ABSTRACT
INTRODUCTION: Frequency of extended-spectrum beta-lactamases (ESBLs) and its variants may vary in different geographical areas, as reports indicate their spread in some certain communities. The aim of this study was to determine the frequency of ESBLs in strains of Klebsiella and E. coli, isolated from patients hospitalized in teaching hospitals of Yazd. METHODS: This cross-sectional study was carried out on samples including E. coli and Klebsiella strains collected from laboratories of Shahid Sadoughi and Shahid Rahnemoun hospitals in Yazd, Iran in the period of 2011-2012. The colonies which were positive in lactose Eosin methylene-blue (EMB) medium were identified by biochemical methods, and 270 strains of Klebsiella and E. coli were isolated. Collected data and information were analyzed using Fisher's exact test and descriptive statistics such as mean in SPSS software, version 15, at a significant level of 0.05. RESULTS: In this study, 270 samples were examined, including 152 samples of E. coli (56.3%) and 118 samples of Klebsiella pneumonia (43.7%). Among the 152 samples of E. coli, 45 strains (30%) were producers of ESBLs. In addition, among the 118 samples of Klebsiella pneumonia, 44 strains (37.3%) were producers of ESBLs. E. coli strains showed the most resistance to Cefotaxime (100%), Ceftazidime (97.7%), and Cefepime (75.5%) respectively and Klebsiella strains showed the most resistance to Cefotaxime (100%), Ceftazidime (100%) and Cefepime (79.5%), respectively. CONCLUSION: Frequency of ESBLs in Klebsiella strains was higher than E. coli strains. No significant relationship was found between frequency of ESBLs and age or gender. In addition, E. coli strains showed the highest sensitivity to Imipenem, Amoxicillin/clavulanate, and Ciprofloxacin, while the highest antibiotic sensitivity of Klebsiella strains was shown to be to Piperacillin, Imipenem, and Amoxicillin/clavulanate.
ABSTRACT
Cutaneous actinomycosis of finger is very unusual, chronic granulomatous disease caused by a group of anaerobic or microaerophilic Gram-positive filamentous bacteria that normally colonize the mouth, colon and urogenital tract. Actinomycosis of finger is rare but clinically important condition that requires suitable evaluation for guiding appropriate therapy. We hereby report a case of cutaneous actinomycosis of the right finger- a rare site, in a 34-year-old female patient which underwent usual treatment of surgical excision. This patient complained of existence of a mass and tenderness in the pulp of right index finger. The X-ray of hand revealed no significant abnormality. The patient was treated successfully with surgical excision. Surgery detected five small nodules measuring 0.5 to 1 cm in size. Histopathologic examination of the biopsy from the lesions confirmed diagnosis of cutaneous actinomycosis. Here, we report a cutaneous actinomycosis in a 34-year-old female located in the index finger.
ABSTRACT
Duodenal ulcer is an uncommon condition in children, that is why it is not usually considered as the differential diagnosis unless it presents with complications including perforation and haemorrhage. Moreover, duodenal ulcer perforation is an uncommon entity in paediatric age group. Early diagnosis and treatment is crucial in order to improve survival. A three-day-old male neonate was admitted to our hospital because of abdominal distension. The neonate was lethargic. He underwent laparotomy. There was a perforated ulcer, 5×5mm in size, on the anterior aspect of the first part of the duodenum. The perforated ulcer was closed with a single layer. Six-month follow-up revealed no abnormality.
ABSTRACT
Pseudo-exstrophy of bladder is an uncommon condition characterized by the major musculoskeletal defects without urinary system defects. A two-day-old female neonate was presented with pseudo-exstrophy of the bladder and unilateral renal agenesis- A rare combination of two anomalies. She was born at 37 weeks gestational age with caesarean section delivery. The X-ray of hip revealed pubic diastasis. Ultrasonography clearly showed absence of the left kidney with a normal right kidney. The patient was treated successfully with proper surgical management. We, hereby, report a rare variant case of pseudo-exstrophy of bladder with lower set umbilicus and infra-umbilical midline of lower anterior abdominal wall defect in a neonate who was born in Shahid Sadoughi Hospital, Yazd, Iran.
ABSTRACT
Toll-like receptor family (TLRs), pattern recognition receptors, is expressed not only on immune cells but also on non-immune cells, including cardiomyocytes, fibroblasts, and vascular endothelial cells. One main function of TLRs in the non-immune system is to regulate apoptosis. TLRs are the central mediators in hepatic, pulmonary, brain, and renal ischemic/reperfusion (I/R) injury. Up-regulation of TLRs and their ligation by either exogenous or endogenous danger signals plays critical roles in ischemia/reperfusion-induced tissue damage. Conventional TLR-NF-κB pathways are markedly activated in failing and ischemic myocardium. Recent studies have identified a cross talk between TLR activation and the PI3K/Akt pathway. The activation of TLRs is proposed to be the most potent preconditioning method after ischemia, to improve the cell survival via the mechanism involved the PI3K/Akt signaling pathway and to attenuate the subsequent TLR-NF-κB pathway stimulation. Thus, TLRs could be a great target in the new treatment approaches for myocardial I/R injury.
