bluuebunny/crossref_metadata_2025 huggingface dataset:
Perception of medical students towards online learning during COVID-19 pandemic: a cross-sectional study in South Kerala, India
Authors: Kuriakose Allen , Abraham Joe , Kurian Nisha , Mathew Elsheba
Published: December 2021

Background: Coronavirus disease 2019 (COVID-19) pandemic has brought major changes in every sector including education. From school to college level, traditional classroom learning was forced to change to online learning. There were many challenges from inexperience to mental and physical health issues. This study aimed to find the perception of medical students about current medical online learning system in south Kerala.Methods: An online survey was conducted in November 2020 using a self-designed pretested questionnaire consisting of three sections: socio demographic profile, a 4-point Likert scale having 29 items to assess the perception of online learning, questions to assess certain parameters like health problems, duration of electronic usage etc. Frequencies, percentages, and descriptive statistics were calculated, and Chi-square test was used for statistical significance.Results: Study showed nearly three-fourth (74%) of students have a negative perception towards online learning. Of the different formats of e-learning used by students during the study period, most preferred were live lectures. Among the participants, more than half (57%) suggested a need for improvement in the quality of classes. Majority (75%) of students agreed that long hours of online classes had caused health problems.Conclusions: Though online learning is the need of the hour; majority of the students have a negative perception towards it which demands an enhancement in its standards and change to a preferred format
Efficacy of multi-powered continuous positive airway pressure device on neonates bearing respiratory distress syndrome: an observational analytical study
Authors: . Jagadeesh , M. S. Bhavana , Singh Megha , . Kavitha , Chander Ravi
Published: December 2021

Background: CPAP (continuous positive airway pressure), an effective intervention for respiratory distress in neonates. Following the development of simple, safe and relatively inexpensive CPAP devices. Saans (CPAP device) is one such portable, easy to use device which is operable in low resource settings, can be used as T-piece resuscitator in the delivery room and during transport. The aim of this study was to evaluate the efficacy of a low cost, multi-powered and easy to use CPAP device Saans, developed by Coeo Labs Pvt. Ltd., Bangalore, on neonates with respiratory distress.Methods: An observational analytical study per the protocol, 35 neonates gestational age >30 weeks were enrolled. Primary outcome variable was the need for mechanical ventilation. Secondary outcome variables were the rate of survival, duration of oxygen in hours, duration of ventilation in hours, duration of hospital stay in days, change Downe score, SAS score, heart rate, respiratory rate and FiO2 from enrolment 6 hours of intervention.Results: 89% (31 neonates) enrolled with respiratory distress. 11% (4 neonates) failed to improve on CPAP therapy. A significant decline in the need for FiO2, mean Downe score, mean R and heart rate observed from the baseline 6 hours CPAP (p<0.001), t test analysis, factors significantly associated CPAP failure were high FiO2 at 1 hour and high positive end-expiratory pressure within 1 hour initiating CPAP (p<0.001).Conclusions: Saans (CPAP device), successful therapeutic option for neonates with respiratory distress and can be effective even in a resource-constrained clinical setting.
Auditory performance and speech intelligibility among children with cochlear implant under a state-sponsored insurance scheme: a cross-sectional study
Authors: Selvavinayagam T. S. , Subramaniam Sudharshini , Kumar P. Senthil
Published: December 2021

Background: Cochlear implant is the intervention for improving the auditory performance and speech ability for children between 6-12 years with congenital deafness under the Chief Minister’s Comprehensive Health Insurance Scheme, a state-sponsored insurance scheme in Tamil Nadu. Until 2020, 4107 children had been provided with a cochlear implant under the scheme. However, the outcome of this intervention was not studied so far. Hence, as a program evaluation auditory performance and speech intelligibility among patients who received cochlear implant under the scheme is studied.Methods: A cross-sectional study was conducted among 203 patients who had received a cochlear implant at least 1 year ago. Children were evaluated for auditory performance and speech intelligibility using revised Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scores by trained speech therapists in Government Medical College hospitals. The proportion of good scorers in CAP (level ≥7) and SIR (category ≥ 3) was computed. The difference in proportion between different demographics was tested using the Chi-square test and Fischer exact test.Results: The median CAP and SIR scores of the children were 8 (Interquartile Range – 4) and 3 (IQR – 2) respectively. Almost 2/3rd of the children had good auditory performance and speech intelligibility. Factors that were associated with good auditory performance and speech intelligibility were being a girl child, getting the implant before 3 years of age, and getting it in a private institution.Conclusions: Gender and age at implant influences auditory performance and speech intelligibility after cochlear implant. Hence, early screening for deafness should be made a routine to enable early detection and management, thereby preventing permanent disability.
Etiology, prevalence and clinical signs of erythema toxicum neonatorum
Authors: Alghamdi Abdulwahid Mohammad , Alomrani Noura Muhammed , Almarri Ahmed Khaled , Alqasimi Mohammad Abdulghani , Qutah Faisal Khalid , Abuaziz Roayad Mouayed , Alshamrani Haidar Makhasir , Aljalfan Abdullah Ali , Alothayqi Jawaher Hussain , Alharbi Waleed Fawaz , Alhudaif Ali Mohammed
Published: December 2021

Evidence shows that erythema toxicum neonatorum (ETN) has been described in the literature since the 15th decade as a primarily rash in pediatric patients. Clinical studies show that the lesion of ETN is mainly characterized by the presence of minute yellowish papules and pustules that are usually surrounded by an irregular reddish wheal. It should be noted that evidence also demonstrated the pathology of these lesions is temporary and usually disappears within a few hours. In the present literature review, we discussed the etiology, prevalence, risk factors, and clinical signs of ETN based on findings from relevant research. The etiology of ETN is not clear among the different studies. However, some studies show involvement of immune and potential allergic reactions. The prevalence of the condition among infants is also remarkably variable among the relevant studies worldwide. There is also inconsistency in reporting the significance of the risk factors related to the prevalence and severity of the condition. On the other hand, the clinical signs among studies seem to be consistent and easily detected except when evaluating dark-skinned infants. Further studies are needed better to understand the etiology and epidemiology of the condition.
Study of surgical outcome of mid third clavicle fractures surgically managed by locking compression plate
Authors: Rani Potharaju Swetha , Vasif M. Zeeshan
Published: December 2021

Clavicle is one of the most frequently fractured bones in young and active individuals. They account for 2.6-12% of all fractures and for 44-66% of fractures around the shoulder. Majority of clavicle fractures are mid shaft (80-85%). Functional outcome of midshaft fracture not only depends on the union but also on its length which has to be maintained. Thus a displaced or comminuted fracture carries a risk of symptomatic malunion, non-union or poor functional outcome with cosmetic deformity. The recent trend is shifting to internal fixation of these displaced mid shaft clavicle fracture. This was a prospective study of 20 cases of fresh mid third clavicle fracture admitted to MNR medical college and hospital from August 2020 to September 2021. Cases were taken according to inclusion and exclusion criteria. Medically unsuitable and patients not willing for surgery were excluded from the study. There were 17 male patients and 3 female patients with mid 1/3 closed clavicle fracture. 12 patients had right sided clavicle fracture and 8 patients had fracture of the left clavicle. All 20 fractures were closed fractures. Majority of the patients sustained fracture due to road traffic accident (high energy trauma) in 16 cases, fall from height in 3 cases and assault in one case. The mean duration to surgery from the day of presentation and injury was 2.1 days for middle third clavicle fractures. Functional outcome as assessed by constant and Murley scoring was favourable with excellent to good result in 97% cases and fair in 3% cases. The average constant score was 93.35 in one year follow up in middle third group. This study has some limitations. The conclusions drawn from this analysis cannot be generalized because of the small number of cases. In conclusion, for middle third clavicle fractures bony union could be achieved with locking compression plates and the clinical outcomes were satisfactory. All the fractures united and there were no cases of nonunion.
Role of yoga prana vidya healing techniques in successful and speedy recovery of orthopaedic cases of bone injuries and fractures: a multiple case study
Authors: Shah Saloni D. , M. Atheesh Kumar , Nanduri Venkata S.
Published: December 2021

Bones form a vital part of the skeletal system providing mechanical support, strength, structure and protection to the human body. Inability of the bone to resist any kind of stress caused accidently can result in a bone injury or a fracture. This article provides a summary of eleven cases of bone injury and fracture treated successfully by yoga prana vidya (YPV) techniques as a complementary medicine for faster recovery. The study was carried out by two healers who independently healed eleven cases of bone injury and fracture using the bone regeneration techniques of YPV. Further, the data was collected and the results were analysed. By application of YPV healing techniques complementarily, it is observed that full recovery took place within 10 days to 45 days for the 3 hospitalised cases, and within 3 to 8 days for the two patients who had bandage/dressing done at a medical facility. In case of the remaining 6 patients who sought YPV healing help in preference to seeking medical help the recovery took place within 5 to 20 days. helping the patients to lead a normal life thereafter. It is observed that YPV techniques can be used for faster recovery of patients with injured and fractured bones. This paper shows the successful results when the techniques were applied on eleven participants. It is recommended to conduct further studies on a larger scale for the healing of bone related cases such as injury and fractures.
Surgical management of septic knee arthritis with open arthrotomy and debridement-a case report
Authors: Mahajan Neetin Pralhad , Pande Kartik Prashant , Dadhaniya Ravi Rameshbhai , Talukder Pritam
Published: December 2021

Septic arthritis is an inflammatory destruction of the native joint following inoculation of pathogen. Most common organisms causing septic arthritis are Staphylococcus and Streptococcus. Large joints are commonly involved with hip and knee joint accounting for approximately 60% of the total cases. Diagnosis is usually straightforward with the patient presenting with obvious local signs and symptoms along with toxic constitutional symptoms owing to the aggressive nature of the disease. Medical management in form of intra-venous antibiotics forms the mainstay of treatment but it is often required for a prompt surgical intervention in order to provide acute relief from symptom and also to decrease the disease load so as to save the joint from irreversible damage. We have a 63-year-old male patient came presented to us with a right knee swelling and tenderness of 3 weeks duration with restricted ROM with severe toxic constitutional symptoms of 1 week duration. Patient was planned for open arthrotomy and debridement and drainage of the pus and was started on an empirical therapy of injection piperacillin and tazobactam combination for 3 weeks. Immediate relief from symptoms following arthrotomy with good range of motion at 4 weeks post-surgery. As is clear from our case, an early diagnosis of septic arthritis and starting of appropriate antibiotics along with appropriately aggressive surgical interventions in the form of open debridement is the key for treatment of septic arthritis in order to save the joint from irreversible inflammatory damage. Surgical intervention not only gives immediate symptomatic relief but also decreases the load over antibiotics and increases local blood supply subsequently helping in better healing.

 
Effect of different irrigation porotocols on root dentine micro-hardness-An invitro study
Authors: Choudhary Ashish , Kour Sukhbir , Malik Azhar
Published: December 2021

IIrrigation solutions used and time of use has a definite effect on the micro hardness & other physical properties of dentin which in turn have direct consequence on the longevity functional performance of root canal treated teeth.

To evaluate the effect of different irrigation solutions on micro hardness of root dentin.

Forty extracted single rooted lower premolars were used. After instrumentation all the root halves were randomly assigned into 4groups (n=10) and brought in contact with one of the following irrigants for 5 minutes.

Group I: 10 ml of 5% Sodium Hypochlorite (NaOCl).

Group II: 10 ml of 17% ethylene diamine tetra-acetic acid (EDTA) followed by 10 ml of 5% NaOCl.

Group III: 10 ml of 5% NaOCl followed by 10 ml of 2% chlorhexidine digluconate (CHX).

Group IV: 10 ml of 5% NaOCL followed by flush of 10 ml distilled water then by 10ml of 2% CHX.

Dentin micro hardness was measured at baseline and after treatment to determine the change in micro hardness, using Vickers tester.

Data was analyzed using following parametric tests t-test, ANOVA test and Post Hoc test. Group II ie final irrigation with EDTA showed the highest percentage decrease in micro hardness values, followed by group III, then group IV and the lowest was group I. All groups showed a significant difference between each other (P < 0.05), except group III and IV. The coronal third showed the highest percentage decrease with significant difference between apical and middle thirds (P < 0.05).

EDTA with NaOCl causes greatest changes in dentine micro hardness, an intermediate flush with normal saline should be given for prevention of precipitation with NaOCl & CHX.
Clinical guide to border moulding and secondary impression in complete dentures
Authors: Ashok K  , Rao Suneetha , Swetha M U , Eshwar Prerana , Jyothi S  , Anil Anju
Published: December 2021

One of the major reason for a successful denture treatment is a good impression and the cast made out of it. It’s a well known fact, that the denture can only be as good as the impressions made. Therefore, attention to every detail and depth of the impressions plays a pivotal role for a successful clinical result, for which border moulding is an essential procedure for the same. Impressions convey operator’s extent of knowledge, understanding and the clinical results that can follow. A combination of a sound knowledge, along with acquired skill, experience, and patience can result in a successful and aesthetic prosthesis with adequate retention, stability and support with minimal post placement corrections. This article gives an insight into the necessary requisites to be followed during border moulding and secondary impression in making of a successful complete dentures.
Evaluation of possible reasons for asymmetries associated with Class II subdivision, Class II division 1 and normal malocclusion
Authors: Ratan Velagapalli Jessie , Kumar Kiran , Krishna K Ravi , Prasad S Eswar , Pavan K  , Siddhartha N  , Naresh V
Published: December 2021

: To evaluate and compare the asymmetries in subjects with two malocclusions that is Class II subdivision, Class II div 1 and normal occlusion.

: 90 subjects ranging from 15 to 30 years divided into 3 groups A, B, C. Group A – Class II subdivision, Group B – Class II division I, Group C – Normal Class I occlusion. Angular, linear paired, linear unpaired measurements were calculated based on the Van De Coppell analysis using PA views.

: Asymmetry was found in all the three groups where Group A patients showed greater degree of asymmetry near maxillary buttress and piriform aperture areas compared to the three groups. Group C patients showed greater degree of asymmetry in the occlusal plane angle.

All the three malocclusions that is Class II div 1 Subdivision, Class II div 1 and Class I malocclusions showed equal amounts of asymmetry. Class II subdivision patients showed greater asymmetry near maxillary buttress area and piriform aperture. Class I malocclusion showed deviation in occlusal plane angle. Along with the lower third involving mandible, maxillary area also can equally show asymmetry in both skeletal and dental parameters.
Various methods of canine retraction in premolar extraction space: A case series
Authors: Shukla Neeteesh K , Verma Shivam , Dwivedi Parnita , Gupta Nimmi , Singh Sneha
Published: December 2021

Following article is the review and presentation of various methodologies of canine retraction [e.g.– methods under sliding and friction less mechanics, facilitation with TADs (Temporary Anchorage Devices) and MOPs (Micro-Osteo-Perforations), and invasive procedures etc.] and comparison of these methods in terms of rate of canine retraction, and molar anchorage loss. Patient’s age ranges between 15y to 19y and only right maxillary canine was taken for comparison purpose.
Social self-organization in Russia in the 2nd half of the XIX – the beginning of XX centuries. The problem of aggregating of political interest
Authors: Omelaenko Valentina
Published: December 2021

The article is devoted to the phenomenon of social self-organization in Russian society in the late 19th – early 20th centuries. According to the example of the Moscow Law Society, created in the sixties of the XIX century, the trends of the development of voluntary associations in societies that did not have experience of representation until that time, are revealed. It is noted that the members of the MLS – the first domestic public organization of a legal profile - made a significant contribution to the formation of the liberal movement, the development of legal culture, the formation of the rule of law in Russia in the late 19th – early 20th centuries. It is concluded that the Moscow Law Society and other voluntary public associations, gradually acquiring the features of pro-party organizations, served as a kind of "school of democracy" for Russian society at the turn of the century.
A Transfer Learning Approach for Diabetic Retinopathy and Diabetic Macular Edema Severity Grading
Authors: Nasir Nida , Afreen Neda , Patel Ranjeeta , Kaur Simran , Sameer Mustafa
Published: December 2021

Diabetic Retinopathy (DR) and Diabetic Macular Edema (DME) are complication that occurs in diabetic patient especially among working age group that leads to vision impairment problem and sometimes even permanent blindness. Early detection is very much needed for diagnosis and to reduce blindness or deterioration. The diagnosis phase of DR consumes more time, effort and cost when manually performed by ophthalmologists and more chances of misdiagnosis still there. Research community is working on to design computer aided diagnosis system for prior detection and for DR grading based on its severity. Ongoing researches in Artificial Intelligence (AI) have set out the advancement of deep learning technique which comes as a best technique to perform analysis and classification of medical images. In this paper, research is applied on Resnet50 model for classification of DR and DME based on its severity grading on public benchmark dataset. Transfer learning approach accomplishes the best outcome on Indian Diabetic Retinopathy Image Dataset (IDRiD).
Удосконалення обліку доходів виробничих підприємств: прикладні аспекти
Authors: Руденко Микола , Кравченко Олена , Ткаль Ярміла , Мельник Тетяна
Published: December 2021

В статті проведено аналіз прикладних аспектів обліку доходів виробничих підприємств. Визначено, що класифікація доходів підприємств має відповідати двом базовим критеріям: вона має бути теоретично обґрунтованою та застосування її на практиці визначається виробничою чи обліковою необхідністю підприємства. Розроблено робочий план рахунків до субрахунків 26, 701 для обліку доходів від реалізації продукції, а також оборотну відомість для комплексного моніторингу виробленої та реалізованої готової продукції за робочим планом рахунків.
Екосистема та регулювання фінансової інклюзії в Україні
Authors: Запорожець Світлана , Тригуб Юлія
Published: December 2021

У статті досліджено сутність поняття фінансової інклюзії з позиції формування   екосистеми взаємозалежних детермінант її забезпечення, обґрунтовано роль регуляторної складової як важливої передумови забезпечення фінансової інклюзії та визначено регуляторні напрями активізації розвитку фінансової інклюзії в Україні.
SZUPERÉRZÉKENYSÉG ÉS A VIZSGASZORONGÁS KAPCSOLATA EGY SZABOLCS-SZATMÁR-BEREG MEGYEI GIMNÁZIUMBAN VÉGZETT FELMÉRÉS ALAPJÁN
Authors: Ware Anna Julia
Published: December 2021

Jelen tanulmány a szuperérzékenység és a vizsgaszorongás közötti kapcsolat vizsgálatára fókuszál. A téma aktualitását az adja, hogy a szuperérzékenység, mint személyiségvonás magyarországi viszonylatban (főleg a szuperérzékeny gyerekek különleges bánásmódra való igényét illetően) kevéssé vizsgált terület, míg külföldön egyre több kutatás jelenik meg a témában. A vizsgálat arra keresi a választ, hogy a magasabb érzékenység együtt jár-e magasabb vizsgaszorongás-szinttel. Minta: 133 fő (jellemzőik: Mkor=15.3; nemi eloszlás 25,56% fiú, 74,44% lány; évfolyambeli eloszlás 9. osztály 78,95 % 10. osztály 21,05%). Módszer: online és anonim módon kitölthető kérdőívcsomag három kérdőívvel. A demográfiai jellemzők felvételéhez önállóan összeállított demográfiai kérdőív alkalmazására került sor, a szorongás vizsgálatához a TAI-H (Sipos, Sipos & Spielberger, 1988), az érzékenység vizsgálatához a HSPS-H (Aron, 1999, ford. Komjáthy, 2011; Pluess, 2013) került felhasználásra. Eredmény: az érzékenyebb diákoknak szignifikánsan magasabb a vizsgaszorongás-szintjük kevésbé érzékeny társaikéhoz képest. Következtetés: a pedagógiai gyakorlatban érdemes figyelembe venni a tanulók érzékenységét, hiszen sok egyéb tényező mellett ez a veleszületett jellemvonás befolyásolhatja a vizsgaszorongás-szintet és így a teljesítményt.
Health Literacy and Aging
Authors: Bahrevar Vali , Hazar Narjes , Hosseini Saeed
Published: December 2021

The article's abstract is not available.
Fluid Intake Status and its Relationship with Cognitive Impairment among Elderlies of Naein City, Iran
Authors: Kaseb Fatemeh , Motavalian Zahra , Fallahzadeh Hossein
Published: December 2021

Introduction: Water, as one of the most essential nutrients, is involved in almost all biochemical processes of the human body. Although different degrees of dehydration have various symptoms such as physical and mental decline, severe dehydration is associated with decreased survival capacity in the physiological environment of the body that can put individuals, especially the elderly, at the risk of death. The present study aimed to determine the status of fluid intake and its association with cognitive impairments in the elderly people of Naein City in 2018.
Methods: This cross-sectional study was conducted among 225 randomly selected elderlies in Naein City. Data collection tools included demographic questionnaire, Mini–Mental State Examination, and 24-hour food recall questionnaire. The obtained data were analyzed using ANOVA, t-test and chi-square via SPSS software.
Results: The mean of total fluid intake was 2637.05 ± 772.35 ml / day. Among 225 participants, 36.4%, 37.3%, and 26.2% had normal, mild, and moderate cognitive impairment, respectively. Cognitive impairment had a significant relationship with gender, occupational status, level of education, marital status, and place of residence (p < 0.05). No significant relationship was observed between the mean of water consumption and cognitive impairment (p = 0.6).
Conclusion: The amount of fluid intake in elderly people living in Naein City was at a satisfactory level. Since no significant relationship was observed between the amount of fluid intake and cognitive impairments and more than half of the participants had cognitive impairments, we hypothesize that other factors are  involved in  prevalent of cognitive impairment.
Quality of Life among Older Adults Covered by Various Pension Funds, Tabriz, Iran
Authors: Sadighiyan Hadi , Abbasian Mehdi , Yousefi Mahmood , Maasoumi Narjes , Nikanfar Reza , Matlabi Hossein
Published: December 2021

Introduction: Quality of life (QoL) is known to be one of the main challenges of the present century in the growing heterogeneous elder population. Therefore, determining the affecting factors of QoL among older people could be imperative. The present study aims at the comparative investigation of the QoL the old people covered by the various pension funds in the city of Tabriz, Iran.
Methods: A cross-sectional study was conducted among 212 older people in Tabriz, Iran. All of the participants were selected based on a stratified sampling considering the study population’s preliminary distribution in three kinds of funds (the State, Armed forces, and Social security). A reliable Iranian LEIPAD questionnaire was used in a comparative investigation of the older adult’s QoL. Data were analyzed with SPSS 21 using t-test, ANOVA, person corellation tests and multiple linear regression.
Results: The majority of the participants were male (84.4%) and married (94.8%). One-third of older people possessed academic qualifications. The average age of pensioners in the State fund was 8 years older than other funds. Social security pensioners received the lowest wages (i.e. 0.76 of State and 0.71 of Armed forces pensioners). The total mean score of QoL was 65.63 ± 12.27 (range: 0-93). The relationship between QoL and education level (β = 0.30) and marital status (β = 0.22) was positive and significant. Moreover, a significant difference was observed between scores of QoL and type of pension funds, marital status, education level (p < 0.05).
Conclusion: Pension funds can improve the QoL among older people by increasing the pension amount, quality of services and payment benefits of those covered retirees.
Conjunctival polymerase chain reactions in COVID-19 patients and its correlation with clinical and paraclinical indexes
Authors: Farzin Maral , Rasoulinejad Seyed Ahmad , Babaei Mansour , Sadeghi Farzin , Sadeghi-Haddad-Zavareh Mahmoud , Firouzjahi Alireza , Heidari Behzad
Published: December 2021

Background and Objectives: This study aimed to detect SARS-CoV-2 in conjunctival samples of COVID-19 patients to investigate the transmission route of COVID-19 and its correlation with laboratory indexes.
Materials and Methods: In this cross-sectional study, 44 COVID-19 patients were tested for conjunctival PCR in Ayatollah Rouhani hospital of Babol, Iran, in January and February 2021. The conjunctival samples were collected using a conjunctival swab and suspended in a viral transport medium. After RNA extraction and cDNA synthesis, real-time PCR was performed to investigate the SARS-CoV-2 genome in samples. The ocular manifestations and laboratory indexes were evaluated for all patients.
Results: Among 44 COVID-19 patients, 6 samples (13.63%) were positive in terms of conjunctival PCR. The mean ± SD age of conjunctival PCR-positive patients was 76.17 ± 16.61-year-old, while conjunctival PCR-negative COVID-19 pa- tients were aged 57.54 ± 13.61-year-old (p <0.05). D-dimer serum level is significantly higher in conjunctival PCR-positive COVID-19 patients (4001.00 ± 3043.36 µg/ml) compared to normal individuals (496.80 ± 805.92 µg/ml, p <0.01).
Conclusion: Our study showed that the conjunctiva and tear contain the SARS-CoV-2 in COVID-19 patients as a possible transmission route.
Prevalence of nosocomial infections in Covid-19 patients admitted to the intensive care unit of Imam Khomeini complex hospital in Tehran
Authors: Mohammadnejad Esmaeil , Manshadi Seyed Ali Dehghan , Taghi Beig Mohammadi Mohammad , Abdollai Alireza , Seifi Arash , Salehi Mohammad Reza , Ghanei Gheshlagh Reza
Published: December 2021

Background and Objectives: Nosocomial infections (NIs) are an important cause of mortality and morbidity in intensive care units (ICU). Pneumonia is the most common serious manifestation of infection in Covid-19 patients. The aim of this study was to investigate the prevalence of pneumonia in Covid-19 patients admitted to the ICU.
Materials and Methods: In this cross-sectional study, 1240 Covid-19 patients admitted for more than 48 h in the ICUs of Imam Khomeini Complex Hospital (IKCH) in Tehran for seven months in 2020 were included in the study with initial di- agnosis of Covid-19 (PCR test and chest imaging). Data were collected regarding severity of the illness, primary reason for ICU admission, presence of risk factors, presence of infection, length of ICU and hospital stay, microbial type and antibiotic resistance. In this study, the pattern of antibiotic resistance was determined using the disk difusion method.
Results: In this study, 289 (23.3%) out of 1320 patients experienced NIs. 221 (76.4%) out of 289 patients had underlying diseases and the most common of which were hypertension, diabetes and heart disease, respectively. 163 patients (56.4%) were RT-PCR COVID-19 positive and 200 patients (69%) died. The majority of patients with NIs (71%) were over 55 years old. The most common type of nosocomial infection (66%) was ventilator-associated pneumonia (VAE). The most common microorganisms that cause pneumonia were Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aerugino- sa, respectively.
Conclusion: Pneumonia infection is high in Covid-19 patients admitted to the ICU, it needs to be planned with the diagnosis and measures related to the control and prevention of this infection.
Age and sex trends of Gardnerella vaginalis infection in patients with sexually transmitted infections in Korea
Authors: Yuk Young Sam , Choi Jae Eun , Kim Jae Kyung
Published: December 2021

Background and Objectives: Gardnerella vaginalis and Candida albicans are the most common causative agents of bac- terial vaginosis, and infections with these pathogens lead to inflammation, endometritis, and pruritus. The aim of this retro- spective study was to determine the trends of G. vaginalis infections based on real-time PCR data according to age and sex in patients with sexually transmitted diseases.

Materials and Methods: A total of 59,381 specimens isolated at a clinical laboratory from September 2018 to December 2020 were subjected to real-time PCR for the detection of G. vaginalis DNA. Sample types included catheter, pus, tissue, swab, and urine samples.

Results: Among 59,381 samples, 20,718 (34.8%) were positive for G. vaginalis. Of the positive samples, 13,186 (63.7%) were from male patients and 7,532 (36.3%) were from female patients. Average patient age was 39.1 years (the average age of male and female patients was 38.34 and 40.43 years, respectively). Female patients younger than 19 years exhibited the highest incidence of G. vaginalis, at 71.57%, followed by 68.46% incidence in those aged 20-29 years; the lowest incidence was in women aged 40-49 years. Further, among specimen types, the highest number of G. vaginalis-positive specimens was obtained by the swab sampling method.
Conclusion: From 2018 to 2020 in Korea, the number of tests conducted for bacterial vaginosis has increased, while the incidence of G. vaginalis infections appears to have decreased. the finding that female adolescents have a high tendency to carry the pathogen is important. and for effective surveillance of BV, sampling by cotton swabs and detection by multiplex PCR might be a good approach.
Toxin gene profiles and antimicrobial resistance of Clostridioides difficile infection: a single tertiary care center study in Iran
Authors: Sholeh Mohammad , Kouhsari Ebrahim , Talebi Malihe , Hallajzadeh Masoumeh , Godarzi Forough , Amirmozafari Nour
Published: December 2021

Background and Objectives: Due to the reduced susceptibility of clinical Clostridioides difficile strains in hospitals to var- ious antimicrobial agents, the importance of antimicrobial susceptibility testing (ASTs) has increased. This study aimed to investigate the toxin gene profiles and the antimicrobial resistance of C. difficile isolated from hospitalized patients suspected of having Clostridioides difficile infection (CDI) in Tehran, Iran.
Materials and Methods: The stool samples were obtained from a hospitalized patients. The samples were shocked by al- cohol and the patients cultured on cycloserine-cefoxitin-fructose agar in anaerobic Conditions. Toxin assay was performed for detection of toxinogenic isolates. An antibiotic susceptibility test was done. Furthermore, their genome was extracted for PCR to confirm C. difficile and detect toxin gene profile.
Results: Toxigenic C. difficile were identified in 21 of the 185 stool samples (11.3%). PCR detected seven toxin gene profiles; the highest prevalence was related to tcdA+B+, cdtA+B-  toxin gene profile (57.1%). There were 14.3% and 28.6% resistant rates of the isolates towards vancomycin and metronidazole with the toxin gene profiles; tcdA+B+, cdtA±B+; and tc- dA+B-, cdtA-B+. All resistant isolates to moxifloxacin, clindamycin, and tetracycline were belonged to the toxin gene profiles; tcdA+B+, cdtA+B+; tcdA+B+, cdtA+B-, and tcdA-B+, cdtA+B-.
Conclusion: Relative high resistance was detected towards metronidazole and vancomycin, although, still have acceptable activity for CDI treatment. However, a proper plan for the use of antibiotics and more regular screening of C. difficile anti- biotic resistance seems necessary.
The compliance of surgical prophylactic antibiotics with standard protocols in Imam Reza teaching hospital of Birjand, Iran
Authors: Ebrahimzadeh Azade , Najafi Mohammad , Bijari Bita , Amouzeshi Ahmad , Abedini Mohammad Reza , Mosavi Tahoora , Sattar Pagheh Abdol
Published: December 2021

Background and Objectives: Taking unnecessary or inappropriate prophylactic antibiotics can cause infections with re- sistant organisms. The present study aimed to investigate administration prophylactic antibiotics in surgery ward and its compliance with standard protocol in Imam Reza teaching hospital of Birjand, Iran.
Materials and Methods: This descriptive-analytical study was performed to evaluate the pattern of prophylactic antibiotics on patients who underwent surgical operations from October to December 2019. A checklist including demographic informa- tion, type of prophylactic antibiotics, dose and duration of using drug, type of surgery, and compliance with standard protocol was used. The validity and reliability of the checklist were evaluated and confirmed prior to the study. All eligible patients were enrolled and the information of the prescribed drugs in the surgical wards was compared with the Schwartz’s principles of surgery as standard protocol.
Results: Out of a total of 300 patients, 187 (62.3%) were male. Among the patients, 155 (51.7%) cases underwent general surgery, 119 (39.6%) cases orthopedic surgery, and 26 (8.7%) cases neurosurgery. The most popular prescribed antibiotics were cefazolin (170 cases) and ceftriaxone + metronidazole (67 cases). Furthermore, the maximum antibiotic administrations were two days (127 cases) and one day (93 cases). More importantly, 67.7% and 92.3% of the patients were in compliance with the standard protocol in terms of the type and time of administration, respectively.
Conclusion: Our results showed that duration and route of administrating antibiotics were consistent with the standard pro- tocol, but the type of drugs and indication did not match.
Optimization of antimicrobial efficiency of silver nanoparticles against three oral microorganisms in irreversible hydrocolloid impressions
Authors: Jafari Ahmad , Mazaheri Nezhad Fard Ramin , Shahabi Sima , Abbasi Farid , Javdani Shahedin Golshid , Bakhtiari Ronak
Published: December 2021

Background and Objectives: Silver nanoparticles (Ag-NPs) are potent antimicrobial agents, which have recently been used in dentistry. The aim of the current study was to optimize antimicrobial activity of Ag-NPs used in preparing irre- versible hydrocolloid impressions against three microorganisms of Escherichia coli, Streptococcus mutans and Candida albicans.
Materials and Methods: After assessing antimicrobial activity of the compound using disk diffusion method, three parame- ters of concentration of Ag-NPs (250-1000 ppm), ratio of hydrocolloid impression material powder to water (0.30-0.50) and time of mixing (20.0-60.0 s), affecting antimicrobial activity of irreversible hydrocolloid impression materials against the three microorganisms, were optimized. This combined process was successfully modeled and optimized using Box-Behnken design with response surface methodology (RSM). Decreases in colony number of E. coli, S. mutans and C. albicans were proposed as responses.
Results: Qualitative antimicrobial assessments respectively showed average zone of inhibition (ZOI) of 3.7 mm for E. coli, 3.5 mm for S. mutans and 4 mm for C. albicans. For all responses, when the mixing duration and powder-to-water ratio increased, the circumstances (mixing duration of 59.38 s, powder-to-water ratio of 0.4 and Ag-NP concentration of 992 response) increased. Results showed that in optimum ppm, the proportion of decreases in colony numbers was maximum (89.03% for E. coli, 87.08% for S. mutans and 74.54% for C. albicans). Regression analysis illustrated a good fit of the ex- perimental data to the predicted model as high correlation coefficients validated that the predicted model was well fitted with data. Values of R2Adj with R2Pred were associated to the accuracy of this model in all responses.
Conclusion: Disinfection efficiency dramatically increased with increasing of Ag-NP concentration, powder-to-water ratio and mixing time.
Satisfaction Level with the Health Transformation Plan in Iran: A Systematic Review
Authors: Hashempour Reza , Bouzarjomehri Hossein , Hadian-Shiva Elyas , Chivaee Dariush , Mokhtari-Payam Mahdi , Herandi Yasaman
Published: December 2021

Background: The Health Transformation Plan (HTP) had been one of the most significant recent reforms in the Iranian health system. Notwithstanding, it has strengths and weaknesses that should be assessed. One of the most important aspects of assessing programs is the people and the personnel's satisfaction. Consequently, this study has reviewed studies that have measured satisfaction with HTP.
Methods: In this systematic review, databases of Web of Science, Scopus, PubMed, Google Scholar were searched until May 2019. The Ministry of Health website, and the National Institutes of Health Research website were also searched. All studies that evaluated HTP satisfaction were included. Data were collected and analyzed utilizing a data extraction form and reported by narrative review.
Results: 20 studies were included that were conducted in the period 2014 to 2017. The overall results of the studies indicate that nurses and physicians have not been satisfied with HTP, while retaining physicians in disadvantaged regions and patients have been approximately satisfied with HTP. Only three before and after studies have been conducted, and the rest studies are related to after HTP. Two before and after studies concluded that patients and nurses 'satisfaction is decreased and one study concluded that mothers' satisfaction is increased. Nurses and physicians dissatisfaction was due to the causes such as increasing the number of clients, injustice in payments, unbalanced workload and salary and other working conditions.
Conclusion: Influential, comprehensive, and national studies, including satisfactory before- and after-studies, are still not available to draw definite conclusions about public and employee satisfaction with HTP. It appears that despite the expensive cost of HTP and relative satisfaction of patients, the government did not meet all the demands of nurses and some physicians.
Assessment Optimization of Safety and Health Risks Using Fuzzy TOPSIS Technique (Case Study: Construction Sites in the South of Iran)
Authors: Sekhavati Eghbal , Jalilzadeh Yengejeh Reza
Published: December 2021

Introduction: Safety and health risk assessment in industries is associated with uncertainties due to the variables affecting it. Therefore, in this research, optimizing safety and health risk assessment was investigated in construction sites by combining a multi-criteria decision-making technique (TOPSIS) and a fuzzy system. In the present study, to answer this question, a new method was used to optimize health risk assessment in construction workshops.
Materials and Methods: The case study was construction sites in Lar, a city in the south of Iran. Based on previous studies and expert opinions, ten criteria were determined to assess safety and health risks in the construction sites. Also, 15 safety and health risks were identified resulting from 12 types of activities in the construction sites. Triangular fuzzy numbers were used for linguistic variables in Fuzzy TOPSIS with R version 1.1 software.
Results: Based on the results, the risk of the collapse of adjacent buildings related to the excavation process was the most important safety and health risk in the construction sites with a coefficient value of 0.5.
Conclusion: This method can provide desired results with the least uncertainty in prioritizing safety and health risks.
An In-Depth Analysis of Water Quality Using GIS and Heavy Metal Pollution Index near a Gold Mining Area, Qorveh, Iran
Authors: Jahangiri-rad Mahsa , Shariati Mohsen , Yaaghoubi Mahdieh , Haghmoradkhani Ali , Akbarzadeh Abbas
Published: December 2021

Introduction: Inappropriate management of mining activities may bring about water pollution and pose a heavy complication on aquatic ecosystem and humans. The study aimed to evaluate the effect of Qorveh gold mining activities on the quality of nearby groundwater.
Materials and Methods: The concentration of seven eco-toxic metals along with some general hydrochemical parameters were investigated for 27 sampling stations in the study area using Atomic Absorption Spectrometry (AAS) and conventional hydrochemical methods. The analysis results were further applied to compute pollution indices, namely heavy metal pollution index (HPI) for irrigation purposes.
Results: The main elements were within the World Health Organization (WHO) and Iranian National Water Standards (INWS) for irrigation water quality, except for NH4+ in some sampling points. The concentration of heavy metals followed the order Cu > Zn > Pb > Hg > Cd > As. The contents of Hg, As, Cd, and Cu in most sites were higher than the recommended values. Except for two stations, the value of HPI based on the mean concentration was found to be far beyond the critical pollution index value of 100, suggesting that the area is highly polluted with some heavy metals.
Conclusion: Elevated concentration of trace elements found in groundwater of this area represented the release of harmful elements from gold mining activities on surrounding environment.
Investigating the Etiology and Diagnosis of Sacroiliac Joint Pain
Authors: Abotalebi Mohammad Hossein , Shafiei Seyyed Hossein
Published: December 2021

The sacroiliac (SI) joint is often characterized as a large, auricular-shaped, and diarthrodial synovial joint. The SI ligamentous structure is more extensive in the dorsal part due to the absence of the posterior capsule, which functions as a connecting band between the sacrum and ilium. In addition, a network of muscles supports the SI joint that helps deliver regional muscular forces to the pelvic bones. The third and fourth decades of life promote senescent changes manifested by surface irregularities, crevice formation, fibrillation, and clumping of chondrocytes.
Forearm Amputations and Crush Injuries, Different Scenarios and Treatments: Educational Corner
Authors: Khajeh Rohollah , Moharrami Alireza , Farzan Mahmoud , Molaei Hojjat , Moazen-Jamshidi Mir Mansour , Zarei Mohammad
Published: December 2021

The article's abstract is not available.
A Novel Case of Neglected Monteggia Fracture Dislocation
Authors: Najafi Arvin , Basiri Pouria , Azarsina Salman , Mirhoseini Mohamad Sajad , Seif Ehsan
Published: December 2021

Background: The Monteggia fracture-dislocation is a rare condition among children, and its treatment is still controversial. The treatment can become quite complicated when the diagnosis is delayed. There is a broad range of surgical treatments with various complications like subluxations, degenerative changes, and radial head deformity. The present case was reported as a novel surgical treatment choice for neglected Monteggia fracture-dislocation.
Case Report: A 16 year-old boy presented with left elbow severe range of motion (ROM) limitation and pain who was diagnosed with neglected Monteggia fracture-dislocation. The patient went through open reduction beside internal fixation of the ulnar shaft via Limited Contact Dynamic Compression Plate (LC-DCP) and radio-capitellar joint reduction and provisional fixation by a pin. The patient recovered after three months with a significant increase in elbow ROM without any complications.
Conclusion: This method could be an appropriate treatment of choice for neglected Monteggia fractures which indeed had excellent outcomes without complication.
NEW RELATIVISTIC APPROACH TO COMPUTING SPECTRAL PARAMETERS OF MULTICHARGED IONS IN PLASMAS
Authors: Ternovsky E. , Mykhailov A.
Published: December 2021

It is presented  a new relativistic approach to computing the spectral parameters of multicharged ions in plasmas for different values of the plasmas screening (Debye) parameter (respectively, electron density, temperature). The approach used is based on the generalized relativistic energy approach combined with the optimized relativistic many-body perturbation theory (RMBPT) with the Dirac-Debye shielding model as zeroth approximation, adapted for application to study the spectral parameters of ions in plasmas. An electronic Hamiltonian for N-electron ion in plasmas is added by the Yukawa-type electron-electron and nuclear interaction potential. The special exchange potential as well as the electron density with dependence upon the temperature are used.
CASCADE OF AUGER TRANSITIONS IN SPECTRUM OF XENON: THEORETICAL DATA
Authors: Chernyshev A. , Efimova E. , Buyadzhi V. , Nikola I.
Published: December 2021

The energy parameters of the Auger transitions for the xenon atomic system are calculated within the combined relativistic energy approach and relativistic many-body perturbation theory with the zeroth order density functional approximation. The results are compared with reported experimental data as well as with those obtained by semiempirical method. The important point is linked with an accurate accounting for the complex exchange-correlation (polarization) effect contributions and using the optimized one-quasiparticle representation in the relativistic many-body perturbation theory zeroth order that significantly provides a physically reasonable agreement between theory and experiment.