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Early commencement of enteral nutrition (EEN) in critically ill patients requiring mechanical ventilation may improve outcomes. But there is a lack of enough data regarding EEN effects on COPD exacerbation patients’ outcomes. This retrospective study involved 129 COPD exacerbation patients who received invasive mechanical ventilation in ICU. The clinical outcomes were compared based on the timing of enteral nutrition (<48h vs >48h) during 60 days of ICU stay. We surveyed and analyzed mortality, pleural effusion, ventilator-associated pneumonia, weaning failure, cardiac arrhythmias, GI bleeding, electrolyte imbalances, renal dysfunction and length of ICU stay. All analyses were performed using SPSS software version 22.0. 129 COPD-exacerbated patients (EEN group n=66; DEN group n=63) who met the inclusion criteria were enrolled in the study. EEN group had a lower death rate (39% vs 44.4%) than the DEN group, but no significant difference was found in the overall mortality during the 60-day follow-up (P 0.561). The EEN group also had lower ICU stay and pleural effusion rate than the DEN group (P:0.006 and 0.020 respectively). No significant differences were found in other outcomes. Early enteral nutrition might be associated with shorter ICU stay and lower odd ratio of acquisition of pleural effusion in COPD patients requiring invasive mechanical ventilation. EEN could not decrease mortality rate compared with DEN in the current study. [ABSTRACT FROM AUTHOR]

In this paper, Cu-Au nanospherical structures were formed on glass surfaces by nanosecond UV laser irradiation. ArF laser pulses (193 nm wavelength, 15 ns time duration) were used for the experiments. Cu-Au bimetallic thin-film sample surfaces are structured under ArF excimer laser irradiation during the ablation process. Laser irradiation experiments were carried out using different laser fluences, the number of pulses, and focusing optics. Morphology of the irradiated surfaces and images of the nanostructures were obtained by the scanning electron microscopy method. Also, the optical and plasmonic behaviors of the nanostructures were collected by UV-Vis spectroscopy. Elemental composition and its spatial distribution were obtained using energy-dispersive x-ray spectroscopy (EDS) and mapping. EDS mapping shows that bimetallic nanospheres have a core-shell structure. Our results show that different laser irradiation parameters change the nanostructures' composition, size, distribution, morphology, and optical properties. Cu-Au nanospherical structures can be used for nano-biosensing, catalysis, and enhanced spectroscopy applications. [ABSTRACT FROM AUTHOR]

BACKGROUND: The new coronavirus causes systemic inflammation and damage to various organs. So, this study aimed to follow up patients with COVID −19 after recovery for three months by performing cardiac, pulmonary and laboratory tests. MATERIALS AND METHODS: This was a prospective cohort study of COVID-19 patients who were discharged from Baharloo Hospital. The diagnosis of COVID-19 was confirmed by PCR or long CT scan. Inclusion criteria were age over 18 years and patients with more than 50% of pulmonary involvement in lung CT scan. The patients were called to Baharloo hospital three months after recovery and were examined for cardiac, pulmonary and blood tests. RESULT: Our study included 178 participants with mean age of 55.70, and 50.6% of them were male. Among pulmonary factors in the hospital, 71.9%, 15.7%,1.7%,19.1% and 53.4% had positive GGO, consolidation, reverse halo sign, traction bronchiectasis and vascular enlargement, respectively. After three months follow up, percentage of patients who had reticulation, honeycombing, fibrotic brand and bullae were 12%, 1.1%,8.4% and 0%, respectively. The Mean values of FVC and FEV1 were reported 4.21 and 3.01, respectively. Among Cardiac factors, positive PVC, PAC and mean Pap were decreased after three months. Only Growth in myalgia and Decreased sense of taste were statistically significant. Also, D dimer, UA protein, PMN, Ferritin CRP, PMN, LDH and HB amounts had decreased significantly. CONCLUSION: Our study indicated that in addition to pulmonary changes, rapid damage to other organs and the occurrence of cardiac symptoms and changes in laboratory result were also reported in patients recovered from COVID-19. [ABSTRACT FROM AUTHOR]

Several months have passed since the onset of the COVID-19 pandemic. Multiple characteristics have been proposed as prognostic factors so far. This study aims to provide evidence on the association of neutrophil-to-lymphocyte ratio (NLR) at the hospitalization time and three desired outcomes (mortality, prolonged hospitalization, and intensive care unit [ICU] admission). We designed a single-centre retrospective observational study in Baharloo Hospital (Tehran, Iran) from 20 February to 19 April 2020. Patients with confirmed COVID-19 diagnosis via rt-PCR or chest CT imaging were included. Demographic and clinical data were obtained. The sample was divided into three groups, using tertile boundaries of initial NLR. The differences in mortality, comorbidities, hospitalization duration, drug administration, and ICU admission between these three groups were investigated. The identified confounding factors were adjusted to calculate the odds ratio of death, ICU admission, and prolonged hospitalization. Nine hundred sixty-three patients were included. In total, 151 and 212 participants experienced mortality and ICU admission, respectively. In multivariate logistic regression models, the adjusted odds ratio for mortality event in the second and third tertile of initial NLR after full adjustment were 1.89 (95% CI:1.07-3.32) and 2.57 (95% CI:1.48-4.43) and for ICU admission were 1.85 (95% CI:1.14-3.01) and 2.88 (95% CI:1.79-4.61), respectively. The optimal cut-off value of the initial NLR for predicting mortality was 4.27. Initial NLR can predict mortality and ICU admission in COVID-19 patients. Further investigations for curating the calculated cut-off can propose initial NLR as an indicator of poor prognosis for COVID-19 patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: The new coronavirus causes systemic inflammation and damage to various organs. So, this study aimed to follow up patients with COVID -19 after recovery for three months by performing cardiac, pulmonary and laboratory tests. MATERIALS AND METHODS: This was a prospective cohort study of COVID-19 patients who were discharged from Baharloo Hospital. The diagnosis of COVID-19 was confirmed by PCR or long CT scan. Inclusion criteria were age over 18 years and patients with more than 50% of pulmonary involvement in lung CT scan. The patients were called to Baharloo hospital three months after recovery and were examined for cardiac, pulmonary and blood tests. RESULT: Our study included 178 participants with mean age of 55.70, and 50.6% of them were male. Among pulmonary factors in the hospital, 71.9%, 15.7%,1.7%,19.1% and 53.4% had positive GGO, consolidation, reverse halo sign, traction bronchiectasis and vascular enlargement, respectively. After three months follow up, percentage of patients who had reticulation, honeycombing, fibrotic brand and bullae were 12%, 1.1%,8.4% and 0%, respectively. The Mean values of FVC and FEV1 were reported 4.21 and 3.01, respectively. Among Cardiac factors, positive PVC, PAC and mean Pap were decreased after three months. Only Growth in myalgia and Decreased sense of taste were statistically significant. Also, D dimer, UA protein, PMN, Ferritin CRP, PMN, LDH and HB amounts had decreased significantly. CONCLUSION: Our study indicated that in addition to pulmonary changes, rapid damage to other organs and the occurrence of cardiac symptoms and changes in laboratory result were also reported in patients recovered from COVID-19. [ABSTRACT FROM AUTHOR]

Aims: We hypothesised that omega‐3 fatty acids would be an appropriate adjunct therapy for alleviating the inflammatory response and clinical manifestation in hospitalised patients with Covid‐19 disease. Methods: This was a single‐blind randomised controlled trial in Amir‐Alam hospital in Tehran. Thirty adult men and women diagnosed with Covid‐19 were allocated to either control group (receiving Hydroxychloroquine) or intervention group (receiving Hydroxychloroquine plus 2 grams of Docosahexaenoic acid [DHA] + Eicosapentaenoic acid [EPA]) for 2 weeks. Primary outcome of the intervention including C‐reactive protein (CRP), erythrocyte sedimentation rate (ESR) as well as clinical symptoms including body pain, fatigue, appetite and olfactory and secondary outcomes including liver enzymes were determined at the baseline and after omega‐3 supplementation. Clinical signs were measured using self‐reported questionnaires. There were commercial kits for determination of CRP and liver enzymes concentrations in the serum of patients. For determination of ESR automated haematology analyser was applied. The study of "Comparison of the effectiveness of omega‐3 and Hydroxychloroquine on Inflammatory factors, liver enzymes and clinical symptoms in diabetic Covid‐19 patients" was registered in Iranian Registry of Clinical Trials (IRCT) with ID number: IRCT20200511047399N1. Results: In comparison to control group, patients receiving omega‐3 indicated favourable changes in all clinical symptoms except for olfactory (P <.001 for body pain and fatigue, P =.03 for appetite and P =.21 for olfactory). Reducing effects of omega‐3 supplementation compared with control group were also observed in the levels of ESR and CRP after treatment (P <.001 for CRP and P =.02 for ESR). However, no between group differences in the liver enzymes serum concentrations were observed after supplementation (P >.05). Conclusion: Current observations are very promising and indicate that supplementation with moderate dosages of omega‐3 fatty acids may be beneficial in the management of inflammation‐mediated clinical symptoms in Covid‐19 patients. [ABSTRACT FROM AUTHOR]

The emergence of multidrug (MDR) isolates of Escherichia coli has made the treatment of urinary tract infections (UTI) very challenging. Integrons are considered to be one of the most important mechanisms in the dissemination of resistance genes. In the current study, we sought to investigate the antibiotic resistance patterns, class 1–3 integrons and corresponding gene cassettes in urinary isolates of E. coli in the southwest of Iran. A total of 144 E. coli isolates were collected from the patients with UTIs. Antibiotic susceptibility test conducted by the disc diffusion method using 12 different antibiotics. The polymerase chain reaction (PCR) was used for the detection of intl1, intI2, and intI3 genes. To analyze the gene cassettes, variable regions of class 1 integron were amplified by PCR and subjected to sequencing. The highest rates of resistance were exhibited to amoxicillin/clavulanic (73.6%), trimethoprim-sulfamethoxazole (63.9%) and tetracycline (63.2%). Totally, intI1 and intI2 genes were identified in 62.5 and 9% of isolates. One-hundred and nine (75.7%) E. coli isolates were multidrug resistance (MDR), among which 78% harbored intI1 gene. Also, all of the intI2 positive E. coli isolates were MDR. Ten different gene cassette arrays were found in intl1 positive E. coli including dfrA5, dfrA25, dfrA7, aacA4, aadA1, aadB-catB3, dfrA17-aadA5, dfrA12-orfF-aadA2, aadA1-blaOXA-30, and dfrA5-catB3-aacA4. The dfrA17-aadA5 was the most prominent gene cassette array among E. coli isolates. Characterization of resistance gene cassettes located in integrons in this study showed a high frequency of dfrA and aad genes which confer resistance to trimethoprim and aminoglycosides. The obtained result from this study could be useful in planning to prevent the rising rate of antibiotic resistance. [ABSTRACT FROM AUTHOR]

The non-thermal plasma (NTP) is a superior proposed method for nitric oxide removal because of operation at atmospheric pressure and ambient temperature. The energy consumption is the main challenge of using this technology. The packed plasma reactor with dielectric materials has been extensively investigated; it has higher energy efficiency. In this study, the energy efficiency and the other effectiveness factors in nitric oxide removal by NTP reactor packed with ceramic and glass beads optimized and modeled using Response Surface Methodology. The findings showed the maximum energy efficiency was 132.69g/J in the optimal conditions of initial concentration, gas flowrate, and duty cycle(voltage) equal to 1050 ppm, 2.5 L/min, and 9%(22KV), respectively in the packed reactor with ceramic beads by 1.7 times than the empty reactor. It is concluded that the use of ceramic beads as a dielectric material in the discharge space significantly increased energy efficiency in the removal of nitric oxide. [ABSTRACT FROM AUTHOR]

Chronic Eosinophilic Pneumonia (CEP) is an idiopathic disorder characterized by an abnormal marked accumulation of eosinophils in the interstitial and alveolar spaces of the lung. CEP is typically suspected in a patient with progressive dyspnoea over one to four months and a chest radiograph showing bilateral peripheral or pleural-based opacities. Dominant extrapulmonary manifestations in CEP are rare. We report a 44-year-old Iranian woman with progressive dyspnea, peripheral chest opacity, and cardiac involvement. A diagnosis of CPE was considered base on clinical and para clinical criteria. [ABSTRACT FROM AUTHOR]

Background: Long term occupational exposure to cotton dust is associated with respiratory symptoms and loss of pulmonary function. Aim: This study was conducted to explore respiratory symptoms, pulmonary function tests and chest radiography of workers, and to evaluate the findings of high resolution computed tomography and its correlation with pulmonary function tests (PFT). Material and Methods: The study was conducted on 100 cotton workers as exposed group and 100 unexposed subjects. Smokers were excluded from the study. All workers were interviewed and examined by the pulmonologist. PFT and chest radiography were conducted for all subjects. HRCT was performed for those with abnormal PFT or chest radiography. Results: A total of 51% and 31% of the cotton textile workers had one or more respiratory symptoms and respiratory signs respectively. 28% of subjects in the exposed group and 5% of subjects in unexposed group had obstructive pattern. Bronchia wall thickening and air trapping were the most frequent chest radiography and HRCT abnormalities respectively. There was a significant correlation between HRCT and the results of PFT. Conclusion: We conclude that long term exposure to cotton dust is associated with obstructive disease that increase with duration of exposure (history of working years), also use of HRCT as a sensitive tool in the assessment of pathologic changes and it's correlation with PFT, confirms the expected pathophysiology of airway obstruction in cotton workers. [ABSTRACT FROM AUTHOR]

Objective: There are some metabolic similarities between women with gestational diabetes mellitus (GDM) and polycystic ovary syndrome (PCOS); it is still uncertain, however, to what extent coexistence GDM and PCOS affects pregnancy outcome. The present study was designed to determine the obstetric and neonatal outcome in PCOS with GDM. Materials and methods: A case-control study was conducted involving 261 GDM women. Thirty hundredone cases had PCOS based on Rotterdam criteria and the other thirty hundred cases (control group) were women without PCOS. The subjects in each group were evaluated regarding obstetric and those women whose documentation's were complete entered the study. Results: In present study, women with PCOS and GDM had more than twofold increased odds of preeclampsia (p = 0.003, CI = 1.56-5.01, and OR = 2.8) and PIH (p= 0.04, CI = 1.28-4.5, and OR= 2.4). Maternal PCOS and GDM were also associated with threefold increased odds of neonatal hypoglycemia (p= 0.004, CI= 1.49-6.58, and OR= 3.13). Conclusion: Our finding emphasized that pregnant PCOS patients should be followed carefully for the occurrence of various pregnancy and neonatal complications including hypertension and hypoglycemia. We suggested that these neonates should be given more care regarding hypoglycemia symptoms. [ABSTRACT FROM AUTHOR]

The article discusses about lower and upper respiratory tract information during the Hajj pilgrimage and their effect on the health of pilgrims. Topics discussed include the epidemiology and statistics of upper respiratory tract infection (ARI) during Hajj, diagnosis and treatment of pneumonia, and the outbreak of pulmonary tuberculosis (TB) during Hajj.

Introduction: Early differentiation of biliary atresia from neonatal hepatitis is of utmost importance, since on time surgery of biliary atresia significantly improves the outcome. Hepatobiliary scintigraphy is an integral part of diagnosis work-up of these patients; however its specificity for diagnosis of biliary atresia is suboptimal. In this study we evaluated the value of ursodeoxycholic acid pre-treatment for improvement of hepatobiliary scintigraphy specificity. Methods: Thirty consecutive infants with direct heperbilirubinemia were included into the study. All infants underwent hepatobiliary scintigraphy with 99mTc-bromo iminodiacetic acid (99mTc-BRIDA) twice (first after pretreatment with phenobarbital and the other time after pre-treatment with ursodeoxycholic acid). Results: Of 30 patients included into our study 13 had final diagnosis of extrahepatic biliary atresia and 17 had neonatal hepatitis. Bowel was visualized in 11 patients with neonatal hepatitis after phenobarbital pre-treatment and in 16 after ursodeoxycholic acid pretreatment which amounts to 80 % and 96.6 % specificity for diagnosis of biliary atresia with phenobarbital and ursodeoxycholic acid respectively. All patients had complications of phenobarbital administration (lethargy, poor feeding, irritability, hypotonia, etc) to some extent. These findings decreased significantly after discontinuation of phenobarbital and were not present with ursodeoxycholic acid. Conclusion: Ursodeoxycholic acid is a safe and efficient drug for pre-treatment of patients with neonatal cholestasis syndrome who are going to undergo hepatobiliary scintigraphy. Compared to phenobarbital, this drug has fewer complications and is more efficient. [ABSTRACT FROM AUTHOR]