Designing a MOF-functionalized Nanofibrous Aerogel via Vapor-Phase Synthesis.

Designing 3D mechanically robust and high-surface-area substrates for uniform and high-density deposition of metal-organic frameworks (MOFs) provide a promising strategy to enhance surface accessibility and application of these highly functional materials. Nanofibrous aerogel (NFA) with its highly porous self-supported structure composed of interconnected nanofibrous network offers an ideal platform in this regard. Herein, a facile one-pot strategy is introduced, which utilizes direct deposition of MOF on the nanofibrous surface of the NFAs. NFAs are synthesized using electrospun polyacrylonitrile/polyvinylpyrrolidone (PAN/PVP) polymer nanofibers containing zinc acetate (Zn(Ac)2), which are subjected to freeze drying and thermal treatment. The latter converts Zn(Ac)2 to zinc oxide (ZnO), providing the sites for MOF growth while also adding mechanical integrity to the NFAs through cyclization of the PAN. Exposure of the NFA to the vapor-phase of organic ligand, 2-methylimidazole (2-MeIm) enables in situ growth of zeolitic imidazolate framework-8 (ZIF-8) MOF on the NFA. ZIF-8 loading on the NFAs is further improved by more than tenfold by synthesizing ZnO nanorods/protrusions on the nanofibers, which enables more sites for MOF growth. These findings underscore a significant advancement in designing MOF-based hybrid aerogels, offering a streamlined approach for their use in diverse applications, from catalysis to sensing and water purification.

Recent advances in synergistic use of GQD-based hydrogels for bioimaging and drug delivery in cancer treatment.

Graphene quantum dot (GQD) integration into hydrogel matrices has become a viable approach for improving drug delivery and bioimaging in cancer treatment in recent years. Due to their distinct physicochemical characteristics, graphene quantum dots (GQDs) have attracted interest as adaptable nanomaterials for use in biomedicine. When incorporated into hydrogel frameworks, these nanomaterials exhibit enhanced stability, biocompatibility, and responsiveness to external stimuli. The synergistic pairing of hydrogels with GQDs has created new opportunities to tackle the problems related to drug delivery and bioimaging in cancer treatment. Bioimaging plays a pivotal role in the early detection and monitoring of cancer. GQD-based hydrogels, with their excellent photoluminescence properties, offer a superior platform for high-resolution imaging. The tunable fluorescence characteristics of GQDs enable real-time visualization of biological processes, facilitating the precise diagnosis and monitoring of cancer progression. Moreover, the drug delivery landscape has been significantly transformed by GQD-based hydrogels. Because hydrogels are porous, therapeutic compounds may be placed into them and released in a controlled environment. The large surface area and distinct interactions of graphene quantum dots (GQDs) with medicinal molecules boost loading capacity and release dynamics, ultimately improving therapeutic efficacy. Moreover, GQD-based hydrogels' stimulus-responsiveness allows for on-demand medication release, which minimizes adverse effects and improves therapeutic outcomes. The ability of GQD-based hydrogels to specifically target certain cancer cells makes them notable. Functionalizing GQDs with targeting ligands minimizes off-target effects and delivers therapeutic payloads to cancer cells selectively. Combined with imaging capabilities, this tailored drug delivery creates a theranostic platform for customized cancer treatment. In this study, the most recent advancements in the synergistic use of GQD-based hydrogels are reviewed, with particular attention to the potential revolution these materials might bring to the area of cancer theranostics.

AI chatbots in pet health care: Opportunities and challenges for owners.

The integration of artificial intelligence (AI) into health care has seen remarkable advancements, with applications extending to animal health. This article explores the potential benefits and challenges associated with employing AI chatbots as tools for pet health care. Focusing on ChatGPT, a prominent language model, the authors elucidate its capabilities and its potential impact on pet owners' decision-making processes. AI chatbots offer pet owners access to extensive information on animal health, research studies and diagnostic options, providing a cost-effective and convenient alternative to traditional veterinary consultations. The fate of a case involving a Border Collie named Sassy demonstrates the potential benefits of AI in veterinary medicine. In this instance, ChatGPT played a pivotal role in suggesting a diagnosis that led to successful treatment, showcasing the potential of AI chatbots as valuable tools in complex cases. However, concerns arise regarding pet owners relying solely on AI chatbots for medical advice, potentially resulting in misdiagnosis, inappropriate treatment and delayed professional intervention. We emphasize the need for a balanced approach, positioning AI chatbots as supplementary tools rather than substitutes for licensed veterinarians. To mitigate risks, the article proposes strategies such as educating pet owners on AI chatbots' limitations, implementing regulations to guide AI chatbot companies and fostering collaboration between AI chatbots and veterinarians. The intricate web of responsibilities in this dynamic landscape underscores the importance of government regulations, the educational role of AI chatbots and the symbiotic relationship between AI technology and veterinary expertise. In conclusion, while AI chatbots hold immense promise in transforming pet health care, cautious and informed usage is crucial. By promoting awareness, establishing regulations and fostering collaboration, the article advocates for a responsible integration of AI chatbots to ensure optimal care for pets.

Comparison of nine trauma scoring systems in prediction of inhospital outcomes of pediatric trauma patients: a multicenter study.

Hereby, we aimed to comprehensively compare different scoring systems for pediatric trauma and their ability to predict in-hospital mortality and intensive care unit (ICU) admission. The current registry-based multicenter study encompassed a comprehensive dataset of 6709 pediatric trauma patients aged ≤ 18 years from July 2016 to September 2023. To ascertain the predictive efficacy of the scoring systems, the area under the receiver operating characteristic curve (AUC) was calculated. A total of 720 individuals (10.7%) required admission to the ICU. The mortality rate was 1.1% (n = 72). The most predictive scoring system for in-hospital mortality was the adjusted trauma and injury severity score (aTRISS) (AUC = 0.982), followed by trauma and injury severity score (TRISS) (AUC = 0.980), new trauma and injury severity score (NTRISS) (AUC = 0.972), Glasgow coma scale (GCS) (AUC = 0.9546), revised trauma score (RTS) (AUC = 0.944), pre-hospital index (PHI) (AUC = 0.936), injury severity score (ISS) (AUC = 0.901), new injury severity score (NISS) (AUC = 0.900), and abbreviated injury scale (AIS) (AUC = 0.734). Given the predictive performance of the scoring systems for ICU admission, NTRISS had the highest predictive performance (AUC = 0.837), followed by aTRISS (AUC = 0.836), TRISS (AUC = 0.823), ISS (AUC = 0.807), NISS (AUC = 0.805), GCS (AUC = 0.735), RTS (AUC = 0.698), PHI (AUC = 0.662), and AIS (AUC = 0.651). In the present study, we concluded the superiority of the TRISS and its two derived counterparts, aTRISS and NTRISS, compared to other scoring systems, to efficiently discerning individuals who possess a heightened susceptibility to unfavorable consequences. The significance of these findings underscores the necessity of incorporating these metrics into the realm of clinical practice.

The effect of peer mentoring program on clinical academic progress and psychological characteristics of operating room students: a parallel randomized controlled trial.

BACKGROUND: One of the new educational systems is the mentorship method. This study aimed to investigate the effect of peer mentoring program on clinical academic progress and psychological characteristics of operating room students. METHODS: This research was a randomized controlled trial that was conducted on undergraduate students in the operating room department of Khomein Faculty of Medical Sciences, Markazi Province in Iran. The number of operating room students were 70 that were divided into intervention and control groups by random allocation using Permuted Block Randomization. Inclusion criteria included all operating room students who were in internship, and exclusion criteria included failure to complete the questionnaires. The data collection tools were the demographic questionnaire, Depression Anxiety Stress Scale, Rosenberg Self-Esteem Scale and Situational Motivational Scale. In the control group, clinical training was done in the traditional way. In the intervention group, training was done by peer mentoring method. The obtained data were analyzed using descriptive statistics, independent t-test, paired t-test, chi-square test, ANCOVA, univariable and multivariable linear regression. RESULTS: The study revealed significant differences between the intervention and control groups. Post-intervention, the intervention group demonstrated substantial increases in self-confidence (mean difference = 5.97, p < 0.001) and significant reductions in stress levels (mean difference = -3.22, p < 0.001). Conversely, minimal changes were noted in the control group for both self-confidence (mean difference = 0.057, p = 0.934) and stress levels (mean difference = 0.142, p = 0.656). Although both groups experienced decreases in anxiety and depression levels, these changes were not statistically significant (p > 0.05). Furthermore, the intervention significantly enhanced academic progress in the intervention group compared to the control group (mean difference = 20.31, p < 0.001). CONCLUSION: The results showed that the implementation of the peer mentoring program was effective in improving academic progress, self-confidence, and reducing the stress of operating room students. Therefore, this educational method can be used in addition to the usual methods to improve the education of operating room students.

An updated systematic review and Meta-analysis of the prevalence of type 2 diabetes in Iran, 1996-2023.

Background: Diabetes mellitus (DM) poses a significant threat to public health, and the anticipated surge of over 100% in the age-standardized prevalence of type 2 diabetes in Iran between 2021 and 2050 underscores the pressing need for focused attention. The rationale for estimating the prevalence of type 2 diabetes in Iran becomes even more compelling when considering the potential cascading effects on the healthcare system, quality of life, and economic burden. The aim of this study was to estimate the prevalence and trends of DM from 1996 to 2023 in the Islamic Republic of Iran. Methods: Up to July 2023, without deadlines, the search for appropriate articles in Persian and English. Iranian sources including SID, Magiran, and Element were included in the databases, along with foreign ones like PubMed/MEDLINE, Web of Science, Science Direct, Embase, Scopus, ProQuest, and Google Scholar. Using the JBI quality checklist, the study's level of quality was evaluated. Version 14 of STATA was used to carry out the statistical analysis. The Dersimonian and Liard random-effects models were used because of heterogeneity. To investigate the causes of heterogeneity, subgroup analysis and univariate meta-regression were utilized. Sensitivity analysis was then carried out to see how each study's findings affected the final findings. The prevalence pattern over time was also followed using cumulative meta-analysis. Results: There were 53 studies in all, with a combined sample size of 1,244,896 people. Men were predicted to have a type 2 diabetes prevalence of 10.80% (95% CI: 9.1-12.4), while women were assessed to have a prevalence of 13.4% (95% CI: 11.6-15.3). Additionally, the prevalence of diabetes was much higher in the 55-64 age group, coming in at 21.7% (95% CI: 17.5-25.0). The anticipated prevalence of diabetes was 7.08% for 1988 to 2002, 9.05% for 2003 to 2007, 9.14% for 2008 to 2012, 15.0% for 2013 to 2017, and 13.40% for 2018 to 2023, among other time periods. Geographically, type 2 diabetes was most prevalent in Khuzestan (15.3%), followed by Razavi Khorasan (14.4%), Qazvin (14.3%), and Yazd (12.6%). Conclusion: The prevalence of type 2 diabetes was estimated at 10.8%, highlighting variations across gender, age groups, and geographic regions that underscore the necessity for specific interventions. These findings advocate for proactive measures, including tailored screening and lifestyle modification programs. The notable temporal increase from 2013 to 2017 signals the need for policymakers and healthcare practitioners to develop effective strategies, anticipating and addressing the potential future burden on the healthcare system. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023437506, identifier: CRD42023437506.

Recent advances and synergistic effect of bioactive zeolite imidazolate frameworks (ZIFs) for biosensing applications.

The rapid developments in the field of zeolitic imidazolate frameworks (ZIFs) in recent years have created unparalleled opportunities for the development of unique bioactive ZIFs for a range of biosensor applications. Integrating bioactive molecules such as DNA, aptamers, and antibodies into ZIFs to create bioactive ZIF composites has attracted great interest. Bioactive ZIF composites have been developed that combine the multiple functions of bioactive molecules with the superior chemical and physical properties of ZIFs. This review thoroughly summarizes the ZIFs as well as the novel strategies for incorporating bioactive molecules into ZIFs. They are used in many different applications, especially in biosensors. Finally, biosensor applications of bioactive ZIFs were investigated in optical (fluorescence and colorimetric) and electrochemical (amperometric, conductometric, and impedance) fields. The surface of ZIFs makes it easier to immobilize bioactive molecules like DNA, enzymes, or antibodies, which in turn enables the construction of cutting-edge, futuristic biosensors.

Photocatalysis air purification systems for coronavirus removal: Current technologies and future trends.

Air pollution causes extreme toxicological repercussions for human health and ecology. The management of airborne bacteria and viruses has become an essential goal of air quality control. Existing pathogens in the air, including bacteria, archaea, viruses, and fungi, can have severe effects on human health. The photocatalysis process is one of the favorable approaches for eliminating them. The oxidative nature of semiconductor-based photocatalysts can be used to fight viral activation as a green, sustainable, and promising approach with significant promise for environmental clean-up. The photocatalysts show wonderful performance under moderate conditions while generating negligible by-products. Airborne viruses can be inactivated by various photocatalytic processes, such as chemical oxidation, toxicity due to the metal ions released from photocatalysts composed of metals, and morphological damage to viruses. This review paper provides a thorough and evaluative analysis of current information on using photocatalytic oxidation to deactivate viruses.

Prevalence of Anaplasma, Ehrlichia and Rickettsia infections in dogs in Iran: A meta-analysis study.

The current study aims to assess the prevalence of different genera of Rickettsiales, intracellular bacteria, in dogs across various regions of Iran. Rickettsiales, as zoonotic pathogens, can have various manifestations in different species, including immunosuppression, anaemia and neuropathy. Due to their close interactions with people and livestock, dogs can serve as reservoirs and transmit these pathogens to humans and other animals. The data from this research can be valuable for managing and controlling related diseases and complications in Iran and possibly neighbouring countries. Pertinent data for this study was gathered without time limitations until 1 March 2022, from different databases. Of all the inspected studies, 26 were eligible based on the inclusion criteria. The Egger test result and asymmetry in the funnel plot revealed significant publication bias; therefore, the meta-analysis model was corrected with the trim-and-fill method. After correction, the prevalence of rickettsial infections among dogs varies by genus - 20.1% for Anaplasma spp. and 10% for Ehrlichia spp. - with an overall prevalence estimated at 18.3% by random-effects analysis. The highest and lowest estimated pooled prevalences were associated with the southwestern (38.5%) and southern (0.3%) provinces of Iran, respectively. The pooled prevalence of rickettsial infection was higher in female dogs (OR = 1.198; p < 0.978; 95% CI, 0.842-1.705) and in dogs ≤2 years (OR = 1.014; p < 0.312; 95% CI, 0.598-1.72), but the difference was not statistically significant. Ultimately, the pooled prevalence of rickettsial infections among dogs is relatively low compared to other countries like Qatar, Iraq, Saudi Arabia and Turkey, which are nearby Iran. Given the significant clinical outcomes of this disease, necessary measures for prevention should be taken.

Temporal Analysis of Cutaneous Leishmaniasis Incidence in an Endemic Area of Southeast Iran.

PURPOSE: Cutaneous leishmaniasis (CL) is the most common type of leishmaniasis in tropical and subtropical areas. This study investigated the trend of CL changes from 2009 to 2022, and predicted the number of leishmaniasis cases until 2024. METHODS: This ecological study was performed on new monthly confirmed CL cases from 2009 to 2022 from the leishmaniasis registration system in southeast Iran. The time series method was used to investigate the trend of changes in CL from 2009 to 2022. SARIMA model was run to predict the number of leishmaniasis cases until 2024 by controlling the effect of climatic variables on the disease process. RESULTS: The analysis showed a significant increase in CL cases in 2015 and from 2021 to 2022. The minimum number of registered cases was observed in 2018, with 81 cases. The maximum number was also observed in 2021, with 318 patients. The leishmaniasis cases decreased from January to June and increased from July to December. According to the results of SARIMA (1, 0, 0) (1, 0, 0) multivariate analysis, the temperature in log 12 has a significant negative correlation with the number of leishmaniasis cases. This model predicted a decreasing trend in leishmaniasis cases until 2024. CONCLUSION: The southeast region of Fars province is one of the hyper-endemic regions of the disease, and it is prone to periodic outbreaks. An active surveillance system must investigate the CL incidence trend and evaluate the effectiveness of interventions to prevent the occurrence of new outbrea.

Global Seroprevalence of Toxocara spp. in Children: A Systematic Review and Meta-analysis.

BACKGROUND: In the present study, we performed a systematic review and meta-analysis to assess the global and regional seroprevalence of Toxocara spp. and associated risk factors among children. METHODS: The present systematic review and meta-analysis was followed based on the Preferred Reporting. Items for Systematic Reviews and Meta-analyses (PRISMA) protocol. We searched the online databases (PubMed, Scopus, and Web of Science) and Google Scholar search engine for studies that measured seroprevalence of Toxocara spp. among children, published between 1 January 2000 and 15 January 2022. Accordingly, the pooled seroprevalence and 95% confidence intervals (CI) were estimated using a random-effects meta-analysis model. RESULTS: A total of 65 articles from 22 countries met the inclusion criteria. The global seroprevalence of Toxocara spp. infection among children was estimated as 25% (95% CI 22-29). Meta-regression analysis showed that the type of population studied (p = 0.002) and year of publication (p = 0.044) it may be the source of heterogeneity. The highest and lowest pooled seroprevalence of Toxocara spp. infection were estimated in Thailand and Colombia as 58.2% (95% CI 50.9-65.5) and 7.04% (95% CI 3.05-11.3), respectively. Male gender was associated with a higher risk of Toxocara spp. compared to females, and this association was statistically significant (OR = 1.24; 95% CI 1.09-1.41, p = 0.001). However, residing in rural areas did not show a statistically significant increase in risk compared to living in urban areas (OR = 1.39; 95% CI 0.88-2.21, p = 0.143). CONCLUSION: Toxocariasis is common among children, hence, prevention and control scheme of this helminth in children should be considered by health officials and health policymakers, especially in developing countries, where seroprevalence is highest.

Systematic review and meta-analysis of knowledge, attitudes, and practices regarding COVID-19 among chronic disease patients: A global perspective.

Background: Chronic health conditions were significantly correlated with an increased clinical severity of coronavirus 2019 (COVID-19) and a heightened risk of COVID-19 mortality. This study aims to determine global knowledge, attitudes, and practices (Knowledge Abuse Profile) of the patients with chronic diseases toward COVID-19. Methods: The study was initiated in December 2019 and extended until April 2023, during which an extensive search for relevant English-language literature was conducted as part of this systematic review and meta-analysis. Google Scholar, Scopus, PubMed/MEDLINE, Science Direct, Web of Science, EMBASE, Springer, and ProQuest were utilized for the search. The quality of included studies was assessed using a quality rating checklist created by Joanna Briggs Institute for cross-sectional research. In the STATA software version 14, inverse variance and Cochran Q statistics were used for statistical analysis to assess heterogeneity among the studies. The Dersimonian and Liard random-effects models were applied in cases where heterogeneity existed. Results: A total of 23 studies involving 14,587 patients contributed to this meta-analysis. These studies comprised 21 studies focused on knowledge, with 6864 participants, 12 studies on attitudes involving 3597 patients, and 12 on practices, encompassing 4126 patients. The pooled estimates for sufficient knowledge, positive attitudes, and COVID-19 preventive behaviors among chronic disease patients were determined as 48.2% (95% confidence interval [95% CI]: 33.9%-62.5%), 60.8% (95% CI: 46.8%-74.8%), and 58.3% (95% CI: 39.5%-77.0%), respectively. Over the years, there was a consistent decrease in adequate knowledge, positive attitudes, and COVID-19 preventive behaviors among the population. Specifically, regarding knowledge, the rates declined from 50.2% in 2020 to 49.7% in 2021 and dropped to 45.1%. Similarly, the percentage of individuals with a positive attitude fell, decreasing from 64.1% in 2020 to 60.3% in 2021 and dropping to 57.9% in 2022. Furthermore, COVID-19 preventive behaviors showed fluctuations, with the rates recorded at 63.7% in 2020, increasing to 75.4% in 2021, and then decreasing to 47% in 2022, in line with the publication dates of included studies. Conclusion: The findings of meta-analysis show a significant decrease in the levels of knowledge, attitudes, and adherence to preventative interventions for COVID-19 among individuals with chronic diseases. The findings emphasize the need for targeted interventions, and ongoing education to address this trend.

Epidemiology of cervical cancer in Iran in 2016: A nationwide study of incidence and regional variation.

BACKGROUND: Cervical cancer is a common, and fatal cancer in women worldwide. This cancer is the fourth most common cancer in women after breast, colorectal, and lung cancer. AIMS: This study aims to investigate the age-standardized incidence rate (ASR) and the geographical distribution of Cervical Cancer in Iran. METHODS: This study was designed as a descriptive cross-sectional investigation. The study sample comprised all individuals registered as cervical cancer patients in the National Cancer Registry system in 2016. The crude rate and ASR for each province were computed independently. Furthermore, we employed ArcMap10.5 software and geographic information system to conduct an analysis of the gathered data. In order to ascertain the spatial distribution and clustering of cervical cancer incidence, we utilized Moran's I, which measures spatial autocorrelation. RESULTS: We studied a total of 808 cases of cervical cancer with a median age to be 52.19 years (IQR≈1.35). Among these cases, 685 (84.7%) were diagnosed based on the pathological reports with morphological verification, while 81 patients (10.1%) were clinically identified, and 42 cases (5.2%) were diagnosed using the death certificate-only method. Squamous cell carcinoma accounted for 61% of all cases (n = 497). The ASR of cervical cancer in Iran was 1.90 per 100 000 populations. The provincial ASR ranged from 0.29 to 5.03 per 100 000, with the highest rates observed in Golestan (5.03), East Azerbaijan (4.07), and Ilam (3.72). We found no clustering patterns in the distribution of provincial crude, age-specific, and age-standardized incidence rates (p > .05). CONCLUSION: The incidence of cervical cancer in Iran was lower than the global average, and we did not identify any significant disparities in the incidence rates among the provinces. Although there were differences in incidence rates among the areas, these were not clustered. It is crucial to remember that cervical cancer is still a major public health issue in Iran, and in order to lessen the disease's burden, national initiatives to enhance screening, early identification, and access to efficient treatment should continue to be top priorities.

Prevalence of Giardia duodenalis among Asian children: a systematic review and meta-analysis.

Giardia duodenalis is one of the major causes of diarrhea among children. We performed a systematic review and meta-analysis to assess the prevalence of G. duodenalis and associated risk factors among Asian children. We searched online databases (PubMed, Scopus and Web of Science) and Google Scholar search engine for studies published from 1 January 2000 to 15 March 2022 that measured the prevalence of G. duodenalis among Asian children. Accordingly, the pooled prevalence and 95% CIs were estimated using a random-effects meta-analysis model for the included studies. A total of 182 articles from 22 Asian countries met the inclusion criteria. The pooled prevalence of G. duodenalis infection among Asian children was estimated as 15.1% (95% CI 14.1 to 16%). The highest and lowest pooled prevalence values of G. duodenalis infection were estimated for Tajikistan and China as 26.4% (95% CI 22.9 to 30%) and 0.6% (95% CI 0.001 to 1.02%), respectively. The infection had a higher prevalence in males than in females (OR=1.24; 95% CI 1.16 to 1.31; p<0.001), which was statistically significant. Giardiasis is common among Asian children, hence, a prevention and control scheme of this protozoan in children should be considered by health officials and health policymakers, especially in Asian countries where the prevalence is highest.

Recent Progress in Prompt Molecular Detection of Exosomes Using CRISPR/Cas and Microfluidic-Assisted Approaches Toward Smart Cancer Diagnosis and Analysis.

Exosomes are essential indicators of molecular mechanisms involved in interacting with cancer cells and the tumor environment. As nanostructures based on lipids and nucleic acids, exosomes provide a communication pathway for information transfer by transporting biomolecules from the target cell to other cells. Importantly, these extracellular vesicles are released into the bloodstream by the most invasive cells, i. e., cancer cells; in this way, they could be considered a promising specific biomarker for cancer diagnosis. In this matter, CRISPR-Cas systems and microfluidic approaches could be considered practical tools for cancer diagnosis and understanding cancer biology. CRISPR-Cas systems, as a genome editing approach, provide a way to inactivate or even remove a target gene from the cell without affecting intracellular mechanisms. These practical systems provide vital information about the factors involved in cancer development that could lead to more effective cancer treatment. Meanwhile, microfluidic approaches can also significantly benefit cancer research due to their proper sensitivity, high throughput, low material consumption, low cost, and advanced spatial and temporal control. Thereby, employing CRISPR-Cas- and microfluidics-based approaches toward exosome monitoring could be considered a valuable source of information for cancer therapy and diagnosis. This review assesses the recent progress in these promising diagnosis approaches toward accurate cancer therapy and in-depth study of cancer cell behavior.

Global knowledge and attitudes towards mpox (monkeypox) among healthcare workers: a systematic review and meta-analysis.

BACKGROUND: The recent increase in human mpox (monkeypox) cases emphasizes the importance of early detection, prompt response and preventive management to control the spread of the disease. Healthcare workers (HCWs) play a crucial role in this process. This study aimed to determine the global knowledge and attitudes towards mpox among HCWs. METHODS: This study searched multiple databases, including Google Scholar, Scopus, PubMed/MEDLINE, Science Direct, Web of Science, Embase, Springer and ProQuest, to locate various publications. The search was limited to English-language articles published between May 2022 (when the increase in mpox incidence was reported) and August 2023. The Joanna Briggs Institute (JBI) quality checklist was utilized to evaluate the quality of the included studies. Data were obtained using a Microsoft Excel spreadsheet and subsequently scrutinized through STATA software, version 14. The heterogeneity of the studies was assessed using the inverse variance and Cochran Q statistics based on the I2 test statistics. The Dersimonian and Liard random effects models were used where heterogeneity existed. Subgroup analysis and univariate and multivariable metaregression techniques were used to examine the causes of heterogeneity. RESULTS: A total of 22 studies, including 22 studies for knowledge (27 731 HCWs) and 6 studies for attitudes (14 388 HCWs), were included in the meta-analysis. The pooled estimates for good knowledge and positive attitudes among HCWs were 26.0% (95% confidence interval [CI] 17.8 to 34.2) and 34.6% (95% CI 19.0 to 50.2), respectively. Moreover, the knowledge was 34.8% (95% CI 24.1 to 45.6) among HCWs with <5 y of work experience and 41.6% (95% CI 33.1 to 50) among individuals possessing >5 y of professional background. CONCLUSIONS: Good knowledge of HCWs is at a low level. It is suggested that training sessions should be tailored towards younger HCWs with less healthcare experience. Additionally, it is essential to identify strategies on how to improve the knowledge and attitudes for better practice about the disease in HCWs worldwide.

A comparison of misoprostol with and without methylergometrine and oxytocin in outpatient medical abortion: a phase III randomized controlled trial.

OBJECTIVE: The complications associated with miscarriages have surfaced as a major concern in maintaining women's physical and mental health. The present study evaluated the efficacy of three medication regimes for the complete expulsion of retained intrauterine tissues in patients who underwent a miscarriage. METHODS: In this randomized clinical trial, 90 patients participated with their gestational age below 12 weeks, each having undergone a recent miscarriage. After being screened for underlying diseases and coagulative blood disorders, they were randomly allocated into three groups. For the first group, labeled as the control group, misoprostol was administered alone. In contrast, the combination of misoprostol plus methylergometrine and misoprostol plus oxytocin was prescribed for the second and third groups, respectively. Further, the data obtained were analyzed by descriptive and inferential statistics using Stata software version 14. RESULTS: The mean age of participants and gestational age were 29.76 ± 5.53 years and 8.23 ± 2.29 weeks, respectively. There was no significant difference between the three treatment groups regarding the amount of bleeding after the abortion(P = 0.627). Regarding pain severity, the group that received Misoprostol plus Methylergometrine had less pain intensity than the other two groups(p = 0.004). The mean rate of RPOC expulsion was in the Misoprostol plus Oxytocin (9.68 ± 10.36) group, Misoprostol plus Methylergometrine (11.73 ± 12.86), and Misoprostol groups (19.07 ± 14.31)(p = 0.013). The success rate in outpatient medical abortion in the misoprostol plus oxytocin and misoprostol plus methylergonovine group was 93.33%, but in patients treated by misoprostol alone was 83.33%. CONCLUSION: The effectiveness of the drugs in the two drug groups combined with oxytocin and methylergometrine is higher than the misoprostol group alone. An outpatient approach was deemed more satisfactory against surgical maneuvers and hospitalizations by patients since family support influenced their pain coping mechanism. TRIAL REGISTRATION: The trial was registered in the Iranian registry of clinical trials on 04/10/2019. ( https://fa.irct.ir/trial/34519 ; registration number: IRCT20150407021653N19).

Multiple sclerosis and ulcerative colitis: A systematic review and meta-analysis.

Background: Comorbidity is a current area of interest in multiple sclerosis (MS) and is essential for multidisciplinary management. Although recent studies suggest that patients with MS have an elevated risk of developing inflammatory bowel diseases (IBD), this systematic review and meta-analysis aimed to estimate the overall risk of developing ulcerative colitis (UC), specifically in patients with MS. Methods: In 2021, a comprehensive literature search was performed on PubMed, Scopus, Embase, and Web of Science to identify studies investigating the association between UC and MS. The selected papers were utilized to estimate the associations, risk ratios (RRs), and a 95% confidence interval (CI). Results: The analysis revealed a slightly elevated risk of UC incidence in patients with MS compared to controls, but this finding was not statistically significant (RR: 1.27 [95% CI: 0.96-1.67]). In contrast, the study found that patients with UC have a significantly higher risk of developing MS than controls (RR: 1.66 [95% CI: 1.15-2.40]). Conclusion: Our findings highlight that the presence of UC increases the risk of developing MS by more than 50%, whereas the presence of MS does not increase the risk of UC occurrence. These results underscore the importance of considering the potential development of UC in the clinical management and early diagnosis of patients with MS, as it may contribute to better therapeutic outcomes.

Pure testicular choriocarcinoma with gastrointestinal metastasis and paraneoplastic symptoms: a case report.

BACKGROUND: Pure testicular choriocarcinoma is a rare type of non-seminomatous germ cell tumor extremely poor prognostic with the tendency to bleed at the metastatic site. At the time of the diagnosis, 70% of patients have metastatic lesions. Depending on the site of the metastasis, symptoms vary. Gastrointestinal involvement is seen in less than 5% of cases, mostly in the duodenum. CASE PRESENTATION: We present a 47 years old male with testicular choriocarcinoma involving the jejunum, lung, liver, and kidney presenting with acute abdominal pain, melena, and dyspnea with some paraneoplastic symptoms. The patient had increased, severe and constant pain in the right lower quadrant for the previous four days. Additionally, he was complaining of nausea, vomiting, anorexia, and a history of melena for the last 10 days. Dyspnea on exertion, hemoptysis, and dry cough were the symptoms he was suffering from, for almost one year. The patient's general appearance was pale, ill, and thin with 10 kg of weight loss during the last some months. The computed tomography (CT) scan reported multiple metastatic lesions in both liver lobes and the left kidney. Pathologic study of the samples of small bowel lesions showed metastatic choriocarcinoma. Following the patient had been referred to an oncologist to start the chemotherapy regime. Finally, the patient has expired after 40 days of his first admission. CONCLUSIONS: Testicular choriocarcinoma is a rare but fatal malignancy among young men. Gastrointestinal metastases are infrequent involvement represented by melena and acute abdominal pain, obstruction, and mass. Physicians should consider it as a differential diagnosis for acute abdomen and gastrointestinal bleeding causation.

The incidence of oral cavity cancer in Iran: A systematic review and meta-analysis.

BACKGROUND AND AIMS: Oral cancer is now a top priority for non-communicable illnesses and universal health care plans, according to the WHO. There is no general estimate of the incidence of oral cavity cancer in Iran, despite multiple investigations. The purpose of this study is to evaluate the age-standardized incidence rate (ASR) of oral cavity cancers in Iran. METHOD: In accordance with the MOOSE (Meta-analyses of Observational Studies in Epidemiology) Checklist recommendations, this systematic review was conducted. PubMed/MEDLINE, Web of Science, ScienceDirect, Embase, Scopus, ProQuest, and Google Scholar were used as the international databases for the systematic literature search, while SID (Scientific Information Database), Magiran and element were used as the Iranian databases. The heterogeneity of the research will be evaluated by means of the inverse variance and Cochran Q tests, along with random-effect models. It was determined what caused the heterogeneity using a meta-regression model. By eliminating experiments one at a time, sensitivity analysis was used. The meta-analysis was corrected utilizing the Trim-and-fill method due to the identification of noteworthy publication bias via the Egger's test and asymmetry of the funnel plot. RESULTS: This research incorporated a total of 22 journal articles. The pooled ASR of oral cavity cancer for males and females was estimated at 1.96 (95% CI: 1.65-2.26) (Q statistic = 1118.09, df = 25, p < .0001, I2 = 97.8%), and 1.46 (95% CI: 1.14-1.77) (Q statistic = 2576.99, df = 26, p < .0001, I2 = 99.0%), respectively. According to the funnel plots and Egger's test, there is no evidence of publication bias in studies reporting on males (bias = 1.3220, 95% CI: -3.9571, 6.6012, p = .610), but for ASR in females, Egger's test was significant (bias = -7.6366, 95% CI: 2.2141, 13.05904, p = .008). Based on Trim-and-fill methods, overall ASR corrected in females was estimated to be 1.36 (95% CI: 1.05%-1.66%). CONCLUSION: Iran's oral cavity cancer incidence was lower than the global average, but owing to variables including an aging population, a rise in life expectancy, and exposure to risk factors like smoking, we anticipate an increasing trend.