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Backgroundand Aim. Natural organic matter (NOM) has become one of the most serious environmental problems due to its persistence in aqueous solutions and the risk of carcinogenesis. In this study, the removal efficiencies of real and synthetic humic acid (HA) by multi-walled carbon nanotubes (MWCNTs) coated with iron oxide were evaluated. Materials and Methods. The MWCNs were synthesized and coated with iron oxide. In addition, the effects of pH, contact time, mixing speed, and adsorbent dose on the removal efficiency of NOM by MWCNTs-Fe3O4 were studied. Then, the removal efficiency of NOM from real samples was investigated at optimal conditions. The MWCNT-Fe3O4 was characterized by scanning electron microscopy (SEM) test and X-ray diffraction (XRD), respectively. Data analysis was performed using Minitab software based on the Taguchi method. Results. The results showed that MWCNTs were coated with Fe3O4. The SEM test shows particle (MWCNTs-Fe3O4) size in the range of 48–143 nm, and the particles have uniform spherical shapes. Enix software was used to identify the phase in this sample. The conditions including p H = 3 , mixing speed = 120 rpm, adsorbent dosage = 1.5 g·L−1, and contact time = 90 minutes were selected as optimal for NOM adsorption. The mean removal efficiencies of NOM in synthetic samples at 5, 10, and 20 mg·L−1 concentrations were 86.6%, 84.87%, and 95.41%, respectively. In addition, the mean removal efficiency of NOM in Choghakhor Wetland was 77%. Conclusion. Our findings demonstrated that the MWCNTs-Fe3O4 can be potentially used as an adsorbent for removing natural organic matter (HA) from aqueous solutions.

Background and aims: Multiple sclerosis (MS) is one of the most common progressive neurological diseases in young people. Tremor is a common and debilitating symptom in people with MS, significantly affecting their quality of life. This study aimed to evaluate the effect of a self-care program based on a mobile application on tremors in people with MS. Methods: This semi-experimental study was conducted on 72 patients with MS in Chaharmahal and Bakhtiari province in 2019. Samples were selected by convenience sampling and randomly assigned to intervention and control groups (36 people in each group). For the intervention group, a self-care program in the form of a mobile application was installed on their mobile phones and, for two months, used by patients. The use of the program was measured using self-report checklists and telephone tracking. The control group receives routine intervention only. Data were collected before and two months after the intervention using the Fahn-Tolosa-Marin Tremor Rating Scale and analyzed using SPSS software version 21 and descriptive and inferential statistics (chi-square, independent t test, and paired t test). Results: There was no statistically significant difference between the two groups in the mean tremor score before the intervention (P=0.768). However, after the intervention, this difference was significant (P=0.022). Conclusion: According to the findings, teaching a self-care program through a mobile application effectively improves the tremor of patients with MS and can be considered an effective intervention method.

Background and aims: The distraction of thought is a technique in which a pleasant stimulus is presented to the patient. This study aimed to investigate the effect of the distraction of thought by music on pain relief in patients undergoing extracorporeal shock wave lithotripsy (ESWL). Methods: This clinical trial was performed on 120 patients referring to Ayatollah Kashani Hospital in Shahrekord for ESWL in 2019. Patients were randomly divided into two experimental and control groups. In addition to routine care, the experimental group received the natural sound of the event, along with its beautiful scenery, while the control group only received routine care. The pain score was measured by the McGill Pain Questionnaire. The data obtained were analyzed by SPSS (version 18) using paired and independent t-tests and Tukey’s test. Results: The two groups were significantly different in terms of pain changes (P=0.007). The mean difference in addictive drug consumption between the control and experimental groups was significant (P=0 004). Conclusion: Thought distraction by music reduces pain and narcotic use of analgesics by the patients under ESWL.

Polycyclic aromatic hydrocarbons have adverse effects on the organisms, plants, and soil structure. Therefore, they should be removed by an appropriate and effective method. In this study, simultaneous removal of 500 mg/kg(soil) of phenanthrene and pyrene was investigated for the individual and combined application of Tween 80, Triton X-100, and sodium persulfate from the alluvial soil. The results revealed that the maximum removal efficiencies of phenanthrene (94.06 +/- 0.30%) and pyrene (90.07 +/- 0.19%) were observed in the presence of Triton X-100 + sodium persulfate (0.5 M) within 1 hour, respectively. Also, individual application of surfactants and sodium persulfate had efficiencies of less than 80%. It should be noted that the removal of phenanthrene and pyrene followed the first-order kinetic model. Economic evaluations of combined treatment demonstrated that the application of more proportion of Triton X-100 (10000 mg/L) + less proportion of sodium persulfate (0.3 M) is more cost-effective for the remediation of soil in the field study. Based on the results, the combined application of the washing process by Triton X-100 and persulfate oxidant can significantly improve the removal efficiencies and is a promising technique in the remediation of polycyclic aromatic hydrocarbons contaminated soil.

Background and aims: Stroke is the first leading cause of disability in adults. Long-term disability after stroke necessitates long-term caregiving by family members. The family caregivers (FCGs) of patients with stroke (PWS) experience different problems and hence, require self-management (SM) skills. The aim of this study was to assess the effects of an SM program based on Strauss and Corbin’s SM model on perceived social support (PSS) among the FCGs of PWS. Methods: This quasi-experimental study was conducted in 2019–2020. Participants were eighty FCGs of PWS who were hospitalized in Kashani hospital, Shahrekord, Iran. They were purposefully- recruited and randomly allocated to a control and an intervention group. An SM program based on Strauss and Corbin’s SM model was implemented in six ninety-minute sessions for participants in the intervention group. The Multidimensional Scale of PSS was used for PSS assessment before, immediately after, and two months after the intervention. Data were analyzed using the SPSS software (v. 16.0). Results: There was no significant difference between the groups in terms of the pretest mean score of PSS (P=0.76), while the mean score of PSS in the intervention group was significantly greater than the control group at both posttests (P0.05), but significantly increased in the intervention group (P

The myocardial infarction is the most severe manifestation of coronary artery disease. The promotion of self-efficacy in these patients can be effective in the improvement of their quality of life. The aim of this study was to investigate the effects of a self-management program based on 5 A`s model on the quality of life and self-efficacy of the patients with myocardial infarction.The current study was a clinical trial that was conducted in Ayatollah Kashani and Hajar hospitals in Shahr-e Kord (Iran) with the participation of 96 patients with myocardial infarction. The research units were blocked randomly into two 48-patient intervention and control groups. The training content was provided to the intervention group in five stages and they were asked to implement in three months. The demographic information questionnaire, the Ferrans and Powers Quality of Life questionnaire, and Sullivan Self-Efficacy questionnaire were the data collection instruments. The mean scores of pre and post-intervention were compared by the use of SPSS, version 16, software, paired t-test, single t-test, chi-square, and Fisher's Exact Test.The results showed that the mean squares of quality of life and self-efficacy in pre and postintervention had a significant difference and the intervention group had a higher quality of life and self-efficacy levels compared to the control group (P0.001).According to the results of the study, it is suggested to use this model for empowerment and caring of patients besides the medicinal treatments, so that it would not lead to inability, reduction about the medical centers, frequent hospitalization, and ultimately, reduction in medical costs, and promotion of the society's health.

Introduction: Tele-nursing is a modern way of promoting quality of nursing care, treatment outcome, reducing medical costs and the need for visits, patient and family involvement in decision making, and careful patient monitoring by using all kinds of technologies. The aim of this article was to determine the most popular methods and related reasons for their common use in Iran. Methods: In this narrative literature review, PubMed, Science Direct, Google Scholar, SID, and Nindex were searched for full texts of Iranian studies published in English or Persian by using the descriptors of Tele-nursing, MHealth, nursing care, Telecare, and follow-up with phone calls between 2010 and 2020. The search found 472 articles and after considering the eligibility of articles, 56 articles were included. Results: The review found that 74% of papers reported the telephone as the first common method for tele-nursing. The second popular method was short message service (SMS) followed by internet and smartphone software. Conclusion: Tele-nursing includes many methods that nurses can use for distance nursing care which is not limited to telephone or SMS. In Iran, about 68 million people have a smartphone and have access to the internet. Nurses can use this potential capacity to improve nursing care.

Introduction: The most important compliant of post-operative orthopedic patients is severe and intolerable pain. This pain has negative impacts on patient’s satisfaction with pain management and bone healing after surgery. This study was conducted with the aim of evaluating the effects of Melissa officinalis (Melissa) tea and Matricaria chamomilla (Chamomile) tea on pain intensity and satisfaction with pain management in patients after lower limb orthopedic surgery. Methods: This was a randomized controlled trial conducted on 96 patients after lower limb orthopedic surgery in Ayatollah Kashani hospital of Shahrekord city, Iran. Patients were randomized to M. officinalis, Chamomile and control groups with blocking randomization method. For M. officinalis group, 1 g of Melissa tea, for Chamomile group 1 g chamomile tea and for control group black tea was prescribed 3 times a day. Study variables were evaluated before and 30 min after each stage of intervention and then the mean changes of pain intensity and satisfaction before interventions and after each step of intervention were compared between groups. Significance level was considered as PResults: Before intervention, the mean scores of pain intensity and satisfaction with pain management had no significance difference between groups. The mean changes of pain intensity and satisfaction with pain management (after first 3 steps of intervention) in M. officinalis and M. chamomilla groups were significantly greater than the ones in control group (PConclusion: Prescription of M. officinalis tea or Chamomile tea might be used as effective remedy for reducing pain and increasing satisfaction with pain management after orthopedic surgery.

Background and aims: Postpartum depression has a high prevalence in communities and needs great financial resources. On the other hand, the world views the spiritual health as a new and complementary dimension of health. The aim of this study was to investigate the correlation between postpartum depression and spiritual health.Materials and Methods: This correlational-analytic study was conducted on 152 women who gave birth 8 months ago, referred to Hajar Hospital, Imam Ali hospital, Molavi clinic, or other health centers of Shahrekord, and were also satisfied with participating in the study. They were selected by the simple sampling method and completed the Palutzian and Ellison Spiritual Health Questionnaire. Finally, the collected data were entered in SPSS software and descriptive statistics in addition to the Pearson correlation coefficient and K2 test were used to analyze the data.Results: In the present study, the mean age of the subjects was 29.15 (SD=5.45) with the range of 16-45 years. The mean scores of spiritual health and depression were obtained 96.3 and 8.94, respectively. The results of this study showed that the Pearson correlation coefficient was -75.5% (P˂ 0.001), demonstrating an inverse correlation between the scores of postpartum depression and spiritual health.Conclusion: In general, the correlation between postpartum depression and spiritual health was an inverse correlation and the level of depression decreased by an increase in spiritual health. It can be concluded that without the need for specific treatments, the level of postpartum depression can be reduced by increasing the level of spiritual health.

Bromodomain and extra-terminal (BET) proteins are recognized acetylated lysine of histone 4 and act as scaffolds to recruit many other proteins to promoters and at enhancers of active genes, especially at the super-enhancers of key genes, driving the transcription process and have been identified as potential therapeutic targets in breast cancer. However, the efficacy of BET inhibitors such as JQ1 in breast cancer therapy is impeded by IL-6 through an as yet defined mechanism. We investigated the interplay between IL-6 and JQ1 in MCF-7 and MDA-MB-231 human breast cancer cells. Here we demonstrate that the efficacy of JQ1 on the inhibition of cell growth and apoptosis was stronger in MDA-MB-231 cells than in MCF-7 cells. Further, MCF-7 cells, but not MDA-MB-231 cells, exhibited increased expression of CXCR4 following IL-6 treatment. JQ1 significantly reduced CXCR4 surface expression in both cell lines and diminished the effects of IL-6 pre-treatment on MCF-7 cells. While IL-6 suppressed the extension of breast cancer stem cells (BCSCs) in MCF-7 cells, JQ1 impeded its inhibitory effect. In addition, in MCF-7 cells JQ1 increased the number of senescent cells in a time-dependent manner. Analysis of gene expression indicated that JQ1 and IL-6 synergistically increase SNAIL expression and decrease c-MYC expression in MCF-7 cells. So, the BET proteins are promising, novel therapeutic targets in late-stage breast cancers.

Background: Electroconvulsive therapy (ECT) is an effective strategy in the treatment of mood disorders; however, it is associated with some cognitive complications. Objectives: This study aimed to evaluate the efficacy of donepezil as an acetylcholinesterase inhibitor in improving cognitive impairment induced by ECT in mood disorder patients. Methods: Ninety-six mood disorder patients were randomly assigned to the donepezil (5mg/day) or placebo groups. The Persian versions of the Mini-Mental Status examination (MMSE) and Addenbrooke’s Cognitive Examination Revised (ACE-R) were used to evaluate cognitive performance before the first ECT session, after the fourth ECT session, and four weeks after the last ECT session. Results: The mean scores of MMSE and ACE-R revealed significant improvement in the donepezil group over time (P < 0.001). All ACE-R subscales increased significantly following the intervention implementation in the donepezil group (P < 0.001). Furthermore, the donepezil group reported no remarkable complications and completed the study. Conclusions: Donepezil co-administration with ECT may improve the ECT-induced cognitive disturbances.

Lead is one of the stable and biodegradable pollutants released from industrial, agricultural and technological development activities more than the permitted level in the environment. This metal, due to its toxicity, even at low concentrations, has adverse effects on the environment and health of living organisms. The aim of this study is to investigate the bio-absorption of lead by the fungus Penicillium notatum in aqueous solutions. For this purpose, the fungus Penicillium notatum PTCC 5074 was prepared from the Iranian Scientific Research Organization as lyophilisation and to culture and reproduce it in the culture medium of potato dextrose agar and sabouraud dextrose broth. In this study, the effect of some parameters such as lead concentration, ion intensity, biomass concentration, temperature and contact time on the rate of adsorption of lead by abiotic biomass at pH = 5 were evaluated. The maximum absorption rate was 180.75 mg g(-1) under optimal conditions (concentration of metal = 228 mg L-1, ion intensity = 43.2 mg L-1 Ca2+, biomass concentration = 1.2 g L-1 of dry weight of biomass, temperature = 33 degrees C, and contact time = 105 min). Absorption data were better fitted by Langmuir model R-2 = 0.9820). Also, due to the thermodynamic constants, it was found that lead absorption process is thermally abiotic by a biomass. Gibbs free energy values (Delta G) showed that all absorption processes are spontaneous and physical. The false quadratic equation (R-2 = 1) has the best compatibility with regard to kinetic data. BET, SEM and EDX tests were also used to determine the biomass characteristics.

The application of halotolerant microorganisms capable of decolorizing is attractive. Decolorization mechanism, the effect of different parameters on the decolorization percentage, and toxicity analysis of Reactive Black 5 before and after decolorization were investigated in the present study. The decolorization percentage for live cells of Staphylococcus sp. strain MEH038S was more than dead cells, which demonstrated that Reactive Black 5 was decolorized through the degradation process. The results confirmed that an FMN-dependent NADH-azoreductase gene was responsible for the decolorization and then was identified as Staphylococcus sp. EFS01 azoreductase from a moderately halotolerant Staphylococcus strain for the first time. The maximal decolorization of 98.15% was observed at pH 6.5 and 35 degrees C for 50 mg/L of Reactive Black 5. In addition, more than 90% decolorization was achieved with 5-40 g/L of NaCl. The results of Gas chromatography-mass spectrometry and Fourier transform infrared spectroscopy showed that Reactive Black 5 was broken to the lower molecular weight compounds without any chromophoric azo groups. Phytotoxicity and fish toxicity proved that the biotransformed metabolites of Reactive Black 5 degradation were more toxic than the original dye. The moderate halotolerant strain exhibited a remarkable decolorization capability and can be applied for textile wastewater treatment. Practitioner Points An azoreductase gene from a moderately halotolerant Staphylococcus was identified. More than 90% decolorization efficiency was observed under high-salt conditions. Biotransformed metabolites of RB5 degradation were identified. Toxicity analysis of biotransformed metabolites was investigated.

Chronic Obstructive Pulmonary Disease (COPD) is an irreversible condition and it is of great importance for the patients to practice self-care. Given the impact of inadequate health literacy on people's self-efficacy in a self-care program, the aim of this study was to improve health literacy and self-efficacy in people with COPD.The present quasi-experimental study was conducted on 70 patients with COPD admitted to Shahrekord educational hospitals in 2019. Using random allocation software, the samples were randomly divided into intervention and control groups. Data collection tools included three questionnaires including demographic, health literacy, and perceived self-efficacy questionnaires. A training program, with three weekly sessions of theoretical and practical trainings, was conducted for the intervention group in classes in the hospital. The time of each session was 40 min. Data were collected three times i.e., before, immediately after, and three months after the trainings. Data were analyzed by means of SPSS 21 statistical software using descriptive and inferential statistics.Before the intervention, the mean scores of perceived self-efficacy and health literacy did not differ significantly between the two groups, but after the intervention, the scores of the members in the intervention group increased significantly (The results of the study indicated an increase in the scores of perceived self-efficacy and health literacy in people with COPD. The use of targeted educational interventions can have a positive effect on the treatment and control of the disease.

One of the basic practices in the field of waste management is the collection and treatment of leachate. Leachate from municipal waste due to high chemical oxygen demand (COD) and dark color is a potential pollutant of the environment, which causes a lot of problems in the absence of treatment and direct discharge to the environment. This study aimed to determine the efficiency of ultrasonic process in combination with coagulation and flocculation process using sodium ferrate in COD and color reduction.In this experimental study, all experiments were performed in batch conditions and with changing process variables such as pH and sonication time, and the effect of three parameters, including ultrasonic reaction time (15, 30, and 45 min), pH (2, 4, 5/5, and 7), and coagulant dosage (from 1 to 150 g/l) on the COD reduction and color removal, was evaluated. Coagulant concentration and then the removal efficiency of COD and color were analyzed by ANOVA using SPSS 18.The COD reduction and color removal were 87.05% and 88.6% in optimal condition (using 120 g/L of sodium ferrate at pH 5.5), with coagulation/flocculation, after ultrasound (15 min). Ultrasound (15 min) + sodium ferrate (without coagulation/flocculation) achieved 46.25% of COD reduction and 90.35% of color elimination, whereas the ultrasonic process alone allowed removing the COD and color in the leachate by less than 50%.The results indicate that C-F followed by ultrasonic can be used to efficiently reduce the organic matter and color from municipal waste leachate, and it would be an ideal option for leachate treatment.

Background: In the recent years, one of the most important issues of the demographic day that has attracted a lot of attention and will intensify is the aging population and the consequences of trend population growth. This study was aimed to estimate the Ageing Index (AI) of Iran from 1966 to 2016 and prediction of these indices in 2026. Methods: This quantitative cross-sectional study included Ageing Index of Iran from 1966 to 2016 was investigated and then, using Minitab16 software and time series models, the prediction of these indicators for the next 10 years (2026) was studied. The library and documentary methods have been used to collect information and raw data from the General Population and Housing Census in 2016. The statistical population includes the total population of the elderly (65 years and above) of urban and rural areas of Iran.Results: According to our findings, the index of aging will reach 6.36% in 1966 to 37.36% in 2016, and is expected to increase to 10.2% in 2026. The life expectancy of women and men in 2016 was 76.7 and 74.5, respectively, and expected to reach 78.3 and 76 years in 2026, respectively. The Human Development Index has risen from 52.0% in 1355 to 0.77% in 2016 and is expected to reach 80.8% by 2026. Based on result this study the evaluation of demographic indices such as sex ratio, the proportion, average annual growth rate, dependency ratio and ageing index for the Iranian elderly population at 2006 were 108,7.3%, 2.5%, 43.4% and 29, respectively. Conclusion: According to the results, the aging indicator has a rising trend that requires proper planning for proper welfare. Based on trend population growth in the next decades Iran will going to experience an increasing proportion of elder population. Attention to needs and quality of life in elderly is very important because of improving living condition in this population could lead to improved quality of life. Also, policy makers should pay more attention to the health demands of the elderly.

Background: Anxiety is one of the most common psychological problems after myocardial infarction and can lead to many problems in acute coronary syndrome (ACS). Two possible ways to reduce anxiety are to listen to music and to recite the Holy Quran, the effects of which have never been compared to date. Objectives: The aim of this study was to compare the effect of listening to instrumental music and listening to Quran recitation on the anxiety level of patients with acute coronary syndrome. Methods: This semi-experimental study was conducted among 96 patients with ACS referred to Hajar Hospital, Shahrekord, Iran, from 3/10/2019 to 4/30/2019. The patients were entered into the study using the convenience sampling method and then randomly assigned to the three groups of Quran recitation, instrumental music, and control. In this study, the patients’ anxiety level was measured using Spielberger’s state-trait anxiety inventory (STAI) before and after listening to Quran recitation and instrumental music. Data were analyzed by SPSS version 16 using descriptive and analytical tests, including paired samples t-test, Chi-square, and one-way ANOVA. Results: Anxiety level decreased from 43.1 ± 6.15 to 38.5 ± 3.82 in Quran recitation group (P < 0.001) and from 44.2 ± 1.21 to 39.1 ± 4.17 in the instrumental music group (P = 0.035), and from 46.3 ± 3.84 to 44.7 ± 6.21 in the control group (P < 0.001). There was no significant difference between the three groups before the program. However, the mean score of anxiety level showed a significant difference, indicating that listening to Quran recitation had a greater effect than listening to instrumental music in reducing the patients’ anxiety (P = 0.02). Conclusions: Both interventions can be useful in decreasing the anxiety level of patients with ACS; however, the Holy Quran recitation had a greater effect in this regard.

Introduction: Decreased vitamin D levels may have a role in the development of metabolic syndrome due to its effect on the metabolic syndrome components or because of insulin resistance. Objectives: The aim of this study was to investigate the prevalence of vitamin D deficiency in obese individuals and to determine the relationship between deficiency of vitamin D with metabolic syndrome in obese people with metabolic syndrome and healthy individuals. Patients and Methods: In this descriptive-analytical study, samples were selected among obese individuals admitted to Hajar and Kashani hospitals in Shahrekord. Metabolic indices of the samples were measured and recorded along with information such as demographic characteristics. According to the indices, the subjects (n= 192) were divided into two equal groups of healthy obese and obese people with metabolic syndrome. Vitamin D levels were measured in both groups followed by determination of relationships between the vitamin D levels with metabolic syndrome and its indices. Results: The mean ages of the patients and healthy groups were 50.09±1.95 years and 52.57±2.05 years, respectively. The average serum vitamin D levels in the two groups showed a significant difference with significantly lower vitamin D levels in the metabolic syndrome group than those in the obese subjects (P 0.05). Conclusion: The results of this study indicated that vitamin D determination can be used for the prognosis and early detection of people at risk for metabolic syndrome.

Introduction: Serum level of high sensitivity C-reactive protein (hs-CRP), as an inflammatory marker, can play a role in development of metabolic syndrome in obese individuals. Objectives: This study aimed to determine serum concentration of hs-CRP in obese patients with metabolic syndrome and determine the association of this factor with factors involved in the progression of metabolic syndrome. Patients and Methods: In this study, samples were selected by convenient method from obese patients, admitted to Kashani and Hajar hospitals (Shahrekord, Iran). First, based on NCEP-ATPIIIdefined metabolic syndrome, parameters of metabolic syndrome and serum levels of vitamin D were measured and a questionnaire containing demographics was completed for each participant. Accordingly, the samples (n=192) were divided into two identical groups; obese individuals without metabolic syndrome (controls) and obese individuals with metabolic syndrome (case group). HsCRP levels were measured in both groups. Results: Serum level of hs-CRP in the case group was 17.58±1.40 µg/mL and in the control group was 9.04±1.26 µg/mL, which was significantly higher in the case group than the control group (P 0.05). Conclusion: Hs-CRP can be used for prognosis and early detection of patients at risk of metabolic syndrome.

Reactive dyes have been applying extensively in textile industries. The treatment of textile industry waste waters is one of the main concerns of environmental health experts due to having excessive dyes and pollution. The aim of this study was to remove the Reactive Black 5 (RB5) dye from synthetic textile waste waters using agricultural wastes and determination of adsorption isotherm. In this research, Glycyrrhiza glabra root ash was prepared in laboratory condition and graded by standard sieve. The reactive Black 5 dye removals from textile synthetic wastewater using this adsorbent were tested. The effect of some parameters such as contact time (10–180 min), initial dye concentration (20, 40 and 60 mg/g) adsorbent dosage (0.2–2 g) and pH (2–12) were evaluated. Measurements were performed using an ultra violet-visible spectrophotometer at a wavelength of 597 nm and adsorption isotherm analyses were carried out. The results showed that data follow better the Langmuir adsorption model and the RL = 0.1123 was in the range of 0 to 1. Adsorption efficiency was reduced with increasing initial dye concentration and decreasing the adsorbent dosage. According to the results, the remaining root as an agricultural waste showed proper efficiency economically for the removal of dyes from textile industry wastewater

Introduction: Some assumptions have been made on the probable association between fever and pyuria. Objectives: The present study aimed to investigate the association between fever and pyuria. Patients and Methods: In this case-control study, 90 febrile and 90 non-febrile children aged more than one month who were admitted to the pediatric ward were included. Urine specimens of children less than 2 years of age were collected by urine bag. Midstream urine samples were collected and immediately sent to the laboratory for complete urinalysis and urine culture. Results: Overall, 6.7% in febrile children and 2.2% in control group had pyuria however there was no significant association between fever and pyuria (P>0.05). Additionally, no association between the presence of pyuria and type of disease was detected (P>0.40). Conclusion: The present study could not reveal any association between fever and pyuria in children older than one month.

Exposure to inhalation aerosols and particulate matter (PM) in different concentrations can increase the risk of respiratory, cardiovascular, and other related diseases. The inhalation exposure studies are implemented to assess the biological effects of these hazardous agents in human or animal models, in whole-body (WB) or nose/head-only conditions. Several factors can affect the performance of the inhalation exposure chambers and if left uncontrolled, the results may not be desirable. The current study reviewed the characteristics, structures, and factors affecting the performance of the WB chambers, especially the ones designed for small animal exposure to the PM. At the primary stage, the criteria and the search strategy were determined and the keywords were searched in the scientific electronic databases. Totally, 1051 articles were extracted in the first stage, and finally seven articles were adopted. The technical and design details, materials, coefficient variations (CVs) of concentration, assessment methods, type and number of laboratory animals, procedure, and animals housing conditions were extracted from the selected articles. Then the most desirable WB inhalation exposure chamber was determined based on the criteria for assessing the presented exposure chambers such as the animal housing and least CVs of the concentration in the respiratory zones of the animals under study. It was concluded that the Kimmel design was the best and the most desirable chamber structurally and geometrically, since the concentration of the particle (NaCl) injected into the chamber varied from 3.5% to 5.2%, under standard conditions. Keywords:Inhalation Chamber; Whole-Body; Inhalation Exposure; Particulate Matters

Having desired facial features creates a better mental image, results in increased self-confidence and boosts social activities to a more acceptable level. The goal of the current study is to investigate how rhinoplasty surgery affects patients admitted to Shahrekord surgical clinic. The study was conducted on 100 patients randomly selected and referring for rhinoplasty surgery. The required information was collected through demographic questionnaires of rhinoplasty outcomes F 36 and Rosenberg’s self-esteem scale. The questionnaires were filled out by patients before surgery and 3 months after surgery. The data were analyzed using SPSS and data mining software. Out of the hundred participants, 63% were female and 37% were male. The number of individuals in the studied groups decreased in older age groups so that most of the participants were in the 20–24-year group followed by 25–30 y/o group. Patients from other age groups were less frequent. In terms of educational attainment, the highest frequency was associated with a BSc and the lowest with a diploma. In terms of employment status, the highest frequency was among students and the unemployed and employees and the self-employed followed. Body image and self-esteem were significantly improved after surgery (p

Traditional statistical models often are based on certain presuppositions and limitations that may not presence in actual data and lead to turbulence in estimation or prediction. In these situations, artificial neural networks (ANNs) could be suitable alternative rather than classical statistical methods. A prospective cohort study.The study was conducted in Shahrekord Blood Transfusion Center, Shahrekord, central Iran, on blood donors from 2008-2009. The accuracy of the proposed model to prediction of number of return to blood donations was compared with classical statistical models. A number of 864 donors who had a first-time successful donation were followed for five years. Number of return for blood donation was considered as response variable. Poisson regression (PR), negative binomial regression (NBR), zero-inflated Poisson regression (ZIPR) and zero-inflated negative binomial regression (ZINBR) as well as ANN model were fitted to data. MSE criterion was used to compare models. To fitting the models, STATISTICA 10 and, R 3.2.2 was used RESULTS: The MSE of PR, NBR, ZIPR, ZINBR and ANN models was obtained 2.71, 1.01, 1.54, 0.094 and 0.056 for the training and 4.05, 9.89, 3.99, 2.53 and 0.27 for the test data, respectively.The ANN model had the least MSE in both training, and test data set and has a better performance than classic models. ANN could be a suitable alternative for modeling such data because of fewer restrictions.

Helicobacter pylori is an important risk factor for chronic gastritis, peptic ulcer, and gastric cancer. Three-drug regimen is the first-line treatment for this infection, but the response rate to treatment varies in different geographical regions. This study was conducted to comparatively determine the effect of amoxicillin and metronidazole on three-drug regimen to treat H. pylori infection in 1–15-year-old children. This clinical trial was conducted on 82 patients aged 1–15 years with convenience sampling referring to the Endoscopy Unit of Hajar Hospital, Shahrekord. Group 1 was administered with clarithromycin, amoxicillin, and omeprazole (CAO), and Group 2 with, clarithromycin, metronidazole, and omeprazole (CMO). One month after completion of the treatment, stool antigen test was used to study the eradication of H. pylori. Data were analyzed using SPSS software by Chi-square test. Three of the 82 patients were excluded from the study because of side effects caused by drugs. Nearly 87.2% of the patients in CAO-treated group and 92.5% in CMO-treated group had response to treatment. There was no significant difference in eradication rate between the two regimens (P = 0.43). The two regimens displayed no superiority over each other for eradicating H. pylori infection and response rate to treatment in children aged 1–15 years.

Introduction: Jaundice is one of the most common causes of admission to hospital in newborns which is often associated with several complications. Aim: The present study was conducted to evaluate the effect of H. vulgare in reducing jaundice. Materials and Methods: In this double-blind, randomized controlled trials 70 term infants hospitalized due to jaundice in 2014 were enrolled. Control group was treated with full-time phototherapy alone using LED except when the infants were breastfed and case group with phototherapy, as per the protocol in the control group, along with and topical H. vulgare seed flour three times a day. Data were analysed using and analysis of covariance (ANCOVA) and paired t-test in SPSS version 16.0. Results: There was a significant difference in mean indirect bilirubin level between the two groups p0.05. Conclusion: H. vulgare flour can cause decrease in indirect bilirubin. Because the rate of decrease in indirect bilirubin can be effective in preventing severe complications due to bilirubinemia, H. vulgare can be used as a complementary therapy to treat jaundice.

Background: In medical studies, when the joint prediction about occurrence of two events should be anticipated, a statistical bivariate model is used. Due to the limitations of usual statistical models, other methods such as Artificial Neural Network (ANN) and hybrid models could be used. In this paper, we propose a hybrid Artificial Neural Network-Genetic Algorithm (ANN-GA) model to prediction the occurrence of heart block and death in myocardial infarction (MI) patients simultaneously. Methods: For fitting and comparing the models, 263 new patients with definite diagnosis of MI hospitalized in Cardiology Ward of Hajar Hospital, Shahrekord, Iran, from March, 2014 to March, 2016 were enrolled. Occurrence of heart block and death were employed as bivariate binary outcomes. Bivariate Logistic Regression (BLR), ANN and hybrid ANN-GA models were fitted to data. Prediction accuracy was used to compare the models. The codes were written in Matlab 2013a and Zelig package in R3.2.2. Results: The prediction accuracy of BLR, ANN and hybrid ANN-GA models was obtained 77.7%, 83.69% and 93.85% for the training and 78.48%, 84.81% and 96.2% for the test data, respectively. In both training and test data set, hybrid ANN-GA model had better accuracy. Conclusions: ANN model could be a suitable alternative for modeling and predicting bivariate binary responses when the presuppositions of statistical models are not met in actual data. In addition, using optimization methods, such as hybrid ANN-GA model, could improve precision of ANN model.

Background: Time to donating blood plays a major role in a regular donor to becoming continues one. The aim of this study was to determine the effective factors on the interval between the blood donations. Methods: In a longitudinal study in 2008, 864 samples of first-time donors in Shahrekord Blood Transfusion Center, capital city of Chaharmahal and Bakhtiari Province, Iran were selected by a systematic sampling and were followed up for five years. Among these samples, a subset of 424 donors who had at least two successful blood donations were chosen for this study and the time intervals between their donations were measured as response variable. Sex, body weight, age, marital status, education, stay and job were recorded as independent variables. Data analysis was performed based on log-normal hazard model with gamma correlated frailty. In this model, the frailties are sum of two independent components assumed a gamma distribution. The analysis was done via Bayesian approach using Markov Chain Monte Carlo algorithm by OpenBUGS. Convergence was checked via Gelman-Rubin criteria using BOA program in R. Results: Age, job and education were significant on chance to donate blood (P

Objective: Diarrhea is the second leading cause of death in children. Therefore, the aim of this study was to investigate the effect of probiotics in the treatment of acute noninflammatory diarrhea in children aged 2–10 years in the Pediatric Ward of Hajar Hospital in Shahrekord. Methods: This clinical trial was performed on 184 children with diarrhea. Eighty‑six children were randomly assigned to the KidiLact probiotic group and 87 ones to the control group. Patients’ demographic information, symptoms, and other variables were recorded in a checklist. The data were analyzed by SPSS version 16 (Chicago, IL) using Chi‑square and independent t‑test. Results: The mean frequency of diarrhea in the 2nd and 4th days (P < 0.001), duration of fever (P = 0.01), duration of diarrhea (P < 0.001), and duration of hospital stay (P = 0.001) were significantly lower in the probiotic group than those in the control group. The frequency of recovery in the 2nd (P = 0.013) and 4th (P < 0.001) days was significantly higher in the probiotic group than that in the control group. There was no significant difference in the frequency of dyspepsia between the patients of the two groups (P = 0.331). Conclusion: Probiotics are effective in the treatment of acute noninflammatory diarrhea in children aged 2–10 years and can be used as a safe treatment alongside the standard treatment.

Proteinuria is the most reliable marker of diabetic nephropathy and an index of atherosclerosis and cardiovascular mortality in diabetic patients. In addition, common carotid artery intima-media thickness (CIMT) is a sensitive marker of early atherosclerosis and cardiovascular risk. The aim of this study was to evaluate the association between proteinuria and CIMT in type 2 diabetic patients.In a cross-sectional study, 154 patients with type 2 diabetes mellitus were enrolled. The CIMT was measured for all of the patients by one researcher. The 24-hour urine protein was measured using trichloroacetic acid method.A total of 154 type 2 diabetic patients were enrolled with a mean diabetes mellitus duration of 8.91 ± 6.99 years (95 women and 55 men). The mean urinary protein in the patients was 294.70 ± 525.85 mg/24 h. The mean CIMT in all of the patients was 0.84 ± 0.19 mm, and it was greater in the men than in the women (P = .03). The CIMT significantly correlated with patients' age (P.001), systolic blood pressure (P.001), and urinary protein excretion (P = .001). There was a marginal positive correlation between diabetes mellitus duration and the CIMT (P = .049).This study showed a significant association between CIMT, as a sensitive marker of macrovascular complication of diabetes mellitus, and proteinuria as an important index of microvascular complication of the disease.

Background: Considering the increasing trend of childhood obesity and subsequent burden of the disease in Iran and other countries and importance of early life intervention for achieving sustained effect on health of children and adolescents, this study aimed to investigate the effect of two different dose of folic acid on homocysteine (Hcy) level and insulin resistance of obese children. Materials and Methods: In this randomized, double-blind controlled clinical trial study, 60 obese and overweight children aged 5–12 years were enrolled. Selected obese children randomly allocated in two interventional (1 mg/day folic acid and 5 mg/day folic acid, for 8 weeks) and one control groups. Biochemical measurements including folic acid, Hcy, insulin and insulin resistance were measured between and within groups before and after trial. Results: In each group, 20 obese children were studied. The three groups were age and sex matched. After folic acid administration, mean of Hcy, insulin resistance and insulin decreased significantly in two groups which folic acid administrated with two different doses (P < 0.05). The reduction in studied biochemical variables was similar in two interventional groups (1 and 5 mg folic acid daily) (P > 0.05). Mean differences for Hcy, insulin resistance and insulin, in two intervention groups were significantly higher than the control group (P < 0.0001). Mean differences of Hcy, insulin resistance and insulin, in two intervention groups were not different significantly (P > 0.05). Conclusion: The findings of current trial showed that folic acid in two studied doses could be a safe and effective supplement for obese children to reduce Hcy level and insulin resistance, which consequently could prevent obesity-related complications including cardiovascular and metabolic disorders.

BACKGROUND: The present study aimed to describe the long-term alterations of pulmonary function and also to describe its association with post-operative pain after coronary artery bypass grafting (CABG) surgery. METHODS: In this prospective study, thirty non-smoker male patients undergoing isolated on-pump CABG were consecutively included in this study. Pulmonary function measurements were performed, in a sitting position, preoperatively, a week postoperatively, and 6 months after the surgery using a Medical Graphics PF/Dx pulmonary function system. Pain was determined by using visual analog scale (VAS) pain scores with a standardized questionnaire’s. RESULTS: Regarding functional class, all patients had New York Heart Association (NYHA) Class II to III. A week after operation, a severe restrictive pulmonary impairment was revealed with a mean decrease in VC to 60.9 ± 9.2% and in forced expiratory volume in one second (FEV1) to 64.6 ± 12.2% of pre-operative values (P < 0.001). Regarding sternotomy related pain, the mean pain VAS score was preoperatively 3.3 ± 1.5 that reached to 6.2 ± 2.5 and 4.8 ± 2.2 1 week and 6 months after the operation (P < 0.001). The trend of the changes in pain score within 6 months of operation was significantly similar to the trend of the changes in some pulmonary function indices such as FEV% and residual volume (RV). CONCLUSION: A significant reduction is expected in most pulmonary functional parameters following CABG despite normal pulmonary function state preoperatively. Severe pain originated from sternotomy may be an important factor related to pulmonary dysfunction following CABG. &nbsp

The inability to communicate easily and clearly can have far-reaching debilitating effects, not only in childhood, but throughout a lifetime. The aim of this study was to determine the prevalence of stuttering, voice disorder, and speech sound disorders in Persian preschoolers in Shahrekord, Iran. Information about 1,387 children ages 5 to 6 was obtained via face-to-face screening and assessment. The total prevalence of speech disorders was 17.1%. The prevalence of stuttering was 1.5%, while 13.4% had a speech sound disorder, and 2.2% had voice disorder. The prevalence of stuttering was higher in males (2.2%) than females (0.7%); of speech sound disorders was higher in males (17.4%) than females (9.1%); and of voice disorder was higher in males (2.6%) than females (1.6%). The prevalence of stuttering and speech sound disorder was significantly different according to gender and positive family history. The prevalence figures revealed that a considerable number of preschoolers with speech disorders were missed in parents’ and teachers’ reports. Those children required more intensive communication support than they were receiving. Therefore, classroom teachers should work with speech and language pathologists to identify and assess preschoolers with communication disorders, and to develop intervention strategies.