Objective:To assess the effect of a course of intravenous dexamethasone on pain after tonsillectomy.Method:Sixty patients who underwent tonsillectomy or adenoidectomy and tonsillectomy were randomly divided into experimental group and control group. Postoperatively, 30 patients in experimental group received anti-inflammatory drug and dexamethasone for 4 days, and the other 30 patients in control group received anti-inflammatory drug and placebo. Degree of postoperative pain was measured with visual analogue scale in the patients more than 12 year old and with Wong-Baker faces pain scale in the patients less than or equal to 12 year old. The measurement was made twice daily for 5 days.Result:During the postoperative period, the scale value was decreasing every day in the all patients.But the value in experimental group was less than that in control group, and the difference was statistically significant (P<0.05).Conclusion:Dexamethasone given in this regime reduces postoperative pain and odynophagia after tonsillectomy.

In this study, indomethacin (IND) loaded solidified-polymeric micelles (IND-SPM) were prepared. Their in vitro characteristics were investigated. Methoxy-poly(ethylene glycol) poly(D, L-lactide) copolymer (mPEG-PDLLA) was used as IND carrier. The preparation of IND-SPM was conducted by solution-absorption method and evaporation by rotary evaporator. Polyplasdone XL-10 was used as adsorbent. The solution-absorption method was conducted by the following procedure; IND and mPEG-PDLLA were dissolved in acetone, followed by addition of polyplasdone XL-10 and stirred to obtain a suspension. The powder of IND-SPM was simply obtained after the organic solvent was completely evaporated. More than 90% (w/w) of IND (20 mg) in the powder was dissolved in 250 mL PBS within 30 min. DSC, 1H NMR and SEM results proved that IND was encapsulated within mPEG-PDLLA. The solubility of IND in the system increased 4.6 times with the highest amount of copolymer. The solidified particles were found to be suitable for the formulation of tablets or capsules.

Fournier’s gangrene is a severe life-threatening infection involving the perianal area, perineum, and external genitalia. It demands prompt recognition, critical care therapy, surgical therapy, and a combination of antibiotics. The infection commonly spreads via the fascial planes and causes superficial vascular thrombosis within the Colles’ fascia around the external genitalia. It can extend cephalad to involve the Scarpa’s fascia and Camper’s fascia in the abdominal wall. The treatment would include multiple debridements, which would result in disfiguring scars of the perineum and might lead to significant physical and psychological complications. We describe a case of a 58-years-old man presenting with Fournier’s gangrene resulting from an infection of an impacted urethral stone. The patient previously had obstructive voiding symptoms for 1 month but chose to neglect them. The resultant infection was severe and caused penile and right testicular gangrene. He underwent multiple wound debridements, which included a total penectomy and right orchiectomy. Psychological and rehabilitative support was necessary for him to overcome his loss and disfigurement.

BACKGROUND AND OBJECTIVES: Tinnitus is characterized as a perception of numerous auditory sounds in absence of external stimulus. Tinnitus can have a considerable consequence on a person’s quality of life, and is considered to be very complicated to quantify. The aim of this study was to investigate the reliability and validity of Urdu translation of the Tinnitus Handicap Inventory (THI) in Pakistan. It was designed to assess the presence of various auditory sounds without the external stimulus. Scale consisted of 25 items having three subscales functional, emotional, and catastrophic. SUBJECTS AND METHODS: The study comprised into two stages, preliminary and main studies. The results of preliminary study revealed that the overall scale had high internal consistency [alpha coefficient of Urdu version of THI (THI-U)= 0.99, alpha coefficient of English version of THI=0.98]. The overall scale had test-retest correlation over a fifteen days period of interval (0.99). Main study was performed on 110 tinnitus patients. The results of main study showed that the internal consistency and reliability of Urdu version was (α=0.93). The THI-U and its subscales demonstrated good internal consistency reliability ( α =0.81 to 0.86). RESULTS: High to moderate correlations were noted between tinnitus symptom ratings. A confirmatory factor analysis was used to validate the three subscales of THI-U, and high inter-correlations were found between the subscales also results revealed that a three-factor model for the THI-U was most tenable. The results displayed that the confirmatory factor analysis confirmed to validate the three subscales of THI-U. CONCLUSION: THI-U might present important information about precise facets of tinnitus distress along with diagnostic interviews in clinical practice.
Humans ; Pakistan ; Quality of Life ; Reproducibility of Results ; Tinnitus

The present study was designed to develop and describe the psychometric properties of the Sense of Belonging Scale (SoBS) among adolescents for the teen’s sample. The research included three distinct studies. In Study 1, item pool generation and evaluation of content validity of the new scale by expert panel were carried out. In Study 2 (n=412), the factor structure of SoB was examined with Exploratory Factor Analysis (EFA) and the internal consistency of the new scale was evaluated. In Study 3 (n=362) Confirmatory Factor Analysis (CFA) was performed on the items determined by EFA in a different sample and the convergent validity of the new scale was assessed. EFA results displayed that SoB had five factors accounting for 43.064% of the initial total variance and CFA results confirmed that these five distinct but correlated factors were related to school belonging, home country connectedness, religious affiliation, culture connectedness, and family belonging. The internal consistency (Cronbach’s alpha and McDonald’s omega) of the SoBS was 0.90 and all subscales had high internal consistency. To assess the convergent validity, SoBS was administered together with Psychological Wellbeing (18 items), Rosenberg Self Esteem Scale (RSES), Positive and Negative Affect Scale (PANAS), and Beck Depression Inventory (BDI). The results revealed that SoBS was positively correlated with the Psychological Wellbeing, positive affect, and RSES while it was negatively correlated with negative affect and BDI. Test-retest reliability (N=83) for total SoBS was 0.81. Findings suggest that SoBS is a psychometrically valid and reliable tool to assess sense of belonging among adolescents.

Aims: This study aimed to investigate the effect of acidic electrolyzed water (AEW) as pre-refrigeration and pre-freezing processing steps for chicken meat in regard to the behavior of S. Typhimurium and E. coli during storage. Methodology and results: AEW (free available chlorine 30 ppm and pH 2.7) was tested against S. Typhimurium and E. coli in growth media (brain heart infusion broth) and by exposing inoculated chicken fillets. The in vitro study appointed 10 minutes as the straightening exposure time of fresh prepared AEW for S. Typhimurium and E. coli. The reduction effect of AEW was significant (p<0.05) for both S. Typhimurium and E. coli along the 8 days of refrigerated storage with a maximum reduction after 24 h of post-treatment reaching 23.3% (1.4 log CFU/g) and 32.43% (2.15 log CFU/g) for S. Typhimurium and E. coli, respectively. AEW resulted in a significant reduction (p<0.05) as a pre-freezing application for both microorganisms, where the maximum reductions of 20% (1.2 log CFU/g) and 31.84% (2.14 log CFU/g) for S. Typhimurium and E. coli, respectively, were reported at zero time (just after dipping). In exposed samples to AEW, S. Typhimurium could not be detected by the 6th week of frozen storage while E. coli continued detectable until till 10th week but with a reduced population of 30% compared to control. Conclusion, significance and impact of study The findings of the present study suggest the application of AEW as a pre-refrigeration and pre-freezing treatment for chicken products. AEW application significantly improved the safety of chicken products.
Electrolytes ; Chickens--microbiology ; Salmonella typhimurium ; Escherichia coli

BACKGROUND: Most children with acute lymphoblastic leukemia (ALL) receive blood transfusions. Transfusions may affect ALL outcomes through transfusion-related immunomodulation (TRIM). METHODS: We analyzed overall survival (OS) and event-free survival (EFS) in relation to leukocyte reduced and irradiated (LR/IRR) blood products transfused during the induction phase in 136 children with ALL. Hazard ratios (HRs) for death and relapse were estimated through Cox regression analysis. RESULTS: One hundred and twenty patients (89%) were transfused with packed red blood cells (PRBCs) and 79 (58%) with single donor platelets (SDPs). The median number of transfusions was 2 (interquartile range [IQR]=1-3 events) and 1 (IQR=0-3 events) for PRBCs and SDPs, respectively. Patients who had white blood cell (WBC) count >50,000x10(9)/L, were classified as high risk according to the high National Cancer Institute criteria, displayed a T cell phenotype, or were minimal residual disease-positive at end of induction were more likely to receive >3 transfusions during induction (P=0.001, 0.002, 0.03, and 0.01, respectively). In univariate analysis, PRBC, SDP, and fresh frozen plasma transfusions did not have any significant association with relapse or death. For PRBC transfusions, the HRs for EFS and OS were 1.02 (95% CI, 0.85-1.24; P=0. 76) and 1.03 (95% CI, 0.83-1.27; P=0.76), respectively. For SDP transfusions, HRs were 1.03 (95% CI, 0.90-1.18; P=0.64) and 0.98 (95% CI, 0.80-1.20; P=0.87) for EFS and OS, respectively. CONCLUSION: LR/IRR blood products may not confer a TRIM effect in childhood ALL and are unlikely to affect outcome.
Blood Platelets ; Blood Transfusion ; Child ; Disease-Free Survival ; Erythrocytes ; Humans ; Immunomodulation ; Leukocytes ; National Cancer Institute (U.S.) ; Phenotype ; Plasma ; Polymethacrylic Acids ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prognosis ; Recurrence ; Tissue Donors

In this study, indomethacin (IND) loaded solidified-polymeric micelles (IND-SPM) were prepared. Their in vitro characteristics were investigated. Methoxy-poly(ethylene glycol) poly(D, L-lactide) copolymer (mPEG-PDLLA) was used as IND carrier. The preparation of IND-SPM was conducted by solution-absorption method and evaporation by rotary evaporator. Polyplasdone XL-10 was used as adsorbent. The solution-absorption method was conducted by the following procedure; IND and mPEG-PDLLA were dissolved in acetone, followed by addition of polyplasdone XL-10 and stirred to obtain a suspension. The powder of IND-SPM was simply obtained after the organic solvent was completely evaporated. More than 90% (w/w) of IND (20 mg) in the powder was dissolved in 250 mL PBS within 30 min. DSC, 1H NMR and SEM results proved that IND was encapsulated within mPEG-PDLLA. The solubility of IND in the system increased 4.6 times with the highest amount of copolymer. The solidified particles were found to be suitable for the formulation of tablets or capsules.
Administration, Oral ; Anti-Inflammatory Agents, Non-Steroidal ; administration & dosage ; chemistry ; Drug Carriers ; chemistry ; Drug Compounding ; Drug Delivery Systems ; Indomethacin ; administration & dosage ; chemistry ; Micelles ; Polyesters ; chemistry ; Polyethylene Glycols ; chemistry ; Povidone ; chemistry ; Solubility

BACKGROUND:We sought to evaluate the risk factors for developing ventilator-associated pneumonia (VAP) and whether the location of intubation posed a risk in trauma patients. METHODS:Data were retrospectively reviewed for adult trauma patients requiring intubation for > 48 hours, admitted between 2010 and 2013. Patients' demographics, clinical presentations and outcomes were compared according to intubation location (prehospital intubation [PHI] vs. trauma room [TRI]) and presence vs. absence of VAP. Multivariate regression analysis was performed to identify predictors of VAP. RESULTS:Of 471 intubated patients, 332 patients met the inclusion criteria (124 had PHI and 208 had TRI) with a mean age of 30.7±14.8 years. PHI group had lower GCS (P=0.001), respiratory rate (P=0.001), and higher frequency of head (P=0.02) and chest injuries (P=0.04). The rate of VAP in PHI group was comparable to the TRI group (P=0.60). Patients who developed VAP were 6 years older, had significantly lower GCS and higher ISS, head AIS, and higher rates of polytrauma. The overall mortality was 7.5％, and was not associated with intubation location or pneumonia rates. In the early-VAP group, gram-positive pathogens were more common, while gram-negative microorganisms were more frequently encountered in the late VAP group. Logistic regression analysis and modeling showed that the impact of the location of intubation in predicting the risk of VAP appeared only when chest injury was included in the models. CONCLUSION:In trauma, the risk of developing VAP is multifactorial. However, the location of intubation and presence of chest injury could play an important role.

Background/Aims: Despite huge evidence on the link between adherence to dietary approaches to stop hypertension (DASH) eating pattern and several metabolic abnormalities, the association of this diet with irritable bowel syndrome (IBS) has not been investigated so far. We aim to examine the association between adherence to the DASH diet and prevalence of IBS symptoms and subtypes in adults. Methods: This cross-sectional study was done among 3362 adult people in Isfahan, Iran. Usual dietary intakes were assessed using a validated 106-item dish-based semi-quantitative food frequency questionnaire. To investigate participants’ adherence to DASH-style diet, we created DASH score based on 8 main foods and nutrients emphasized or minimized in the DASH diet. Participants were classified into 3 categories according to their DASH-style diet scores. A validated modified Persian version of the Rome III questionnaire was applied for assessment of IBS. Results: Totally, 22.2% of study participants were affected by IBS. After adjustment for potential confounding factors, we found that participants in the highest tertile of DASH score had lower odds of IBS (OR, 0.65; 95% CI, 0.50-0.83) compared with those in the lowest tertile. The same findings were also reached for IBS with constipation (OR for the highest vs the lowest tertile of DASH-style diet = 0.56; 95% CI, 0.38-0.85). No significant association was seen between adherence to DASH-style diet and IBS with diarrhea (OR, 1.31; 95% CI, 0.83-2.06). Conclusions We found a significant inverse association between adherence to DASH dietary pattern and odds of IBS and IBS with constipation.Further prospective studies are required to confirm these findings.