Objective This study was conducted to evaluate the concentration of potentially toxic elements (PTEs) such as arsenic (As),cadmium (Cd),mercury (Hg),and lead (Pb) in fruit samples collected from Markazi Province,Iran.A probabilistic health risk assessment due to ingestion of PTEs through the consumption of these fruits was also conducted.Methods The concentration of PTEs in 90 samples of five types of fruits (n =3) collected from six geographic regions in Markazi Province was measured.The potential health risk was evaluated using a Monte Carlo simulation model.Results A significant difference was observed in the concentration of PTEs between fruits as well as soil and water samples collected from different regions in Markazi Province.The order of PTE concentration in the soil and water samples was as follows:Pb ＞ As ＞ Hg ＞ Cd.Furthermore,the highest level of transfer factor for Cd and Hg correlated with the grape.The estimated daily intake for adults and children was lower than the recommended tolerable daily intake.Conclusion The population in Markazi Province,Iran,is not at considerable noncarcinogenic or carcinogenic risk due to the ingestion of PTEs through the consumption of the examined fruits.

The present study was done to scrutinize the possible relation between infective genes and antimicrobial resistance in Enterococcus faecalis and Enterococcus faecium. Considering the fact that the presence of recognized infective determinants among clinical isolates may promote the emergence of infections and persistence of Enterococci in hospital settings, which can lead to an increase in antimicrobial resistance. 175 E. faecalis and 67 E. faecium isolated from clinical specimens were used. The isolates were identified, and then antibiotic susceptibility testing was performed. The MIC of vancomycin and teicoplanin were determined by broth microdilution method. The presence of infective genes esp, hyl and asa₁ was scrutinized using PCR. Of the 280 enterococcal isolates, 175 (62.5%) isolates were identified as E. faecalis, 67 (24%) as E. faecium and 38 (13.5%) as Enterococcus spp. The results of the antibiotic susceptibility testing showed resistance rates of 5% and 73% to vancomycin and teicoplanin in E. faecalis and E. faecium isolates, respectively. The statistical analysis showed that the esp infective gene has significant associations with ciprofloxacin, erythromycin and tetracycline in E. faecium and with chloramphenicol in E. faecalis strains; the hyl with teicoplanin and vancomycin in E. faecium strains; and also asa₁ with vancomycin in E. faecium and with ampicillin and chloramphenicol in E. faecalis strains. Regarding the relationships between virulence genes and antibiotic resistance in strains of E. faecalis and E. faecium, detection of infective factors associated with invasive diseases has become a major issue of concern.
Ampicillin ; Anti-Bacterial Agents ; Chloramphenicol ; Ciprofloxacin ; Drug Resistance, Microbial ; Enterococcus ; Enterococcus faecalis ; Enterococcus faecium ; Erythromycin ; Iran ; Methods ; Polymerase Chain Reaction ; Teicoplanin ; Tetracycline ; Vancomycin ; Virulence

Hydatid cyst caused by Echinococcus granulosus is one of the most important parasitic diseases around the world and many countries in Asia, including Iran, are involved with this infection. This disease can cause high mortality in humans as well as economic losses in livestock. To date, several molecular methods have been used to determine the genetic diversity of E. granulosus. So far, identification of E. granulosus using real-time PCR fluorescence-based quantitative assays has not been studied worldwide, also in Iran. Therefore, the aim of this study was to investigate the genetic diversity of E. granulosus from center of Iran using real-time PCR method. A total of 71 hydatid cysts were collected from infected sheep, goat, and cattle slaughtered in Isfahan, Iran during 2013. DNA was extracted from protoscolices and/or germinal layers from each individual cyst and used as template to amplify the mitochondrial cytochrome c oxidase subunit 1 gene (cox1) (420 bp). Five cattle isolates out of 71 isolates were sterile and excluded from further investigation. Overall, of 66 isolates, partial sequences of the cox1 gene of E. granulosus indicated the presence of genotypes G1 in 49 isolates (74.2%), G3 in 15 isolates (22.7%), and G6 in 2 isolates (3.0%) in infected intermediate hosts. Sixteen sequences of G1 genotype had microgenetic variants, and they were compared to the original sequence of cox1. However, isolates identified as G3 and G6 genotypes were completely consistent with original sequences. G1 genotype in livestock was the dominant genotype in Isfahan region, Iran.
Animals ; Cattle ; Cluster Analysis ; DNA, Helminth/chemistry/genetics ; Echinococcosis/parasitology/*veterinary ; Echinococcus granulosus/*classification/*genetics/isolation & purification ; Electron Transport Complex IV/genetics ; *Genetic Variation ; Genotype ; Goats ; Iran ; Phylogeny ; Real-Time Polymerase Chain Reaction ; Sequence Analysis, DNA ; Sheep

OBJECTIVES: Since poisoning is one of the most important preventable factors contributing to the hospitalization and death of children who present to emergency departments, this study was carried out to investigate the risk factors contributing to the incidence and mortality of acute childhood poisoning. METHODS: This hospital-based case-control study included 243 cases and 489 controls, drawn from daily admissions to the emergency departments of the included hospitals according to the inclusion and exclusion criteria. RESULTS: Gastrointestinal poisoning was the most common poisoning type, found in 87.7% of subjects, and medications were the most common cause of poisoning (49.8%). Multiple logistic regression analysis showed that a history of poisoning (odds ratio [OR], 10.44; 95% confidence interval [CI], 5.58 to 19.51; p<0.001) and the availability of poisonous substances (OR, 8.88; 95% CI, 5.41 to 14.56; p<0.001) were among the most important predictors of childhood poisoning. Respiratory poisoning (OR, 6.72; 95% CI, 1.40 to 32.07; p<0.05) and the presence of addiction in the family (OR, 4.54; 95% CI, 1.10 to 18.68; p<0.05) were the most important predictors of mortality among children with poisoning. CONCLUSIONS: Addiction and the presence of physical or psychological disorders in family members, a history of poisoning, and the availability of poisonous substances were significantly associated with the incidence of childhood poisoning and resultant mortality.
Case-Control Studies ; Child ; Emergencies ; Emergency Service, Hospital ; Hospitalization ; Humans ; Incidence ; Iran ; Logistic Models ; Mortality ; Poisoning ; Risk Factors

OBJECTIVES: Since poisoning is one of the most important preventable factors contributing to the hospitalization and death of children who present to emergency departments, this study was carried out to investigate the risk factors contributing to the incidence and mortality of acute childhood poisoning.METHODS: This hospital-based case-control study included 243 cases and 489 controls, drawn from daily admissions to the emergency departments of the included hospitals according to the inclusion and exclusion criteria.RESULTS: Gastrointestinal poisoning was the most common poisoning type, found in 87.7% of subjects, and medications were the most common cause of poisoning (49.8%). Multiple logistic regression analysis showed that a history of poisoning (odds ratio [OR], 10.44; 95% confidence interval [CI], 5.58 to 19.51; p<0.001) and the availability of poisonous substances (OR, 8.88; 95% CI, 5.41 to 14.56; p<0.001) were among the most important predictors of childhood poisoning. Respiratory poisoning (OR, 6.72; 95% CI, 1.40 to 32.07; p<0.05) and the presence of addiction in the family (OR, 4.54; 95% CI, 1.10 to 18.68; p<0.05) were the most important predictors of mortality among children with poisoning.CONCLUSIONS: Addiction and the presence of physical or psychological disorders in family members, a history of poisoning, and the availability of poisonous substances were significantly associated with the incidence of childhood poisoning and resultant mortality.
Case-Control Studies ; Child ; Emergencies ; Emergency Service, Hospital ; Hospitalization ; Humans ; Incidence ; Iran ; Logistic Models ; Mortality ; Poisoning ; Risk Factors

OBJECTIVES: Since poisoning is one of the most important preventable factors contributing to the hospitalization and death of children who present to emergency departments, this study was carried out to investigate the risk factors contributing to the incidence and mortality of acute childhood poisoning. METHODS: This hospital-based case-control study included 243 cases and 489 controls, drawn from daily admissions to the emergency departments of the included hospitals according to the inclusion and exclusion criteria. RESULTS: Gastrointestinal poisoning was the most common poisoning type, found in 87.7% of subjects, and medications were the most common cause of poisoning (49.8%). Multiple logistic regression analysis showed that a history of poisoning (odds ratio [OR], 10.44; 95% confidence interval [CI], 5.58 to 19.51; p<0.001) and the availability of poisonous substances (OR, 8.88; 95% CI, 5.41 to 14.56; p<0.001) were among the most important predictors of childhood poisoning. Respiratory poisoning (OR, 6.72; 95% CI, 1.40 to 32.07; p<0.05) and the presence of addiction in the family (OR, 4.54; 95% CI, 1.10 to 18.68; p<0.05) were the most important predictors of mortality among children with poisoning. CONCLUSIONS Addiction and the presence of physical or psychological disorders in family members, a history of poisoning, and the availability of poisonous substances were significantly associated with the incidence of childhood poisoning and resultant mortality.

PURPOSE: Abdominal CT scan using oral and intravenous (IV) contrast is helpful in the diagnosis of intra-abdominal injuries. However, the use of oral and IV contrast delays the process of diagnosis and increases the risk of aspiration. It has also been shown that CT scan with IV contrast alone is as helpful as CT scan with oral and IV contrast and rectal CT scan in detecting abdominal injuries. Therefore, the present study aims to prospectively compare the diagnostic value of CT scan with oral and IV contrast versus CT scan with IV contrast alone in the diagnosis of blunt abdominal trauma (BAT). METHODS: Altogether 123 BAT patients, 60 (48.8%) women and 63 (51.2%) men with the mean age of (40.4 ± 18.7) years who referred to the emergency department of Imam Khomeini Educational and Medical Center in Sari, Iran (a tertiary trauma center in north of Iran) from November 2014 to March 2017 and underwent abdominal CT scans + laparotomy were investigated. Those with penetrating trauma or hemodynamically unstable patients were excluded. The participants were randomly allocated to two groups: abdominal CT scan with oral and IV contrast (n = 63) and CT scan with IV contrast alone (n = 60). No statistically significant difference was found between two groups regarding the hemodynamic parameters, age, gender, injury mechanisms (all p > 0.05). The results of CT scan were compared with that of laparotomy results. The collected data were recorded in SPSS version 22.0 for Windows. Quantitative data were presented as mean and SD. RESULTS: The sensitivity and specificity of CT scan using oral and IV contrast in the diagnosis of BAT were estimated at 96.48 (95% CI: 90.73 - 99.92) and 92.67 (95% CI: 89.65 - 94.88), respectively; while CT scan with IV contrast alone achieved a comparable sensitivity and specificity of 96.6 (95% CI: 87.45 - 99,42 and 92.84 (95% CI: 89.88 - 95.00), respectively. CONCLUSION CT scan with IV contrast alone can be used to assess visceral injuries in BAT patients with normal hemodynamics to avoid diagnostic delay.
Male ; Humans ; Female ; Young Adult ; Adult ; Middle Aged ; Delayed Diagnosis ; Tomography, X-Ray Computed ; Wounds, Nonpenetrating/diagnostic imaging* ; Abdominal Injuries/diagnostic imaging* ; Sensitivity and Specificity ; Retrospective Studies

Purpose: Treatment outcomes of locally advanced rectal cancer have improved significantly in recent decades. This retrospective study aimed to assess the efficacy of neoadjuvant chemoradiotherapy (nCRT) followed by surgery in patients with T4 rectal cancer and the different outcomes between T4a and T4b patients. Materials and Methods: A total of 60 clinically T4 rectal cancer patients who underwent nCRT were included in the analysis. Patient characteristics, treatment regimens, down-staging rates, pathological response, and overall survival (OS) were evaluated. Results: Both T4a and T4b patients experienced down-staging following nCRT (36.6% and 6.2% respectively; p = 0.021). T4a patients exhibited a higher rate of pathological complete response (pCR) than T4b patients (13.3% in T4a vs. 0% in T4b; p = 0.122). After a median follow-up of 36 months, the OS and recurrence-free survival (RFS) of T4a patients were significantly higher compared to T4b patients (hazard ratio [HR] = 2.52, 95% confidence interval [CI] 1.05–6.05, p = 0.038 for OS; HR = 2.32, 95% CI 1.09–4.92, p = 0.025 for RFS). Conclusion This study provides valuable insights into the effectiveness of nCRT in T4 rectal cancer patients. Although down-staging was observed in both T4a and T4b subgroups, achieving a pCR remains a challenge, particularly in T4b patients. Further research is needed to optimize treatment strategies and enhance pCR rates in T4 rectal cancer patients to improve oncologic outcomes.

Purpose: Treatment outcomes of locally advanced rectal cancer have improved significantly in recent decades. This retrospective study aimed to assess the efficacy of neoadjuvant chemoradiotherapy (nCRT) followed by surgery in patients with T4 rectal cancer and the different outcomes between T4a and T4b patients. Materials and Methods: A total of 60 clinically T4 rectal cancer patients who underwent nCRT were included in the analysis. Patient characteristics, treatment regimens, down-staging rates, pathological response, and overall survival (OS) were evaluated. Results: Both T4a and T4b patients experienced down-staging following nCRT (36.6% and 6.2% respectively; p = 0.021). T4a patients exhibited a higher rate of pathological complete response (pCR) than T4b patients (13.3% in T4a vs. 0% in T4b; p = 0.122). After a median follow-up of 36 months, the OS and recurrence-free survival (RFS) of T4a patients were significantly higher compared to T4b patients (hazard ratio [HR] = 2.52, 95% confidence interval [CI] 1.05–6.05, p = 0.038 for OS; HR = 2.32, 95% CI 1.09–4.92, p = 0.025 for RFS). Conclusion This study provides valuable insights into the effectiveness of nCRT in T4 rectal cancer patients. Although down-staging was observed in both T4a and T4b subgroups, achieving a pCR remains a challenge, particularly in T4b patients. Further research is needed to optimize treatment strategies and enhance pCR rates in T4 rectal cancer patients to improve oncologic outcomes.

Purpose: Treatment outcomes of locally advanced rectal cancer have improved significantly in recent decades. This retrospective study aimed to assess the efficacy of neoadjuvant chemoradiotherapy (nCRT) followed by surgery in patients with T4 rectal cancer and the different outcomes between T4a and T4b patients. Materials and Methods: A total of 60 clinically T4 rectal cancer patients who underwent nCRT were included in the analysis. Patient characteristics, treatment regimens, down-staging rates, pathological response, and overall survival (OS) were evaluated. Results: Both T4a and T4b patients experienced down-staging following nCRT (36.6% and 6.2% respectively; p = 0.021). T4a patients exhibited a higher rate of pathological complete response (pCR) than T4b patients (13.3% in T4a vs. 0% in T4b; p = 0.122). After a median follow-up of 36 months, the OS and recurrence-free survival (RFS) of T4a patients were significantly higher compared to T4b patients (hazard ratio [HR] = 2.52, 95% confidence interval [CI] 1.05–6.05, p = 0.038 for OS; HR = 2.32, 95% CI 1.09–4.92, p = 0.025 for RFS). Conclusion This study provides valuable insights into the effectiveness of nCRT in T4 rectal cancer patients. Although down-staging was observed in both T4a and T4b subgroups, achieving a pCR remains a challenge, particularly in T4b patients. Further research is needed to optimize treatment strategies and enhance pCR rates in T4 rectal cancer patients to improve oncologic outcomes.