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Re-Evaluating Risk Factors, Incidence, and Outcome of Aneurysmal and Non-Aneurysmal Subarachnoid Hemorrhage
No full textOBJECTIVE: Subarachnoid hemorrhage (SAH) is one of the world's most life-threatening types of stroke. SAH can be classified into two main categories, aneurysmal (aSAH) and non-aneurysmal SAH (naSAH). In the present study, we aimed to prospectively evaluate SAH and its subcategories incidences, risk factors, complications, and outcomes in central Iran.METHODS: All SAH patients diagnosed between 2016 and 2020 were included in Isfahan SAH Registry. Demographic, clinical characteristics, incidence rates (based on age categories), and laboratory/imaging findings were collected and compared between aSAH and naSAH subgroups. Complications during hospital stay and outcomes were also analyzed. Binary logistic regression analysis was performed to investigate the predictors of aSAH versus naSAH. Kaplan -Meier curves and Cox regression were used to evaluate the survival probability.RESULTS: A total of 461 SAH patients were included through Isfahan SAH Registry. The SAH annual incidence rate was 3.11 per 100,000 person-years. aSAH had higher incidence rate than naSAH (2.08/100,000 vs. 0.9/100,000 person-years,respectively). In-hospital mortality was 18.2. Hypertension (P=0.003) and smoking (P=0.03) were significantly associated with aSAH, whereas diabetes mellitus (P < 0.001) was more associated with naSAH. After Cox regression analysis, there were higher hazard ratios for reduced in-hospital survival in conditions including altered mental status, Glasgow Coma Scale =13, rebleeding, and seizures.CONCLUSIONS: This study provided an updated estimation of SAH and its subgroups incidences in central Iran. Risk factors for aSAH are comparable to the ones reported in the literature. It is noteworthy that diabetes mellitus was associated with a higher incidence of naSAH in our cohort
Adsorptive of vanadium and palladium ions using chitin-extracted from shrimp shell wastes: genetic programming modeling
No full textIn this study, chitin was extracted from shrimp shells (SS) and characterized by scanning electron microscopy, X-ray diffraction, and Fourier transforms infrared spectroscopy. And investigate the adsorption of vanadium (V) and palladium (Pd) toxic metals onto the chitin. The effect of parameters such as the concentration of V and Pd, contact time, solution pH, adsorbent dose, cations, and anions were studied on the adsorption process. Kinetic, isotherm, and thermodynamic models were investigated. Genetic programming (GP) is used to obtain an appropriate equation showing the relationship between the variables. Experimental optimum conditions were found in the V and Pd concentrations of 25 mg/L, pH of 9, an adsorbent dose of 0.8 g/L and a contact time of 15 minutes. The maximum adsorption capacities (q(m)) of 13.15 and 12.65 mg/g were obtained for V and Pd, respectively. Among the anions and cations examined in this study, Ca2+ and SO42- had the greatest effect on the absorption of V and Pd on chitin. The adsorption kinetics followed a pseudo-second-order kinetic model and the equilibrium data showed a good fit of the Langmuir model and demonstrated a monolayer and favorable physisorption process. The thermodynamic analysis depicted that the process of adsorbing V and Pd using chitin was endothermic and spontaneous. Findings also presented GP as a potential tool for identifying the behavior of V and Pd adsorption. It can be concluded that chitin extracted from SS wastes, as a nontoxic and cheap adsorbent, could efficiently remove V and Pd from aqueous solutions
microRNA-382 as a tumor suppressor? Roles in tumorigenesis and clinical significance
No full textMicroRNAs (miRNAs) are small single-stranded RNAs belonging to a class of non-coding RNAs with an average length of 18-22 nucleotides. Although not able to encode any protein, miRNAs are vastly studied and found to play role in various human physiologic as well as pathological conditions. A huge number of miRNAs have been identified in human cells whose expression is straightly regulated with crucial biological functions, while this number is constantly increasing. miRNAs are particularly studied in cancers, where they either can act with oncogenic function (oncomiRs) or tumor-suppressors role (referred as tumor-suppressor/oncorepressor miRNAs). miR-382 is a well-studied miRNA, which is revealed to play regulatory roles in physiological processes like osteogenic differentiation, hematopoietic stem cell differentiation and normal hematopoiesis, and liver progenitor cell differentiation. Notably, miR-382 deregulation is reported in pathologic conditions, such as renal fibrosis, muscular dystrophies, Rett syndrome, epidural fibrosis, atrial fibrillation, amelogenesis imperfecta, oxidative stress, human immunodeficiency virus (HIV) replication, and various types of cancers. The majority of oncogenesis studies have claimed miR-382 downregulation in cancers and suppressor impact on malignant phenotype of cancer cells in vitro and in vivo, while a few studies suggest opposite findings. Given the putative role of this miRNA in regulation of oncogenesis, assessment of miR-382 expression is suggested in a several clinical investigations as a prognostic/diagnostic biomarker for cancer patients. In this review, we have an overview to recent studies evaluated the role of miR-382 in oncogenesis as well as its clinical potential
In Silico Characterization of an Important Metacyclogenesis Marker in Leishmania donovani, HASPB1, as a Potential Vaccine Candidate
No full textVisceral leishmaniasis is a life-threatening infectious disease worldwide. Extensive experiments have been done to introduce potential vaccine candidates to combat leishmaniasis. The present study was done to evaluate Leishmania donovani hydrophilic acylated surface protein B1 as a potential vaccine candidate using in silico methods. For this aim, server-based predictions were performed regarding physicochemical characteristics, solubility, antigenicity, allergenicity, signal peptide, transmembrane domain, and posttranslational modifications (PTMs). Also, secondary and tertiary structures were predicted using NetSurfP-3.0 and I-TASSER, respectively. The 3D model was further subjected to refinement and validation, and promising B-cell, cytotoxic T-lymphocyte (CTL; human, dog), and helper T-lymphocyte (HTL; human) epitopes were predicted. The protein had a molecular weight of 42.19 kDa, with high solubility (0.749), stability (instability index: 21.34), and hydrophilicity (GRAVY: -2.322). No signal peptide or transmembrane domain was predicted, and the most abundant PTMs were phosphorylation, O-glycosylation, and acetylation. Many coils and disordered regions existed in the secondary structure analysis, and the tertiary model had a good confidence score (-0.79). Next, the ProSA-web and PROCHECK tools showed adequate improvements in the refined model compared to the crude model. Only 4 shared B-cell epitopes among three web servers (ABCpred, BepiPred 2.0, and SVMTriP) were shown to be antigenic, nonallergenic, and with good water solubility. Also, five potent CTL epitopes in dogs and five in humans were predicted. Notably, two HTL epitopes were found to be potential IFN-gamma inducers. In conclusion, our results demonstrated several immunogenic epitopes in this protein, which could be directed towards multiepitope vaccine design
Clinical efficacy of endovascular treatment approach in patients with carotid cavernous fistula: A systematic review and meta-analysis
No full textBACKGROUND AND OBJECTIVES: Carotid-cavernous fistulas (CCFs) represent a group of rare, abnormal arteriovenous communications between the carotid arterial system and the cavernous sinuses (CS). CCFs often produce ophthalmologic symptoms related to increased CS pressures and retrograde venous drainage of the eye. Although endovascular occlusion remains the preferred treatment for symptomatic or high-risk CCFs, most of the data for these lesions is limited to small, single-center series. As such, we performed a systematic review and meta-analysis evaluating endovascular occlusions of CCFs to determine any differences in clinical outcomes based on presentation, fistula type, and treatment paradigm. METHOD: A retrospective review of all studies discussing the endovascular treatment of CCFs published through March 2023 was conducted using PubMed, Scopus, Web of Science, and Embase databases. A total of 36 studies were included in the meta-analysis. Data from the selected articles were extracted and analyzed using Stata software version 14. RESULTS: 1494 patients were included. 55.08 were female and the mean age of the cohort was 48.10 years. A total number of 1516 fistulas underwent endovascular treatment, 48.05 of which were direct and 51.95 of which were indirect. 87.17 of CCFs were secondary to a known trauma while 10.18 were spontaneous. The most common presenting symptoms were 89 exophthalmos (95 CI: 78.0-100.0; I(2) = 75.7), 84 chemosis (95 CI: 79.0-88.0; I(2) = 91.6), 79 proptosis (95 CI: 72.0-86.0; I(2) = 91.8), 75.0 bruits (95 CI: 67.0-82.0; I(2) = 90.7), 56 diplopia (95 CI: 42.0-71.0; I(2) = 92.3), 49 cranial nerve palsy (95 CI: 32.0-66.0; I(2) = 95.1), 39 visual decline (95 CI: 32.0-45.0; I(2) = 71.4), 32 tinnitus (95 CI: 6.0-58.0; I(2) = 96.7), 29 elevated intraocular pain (95 CI: 22.0-36.0; I(2) = 0.0), 31 orbital or pre-orbital pain (95 CI: 14.0-48.0; I(2) = 89.9) and 24 headache (95 CI: 13.0-34.0; I(2) = 74.98). Coils, balloons, and stents were the three most used embolization methods respectively. Immediate complete occlusion of the fistula was seen in 68 of cases and complete remission was seen in 82. Recurrence of CCF occurred in only 35 of the patients. Cranial nerve paralysis after treatment was observed in 7 of the cases. CONCLUSIONS: Exophthalmos, Chemosis, proptosis, bruits, cranial nerve palsy, diplopia, orbital and periorbital pain, tinnitus, elevated intraocular pressure, visual decline and headache are the most common clinical manifestations of CCFs. The majority of endovascular treatments involved coiling, balloons and onyx and a high percentage of CCF patients experienced complete remission with the improvement of their clinical symptoms
Examining the level of compliance with health protocols in elementary schools in Ilam city during the outbreak of the SARS-CoV-2 in 1400-1401
No full textBackground and Objective: One of the basic strategies to reduce the prevalence of diseases among people in society, especially children and adolescents, during the epidemic of COVID-19 disease, is to observe hygiene and personal protection behaviors. The present study was conducted to determine the level of compliance with health protocols in primary schools of Ilam city during the outbreak of the SARS-CoV-2 in 1400-1401. Materials and Methods: This descriptive-cross-sectional study was conducted in primary schools of Ilam city with a statistical sample of 49 schools (25 girls' schools and 24 boys' schools). In this study, the 2019 new coronavirus disease care and control checklist was used in schools, which has 15 questions with a total score of 100. Data with Kolmogorov-Smirnov and T-Test statistical tests using SPSS software. V21 was analyzed. Results: The results of this study showed that the highest and lowest scores are respectively related to the parameters of school health assessment before reopening (100 percent) and screening of people in terms of vaccination by PCR test (zero percent). The average score of compliance with the checklist was 74.3 in girls' schools and 74.38 in boys' schools. Also, the results of the T-Test showed that there is no significant relationship between the mean scores of girls' and boys' schools (p<0.05). Conclusion: The results of the present study showed that the score obtained for compliance with the checklist parameters of all schools in Ilam city is less than 85 points, and the main reason for this is the non-compliance of the screening parameter of people in terms of vaccination/PCR test in schools. © 2023 Iranian Association of Environmental Health, and Tehran University of Medical Sciences
Post-traumatic stress disorder in medical workers involved in earthquake response: A systematic review and meta-analysis
No full textINTRODUCTION: Medical workers involved in responding to the earthquake are exposed to frightening scenes and witness dead bodies and severely injured moaning people, predisposing them to multiple mental health consequences. This study was aimed to determine the prevalence of Post-Traumatic Stress Disorder (PTSD) after earthquakes among medical workers using a systematic review and meta-analysis. MATERIALS AND METHODS: The review study was performed following PRISMA guidelines, and the study's protocol was registered in PROSPERO with the code CRD42022333069. The data resources of Google Scholar, Science Direct, Web of Science, PubMed, and Scopus were searched to specify the related studies. To perform meta-analysis, the random effects model was utilized, and the I(2) index was considered to assess heterogeneity between studies. The STATA software was used for data analysis. RESULTS: In the initial data resources search, 1399 articles were identified. From these articles, 13 were finally chosen for meta-analysis and quality assessment. The meta-analysis results indicated that the prevalence of post-earthquake PTSD among medical workers involved in the earthquake response was 16.37 (95 CI: 11.63-21.11, I(2) = 97.33, p = 0 < 0.001). CONCLUSION: The medical workers involved in response to the earthquake have a relatively high risk of PTSD in the short and long term. Therefore, medical workers involved in response to disasters should undergo screening for mental health disorders before and after disasters and receive the necessary training with regard to stress management, psychological resilience, and how to express their feelings and emotions
Workplace violence against health care workers during the COVID-19 Pandemic: A systematic review and meta-analysis
No full textIntroduction: During the COVID-19 pandemic, Health Care Workers (HCWs) have been at the frontline against the disease and have direct contact with patients and their companions, so they are exposed to all sorts of Workplace Violence (WPV). The aim of this study was to investigate the prevalence of WPV against HCWs during the COVID-19 pandemic. Method: This study was conducted according to the PRISMA guideline, and its protocol was registered at the PROSPERO under the code of CRD42021285558. Articles were obtained from data resources such as Scopus, PubMed, Web of Science, Science Direct, Google Scholar, and Embase. A literature search was conducted from the beginning of 2020 to the end of December 2021. Meta-analysis was conducted using the Random effects model, and the I2 index was used to check the heterogeneity. Results: In this study, 1,054 articles were initially obtained during the primary search, of which 13 were finally entered in the meta-analysis. According to the results of the meta-analysis, the prevalence of physical and verbal WPV were 10.75 (95 CI: 8.20–13.30, I2 = 97.8, P = 0 < 001) and 45.87 (95 CI: 36.8–54.93, I2 = 99.6, P = 0 < 001), respectively. The overall prevalence of WPV was obtained, 45.80 (95 CI: 34.65–56.94, I2 = 99.8, P = 0 < 001) were reported. Conclusion: The results of the present study showed that the prevalence of WPV against HCWs was relatively high during the COVID-19 pandemic; nevertheless, it was lower compared to the area prior to the pandemic. Therefore, HCWs need essential training to reduce stress and increase resilience. Also, considering organizational interventions (including policies to ensure that HCWs report WPV to their supervisors, increasing staffing per patient, and installing systems for HCWs to call for immediate assistance) can increase the resilience HCWs. © 202
The Therapeutic Effects of Curcumin-coated Gold Nanoparticle Against Leishmania Major Causative Agent of Zoonotic Cutaneous Leishmaniasis (ZCL): An In Vitro and In Vivo Study
No full textWe synthesized and characterized curcumin-coated gold nanoparticles (Cur@AuNPs) and investigated their stability, cytotoxicity, leishmanicidal activity in in vitro and in in vivo experiments. Cur@AuNPs synthesized through a simple one-pot green chemistry technique. The in vitro leishmanicidal activity of curcumin-coated gold nanoparticles against extracellular promastigotes and intracellular amastigotes of protozoan parasite Leishmania major (L. major) was determined by applying the tetrazolium reduction colorimetric quantitative MTT technique. For in vivo assessment, the footpad lesion size and parasite burden in two infection site organs including lymph nodes and footpads of susceptible BALB/c mice infected with L. major were measured. Mice immune responses in all study groups were quantified by measuring the levels of gamma interferon (IFN-gamma) and interleukin-4 (IL-4). Viability of Leishmania promastigotes significantly diminished with the inhibition in promastigotes growth (IC50) of 64.79 mu g/mL and 29.89 mu g/mL for 24 h and 48 h, respectively. In vitro nanoparticles treatment efficiently cleared the L. major amastigotes explanted in macrophages but had no harmful toxicity on the mice cells. In the in vivo condition, in the treated infected BALB/c mice the CL lesion size, Leishmania parasite burden, and IL-4 were decreased, while IFN-gamma was significantly increased. The results suggest that Cur@AuNP was an effective compound against Leishmania parasite in vitro and in vivo, efficiently induced T-helper 1 (Th1) responses and augmented host cellular immune responses, and ending in a reduced Leishmania parasite burden. Therefore, it may be identified as a novel potential therapeutic approach for the local therapy of zoonotic CL treatment with high cure rates
Prevalence of Suicide Ideation and Attempt during COVID-19 Pandemic: A Systematic Review and Meta-Analysis
No full textAn epidemic of infectious diseases such as COVID-19 can affect mental health, which may be associated with suicidal behaviors. This study was conducted based on the systematic review and meta-analysis methods for evaluating the prevalence of suicide ideation during COVID-19. This study used Preferred Systematic Review Reporting System and Meta- Analysis guideline and valid keywords. The articles related to the prevalence of suicide ideation during COVID-19 pandemic were obtained by searching among different databases including Scopus, Web of science, PubMed, ISC, Google scholar, SID, and Magiran. All of the articles published from the beginning of January 2020 to the end of May 2021 were reviewed. Among 478 articles screened, 377 articles were related to the studied topic, among which 38 articles were selected after assessing the title and abstract of which for reviewing the full text and finally 18 studies were included in the meta-analysis. Based on the results, the prevalence of suicide ideation and attempt among all studies were equal to 13 (95 confidence interval = 0.11-0.15, I2 = 99.7, P = 0.00) and 1 (95 confidence interval = 0.00-0.01, I2 = 95.5, P = 0.00), respectively. Based on the results, the prevalence of suicide attempt and ideation is possible during the COVID-19 pandemic. Therefore, health officials should pay attention to mental health issues in addition to the protective measures for preventing or reducing the infection with COVID-19. The increase of psychological consequences is probably related to the effect of lifestyle changes which associates with the spread of the disease. In the current meta-analysis performed, the prevalence of suicidal ideation and suicidal attempt was examined during the COVID-19 pandemic period and compared to the previous period without COVID-19. The effect of COVID-19 on suicidal ideation and suicidal attempt has never been studied