Study of alpha1-antitrypsin phenotypes frequencies in patients with primary antibody deficiency

Primary antibody deficiencies are the most frequent primary immunodeficiency disorders. Bronchiectasis as a feature of these disorders may be developed due to some factors such alpha-1- antitrypsin deficiency. In order to determine the prevalence of two common alpha-1-antitrypsin deficiency alleles (PI*Z and PI*S) in Iranian patients with antibody deficiency, this study was performed. The prevalence of PI*M, PI*S, and PI*Z allele combinations was determined in 40 patients with primary antibody deficiency (with and without bronchiectasis) and compared with 60 healthy control subjects. Phenotyping was performed by isoelectric focusing. The phenotype frequencies among patients were as follow: M in 92.5%, S in 2.5% and Z in 5%. There was not any significant difference in distribution of alleles or phenotypes between patients and control subjects. Moreover, no significant difference was found between patients with and without bronchiectasis. We did not find evidence to support an association between alpha-1-antitrypsin phenotypes and primary antibody deficiencies in a small, controlled study. Larger studies will be required to clarify the relationship between alpha-1-antitrypsin genotype and susceptibility to bronchiectasis in patients with antibody deficiency.     

QTc interval measurement in patients with right bundle branch block: A practical method

Background and Aim

Prolonging the QT interval in the right bundle branch block (RBBB) can create challenges for electrophysiologists in estimating repolarization time and eliminating the effect of depolarization changes on QT interval. In this study, we aimed to develop a practice formula to eliminate the effect of depolarization changes on QT interval in patients with RBBB.

Methods

This prospective study evaluated accidentally induced RBBB in patients undergoing electrophysiological study. Two expert electrophysiologists recorded the ECG parameters, including QRS duration, QT interval, and cycle length, in the patients. The formula was developed based on QT interval differences (with and without RBBB) and its proportion to QRS. Additionally, the Bazzet, Rautaharju, and Hodge formulas were used to evaluate QTc.

Results

We evaluated 96 patients in this study. The mean QT interval without RBBB was 369.39 ± 37.38, reaching 404.22 ± 39.23 after inducing RBBB. ΔQT was calculated as 34.83 ± 17.61, and the ratio of ΔQT/QRS with RBBB was almost 23%. Our formula is: (QT_{with RBBB} − 23% × QRS). Subtraction of 25% instead of 23% seems more straightforward and practical. Our formula could also predict the QTc interval in RBBB based on the Bazzet, Rautaharju, and Hodge formulas.

Conclusion

Previous formulas for QT correction were hard to apply in the clinical setting or were not specified for RBBB. Our new formula allows a rapid and practical method for QT correction in RBBB in clinical practice.     

Expression of Genes Involved in the Biosynthesis of Crocin and Safranal in Cell Suspension Culture of Saffron (Crocus sativus)

Pharmaceutical Chemistry Journal - Saffron possesses important medicinal properties, all of which are due to the secondary metabolites such as crocin, picrocrocin, and safranal. This study aims at...     

Synthesis, calcium-channel blocking activity, and conformational analysis of some novel 1,4-dihydropyridines: application of PM3 and DFT computational methods

Novel 1,4-dihydropyridines were synthesized and subjected to calcium-channel blocking evaluation and conformational analysis using semi-empirical (PM3) and density functional theory (DFT) as computational methods. All molecules had a boat-like 1,4-dihydropyridine ring in both the methods. In PM3 method almost 54% of the molecules were deviated from planarity, but in DFT method all the molecules had perfect flattened-boat conformation. Using both the methods, the C-4 substituent was pseudoaxial with its phenylamino substitution in sp orientation in 82.14% of the molecules. Trans–trans and cis–cis conformation had the greatest and lowest proportion in the molecules, respectively. Trans–trans conformers which possessed sp conformation for the substituted group on the imidazole ring were active calcium-channel blocking agents.     

Formaldehyde exposure,acute pulmonary response,and exposure control options in a gross anatomy laboratory

Formaldehyde exposure, acute pulmonary response, and exposure control options were evaluated in a group of 34 workers in a gross anatomy laboratory. Time-weighted average (TWA) exposure to formaldehyde ranged from 0.07–2.94 parts per million (ppm) during dissecting operations. More than 94% were exposed to formaldehyde in excess of the ceiling value of 0.3 ppm recommended by the American Conference of Governmental Industrial Hygienists (ACGIH). The eight-hour TWA exposure of 31.7% of the subjects exceeded the action level of 0.5 ppm set by the Occupational Safety and Health Administration (OSHA). Reported symptoms included irritation of eye (88%), nose (74%), throat (29%), and airways (21%). Forced vital capacity (FVC) and forced expiratory volume in 3 seconds (FEV₃) decreased, and FEV₁/FVC increased during the exposure. The changes of FEV₃ were statistically different from those of the controls. The results strongly support the necessity for designing and testing special local exhaust-ventilated worktables with necessary flexibility for dissecting operations.     

Effect of an educational course at an Iranian dental school on students' knowledge of and attitudes about HIV/AIDS

This study investigated the effects of an educational program designed to improve the knowledge and attitudes of senior dental students in an Iranian dental school about caring for patients with HIV/AIDS. As part of an extramural program in community dentistry, a new educational program about HIV/AIDS was developed at Tehran University of Medical Sciences in 2009. The program consisted of two days' observation at the Consultation Center for Behavioral Diseases and a one-day workshop on infection control. A control group was selected from dental students at Shahid Beheshti University of Medical Sciences. Before and after the intervention, students in both the intervention and control groups completed a questionnaire concerning their knowledge of and attitudes about HIV/AIDS. Students in the intervention group also expressed their opinions in a post-test questionnaire. An independent sample t-test was used for statistical analysis. In the control group, the means of students' knowledge and attitude scores did not differ significantly from pre-test to post-test. In the intervention group, however, the means of both knowledge and attitude scores on the post-test were significantly higher than on the pre-test (p=0.001 and p=0.009, respectively). In the intervention group, more than 96 percent of the students reported that they would completely follow infection control principles in future practice. This study concludes that the educational program improved the students' knowledge of and attitudes about HIV/AIDS and will have a positive effect on their future practice.     

Crystalline silica dust and respirable particulate matter during indoor concrete grinding - wet grinding and ventilated grinding compared with uncontrolled conventional grinding

The effectiveness of wet grinding (wet dust reduction method) and ventilated grinding (local exhaust ventilation method, LEV) in reducing the levels of respirable crystalline silica dust (quartz) and respirable suspended particulate matter (RSP) were compared with that of uncontrolled (no dust reduction method) conventional grinding. A field laboratory was set up to simulate concrete surface grinding using hand-held angle grinders in an enclosed workplace. A total of 34 personal samples (16 pairs side-by-side and 2 singles) and 5 background air samples were collected during 18 concrete grinding sessions ranging from 15-93 min. General ventilation had no statistically significant effect on operator's exposure to dust. Overall, the arithmetic mean concentrations of respirable crystalline silica dust and RSP in personal air samples during: (i) five sessions of uncontrolled conventional grinding were respectively 61.7 and 611 mg/m(3) (ii) seven sessions of wet grinding were 0.896 and 11.9 mg/m(3) and (iii) six sessions of LEV grinding were 0.155 and 1.99 mg/m(3). Uncontrolled conventional grinding generated relatively high levels of respirable silica dust and proportionally high levels of RSP. Wet grinding was effective in reducing the geometric mean concentrations of respirable silica dust 98.2% and RSP 97.6%. LEV grinding was even more effective and reduced the geometric mean concentrations of respirable silica dust 99.7% and RSP 99.6%. Nevertheless, the average level of respirable silica dust (i) during wet grinding was 0.959 mg/m(3) (38 times the American Conference of Governmental Industrial Hygienists [ACGIH] threshold limit value [TLV] of 0.025 mg/m(3)) and (ii) during LEV grinding was 0.155 mg/m(3) (6 times the ACGIH TLV). Further studies are needed to examine the effectiveness of a greater variety of models, types, and sizes of grinders on different types of cement in different positions and also to test the simulated field lab experimentation in the field.     

Quality Assessment of Services in Primary Healthcare in Iran: A Systematic Review and Meta-analysis

BackgroundPrimary healthcare (PHC) plays an important role in achieving universal health coverage (UHC). The SERVQUAL instrument is the tool for evaluating the quality of services in the health sector. The main purpose of this study is to evaluate the quality of services provided in PHC in Iran using the SERVQUAL instrument.Materials and MethodWe searched eight databases from January 2000 to September 2021. We analyzed the mean of various SERVQUAL instrument items using the DerSimonian-Laird approach via a random model with 95% confidence interval. Also, we used I2 to evaluate the heterogeneity of the studies.ResultsFinally, 17 studies were chosen for analysis in the present study. There were 8,767 study participants, out of which 8,237 were female and 530 were male. The mean dimensions of perception were as follows: Tangibles = 3.71, reliability = 4, responsiveness = 3.79, assurance = 3.83, and empathy = 3.86. For the expectation, the mean dimension were: Tangibles = 4.46, reliability = 4.46, responsiveness = 4.36, assurance = 4.36, and empathy = 4.36 respectively. The total gap quality between perception and expectation was -0.53.ConclusionAll dimensions of quality based on SERVQUAL were negative, and the quality of service in PHC is not satisfactory. Therefore, policymakers must adopt serious and effective programs to improve services in this area. We also recommend that quality management of services in PHC in Iran should move toward comprehensive optimization in all areas, and quality in this area should be a priority.     

An evaluation of ventilation system flow rates and levels of carbon dioxide,ambient temperature,and relative humidity in restaurants

Studies of the indoor air quality of restaurants have rarely focused on ventilation system performance in relation to air pollutants and climatic factors. This study was conducted in eight restaurants to examine this issue by determining the ventilation flow rates and the levels of carbon dioxide (CO2), ambient temperature, and relative humidity during at least one complete shift of serving a meal. The mean values of number of dining patrons, ventilation flow rates, and the levels of CO2, ambient temperature, and relative humidity were not significantly different in the nonsmoking dining rooms and the smoking dining rooms. The mean ventilation flow rates in individual restaurants ranged from 42-113 cubic feet per minute per person (cfm/person), overall exceeding the recommended lower limit of 30 cfm/person. The mean levels of CO2 in two restaurants (646 and 819 ppm) were below, and in the other six restaurants (ranging 1,012-1,820 ppm) were above the recommended upper limit of 1000 ppm. The levels of CO2 in each restaurant significantly correlated with the number of dining patrons and in four restaurants accumulated gradually over time. In the nonsmoking dining rooms, the levels of CO2 increased significantly as the ventilation How rates decreased. The mean ambient temperature in restaurants (ranging from 22 degrees C - 24 degrees C) were within the recommended range of 20 degrees C - 26 degrees C. The mean relative humidity in six restaurants (ranging from 46%-59%) were within the recommended upper limit of 60 percent, and in two restaurants (62% and 71%) were slightly higher than this recommended limit. It was concluded that although the mean ventilation flow rates in all restaurants exceeded the recommended value, the design of the ventilation system or the distribution of air flow rate in some sections of restaurants were not appropriate to keep the levels of CO2 and relative humidity at some measurement locations below the recommended limits.