Novel outbreak with coronavirus 2019 began since 31 December 2019. Coronaviruses can cause multiple systemic infections that respiratory complications are the most obvious symptoms. In this report, we describe the symptoms of Guillain Barre syndrome (GBS) in one infected patient with COVID-19, for the first time. We reported a 65-years-old male patient with complaints of acute progressive symmetric ascending quadriparesis. Two weeks prior to hospitalization, the patient suffered from cough, fever, and RT-PCR was reported positive for COVID-19 infection. The electrodiagnostic test showed that the patient is an AMSAN variant of GBS. COVID-19 stimulates inflammatory cells and produces various inflammatory cytokines and as a result, it creates immune-mediated processes. GBS is an immune-mediated disorder and molecular mimicry as a mechanism of autoimmune disorder plays an important role in creating it. It is unclear whether COVID-19 induces the production of antibodies against specific gangliosides. Further investigations should be conducted about the mechanism of GBS in patients with COVID-19, in the future.

Objectives: Work ability is a crucial occupational health issue in health care settings where a high physical and psychosocial work capacity is required and a high risk of disabling injuries and illnesses is predictable. This study aims to examine the association between the work ability index (WAI) and individual characterizations, workload, fatigue, and diseases among intensive care units' ( ICUs' ) nurses. Methods : The study sample included 214 nurses selected by a random sampling method from a target population consisting of 321 registered nurses working in eight ICUs. Multiple linear regression analysis was used to test the association between WAI scores and each of the independent variables. Results: Results of multivariate analysis revealed a strong and negative association between WAI scores and diseases P<0.001). Among the studied individual characterizations, body mass index (BMI) was significantly and inversely associated with WAI scores. A significant and negative association was also found between WAI scores and dimensions of MFI-20, such as general fatigue (B=-0.31, 95% CI=-0.53, -0.09, P=0.005) and physical fatigue (B=-0.44, 95% CI = -0.65, -0.23, P < 0.001 ) . From dimensions of workload, frustration (B=-0.04, 95% CI=-0.07, -0.02, P< 0.001) and temporary demand (B=-0.04, 95% CI=-0.08, -0.0001, P=0.04) showed a negative and significant association with WAI scores, while performance showed a positive and significant association (B= 0.04, 95% CI = 0.01, 0.07, P=0.005). Conclusions: Based on the study findings, development of health care programs with the aim of setting up a healthy work environment characterized by a well-structured preventive attitude toward controlling diseases, and a well-designed organizational framework toward increasing the level of performance and motivation, reducing the level of fatigue, as well as reducing the workload, is necessary to promote work ability among ICUs' nurses.

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Remote preconditioning (rPeC) is a phenomenon by which short-time intermittent ischaemia-reperfusion (I/R) of a remote organ during ischaemia protects other organs from I/R injury (IRI). The aim of the present study was to investigate the protective effect of rPeC on renal IRI in rats. Rats were subjected to right nephrectomy and randomized as into a sham group (no additional intervention), an I/R group (subjected to 45 min left renal pedicle occlusion) and an rPeC group (subjected to four cycles of 5 min I/R of the left femoral artery administered at the beginning of renal ischaemia). After 24 h, blood, urine and tissue samples were collected. Compared with the sham group, I/R resulted in renal dysfunction, as evidenced by significantly lower creatinine clearance (CCr; 0.52 ± 0.06 vs 0.11 ± 0.02 mL/min, respectively) and higher fractional excretion of sodium (FE(Na) ; 0.80 ± 0.07% vs 2.46 ± 0.20%, respectively). This was accompanied by decreased superoxide dismutase (SOD; 6.9 ± 1.7 vs 26.7 ± 2.7 U/g tissue) and catalase (CAT; 20.2 ± 8.8 vs 32.2 ± 8.7 K/g tissue) activity in the I/R group, as well as decreased levels of reduced glutathione (GSH; 21.7 ± 8.1 vs 81.2 ± 20.2 μmol/g tissue) and increased malondialdehyde levels (MDA; 1.2 to 0.1 vs 0.5 ± 0.2 μmol/100 mg), cyclo-oxygenase (COX)-2 expression and histological damage. In the rPeC group, renal histology and function were significantly improved (CCr 0.32 ± 0.02 mL/min; FE(Na) 1.33 ± 0.12%) compared with the I/R group. Furthermore, compared with the I/R group, the rPeC group exhibited increases in SOD and CAT activity (22.8 ± 3.8 U/g tissue and 21.7 ± 8.6 K/g tissue, respectively), increased GSH levels (74.0 ± 4.9) and decreased MDA levels (1.1 ± 0.3 μmol/100 mg) and COX-2 expression. In conclusion, rPeC appears to exert protective effects against renal IRI. This protection may be a consequence of reductions in lipid peroxidation, intensification of anti-oxidant systems and downregulation of COX-2 expression. A simple approach, rPeC may be a promising strategy for protection against IRI in clinical practice.

Background The problem of substance use disorder in Iran is of great national concern. The aim of this study was to measure the association between substance use disorder and demographic, social and behavioral factors in Yasuj city, located at southwest of Iran. Methods As the second phase of a previously published study, this case-control study was conducted in 2015–2016 on 362 addicted participants and 207 controls (with no history of substance use disorder). The control group was selected from male hospital visitors in Yasuj city during the same period of selection of the case group. The required information was collected via a self-administered questionnaire. Results Based on the results of multivariate analysis, significant associations were found between the number of sisters (OR = 0.82, 95%CI = 0.68 to 0.99, P = 0.04), history of smoking (OR yes/no = 19.89, 95%CI = 10.02 to 39.49, P < 0.001), leisure time activity (OR with friends/home = 8.98, 95%CI = 3.99 to 20.19, P < 0.001) and substance use disorder. Conclusion This study introduced smoking, number of sisters, education and way of spending leisure time as predictors of substance use disorder. Among these factors, smoking was the most powerful risk factor and spending leisure time with family and having sister were the most powerful preventive factors for substance use disorder.

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Introduction We recently reported that a series of brief hind limb ischemia and reperfusion (IR) at the beginning of renal ischemia (remote per-conditioning – RPEC) significantly attenuated the ischemia/reperfusion-induced acute kidney injury. In the present study, we investigated whether the nitric oxide synthase (NOS) pathway is involved in the RPEC protection of the rat ischemic kidneys. Material and methods Male rats were subjected to right nephrectomy and randomized as: (1) sham, no additional intervention; (2) IR, 45 min of renal ischemia followed by 24 h reperfusion; (3) RPEC, four 5 min cycles of lower limb IR administered at the beginning of renal ischemia; (4) RPEC+L-NAME (a non-specific NOS inhibitor, 10 mg/kg, i.p .) (5) RPEC + 1400W (a specific iNOS inhibitor, 1 mg/kg, i.p .). After 24 h, blood, urine and tissue samples were collected. Results The protective effect of RPEC on renal function, oxidative stress indices, pro-inflammatory marker expression and histopathological changes of kidneys subjected to 45 min ischemia were completely inhibited by pretreatment with L-NAME or 1400W. It was accompanied by increased iNOS and eNOS expression in the RPEC group compared with the IR group. Conclusions These findings suggest that the protective effects of RPEC on renal IR injury are closely dependent on the nitric oxide production after the reperfusion and both eNOS and iNOS are involved in this protection.

BackgroundThermal component of the atmospheric environment is an important issue which is related to human’s health. Thermal environment includes both heat exchange conditions (stress) and the physiological response (strain). The aim of this study was to measure the association of heat indices (PSI, HSI, Humidex) especially subjective one (STI) with some physiological parameters (Blood pressure, pulse rate and skin temperature).MethodsThis is a cross-sectional study conducted on 387 male farmers on Boukan, West Azerbaijan, Iran in 2016. Sampling was conducted on the hottest days in summer on July based on the meteorological report. Heat parameters was measured 3 times in each session. ResultsDirect associations were found between heat indices and physiological parameters except systolic BP. However, invers associations were found between blood pressure, skin and core body temperature, pulse rate with all heat indices. Based on the results of linear regression analysis, significant association was found between WBGT and skin temperature (B = 0.31, CI: 0.02, 0.61, P = 0.03). Results also showed significant association between Humidex and skin temperature (B = 0.21, CI: -0.03, 0.40, P = 0.02). However, no significant associations were found between other heat stress indices including UTCI, PHS, HIS, STI and Humidex with all study physiological parameters (core body temperature, systolic and diastolic blood pressure and also pulse rate).ConclusionAs expected, farmer’s health is affected by physiological parameters. Moreover, among assessed types of heat stress indices WBGT and Humidex were more powerful to show better the association with mentioned physiological parameters.