The Association between Waterpipe Smoking and Metabolic Syndrome: A Cross-Sectional Study of the Bushehr Elderly Health Program

Waterpipe(WP),a less common method of tobacco smoking than cigarette smoking(CS),has become increasingly popular over the last decade.Contrary to popular belief,WP smoking is far from harmless and has multiple health risks similar to,or even exceeding,those seen in CS[1,2].

Global elimination of hepatitis C virus infection:Progresses and the remaining challenges

Today, with the introduction of interferon-free direct-acting antivirals and outstanding progresses in the prevention, diagnosis and treatment of hepatitis C virus(HCV) infection, the elimination of HCV infection seems more achievable. A further challenge is continued transmission of HCV infection in high-risk population specially injecting drug users(IDUs) as the major reservoir of HCV infection. Considering the fact that most of these infections remain undiagnosed, unidentified HCVinfected IDUs are potential sources for the rapid spread of HCV in the community. The continuous increase in the number of IDUs along with the rising prevalence of HCV infection among young IDUs is harbinger of a forthcoming public health dilemma, presenting a serious challenge to control transmission of HCV infection. Even the changes in HCV genotype distribution attributed to injecting drug use confirm this issue. These circumstances create a strong demand for timely diagnosis and proper treatment of HCV-infected patients through risk-based screening to mitigate the risk of HCV transmission in the IDUs community and, consequently, in the society. Meanwhile, raising general awareness of HCV infection, diagnosis and treatment through public education should be the core activity of any harm reduction intervention, as the root cause of failure in control of HCV infection has been lack of awareness among young drug takers. In addition, effective prevention, comprehensive screening programs with a specific focus on high-risk population, accessibility to the new anti-HCV treatment regimens and public education should be considered as the top priorities of any health policy decision to eliminate HCV infection.

Lurking epidemic of hepatitis C virus infection in Iran: A call to action

Despite having a relatively low prevalence in the Iranian general population, the burden of hepatitis C virus(HCV) infection is on the rise, and hepatitis C is predicted to be the most important leading cause of viral hepatitis-related mortality in the near future in Iran. The recent population-based epidemiological studies have revealed the predominant role of injecting drug use in increasing prevalence of HCV infection. Undoubtedly, new management paradigm is required to drive down the rising wave of hepatitis C in Iran. Priority should be given to young injecting drug users as the cornerstone of the lurking epidemic of HCV infection in Iran.

Epidemiological patterns of animal bites in Abadeh district of central Iran from 2012 to 2018: A cross-sectional study

Objectives:To investigate the epidemiology of animal bites and associated factors in Abadeh district(central Iran)from 2012 to 2018.Methods:In this cross-sectional study,1407 individuals with animal bites who were referred to the Abadeh Rabies Treatment Center were investigated by using the census method from 2012 to 2018.The variables included the victim's demographic information(age,gender,occupation),the type of biting animals(dog,cat,and other animals),the domesticated and wild animals,the time of biting based on year and month,the residence location(urban or rural),the treatment status,and the anatomical location of the wounds.Results:The annual incidence rate of animal bites was 189.62 per 100000 population.Totally 83.4%of the victims were male.The average age was(33.66±18.97)years and individuals in the age range of 36-50 years were greater at risk.Most of the animal bites were from dogs(77.8%).About two thirds(62.1%)of the bites were from household animals.A total of 57.1%of individuals lived in urban areas.Most victims were engaged in farming and animal husbandry.The highest prevalence of animal bites(37.4%)happened in the summer.None of the patients had any clinical signs of rabies.Conclusions:To reduce the incidence of animal bites,high-risk groups including farmers and ranchers should be educated about bite prevention,and it should be ensured that they are managed correctly.

Circulation of Brucellaceae,Anaplasma and Ehrlichia spp.in borderline of Iran,Azerbaijan,and Armenia

Objective:To estimate the infection of ticks to Anaplasma,Ehrlichia,Babesia,Theileria,and Brucellaceae using molecular methods in borderline of Iran,Azerbaijan,and Armenia.Methods:Totally,2022 ticks were collected from different livestock.Then,species were diagnosed under stereomicroscope according to valid morphological keys.Tick DNA was extracted followed by PCR to detect Anaplasma,Ehrlichia,Theileria,Babesia and Brucellaceae infection in ticks.Results:A total of 498 males[24.62%(95%CI 22.76%-26.57%)],741 females[36.64%(95%CI 34.54%-38.79%)],782 nymphs[38.67%(95%CI 36.55%-40.84%)]and 1 larva[0.04%(95%CI 0.00%-0.28%)]were identified.Among identified samples,we found four genera including Hyalomma,Rhipicephalus,Haemaphysalis,and Dermacentor.Molecular assay revealed that the prevalence of ticks to Anaplasma or Ehrlichia,and Brucellaceae was 22.02%(95%CI 16.01%-29.06%)and 15.03%(95%CI 9.43%-22.26%),respectively.Phylogenetic analysis showed that the identified Anaplasma sp.had the most similarity with Anaplasma centrale,Anaplasma platys,Anaplasma camelii,and Anaplasma phagocytophilum,submitted in GenBank.Furthermore,the detected Ehrlichia sp.and Brucellaceae bacterium had the most similarity with Ehrlichia ruminantium and Mycoplana peli,respectively.However,no sign of the presence of Theileria and Babesia spp.was seen in the studied samples.Conclusions:Anaplasmosis,ehrlichiosis and brucellosis should be considered as important health threats in northwestern Iran and consistent monitoring on infection of ticks and livestock should be performed regularly.

Dynamics of host immune responses to SARS-CoV-2

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),the most recent global health threat,is spreading throughout the world with worrisome speed,and the current wave of coronavirus disease 2019(COVID-19)seems to have no mercy.While this mysterious virus challenges our ability to control viral infections,our opportunities to control the COVID-19 pandemic are gradually fading.Currently,pandemic management relies on preventive interventions.Although prevention is a good strategy to mitigate SARS-CoV-2 transmission,it still cannot be considered an absolute solution to eliminate this pandemic.Currently,developing a potent immunity against this viral infection seems to be the most promising strategy to drive down this ongoing global tragedy.However,with the emergence of new challenges in the context of immune responses to COVID-19,the road to control this devastating pandemic seems bumpier;thus,it is pivotal to characterize the dynamics of host immune responses to COVID-19,in order to develop efficient prophylactic and therapeutic tools.This begs the question of whether the effector mechanisms of the immune system are indeed potent or a possible contributing factor to developing more severe and lethal forms of COVID-19.In this review,the possible role of the immunopathologic phenomena including antibody-dependent enhancement,cytokine storm,and original antigenic sin in severity and mortality of COVID-19 will be discussed.

Evaluation of Individual and Environmental Sound Pressure Level and Drawing Noise-Isosonic Maps Using Surfer V.14 and Noise at Work V.5.0

Noise pollution is one of the common physical harmful factors in many work environments.The current study aimed to assess personal and environmental sound pressure level and project the sound-Isosonic map in one of the Razavi Khorasan Paste manufacture using Surfer V.14 and Noise at work V.5.0.This cross-sectional,descrip-tive study is analytical that was conducted in 2018 in the Paste factory that contains Canister,production and Brewing unit.Following ISO 9612:2009,Casella Cel-320 was used to measure personal sound pressure level,while CEL-450 sound level meter(manufactured by Casella-Cel,the UK)was employed to assess environmental sound pressure level.Statistical analyzes was done using SPSS V.18 and Linear Regression test.The sound-isosonic maps were projected using Surfer V.14 and Noise at work V.5.0.The results of assessing personal sound pressure level indicated that the highest received dose(172.21%)and personal equivalent sound level(87.36 dBA)were recorded for workers in the Canister unit.According to results of measuring of the environmental sound pressure level,out of 16 measurement stations in this unit,overall 87.5%were regarded as danger and caution areas.The lowest and highest sound pressure levels in this units were 61 dBA and 92 dBA that belong to Brewing and Canister units respectively.Results indicate Over 75%of the Canister and production units had a sound pressure level greater than 85 dBA and these two units were regarded as the most dangerous area in terms of noise pollution.It is there-fore necessary to implement noise control measures,apply hearing protection program and auditory tests among workers in these units.

A Comparative Assessment of Patient Safety Culture between Iranian Selected Hospitals and Agency for Healthcare Research and Quality (AHRQ) Report

Establishing a culture of patient safety can be effective in reducing the incidence of medical errors and solving concerns of safety inadequacy in health systems. The purpose of this study was to assess the culture of patient safety in the selected hospitals, and compare the results with published reports of AHRQ. This study was approved by the Ethical Committee of BPUMS. The subjects signed the informed consent form to participle in the study. Confidentiality was maintained throughout the study reports. Cross-sectional study was conducted in 2012;the study sample was composed of 364 staffs working at two selected hospitals affiliated to Bushehr University of Medical Sciences. Hospital Survey on Patient Safety Culture was used to collect data. Descriptive statistical analysis was used to analyze the data. No reports of events in both studied hospitals and benchmark were accounted for the most of the reported errors, although this indicator in studied hospitals was nearly 23% higher than that of the benchmark report. The highest patient safety grade in studied hospitals and benchmark was “acceptable” and “very good”, respectively. The highest percentage of positive response to patient safety dimension was organization learning and then teamwork within units in studied hospitals. Teamwork within units also was the highest average percent in benchmark report. Non-punitive response to errors had the lowest positive percentage of participant responses in both studies. To achieve the patient safety culture, we do not need to blame individual and apply punitive approach when errors occur. This makes person accept responsibility for their actions honestly and report errors in a timely manner to prevent reoccurrence of similar errors.

Epidemiology of hepatitis E virus in Iran

Iran is known as an endemic country for hepatitis E virus(HEV) infection, while there are variations in the epidemiology of HEV infection throughout the country. The available epidemiological studies in different regions of Iran show HEV seroprevalence of 1.1%-14.2% among general population, 4.5%-14.3% among blood donors, 6.1%-22.8% among injecting drug users, 6.3%-28.3% among hemodialysis patients, 1.6%-11.3% among patients infected with other hepatitis viruses, 27.5% among patients with chronic liver disease, 30.8% among kidney transplant recipient patients, and 10%-16.4% among human immunodeficiency virus-infected patients. These variations reflect differences in the status of public health and hygiene, risk factors, and routes of transmission in different regions and groups. Therefore, it is necessary to review the epidemiology of HEV infection to determine the most prevalent risk factors and routes of transmission, and to evaluate the effectiveness of preventive strategies employed in the public health services of the country. Moreover, the other epidemiological aspects of HEV, including the genotypic pattern, extra hepatic manifestations, and incidence of chronic infection need to be investigated among Iranian population to expand the current knowledge on the epidemiology of HEV and to clarify the real burden of HEV infection. Therefore, this review was performed to provide a general overview regarding the epidemiology of HEV in Iran.

Causes of delay in offering rabies post-exposure prophylaxis services in Abadeh district of Iran

Objective:To identify the reasons for delayed reception of post-exposure prophylaxis(PEP).Methods:In this cross-sectional study,a total of 1407 individuals with animal bites who were referred to the Abadeh Rabies Treatment Center were investigated using the census method from January 2012 to December 2018.The patients were divided into two groups based on their delay times to referral and receive PEP:timely referral(less than 48 h after the bite)and delayed referral(equal to or longer than 48 h after the bite).Frequency,Chi-square,and logistic regression tests were used.Results:.The average delay time was(16.33±11.37)h.Low level of education(OR:3.87;95%CI:1.19-12.54;P=0.02),active economic age(21-35 and 36-50 years-old,OR:12.81;95%CI:3.16-51.97;P<0.001 and OR:3.83,95%CI:3.83-58.61;P<0.001 respectively),occupation(OR:9.16;95%CI:1.89-44.29;P=0.006),long distance from the rabies treatment center(OR:3.41;95%CI:2.03-5.72;P<0.001),bites by household and domestic animals(OR:12.22;95%CI:2.29-65.18,P=0.003),superficial injuries(OR:4.51;95%CI:1.38-14.73;P=0.01),and residence in rural area(OR:12.74;95%CI:6.58-24.66;P<0.001)had significant correlations with delayed referral of victims.Conclusions:To reduce the delay time,the high-risk groups should be informed about the importance of timely referral via educational measures.Furthermore,rabies treatment services should be rendered at the nearest possible center.

Chemical identification,antioxidant,cholinesterase inhibitory,and cytotoxic properties of fucoidan extracted from Persian Gulf Sargassumangustifolium

Marine macroalgal sulfated fucose-containing polysaccharides,like fucoidan,have drawn significant attention due to their biotechnological potentials,such as anti-cancer,antioxidant,and anti-cholinesterase activities.The fucoidan derived from brown macroalgae Sargassum angustifolium species(FSA)was investigated for its cytotoxic effects and alterations in cell proliferation,and cell cycle-related gene expression in the present study occurred on NB4 cell line.The results showed that FSA would induce p53,p21,pro-apoptotic genes and increase expression of the p15 gene as a cell arrest marker.Also,FSA inhibited the anti-apoptotic effect of the Bcl-2 gene and decreased dnmt-1 gene expression.FSA significantly exhibited potent 2,2-diphenyl-1-picrylhydrazyl(DPPH)radical scavenging activity(p<0.05)with an IC_(50) value of 0.157 mg/mL and showed moderate anti-acetylcholinesterase activity with an IC_(50) value of 1.20μg/mL.These results indicated the potential of FSA for the development of therapeutic or preventive agents of cancer and Alzheimer’s disease mainly through cytotoxic effect and AChE(acetylcholinesterase)inhibition as well as additional antioxidant capacities.

Evaluation of Association between <i>Chlamydophila pneumoniae</i>and Atherosclerotic Plaques in Coronary Artery Disease Patients with Abnormal Angiography

The role of Chlamydophila pneumoniae in pathogenesis of atherosclerosis is one of the most important discussions in coronary artery diseases. In this study, the relationship between C. pneumoniae seropositivity and atherosclerotic plaque was evaluated among two groups: one group with significant coronary stenosis and one group with normal coronary angiography. Serum C. pneumonia IgM and IgG were evaluated and compared in case and control groups. The seropositivity rates of IgM and IgG antibodies were not statistically differ between case and control groups, although the incidences of positivity were more in case group. The results of our study did not show a correlation between C. pneumonia infection and atherosclerotic plaque or coronary artery stenosis neither in acute nor in chronic infection. More precise studies are needed to clarify the probable inflammatory cascade that starts with C. pneumonia infection and lead to development of atherosclerotic plaque.

Response of Juvenile Freshwater Prawn Macrobrachium rosenbergii （de Man） to Different Levels of Bacillus subtilis Isolated from Chicken Intestine as Probiotics

A feeding experiment was conducted to investigate the effect of Bacillus subtilis bacterium and its suitable level on survival and growth rate of juvenile Macrobrachium rosenbergii （de Man） during March 28 to May 28, 2010. A B. subtilis bacterium isolated from chicken intestine was added to commercial prawn feed as a probiotic. Six diets were prepared by soaking prawn feed into the B. subtilis to achieve 10^10, 10^9, 10^8, 10^7 and 106 levels with a non-treated control. After 60 days, the prawns fed diet at level 10^8 showed a higher mean weight gain （593.45 g） or 170.29% increase in growth over control. The mean weight gain showed a decreasing trend as the B. subtilis level decreased from 10^8 to 10^6 and the B. subtilis level increased from 10^8 to 10^10 in the diets. There were significant differences （P 〈 0.05） in weight gain, feed intake, daily growth and feed conversion ratio （FCR） among treated and controlled groups. There were significant differences （P 〈 0.05） among treatments and control in survival rate but no significant differences （P 〉 0.05） in water quality and biochemical composition among treated and controlled groups. Clearly, treated with B. subtilis appeared to enhance growth and survival of M. rosenbergii. It was concluded that the tested strain may be a promising probiotics for M. rosenbergii at a level of 10^8 B. subtilis into the prawn feed.

Do Endocrinopathies Differ in Most Prevalent Hemoglobinopathy of Middle East:Beta-thalassemia?

Repeated blood transfusions in thalassemia patients is followed by endo-crinopathies as diabetes,hypothyroidism,hypogonadism,hypoparathy-roidism,and disorders in calcium and vitamin D homeostasis.The aim of this study was to evaluate the association of beta-thalassemia patients endocrinopathies and osteoporosis.Serum level of some factors related to the function of gonads,thyroid,adrenal,and pancreas along with serum levels of calcium,phosphate,albumin,vitamin D,and iron were measured.Bone marrow density was tested via dualenergy x-ray absorptiometry(DXA densitometry).In this study,56 patients with major thalassemia were investigated.Paraclinical analysis indicated osteopenia in 17(30.4%)and osteoporosis in 39 patients(69.6%)in addition to other types of endocrine disorders,such as hypogonadism in 29(51.8%),hypothyroidism in 13(23.2%),hypoparathyroidism in 1(1.8%),hypocortisolism in 2(3.6%),and diabetes in 9(16.1%)patients.Endocrinopathies had no signifi cant relationship with osteoporosis and osteopenia in men.However,hypogonadism had a significant relationship with osteoporosis and osteopenia in women with thalassemia.Estradiol level was lower in women with osteoporosis in comparison with women with osteopenia.Ferritin levels had neither association with osteoporosis nor with LH levels(P>0.05).Secondary hypogonadism disorders are the main causes of osteoporosis and osteopenia in female beta-thalassemia patients.

Exosomes in viral infection:Effects for pathogenesis and treatment strategies

Exosomes are small vesicles that carry molecules from one cell to another.They have many features that make them interesting for research,such as their stability,low immunogenicity,size of the nanoscale,toxicity,and selective delivery.Exosomes can also interact with viruses in diverse ways.Emerging research highlights the significant role of exosomes in viral infections,particularly in the context of diseases like COVID-19,HIV,HBV and HCV.Understanding the intricate interplay between exosomes and the human immune system holds great promise for the development of effective antiviral therapies.An important aspect is gaining clarity on how exosomes influence the immune system and enhance viral infectivity through their inherent characteristics.By leveraging the innate properties of exosomes,viruses exploit the machinery involved in exosome biogenesis to set replication,facilitate the spread of infection,and eliminate immune responses.They can either help or hinder viral infection by modulating the immune system.This review summarizes the recent findings on how exosomes mediate viral infection and how they can be used for diagnosis or therapy.This could lead to new clinical applications of exosomes in disease management.

Impact of alcoholic extract from sea cucumber(Holothuria parva)on letrozole-induced polycystic ovary syndrome in adult female rats

Objective:To explore the potential therapeutic impact of an alcoholic extract derived from the sea cucumber(Holothuria parva)on letrozole-induced polycystic ovary syndrome(PCOS)in adult female Sprague-Dawley rats.Methods:Sixteen female rats,aged 8 to 10 weeks,with a mean weight of(200±20)g,were randomly assigned to four groups:the control,PCOS,and two treatment groups receiving sea cucumber extract and metformin,respectively.PCOS was induced by administering letrozole at a dose of 1 mg/kg to initiate the treatment period at 60 days of age.The study spanned four weeks,during which ovarian and uterine tissues were collected for histological examination,and blood samples were collected for hormonal levels.Results:Significant decreases in luteinizing hormone/follicle stimulating hormone(LH/FSH)and testosterone and increases progesterone levels among groups treated with sea cucumber extract were observed.While no significant differences were observed in follicle-stimulating hormone(FSH)and testosterone levels,the distinctive variations in key hormones suggested a potential role for sea cucumber alcoholic extract in ameliorating PCOS symptoms.Conclusions:This research highlights the moderate efficacy of sea cucumber extract as a therapeutic intervention for PCOS,providing a novel perspective in the search for effective remedies.The observed hormonal alterations,particularly in LH,estradiol,and progesterone,underscore the need for further exploration into the underlying mechanisms and for optimizing the application of sea cucumber extract in PCOS management.

Hepatitis C virus core protein modulates several signaling pathways involved in hepatocellular carcinoma

Hepatocellular carcinoma(HCC) is the fifth most common cancer, and hepatitis C virus(HCV) infection plays a major role in HCC development. The molecular mechanisms by which HCV infection leads to HCC are varied. HCV core protein is an important risk factor in HCV-associated liver pathogenesis and can modulate several signaling pathways involved in cell cycle regulation, cell growth promotion, cell proliferation, apoptosis, oxidative stress and lipid metabolism. The dysregulation of signaling pathways such as transforming growth factor β(TGF-β), vascular endothelial growth factor(VEGF), Wnt/β-catenin(WNT), cyclooxygenase-2(COX-2) and peroxisome proliferator-activated receptor α(PPARα) by HCV core protein is implicated in the development of HCC. Therefore, it has been suggested that this protein be considered a favorable target for further studies in the development of HCC. In addition, considering the axial role of these signaling pathways in HCC, they are considered druggable targets for cancer therapy. Therefore, using strategies to limit the dysregulation effects of core protein on these signaling pathways seems necessary to prevent HCV-related HCC.

Hair follicle stem cells: In vitro and in vivo neural differentiation

Hair follicle stem cells(HFSCs) normally give rise to keratinocytes, sebocytes, and transient amplifying progenitor cells. Along with the capacity to proliferate rapidly, HFSCs provide the basis for establishing a putative source of stem cells for cell therapy. HFSCs are multipotent stem cells originating from the bulge area. The importance of these cells arises from two important characteristics, distinguishing them from all other adult stem cells. First, they are accessible and proliferate for long periods. Second, they are multipotent, possessing the ability to differentiate into mesodermal and ectodermal cell types. In addition to a developmental capacity in vitro, HFSCs display an ability to form differentiated cells in vivo. During the last two decades, numerous studies have led to the development of an appropriate culture condition for producing various cell lineages from HFSCs. Therefore, these stem cells are considered as a novel source for cell therapy of a broad spectrum of neurodegenerative disorders. This review presents the current status of human, rat, and mouse HFSCs from both the cellular and molecular biology and cell therapy perspectives. The first section of this review highlights the importance of HFSCs and in vitro differentiation, while the final section emphasizes the significance of cell differentiation in vivo.

The relationship between <i>Helicobacter pylori</i>disease and bacterial count in stomach

Several studies showed significant relationships between bacterial counts and the severity and type of disease in patients. The aim of this study was to evaluate the relationship between Helicobacter pylori disease and bacterial count. In this study, 287 patients with dyspeptic symptoms were evaluated. Three variables including patient-reported data, clinical signs and bacterial load of gastric specimens were analyzed. Biopsy samples were collected from patients who were referred for endoscopies because of dyspeptic symptoms. Initially, the clinical status was evaluated and recorded by a questionnaire. DNA extraction was performed and H. pylori was analyzed for bacterial count by Real-time PCR assay and specific primers and probe. The variety range of bacteria in specimens was 104 to 1012. The results revealed that a greater relationships existed between 1012 and gastric cancer (p = 0.036), also 104 and acid reflux (p = 0.006) and vomiting (p = 0.047). Real-time PCR assay provides a highly accurate, rapid and precise method for detection of H. pylori and determination of progressive disease due to this bacterium.

Going toward Green Hospital by Sustainable Healthcare Waste Management: Segregation, Treatment and Safe Disposal

Hospitals have always been the focal point of social systems identity. Thus, they acte as the mirror of the community and should be responsible for it. Hospitals have been recognized as a significant source of contamination all around the world, therefore helping to endanger public health on an unintentional process. Although, the main mission of the hospital is to promote human health, it cannot be assumed as an island apart from its urban environment. “Green Hospital”, as an approach to address environmental challenges and to meet communities need in health issues, has emerged recently as a try to improve the health, in line with its main mission. In this approach, all the environmental aspects of waste management are important and to be addressed. Hospitals’ administrators can manage wastes disposal through composting, recycling and better supplying methods (downsizing packaging, using reusable products instead of disposables and using recycled products). This article is a review of the subject matter, in nature, using many library and online sources;it discusses about the need to move towards the green hospital approach, the administration and leadership role in its establishment, the environmental impact of hospital operations and assessment of the effects, wastes management and control, and also the methods in wastes disposal and treatment.