Publications by authors named "Mohsen Ebrahimi"

53 Publications

COVID-19 as a worldwide selective event and bitter taste receptor polymorphisms: An ecological correlational study.

Int J Biol Macromol 2021 Apr 11;177:204-210. Epub 2021 Feb 11.

Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran. Electronic address:

Background: Given the observed olfactory and gustatory dysfunctions in patients with COVID-19 and recent findings on taste receptors possible important activities in the immune system, we elected to estimate the correlation between COVID-19 mortality and polymorphism of a particular type of bitter taste receptor gene called TAS2R38, in a worldwide epidemiological point of view.

Methods: Pooled rate of each of the rs713598, rs1726866, rs10246939, and PAV/AVI polymorphisms of the TAS2R38 gene was obtained in different countries using a systematic review methodology and its relationship with the mortality of COVID-19. Data were analyzed by the comprehensive meta-analysis software and SPSS.

Results: There was only a significant reverse Pearson correlation in death counts and PAV/AVI ratio, p = 0.047, r = -0.503. Also, a significant reverse correlation of PAV/AVI ratio and death rate was seen, r = -0.572 p = 0.021. rs10246939 ratio had a significant positive correlation with death rate, r = 0.851 p = 0.031. Further analysis was not significant. Our results showed that the higher presence of PAV allele than AVI, and a higher rate of G allele than A in rs10246939 polymorphism in a country, could be associated with lower COVID-19 mortality. While assessing all three polymorphisms showed a huge diversity worldwide.

Conclusion: Due to extraoral activities of bitter taste receptor genes, especially in mucosal immunity, this gene seems to be a good candidate for future studies on COVID-19 pathophysiology. Also, the high worldwide diversity of TAS2R38 genes polymorphism and its possible assassination with mortality raises concerns about the efficiency of vaccine projects in different ethnicities.
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http://dx.doi.org/10.1016/j.ijbiomac.2021.02.070DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8043766PMC
April 2021

A qualitative exploration of the factors associated with initiation to methamphetamine use in Iran.

BMC Public Health 2020 Nov 23;20(1):1773. Epub 2020 Nov 23.

Health Education and Promotion, Environmental Health Research Center, Faculty of Health, Golestan University of Medical Sciences, Late Falsefi University Complex, KM 5of Gorgan-Sari Road, Golestan, Iran.

Background: Crystal (methamphetamine) is a strong stimulant of addictive substances that affects the central nervous system. The consumption of this substance is increasing among teenagers and adult young people in the country. In this matter, one of the practical and important ways to its control is to identify the factors leading to its first use. Thus this paper, explores the factors related to the first crystal use in Golestan province, Iran.

Methods: In a qualitative study, 19 crystal users were recruited in the study conducted in Golestan province by snowball sampling from DIC (Drop-In Center) in addiction treatment centers. The interviews were mostly carried out individually with the participants; only one interview was conducted in an addiction treatment camp in the form of a group-focused discussion. Data analysis was implemented through content analysis in MAXQDA 10 software.

Results: The mean age of the participants was 35.05 ± 6.06 years with a range of 23-46 years. Meanwhile, the mean of crystal use period was 7.42 (SD: 3.61) and a range of 1-14 years. Based on the obtained data, the reasons for first crystal use could be categorized in six; 1: "crystal use to other drugs rehabilitation"; 2: "Lack of awareness of the addictive nature of crystal"; 3: "stimulating curiosity in public with crystal-use friends", 4: affordable and convenient use", 5: "anti-sleeping effects and increasing work efficiency", and 6: "therapeutic and other misconceptions".

Conclusions: The results indicated that crystal is mostly abused to opium rehabilitation. The lack of awareness and misconceptions about this substance can lead people to crystal use. Therefore, designing public health interventions to increase awareness about negative consequences of crystal use is fundamental to prevent people from abusing it. We suggest designing public health program to promote awareness about health risks of crystal and modifying related misconceptions. Finally, the government can establish policies to mandate sale tax for crystal producers and reduce easy access to crystal especially among youth.
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http://dx.doi.org/10.1186/s12889-020-09908-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7684954PMC
November 2020

Differentiation of human induced pluripotent stem cells into erythroid cells.

Stem Cell Res Ther 2020 11 16;11(1):483. Epub 2020 Nov 16.

Physiology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

During the last years, several strategies have been made to obtain mature erythrocytes or red blood cells (RBC) from the bone marrow or umbilical cord blood (UCB). However, UCB-derived hematopoietic stem cells (HSC) are a limited source and in vitro large-scale expansion of RBC from HSC remains problematic. One promising alternative can be human pluripotent stem cells (PSCs) that provide an unlimited source of cells. Human PSCs, including embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs), are self-renewing progenitors that can be differentiated to lineages of ectoderm, mesoderm, and endoderm. Several previous studies have revealed that human ESCs can differentiate into functional oxygen-carrying erythrocytes; however, the ex vivo expansion of human ESC-derived RBC is subjected to ethical concerns. Human iPSCs can be a suitable therapeutic choice for the in vitro/ex vivo manufacture of RBCs. Reprogramming of human somatic cells through the ectopic expression of the transcription factors (OCT4, SOX2, KLF4, c-MYC, LIN28, and NANOG) has provided a new avenue for disease modeling and regenerative medicine. Various techniques have been developed to generate enucleated RBCs from human iPSCs. The in vitro production of human iPSC-derived RBCs can be an alternative treatment option for patients with blood disorders. In this review, we focused on the generation of human iPSC-derived erythrocytes to present an overview of the current status and applications of this field.
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http://dx.doi.org/10.1186/s13287-020-01998-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7667818PMC
November 2020

Evaluation of Beneficial Influence of Local Application of . Extract on Healing of Full Thickness Excisional Infected Wounds in Diabetic Rats.

Bull Emerg Trauma 2020 Jul;8(3):169-178

Department of Clinical Science, Faculty of Specialized Veterinary Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran.

Objective: To evaluate the wound healing activity of leaves extract on infected wounds in diabetic rats.

Methods: Fifty male diabetic rats were randomized into two sets of 25 animals each. Each group was sub divided into five groups of five animals, each for excisional and incisional wound models, respectively. Induction of diabetes was achieved using 60 mg/kg streptozotocin. In group I, 0.1 mL sterile saline 0.9% solution was added to the wounds with no infection. In group II, the wounds were infected with Methicillin-resistant staphylococcus aureus (MRSA) and only treated with 0.1 mL the sterile saline 0.9% solution. In group III, infected wounds were treated with application of base formulation ointment. In group IV, animals with infected wounds were treated with 0.1 mL topical application of 1 mg/mL methicillin and base formulation ointment. In group V, animals with infected wounds were treated with topical application of 0.1 mL solution of methicillin (1 mg/mL) and with 1g of powder extract of the plant material in ointment. The healing of the wound was assessed based on planimetry, hydroxyproline estimation, microbiological, biomechanical and biochemical studies.

Results: Microbiological examination, planimetric, histological and quantitative morphometric studies and determination of hydroxyproline levels showed that there was significant difference between animals in group V compared to other groups (=0.001). Biomechanical indices in incisional groups showed there was significant difference between animals in group V compared to other groups (=0.001).

Conclusion: It was possible to conclude that the ointment of the extract of . leaves have significant wound-healing activity in diabetes.
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http://dx.doi.org/10.30476/BEAT.2020.82567DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468216PMC
July 2020

COVID-19 and Substance Use Disorder: Study Protocol for the International Society of Addiction Medicine Practice and Policy Interest Group Global Survey.

Basic Clin Neurosci 2020 Mar-Apr;11(2):155-162. Epub 2020 Apr 15.

Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran; Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

Introduction: As one of the major health problems in the present century, the COVID-19 pandemic affected all parts of the global communities and the health of substance users are potentially at a greater risk of harm. This global study has been designed and conducted by the International Society of Addiction Medicine Practice and Policy Interest Group (ISAM-PPIG) to understand better the health related issues of people with Substance Use Disorders (SUD) as well as responses of the relevant health care systems during the pandemic.

Methods: This is a cross-sectional study using convenient sampling. The data gathering was carried out with two follow-up stages each two months apart through an online conducted survey prepared using Google platform. The survey started by emergence of COVID-19 as a pandemic in March 2020 and respondents were followed till September 2020 when most of the initial lockdowns by most countries are supposed to be reopened.

Ethics And Dissemination: The study was approved by the ethics committee of University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. The results will be published in relevant peer reviewing journals and communicated with different international stakeholders.
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http://dx.doi.org/10.32598/bcn.11.covid19.2545.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7368101PMC
April 2020

Point-of-care detection of O157:H7 in water using AuNPs-based aptasensor.

Iran J Basic Med Sci 2020 Jul;23(7):901-908

Department of Pharmacology and Toxicology, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran.

Objectives: Access to safe drinking and irrigation water has always been one of the major human concerns worldwide. Thus, rapid, sensitive, and inexpensive approaches for pathogenic bacteria detection, such as O157:H7 (EHEC) that can induce important infectious diseases, are highly on demand.

Materials And Methods: In this study, a sensitive aptamer-based AuNPs bioassay was developed that demonstrated its potential to detect EHEC. In the presence of the target bacterium, the specific adsorbed aptamer, leaves AuNPs surface and interacts with EHEC. The bare nanoparticles aggregate in the presence of NaCl and the color shifts from red to purple and blue depending on the bacterial concentration.

Results: The proposed aptasensor exhibited a good linear response over a wide concentration range of 876 to 107 CFU/ml and was closely correlated with the line equation of "y=0.0094x+0.0006" (R2= 0.9861). It also showed a low detection limit (LOD) of 263 CFU/ml (Signal/Noise=3). No response was recorded in the presence of other tested bacterial strains including and , indicating the high selectivity of the aptasensor.

Conclusion: This biosensor may be used as a smart device to screen water reservoirs and prevents the outbreak of EHEC-related life-threatening contagious diseases.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7395186PMC
July 2020

Erratum: Retinal image mosaicking using scale-invariant feature transformation feature descriptors and Voronoi diagram (Erratum).

J Med Imaging (Bellingham) 2020 Jul 28;7(4):049801. Epub 2020 Jul 28.

Tehran University of Medical Sciences, School of Medicine, Medical Physics and Biomedical Engineering Department, Tehran, Iran.

[This corrects the article DOI: 10.1117/1.JMI.7.4.044001.].
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http://dx.doi.org/10.1117/1.JMI.7.4.049801DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7385534PMC
July 2020

Retinal image mosaicking using scale-invariant feature transformation feature descriptors and Voronoi diagram.

J Med Imaging (Bellingham) 2020 Jul 15;7(4):044001. Epub 2020 Jul 15.

Tehran University of Medical Sciences, School of Medicine, Medical Physics and Biomedical Engineering Department, Tehran, Iran.

Peripheral retinal lesions substantially increase the risk of diabetic retinopathy and retinopathy of prematurity. The peripheral changes can be visualized in wide field imaging, which is obtained by combining multiple images with an overlapping field of view using mosaicking methods. However, a robust and accurate registration of mosaicking techniques for normal angle fundus cameras is still a challenge due to the random selection of matching points and execution time. We propose a method of retinal image mosaicking based on scale-invariant feature transformation (SIFT) feature descriptor and Voronoi diagram. In our method, the SIFT algorithm is used to describe local features in the input images. Then the input images are subdivided into regions based on the Voronoi method. Each pair of Voronoi regions is matched by the method zero mean normalized cross correlation. After matching, the retinal images are mapped into the same coordinate system to form a mosaic image. The success rate and the mean registration error (RE) of our method were compared with those of other state-of-the-art methods for the P category of the fundus image registration database. Experimental results show that the proposed method accurately registered 42% of retinal image pairs with a mean RE of 3.040 pixels, while a lower success rate was observed in the other four state-of-the-art retinal image registration methods GDB-ICP (33%), Harris-PIIFD (0%), HM-2016 (0%), and HM-2017 (2%). The proposed method outperforms state-of-the-art methods in terms of quality and running time and reduces the computational complexity.
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http://dx.doi.org/10.1117/1.JMI.7.4.044001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361374PMC
July 2020

Are Pediatric Triage Systems Reliable in the Emergency Department?

Emerg Med Int 2020 10;2020:9825730. Epub 2020 Jul 10.

Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Background: Few studies have focused on the agreement level of pediatric triage scales (PTSs). The aim of this meta-analytic review was to examine the level of inter-rater reliability of PTSs.

Methods: Detailed searches of a number of electronic databases were performed up to 1 March 2019. Studies that reported sample sizes, reliability coefficients, and a comprehensive description of the assessment of the inter-rater reliability of PTSs were included. The articles were selected according to the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) taxonomy. Two reviewers were involved in the study selection, quality assessment, and data extraction and performed the review process. The effect size was estimated by -transformation of reliability coefficients. Data were pooled with random-effects models, and a metaregression analysis was performed based on the method of moments estimator.

Results: Thirteen studies were included. The pooled coefficient for the level of agreement was 0.727 (confidence interval (CI) 95%: 0.650-0.790). The level of agreement on PTSs was substantial, with a value of 0.25 (95% CI: 0.202-0.297) for the Australasian Triage Scale (ATS), 0.571 (95% CI: 0.372-0.720) for the Canadian Triage and Acuity Scale (CTAS), 0.810 (95% CI: 0.711-0.877) for the Emergency Severity Index (ESI), and 0.755 (95% CI: 0.522-0.883) for the Manchester Triage System (MTS).

Conclusions: Overall, the reliability of pediatric triage systems was substantial, and this level of agreement should be considered acceptable for triage in the pediatric emergency department. Further studies on the level of agreement of pediatric triage systems are needed.
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http://dx.doi.org/10.1155/2020/9825730DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7368955PMC
July 2020

Accuracy of the Emergency Department Triage System using the Emergency Severity Index for Predicting Patient Outcome; A Single Center Experience.

Bull Emerg Trauma 2020 Apr;8(2):115-120

Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Objective: To evaluate the accuracy of the five-level triage system using the emergency severity index (ESI) and to determine the compliance of the triage level with patient outcomes.

Methods: This was a cross-sectional study which was performed in the emergency department of Imam Reza Hospital of Mashhad during 2017. We included all the adult patients (≥15 years of age) referring to the emergency department. The data were recorded in a questionnaire containing three sections including demographic information, results of triage by ESI and final outcome of the patient. Patients referred to the triage unit were simultaneously triaged by triage nurse and some emergency medicine physicians. The triage was performed by a nurse with an emergency medicine physician (EMP) was considered as a gold standard and the outcome was compared in 24 hours later.

Results: Overall, we included 400 patients with a mean age of 46.40 ± 18.52 years among whom there were 211 (52.8%) men and 189 (47.3%) women. Finally, 123 patients were hospitalized, 12 died, 256 were discharged by a physician, and 9 people left the hospital with their own consent. The calculated weight kappa was used to determine the agreement between the observers (nurse triage and physician) at 0.701 so that the agreement between the triage performed by a nurse and an EMP was in an excellent level (<0.001). There was a significant relationship between the triage levels (determined by physicians) and the outcome of the patient (<0.001), and the five-level system had a high overlap and significant relation with patient's outcome.

Conclusion: The results of the current study revealed that the five-level triage system using the ESI has a high accuracy in triage and estimates the patient outcomes effectively and thus, could be used as an effective system in hospital triage.
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http://dx.doi.org/10.30476/BEAT.2020.46452DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211387PMC
April 2020

Comparison between stroke triage scale and emergency severity Index to triage patients with neurological Complaints: A randomized clinical trial.

Int Emerg Nurs 2020 Nov 18;53:100871. Epub 2020 Apr 18.

Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address:

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http://dx.doi.org/10.1016/j.ienj.2020.100871DOI Listing
November 2020

Regenerative Capacities of Chitosan-Nanoselenium Conduit on Transected Sciatic Nerve in Diabetic Rats: An Animal Model Study.

Bull Emerg Trauma 2020 Jan;8(1):10-18

Department of Clinical Science, Faculty of Specialized Veterinary Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran.

Objective: To assess regenerative capacities of chitosan-nanoselenium conduit on transected sciatic nerve in diabetic rats.

Methods: A 10-mm sciatic nerve defect was bridged using a chitosan-nanoselenium conduit filled with phosphate buffered saline. In chitosan group, the chitosan conduit was filled with phosphate buffered saline solution. In sham-operated group, sciatic nerve was exposed and closed. In transected group, right sciatic nerve was transected and nerve cut ends were fixed in the adjacent muscle. The regenerated fibers were studied within 12 weeks after surgery.

Results: The behavioral and functional and electrophysiological tests confirmed faster recovery of the regenerated axons in chitosan-nanoselenium conduit group compared to chitosan group (0.001). The mean ratios of gastrocnemius muscles weight were measured. There was statistically significant difference between the muscle weight ratios of chitosan-nanoselenium conduit and chitosan groups (0.001). Morphometric indices of regenerated fibers showed number and diameter of the myelinated fibers were significantly higher in chitosan-nanoselenium conduit group than in chitosan group.

Conclusion: chitosan-nanoselenium conduit resulted in acceleration of functional recovery and quantitative morphometric indices of sciatic nerve.
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http://dx.doi.org/10.29252/beat-080103DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071936PMC
January 2020

Adsorption system for Mg removal from aqueous solutions using bentonite/γ-alumina nanocomposite.

J Colloid Interface Sci 2020 May 16;568:245-254. Epub 2020 Jan 16.

Ceramics Department, Materials and Energy Research Center (MERC), 14155-4777 Tehran, Iran; College of Materials Science and Engineering, Nanjing Forestry University, Nanjing, 210037 Jiangsu, China.

Calcium and magnesium are the most common sources of water hardness. These divalent ions can react with soap anions decreasing the cleaning efficiency and hence, high consumption of detergents occurred as a result. Development of novel low-cost adsorbents for metals removal has attracted a great attention. In this study, bentonite/γ-alumina nanocomposites were used to remove Mg from water. Effects of process parameters including γ-alumina content, initial ion concentration, adsorbent dosage, contact time and pH on adsorption process were investigated. Increasing the amount of alumina in composite from 1 to 3 and 5 wt%, caused a negative effect on the amount of adsorbed magnesium ions per gram of adsorbent; while increasing the initial ion concentration from 60 ppm to 100 ppm resulted in higher uptake per unit mass of the adsorbent from 2.15 mg/g to 2.80 mg/g, respectively. Langmuir, Freundlich and D-K-R isotherm models were used for data analysis, among which the Langmuir model was found to be more successful (R = 0.9955), obtaining the maximum adsorption capacity (Q) of 3.478 mg/g. Moreover, calculation of the adsorption energy (E) from DKR isotherm model depicted the physical nature of the adsorption of Mg onto bentonite/γ-alumina nanocomposite powder.
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http://dx.doi.org/10.1016/j.jcis.2020.01.036DOI Listing
May 2020

Enhanced bactericidal effect of ceftriaxone drug encapsulated in nanostructured lipid carrier against gram-negative Escherichia coli bacteria: drug formulation, optimization, and cell culture study.

Antimicrob Resist Infect Control 2020 02 10;9(1):28. Epub 2020 Feb 10.

Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Background: Ceftriaxone is one of the most common types of antibiotics used to treat most deadly bacterial infections. One way to alleviate the side effects of medication is to reduce drug consumption by changing the ordinary drug forms into nanostructured forms. In this study, a nanostructured lipid carrier (NLC) containing hydrophilic ceftriaxone sodium drug is developed, and its effect on eliminating gram-negative bacteria Escherichia coli death is investigated.

Methods: Double emulsion solvent evaporation method is applied to prepare NLC. Mathematical modeling based on the solubility study is performed to select the best materials for NLC preparation. Haftyzer-Van Krevelen and Hoy's models are employed for this purpose. Drug release from optimized NLC is examined under in vitro environment. Then, the efficacy of the optimized sample on eliminating gram-negative bacteria Escherichia coli is investigated.

Results: Mathematical modeling reveals that both methods are capable of predicting drug encapsulation efficiency trends by chaining solid and liquid lipids. However, Haftyzer-Van Krevelen's method can precisely predict the particle size trend by changing the surfactant types in water and oily phases of emulsions. The optimal sample has a mean particle size of 86 nm and drug entrapment efficiency of 83%. Also, a controlled drug release in prepared nanostructures over time is observed under in-vitro media. The results regarding the effectiveness of optimized NLC in killing Escherichia coli bacteria suggests that by cutting drug dosage of the nanostructured form in half, an effect comparable to that of free drug can be observed at longer times.

Conclusion: Results confirm that NLC structure is an appropriate alternative for the delivery of ceftriaxone drug with a controlled release behavior.
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http://dx.doi.org/10.1186/s13756-020-0690-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011525PMC
February 2020

The Effects of Using Checklists on Electrocardiogram Interpretation: A Cross- Sectional Study on Medical Interns.

Adv Med Educ Pract 2019 31;10:1089-1095. Epub 2019 Dec 31.

Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Introduction: Electrocardiogram (ECG), behind medical examination, is the easiest way to check the heart diseases, especially in an emergency department. Although the acquisition of Terrace from patients in the right method does not require a high level of expertise, the interpretation of this Terrace needs adequate knowledge, proficiency, and experience. The purpose of this study was to examine the effect of using the checklist in the ECG interpretation by medical interns.

Methods: The present cross-section descriptive study was carried out on medical interns of Mashhad University of Medical Sciences in 2015. 40 students who were attending a one-month emergency medicine course were randomly divided into two groups of 20. In one group, 9 standard tracings classified with equal difficulty level (easy, medium, and hard) with a standard checklist form and a questionnaire for each were completed and in the other group, the same tracings of the first group were first handed without checklists and then handed with checklists for the second time. Finally, the scores of completing the checklists and the correctness of tracing interpretations were recorded in both groups. Data analysis was done using descriptive and inferential statistical tests.

Results: There was no statistically significant difference between the two groups in terms of baseline variables. The first group identified 41.6% of the terraces correctly using the checklist. The second group, without using the checklist, correctly identified 25.5% of the terraces; and after using the checklist, this indicator increased to 32.7% in this group. Considering at least three correct responses in the ECG interpretation as "desirable response", it was found that 50% of the subjects in the first group (using the checklist) (n=10) and only 15% (n=3) of the second group (without using the checklist) had desirable responses (p = 0.531). On the other hand, the comparison of responses before and after the use of the checklist in the second group showed a significant improvement in the number of desirable responses (15% (n=3) versus 25% (n=5), p = 0.009).

Conclusion: The use of a checklist for the ECG interpretation by interns of emergency medicine did not affect improving the accuracy of the interpretation than the object-oriented system, but was effective in the diagnostic review and confirmation step.
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http://dx.doi.org/10.2147/AMEP.S218542DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6942512PMC
December 2019

Diagnostic Accuracy of Ultrasonography in Diagnosis of Metatarsal Bone Fracture; a Cross Sectional Study.

Arch Acad Emerg Med 2019 17;7(1):e49. Epub 2019 Aug 17.

Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran.

Introduction: Metatarsus is one of the most common sites in the sole of foot bones fractures. The aim of this study was to determine the diagnostic accuracy of ultrasound in diagnosis of metatarsal bone fractures following foot trauma.

Methods: This cross-sectional study was carried out on patients with blunt foot trauma admitted to emergency department of a hospital in Mashhad, Iran from January to September 2016. All patients were evaluated with bedside ultrasound for the presence of first to fifth metatarsal fractures and screening performance characteristics of ultrasonography in detection of metatarsal fractures were calculated considering foot radiography as the reference test.

Results: The study was conducted on 102 patients with a mean age of 35.14±14.32 years (56.8% male). The most common signs of trauma in physical examination were pain and tenderness (100%), swelling (96.1%), ecchymosis (14.7%) and deformity (1.9%). Sensitivity, specificity, and positive and negative likelihood ratio of ultrasonography in detection of metatarsal bone fracture were 96.7% (95% CI: 0.83-0.99), 84.5% (95% CI: 0.73-0.92), 73.1% (95% CI: 0.57-0.85), and 98.3% (95% CI: 0.91-0.99), respectively. The overall accuracy of ultrasonography was 0.906 (95% CI: 0.844 - 0.969) based on area under the receiver operating characteristic (ROC) curve.

Conclusion: Considering the excellent diagnostic accuracy, ultrasonography can be used as an alternative means in diagnosis of metatarsal bone fractures.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6785212PMC
August 2019

Comparison between Emergency Severity Index plus peak flow meter and Emergency Severity Index in the dyspneic patients with chronic obstructive pulmonary disease: A randomized clinical trial.

Turk J Emerg Med 2019 Apr 17;19(2):68-72. Epub 2019 Apr 17.

Department of Biostatistics and Epidemiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Introduction: It is unclear whether the Emergency Severity Index (ESI) can identify high-risk patients with Chronic Obstructive Pulmonary Disease (COPD). This study aims to compare the mistriage rates of the ESI plus the Peak Expiratory Flowmeter (PEF) approach and ESI approach among dyspneic patients with COPD.

Methods: This study was a randomized clinical trial conducted between July and October 2018. We randomly assigned COPD patients with dyspnea to the ESI + PEF or ESI groups. Triage levels, disposition rates, number of resources used, and time to first physician contact were compared in patients admitted to the Intensive Care Unit (ICU), the Pulmonary Care Unit (PU), or discharged from the ED. Reliability of the ESI was evaluated by using the interobserver agreement (Kappa).

Results: Seventy COPD patients were equally assigned to the ESI + PEF and ESI groups. The under-triage rates were 11.42% and 0%, the over-triage rates were 31.42% and 2.85% in the ESI and ESI + PEF groups, respectively. The triage levels of the patients admitted to the ICU (2 vs. 3), the PU (2 vs. 4), or discharged from the ED (3 vs. 2) were significantly different between the ESI + PEF and ESI groups.

Conclusions: Addition of PEF to the ESI provides a more accurate method for triaging COPD patients compared to ESI alone. We recommend using PEF for the triage of COPD patients in the ED.
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http://dx.doi.org/10.1016/j.tjem.2019.01.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6495057PMC
April 2019

Ultrasound wave assisted removal of Ceftriaxone sodium in aqueous media with novel nano composite g-CN/MWCNT/BiWO based on CCD-RSM model.

Ultrason Sonochem 2020 Nov 22;68:104460. Epub 2019 Jan 22.

Young Researchers and Elite Club, Bushehr Branch, Islamic Azad University, Bushehr, Iran. Electronic address:

The aim of this study was ultrasound assisted removal of Ceftriaxone sodium (CS) based on CCD model. Using sonochemical synthesized BiWO implanted on graphitic carbon nitride/Multiwall carbon nanotube (g-CN/MWCNT/BiWO). For this purpose g-CN/MWCNT/BiWO was synthesized and characterized using diverse approaches including XRD, FE-SEM, XPS, EDS, HRTEM, FT-IR. Then, the contribution of conventional variables including pH, CS concentration, adsorbent dosage and ultrasound contact time were studied by central composite design (CCD) under response surface methodology (RSM). ANOVA was employed to the variable factors, and the most desirable operational conditions mass provided. Drug adsorption yield of 98.85% obtained under these defined conditions. Through conducting five experiments, the proper prediction of the optimum point were examined. The respective results showed that RSD% was lower than 5% while the t-test confirmed the high quality of fitting. Langmuir isotherm equation fits the experimental data best and the removal followed pseudo-second order kinetics. The estimation of the experimentally obtained maximum adsorption capacities was 19.57 mg.g of g-CN/MWCNT/BiWO for CS. Boundary layer diffusion explained the mechanism of removal via intraparticle diffusion.
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http://dx.doi.org/10.1016/j.ultsonch.2019.01.018DOI Listing
November 2020

Regression to Middle Effect May Threaten Validity of Triage Scales; a Letter to Editor.

Emerg (Tehran) 2018 18;6(1):e60. Epub 2018 Nov 18.

Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289162PMC
November 2018

Japan Triage and Acuity Scale needs to revise level 5 criteria.

Emerg Med J 2019 05 22;36(5):315. Epub 2018 Dec 22.

Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

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http://dx.doi.org/10.1136/emermed-2018-208200DOI Listing
May 2019

Effect of vitamins B, B and B (Neurobion) on Diisopropylfluorophosphate-induced Delayed Neuropathy in Mice.

Iran J Pharm Res 2018 ;17(3):1116-1124

Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran.

Certain organophosphorus esters, such as diisopropylfluorophosphate (DFP), cause delayed neuropathy by inhibition of neuropathy target esterase (NTE) keeping the neuron in normal function. In this study, effects of neurobion alone and in combination with dexamethasone on DFP-induced delayed neuropathy were evaluated. Thirty-five mice were divided into five groups, each consisting of 7 mice. Except group1 (Normal group), group 2 received normal saline and 1h later, 1 mg/kg DFP; groups 3, 4 and 5 received 150 mg/kg neurobion, 2 mg/kg dexamethasone and 150 mg/kg neurobion plus 2 mg/kg dexamethasone, respectively and 1h later 1mg/kg DFP. Twenty one days after the last injection, the mice were killed by decapitation under deep anesthesia. NTE level was determined in the brain and though there was no significant difference between the groups, neurobion and neurobion plus dexamethasone partly- not significantly ( > 0.05)- were able to prevent reduction of NTE in the brain caused by DFP. Histopathological evaluation of sciatic nerves showed that neurobion and neurobion plus dexamethasone significantly suppressed the harmful effect of DFP. We also evaluated the activity of acetylcholine esterase (AChE), concentration of glutathione (GSH), and malondialdehyde (MDA) levels in the serum. Results showed dexamethasone ( < 0.001) and dexamethasone in combination with neurobion ( < 0.01) diminished AChE activity significantly compared to the DFP group. Neurobion caused a significant increase in the GSH level ( < 0.05). No significant change was seen in MDA. It is suggested that neurobion should be added and used in the first aid equipment and techniques for exposure to organophosphorus compounds, e.g. pesticides and chemical warfare.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6094411PMC
January 2018

Characterization of specific DNA markers at VRN-H1 and VRN-H2 loci for growth habit of barley genotypes.

J Genet 2018 Mar;97(1):87-95

Department of Agronomy and Plant Breeding Sciences, College of Aburaihan, University of Tehran, Tehran 3391653755, Iran.

Requirement of vernalization is an important factor which plays a crucial role in cereals to transit from vegetative to reproductive phase. There are three types of growth habit in barley: winter, spring and facultative types; in which spring type does not require vernalization but winter and facultative genotypes require full and partial vernalization, respectively. Combination of two loci, Vrn-h1 and Vrn-h2, regulates vernalization in barley genotypes. Specific DNA markers have been identified for growth habit regulator genes in barley. In this study, we examined 24 barley genotypes using specific primers for detecting Vrn-h1and Vrn-h2 loci. Results showed that among all differently suggested primer combinations, a few markers were precisely correlated with seasonal growth habit in barley. The specific markers of 600, 600 and 200 bps were verified for ZCCT-Ha, ZCCT-Hb and ZCCT-Hc loci, respectively. Our field growth habit test showed that cultivar Bahman as a winter growth habit, where all the others genotypes exhibited spring growth habit. By using specific primers for Vrn-h1, only Bahman cultivar produced 616 bp and 830 bp fragments and spring genotypes showed 574 bp or 616 bp alleles without any amplification for 830 bp fragments. Therefore, presence of 616 bp and 830 bp alleles together in each genotype can be considered as an informative marker for winter growth habit in barley. These informative markers can be used easily in barley breeding programmes for detection of growth habit types in the seedling stage.
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March 2018

Effect of yoga and aerobics exercise on sleep quality in women with Type 2 diabetes: a randomized controlled trial.

Sleep Sci 2017 Apr-Jun;10(2):68-72

Department of Sports Sciences, Semnan University, Semnan, Iran.

Objective: The aim of this study was investigating the effect of 12 weeks of yoga and aerobic exercise (running on a treadmill) on the sleep quality in women with Type 2 diabetes.

Materials And Methods: 39 diabetic women were selected from Semnan city with the mean age of 46.85±3.35 years, weight of 69.79±17.18 kg, height of 155.03±5.00, BMI of 29.64±5.00 kg/m who had a background of diabetes for 6.46±2.69 years. They were then randomly divided into yoga exercise (n=15), aerobic exercise (n=13), and control group (n=11). The exercise program was performed for 12 weeks, three sessions per each week. In order to measure the sleep quality, the Pittsburgh Sleep Quality Index (PSQI) was used. The data were analyzed by non-parametric wilcoxon and Kruskal-Wallis Test at significance level of <0.05.

Results: Overall score of sleep quality improved after six (=0.001) and 12 (=0.001) weeks of yoga exercise. Also, significant effect was observed after 6 weeks of aerobic exercise (=0.039). However, the positive effect was diminished to under significant levels after 12 weeks of aerobic exercise (=0.154). Kruskal-Wallis Test showed significant differences between yoga and aerobic groups after 12 weeks of exercise (=0.002). No significant differences were observed in control groups in all situation.

Conclusions: It can be concluded that yoga exercise is more effective in improving the sleep quality in comparison with the same course of aerobic exercise in women suffering from diabetes Type 2. Thus, yoga exercise can be suggested to these patients.
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http://dx.doi.org/10.5935/1984-0063.20170012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5612039PMC
October 2017

The Efficacy of Oral Immunotherapy in Patients with Cow's Milk Allergy.

Iran J Allergy Asthma Immunol 2017 Jun;16(3):183-192

Department of Allergy and Clinical Immunology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

Cow's milk allergy is the most common type of food allergy that decrease the quality of life of patients and their families. The aim of this study was to evaluate the efficacy of oral immunotherapy in patients with cow's milk allergy. 14 patients above 3 years of age with a history of cow's milk allergy confirmed by positive double blind placebo controlled food challenge (DBPCFC) test, presence of serum IgE against cow's milk and positive SPT (skin prick test) were enrolled in this study. During the immunotherapy all patients received increasing amounts of cow's milk during three phases. The type and severity of allergic reactions were recorded after each dose. The serum IgE and SPT were measured at the beginning and at the end of study. Since February 2014 to March 2015, 14 patients with the median age of 4.75 (3.7-7) years were studied. 13 patients (92.9%) completed the build up and maintenance phase successfully and became desensitized to cow's milk. During the build up and maintenance phase, 24 (2.0%) and 11 (0.9%) episodes of allergic reactions occurred, respectively. The median serum IgE level against cow's milk proteins and casein decreased from 39.3 to 10.4 and 7.72 to 2.83 (ku/L), respectively. The median of the difference of the wheal diameter in SPT with the control, decreased from 10 to 6 mm during the immunotherapy protocol. Oral immunotherapy is effective to decrease the frequency and the severity of allergic reactions but due to high rate of allergic reactions and possible anaphylaxis, it must be done under strict supervision of both clinicians and caregivers.
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June 2017

Assessment of mechanism, type and severity of injury in multiple trauma patients: A cross sectional study of a trauma center in Iran.

Chin J Traumatol 2017 Apr 6;20(2):75-80. Epub 2017 Feb 6.

Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Purpose: To accurately assess the mechanism, type and severity of injury in Iranian multiple trauma patients of a trauma center.

Methods: Patients with multiple traumas referring to the emergency department of Hasheminejad University Hospital in Mashhad, Iran, entered this cross sectional study from March 2013 to December 2013. All the patients with injury severity score (ISS) > 9 were included in this study. Data analysis was performed by SPSS software (Version 11.5) and P values less than 0.05 were considered as significant differences.

Results: Among the 6306 hospitalized trauma patients during this period, 148 had ISS>9. The male female ratio was 80%. The mean age of the patients was (33.5 ± 19.3) years. And 71% of the patients were younger than 44 years old. There were 19 (13%) deaths from which 68.5% were older than 44 years old. The mean transfer time from the injury scene to hospital was (55 ± 26) minutes. The most frequent mechanisms of injury were motorcycle crashes and falling from height, which together included 66.2% of all the injuries. A total of 84% of hospital deaths occurred after the first 24 h of hospitalization. Head and neck were the most common body injured areas with a prevalence of 111 cases (75%).

Conclusion: Motorcycle crashes have high frequency in Iran. Since most victims are young males, injury prevention strategies should be considered to reduce the burden of injuries.
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http://dx.doi.org/10.1016/j.cjtee.2016.02.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5392716PMC
April 2017

The Australasian Triage Scale Level 5 Criteria may need to be revised.

Emerg (Tehran) 2017 14;5(1):e50. Epub 2017 Jan 14.

Department of Emergency Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5325922PMC
January 2017

A Rare Case of Gastrointestinal Tract Foreign Body; Glassy Stomach.

Emerg (Tehran) 2017 14;5(1):e44. Epub 2017 Jan 14.

Department of Emergency Medicine, Afzalipour Hospital, Kerman University of Medical sciences, Kerman, Iran.

Ingestion of foreign bodies is common and conservative treatment can eliminated most particlesfrom the gastrointestinal tractunless peritoneal signs appear. A 22-year-old man presented to emergency department who had ingested glass particles of a crushed beveragebottle.Hecomplained ofepigastric and periumbilical pain. Physical examination did not revealany peritoneal signs. Abdominal X-ray showed stomach full of small glass particles. Conservative treatment, without any surgical intervention,resulted insafely eliminating glass particlesin this patient.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5325915PMC
January 2017

Nonemergent Patients in the Emergency Department: An Ethnographic Study.

Trauma Mon 2016 Sep 27;21(4):e23260. Epub 2016 Mar 27.

Department of Social Sciences, Faculty of Letters and Humanities, Ferdowsi University of Mashhad, Mashhad, IR Iran.

Background: Triage in the interactive atmosphere of the emergency department (ED) has been described as complex and challenging. Nonemergent ED visits have been accompanied by ethical and legal conflicts.

Objectives: The aim of this study was to gain an understanding of ED nurses' practice regarding triage of nonemergent patients.

Patients And Methods: Focused micro-ethnography based on Spradley's developmental research sequence (DRS) was used. This study was conducted in an emergency department. Data was collected through complete participant observations along with formal and informal interviews, and then analyzed using DRS.

Results: Nine key informants were interviewed formally. Four main categories emerged from the nurses' culture: nonemergent patient as an uninvited guest, nonemergent patient as an elephant in a dark room, nonemergent patient as an aggressive client, and being nonemergency unless at risk of death.

Conclusions: Providing care in the emergency department is significantly affected by nonemergent patients, as the emergency department is a place for critically ill patients thus awareness training program is recommended.
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http://dx.doi.org/10.5812/traumamon.23260DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5282938PMC
September 2016

Digital culture may mediate concordance among medical students.

Intern Emerg Med 2017 03 3;12(2):273-274. Epub 2017 Feb 3.

Department of Emergency Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Imam Reza Circle, Mashhad, Razavi Khorasan, 9137913316, Iran.

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http://dx.doi.org/10.1007/s11739-017-1614-zDOI Listing
March 2017

Structural Insight into Binding Mode of 9-Hydroxy Aristolochic Acid, Diclofenac and Indomethacin to PLA.

Interdiscip Sci 2018 Jun 22;10(2):400-410. Epub 2016 Nov 22.

Department of Medicinal Chemistry, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran.

Phospholipase A (PLA) catalyzes the hydrolysis of phospholipids into arachidonic acid and lysophospholipids. Arachidonic acid is modified by cyclooxygenases into active compounds called eicosanoids that act as signaling molecules in a number of physiological processes. Excessive production of eicosanoids leads to several pathological conditions such as inflammation. In order to block the inflammatory effect of these compounds, upstream enzymes such as PLA are valid targets. In the present contribution, molecular dynamic analysis was performed to evaluate the binding of diclofenac, 9-hydroxy aristolochic acid (9-HAA) and indomethacin to PLA. Obtained results revealed that 9-HAA could form a more stable complex with PLA when compared to diclofenac and indomethacin. Furthermore, analysis of intermolecular binding energy components indicated that hydrophobic interactions were dominant in binding process. On the basis of obtained data, inhibitors bearing fused rings with hydrogen acceptor/donor substituent(s) interacted with His48 and Asp49 residues of the active site. More affinity toward PLA might be envisaged through negatively charged moieties via interaction with Trp31, Lys34 and Lys69.
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http://dx.doi.org/10.1007/s12539-016-0197-0DOI Listing
June 2018