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OBJECTIVES@#This study was conducted to assess changes in spirometric parameters after protective interventions among workers at a chlorine production plant in Semnan, Iran during 2012-2016. @*METHODS@#This quasi-experimental study included 100 workers at a chlorine production plant in Semnan during 2012-2016. Spirometric parameters (forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1], FEV1/FVC, peak expiratory flow [PEF], and PEF occurring in the middle 50% of the patient’s exhaled volume [PEF 25-75%]) were measured in all workers before the initial intervention in 2012. Protective interventions were then implemented for 4 consecutive years and the parameters were measured annually. A multivariable linear regression model was used to assess the factors affecting spirometric parameters before and after the protective interventions in SPSS version 24. @*RESULTS@#The mean values of all spirometric parameters significantly increased after the protective interventions (p<0.05). Multivariable linear regression showed that age (β=-0.40), body mass index (BMI) (β=0.71; 95% confidence interval [CI], 0.11 to 1.31), and type of mask (β=-7.88; 95% CI, -15.96 to -0.46) had significant effects on the mean difference in FVC. Similarly, age (β=-0.35; 95% CI, -0.70 to -0.01), BMI (β=0.80; 95% CI, 0.20 to 1.41) and type of mask (β=-8.88; 95% CI, -16.98 to -0.79) had significant associations with the mean difference in FEV1. The type of mask (β=-12.81; 95% CI, -25.01 to -0.60) had a significant effect on the mean difference in PEF. @*CONCLUSIONS@#All spirometric parameters significantly increased in workers after protective interventions were implemented. Therefore, protective interventions to prevent respiratory disorders in workers exposed to chlorine gas are suggested.
ABSTRACT
OBJECTIVES@#This study was conducted to assess changes in spirometric parameters after protective interventions among workers at a chlorine production plant in Semnan, Iran during 2012-2016. @*METHODS@#This quasi-experimental study included 100 workers at a chlorine production plant in Semnan during 2012-2016. Spirometric parameters (forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1], FEV1/FVC, peak expiratory flow [PEF], and PEF occurring in the middle 50% of the patient’s exhaled volume [PEF 25-75%]) were measured in all workers before the initial intervention in 2012. Protective interventions were then implemented for 4 consecutive years and the parameters were measured annually. A multivariable linear regression model was used to assess the factors affecting spirometric parameters before and after the protective interventions in SPSS version 24. @*RESULTS@#The mean values of all spirometric parameters significantly increased after the protective interventions (p<0.05). Multivariable linear regression showed that age (β=-0.40), body mass index (BMI) (β=0.71; 95% confidence interval [CI], 0.11 to 1.31), and type of mask (β=-7.88; 95% CI, -15.96 to -0.46) had significant effects on the mean difference in FVC. Similarly, age (β=-0.35; 95% CI, -0.70 to -0.01), BMI (β=0.80; 95% CI, 0.20 to 1.41) and type of mask (β=-8.88; 95% CI, -16.98 to -0.79) had significant associations with the mean difference in FEV1. The type of mask (β=-12.81; 95% CI, -25.01 to -0.60) had a significant effect on the mean difference in PEF. @*CONCLUSIONS@#All spirometric parameters significantly increased in workers after protective interventions were implemented. Therefore, protective interventions to prevent respiratory disorders in workers exposed to chlorine gas are suggested.
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Background: Upper gastrointestinal bleeding [UGIB] is an important complication of low-dose aspirin. There are few and conflicting results about the etiology of UGIB in relation to low-dose aspirin. The aim of the present study was to evaluate the upper gastrointestinal endoscopy of patients taking low-dose aspirin who developed UGIB.
Materials and methods: The medical records of patients with UGIB who referred to Fatemieh Hospital, Semnan, Iran during 2001-2011 were studied and eligible patients were enrolled to the study. The endoscopic data were extracted and compared between the patients taking low-dose aspirin and who were not taking aspirin [control].
Results: 419 cases were studied. 58 [13.8 Percent] patients consumed low-dose aspirin and 204 [48.7 Percent] patients did not consume aspirin. The average age of the patients who received low-dose aspirin and those in the control groups were 65.9 +/- 5.9 and 50.4 +/- 22.3 years, respectively [p = 0.000]. 46.6 Percent and 32.4 Percent of the patients in low-dose aspirin and control groups were women, respectively, and the remaining patients were men [p > 0.05]. The main endoscopic findings in low-dose aspirin and control groups were erosions of the stomach, duodenum, and esophagus [55.9 Percent and 51.7 Percent] and peptic ulcer [50 Percent and 43.6 Percent], respectively. The other findings such as neoplasia, Mallory Weiss, and hiatal hernia were uncommon [1.7 Percent and 5.9 Percent]. The prevalence of endoscopic findings was not statistically significant between the two groups [p > 0.05].
Conclusion: In this small study, although patients with UGIB and low-dose aspirin consumption had more peptic ulcers and erosions in comparison with the control group, the difference was not significant
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Objective: Although stem cell transplantation has beneficial effects on tissue regeneration, but there are still problems such as high cost and safety issues. Since stem cell therapy is largely dependent on paracrine activity, in this study, utilization of transplantation of bone marrow stromal cells [BMSCs]-secretome instead of the cells, into damaged ovaries was evaluated to overcome the limitations of stem cell transplantation
Materials and Methods: In this experimental study, BMSCs were cultured and 25-fold concentrated conditioned medium [CM] from BMSCs was prepared. Female rats were injected intraperitoneally with cyclophosphamide [CTX] for 14 days. Then, BMSCs and CM were individually transplanted into bilateral ovaries, and the ovaries were excised after four weeks of treatment. The follicle count was performed using hematoxylin and eosin [H and E] staining and the apoptotic cells were counted using TUNEL assay. Ovarian function was evaluated by monitoring the ability of ovulation and the levels of serum estradiol [E2] and follicle-stimulating hormone [FSH]
Results: Evaluation of the ovarian function and structure showed that results of secretome transplantation were almost similar to those of BMSCs transplantation and there was no significant differences between them
Conclusion: BMSCs-secretome is likely responsible for the therapeutic paracrine effect of BMSCs. Stem cell- secretome is expected to overcome the limitations of stem cell transplantation and become the basis of a novel therapy for ovarian damage
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Low-dose ketamine has been considered a good substitute for opioids for controlling postoperative pain. The purpose of this study was to determine the effect of low-dose intravenous ketamine following cesarean section with spinal anesthesia on postoperative pain and its potential complications. One hundred and sixty pregnant women volunteered to participate in this randomized controlled trial. Participants were randomly divided into two groups [n=80 for each group]. Five minutes after delivery, the experimental group received 0.25 mg/kg ketamine while the control group received the same amount of normal saline. There was a significant difference between the two groups in the severity of pain at one, two, six, and 12 hours following surgery. Postoperative pain was significantly less severe in the experimental group. Compared to the control group, the experimental group felt pain less frequently and therefore asked for analgesics less often. On average, the number of doses of analgesics used for the participants in the experimental group was significantly less than the number of doses used for the control group. Analgesic side effects [including nausea, itching, and headache] were not significantly different between the two groups. However, vomiting was significantly more prevalent in the control group and hallucination was more common in the experimental group. We conclude that administration of low doses of ketamine after spinal anesthesia reduces the need for analgesics and has fewer side effects than using opioids. Further studies are required to determine the proper dose of ketamine which offers maximum analgesic effect. Furthermore, administration of low-dose ketamine in combination with other medications in order to minimize its side effects warrants further investigation
Subject(s)
Humans , Female , Administration, Intravenous , Pain, Postoperative/drug therapy , Cesarean Section , Pregnancy , Anesthesia, SpinalABSTRACT
Because of high psychological burden and considerable costs of in-vitro fertilization, it is greatly important to identify all factors that may influence its results. In this study, general anesthesia and spinal analgesia used for oocyte retrieval were compared in terms of success in treating infertility among couples who had undergone in-vitro fertilization at an infertility center in Tehran, Iran. This cohort study that was based on analysis of patient records at Mirza Kochak Khan Hospital, Tehran University of Medical Sciences, in 2008-2009. In this study, the status of chemical pregnancy among those who experienced general anesthesia or spinal anesthesia for in-vitro fertilization for the first time were compared, and the possible effects of clinical and laboratory factors using logistic regression models were considered. Considering the number of transferred embryos, underlying cause of infertility and fetus grade, it was found that practicing spinal anesthesia is significantly related to increased chance of chemical pregnancy [adjusted Odds Ratio=2.07; 95% CI: 1.02,4.20; p=0.043]. According to analysis of recorded data in an infertility treatment center in Iran, it is recommended to use spinal anesthesia instead of general anesthesia for oocyte retrieval to achieve successful in-vitro fertilization outcome. This can be studied and investigated further via a proper multicentric study in the country.
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Objective [s]: This study was performed to translate and validatie the Persian version of Critical Care Family Needs Inventory [CCFNI] assessing family needs of admitted patients in the intensive care units and to determine its validation
Methods: After translation qualitative face validity and content validity was established for the questionnaire. In order to evaluate the construct validity, known-groups comparison [nonsurgical versus surgical patients] was performed and to determine its differential validity, intensive care unit were compared with the conventional wards using independent-sample t -test. The internal consistency [Cronbach's alpha coefficients] were used to assess the scale reliability. 150 family members of patients in intensive care units and 150 patients' family members in general medical and surgical wards participated in this study
Results: Significant differences were found between surgical and nonsurgical patients' family [p=0.03] as well as the intensive care unit and conventional wards [p=0.007]. There were significant positive correlations between all scale dimensions [0.684
Conclusion: The findings confirmed that the Iranian version of Critical Care Family Need Inventory is a valid measure for assessing family needs of patients admitted to intensive care units
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In the present research, the association between C-reactive protein [CRP] and high-density lipoprotein of cholesterol [HDL-C] is studied among healthy adults in Tehran city. It is performed as a cross-sectional study using data of adults with age 18 and more enrolled in the first phase of the "Evaluation of novel risk factors of NCD" project in the Research Institute for Endocrine Sciences [Tehran, Iran] in 2001. Analyses were done by logistic regression models using crude and adjusted odds ratio [OR] to demonstrate the associations between CRP and HDL-C regarding their age, gender, body mass index and smoking status as underlying variables. To get final reduced logistic model we used backward elimination strategy with likelihood ratio test. Based on the findings of analysis on data of 126 men and 208 women, it was reported a significant association between blood concentration of CRP and HDL-C [P<0.001]. Logistic regression analysis revealed that increasing the concentration of CRP to 0.2 mg/l and more in serum, increased the likelihood of decreasing the serum concentration of HDL-C to 40 and 50 mg/dl and less about two folds in men and women respectively [adjusted OR: 2.25, 95% CI: 1.49-3.41]. In apparently healthy adults from Tehran city, independent of age, sex, body mass index, blood pressure, fasting blood sugar, and smoking, serum concentrations of CRP and HDL-C are reversely associated while both of them are considered as independent factors related with cardiovascular disorders and complications
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The aim of the study was to evaluate potential risk factors of children mortality between 1-59 months of age. This nested case-control study was conducted among children born from June 1999 to March 2009 in rural areas of Shahroud, located in the central region of Iran using health care visit reports and follow-up data available in household health records. Mortality was significantly associated with breastfeeding duration [OR: 0.87, 95% CI: 0.81-0.93], total health care visits [OR: 0.90, 95% CI: 0.83-0.98] and low birth weight [LBW] [OR: 7.38, 95% CI: 1.37-39.67]. In our study, a longer breastfeeding period and more frequent health care visits were two important protective factors, while LBW was an important risk factor for 1-59 month child mortality. It seems, that complex and multiple factors may be involved in mortality of under 5-year-old children, so combined efforts would be necessary to improve child health indicators
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Thalassaemia is one of the most common Mendelian disorders in Mediterranean area. Iran has about 26,000 Thalassaemic patients, so it is one of the most affected countries. The aim of this study was to evaluate the screening program and cost analysis of Thalassaemia prevention program in West-Azerbaijan province of Iran. This study evaluated the efficacy of Health system's Thalassaemia prevention program with a sensitivity analysis for its costs. The second five years of the program was evaluated. The economic burden of Thalassaemia is determined by the birth prevalence of the affected infants and the cost that is accrued to treat the infected individuals and was compared with the total cost of screening the couples for thalassemia trait. The average incidence rate of major Thalassaemia was 19.8 per 100,000 live births and mean coverage rate of program was 74%. The rate of canceling the marriage among carrier couples was 53%. Cost analysis showed that the cost of screening and prenatal diagnosis program was much lower than the cost of treatment in potential thalassaemic patients. The prevention program of Thalassaemia including a premarital and pre-natal screening in west Azerbaijan province is demonstrated to be cost-effective. Taking some actions in order to increase the coverage of pre-marital screening, providing prenatal diagnosis in private and public sector, complete insurance coverage for the high-risk couples to perform the investigations more easily, were recommended