Background:One of the most important ways of pathologic and non-pathologic parasites transmission is through eating raw vegetables. Iranian people believe that eating raw vegetables is an important way to get some essential vitamins and minerals. Objectives: According to the high prevalence of pathologic parasites and also exporting different vegetables to the other provinces such as Tehran, we conducted this study to evaluate the parasitic pollution of raw vegetables in Amol city. Materials and Methods: This is a descriptive and analytic study compromised of 200 samples from 10 different vegetables including spinach, garden cress, parsley, lettuce, peppermint, radish, green onion, basil, coriander and scallion. The samples were evaluated using timely-sediment method and then centrifuging concentrating. The obtained results were analyzed by SPSS software and χ 2/Fisher's Exact Test. Results: Results showed that 93 (46.5%) of all vegetables (collected from 20 regions) were contaminated with pathologic and nonpathologic parasites. Among these, spinach and coriander were the highest (17.2%) and the lowest (3.2%) contaminated samples, respectively. The isolated parasites were nematode larva 25.8%, Giardia cyst 22.5%, Entamoeba coli cyst 19.3%. However, the obtained results from 100 restaurants and kebab samples did not show any parasitic contamination. Conclusions: Given hygiene issues and health status of people, the prevalence of some parasitic contaminations is the biggest problems among vegetable consumers. Using organized and new methods for irrigating the agricultural fields, preventing animals to enter the vegetable's farmlands and also improving people's knowledge on proper washing of vegetables can be useful in decreasing parasites prevalence.
Background Traditionally, laparoscopic procedures have been performed under general anesthesia. Spinal anesthesia is an effective alternative to general anesthesia. However, one of the intraoperative complications of performing laparoscopic surgery under spinal anesthesia is shoulder pain. This study aimed to compare the effect of transcutaneous electrical nerve stimulation (TENS) with fentanyl on pain relief in patients who underwent gynecologic laparoscopy under spinal anesthesia. Methods We conducted a prospective randomized clinical trial from May 2016 to March 2017. A sample of patients who underwent gynecological laparoscopy under spinal anesthesia was recruited. If they had shoulder pain, they randomly received either transcutaneous electrical nerve stimulation (TENS) or 50 mg of fentanyl. Pain intensity was measured using the single item visual analogue scale (VAS-10 cm) immediately before and 5, 10, 20, and 30 minutes after treatment. Also, the effect of higher doses of analgesia on pain relief was analyzed. Results In all, 80 patients (40 patients in each group) were entered into the study. The mean pain intensity score was 9.02 ± 1.32 in the TENS group and 8.95 ± 1.33 in the fentanyl group at baseline (P = 0.80). Repeated measures analysis of variance indicated that there was no significant difference on overall pain scores between the two treatment groups adjusted for age, BMI, total analgesia used, and baseline pain score (F (1, 74) = 1.44, P = 0.23). The use of analgesic drugs in the TENS group was significantly higher than the fentanyl group (P = 0.01). In addition, we found that nine patients (22.5%) complained of nausea/vomiting in the TENS group compared to thirteen patients (32.5%) in the fentanyl group (P = 0.31). Conclusions The findings indicated that TENS was not superior to fentanyl for pain relief in laparoscopic surgery. It seems that the correct use of TENS parameters might merit further investigation. This trial is registered with: IRCT2016031216765N3.
Introduction. The goal of this systematic review and meta-analysis was to consolidate the available data on the role of the neutrophil to lymphocyte ratio (NLR) in predicting adnexal torsion (AT), to help guide clinical decision-making and outcomes. Methods. We used Web of Science, PubMed, and Scopus to conduct a systematic search for relevant publications published before June 26, 2022. We reported standardized mean difference (SMD) with a 95% confidence interval (CI). Because a significant level of heterogeneity was found, we used the random-effects model to calculate pooled effects. We used the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) too for quality assessment. Results. Overall, 15 articles were included in the analysis. A random-effects model revealed that patients with AT had elevated levels of NLR compared to those with other adnexal masses ( SMD = 1.06 , 95 % CI = 0.67 to 1.45, p < 0.001 ). So, NLR had diagnostic value. In the subgroup analysis according to ethnicity, we found that Caucasian patients with AT had elevated levels of NLR compared to patients who were operated due to adnexal mass and reported as having a benign ovarian cyst, without torsion ( SMD = 1.12 , 95 % CI = 0.71 to 1.54, p < 0.001 ). However, in the case of East Asian patients, there was no difference between cases and controls ( SMD = 0.86 , 95 % CI = − 0.21 to 1.94, p = 0.11 ). The pooled sensitivity of NLR was 0.79 ( 95 % CI = 0.72 – 0.85 ), and the pooled specificity was 0.84 (95% CI, 0.74–0.91). Conclusion. In conclusion, there has been an interest in the use of NLR as a diagnostic marker for AT.
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