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A Hazard and Operability Study for Assessing Hazard Risks using Fault Tree Analysis in an Iranian Petrochemical Industry Unit (2016)
Get PDFBackground: Risk assessment is an important tool for reducing casualties and financial
damage in the oil and gas industry. This research aimed to identify and evaluate process
hazards in the petrochemical industry in 2016.
Material and Methods: In this case study, a team was organized and briefed on the
process. Besides, hazard identification was performed using the Hazard and Operability
Study. Next, causes were analyzed using the Fault Tree Analysis and occurrence
probability of top events. Finally, events and subevents were ranked. The minimum cut
sets were determined using Boolean algebra.
Results: A total of 77 events were identified. Accordingly, unacceptable, tolerable, and
acceptable risk levels were 41, 31, and 5 events, respectively. Fire was the most
unacceptable risk level, with the final events of "human errors in correct gasket
installation on the flange surface" and "flange defects" having had the shares of 51.2 and
21.55%, respectively.
Conclusion: The combination of the two HAZOP and FTA techniques is useful in
process industries in which incomplete performance of the system and control systems is
the most effective factor in the potential occurrence of fire. Human errors and flange
defects are the two main factors in this event, so occupational safety and health must be
improved in this system. Thus, due to complex interactions between humans, machines,
materials, and the environment in systems, such as the petrochemical industry, which
lead to uncertainties in safety results of the process, risk assessment is recommended to
be performed periodically using different techniques
The Alteration of Clinical and Laboratory Signs and Symptoms of COVID-19 in Re-infection: A Case Report
Get PDFBackground: Patients can be carriers of the virus for a long time or become re-infected or reinfected following the use of immunosuppressive drugs. Clinical manifestations in patients are
very diverse and can range from asymptomatic to severe illness with death. Patients may also
present with manifestations such as coagulation disorders, cardiac dysfunction and arrhythmias,
acute coronary syndrome, kidney injury, liver injury, Refer to diabetic hyperglycemia and
ketoacidosis. This is an essential point in the prevention of Coronavirus Disease 19 (COVID-19).
Case Presentation: We reported a case in which the Polymerase Chain Reaction (PCR) test
was positive after re-negative after 5 months. Moreover, the patient presented different and
more severe symptoms than the previous infection, as the genetic difference between the strains
increased over time.
Conclusion: As a result, immunization may become more complicated, and different clinical
pictures occur; thus, this condition can challenge vaccine immunization
A mediating role for mental health in associations between COVID-19-related self-stigma, PTSD, quality of life, and insomnia among patients recovered from COVID-19
Get PDFntroduction: Patients with COVID-19 often suffer from psychological problems such as post-traumatic stress disorder (PTSD) and self-stigmatization that may negatively impact their quality of life and sleep. This study examined mental health as a potential mediating factor linking self-stigmatization and PTSD to quality of life and sleep.
Methods: Using a cross-sectional design, 844 people who had recovered from COVID-19 were called and interviewed. Data were collected using structured scales. Structural equation modeling was applied to assess fitness of a mediation model including self-stigma and PTSD as independent factors and quality of life and insomnia as dependent variables.
Results: Mental health, COVID-19-related self-stigma, and mental quality of life were associated. Insomnia, PTSD, and COVID-19-related self-stigma displayed significant direct associations (r = .334 to 0.454; p < .01). A mediation model indicated satisfactory goodness of fit (CFI = 0.968, TLI = 0.950, SRMR = 0.071, RMSEA = 0.068). Mental health as a mediator had negative relationships with COVID-19-related self-stigma, PTSD, and insomnia and positive associations with quality of life.
Conclusion: Mental health may mediate effects of COVID-19-related self-stigma and PTSD on quality of life and insomnia. Designing programs to improve mental health among patients with COVID-19 may include efforts to reduce negative effects of PTSD and COVID-19-related self-stigma on quality of life and insomnia.
Keywords: COVID-19; coronavirus; quality of life; sleep disorders; stigmatization; stress
A case report of rhino-facial mucormycosis in a non-diabetic patient with COVID-19: a systematic review of literature and current update
Get PDFBackground: COVID-19 disease may be associated with a wide range of bacterial and fungal infections. We report a patient with COVID-19 infection who developed rhino-facial mucormycosis during treatment with corticosteroids.
Case presentation: A 59-year-old non-diabetic male patient was admitted with a diagnosis of COVID-19 based on positive RT-PCR and CT of the lungs. Due to sever lung involvement, he was treated with methylprednisolone. The patient was re-admitted to hospital, due to nasal obstruction and left side facial and orbital swelling, several days after discharge. In sinus endoscopic surgery, debridement was performed and the specimens were sent to pathology and mycology laboratories. A nasal biopsy showed wide hyphae without septa. The sequenced PCR product revealed Rhizopus oryzae. Despite all medical and surgical treatment, the patient died. In addition, the characteristics of patients with COVID-19-associated mucormycosis were reviewed in 44 available literatures. In most studies, diabetes mellitus was the most common predisposing factor for mucormycosis.
Conclusion: Our report highlights the need for assessing the presence of mucormycosis in patients with COVID-19 and also it shows that physicians should consider the potential for secondary invasive fungal infections in COVID-19 cases.
Keywords: COVID-19; Mucormycosis; Rhizopus oryzae
Burnout and its relationship to self- reported quality of patient care and adverse events during COVID- 19: A cross- sectional online survey among nurses
Get PDFAims: To assess nurses' burnout and its association with their perceived quality of patient care and occurrence of adverse events (AEs) during COVID- 19. Background: Burnout is a serious problem among nursing staff internationally with negative impacts on the quality of care and patient safety. Methods: We conducted a cross- sectional online study among 1,004 Iranian nurses through the convenience sampling technique. Data were collected using the Maslach Burnout Inventory, five items of questions related to self- reported poor patient care quality and estimated occurrence of AEs. Results: Prevalence of high burnout among nurses was 31.5%. The risk of AEs ranged from 26.1% to 71.7%. Self- reported quality of patient care was found to be poor. A positive correlation was found between emotional exhaustion and depersonalization scores and patient care quality, whereas a negative correlation was found between personal accomplishment scores and all poor care item scores. Depersonalization was found to increase the risk of the onset of all AEs (odds ratio [OR] = 1.06– 1.08). Also, Personal accomplishmentreduced the risk of occurrence of ‘medication errors’ (OR = 0.99) and the onset of ‘patient and their family verbal abuse’ (OR = 0.97). Conclusions: Our findings confirmed the hypothesis that a higher degree of burnout is correlated with a perceived higher number of AEs and reduced perceived patient care quality. Implications for Nursing Management: Reducing burnout among nurses through implementing interventions may be an effective strategy to enhance patient care quality and reduce the number of AEs in Iranian public hospitals. Therefore, in order to minimize work burnout, primary approaches include access to psychosocial support, including Web- based services, psychological first aid, mental support hotlines and self- care techniques during the COVID- 19 pandemic
Deciphering the DNA-binding affinity, cytotoxicity and apoptosis induce as the anticancer mechanism of Bavachinin: An experimental and computational investigation
Get PDFOne of the most important mechanism by which bioflavonoids can exert their effects in cancer treatment, is through their interaction with bio-macromolecules such as DNA. Recent literature emphasizes the role of Bavachinin (BVC) as an emerging anticancer agent. However, there are no reports on its ability to interact with DNA. The present study investigated the DNA binding properties of BVC by many spectroscopic and computational approaches. The evidences are provided from UV–visible and CD spectral analyses
illustrated that BVC interacted with ctDNA through minor groove binding mode. Based on the thermodynamic analyses, it can be inferred that the binding process was spontaneous, and the hydrophobic interaction played a major role in BVC-ctDNA binding. In silico molecular docking and dynamic simulation finally strengthened our experimental results that BVC was located in the minor groove (AT- rich) region
of B-DNA structure and resulted in the slight alteration in the secondary structure of DNA during the interaction process. Additionally, BVC indicated significant cytotoxicity against MCF-7 breast cancer cells. Furthermore, quantitative analyses demonstrate that BVC treatment significantly increased the expression of pro-apoptotic genes; p53, caspase-3, -8, and -9 in MCF-7 cells. In order to further investigate the molecular targets of BVC, molecular docking studies indicated a relatively good binding affinity of BVC with pro-apoptotic proteins. In effect, BVC can be considered as a small organic compound with DNA binding property, appropriate cytotoxic activity, and potential of apoptotic inducing that can be
adopted for medical science and pharmacy
Labor induction with randomized comparison of cervical, oral and intravaginal misoprostol
Get PDFBackground: This study attempts to evaluate the safety and efectiveness of 50μgm intracervical misoprostol in
comparison with intravaginal and sublingual for the induction of labor at term pregnant women.
Methods: This study is designed as a parallel clinical trial study. Three hundred and ffteen term pregnancies requiring induction of labor were treated with the maximum used misoprostol intracervical, sublingual, and vaginal doses.
Participants were randomly allocated into three groups of 105. The dose was repeated every 4h until adequate
uterine contraction and Bishop Score were achieved. The duration of induction to births, time to the active phase,
the rate of births, and the need for caesarean section were compared in three groups. Additionally, labor course and
side efects were recorded and analyzed. Data were analyzed using SPSS software. A signifcance level of p< 0.05 was
considered for statistical analyses.
Findings: Labor was successfully induced in all cases most (63%) of which required a single dose of misoprostol.
Ninety-three (93.0%, p< 0.05) cervical participants proceeded to vaginal births. This fgure was also the same in the
vaginal and sublingual group of 83 cases (83.0%). The other 41 cases received caesarean section with more indications
of failure to progress and meconium-stained liquor. The results indicated that 278 (92.7%) births were achieved in less
than 10h. Time from start of medication to the active phase of labor and childbirth was 3.01±0.86 and 6.1±1.3h
in the Cervical group, 4.2±0.66 and 8.4±0.92h in the sublingual group, and 5.06±1.1 and 9.2±1.5h in the vaginal group respectively (p<0.001). The Caesarean rate was lower in the cervical group than in the two other groups
(p=0.05). No signifcant diferences were observed between the study groups in terms of Apgar score and meconium-stained amniotic fuid. Furthermore, no maternal and neonatal complications were observed.
Conclusion: In addition to the sublingual and intravaginal routes of administration, intracervical misoprostol at a
single dose of 50μgm appears to be an efective method for induction of labor in women with an unfavorable cervix.
Like all medical interventions, a discussion of the risks, benefts, and alternatives to induction of labor with this medication in each woman should be undertaken before treatment.
Trial registration: This clinical study was approved by the Iranian Registry of Clinical Trials with IRCT ID: IRCT201904
15043278N1. Registration date was on May 13, 2019 and May 27, 2019 respectively (http://www.irct.ir).
Keywords: Misoprostol, Labor induced, Term birt
The Sensitivity and Specificity of Loop-Mediated Isothermal Amplification and PCR Methods in Detection of Foodborne Microorganisms: A Systematic Review and Meta-Analysis
Get PDFAbstract
Background: The loop-mediated isothermal amplification (LAMP) method is frequently used for identifying many
microorganisms. The present review aimed to evaluate the sensitivity and specificity of LAMP method for detection
of food-borne bacteria and to compare these features with those of polymerase chain reaction (PCR), as an alternative molecular diagnostic procedure, and with cultivation method, as the gold standard method.
Methods: The literature was searched in electronic databases (PubMed, Scopus, Web of Science, and EMBASE)
for recruiting publications within Jan 2000 to Jul 2021. We used the combinations of keywords including foodborne
disease, LAMP, PCR, Loop-mediated isothermal amplification, and polymerase chain reaction. Meta-analysis was
used to adjust the correlation and heterogeneity between the studies. The efficiency of the methods was presented
by negative likelihood ratio, positive likelihood ratio, sensitivity, specificity, and odds ratio using forest plots. A Pvalue less than 0.05 was considered as statistical significance cut off. The confidence intervals were presented at the
95% interval.
Results: Overall, 23 relevant studies were analyzed. The sensitivities of LAMP and PCR methods were estimated to
be 96.6% (95% CI: 95.0-97.7) and 95.6% (95%CI: 91.5-97.8), respectively. The specificities of LAMP and PCR were
also estimated to be 97.6% (95%CI: 92.6-99.3) and 98.7% (95%CI: 96.5-99.5), respectively.
Conclusion: The specificities of LAMP and PCR assays were determined by comparing their results with cultivation method as the gold standard. Overall, the specificity of both PCR and LAMP methods was low for detection of
fastidious bacteria. Nevertheless, LAMP and PCR methods have acceptable specificities and sensitivities, and their
application in clinical practice necessitates more studies.
Keywords: Food-borne pathogen; Specificity; Sensitivity; Loop-mediated isothermal amplification (LAMP); Polymerase chain reactio
Relationship between rs3918242 Polymorphism of Matrix Methaloproteinase-9 Gene and Preeclampsia in Pregnant Women
Get PDFBackground Preeclampsia is a complex disorder of pregnancy with an unknown etiology. Numerous
studies have shown the possible role of gene polymorphisms, especially metalloproteinases, in development
of this disease, but there are no definitive results.
Objective This study aims to investigate the possible association between rs3918242 (−1562C>T) polymorphism
in Matrix Metalloproteinase 9 (MMP9) gene with the risk of preeclampsia in pregnant women.
Methods In this cross-sectional study, participants were 90 pregnant women with preeclampsia and 199
healthy pregnant women (controls). The genotypes of rs3918242 polymorphism were investigated using
Polymerase Chain Reaction technique and Limited Fragment Length Polymorphism method. Logistic
regression analysis was used to investigate the relationship between rs3918242 polymorphism and
preeclampsia.
Findings The frequency of CC, CT, TT genotypes of rs3918242 polymorphism was reported 47.8%, 47.8%
and 4.2% in patients and 84.8, 13.1 and 2% in controls, respectively, and the difference between groups
was significant (P<0.001). The frequency of TT genotype in patients was significantly higher than in controls
(P<0.001). Moreover, the frequency of T allele in patients was 52.2%, while in controls it was 15.2%
and the difference between the two groups was significant (P<0.001).
Conclusion The rs3918242 polymorphism of MMP9 gene plays an important role in the incidence of
preeclampsia in pregnant women