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An Evaluation of Uncivil Behaviors in Clinical Learning Environments from the Perspective of Nursing Students in Western Iran in 2020
No full textBackground: Uncivil behavior in clinical learning environments is a growing challenge that severely disrupts the teaching and learning process. Objectives: The aim of this study is to evaluate the incidence of uncivil behavior in clinical learning environments from the perspective of nursing students in western Iran. Methods: In this self-report descriptive cross-sectional study in the 2020 year, 135 undergraduate nursing students of semesters 3, 4, 6, and 8, who were taking training and internship courses, were enrolled. The standard UBCNE questionnaire with 20 questions based on the Likert scale and subscales of exclusionary, hostile/rude, and dismissive behaviors constituted research tools. Data were analyzed using SPSS version 21 and descriptive and inferential statistics. Results: 103 (76.3) trainees and 32 (23.7) interns with a mean age of 21.53 years (1.60) participated in this study. According to the results of the Kruskal-Wallis test, the mean scores of hostile/rude, exclusionary, and dismissive behaviors and the total score in different semesters were significantly different (P<0.001). In terms of the semester, these behaviors had the highest rate in semester 6 students and the lowest in semester 8 students. There was no statistically significant relationship between gender and the mean incidence of these behaviors in students. Conclusions: The results show the students' experience with different behaviors in clinical settings according to different contexts. Further research is required to understand these behaviors in clinical settings better and to provide strategies to minimize such behaviors
The Role of Zonulin as a Prognostic Biomarker in Liver Diseases: A Systematic Review
No full textLiver diseases have become a serious concern in the health care systems worldwide. There is an association between gut permeability and several liver diseases. Zonulin is recognized as a marker of intestinal permeability. Hence, this study summarizes the current knowledge about the role of zonulin as a prognostic biomarker in liver diseases. The present systematic review was performed according to the guidelines of the 2015 Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statements. Until May 2022, PubMed/Medline, Science Direct, Scopus, and Google Scholar as well as Google databases were searched using the relevant keywords including "Zonulin " and "Liver Diseases ", "Fatty Liver ", "Hepatitis ", "Cirrhosis ", "Carcinoma ", "Liver Steatosis ". Of 279 identified records through database searching, 37 articles were included in this systematic review. The evidence of this review revealed that the level of zonulin as the major biomarker of intestinal permeability increased in various types of liver diseases. Overall, we found that increased level of zonulin is associated with inflammatory responses in liver tissue and development of liver diseases. However, further studies could indicate the diagnostic and therapeutic role of zonulin in liver diseases including non-alcoholic fatty liver disease (NAFLD), Hepatitis, cirrhosis and hepatocellular carcinoma (HCC)
Route exposure and adverse effects monitoring of Aflatoxin B1 in the workers of wet waste management, the role of body redox system modulation
No full textExposure to dust, containing different fungi metabolites such as aflatoxins is a risk factor for developing liver and kidney health abnormalities. Occupational evaluation of the aflatoxin's exposure-induced health abnormalities should include the monitoring of bioaerosols in the workplace and personal air, and applying of appropriate blood biomarkers to assess Aflatoxin B1 (AFB1) detrimental effects on a worker's health. However, to the best of our knowledge, these appropriate methods, especially determining the associated-adverse effects on health, following exposure, haven't been well documented in the literature at the wet waste handling sites. In the current study, the AFB1 quantity in the area, personal, and settled dust in wet household waste handling samples and AFB1-Albumin levels in the serum of workers in comparison with the control group were determined using high-pressure liquid chromatography with a fluorescent detector (HPLC-FLD) methods. Moreover, the adverse effects of AFB1 on the liver and kidney biochemical profiles of the exposed workers and its relation to antioxidant capacity in the household wet waste sorting were recorded in a consolidated investigation. The results demonstrated that the average airborne dust concentration and its associated AFB1 content were significantly higher in wet waste management sections as compared to the control place, corresponding to the serum AFB1- Albumin levels of workers. Furthermore, AFB1-induced changes in the serum biochemicals evaluating liver and kidney function tests and antioxidant profiles of workers in wet waste handling sections were indicative of their function abnormalities. The results imply AFB1-induced adverse effects on the liver and kidney functions may be mediated through the body redox system modulation
View of the Renin-Angiotensin System in Acute Kidney Injury Induced by Renal Ischemia-Reperfusion Injury
No full textRenal ischemia-reperfusion injury (RIRI) is a sequence of complicated events that is defined as a reduction of the blood supply followed by reperfusion. RIRI is the leading cause of acute kidney injury (AKI). Among the diverse mediators that take part in RIRI-induced AKI, the renin-angiotensin system (RAS) plays an important role via conventional (angiotensinogen, renin, angiotensin-converting enzyme (ACE), angiotensin (Ang) II, and Ang II type 1 receptor (AT(1)R)) and nonconventional (ACE2, Ang 1-7, Ang 1-9, AT(2) receptor (AT(2)R), and Mas receptor (MasR)) axes. RIRI alters the balance of both axes so that RAS can affect RIRI-induced AKI. In overall, the alteration of Ang II/AT(1)R and AKI by RIRI is important to consider. This review has looked for the effects and interactions of RAS activities during RIRI conditions
Effectiveness of emotion regulation training based on gross model in impulsivity and sensation seeking in men with substance abuse on methadone maintenance therapy in thewest of iran (Ilam province)
No full textBackground: The low level of emotional regulation, caused by the inability to deal with emotions and manage them, plays a role in substance abuse. Objectives: This study aimed to determine the effectiveness of emotion regulation training, based on the Gross model, in impulsivity and sensation seeking in substance abusers on methadone maintenance therapy in Ilam province. Methods: The current quasi-experimental study used a pretest-posttest design. The population of this research included all substance users in the rehabilitation centers (clinics) throughout Ilam province receiving methadone maintenance therapy. Sixty individuals were selected by random sampling and assigned randomly into two groups (n = 30) of control and experiment (n = 30). The experimental group received an eight-week intervention (a 90-minute session perweek), and the control group did not receive any intervention or training. At the end of the course, a posttest was administered for both groups. Data were collected through two questionnaires of Barret and ZSSSC (Zuckerman’s sensation-seeking scale) and analyzed using MANCOVA. Results: Covariance analysis showed that training addicts on methadone maintenance therapy to regulate their emotions reduced impulsivity and excitement compared to the control group (P 0.0001). Conclusions: As male substance abusers are more exposed to negative emotions, they act impulsively and without a plan in this situation. Therefore, training them to regulate their emotions can increase their control in such cases. © 2023, Author(s)
Evaluation of Oral and Dental complications caused by Cyclophosphamide in patients with breast cancer in the Shahid-Mostafa Hospital, Ilam, 2019
No full textIntroduction: The use of chemotherapy over many years has attracted the attention of cancer patients for the treatment or prolongation of significant benefits, but unfortunately, in addition to all the advantages it has, there are consequences. Side effects of chemotherapy in the oral-pink area include inflammation, mouth ulcers, increased prevalence of viral, fungal, bacterial and bleeding infections. These side effects cause significant pain, malnutrition, and even, in some cases, a reduction in the amount of chemotherapy used by the treating physician. The aim of this study was to determine the oral and dental complications caused by cyclophosphamide in patients with breast cancer in the Department of Chemotherapy of Shahid Mostafa Hospital, Ilam Province in 2019. Materials and Method: The present study is an analytical-cross-sectional study performed on patients with breast cancer at Shahid Mostafa Hospital in Ilam in 2019-2020 and a researcher-made questionnaire was used to collect information. Results: The mean age of patients was 8.81±50.89 and their age range was between 36 and 69 years, and the mean body mass index was 2.56±24.18 and the range was between 29-19. All patients were female. 68.1 of dental patients, 20.3 had no dental caries, and 11.6 had no debar. The results showed that 89.9 of the patients had oral and dental complications with the use of silcophosphamide. 44.9 of pat ients had mild mucositis, none of them had moderate mucositis, and 55.1 had severe mucositis. Significant relationships were also found between dry mouth and the severity of mucositis. Patients with low-and moderate-grade dry mouth with severe mucositis were reported to be 31.3 and 75 percent, respectively. Conclusion: In the case of mucositis, the importance of oral hygiene in cancer patients should be emphasized. Although there is no scientific evidence that oral hygiene plays a role in the prevention and treatment of mucositis, most researchers believe that oral hygiene can reduce the duration and severity of mucositis. © RJPT All right reserved
Transdifferentiation of Human Umbilical Cord-Derived Mesenchymal Stem Cells in Dopaminergic Neurons in a Three-Dimensional Culture
No full textIntroduction: The induction of human umbilical cord-derived mesenchymal stem cells (HUC-MSCs) toward dopaminergic neurons is a major challenge in tissue engineering and experimental and clinical treatments of various neurodegenerative diseases, including Parkinson disease. This study aims to differentiate HUC-MSCs into dopaminergic neuron-like cells. Methods: Following the isolation and characterization of HUC-MSCs, they were transferred to Matrigel-coated plates and incubated with a cocktail of dopaminergic neuronal differentiation factors. The capacity of differentiation into dopaminergic neuronlike cells in 2-dimensional culture and on Matrigel was assessed by real-time polymerase chain reaction, immunocytochemistry, and high-performance liquid chromatography. Results: Our results showed that dopaminergic neuronal markers' transcript and protein levels were significantly increased on the Matrigel differentiated cells compared to 2D culture plates. Conclusion: Overall, the results of this study suggest that HUC-MSCs can successfully differentiate toward dopaminergic neuron-like cells on Matrigel, having great potential for the treatment of dopaminergic neuron-related diseases. © 2022 Iran University of Medical Sciences. All rights reserved
Thymol Nanopolymer Synthesis and Its Effects on Morphine Withdrawal Syndrome in Comparison With Clonidine in Rats
No full textThe drug delivery system is valuable in the treatment of the disease. A nanopolymer as a thymol and Thymbra spicata release system was synthesized and its effects on morphine withdrawal syndrome in comparison with clonidine in rats were studied. The nanopolymer was characterized by different methods, namely, IR, HNMR, CNMR, GPC, DLS, and AFM. Thymol in T. spicata extract was assessed. The loading and release rate of thymol and T. spicata extract on the nanopolymer were evaluated by HPLC. The median lethal dose (LD50) of the T. spicata extract, thymol, extract nanopolymer, and thymol nanopolymer was studied. The frequency of jumping, rearing, and teeth chattering in naloxone-induced morphine withdrawal syndrome was studied. Synthesized nanopolymer was desirable as a carrier for the drug. The loaded amount of extract and thymol on nanopolymer was estimated 55 +/- 3.2 and 48 +/- 2.6 and the drug released was 71 and 68, respectively. LD50 of the T. spicata extract, thymol, extract nanopolymer, and thymol nanopolymer was 975, 580, 1,250, and 650 mg/kg, respectively. This study showed that thymol nanopolymer was more effective than clonidine to reduce the frequency of morphine withdrawal symptoms. Our results suggest that T. spicata extract, thymol, extract nanopolymer, and thymol nanopolymer are mighty in reducing the narcotic withdrawal signs. The mechanism of action and therapeutic potential is maybe similar to clonidine
Comparing the effect of drugs atorvastatin and rosuvastatin on the level of laboratory markers acute coronary syndrome patients
No full textPharmacotherapy is one of the most important measures for improving the health status of patients, which can play a key role in this regard. The present study was performed to compare the effect of atorvastatin plus rosuvastatin on the value of laboratory markers in CVD patients. This research is a clinical trial study, whose research population consisted of the patients with ACS in Ilam city in 2021. The patients were randomly assigned into three groups: control, intervention A (receiving atorvastatin), and intervention B (receiving rosuvastatin). The patients who met the inclusion criteria were enrolled in the study through available sampling, for all of whom the required tests were performed. The laboratory variables including tests of triglyceride, cholesterol, ALT, AST, ALP, LDH, and LDL, using a single device which was in the laboratory in Ilam city were completed and the documents related to them were considered as assessment criteria. The data analysis was done using SPSS 16 software. The table indicated the comparison of laboratory index scores before and after taking rosuvastatin. According to the findings, in all laboratory indices after taking rosuvastatin, the status of the index has changed significantly to improve the patient's health status (p <0.05). Considering the greater effect of rosuvastatin compared to atorvastatin on improving the laboratory variables, prescription of this drug is suggested for improving the status of CVD patients
Prognostic accuracy of visual lung damage computed tomography score for mortality prediction in patients with COVID-19 pneumonia: a systematic review and meta-analysis
No full textBackground: Chest computed tomography (CT) findings provide great added value in characterizing the extent of disease and severity of pulmonary involvements. Chest CT severity score (CT-SS) could be considered as an appropriate prognostic factor for mortality prediction in patients with COVID-19 pneumonia. In this study, we performed a meta-analysis evaluating the prognostic accuracy of CT-SS for mortality prediction in patients with COVID-19 pneumonia. Methods: A systematic search was conducted on Web of Science, PubMed, Embase, Scopus, and Google Scholar databases between December 2019 and September 2021. The meta-analysis was performed using the randomeffects model, and sensitivity and specificity (with 95CIs) of CT-SS were calculated using the study authors' prespecified threshold. Results: Sensitivity estimates ranged from 0.32 to 1.00, and the pooled estimate of sensitivity was 0.67 95%CI (0.59-0.75). Specificity estimates ranged from 0.53 to 0.95 and the pooled estimate of specificity was 0.79 95%CI (0.74-0.84). Results of meta-regression analysis showed that radiologist experiences did not affect the sensitivity and specificity of CT-SS to predict mortality in COVID-19 patients (P = 0.314 and 0.283, respectively). The test for subgroup differences suggests that study location significantly modifies sensitivity and specificity of CT-SS to predict mortality in COVID-19 patients. The area under the summary receiver operator characteristic (ROC) curve was 0.8248. Conclusion: Our results have shown that CT-SS has acceptable prognostic accuracy for mortality prediction in COVID-19 patients. This simple scoring method could help to improve the management of high-risk patients with COVID-19