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Spent bleaching clay (SBC) is a problematic waste from the palm oil industry with worldwide availability. In this study, geopolymer was synthesized from SBC, a kind of aluminosilicate material with an alkaline activator solution that is made up of sodium hydroxide and sodium silicate. Calcium silicate (CS), which is a by-product of the silicates removal from wastewater, was also added to the formulation. The geopolymer mixture paste was cured in an oven at 80 °C for 24 h and at room temperature for 7 days. The characterizations were carried out using FTIR spectroscopy, SEM/EDX, TGA, BET, and XRD. The SEM images showed an aggregate of aluminosilicate material is formed with some unreacted particles on the surface of the geopolymer. The TGA results show that the geopolymers decomposed at a higher temperature than SBC, demonstrating its heat resistance properties. The BET results showed the addition of CS formed a denser geopolymer with a total pore volume of 0.0636 cm 3 /g., (© 2022 Wiley-VCH GmbH.)

Background: Ramadan fasting is regarded as a form of worship amongst Muslims. However, patients with a high risk of diabetic complications are advised to avoid fasting, as the practice is associated with significant impacts on several health factors for type 2 diabetic patients, including glycaemic control. Thus, a lack of focused education before Ramadan may result in negative health outcomes., Aim: To evaluate the impact of a Ramadan-focused diabetes education programme on hypoglycaemic risk and other clinical and metabolic parameters., Methods: A systematic literature search was performed using Scopus, PubMed, Embase, and Google Scholar to identify relevant studies meeting the inclusion criteria from inception. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and guidelines were followed when performing the search and identification of appropriate studies., Results: Seventeen studies were included in this systemic review; five of them met the criteria to compile for a meta-analysis. The included studies were with various study designs, including randomised controlled trials, quasi-experimental and non-randomised studies. Overall, the results revealed a significant reduction of hypoglycemia risk (81% reduction) for fasting patients in intervention groups who received Ramadan-focused education compared with patients receiving conventional care (OR 0.19, 95% CI: 0.08-0.46). Moreover, HbA1c significantly improved amongst patients who received a Ramadan-focused diabetes education intervention, compared with those receiving conventional care., Conclusion: Ramadan-focused diabetes education had a significant impact on hypoglycemia and glycaemic control, with no significant effect on body weight, blood lipids or blood pressure., (© 2020 John Wiley & Sons Ltd.)

The appropriate disposal practice of unused and expired medications has become a global challenge that has caught the attention of health policymakers, pharmaceutical organizations, healthcare professionals, and the wider community. The current study aimed to evaluate the awareness, attitudes, and behaviors relating to the disposal practice of unused and expired medications and medication wastage issues among the general public in Selangor, Malaysia. The quantitative, cross-sectional study was conducted using a pre-validated structured survey form. Among the approached individuals, 426 showed their willingness to participate in the study. More than 80% of the study population reported being aware of the medication wastage issue and its impact on patients and the economy. The respondents with a higher level of education (OR = 1.85; 95% CI = 1.18-2.52; p < 0.003) were more likely to be cognizant of the detrimental consequences of inappropriate waste disposal. The female respondents were more likely to report comprehending that the availability of free healthcare resources is contributing to medication waste (OR = 1.33, 95% CI = 1.015-2.34; p < 0.005). The majority of respondents reported throwing away unused medications (202; 47.4%) and expired medications (362; 84.9%) in the garbage. The respondents believed that the provision of appropriate directions by healthcare professionals (312; 73.2%) and prescribing/dispensing medications in quantities for the duration that ensures patient adherence (114; 26.7%) could minimize medication wastage. The Ministry of Health (258; 60.5%), pharmaceutical organizations (212; 49.7%), and pharmacists (193; 45.3%) were the respondents' perceived responsible sources of information. The current findings reported that respondents were familiar that inappropriate practices of medication wastage might have harmful consequences. However, a gap exists between their awareness and practice, and the disposal approaches practiced by the respondents were generally not appropriate.

Nanofibrous materials produced by electrospinning processes have potential advantages in tissue engineering because of their biocompatibility, biodegradability, biomimetic architecture, and excellent mechanical properties. The aim of the current work is to study the influence of the electron beam on the poly L-lactide acid/ carboxy-methyl starch/β-tricalcium phosphate (PLLA/CMS/β-TCP) composite nanofibers for potential applications as bone-tissue scaffolds. The composite nanofibers were prepared by electrospinning in the combination of 5% v / v carboxy-methyl starch (CMS) and 0.25 wt% of β-TCP with the PLLA as a matrix component. The composites nanofibers were exposed under 5, 30, and 100 kGy of irradiation dose. The electron-beam irradiation showed no morphological damage to the fibers, and slight reduction in the water-contact angle and mechanical strength at the higher-irradiation doses. The chain scission was found to be a dominant effect; the higher doses of electron-beam irradiation thus increased the in vitro degradation rate of the composite nanofibers. The chemical interaction due to irradiation was indicated by the Fourier transform infrared (FTIR) spectrum and thermal behavior was investigated by a differential scanning calorimeter (DSC). The results showed that the electron-beam-induced poly L-lactide acid/carboxy-methyl starch/β-tricalcium phosphate (PLLA/CMS/β-TCP) composite nanofibers may have great potential for bone-tissue engineering.

Background: Excessive and inappropriate antimicrobial use in the community is one risk factor that can result in the spread of antimicrobial resistance. Upper respiratory tract infections are most frequently reported among children and mainly of viral origin and do not require antibiotics. We have conducted Knowledge, Attitude and Perception (KAP) survey of parents to explore the parent's knowledge, attitude & perception of Saudi parents., Methods: A knowledge attitude perception questioner was adopted from a previous study conducted in Greece by Panagakou et al. Raosoft online sample size calculator calculated the sample size by adding the total estimated Makkah population of 5,979,719 with a response rate of 30%, 5% margin of error and 99% confidence interval. Based on the described criteria five hundred & fifty-eight was the required sample size of the study. Incomplete questioners were excluded from the statistical analysis. SPSS version 21 was used to analyse data and to produce descriptive statistics., Results: Most of the mothers (95%) responded among parents. 67% had no health insurance to cover medications costs. Most of them (74%) were related to medium income level. Seventy per cent of the parents believed physicians as a source of information for judicious antibiotics use. Interestingly, only 8% were agreed that most of the upper respiratory tract infections are caused by viral reasons. Majority of Saudi parents (53%) expect pediatricians to prescribe antimicrobials for their children for symptoms like a cough, nose discharge, sore throat and fever. Moreover, most the parents had the poor knowledge to differentiate commonly used OTC medications for URTI and antibiotics like Augmentin (Co-amoxiclav), Ceclor (cefaclor) and Erythrocin (Erythromycin). While comparing males and female's knowledge level, few males have identified Amoxil (Amoxicillin). Similarly, parents of age 20-30 years have good knowledge about the antibiotics., Conclusions: Majority of Saudi parents believe in pediatricians and use antibiotics on physician's advice. Most of them expect antibiotics from their physicians as a primary treatment for upper respiratory tract infections. There is need for more educational activities to parents by the pharmacists to prevent antibiotics overuse among children.

Coating fertilizer particles with thin films is a possibility to control fertilizer release rates. It is observed that novel urea cross-linked starch-lignin composite thin films, prepared by solution casting, swell on coming into contact with water due to the increase in volume by water uptake by diffusion. The effect of lignin content, varied from 0% to 20% in steps of 5% at three different temperatures (25°C, 35°C and 45°C), on swelling of the film was investigated. By gravimetric analysis, the equilibrium water uptake and diffusion coefficient decrease with lignin content, indicating that the addition of lignin increases the hydrophobicity of the films. When temperature increases, the diffusion coefficient and the amount of water absorbed tend to increase. Assuming that swelling of the thin film is by water uptake by diffusion, the diffusion coefficient is estimated. The estimated diffusion coefficient decreases from 4.3 to 2.1 × 10 -7  cm 2 /s at 25°C, from 5.3 to 2.9 × 10 -7  cm 2 /s at 35°C and from 6.2 to 3.8 × 10 -7  cm 2 /s at 45°C depending on the lignin content. Activation energy for the increase in diffusion coefficient with temperature is observed to be 16.55 kJ/mol. An empirical model of water uptake as a function of percentage of lignin and temperature was also developed based on Fick's law.

Context: Barrett's esophagus is a common pathological condition in patients with gastro-esophageal reflux disease., Objective: The aim of this study was to compare endoscopic diagnosis versus histological confirmation., Design: Cross-sectional., Setting: Cancer Institute of the Imam Khomeini Hospital., Material and Methods: A total of 50 patients with a history of gastro-esophageal reflux were recruited and underwent upper endoscopy at this cross-sectional survey. Four-quadrant biopsy was taken from all suspected areas of intestinal metaplasia. Sections of blocks were stained with Mixed Alcian Blue (PH 2.5)/PAS and haematoxylin-eosin stainings for the diagnosis of intestinal metaplasia (complete vs. incomplete types) and goblet cell / columnar cell / dysplasia, respectively., Main Outcome Measure: The presence of Helicobacter pylori was assessed by Giemsa staining., Results: There were 44 cases of short-segment Barrett's esophagus and 6 of long-segment Barretts esophagus by endoscopy. When examined by histologic examination, 12 patients with short-segment Barrett's esophagus and 4 with long-segment Barrett's esophagus had intestinal metaplasia. Haematoxylin-eosin staining diagnosed 12 cases of intestinal metaplasia, whereas mixed alcian blue/PAS was used to diagnose 16 cases (κ = 80%, p < 0.001). The positive predictive value in the diagnosis of goblet cell metaplasia and columnar cell metaplasia was 32% and 66%, respectively. Helicobacter pylori infection was observed in 10 cases of those with columnar cell metaplasia without goblet cells, while none of the patients with intestinal metaplasia were infected., Conclusion: Our findings suggest that biopsy taking is necessary in all patients with gastro-esophageal reflux disease, whose results suggest columnar cell lining in distal esophagus in endoscopy.

Introduction: The simultaneous presence of Takayasu's arteritis and Crohn's disease in a patient seems to be rare. To our knowledge, no patient with the combination of Crohn's disease and Takayasu's arteritis has been reported from our region., Case Presentation: Herein we present the case of a 22-year-old Iranian woman previously diagnosed as Crohn's disease and who had subsequently developed Takayasu's arteritis., Conclusion: Clinical suspicion, proper imaging, and consideration of the differential diagnosis are important for the correct diagnosis and management of patients with this coincidence.

Aim: To determine whether hepatitis C virus (HCV) infection of index cases increases intrafamilial transmission (sexual and nonsexual contacts) of HCV., Methods: In a case-control descriptive study we enrolled 300-household contacts of 60 index cases (40 males and 20 females) of HCV infection and 360 pair-matched controls in Ahwaz JundiShapour University Hospitals from August 1, 1998 to September 1, 2003. The control group consisted of first time blood donors referred to the Regional Blood Transfusion Organization. Serum samples and demographic data and a medical history including the existence of risk factors for HCV (after a questionnaire on the risk factors for parenteral exposure) were obtained from each subject. Antibodies to HCV were detected employing a commercially available second-generation enzyme immunoassay (EIA, Abbott II). Positive serum specimens were retested using a second-generation recombinant immunoblot assay (RIBA-2) and a polymerase chain reaction for HCV RNA. Data analysis was carried out for intra-household clustering., Results: Only 4 of 300 (1.33%) cases of household contacts without percutaneous risk factors were positive for HCV Ab while the remaining 296 family contacts were negative for anti-HCV. The mean age of the index cases was 28.4 (Std 15.22) years. The anti-HCV prevalences in parents, spouses, children of the index cases were 0.87% (1/115), 3.39% (2/59)) and 0.79% (1/126), respectively. Among couple partners negative for anti-HCV antibodies, the mean duration of the sexual relationship was 6 years. The two-couple partners positive for anti-HCV antibodies married the index cases for longer than 15 years. The prevalence of positive HCV Ab among household contacts (1.33%) was not significantly higher than that in the controls (1%) (P > 0.06)., Conclusion: Intrafamilial transmission of HCV is not the significant transmission route and sexual transmission does not seem to play a role in the intrafamilial spread of HCV infection. Intrafamilial transmission of HCV is possible but occurs at a low rate.

Background: Peptic ulceration following infection of the stomach with H. Pylori is a common disease. Accurate and rapid detection of the bacteria can lead to the implementation of appropriate treatment and recovery. Chronic infection of the gastric milieu with H. Pylori may lead to gastric carcinoma. Routine detection of this bacterium in peptic ulcer is based on the urease test and culture of peptic biopsies. Unfortunately, the sensitivity and specificity of both tests are not satisfying. Molecular techniques have been successfully applied for the rapid and accurate detection of bacterial agents in clinical samples. This study was undertaken to evaluate the sensitivity and specificity of fluorescent in situ hybridization (FISH) in the detection of H. Pylori in patients suffering from dyspepsia., Material/methods: One hundred gastric biopsy samples taken by endoscopy from the antrum and corpus of the stomach were tested by FISH and compared with the conventional culture method complemented by biochemical tests., Results: FISH detected H. Pylori in 48 clinical samples, while the conventional method detected 42 samples. The sensitivity and specificity of FISH for the detection of H. Pylori were calculated as 98% and 100%, respectively., Conclusions: The findings of this study suggest that FISH is a highly suitable and rapid method for diagnosing H. Pylori. Especially when the samples are taken from the antrum and the corpus of the stomach, this technique potentially can be applied routinely for the detection of this bacterium in clinical samples.

Objective: Hepatocellular carcinoma (HCC) is one of the most common cancers in the world. Its etiology and incidence differ according to geographic area. In the present study, we sought to identify risk factors for HCC among a group of patients with HCC in Southern Iran., Methods: During a 5-year period we retrospectively studied the characteristics of 71 HCC patients at Ahwaz Jundishapur University Hospital, Iran from February 1999 to August 2004. Blood samples and questionnaire data obtained from 71 (45 male and 26 female) incident cases of HCC, were pathologically diagnosed. Sera were tested for hepatitis B surface antigen and antibodies to hepatitis B core antigen, anti-hepatitis C virus and serum ferritin, iron and alfa fetoprotein (AFP), by enzyme immunoassays and cuper study., Results: In 46.5% (33/71) of patients there was a history of chronic liver disease, and in 30 (42%) patients liver cirrhosis was documented. Of the 71 patients, 37 (52.1%) had hepatitis B, 6 (8.5%) had hepatitis C, and 2 (2.8%) had a history of excess alcohol intake. Of the 2 patients with a history of heavy alcohol intake, one had concomitant chronic viral hepatitis infection, and alcohol alone was the etiology of HCC in only one case (1.40%). No etiologic cause was identified in 23 cases (32.4%), there were 2 cases of diabetes mellitus. The value of AFP of >20 ng/ml was found in 29 cases (41%), varying from 24 ng/ml to 364 ng/ml (average 74.6 ng/ml)., Conclusions: In Southern Iran, the predominant etiology of HCC was hepatitis B, hepatitis C, but alcohol and metabolic diseases were only found in rare cases. Cryptogenic cases may be found in one fifth of patients hence, the contribution of virus infection, may have been underestimated in this area, which is based on serological testing only.

Interactions involving the immune responses to equine herpesvirus types 1 and 4 (EHV-1 and EHV-4) were studied in a murine infection model. When mice were inoculated intranasally with EHV-1, virus replication occurred in the respiratory tract and clinical signs were produced. In contrast, mice that were similarly inoculated with EHV-4 produced no evidence of virus replication and showed no clinical signs. When mice that had been inoculated with live EHV-4 were challenged 1 month later with EHV-1 they were partially protected. Although clinical signs were apparent on reinfection, virus replication in the respiratory tract was reduced in these mice compared with control mice that had not been previously immunized. Mice primed with heat-inactivated EHV-4, however, were not so protected. Live EHV-4-primed mice developed very low levels of antibody to EHV-1 and the humoral response could not account for this protection. However, the infected mice did give a strong delayed-type hypersensitivity reaction in a skin test using either EHV-1 or EHV-4 antigen. Spleen cells from EHV-4-primed donors provided a source of immune cells, including T cells which were used for transfer to recipient mice which were then challenged with EHV-1. The cells were protective; there was a reduction of virus replication on challenge with EHV-1 which correlated with the number of cells transferred. Modulation of the protective effect of primed cell populations was tested after depletion in vivo by means of complement-mediated lysis. The depletion of CD4-bearing cells produced the least effect on the protection afforded by cell transfer. In contrast, depletion of CD8-bearing cells markedly reduced the protection in recipients. EHV-1 and EHV-4 are widespread in horses and cross-infections are common. These results gained from a murine model indicate that important interactions occur at the level of T cell immunity between the two virus types which warrant further investigation in the natural host.

Protection against equine herpesvirus type 1 (EHV-1) infection in a mouse model has been studied by means of delayed-type hypersensitivity (DTH) and adoptive transfer of immune spleen cells. Mice were found to develop a positive DTH response to EHV-1 antigen which was sustained for several months after primary inoculation. The response was found to cross-react with EHV-4-derived antigen. Immune cells (from mice primed with live or heat-inactivated EHV-1) conferred an enhanced DTH response on recipients; however, only the immune cells that were previously primed with live EHV-1 gave protection against re-infection. The degree of protection was also dependent on the number of spleen cells transferred. Immune cells from mice primed with heat-inactivated EHV-1 appeared to enhance virus replication following subsequent inoculation. The serum antibody response to EHV-1 appeared to be slightly suppressed in recipients of spleen cells from mice primed with either live or heat-inactivated virus. These results support the important role for cell-mediated responses in protective immunity to EHV-1 and provide clues to the nature of protection and immunopathology in the natural host.