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Abstract Background Systemic lupus erythematosus is a multi-organ autoimmune disorder that is treated by immunosuppressive agents that weaken the immune defense against opportunistic pathogens and latent infections such as strongyloidiasis. Herein, we report the case of a 43-year-old woman known to have systemic lupus erythematosus who presented with gastrointestinal symptoms, edema, and bone pain 2 months after receiving immunosuppressive treatment. Case presentation A 43-year-old Iranian female known to have systemic lupus erythematosus and antiphospholipid syndrome presented with abdominal pain, nausea, vomiting, and generalized edema. She was on CellCept, prednisolone, and hydroxychloroquine. The vital signs were within the normal range. On physical examination, no rash was observed on the skin. There was only a mild tenderness in epigastric region. The results of blood analysis revealed hypochromic microcytic anemia, normal leukocyte count with mild eosinophilia. Liver enzymes as well as renal function tests were within the normal range. Stool examination was negative for trophozoites, ova, or cysts of parasites. Endoscopic findings included a generalized nodular appearance of duodenum with an infiltrative mucosa in the wall of duodenum, suggesting lymphoma. The pathology report determined the diagnosis of strongyloidiasis. Cap albendazole 400 mg was administered twice a day for 2 weeks. Abdominal pain was completely relieved 1 week after starting the treatment. The patient was eventually discharged after 10 days. Conclusion The significance of this case report is the necessity to send complete blood count and serologic assays to screen latent strongyloidiasis before receiving immunosuppressive agents in patients with systemic lupus erythematosus.

Abstract Background Metabolic syndrome (MetS) contributes to an increased risk of cardiovascular diseases. Traditional metrics like body mass index (BMI) have limitations in discerning fat distribution. The purpose of this study was to evaluate the diagnostic accuracy of traditional and novel anthropometric indices in metabolic syndrome and its components in the south coast of Iran. Methods In this cross-sectional study, 2694 adults aged 35 to 70 were included. Comprehensive anthropometric and biochemical data were collected and analyzed. There were eight anthropometric indices evaluated in this study, including a body shape index (ABSI), body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), body roundness index (BRI), abdominal volume index (AVI), weight-adjusted waist index (WWI) and waist-height ratio (WHtR). Results WHtR (AUC: 0.766 for males, 0.799 for females), BRI (AUC: 0.766 for males, 0.799 for females), and AVI (AUC: 0.769 for males, 0.793 for females) were the best predictors of MetS. ABSI had the weakest correlation with metabolic variables. Conclusions AVI, WHtR, BRI, and WHR were superior to other measures as anthropometric indexes for determining MetS and its components. The study contributes valuable insights into the utility of traditional and novel metrics in clinical practice, highlighting the need for standardized diagnostic approaches and further research in diverse populations.

Abstract Background Metabolic Syndrome (MetS) is characterized by the co-occurrence of various metabolic risk factors, significantly increasing the risk of cardiovascular diseases (CVD) and type 2 diabetes (T2DM). This study investigates the potential of hematological indices, specifically the neutrophil to high-density lipoprotein cholesterol ratio (NHR) and lymphocyte to high-density lipoprotein cholesterol ratio (LHR), as predictors of MetS in a population from southern Iran. Methods Utilizing baseline data from the Bandare-Kong Non-Communicable Diseases (BKNCD) Cohort, part of the Prospective Epidemiological Research Studies in IrAN (PERSIAN), A total of 2,684 participants aged 35–70 years were analyzed. Participants were evaluated using the Iranian National Cholesterol Education Program (NCEP) criteria to diagnose MetS. Receiver operating characteristic (ROC) analysis was conducted to assess the predictive validity of NHR and LHR across different demographic categories. Results The mean LHR and NHR values were significantly higher in individuals diagnosed with MetS (P

Background and aimThe neurological processes responsible for irritable bowel syndrome (IBS) pathophysiology and its clinical potentials are not fully understood. The current study aimed to examine white matter microstructural abnormalities and the reasons behind white matter impairment in individuals with irritable bowel syndrome by performing a meta-analysis of diffusion tensor imaging studies.MethodsPubMed, Scopus and Web of Science were searched until April 2024. Chosen articles based on our defined eligibility criteria were extracted for the data relating to fractional anisotropy and brain connectivity. Webplot digitizer was used to extract digital data. We used the latest version of STATA(ver18) to meta-analyze the data. Quality assessment of studies was done using a critical appraisal tool. Egger’s test for minor study effects assessed the publication bias.Results543 IBS cases and 472 healthy controls were included in this study. The mean age of the case and control group was 35.2 ± 17.4 and 33.6 ± 15.8 (mean ± SD), respectively. There was no statistically significant difference in age between groups (p > 0.05). Analyzed Standard mean difference using a fixed model for Fractional anisotropy of regions of interest (ROI) associated with sensory processing, such as the thalamus, insula, primary somatosensory cortex, dorsal cingulum and the fornix in selected studies showcased decreased white matter interactivity in case group however this decrease was not statistically different [SMD −88, 95%CI (−1.32, −0.44), p > 0.05].ConclusionFurther investigation is necessary to ascertain whether the modified structural connectivity mentioned in this study is a contributing factor to IBS, an outcome of the condition, a risk factor for it, or, more probably, a consequence of a mutually influential relationship between the changes observed in the white matter tract and IBS symptoms.

Background: The present study attempted to determine the antibiotic susceptibility of bacteria isolated from endotracheal tube culture on patients admitted to the intensive care units (ICUs) of Shahid Mohammadi hospital in Bandar Abbas. Materials and Methods: This cross-sectional study was conducted on 114 patients hospitalized in the pulmonary ICU of Shahid Mohammadi hospital in Bandar Abbas from March 2018 to March 2019. The samples of the patients’ endotracheal tube secretions were collected for the culture purpose on the first and fifth days of hospitalization in the ICU where the disk diffusion method was used to determine antibiotic susceptibility. Results: The most common isolated microorganisms from the first day of culture were 26 Acinetobacter spp. isolates (22.8%), 10 Candida isolates (8.8%), and 9 Pseudomonas aeruginosa isolates (7.9%). The most common microorganisms which were isolated on the fifth day comprised Acinetobacter spp. with 57 isolates (51.8%), Candida with 6 isolates (5.5%), and P. aeruginosa with 6 isolates (5.5%). The highest resistant bacteria isolated from Acinetobacter spp. samples on the first-day were amikacin (92.3%) and meropenem (84.6%). The highest resistance of P. aeruginosa was against meropenem (77.8%), while the highest resistance of Acinetobacter spp. isolates was found to be amikacin (94.7%) and meropenem (86%) from the fifth-day samples. Further, P. aeruginosa isolates had the highest resistance in meropenem (83.3%), co-trimoxazole, and cefepime (66.7% for each of them). Conclusion: Ventilator-associated pneumonia (VAP) is considered a warning condition due to multidrug-resistant bacteria. According to the present study, the most common VAP-causing bacteria are gram-negative, especially Acinetobacter, with high antibiotic resistance.

Abstract Two-dimensional (2D) heterostructures (HS) formed by transition-metal dichalcogenide (TMDC) monolayers offer a unique platform for the study of intralayer and interlayer excitons as well as moiré-pattern-induced features. Particularly, the dipolar charge-transfer exciton comprising an electron and a hole, which are confined to separate layers of 2D semiconductors and Coulomb-bound across the heterojunction interface, has drawn considerable attention in the research community. On the one hand, it bears significance for optoelectronic devices, e.g. in terms of charge carrier extraction from photovoltaic devices. On the other hand, its spatially indirect nature and correspondingly high longevity among excitons as well as its out-of-plane dipole orientation render it attractive for excitonic Bose–Einstein condensation studies, which address collective coherence effects, and for photonic integration schemes with TMDCs. Here, we demonstrate the interlayer excitons’ out-of-plane dipole orientation through angle-resolved spectroscopy of the HS photoluminescence at cryogenic temperatures, employing a tungsten-based TMDC HS. Within the measurable light cone, the directly-obtained radiation profile of this species clearly resembles that of an in-plane emitter which deviates from that of the intralayer bright excitons as well as the other excitonic HS features recently attributed to artificial superlattices formed by moiré patterns.

BackgroundMetabolic syndrome (MetS) is defined as the presence of several metabolic risk factors. The traditional MetS criteria have been considered insufficient for evaluating individuals at risk. MetS has always been categorized using binary criteria, which deny that the risk associated with MetS is likely to exist as a continuum. Also, MetS may present differently depending on age, sex, race, or ethnicity. We aimed to derive age-sex-specific equations for MetS severity scores within a southern Iranian population.MethodsThis study used first-phase data from the Bandare-Kong Non-Communicable Diseases (BKNCD) Cohort Study as part of the Prospective Epidemiological Research Studies in IrAN (PERSIAN). After exclusion of the pregnant women, diabetic patients, and individuals taking antihypertensive, antihyperlipidemic, and antidiabetic medications, 2,735 individuals aged 35 to 70 years were selected for analysis. The diagnosis of MetS was based on the National Cholesterol Education Program (NCEP) criteria for the Iranian population. Confirmatory factor analysis (CFA) was performed to formulate MetS severity scores. The receiver operating characteristic (ROC) analysis was performed to validate MetS severity score equations for age-sex-specific categories.ResultsTriglyceride had the highest factor loading range in all age-sex categories for determining the MetS severity score. Conversely, systolic blood pressure and fasting plasma glucose (FPG) exhibited the lowest factor loadings across all age-sex groups. In both sexes, when age was considered, systolic blood pressure and FPG factor loadings were less significant among subjects aged ≥45 and 35–44 years, respectively.ConclusionMetS severity scores might be more applicable than the current criteria of MetS. Prospective population-based studies should be conducted to assess the accuracy and validity of the MetS severity score for predicting cardiometabolic diseases.

Abstract Background A variety of health problems, such as metabolic syndrome (MetS), have been linked to sleep disorders. While numerous epidemiological studies have shown a U-shaped relationship between sleep duration and poor health outcomes, the results were limited and inconsistent. This study was designed to evaluate the relationship between sleep duration and MetS. Methods This population-based study was conducted on the participants aged 35–70 of Bandare-Kong Non-Communicable Diseases (BKNCD) Cohort Study, a part of Prospective Epidemiological Research Studies in IrAN (PERSIAN). MetS was diagnosed according to the National Cholesterol Education Program (NCEP) criteria and the Iranian-specific cut-off for waist circumference (≥ 95 cm). Sleep information was extracted through a standard questionnaire based on self-reported information. Data were analyzed by R software using generalized additive models (GAMs). A statistically significant level was considered as P

Abstract Objectives Severe acute respiratory infection (SARI) caused by the SARS-CoV-2 virus may cause lung failure and the need for mechanical ventilation. Infection with SARS-COV-2 can lead to activation of inflammatory factors, increased reactive oxygen species, and cell damage. In addition to mucolytic effects, N-Acetylcysteine has antioxidant effects that we believe can help patients recover. In this study, we evaluate the efficacy of N-Acetylcysteine in patients with severe COVID-19. Trial design This is a prospective, randomized, single-blinded, phase 3 controlled clinical trial with two arms (ratio 1:1) parallel-group design of 40 patients, using the placebo in the control group. Participants All severe COVID-19 patients with at least one of the following five conditions: (respiration rate > 30 per minute), hypoxemia (O2 ≤ saturation, arterial oxygen partial pressure ratio 50% of lung area during 24 48 h), Lactate dehydrogenase (LDH) > 245 U / l, Progressive lymphopenia, and admitted to the intensive care unit of Shahid Mohammadi Hospital in Bandar Abbas and have positive PCR test results for SARS-Cov-2 and sign the written consent of the study will be included. Patients will be excluded from the study if they have a history of hypersensitivity to N-Acetylcysteine, pregnancy, or refuse to participate in the study. Intervention and comparator After randomization, participants in the intervention group receive standard of care (SOC) according to the National Committee of COVID-19 plus N-acetylcysteine (EXI-NACE 200mg/mL, in 10mL ampules of saline for parenteral injection (EXIR pharmaceutical company)) at a dose of 300 mg/kg equivalent to 20 gr as a slow single intravenous injection on the first day of hospitalization. In the control group patients receive SOC and placebo ( Sterile water for injection as the same dose). The placebo is identical in appearance to the N-acetylcysteine injection (EXIR pharmaceutical company as well). Main outcomes The primary endpoint for this study is a composite endpoint for the length of hospitalization in the intensive care unit and the patient's clinical condition. These outcomes were measured at the baseline (before the intervention) and on the 14th day after the intervention or on the discharge day. Randomisation Eligible participants (40) will be randomized in two arms in the ratio of 1: 1 (20 per arm) using online web-based tools and by permuted block randomization method. To ensure randomization concealment, random sequence codes are assigned to patients by the treatment team at the time of admission without knowing that each code is in the intervention or comparator group. Blinding (masking) All participants will be informed about participating in the study and the possible side effects of medication and placebo. Patients participating in the study will not be aware of the assignment to the intervention or control group. The principal investigator, health care personnel, data collectors, and those evaluating the outcome are aware of patient grouping. Numbers to be randomised (sample size) A total of 40 patients participate in this study, which are randomly divided; 20 patients in the intervention group will receive SOC and N-acetylcysteine, 20 patients in the control group will receive SOC and placebo. Trial status First version of the protocol was approved by the Deputy of Research and Technology and the ethics committee of Hormozgan University of Medical Sciences on February 14, 2021, with the local code 990573, and the recruitment started on March 2, 2021 and the expected recruitment end date is April 1, 2021. Trial registration The protocol was registered before starting participant recruitment entitled: Evaluation of the efficacy of N-Acetylcysteine in severe COVID-19 patients: a randomized controlled phase III clinical trial, IRCT20200509047364N3 , at Iranian Registry of clinical trials on 20 February 2021. Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2).

Background and aim: Contamination of microorganisms, including Staphylococcus Aureus, in oral saliva and oral tissues, is a common problem. Therefore, in this study, photodynamic therapy's effect on the number of oral Staphylococcus Aureus colonies. Was evaluated using two indices of Indocyanine Green and Methylene Blue with sensitizer with Chlorhexidine mouthwash. Materials and methods: In the first stage, a new culture of ATCC St.Aureus 25923 was performed. Colonies of Staphylococcus Aureus were counted. The teeth were randomly divided into four groups: the first group was Methylene Blue, and the second group was subjected to 2% Indocyanine Green. All samples from both groups were sampled before laser irradiation and colonized in the culture medium for 24 hours. The third group of teeth was immersed in 2% Chlorhexidine mouthwash and sampled. The fourth group was considered as the control group. Also, Post hoc analysis was used for comparing before and after treatment in each group. Results: This study showed that all three experimental groups reduced the number of Staphylococcus Aureus colonies. However, Indocyanine Green and Methylene Blue did not significantly decrease the number of colonies before and after treatment (p> 0.05), but Chlorhexidine caused a significant decrease in the number of Staphylococcus colony Aureus (p

Background: While many dental procedures induce pulpal damage by increase the temperature, this study was established to evaluate the thermally effect of different laser methods on pulp, oral soft and hard tissues. Objectives: In this study, laser irradiation applied to measure how increased in power output can influence on dental pulp by using CT images. Methods: Ten adult New Zealand white rabbits were divided into 2 groups receiving 3 and 5 watt for 15 second respectively on left side cheek teeth after shortening of third upper and first lower premolars. Right cheek teeth trimmed as well and served as control. CT scans were taken immediately after lasing and repeated every week for one month. Results: The statistical analysis of dental measurements shows that teeth length of right and left third upper premolar was significantly different during time (P0.05). Only third upper premolar in fourth week showed a significant difference between two groups (P=0.047). Conclusions: laser radiation could influence on tooth growth in both groups. This study revealed that the higher laser power would have been more effective on reduction of growth rate of teeth. In addition, 3D CT scans could be an appropriate tools for dental growth investigation.

Herein, the interaction of hen egg white lysozyme (HEWL) with iron nanoparticle (Fe NP) was investigated by spectroscopic and docking studies. The zeta potential analysis revealed that addition of Fe NP (6.45±1.03 mV) to HEWL (8.57±0.54 mV) can cause to greater charge distribution of nanoparticle-protein system (17.33±1.84 mV). In addition, dynamic light scattering (DLS) study revealed that addition of Fe NP (92.95±6.11 nm) to HEWL (2.68±0.37 nm) increases suspension potential of protein/nanoparticle system (51.17±3.19 nm). Fluorescence quenching studies reveled that both static and dynamic quenching mechanism occur and hydrogen bond and van der Waals interaction give rise to protein-NP system. Synchronous fluorescence spectroscopy of HEWL in the presence of Fe NP showed that the emission maximum wavelength of tryptophan (Trp) residues undergoes a red-shift. ANS fluorescence data indicated a dramatic exposure of hydrophobic residues to the solvent. The considerable reduction in melting temperature (T(m)) of HEWL after addition of Fe NP determines an unfavorable interaction system. Furthermore circular dichoroism (CD) experiments demonstrated that, the secondary structure of HEWL has not changed with increasing Fe NP concentrations; however, some conformational changes occur in tertiary structure of HEWL. Moreover, protein-ligand docking study confirmed that the Fe NP forms hydrogen bond contacts with HEWL.

Accurate modelling is required to estimate crack propagation in a beam–column joint. In this study, a numerical method is developed to model crack propagation and failure loading in a beam–column joint under static load. To realize this objective, a four-node, thin-layer interface element is produced to model the fracture process zone and crack propagation. Moreover, the fracture criterion for determining the growth of a crack based on the release rate of strain energy is established. To validate the present model, ABAQUS software is used to simulate crack propagation by conventional cohesive elements. The numerical results obtained are extremely close to the experimental results within an accuracy level ranging from 4.3% to 6.7%. Meanwhile, the ABAQUS software data and the experimental data are predicted at a margin of error ranging from 12.4% to 16%.