple sclerosis (MS). The blood samples were collected from 135 MS patients and 135 healthy subjects as a control group. The patients have relapsing-remitting (RRMS; n = 65), primary progressive (PPMS; n = 47), secondary progressive (SPMS; n = 35) or progressive relapsing (PRMS; n = 14) patterns. The serum levels of CCL20 were measured by ELISA. The DNA was analyzed for CCL20 polymorphism using PCR-RLFP. The mean serum levels of CCL20 in the MS group were significantly higher than in the healthy group (P < 0.001). In patients with a SPMS pattern, the frequency of CT genotype at rs6749704 (24.3 %) was significantly lower as compared to patients with other patterns (42.8 %; P < 0.04). No significant differences were observed between subjects with different genotypes in rs6749704 regarding the CCL20 levels. The mean serum levels of CCL20 in both newly diagnosed and previously diagnosed patients was significantly higher than in the healthy group (P < 0.05 and 0.001, respectively). The mean serum levels of CCL20 in patients with RRMS, SPMS and PPMS patterns were significantly higher than in the healthy group (P < 0.004, P < 0.04, and 0.05, respectively). The levels of CCL20 in untreated patients and in patients who received interferon-ß, methylprednisolone or the combination of interferon-ß plus methylprednisolone were higher as compared to the control group (P < 0.05, P < 0.03, P < 0.005, and P < 0.05, respectively). These results showed higher levels of CCL20 in patients that represent that the chemokine may play an important role in the pathogenesis of MS. The rs6749704 polymorphism was an associated SPMS pattern. The levels of CCL20 were not influenced by gender, disease pattern and treatment.

Lower serum levels of Th2-related chemokine CCL22 in women patients with multiple sclerosis: a comparison between patients and healthy women.

Chemokines play a major role in autoimmune diseases such as multiple sclerosis (MS). Gender also affects the susceptibility and course of MS. The aim of this study was to investigate the serum levels of the macrophage-derived chemokine (CCL22) in women and men patients with MS. Blood samples were collected from 135 healthy subjects (35 men and 100 women) and 135 MS patients (29 men and 136 women; 47 newly diagnosed and 88 treated patients and have relapsing-remitting (RRMS; n = 65), secondary progressive (SPMS; n = 37), primary progressive (PPMS; n = 19), or progressive relapsing (PRMS; n = 14) patterns). The serum levels of CCL22 were measured by ELISA. The difference of the mean serum levels of CCL22 between the newly diagnosed MS men and healthy men was not significant, but in newly diagnosed MS women, the mean serum levels of CCL22 were significantly lower than those in treated MS women and healthy women (P < 0.006 and P < 0.0001, respectively). The differences of the mean CCL22 levels between men patients with different treatment programs were not significant, but the mean CCL22 levels were significantly higher in women treated with interferon-ß or the combination of interferon-ß plus methylprednisolone as compared to untreated women patients (P < 0.01 and P < 0.05, respectively). The CCL22 levels were also significantly higher in women with RRMS and PRMS patterns in comparison to healthy women (P < 0.05 and P < 0.01, respectively). These results showed lower levels of CCL22 in women patients which represents that the reduction in CCL22 levels may play an important role in the pathogenesis of the disease in women. In women patients, the levels of CCL22 were influenced by disease pattern and treatment.

Phospholipase, esterase and hemolytic activities of Candida spp. isolated from onychomycosis and oral lichen planus lesions.

OBJECTIVE OF THE STUDY: Candidiasis is an opportunistic fungal infection caused by many species of Candida that affects different sites of the body. Secretion of exoenzymes plays an important role in virulence and pathogenesis. The aim of this study was to evaluate the potential role of phospholipase, esterase and hemolytic activity of Candida species isolated from onychomycosis and oral lichen planus patients in candidiasis. METHODS: A total of 84 Candida isolates including 24 C. albicans and 46 C. parapsilosis from onychomycosis, and 14 C. albicans from oral lichen planus patients were included in our study. Egg yolk agar, Tween 80 opacity medium and blood agar plate assays were used for determining phospholipase, esterase and hemolytic activities, respectively. Statistical analyses were performed using the Fischer exact test. RESULTS: C. parapsilosis isolates had the least exoenzyme activity among the isolates (P≤0.001). C. albicans isolates from lichen planus showed less exoenzyme activity in comparison to the onychomycosis isolates. Only 16.08% of C. parapsilosis isolates had phospholipase activity. This difference between C. albicans and C. parapsilosis was statistically significant (P≤0.001). All of the C. albicans isolates from onychomycosis patients had beta hemolysin activity. There was more hemolytic activity in the C. albicans isolates when compared with C. parapsilosis and between C. albicans isolates, no significant difference was seen. All of the C. albicans isolates produced esterase enzyme on day three and no significant differences were seen between the two groups of C. albicans for esterase activity. Two strains of C. albicans had no phospholipase or esterase activity. CONCLUSION: This study showed that most of the isolates tested had different enzymatic patterns and C. parapsilosis strains had less phospholipase activity.

Comparing the Effect of Phenytoin Syrup and Triamcinolone Acetonide Ointment on Aphthous Ulcers in Patients with Behcet's Syndrome.

BACKGROUND: Recurrent aphthous stomatitis (RAS) appears to be the most common type of oral ulcers. The lesion is usually self limited but its painful presentation results in some difficulties. Therefore, an efficient therapeutic strategy is required and currently existing therapies seem to be inadequate because of its unclear etiology. Here the therapeutic effect of triamcinolone acetonide ointment as a relatively expensive medication has been compared with phenytoin syrup on aphthous ulcers in patients with Behcet's syndrome. METHODS: Thirty out of 60 our patients with Behcet's syndrome were randomly treated by phenytoin syrup and the remaining were advised to use 0.1% triamcinolone acetonide ointment. After a week, they were visited again to determine the status of aphthous ulcers. RESULT: Positive response in the triamcinolone acetonide group and phenytoin group was 86.7% and 53.3%, respectively. CONCLUSION: The effectiveness of triamcinolone acetonide ointment was more than phenytoin on aphthous ulcers in patients with Behcet's syndrome.

Does ghrelin level change after epileptic seizure in rats?

AIM: Epilepsy is one of the most common neurologic problems worldwide. A relationship between epilepsy and hormones has been demonstrated. This study was designed to investigate the effect of seizure on blood ghrelin level. METHODS: Twenty male Wistar rats were divided into two groups. The control group received saline and the pentylenetetrazole (PTZ) group received a single convulsive dose (50mg/kg) of PTZ. Thirty minutes later blood samples were collected and acylated and unacylated ghrelin levels in the plasma were assayed. RESULTS: Acylated or active form of ghrelin decreased significantly (p<0.05) after a PTZ-induced seizure, but the reduction of unacylated and total blood ghrelin levels failed to reach statistical significance. CONCLUSION: These findings may reflect that PTZ-induced epilepsy decreases AG of plasma.

Needlestick Injuries among Nurses.

BACKGROUND: Needlestick injuries (NSIs) are among the most important occupational injuries for health care workers (HCWs). In Iran, the problem of exposure to contaminated blood among nursing personnels has not well documented. The aim of this study was to determine the incidence of needlestick injuries in population of nurses in Shahroud Imam Hossein Hospital, northern Iran. METHODS: A self-administrated questionnaire was completed by 180 nurses in September and October 2005 for their NSIs experience in the past year. In this study, needlestick injury was defined as percutaneous injury caused by hollow-borne needles, suturing needles, scalpel blades and lancets. RESULTS: The case incidence of NSIs was 63.3% (114/180). The total number of episodes of NSIs among respondents was 220 (range: 1-5 episodes) with incidence rate of episodes i.e. 1.2 per person/year. 12.8% of nurses had not been vaccinated against hepatitis B virus (HBV). The causal devices in 105 cases (92.1%) were hollow-borne needles and the main causes of percutaneous injuries with hollow-bore needles were recapping (32.4%) and manipulating needles in patients (18.1%). The majority (51.8%) of injuries occurred after use and before disposal of the objects. CONCLUSION: Nurses working in Imam Hossein Hospital are frequently exposed to blood-borne infection. NSIs were highly prevalent in these nurses therefore more intensive education programs should be directed at nurses to increase their awareness of and compliance with universal precautions (UP). We recommend a surveillance system and a center for managing injured persons.