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Objectives: Excessive blood loss is a critical complication of total hip arthroplasty. We intended to determine whether preoperative fibrinogen administration reduces perioperative bleeding and the need for blood transfusion in total hip arthroplasty surgery., Methods: In 4 months, 178 patients who underwent total hip arthroplasty were randomly assigned equally to intervention and placebo-control groups in a double-blinded, parallel two-arm randomized controlled trial. Both intravenously, 30 min before the start of the surgery, the intervention group received two grams of fibrinogen concentrate dissolved in 100 ml of distilled water. In contrast, the control group received 100 ml of normal saline solution. The amount of postoperative blood loss served as the main result, and the requirement for blood transfusions served as the secondary outcome., Results: In comparison to the placebo, administering fibrinogen concentrate considerably reduced the amount of blood loss (P=0.001) and the requirement for blood transfusions (P=0.004). Patients who got fibrinogen concentrate experienced no side effects. In addition, patients in the fibrinogen group had significantly lower hemoglobin and higher fibrinogen levels in the recovery room and received lesser blood transfusions (P<0.005) than the placebo group., Conclusion: In total hip arthroplasty, fibrinogen concentrate lessens postoperative bleeding and the requirement for blood transfusions., Competing Interests: None, (2023 © BY THE ARCHIVES OF BONE AND JOINT SURGERY.)

Antibiotic resistance is one of the world's most urgent public health problems. Due to its antibacterial properties, cold atmospheric plasma (CAP) may serve as an alternative method to antibiotics. It is claimed that oxidative stress caused by CAP is the main reason of bacteria inactivation. In this work, we computationally investigated the effect of plasma-induced oxidation on various glycolysis metabolites, by monitoring the production of the biomass. We observed that in addition to the significant reduction in biomass production, the rate of some reactions has increased. These reactions produce anti-oxidant products, showing the bacterial defense mechanism to escape the oxidative damage. Nevertheless, the simulations show that the plasma-induced oxidation effect is much stronger than the defense mechanism, causing killing of the bacteria., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Traditional thermophillic composting is commonly for treatment of sludge. A related technique as vermicomposting process, using earthworms to breakdown sludge, is also becoming popular. These two techniques have their inherent advantages and disadvantages. The combined approach suggested in this study to enhance the overall process and improve the products qualities. Two systems, vermicomposting and combined compost-vermicomposting processes, have been investigated in this study. The sludge used in this study was obtained from the drying beds of South Isfahan wastewater treatment plant. The sludge mixed with sawdust to provide C/N ratio of 25/1. Eisenia fetida was the species of earthworms used in the vermicomposting processes. The results obtained indicate reduction in the amount of volatile solids, total carbon and C/N ratio with the vermicompost age, which indicates the reduction in the biodegradable organic content and mineralization of sludge. Also increase in phosphorus concentration by the end process because of mineralization of organic matter. The results indicate that, a system that combines the two mentioned processes not only shortens stabilization time, but also improves the products quality. Combining the two systems resulted in a product that was more stable and homogenous; the product could meet the pathogen reduction requirements.

To investigate the inactivation of potential pathogens, we evaluated survival rates for Escherichia coli, Enterococcus faecalis, Aeromonas hydrophila and Salmonella typhi in samples taken from the Isfahan drinking water system. Chlorine residual, pH, temperature and total organic carbon levels were measured. The organism most sensitive to chlorine was A. hydrophila. It was inactived in < 100 minutes at chlorine levels of 0.11 mg/L to 0.90 mg/L. The other 3 organisms showed higher resistance. E. coli tolerated 0.30 mg/L chlorine for > 1000 minutes while Ent. faecalis and S. typhi survived at total chlorine concentration of 0.50 mg/L for 100 minutes. We concluded that total chlorine levels of less than 0.71 mg/L in water supply systems cannot provide the recommended safety levels.