Resistance pattern of isolated microorganisms from 783 clinical specimen cultures in patients admitted to Yasuj Educational Hospitals, Iran.

BACKGROUND: Infectious diseases are still one of the leading causes of morbidity and mortality in resource-limited settings. Serious infection caused mostly by gram-negative pathogens causes significant morbidity. According to the Centers for Disease Control and Prevention, antimicrobial resistance kills over 700,000 people worldwide. Antibiotic resistance is on the rise, and as a consequence, serious public health issues are arising. The present study investigated isolated clinical samples from Yasuj teaching hospitals to determine the antimicrobial resistance profile to various antibiotics. MATERIALS AND METHODS: Microbial isolates regarding cultures from urine, blood, wound, abdominal tap, throat, stool, cerebrospinal fluid, endotracheal tube, sputum, skin lesion, nasal, and mouth secretion were collected from patients admitted to hospitals affiliated with Yasuj teaching hospitals. Antibiotic susceptibility profiles were determined by using the Kirby-Bauer disc diffusion method. Data were tabulated and analyzed with SPSS version 26.0. RESULTS: A total of 783 samples were evaluated in our study, with an average of 30.6 years and 54.5% female patients. Most of the bacterial isolates were gram-negative (64.2%). The majority of cultures were Escherichia coli (49.9%), mainly among urine samples (64.2%). The frequency distribution of norfloxacin antibiotic resistance was more common in internal medicine (66.7%), infectious (63.6%), and emergency wards (58.8%). The frequency distribution of penicillin antibiotic resistance was statistically significant in different wards. All cases of oxacillin were resistant. CONCLUSION: Our data showed a high level of antibiotic resistance among bacterial isolates in our center. Considering widespread empirical antibiotic therapy in Iran, the rate of increasing resistance to common antibiotics prescribed for ambulatory and hospitalized patients is concerning. We recommend providing more strict guidelines and policies to control the overuse and overprescription of antimicrobials by health policy-making organizations.

Comparison of the Efficacy of Dexamethasone and Methylprednisolone in Infiltration Injection for Postendodontic Pain in Patients with Necrotic Pulp: A Randomized Controlled Clinical Trial.

PURPOSE: Postendodontic pain is one of the problems of root canal therapy. This clinical study aimed to evaluate the effect of infiltration injection of dexamethasone and methylprednisolone on postendodontic pain in patients with necrotic pulp. METHODS: A total of 80 volunteers with necrotic pulp teeth were included and assigned to two groups (n = 40). After the administration of local anesthesia and before root canal therapy, in group 1, an infiltration injection of 1 ml of dexamethasone was done and in group 2, an infiltration injection of 1 ml of methylprednisolone was done in the buccal vestibule of each tooth. Patients' pain was reported using a visual analogue scale at pretreatment and 6, 12, 24, and 48 hours after treatment. RESULTS: There was no significant difference between the two groups receiving dexamethasone and methylprednisolone at pretreatment and 6, 12, 24, and 48 hours after endodontic treatment. CONCLUSIONS: Infiltration injection of dexamethasone and methylprednisolone had a significant effect in reducing pain after the endodontic treatment in necrotic pulp teeth, but between 6 and 12 hours, methylprednisolone had significantly more effect on pain relief than dexamethasone. Overall, the use of any of these drugs to reduce postendodontic pain is recommended.

Effect of Pentoxifylline on Inflammatory Cytokines, Adequacy of Dialysis, Anemia and Biochemical Markers of Hemodialysis Patients: a Randomized Controlled Trial.

BACKGROUND: The main cause of death in hemodialysis patients is cardiovascular disease (CVD). Chronic inflammation is strongly related with CVD, atherosclerosis, and malnutrition in end-stage renal disease (ESRD) patients. We aimed to investigate the effect of pentoxifylline on adequacy of dialysis, anemia, inflammatory cytokines, and biochemical markers in patients with ESRD on hemodialysis. METHODS: This was a randomized controlled trial with a negative result conducted on 42 hemodialysis patients. The patients were randomly divided to two groups; intervention group (400 mg pentoxifylline every night for three months) and control group (followed up without taking pentoxifylline). The blood samples were taken to measure the levels of inflammatory cytokines, anemia-related parameters, and biochemical markers at baseline and the end of treatment. RESULTS: Thirty-six patients finished the study (18 patients in each group). There was significant reduction in C-reactive protein (CRP) [9.25 (4.60, 17.62) vs. 5.60 (1.90, 11.52), p = 0.048] and TNF-α [28.06 (19.76, 61.22) vs. 18.06 (14.39, 28.97), p = 0.029], and significant increase of albumin levels (4.05 ± 0.25 vs. 4.35 ± 0.24, p = 0.000) in the intervention group, but these changes were not significant in comparison with the control group. No statistically significant difference was observed between intervention and control groups in other parameters. CONCLUSIONS: Although pentoxifylline administration had caused significant reduction in CRP and TNF-α, as well as significant increase of albumin levels in the intervention group, but these changes were not significant in comparison with control group. The current study does not support the use of pentoxifylline in hemodialysis patients.

Advanced Parental Age and Risk of Positive Autism Spectrum Disorders Screening.

BACKGROUND: Autism Spectrum Disorder (ASD) is a life -long neurodevelopmental disorder and significantly influences the quality of life in children. The screening of ASD in children aged between 16-30 months to early detection and early intervention for better prognosis. METHODS: This cross-sectional study was conducted in the southwest of Iran (Yasuj) with dominant Lore ethnicity in 2017. A total of 1504 mother- child pairs with children aged between 16-30 months were selected through simple random sampling from the integrated national health system as the framework. ASD screening was implemented using the Modified checklist for autism in toddlers- revised, with follow-up interview (M-CHAT-R/F). Demographic data such as sex of children, and parental age at their time of pregnancy were collected for all children. RESULTS: Risk of ASD was low, moderate and high in 1447 (96.2%), 54 (3.6%) and 3 (0.2%) in screening, respectively. The estimated rate of ASD prevalence was 80 per 10000 (12 out of 1504) or 1 in 125. Mother's age ≥35 (P value = 0.002, OR = 11.65, CI95%: 2.49-54.35) and father's age ≥40 (P value = 0.0001, OR = 19.64, CI95%: 4.89-78.82) were predicting factors of ASD in toddlers aged 16-30 months. CONCLUSIONS: Given that, increasing the age of marriage in Iran and recent trend towards delayed childbearing; children born to older parents are at a higher risk for having ASD. So, increasing the public awareness is necessary.

Association of single nucleotide autophagy-related protein 5 gene polymorphism rs2245214 with susceptibility to non-small cell lung cancer.

INTRODUCTION: Autophagy is a mechanism that is involved in the regulation of cellular life, apoptosis, and stemness while its intervening genes play important functions in various cancers including lung cancer. ATG5 is one of the key genes for the regulation of the autophagy pathway. In this study, our team has investigated the potential relationship between ATG5 gene polymorphism rs2245214 with non-small cell lung cancer (NSCLC) in a subpopulation of patients from southern Iran. In this study, 34 patients with NSCLC (20 males and 14 females [mean age: 12.86 ± 60.47 years]) and 50 healthy subjects (30 males and 20 females [mean age: 13.09 ± 56.62 years]) were studied in terms of the genotype of the ATG5 gene. We used restriction fragment length polymorphism and analyzed the results using SPSS software (v.23). The results revealed that subjects harboring the guanine/cytosine (GC) genotype of the rs2245214 ATG5 gene polymorphism had suffered less from NSCLC, whereas the prevalence of the C-allele of this polymorphism was significantly higher in patients with NSCLC ( P < 0.05). On the basis of the results of logistic regression, the presence of this C-allele may predict the risk of lung cancer ( P value = 0.011; OR, 3.52; 95% CI, 1.33-9.26). This study concludes that the C-allele of the rs2245214 ATG5 gene polymorphism is associated with increased susceptibility to NSCLC, whereas the GC genotype of this polymorphism is associated with decreased risk and might therefore have a protective role in the development of NSCLC.

Relationship of SNP rs2645429 in Farnesyl-Diphosphate Farnesyltransferase 1 Gene Promoter with Susceptibility to Lung Cancer.

BACKGROUND AND PURPOSE: The mevalonate pathway is one of the major metabolic pathways that use acetyl-CoA to produce sterols and isoprenoids. These compounds can be effective in the growth and development of tumors. One of the enzymes involved in the mevalonate pathway is FDFT1. Different variants of this gene are involved in the risk of suffering various diseases. The present study examined the relationship between FDFT1 rs2645429 polymorphism and the risk of nonsmall cell lung cancer (NSCLC) in a population from southern Iran. METHOD: The genotypes of rs2645429 polymorphism of FDFT1 gene were examined in 95 samples: 34 patients with NSCLC and 61 healthy individuals by RFLP method. RESULTS: The results of this study indicated that C allele of this polymorphism was effectively associated with the risk of NSCLC in the Iranian population (p value = 0.023; OR = 2.71; 95% CI = 1.12-6.59) and CC genotype has significant relation with susceptibility to NSCLC (p value = 0.029; OR = 3.02; 95% CI = 1.09-8.39). This polymorphism is located in the promoter region FDFT1 gene, and CC genotype may increase the activity of this promoter. This study also found a significant relationship between C allele and metastatic status. C allele was more common in NSCLC patients. (p = 0.04). CONCLUSION: C allele of FDFT1 rs2645429 polymorphism gene can be a risk factor for NSCLC, whereas T allele probably has a low protective role.

Sonochemical incorporated of cytosine in Cu-H2bpdc as an antibacterial agent against standard and clinical strains of Proteus mirabilis with rsbA gene.

The cytosine embedded copper based metal-organic framework (Bio-MOF) was synthesized by facile one-step sonochemical method by simply mixing of 4-4, biphenyldicarboxylic, cytosine and copper nitrate (Bio-Cu-H2bpdc-Cy). The prepared bio-MOF was characterized by XRD, FTIR and FE-SEM techniques. The effect of Cu-H2bpdc-Cy on the expression of the rsbA gene was evaluated in the clinical and standard Proteus mirabilis and study of MIC of Cu-H2bpdc-Cy by microdilution against them that have the rsbA gene. According to different concentrations of MIC, MBC concentrations was cultured on blood agar culture medium. Regarding to the concentration of MIC, gene expression changes were obtained by real-time PCR. MIC for standard and clinical strains of Proteus mirabilis was 1.6 and 1.8 mg/ml, and also MBC was obtained to be 1.8 and 2.0 mg/ml, respectively. Finally, in the real time PCR method, expression of the rsbA gene in presences of bio-Cu-H2bpdc-Cy was reduced, but has no effect on the gene expression of the Housekeeping DNA Gyrase-B gene. Considering the effect of Cu-H2bpdc-Cy on the rsbA gene in Proteus mirabilis bacteria, it is possible to use of Cu-H2bpdc-Cy agent as a therapeutic supplement against this bacterium.

Sonochemical-solvothermal synthesis of guanine embedded copper based metal-organic framework (MOF) and its effect on oprD gene expression in clinical and standard strains of Pseudomonas aeruginosa.

The guanine incropped Cu based metal-organic framework (Guanine-Cu-MOF) was synthesized by facile one-step sonochemical method by simply mixing of 4-4, biphenyldicarboxylic, guanine and copper nitrate (Bio-Cu-H2bpdc-Gu). The prepared guanine-MOF was characterized by using X-Ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), and Field emission scanning electron microscopy (FE-SEM) techniques. The morphology of prepared material was sponge-shaped which it was well documented, together with the presence of existing functional groups. The effect of prepared material on oprD Gene Expression was investigated in Clinical and Standard Strains of Pseudomonas aeruginosa (PAO-1) and minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of prepared samples against P. aeruginosa strains were determined through the broth micro-dilution method. The expression of oprD gene in strains affected by Cu-H2bpdc-Gu was quantitatively investigated through real-time PCR. MIC of Bio-Cu-H2bpdc-Gu was 400 µg/mL for the standard and clinical strains of P. aeruginosa, while, MBC of this compound was 700 µg/mL for standard strain and 800 µg/mL for clinical strains. The highest and the lowest rate of oprD gene expression were found to be 3.6 and 1.1 fold in the strains, respectively.

Policy makers' viewpoints on implementation of the World Health Organization Framework Convention on Tobacco Control in Iran: A qualitative investigation of program facilitators.

BACKGROUND: The epidemic of smoking is a great concern of health systems. Moreover, the number of smokers is increasing worldwide and this has led to an escalating trend of morbidity, mortality, and burden of smoking-related diseases. Therefore, monitoring the implementation of tobacco control laws in different countries is of extreme importance. This study aimed to describe policy makers' experiences and perceptions of the facilitating factors of the implementation of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) in Iran. METHODS: This was a qualitative research in which data were collected through individual interviews. The participants included policy makers who were members of the national assembly for tobacco control. In this study, 13 unstructured interviews of about 45 to 60 minutes duration were conducted in an extrapolative manner. The qualitative content analysis method was applied until extrapolation of basic themes was complete. RESULTS: As a result of the analysis, the themes of performance through training, through research, through intersectoral collaboration, and through setting priorities emerged. The emerged themes connote some critical points that have key roles in promoting the effective implementation of the WHO FCTC. Furthermore, the main role of the health sector becomes predominant. CONCLUSION: The study findings suggested the managed and coordinated work as one of the main facilitating factors of the implementation of the WHO FCTC at a national level.

Do Iranian tobacco growers support the World Health Organization framework convention on tobacco control?

CONTEXT: Studies on the World Health Organization Frame-work Convention on Tobacco Control (FCTC) are scarce in Iran and the Eastern Mediterranean region (EMR). AIM: This study was conducted in 2007-2008 in Iran to design a practical evaluation model of the implementation of FCTC with the potential to be adopted in the EMR. Given that, the findings of this evaluation can be useful in increasing political and public support for enforcing the implementation of legislations, testing their feasibility, and maintaining sustainability. The viewpoints of tobacco growers as part of stakeholders in this regardwould have an influential role. SETTINGS AND DESIGN: This study was a qualitative one to investigate the tobacco growers viewpoints about thestrengths/weaknesses of FCTC implementation in Iran. MATERIALS AND METHODS: In this study, we conducted semi-structured in-depth individual interviews with 5 tobacco growers. All interviews were carried out with their permissionwere recorded and were assured that their interviews will be kept confidential. All questions were related to different FCTC articles, then written transcripts were prepared and the basic concepts were extrapolated. STATISTICAL ANALYSIS: After transcribing the recorded interviews, we extracted first level codes and main concepts from them. RESULTS: The findings suggested that although tobacco growers agreed with FCTC implementation, however, subjects like the necessity to support tobacco growers and obtaining insurance from the government, the necessity of the enforcement of national tobacco control law and planning to decrease access to tobacco by policy makers were the most key points that tobacco growers pointed to them. CONCLUSION: Our results showed that tobacco growers agreed with the implementation of FCTC but they worried about their job and the expenses of their daily life. Therefore, it seems that policy makers have to design a plan to support tobacco growers for changing tobacco with a safe cultivate.

Prevalence of human papilloma virus among women with breast cancer since 2005-2009 in Isfahan.

BACKGROUND: Human papilloma virus (HPV) DNA has been detected in breast carcinoma by different laboratorial techniques, suggesting that the virus could play a role in the pathogenesis of this tumor. MATERIALS AND METHODS: It was a descriptive study. Systematic random sampling was used for selecting 55 cases of breast cancer and 51 controls of benign breast lesions from the file of Seyedshohada hospital of Isfahan since 2005-2009. A total of 106 paraffin-embedded specimens were selected and HPV DNA was analyzed by polymerase chain reaction and sequenced for different types of HPV in case of positivity for HPV DNA. Data analysis was performed by SPSS 16 software using descriptive statistic, Chi-square, and Fisher's exact tests. RESULTS: Out of 55 malignant and 51 benign breast specimens, 18.2% (10) and 13.7% (7) were positive to HPV DNA, respectively (P = 0.53); 70% (7) malignant and 43% (3) benign breast specimens were positive to high-risk HPV genotypes. In malignant specimens, the most common high- and low-risk genotypes were HPV-16 (3.6%) and HPV-11 (3.6%), respectively. In benign specimens, the most common high- and low-risk genotypes were HPV-31 (3.9%) and HPV-43 (3.9%), respectively. Among malignant and benign specimens, ductal carcinoma and fibro adenoma were the most common lesions positive to different types of HPV, respectively. CONCLUSION: This study demonstrated the presence of HPV genome in both malignant and benign tumor tissues in women with breast lesions in Isfahan; therefore, further larger epidemiologic studies need to be analyzed to establish the exact role of this virus in the pathogenesis of breast cancer.