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Using logistic regression to develop a diagnostic model for COVID-19: A single-center study
No full textBACKGROUND: The main manifestations of coronavirus disease-2019 (COVID-19) are similar to the many other respiratory diseases. In addition, the existence of numerous uncertainties in the prognosis of this condition has multiplied the need to establish a valid and accurate prediction model. This study aimed to develop a diagnostic model based on logistic regression to enhance the diagnostic accuracy of COVID-19. MATERIALS AND METHODS: A standardized diagnostic model was developed on data of 400 patients who were referred to Ayatollah Talleghani Hospital, Abadan, Iran, for the COVID-19 diagnosis. We used the Chi-square correlation coefficient for feature selection, and logistic regression in SPSS V25 software to model the relationship between each of the clinical features. Potentially diagnostic determinants extracted from the patient's history, physical examination, and laboratory and imaging testing were entered in a logistic regression analysis. The discriminative ability of the model was expressed as sensitivity, specificity, accuracy, and area under the curve, respectively. RESULTS: After determining the correlation of each diagnostic regressor with COVID-19 using the Chi-square method, the 15 important regressors were obtained at the level of P < 0.05. The experimental results demonstrated that the binary logistic regression model yielded specificity, sensitivity, and accuracy of 97.3, 98.8, and 98.2, respectively. CONCLUSION: The destructive effects of the COVID-19 outbreak and the shortage of healthcare resources in fighting against this pandemic require increasing attention to using the Clinical Decision Support Systems equipped with supervised learning classification algorithms such as logistic regression
Photoactivation of Curcumin Doped Poly-Lactic-Co-Glycolic Acid Nanoparticles in Rat Model with Fixed Orthodontic Appliances
No full textThis study aimed to evaluate the antimicrobial effect of curcumin doped poly-lactic-co-glycolic acid nanoparticles (Cur-PLGA-Nps)-mediated antimicrobial photodynamic therapy (aPDT), as well as the probiotics on S. mutans in rats with fixed orthodontic appliances. Orthodontic appliances were ligated to the right maxillary of the rats. After the oral colonization of S. mutans, the rats were then treated in four groups including Cur-PLGA-Nps, light-emitting diode, Cur-PLGA-Nps-mediated aPDT, and probiotic (Lactobacillus acidophilus). After that, the S. mutans counts and the gtfB gene expression of S. mutans were determined on days 4, 7, 15, and 30. Probiotic and Cur-PLGA-Nps-mediated aPDT groups significantly reduced the count of S. mutans in a time-dependent manner (P < 0.05). So, probiotics and Cur-PLGA-Nps-mediated aPDT were able to reduce S. mutans more than other groups on the 30(th) day. Also, there was no considerable difference between Cur-PLGA-Nps-mediated aPDT and probiotic groups in bacterial growth inhibition. The expression level of gtfB gene was significantly downregulated at all-time intervals after exposure to Cur-PLGA-Nps-mediated aPDT compared with untreated bacteria (P < 0.05). According to the results, simultaneous use of Cur-PLGA-Nps-mediated aPDT and probiotic therapeutic approaches can be suggested to increase effectiveness
Effects of remifentanil on the recovery quality among pediatric candidates for dental procedures under general anesthesia
No full textBackground: Remifentanil is a short-acting synthetic opioid, seems to facilitate hospital discharge, induce less agitation and better recovery quality. The aim of this study was to investigate the effects of remifentanil on the quality of recovery among healthy children who were candidate for dental procedures under general anesthesia. Materials and Methods: This study was a double blind randomized controlled clinical trial on healthy children who referred to the Department of Pediatric dentistry, School of Dentistry, Isfahan University of Medical Sciences. Both groups were anaesthetized using 5 mg/kg thiopental sodium, 1 mug/kg fentanyl and 0.6 mug/kg atracurium. The first group received propofol to maintain anesthesia and the second group was given remifentanil along with propofol. Then, the time span to regain consciousness, level of agitation during recovery and time of discharge were monitored and compared between the two groups. Data were analyzed using the Mann-Whitney U-test, and the Kruskal-Wallis test at P < 0.05 level of significance. Results: Findings showed that the propofol + remifentanil group recovered faster than the propofol group. Chi-square test showed a significant difference in recovery time between the two groups (P < 0.05). About 45 min after regaining consciousness, the mean pediatric anesthesia emergence delirium score in the propofol group was 4.02 +/- 2.19 and was significantly higher than the propofol + remifentanil group (3.02 +/- 2.83) (P < 0.05). In addition, the mean Postanesthetic Discharge Scoring System score in the propofol group was 6.04 +/- 1.74 and was significantly higher than the propofol + remifentanil group (7.58 +/- 2.14) (P < 0.05). Conclusion: Combination of propofol and remifentanil significantly reduced the time taken for recovery, discharge and agitation level compared to propofol
Clinical Manifestations, Imaging Procedures and Laboratory Parameters among Hospitalized Patients with COVID-19 in Ilam Province, Western Iran
No full textBACKGROUND: COVID-19 is the last global threat which WHO confirmed it as a pandemic on March 11, 2020. In the Middle East, Iran was the first country where the SARS-Cov-2 was detected. The epidemiological and economic challenges of Iran make this country a particularly relevant subject of study. In the current study, we aimed to evaluate the clinical, radiological and laboratory findings in hospitalized COVID-19 confirmed cases in Ilam province, western of Iran. METHODS: Overall, 2204 hospitalized RT-PCR confirmed patients with COVID-19 were considered in this study. Electronic medical records, including clinical symptoms, radiological images, laboratory findings, and the comorbidities of patients with COVID-19 were collected and analyzed. In addition, the medication regimens used in these patients were evaluated. The patients were classified in discharged and died groups according to their outcomes. Then, clinical, radiological and laboratory findings as well as treatment regimens and underlying diseases were compared in these two groups. RESULTS: Among the patients, 1209 (54.85) were male and 995 (45.14) were female. Pneumonia, dyspnea and cough, were the most common clinical data in both discharged and died groups. Among the comorbidities, COPD, and cancer were significantly more common in the dead patients than in the living. The results of laboratory tests showed that blood creatinine, BUN, ESR, Na+, WBC, and neutrophil count have increased in deceased group compared to the survivors. However, the lymphocyte count decreased in deceased patients. The evaluation of radiographs demonstrated that there were significant correlations between bilateral pneumonia, ground glass opacity, bilateral patchy shadowing, and pleural effusion with death. CONCLUSION: The current investigation indicated the special profile of COVID-19 in west of Iran. Discharged and dead patients with COVID-19 had distinct clinical, radiological and laboratory features, which were separated by principal component analysis. Identifying these characteristics of the disease would translate into the implementation of practical measures to improve results
relBE toxin-antitoxin system as a reliable anti-biofilm target in Pseudomonas aeruginosa
No full textAims The ability of the pathogenic bacterium Pseudomonas aeruginosa to produce biofilms has made it more difficult to treat its infections with current antibiotics. Several genes are involved in biofilm production, and toxin-antitoxin (TA) loci have been reported to be responsible for the regulation of biofilm-associated genes. This study was aimed at evaluating various TA loci in P. aeruginosa to find a reliable target in order to disrupt biofilm formation. Methods and Results Thirty clinical isolates of P. aeruginosa were assessed for biofilm production as well as the presence of various TA loci in their genomes. The relBETA locus was present in all 30 P. aeruginosa isolates but its expression was not detectable in isolates that did not show biofilm production. Quantitative real-time -PCR (q-PCR) also demonstrated that the expression of relBE was higher in isolates with stronger biofilm-producing capability. Knocking out the relBE locus in one biofilm-producing P. aeruginosa isolate led to the cessation of biofilm-producing capacity in that isolate and eliminated the expression of ndvB, which is among the genes involved in biofilm production. Conclusions These results inferred the involvement of relBE TA locus in the regulation of biofilm production in P. aeruginosa and indicated the possibility of relBE as an anti-biofilm target for this pathogen
Anti-human lung adenocarcinoma, cytotoxicity, and antioxidant potentials of copper nanoparticles green-synthesized by Calendula officinalis
No full textCalendula officinalis is known as a popular plant with various uses as pharmaceutical agent or food additive around the world. In this study, cooper nanoparticles were green synthesized using the aqueous extract of Calendula officinalis as the stabilizing, reducing, and capping agents. The formation of CuNPs@C. officinalis was screened using different chemical technique such as FT-IR spectroscopy, XRD, SEM, and Energy EDS. The antioxidant and anti-cancer activity of CuNPs@C. officinalis was studied using common assay including free radical scavenging and MTT assays. The results confirm the green synthesized of CuNPs@C. officinalis with aspherical morphology in the range size of 19.64 to 39.15 nm. In the antioxidant test, the IC50 of CuNPs@C. officinalis and BHT against DPPH free radicals were 193 and 154 mu g/mL, respectively. In the cellular and molecular part of the recent study, the treated cells with CuNPs@C. officinalis were assessed by MTT assay for 24, 48, and 72 h about the cytotoxicity and anti-human lung adenocarcinoma properties on normal (HUVEC) and lung adenocarcinoma cell lines, i.e. lung moderately differentiated adenocarcinoma (LC-2/ad), lung poorly differentiated adenocarcinoma (PC-14), and lung well-differentiated bronchogenic adenocarcinoma (HLC-1). The IC50s of CuNPs@C. officinalis were 297, 328, and 514 mu g/mL against PC-14, LC-2/ad, and HLC-1 cell lines, respectively. The viability of malignant lung cell line reduced dose-dependently in the presence of CuNPs@C. officinalis. It seems that the anti-human lung adenocarcinoma effect of recent nanoparticles is due to their antioxidant effects
Antimicrobial effects and mechanical properties of poly(methyl methacrylate) as an orthodontic acrylic resin containing Curcumin-Nisin-poly(l-lactic acid) nanoparticle: an in vitro study
No full textBackground The porous surface of acrylic orthodontic removable appliances creates a niche for microbial plaque accumulation, and changes the oral flora by raising cariogenic bacteria including Streptococcus mutans. In this study, we evaluated the mechanical properties and antimicrobial activities of incorporating different concentrations of Curcumin-Nisin-poly(l-lactic acid) nanoparticle (CurNisNps) into orthodontic acrylic resin against Streptococcus mutans and Candida albicans. Methods Following synthesis and characterization of CurNisNps, acrylic resin specimens with different concentrations of CurNisNps (0, 1, 2, 5, and 10 w/w) were fabricated. Flexural strength values, antimicrobial effects, anti-biofilm potential, and anti-metabolic activity against S. mutans and C. albicans were assessed at different time intervals. Also, the expression of the virulence-factor-related genes of S. mutans and C. albicans was assessed by quantitative real-time polymerase chain reaction following treatment with CurNisNps. Results Acrylic resin containing 10 CurNisNps (30.76 +/- 3.91 MPa) showed flexural failure in comparison with acrylic resin specimens without CurNisNps (50.67 +/- 1.82 MPa) as the control group (P 0.05). Acrylic resin with 5 CurNisNps showed the highest concentration of CurNisNps and clinically accepted flexural strength value (14.89 +/- 3.26 MPa, P < 0.05) simultaneously. In the disc agar diffusion assay, 5 CurNisNps showed a high level of inhibitory activity for the test microorganisms. The reduction of growth inhibition zones of the different concentrations of CurNisNps against test microorganisms was positively associated with the time, in such a way that it was reduced significantly after 60 days. The anti-biofilm and anti-metabolic activities of acrylic resin specimens containing a 5 concentration of CurNisNps against S. mutans and C. albicans could significantly decrease the expression levels of gtfB (6.8-fold) and HWP (3.4-fold) in S. mutans and C. albicans, respectively. Conclusions Our data support that 5 (w/w) of CurNisNps can serve as an excellent orthodontic acrylic resin additive against S. mutans and C. albicans biofilm without adverse effects on its mechanical property
Sufficient Sleep, Time of Vaccination, and Vaccine Efficacy: A Systematic Review of the Current Evidence and a Proposal for COVID-19 Vaccination
No full textIntroduction: The emergence of the novel Coronavirus Disease 2019 (COVID-19) sparked an unprecedented effort to develop effective vaccines against the disease. Some factors may boost the vaccine efficacy, including sufficient sleep and morning vaccination. We aimed to conduct a rapid systematic review to summarize data regarding the association between sleep and time of vaccination with immunity after vaccination. Materials and Methods: The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, and three databases (PubMed, Web of Science, and Scopus) were searched up to March 12, 2022. Results: Eight studies were included regarding the sleep and immune response after vaccination, of them, five studies were on influenza, two studies on hepatitis A (HAV), and one study on hepatitis B. Accordingly, six out of eight studies found a positive correlation between sleep and immune response after vaccination. Regarding the time of vaccination, seven studies were eligible to be included (two studies on influenza, one study on HAV and influenza, one study on BCG, one study on hexavalent vaccine, and two studies on SARS-CoV-2 vaccine). Among them, four out of seven studies (including a study on SARS-CoV-2 inactivated vaccine) reported the priorities of morning versus afternoon vaccination regarding antibody production and immune response after vaccination. Conclusion: Taken together, cumulative evidence suggests that sufficient sleep and vaccination in the morning could enhance the immune response after vaccination. Hence, modulating the time of vaccination and sufficient sleep could a be simple and applicable strategy for increasing vaccine efficacy. Future studies could be performed with SARS-CoV-2 vaccines to investigate the effects of time of vaccination and sufficient sleep on COVID-19 vaccine efficacy
Investigating the effect of methylprednisolone pulse on treatment of back pain
No full textPain is a common problem afflicting humanity. Back pain is a musculoskeletal disorder with a high prevalence; this pain may occur to anyone at least once during their lifetime. The present study was performed to investigate the effect of methylprednisolone pulse on the pain status of patients suffering from back pain in Ilam city. This double-blind study in 2021 in Ilam city with experimental and control. The patients with vertebral disc herniation diagnoses suffering from diffuse pain with the right leg were assigned into experimental and control groups. A methylprednisolone 500 mg IV would be administered to the patient as pulse inside DW 500 cc serum. The extent of pain was compared before and after the intervention at one, two, three, and seven days later. Placebo was applied for the control group patients. The data were analyzed by SPSS 16 and based on descriptive and analytical tests. Results showed no statistically significant difference between the demographic characteristics and pain of patients receiving methylprednisolone and patients in the control group(p0.05). Considering the effect of methylprednisolone on mitigating the pain of patients suffering from back pain, it is suggested to use injective methylprednisolone to reduce the pain of patients suffering from back pain
Tuberculosis challenges: Resistance, co-infection, diagnosis, and treatment
No full textEarly diagnosis of tuberculosis (TB), followed by effective treatment, is the cornerstone of global TB control efforts. An estimated 3 million cases of TB remain undetected each year. Early detection and effective management of TB can prevent severe disease and reduce mortality and transmission. Intrinsic and acquired drug resistance of Mycobacterium tuberculosis (MTB) severely restricted the anti-TB therapeutic options, and public health policies are required to preserve the new medications to treat TB. In addition, TB and HIV frequently accelerate the progression of each other, and one disease can enhance the other effect. Overall, TB-HIV co-infections show an adverse bidirectional interaction. For HIV-infected patients, the risk of developing TB disease is approximately 22 times higher than for persons with a protective immune response. Analysis of the current TB challenges is critical to meet the goals of the end TB strategy and can go a long way in eradicating the disease. It provides opportunities for global TB control and demonstrates the efforts required to accelerate eliminating TB. This review will discuss the main challenges of the TB era, including resistance, co-infection, diagnosis, and treatment