Comparison of Molecular, Microscopic, and Culture Methods for Diagnosis of Cutaneous Leishmaniasis.

Cutaneous leishmaniasis (CL) is endemic in the northwest of Isfahan province, Iran. Increase in the incidence of the disease in Kashan has made it necessary to find out the best method for diagnosis and molecular characterization of Leishmania species. In the present study, 130 patients suspected to cutaneous leishmaniosis referred to health care centers of Kashan were examined. Serosity of lesion was collected for smear preparation and cultured in Novy-Nicolle-McNeal medium. DNA was extracted from serosity, and Leishmania species was determined by polymerase chain reaction (PCR) and nested PCR using kinetoplast DNA (kDNA) specific primers. The diagnostic criteria of CL were based on the observation of amastigotes in the smear, promastigotes in culture, presence of expected bands in PCR, or nested PCR. Of 130 specimens, 87 (66.9%), 72 (56.2%), 98 (75.4 %), 96 (73.8%), and 99 (76.2%) were positive for microscopic culture, PCR, nested PCR, and combined PCR and microscopy (proposed method), respectively. Sensitivity, specificity, positive and negative predictive values of PCR were 99%, 100%, 100%, 96.9%, respectively, for microscopy 87.9%, 100%, 100%, 72.1%, for culture 72.7%, 100%, 100%, 53.4 %, and for nested PCR 97%, 100%, 100%, 91.2%, respectively. Based on the results of the study, kDNA-PCR was the most sensitive method for diagnosis of CL.

Prediction of mortality in hip fracture patients: role of routine blood tests.

BACKGROUND: To assess the mortality predictive value of routine blood tests in patients with hip fracture. METHODS: In a retrospective descriptive study, medical records of 204 hip fractured patients with the age of 60 or older who were admitted to the Department of Orthopedics was considered regarding routine laboratory tests. Predictive values of these tests were assessed using receiver operating characteristic curve (ROC). RESULTS: The incidence of death due to hip fracture was 24%. The mortality rate was significantly increased with age > 65 (OR= 15). There was no significant difference between mortality in regards to gender. High plasma BUN (more than 20 mg/dl) and creatinine (more than 1.3 mg/dl) significantly increased the chance of mortality. [OR= 3.0 and OR=2.5 for BUN and creatinine, respectively]. Patients' mortality did not show any correlation with sodium and potassium plasma levels and blood hemoglobin. CONCLUSIONS: There is direct correlation between plasma levels of BUN and creatinine and 3-month mortality after hip fractures. Patients with high plasma levels of BUN were three times more likely to die than those with normal BUN. Also, patients with high plasma creatinine levels were 2.5 times more likely to die than those who had normal values. Mortality was also associated with increasing age but did not vary with gender. Patients aging more than 65 were 15 times more likely to die following a hip fracture than those with younger age.

The frequency of Neisseria gonorrhoeae endocervical infection among female carrier and changing trends of antimicrobial susceptibility patterns in Kashan, Iran.

BACKGROUND AND OBJECTIVES: Neisseria gonorrhoeae is the second most sexually transmitted diseases agents in developing countries. Antimicrobial resistance strains have created serious health concern. The aim of this study was to determine the frequency of endocervical gonococcal infection and antimicrobial susceptibility of N. gonorrhoeae in Kashan, Iran. MATERIALS AND METHODS: In this study, 294 endocervical swabs were collected from married women referred to the obstetrics and gynecology clinics in Kashan from December 2012 to May 2013. The samples were cultured in modified Thayer Martin in 37°C with 5-10% CO2 for 72 hours. Gram staining, oxidase, catalase and carbohydrate utilization tests were used to identify the isolated species. All isolates were tested for their susceptibilities to antimicrobials using the Kirby Bauer-disk diffusion techniques. RESULTS: N. gonorrhoeae was detected in 2.38% of studied cases (95% confidence interval [CI] 1.5-3.26%). All isolates were resistance to ceftriaxone, penicillin G, ciprofloxacin, cefepime, and two isolate (28.5%) showed intermediate sensitivity to tetracycline. CONCLUSION: Continued monitoring of prevalence of N. gonorrhoeae is important for preventing the dissemination of this microorganism. The present study emphasizes the importance of surveillance of antimicrobial resistance of N. gonorrhoeae in order to manage the rate of resistant strains and to revise the treatment policies.