مجله دانشکده پزشکی اصفهان
پیاپی 691 (هفته سوم آذر 1401)

Leishmaniasis is one of the endemic diseases in Iran and Isfahan province. This study was conducted to investigate the trend of cutaneous leishmaniasis in 6 main centers of Isfahan province during the years 2007 to 2018.

This research is a cross-sectional descriptive-analytical study that was conducted based on the data available in the Zoonosis Diseases Unit located in the Isfahan Health Vice-Chancellor. The data related to the new cases of cutaneous leishmaniasis that were reported by the detection laboratories as well as the data related to the control measures and the fight against the reservoir were collected. The trend of disease incidence was analyzed separately by foci, year and the relationship between disease incidence and control measures.

The results showed that during this 11-year period, the incidence of leishmaniasis is decreasing, but some centers, such as the number 1 Isfahan region, have had severe fluctuations in some years. The relationship between the average incidence of the disease and the total number of poisons consumed using the Pearson Correlation statistical test was linear and significant. In other words, in the centers where the highest amount of poison has been consumed, the incidence rate of leishmaniasis is also reported to be higher.

Considering the fluctuations of the disease in some years, and the number 1 Isfahan region has the highest rate of incidence despite the highest amount of poisons consumed compared to the Shahin-shahr region, the effectiveness of this type of intervention in the long term is doubtful.

Sepsis is a potentially life-threatening condition characterized by the body's deregulated response to infection, in turn causing injury to its own tissues and organs. The present study investigated the effect of co-administration of thiamine and vitamin C on reducing mortality in patients with severe sepsis.

In this randomized clinical trial study, 86 patients with severe sepsis were assigned to treatment and control groups, each comprising 43 patients. The treatment group received thiamine 600 mg orally every 12 hours and vitamin C at a dose of 50 mg / kg, intravenously daily for 96 hours alongside standard treatment and the control group received standard treatment. Therapeutic outcome (recovery or death), duration of hospitalization and duration of ventilator connection were recorded for patients in both groups. Also, procalcitonin level (PCT) and CRP levels were measured and recorded at the beginning and after 96 hours.

The odds ratio of death outcome in the treatment group was significantly lower than the control group (0.913-0.116: 95% CI, P = 0.033, OR = 0.32). The mean length of hospital stay in the treatment group was about 7 days that was less than the control group significantly. The mean length of ICU hospitalization in the treatment group was less than the control group significantly too.

Co-administration of vitamin C and thiamine in sepsis patients can reduce the length of hospital stay in the intensive care unit and hospital and also reduce the serum level of inflammatory factors and reduce the rate of death in these patients.

Lead is the most widely used material for radiation protection in diagnostic radiology because its ability to attenuate x-rays is superior to other materials due to its high atomic number, high density, and its higher economic affordability. However, lead shields have serious disadvantages, such as high toxicity, heavy weight, poor flexibility, and low chemical stability. These disadvantages have oriented extensive research toward the use of non-lead composite shields. This study aims to review the materials and compounds proposed as alternatives to lead in x-ray shields and investigate their effectiveness in removing the limitations of standard lead shields. In total, 83 articles were reviewed using databases such as Google Scholar, Medline, Web of Science, Scopus, and Embase with the keywords of radiation protection, lead-free shields, and dianostic radiology. Since a wide range of materials can be used as radiation shields, the results show that in addition to the atomic number, the size of the particles can also be effective in increasing the radiation attenuation efficiency to the extent that the nano-sized non-lead shields have been more effective in radiation protection. Also, compared to common single and combined materials, multilayer polymer composites have better photon attenuation capability and reduce the possibility of x-ray penetration more effectively. Research to find appropriate alternative materials for lead and the optimization of the efficacy of radiation shields, should be continued, as it is difficult to achieve a light, flexible, low cost shield with a high x-ray attenuation in the entire range of diagnostic photon energies.