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Comparative efficacy and safety of nirmatrelvir/ritonavir and molnupiravir for COVID-19: A systematic review and meta-analysis
No full textThis study aimed to compare the efficacy and safety of nirmatrelvir/ritonavir (Paxlovid) with molnupiravir in the treatment of coronavirus disease 2019 (COVID-19). To end this, PubMed, Cochrane Library, Web of Science, medRxiv, and Google Scholar were systematically searched to collect relevant evidence up to February 15, 2023. The risk of bias was evaluated using the risk of bias in nonrandomized studies of interventions tool. Data were analyzed using Comprehensive Meta-Analysis software. Eighteen studies involving 57 659 patients were included in the meta-analysis. The meta-analysis showed a significant difference between nirmatrelvir/ritonavir and molnupiravir in terms of all-cause mortality rate (odds ratio OR = 0.54, 95% confidence interval CI: 0.44-0.67), all-cause hospitalization rate (OR = 0.61, 95% CI: 0.54-0.69), death or hospitalization rate (OR = 0.61, 95% CI: 0.38-0.99), and negative polymerase chain reaction conversion time (mean difference = -1.55, 95% CI: -1.74 to -1.37). However, no significant difference was observed between the two groups in terms of COVID-19 rebound (OR = 0.87, 95% CI: 0.71-1.07). In terms of safety, although the incidence of any adverse events was higher in the nirmatrelvir/ritonavir group (OR = 2.52, 95% CI: 1.57-4.06), no significant difference was observed between the two treatments in terms of adverse events leading to treatment discontinuation (OR = 1.18, 95% CI: 0.69-2.00). The present meta-analysis demonstrated the significant superiority of nirmatrelvir/ritonavir over molnupiravir in improving clinical efficacy in COVID-19 patients during the prevalence of Omicron variant. These findings, however, need to be further confirmed
Relationship between job stress and work-related quality of life among emergency medical technicians: a cross-sectional study
No full textObjectiveThis study was aimed to determine the relationship between job stress and work-related quality of life (WRQoL) among emergency medical technicians (EMTs) in Lorestan province, Western Iran.DesignThis was a cross-sectional study.MethodsTotally 430 EMTs who had been engaged in their respective units for more than 6months from all emergency facilities in Lorestan province were selected using single stage cluster sampling method. Data were collected from April to July 2019 using two standard questionnaires: job stress (Health and Safety Executive (HSE)) and WRQoL. The OR with 95 CI was used to declare the statistical association (p <= 0.05).ResultsAll participants were exclusively males, with a mean age of 326.87 years. The overall average score of job stress using the HSE scale was 2.69 +/- 0.43; while the overall quality of working life score was 2.48 +/- 1.01. The type of working shift was found to have a significant impact on the HSE-average score (F(3,417)=5.26, p=0.01); and on the WRQoL-average score (F(3,417)=6.89, p<0.01).ConclusionTwo-thirds of EMTs working in governmental hospitals had job stress and a low quality of work-related life. Additionally, work shift was statistically significant associated with EMTs' job stress and WRQoL
Extraction and determination of mercury from spring water, beverage and rice samples using combined microwave-assisted cloud point and dispersive-solid phase extraction in micellar media
No full textThe determination of inorganic mercury species in water, beverages and foods has been a special research priority in recent years because mercury, as a highly carcinogenic species, even in trace concentration, has high adverse effects on the body of living organisms. In this research, combining two extraction techniques, including microwave-assisted cloud point extraction and dispersive-solid phase extraction (MA-CP-dSPE), for the separation and pre-concentration of mercury in environmental samples is presented. This method is based on the dispersion of nanoparticles in micellar media in the presence of a novel mono-thiosemicarbazone Schiff base (2 N & PRIME;-4-diphenylaminobenzylidene) hydrazinecarbothiohydrazide) ligand. Using the experimental conditions defined in the optimization, the method allowed mercury determination from 0.020 to 350 mg/L with a detection limit of 0.005 mg/L. The accuracy of the procedure was tested by analysing certified reference material. The method was successfully applied to copper determination in spring water, beverage and rice samples
Role of FokI rs2228570 and Tru9I rs757343 Polymorphisms in the Mortality of Patients Infected with Different Variants of SARS-CoV-2
No full textBackground and aim. Low vitamin D levels are associated with the severity of coron-avirus disease 19 (COVID-19). Vitamin D receptor gene polymorphisms, such as Tru9I rs757343 and FokI rs2228570, have been suggested to be potential risk factors for severe COVID-19 outcomes. This study investigated how Tru9I rs757343 and FokI rs2228570 polymorphisms influenced the mortality rate of COVID-19 in relation to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants. Methods. The polymerase chain reaction-restriction fragment length polymorphism assay was used to genotype Tru9I rs757343 and FokI rs2228570 genotypes in 1,734 recovered and 1,450 deceased patients. Results. Our results demonstrated that the high mortality rate was correlated with FokI rs2228570 TT genotype in all three variants but was much higher in the Omicron BA.5 variant than in the Alpha and Delta variants. Furthermore, in patients infected with the Delta variant, FokI rs2228570 CT genotype was more highly correlated with the mortality rate compared to other variants. Thus, a high mortality rate was correlated with the Tru9I rs757343 AA genotype in the Omicron BA.5 variant, whereas this relationship was not observed in the other two variants. The T-A haplotype was related to COVID-19 mortality in all three variants, but its effect was more pronounced in the Alpha variant. Moreover, the T-G haplotype was significantly associated with all three variants. Conclusion. Our findings showed that the effects of Tru9I rs757343 and FokI rs2228570 polymorphisms were related to SARS-CoV-2 variants. However, further studies are still required to validate our findings. & COPY; 2023 Instituto Mexicano del Seguro Social (IMSS). Published by Elsevier Inc. All rights reserved
Intestinal necrosis in the context of torsion in a pregnant woman: A case report study
No full textIntroduction and importance: Bowel obstruction is known as an increasing complication during pregnancy. This case report showed a pregnant woman with intestinal necrosis in the context of torsion. Case presentation: A 33-year-old Asian woman, primigravida at 25 weeks and 4 days gestation, presented to hospital with a history of nausea and epigastric pain. Patient' past medical history showed usual evaluating abdominal pain with vaginal bleeding and leaking of fluid in her obstetric history. Clinical discussion: The patient was discharged from hospital in a good general condition one week after the surgery. A full-term infant weighted 3000 g was delivered by caesarean section in 39 weeks gestational age with 1-5 minute Apgar scores of 7-10. Conclusion: The aim of the study is to report a new case of intestinal necrosis in a pregnant woman
Molecular evaluation of aminoglycosides resistance and biofilm formation in Klebsiella pneumoniae clinical isolates: A cross-sectional study
No full textBackground and AimsResistance to antibiotics and the capability to develop biofilm as two main virulent determinants of Klebsiella pneumoniae have important role in infection persistence. The aim of the study was to evaluate the association between the prevalence of aminoglycoside resistance and virulence genes and biofilm formation capacity in K. pneumoniae strains isolated from hospitalized patients in South-West of Iran. MethodsA total of 114 non-duplicate clinical isolates of K. pneumoniae collected from Ahvaz teaching hospitals. Identification of species was performed by biochemical tests and then confirmed by polymerase chain reaction (PCR) of rpoB gene. The susceptibility to antibiotics was determined by Kirby-Bauer disk diffusion method. Biofilm formation was assessed by microtiter plate method. Finally, PCR was conducted to detect virulence gene determinants including fimbrial genes, aminoglycoside modifying enzymes- and 16S rRNA methylase (RMTase) genes. ResultsTotally, all collected strains were carbapenem resistant and showed multidrug- and extensively drug-resistance phenotype (75 and 25, respectively). Seventy-one percent (n = 81) of isolates were non-susceptible to aminoglycosides. Among aminoglycoside antibiotics, K. pneumoniae isolates showed the highest and lowest resistance rates to tobramycin (71) and the amikacin (25), respectively. All biofilm producer strains were positive for the presence virulence determinants including ecpA, fimA, mrkD, and mrkA. Of 81 aminoglycosides non-susceptible isolates 33 were positive for the presence ant (2 '')-Ia as the most prevalent gene followed by aac (3 ')-IIa and armA (27), aac (6 ')-Ib (18), and aph (3 ')-Ia (15). ConclusionK. pneumoniae isolates showed the highest and the lowest aminoglycoside resistance rates to tobramycin and amikacin, respectively. Majority of isolates were biofilm producers and there was significant association between antibiotic resistance pattern and the strength of biofilm production. The ant(2 '')-Ia, aac (3 ')-IIa, and armA genes in aminoglycoside-resistant isolates
The role of viruses in cancer development versus cancer therapy: An oncological perspective
No full textDespite great medical advances, oncological research is still looking for novel therapeutic approaches due to the limitation of conventional therapeutic agents. Virotherapy is one of these new emerging therapeutic approaches that attract attention with their widespread applications. Virotherapy use lives oncolytic viruses or genetically engineered viruses that selectively infect the tumor cells, replicate, and disrupt the cancerous cells that also induce their anticancer activity by stimulating the host antitumor immune response. Moreover, viruses are widely used as target delivery vectors for specifically delivering different genes, therapeutic agents, and immune-stimulating agents. In addition to having antitumor activity by themselves in combination with conventional therapeutic agents like immune therapy and chemotherapy, Virotherapy agents also elicit promising outcomes. Therefore, in addition to their promising result in monotherapy use, virotherapy agents can also be used in combination with conventional cancer therapy, epigenetic modulators, and even microRNAs without any cross-resistance, which allows the patient not to be deprived of her routine medicine. Still, this combination therapy reduces the adverse effect of the conventional therapies. All together suggest that virotherapy agents as novel potential agents in the field of cancer therapy
Expression of TRIM56 gene in SARS-CoV-2 variants and its relationship with progression of COVID-19
No full textTweetable abstract#Tavakoli et al. discovered that the TRIM56 gene, which plays a crucial role in the body's immune response to viruses, is likely associated with severe COVID-19 infections. Plain language summaryScientists looked at a protein called TRIM that helps fight viruses to see if a specific TRIM protein, TRIM56, was linked to how poorly people became with COVID-19. The study looked at the blood samples of 330 patients and found that COVID-19 patients had less TRIM56 than healthy people, especially those who were particularly ill. Aim: The present study aimed to determine a correlation between differential TRIM56 expression levels and severe infections of COVID-19 between the Alpha, Delta and Omicron BA.5 variants. Materials & methods: This study was performed on 330 COVID-19 patients, including 142 with severe and 188 with mild infections, as well as 160 healthy controls. The levels of TRIM56 gene expression were determined using a qPCR. Results: TRIM56 gene showed significantly lower mRNA expression in the severe and mild groups compared with healthy individuals. Our finding indicated the high and low reduction of TRIM56 mRNA expression in Delta and Omicron BA.5 variant, respectively. Conclusion: Further research is needed to characterize the impact of TRIM proteins on the severity of COVID-19
Techno-environmental study on the consequences of carwash wastewater and its management methods
No full textCarwash wastewater (CWW) is an important source of environmental pollution. The aim of this study was to investigate the characteristics of CWW and technical comparison of its treatment methods. For this purpose, a systematic search was conducted and after three stages of screening the found articles, finally 30 articles were selected for this review. The results showed that due to the differences in the type of washing, the geological condition, the type of car, and the climatic conditions, the CWWs have temporal and spatial variation in the concentration of pollutants. However, the most important pollutants of CWW include oil, suspended solids, detergents, and organic compounds. The most widely used methods in CWW treatment in the main stages included chemical coagulation and electrocoagulation, which reduce turbidity by more than 90 and COD by more than 50 in the best efficiency. Also, membrane technology was a common method in CWW treatment systems to achieve proper effluent quality. COD reduction by ultrafiltration, nanofiltration, microfiltration, and reverse osmosis was 95-77, more than 90, 81-73, and 87, respectively. The efficiency of membrane technologies in reducing turbidity was often more than 90 and in few cases more than 50. Sludge production in the coagulation process, energy consumption in electrochemical processes, and the low water recovery rate in membrane processes are important challenges in CWW treatment that must be managed by modifying the process or using combined methods. © 2023 The Author
The effect of music therapy on labor pain: Systematic review and meta-analysis
No full textIntroduction: Music therapy is a non-pharmacological method for pain reduction. Our aim was to investigate the effect of music therapy on labor pain. Methods: This review study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The ISI, Cochrane library, Google Scholar, Pub Med, Scopus, and Science Direct databases were independently searched by two of the researchers to find related articles about music therapy and labor pain. The search was performed using the Mesh keywords of “music therapy”, “labor pain” and the phrase of “non-pharmacological methods for pain reduction” to recruit articles published between 2000 and 2018. Data was analyzed using meta-analysis and STATA software. The Q and I2 were used to assess the heterogeneity. Result: A total of 40 articles were found from which 8 articles with good qualities entered the systematic review process. The mean pain scores in the experimental group were 8.67 (95 CI: 8.22–9.12) and 5.26 (95 CI: 4.98–5.54) before and after music therapy respectively. These results showed that music therapy reduced the pain by 3.41 times. The mean pain scores in the control group were8.05 (95 CI: 7.33–8.87) and 8.28 (95 CI: 7.49–8.97) before and after the intervention respectively showing a pain increment by 0.18. Based on the visual analog scale, labor pain was mild (i.e., score 2–4), moderate (i.e., score 5–7), and severe (i.e., score 8–10) in 24.8, 36.5, and 23.5 of the studied women. Meta-regression results showed a reduction in pain score by increasing the year of study and sample size. Conclusion: Music therapy can be considered as a non-pharmacological approach to reduce labor pain and improve the quality of maternity care. It is suggested that music therapy to be included in the protocols of maternity cares to increase their quality and efficiency. © 2023 Elsevier Masson SA