فهرست مطالب

Journal of Clinical and Basic Research
Volume:2 Issue: 1, Winter 2018

  • تاریخ انتشار: 1397/02/10
  • تعداد عناوین: 8
|
  • Vaibhavi Vijay Nanoty, Gopal Nandlal Agrawal, Supriya Sanjay Tankhiwale Pages 1-5
    Introduction
    Antimicrobial resistance in bacterial pathogens is associated with high morbidity and mortality. We aimed to evaluate antibiotic resistance and β-lactamase production in clinical isolates of a tertiary care hospital in Central India.
    Materials And Methods
    Clinical isolates (n=6472 isolates) from patients with infection were identified using standard microbiological techniques. Antibiotic susceptibility testing was performed according to the CLSI guidelines using the Kirby-Bauer disc diffusion technique. AmpC production in Enterobacteriaceae isolates was tested in screening test. Cloxacillin combined disc diffusion test was performed for both inducible and non-inducible AmpC using cefoxitin disc with and without cloxacillin. Metallo-β-lactamase production in Enterobacteriaceae isolates was tested in screening test (positive= zone diameter of
    Results
    Majority of the bacteremia cases were caused by Staphylococcus aureus (43.13%), non-fermenting spp. (27.44%) and coagulase-negative staphylococci (11.76%). Escherichia coli (55.85%) was the main cause of urinary tract infection followed by Acinetobacter spp. (11.71%) and Klebsiella pneumoniae (10.36%). No resistance to linezolid was seen in Gram-positive isolates. Frequency of vancomycin-resistance was about 9% in Enterococcus spp. Methicillin resistance was seen in 19% of S. aureus isolates. Enterobacteriaceae and Citrobacter freundii isolates were completely resistant to aminopenicillin, first and second-generation cephalosporins and cefamycin. Moreover, Klebsiella isolates were resistant to aminopenicillin. Enterobacteriaceae isolates showed resistance to aminopenicillin (89.87%), cephalosporins (54-90%) and cephamycin (37-45%). E. coli isolates were sensitive to PIT (87-96%) and imipenem (99.68-100%). ESBL production was seen in 166 Enterobacteriaceae isolates (30.24%) in DDST and CPCT. AmpC production was seen in 15 (2.73%) Enterobacteriaceae isolates. Total β-lactamase production was found in 19.23% of the isolates tested. The frequency of β-lactamase production was highest in K. pneumoniae (51.67%). Co-production of β-lactamases was not observed.
    Conclusions
    It is necessary to closely monitor drug resistance and β-lactamase production. Moreover, it is recommended to perform routine β-lactamase testing in microbiology laboratories for determining prevalence of antibiotic resistance and controlling their spread.
    Keywords: Antibiotic Resistance, ESBL, β, lactamase, Enterobacteriaceae
  • Hojatollah Moemeni, Durdi Qujeq, Alijan Ahmadi Ahangar, Karimollah Hajian, Hadi Parsian Pages 6-10
    Introduction
    Many studies have shown a relationship between serum level of trace elements and risk of stroke, but the exact mechanism of this relationship is not clear. The purpose of this study was to measure changes of serum magnesium, iron, copper, and zinc levels in ischemic and hemorrhagic stroke patients to evaluate their potential diagnostic utility.
    Materials And Methods
    Overall, 53 healthy individuals (30 men, 32 women) and 53 ischemic and hemorrhagic stroke patients (30 men, 23 women) who were admitted to the Rouhani Hospital in Babol (Iran) were enrolled in the study within 24 hours after stroke onset. Diagnosis was made based on medical history and physical examination by a neurologist. After blood sampling, serum copper was assessed by atomic absorption spectrophotometry, and zinc, magnesium and iron levels were assessed by spectrophotometry. Data analysis was performed in SPSS (version 21) using independent sample t-test and chi-square test.
    Results
    Serum concentrations of copper was significantly higher in the patients (58.8 ±14.7 mg/dL) compared with the controls (45.7 ±10.0 mg/dL). Serum concentrations of zinc was significantly higher in the patients (113.2 ±17.3 mg/dL) compared with the controls (95.60 ±12.80 mg/dl). Moreover, serum concentrations of iron was significantly higher in the patients (148.5 ±30.4 mg/dL) compared with the controls (74.22 ±33.3 mg/dL). However, the patients (1.4 ±0.8 mEq/L) had significantly lower level of magnesium level compared to the controls (2.1 ±0.3 mEq/L).
    Conclusions
    Our results suggest that evaluation of serum magnesium, iron, copper and zinc levels in ischemic and hemorrhagic stroke patients may be useful for the prediction and diagnosis of stroke status.
    Keywords: Stork, magnesium, zinc, iron, copper
  • Mojtaba Pourmomen, Alireza Mohebbi, Hanieh Bagheri, Alireza Nourozi, Alireza Tahamtan, Mohammad Yasaghi, Hamidreza Pordeli, Alijan Tabarraei Pages 11-15
    Human cytomegalovirus (CMV) isa ubiquitous organism thatcan infect multiple organs butrarely causes gastrointestinal (GI) symptoms. However, it can be reactivated in the GI tractand lead to gastric cancer. Here, we investigatedCMV infection in patients with gastric complaints.
    Material and
    Methods
    In this study,99 biopsy samples were collected from patientswith GI symptoms and CMV genome was detected by polymerase chain reaction. Sequencing was performed for computational genotyping.
    Results
    We observed that 88.99% of the sampleswere urease positive and 5.99% of the sampleswere CMV positive. Moreover, genotype of the samples belonged to group 4 (gB4). There was a relatively high incidence of CMV infection in patients with GI problems.
    Conclusions
    Although symptomatic CMV-associated diseases of GI tract are rare in immunocompetent individuals, theymight be considered as potential complications of CMV infection.
    Keywords: Human cytomegalovirus, Gastrointestinal infection, Gastric biopsy, Urease positive
  • Afsaneh Tabandeh, Samira Eshghinia, Hamid Reza Joshaghani, Mashallah Azarian, Saba Besharat Pages 16-19
    Preeclampsia is the most common cause of prenatal and maternal mortality in the world. It is also the second most common cause of maternal death in Iran. Deficiency of some trace elements such as zinc, calcium and magnesium in pregnant women may be involved in preeclampsia. The aim of this study was to measure serum and urinary levels of zinc, calcium and magnesium in healthy pregnant women and those with preeclampsia.
    Materials And Methods
    In this cross-sectional study, we recruited 100 pregnant women (second trimester) who were referred to the gynecology clinic of 5th Azar hospital in Gorgan (Iran) during 2014-15. The subjects were assigned into a preeclampsia group (N=50) and an age-matched healthy control group (N=50). Serum and urinary levels of zinc, calcium and magnesium were measured by enzymatic method. Data were analyzed by SPSS (version 19) using t-test and chi-square test. P-values less than 0.05 were considered as statistically significant.
    Results
    Mean serum concentration of calcium in the preeclampsia group (8.17± 0.64mg/dl) was significantly lower than that in the control group (8.70±0.40mg/dl). However, the mean urinary level of calcium in the preeclampsia group (222.33± 19.35mg/dl) was significantly higher than that in the control group (158.61± 40.16 mg/dl). Mean urinary level of zinc in the preeclampsia group was significantly lower than that in the control group. No significant difference was found between serum concentrations of zinc and magnesium in the preeclampsia and control group.
    Keywords: Preeclampsia, serum, urine, zinc, magnesium, calcium
  • Bahare Ameri, Moussa Abolhassani, Fatemeh Mehravar Pages 20-25
    Introduction
    Mucopurulent cervicitis (MPC) is a clinical syndrome characterized by mucopurulent discharge from the cervix and other signs of inflammation. In this study, we evaluated the prevalence and risk factors of MPC in married women referred to health centers of Shahroud (northeast of Iran) in 2016.
    Methods
    In this cross-sectional study, 346 married women aged ≥18 years were screened for MPC via clinical examination by a gynecologist. Logistic regression was used to evaluate association of sociodemographic, behavioral and sexual health related variables with prevalence of cervicitis.
    Results
    Mean age of subjects was 31.5 years (range 14–69 years) and 121 (35%) subjects had MPC. In addition, 38.2% of the subjects were with less than a high school diploma and 72.8% were housekeeper. The mean (standard deviation) value of body mass index was 25.2 (4.3) Kg/m2 (range: 16.2-38.5 Kg/m2). Coital frequency per week (P=0.004) and method of delivery (P=0.02) were significantly associated with the prevalence of cervicitis.
    Conclusion
    Our findings suggest that weekly coital frequency, method of delivery, vaginal discharge and history of genital herpes may be associated with the risk of cervicitis.
    Keywords: Mucopurulent cervicitis, MPC, Inflammation, Shahroud
  • Alireza Ghari Arab, Maryam Zahedi, Vahideh Kazemi Nejad, Akram Sanagoo, Maryam Azimi Pages 26-31
    Introduction
    Hyperlipidemia is a common risk factor for diabetes and its cardiovascular complications. The aim of this study was to investigate the association between hemoglobin A1c (HbA1c) levels and serum lipids in patients with type 2 diabetes.
    Materials And Methods
    This descriptive-analytical and cross-sectional study was conducted in 2016 on 484 patients with type 2 diabetes referred to the Diabetes Clinic in Gorgan, Iran. Blood samples were taken from all patients and sent to laboratory for measurement of HbA1c, FBS and serum lipids. Data were collected via registration forms. The data were analyzed with SPSS software (version 20) using independent t-test, Mann-Whitney U test and Pearson’s and Spearman’s coefficient tests.
    Results
    Mean age of subjects was 56.61 ± 12.65 years with age range of 17 to 92 years. Mean duration of the disease was 13.52 ± 7.55 years (range: 1-44 years). Mean HbA1c level was 8.83 ± 1.8 mg/dl. There was a statistically significant correlation between HbA1c level and serum cholesterol (P=0.001), triglyceride (P=0.009), low-density lipoprotein (P=0.003) and FBS (P=0.0001). However, there was no statistically significant relationship between HbA1c and high-density lipoprotein levels (P= 0.8).
    Conclusions
    High level of HbA1C is associated with dyslipidemia and can be used as predictors of cardiovascular disease in type 2 diabetes patients.
    Keywords: HbA1c, Serum lipids, Diabetes Mellitus, Fasting blood sugar
  • Zahra Shokhmgar, Malihe Mohammad Pour, Mohammad Sanjari Pages 32-38
    This was a quasi-experimental study with a pretest-posttest design, a control group and follow-up. The study population included all high school students in the city of Torbat-e Jam (Iran) in 2016. The subjects were selected via availability sampling and then randomly assigned into two groups of 20 (an experimental and a control group). The subjects in the experimental group participated in 60-minute weekly self-efficacy group training sessions for seven weeks. No intervention was done for the control subjects. After the training sessions, the achievement motivation and self-efficacy scales were used to collect posttest data. The collected data were analyzed with SPSS (version 16) using descriptive statistics, analysis of covariance, the Levene’s test, regression analysis and the Bonferroni post-hoc test. All statistical analyses were performed at significance of 0.05.
    Results
    After the training period, the mean self-efficacy score increased from 13.76 ± 3.02 to 14.34 ± 3.47 and the achievement motivation score increased from 12.58 ± 6 to 14.37 ± 4.1. There were statistically significant differences in terms of pretest and posttest scores between the two groups. Results after two months of follow-up also indicated that the intervention results persisted in the experimental group.
    Conclusions
    Considering the positive impact of the self-efficacy group training on self-efficacy and achievement motivation, it can be suggested as an effective cognitive intervention in educational counseling.
    Keywords: Self, efficacy training, achievement motivation, self, efficacy, high school students
  • Sudhir M., Pruthvi Raj Pages 39-47
    Introduction
    Gallbladder-related disease is currently one of the most commonindications for elective and emergency surgical management of cholecystitis. Considering the increasing rate of complications, there has been a notable paradigm shift in the management of patients since the introduction of laparoscopic cholecystectomy.We aimed to develop a new preoperativescoring model for evaluation of the laparoscopic cholecystectomy outcome.
    Materials And Methods
    All patients admitted to the Kempegowda Institute of Medical Sciences from January 2016 to August 2017 with symptoms of gallstone disease were screened for cholelithiasis. Hundred patients undergoing laparoscopic cholecystectomy were randomlyselected. Before the surgery patients were scored according the preoperative model, and the intraoperative scoring was recorded during the surgery.Finally, the two scoring systems were compared.
    Results
    Preoperative scoring had a sensitivity of 95.71%, specificity of 50%, positive predictive value of 81.71%, negative predictive value of 83.3%, diagnostic accuracy of 82%, and Kappa agreement of 0.5161 compared to the intraoperative scoring system.
    Conclusions
    We strongly recommend to use the preoperativescoring system for predicting the degree ofdifficulty for laparoscopic cholecystectomy. In addition, it is also recommended to conduct more studies on the application of the intraoperative scoring system.
    Keywords: Gallbladder disease, Laparoscopic cholecystectomy, Grading system, Preoperative, Intraoperative