Quercetin as a possible complementary therapy in multiple sclerosis: Anti-oxidative, anti-inflammatory and remyelination potential properties

Multiple sclerosis (MS) is a complex autoimmune disorder of the central nervous system (CNS) which causes various symptoms such as fatigue, dyscoordination weakness and visual weakness. The intricacy of the immune system and obscure etiology are the main reasons for the lack of a definite treatment for MS. Oxidative stress is one of the most important key factors in MS pathogenesis. It can enhance inflammation, neurodegeneration and autoimmune-mediated processes, which can lead to excessive demyelination and axonal disruption. Recently, promising effects of Quercetin as a non-pharmacological anti-oxidant therapy have been reported in preclinical studies of MS disease. In this review, we provide a compendium of preclinical and clinical studies that have investigated the effects of Quercetin on MS disease to evaluate its potential utility as a complementary therapy in MS. Quercetin treatment in MS disease not only protects the CNS against oxidative stress and neuroinflammation, but it also declines the demyelination process and promotes remyelination potential. The present study clarifies the reported knowledge on the beneficial effects of Quercetin against MS, with future implication as a neuroprotective complementary therapy.

Thiolated chitosan hydrogel-embedded niosomes: A promising crocin delivery system toward the management of aphthous stomatitis

Aphthous stomatitis is a common inflammatory oral disease with challenging management. Crocin is a natural carotenoid that has shown great anti-inflammatory properties. The aim of this study was to develop thiolated chitosan (TCS)-based hydrogels containing niosomes to serve as a mucoadhesive crocin delivery system for aphthous stomatitis. Crocin-loaded niosomes were prepared and the impact of surfactant type, cholesterol content, and lipid to drug ratio on the characteristics of niosomes was evaluated. TCS was synthesized and the success of thiolation was investigated. The optimum niosomal formulation was loaded into the hydrogel and the hybrid system was characterized regarding the morphology, mucoadhesive properties, viscosity, chemical structure, in vitro drug release, and in vivo efficacy. The optimized niosome formulation showed 77% crocin entrapment, a particle diameter of 59 nm, and a zeta potential of -18 mV. The niosome-containing hydrogel exhibited pseudoplastic rheological behavior, mucoadhesive properties, suitable swelling, and sustained release of crocin. In vivo study revealed that the niosome-containing hydrogel improved ulcer healing and decreased the expression of tumor necrosis factor-alpha (TNF-α) and p53 while increasing the expression of vascular endothelial growth factor (VEGF) and alpha-smooth muscle actin (α-SMA). Collectively, TCS hydrogel-embedded crocin-loaded niosomes is a promising therapeutic option for aphthous stomatitis. CHEMICAL COMPOUNDS STUDIED IN THIS ARTICLE: Crocin (PubChem CID: 5281233) Chitosan (PubChem CID: 71853) Thioglycolic acid (PubChem CID: 1133) 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride (PubChem CID: 2723939) 5,5'-dithiobis (2-nitrobenzoic acid) (PubChem CID: 6254) Cholesterol (PubChem CID: 5997).

Exosomes as cutting-edge therapeutics in various biomedical applications: An update on engineering, delivery, and preclinical studies

Exosomes are cell-derived nanovesicles, circulating in different body fluids, and acting as an intercellular mechanism. They can be purified from culture media of different cell types and carry an enriched content of various protein and nucleic acid molecules originating from their parental cells. It was indicated that the exosomal cargo can mediate immune responses via many signaling pathways. Over recent years, the therapeutic effects of various exosome types were broadly investigated in many preclinical studies. Herein, we present an update on recent preclinical studies on exosomes as therapeutic and/or delivery agents for various applications. The exosome origin, structural modifications, natural or loaded active ingredients, size, and research outcomes were summarized for various diseases. Overall, the present article provides an overview of the latest exosome research interests and developments to clear the way for the clinical study design and application.

Effects of Calorie Restriction on Multiple Sclerosis: A Review of the Preclinical and Clinical Studies

It has been indicated that calorie restriction (CR) leads to several neuroprotective effects against physiological aging and different neurodegenerative disorders. Unfortunately, the definite therapeutic strategy is not introduced for Multiple sclerosis (MS) as an autoimmune disease of central nervous system (CNS) and researchers are striving to find the best treatment procedures and then optimize them. More recently, several preclinical studies have reported beneficial effects of CR on MS. It was stated that CR can decline demyelination, improve remyelination and decrease neuroinflammation in animal model of MS, as well as reduce body weight and enhance emotional wellbeing in MS patients. In this context we designed this review to examine studies exploring the effects of CR on MS disease based on the clinical and animal models to highlight involved mechanistic implications and future prospective.

Evaluation of Blood Biochemistry and Cardiopulmonary status of Hospitalized Covid-19 Patients in 3 Months Post Discharged Follow up Survey

BACKGROUND

The new coronavirus causes systemic inflammation and damage to various organs. So, this study aimed to follow up patients with COVID -19 after recovery for three months by performing cardiac, pulmonary and laboratory tests.

MATERIALS AND METHODS

This was a prospective cohort study of COVID-19 patients who were discharged from Baharloo Hospital. The diagnosis of COVID-19 was confirmed by PCR or long CT scan. Inclusion criteria were age over 18 years and patients with more than 50% of pulmonary involvement in lung CT scan. The patients were called to Baharloo hospital three months after recovery and were examined for cardiac, pulmonary and blood tests.

RESULT

Our study included 178 participants with mean age of 55.70, and 50.6% of them were male. Among pulmonary factors in the hospital, 71.9%, 15.7%,1.7%,19.1% and 53.4% had positive GGO, consolidation, reverse halo sign, traction bronchiectasis and vascular enlargement, respectively. After three months follow up, percentage of patients who had reticulation, honeycombing, fibrotic brand and bullae were 12%, 1.1%,8.4% and 0%, respectively. The Mean values of FVC and FEV1 were reported 4.21 and 3.01, respectively. Among Cardiac factors, positive PVC, PAC and mean Pap were decreased after three months. Only Growth in myalgia and Decreased sense of taste were statistically significant. Also, D dimer, UA protein, PMN, Ferritin CRP, PMN, LDH and HB amounts had decreased significantly.

CONCLUSION

Our study indicated that in addition to pulmonary changes, rapid damage to other organs and the occurrence of cardiac symptoms and changes in laboratory result were also reported in patients recovered from COVID-19.

Neutrophil-to-Lymphocyte Ratio Cut-Off Point for COVID-19 Mortality: A Retrospective Study

Several months have passed since the onset of the COVID-19 pandemic. Multiple characteristics have been proposed as prognostic factors so far. This study aims to provide evidence on the association of neutrophil-to-lymphocyte ratio (NLR) at the hospitalization time and three desired outcomes (mortality, prolonged hospitalization, and intensive care unit [ICU] admission). We designed a single-centre retrospective observational study in Baharloo Hospital (Tehran, Iran) from 20 February to 19 April 2020. Patients with confirmed COVID-19 diagnosis via rt-PCR or chest CT imaging were included. Demographic and clinical data were obtained. The sample was divided into three groups, using tertile boundaries of initial NLR. The differences in mortality, comorbidities, hospitalization duration, drug administration, and ICU admission between these three groups were investigated. The identified confounding factors were adjusted to calculate the odds ratio of death, ICU admission, and prolonged hospitalization. Nine hundred sixty-three patients were included. In total, 151 and 212 participants experienced mortality and ICU admission, respectively. In multivariate logistic regression models, the adjusted odds ratio for mortality event in the second and third tertile of initial NLR after full adjustment were 1.89 (95% CI:1.07-3.32) and 2.57 (95% CI:1.48-4.43) and for ICU admission were 1.85 (95% CI:1.14-3.01) and 2.88 (95% CI:1.79-4.61), respectively. The optimal cut-off value of the initial NLR for predicting mortality was 4.27. Initial NLR can predict mortality and ICU admission in COVID-19 patients. Further investigations for curating the calculated cut-off can propose initial NLR as an indicator of poor prognosis for COVID-19 patients.

The effects of Alzheimer's and Parkinson's disease on 28-day mortality of COVID-19

We compared the prognosis of inpatients with a known diagnosis of Alzheimer's or Parkinson's disease who have COVID-19 infection with other hospitalized patients with COVID-19. Our cohort study started in October 2020 and ended in May 2021 and included inpatients with COVID-19 infection who were admitted to hospitals. From a total of 67,871 patients with a confirmed diagnosis of COVID-19, a sample of 3732 individuals were selected of which 363 had Alzheimer's, and 259 had Parkinson's disease. All patients had both positive RT-PCR test and positive chest CT for COVID-19. The outcome was dead within 28 days of admission and the predictors were a large number of demographic and clinical features, and comorbidities recorded at patients’ bedside. Mortality were 37.5%, 35.1%, and 29.5% in patients with Alzheimer's disease, Parkinson's disease; and in other patients, respectively. The hazard ratio for Alzheimer's disease was 1.27 (95% CI, 1.06–1.53, p = 0.010) and for Parkinson's disease was 1.17 (95% CI, 0.94–1.46, p = 0.171). Age was a predictor of mortality, hazard ratio = 1.04 (95% CI, 1.03–1.05, p < 0.001). Patients with Alzheimer's disease and COVID-19 infection were older and more likely to have a loss of consciousness on admission (both p ≤ 0.001). We concluded that inpatients with Alzheimer's disease have an increased risk for 28-day mortality from COVID-19 and healthcare settings should be ready to provide critical care for them such as early intubation and immediate O₂ therapy. However, Parkinson's disease does not significantly predict higher mortality of COVID-19.

Alkaline phosphatase and score of HRCT as indicators for predicting the severity of COVID-19

BACKGROUND

The clinical symptoms, blood laboratory data, O2 saturation and high-resolution computed tomography (HRCT) findings are critical factors in diagnosis of COVID-19 infection.

METHODS

In this study, 105 hospitalized patients suspected of having COVID-19 were evaluated. Finally, the laboratory and HRCT and related factors data of 83 confirmed cases by HRCT and RT-PCR were analyzed. To compare the median of quantitative variables in the two groups, the Mann-Whitney U test was used. Also, to determine the factors associated with the positiveness of the HRCT result, a univariate logistic model was fitted. Moreover, receiver operating characteristic (ROC) curves were constructed to test the ability of the final model to predict the positiveness of HRCT result.

RESULTS

61.40% of the patients had a comorbidity disease. 89.20% had fever, 92.00% cough, 91.40% dyspnea. Abnormal CRP was seen in 77.80% of the patients, followed by 66.70% lymphopenia, and 60.30% neutrophilia. Also, ALP (abnormal vs. normal) and score of HRCT assessment variables had a significant effect on the positiveness of HRCT findings. 87.95% had abnormal HRCT with 41% bilateral multi lobar patchy ground glass opacity (GGO). Moreover, there was a statistically significant association between the level of O2 saturation and HRCT results.

CONCLUSION

Our findings showed that male patients with middle age and comorbidity disease were more susceptible to the COVID-19 infection. Additionally, clinical features, blood laboratory findings, O2 saturation and HRCT findings are critical factors in the prognosis of COVID-19 infection.

Alleviation of cisplatin-induced hepatotoxicity by gliclazide: Involvement of oxidative stress and caspase-3 activity

AIMS

Cisplatin (CP), as an effective alkylating agent, is widely used in cancer treatment, while hepatotoxicity is one of its side effects. Gliclazide (GLZ), as an oral hypoglycemic drug, has antioxidant and anti-inflammatory properties. This study was designed to investigate the protective effect of GLZ against CP-induced hepatotoxicity in mice.

METHODS

In this experimental study, 64 adult male mice randomly were allocated into eight groups (8 mice/group). Control, GLZ (5, 10, and 25 mg/kg, orally), CP (10 mg/kg, single dose, intraperitoneally), and CP+GLZ (in three doses). GLZ was administrated for 10 consecutive days. CP was injected on the 7th day of the study. At the end of the experiment, hepatotoxicity was evaluated by serum and tissue biochemical, histopathological, and immunohistochemical assessments.

RESULTS

The data were revealed that CP increased oxidative stress (increased MDA and reduced GSH), liver damage enzymes (ALT, AST, and ALP), and immunoreactivity of caspase-3 in liver tissue of CP-injected mice. Also, CP induced histopathological changes such as eosinophilic of hepatocytes, dilatation of sinusoids, congestion, and proliferation of Kupffer cells. GLZ administration significantly ameliorated serum functional enzyme and hepatic oxidative stress markers in CP-injected mice. In addition, the histological and immunohistochemical alterations were ameliorated in GLZ-treated mice. Of the three doses, 10 and 25 mg/kg were more effective.

CONCLUSIONS

In conclusion, GLZ with its antioxidant, anti-inflammatory, and anti-apoptotic activities, can be suggested as a promising drug in the treatment of CP-induced hepatotoxicity.

Anxiety and Depression in Health Workers and General Population During COVID-19 in IRAN: A Cross-Sectional Study

BACKGROUND

The COVID-19 outbreak has exerted a great deal of psychological pressure on Iranian health workers and the general population. The aim of this study was to determine the effect of pandemic on anxiety and depression in Iranian population.

METHODS

An online cross-sectional study was conducted for the general public and healthcare workers in Iran using a questionnaire comprised of demographic questions and Hospital Anxiety and Depression Scale. Chi-square test and univariate and multivariate logistic regression models were conducted.

RESULTS

Of the 2045 participants, 1136 (65.6%) were considered to have moderate and severe anxiety symptoms, and 865 (42.3%) had moderate and severe depression symptoms. The prevalence of anxiety was higher in the females than in the males (OR = 1.4, 95% CI: 1.123-1.643, P = .002); the prevalence of anxiety was significantly higher in those aged 30-39 years than in other age-groups (OR = 1.6, 95% CI: 1.123-2.320, P = .001); furthermore, the prevalence of anxiety and depression was significantly higher in doctors and nurses compared with other occupations ((OR = 1.9, 95% CI: 1.367-2.491, P < .001) and (OR = 1.5, 95% CI: 1.154-2.021, P = .003)). In addition, the prevalence of anxiety symptoms in the likely infected COVID-19 group was higher than in the noninfected COVID-19 group (OR = 1.35, 95% CI: 1.093-1.654, P = .005).

CONCLUSIONS

Regarding the high prevalence of anxiety and depression symptoms, especially among healthcare workers, appropriate psychological/psychiatric intervention necessitates.

Validity of self-reporting depression in the Tabari cohort study population

Aims

Depression is a common cause of mortality and morbidity worldwide. To detect depression, we compared BDI‐II scoring as a valid tool with participants' self‐reporting depression.

Methods

The sample size was determined to include 155 participants with positive self‐reporting of depression in a total of 1300 samples with 310 healthy participants were included in the study through random selection. In order to evaluate the diagnostic value of self‐reporting, BDI‐II was completed by blind interviewing to the case group as well as to another group who reported that they were not depressed, as control.

Results

Sensitivity, specificity, accuracy, false positive, false negative, positive, and negative predictive values of self‐reporting were calculated 58.4%, 79.1%,73.4%, 20.8%, 41.6%, 51.8%, and 83.2% for the total population, respectively, as well as, sensitivity, specificity, accuracy, positive, and negative predictive values of self‐report in males were 83.3%, 77.2%, 77.1%, 43.8%, and 95.6% and 53.7%, 78.1%, 71.2%, 49.2%, and 81.1% for females, respectively.

Conclusion

The positive predictive value and sensitivity of self‐reporting are insufficient in total population and females, and therefore self‐reporting cannot detect depressed patients, but regarding to its average positive predictive value, perhaps, it can be used to identify nondepressant individuals.

The positive predictive value and sensitivity of self‐reporting are insufficient in total population and females, and therefore self‐reporting cannot detect depressed patients, but regarding its average positive predictive value, perhaps, it can be used to identify nondepressant individuals.

Naso-pharyngeal discharge: The first symptom of COVID-19 infection: Report two cases from Iran

Naso‐pharyngeal discharge as the first symptom of COVID‐19 infection is presented in two cases. Actually, based on the presented cases here we concluded that the early clinical symptoms of COVID‐19 may be mimicked the common cold features. Appropriate diagnosis and isolation of the patients help reduce further transmission.

Gliclazide attenuates cisplatin-induced nephrotoxicity through inhibiting NF-κB and caspase-3 activity

Cisplatin (CP), as a chemotherapeutic drug, causes nephrotoxicity that has limited the clinical utility of CP. Gliclazide (GLZ), as an antihyperglycemic drug, at low dose has antioxidant property. In this study, we aimed to investigate the protective effect of GLZ against CP-induced acute renal injury. Sixty-four BALB/c mice were randomly divided into eight groups. The groups were included as control, GLZ (5, 10, and 25 mg/kg), CP, and GLZ (5, 10, and 25 mg/kg) + CP. Renal function markers (serum creatinine and blood urea nitrogen), oxidative stress markers (malondialdehyde and glutathione), apoptotic marker (caspase-3), and NF-κB were histopathologically evaluated. The results of our study showed that increased urea and creatinine were evidence of CP-induced nephrotoxicity. Histopathological examination revealed tubular epithelial and Bowman degeneration, edema, and cytoplasmic vacuolation in renal tissue structure. Administration of GLZ reduced oxidative stress, caspase-3, and NF-κB activity, and improved kidney function markers in CP-treated mice compared with CP alone group. Also, we observed that the histological tissue structure of the kidney was maintained. GLZ at dose of 25 mg/kg had higher protective effect as compared with other doses. Overall, our study suggests that GLZ with antioxidant, antiapoptotic, and anti-inflammatory properties may be a promising new therapeutic agent to prevent CP-induced nephrotoxicity.

Efficacy of guided self-change for smoking cessation in chronic obstructive pulmonary disease patients: A randomized controlled clinical trial

INTRODUCTION

The aim of this study was to examine the efficacy of guided self-change (GSC), nicotine replacement therapy (NRT), and their combination, on smoking cessation among patients with COPD.

METHODS

A total of 60 participants were randomly assigned to three groups for GSC (n=20), nicotine replacement therapy (NRT) (n=20) or their combination (n=20), from December 2016 to November 2017. The quality of life (QoL) questionnaire, clinical assessment test (CAT) and exhaled carbon monoxide (CO), were measured at baseline and post-treatment.

RESULTS

At 6, 12, and 29 weeks, the abstinence rate in the NRT group was 5.3%, 15.8% and 21.1%, in the GSC group 21.1%, 31.6% and 47.4%, and in the combined group 36.8%, 36.8% and 47.4%, respectively. The exhaled CO in the NRT group was greater than the GSC group, however this difference was not statistically significant (3.4; 95% CI: -0.24–7.0; p=0.067), CO levels in the combined group were less than the GSC group, while this difference was also not significant (-0.75; 95% CI : -4.2–2.7; p=0.68). CAT and QoL recovery in the GSC and combined groups were higher than in the NRT group (9.2; 95% CI: 5.0–13.4; p=0.001) and (-4.5; 95% C: -8.1– -0.6; p=0.02), respectively. However, differences between combined and GSC groups were not significant (p=0.24 and p=0.41, respectively). There was a statistically significant difference between the abstinence rate in the GSC or combined group and the NRT group (p=0.001). The GEE model showed that GSC reduced the odds of smoking compared with the NRT group (interaction group effect) (OR=0.31, 95% CI: 0.022–0.545; p=0.001).

CONCLUSIONS

In our context among COPD patients, GSC was more effective in decreasing smoking than NRT alone. Moreover, the recovery of exhaled carbon monoxide, CAT and QoL in GSC was more than in the NRT group. Moreover, since GSC was as effective as GSC plus NRT, the effectiveness of the combination method for smoking cessation in COPD patients may be attributed to GSC.

Clinical trial registration details: IRCT201609271457N11; www.irct.ir

An Overview of the Research Reports on Addiction in Iranian Journals from 2010 to 2015

Background

The articles and research reports presented in the scientific journals are selected without a proper critical appraisal in many cases. This is a major problem, as it leads to the opinions of the experts being neglected in many of these scientific journals. A descriptive study was done in fall and winter of 2016.

Methods

Journals were identified searching the electronic databases, including PubMed, Medline, Scopus, Google Scholar, and national Persian databases of SID and Magiran. All the articles on addiction published in the time span of 2010-2015 in 8 psychiatry, psychology, and addiction journals were included in this study. The journals included Journal of Behavioral Sciences, Iranian Journal of Psychiatry and Clinical Psychology, Journal of Fundamentals of Mental Health, and Journal of Research on Addiction in Persian, and Health and Addiction Journal, International Journal of Psychiatry and Behavioral Sciences, Journal of Research in Behavioral Sciences, and International Journal of Psychological Studies in English. These journals were evaluated according to their research design and methodology, scientific writing style, and the validity of the references. For all of the 264 articles, the research design and references were thoroughly evaluated.

Findings

The most frequent problems were seen in the introduction section, the sampling method of study, the exclusive criteria, analysis, and the limitations of the study.

Conclusion

Major deficiencies in the articles on addiction in Iranian journals were seen. It can be prevented by including important items in the checklists published by some of the journals for reviewers.

Methadone Replacement Therapy and Sexual Disorders among Opium Dependent Iranian Men: A Meta-Analysis Study

BACKGROUND

Evaluation of sexual disorders among persons receiving methadone replacement therapy is of great importance, because these problems may lead to non-compliance and relapse. This study aimed to estimate the effect of methadone maintenance therapy (MMT) on sexual function among addicted Iranian men using met-analysis.

METHODS

Investigating the available data banks, relevant studies were identified. After exclusion of duplicates, irrelevant papers and low quality articles, eligible papers were entered into the meta-analysis. Prevalence and standardized mean difference of sexual function scores were illustrated by forest plots based on sexual desire, orgasm and erectile function.

FINDINGS

During the primary search, 5341 evidences were identified. After application of the inclusion/exclusion criteria and quality assessment, nine papers were detected eligible for final meta-analysis. Total prevalence [95% confidence intervals (CI)] of sexual disorders and erectile dysfunction among Iranian men under methadone therapy were estimated as 66.3% (27.1-105.5) and 77.5% (61.9-93.1), respectively. The standardized mean differences (95% CI) of Sexual desire, orgasm and erection before and after methadone therapy were estimated as 0.16 (-0.68, 0.99), -0.01 (-0.75, 0.74) and 0.11 (-0.41, 0.64), respectively.

CONCLUSION

This meta-analysis showed that methadone therapy did not significantly influence the sexual desire, erectile function and orgasm among opium dependent men.

Procrastination and Self-Efficacy Among Intravenous Drug Users on a Methadone Maintenance Program in Sari City, Iran, 2013

Background:

Self-efficacy is the belief that one has the ability to implement the behaviors needed to produce a desired effect. There has been growing interest in the role of self-efficacy as a predictor and/or mediator of treatment outcome in a number of domains. Procrastination is a self-regulatory failure, defined as the voluntary delay of an intended course of action despite expecting to be worse off for the delay. Behavioral procrastination is a self-sabotage strategy that allows people to shift blame and avoid action; the decisional procrastination strategy is to put off making a decision when dealing with conflicts or choices. Procrastination has a great role in quitting drug addiction.

Objectives:

The aim of this study was to determine the relationship between procrastination and self-efficacy and other factors among intravenous drug users.

Patients and Methods:

This cross-sectional study was conducted on 178 intravenous drug users in the behavioral disease counseling, health center in Sari city, Mazandaran province, Iran, in 2013. The samples were selected through census sampling, descriptive and inferential statistics were used to measure the properties of distribution that depicts a set of data shown as frequency distribution tables, while for the mean and standard deviation, chi-square, Fisher and Spearman-Brown coefficients were used to analyze the data.

Results:

The mean age of the participants was 43 years. Seventy-two percent of them were married and opium was the first drug used. The first substance used in them was 54% of opium, 33% cannabis and 5% alcohol and 79% smoking. The reason of the first drug use in 32% of the subjects was temptation and in 10% a friend’s influence. The mean age of the first drug use was 23 years, and the frequency was 2 times per day. All of them had relapse at least once. Seven percent of them currently use other materials (2% crystal, 5% alcohol and opium and crack) both in methadone treatment. Behavioral procrastination in 60.5% of them and decisional procrastination in 62% is from low to average range. There was a significant relationship between relapse and self-efficacy as well as between self-efficacy and the age of the first drug use, drug dose, and procrastination for treatment, marriage, employment and job. Also, the relationship between behavioral procrastination and self-efficacy was significant and inverse.

Conclusions:

This study found a significant difference between procrastination and self-efficacy as well as other related factors. It is important to include drug users and the society organizations representing them in every stage of the governmental policy and program development process to make them responsive to the needs of the community.

Drug Use and High-Risk Sexual Behaviors of Women at a Drop-In Center in Mazandaran Province, Iran, 2014

BACKGROUND

Female drug users are more likely to transmit human immunodeficiency virus (HIV) to their sexual partners. Little is known about HIV, sexually transmitted diseases (STDs), cervicitis, and drug abuse among female sex workers in Iran.

OBJECTIVES

Therefore, this study was conducted at a drop-in center (DIC) in Iran to investigate the prevalence of HIV associated risk factors, the prevalence of drug use, high-risk sexual behaviors, and the relationship between the associated factors in women.

PATIENTS AND METHODS

This quantitative cross-sectional study was conducted on 190 female sex workers (SW) in a DIC in Sari, Mazandaran, Northern Iran, in January and February 2014. The study sample was selected through census sampling. In the end, 190 female SWs referring to the DIC participated in our study. There was no limitation in sampling. The self-administered questionnaire was completed via an interview.

RESULTS

The results showed that 39% of the female SWs were less than 30 years old and 64% had elementary school education. In addition, 59% of the participants took some type of illegal drugs and 1.1% of them were reportedly injecting drug users. Moreover, 43% of them had substance dependent husbands, and 39% were reportedly regular condom users. They had 1 - 10 sexual partners on average per week. The overall prevalence of HIV infection was 4%. A significant relationship was found between the type of drugs used and factors such as having a substance dependent husband, use of condom during the last sexual contact, regular condom use, and the number of sexual acts per week. A significant correlation exists between using psychiatric drugs and factors like regular condom use, education, cervicitis, and the number of sexual conducts per week.

CONCLUSIONS

Female sex workers often engage in sex for financial reasons and are at high risk of drug abuse, HIV, and cervicitis. In addition, the rate of cervicitis among females with high-risk sexual behavior is considerable in Mazandaran, Iran. Therefore, the state authorities should provide sex workers with health care services and help them acquire a good job to support their life.

A novel polyvinyl chloride-membrane optical sensor for the determination of Cu(2+) ion based on synthesized (N'(1)E,N'(2)E)-N'(1),N'(2)-bis(pyridine-2-ylmethylene)oxalohydrazide: experimental design and optimization

A copper (Cu(2+)) ion-selective bulk optode was constructed by using (N'(1)E,N'(2)E)-N'(1),N'(2)-bis(pyridine-2-ylmethylene)oxalohydrazide as ionophore and NaTPB in DBP matrices. Central composite design under response surface methodology was applied for the optimization of variables including pH, amount of ligand, amount of additive and response time which significantly affect the response of proposed sensor. At optimum specified conditions, the high stability, reproducibility and relatively long lifetime of the optical sensor suggest its ability for accurate and precise monitoring of Cu(2+) ion content in various real samples over a concentration range of 1.6×10(-6) to 3.17×10(-5)molL(-1) with a limit of detection of 8.1×10(-7)molL(-1) during response time 6.9min. The proposed optical sensor was successfully applied for the determination of Cu(2+) ion in tap water and different samples.

Asymmetric supercapacitor based on an α-MoO3 cathode and porous activated carbon anode materials

Low cost porous carbon materials were produced from cheap polymer materials and graphene foam materials which were tested as a negative electrode material in an asymmetric cell configuration with α-MoO₃ as a positive electrode.

Adaptive neuro-fuzzy inference system model for adsorption of 1,3,4-thiadiazole-2,5-dithiol onto gold nanoparticales-activated carbon

In this research, a novel adsorbent gold nanoparticle loaded on activated carbon (Au-NP-AC) was synthesized by ultrasound energy as a low cost routing protocol. Subsequently, this novel material characterization and identification followed by different techniques such as scanning electron microscope(SEM), Brunauer-Emmett-Teller(BET) and transmission electron microscopy (TEM) analysis. Unique properties such as high BET surface area (>1229.55m(2)/g) and low pore size (<22.46Å) and average particle size lower than 48.8Å in addition to high reactive atoms and the presence of various functional groups make it possible for efficient removal of 1,3,4-thiadiazole-2,5-dithiol (TDDT). Generally, the influence of variables, including the amount of adsorbent, initial pollutant concentration, contact time on pollutants removal percentage has great effect on the removal percentage that their influence was optimized. The optimum parameters for adsorption of 1,3,4-thiadiazole-2, 5-dithiol onto gold nanoparticales-activated carbon were 0.02g adsorbent mass, 10mgL(-1) initial 1,3,4-thiadiazole-2,5-dithiol concentration, 30min contact time and pH 7. The Adaptive neuro-fuzzy inference system (ANFIS), and multiple linear regression (MLR) models, have been applied for prediction of removal of 1,3,4-thiadiazole-2,5-dithiol using gold nanoparticales-activated carbon (Au-NP-AC) in a batch study. The input data are included adsorbent dosage (g), contact time (min) and pollutant concentration (mg/l). The coefficient of determination (R(2)) and mean squared error (MSE) for the training data set of optimal ANFIS model were achieved to be 0.9951 and 0.00017, respectively. These results show that ANFIS model is capable of predicting adsorption of 1,3,4-thiadiazole-2,5-dithiol using Au-NP-AC with high accuracy in an easy, rapid and cost effective way.

Comparison of nickel oxide and palladium nanoparticle loaded on activated carbon for efficient removal of methylene blue

Palladium nanoparticles (Pd-NPs) and nickel oxide nanoparticles (NiO-NPs) were synthesized and loaded on activated carbon (AC). This novel material successfully used for the removal of methylene blue (MB) dye from aqueous medium. Full characterization of both material using X-ray diffraction, transmission electron microscopy, scanning electron microscopy and Brunauer–Emmet–Teller analyses for Pd-NP show their high surface area (>1340 m2/g) and low pore size (<20 Å) and average particle size lower than 45 Å and for NiO-NP show their high surface area (>1316.1554 m2/g) and low pore size (<20 Å) and average particle size lower than 46 Å in addition to high reactive atom and presence of various functional groups. These unique properties make them possible for efficient removal of MB. In batch experimental set-up, optimum conditions for maximum removal of MB by both adsorbents were attained following searching effect of variables such as central composite design. The Langmuir isotherm was found to be highly recommended for fitting the experimental equilibrium data. The kinetic of adsorption of MB on both adsorbents strongly can be fitted by a combination of pseudo-second order and intraparticle diffusion pathway. The experimental result achieved in this article shows the superiority of Pd-NP-AC for MB removal than NiO-NP-AC, so the maximum adsorption capacities of Pd-NP-AC and NiO-NP-AC were 555.5 mg/g and 588.2 mg/g, respectively.

Comparison of the efficiency of Cu and silver nanoparticle loaded on supports for the removal of Eosin Y from aqueous solution: Kinetic and isotherm study

In this study, the efficiency of a novel copper containing ionic liquid based nanoporous organosilica (Cu@IL-ONO) and palladium nanoparticles loaded on activated carbon (Pd-NP-AC) for the removal of Eosin Y from aqueous solution was investigated. The Cu@IL-ONO was prepared by hydrolysis and co-condensation of tetramethoxysilane (TMOS) and 1,3-bis (trimethoxysilylpropyl) imidazolium chloride in the presence of surfactant template following immobilization of copper chloride dihydrate. These materials were characterized by nitrogen adsorption-desorption analysis and scanning electron microscopy (SEM) and subsequently used for the successful removal of Eosin Yellow (EY) from aqueous solution. The effects of pH, contact time, amount of adsorbents, initial dye concentration was optimized and set as following: 0.005g/50mL Cu@IL-ONO and 0.015g/50mL Ag-NP-AC at pH=2 for Cu@IL-ONO and pH=3 for Ag-NP-AC and contact time less than 14min. The experimental removal percentage data at various situations was fitted by conventional isotherm models like Langmuir, Freundlich, Tempkin and Dubinin-Radushkevich (D-R). Judgment based on linear regression coefficient (R(2)) and error analysis show high usability of the Langmuir isotherm for best explanation of experimental data with maximum monolayer adsorption capacities 286 and 250mgg(-1) at room temperatures for Cu@IL-ONO and Ag-NP-AC, respectively. Fitting the corresponding data of removal percentage at various experimental conditions shows the suitability of second order and interparticle diffusion model for interpretation of real data.

Relationship between addiction relapse and self-efficacy rates in injection drug users referred to Maintenance Therapy Center of Sari, 1391

BACKGROUND & PURPOSE

Self-efficacy is the belief that one has the ability to implement the behaviors needed to produce a desired effect. There has been growing interest in the role of self-efficacy as a predictor and/or mediator of treatment outcome in number of domains. In numerous studies of substance abuse treatment, self-efficacy has emerged as an important predictor of outcome, or as a mediator of treatment effects. In the event of a slip, highly self-efficacious persons are inclined to regard the slip as a temporary setback and to reinstate control, whereas those who have low self-efficacy are more likely to proceed to a full-blown relapse. This study was carried out to determine relationship between relapse and self-efficacy and other factors in injected drug users.

MATERIALS & METHODS

We conducted this study in 200 addicts in the center of counseling behavioral disease in health center of sari city (methadone maintenance therapy center or MMTC). A cross-sectional study was carried out on all of these addicts.

RESULTS

The average age in addictions was 38 and its range was 20-60.72%of them were married and the first drug used was opium. All of them had relapse at least one time .we found a relationship between relapse and self-efficacy as well as the relationship between self-efficacy with the age of the first of drug use, dose, and procrastination for treatment, marriage, employment and job was significant.

CONCLUSION

This study found that there was a significant difference between relapse and self-efficacy as well as other related factors. It is important to include drug users and common society organizations representing them in every stage of the governmental policy and program development process to make them responsive to the needs of the community.

Reliability and validity of the Persian version of Foot and Ankle Ability Measure (FAAM) to measure functional limitations in patients with foot and ankle disorders

OBJECTIVE

To translate the Foot and Ankle Ability Measure (FAAM) into Persian and to evaluate the psychometric properties of the Persian version of FAAM.

METHODS

93 patients with a range of foot and ankle disorders, completed the Persian version of the FAAM and Short-Form 36 Health Survey (SF-36) in the test session. With an interval of 2-6 days, 60 patients filled out the FAAM in the retest session. The FAAM is composed of two subscales including activities of daily living (ADL) and SPORTS. Internal consistency was assessed using Cronbach's alpha, test-retest reliability using intraclass correlation coefficient (ICC) and standard error of measurement (s.e.m.), item internal consistency and discriminant validity using Spearman's correlation coefficient and construct validity using Spearman's correlation coefficient and Independent t-test.

RESULTS

Cronbach's alpha coefficient of 0.97 and 0.94 was obtained for ADL and SPORTS subscales, respectively. The ICC and s.e.m. were 0.98 and 3.13 for ADL and 0.98 and 3.53 for SPORTS subscale. Items were stronger measures of their hypothesized subscale than of other subscale. The ADL and SPORTS subscales had stronger correlation with SF-36 physical function (r=0.60, 0.53) and physical health summary measure (r=0.61, 0.48) than with SF-36 mental health (r=0.21, 0.10) and mental health summary measure (r=0.36, 0.27). A high correlation was found between FAAM scores and global scale of functional status for SPORTS (r=0.73) but not for ADL (r=0.42). FAAM scores were greater in individuals who rated their function as normal or nearly normal compared with those who rated as abnormal or severely abnormal for SPORTS (P=0.04) but not for ADL (P=0.15).

CONCLUSION

The Persian version of FAAM is a reliable and valid measure to quantify physical functioning in patients with foot and ankle disorders.

Health status in patients with disturbed sleep and obstructive sleep apnea

The health status of 435 consecutive patients with sleep disturbances necessitating polysomnography was investigated. Patients underwent overnight polysomnography and health status assessment, including the Medical Outcomes Study SF-36 Health Survey and the Pittsburgh Sleep Quality Index. Based on a respiratory distress index (RDI) greater than 10 to define apnea, patients with apnea were significantly (P < 0.05) more likely to be male, be older, and have higher body mass index and lower oxygen saturation levels than patients without apnea. Multiple domains of the SF-36 Health Survey and the Pittsburgh Sleep Quality Index were significantly worse (P < 0.05) for this population when normative data were compared. Although few differences were observed between the apneic and nonapneic patients when a cutoff point for apnea was defined as an RDI greater than 10 or 20, increasing RDI was significantly associated with worsening physical functioning scores. Overall, decrements in health status measures were more strongly correlated with the number of oxygen desaturations below 85% than with increasing RDI. We conclude that patients with sleep disturbances demonstrate significant decrements in general and sleep-specific health status, but these decrements are more closely associated with oxygen desaturation than RDI.

Outcomes of septoplasty

A prospective nonrandomized study of consecutive patients presenting to the Massachusetts Eye and Ear Infirmary for septoplasty was conducted to evaluate patient-based outcome. Patients received statistically validated measures of general health status (Short Form-12) and nasal specific health (Nasal Health Survey) before and 6 and 12 months after surgery. Multiple perioperative patient- and surgeon-dependent treatment variables were also evaluated to determine the impact on outcome. A total of 161 patients were entered into the study, and 93 were available for statistical analysis. At 9 months the mean follow-up (range 6-12 months), both symptom and medication subscores of the Nasal Health Survey, and the total score demonstrated significant improvement (P < 0.05); 71% of patients had clinically significant improvement as determined by at least a 50% decrease in duration of nasal symptoms. Measures of general health did not differ significantly from normative values at baseline and did not change after surgical intervention. Predictor analysis revealed that female gender and a history of previous nasal surgery predicted worse outcome.

Stapled cystograstrotomy. A method of treatment for pediatric pancreatic pseudocyst

An uncommon complication of pancreatic inflammatory disease or pancreatic trauma in children is the development of a pseudocyst. The English literature records less than 100 cases in children and emphasizes that surgical intervention is the indicated form of treatment. The authors have had experience with nine pediatric patients suffering from pseudocysts in a seven year period. All except one were successfully treated by internal drainage; the other spontaneously resolved. Four had cystogastrostomy using a stapler. This method is discussed as far as indications, technique, advantages and complications.

Nectotizing enterocolitis: is there a place for resection and primary anatomosis?

While most situations of peritonitis, perforation and compromised blood flow in necrotizing enterocolitis are best handled by resection and stoma formation, primary resection and anastomosis should be considered in selected cases. Nine premature infants with NEC underwent bowel resection with primary anastomosis in the face of localized perforation and peritonitis. Eight survived and had no problems when oral alimentation was started. One patient with small bowel involvement underwent two anastomoses rather than a high jejunostomy; the proximal anastomosis leaked and led to the death of the patient.