The Rh blood group system is a complex blood group which includes different antigen specificities such as c antigen. Anti-c antibody is associated with both acute and delayed hemolytic transfusion reactions as well as hemolytic disease of the newborn (HDN). Rh mediated hemolytic transfusion reactions (HTR) are mostly immunoglobulin G (IgG) mediated and results in extravascular hemolysis and delayed HTR (DHTR). However, we are presenting a case of acute intravascular hemolytic transfusion reaction due to anti-c in a patient with acute subdural hematoma. A 77-year-old woman was referred to our hospital with a loss of conscious and left-sided hemiparesis. After an emergency MRI, she was diagnosed with Acute Subdural hematoma, and an emergency craniotomy was performed. Since Acute Subdural hematoma is a neurosurgery emergency, laboratory technician performed an Immediate-spincrossmatchedd for blood bag to preserve time. During the transfusion of the first packed cell, the patient developed severe hypotension and tachycardia. Thus, the transfusion was stopped. Laboratory results raised the suspicion of an Acute Intravascular Hemolysis. Antibody identification revealed that the patient had an irregular blood phenotype (C2+/c-/E-/e3+/K-), and the presence of alloantigen-c Rh antibody confirmed the suspicion of HTR. In patients with multi transfusion history and pregnant women, pre-transfusion screening of irregular antibodies must be performed. The immediate spincrossmatchh must be prevented in patients with a history of multi transfusions, even in emergency situations.

Background: There are many well-known biologic and anthropometric risk factor for Developing Cardiovascular Diseases (CVD). Shift Work (SW) may be associated with CVD risk factors. Objectives: This study was performed to investigate the relationship of shift work and some of CVD risk factors. Materials & Methods: This analytical cross-sectional study was done in Occupational Medicine Center of Gonabad University of Medical Sciences from April to December in 2021. A total of 743 workers who referred for periodic health examination were selected by simple random sampling. Those workers with at least one year of work experience who had Satisfaction for participation were included to the study. Having congenital heart disease, heart failure, kidney disease, Taking drugs that increase blood pressure, blood lipid and sugar and pregnant women were excluded. Demographic data, Physical examination and Blood cholesterol, triglyceride and glucose measures were collected. Data analysis was performed using Mann–Whitney U test, student t-test, Chi-Square and Multivariate Linear Regression model with SPSS software version 21 at a significant level of 0.05. Results: Of total, 73.4% were men and 47.3% were shift workers. The Mean±Standard Deviation of age was 33.9±5.07 among shift workers, and 36.32±5.81 among Day-time workers. There was significant independent association between shift work and triglyceride (B=7.5, 95%CI=1.02,1.21, P=0.03) and cholesterol (B=7.2, 95%CI=1.12,1.22, P=0.028) values. Conclusion: The results of the present study showed that the concentration of blood triglycerides and cholesterol is higher in shift workers than day-time workers. Therefore, particular follow-up of shift workers should be recommended for screening and preventing cardiovascular risk factors

Background: The prevalence of sleep disorders in the general population is between 26.4% and 39.4% in Asia, which has increased in Iran in recent decades. Low sleep quality and reduced sleep hours result in work impairment and physical and mental illnesses. This study aimed to improve sleep quality and determine the factors affecting the quality of sleep. Materials and Methods: This cross-sectional study was performed in 2018 among 243 employees presenting to the Center for Occupational Medicine at Gonabad University of Medical Sciences. Demographic data such as age, shift work and education level were asked of the staff. Weight, blood pressure, height and waist circumference were measured. The sleep quality score was extracted by completing the Pittsburgh Sleep Quality Index. Glucose, triglyceride and cholesterol were also measured. Logistic regression analysis was performed. Significance level was set at 0.05. Results: Among 243 men studied, 99 men (40.7%) had low sleep quality and 126 men (51.9%) reported sleeping less than seven hours a day. age (p=0.021) and waist circumference (p=0.036) and shift work had a direct effect while education had a reverse effect on the quality of sleep. Fasting blood suger, cholesterol, triglesride, body mass index did not have a significant effect on sleep quality. Conclusion: Low sleep quality and inadequate sleep hours causes physical and psychological complications, which mandates planning and training to reduce factors affecting low sleep quality.

High proportions of patients have reported neuropathic pain after traumatic nerve injury. [1][2][3] A lesion or disorder of the somatosensory nervous system may result in neuropathic pain 4 which can cause a higher prevalence of sleep disturbances, 5 anxiety, 6 and depression 7 in patients. The prevalence of neuropathic pain has been estimated at around 6.9%-10%. 8 Risk factors for neuropathic pain include demographic, psychological, social/lifestyle, and genetic factors. 9 Post-traumatic peripheral neuropathic pain (PTNP) is defined as chronic neuropathic pain due to damage to peripheral nerves. 10 Some therapeutic interventions have been suggested as treatments for PTNP such as transcutaneous magnetic stimulation, 11 gabapentin, 12 and pregabalin. 13 The potential treatment of pregabalin has been shown in both central and peripheral neuropathic pain. 1,14,15 Some studies showed its efficacy as off-label uses for other conditions such as generalized anxiety disorder, 16 restless legs syndrome, 17 bipolar disorder, 18 and insomnia. 19 Most meta-analyses have been undertaken on the therapeutic value of pregabalin in patients with diabetic peripheral neuropathy (DPN), 20,21 post-herpetic neuralgia (PHN), 22,23 fibromyalgia, 24 and spinal cord injury