Search

Mediastinal malignant rhabdoid tumor (MRT) is an exceedingly rare and aggressive neoplasm, particularly uncommon in infants. We present the case of a previously healthy 7-month-old male infant with mediastinal MRT. The patient initially presented with left eyelid ptosis and was otherwise asymptomatic. Initial investigations, including brain MRI, yielded unremarkable results, and the infant was discharged with vitamin B supplements. However, he was readmitted a week later with prolonged fever, poor feeding, diarrhea, and respiratory distress. Despite an initial diagnosis of bronchiolitis/viral respiratory tract infection, the patient's condition rapidly deteriorated. Subsequent evaluation revealed mediastinal MRT as the underlying cause. This case underscores the diagnostic challenges associated with mediastinal MRT in infants and highlights the importance of considering rare neoplastic etiologies in atypical clinical presentations.

Objective: To investigate cardiovascular risk factors affecting COVID-19 outcomes in a tertiary referral hospital. Methods: This prospective cohort study analyzed 269 participants with COVID-19. The primary outcomes were ICU admission, prolonged hospital stay duration, and in-hospital death. The secondary outcomes included death, chronic symptoms, and NYHA functional class during follow-up periods. Results: A total of 412 patients with COVID-19 symptoms were enrolled in the study, and out of which 269 patients had complete medical records and positive SARS-CoV-2 PCR test results, fulfilling the study criteria were analyzed. The patients were divided into two groups, with cardiovascular comorbidities (group A, n=122), such as established cardiovascular disease, diabetes mellitus, and hypertension, and without cardiovascular comorbidities (group B, n=147). Binary logistic regression analysis showed that patients with underlying hypertension, diabetes, and established cardiovascular disease had a 1.55 (95% CI: 1.28-2.26), 1.62 (95% CI: 1.34-2.13), and 1.63 (95% CI: 1.07-5.34)-fold risk of mortality, respectively in the adjusted model. Conclusions: Hospitalized COVID-19 patients with predisposing cardiovascular risk factors are more susceptible to develop worse outcomes. More attention should be paid to the management and follow-up of these patients.

Abstract Neuromyelitis optica spectrum disorder (NMOSD) is an immune-related demyelinating defect. Long non-coding RNAs (lncRNAs) might influence the pathobiology and progression of NMOSD. The current study assessed expression level of NEAT1, PANDAR, MEG3 and TUG1 lncRNAs in the peripheral blood of NMOSD patients compared with healthy individuals. All mentioned lncRNAs were shown to be over-expressed in total NMOSD cases, male NMOSD cases and female NMOSD cases compared with the matching control subgroups. MEG3 had the most robust over-expression in patients subgroups compared with normal subjects. There was no noteworthy difference in the expression of any of lncRNAs between female and male patients. MEG3 had an ideal performance in the differentiation of NMOSD cases from healthy persons (Sensitivity and specificity values = 100%). Other lncRNAs could also efficiently separate NMOSD cases from control subjects (AUC values = 0.97, 0.89 and 0.88 for PANDAR, NEAT1 and TUG1, respectively). Cumulatively, NEAT1, PANDAR, MEG3 and TUG1 lncRNAs can be considered as appropriate disease markers for NMOSD.

Iran’s healthcare system is considered to be one of the most enduring and resilient ones in the Middle East (1). It had successful records in tackling various infectious diseases by producing vaccines at the Pasteur and Razi institutes for several years’ duration (2). However, COVID-19 has severely affected the healthcare system in Iran. From the beginning of the pandemic until January 01, 2024, over 146,000 cases lost their lives to COVID-19, with almost nine peaks resurgence (3). In this paper, the challenges regarding the control of COVID-19 in Iran are discussed, while the competences were discussed earlier (1).

Abstract Background The oral nutrition is big challenge for preterm neonates. Since the best oral feeding method for preterm neonates is not yet known, the present study aimed to evaluate the effect of cup, syringe, and finger feeding methods on reaching the time of full oral feeding and weight gain among preterm neonates. Method This randomized clinical trial study was conducted on 99 preterm neonate’s, born at 30–34 weeks gestation, admitted to the neonatal intensive care unit (NICU) of Al-Zahra and Taleghani Therapeutic-Educational Centers in Tabriz, Iran. Subjects were assigned into finger feeding (n = 33), cup feeding (n = 33), and syringe feeding (n = 33) groups in the allocation ratio of 1:1:1 using block randomization with a block size 6 and 9. They were studied in terms of reaching the time of full oral feeding and weight gain. The data were analyzed using SPSS/version21 software, and ANOVA, chi-square, and ANCOVA tests. Results There was no significant difference in the mean score of reaching the time of full oral feeding among cup, finger, and syringe feeding groups (p = 0.652). The mean score of daily weight gain, oxygen saturation (SaO2), and heart rate after feeding was not significantly different among the three groups (p > 0.05). The effect of confounding variables, including birth weight and age, arterial oxygen saturation, and heart rate before feeding, was controlled. Conclusion Based on the results, one of the cup, finger, and syringe feeding methods can be applied in the NICU, considering the staff’s proficiency in feeding neonates. Trial registration IRCT20150424021917N11.

Background & Objective: It is argued that students have less tendency to communicate in English classes even after several years of attending language courses. The general objective of this research was to find the effective factors for willingness to communicate in English across medical classes. Materials & Methods: The participants in this study were 252 medical students from Zanjan University of Medical Sciences who were majoring in one of the fields of dentistry, medicine and pharmacy and were taking the course of English for Specific Purposes. Macintyre’s Willingness to Communicate questionnaire was used to compile the data. After collecting the data using the questionnaire, they were processed in the statistical package. The collected data were then tabulated and analyzed via SPSS (20) and AMOS. Results: In the structural model, there were significant pathways between self-confidence and motivation and WTC in ESP classes. Motivation had a positive effect on self-confidence. The teacher's immediacy, with its negative impact on shyness, increased the motivation to communicate in the ESP class. On the other hand, the paths of shyness to motivation and self-confidence were negative. All pathways were significant at 0.05. Conclusion: The findings of this study showed that, as in the previous studies, the tendency to communicate in language classes depends on several variables. Given that communication and speaking are the most important language skills, language learning planning is recommended to consider the importance of this skill. Language teachers should create conditions with low anxiety to encourage learners to speak and communicate. Shyness was another variable during the study that had a negative effect on the WTC. The results of this study also emphasize that highly motivated learners are more likely to participate in classroom activities and communication due to their self-confidence. Also, in this study, the teacher's intervention had a positive effect on reducing anxiety. Thus, it is recommended that teachers play an important role in motivating students to communicate I ESP classes.

Background and Objective: Sepsis is a syndrome involving physiological, pathological, and biochemical abnormalities caused by infection. Very few studies have been performed to evaluate the prognostic value of the neutrophil-to-albumin ratio. The present study aimed to evaluate the neutrophil-to-albumin ratio in patients with sepsis admitted to the intensive care unit (ICU). Materials and Methods: All patients admitted to the ICU with a diagnosis of sepsis were included in the study. The inclusion criteria entailed the age range of ≥18 years, having sepsis, and hospitalization in the ICU for more than two weeks. Results: A total of 75 patients with a mean age of 72.34 years were evaluated, and 57.8% of cases died. There was a significant difference between neutrophils on the second and third days between deceased and discharged patients. The neutrophil-to-albumin ratio at the time of admission, the second day, and the third day were 31.62, 33.36, and 34.31, respectively; nonetheless, no significant difference was observed between the deceased and discharged (P>0.05). Conclusion: As evidenced by the results of this study, the neutrophil-to-albumin ratio in deceased patients was higher than that in discharged ones; however, this difference was not statistically significant. Moreover, neutrophil percentage, duration of mechanical ventilation, and duration of hospitalization in deceased patients were significantly higher, as compared to those in discharged patients.

Introduction: Grape is a non-climacteric fruit with a low rate of physiological activity but is subject to serious physiological and parasitic disorders after harvest and during long term storage (Ciccarese et al., 2013). Currently, Edible coatings have been studied as potential substitutes for conventional plastics in food packaging. Edible coating is a thin layer of edible material formed as a coating on a food product. Edible coating can offer several advantages to the fresh fruit and vegetable industry such as improvement in the retention of color, acids, sugar and flavor components, the maintenance of quality during shipping and storage, the reduction of storage disorders and improved consumer appeal (Antoniou et al., 2015; Cazon et al., 2017; Fakhouri et al., 2015; Galus & Kadzińska, 2015). Farsi gum as a novel source of polysaccharides has drawn much attention in a wide range of various fields such as pharmaceutics, food and cosmetics industries. Functional properties of Farsi gum are influenced by its structure and molecular weight (Hadian et al., 2016; Joukar et al., 2017). By inclusion of bioactive compounds in the Farsi gum network the aforementioned impairments could be overcome and moreover, new protective and functional valences could be added. The inclusion of lipid-based component in Farsi gum gives it excellent light and moisture barrier properties. The benefic impact on human health of hemp seed oil is worldwide recognized. A recent study demonstrated the antimicrobial properties of hemp seed oil. Due to their abundance in biologically active compounds, hemp seed oil is promising natural alternatives that may extend the shelf-life, microbiological safety and nutritional values of food (Cozmuta et al., 2015; Leizer et al., 2000; Salarnia et al., 2018). Growing awareness of the quality of fruit has necessitated increasing effort to develop rapid and non-destructive methods for evaluating fruit quality (Bhargava & Bansal, 2020; Rachmawati et al., 2017; Tao & Zhou, 2017; Wu & Sun, 2013). The aim of this study was the consideration of image processing application for grape sorting based on visual surface characterize. Materials and Methods: Coating emulsion was prepared using (Farsi gum (0%, 1.5% and 3%), hemp seed oil (0%, 0.075% and 0.15%) and glyceride (0.3%)). grape fruit were coated by immersion in coating dispersion for 5 min. Samples were then allowed to loss the excess coating dispersion. Coatings were developed at room temperature during an hour. Samples were refrigerated at 4± 1°C for 28 days and analyses were performed at days 0 and 28. Defect identification and maturity detection of grape fruits are challenging task for the computer vision to achieve near human levels of recognition. The image acquisition was performed in a homogenously controlled lighting condition. Considering the camera lens’s focal length, the samples were placed 25 cm under the camera’s lens to be under camera’s field of view. The images of grape were segmented from the background using thresholding of the high contrast images via MATLAB software (R2019a, image processing toolbox). The optimum threshold value was obtained to be 0.35, 0.45 and 0.30 for R, G and B channel, respectively. Results and Discussion: The proposed techniques can separate between the defected and the healthy grape fruits, and then detect and classify the actual defected area. Classification is performed in two manners which in the first one, an input grape is classified with two different algorithms (RGB and binary). The Result showed that the accuracies for detecting the surface defects on grape were 97.73% and 96.30% using RGB and binary algorithms, respectively. Proposed method can be used to detect the visible defects of coated grape, and to grade the grape in high speed and precision. Conclusions: The results of this research and similar ones can provide helpful recommendations in grading fruits for fresh consumption. The simplicity and the efficiency of the proposed techniques make them appropriate for designing a low-cost hardware kit that can be used for real applications.

In the machine learning jargon, multi-label classification refers to a task where multiple mutually non-exclusive class labels are assigned to a single instance. Generally, the lack of sufficient labeled training data demanded by a classification task is met by an approach known as semi-supervised learning. This type of learning extracts the decision rules of classification by utilizing both labeled and unlabeled data. Regarding multi-label data, however, current semi-supervised learning methods are unable to classify them accurately. Therefore, with the goal of generalizing the state-of-the-art semi-supervised approaches to multi-label data, this paper proposes a novel two-stage method for multi-label semi-supervised classification. The first stage determines the label(s) of the unlabeled training data by means of a smooth graph constructed using the manifold regularization. In the second stage, thanks to the capability of the twin support vector machine to relax the requirement that hyperplanes should be parallel in classical SVM, we employ it to establish a multi-label classifier called LP-MLTSVM. In the experiments, this classifier is applied on benchmark datasets. The simulation results substantiate that compared to the existing multi-label classification algorithms, LP-MLTSVM shows superior performance in terms of the Hamming loss, average precision, coverage, ranking loss, and one-error metrics.

Objectives: Due to recent advances in caring for premature neonates, premature retinopathy has become an important cause of preventable blindness and ocular disabilities. Therefore, more attention is paying to its diagnostic-therapeutic methods. Thus, the current trial assessed the efficacy of oral propranolol on the treatment of retinopathy of prematurity (ROP) in neonates. Materials and Methods: In the current trial, 58 neonates with ROP were included and the efficacy of oral propranolol (0.5 mg/kg every 8 hours) was compared with the control group. Results: In the intervention group, the stage of ROP was almost the same as the control group while 31.1% of neonates in the control group were progressed to stage 3. On the other hand, it was only 6.9% (P=0.009) in the intervention group. In patients receiving propranolol, only 2 cases required invasive therapeutic interventions whereas 9 patients required such interventions in the control group (P=0.009). The ROP improvement rate was significantly higher in the intervention group. In the control group, the overall progression to higher stages was about 48.3% while it was 13.8% for the intervention group. The mean age of neonates at the time of retinal artery completion was 91.40±22.16 and 128.08±79.89 days for the control and intervention groups, respectively (P=0.136). Conclusions: The results of this study showed that adding oral propranolol to standard therapy can reduce the rate of ROP progression to higher stages in preterm neonates with low birth weight, and the need for invasive treatments.

Introduction: Bacterial natural products such as biosurfactants and surface-active agents are important compounds which exhibit many applications in the fields of medicine.Aim: The aim of the present study was to isolate and identify Nocardia strains with high biosurfactant production and antibiofilm ability.Materials and methods: In the present study, a biosurfactant producing Nocardia species was isolated and identified by a laboratory method. Nocardia species were initially screened and then tested for their ability to produce biosurfactant. The oil spreading test and the surface tension measurements showed that one strain was a biosurfactant producer. The strain with the best surface activity results was selected for further studies and identified by 16S rRNA gene sequencing method. Fourier transform infrared spectroscopy (FTIR) and compositional analysis proved a biosurfactant structure.Results: Oil spreading test and blue agar plate test confirmed biosurfactants and extracellular anionic glycolipids. E24% assay using olive oil revealed strong emulsifying characteristic of the extracted biosurfactant with 100% emulsifying strength. FTIR spectrum indicated the presence of aliphatic hydrocarbon chain (lipid) along with the polysaccharide portion, confirming the glycolipid nature of the biosurfactant. The stability of the biosurfactant produced in different conditions was significant. Increasing concentration of BS significantly inhibited Pseudomonas aeruginosa biofilm.Conclusions: N. coubleae can be a representative of the genus Nocardia for the production of biosurfactants with beneficial physicochemical properties.

Background: We aimed to elucidate the pathogenic bacterial and fungal profiles of specimens obtained from suspected ocular infections at Farabi Eye Tertiary Referral Hospital, Tehran, Iran. Methods: In this cross-sectional study, we collected data from ocular specimens taken during the seven-year period of 2011 to 2018, and the results were then retrospectively analyzed. Samples had been obtained from patients who were investigated for ocular infections. Results: Overall, 16,656 ocular samples were evaluated. The mean patient age was 48.31 ± 26.62 years. Most patients were men (60.33%), and men in the 7th decade of life were the largest represented group. The seasonal distributions of specimen collection sites followed the overall distribution of collection sites by year. Specimens obtained from the cornea were the most common (49.24%), also representing the largest number of specimens in all seasons. The most commonly isolated fungal microorganisms were Fusarium spp., followed by Aspergillus spp. and Candida albicans. Of the 6,556 specimens with positive bacterial cultures, 59% produced gram-positive bacteria, while the remainder produced gram-negative pathogens. The most commonly isolated bacteria were Pseudomonas aeruginosa (17.77%), Staphylococcus epidermidis (13.80%), Streptococcus pneumoniae (13.27%), S. viridans (12.23%), and S. aureus (11.18%). Conclusion: Most submitted specimens were obtained from the cornea. The most commonly isolated fungal microorganisms were Fusarium spp., followed by Aspergillus spp. and C. albicans. The most commonly isolated bacteria were P. aeruginosa, followed by S. epidermidis and S. pneumoniae.

.............................................................................................................................................................................................. .............................................................................................................................................................................................. ..............................................................................................................................................................................................

No Abstract

Abstract Background Coronavirus disease 2019 (COVID-19) has infected people in many countries worldwide. Discovering an effective treatment for this disease, particularly in severe cases, has become the subject of intense scientific investigation. Therefore, the objective of this study was to evaluate the efficacy of intravenous immunoglobulin (IVIg) in patients with severe COVID-19 infection. Methods This study was conducted as a randomized placebo-controlled double-blind clinical trial. Fifty-nine patients with severe COVID-19 infection who did not respond to initial treatments were randomly assigned into two groups. One group received IVIg (human)—four vials daily for 3 days (in addition to initial treatment), while the other group received a placebo. Patients’ demographic, clinical, and select laboratory test results, as well as the occurrence of in-hospital mortality, were recorded. Results Among total study subjects, 30 patients received IVIg and 29 patients received a placebo. Demographics, clinical characteristics, and laboratory tests were not statistically different (P > 0.05) between the two groups. The in-hospital mortality rate was significantly lower in the IVIg group compared to the control group (6 [20.0%] vs. 14 [48.3%], respectively; P = 0.022). Multivariate regression analysis demonstrated that administration of IVIg did indeed have a significant impact on mortality rate (aOR = 0.003 [95% CI: 0.001–0.815]; P = 0.042). Conclusions Our study demonstrated that the administration of IVIg in patients with severe COVID-19 infection who did not respond to initial treatment could improve their clinical outcome and significantly reduce mortality rate. Further multicenter studies with larger sample sizes are nonetheless required to confirm the appropriateness of this medication as a standard treatment. Trial registration A study protocol was registered at the Iranian Registry of Clinical Trials ( www.IRCT.ir ), number IRCT20200501047259N1 . It was registered retrospectively on May 17th, 2020.

Background and Aim: Diabetes mellitus is one of the leading causes of death, and its prevalence is increasing annually because of the change in lifestyle. Increased blood glucose level and dyslipidemia are the major symptoms of this metabolic disease. Currently, the main and effective treatment for diabetes is the use of medication such as insulin. Its control by using herbal products has received a lot of attention in the world. The aim of this study is to evaluate the effects of bioflora (a probiotic supplement) and aqueous extract of cinnamon in improvement of blood glucose level, dyslipidemia, and reduction of cardiovascular diseases in diabetic rats. Methods & Materials: Thirty-five male Wistar rats were prepared and randomly divided into five groups of negative control, positive control, probiotic (treated with bioflora 3.2×108 CFUs/day for 30 days), cinnamon (treated with 200 mg/kg of cinnamon aqueous extract for 30 days), and probiotic + cinnamon. Diabetes was induced by intra-peritoneally injection of streptozotocin. The rats’ weight, blood glucose level, lipid profile, high sensitivity C-Reactive Protein (hs-CRP) and Atherogenic Index (AI) were measured at the end of experiment to predict the risk of cardiovascular diseases. Ethical Considerations: This study ethically approved in Research Centre of Islamic Azad University of Arak (Code: IR.IAU.ARAKREC1397.005). All interventions performed in accordance with the Guide for Care and Use of Laboratory Animals prepared by the Institute of Laboratory Animal Resources. Results: Induction of diabetes caused severe weight lost in rats, but the weight loss was lower in groups treated with probiotic. The blood glucose level in probiotic + cinnamon group was significantly reduced. Bioflora reduced triglyceride, cholesterol, and Low-Density Lipoprotein Cholesterol (LDL-C) levels, while cinnamon extract significantly reduced triglyceride and LDL-C levels compared to the positive control group. AI and hs-CRP values were reduced in the probiotic group compared to control groups. There was no synergistic effect by combined use of bioflora and cinnamon extract. Conclusion: Bioflora effectively prevented dyslipidemia by improving intestinal microbiota, lowering blood glucose level, and improving lipid profile and, therefore, reduced the risk of cardiovascular diseases.

Background and Aim: Ventilator-acquired pneumonia is common in invasive mechanical ventilatory patients. There are various methods to prevent and reduce the incidence of ventilator-acquired pneumonia, one of which is the use of combined mouthwashes. The purpose of this study was to evaluate the effect of combined mouthwash on the prevention of ventilator-acquired pneumonia. Materials and Methods: In this clinical-trial study, patients were randomly selected and divided into control and study group. The patients with GCS = 3 and brain death and mechanical ventilation less than 48 hours were excluded from the study. The control group received 0.2% chlorhexidine for mouthwash and the study group received gentamicin 2%, colistin 2% and vancomycin 2%. Mouthwashes were used until the creation of pneumonia symptoms, patient mortality, and endotracheal intubation. Statistical analysis was completed after the study. Results: The incidence of pneumonia was 19 (30.64%) in the study group and 16 (25.8%) in the control group (P = 0.23). In the study group, 39 (62/9%) patients and in the control group 40 patients (64/5%) were discharged (P = 49/0). Cultures endotracheal secretions were reported negatively in 40 patients (5.64%) of study group and 45 patients (58.72%) in control group (P = 0.04). The isolated bacteria in the study group included 11 cases of Acinetobacter (50%), four cases of Pseudomonas (18.18%), two cases of E.coli (9.09%), two cases of Klebsiella (9.09%) and three cases of Gram -positive (16.63%). Also these bacteria were reported as 11 cases of Acinetobacter (64.7%), three cases of Klebsiella (17/64%), two cases of Pseudomonas (11.76%), one case of E.coli (5.9%) in control group (P = 0.001). Conclusion: This study showed that a mouthwash with a combination of Gentamicin-Clestin and Vancomycin, compared to chlorhexidine, was not more effective in preventing ventilator-associated pneumonia in patients undergoing mechanical ventilation.

BACKGROUND: The aim of this study was to evaluate visual and refractive outcomes and quality of vision after implantation of the AT LISA tri 839MP intraocular lens (IOL). PATIENTS AND METHODS: This interventional clinical trial comprised 46 cataractous eyes of patients who underwent phacoemulsification with IOL implantation (mean age of 58.08 ± 11.01 years; range: 36–76 years old). Spherical equivalent (SE), uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), corrected intermediate visual acuity (CIVA), uncorrected near visual acuity (UNVA), and corrected near visual acuity (CNVA) were measured 1, 3, and 6 months after surgery. Contrast sensitivity (CS) was measured at 6 months. Subjective quality of vision and presence of dysphotopsia by a short questionnaire were evaluated postoperatively. RESULTS: At 6 months, the mean visual acuity was 0.08 ± 0.11, 0.03 ± 0.08, 0.07 ± 0.09, 0.02 ± 0.08, 0.05 ± 0.09, and 0.02 ± 0.08 LogMAR for UDVA, CDVA, UIVA, CIVA, UNVA, and CNVA, respectively. The mean values of SE were − 0.4728 ± 0.32D. These variables improved over time, yet significant changes were detected in UDVA (P = 0.009) and SE (P = 0.0001). The mean CS value was 1.74 ± 0.08. The mean scores (0% = no symptoms; 100% = strong symptoms/unable to perform activities) for glare and halos were 7.07 ± 0.22% and 8.70 ± 0.23%, respectively. These items were reduced over time. Patients' level of satisfaction mean score for performing activities was 96.66%. CONCLUSIONS: The AT LISA tri 839MP IOL provides excellent uncorrected distance, intermediate and near vision, and CS. This IOL showed a minimal level of photic phenomena and a high level of patient satisfaction.

Background: There are successful reports of the concomitant management of herpes infection and coronavirus disease 2019 (COVID-19), using both acyclovir (ACV) and COVID-19 treatment regimens. Furthermore, ACV has been proposed to effectively treat COVID-19, through various mechanisms, such as inhibition of viral proteases, multiple viral gene expressions, and RNA dependent RNA polymerase (RdRP). Therefore, this study aimed to review the reported cases of patients with concomitant herpes infection and COVID-19, receiving concurrent antiviral drugs for herpetic lesions. Methods: A search was done to find the relevant articles, published between December 2019 and December 2020, with no language limitations, in the PubMed database, using the Medical subject headings (MeSH) terms related to herpes simplex virus or herpes zoster (namely, shingles)combined with COVID-19. Accordingly, the reports of the concomitant herpes infection andCOVID-19, receiving concurrent antiviral drugs for herpetic lesions were included. Results: Out of 90 articles, 11 records reporting the cases of herpes infection and concurrent laboratory-confirmed COVID-19, receiving antiherpetic therapies, were reviewed. There were28 patients (age range of 7-82 years) with laboratory-confirmed COVID-19, concomitant with reactivation of herpes infection, receiving antiviral drugs alongside candidate COVID-19treatment regimens, but no mortality. The mean (standard deviation [range]) age of these 28patients during treatment was 56.4 (18.6 [7-82]) years, and the majority were male (n=18, 64.3%). A total number of 20 patients had also received ACV and eight cases had been administered with other two antiviral compounds, including seven cases with valacyclovir, and one case with famciclovir, with no mortality. Conclusion: The potential use of ACV, as an add-on therapy, along with candidate COVID-19treatment regimens was proposed in this study. However, further clinical trials are recommended to test this hypothetical adjuvant therapy.

Background and objective: Nocardia is a germ-positive filamentous bacterium with relative acid-fast properties that ubiquitously exists as an environmental saprophyte. Nocardiosis is usually characterized as an acute or chronic illness associated with pus or granulomatosis, which can cause an aggressive disease both in healthy people and immunosuppressive patients. The aim of this study was to identify the biodiversity of Nocardia species isolated from Tehran hospitals via phenotypic and PCR molecular approaches. Materials and methods: 200 samples were collected from Tehran hospitals. After being separated by paraffin baiting technique, the colonies were evaluated for their growth abilities in liquid lysozyme and at 45°C and based on other biochemical tests via macroscopic examinations and then microscopic gram and relative acid-fast staining practices. Ultimately, we designed a genus-specific primer set and performed the PCR reaction to compare both results. Results: From the 200 samples, 30 samples were identified as positive based on the culture and biochemical tests and molecular method. Conclusion: Considering the species diversity of Nocardia genus and the existence of different conditions for performing phenotypic and biochemical tests, it is very probable that another genus relevant to the actinomycete family be mistakenly identified as Nocardia. Thus, molecular methods can provide confirmation of the phenotypic approach.

Naser Gharebaghi,1 Amin Sedokani,2 Mojhdeh Mehrno21Department of Infectious Disease, Faculty of Medicine, Urmia University of Medical Science, Urmia, Iran; 2Student Research Committee, Urmia University of Medical Sciences, Urmia, IranAbstract: Brucellosis is a systemic disease which may involve any organ or system of the body, and is listed in the differential diagnosis of many diseases. In spite of described cutaneous involvements, skin manifestations are not common in brucellosis, particularly papulonodular lesions with dermatomal patterns that may overlap with dermatomal skin lesions. This may prevent correct diagnosis and treatment in practice, harming patients’ health and leading to financial costs to the health system and patient. In this case, at first, due to left thigh and buttock skin lesions and dermatomal pattern, the patient was diagnosed with Herpes zoster infection. After medical treatment and no improvement of lesions, the patient was referred to the infectious clinic with low back pain; magnetic resonance imaging (ordered by a neurosurgeon) suggested infectious spondylodiscitis. At the infectious ward, brucellosis spondylitis was diagnosed and a biopsy was taken from dermatomal lesions. The patient’s follow-up after 1, 2, and 3 months revealed that treatment of brucellosis had led to healing of lesions. Surprisingly, the histopathological assessment of the biopsy suggested psoriasis vulgaris. This was a rare case of manifestation of cutaneous brucellosis which could not even be diagnosed by histopathological assessment.Keywords: brucellosis, cutaneous manifestations, dermatomal pattern, psoriasis

Background: We aimed to use the scientometric approach to evaluate immunological studies on the subject of sulfur mustard over the past 20 years. Methods: In this scientometric study, the Web of Science Core Collection was searched on the studies about sulfur mustard. The published papers related to the field of immunology were retrieved from these papers. HistCite software and VOSviewer were the applied software packages for bibliometric analysis, information visualization, and creating bibliometric networks. Results: Over the past 20 years, 741 researchers from 22 countries have published 201 scientific papers in 95 journals. Iran and the United States with 93 and 68 published articles ranked at the top. The Journal of International Immunopharmacology, with 33 published papers, 439 Total Global Citation Score (TGCS), and 105 Total Local Citation Score (TLCS) was the most productive and most influential in this regard. The paper entitled "Biomonitoring of exposure to chemical warfare agents: A review" and another paper entitled "Sardasht-Iran Cohort Study of Chemical Warfare Victims: Design and Methods" were the most influential papers in this topic with 200 TGCS and 27 TLCS, respectively. The most productive and the most influential centers were “Immunoregulation Research Center of Shahed University” and “The Janbazan Medical and Engineering Research Center (JMERC),” respectively. Conclusion: The result of our report as the unique scientometric evaluation of the research on sulfur mustard and Immunology can be used as a roadmap for authors, researchers, and policymakers to define the best ways to allocate their financial and executive resources.

No Abstract

Coronavirus disease 2019 or COVID-19 has rapidly emerged as a global pandemic. This viral infection involves the upper respiratory tract and could lead to severe pneumonia with respiratory distress or even death. Certain studies have found higher initial plasma levels of most pro-inflammatory cytokines during the course of the infection. In this context, both in vitro and in vivo studies have revealed that metronidazole could decrease the levels of several cytokines, which are known to increase during the COVID-19 infection, including interleukin (IL)8, IL6, IL1B, tumor necrosis factor (TNF)α, IL12, IL1α, and interferon (IFN)γ, as well as the levels of C-reactive protein (CRP) and neutrophil count. Furthermore, the drug could decrease neutrophil-generated reactive oxygen species during inflammation. Metronidazole could counteract majority of the immunopathological manifestations of the COVID-19 infection. Therefore, studies with a large sample size are required to determine the efficacy of metronidazole in the treatment of COVID-19 infection.Â

Naser Gharebaghi,1 Miramir Aghdashi,2 Seyed Arman Seyed Mokhtari3 1Department of Infectious Disease, Faculty of Medicine, Urmia University of Medical Science, Urmia, Iran; 2Department of Rheumatology and Internal Medicine, Faculty of Medicine, Urmia University of Medical Science, Urmia, Iran; 3Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran Abstract: Kawasaki disease (KD) is characterized with an acute systemic vasculitis of the medium- and small-sized vessels. This disease mainly involves children within the age of 6 months to 5 years and it is often self-limited and patients seem to recover well; however, it may lead to devastating and fatal cardiovascular complications such as coronary artery aneurysm. Thus, early diagnosis and appropriate management of this disease have a significant effect on improving the prognosis and preventing its serious complications. Adult-onset KD (AKD) is rare and often misdiagnosed. Here we report a rare case of KD that occurred in a 17-year-old young adult who presented 4 weeks post splenectomy, with clinical signs and symptoms consistent with AKD. This may potentially highlight the association of AKD with infectious etiologies. Keywords: Kawasaki disease, adult, splenectomy

AIM: To explore the relationship between different parameters of Ocular Response Analyzer (ORA) and Corvis ST (CST) in a sample of healthy Iranian school-aged children and the relationship between parameters of these 2 instruments against intraocular pressure (IOP), measured by the Goldmann applanation tonometer (GAT-IOP), age and gender, and find possible correlation between ORA and CST with GAT. METHODS: This cross-sectional study included 90 healthy children. A general interview and complete eye examination were performed. Following successful GAT-IOP measurement, ORA and CST were conducted. The CST parameters were A 1/2 length (A1L, A2L), A 1/2 velocity (A1V, A2V), highest concavity deformation amplitude (HCDA), radius of curvature (RoC), peak distance (PD), central corneal thickness (CCT) and IOP. The ORA parameters were corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated IOP (IOP-G) and corneal compensated IOP (IOP-CC). Extracted data was analyzed using the Statistical Package for Social Science software. RESULTS: Totally 39 males with age of 9.08±1.60 (6-12)y and 51 females with age of 8.96±1.55 (6-13)y were included. Many CST parameters were significantly correlated with CH, CRF, IOP-G and IOP-CC. Some CST parameters had a significant correlation with GAT-IOP, including IOP-CST in both eyes and HCDA, A2L, PD, and RoC in the left eye, but none with age, except A2L in the right eye. The CRF measurement showed a significant correlation with GAT-IOP in both eyes and CH in the right eye, yet, none with age. Among all CST and ORA parameters, CCT-CST in both eyes and A1L in right eye had a significant correlation with gender, although this was a negligible negative correlation. Comparison of mean IOP values by different devices showed a significantly highest IOP overestimation by CST and lowest by IOP-CC compared with GAT. Also, IOP-G versus IOP-CST significantly had the lowest IOP overestimation among others. Overall, either low positive correlation or negligible correlation was found between IOP measurements by 3 instruments. CONCLUSION: The study finds the highest IOP overestimation by CST and lowest by IOP-CC compared with GAT. Overall, either low positive correlation or negligible correlation is found between IOP measurements by the 3 instruments.

Background and Objective: Refeeding syndrome (RFS) is comprised of severe electrolyte disturbances and metabolic abnormalities that occur after the reinstitution of nutrition to starved patients. Materials and Methods: This prospective study was conducted on patients aged over 18 years who were admitted to the Intensive Care Unit (ICU) of Taleghani and Emam hospitals in Urmia, Iran, during the first half of 2017. The included participants had the ICU stay of more than 48 h, were kept on nil per os, and were under nutritional support. The patients’ serum levels of phosphorus, magnesium, and potassium were measured on the 1st, 3rd, and 7th days of hospital stay. The frequency of RFS, hypophosphatemia, hypomagnesemia, hypokalemia, and the short-term outcomes of patients were obtained and compared. The patients with acute and chronic renal failure, cancer, previous gastrointestinal and hepatic diseases, and electrolyte disorder were excluded from the study. Results: The mean length of ICU stay and duration of mechanical ventilation were 35 and 28.5 days, respectively. The frequency of mortality among the patients was 36.96% (n=95). Furthermore, RFS, hypophosphatemia, hypokalemia, and hypomagnesemia had the frequencies of 13.23%, 25.7%, 21.4%, and 37.7%, respectively. There were significant differences between the patients with RFS and those without RFS in terms of the body mass index, duration of mechanical ventilation, ICU length of stay, and mortality (P

For structural reliability assessment or risk analysis of aging offshore steel structures, it is essential to have a probabilistic model, which contains specific statistical parameters, and predicts long term corrosion loss as a function of time. The aim of this study is to propose such model for offshore jacket platforms in the Persian Gulf. Field measurements for material loss due to uniform corrosion for submerged members in seawater have been collected and statistically analyzed to identify the probability density distribution function for dispersion and variation of corrosion loss value according to the passage of time. To predict the corrosion loss, two probabilistic models with different approaches and time dependent parameters are suggested, based on the statistical analysis results. For a comparative study, the application of aforementioned models on the reliability analysis of a simple plate structure is investigated. Prediction results, obtained from the proposed probabilistic models, are consistent well with filed measurements.

Objective: To investigate cardiovascular risk factors affecting COVID-19 outcomes in a tertiary referral hospital. Methods: This prospective cohort study analyzed 269 participants with COVID-19. The primary outcomes were ICU admission, prolonged hospital stay duration, and in-hospital death. The secondary outcomes included death, chronic symptoms, and NYHA functional class during follow-up periods. Results: A total of 412 patients with COVID-19 symptoms were enrolled in the study, and out of which 269 patients had complete medical records and positive SARS-CoV-2 PCR test results, fulfilling the study criteria were analyzed. The patients were divided into two groups, with cardiovascular comorbidities (group A, n=122), such as established cardiovascular disease, diabetes mellitus, and hypertension, and without cardiovascular comorbidities (group B, n=147). Binary logistic regression analysis showed that patients with underlying hypertension, diabetes, and established cardiovascular disease had a 1.55 (95% CI: 1.28-2.26), 1.62 (95% CI: 1.34-2.13), and 1.63 (95% CI: 1.07-5.34)-fold risk of mortality, respectively in the adjusted model. Conclusions: Hospitalized COVID-19 patients with predisposing cardiovascular risk factors are more susceptible to develop worse outcomes. More attention should be paid to the management and follow-up of these patients. [ABSTRACT FROM AUTHOR]

As one of the consequences of heavy metal pollution in soil, water and air, plants are contaminated by heavy metals. Thus, this work aims to evaluate the response of two basil species (Ocimum basilicum L. and Ocimum basilicum var. Purpurescens) to treatment with cadmium (heavy metal) in the roots and leaves of young plants. This experiment was conducted on the basis of a completely randomized design (CRD) in greenhouse condition with four doses (0, 5, 10, 20 mg/lit) of cadmium heavy metal. The results indicated that germination of seeds was inhibited by cadmium as compared to control. In addition number of leaves, plant height, plant height above cotyledon leaves and root length were clearly shortened when the concentration of cadmium exceeded. Generally, it was shown that Cd is more toxic for Ocimum basilicum var. Purpurescens than Ocimum basilicum L.

An amendment to this paper has been published and can be accessed via the original article.

Background: Association of Selenium (Se) deficiency, an essential trace element, has been found with human diseases. Identifying literature trends on the effects of Se on the thyroid may guide in planning future studies. Methods: A literature search was conducted using the Web of Science database to identify studies on Se and the thyroid published over the 20 years duration (1995-Dec 2014). Scientometric indices were used to draw field maps. The scientific processes, structure, evidence history, and international collaborations were included in the map. The most influential authors, journals, institutions, and countries were also examined. Results: Our search identified 184 research and review papers. The number of scientific studies on Se and the thyroid has been irregular, but interest in this topic has increased in recent years. The highest number of studies was published in 2014 (16 papers) and overall growth factor of publication was 3.78. Overall, 744 authors from 282 institutions in 43 countries published in this field. The author J. Kohrle (828 citations, 14 publications), and German scientists (1272 citations, 30 publications) were most influential. Conclusion: This study reveals the interrelationships between different publications on the effects of Se on the thyroid. Leading scientific issues and their extent of impact were successfully determined by examining citations. The results of systematic citations and mapping fields can be used to assist in policy and management contexts.

Mobility is fundamental for social participation. Everyone benefits from pedestrian networks for their mobility and daily activities. People without disabilities may have little difficulty walking on narrow sidewalks, over potholes, and so on. However, people with motor disabilities (PWMD) may find it more difficult to deal with such conditions. For PWMD, even routine trips are often fraught with problems, with many different obstacles restricting their mobility and consequently rendering their participation in social and recreational activities difficult. The potential problems and risks associated with mobility for PWMD could be significantly reduced if navigation systems provided them with appropriate accessible routes. These routes should consider PWMD’s personal capabilities as well as sidewalk-network conditions. In this paper, we propose a novel approach for computing a user-specific route for PWMD. Such a route is personalized based on the user’s confidence to deal with obstacles such as slopes, uneven pavement, etc. We show how user reported confidence levels could be used to aggregate sidewalk conditions in a routing model to offer user-specific routes. The proposed methodology was developed using a fuzzy approach and is evaluated by manual wheelchair users in Quebec City.

Social dimension of environment is an important aspect that should be reflected in research works related to studying the interactions between human and the environment. However, this dimension is usually neglected when representing the environment in geographic information systems for different applications. For instance, disability as a result of the interaction between human and environment is influenced by social and physical dimensions of environment. Although, this aspect is highlighted in most conceptual disability models by defining various taxonomies of the environment, from ontological perspective justifying and connecting social dimension to the physical dimension of the environment is not clearly determined. Integrating social dimension of the environment with its physical dimension for disability studies is a challenging task, which is the main objective of the present study. Here, we review some of the disability models and their perspective about classifying the environment. Then, from ontological perspective, their limitations are discussed and a new approach for the classification of concepts form the environment is presented. This approach facilitates and simplifies integration of social dimension in ontologies for more effective assessment of disability issue in Geographic Information System.