Ardabil University of Medical Sciences
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Evaluation of positive bacterial culture results in cancer patients with nosocomial infections and related risk factors in Imam Khomeini Hospital in Ardabil during 2018-20
Get PDFBackground: Nosocomial infections are one of the leading causes of death in hospitalized patients. Infection is one of the most important causes of morbidity and mortality in people with malignancy. Given that the goal of treatment in people with cancer is to increase the life expectancy of these patients, but one of the side effects of these treatments that threaten the life of these people is a secondary infection with immunodeficiency
Aim: Determination of positive bacterial culture results in cancer patients with nosocomial infections and related risk factors in Imam Khomeini Hospital in Ardabil
Methods and meterials: All cancer patients who were admitted to Imam Khomeini Hospital in Ardabil and their culture was positive for nosocomial infection were included in the study. The required information for each patient including age, sex, type of culture, type of microorganism isolated in culture, antibiogram and results of drug resistance, length of hospital stay and patient mortality were collected through a study of patient records. To determine the risk factors for infection by the number of positive cultures collected separately, patients with a diagnosis of cancer without positive culture were randomly selected and the individuals in terms of age, sex, type of cancer, length of hospital stay with incidence Infections were examined
Results: 4789 patients were admitted to hospital wards. 71 positive cultures were found, of which 62% were women and the rest were men. The most positive culture was urine culture. The most isolated bacterium was Escherichia coli. There is a significant relationship between patients' gender (p=0.029), type of cancer (p=0.002) and incidence of infection. There is no statistically significant relationship between the incidence of infection and the age of patients. (p=0.185) There is a significant relationship between the incidence of infection and the increase in hospitalization days (p=0.031) and mortality (p=0.033)
Conclusion: Imam Khomeini Medical Center in Ardabil probably has a unique pattern of nosocomial infections. Adherence to health protocols, both at the level of staff-patient communication and at the level of communication between patients, can greatly prevent the occurrence of nosocomial infections. Female gender was identified as one of the risk factors for nosocomial infections and nosocomial infections are an issue that affects mortality and length of hospitalizatio
Living or deceased-donor kidney transplant: the role of psychosocioeconomic factors and outcomes associated with each type of transplant
Get PDFBackground: Kidney transplant improves patients’ survival and quality of life. Worldwide, concern about the
equality of access to the renal transplant wait-list is increasing. In Iran, patients have the choice to be placed on
either the living or deceased-donor transplant wait-list.
Methods: This was a prospective study performed on 416 kidney transplant recipients (n = 217 (52.2%) from living
donors and n = 199 (47.8%) from deceased donors). Subjects were recruited from four referral kidney transplant
centers across Tehran, Iran, during 2016–2017. The primary outcome was to identify the psycho-socioeconomic
factors influencing the selection of type of donor (living versus deceased). Secondary objective was to compare the
outcomes associated with each type of transplant. The impact of psycho-socioeconomic variables on selecting type
of donor was evaluated by using multiple logistic regression and the effect of surgical and non-surgical variables on
the early post-transplant creatinine trend was assessed by univariate repeated measure ANOVA.
Results: Based on standardized coefficients, the main predictors for selecting living donor were academic
educational level (adjusted OR = 3.25, 95% CI: 1.176–9.005, p = 0.023), psychological status based on general health
questionnaire (GHQ) (adjusted OR = 2.46, 95% CI: 1.105–5.489, p = 0.028), and lower monthly income (adjusted OR =
2.20, 95% CI: 1.242–3.916, p = 0.007). The waiting time was substantially shorter in patients who received kidneys
from living donors (p < 0.001). The early post-transplant creatinine trend was more desirable in recipients of living
donors (β = 0.80, 95% CI: 0.16–1.44, p-value = 0.014), patients with an ICU stay of fewer than five days (β = − 0.583,
95% CI: − 0.643- -0.522, p-value = < 0.001), and those with less dialysis duration time (β = 0.016, 95% CI: 0.004–0.028,
p-value = 0.012). Post-operative surgical outcomes were not different across the two groups of recipients (p = 0.08),
however, medical complications occurred considerably less in the living-donor group (p = 0.04)
Virtual Analysis in Repurposing of Various Drug Classes as Antileishmanial Agents
No full textBackground and purpose: Drug repurposing or the study on the possible application of some drugs for treatment or control of other diseases, is an important and applied research domain. A major advantage of “drug repurposing” with regard to other drug discovery methods is that a nominated drug molecule with acceptable pharmacokinetics as a lead compound does not cause serious problems in optimizing toxicity and it may be focused on pharmacodynamics. According to the importance of the subject, a present contribution has been dedicated to the in-silico analysis of a few drug classes with the aim of achieving potential anti-leishmanial pharmacophores.
Materials and methods: At first, diverse protein receptors within leishmania parasite were identified via surveying Brookhaven Protein Data Bank (PDB) and literature review (7 enzymes). Ligand database included 128 FDA approved drugs within different pharmacological classes. After validation of AutoDock 4.2 by re-docking of crystallographic ligands, ligand structures were docked into the binding sites of targets to rank the drugs on the basis of qualitative and quantitative analysis of drug-enzyme binding patterns. Top binded drugs were subjected to more delicate evaluations to offer hypothetical anti leishmanial pharmacophores.
Results: Several results were obtained from the present study particularly as the structure-binding relationship view but just the most important once are presented here. Highest free binding energy was estimated for an antidiabetic drug Nateglinide (ΔGb =30/13-kcal/mol) in binding to farnesyl diphosphate synthase. Amomg steroids as the top ranked derivatives with regard to the number of interacting leishmanial enzymes, Norgestrol (ΔGb = -9/48 kcal/mol) and Testosterone (ΔGb = 05/8-kcal/mol) exhibited higher enzyme binding affinities to adenine phosphoribosyl transferase. Arg82 was found as a key residue in making hydrogen bonds to this enzyme. Results of the current study revealed that fused tricyclic structural pattern could also make desirable binding interactions with some leishmanial targets and in particular mitogen activated protein kinase (MAPK) and pteridine reductase 1 (PTR1).
Conclusion: Results of molecular docking indicated that superior structure with regard to the binding affinity to leishmanial targets and in particular adenine phosphoribosyl transferase is a steroid. Incorporation of any rings to the steroid rings A or D (Danazol and spironolactone) caused decreased free binding energies which might be attributed to the steric hindrance of bulkier molecules. Among the drugs with fused tricyclic scaffold, enzyme binding could also be related to fusing pattern of the rings and as could be observed in the cases of Mirtazapine and Carbamazepine, besides fusing pattern, substitution of 6-membered side rings with smaller 5-membered ones (Alprazolam and Flumazenil) led to the decreased binding affinities. Purely hydrophobic binding interactions of Norgestrol in binding site of triosephosphate isomerase and PTR1, Testosterone in binding site of farnesyl diphosphate synthase and MAPK and Mirtazapine in binding site of deoxy uridine triphosphate emphasized on the potential of these drugs as primary structural patterns for designing enzyme antagonists. Regarding the obtained results for steroids and fused tricyclic scaffolds, it might be possible to think about anti-leishmanial molecules with multi-target inhibitory potentials
Invitro comparison of apical extrusion of debris during root canal preparation by using a novel preparation technique with standard rotary and manual technique
No full textBackground and Aim
Apical extrusion of dentinal debris and pulp materials during root canal instrumentations may lead in increased inflammation, flare-ups and prolonged healing time. Therefore; achieving to an instrumentation file or technique with the least apically extruded debris would be desirable in these treatments. This study aimed to compare the amount of apically extruded debris associated with a novel preparation technique with standard rotary and manual technique Invitro.
Materials and Methods
In this experimental invitro trial, 66 human mandibular premolars with similar root length, apical diameter and canal curvature were selected and randomly assigned to 3 groups. The root canals were instrumented regarding the manufacturer's instructions using the Gentle files of the tornado system, protaper universal system and step back technique. The apically extruded debris was collected in pre-weighed vials and following drying in an incubator, they were quantified using a balance with 0.00001 gr exact. The time needed for each instrument was expressed by seconds. The debris volume and time was statistically analyzed using ANOVA test in 3 groups while the paired comparisons were done by Tukey's test.
Results
The mean (+ standard deviation) of the apically extruded debris using Gentle files of the tornado system, Protaper universal system and step back technique were .0021709 ±.00192509, .0009609 ± .00085831, .0022845 ± .00233748 respectively. The apical debris volume were significantly lower in the ProTaper system than manual technique (p=.048) no other significant differences were found among the instruments. The longest preparation time was reported for manual technique (mean 180.48 sec) being significantly higher than protaper sysytem (mean 142.36sec)(P=.001) and Tornado system (mean 166.82sec)(P=.001).
Conclusion
Al instruments were associated with extruded debri. Higher amount of debris and preparation time were in manual technique, in these 3groups protaper had the lowest amount of debris and preparation tim
Infantile Tachyarrhythmia:Management Strategy and Short_ Term Results in a High_ Volume Referral Center
No full textBackground
Arrhythmia is an uncommon but serious cause of the admission of neonates and infants to emergency wards. The rarity of the condition creates challenges in the diagnostic and therapeutic process.
Methods
The study was conducted in Rajaie Cardiovascular, Medical, and Research Center, Tehran. All infants (aged ≤ 12mon) with tachy-arrhythmia admitted within a 2-year period (September, 2014 to August 2016) were included. Stepwise drug therapy based on the arrhythmia mechanism desired for all. In cases that were refractory to drug therapy catheter ablation was done.
Results
Of 55 cases 47 infants treated with antiarrhythmic drugs, 3 patients (with AFL) received cardioversion, and 3 treated with catheter ablation. In one case arrhythmia (AT) eliminated after a single dose of adenosine. In the remainder one case the arrhythmia (AT) was eliminated spontaneously. No mortality was observed.
Conclusion
Most of infantile arrhythmias are controllable with available antiarrhythmic drugs. Catheter ablation is a good choice for refractory cases
The prevalence of respiratory allergens in patients with asthma and allergic rhinitis in Ardabil province
No full textBackground: Because of geographic variation and regional types of allergens, it is recommended that allergists identify common allergens in their area of activity. In the present study, the prevalence of respiratory allergens in patients with asthma and allergic rhinitis was investigated.
Methods: This study is descriptive and retrospective. The required data of this study were extracted from the records of 661 patients who were referred to the Asthma and Allergy Clinic of Ardabil University of Medical Sciences (Ardabil province, Northwest of Iran) from April 2016 to March 2017. After confirmation of allergic asthma or rhinitis by the asthma and allergy specialist, these patients were subjected to a prick test with allergen extracts. In the group of grasses the extract of nine grasses, in trees the extract of 11 Tree mix, in weeds the extract of Common weed mix, in animal allergens the three extracts of Standard cat, Dog epithelia, Cockroach mix, in weeds the Mite mix and in fungi, three extracts of Mold mix1, Alternaria and Aspergillus mix were used. All the data were analyzed using SPSS software, version 25.
Results: According to results, of the 661 patients who were studied, 462 ones had positive and 273 had significant prick test results. The grasses group with 293 positive (44.3%) and weeds group with 259 positive results (39.2%) were more common than the other categories. Among the significant positive tests, these two categories with 161 and 142 significant positive tests were indicated as the most common allergens. Respiratory allergens were also more common in patients with a family history of allergies in weeds and trees categories, but there was no significant difference in sensitization pattern according to the history of tonsillectomy.
Conclusion: Patients in Ardabil with allergic rhinitis and asthma were more sensitized to weeds and grass mixtures. It is recommended to provide preventive recommendations to allergic patients and the development of localized skin testing packages and additional studies should be conducted focusing on these two categories of allergens
Evaluation of Musculoskeletal Disorders and Its Relationship with Physical Activity Level of Ardabil Cement Factory Workers in 1397
No full textIntroduction: Musculoskeletal disorders are the most common debilitating causes in workers and the main reason for medical leaves. Medial leave brings health, social, and economic consequences for individuals and society. The relationship between medical leaves due to pain and discomfort in different parts of the body and physical activity level at work, practice of sport, and leisure time in workers in cement industry in 2019 was examined. Methods: A descriptive-analytical study was conducted on 150 workers of a cement factory. The participants were selected randomly. Data gathering tools were demographics form, Nordic Musculoskeletal Questionnaire, and Baecke Physical Activity Questionnaire and the collected data was analyzed using SPSS (v.22). Results: The participants noted that the main painful areas over the past year were the waist, knee, ankle, and neck. There was a significant relationship between medical leave due to pain in the neck and overtime work. There was a significant relationship between the type of work activity and medical leave due to a pain in knee and ankle. Conclusion: The workers who used such medical leaves had a higher PAL at work. PAL at work increased the requests of medical leaves due to the pain in knee and waist. The PAL at sport practice decreased the rate of request for medical leave due to a pain in the Waist and Kne
COVID-19 and beliefs about tobacco use: an online cross-sectional study in Iran
No full textThere is mixed evidence surrounding the relationship between tobacco use and COVID-19 infection/progression. The current study investigates beliefs and tobacco use behaviors and COVID-19 infection among a sample of smokers and never-smokers. Data were collected using an online survey distributed through Telegram, a cloud-based social media networking application in Iran from April 1 to May 31, 2020. The study participants included never-smokers (n = 511), current (past-month) waterpipe smokers (n = 89), current cigarette smokers (n = 158), and ex-smokers (n = 172). Multinomial logistic regression was used to compare tobacco use groups with never- smokers on beliefs, controlling for potential confounders. The study participants (n = 944) was mostly male (64%), had > high school education (76%), and lived in an urban area (91%), with mean ± SD age of 35.3 ± 10.8. Key findings of this study are that compared with never-smokers: (1) cigarette smokers were less likely to believe that smoking cigarette can lead to spreading COVID-19; (2) waterpipe smokers were more likely to believe that smoking waterpipe at home was a safe practice, that waterpipe protects against COVID-19, and smoking waterpipe may lead to a more rapid recovery from COVID-19; (3) both waterpipe and cigarette smokers believed that using e-cigarettes in public places was a safe practice during the COVID-19 pandemic; and (4) more than half of the ex-smokers stopped smoking due to COVID-19 and most of them planned to continue abstaining from smoking after the pandemic. Our findings underscore the need to raise awareness about the unsupported claims of a lower hazard of using tobacco products or possible protective effects against COVID-19 and to promote cessation programs