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A cellular and molecular biology-based update for ivermectin against COVID-19: is it effective or non-effective?
No full textDespite community vaccination against coronavirus disease 2019 (COVID-19) and reduced mortality, there are still challenges in treatment options for the disease. Due to the continuous mutation of SARS-CoV-2 virus and the emergence of new strains, diversity in the use of existing antiviral drugs to combat the epidemic has become a crucial therapeutic chance. As a broad-spectrum antiparasitic and antiviral drug, ivermectin has traditionally been used to treat many types of disease, including DNA and RNA viral infections. Even so, based on currently available data, it is still controversial that ivermectin can be used as one of the effective antiviral agents to treat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or not. The aim of this study was to provide comprehensive information on ivermectin, including its safety and efficacy, as well as its adverse effects in the treatment of COVID-19
Co-delivery of silymarin and metformin dual-loaded in mesoporous silica nanoparticles synergistically sensitizes breast cancer cell line to mitoxantrone chemotherapy
No full textThe development nano-carriers based therapeutic methods is a potent strategy for enhancing cellular delivery of drugs and therapeutic efficiency in cancer chemotherapy. In the study, silymarin(SLM) and metformin (Met) were co-loaded into mesoporous silica nanoparticles (MSNs) and evaluated the synergistic inhibitory effect of these natural herbal compound in improving chemotherapeutic efficiency against MCF7MX and MCF7 human breast cancer cells. Nanoparticles have been synthesized and characterized by FTIR, BET, TEM, SEM, and X-ray diffraction. Drug loading capacity and release determined. The both single and combined form of SLM and Met (free and loaded MSN) were used for MTT assay, colony formation and real time-PCR in cellular study. The synthesis MSN were uniformity in size and shape with particle size of approximately 100 nm and pore size of approximately 2 nm. The Met-MSNs IC30, SLM –MSNs IC50 and dual-drug loaded MSNs IC50 were much lower than of free-Met IC30, free-SLM IC50 and free Met-SLM IC50 MCF7MX and MCF7cells. The co-loaded MSNs treated cells were increased sensitivity to mitoxantrone with the inhibition of BCRP mRNA expressions and could induce apoptosis in MCF7MX and MCF7 cells in comparison with other groups. Colony numbers were significantly reduced in comparison to with other groups in the co-loaded MSNs -treated cells (p < 0.01). Our results indicate that Nano-SLM enhances the anti-cancer effects of SLM against human breast cancer cells. The findings of the present study suggest that the anti-cancer effects of both metformin and silymarin enhances against breast cancer cells when MSNs are used as a drug delivery system
Bystander Effect of Sonodynamic Therapy in the presence of Gold Nanoparticles: An in-vitro study
No full textBackground: Bystander (B.s) effect can influence non-irradiated cells and affect the desired effect in cancer treatment. This study was conducted to assess this effect on simultaneous administration of ultrasound (US) and Gold nanoparticles as a sonodynamic therapy (SDT) which is an important newly stimuli-responsive method in cancer treatment. Materials and Methods: Firstly, the appropriate concentration of Gold nanoparticles (GNPs) and US intensity for SDT on melanoma cancer cells (A375) were evaluated. After treatments, the target cell culture was transferred to the bystander cells and the induced bystander effects including cell viability, apoptosis, expression of P53 (a promoter of apoptosis gene) and HO-1 (an inhibitor of apoptosis gene) were examined. Results: According to the MTT results, 50 mu g/ml concentration of GNPs and 1.5 W/cm2 intensity of US wave were selected. Our results revealed that SDT induced B.s effect can alter the cell viability and apoptosis up to 20% and 51.61%, respectively. Moreover, a 2.9-fold increase in p53 gene expression and a decrease in OH-1 gene expression to 0.181-fold in comparison to the control groups were observed. Conclusions: These results confirmed that B.s effect of sonodynamic can reduce the cancerous cell viability. Our finding showed that this treatment can be an alternative to traditional treatment modalities
The influential role of parents’ socioeconomic status and diet quality on their children’s dietary behavior: results from the LIPOKAP study among the Iranian population
No full textPurposeThere is a paucity of evidence regarding the influential factors on Iranian children's diet quality. To assess this issue, we explore the relationship between parental diet quality, socioeconomic status (SES), and nutritional knowledge with their children's diet quality using a cross-sectional sample of the Iranian population.MethodsIn this study, paired parents along with one of their children (aged 6-18 years old) who lived with them were included. Dietary intake was assessed using a food frequency questionnaire (FFQ) and diet quality was determined using an Alternative Healthy Eating Index-2010 (AHEI). Nutritional knowledge and SES were also explored using validated questionnaires. Multiple linear regression analysis was used and beta (beta) and corresponding 95% confidence interval (CI) were reported.ResultsAfter controlling for potential confounders, the parents' AHEI was significantly associated with their children's diet quality (beta = 12.34, 95% CI: 10.75, 13.93; P < 0.001). The nutritional knowledge of parents was significantly associated with children's AHEI after controlling for potential confounders (beta = 1.63, 95% CI: 0.14, 3.11; P = 0.032). Moreover, the parents' SES was inversely associated with the AHEI of children (beta=-3.76, 95% CI: -5.40, -2.11; P < 0.001); however, further adjustment for confounders attenuated this relationship (Model 3: beta = 0.87, 95% CI: -0.76, 2.34; P = 0.269).ConclusionsWe found that the children's diet quality could be influenced by their parents' SES, nutritional knowledge, and diet quality. Our findings suggest that improving the nutritional knowledge of parents not only may improve the healthy eating pattern of parents but also could influence their children's diet quality
Global, regional, and national burden of other musculoskeletal disorders, 1990-2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021
No full textBackground Musculoskeletal disorders include more than 150 different conditions affecting joints, muscles, bones, ligaments, tendons, and the spine. To capture all health loss from death and disability due to musculoskeletal disorders, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) includes a residual musculoskeletal category for conditions other than osteoarthritis, rheumatoid arthritis, gout, low back pain, and neck pain. This category is called other musculoskeletal disorders and includes, for example, systemic lupus erythematosus and spondylopathies. We provide updated estimates of the prevalence, mortality, and disability attributable to other musculoskeletal disorders and forecasted prevalence to 2050. Methods Prevalence of other musculoskeletal disorders was estimated in 204 countries and territories from 1990 to 2020 using data from 68 sources across 23 countries from which subtraction of cases of rheumatoid arthritis, osteoarthritis, low back pain, neck pain, and gout from the total number of cases of musculoskeletal disorders was possible. Data were analysed with Bayesian meta-regression models to estimate prevalence by year, age, sex, and location. Years lived with disability (YLDs) were estimated from prevalence and disability weights. Mortality attributed to other musculoskeletal disorders was estimated using vital registration data. Prevalence was forecast to 2050 by regressing prevalence estimates from 1990 to 2020 with Socio-demographic Index as a predictor, then multiplying by population forecasts. Findings Globally, 494 million (95% uncertainty interval 431-564) people had other musculoskeletal disorders in 2020, an increase of 123 center dot 4% (116 center dot 9-129 center dot 3) in total cases from 221 million (192-253) in 1990. Cases of other musculoskeletal disorders are projected to increase by 115% (107-124) from 2020 to 2050, to an estimated 1060 million (95% UI 964-1170) prevalent cases in 2050; most regions were projected to have at least a 50% increase in cases between 2020 and 2050. The global age-standardised prevalence of other musculoskeletal disorders was 47 center dot 4% (44 center dot 9-49 center dot 4) higher in females than in males and increased with age to a peak at 65-69 years in male and female sexes. In 2020, other musculoskeletal disorders was the sixth ranked cause of YLDs globally (42 center dot 7 million 29 center dot 4-60 center dot 0]) and was associated with 83 100 deaths (73 600-91 600). Interpretation Other musculoskeletal disorders were responsible for a large number of global YLDs in 2020. Until individual conditions and risk factors are more explicitly quantified, policy responses to this burden remain a challenge. Temporal trends and geographical differences in estimates of non-fatal disease burden should not be overinterpreted as they are based on sparse, low-quality data
Early vitrectomy: An effective treatment for acute postcataract surgery endophthalmitis
No full textBackground: Endophthalmitis is a rare but a high morbid complication after cataract surgery, and a gold standard treatment is not recommended yet. In this study, we aim to evaluate the effect of early vitrectomy on the visual acuity of patients with postcataract endophthalmitis.
Materials and Methods: This study was a single-arm clinical trial on 27 patients with postcataract surgery endophthalmitis. Early vitrectomy was the intervention. Visual acuity as the primary outcome was evaluated and compared at baseline, at discharge, and 1 and 3 months after the intervention.
Results: From 27 patients who included in our study, six patients gain favorable visual acuity of 5/10 and above (success rate = 22%), and four of them have no improvement in their visual acuity. Retinal detachment was reported as a complication in just one case. Negative culture was a predictor for success in terms of visual acuity after the surgery. All patients who gain favorable results, presented in the first 15 days after the cataract surgery.
Conclusion: The result of our study showed that, considering complete, early vitrectomy for the treatment of postcataract surgery endophthalmitis, especially for those who presented in the first 15 days of cataract surgery and for those who have negative culture is promising
Experiences of Surgical Technology Students of Their First Appearance in the Operating Room
No full textBackground: Clinical education is a critical stage of education and plays a major role in shaping students’ professional competencies. The clinical learning environment has a complex nature and has a significant impact on students, especially newly admitted ones. Thus, the initial experience in clinical settings will significantly affect the student’s performance. To this end, this study sought to explore the experiences of surgical technology students of their first appearance in the operating room. Methods: This qualitative study was conducted using a descriptive phenomenological approach. The participants were 15 secondand third-semester students of surgical technology who entered the study through purposive sampling. The data were collected through individual interviews. Data analysis was performed simultaneously with data collection through Colaizzi’s seven-step content analysis method. Results: A total of 101 primary codes were extracted from the collected data. The extracted codes were grouped into 7 subcategories. After removing duplicate codes, 3 main themes were revealed from the participants’ experiences (conflicting perceptions in the learning environment, preparedness before attending the operating room, and feelings and emotions). Conclusion: The students’ experiences of their first appearance in the operating room indicated that their expectations changed compared to what they imagined. The stressful nature of surgical technology and the students’ experiences when starting the internship highlight the need for some necessary measures to prepare students before entering the hospital and to improve the quality of clinical education for these students
Global, regional, and national mortality due to unintentional carbon monoxide poisoning, 2000–2021: results from the Global Burden of Disease Study 2021
No full textBackground: Unintentional carbon monoxide poisoning is a largely preventable cause of death that has received insufficient attention. We aimed to conduct a comprehensive global analysis of the demographic, temporal, and geographical patterns of fatal unintentional carbon monoxide poisoning from 2000 to 2021. Methods: As part of the latest Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), unintentional carbon monoxide poisoning mortality was quantified using the GBD cause of death ensemble modelling strategy. Vital registration data and covariates with an epidemiological link to unintentional carbon monoxide poisoning informed the estimates of death counts and mortality rates for all locations, sexes, ages, and years included in the GBD. Years of life lost (YLLs) were estimated by multiplying deaths by remaining standard life expectancy at age of death. Population attributable fractions (PAFs) for unintentional carbon monoxide poisoning deaths due to occupational injuries and high alcohol use were estimated. Findings: In 2021, the global mortality rate due to unintentional carbon monoxide poisoning was 0·366 per 100 000 (95% uncertainty interval 0·276–0·415), with 28 900 deaths (21 700–32 800) and 1·18 million YLLs (0·886–1·35) across all ages. Nearly 70% of deaths occurred in males (20 100 [15 800–24 000]), and the 50–54-year age group had the largest number of deaths (2210 [1660–2590]). The highest mortality rate was in those aged 85 years or older with 1·96 deaths (1·38–2·32) per 100 000. Eastern Europe had the highest age-standardised mortality rate at 2·12 deaths (1·98–2·30) per 100 000. Globally, there was a 53·5% (46·2–63·7) decrease in the age-standardised mortality rate from 2000 to 2021, although this decline was not uniform across regions. The overall PAFs for occupational injuries and high alcohol use were 13·6% (11·9–16·0) and 3·5% (1·4–6·2), respectively. Interpretation: Improvements in unintentional carbon monoxide poisoning mortality rates have been inconsistent across regions and over time since 2000. Given that unintentional carbon monoxide poisoning is almost entirely preventable, policy-level interventions that lower the risk of carbon monoxide poisoning events should be prioritised, such as those that increase access to improved heating and cooking devices, reduce carbon monoxide emissions from generators, and mandate use of carbon monoxide alarms. Funding: Bill & Melinda Gates Foundatio
The Effect of Oral Silymarin on Remdesivir-Induced Hepatotoxicity and Clinical Course in Covid-19 Patients; A Double-Blind Randomized Controlled Trial
No full textBackground: Remdesivir is a nucleoside inhibitor of RNA polymerase with the antiviral activity used in the treatment of COVID-19 pneumonia. One of the remdesivir side effects is hepatotoxicity. Given the growing body of data supporting silymarin's antiviral and hepatoprotective properties, the present research sought to explore the impact of silymarin on laboratory parameters, frequency of symptoms, and liver enzymes in COVID-19 patients. Materials and Methods: In this double-blind randomized clinical trial 70 patients were divided into two groups of 35. Intervention group received remdesivir + 140 mg Silymarin, 3 times, daily for 1 week, and the control group received remdesivir + placebo. Patients' symptoms and laboratory findings were assessed at baseline and 5,7,10, and 14 days’ post enrollment. Results: Liver enzymes level (aspartate aminotransferase, and alkaline phosphatase), and lactate dehydrogenase were significantly decreased in the intervention group (p < 0.05). Among the clinical symptoms, cough (p=0.03), shortness of breath (p= 0.006), headache (p=0.01), and muscle pain (p=0.03) were significantly lower in the treatment group comparing to the control group. Moreover, the severity of disease in the intervention group was substantially lower than that among the control group. Conclusion: Concomitant use of remdesivir with silymarin might reduce hepatotoxicity and ultimately improve the patients' condition. More clinical trials with different dosages and larger sample sizes are recommende
Investigating the Effect of Virtual Professional Ethics Training on the Communication Skills of Operating Room Staff
No full textBackground and Aim: Communication skills are considered as the most important feature required for health care workers and provide the basis for the development of professional ethics. Since working in the operating room requires team effort and establishing communication between team members, the importance of communication skills in operating room nurses is more visible. Therefore, in the present study was performed, with the aim of determining the effect of virtual training on the principles of professional ethics on communication skills of operating room staff of Ayatollah Kashani and Hajar hospitals of Shahrekord University of Medical Sciences. Materials and Methods: A quasi-experimental study with a single-group plan before and after in 2020 was performed on 35 operating room staff of Kashani and Hajar teaching hospitals in Shahrekord who were selected by random sampling. Demographic information questionnaire and Queen Dam communication skills questionnaire were used to collect the data. Data analysis was performed by SPSS software using independent t test, Analysis of variance, paired t-test and ANOVA statistics. Results: Paired t-test showed that the mean of communication skills after the intervention was significantly different from before (P<0.001). The mean of communication skills before the intervention was 65.85±24.52 and after the intervention was 139.77±5.70. No significant relationship was reported between communication skills and age, service history and number of working hours (P>0.05.). Also, there was no significant difference in the average of communication skills according to the variables of gender, marital status, field of study and degree (P>0.05). Conclusion: The present study showed that professional ethics training was able to improve the communication skills of employees. Therefore, it seems necessary to compile virtual professional ethics training for health care providers and other groups providing health services who do not have enough time to participate in face-to-face classes. According to the results obtained, managers of health systems are recommended to use strategies such as holding workshops on the principles of professional ethics to develop communication skills in their employees