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Lightening creams are among the most frequently used cosmetic products applied to the face to obtain a lighter tone or as an anti-spot. Heavy metals are the most common ingredients in powder creams that are sometimes present in impurities or added to improve the quality and shine.These metals can threaten human health. The presentstudy aimed to determine the concentrations of heavy metals in cream foundations. For this purpose, the concentrations of five heavy metals, including lead, cadmium, nickel, chromium, and cobalt, were measured in four brands of cream foundations selected from the Iranian market (two domestic and two imported brands). Measurements were performed usinginductively coupled plasma optical emission spectrometry(ICP-OES) in 36 samples in three colours of dark, beige, and light. According to the obtained results, the lead (Pb) concentration was 1.45–398.5, cadmium (Cd) ND-4.77, nickel (Ni) 1.75–16.92, chromium (Cr) 3.52–30.9, and cobalt (Co) 0.45–3.77 µg/g. The total content of heavy metals was higher in the two Iranian brands than the two imported ones. In terms of colour, the results indicated that heavy metals' distributiondid not follow a certain pattern in different colours. According to the guidelines, all the tested samples were within the safe range in terms of non-carcinogenicity, carcinogenicity, and dermal sensitivity. However, due to the high concentrations of trace elements in the samples, the health consequences of heavy metals for consumers should not be overlooked. [ABSTRACT FROM AUTHOR]

Background: Mycobacterium tuberculosis affects the lungs in 85% of all cases and the remaining 15% through extra pulmonary affecting other parts of the body such as lymph nodes, pleura, and the genitourinary system. This study aimed to investigate extra-pulmonary tuberculosis (TB) associated factors, failure of treatment, and trends between 2004-2017 in Kashan, Iran. Materials and Methods: This study was conducted during 2004-2017 on newly registered extrapulmonary tuberculosis patients referred to TB Referral Center in Isfahan province, Kashan city, Iran. Information (demographic characteristics, related factors of the disease, and treatment status) of 197 extrapulmonary tuberculosis (EPTB) patients was extracted from Medical case records. Results: In total, 527 cases of Tuberculosis were reported, of which, 159 (30.17%) were confirmed extrapulmonary TB. Eighty-five (53.5%) and 74 (46.5%) were male and female, respectively. Also, 74 (46.5%), and 84 (53.5%) of EPTB were from Iran, and Afghanistan immigrants, respectively. The average age of patients was 41.9±2.18. Among underlying diseases in extrapulmonary TB positive, diabetes mellitus (DM) was predominant with a prevalence of 31 (19.5%), while, 128 (80.5%) cases did not show any underlying disease. Most of the patients were in the age group (21-40 years) with a frequency of 60 (37.7%), and the lowest of patients belonged to the age group (>80 years) with a frequency of 9 (5.7%). No correlation was found between related factors and infection with EPTB (p> 0.05). Conclusion: Our findings showed that the prevalence of EPTB in Kashan was relatively high, but, a relative decrease was shown during 2004-2017, which with preventative measures can be reduced the prevalence. [ABSTRACT FROM AUTHOR]

Background: Hypothermia is usually used during cardiac surgery to further protect against cardiac and cerebral ischemia. However, cognitive impairment could be a common complication after open heart surgery. This study aims to determine the effect of rewarming on the cognitive status of patients after open heart surgery. Methods: The present study was conducted as a double-blind, randomized clinical trial at Tehran Heart Center, Tehran, Iran. In this clinical trial, 80 patients referred for open heart surgery were selected and randomly assigned into the intervention (n=40) and control (n=40) groups. In the intervention group, rewarming the mattress was started after the patient entered the intensive care unit. Warming continued until the patient's body temperature reached the normothermia level (37°C to 37.5°C). The data were collected by demographic-clinical questionnaire and Mini-Mental State Examination at three time points: before, 7 days, and 1 month after the surgery. The data were analyzed in SPSS software, version 16 using descriptive statistics, independent t test, chi-square test, repeated measure ANOVA, and paired t test. The significance level was considered less than 0.05. Results: The difference between the Mean±SD scores of cognitive status in the intervention group before the surgery (28.73±0.87), 7 days (27.63±1.03), and 1 month after the surgery (28.93±1.21) was significant (P=0.008). The difference between the Mean±SD scores of cognitive status in the control group before the surgery (28.42±1.02), 7 days (26.61±0.86), and 1 month after the surgery (27.85±1.06) was also significant (P=0.042). The results indicated that the mean score of cognitive status improves after 1 month, and it is greater in the intervention group (F=20.37, df=2, P<0.001). Significant differences were observed between the first and second time of measurements (P<0.0001) and also the second and third time of measurements (P<0.0001). Conclusion: Rewarming patients after open heart surgery improves their cognitive status. Therefore, this procedure can be used as a safe and non-invasive method to prevent cognitive complications by nurses after open heart surgery. [ABSTRACT FROM AUTHOR]

Background and Objectives: Traumatic brain injuries (TBIs) are among leading causes of debility and death at a global scale. The current study aimed at investigating the possible advantage of administrating tranexamic acid (TXA) in patients with post-TBI brain contusion and intraparenchymal hemorrhage (IPH). Materials and Methods: This double-blind randomized clinical trial was conducted on patients who had brain contusion/IPH according to their on-admission brain computed tomography (CT) scan, referring to Shahid Beheshti Hospital, Kashan University of Medical Sciences, during 2018-2021. The patients were randomly allocated to either the intervention group (receiving TXA through an antecubital vein access) or the control group (receiving Normal Saline via a similar route). TBI severity, ICH volume, and compressive effects of hemorrhagic mass on admission, 24 h, and 72 h after treatment were assessed. Then 3-month outcome estimated by Glasgow Outcome Scale (GOS). Results: There was no significant difference between patients' age, gender, TBI etiology (traffic collision or fall from height), and skull fracture between the study groups. Compressive effects of hemorrhagic mass, new bleeding and brain edema during 24 and 72 hours after intervention were not significantly different between the TXA and placebo groups. The alterations in ICH volume from preintervention to 24/72 h postintervention were similar between the intervention and placebo subgroups (P > 0.05). Majority of participants (82.5%) showed a good 3-month neurological outcome according to GOS, but that was not significantly different between the study groups. One case of death occurred in each subgroup, and both of them died after hospital discharge. Conclusion: TXA neither has a preventive effect against in-hospital post-TBI hemorrhage enlargement nor on neurological outcomes three months after hospital discharge. [ABSTRACT FROM AUTHOR]

Background and Objectives: Traumatic brain injury (TBI) is one of the main causes of disability. Since individuals with TBI experience many problems in their daily life, they must be highly supported. Regarding the nature of their problems, their caregivers suffer from many psychological problems. The current study aimed to investigate the effect of group acceptance and commitment therapy (ACT) on the family function, experiential avoidance, and anxiety of the TBI patients' caregivers. Methods: The current study was a randomized clinical trial with waiting list and intervention groups. Forty caregivers of TBI patients who referred to Kashan's Shahid Beheshti Hospital, Iran, since 2017 until 2019 were randomly assigned to the experimental (n = 20) and the waiting list control (n = 20) groups. Both the groups completed a demographic information questionnaire, the Family Assessment Device, the Experiential Avoidance in Caregiving Questionnaire, and the anxiety subscale of the Depression, Anxiety, and Stress Scale in pretest, posttest, 3-month follow-up, and 6-month follow-up. Results: The results of repeated measures analysis of variance showed that ACT program can significantly decrease the anxiety, experiential avoidance, and most of the dimensions of the family functions (P < 0.005). Conclusion: ACT could be utilized to improve the family functions and reduce the experiential avoidance and the anxiety of the TBI patients' caregivers. This trial is registered with the Registry of Clinical Trials: "IRCT20190704044100N1." [ABSTRACT FROM AUTHOR]

Objective(s): Klebsiella pneumoniae is the common cause of pneumonia in hospitalized patients, particularly in intensive care units (ICU). The infection can transfer by medical equipment such as mechanical ventilators. This study aimed to investigate the molecular typing of the extended-spectrum beta-lactamase-producing K. pneumoniae isolates recovered from Beheshti Hospital, Kashan, Iran. Materials and Methods: K. pneumoniae isolates producing ESBLs have been collected from the samples obtained from Shahid Beheshti hospital, Kashan, Iran. Antimicrobial susceptibility was determined using the Kirby Bauer disk diffusion method. The presence of ESBLs was evaluated using CLSI for ESBL screening by the double-disk diffusion method. Molecular typing was conducted by pulsed-field gel electrophoresis (PFGE). In total, 89 K. pneumoniae isolates were recovered, of which 47.1% were ESBL producers. Results: Results showed that all of the clinical and environmental isolates were resistant to ceftriaxone, meropenem, cefazolin, cefotaxime, cephalothin, and piperacillin-tazobactam. All isolates were grouped under four clusters (A-D). The major cluster was related to the C cluster with 22 isolates (19 clinical and 3 environmental). Seventy-two percent of isolates were from the ICU ward. There was no correlation between antibiotic resistance patterns and PFGE clusters (P=0.2). Conclusion: We observed a common molecular signature among both clinical and environmental K. pneumoniae isolates, indicating a similar genotype and likely a common origin for ESBL producer isolates found in different hospital wards. Therefore, hospitals need to implement an effective infection control system to decrease the spreading of ESBL strains within the hospitals and subsequently the transmission of the infection to patients. [ABSTRACT FROM AUTHOR]

Aims: Management of water resources, especially groundwater in arid and semiarid regions, is of particular importance. Various natural and human factors in recent decades have created critical conditions for these resources. Therefore, this study was conducted to investigate changes in groundwater levels over the past 28 years. Materials and Methods: To conduct this research, statistics related to 64 piezometer wells were studied during the years 1990–2018, and the effect of rainfall and extraction from groundwater resources was interpreted and analyzed. Results: The results of the study showed that according to the hydrograph of 64 piezometer wells in Kashan plain, the groundwater level has a downward trend and has decreased by 15.29 m during 28 years. The annual drop was 0.54 m. An increasing peak of water table was also observed. Moreover, the water level has decreased slightly in some years and has not decreased in some years. Conclusion: The study shows that uncontrolled harvesting in the long run has had a more significant impact than rainfall on groundwater resources. Moreover, water abstraction has occurred on average in the southern and southeastern parts of the plain, which can be due to the concentration of agricultural lands in this area. To reduce this trend, strong management strategies should be adopted and appropriate to the situation. [ABSTRACT FROM AUTHOR]