Analysis of polychlorinated biphenyls (PCBs) in dairy products by modified QuEChERS/GC-QqQ-MS/MS method: A risk assessment study.

Polychlorinated biphenyls (PCBs) are harmful chemicals that are persistent in the environment and can accumulate in the food chain. The purpose of the present research was to assess non-dioxin-like polychlorinated biphenyls (NDL-PCBs) in some dairy products (yogurt, doogh, and kashk) using modified QuEChERS (Quick, Easy, Cheap, Effective, Rugged, and Safe) technique and gas chromatography-triple-quadrupole mass spectrometry (GC-QqQ-MS/MS) method and risk assessment study. The LOQs (limit of quantifications), LODs (limit of detections), recovery, and RSD for the PCB analytes were 0.180-0.360, 0.06-0.12 ng/g fat, 97.45-102.63%, and 6.33-8.86%, respectively. The results revealed that the mean concentrations of Æ©6-NDL-PCBs in samples were 15.17 ± 3.44 ng/g fat, which was lower than the standard level established by European Union (EU, 40 ng/g fat). The maximum mean level was PCB 180 (9.98 ± 2.04 ng/g fat) and the minimum mean level of PCBs in samples was PCB 28 (0.09 ± 0.06 ng/g fat). Also, results showed that kashk samples had a maximum mean level of 6-NDL-PCBs (18.66 ± 2.42 ng/g fat) and doogh samples had a minimum mean level of 6-NDL-PCBs (12.21 ± 2.22 ng/g fat). The mean level of 6-NDL-PCBs in yogurt samples was 14.65 ± 2.02 ng/g fat. The heat map results showed the correlation between the spectral indices of 6-NDL-PCBs in different dairy products. According to the Monte Carlo method, risk assessment was done using calculating the Estimated Daily Intake (EDI) and Incremental Life Cancer Risk (ILCR). The EDI values of 6 NDL-PCBs based on the 95th percentile in yogurt, doogh, and kashk were 14.3, 1.49, and 0.5 ng/kg.day, respectively. Considering that the contaminant level in the samples is lower than the EU limit, it can be concluded that dietary exposure to 6 NDL-PCBs may not pose a risk to the health of consumers.

Hospital wastewater treatment methods and its impact on human health and environments.

The scientific development and economic advances have led to the identification of many pathogenic agents in hospital effluents. Hospital wastewaters are qualitatively similar to municipal wastewaters, with the difference that these wastewaters contain toxic and infectious substances and compounds that can be dangerous for the health of the environment, employees of these centers, and the entire community. Therefore, in the last few years, it has been emphasized that all hospitals and medical and health centers should have a treatment facility for their produced wastewater so that the health of the society and people is not threatened. An issue that is not paid attention to has become one of the environmental problems and concerns of the world today. The present study focused on the investigate hospital wastewater treatment methods and its impact on human health and the environment. In this narrative study, the first literature search was performed with four hundred and twenty-three articles were retrieved based on PubMed, Elsevier, Web of science, Spring, and Google Scholar databases. The results of this study showed that wastewater from hospitals and medical centers can play a significant impress in polluting soil and aquatic environments and spreading infectious diseases. According to the mentioned contents, collection and treatment of hospital wastewater is essential. In addition, if hospital wastewater enters the wastewater collection network without knowing its characteristics or with incomplete treatment and finally enters the municipal wastewater treatment plant. It causes many problems, including disturbing the balance of the biological system of the treatment plant. Purification and disposal of hospital wastewater is considered a vital action based on environmental standards. The results of this study also showed that the treatment methods of this type of hospital wastewater can play a significant role in reducing the spread of diseases caused by hospital wastewater treatment, including infectious diseases. The results of this study can be very useful for politicians, the managers of the Ministry of Energy and Health and the Environmental Organization in choosing the appropriate methods and process to reduce hospital wastewater and increase the efficiency of hospital wastewater treatment plants.

The Use of Feature Tracking Technique for the Quantification of Ventricular Strain Pattern in Patients with Ebstein's Anomaly: A Case-Control Study.

Background: Ebstein's anomaly (EA) is a congenital heart disorder characterized by abnormal function of the tricuspid valve. There are several ways to study tissue composition using magnetic resonance imaging (MRI). One of the most accurate methods is strain calculation using the feature tracking (FT) technique. Due to the novelty of the FT technique in cardiac magnetic resonance (CMR) imaging, there is a lack of comprehensive guidelines to conduct FT-MRI and to present a quantitative report. The current study is aimed to evaluate the FT technique in EA patients and to compare the obtained numerical values with those of healthy individuals. Methods: A total of 33 individuals were enrolled in a study conducted in 2018-2019 at Shahid Rajaei Hospital, Tehran, Iran. Radial, longitudinal, and circumferential strain patterns of the left and right ventricles were determined in both the patients and the controls using the FT technique. Data were analyzed using SPSS software, version 22.0. Results: The results showed a significantly lower left ventricular (LV) radial strain in EA patients compared to the control group (P=0.002). In addition, the right ventricular (RV) global longitudinal strain (GLS) in EA patients was significantly lower than in the controls (P=0.001). Other parameters (LV global longitudinal strain, RV radial strain, LV circumferential strain, and RV circumferential strain) did not differ significantly between the two groups. Conclusion: Determination of strain patterns using cardiac MRI is a promising method for the diagnosis of EA. Markers such as LV longitudinal strain and RV-GLS are the most suitable parameters for the early diagnosis of heart dysfunction.

Probabilistic Health Risk Assessment of Trace Elements in Baby Food and Milk Powder Using ICP-OES Method.

This study was conducted to evaluate the concentration and health risk of trace elements in milk powder and baby food samples marketed in Iran using inductive couple plasma/optical emission spectroscopy (ICP-OES) method. The limit of detection (LOD) and limit of quantification (LOQ) were ranged from 1.80 × 10-5 to 2.17 × 10-3 and 6.00 × 10-5 to 7.22 × 10-3 mg/kg, respectively, with recoveries ranged from 92 to 105%. Zinc (Zn) was found in a high mean concentration (8.49 × 10-1 ± 3.93 × 10-2 mg/kg) in milk powder, and iron (Fe) was found in the highest mean concentration (2.04 ± 3.61 × 10-2 mg/kg) in baby food. The Monte Carlo simulation results for the infants revealed that the rank order of the hazard quotient (HQ) index was mercury (Hg) > nickel (Ni) > arsenic (As) > cadmium (Cd) > aluminum (Al). Further, the result of non-carcinogenic and probability of carcinogenic risk was lower than the limits of safe risk (HQ > 1 and cancer risk (CR) > 1 × 10-4). In conclusion, the toxic elements content in the tested products was sufficiently low, and all of the milk powder and baby food sold in Iran could be considered safe for infants and children.

Monitoring of polycyclic aromatic hydrocarbons and probabilistic health risk assessment in yogurt and butter in Iran.

This study was conducted to determine the polycyclic aromatic hydrocarbons (PAHs) levels and health risk of yogurt and butter samples collected from Tehran using MSPE/GC-MS (magnetic solid-phase extraction/gas chromatography-mass spectrometry). The results revealed that the limit of detection (LOD) and limit of quantification (LOQ) were ranged from 0.040 to 0.060 and 0.121 to 0.181 µg/kg, respectively; with recoveries ranged from 86.1% to 100.3%. The highest mean of total PAHs was higher in butter (6.87 ± 1.21 µg/kg) than in yogurt (3.82 ± 0.54 µg/kg). The level of benzo (a)pyrene in all samples was lower than of standard levels of the European Union (EU). The highest value of all PAHs in samples was recorded in the winter season and also in the expiration date. The percentile 95% of the total hazard quotient (THQ) due to the consumption of yogurt and butter recorded 1.33E-02 and 3.69E-04 in adults and 6.12E-02 and 1.75E-03 in children, respectively. The percentile of 95% incremental lifetime of cancer risk (ILCR) due to the ingestion of yogurt and butter recorded 1.17E-06 and 2.02E-08 for adults and 5.51E-06 and 9.46E-08 for children, respectively. The rank order of 7 PAHs in adult and children based on P95% Hazard Quotient (HQ) in all samples was benzo(a)anthracene (BaA) > pyrene (P) > fluorene (F) > fluoranthene (Fl) > acenaphthylene (Ace) > anthracene (A) > naphthalene (NA). According to the Monte Carlo Simulation (MCS) method, health-risk assessment showed that children and adults are not at significant health risk.

Trends in burden of chronic obstructive pulmonary disease in Iran, 1995-2015: findings from the global burden of disease study.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disorder that progresses over time, and currently it is the fourth leading cause of death across the globe. The World Health Organization (WHO) predicts that the disease will become the third leading cause of death by 2030. The present study aimed to assess the burden trends of COPD in Iran by estimating the disability-adjusted life years (DALYs) from 1995 to 2015. METHODS: Data were retrospectively collected as the Global Burden of Disease (GBD) from 1995 to 2015 and published by the Institute for Health Metrics and Evaluation. We applied DALYs, incidence and prevalence rate to report the burden of COPD in Iran. To assess the statistical significance according to trend, the Cochran-Armitage test was applied. Additionally, the t-test was used to analyze the DALYs number by gender and Onaway ANOVA by age groups at a significance level set at P  < 0.05. RESULTS: From 1995 to 2015, there were approximately 1.1 million DALYs attributable to COPD in Iran. In both genders and at all ages, the number of DALYs increased significantly from 176,224 in 1995 to 253,618 in 2015. The incidence and prevalence rate were 76.65 and 1491.37 per 100,000 population, respectively in both genders in 2015 in Iran. It is noticeable that the number of deaths during the study years, 1995 to 2015, was 39,064. This study showed that the COPD burden was significantly different by age groups and gender. CONCLUSIONS: COPD is still a public health problem in Iran and has an increasing trend. The majority of DALYs were due to the years of life lost as a result of premature death (YLLs), indicating that prevention and early detection, especially in the age groups of 15 to 70 years, should be considered.

Frontal fibrosing alopecia: An update on the hypothesis of pathogenesis and treatment.

Frontal fibrosing alopecia (FFA) is a relatively new scarring alopecia that is considered a variant of lichen planopilaris (LPP) with no recognized promising treatments. In this study, we tried to clarify the underlying signaling pathways and their roles in the pathogenesis and progression of FFA. Because of several differences in clinical manifestations, response to treatments, and pathological findings, these two conditions could be differentiated from each other. Taking into account the already discussed signaling pathways and involved players such as T cells, mast cells, and sebaceous glands, different possible therapeutic options could be suggested. In addition to treatments supported by clinical evidence, such as 5 alpha-reductase inhibitors, topical calcineurin inhibitors, hydroxychloroquine, peroxisome proliferator-activated receptor gamma agonists, and oral retinoid agents, various other treatment strategies and drugs, such as phototherapy, Janus kinase inhibitors, dehydroepiandrosterone, sirolimus, cetirizine, and rituximab, could be suggested to mitigate disease progression. Of course, such lines of treatment need further evaluation in clinical trials.

Lichen planopilaris: retrospective study on the characteristics and treatment of 291 patients.

Lichen planopilaris (LPP) is an immune-mediated cicatricial alopecia. The main clinical presentations of LPP include classic form, frontal fibrosing alopecia (FFA), and Graham-Little-Piccardi-Lassueur syndrome (GLPLS). We reviewed medical records of all 291 patients diagnosied with LPP from 2006 to 2017 in Department of Dermatology, Tehran University of Medical Sciences. LPP was more common in women than men. Lichen planus (LP) was seen in 59 of patients (20.3%). Parietal lesions (69.75%), frontal (27.14%), occipital (23.71%), and temporal (21.64%) were frequently seen in LPP patients. However, trunk hair involvement (15.4% vs. 2.7%; p = .011) and eyebrow involvement (57.7% vs. 0%; p < .0001) were high in FFA patients. The response rates of cyclosporine (CSP) and methotrexate (MTX) were highest, 100% and 85%, respectively. Those treated with CSP achieved partial remission (PR) and complete remission (CR) faster than MTX-treated group. Moreover, MTX was more effective than MMF but not different in time to reach PR (p = .23) or CR (p = .56). However, CSP and MTX were less safe compared with MMF. 5-alpha reductase inhibitors, systemic retinoids (isotretinoin) or their combination were the most effective therapeutic options for FFA patients.

Method development for determination of migrated phthalate acid esters from polyethylene terephthalate (PET) packaging into traditional Iranian drinking beverage (Doogh) samples: a novel approach of MSPE-GC/MS technique.

In the current study, a novel magnetic solid phase extraction (MSPE) technique combined with a gas chromatography/mass spectroscopy (GC/MS) was developed to determine the phthalate ester content of bottled Doogh samples. Doogh is a yogurt-based drinking beverage, which is frequently consumed in Middle East and Balkans. It is produced by stirring yogurt in Chern separation machine and consists of substances such as water, yogurt, and salt in addition to aqueous extracts of native herbs. The magnetic multi-walled carbon nanotubes (MWCNT-Fe3O4) were used as adsorbents of phthalate acid esters (PAEs) due to a superior adsorption capability of hydrophobic compounds. In this context, the quantity of the extractable migrated phthalate esters (dibutyl phthalate (DBP), dimethyl phthalate (DMP), butyl benzyl phthalate (BBP), diethyl phthalate (DEP), di-N-octyl phthalate (DNOP), and bis (2-ethylhexyl) phthalate (DEHP)) from polyethylene terephthalate (PET) bottles into Doogh samples was measured. The correlation between the concentration of migrated PAEs and some factors such as the type of Doogh (gaseous and without gas), difference in brand (five brands), volume (1500 and 300 mL), and the storage time also was investigated. The migration level into Doogh samples was increased by incorporating of gas as well as increasing the volume of PET bottles. Also, with elaborating of storage time, the migration of some phthalates such as DEHP (the mean from 2419.85 ng L-1 in the first week to 2716.15 ng L-1 in the second month), DEP, and total phthalate was increased. However, no significant difference in concentrations of migrated phthalate esters among different examined brands was noted. Finally, the concentration of migrated PAEs from bottle into all the examined Doogh samples was below the defined standards by EPA; 6 µg/L for DEHP in drinking water. Graphical abstract ᅟ.

Time-dependent antibacterial effects of Aloe vera and Zataria multiflora plant essential oils compared to calcium hydroxide in teeth infected with Enterococcus faecalis.

AIM: In the present in vitro study, we investigated the time-related antimicrobial efficacy of Aloe vera and Zataria multiflora (Z. multiflora) plant essential oils compared to calcium hydroxide ([Ca[OH]2 ) to eliminate Enterococcus faecalis (E. faecalis) from root canals. METHODS: A new strain of E. faecalis (Enterococcus spp. AGH04) was isolated from a previously root-filled tooth with persistent apical periodontitis. The 16S rRNA sequence was analyzed and deposited in GeneBank under accession number KF465681. A total of 108 extracted human single-rooted teeth were contaminated with this bacterial strain and treated with Aloe vera essential oil, Z. multiflora essential oil, and Ca(OH)2 for 1, 7, and 14 days. Gas chromatography-mass spectrometry (GC-MS) was used to determine the chemical composition of the oils. The percentage reduction from initial c.f.u./mL counts were calculated and analyzed. RESULTS: Carvacrol, thymol, and linalool were the main constituents of both essential oils. The c.f.u./mL count reductions significantly increased for all three medicaments when the contact time was extended. A statistically-significant difference was observed between the medicaments after 1 and 7 days, but there was no significant difference after 14 days. CONCLUSIONS: Both medicinal herbs showed equal antimicrobial efficiency against E. faecalis, comparable to Ca(OH)2 for the prolonged contact time of 14 days.

Fatal paraneoplastic pemphigus after removal of Castleman's disease in a child.

Paraneoplastic pemphigus (PNP) is seen most frequently in the setting of Castleman's disease (CD) in childhood. We report herein a 10-year-old girl with PNP appearing a few weeks after resection of a recurrent CD. Despite improvement in skin and mucosal lesions with prednisolone and azathioprine, she had severe bronchiolitis obliterans and died from respiratory failure a few months later.

Comparison of topical 8-methoxypsoralen and narrowband ultraviolet B with narrowband ultraviolet B alone in treatment-resistant sites in plaque-type psoriasis: a placebo-controlled study.

BACKGROUND: Combination of topical methoxsalen and narrowband ultraviolet B (NBUVB) was shown to be more effective than NBUVB alone in treating plaque-type psoriasis. OBJECTIVE: To find out whether topical methoxsalen and NBUVB had any benefit in induction of remission on treatment-resistant plaques of psoriasis on the legs in comparison with NBUVB alone. METHODS: Ten patients were included. Two symmetric lesions with similar Psoriasis Severity Index score on the lower legs were randomly assigned to be treated with cold cream as placebo or 0.1% 8-methoxypsoralen (8MOP) cream 15 min before phototherapy with NBUVB. Phototherapy was given three times per week for up to three months. Severity scores were recorded each week and side effects were observed before each session. RESULTS: Significant decrease in the severity score was observed in both groups (P-value < 0.001), but none of the lesions cleared completely at the end of the study. The decrease of the score in the 8MOP arm was greater than the control arm; however, the difference was not significant. The only side effect was pigmentation that occurred in all of the 8MOP-treated patients after 2 weeks. CONCLUSION: We could not confirm any significant benefit of topical methoxsalen and NBUVB in comparison to NBUVB alone in treating resistant plaques of psoriasis on the legs.

Serum immunoglobulin levels in splenectomized and non- splenectomized patients with major Beta-thalassemia.

OBJECTIVE: Thalassemia is a common disease in many countries, in which several complications such as infections can occur. Although aberration in the function of the immune system could be a reason for such complication, a little is known about the status of humoral immune system in major beta thalassemia. In this study we measured serum immunoglobulins level in a group of patients with major beta thalassemia. METHODS: Ninety nine patients with major beta thalassemia were enrolled in this study divided into two groups of splenctomized and not splenctomized patients. Serum IgG, IgM and IgA levels of these patients were measured and analyzed. FINDINGS: Serum mean levels of IgG and IgM in patients of all ages in both groups were normal. The mean serum IgA level in the group of not splenectomized patients aged less than five years as well as in the splenectomized patients aged more than twenty years was increased. However, it was normal in other age groups. CONCLUSION: Although this study could not show any defect in the humoral immune system, evaluation of immunoglobulins could be useful to understand the relmarkable high rate of infection in the patients with major beta thalassemia.