Ardabil University of Medical Sciences
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Magnesium sulfate protects blood–brain barrier integrity and reduces brain edema after acute ischemic stroke in rats
No full textBrain edema is a fatal complication of acute ischemic stroke and associated with worse outcomes in patients. This study was designed to evaluate the effects of magnesium sulfate on vasogenic brain edema formation and blood–brain barrier (BBB) disruption caused by ischemia-reperfusion (IR) in a rat model of ischemic stroke. A total of 72 male Sprague-Dawley rats were categorized into the following three primary groups: sham, control ischemic, magnesium-sulfate-treated (300 mg/kg loading dose, followed by an additional 100 mg/kg) ischemic (n = 24 in each group). Transient focal cerebral ischemia was induced by 60-min-long occlusion of the left middle cerebral artery, followed by 24-h-long reperfusion. Sensorimotor deficits, infarct volume, and brain edema were evaluated at the end of the reperfusion period. The BBB permeability was assessed by Evans Blue extravasation technique. Lipid peroxidation levels were assessed by measuring the malondialdehyde content in the brain tissue homogenate, and the activities of the antioxidant enzymes superoxide dismutase, catalase, and glutathione peroxidase were detected according to the technical manual of the assay kits. Induction of cerebral ischemia in the control group produced considerable BBB damage in conjunction with severe brain edema formation. Treatment with magnesium sulfate significantly attenuated brain edema and protected BBB integrity in the ischemic lesioned hemisphere. In addition, magnesium sulfate reduced lipid peroxidation and increased antioxidant protection of brain tissue by upregulating the activities of antioxidant enzymes. Treatment with magnesium sulfate protected BBB integrity against IR-induced damage and reduced vasogenic edema formation partly via antioxidant mechanisms in a rat model of acute ischemic stroke
Quality of life and its related factors in kidney transplant recipients
Get PDFPatients undergoing transplantation, experience significant changes in their quality of life. The aim of this study was to determine the quality of life and related factors in kidney transplant recipients. This descriptive-analytic cross-sectional study was performed on 136 kidney transplant recipients referring to nephrology clinic of Imam Khomeini Hospital in Ardabil through convenience sampling method in 2016. Data was collected by using a demographic form, Short Form Health Survey (SF36), physical stress index, Kidney Transplantation Self-Management Scale, Kidney Transplantation Self-Care Self-Efficacy Scale and Beck's Depression Inventory. Data were analyzed by SPSS software version 16 using descriptive and analytical methods. The mean score of physical health (55.01 ±19.48) was slightly higher than the mental health (42.86 ± 20.91). Self-efficacy (β = 0.29), depression symptoms (β = -0.34), age (β = -0.36) and gender (β = 0.15) were as predictors of the physical health component of quality of life. Self-efficacy (β = 0.58), depression symptoms (β = -0.25), age (β = -0.16) and education level (β = -0.28) were determined as predictors of the mental health component of quality of life. It is imperative that the kidney transplant care team improve patients' quality of life by teaching self-care behaviors to improve patients' self-efficacy and early screening for depression symptoms. On the other hand, care services should be provided with greater support from women and the elderly patients in order to improve their physical and mental health
High Frequency of Macrolide-Resistant Streptococcus pneumoniae Colonization in Respiratory Tract of Healthy Children in Ardabil, Iran
No full textBackground: Streptococcus pneumoniae (S. pneumoniae) is one of the most common causes of human diseases in young children. Macrolides are commonly antibiotics used for empirical treatment of community-acquired respiratory infections. The purpose of this study was to determine antibiotic resistance pattern as well as the relationship between macrolide resistance and the major mechanisms of resistance in pneumococci isolated from healthy children. Materials and Methods: In this cross-sectional study, 43 isolates of S. pneumoniae were collected from healthy children in Ardabil. Resistance pattern against tested antibiotics was determined using the disk diffusion method. The Minimum Inhibitory Concentration (MIC) of erythromycin was determined using the E-test strips. The mefA/E and ermB gene were detected in erythromycin-resistant isolates using the specific primers and Polymerase Chain Reaction (PCR) technique. Results: According to antimicrobial susceptibility testing, 74.4 % of the isolates were resistant to erythromycin, 95.3 % to penicillin, 81.3 % to co-trimoxazole, 72 % to azithromycin, 41.8 % to tetracycline, 27.9 % to clindamycin, and 16.2 % to chloramphenicol. All isolates were susceptible to levofloxacin and vancomycin. In the case of rifampin, 95.3% of the isolates were sensitive and 4.6% semi-sensitive. The MIC of erythromycin for resistant isolates was between 1.5 and ≥ 256 μg/ml. PCR results revealed that 100% of erythromycin-resistant isolates contained mefA/E gene and 81.25 % contained both the ermB and mefA/E genes. Conclusion: The prevalence of antibiotic-resistant strains of S. pneumoniae, especially resistance to macrolides, was high among healthy children in Ardabil. According to the results of this study, we suggest using levofloxacin, rifampin and vancomycin antibiotics as an appropriate prophylactic regimen in pneumococcal infections. Key words: S. pneumoniae, Healthy children, Macrolide, Antibiotic resistance, ermB, mefA/
Development and validation of a cultural competence questionnaire for health promotion of Iranian midwives
Get PDFINTRODUCTION: Cultural competence is the main component of cultural care; therefore, it is necessary to be aware of its levels. The lack of a suitable tool that can measure cultural competence levels among midwives led us to carry out the present study aiming to develop and validate a cultural competence questionnaire for health promotion of Iranian midwives. METHODOLOGY: This methodological study was performed on 302 midwives selected through three-stage cluster sampling method in 2018 in East Azarbaijan Province. The initial tool was designed after qualitative study and searching similar studies. Then, the tool validity was assessed through evaluating the face and content validity in midwives and performing survey and psychometrics. Finally, the data were statistically analyzed by SPSS version 19 through exploratory factor analysis, item analysis, Cronbach's alpha coefficient, and Pearson correlation, at the significant level of <0.05. RESULTS: The initial tool was constructed with 42 items in the five-point Likert scale. By eliminating 9 items during face and content validation and 6 items during factor analysis, the final 25-item questionnaire was developed in five areas of theoretical and practical learning, clinical application, cultural skill, cultural excellence, and cultural competence. According to Cronbach's alpha, reliability of the tool was at a good level (0.889) with a confidence interval of 0.95 (P < 0.001). CONCLUSION: The cultural competence questionnaire for Iranian midwives, with five-factor verification and acceptable validity and reliability can be used in studies considering the components of Iranian culture
Risk Factors and Clinical Manifestations of Cerebral Venous Thrombosis (CVT) in Patients Admitted to Ardabil City Hospitals during 2012-2017
Get PDFBackground and objective: In Cerebral venous thrombosis (CVT), blood clots create in the veins and sinuses. Detection of disease due to the wide spectrum of clinical symptoms may be delayed, the importance of timely diagnosis of this disease is that with early treatment, death can be avoided and serious and lifelong complications can be prevented in many patients. Also, recognizing the underlying causes and other factors that contribute to the onset of the disease can prevent the disease.
Methods: This cross-sectional descriptive study has been done on 28 patients diagnosed with cerebral venous sinus thrombosis during years 2012 to 2017 that hospitalized in Ardabil city hospital. Demographic data of patients and information about laboratory tests and clinical and Para-clinical findings were entered in a checklist and then analyzed by statistical methods in SPSS version 19.
Results: The mean age of the patients was 36.6 ± 8.7 years and most of them were in age group less than 30. Of all patients, 53.6% were female. The most prevalent symptoms and signs among patients was headache. Upper sagittal sinus with 50% was the most prevalent involved vein. 53.4% of women were taking oral contraceptive pills (OCP) and 46.2% of male patients had smoking and drug addiction. Thrombotic occlusion often affected the sagittal and then transverse sinuses. 10 cases (35.7%) had findings based on ischemia and 4 (14.3%) had intracranial hemorrhage.
Conclusion: The results showed that the high incidence of CVT in females was more than males which can be the sign for relation between CVT with factors such as OCP use and pregnancy. Also regarding to the vomiting and dizziness as the most common clinical symptoms in patients so it can be a means of distinguishing headaches caused by the disease with other common headaches and help in diagnosis
Communication skills and its related factors in Ardabil Alavi Hospital nurses and staff
Get PDFBackground: Communication skills (CS) is an important topic which help the nurses and staff to maintain effective relationships and have professional standards in all legal, ethical and clinical areas. So low level of CS between nurses could be led to more medical mistakes and reduce the patient’s quality of care. The aim of this study was to determine the level of CS among Ardabil teaching hospitals nurses and staff and its related factors.
Methods: This descriptive-analytical study was conducted on 145 Ardabil Alavi hospitals’ nurses and staff from May 2019 to November 2019. The data collection tool was communication skills questionnaire of Burton G (1990) which included demographic data and interpersonal communication skills test (18 items) with a range of 18-90. Data analyzed in SPSS version 21 by using descriptive and analytical statistics tests such as; Spearman, Mann-Whitney U, and Kruskal Wallis at significant level of p<0.05.
Results: Of all students, 72.4% were women and the rest were men. The average age of participants, was 36.9±8.4 years. The mean score of total communication skills was calculated 59.2±7.3. The mean score of verbal skill, listening skill, and feedback skill were calculated in order to 20.8±3.43, 17.6±4, and 20.7±3.2, respectively. Total Communication skills was significantly related with past work experience but other demographic variables hadn’t significant relation with CS.
Conclusions: The results indicated that the CS of Ardabil hospital nurses and staff were in moderate levels. So, providing training programs for raising their CS in future is essential
Comparison of Glasgow Blatchford Score and AIMS65 in Predicting Mortality in Patients with Upper Gastrointestinal Bleeding
Get PDFIntroduction: Upper gastrointestinal bleeding (UGIB) is the most common cause of emergency admission in gastrointestinal disease. UGIB could accompany with adverse events if not treated timely. Different scoring systems have been suggested for diagnosing these patients, In this study we aimed to compare the predictive value of two scoring systems AIMS65 and Glasgow Blatchfors scale (GBS) in patients with UGIB. Methods: In this cross-sectional study, 153 patients (71.9% male with mean age of 56.72±21.64 years) with acute UGIB between April 2017 and September 2018 were included. Demographic findings, past medical history, laboratory findings, AMIS65 and GBS score, as well as, need for urgent endoscopy, transfusion and mortality were recorded. Both methods value in predicting the outcomes were measured using ROC curves. Results and Conclusion: Urgent endoscopy was performed in 44.4%. The most common finding was peptic ulcer with mostly clean base type. Rebleeding occurred in 15%, need for transfusion was in 44.4% and mortality rate was 5.2%. AIMS65 compared to GBS was superior in predicting mortality (AUC of 0.947 vs. 0.80) but was inferior compared to GBS in predicting need for transfusion (0.849 vs. 0.947). None of the systems could predict the need for urgent endoscopy. AIMS65 with cut off 2 and 0 and GBS with cut off of 12 and 8 could predict mortality and need for transfusion. GBS seems a better system in predicting the need for blood transfusion, while AIMS65 is better system for predicting in-hospital mortality in patients with UGIB
A Systematic Review and Meta-analysis on the Epidemiology of Antibiotic-resistant Yersinia Species in Food and Clinical Specimens in Iran
Get PDFObjective: The aim of the present study was to investigate the antimicrobial susceptibility profiles of Yersinia species, especially Y. enterocolitica from non-clinical and clinical isolates in Iran.
Materials and Methods: We systematically searched PubMed, Scopus, Google Scholar, and the Scientific Information Database (SID) using “antibiotic resistance”, “Yersinia”, and “Iran” as major keywords until June 10, 2019. According to the predefined article selection criteria, published studies addressing the epidemiology of antibiotic-resistant Yersinia species in Iran were included in the meta-analysis. Data were extracted and exported to the Comprehensive Meta-Analysis Software to evaluate antibiotic resistance rates, heterogeneity of studies and publication bias.
Results: Twelve studies reported antimicrobial susceptibility testing using disk diffusion method. The pooled prevalence of antibiotic-resistant Yersinia species in food and clinical specimens in Iran was as follows: 22.4% to amoxicillin, 41.9% to ampicillin, 6% to gentamicin, 17% to trimethoprim/sulfamethoxazole, 19% to tetracycline, 10.3% to ciprofloxacin, 10.5% to streptomycin, 3.8% to chloramphenicol, 79.3% to cephalothin, 18.4% to nalidixic acid, 6.6% to cefotaxime, and 12.2% to trimethoprim.
Conclusion: This study revealed a high prevalence of resistant Y. enterocolitica strains isolated from food and clinical specimens in Iran to β-lactams, while the resistance rates to aminoglycosides, fluoroquinolone and chloramphenicol were low. Our findings recommended the necessity of a continuous surveillance of the resistance patterns and prudent use of trimethoprim/sulfamethoxazole, tetracycline, and nalidixic acid to prevent the development of antibiotic-resistant Y. enterocolitica strains in Iran
Changing trend of tuberculosis indicators in Ardabil province, 2005-2012: a province in north-west of Iran
Get PDFBackground: Since 1993, the Directly Observed Treatment, Short Course program was done for registry the Tuberculosis (TB) cases in all the countries to prevent the widespread of disease in society. Annually, 9 million persons are infected by TB, and it was estimated that at future 10 years more than 30 million people will die due to TB. TB is the reason of 26% of preventable death at development countries and reports showed that Multi Drug Resistant (MDR) is increased in Iran. The aim of this study was evaluated the changing trend of TB indicators in Ardabil province during 2005-2012. Methodology: This is a cross-sectional study that has been done on 1,098 registered cases of TB during 2005-2012 years. Information was collected by a checklist from recorded data by provincial health department and the analyzed by statistical methods in Statistical Package for the Social Sciences version 16. Results: 61.6% of cases were pulmonary TB cases and 38.5% were extra-pulmonary TB cases. The total incidence of TB during study years was 9.42 per 100,000. Conclusion: The results showed that the rate of TB relapse and MDR in Ardabil province has been increased in compared to previous years. Therefore, doing more exact studies in this topic is essential in future
Cytotoxic effect of Agrostemma githago on human umbilical vein endothelial cell line:HUVECs
No full textIntroduction & Objevtive: Angiogenesis has a vital role in both physiological and pathological situations. Recently, herbal medicine is targeted by many trial investigations to develop new strategies for angiogenesis related diseases such as cancers and atroscolrosis. At the present study, we evaluated the effect of extract of Agrostemma githago seed on viability of HUVECs.
Material & Methods: We first examined the viability of HUVECs following treatment with different concentration of Agrostemma githago extract using MTT assay and IC50 was determined. The activity of caspase 3 and 7 was measured via Caspase-Glo® 3/7 assay kit.
Results: Our results showed that Agrostemma githago could inhibit HUVECs viability. IC50 were calculated as 10.78 and 10.33 µg/ml for 48 and 72 hours of Agrostemma treatment, respectively. Moreover, the level of caspase 3 and 7 activites were significantly increased compared to control group.
Conclusion: Although more studies are needed, the cytotoxicity of the extract on endothelial cells and the induction of apoptosis may considered Agrostemma githago as a plant with anti-angiogenic properties