Efficacy evaluation of budesonide nebulizer as an adjunctive medication in post-rain asthma acute phase attack.

INTRODUCTION: Bronchospasm attacks occur following syndromic rainfall and are increasing due to air pollution and need effective treatments. In this study, the effect of salbutamol nebulizer in comparison with salbutamol plus budesonide nebulizer in patients referred to the emergency department with dyspnea was investigated. MATERIAL AND METHODS: The trial study was conducted on 228 patients with dyspnea after the first rainfall in Ahvaz. Two groups of 114 patients have been randomly allocated. On the course of treatment, the first group received salbutamol plus budesonide nebulizer and the second group received salbutamol alone. In the experimental group, budesonide 0.5 mg with salbutamol was nebulized three times for 20 minutes. In all patients, 20, 40, and 60 minutes after the start of the intervention, forced expiratory volume in 1 second (FEV1) and peak expiratory flow rate (PEFR) and vital signs of size were recorded and analyzed by SPSS and t-test. RESULTS: Data revealed that there were significant differences between PEFR parameters of studied. Groups in minute 40 and 60 after intervention (p = 0.000001). There was better improvement.in PEFR values in minute 40 and 60 in budesonide plus salbutamol study group. There were no significant differences for FEV1 in minute 0, 20, 40, 60 between to studied group. Also there were no significant differences for borg dyspnea scale for minute 0 and 60 between two experimented group. Respiratory rates have significant differences in minutes 20, 40 after intervention and there was better improvement for salbutamol plus budesonide group rather than sulbutamol intervention group alone.(p = 0.001142). CONCLUSION: Experiment data revealed. that due to the significant difference between PEFR and increased FEV1 in the combination of the two drugs and due to the corticosteroid effects of budesonide in reducing and preventing inflammation and swelling of the lungs, nebulizer salbutamol + budesonide has better effects on moderate breath than in nebulizer salbutamol.

Evaluation of the effect of fixed speed cameras on speeding behavior among Iranian taxi drivers through telematics monitoring.

OBJECTIVE: Installation of speed cameras is a common strategy to reduce over-speeding; however, there is evidence that their efficacy in speed reduction is limited to the proximity of the camera. This study aimed to evaluate driving speeds in relation to the position of cameras among Iranian taxi drivers. METHODS: Speed data were collected from April 2020 to January 2021 via telematics devices (using on-board computer, gyroscope, and GPS) installed on taxis in southern Tehran, Iran. All drivers were males above 20 years of age. Throughout the study, taxi drivers were not changed. Eligible road segments were selected based on: a) not containing any obstacle that would cause speed reduction; b) having ≤5 entry/exit points; c) absence of park and ride or taxi stations; and d) availability of at least 5,000 datapoints. The average speed was compared between the camera- and non-camera zones. Camera zone was defined as the area within 300 meters of the speed cameras. RESULTS: The telematics system included 2,644,846 datapoints gathered from 50 taxis. Two highways' segments with three lanes in each direction were included: Tehran-Varamin (18 taxis, 18,978 datapoints) and Ghadir (17 taxis, 8,203 datapoints). On both highways, speed was significantly lower in the camera zones (Tehran-Varamin: 84.9 ± 12.2 km/h versus 86.7 ± 13.7 km/h; P = 0.005; Kolmogorov-Smirnov test (KS) P < 0.001/Ghadir: 68.7 ± 13.7 versus 73.1 ± 11.3; P = 0.008; KS P < 0.001), indicating a V-shaped distribution of speed near the position of cameras (Presence of Kangaroo effect). Drivers were more likely to exceed speed limits in the non-camera zones compared to camera zones (Tehran-Varamin: 14.6% versus 8.4%/Ghadir: 23.1% versus 17.3%). This effect of the cameras was consistently observed in a subgroup analysis based on time of day (daytime versus nighttime). CONCLUSIONS: Among Iranian taxi drivers in southern Tehran, average speed was significantly lower in the vicinity of speed cameras, suggesting the presence of camera manipulation. Alternative speed control interventions are required to improve the safety of the taxi service.

Evaluation of efficacy of nebulized low molecular weight heparin as an adjunctive extra treatment for acute mild-moderate asthma attack; a randomized clinical trial study.

BACKGROUND: Asthma is the most common chronic disorders of the respiratory tract. This study aimed to evaluate the effect of low-molecular-weight heparins (LMWHs) in the treatment of acute asthma. METHODS: In this randomized clinical trial, patients with acute asthma attacks were enrolled. The patients were divided randomly into two groups. Patients in the intervention group received nebulized LMWH (1 mg/kg) with albuterol (2.5 mg) every 20 min for 10 min. The patients in the control group received nebulized albuterol with the same dose. Then peak expiratory flow rates (PEFR) and forced expiratory volume in 1 s (FEV1), and hemodynamic parameters in both groups were assessed for every 20 min. RESULTS: In total 70 patients enrolled in this study. We found that the mean PEFR at 40 min was higher in the LMWH group than the control group (202.51 L/min and 180.2 L/min) (p = 0.001). Moreover, this difference remains significant in the 60th minute (p < 0.001). Further, FEV1 was significantly higher in the LMWH group after 60 min (1.82 L/min vs 1.48 L/min, p < 0.001). Moreover, we found that the hemodynamic parameters were sustainable in the intervention group. CONCLUSION: The study suggests that LMWH in mild-moderate asthma attacks may be beneficial in the short term and could be prescribed in addition to standard albuterol therapy.

Haarlem 3 is the predominant genotype family in multidrug-resistant and extensively drug-resistant Mycobacterium tuberculosis in the capital of Iran: A 5-year survey.

The objective of this study was to further understand the genetic diversity of multidrug-resistant (MDR) and extensively drug-resistant (XDR) Mycobacterium tuberculosis isolates prevalent in Tehran, the capital city of Iran. From January 2010 to March 2015, a total of 723 M. tuberculosis strains were isolated from patients with pulmonary tuberculosis (TB). A total of 23 MDR, pre-XDR and XDR M. tuberculosis isolates were genotyped by spoligotyping and 24-loci mycobacterial interspersed repetitive unit-variable-number tandem repeat (MIRU-VNTR) typing. The results showed that the MDR, pre-XDR and XDR M. tuberculosis strains mainly belonged to the Haarlem 3 genotype (11/23; 47.8%), followed by the Beijing family (9/23; 39.1%). In addition, the 23 strains were clustered into 21 genotypes using a 24-loci MIRU-VNTR. In conclusion, Haarlem 3 genotype was the predominant genotype among the isolates from MDR-TB cases in this study, which could be of special concern.

Design and synthesis of new 1,4-dihydropyridines containing 4(5)-chloro-5(4)-imidazolyl substituent as a novel calcium channel blocker.

New analogues of nifedipine, in which the ortho-nitro phenyl group at position 4 has been replaced by 4(5)-chloro-5(4)-imidazolyl substituent and which are able to interact with the receptor by hydrogen binding were designed, synthesized, and evaluated as calcium channel antagonists. The designed dihydropyridines were synthesized using the Hantzsch condensation and evaluated as calcium channel antagonists using the high K+ contraction of guineapig ileal longitudinal smooth muscle. A docking study was performed using the AutoDock4 program, and QSAR equations were obtained using multilinear regression. Our computational studies indicated that the oxygen of the ester (O10) and the N3' of the imidazole ring form a hydrogen bonding interaction with the NH of HIS 363 and NH of LYS354, respectively, and that the sum of the BEHp5 and RDF075p are the most significant descriptors. The results of calcium channel antagonist evaluation demonstrated that increasing the chain length in C3 and C5 ester substituents increased activity. The most potent compound was the bis-phenylpropyl ester (5l) derivative, in that it was more active than the reference drug nifedipine and that the bis-phenylethyl ester (5k) derivative had comparable activity with nifedipine. The present research revealed that the 4(5)-chloro-5(4)-imidazolyl moiety is a bioisoster of o-nitrophenyl in nifedipine and provided novel dihydropyridines with more activity as calcium channel antagonists.

Synthesis and docking studies of new 1,4-dihydropyridines containing 4-(5)-Chloro-2-ethyl-5-(4)-imidazolyl substituent as novel calcium channel agonist.

1,4-Dihydropyridines have been recognized as calcium channel agonist. Three new analogues of Bay K8644 in which the ortho trifluromethyl phenyl group at position 4 is replaced by the 4-(5)-Chloro-2-ethyl-5-(4)-imidazolyl substituent, were designed and synthesized as calcium channel agonist. For this propose, the structures of designed compounds were drawn by HYPERCHEM program. Conformations of the compounds were optimized through semi-empirical method followed by PM3 calculation. Then the crystalin stucture of L-type calcium channel was obtained from the Protein Data Bank (PDB) server. Docking calculations were carried out using Auto-Dock.4 program. The good interaction of our 1,4-DHP derivatives showed that they can be as possible calcium channel agonist agents. Finally compounds were synthesized according to a modified Hantzsch condensation procedure.