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Lower lobe pneumonia presenting as singultus (hiccups)
Get PDFBackground: Persistent hiccups can be a debilitating symptom and many such patients present to the emergency department seeking relief. A variety of serious conditions have been associated with persistent hiccups. Cases of pneumonia as a cause of hiccups have been rarely described.
Case presentation: A 79-year-old male patient presented to the hospital due to persistent hiccups for 4 days. Despite lack of new respiratory symptoms or fever, a chest x-ray demonstrated a left lower lobe consolidation, which was also confirmed with a chest CT. The patient was treated with levofloxacin and at 1-month follow-up hiccups had completely resolved, while a repeat chest CT demonstrated resolution of the consolidation.
Conclusions: The presentation of pneumonia in elderly patients may be atypical and may lack the symptoms and signs observed in younger patients. Hiccups may be the main presenting symptom of pneumonia
A Case Report of Abnormal Branched Right Coronary Artery from Left Sinus of Valsalva
Get PDFBACKGROUND AND OBJECTIVE: Abnormal origin of coronary arteries, which are responsible for providing the heart with freshly oxygenated blood, can lead to complications affecting daily activity. This variation could be harmless and controlable with the aid of medication but sometimes the bad anatomical situation requires operation. In this severe types, early diagnosis is very important. The aim of thid study was to teach medical students about coronary arteries’ anomalies.
CASE REPORT: Through the thorax dissection sessions of a 57 years old man, we observed that the right coronary artery along with the left main coronary artery is originated from the left sinus of Valsalva. As it passed posteriorly to the aorta, it could have been pressed by the esophagus or the right auricle of the right atrium.
CONCLUSION: This study showed that the right coronary artery arises from left sinus of Valsalva. Together with the significant cardiomegaly and extra pericardial fat, this abnormally originated right coronary artery could be one of the main causes of this person’s health complications while alive
The Relationship between Perceived Stress and Attitude towards Delivery and Choosing Mode of Delivery among Pregnant Women
Get PDFBACKGROUND AND OBJECTIVE: Since choosing mode of delivery is one of the most important choices in a woman's life, the factors affecting this choice are necessary to be considered. In recent years, the effect of various psychological factors on attitude towards delivery has been considered. One of these factors is the mother's perceived stress. Therefore, this study was conducted to determine the relationship between perceived stress and attitude towards delivery and choosing mode of delivery among pregnant women.
METHODS: This prospective cohort study was conducted among 305 pregnant women who were at week 32 of their pregnancy or above who referred to selected health centers of Ahvaz in 2016. "Demographic information", "Perceived stress" and "Attitude towards mode of delivery" were collected using a questionnaire. Perceived stress score was from zero to 56 (higher score indicates higher perceived stress), and attitude towards delivery score was from 68 to 204 (higher score indicates more positive attitude towards delivery).
FINDINGS: The mean perceived stress score in subjects with positive, neutral and negative attitudes toward delivery were 27.08±10.86, 25.70±8.82 and 22.36±15.14, respectively, and in women with virginal and cesarean deliveries were 26.45±10.18 and 25.24±10.44, respectively. There was no significant correlation between perceived stress and attitude towards delivery (p=0.22) and choosing mode of delivery (p=0.49).
CONCLUSION: The results of the study showed that there is no relationship between perceived stress and attitude towards delivery and choosing mode of delivery
Status of using institutional repositories in Iranian higher education centers: A short communication
Get PDFBackground and aim: Institutional repositories are digital archives to collect, manage, disseminate and preserve the scientific resources. The aim of this study was to investigate the status of using institutional repositories in different higher education centers of Iran. Material and methods: In this survey study, OpenDOAR and ROAR directories were used to extract the Iranian's institutional repositories as well as the Ranking Web of World Repositories website were applied to assess the rank of institutional repositories. Findings: The findings showed that 17 organizational institutional repositories were active in Iran's scientific centers, of these, 13, 3 and 1 institutional repositories were used Eprints and Dspce and Green Stone softwares. Moreover, none of Iranian institutional repositories has been included in the webometric ranking. Conclusion: The use of institutional repositories in Iran's universities has been growing, but it is very low compared to the number of Iranian academic and research centers
Cryptosporidium spp. infection in Iranian children and immunosuppressive patients: A systematic review and meta-analysis
Get PDFBackground: Cryptosporidiosis is an important cause of diarrhea in children and immunosuppressive patients. The current study was intended to evaluate the prevalence rate of Cryptosporidium infection and clarify the epidemiological characteristics of the infection in both children and immunosuppressive patients in Iran.
Methods: Five English electronic databases including PubMed, Google Scholar, Science Direct, Scopus and Cochrane, and two Persian language databases Magiran and Scientific Information Database were searched. Additionally, reports from the Iranian congresses of parasitology and graduate student thesis dissertations were assessed manually.
Results: Out of 1856 studies from the literature search, our search resulted in a total of 27 articles published from 1991 to 2016. These include 14 reports on cryptosporidiosis in children and 13 papers regarding immunosuppressive patients. 8520 children and 2015 immunosuppressed cases were evaluated. Oocysts of Cryptosporidium were found in 3.8% and 8% children cases and immunosuppressed patients, respectively. There was a relatively high variation in the prevalence estimates among different studies, and the Q statistics was high among articles regarding children (p<0.0001) and also between records regarding immunosuppressed patients (p<0.0001). Findings showed that the prevalence rates of Cryptosporidium infection are significantly higher in children under 5 years (P=0.00).
Conclusions: In summary, the present study provides a comprehensive view of the epidemiology of Cryptosporidium in children and immunosuppressive patients in Iran. Furthermore, a multidisciplinary and multicenter study to evaluate the real prevalence of Cryptosporidium infection and to determine its risk factors using an adequate sample size and standardized methods is highly recommended
Anti-coagulation therapy following coronary endarterectomy in patient with coronary artery bypass graft
Get PDFBackground: Since there is a lack of research on postoperative anticoagulation protocol in patients undergoing coronary artery bypass graft (CABG) / coronary endarterectomy (CE), we recommend a new protocol for anticoagulation in these patients.
Methods: In this double-blind randomized clinical trial study, 52 patients undergoing CABG / CE entered the study and were divided into two groups. In group 1, the patients were given warfarin(international normalized ratio (INR) between 2-3) together with 80 mg aspirin daily for 3 months. In group 2, the patients were given 75 mg plavix daily together with 80 mg aspirin daily for 3 months. We evaluated patients with electrocardiography, echocardiography and checking ceratin phosphokinase MB and troponin I in the several stages. The data were analysed SPSS Version18 software.
Results: There was no significant difference between pre and post-operative Ejection fraction in patients with plavix (P=0.21) and warfarin (P=0.316) regimen. However, wall mrotion score was significantly better in clopidogrel – aspirin patients in late (3 months) post operation (p<0.001).
Conclusions: Since warfarin has serious hemorrhagic complications and requires closed monitoring of serum drug activity by serial INR checking, it is recommended that clopidogrel – aspirin can be the preferred alternative anticoagulation therapy in CABG / CE patients
Antibiotic prophylaxis in the prevention of urinary tract infection in patients with sterile urine before extracorporeal shock wave lithotripsy
Get PDFBackground: One of the lithotripsy complications is urinary tract infection (UTI) and sepsis after extracorporeal shock wave lithotripsy (ESWL). The aim was to study the prophylactic effect of antibiotics on UTI after ESWL.
Methods: This randomized double-blind clinical trial was carried out on 600 patients admitted to Babol Clinic hospital in 2014-2015. Patients were randomly divided into treatment group (receiving 200 mg ofloxacin and control group (receiving placebo. The effect of prophylactic antibiotics on the incidence of bacteriuria after ESWL and the impact of variables such as gender, age, urolithiasis size and location and underlying diseases in the incidence of UTI after ESWL were evaluated.
Results: Totally, 67 of the population had positive urine cultures. Twenty-nine (10.13%) of them were in the treatment group (n=286) and 38 (13.01%) of them were in the control group (n=292). All 67 patients had asymptomatic bacteriuria. Escherichia coli and proteus were the grown microorganisms in most samples. The mean age of sample population was 44.8±23, and 67.16% of patients with positive urine culture were older than 45 years.
Conclusions: The results indicated that prophylactic antibiotics prior to ESWL in patients with urinary calculi and negative urine culture had no significant decrease in urinary tract infection after lithotripsy. It is better that the use of prophylactic antibiotics is limited to patients with risk factors
Comparision of Aqueous and Hydroalcoholic Extracts of Foeniculum Vulgare and Carum Copticum with Gentamicin on Escherichia Coli Strains: in Vitro Study
Get PDFBACKGROUND AND OBJECTIVE: Due to bacterial resistance to antibiotics, new antibacterial agents is essential. In Persian medicine Fennel (Fuenoculum vulgare Mill.) and Ajwain (Carum copticum (L.) Benth. & Hook.f.) are recommended for the treatment of some infections. In this research, bacteriostatic and bactericidal effects of aqueous and hydroalcoholic extracts of fennel and Ajwain on E. coli were investigated.
METHODS: In an in-vitro study 30 clinical isolates of urine culture of children with urinary tract infection from Amirkola Pediatric Hospital in Babol and a standard sample were used. Antibacterial effects of 4 grouos including aqueous and hydroalcoholic extracts of fennel and Ajwain by measuring the diameter of the inhibition zone using disc diffusion (concentrations 16, 32, 64, 128, 256 and 512 mg/disc) and determination of Minimum Inhibitory Concentrations (MIC) and Minimum Bactericidal Concentration (MBC) with Microdilution method was compared with Gentamicin (30mg/disc) as a positive control
FINDINGS: There was no significant difference in inhibition zone with Gentamicin at concentrations of 64, 128, 256, and 512 mg/disc in standard and clinical samples. At concentrations of 16 and 32, Gentamicin was significantly better. The extract of 512 mg/disc (12.93±2.66) of hydroalcoholic extract of Carum copticum was significantly better than 256 mg/disc (9.53±1) (p=0.002). The MIC and MBC for standard samples were 4 and 8, respectively, and for clinical samples 3.83±2.36 and 5.8 mg / ml, respectively. Other extracts were not able to inhibit the growth of Escherichia coli.
CONCLUSION: The results showed that the Hydroalcoholic extract of Carum copticum has bacteriostatic and bactericidal effects on standard and clinical isolates of Escherichia coli
Production of recombinant CAMP – Sialidase protein and preparation of chitosan nanoparticles carrying this protein to be used as a candidate for vaccines targeting Propionibacterium acnes
Get PDFBACKGROUND AND OBJECTIVE: Acne vulgaris is one of the most common skin diseases that imposes too much mental pressure and high costs on patients. The existing treatments have low efficacy and include antibiotics and anti-inflammatory drugs, which have many complications due to the chronic nature of the disease, especially at young age, including antibiotic resistance and allergic reactions. For this reason, one of the new therapeutic approaches is the use of a vaccine with the help of the bacterium or its components. The aim of this study is to produce nanoparticles carrying the recombinant CAMP – Sialidase protein as a new chimeric antigen to be used in acne vaccine.
METHODS:To express the recombinant CAMP – Sialidase protein, E. coli BL21 DE3 was used as the host. Purification of protein was done through combined urea/imidazole method and using a nickel-nitroacetic acid column. The recombinant protein was confirmed using Western Blotting by Anti – Histidine Antibody. Then, the loaded nanoparticles were prepared by recombinant protein using ionic gelation technique and tripolyphosphate. Finally, the size and zeta potential of the nanoparticles were determined by the DLS device.
FINDINGS: The recombinant CAMP – Sialidase protein was confirmed after expression and purification. The size and zeta potential of nanoparticles containing recombinant CAMP – Sialidase protein at a concentration of 0.6 mg / ml were determined to be 80 nm and +27 mV, respectively, using the DLS device. The loading rate of the protein in the nanoparticles was found to be 88%.
CONCLUSION: The results show that the recombinant protein is expressed completely and is successfully encapsulated in the chitosan nanoparticles
Effectiveness of Nutritional program and cognitive-behavioral training in Anxiety, anger & aggression Premenstrual Syndrome
Get PDFBACKGROUND AND OBJECTIVE: Premenstrual syndrome (PMS) is a common disorder in women that affects their quality-of-life and performance.The present study was aimed to evaluate the nutrition based on traditional medicine and cognitive behavioral therapy (CBT) on anxiety and anger in this syndrome..
METHODS: This quasi-experimental study was performed on 45 women with premenstrual syndrome who were randomly divided into three groups of CBT recipients alone, CBT with nutrition and control group for two months. The nutrition content was adjusted in a form and the subject started two weeks prior to menstruation and followed it up to the end of the menstrual period. Cognitive-behavioral training was provided over 8 90-minute sessions. Data were recorded before and after training and two months follow-up. Anxiety questionnaires (0 to 63 scores), aggression (0 to 90 scores) were used to evaluate the variables.
RESULTS: There was a significant difference in the anxiety (28% reduction in CBT and 31% in CBT and nutrition) and anger (65% reduction in CBT and 55% in CBT and nutrition) variables in both groups except control (p 0.05).
CONCLUSION: The results of this study showed that the use of both CBT and nutritional training methods is effective in controlling anxiety and anger