Inflammation plays an important role in the outcome of patients with cystic fibrosis (CF). It may develop due to cystic fibrosis transmembrane conductance regulator protein dysfunction, pancreatic insufficiency, or prolonged pulmonary infection. Fecal calprotectin (FC) has been used as a noninvasive method to detect inflammation. Therefore, the aim of the current metaanalysis was to investigate the relationship between FC and phenotype severity in patients with CF. In this study, searches were conducted in PubMed, Science Direct, Scopus, and Embase databases up to August 2021 using terms such as “cystic fibrosis,” “intestine,” “calprotectin,” and “inflammation.” Only articles published in English and human studies were selected. The primary outcome was the level of FC in patients with CF. The secondary outcome was the relationship between FC and clinical severity. Statistical analysis was performed using Comprehensive Meta-Analysis software. Of the initial 303 references, only six articles met the inclusion criteria. The mean (95% confidence interval [CI]) level of FC was 256.5 mg/ dL (114.1-398.9). FC levels were significantly associated with pancreatic insufficiency (mean, 243.02; 95% CI, 74.3 to 411.6; p=0.005; I2 =0), pulmonary function (r=–0.39; 95% CI, –0.58 to –0.15; p=0.002; I2 =60%), body mass index (r=–0.514; 95% CI, 0.26 to 0.69; p<0.001; I2 =0%), and Pseudomonas colonization (mean, 174.77; 95% CI, 12.5 to 337.02; p=0.035; I>2 =71%). While FC is a reliable noninvasive marker for detecting gastrointestinal inflammation, it is also correlated with the severity of the disease in patients with CF.

Objective: Iran has a low incidence of cervical cancer (CC). The country is introducing an organized screening system, including human papillomavirus screening. Studies show a high dropout rate among eligible women in continuing testing. Methods: This descriptive-analytic study was part of the first phase of a clinical trial conducted on a random sample of 400 women aged 18–49 in Andimeshk City, Khuzestan Province, in 2020. The data collection tool consisted of a man-made questionnaire that included domains of demographic characteristics, knowledge, attitude, practice, and self-efficacy in the Pap smear test. The data were analyzed with Stata-16 using linear and logistic regression models. Results: The mean knowledge, attitude, and self-efficacy scores were 6.80±2.33, 34.99±4.32, and 28.67±7.34, respectively. In the multiple models, every unit increase in the knowledge or attitude scores raised the mean self-efficacy score by 1.04 and 0.48, respectively (P<0.001). Every unit increase in the knowledge and self-efficacy scores increased the chance of performing Pap smear 1.61 and 1.41 times, respectively (P<0.001). Conclusion Given the association of women’s knowledge and self-efficacy with practice in performing the Pap smear, it seems that an effective program promoting women’s health behavior regarding CC screening would include applied education to raise community awareness and improve women’s attitudes, self-efficacy, and practice.

Objective: Iran has a low incidence of cervical cancer (CC). The country is introducing an organized screening system, including human papillomavirus screening. Studies show a high dropout rate among eligible women in continuing testing. Methods: This descriptive-analytic study was part of the first phase of a clinical trial conducted on a random sample of 400 women aged 18–49 in Andimeshk City, Khuzestan Province, in 2020. The data collection tool consisted of a man-made questionnaire that included domains of demographic characteristics, knowledge, attitude, practice, and self-efficacy in the Pap smear test. The data were analyzed with Stata-16 using linear and logistic regression models. Results: The mean knowledge, attitude, and self-efficacy scores were 6.80±2.33, 34.99±4.32, and 28.67±7.34, respectively. In the multiple models, every unit increase in the knowledge or attitude scores raised the mean self-efficacy score by 1.04 and 0.48, respectively (P<0.001). Every unit increase in the knowledge and self-efficacy scores increased the chance of performing Pap smear 1.61 and 1.41 times, respectively (P<0.001). Conclusion Given the association of women’s knowledge and self-efficacy with practice in performing the Pap smear, it seems that an effective program promoting women’s health behavior regarding CC screening would include applied education to raise community awareness and improve women’s attitudes, self-efficacy, and practice.

INTRODUCTIONThis study was designed and conducted to evaluate the effects of vitamin A, C and E supplementation, and omega-3 fatty acid supplementation on the activity of paraoxonase and arylesterase in an experimental model of diabetes mellitus.

METHODSA total of 64 male Sprague Dawley® rats, each weighing 250 g, were randomly distributed into four groups: (a) normal control; (b) diabetic control; (c) diabetic with vitamin A, C and E supplementation; and (d) diabetic with omega-3 fatty acid supplementation. The animals were anaesthetised after four weeks of intervention, and paraoxonase and arylesterase activity in blood plasma, and liver and heart homogenates were measured.

RESULTSArylesterase activity in the heart and liver homogenates was significantly lower in the diabetic control group than in the normal control group (p < 0.01). Vitamin A, C and E supplementation, and omega-3 fatty acid supplementation significantly increased liver arylesterase activity (p < 0.05). No significant change was observed in paraoxonase activity and other investigated factors.

CONCLUSIONVitamin A, C and E, or omega-3 fatty acid supplementation were found to increase liver arylesterase activity in streptozotocin-induced diabetic rats. These supplements may be potential agents for the treatment of diabetes mellitus complications.

Animals ; Aryldialkylphosphatase ; metabolism ; Ascorbic Acid ; pharmacology ; Carboxylic Ester Hydrolases ; metabolism ; Diabetes Mellitus, Experimental ; diet therapy ; metabolism ; Dietary Supplements ; Fatty Acids, Omega-3 ; pharmacology ; Liver ; enzymology ; Male ; Myocardium ; enzymology ; Rats ; Rats, Sprague-Dawley ; Vitamin A ; pharmacology ; Vitamins ; pharmacology

BACKGROUND: In comparison with other industries, the construction industry still has a higher rate of fatal injuries, and thus, there is a need to apply new and innovative approaches for preventing accidents and promoting safe conditions at construction sites. METHODS: In this study, the effectiveness of a new incentive system-the surprising incentive system-was assessed. One year after the implementation of this new incentive system, behavioral changes of employees with respect to seven types of activities were observed. RESULTS: The results of this study showed that there is a significant relationship between the new incentive system and the safety performance of frontline employees. The new incentive system had a greater positive impact in the first 6 months since its implementation. In the long term, however, safety performance experienced a gradual reduction. Based on previous studies, all activities selected in this study are important indicators of the safety conditions at workplaces. However, there is a need for a comprehensive and simple-to-apply tool for assessing frontline employees' safety performance. Shortening the intervals between incentives is more effective in promoting safety performance. CONCLUSION: The results of this study proved that the surprising incentive would improve the employees' safety performance just in the short term because the surprising value of the incentives dwindle over time. For this reason and to maintain the surprising value of the incentive system, the amount and types of incentives need to be evaluated and modified annually or biannually.
Construction Industry ; Motivation*

A 24-year-old male was transferred to the emergency department while being in the state of quadriplegia with a history of performing Parkour sport, which is also called double front flip. Neurological examination revealed that the patient's muscle power was 0/5 at all extremities. The patient did not show any sense of light touch or pain in his extremities. In radiological studies, cervical spine X-ray and CT scan images showed C4-C5 subluxation with bilateral locked facets and spinal cord injury. The results of this very rare case study revealed that exercising Parkour sport without taking into account safety standards could result in irreversible injuries to the cervical spinal cord with fatal outcome.
Cervical Vertebrae ; Humans ; Male ; Radiography ; Running ; injuries ; Spinal Cord Injuries ; diagnostic imaging ; etiology ; Young Adult

Multiple variables can influence triage decision in multiple trauma. Recognition of priorities and selection of the destination can be successfully achieved by field triage and individualized clinical judgment. This narrative review summarizes the new options and protocols for transport of injured subjects. There are four levels of emergency medical providers including first responders and three levels of emergency medical technicians. Two distinct accepted protocols for transport are known as scoop and run and treat and then transfer. The former provides minimum lifesaving treatment at the scene of accident followed by transferring the patient(s) as soon as possible, and the latter mainly emphasizes the need for complete stabilization as a prerequisite for safe transport. The destination and mode of transport are selected according to clinical capabilities of the receiving hospital, transfer time from the scene to the facility, patient's medical condition, accessibility of the scene, and weather. Two common methods of transfer are ground transport, including various type of ambulances, and air medical transport, i.e. helicopter and airplane.
Air Ambulances ; Decision Making ; Humans ; Mass Casualty Incidents ; Multiple Trauma ; therapy ; Transportation of Patients ; organization & administration ; Triage

OBJECTIVEThe high burden of injuries in Iran necessitates the establishment of a comprehensive trauma care system. The purpose of this paper is to describe the current status of trauma system regarding the components and function.

METHODSThe current status of trauma system in all components of a trauma system was described through expert panels and semi-structured interviews with trauma specialists and policy makers.

RESULTSCurrently, various organizations are involved in prevention, management and rehabilitation of injuries, but an integrative system approach to trauma is rather deficient. There has been ongoing progress in areas of public education through media, traffic regulation reinforcement, hospital care and prehospital services. Meanwhile, there are gaps regarding financing, legislations and education of high risk groups. The issues on education and training standards of the front line medical team and continuing education and evaluation are yet to be addressed. Trauma registry has been piloted in some provinces, but as it needs the well-developed infrastructure (regarding staff, maintenance, financial resources), it is not yet established in our system of trauma care.

CONCLUSIONSIt seems that one of the problems with trauma care in Iran is lack of coordination among trauma system organizations. Although the clinical management of trauma patients has improved in our country in the recent decade, decreasing the burden of injuries necessitates an organized approach to prevention and management of trauma in the context of a trauma system.

Accidents, Traffic ; prevention & control ; Emergency Medical Services ; Humans ; Iran ; Leadership ; Wounds and Injuries ; prevention & control ; therapy

AIM: To determine the frequency of HIV-related ocular involvement and to describe the characteristics of involvement in a special clinic in Tehran.METHODS: In this cross sectional study, 141 patients (125 male and 16 female, 282 eyes) of HIV-infected patients with various stages of HIV infection that were referred to Center of behavioral diseases were evaluated during a period of 7 months. Every patient had a complete profile including demographic data, method of HIV transmission, recent CD4 T cell lymphocyte count, serological studies for common sexual or blood-born viruses and toxoplasmosis, history of antiretroviral therapy, and associated systemic disease. RESULTS: A total of 141 patients were evaluated. HIV-related ocular involvement was detected in 15 patients (10.6%), including 3 mycobacterium tuberculosis-related choroiditis, 2 cytomegalovirus retinitis, 2 retinal toxoplasmosis, 2 herpes simplex virus-related lesions, 1 HIV-associated retinopathy, 1 herpes zoster ophthalmicus, 1 undetermined vitritis, and 3 cases of cranial nerve involvement including 2 cases of gaze palsy and 1 case of papilitis. In our study, mean CD4 T cell lymphocyte count was fewer in patients with ocular involvement than in patients without ocular involvement (204.7±123.8 vs 403.7±339.7, P=0.029), but there was no difference in other possible associated factors between two groups.lesions are the most common HIV-related ocular involvements in Tehran that is different from those of recent publications in developed countries.

OBJECTIVETo illustrate mechanisms of spine fractures and the pattern of spinal injuries characterized by the major mechanisms in urban population of Iran.

METHODSData regarding spinal injuries including demographics, mechanism and level of spinal injury, abbreviated injury score, associated injuries and final fate of the patients were extracted from the Iranian national trauma registry database from 1999 to 2004.

RESULTSA total of 619 patients with traumatic spine fractures were identified, of whom 68.5% were males. The peak frequency of these injuries occurred in the 21-40 year age-group. Accidental falls and road traffic crashes (RTCs) were the most common mechanisms of spinal fractures (47.2% and 44.1%, respectively). RTCs tended to occur in younger patients compared with accidental falls. The most common spinal region for spinal fracture was the lumbar spine (53.63%). Cervical spine fractures were significantly more common in RTCs, while lumbar spine fractures were more common in accidental falls (P less than 0.001). A total of 171 (27.6%) patients had associated non-spinal injuries, of whom 127 had associated extremity injuries, and 55 had head injuries. Thirty-six (5.6%) patients had spinal cord injury (SCI).The injury severity score of the RTC group was significantly higher than that of accidental falls (P equal to 0.002). Fifteen (4%) patients died of traumatic injuries. The rate of death was significantly higher in RTCs compared with accidental falls (5.1% vs 2.1%, P equal to 0.039).

CONCLUSIONSThe patterns of spinal fractures are similar to those reported from developed countries. RTCs tend to affect the younger age population and are associated with a higher degree of associated injuries and mortality than accidental falls. Therefore preventive strategies should be based on reduction of the number and severity of RTCs.

Accidental Falls ; Accidents, Traffic ; Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Cross-Sectional Studies ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Spinal Fractures ; etiology