ABSTRACT
Purpose@#Hemorrhoids are the most common benign anorectal diseases. Mucopexy strengthens the anal canal mucosa, which can be performed alone or in combination with Doppler-guided hemorrhoidal artery ligation (DG-HAL). In this study, we compared the postoperative complications between simple mucopexy plus HAL with and without a Doppler guide. @*Methods@#This study was performed as a single-blinded randomized clinical trial. Patients referred to a tertiary colorectal referral clinic with grades 3 and 4 hemorrhoids who were candidates for surgical intervention entered the study. Thirty-six patients were randomly divided into 2 groups. Group A including 18 patients underwent mucopexy and DG-HAL and the other 18 patients (group B) underwent standard mucopexy and HAL without a Doppler guide. Postoperative pain score and the duration of oral analgesic consumption were recorded. Additionally, postoperative symptoms and complications were recorded and compared between the 2 methods. @*Results@#There was no significant difference between the 2 groups in terms of pain score and the duration of postoperative analgesic consumption as well as the incidence of postoperative complications. Besides, the primary grade of hemorrhoids was not significantly associated with recurrence, but there was a significant association between body mass index and Wexner score (WS) with recurrence. The mean WS of patients showed a significant decrease in both groups postoperatively. However, the rate of WS reduction was not remarkably different between the 2 groups. @*Conclusion@#Simple mucopexy with blind HAL (without Doppler guide) might be considered for the treatment of grades 3 and 4 hemorrhoids effectively.
ABSTRACT
Background: bromide is found naturally in groundwater and surface water. The rapid growth of industrial activities, drainage of surface runoff, and use of methyl bromide in pesticides has increased bromide discharge to the environment. Disinfection of water-containing bromide causes the creation of additional products of organo-halogenated that are considered cancer-causing agents. In this study, the effect and optimization of factors in removal of this ion was evaluated by using the nano-photocatalytic UV/ZnO process
Methods: this analytical study was conducted in a batch system by the phenol-red method. The test design was performed through the analysis model of multi-factor variance with 99 subjects, while the main, interactive, and reciprocal effects of variables, such as reaction time, catalyst concentration, bromide concentration, and pH at different levels of each factor, were analysed by using SPSS version 16
Results: the main, interactive, and reciprocal effects of factors were significant in three different levels with P < 0.001, and the optimal level of the factors reaction time, catalyst concentration, bromide concentration, and pH were 120 minutes, 0.5, 0.1, and 7 mg/L, respectively, by using the Schaffer test. The highest removal efficiency of 95% was obtained at least 91.56 and a maximum of 94.76% was obtained under optimal conditions of all factors
Conclusion: the results show that by optimization of factors, this process can be effectively used to remove bromide from aquatic environments
ABSTRACT
Aim: This study evaluated the frequency of C. difficile and CDAD in the ICU of Shahid Bahonhar Hospital, Kerman, Iran
Background: Clostridium difficile [C. difficile] is the most important antibiotic associated diarrhea agent in intensive care unit [ICU] patients. Based on its toxin producing ability, C .difficile is divided to toxigenic and non-toxigenic strains
Methods: A total of 233 diarrheal samples were collected from ICU patients. The samples were cultured on Clostridium difficile medium with 5% defibrinated sheep blood containing cycloserine [500 mg/L], cefoxitin [16 mg/L] and lysozyme [5mg/L]. The isolates were confirmed as C. difficile by polymerase chain reaction [PCR] of 16s rRNA gene and the presence of toxins genes [tcdA, tcdB, cdtA and cdtB] was also confirmed. Then, the toxin production of isolates was evaluated using ELISA
Results: C. difficile was isolated from 49 [21%] out of 233 samples. The total isolates fell into the A-/B-/CDT- [48.97%], A+/B- /CDT- [28%], A+/B+/CDT- [20.4%] and A+/B+/CDT+ [2%] types. Both types of C.difficile, A-/B-/CDT- and A+/B-/CDT-, which account for 77.5% of all isolates, were unable to produce the toxin [nontoxigenic]. On the other hand, A+/B+/CDT+ and A+/B+/CDT- [22.5%], were able to produce toxin or were toxigenic
Conclusion: The frequency of C. difficile was about 21% and only 22.4% of C. difficile isolates were able to produce toxins. It is expected that C. difficile A+/B+/CDT+- are toxigenic and related to C. difficile associated diarrhea [CDAD]. Additionally, about 4.7% of hospitalized patients in ICU suffered from CDAD, which is higher than the rates reported from industrialized countries. Notably, 28% of isolates were C. difficile A+/B-/CDT- which only carries tcdA genes without toxin production
ABSTRACT
Aim: This study aims to determine the serogroup distribution and molecular diagnosis, as well as antimicrobial resistance profiles among Shigella spp. isolated from patients with diarrhea in Kerman, southeast of Iran
Background: Shigella species are frequent cause of bacterial dysentery worldwide. Previous studies have been reported that S. sonnei and S. flexneri are the most prevalent serogroups in various parts of Iran
Patients and Methods: A total of 624 stool samples were randomly collected from patients with diarrhea from June 2013 to August 2014. Biochemical and serological characterizations were performed for identifying Shigella spp. In addition, the multiplex PCR assay was carried out for the detection and differentiation of three pathogenic Shigella spp. Antibiotic susceptibility testing was performed according to the Clinical Laboratory Standards Institute [CLSI] guidelines
Results: Fifty six [9%] Shigella strains were isolated from stool samples. The most common species were S. flexneri 31[55.4%], followed by S. sonnei 18[32.1%] and S. boydii 7[12.5%]. S. dysentery was not detected in the present study. All the isolates that identified by serological test as Shigella spp. were confirmed by the multiplex PCR method. The highest rate of resistance was observed for ampicillin and trimethoprim-sulphamethoxazole antibiotics with 52[92.9%] resistant, followed by tetracycline 44[78.6%] and cefotaxime 33[58.9%]. All Shigella isolates were susceptible to ciprofloxacin. A significant relationship was found between the Shigella species and cefotaxime resistance [p<0.05]
Conclusion: S. flexneri was found as the most prevalent serogroup causing shigellosis. The high rate of resistance to third-generation cephalosporins limits the treatment options available for the management of shigellosis in Kerman, Iran
ABSTRACT
Agricultural advancement and population growth have prompted increases in food supplies, and higher crop yields have been made possible through the application of fertilizers. Large quantities of livestock and poultry on farms, along with the accumulation of biomass and agricultural residues, can cause contamination of ground water resources and other water sanitation concerns in both developing and developed countries. Nitrate is mainly used as a fertilizer in agriculture, and because of its high solubility in water, it can create biological problems in the environment. High usage of nitrite in the food industry as a preservative, flavor enhancer, antioxidant, and color stabilizing agent can cause human exposure to this toxic compound. Nitrite is 10 times as toxic as nitrate in humans. Nitrate is converted to nitrite and nitrosamine compounds in the human stomach, which can lead to bladder cancer. In this review, sources of nitrate and nitrite exposure were investigated. Furthermore, the review evaluates standard levels of nitrate and nitrite in different foods, and acceptable daily doses of these compounds in various countries. Finally, we discuss valid methods of nitrate and nitrite identification and removal in foods
ABSTRACT
Breast cancer is the most common cancer in women that as a sudden event has profound effects on all aspects of patients' lives. Psychosocial interventions may play important roles in reducing anxiety and depression among breast-cancer survivors. Therefore, group training based on acceptance and commitment therapy may help women to cope better with their condition, and decrease their anxiety and depression. In a quasi-experimental study, 30 patients with breast cancer were selected by convenience sampling method and randomly assigned to 2 experimental and control groups. The experimental group attended acceptance and commitment training classes for 8 weeks continuously [each class lasting 90 minutes]. Participants in both the experimental and control groups completed Beck Anxiety Inventory [BAI] and Beck Depression Inventory [BHI-II] as a pretest and posttest. Analysis of Covariance was used as the statistical method. In acceptance and commitment group training, anxiety and depression significantly decreased [p<0/05]. These changes were not observed in the control group. The results showed that group training based on acceptance and commitment therapy is an effective method in reducing anxiety and depression. Hence psychological interventions can be used to reduce psychological difficulties of women with breast cancer
Subject(s)
Humans , Female , Anxiety , Depression , Acceptance and Commitment TherapyABSTRACT
The effect of severe soft tissue injury on the severity of hemorrhagic shock is still unknown. Therefore, the present study was aimed to determine hemodynamic and metabolic changes in traumatic/hemorrhagic shock in an animal model. Forty male rats were randomly divided into 4 equal groups including sham, hemorrhagic shock, soft tissue injury, and hemorrhagic shock + soft tissue injury groups. The changes in blood pressure, central venous pressure [CVP] level, acidity [pH], and base excess were dynamically monitored and com-paredsented. Mean arterial blood pressure decreased significantly in hemorrhagic shock [df: 12; F=10.9; p<0.001] and severe soft tissue injury + hemorrhagic shock [df: 12; F=11.7; p<0.001] groups 15 minutes and 5 minutes after injury, respectively. A similar trend was observed in CVP in severe soft tissue injury + hemorrhagic shock group [df: 12; F=8.9; p<0.001]. After 40 minutes, pH was significantly lower in hemorrhagic shock [df: 12; F=6.8; p=0.009] and severe soft tissue injury + hemorrhagic shock [df: 12; F=7.9; p=0.003] groups. Base excess changes during follow ups have a similar trend. [df: 12; F=11.3; p<0.001]. The results of this study have shown that the effect of hemorrhage on the decrease of mean arterial blood pressure, CVP, pH, and base excess is the same in the presence or absence of soft tissue injury
ABSTRACT
Breast cancer is the most incident cancer and the fifth cause of death due to malignancies among Iranian women. A strong breast cancer patients' sense of meaning and purpose in life appears to decrease anxiety in their life. The present study has investigated the effectiveness of group Logotherapy on the reduction of anxiety in women with breast cancer. The research was quasi-experimental with pre-test, post-test and control group. For this purpose, 30 patients with breast cancer were randomly divided into two experimental group and control group. Then, all patients completed the Beck Anxiety Inventory [BAI]. The experimental group received Logotherapy-based group counseling for eight sessions; however, the control group did not receive any specific training. In the end, both groups were tested again. After collecting the questionnaires, data was analyzed by the statistic software SPSS version 18 and using analysis of covariance. The research results showed that group Logotherapy was effective in reducing anxiety in women with breast cancer [p<0.005]. In other words, this intervention could reduce anxiety in the experimental group. The results suggest that in line with current medical treatment, psychosocial interventions can be used to reduce anxiety in the breast cancer patients
ABSTRACT
The administration of crystalloid fluids is considered as the first line treatment in management of trauma patients. Infusion of intravenous fluids leads to various changes in hemodynamic, metabolic and coagulation profiles of these patients. The present study attempted to survey some of these changes in patients with mild severity trauma following normal saline infusion. This study comprised 84 trauma patients with injury of mild severity in Shahid Rajaei Hospital, Shiraz, Iran, during 2010-2011. The coagulation and metabolic values of each patient were measured before and one and six hours after infusion of one liter normal saline. Then, the values of mentioned parameters on one and six hours after infusion were compared with baseline measures using repeated measures analysis of variance. Eighty four patients included in the present study [76% male]. Hemoglobin [Hb] [df: 2; F=32.7; p<0.001], hematocrit [Hct] [df: 2; F=30.7; p<0.001], white blood cells [WBC] [df: 2; F=10.6; p<0.001], and platelet count [df: 2; F=4.5; p=0.01] showed the decreasing pattern following infusion of one liter of normal saline. Coagulation markers were not affected during the time of study [p>0.05]. The values of blood urea nitrogen [BUN] showed statistically significant decreasing pattern [df: 2; F=5.6; p=0.007]. Pressure of carbon dioxide [PCO2] [df: 2; F=6.4; p=0.002], bicarbonate [HCO3] [df: 2; F=7.0; p=0.001], and base excess [BE] [df: 2; F=3.3; p=0.04] values showed a significant deteriorating changes following hydration therapy. It seems that, the infusion of one liter normal saline during one hour will cause a statistically significant decrease in Hb, Hct, WBC, platelet, BUN, BE, HCO3, and PCO2 in trauma patients with mild severity of injury and stable condition. The changes in, coagulation profiles, pH, PvO2, and electrolytes were not statistically remarkable
ABSTRACT
The aim of this study was to assess the etiological characteristics and visual outcomes of ocular trauma with more attention to eyelid laceration. In a cross-sectional study, 98 cases of isolated traumatic eyelid laceration were consecutively studied and its epidemiology, etiology and association with visual outcome were evaluated. The findings of this study could be used to develop healthcare related precautions and work place safety recommendations. Of the 98 patients included in the study, men exhibited a greater vulnerability and they were mostly aged around 29 years old. In terms of the place of trauma, 42 [42.8%] cases occurred in the street, 29 cases [29.6%] occurred at home, and 18 cases [18.4%] occurred at the workplace, while 5 cases [5.1%] happened in entertaining environments like parks. For 3 patients [3%], the incident took place at a public pathway, and in 1 patient [1%], the case occurred at school. As the most common cause of trauma, 41 patients [41.8%] had an object hit their eyes. In addition, assaults were a major cause of injury. The right eye and the upper lid were also the most common sites of injuries. Although no blindness occurred due to trauma causing eyelid laceration, the visual outcomes were correlated with severity of the incident defined based on the presence of open globe injuries. This study could possibly highlight the risk factors of eyelid laceration and provide the healthcare community with the essential recommendations regarding the safety precautions in dangerous settings, including daily/routine work places
Subject(s)
Humans , Female , Male , Lacerations/etiology , Cross-Sectional Studies , Lacerations/epidemiologyABSTRACT
Oxycodone is widely used to alleviate moderate-to severe acute pain, It is an effective analgesic for many types of pain, and is especially useful for paroxysmal spontaneous pain, steady pain, allodynia associated with postherpetic neuralgia, and it is also increasingly used in the management of cancer-related and chronic pain, oxycodone has been found to improve the quality of life of patients with many types of pain. In 2011, following chemical and physical manipulation, an extended-release form of oxycodone was developed in order to maintain its rate-controlling mechanism. This new formulation significantly improved analgesia among patients with moderate-to-severe chronic osteoarthritis pain with an adverse event profile similar to that of other opioids. The long-term safety and efficacy of extended-release form of oxycodone in relieving moderate-to-severe chronic pain has been demonstrated. In this study we discussed about different aspects of this drug in managing of various types of pain
ABSTRACT
To assess the effect of processes of change on resistance skills against substance abuse among petrochemical workers in Assaluyeh Plant in Iran. This was an experimental study [randomized intervention trial]. In all 181 workers of petrochemical company in Assaluyeh were enterd into the study [90 participants in intervention group and 91 participants in control group]. Data were collected by a questionnaire that was designed and validated by the researchers based on the Trans Theoretical Model [TTM]. Both groups were interviewed before the intervention, based on which the educational needs were identified. One of the diagnostic surveys showed lack of resistance skills against substance abuse that required further education. To meet this requirement a TTM based education for intervention was applied. The study showed significant improvement in most of the resistance skills among the intervention group, while both groups showed no significant differences in use of processes of change before the intervention [except for construct self revolution, that was higher in control group]. The results after the intervention showed that intervention group had used all elements of processes of change [except dramatic relict]. This study showed that processes of change in the TTM would lead to improved knowledge, attitude, self efficacy and self control. It also confirmed that the training materials based on the trans theoretical model can develop resistance skills against substance abuse that will ultimately result in a better health among the workers and could create a drug free workplace [safe workplace]. Based on these findings the investigators recommend that all studies on health related change behavior should continually use the behavioral theories and models