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Survey on phenotypic resistance in Enterococcus faecalis: comparison between the expression of biofilm-associated genes in Enterococcus faecalis persister and non-persister cells
No full textBackground Phenotypic resistance is considered as a serious therapeutic challenge for which a definitive remedy has not been discovered yet. Biofilm and persister cell formation are two well-studied phenotypic resistance phenomena, leading to the recalcitrance and relapse of different types of chronic infections. The presence of persister cells in biofilm structures seems to be one of the main factors contributing to the relapse of infections and treatment failure. Given the dormant and inert nature of persister cells, they can be easy targets for the immune system factors. Biofilm formation can be a survival strategy for the defenseless persister cells. Thus, this study was aimed to evaluate the expression of biofilm-associated genes in Enterococcus faecalis persister and non-persister cells. Methods Vancomycin susceptibility and biofilm formation ability were investigated among 95 E. faecalis clinical isolates using microtiter broth dilution and microtiter plate assays, respectively. PCR was used to determine the presence of biofilm-related genes (gelE, esp, and agg) among the vancomycin-susceptible, biofilm producer E. faecalis isolates (91 isolates). Minimum bactericidal concentration for biofilms (MBCB) were determined for vancomycin using the MTP assay. Bacterial persister assay was performed using an enzymatic lysis assay. Finally, the expression of biofilm-related genes was compared between the persister and non-persister isolates of E. faecalis using real-time qPCR. Results E. faecalis isolates showed a high level of susceptibility (95.8) to vancomycin (MIC 2500 mu g/mL. Based on the enzymatic lysis assay, only 3 isolates, out of the 91, had the ability to form persister cells. The expression of biofilm-associated genes was higher among the persister compared to non-persister E. faecalis isolates. Conclusions Biofilm-associated persister cells indicated a high vancomycin tolerance compared to non-persister cells. Moreover, persister isolates showed a higher tendency for biofilm formation and a higher expression level of the biofilm-associated genes, compared to non-persister isolates
Decomposition of Economic Inequality in Cataract Surgery Using Oaxaca Blinder Decomposition: Tehran Geriatric Eye Study (TGES)
No full textPurpose: The aim of this study was to investigate economic inequality in cataract surgery and to decompose it into its determinants using Oaxaca-Blinder decomposition. Methods: The Tehran Geriatric Eye Study is a population-based cross-sjal study that was done on individuals above 60 years using stratified cluster random sampling. All subjects underwent full optometric, slit lamp, and fundoscopic examinations. Then, after pupil dilation, the history of cataract surgery, including PC and AC IOL, was determined. Results: The age and sex-standardized prevalence of cataract surgery was 33.51 (95 CI: 31.45 to 35.62). Cataract surgery had a significant positive association with age (OR: 14.06; p 80 vs 60-64 years) and a significant inverse association with education level (OR: 0.55, p: 0.006 for college education vs being illiterate) and economic status (OR: 0.64, p: 0.003 for rich vs poor). A significant difference was found in cataract surgery between the rich and poor (26.22) disfavoring the poor (p < .001). The explained and unexplained portions comprised 95.99 and 4.01 of the difference (p p = .336, respectively). Among study variables, age (p < .001), education (p = .003), economic status (p = .002), insurance (p = .011), and eye examination (p < .001) were significant determinants of inequality in the explained portion. Conclusion: There was a marked difference in the prevalence of cataract surgery between the rich and poor that was mostly caused by the explained portion. Age, economic status, and education had the largest effects on increasing the inequality and history of eye examination by an ophthalmologist and insurance coverage had the largest effects on reducing this inequality
Age- and Sex-Standardized Prevalence of Age-Related Cataract and Its Determinants; Tehran Geriatric Eye Study (TGES)
No full textPurpose To determine the prevalence of cataract and its relationship with some determinants in individuals above 60 years. Methods Of 3792 subjects that were invited, 3310 participated in the study (response rate = 87.31). All subjects underwent full optometric, slit lamp, and fundoscopic examinations. Then, their lenses were evaluated according to the World Health Organization cataract grading system after pupil dilation. Results Age- and sex-standardized prevalence with 95 confidence interval (CI) of nuclear, cortical, posterior subcapsular cataracts (PSC), any type cataract, and all lens change was 53.09 (49.80 to 56.35), 23.02 (20.87 to 25.32), 5.57 (4.62 to 6.70), 58.78 (55.65 to 61.83), and 72.49 (70.14 to 74.71), respectively. Any type, nuclear, cortical, and PSC cataracts, had a positive association with age and an inverse association with education. Moreover, the prevalence of cortical and PSC cataract had an inverse association with economic status. Among all variables, age was the strongest determinant for cataract and its subtype. Conclusion This study found a higher prevalence of cataract compared to some previous studies such that about two-thirds of the geriatric population had cataract in the past or at the time of the study. Considering the association of cataract with variables such as economic status and education level, it seems that training and increased awareness and knowledge of the elderly population regarding the importance of eye care by physicians plays an important role in reducing the burden of cataract
Association of Statin Therapy on Clinical Outcomes in Covid-19 Patients: An Updated Systematic Review and Meta-Analysis on All Related Evidences
No full textIntroduction: Statins is a class of lipid-lowering drugs and our previous investigations showed that statins have antiviral effects and have a wound healing effect in the lung. This systematic review and meta-analysis aimed to evaluate the effects of statin therapy on mortality and clinical outcomes in COVID-19 patients. Methods: A comprehensive search was conducted in international databases, including MEDLINE, Scopus, Web of Science, and Embase from December 1, 2019 until January 26, 2022 without any restriction in language. The random-effects model was used to estimate the pooled odds ratio (OR). Results: The statin therapy overally was associated with decrease in odds of ventilation pooled OR (95% CI): 0.85 (0.70 to 0.99) and mortality pooled OR (95% CI): 0.73 (0.66 to 0.81) but had no effects on the ICU admission pooled OR (95% CI): 0.93 (0.77 to 1.12), oxygen therapy pooled OR (95% CI): 0.85 (0.70 to 0.99), recovery pooled OR (95% CI): 1.85 (0.35 to 9.92), kidney failure pooled OR (95% CI): 1.01 (0.73 to 1.40), hospitalization pooled OR (95% CI): 1.45 (0.88 to 2.36), asymptomatic disease pooled OR (95% CI): 1.33 (0.24 to 7.44), and ARDS pooled OR (95% CI): 1.15 (0.88 to 1.49). Conclusion: The present meta-analysis showed that statin therapy was associated with a reduced risk of mortality and ventilation in patients with COVID-19 but had no effects on other clinical outcomes. © 2022 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences
Epidemiology of Psychiatric Disorders among Children and Adolescents in Kohgiloyeh and Boyer-Ahmad Province, Iran
No full textBackground & Objective: Given the growing rate of psychiatric disorders, especially in young populations, detailed data on frequency of these disorders for further national public health strategiesis of great importance.We aimed to survey the frequency of different psychiatric disorders among children and adolescents in Kohgiloyeh and Boyer-Ahmad province. Materials & Methods: 20.5 (205 out of 1001) of studied cases showed at least one psychiatric disorder and 79.5 showed no sign of any disorders. Anxiety disorders were the most frequent disorders (15.5) followed by the behavioral disorders (7), smoking and drug abuse (6), behavioral disorders (2.4) and neurodevelopmental disorders (2), but no case was observed with psychosis. Results: Our study indicated that pretreatment of rats with KET, HAL and YOH abolished MPH induced-mood and motor activity disturbances. Conclusion: in comparison with other studies from Iran or other countries the prevalence of psychiatric disorders in Kohgiloyeh and Boyer-Ahmad is relatively high and special policies and efforts are suggested for enhancement of mental health values in this region. © 2022, Zanjan University of Medical Sciences and Health Services. All rights reserved
The prevalence of low back pain in emergency medical services personnel: A systematic review and meta-analysis
No full textBackground & Aim: Among musculoskeletal disorders, low back pain causes the most common complaints among emergency medical services personnel worldwide. This study aimed to investigate the prevalence of low back pain among emergency medical services personnel. Methods & Materials: We used the PRISMA guideline in the present systematic review and meta-analysis. The search was conducted in PubMed, Scopus, Web of Science, Cochrane, ProQuest, Science Direct, Google Scholar, and Embase using English keywords and SID, Irandoc, and Magiran data resources with equivalent Persian keywords. Studies were selected based on inclusion and exclusion criteria. The data were gathered without a time limit until the end of June 2021. The quality evaluation of the selected studies was performed using the Appraisal tool for Cross-Sectional Studies (AXIS) tool. The random-effects model was used for meta-analysis, applying the I2 index as a measure to estimate heterogeneity among studies. Results: In the present study, a total of 1038 articles were identified in the primary search, of which ten studies entered the final evaluation phase and meta-analysis after initial screening and removing duplicates. In these studies, 7499 emergency medical services personnel were examined; the prevalence of low back pain was 50.30 (95 CI: 37.98-62.62, I2= 99.1). Conclusion: Our results indicated a considerable prevalence of low back pain among emergency medical services personnel. Also, the heterogeneity between studies was very high. It is recommended to teach the correct methods of lifting the stretcher and equipment as well as redefining the duties of the staff with low back pain. © 2022 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences
Study of health-promoting lifestyle and its effective factors in the employees of Tobacco Company
No full textBackground and Objective: A health-promoting lifestyle is an essential factor in reducing related health problems and increasing the quality of life. The aim of this study was to determine the health-promoting lifestyle and related predictors in the employees of Tobacco Company. Materials and Methods: The present study was a cross-sectional (descriptiveanalytical) that performed on 283 employees of a tobacco company in Tehran. All employees of the tobacco company had a chance to enter the study and after considering the inclusion and exclusion criteria, eligible participants entered the study and those who signed the written consent were investigated. Data were collected through a socio-demographic characteristics questionnaire and a healthpromoting lifestyle questionnaire and were analyzed by SPSS software version 19 (IBM SPSS Statistics 19.0). P <0.05 was considered significant. Results: The mean ±standard deviation of the total health-promoting lifestyle score was 131.53 ±21.17. The lowest and highest mean scores were related to the subscales of physical activity 18.50 ±5.46 and spiritual growth 25.61 ±5.03, respectively. Modified GLM results showed that smoking and work experience variables were predictors of health-prom oting behaviors. So that health-promoting behaviors in smokers are 6 times less than non-smokers (OR: 6.79, CI95: -13.15-0.42), for one year increase in work experience, 7.7 more health-promoting behaviors (OR: 0.77, CI95: 0.09-1.46) and in illiterate people was very low compared to academics (OR: -59.61, CI95: -117.70-1.53). Conclusion: Considering the effects of some individual factors such as work experience and smoking on health-promoting lifestyle, we can conclude that educational programs to increase lifestyle awareness and its effects on physical and mental health as well as program implementation - Health education programs focus on increasing physical activity among employees are essential. © 2022 by the authors
TYPE II TOXIN- ANTITOXIN SYSTEMS IN CLINICAL ISOLATES OF ANTIBIOTIC RESISTANT Acinetobacter baumannii
No full textThe over use of antibiotics to treat infections in humans and animals made a phenomenon of the antibiotic-resistant bacteria. While studies focused to find on new antibiotics but, identification of novel antibacterial targets in bacteria is very important. By Toxin antitoxin systems this hypothesis could be done, whereas by the activation of a toxin or inactivation of an antitoxin, the raised toxin kills the bacterium. These systems are attractive target for antimicrobial therapy. However, the most important step for potency of TA system, as an antibacterial target, is to identify a TA system that is prevalent in all resistant clinical isolates. So, the prevalence of different TA systems among clinical isolates of Acinetobacter baumannii in Emam khomeini hospital, Ilam, Iran was evaluated to determine which TA system is prevalent in all antibiotic resistant A. baumannii. So, one hundred A. baumannii clinical isolates were identified during one-year period in Emam khomeini hospital, Ilam, Iran. A. baumannii clinical isolates were isolated from hospitalized patients in ICU and burn patients. All isolates were resistant to at least one antibiotic. Then, the isolates were subjected to evaluation to find mazEF and higBA TA genes by PCR. The results showed the frequency of mazEF and highBA TA genes in all isolates was 72 and 39, respectively. mazEF or higBA TA systems are not presented in all isolates. So, the potency of these two TA systems are in challenged. Also, all isolates were not positive for one TA gene. So, more research in different geographical area should be done with functionality of TA genes © 2022,Genetika.All Rights Reserve
Developing the required data set for the integration of breast cancer registry systems in Iran
No full textBackground: Breast cancer is a major public health concern due to its increasing incidence and mortality rates. A large volume of data is generated from different healthcare settings with inconsistent and heterogeneous data frameworks. There is an increasing demand to integrate breast cancer data between various information systems to answer specific research questions and future clinical trials. Thus, this study aimed to develop a minimum data set (MDS) for integrating breast cancer registry systems as a prerequisite for multi-center data exchange and research cooperation. Methods: The proposed MDS was developed using a multi-stage process. First, a systematic search was performed in scientific databases. Available data sets and registries related to breast cancer were also reviewed until data saturation. Then, a two-round Delphi survey was performed to reach an agreement on the primary data items. Finally, an additional Delphi stage was carried out to validate the content of the final MDS by calculating the individual item content validity index (CVI), overall scale CVI (S-CVI), and face validity. Results: After the literature review, the primary data set for breast cancer including 309 data items was identified. After the Delphi phase and calculation of I-CVI, S-CVI, and face validity, the breast cancer MDS was finalized with 14 classes and 205 data items. Conclusions: This agreed-upon MDS enables accurate, consistent, and comparable inter-organizational data collection between breast cancer care centers. This data homogeneity enhances the analytic power and depth of variables, thereby contributing to multicenter, large-scale, and more generalizable epidemiological and predictive studies on breast cancer. © 2022 The Author
Uncivil behaviors in nursing education from the perspectives of nursing instructors and students: A cross-sectional study
No full textOne of the serious concerns in nursing education is uncivil behaviors (UBs). These behaviors negatively affect both teaching and learning and result in instructor-student conflicts. Nonetheless, the data about these behaviors is minimal hence the need for a study on them. The study aimed to evaluate UBs in nursing education from the perspectives of nursing instructors and students. This cross-sectional descriptive-analytical study was conducted in 2019 with 52 nursing instructors and 240 nursing students from Kerman, Bam, and Jiroft Universities of Medical Sciences, Iran. Data was collected using the Instructors’ Uncivil Behaviors Scale and the Students’ Uncivil Behaviors Scale and analyzed using the SPSS software (v. 22.0), independent t-test, ANOVA, and Pearson correlation coefficient. Both nursing instructors and students perceived UBs at a moderate level. UBs in the learning climate dimension was the most prevalent and were experienced among both students and instructors. Due to the commonness of UBs, nursing education and healthcare authorities need to employ strategies to minimize these behaviors and reduce their effects on nursing instructors, students, and clients. © 2022 The Author(s