Ardabil University of Medical Sciences
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Group B streptococcus drug resistance in pregnant women in Iran: a meta-analysis
Get PDFStreptococcus (S.) agalactiae colonizes in the female genitourinary and lower gastrointestinal tracts and is
responsible for a wide range of infections in newborns, pregnant women and non-pregnant adults.
Therefore, antibiotic prophylaxis and infection treatment against S. agalactiae is important. The aim of
this study was to determine the prevalence of S. agalactiae antibiotic resistance in Iranian patients,
especially among pregnant women. A systematic literature search was conducted in PubMed, Scopus,
Google Scholar and the Scientific Information Database (SID) databases by using related keywords and
without any time limitation. A total of 26 studies reporting the prevalence of S. agalactiae antibiotic
resistance in Iran met our predefined inclusion and exclusion criteria and were included in the metaanalysis.
High rates of S. agalactiae antibiotic resistance in pregnant women were found against tetracycline
(96.2%), trimethoprim-sulfamethoxazole (84.7%), cefotaxime (41.3%), clindamycin (26.8%) and
erythromycin (21%). Additionally, resistance to penicillin (4.2%), ampicillin (2.7%), cefazolin (7.6%), vancomycin
(2.4%), ceftriaxone (12.5%), ciprofloxacin (13.6%) and nitrofurantoin (0%) was low. Our results
revealed that penicillin and ampicillin among penicillin-tolerant Iranian pregnant women, and vancomycin
and cefazolin among penicillin-allergic women are still drugs of choice in intrapartum prophylaxis
for preventing S. agalactiae vertical transmission and early-onset neonatal disease
Investigation of the prevalence of the fluoroquinolones-resistant Salmonella serotypes in Iran: a systematic review and meta-analysis
No full textcomparison of identity of color doppler and gray scale ultrasound versus FNA samples in thyroid nodules in patients admitted to imam-khomeyni hospital of Ardebil in 2019-20
No full textBackground: Thyroid nodules are one of the most common diseases. In the United States 5 to 10% of the population have a palpable thyroid nodule. Although malignancy occurs in only 7-15% of nodules. It is for 1% of all cancers and 5.5% of all cancer deathes. The incidence of thyroid nodules and thyroid malignancy has increased in recent years. Most recent US data show 63,000 new cases of thyroid cancer each year.
Aim: Due to FNA is invasive in the diagnosis of thyroid nodule malignancy, ultrasound may be used as a non invasive method.
Methods: Seventy five people were included in the study based on inclusion and exclusion criteria. Ultrasound findings of the patient's thyroid nodules were recorded by a radiologist. The nodules were aspirated under an ultrasound guide and their smear was stained and examined under a microscope. Finally, the results were analyzed using appropriate tests in SPSS software.
Results: Seventy five subjects were included in the study, of which 63 were female (84%) and 12 were male (16%). The mean age of the subjects was 46.41±9.32 years. The highest number was related to the age group of 45-55 years with 49.33%. There was a significant relationship between the presence of peripheral halo and FNA resault, so that the rate of benignity in people with peripheral aura was significantly higher. There was a significant relationship between nodule type and nodule margin. So that the malignancy was significantly higher in people with nodules with irregular margins than in people with nodules with regular margins. The mean vascular resistance was 0.63 ± 0.17 in benign nodules with vascularity and 0.71 ± 0.12 in malignant nodules with vascularity. The difference between vascular resistance and FNA results was significant. There was no significant relationship between FNA resault and vascularity indices, structure, echogenicity, calcification and nodule size. Also, these results were not significantly associated with age, sex, level of education, address and history of dental graphy.
Conclusion: Existence of higher vascular resistance in Color Doppler ultrasound and observation of irregular margin and absence of peripheral halo in Gray scale ultrasound can be beneficial for malignancy in thyroid nodule. However, ultrasound cannot replace FNA
The relationship between clinically suspected pneumonia and presence of radiologic findings on chest radiography amongst hospitalized children in Bou-Ali hospital during 2019-2020
No full textBackground: Pneumonia is the state of infectious pulmonary inflammation specially alveoli. Pneumonia causes 13% of all infectious diseases in children under 2 years old. Clinical forms of pneumonia are separated due to their anatomic diffusion to lobar (one lobe), interstitial and bronchopneumonia.
Aim: Determining the relationship between radiologic features with clinical symptoms in children with suspected pneumonia.
Methods and materials: The current study is a cross-sectional one. Sampling was done randomly among all children with suspected pneumonia. Age, gender and clinical presentation data was gathered retrospectively. The basic Chest X-rays of patients were evaluated. Finally, the obtained data were analyzed using SPSS.v.22.
Results: Among all patients, affirmative basic Chest X-rays of pneumonia were confirmed for 211 (70.3%) patients, which 119 (56.4%) ones were boys. The mean age of patients was 4.36±2.96 years. Coughing and fever with a prevalence of 79.6% and 76.3% were the most common clinical manifestations, respectively. In patients under 2 years old, fever was more prevalent than coughing. Reticulonodular involvement pattern was the most prevalent radiological characteristic of the studied cases. Lobar involvement was seen in 12.8% of cases. Also, bilateral pulmonary involvement was reported for approximately 65% of the patients.
Conclusion: The most common pattern of the pulmonary involvement in children suffering from pneumonia in Ardabil was the reticulonodular pattern. Bilateral involvement and focal infiltrates were the most common findings of chest X-ray. Also, fever and coughing were the main clinical presentations in pediatric pneumonia
Design and preparation of a new multi-targeted drug delivery system using multifunctional nanoparticles for co-delivery of siRNA and paclitaxel
No full textDrug resistance is a great challenge in cancer therapy using chemotherapeutic agents. Administration of these drugs with siRNA is an efficacious strategy in this battle. Here, it was tried to incorporate siRNA and paclitaxel simultaneously into a novel nanocarrier. The selectivity of carrier to target cancer tissues was optimized through conjugation of folic acid (FA) and glucose (Glu) onto its surface. The structure of nanocarrier formed from ternary magnetic copolymers based on FeCo-polyethylenimine (FeCo-PEI) nanoparticles and polylactic acid-polyethylene glycol (PLA-PEG) gene delivery system. Biocompatibility of FeCo-PEI-PLA-PEG-FA(NPsA), FeCo-PEI-PLA-PEG-Glu (NPsB) and FeCo-PEI-PLA-PEG-FA/Glu (NPsAB) nanoparticles and also influence of PTX-loaded nanoparticles on in vitro cytotoxicity were examined using MTT assay. Besides, siRNA-FAM internalization was investigated by fluorescence microscopy. The results showed the blank nanoparticles were significantly less cytotoxic at various concentrations. Meanwhile, siRNA-FAM/PTX encapsulated nanoparticles exhibited significant anticancer activity against MCF-7 and BT-474ā€Æcell lines. NPsAB/siRNA/PTX nanoparticles showed greater effect on MCF-7 and BT-474ā€Æcells viability than NPsA/siRNA/PTX and NPsB/siRNA/PTX. Also, they induced significantly higher anticancer effects on cancer cells compared with NPsA/siRNA/PTX and NPsB/siRNA/PTX due to their multi-targeted properties using folic acid and glucose. We concluded that NPsAB nanoparticles have great potential for co-delivery of both drugs and genes for use in gene therapy and chemotherapy
The relationship between ultrasound findings of fatty liver and physical activity in patients referred to ultrasound clinic of Imam Khomeini Hospital and Kowsar Clinic
No full textBackground: Non-alcoholic fatty liver disease (NAFLD) represents a range of clinical and pathological conditions that in the absence of alcohol consumption from simple steatosis to steatohepatitis (NASH), fibrosis, cirrhosis and finally can lead to hepatocellular carcinoma. Non-alcoholic fatty liver disease is currently recognized as the most common chronic liver disease worldwide in adults and children. Based on the available information, the treatment is based on weight loss, physical activity, elimination of drugs and possible toxins, as well as control of diabetes and blood lipids. There is currently no definitive cure for fatty liver disease, but the first priority in prevention and treatment is a lifestyle intervention aimed at losing weight and improving BMI through diet and exercise.
Aim: Determining the relationship between sonographic findings of fatty liver and physical activity
Methods and material: The sample size was divided into two groups of 100 people, one group of patients with fatty liver and the second group of patients with non-fatty liver based on sonographic findings. Demographic questionnaire containing information on age, sex, etc. was filled by them. The IPAQ International Physical Activity Questionnaire was completed and finally analyzed by SPSS 22 statistical analysis software during Pearson correlation test. Finally, the results were presented in the form of tables.
Results: The mean age of the subjects was 49.65±17.2 years. 177 people (88.5%) lived in cities and 23 people (11.5%) lived in rural areas. 48 people (24%) were illiterate, 101 people (50.5%) had less than a diploma and 51 people (25.5%) had a high school diploma. 132 (66%) had no history of smoking and 68 (34%) were smokers. The rate of people with low physical activity in the group of patients was 45%, which was 18% in the group of non-patients. The two groups had significant differences in terms of physical activity and the amount of physical activity in the non-affected group was higher than the affected group (P <0.05). None of the people who were high physically active had Grade 3 fatty liver, according to the ultrasound findings. 87.5% of people who were reported grade 3 fatty liver had little physical activity. In terms of comparing the results of ultrasound and the amount of physical activity, a significant relationship was found between the two, which indicates an increase in the progression of fatty liver disease (Grading) based on sonographic findings with a decrease in physical activity (P <0.05).
Conclusion: The rate of physical activity in people with fatty liver was lower than non-patients. With increasing physical activity in individuals, the severity of fatty liver disease is significantly lower based on ultrasound findings
Social support in students of Ardabil University of Medical Sciences with a chronic patient in the family .
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In regard to ‘What is the quality of hydrogel spacer insertions? and which patients will benefit? A literature review’
No full textWe read the article entitled ‘What is the quality of hydrogel spacer insertions? and which patients will benefit? A literature review’ by Drabble and Drury-Smith with great interest. 1 Their conclusions support previous studies assessing the role of hydrogel spacer (HS) in increasing distance between the prostate and rectum, resulting in rectal dose reduction in prostate radiotherapy. Despite many studies that have evaluated the effectiveness of HS insertion in prostate cancer radiotherapy over the last decade, 2-5 it still remains an active area of research. Although conducting a systematic review is necessary to better understand the clinical benefit of HS insertion, we believe that the article fails to acknowledge some important issues that need consideration.
There is not enough information in the article for someone to replicate their study. What were the key words that were chosen? There are a number of studies evaluating the impact of HS during prostate radiotherapy with regard to dosimetric and clinical benefits, as well as procedure-related toxicity that could be included in the study. For example, in a prospective single-blind randomised phase III trial, Hamstra et al. have reported that late rectal toxicities significantly reduce in HS arm. 3 In contrast, in a non-randomised prospective trial, Whalley et al. did not observe any significant difference in rectal toxicities between patients with and without HS except for grade 1 late rectal toxicity (p = 0·04). 4
In addition, a huge lack of criticism and the pros and cons are not discussed in an adequate manner. Some aspects of toxicity with spacer application, that are, well-reported cases of rectal ulceration, bacterial prostatitis, rectal discomfort and pain and perineal abscess are not mentioned at all. 2 There are several situations that successful insertion of HS does not achieve, including injection into the rectal lumen, unsuccessful prostate-rectum spacing at the time of hydrodissection and previous pelvic radiation likely due to fibrosis and scarring. 2 Furthermore, previous study shows that a repeated hydrogel injection is feasible prior to prostate re-irradiation. 6 A contraindication of HS injection is the presence of imaging abnormalities posterior to the prostate.
With regard to post-prostatectomy radiotherapy, HS can implant in well-selected patients. 7 Of note, there is a potential risk of displacing tumour cells underneath an interstitial gel or balloon during the implantation procedure. Therefore, one can conclude that the prostatic fossa and HS should include within the clinical target volume (CTV) to reduce the potential risk of the remaining tumour cells at the anterior rectal wall. Also, using molecular imaging approaches alone or together with transperineal biopsy can well detect the location of local recurrence.
We agree with authors who reported there is conflicting view on the use of HS on high-risk patients. 1 There are three potential routes of tumour spread to the rectal wall, including direct invading through Denonvilliers’ fascia and infiltration into the rectum, extension by the lymphatic and seeding on biopsy. 8 It should be noted, however, that Denonvilliers’ fascia, as a thick capsule, is an effective barrier for the spread of tumour cells into the rectal wall. In the present time, rectal involvement by prostate cancer is clinically rare. Direct rectal invasion occurs in pT4 prostate cancer, whereas Yeh et al. inserted HS in non-metastatic patients with T1–T3 tumors. 9 Displacing tumour cells underneath an interstitial HS during the implantation procedure may be most relevant. Especially in patients with intermediate and high-risk cancers that present with an increasing incidence of transcapsular tumour spread with increasing risk factors, the dose to the anterior rectal may be crucial for tumour cell killing of those cells beneath the device. Of note, the anterior rectal wall receives more than 50 Gy even with a HS in-place. 10 Up to now, there are no data on compromised prostate-specific antigen (PSA) relapse rates. Thus, this area of research needs to be studied further
The relationships between serum Heart‐type Fatty Acid Binding Protein and right ventricular echocardiographic indices in Chronic Obstructive Pulmonary Disease
No full textBackground
Heart‐type Fatty Acid Binding Protein (H‐FABP) has been used in the diagnosis of myocardial damage. In this study, we assessed the relationships between serum H‐FABP as a marker of cardiac injury and right ventricle (RV) echocardiographic indices in patients with stable COPD.
Materials and Methods
In this case‐control study, 84 participants were investigated (50 COPD patients and 34 healthy subjects). After obtaining consent, 3 ml fasting whole blood sample was collected from each of the participants to test their serum H‐FABP. Echocardiography was performed on all participants by cardiologists.
Results
Serum H‐FABP was found to be significantly correlated with smoking history (P<0.01), Systolic Pulmonary Artery Pressure (S‐PAP), RV Wall Thickness (RV‐WT) and Tricuspid annulus posts systolic excursion (TAPSE) (P<0.01 for all). RV Basal Diameter (RV‐BD), RV Mid Diameter (RV‐MD), and Fractional area change percentage (FAC%) were not observed to have any correlation with serum H‐FABP. Also, the comparative analysis showed statistically significant differences between mean RV‐MD (P<0.001), RV‐BD, FAC%, S‐PAP, RV‐WT (P<0.001) and TAPSE (P<0.05) of patients at different GOLD stages. There was a significant correlation between adjusted serum level of H‐FABP and the airflow limitation based on FEV1 (P<0.001).
Conclusion
The correlation between serum H‐FABP and RV echocardiographic indices such as S‐PAP, RV‐WT and TAPSE, can be related to RV function in COPD patients. Moreover, RV echocardiographic indices are significantly correlated with the severity of COPD as classified in various GOLD stages