International Journal of Health Studies (IJHS - Shahroud University of Medical Sciences)
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Distribution and Antibiotic Resistance Pattern of Bacteria Isolated from Patients with Community-acquired Urinary Tract Infections in Iran: A Cross-sectional Study
Get PDFBackground: Urinary tract infections (UTIs) remain the common infections diagnosed in outpatients as well as hospitalized patients. Multi-drug resistance (MDR) and extensively-drug resistance (XDR) in bacteria is an alarming problem in the world. The aim of this study was to detection of etiologic agents associated with community-acquired urinary tract infections (CA-UTIs) and investigation of antibiotic susceptibility patterns.Methods: This study was performed from September 2014 to March 2015 on outpatients, which referred to Labbafinejad Hospital Clinic, Tehran, Iran. The bacterial pathogenic diversity identified by standard laboratory methods. The antimicrobial resistance rates were performed by Kirby Bauer disc diffusion methods.Results: A total of 303 patients were enrolled in this study, from which 204 (67.3%) were female and 99 (32.5%) were male patients. Escherichia coli was the dominant species (69%), followed by Enterococcus faecalis (12.8%) and Klebsiella pneumoniae (4.6%). High resistance rate to nalidixic acid (73.8%), trimethoprim/Sulfamethoxazole (54.3%), ciprofloxacin (54.3%) in E. coli, and tetracycline (89.7%) in E. faecalis strains and high susceptibility rate to meropenem (96.6%), imipenem (95.2%), amikacin (90.4%), cefoxtin (87.6%), and nitrofurantoin (82.8%) in E. coli, and nitrofurantoin (100%) in E. faecalis strains were observed. In addition, 43.5% of the strains were multidrug-resistant (MDR).Conclusions: This study showed that E. coli was the predominant uropathogen of CA-UTIs in this geographical area. It also demonstrated the empirical treatment of urinary tract infections may be difficult due to high resistance to commonly used antibiotics. Continuous monitoring of MDR organisms and drug resistance patterns are needed to prevent treatment failure and reduce selective pressure. These findings suggest the use of nitrofurantoin, cefoxitin, and amikacin in this area of the country
Lifestyle Changes Reduce the Risk Factors of Osteopenia in Menopause Iranian Women
No full textBackground: This study found a way to change the lifestyle and reduced the risk factors of osteopenia in menopause Iranian women.
Methods: A cross-sectional study was designed in order to enroll 50 years or older asymptomatic women, who referred to the Imam Hossein medical center, Tehran, Iran for outpatient screening from 2013 up to 2015. A questionnaire including forty-one risk factors was completed and bone mass densitometry (BMD) was done by the DXA method. Bone density of femur and lumbar spine according to standard curves was calculated for each person and was recorded in the questionnaire as a study outcome. Data were analyzed using SPSS 17 software. Significant level was set at 0.05.
Results: In the present study, 317 cases participated who had mean age of 52.46 years old. BMD revealed 237 (75%) osteopenia or osteoporosis prevalence. Age, menopause age and BMI related to the study outcomes significantly. Cost of each osteoporosis-osteopenia case in 50 years old or older women was 59 Dollars. Osteoporosisosteopenia was significantly related to age (Pvalue = 0.001) and menopause age (Pvalue = 0.003).
Conclusions: It is reasonable that 75% osteopenia-osteoporosis will be found by BMD screening in 50 years or older Iranian women, especially if BMI be low and in the early menopause age.
Keywords: Osteopenia, Lifestyle, Menopause, Women
The Impact of the Gradual Reduction of Sodium Dialysis Fluid on Occurrence of the Hypotension and Plasma Sodium Level in Hemodialysis Patients
No full textBackground: Dialysis is the most common method of caring end-stage kidney disease, but it has some complications despite its several advantages. The aim of study was to investigate the impact of the gradual reduction of dialysate sodium on occurrence of the hypotension and plasma sodium in hemodialysis patients.
Methods: 56 hemodialysis patients participated in this randomized triple-blind crossover clinical trial. The patients were randomly divided into two groups of A and B. The routine method (Sodium Dialysis Solution) was performed on Group A, whereas the gradual reduction of sodium dialysis fluid was given to Group B for three sessions. These dialysis methods were again implemented three sessions, after one week of routine dialysis (Wash Out).The routine method (Sodium Dialysis Solution) was performed on Group B, and the gradual reduction of sodium dialysis fluid was performed on Group A, for three sessions. Patients\u27 blood pressure was measured three separate times: 15 minutes before dialysis, during dialysis (first, second, third and fourth hours of dialysis) and 15 minutes after of it. Moreover, Patients\u27 sodium level was also measured before and after the intervention. In this way, the descriptive statistics and inferential statistics (repeated measure analysis of covariance) were utilized to implement data analysis.
Results: in the case of routine method, the percentages of the prevalence of hypotension in above mentioned different hours were declared 6.2%, 26.6%, 44.5%, 32.8%, respectively. On the other hand, in the case of the gradual reduction of sodium dialysis fluid, these corresponding percentages were cleared 2.3%, 1.7%, 5.31%, 44.46%, respectively. The mean differences of plasma sodium before and after dialysis in the mentioned methods were obtained as 0.58 in the case of routine method, whereas it is 2.36 in the case of gradual reduction of sodium dialysis fluid method. In this research, there was no significant difference between the rate of hypotension and plasma sodium in the gradual reduction of sodium dialysis fluid by the routine method under 80% powers.
Conclusions: The experimental results revealed that a gradual reduction of the sodium dialysis fluid did not play a significant role in the reduction of blood pressure during dialysis and plasma sodium in hemodialysis patients. However, either confirmation or rejection of this issue will require further studies and resolving the limitations.
Keywords: Sodium Dialysis Fluid, Hypotension, Plasma Sodium, Hemodialysis
The Effectiveness of Parental Reflective Functioning-Based Psycho-educational Program on Improvement of Children with Separation Anxiety Disorder: A Single Subject Study
No full textBackground: Diagnosis of separation anxiety disorder (SAD) in childhood is a critical risk factor of mental health in adulthood. Etiology studies have indicated the significant role of parental psychological factors in children with SAD phenomena. The purpose of present study was to investigate the effectiveness of parental reflective functioning -based psycho-educational program on improvement of children with separation anxiety disorder.
Methods: A single-case experimental design with multiple baselines has been utilized to conduct present study. Subjects of the study included 4 parents (two mothers and two fathers) with children suffering from separation anxiety disorder who referred to psychiatric counseling center and clinic of child and adolescent psychiatrist in Mashhad during May and June of 2010. These parents were selected through convenience purposeful sampling method based on inclusion and exclusion criteria and participated in 12 sessions (two sessions per week) of a parental reflective functioning-based psycho-educational program. The participants completed the parent-separation anxiety questionnaire in three stages of baseline during the implementation of the program (in sessions 5, 9 and 12) as well as one month after follow-up. The obtained data were analyzed using indicators of Percentage recovery / PR, Effect size and Reliable Change Index (RCI).
Results: At the end of the psycho-educational program, the results indicated a significant clinical decrease in the severity of separation anxiety in all four parents. at the end of psycho-educational program, the total score of recovery percentage for the first, second, third and fourth subjects was equal to 70.86, 71.30, 72.21 and 70.96, respectively. The RCI indicator of subjects was -9.93, -10.97, -11.59 and -11.26, respectively. Also, the effect size for the first, second, third and fourth subjects were equal to 7.43, 8.21, 8.67 and 8.43, respectively. Moreover, the overall improvement of all four subjects in subscales of fear of being left alone, fear of abandonment, fear of physical illness and fear of dangerous events was 66.75%, 71.10%, 70.39% and 71.73%, respectively which the values were significant in the clinical term. This improvement process continued throughout the follow-up period.
Conclusions: according to research findings, the parental reflective functioning-based psycho-educational program has a positive effect on improving the symptoms of separation anxiety disorder in children. Therefore, it is recommended to utilize from this program in treatment interventions for separation anxiety disorder.
Keywords: separation Anxiety Disorder, Psycho-Educational Program, Parental Reflective Functioning
Validation of Transcutaneous Bilirubinin Comparison with Serum Bilirubin for the Detection of Hyperbilirubinemia in Neonates
Get PDFBackground: Neonatal hyperbilirubinemia is a common and dangerous complication that should be diagnosed as soon as possible.This study aimed to validate transcutaneous bilirubin in comparison with serum bilirubin for the detection of hyperbilirubinemiain neonates.Methods: This cross-sectional study was conducted in 280 infants with jaundice who were referred to Bahar Hospital in Shahroud in 2016. The serum bilirubin was measured by the photometric method. Three measurements of transcutaneous bilirubin were performed (by Bilichek) for each infant, and their average was recorded. The sensitivity and specificity of transcutaneous bilirubin measurements were assessed in comparison with the measurements using laboratory methods as the gold standard using ROC analysis.Results: Of the 280 neonates, 153 (54.6%) were male. The mean age of the patients was 11.77 ± 4.6 days. The mean bilirubin level was 16.9 ±10.1 mg/dl measured usingthe BiliChek method and 15.3 ± 9.5 mg/dl using the laboratory method, and the difference was significant (p<0.04). The sensitivity and specificity of the BiliChek measurements in neonates were 88.3% and 73.6%, respectively. According to the findings from the ROC curve, the cut off point was determined to be more than 14.7 units (surface area below the curve (AUC) = 87.5%).Conclusion: The results of this study showed that the accuracy (sensitivity and specificity) of the BiliChek device was good and can be used to measure the neonatal bilirubin
The Incidence Rate of Gestational Diabetes and Relevant Factors on Pregnant Women in the City of Shahroud in 2014
Get PDFBackground: The pregnant women suffering from gestational diabetes seem to face higher risks of pregnancy complications in spite of improvements in pregnancy outcomes during recent years. This study designed to define the incidence rate of gestational diabetes associated with its risk factors.Methods: This was a longitudinal study, in which, we studied the pregnant women referred to 11 different urban health care centers in the city of Shahrud (Northeast of Iran) since April to September of 2014. Out of 1300 women with available medical care records, we studied 1098 pregnant women in the mentioned timespan. According to the results of fasting blood sugar (FBS) test, 7 mothers were diagnosed with diabetes at the beginning of the study. Using 75gr glucose, we conducted a 2-hour oral glucose tolerance test (OGTT) for all non-diabetic pregnant women (normal and pre-diabetic ones-1091 subjects) between the weeks 24 and 28 to screen the presence of gestational diabetes. The diagnosis of gestational diabetes was considered definite if one of the following criteria was met: Fasting blood sugar ≥92 mg/dl, 1-hour glucose ≥180 mg/dl or 2-hours glucose ≥153 mg/dl. We used the Log-binomial regression model to estimate the rate of diabetes incidence based on risk factors.Results: The mean age of subjects was equal to 28.0 (SD=5.1) years. The rate of gestational diabetes occurrence was 7.8% (95% CI: 6.3-9.6 (Cases=85 pregnant women). In case of subject over 35 (RR=2.9), the factors of positive family history of diabetes (RR=1.8) and pre-diabetic condition (RR=1.6) increased the risk of gestational diabetes. The factors of BMI, smoking, education, and the pregnancy frequency were not considered in the model.Conclusions: The incidence rate of diabetes in our population was higher compared to previous studies. However, due to variations made in the gestational diabetes screening guidelines, more studies are needed to do comparative research
The Correlation between CD44 and ABCG2 Expression and Pathological Grades of Bladder Carcinoma
No full textBackground: The human bladder cancer progression is accompanied by the growth of side-populations of cancer stem cells (CSCs). The expression of ABCG2 and CD44, as the CSC markers, may be associated with different pathological grades of bladder cancer. This study was designed to identify the changes occurring in ABCG2 and CD44 in different types of bladder tumors at various grades.Methods: The sample included 67 patients with bladder cancer (63 males; 4 females) with a diagnosis of transitional cell carcinoma (urothelial cancer) using cystoscopy. Based on the tumor pathological grade, we divided the tumor biopsies into two low-grade (N=20) and high-grade (N=21) groups. The tumor samples along with 26 normal-looking bladder tissues were analyzed by techniques like immunohistochemistry (IHC) and total RNA extraction for qPCR.Results: Based on the results obtained by IHC analysis of ABCG2 and CD44 protein in bladder low- and high-grade tumors, these CSC markers showed significant elevation in malignant tissues in comparison to the normal bladder tissues. The scoring of ABCG2 expression in normal, low-grade and high-grade tissues was 28, 120, and 140 respectively. The CD44 scores in the normal bladder, low-grade and high-grade tissues were found to be 0.6, 11.5, and 29.0, respectively. The IHC data showed inconsistency with the qPCR data, suggesting an overexpression of ABCG2 (4-6.5 folds) and CD44 (15-22 folds) in the low and high-grade tumors in comparison to the normal bladder tissue.Conclusions: Finding a good relationship between ABCG2 and CD44 markers and different grades of bladder cancer demonstrated that these markers can be seen as potential and predictive indicators of bladder malignancy
Assessment and Spatial Distribution of Mineral Groundwater Quality in Ardabil Province, Iran
Get PDFBackground: The present study was conducted to determine the quality of mineral ground waters and analyze their spatial distribution in Ardabil Province of Iran.Methods: This descriptive analytical study was carried out on natural mineral water wells in Ardabil Province over one year. Samples of water were taken from a total of 44 wells in this province every season, from April 2016 to February 2017. They were then transferred to Khak Azmay-e Moghan Laboratory and their Total Dissolved Solids (TDS), chloride, calcium, magnesium, sulfate, sodium and bicarbonate were measured based on the instructions presented in Standard Methods. The Ground Water Quality Index (GWQI) was then determined based on the measured parameters. The spatial distribution of the ground waters based on the GWQI was then also determined in a Geographic Information System (GIS).Results: The GWQI varied extensively in the natural mineral water wells of Ardabil Province, from 24.88 to 312.58. The best physicochemical quality based on the GWQI was observed in Hammam-e Sangi and the poorest quality in Saghezji-Mardaneh. According to the index, 2.5% of the wells were of very good quality, 30% were of good quality, 32% of moderate quality, 13.5% of poor quality and 22% were of inappropriate quality.Conclusions: According to the results, the most important quality problems included high levels of TDS, chlorine and sulfate and low pH values. Considering that these wells supply people’s drinking water in this region, consumers should be warned of their water quality, and purification procedures should also be carried out to allow the hygienic use of these valuable resources
The Correlation between Happiness and Spiritual Health with Academic Self-Efficacy among Medical Sciences Students
Get PDFBackground: Successful accomplishment of a task or an assignment needs academic self-efficacy. This study was designed to examine the relationship between happiness and spiritual well-being with academic self-efficacy among the students of Shahrud University of Medical Sciences.Methods: We randomly selected 500 students in this cross-sectional study by employing spiritual well-being, happiness, and academic self-efficacy questionnaires in 2018. We applied the SPSS 16 software to analyze the collected data using ANOVA, Chi-square, and Pearson Correlation tests. The significance level was considered 0.05 in all tests.Results: The mean scores obtained for spiritual health and happiness were at a moderate level, accounting for 89.56±16.11 and 39.95±12.52, respectively, while the academic self-efficacy mean score was assessed to be high and equal to 109.32±18.44. We found a significant relationship between spiritual well-being and happiness with academic self-efficacy (P=0.001). The variables of happiness and gender appeared to be significant in the logistic regression final model. According to the results, women had a potential to show higher self-efficacy 1.8 times more than men. In addition, the rate of self-efficacy increased by 5% per every 1 score increase in happiness (OR=1.05).Conclusions: Due to the fact most of students showed a moderate level of spiritual health and happiness and over a third of students had a moderate level of academic self-efficacy, we need to further focus on spiritual health and happiness. Obviously, improving these two factors will be a key in improving the academic self-efficacy
Protein Recovery from Dairy Sludge by Fenton Process
Get PDFBackground: Holding excessive amount of sludge has turned into a major problem for the wastewater treatment plants. Nucleic acids, enzymes, proteins, and polysaccharides are some organic materials which could be found in the sludge. The main objective of this study was to investigate the efficiency of Fenton process in protein recovery from dairy sludge.Methods: Our case for the study was the waste activated sludge produced at the wastewater treatment plant of Fajr dairy industry in Shahrood, Iran. Fenton process was applied to a 1.5 L sludge sample. At first, the pH of the sludge was adjusted to 3 using H2SO4. The second step was the addition of Fe(II) at certain concentrations. Then, different H2O2 concentrations were added to the sample. The mixed sample was stirred at 120 rpm for 6 h and was neutralized with Ca(OH)2.The sludge was dewatered in the pilot-scale filter press and filtered. The soluble protein content in the supernatant of the disintegrated sludge derived from the Fenton process was recovered by dialysis and dried at −40°C for 24 h.Results: The results showed that after the Fenton process, SSi, TCODi, SCODi, and SCODa levels were 11275, 13800, 115, and 3450 mg/L respectively. Also, after the Fenton process, the concentration of the soluble proteins increased from 52.48 to 1732 mg/L, whereas after subsequent protein recovery, its concentration in the supernatant was 1180 mg/L.Conclusions: Based on the findings, the protein recovered from the excess sludge throughout the Fenton process can be used as animal feed