Evaluation of Biofilm Formation and Presence of Ica Genes in Staphylococcus epidermidis Clinical Isolates

OBJECTIVES: Biofilm formation is one of the important features of Staphylococcus epidermidis, particularly in nosocomial infections. We aimed to investigate the biofilm production by phenotypic methods and the presence of ica genes in S epidermidis. METHODS: A total of 41 S epidermidis isolates were recovered from different clinical specimens. Biofilm formation was evaluated by microtiter plate, tube method and Congo red agar method. The presence of icaA and icaD genes was investigated by PCR. Validity of methods (sensitivity and specificity), and metrics for test performance (positive/negative predictive value, and positive/negative likelihood ratio) were determined. RESULTS: By both microtiter plate and tube method, 53.6% of S epidermidis isolates were able to produce biofilm, whilst only 24.4% of isolates provided a biofilm phenotype on Congo red agar plates. icaA and icaD genes were found in 100% and 95.1% of isolates, respectively. Biofilm phenotypes accounted for 4.8% by microtiter plate assay, despite the absence of the ica gene. Congo red agar and PCR exhibited a lower sensitivity (18% and 45.5%, respectively) for identifying the biofilm phenotype in comparison to microtiter plate. CONCLUSION: The microtiter plate method remains generally a better tool to screen biofilm production in S epidermidis. In addition, the ability of S epidermidis to form biofilm is not always dependent on the presence of ica genes, highlighting the importance of ica-independent mechanisms of biofilm formation. The use of reliable methods to specifically detect biofilms can be helpful to treat the patients affected by such problematic bacteria.

[Value of neutrophil to lymphocyte ratio in the prognosis of death of patients with venous thromboembolism]

Background and Objective: Venous thromboembolism [VTE] is a common clinical condition with a mortality rate of 15-20%. Neutrophil to lymphocyte ratio [NLR] is known as an indicator in predicting clinical outcomes in patients with various diseases and malignancies. This study was conducted to determine the value of neutrophil to lymphocyte ratio in the prognosis of death in patients with venous thromboembolism during the short term

Methods: This retrospective cohort study was performed on 93 hospitalized patients with spontaneous venous thromboembolism in Gorgan, northern Iran during 2012-15. Demographic, blood and biochemical parameters of the patients were evaluated in the prediction of fatal outcome in a follow-up of 30 days after thrombose diagnosis

Results: Sixteen patients [17.2%] died within 30 days. The variables of age, white blood cells, neutrophils, NLR, creatine kinase MB and lactate dehydrogenase significantly increased [P<0.05], and lymphocyte also platelet significantly reduced within the occurrence of death in a short period of 30 days follow up [P<0.05]. A cut-off point of 7.21

Conclusion: Neutrophil to lymphocyte ratio can be used as a useful biomarker in the prediction of mortality during short periods of time in VTE patients

Immunogenicity evaluation of a DNA vaccine expressing the hepatitis C virus non-structural protein 2 gene in C57BL/6 mice

Most of the hepatitis C virus [HCV] infections elicit poor immune responses and 75% to 85% of cases become chronic; therefore, the development of an effective vaccine against HCV is of paramount importance. In this study, we aimed to evaluate co-administration of HCV non-Structural Protein 2 and IL-12 DNA vaccines in C57BL/6 mice A plasmid encoding full-length HCV NS2 protein [non-structural protein 2] was generated and used to vaccinate mice. Negative control [an empty expression vector] was also employed to evaluate the background response. To investigate immune responses against vaccine, C57BL/6 mice received three doses of the vaccine with a two-week interval. Cellular immunity was assessed using 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide assay for lymphocyte proliferation, lactate dehydrogenase release for cytotoxic T lymphocyte [CTL] activity and cytokine assay. The findings demonstrated that immunization of mice with plasmid expressing HCV NS2 induced CTL response, interferon gamma production, and lymphocyte proliferation compared to negative control. The results also demonstrated that co-administration of IL-12 with the HCV NS2 plasmid induced significantly better immune response in C57BL/6 mice. DNA vaccine encoding HCV NS2 is an effective candidate that can trigger CTL-based immune response against HCV. In addition, the results suggested that combining the DNA vaccine approach with immune stimulatory cytokines may significantly enhance antigen-specific immune responses

Prevalence of chronic complications of diabete and its related factors in referred type 2 diabetes patients in reydonkenar diabetes center

Introduction and Aims: Diabetes is one of the most common glandular diseases in the world. Patient with diabetes are more than other individuals with eye problems, nervous, cardiovascular, renal insufficiency. According to the importance of the subject and high prevalence of diabetes and its complications, the current study was designed and done with the aim of determinants of Prevalence of chronic complications of type 2 diabetes and its related factors in referred diabetes patients to Freydonkenar diabetes center

Methods: This is a descriptive-analytical study that was done in referred diabetes patients with type 2 diabetes to Freydonkenar diabetes center and 400 records of patient were selected via randomly method. The research instrument was a self-made check-list including demographic characteristics and diabetes complications. Collected data were analyzed by using SPSS18 and Chi-squared and t test

Results: from 400 Records of patients, 77 patients were [19/3%] males and 323 [80/8%] female.90.5% of the patient suffers from chronic complications of diabetes. 65.8% suffer from neuropathy, 26.8% eye complications, 14.5% renal complications and 38.8 cardiovascular complications and 50.5% other complications

Conclusion: The results showed Prevalence of diabetes complications is high. so we recommended appropriate intervention such as educational intervention for promoting knowledge of the patients and screening for preventing complications of the disease

[Relation between drinking water hardness and the incidence of esophageal and gastric cancers]

Esophageal and gastric cancers are among the most prevalent cancers in the world which cause a high mortality rate annually. Several risk factors are supposed for them. Water hardness is considered as a protective factor against above cancers. This ecologic study was designed to determine the correlation between water hardness and upper gastrointestinal cancers. In this ecological study data on water components in Golestan's urban areas were obtained during 2004-05 and the averages were reported. All cases of esophageal and gastric cancers resided in urban areas which were diagnosed during this period were recruited to estimate the incidence and age standardized rates [ASR]. The province was divided into low, intermediate and high incidence, based on 33% and 66% quartiles of both cancers. Pearson correlation coefficient test and regression model were used to analyze the data. The water hardness was in the normal standard range permitted for the drinking water, and did not have any relation with the risk of esophageal and gastric cancers. This study showed that water hardness has no effect on the incidence of esophageal and gastric cancer in this area

[ evaluation of predicting mortality risk of premature infants with very low birthweight by CRIB score]

To evaluate the effectiveness of Neonatal Intensive Cares Many different data banks have been developed. Furthermore, various scoring systems such as SNAP and CRIB have been validated to designate and compared differences among hospitalized patients in NICU. This study was done to determine mortality rate and prevalence of complications in neonates admitted to Taleghani and Dezyani NICU centers in Gorgan - Iran. In this descriptive study a questionnaire including sex, birth weight, gestational age, duration of hospitalization, age at the time of discharge or death, complications and other information needed for CRIB scoring system, was completed for 46 neonates with gestational age of less than 37-week old and birth weight of less than 1500 grams. Mortality rate was 37% [17 neonates] with the most common cause being respiratory failure. RDS was associated with a 101-fold increase for the chance of death [OR=1.1, CI=12.9 793.6]. This probability was 4.7 fold for delivery-time asphyxia. The mean of birth weight, gestational age and CRIB in living and dead infants were 1201 and 934 grams, 30 and 28 weeks and 3.76 and 11.7, respectively. Using a ROC curve, a cut off point of 7 was reached to predict neonatal outcome for CRIB scoring. This study showed that the mortality rate was higher than the rate in most centers of the world. The mortality rate was directly related with the increase of CRIB score, especially for scores more than 11

[Epidemiology of blunt abdominal trauma in Gorgan-Iran [2001-05]]

Trauma is the second most common cause of death regardless of age in Iran and the health system annually defrays a vast cost for trauma patients. The majority of cases comprise abdominal trauma. This study was performed to determine individual and pathologic characteristics of patients with blunt abdominal trauma in Gorgan - Iran. This descriptive and retrospective study was done on 239 patients with blunt abdominal trauma in 5 Azar hospital, Gorgan - Iran from March 2001 to March 2005. 197 [82.4%] of cases were male and 42 [17.6%] were female. The mean age of patients was 23.4 years. The mean of hospital stay was 8.8 days. The most common cause of blunt abdominal trauma was traffic injury. The most common damaged organs were spleen [49.4%] and liver [21.3%] respectively. Mortality rate was 16.3%. The hypovolumic shock was the major cause of mortality. This study showed that epidemiology of trauma is similar to those in other regions of our country. Therefore, programming and attempts of governmental organizations are needed to prevent and decrease traffic accidents

[Knowledge and attitude of university students about ecstasy in Gorgan-Iran]

The compound of MDMA or 3,4methyl deoxy met amphetamine, so called ecstasy, is a new narcotice compound. Ecstasy tablets have a temporary exciting and deteriorating side effects. This study was done to determine the knowledge and attitude of University students about ecstasy tablets in Gorgan, Iran. This descriptive - analytic study was done on 300 university students in Gorgan during 2006. The tools of data collection were questionnaire. This questionnaire developed by authors, consists of demographic, knowledge and attitude questions respectively. The data were analized by SPSS software and Kruskal- Wallis and Mann- Whitney tests. 3% of subjects had previous usage of ecstasy. The 27.3% of students had poor knowledge about ecstasy; also 52.3% and 12.7% of students had middle and high knowledge about ecstasy respectively. There was significant relation between knowledge and attitude with educational level, family income, parents occupation and previous usage of ecstasy [P < 0.05]. But there was not any relation between knowledge and attitude and age, gender, and filed of education and source of information enquiry. There was a positive correlation between knowledge and attitude of students [P < 0.001, r=0.243]. This study showed that knowledge and attitude of University students about ecstasy is low. Therefore an educational program about ecstasy is necessary to increase the knowledge and attitude of university students

Estimation of crude death rate with application of capture- recapture methods

To estimate accuracy of Crude Death Rate [CDR] for the country using mortality data from Gorgan, Iran. Three sources of mortality information in Gorgan were used for estimating the undercount in mortality data. There are some methods for estimating undercount in mortality data. In this study, we estimated it by three different ways of capture-recapture methods. We use Peterson-Chapman, log linear and coverage estimators. The rate of undercount in mortality data by estimate of Peterson and Loglinear was 16.3 and by estimate of coverage method was 18.3. According to these rates the CDR for country is estimated 5.57 and 5.7 in 1000 respectively. Estimated crude death rate for Iran in this study is not significantly different from International Organizations such as UNDP and UNICEF estimation. Their estimation is 5.5 and 5 respectively

[Efficacy of Erythromycin in treatment of pityriasis rosea [A double-blind, placebo-controlled clinical trial]]

Pityriasis rosea is an acute inflammatory dermatosis with an unknown cause. Although it is a self limited disorder and has no chronic side effects [nevertheless it will take between 3-6 weeks] but it may continue for two months. In order to shorten pityriasis rosea course and remove itching and skin lesions, it is advisable to cure the disease with an appropriate drug. Based on the above, the present study was performed to investigate efficacy of Erythromycin in comparison with placebo and improve this disease period. A randomized double blind clinical trail was carried out on typical pityriasis rosea patients who had referred to 5th Azar clinic Gorgan-Iran during December 2004-May 2005. 46 patients were selected and randomly divided into two groups [23 patients in each one]. Since it was a double blind study, treatment for two weeks was prescribed then the cure rate was measured during second, fourth and sixth week. In case group, Erythromycin 1gr/day was prescribed and continued for two weeks. In the other group only placebo was prescribed. Pearson chi-square analysis with 2- sided p value was applied to compare the distribution of pityriasis rosea between patients by using Sspss-11.5 software Regard to the kind of study and qualitative attribute; we used comparison between ratios in order to analyze them. Meaningful level for these tests was alpha =0.05. Results: Even though we gained good results in case group during second, fourth and sixth week after treatment, but there was no significant difference between these two groups at alpha =0.05. This investigation shows that Erythromycin has little effect on pityriasis rosea period. Therefore we suggest complementary study with larger samples in future

correlation between left ventricular hypertrophy in echocardiography and kidney function among patients with essential hypertension

More than 50% of patients with hypertension will have end organ damage [such as: CHF, retinopathy, CVA or renal failure]. Left ventricular hypertrophy [LVH] is an independent risk factor for death and cardiovascular disease. Both renal dysfunction and LVH are signs of end organ damage so we carried out this study to evaluate the correlation between LVH in echocardiography and kidney function in patients with essential hypertension. This descriptive analytic study was carried out on 102 patients whome reffered to 5 Azar hospital in Gorgan-Iran, suffering from essential hypertension and had proved LVH in echocardiography with no other disease during 2005-6. Kidney and urinary tract assessment such as serum BUN, Creatinine level and kidney sonography was done on subjects. Left ventricular hypertrophy was defined as a left ventricular mass index [LVMI] >/= 135g/m2 in men and >/= 110g/m2 in women. Renal function was estimated by means of the serum Creatinine level and proteinuria and sonographic findings of kidney and urinary tract. Data was analysed by Spss-11.5 and Chi-Squre test. The average age of patients were 60 +/- 8.8. 58%, 36% and 7% of patients had mild, moderate and sever LVH respectivly. The means of Creatinine and BUN level were 1.09 +/- 1.12 mg/dl and 20.6 +/- 10.76 mg/dl had direct correlation with kidney dysfunction [P < 0.05]. There was a significant relationship between LVH severity and presentse of Kidney scar in sonography [P < 0.05]. This study showed that a very large fraction of the subjects with essential hypertension have kidney problems. Therefore, serum BUN and Creatinine level and sonographic scar of kidney can be reliable markers for assessing and controlling target organ damages that are induced by Essential hypertension

[Serum ferritin in thalassemic [major] patients with subcutaneous desferal versus subcutaneous and intravenous desferal therapy]

beta-thalassemia is a widespread disease. Long term transfusion is the most important therapy in these patients but the best regimen is controversial yet. In this study two groups of thalassemic patients were compared. Subcutaneous desferal regimen was compared versus subcutaneous in combination with intravenous desferal. This clinical trial was done on thalassemic patients in Pediatric Center who were similar in mean age, number of subcutaneous desferal infusions and number of transfusions. This study was done in one year and serum ferritin was measured every 3 months in patients [cases] and at the end of the study [in controls]. Mean serum ferritin was significantly different in two groups at the end of the study [after one year follow-up], it was higher in case group than in controls [1.7 times] [P value=0.04]. In this study, combination therapy of intravenous and subcutaneous desferal was more effective to reduce the iron overload. With more accurate management we will achieve a better long term prognosis in these patients