Ardabil University of Medical Sciences
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Spatial Distribution of Scorpionism in Ardabil Province, North West of Iran
Get PDFAbstract Background Scorpion stings are the most important health problems in tropical and subtropical countries. The aim of this study was to assess spatial distribution of scorpions and scorpionism in Ardabil province, Iran. Materials and Methods This descriptive–analytic study was carried out in all 10 counties of Ardabil province, Northwestern Iran. The clinical and demographic data of scorpion sting cases were collected from questionnaires belonging to an 8 year - period of 2010 to 2017. In addition, scorpions were captured using Ultra-violet (UV) light, Pitfall traps and digging methods. After species identification, Arc GIS 9.3 software was applied for mapping spatial distribution of them. Data were analyzed by SPSS software (version 21.0). Results A total of 958 scorpion sting cases were documented. One hundred ninety cases (19.83%) of them were occurred in age group <19 years. Stings were mostly recorded in rural areas after midnight and in the early morning hours from April to September. Also, nocturnal envenomation was observed with the highest frequency (52.50%). A total of 142 scorpions were collected and identified. The collected scorpions belonged to Butidae and Scorpionidae families. They were classified into two genera (Mesobuthus, Scorpio), and two species: Mesobotus eupeus (99.29%), and Scorpio maurus (0.71%). Conclusion There was a high prevalence of scorpion stings in rural areas in Ardabil province among age group less than 19 years old. This finding suggests the necessity of preventive programs for decreasing this higher incidence
Preparation, statistical optimization and in vitro evaluation of pramipexole prolonged delivery system based on poly (3-hydroxybutyrate-co-3-hydroxyvalerate) nanoparticles
No full textThe purpose of the current study was to prepare and optimize a long acting formulation for pramipexole based on poly (3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) nanoparticles (NPs). Pramipexole loaded PHBV NPs were prepared by double emulsion solvent evaporation technique. Box-behnken response surface methodology was utilized to assess the effect of independent variables including PVA concentration, polymer percentage and drug concentration on important properties of NPs. The optimized NPs was shown 228 nm size with 85.43% and 5.68% entrapment efficiency and loading capacity, respectively. The spherical structure of the pramipexole loaded PHBV NPs was proved by scanning electron microscope (SEM). Differential scanning calorimetry (DSC) testified both the absence of undesirable chemical interactions between pramipexole and NPs and the incorporation of pramipexole within the matrix of polymer. In vitro release studies demonstrated that 89.9% of pramipexole was gradually released within 30 days based on quasi-fickian diffusion mechanism
Eptifibatide Bolus Dose During Elective Percutaneous Coronary Intervention
No full textBackground: Eptifibatide is a platelet glycoprotein IIb/IIIa receptor antagonist used for the prevention of cardiac ischemic complications of percutaneous coronary intervention (PCI). Eptifibatide has been used with bolus dose only or bolus plus infusion in patients undergoing PCI which have shown less complications, but the risk of bleeding has been increased. We aimed to compare the outcome and bleeding rate of bolus dose alone or plus infusion in elective PCI.
Methods: In this quasi-experimental study, we compared the outcome of elective PCI following single bolus dose intracoronary (41 patients) or bolus plus intravenous infusion (19 patients) of eptifibatide. In-hospital and follow-up major adverse cardiac events (MACEs) and bleeding rate were recorded and evaluated between groups.
Results: Both groups were comparable regarding baseline findings. Bolus only compared to bolus plus infusion group had lower in-hospital (19.5% vs. 31.6%) and follow-up MACE (15.4% vs. 17.6%), lower bleeding in-hospital (14.6% vs. 21.1%) and follow-up (2.4% vs. 5.3%) as well as lower mortality rate in hospital (4.9% vs. 15.8%), but higher follow-up mortality (10.3% vs. 0), but the difference was not significant.
Conclusions: We observed no significant difference regarding bleeding or MACE between intracoronary bolus infusion and bolus plus intravenous infusion of eptifibatide. It seems intracoronary bolus infusion of eptifibatide due to use of lower doses is a better choice in elective PCI to prevent post-PCI MACE
Comparison of the Diagnostic Method of Cultivation with Amsel Standard in the Diagnosis of Gardnerella vaginalis in Patients with Genital Infection
Get PDFBackground & objectives: Vaginal microbial infections are common, and involvement of bacterial agents in genital infection is equal to that of fungal and protozoal agents. Gardnerella vaginalis is an organism that is often thought to play the most important role in bacterial vaginosis. The aim of this study was to compare the value of the diagnostic method of cultivation with Amsel standard in the diagnosis of Gardnerella Vaginalis infection in patients with genital tract infection.
Methods: A cross-sectional study was performed on 150 women aged 15-55 years who complained of vaginal discharge during the period of the study, Jan 2017 to July 2017, in Alawi Hospital in Ardabil and were examined by a clinical examination. For each of the patients, three of the four diagnostic criteria of Amsel, including homogeneous discharge, PH measurements and whiff test were performed, and if two of them were positive, a questionnaire containing general and clinical information was completed. Using three sterile swabs, samples were taken from vaginal discharge. The first swab was used for culture, the second swab for the whiff testing and the third swab for Papanicolaou staining and verifying the presence of clue cell in the vaginal smear sample as a fourth grade of Amsel to diagnose bacterial vaginosis. In general, if three of the four Amsel criteria were positive in one person, it was considered to be positive in terms of Amsel's standard.
Results: Of 150 participants, 21 were diagnosed with Gardnerella vaginalis infection, of which 14 cases (%66.6) had positive Gardnerella culture. All of 21 patients (%100) with Gardnerella vaginalis had clue cells in Pap smear. The pH of vaginal discharge of 20 samples was 4.5 (%95.23), 18 samples had positive Amine tests (%85.71) and 16 samples had homogeneous secretion (%76.19).
Conclusion: The results of this study showed that culture method in comparison with Amsel diagnostic criteria did not have sufficient accuracy to detect Gardnerella vaginalis infection. In addition, the culture method is costly and time consumin
Primary PCI in STEMI
Get PDFPrimary percutaneous coronary intervention (PCI) has been established as the treatment of choice for patients presenting with acute ST elevation myocardial infarction (STEMI) and is associated with high success rate, low mortality in non-shock patients and low complication rates.
STEMI was defined as symptoms of ischemia associated with ST-segment elevation of ≥1 mm in limb leads and/or ≥2 mm in chest leads in ≥2 contiguous leads, or new left bundle branch block, or true posterior myocardial infarction with ST depression of ≥1 mm in ≥2 contiguous anterior leads. There are no situations in which fibrinolytic therapy is preferred over primary PCI unless the patient refuses invasive procedures. Fibrinolytic therapy works best when symptom onset is 3 hours then primary PCI is preferred.The best outcomes occur when primary PCI is performed with a door-to-balloon time of < 90 minutes and when symptoms onset was < 12 hours.Primary PCI is only indicated when symptoms duration is 12-24 hours(delayed presentation) if severe congestive heart failure, hemodynamic/electrical instability or continued angina is present. Primary PCI is notrecommended when symptom onset is more than 12 hours and the patient isasymptomatic .
Catheterization team was activated immediately on confirmation of STEMIdiagnosis. After loading with dual antiplatelets, patients were immediatelyshifted to catheterization laboratory.
After gaining vascular access, non-culprit vessel angiogram was done firstfollowed by the culprit vessel angiogram. Once the decision to go aheadwith angioplasty was taken, heparin was administered in dosage of 70–100 U/kg to achieve an ACT of 250–300. GPIIb/IIIa inhibitor use was left tooperator's discretion. The choice of guidewire, balloon, stent, thrombusaspiration and IABP was on operator's discretion.
Hemodynamically stable patients were kept in CCU for 24–48 h andsubsequently shifted to step down unit and were discharged on 4th or 5th day.At discharge statinsin dose of 40–80 mg and dual anti platelet (DAPT) agentswere prescribed to all patients. ACEI/ARB and beta blockers were used in allpatients without contraindications for their use.
Important predictors significantly associated with mortality are the door toballoon time, Killip class, final TIMI flow and severe LV dysfunctio
Social Anxiety and Benign and Toxic Online Self-Disclosures: An Investigation Into the Role of Rejection Sensitivity, Self-Regulation, and Internet Addiction in College Students
Get PDFThis work aimed to explore the relationship between social anxiety with benign and toxic online self-disclosures with the mediating role of rejection sensitivity, self-regulation, and Internet addiction. In this study, 358 students who were active members of social networks at the Mohaghegh Ardabili University, Iran were evaluated in the form of a structural equation model. The results substantiated that social anxiety could explain 47% of the variance in benign online self-disclosure and 27% of toxic online self-disclosure with the mediating role of rejection sensitivity, self-regulation, and Internet addiction. It was found that people with high social anxiety had higher rejection sensitivity and lower self-regulation. Also, people with higher social anxiety had directly higher benign and toxic online self-disclosures. The results indicated that self-regulation did not have a direct impact on benign online self-disclosure; however, it had a direct negative impact on toxic online self-disclosure
Drug resistance of clinical and environmental isolates of Brucella species in Iran: a meta-analysis
Get PDFBackground: Brucellosis is a contagious and febrile disease endemic to Iran. Increased antibiotic resistance in endemic areas may lead to increased risk of treatment failure and the risk of disease relapse. This systematic review and meta-analysis was performed to determine the antibiotic susceptibility profiles of Brucella species isolated from clinical and environmental samples in Iran.
Methods: Using national and international databases and extracted keywords from the MeSH database, a fully computerized search was done until 11 June 2018. Of 385 collected studies on the prevalence of drug resistance of Brucella species isolated in Iran, six articles were included in the meta-analysis using predefined eligibility criteria.
Results: Overall resistance rates of Brucella species to different antibiotics in Iran were as follows: doxycycline: 0%, tigecycline: 5.1%, trimethoprim/sulfamethoxazole: 5.7%, ciprofloxacin: 2.7%, streptomycin: 5%, rifampin: 9.5%, tetracycline: 4.6%, gentamicin: 3.9%, moxifloxacin: 0%, erythromycin: 33.3%, azithromycin: 5.8% and ceftriaxone: 6.3%.
Conclusion: Our study revealed that the prevalence of drug resistance of Brucella species isolated from clinical and environmental samples in Iran was acceptable and low. However, care should be exercised in the use of common antibiotics for the treatment of brucellosis to prevent the spread of drug resistance
The comparative study of vitamin D serum levels relationship with early onset neonatal sepsis and its outcome (case-control study)
Get PDFBackg¬raund and objective:Neonatal sepsis is a critical condition caused by a generalized bacterial infection in the first month of life. It begins with early onset (7 days of life) and sepsis with late onset (7-27 days) and sepsis in the hospital. Vitamin D is a steroid hormone that has numerous roles in the immune system and reduces inflammation. The relationship between neonatal early sepsis and maternal vitamin D levels has not been established in the studies. Therefore, the purpose of this study is to compare the relationship between serum vitamin D levels and early onset sepsis and the outcome of the disease.
Methods :This study is a case-control study. In this study, newborns were enrolled after interviewing mothers of the newborns with satisfaction. In this study, 43 newborns admitted with early diagnosis of neonatal sepsis under the name of the case group in the neonatal ward of Boual Ali Ardabil Medical Center in 2012 were included. These infants entered the study census. Also, 43 healthy children with age, sex and weight were matched with the case group and were selected from infants admitted in the neonatal department (due to jaundice) and considered safe for sepsis. In these newborns after obtaining a history and collecting information regarding the demographic characteristics of infants, gestational age, delivery method, birth weight, measures taken for the baby at the time of admission, and the extraction of blood and biochemical tests. Was requested. Then, all the findings of neonatal examination as well as the responses of both groups of infants and their mothers were entered into the SPSS v21 statistical program and finally, data analysis was performed.
Results:In this study, 86 neonates were studied, 43 neonates with sepsis and 43 healthy infants. In the study of neonates with sepsis, the mean age was 4.93 days and 72.1% were male. The most common complaints in restless neonates were 74.71%, jaundice in 67.44% and fever in 62.7% of infants. The mean birth weight of neonates was 33.3 kg, gestational age was 38.23 weeks. The duration of hospitalization was 2.5 days. In this study, the average age of mothers with a newborn with sepsis was 26.83 years. 23.3% of mothers had received vitamin D supplementation during pregnancy. Dairy consumption in these mothers was low and the majority of exposure was less than 15 minutes in the sun. In this study, a high percentage of infants in the study had severe to moderate vitamin D deficiency, although this percentage was higher in neonates with sepsis than in healthy subjects. There was no significant difference between the level of vitamin D and sepsis
.
Conclusion:The results of this study showed that there is no significant difference between vitamin D and maternal levels in both groups. However, in the sepsis group, there is a significant relationship between maternal vitamin content and neonatal serum level. Also, there was no significant relationship between neonatal outcome and vitamin D levels
Comparison prevalence of seizure after receiving DTP and DTP-HepB-Hib vaccinations among children less than 1 year of age in Ardabil Bu-Ali hospital
Get PDFBackground and Objective: The prevention of infectious diseases by using the vaccine is one of the great successes of the history of medical science. In the previous vaccination program for children in Iran, a DTP vaccine including diphtheria, tetanus, and pertussis alongside a Hepatitis Type B vaccine were injected, but in the new vaccination program only one vaccine called Pentavalent is being used. The main purpose of this study is to compare the seizure incidence following pentavalent vaccination and DTP vaccination in children who admitted in Buali hospital.
Methods: This study is done as a Health Research Study (HSR) in Ardebil province. For this purpose, referring to the archives of Bu-Ali Ardebil Hospital, the total number of children under 1 year old from September 2015 to September 2017 also from September 2011 to September 2013 were obtained. The required information for each child was obtained by examining hospital records as a questionnaire which includes sex, age of vaccination, seizure frequency in 72 hours, seizure durations, seizure type, febrile convulsion, familial history of seizure and seizure history before vaccination. In some cases information obtained by communicating parents. subsequently obtained data were analyzed by SPSS v24 software using Chi-square and T-test.
Results: Out of 20 cases of seizures following vaccination, 3 cases caused by DTP vaccine and 17 cases caused by pentavalent vaccine.Mean age of Pentavalent group was 3.14 ± 2.1 months and DTP group consisting of 3 persons was 2.0 ± 2.0 months. In the DTP group, there were two boys (66%) and one girl (33%), and in the pentavalent group there were 12 boys (70%) and 5 girls (30%).
Conclusion: Result showed a significant relationship between seizure incidence and pentavalent and DTP vaccinations.Also, there was a significant relationship between duration and age of onset of seizure with vaccine typ
Multiple Repeats of Helicobacter pylori CagA C-Terminal Motifs Predict the Risk of Gastric Cancer in Iran
Get PDFBackground: CagA, a 120- to 145-kD Helicobacter pylori (H. pylori) protein, increases the risk of atrophic gastritis and gastric cancer (GC). The pathogenic CagA contains a highly polymorphic Glu-Pro-Ile-Tyr-Ala (EPIYA) repeat region in the C-terminal portion of the protein. The aim of this study was to determine the number and type of EPIYA (glutamine–proline–isoleucine–tyrosine–alanine) motifs within the cagA 3' variable region among H. pylori isolates and their association with GC.
Materials and Methods:
The total number of 206 individuals (170 controls and 36 patients with GC) referring to the endoscopy units of several cities in Iran (2008-2014) were recruited. The polymerase chain reaction (PCR) amplification was performed to determine the presence of H. pylori, cagA gene, and EPIYA motifs.
Results:
In this study, 81 (47.6%) and 22 (61.1%) of the controls and patients with GC were carriers of cagA+ strains, respectively. The overall frequency of EPIYA-AB, EPIYA-ABC, EPIYA-ABCC, and EPIYA-ABCCC in patients with GC were 0%, 59%, 9%, and 31.8%, respectively. The results of regression analysis showed a significant association between EPIYA-ABCCC motif and the risk of GC [OR = 9.99 (95%CI: 2.17-45.88), p = 0.003].
Conclusion:
We propose that patients infected with H. pylori strains harboring more than one CagA EPIYA C motif (EPIYA-ABCCC) have an increased risk of GC, thus, testing for this genotype may have clinical usefulnes