Chronic fatigue syndrome post-COVID-19: triple-blind randomised clinical trial of Astragalus root extract.

OBJECTIVE: This study aimed to evaluate the effect of Astragalus root extract on nurses suffering from post-COVID-19 chronic fatigue syndrome. MATERIALS AND METHODS: The study was designed as a triple-blind, randomised, controlled trial in Iran in 2023. 64 chronic fatigue syndrome nurses were randomly assigned to one of two groups: an intervention group (n=32) that received Astragalus root extract (500 mg two times per day) or a control group (n=32) that received a placebo. Changes in chronic fatigue syndrome scores were measured before to, at the end of and 1 month after the intervention. Data were analysed using descriptive and analytical statistics (T-tests, χ2, analysis of variances, Cochran's Q tests, McNemar and generalised estimating equations). RESULTS: In comparison to before, chronic fatigue prevalence decreased statistically significantly at the end of the intervention group (13.8%) and 1 month later (17.2%). Further, the frequency differed between before and after (p=0.0001) and 1 month later (p=0.0001). In the control group, chronic fatigue was statistically significantly different before and after the intervention (72.2%; p=0.003). Having an underlying disease (B=0.84, OR=2.33; p=0.04) and being in the control group (B=2.15, OR=12.36; p=0.01) increased the risk of chronic fatigue, whereas increasing the length of time decreased it (B=-0.67, OR=0.50; p=0.0001). CONCLUSION: Astragalus root extract has been shown to reduce chronic fatigue in nurses. Therefore, this herbal extract can be used to reduce the incidence and treatment of chronic fatigue in nurses.

Nurses' motivation for performing cardiopulmonary resuscitation: a cross-sectional study.

BACKGROUND: Nurse motivation can have a significant impact on the quality of cardiopulmonary resuscitation and the patients' survival. Therefore, the present study aimed to examine nurses' motivation for performing cardiopulmonary resuscitation. METHODS: This cross-sectional study focused on 217 nurses in a teaching hospital in Iran, in 2023. A random sample of nurses was selected from four hospital departments (emergency, critical care, medical, and surgery). These nurses completed the demographic information and motivation for cardiopulmonary resuscitation questionnaires. The data were analyzed using Mann-Whitney, Spearman coefficients, and Kruskal-Wallis and multiple linear regression tests. RESULTS: The mean score of the dimension of the feeling of achievement (4.10 ± 0.50) was high in the nurses' motivation for performing cardiopulmonary resuscitation. There were more motivational factors in the emergency department compared to the other departments in terms of the feeling of achievement, high chance of success, low chances of success, recognition and appreciation, perceived importance, and beliefs (p < 0.05). The nurses who had participated in cardiopulmonary resuscitation workshops and had a bachelor's degree had a higher mean score in the dimension of perceived importance (p < 0.05). The correlation coefficient showed that there was a significant negative correlation between the nurses' frequency of participation in cardiopulmonary resuscitation and their motivation scores in the dimensions of the feeling of achievement(r=-0.170), low chances of success(r=-0.183), perceived importance (r = -0.302), and beliefs (r = -0.250; p < 0.05). The department variable predicted the motivation score in the dimensions of feeling of achievement, high chance of success, low chance of success, perceived importance, and beliefs. The sex variable predicted the motivation score in the dimensions of facilitator of resuscitation and high chance of success. Besides, the variable of years of membership in the CPR team predicted the motivation score in the feeling of achievement and high chance of success (p < 0.05). CONCLUSION: Nurses would be more motivated to perform a quality cardiopulmonary resuscitation if they had a feeling of success. The nurses' motivation was affected by certain factors such as their department, sex, education level, years of membership in CPR team, number of participation in CPR, and participation in educational workshops.

Pain and sleep after open-heart surgery-inhalation peppermint essence: double-blind randomized clinical trial.

OBJECTIVE: The aim of this study was to determine the effect of inhaling peppermint essence on pain relief and sleep quality after open-heart surgery. METHODS: In a double-blind randomised clinical trial carried out in Iran in 2020, 64 cardiac patients were selected by convenience sampling and randomly allocated to aromatherapy (n=32) and placebo (n=32) groups. The aromatherapy and control groups received inhaled aromatherapy using peppermint essence and distilled water, respectively. Data gathering tools were the Numeric Pain Rating Scale and St Mary's Hospital Sleep Questionnaire. Data were analysed using an independent t-test, χ2 test, Mann-Whitney U test and generalised estimating equation analysis. RESULTS: The mean severity of pain in the aromatherapy and placebo groups was 3.22±0.88 and 4.56±0.90, respectively, which was a statistically significant difference (p=0.0001). The mean sleep scores after the intervention on day 1 were 20.10±4.90 and 25.76±6.36 in the aromatherapy and placebo groups, respectively, and 18.63±5.56 and 22.62±5.69, respectively, on day 2. The difference between the two groups was statistically significantly different after the intervention in terms of sleep quality (p<0.05). CONCLUSION: Aromatherapy attenuated pain and improved sleep quality after open-heart surgery. Peppermint essence aromatherapy is therefore recommended after surgery.

Risk Factors for In-Hospital Mortality among Patients with Coronavirus-19 in Isfahan City, Iran.

Background: The aim of the study is to explore the risk factors of mortality for hospitalized patients in three designated hospitals in Isfahan province. Materials and Methods: This retrospective cohort study was conducted on all positive coronavirus disease (COVID)-19 patients admitted to Khorshid, Isabn Maryam, and Amin hospitals in Isfahan province. The demographic, clinical, laboratory, and outcome data of patients who were died or discharged from February 24, 2020, to April 18, 2020, were extracted from patient's medical records. Results: Overall 1044 COVID-19 patients were included in this analysis. Based on the findings of this study, older age (≥65 years) (adjusted hazard ratio [aHR]: 2.06; 95% confidence interval [CI]: 1.13-3.76), chronic obstructive pulmonary disease (COPD) history (aHR: 2.52; 95% CI: 1.09-5.83), white blood cell (WBC) counts more than 10 × 10^3/L (aHR: 3.05; 95% CI: 1.42-6.55), Hb level <13 gr/L (aHR: 2.82; 95% CI: 1.34-5.93), bilateral pulmonary infiltrates (aHR: 2.02; 95% CI: 1.12-3.64) at admission, development of acute respiratory distress syndrome (ARDS) (aHR: 1.87; 95% CI: 1.01-3.47), and intensive care unit (ICU) admission (aHR: 2.09; 95% CI: 1.04-4.18) during hospitalization were risk factors for in-hospital mortality in patients with COVID-19. Conclusions: Multiple factors were found related to the severity and death among COVID-19 patients. We were found that older age (≥65 years) with COPD history, high level of WBC, low level of Hb (<13 g/L), bilateral pulmonary infiltrates at admission, development of ARDS, and ICU admission during hospitalization were identified as risk factors of death among COVID-19 patients. More related studies are needed in the future.

The Association Between Heavy Metals Exposure and Sex Hormones: a Systematic Review on Current Evidence.

The general population is voluntarily or unintentionally exposed to heavy metals through ingestion of food, polluted water, or contact with soil, dust, or polluted air. A number of metals are considered as endocrine disruptors and can alter the level of reproductive hormones. This study aims to systematically review the epidemiological studies on the association between heavy metals exposure and sex hormones level. We conducted a systematic search from available databases, including PubMed, Clarivate Web of Science, Scopus, Google Scholar, and Cochrane Collaboration, until April 2021. The relevant studies were selected, and two reviewers conducted the quality assessment. Then, data were extracted based on the inclusion criteria. We identified nine articles related to the association between heavy metals exposure and sex hormones level. We summarized the relevant information. Due to the diversity of metals and the variety of sex hormones, the effect of exposure on hormones level was not clear; however in most studies, at least for one metal, a significant association (inverse or positive) was observed between metals exposure and hormones level. Heavy metals exposure may potentially alter sex hormone levels; however, further research is needed to evaluate the impact of this association.

Sleep disorders during pregnancy and postpartum depression: A systematic review and meta-analysis.

BACKGROUND: Postpartum depression (PPD) is one of the most important mental disorders in recent years. However, the effects of prenatal sleep disorders on the development of PPD among pregnant women have not been elucidated. This review aims to provide a summary of the literature evaluating the relation between sleep disorders during pregnancy and PPD. METHOD: A systematic literature search was conducted in PubMed, Web of Science, Scopus, Google Scholar, and Embase up to September 2020. All observational studies (cross-sectional, case-control, and cohort) and studies that assessed the association between sleep disorders during pregnancy and PPD were included. Total sample of 36,873 women from 13 studies was entered to meta-analysis. An aggregate effect size estimate (odds ratio) was generated using the comprehensive meta-analysis software. A random effects model was set a priori. Heterogeneity and publication bias were examined using the standard meta-analytic approaches. RESULT: We found maternal sleep disorder increased odds of PPD (point estimate, 3.300; 95% confidence interval [CI], 2.136-5.098; p < .001; n = 13). However, there was significant heterogeneity (Q, 131.250; df, 12; p < .001; I2 , 90.857%). The estimated effect size was significant for all categorical studies. According to meta-regression, no moderating factor (age and publication year) significantly mediated the estimated effect size. CONCLUSION: We found a significant relationship between sleep disturbances during pregnancy and PPD. Women with sleep disorders are at an increased risk of developing PPD, which warrants screening pregnant mothers for sleep disturbances. Also, we found that the increasing age in pregnancy was associated with increased risk of PPD.

The effect of aromatherapy with peppermint essential oil on nausea and vomiting after cardiac surgery: A randomized clinical trial.

Background Postoperative nausea and vomiting are common in patients who underwent cardiac surgery. This study aimed to examine the effect of peppermint essential oil inhalation on the postoperative nausea and vomiting after cardiac surgery. Methods In this clinical trial study, 60 cardiac surgery patients were divided into control and intervention groups. The intervention group underwent nebulizer aromatherapy with peppermint essential oil before the endotracheal tube was removed after surgery. Patients' nausea and vomiting were then assessed through a checklist. The independent-samples t-test, chi-square, and Generalized estimating equation were used for data analysis. Results Totally 85.7% of the patients undergone coronary artery bypass graft surgery. The two groups did not significantly differ in terms of their baseline demographic and clinical variables (P > 0.05). Significant differences were found between the intervention and control groups in terms of the frequency of nausea (0.63 ± 0.81 vs. 1.46 ± 1.21), its duration (3.78 ± 5.09 vs. 7.97 ± 5.55 min), and severity (2.43 ± 2.84 vs. 4.61 ± 2.85), and in the frequency of vomiting episodes (0.17 ±.46 vs. 0.73 ±.60) in the first four hours after extubation (P < 0.05). Conclusion: Peppermint essential oil inhalation has beneficial effects on reducing nausea and vomiting after open-heart surgery. Using peppermint essential oil inhalation for managing postoperative nausea and vomiting is recommended.

A comprehensive computational study and simulation of innovative zwitterionic materials for enhanced poly (vinylidene fluoride) membrane hydrophilicity.

The goal of this study is to design a novel zwitterionic (ZW)-poly (vinylidene fluoride) (PVDF) membrane with high hydrophilicity potential using the pair interaction energy decomposition analysis (PIEDA) integrated with fragment molecular orbital (FMO) method. In addition, the differential hydration and efficiency of salt rejection of the novel zwitterion and original PVDF were investigated using molecular dynamics simulation (MDS). Within this study computational methods were applied to investigate the performance of zwitterionic moieties derived from three different anionic groups in the ZW head, specifically, carboxylate, sulfonate, and phosphate. This approach was used in addition to the inclusion of a linker between the ZW head and the PVDF backbone, such as trimethyl ammonium groups and hydroxyl group for an increase in PVDF membrane hydrophilicity. The quantum chemical calculations were employed to examine the hydration structure of moieties, the number of hydrogen bonding instances, and hydration free energy. The interactions between the ZW moieties on PVDF membranes with water molecules confirmed that they depended on the charged groups and the chemical groups between charged groups. The results pointed to differences in hydrophilicity, membrane water uptake due to their structural properties depending on the types of anionic groups involved, polar groups between charged groups, and the hydrophilic groups as a linker between charged groups of the zwitterions to the PVDF polymer backbone. The double zwitterionic PMAL®-C8-CB-OH-SB-PVDF was formed through protonated carboxyl group on backbone of copolymer PMAL®-C8, and protonated nitrogen atom of amide group. This double zwitterion showed strong electrostatic interactions between individual water and secondary ammonium and Oxygen of carboxybetaine, compared to PMAL®-C8-OH-SB-PVDF model. The simulated results using MDS confirmed the hydrophilicity of PMAL®-C8-CB-OH-SB-PVDF and showed that the positive and negative centers of zwitterionic polymer chains on PVDF membrane surface can interact with the ions, contributing into the increase of charge density. Our designed hydrophilic zwitterion PVDF membrane, and especially the double zwitterion membrane, is an exciting development that can be used in a broad range of water applications.

Pair interaction energy decomposition analysis (PIEDA) and experimental approaches for investigating water interactions with hydrophilic and hydrophobic membranes.

The origins of low and high interactions of polar groups with water molecules are still unknown and need to be further examined for effective future membrane synthesis and modification. The primary aim of this research study is to provide a comprehensive overview of the interactions at the molecular level occurring between water molecules and the fragments of hydrophobic and hydrophilic membranes based on pair interaction energy decomposition analysis (PIEDA) as part of the fragment molecular orbital (FMO) method's framework. This direction is critical, since a research study of the reasons for water and membrane interactions can help design groundbreaking membranes with superior hydrophilicity characteristics. To accomplish this, the computational studies, the Polyvinylidene fluoride (PVDF [H(-CH2-CF2-)4CH3]) and Polyacrylonitrile (PAN [(H(-CH2-CH(CN)-)4CH3]) membranes were considered as models for hydrophobic and hydrophilic membranes, respectively. Density-functional theory (DFT), based on B3LYP functional and split-valance 6-311+G (d,p) basis sets, was used in order to optimize the geometry of PAN, PVDF, and their complexes with different numbers of water molecules. Furthermore, fragment molecular orbit (FMO) and the Pair Interaction Energy Decomposition Analysis (PIEDA) were carefully interrogated. These types of analyses included the inter fragment interaction energy (IFIE), like the electrostatic (ES), exchange repulsion (EX), charge-transfer and mixing term (CT + mix) energies. Furthermore, the hydrophilicity and hydrophobicity of the origins of membrane function groups were experimentally evaluated through Fourier-transform infrared spectroscopy (FTIR- ATR), 13C cross polarization magic angle spinning (13C CP MAS) Solid State Nuclear magnetic resonance SSNMR, and Fourier transform Raman (FT-Raman) spectroscopies. Confocal microscopic approach was used to interrogate water transport and the interactions between fluorescence particles and membrane layers. Furthermore, the Infrared (IR) spectroscopy was performed to investigate interaction between water molecules and PVDF and PAN. The theoretical results had a good agreement with experimental result.

Formylation of phenols using formamidine acetate.

We report a new method to formylate phenol derivatives using formamidine acetate and acetic anhydride. This general-purpose transformation is a significant improvement over many other methods and does not require high temperatures or the addition of strong acid or base. Mono-, di-, and tri-formylated product can be obtained, depending on the substrate and conditions used.

First Report on Self-Rated Health in a Nationally-Representative Sample of Iranian Adolescents: The CASPIAN-iii study.

OBJECTIVE: To evaluate predictive factors of adolescents' appraisal of their health. METHODS: The nationwide study, entitled "Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Diseases (CASPIAN) study", was conducted in 2010 among Iranian school students, aged 10-18. In addition to demographic factors and physical examination, variables as family structure, nutrition habits, physical activity, smoking, hygienic habits, violence, school attachment, family smoking, and family history of chronic diseases were assessed. The dependent variable is the self-rated health (SRH) and it was measured by 12 items, which had already been combined through latent class analysis. We had taken a dichotomous variable, i.e. the higher values indicate better SRH. The dependent variable was regressed on all predictors by generalized additive models. RESULTS: 75% of adolescents had a good SRH. The linear and smooth effects of independent variables on SRH were observed. Among all the variables, physical activity had a positive linear effect on SRH (ß = 0.08, P value = 0.003). Smoking, violence, and family history of disease associated to SRH non-linearly (P value < 0.05). Family smoking (ß = -0.01) and hygienic habits (ß = 0.27) related to SRH both linearly and non-linearly. CONCLUSIONS: Physical health and high risk behavior, either of linear or non-linear effect, are factors, which seem to shape the adolescents' perception of health.