Khomeini Research Articles

Liver enzymes as a predictor of mortality in patients with COVID-19? A cross-sectional study

Liver injury in patients with COVID-19 infection may directly result from viral infection of liver cells, immune-mediated inflammation such as cytokine storm, and hypoxia resulting from pneumonia. Additionally, liver injury may occur due to drug toxicity and may lead to liver failure in critically ill COVID-19 patients. Given the significance of the liver and its vulnerability in COVID-19 patients, this study aimed to investigate the correlation of serum liver enzymes with the prognosis of hospitalized COVID-19 patients at Imam Khomeini Hospital in Urmia. This descriptive-analytical study involved hospitalized COVID-19 patients at Imam Khomeini Hospital in Urmia. Patient data were extracted from medical records and recorded in checklists, including demographic characteristics (age and gender), serum levels of Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST), and patient outcomes (recovery and mortality). Subsequently, the serum levels of AST and ALT in recovered and discharged patients were compared with those of deceased patients. The mean AST level was higher in deceased patients compared to recovered and discharged patients, and this difference was statistically significant (P <0.033). Therefore, overall, higher AST levels in COVID-19 patients may indicate a worse prognosis. Similarly, the mean ALT level was higher in deceased patients compared to recovered and discharged patients, and this difference was statistically significant (P <0.015). Thus, higher ALT levels in COVID-19 patients may generally indicate a worse prognosis. Continuous monitoring of liver enzymes in patients with a poor prognosis can lead to early identification and, to the extent possible, prevention of complications and mortality through enhanced care.

Investigation of the Association of Abdominal Circumference Discord-ance and Estimated Fetal Weight Discordance in Twins with Birth Weight Discordance.

Twin pregnancy is associated with a high risk of mortality and morbidity. It is necessary to estimate the weight difference of the fetuses with a reliable method to prevent possible complications. This study was conducted to compare the association between the Estimated fetal weight (EFW) discord-ance and the Abdominal Circumference (AC) discordance with birth weight in twins. This was a descriptive-analytical and retrospective study. The statistical population was all twin pregnant mothers referred to Imam Khomeini Hospital in Ahvaz from 2017 to 2019. The sample size was determined with a census (540 people). Based on AC , the size of head circumference (HC), femur length (FL), and the Biparietal Diameter (BPD), EFW was calculated. Then the EFW Dis-cordance and AC Discordance were calculated and compared with the birth weight. Data were analyzed using SPSS18. Unpaired, Two-Tailed T-test and Pearson correlation test were used. The results showed that the mean discordance of fetal weight in twin pregnancies in the EFW method was 9.25%, in the AC method was 9.89% and finally, at birth, was 10.72%. The correla-tion of the weight difference between the two embryos in the AC method with the time of birth (r = 0.922 and P < 0.001) was higher than in the EFW method with the time of birth (r = 0.69 and P < 0.001) and finally, it was found that in detecting the discordance more than 20% and 25%, AC diagnostic power was good, but EFW was moderate. Therefore, to evaluate the weight and weight difference in twin embryos, the AC method has the appropriate accuracy and compatibility. Another major prospective study to evaluate the diagnostic performance of AC and EFW mismatch based on gestational age at scan, incision point, and maternal and placental characteristics to determine true ultrasound diagnostic accuracy in predict-ing growth mismatch in twin pregnancy and optimal post-case management option is needed.

Comparison of Dexmedetomidine and Ketamine in Serratus Anterior Plane Block for Postoperative Pain Control in Thoracotomy Patients: A Randomized Clinical Trial.

Postoperative pain control after thoracotomy is very important, and if not controlled, it can cause severe complications. This study aimed to compare dexmedetomidine and ketamine in serratus anterior plane block (SAPB) in pain control after thoracotomy. This randomized clinical trial was conducted on 74 patients aged 18 to 60 years old with American Society of Anesthesiologists (ASA) class I or II who were referred to Imam Khomeini hospital in Ahvaz, Iran, for thoracotomy and randomly divided into two groups. After surgery, the SAPB with ultrasound-guided was performed. In the ropivacaine-ketamine (RK) group, ketamine 0.5 mg/kg and 0.4 cc/kg ropivacaine solution 0.25% and in the ropivacaine-dexmedetomidine (RD) group, in addition to 0.4 cc/kg ropivacaine 0.25%, dexmedetomidine 0.5 µg/kg was added. Verbal Numeric Scale (VNS), systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory rate (RR), heart rate (HR), and mean arterial blood pressure (MAP) were recorded. There was no significant difference in both groups in terms of demographic information (P < 0.05). The average VNS was lower in the ketamine group than in the dexmedetomidine group; however, there was a significant difference only at 1, 12, and 24 hours after surgery (P < 0.05). There was no statistically significant difference between the two groups in terms of SBP and DBP, HR, and MAP. There was a significant difference in the RR in the two groups at 12 and 24 hours after the operation (P < 0.05). Dexmedetomidine and ketamine, which were used as supplements to ropivacaine for SAPB in patients undergoing elective thoracotomy, reduced the pain intensity after thoracotomy; nevertheless, the intensity of pain reduction was more and more effective in the group receiving ketamine.

Epidemiology of injuries among patients admitted to Imam Khomeini Hospital, Urmia, affiliated with the national trauma registry of Iran

Objective: Trauma is one of the major causes of mortality and morbidity globally. The current study aimed to improve the understanding of characteristics, severity of injuries and outcomes of trauma patients admitted to Imam Khomeini Hospital, Urmia, Iran.&#x0D; Methods: Data were obtained from the trauma registry of Imam Khomeini Hospital, a level 1 trauma referral center, for all patients admitted to the center from 17 september 2016 to 21 January 2023. Patients’ demographics, injury mechanisms, and patients' outcomes were analyzed.&#x0D; Results: The emergency department attended to 5555 trauma patients. The gender distribution was with 3998 (71.9%) males and 1557 (29.1%) females. Patients' age ranged from 1 to 101 years, with a mean±standard deviation (SD) of 33.1 (±20.7) years. Road traffic accidents followed by falls were the most common causes of traumas reported in 2138 (38.5%) and 1298 (23.4%) trauma patients, respectively. The in-hospital mortality rate was 0.9% (53 patients). The mean (±SD) age of death was 43.5 (±22.4) years. 569 (10.2%) patients were admitted to the intensive care unit (ICU). The univariable logistic regression models showed that there were significant associations between age (P&lt;0.001), Glasgow coma scale (GCS) (P&lt;0.001), injury severity score (ISS) (P&lt;0.001), and mechanical ventilation (P&lt;0.001) as independent variables and death outcome. The univariable and multiple logistic regression analyses showed statistically significant associations between age, cause of trauma, ISS, GCS and body site injury with ICU admission. The odds of ICU admission in patients after being adjusted for age, ISS, GCS, cause of trauma and type of transportation was 1.73 times higher in head, face, and neck injuries compared to limb injuries. (adjusted OR: 1.73, [95% CI: 1.23,2.42]; P&lt;0.01).&#x0D; Conclusion: Older age, low GCS, higher ISS and mechanical ventilation were associated with higher mortality. Older age, higher ISS, lower GCS, body site injury, type of transportation, and cause of trauma were all significant independent predictors of ICU admission.

Clinical Characteristics of Patients with Hematologic Malignancies and Invasive Aspergillosis: A Cross-sectional Clinical Report from Iran

Background: The incidence of invasive aspergillosis (IA) has significantly increased in recent decades. In patients with hematologic malignancies (HM), IA is associated with higher mortality rates. Objectives: This study aimed to assess the clinical features of IA in patients with HM. Methods: In this retrospective study, we used the hospital information system (HIS) database to extract clinical and paraclinical characteristics of patients with various HMs who received a diagnosis of probable or proven IA during their hospitalization at Imam Khomeini Hospital Complex in Tehran, Iran, between March 2018 and March 2022. Results: After evaluating 350 patients with HM, 51 patients with IA (14.6%) were identified, of whom 40 cases (78.4%) were probable and 11 (21.6%) were proven. Among these, 34 individuals (66.7%) were male. The most common symptoms were fever (n = 23, 62.7%), cough (n = 20, 39.2%), and fever that did not respond to antibiotic therapy (n = 16, 31.4%). The most prevalent malignancies were AML (n = 28, 54.9%), ALL (n = 16, 31.4%), and lymphoma (n = 7, 13.7%). Out of the 51 patients with HM and IA, 48 (94.1%) had abnormal findings on chest CT scans, with the majority (n = 31, 72.1%) showing a nodule with a halo sign. Aspergillus flavus (n = 19/24, 79.2%) was the most commonly isolated species. Initially, patients received liposomal amphotericin B or caspofungin as empiric antifungal therapy, which was then switched to voriconazole once the diagnosis of IA was probable or proven. Eight patients (15.6%) died. Conclusions: Patients with HM presenting with fever and cough should undergo close monitoring for IA. A higher incidence of IA is observed in AML patients, and voriconazole could be considered as antifungal prophylaxis in HM patients. A. flavus is likely the most frequent cause of IA in Iranian patients with HM.

Comprehensive Evaluation of COVID-19 Vaccines Antibody Response Among Healthcare Professionals: A Multi-Center Study in Iran

Background: The coronavirus disease 2019 (COVID-19) vaccines are very good at protecting individuals from serious illness, needing hospital care, and dying from different strains of the virus. However, vaccines might not completely prevent individuals from catching and spreading the virus, and this might depend on some personal factors. Objectives: To find out the immune response of COVID-19 vaccines, this cross-sectional study conducted within June 2021 to May 2023 assessed different types of COVID-19 vaccine antibody responses among healthcare professionals and their associations with demographic factors and comorbidity risk factors. Methods: This descriptive-analytical study was conducted on recruited healthcare professionals from Sina, Imam Khomeini Complex, 501 AJA, Baqiayatallah, and Firoozgar hospitals in Tehran, Iran. The vaccines whose antibody response was investigated in this study are Sinopharm® (China), AstraZeneca® (United Kingdom), Sputnik® (Russia), and Covaxin® (India). Anti-spike, anti-receptor-binding domain (RBD), and anti-neutralizing immunoglobulin G (IgG) were evaluated by commercial kits according to instructions. Results: This study involved 1 029 healthcare workers who were over 18 years old. The average age was 41.48 ± 9.9 years, and 602 (58.5%) of them were male. The vaccines they received were Sputnik V (392 or 38.16%), AstraZeneca (335 or 32.61%), Baharat (45 or 4.3%), and Sinopharm (255 or 24.82%). The Covaxin and AstraZeneca vaccines increased both anti-RBD and anti-neutralizing IgG Ab levels; however, the Sinopharm vaccine increased only the latter. The Sputnik vaccine was the least effective. Gender and diabetes influenced the antibody levels, but age did not. Conclusions: This study revealed the substantial effectiveness of COVID-19 vaccines in generating robust antibody responses among healthcare professionals. All four vaccine types, Sinopharm, AstraZeneca, Sputnik, and Covaxin, elicited significant antibody responses in over 70% of participants, highlighting the crucial role of vaccination in building defense against COVID-19.

Investigating the Electrolyte Changes of COVID-19 Patients Admitted to the Intensive Care Unit

Background and Objectives Serum electrolyte imbalance is very common in COVID-19 patients. However, there is conflicting evidence regarding their relationship with COVID-19 and its severity, and their prognostic value is unknown. Our aim of this study is to investigate electrolyte changes in COVID-19 patients admitted to the intensive care unit of Imam Khomeini Hospital in Ahvaz. Subjects and Methods The present study is a cross-sectional and descriptive-analytical epidemiological type that was conducted in 1400. The target population was the COVID-19 patients admitted to the intensive care unit of Imam Khomeini Hospital in Ahvaz. Required tests were performed on all patients admitted to the special care department and diagnostic tests including Ca, K, Na, Cr, BUN, Mg, and P were collected and the effect on the prognosis of patients including intubation, mortality and extubating and discharge from the ward and The hospital was registered. Then the data were analyzed by SPSS 22 software and appropriate statistical tests. Results Finally, 87 people were included in the study. Hyponatremia, hypokalemia, hypomagnesemia and hypocalcemia, Cr, and high BUN respectively in 2.55%, 3.4%, 6.27%, 8.59%, 8.82%, 5.5%, patients with covid- 19 were observed. There was a significant difference between the two groups of men and women and the average potassium was higher in women than in men (P=0.041). No significant relationship was found between other electrolytes and the variables of age, gender, history of disease, intubation, discharge, and mortality (P&gt;0.05). Conclusion The present study showed that electrolyte imbalance is one of the common laboratory abnormalities in COVID-19 disease.

A Five-year Study (2014-2019) of the Etiology and Prevalence of Maxillofacial Fractures in Children Referring to Imam Khomeini Hospital of Ahvaz (2014-2019)

Background and Objectives Facial fractures in children are unusual injuries that make up to 15% of facial fractures. Although maxillofacial trauma is more common in children than in adults, the incidence of facial fractures is lower. Epidemiology and etiology of facial fractures vary from country to country, and depend largely on economic group, culture, and geographical area. Maxillofacial fractures are the most common type of facial fractures. Subjects and Methods This 5-year (2014-2019) retrospective observational-descriptive and cross-sectional study was performed among pediatric patients (1 to 12 years old) referring to the maxillofacial surgery department of Imam Khomeini Hospital in Ahvaz (due to trauma and jaw fracture). The indicators included age, sex, time, cause of fracture, fracture position, type of fracture, and existence of accompanying fracture. Results Based on the results obtained in this study, 32.7% of the participants were girls and 67.3% were boys. The most common causes of jaw fractures were MVA (63.4%) and falling (25%). The highest frequency of jaw fracture due to trauma (17.3%) was at the age of 12 years followed by the ages of 9 and 10 years (15.4%). The highest rate of jaw fracture due to trauma in children (1 to 12 years) was in summer (32.7%). The results of this study show that the most common type of fractures was in the mandible (87.5%) which was more reported in males. The most common treatments used were close reduction (67.3%) and ORIF (26.9%). Conclusion The results of this study show that the most common type of fractures are in the mandible and more in men. The highest rate of fractures was reported between the ages of 8 to 12 years. This study showed that the highest percentages of the cause of jaw fractures were MVA and falling, respectively. Also, the highest percentage of hydrotherapy methods used were close reduction and ORIF.

The Efficacy of Daily Administration of Nebulized Heparin on the Prevention of Endotracheal Tube Blockage in Patients With Pneumonia.

Nosocomial infections pose a significant public health concern, impacting over 100 million people worldwide annually. Within this research, we investigated heparin nebulization through the endotracheal tube and its effect on preventing blockage due to clots and mucus plugs compared to normal saline. A double-blind clinical experiment was done on a cohort of 40 pneumonia patients who were intubated and hospitalized in theintensive care unit (ICU) at Imam Khomeini Hospital in Ahvaz, Iran. The individuals were randomly assigned to two groups of 20 patients using a random allocation technique. The initial cohort was administered 5000 IU of heparin diluted in 4 ccs of 0.9% normal saline every eight hours via a nebulizer through a tracheal tube. In contrast, the second cohort was given 5 ccs of normal saline as a nebulizer through a tracheal tube. The study compared the incidence of tracheal tube obstruction caused by mucus plug or clot, the occurrence of patient hypoxia resulting in emergency tracheal tube replacement, and the frequency of emergency tracheal tube suction due to partial obstruction caused by mucus plug in both the heparin and saline groups. According to our data, the number of patients in the heparin group who could avoid the need for emergency tracheal tube replacement owing to blockage was more significant than in the ordinary saline group (P=0.013). Heparin was significantly correlated with the number of times emergency suction was required to remove a tracheal tube occlusion (P=0.01). Heparin had no significant effect on coagulation factors (international normalized ratio [INR], platelet[PLT], and partial thromboplastin time [PTT]), Acute Physiology and Chronic Health Evaluation (APACHE) score, pneumonia severity index (PSI), saturation of patients, or tracheal tube secretions. There was no statistically significant difference in total time spent in the intensive care unit (P=0.91). Further studies are suggested to determine the effect of heparin nebulization on preventing endotracheal tube obstruction due to clots and mucus plugs in intubated ICU patients.

Relationship between body mass index and disease severity in COVID-19 patients admitted from April to September 2020 at Imam Khomeini Hospital Complex, Tehran, Iran

Relationship between body mass index and disease severity in COVID-19 patients admitted from April to September 2020 at Imam Khomeini Hospital Complex, Tehran, Iran

Virtual reality exposure therapy to decrease anxiety before surgical invasive procedures in hemodialysis patients: an interventional study

BackgroundHemodialysis patients are prone to anxiety and depression due to physiological changes and psychological tensions that leave irreversible effects on the patients. In this regard, the present study was an attempt to provide a simulated situation by using virtual reality on the anxiety level of dialysis patients before performing surgical procedures.MethodsThis non-equivalent groups pre-posttest quasi-experimental study was conducted in 2022 in a hemodialysis ward of Imam Khomeini General Hospital affiliated with Tehran University of Medical Sciences. The study population was patients suffering from kidney failure referred to this hospital. The participants were 30 patients selected from the study population, who were allocated into two groups (15 in each experimental and control group). The control group received routine training in the ward. The experimental group participants watched five educational virtual reality (VR) contents in addition to the routine training. They used head-mounted display VR (VR BOX headset 2.0 virtual reality glasses) to immerse in a virtual environment similar to the real world covering the experience of entering the operating room, during the surgery, and after surgery. The data gathering instrument was a valid and reliable anxiety inventory. The collected data was analyzed at a significance level of 0.05.ResultsThe study findings indicated that the anxiety scores of the experimental and control groups had no significant difference before intervention. However, after the intervention of virtual reality, the state and trait anxiety of the experimental group participants were significantly lower than the control group (P-value < 0.01).ConclusionThe application of VR for maintenance hemodialysis patients before invasive surgical procedures decreases patients’ anxiety. Considering the devastating and undeniable impacts of anxiety on the lives of patients referring to hemodialysis centers, the application of VR is suggested to decrease their anxiety.

The Stability of Sugar Yield in Promising Sugarcane Genotypes (Saccharum officinarum L.)

Stability analysis is one of the most important steps that a breeder should use to release a new variety for a region. To identify and introduce the best sugarcane genotypes, an experiment with 26 promising Sugarcane genotypes along with four commercial varieties was planned and implemented during 2017–2019. This study aimed to determine a promising stable sugarcane genotype for the sugarcane-growing areas of Khuzestan Province in Iran. The effects of genotype × environment interactions on the sugar yield of 26 promising sugarcane genotypes and four standard varieties as controls were investigated for the new plant (P), first ratoon (R1), and second ratoon (R2) at three locations (Amir Kabir, Imam Khomeini, and Mianab) for three cropping seasons. For the final analysis every year, quantitative and qualitative characteristics were measured by sampling 10 stalks of each genotype in each replication and each experiment. A combined analysis was conducted with regard to the fixed effects of the genotype and environment and the random effect of the year. The sugar yield stability of the genotypes was evaluated based on nonparametric, ecovalence, Shukla, simultaneous selection, and AMMI statistical methods. According to the results, g2,g4,g5,g7,g11,g12,g14,g16,g19,g20,g21,g23,g24,g26,g27,g28,g29, and g30 are the most stable genotypes based on statistical analyses. As these genotypes have general stability and can be cultivated in three crops, they are introduced for commercial cultivation. According to an AMMI biplot, genotype g6 was considered to have special adaptation to the first location (Imam Khomeini), genotypes g8 and g15 were specifically adapted to the second location (Amir Kabir), and genotypes g10,g17, and g22 showed special adaptation to the third location (Mianab). Therefore, these genotypes are introduced for commercial cultivation in the mentioned locations.

Mapping a good society model in Ayatollah Khomeini’s religious political thought: Possibilities and challenges

This article identifies the components of a good society in the thought of Ayatollah Khomeini. Over several decades, he experienced a voluntary and compulsory odyssey-like journey, the result of which was theorizing about a good society and Islamic government. From the young Ayatollah Khomeini to the late “Imam” Khomeini, several images are attributed to him. We find that the good society can be realized according to pure Mohammadian Islam and religious democracy. We claim that Khomeini’s thought evolved in the face of the Other and this Other has changed the perception of his identity and thought over time. This study shows that in a historical continuum, there are two breaks along the religious-political thought of Khomeini. Contrary to the common orthodox image of him, we claim that despite the contradictions, his thought has the capacity to reconcile Islam and modernity in a new religious-political framework. Nevertheless, one can observe the transformation, the elitist view, and the multiplicity of positions in his political, cultural, and social opinions.

Comparison of the efficacy Talc solution injection through Chest Tube and Talcum Powder through Pleuroscopy for the Treatment of Malignant Pleural Effusion: a randomized clinical trial

Background: The aim of the present study was to compare the different outcomes and response rates of talc powder injection via chest tube and talc spray through thoracoscopy in the treatment of malignant pleural effusion in patients.&#x0D; Methods: In this randomized controlled trial, patients with malignant pleural effusion, who were hospitalized in the surgery and hematology-oncology departments of Shariati and Imam Khomeini Hospitals, were enrolled. The patients were randomly divided into two groups: chest tube and pleuroscopy, using simple randomization. The mean and standard deviation, frequency and percentage, independent sample t-tests, chi-square, and Fisher’s exact tests were used for data analysis. A p-value of less than 0.05 was considered statistically significant.&#x0D; Results: No significant difference was observed between the two groups in the incidences of chest pain, fever, and both symptoms (p &gt; 0.05). The treatment success rates among the chest tube and pleuroscopy cases were 83.3% and 100%, respectively, and there was no significant difference between the two groups (p = 0.05). Among the five patients who had a recurrence, four (80%) had lung cancer, and one (20%) had liver cancer, and this difference was significant (P = 0.003). Regarding the rate of response to the treatment according to the side with effusion, among the people who had a relapse, two people (40%) had right-sided effusion, and three others (60%) had left-sided effusion (P = 0.623).&#x0D; Conclusions: Both techniques were safe, had minor side effects, were transient, and easy to manage. However, the recurrence of the disease in the thoracoscopic pleurodesis method was significantly less than in the chest tube.&#x0D;

A priority queueing-inventory approach for inventory management in multi-channel service retailing using machine learning algorithms

PurposeNowadays, in many organizations, products are not delivered instantly. So, the customers should wait to receive their needed products, which will form a queueing-inventory model. Waiting a long time in the queue to receive products may cause dissatisfaction and churn of loyal customers, which can be a significant loss for organizations. Although many studies have been done on queueing-inventory models, more practical models in this area are needed, such as considering customer prioritization. Moreover, in many models, minimizing the total cost for the organization has been overlooked.Design/methodology/approachThis paper will compare several machine learning (ML) algorithms to prioritize customers. Moreover, benefiting from the best ML algorithm, customers will be categorized into different classes based on their value and importance. Finally, a mathematical model will be developed to determine the allocation policy of on-hand products to each group of customers through multi-channel service retailing to minimize the organization’s total costs and increase the loyal customers' satisfaction level.FindingsTo investigate the application of the proposed method, a real-life case study on vaccine distribution at Imam Khomeini Hospital in Tehran has been addressed to ensure model validation. The proposed model’s accuracy was assessed as excellent based on the results generated by the ML algorithms, problem modeling and case study.Originality/valuePrioritizing customers based on their value with the help of ML algorithms and optimizing the waiting queues to reduce customers' waiting time based on a mathematical model could lead to an increase in satisfaction levels among loyal customers and prevent their churn. This study’s uniqueness lies in its focus on determining the policy in which customers receive products based on their value in the queue, which is a relatively rare topic of research in queueing management systems. Additionally, the results obtained from the study provide strong validation for the model’s functionality.

Evaluation of the effectiveness of Tadalafil on improving pulmonary function and asthma severity in severe asthmatic patients: a randomized controlled trial study

Phosphodiesterase inhibitors elevate the levels of cyclic adenosine monophosphate and cyclic guanosine monophosphate, which have been associated with various anti-inflammatory effects that can help alleviate asthma symptoms. This study aims to assess the impact of Tadalafil, a selective phosphodiesterase inhibitor, on pulmonary function in patients with asthma. This study was a randomized, double-blind clinical trial conducted in 2021 at Imam Khomeini Hospital in Ahvaz, Iran. The study enrolled 44 patients with severe asthma, who were divided equally into a Tadalafil group and a placebo group. The Tadalafil group received 20 mg/day of Tadalafil, while the placebo group received a placebo at the same dose. The patients' spirometry tests, asthma quality of life questionnaire, 6-minute walk distance, and quality of life were measured at the beginning of the study and one month later. The study results indicated that there was no statistically significant difference between the Tadalafil group and the placebo group in terms of pulmonary parameters (p>0.05). Furthermore, the scores for patients' quality of life (p=0.167) and the 6-minute walk test (p=0.148) at the end of the study did not show any statistically significant improvement compared to the placebo group. Results showed that the use of Tadalafil (20 mg) once daily for one month in patients with severe asthma did not affect clinical and laboratory outcomes.

Ammonia emissions from livestock facilities around an international airport, Tehran, Iran: An experimental and mathematical study

AbstractAmmonia emissions from livestock farms are a major problem for staff and residents near these centers. Anaerobic decomposition of livestock waste and the collection and stacking of waste are the main sources of ammonia gas on livestock farms. This article examined ammonia emissions from livestock facilities near Tehran Imam Khomeini International Airport. First, field measurements were made in the summer (30°C), and collected samples were examined using the indophenol technique. AERMOD, based on Gaussian fluctuating plume theory, was constructed to model ammonia emissions. According to AERMOD, the maximum periodic‐seasonal 2‐hourly and 8‐hourly ammonia concentrations were 15.9, 229, and 63.7 OU (odor unit per unit volume)/m3, respectively. The hourly ammonia emission rate from livestock sources is also 0.0168 gm−2 h−1. AERMOD results mathematical model indicated reasonable agreement with the field measurement, which the coefficient of determination (R2), index of agreement (d), and efficiency coefficient (E) were 0.95, 0.97, and 0.91, respectively. Moreover, Statistical indices, including geometric mean bias (MG), geometric variance (VG), fraction of predictions within a factor of two of observations (FAC2), and normalized mean square error (NMSE), the root mean square error (RMSE) and mean absolute error (MAE) are also indicated by 1.36 and 0.67, respectively, were used to assess the reliability of the model results showed that AERMOD had a good agreement with the field measurement.

Squamous cell carcinoma in young adult with no predisposing factors: A case report

&#x0D; &#x0D; &#x0D; A 39-year-old male was referred to the Oral and Maxillofacial Medicine department of Alborz University of Medical Sciences Dental School with a lesion that he had noticed for 3 weeks. The patient had no signs or symptoms and no cigarette and alcohol consumption. Because the lesion was placed at the lateral posterior portion of the tongue which is a common place for oral malig- nancies a biopsy was done. The pathology result was Squamous cell carcinoma grade 2. The patient was referred to Imam Khomeini Cancer Institute for further treatment.&#x0D; &#x0D; &#x0D;

Explanation and Analysis of Imam Khomeini's Stance on Pahlavi Policies Regarding Women, with an Emphasis on the Unveiling Policy

Addressing women's issues and providing innovative solutions has always been part of modernization in the contemporary world and Iran. In his authoritarian modernization, Reza Shah, with a quasi-modernist approach to the issue of women, adopted the policy of banning and unveiling the hijab. This policy, while maintaining its foundations, continued during the reign of the second Pahlavi with changes in method. This policy provoked widespread social reaction and resistance from segments of society and religious leaders. Among them, Imam Khomeini, in his speeches, repeatedly referred to this government action, criticizing these policies and condemning the Pahlavi regime's approach to the issue of women and the hijab. The present study, aiming to explain Imam Khomeini's stance toward these actions, adopts a descriptive-analytical method using library resources, seeking to answer the question: What was Imam Khomeini's position on Pahlavi's modernist policies regarding women, particularly on the issue of the hijab? The research findings indicate that on one hand, he defended women's hijab and explicitly opposed the unveiling policy of Reza Shah and Mohammad Reza Shah Pahlavi. On the other hand, while raising awareness and warning the public about Pahlavi's negative propaganda against the hijab, he praised the fighters and leaders who stood against the unveiling policy. The influence of Imam's approach in society led to political challenges and increasing divergence between the people and the government, which also played a role in the occurrence of the Islamic Revolution.

Imam Khomeini and Mandela’s Views of Education: Lessons from Iran’s Cultural Revolution and Decolonial Thought in South Africa

Imam Khomeini and Mandela’s Views of Education: Lessons from Iran’s Cultural Revolution and Decolonial Thought in South Africa