فهرست مطالب

  • Volume:28 Issue: 128, 2020
  • تاریخ انتشار: 1399/05/05
  • تعداد عناوین: 8
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  • Mojtaba Kamaliaghdam, Mansour Sadeghzadeh*, Ahmad Jalilvand, Kambiz Eftekhari, Zahra Rezaei Pages 124-131
    Background & Objective

    Escherichia coli (E. coli) is considered to be the most common cause of urinary tract infections (UTIs) worldwide. Due to the recent rise in bacterial resistance to antibiotics and the appearance of multidrug-resistant E. coli, treatment options have been significantly limited, thus increasing the cost of treatment as well as morbidity and mortality rates, especially in developing countries. This study aimed to identify the antibiotic susceptibility patterns of E. coli for use in early empirical treatments and cultures of negative UTIs caused by previous antibiotic usage.

    Materials & Methods

    In the present study, 704 urine samples with a positive culture of E. coli were evaluated in terms of susceptibility to gentamycin, nitrofurantoin, ceftazidime, cefixime, meropenem, cefepime, azithromycin, ceftriaxone and ciprofloxacin using the Kirby-Bauer disc diffusion method. Data were collected based on age, sex, and hospitalization or ambulatory patient status. Data were analyzed using SPSS 22.0.

    Results

    E. coli showed the lowest resistance to nitrofurantoin (4.5%) and the highest resistance to cefixime (34.9). There was a statistically significant relationship between antibiotic resistance and age, gender, and hospitalization status

    Conclusion

    Because of the high resistance rate of E. coli to cefixime, precautions should be taken before using cefixime to treat UTIs.

    Keywords: Antibiotic sensitivity, Escherichia coli, Resistance, Urinary tract infections
  • Alireza Shoghli, Negar Ansari, Nima Motamed, Somayeh Abdollahi Sabet* Pages 132-137
    Background & Objective

    Social support helps patients cope with the outcomes of diseases and therapy side effects. However, there is little information about the social support status among Iranian cancer patients. This study assessed the amount of perceived social support status (SSQN) and satisfaction (SSQS) in gastrointestinal (GI) cancer patients based on socio-economic factors.

    Methods & Materials

    This study was carried out in 2018 on all GI cancer patients referred to health centers in the province of Zanjan (i.e., Vali-e Asr teaching hospital and Mehraneh charity clinic for cancer therapy). The Persian version of Sarason’s social support questionnaire was applied.

    Results

    The questionnaire was completed by 284 patients. The average amount of SSQN was 3.56±1.25. The average score of SSQS was 4.87±0.57. Network dimension and satisfaction status were significantly correlated (P<0.001). Groups were significantly different in terms of their satisfaction (P<0.001), whereas they were the same in terms of network size.

    Conclusion

    Cancer patients reported high levels of social support in terms of network (SSQN), but were not highly pleased with the support received (SSQS). More secure employment, higher income, a higher level of education, and being an urban resident are predictors of high levels of satisfaction of perceived social support.

    Keywords: Cancer, Social determinants, Social support
  • Seyed AmirHassan Habibi, Seyed Soroush Rahmani, Sepide Goudarzi, Mohammad Rohani, Gholamali Shahidi, Behnood Farazmand, Fereshteh Vosough, Farnaz Vosough, Farhad Modara*, Fatemeh Mahdizadeh Pages 138-143
    Background and Objective

    Freezing of gait (FOG) is accompanied by various complications, reduced quality of life, and increased risk of mortality and morbidity in patients with Parkinson’s disease. The incidence of this disabling phenomenon can be predicted in at least one-third of patients with Parkinson’s disease. Therefore, the current study aimed to investigate the prevalence of FOG among Iranian patients with Parkinson’s disease and to determine the predictors of this phenomenon in these patients.

    Materials and Methods

    This cross-sectional study was performed on 135 patients with Parkinson’s disease, referred to Rasoul Akram Hospital, Tehran, Iran. The subjects were selected using the convenience sampling method. FOG was confirmed via clinical examination by two fellows of the movement disorder fellowship program. Variables were evaluated using bivariate and multivariate logistic regression analyses, receiver operating characteristics (ROC) curve analysis, and measurement of the area under the ROC curve (AUC).

    Results

    Out of 135 patients with Parkinson’s disease, 36 (26.7%) had FOG. Based on the results, FOG had a significantly higher prevalence in older patients, compared to younger patients. According to the results, FOG had no significant relationship with other baseline variables, including gender, disease duration, and disease manifestations. According to the multivariate logistic regression model, advanced age (OR: 0.915; P=0.031) and longer disease duration (OR: 0.992; P=0.019) predicted the incidence of FOG in the presence of underlying factors.

    Conclusion

    The prevalence of FOG among patients with Parkinson’s disease was estimated at 26.7%, which is within the global range. The results revealed that age and duration of disease were two factors, which could predict the occurrence of FOG with high sensitivity and specificity.

    Keywords: Determinants, Freezing of Gait, Parkinson's disease, Prevalence, Risk Factors
  • Elham Haghighifar, Razie Kamali Dolatabadi* Pages 144-150
    Background and Objective

    Infections due to burn wounds are serious because of their effects on the course of the disease and its consequences. The rate of burn wound infection is very high in developing countries. The purpose of this study was to identify common bacterial agents causing burn wound infection and determine antimicrobial susceptibility patterns in a burn Hospital, Isfahan, Iran.

    Materials and Methods

    This cross-sectional study was conducted from 2017 to 2018 on all patients with burn wound infection. Burn wounds suspected of infection were collected aseptically and traditional bacteriological methods were used to identify the causes of infection. Antimicrobial resistance test was done by the disk diffusion method in accordance with CLSI recommendations.

    Results

    From the total of 1500 wound culture, 957(63.8%) samples were detected as positive. The highest rate of infection was in the ICU ward and the lowest was in the restoration ward. The most common gram-negative bacteria were Acinetobacter baumannii (34.9%) with the highest and the lowest antibiotic resistance to Ceftazidime and Tobramycin, respectively. Among recovered Gram-positive isolates, Staphylococcus aureus (10.2%) were the predominant isolates with the highest and the lowest antibiotic resistance to Penicillin and Vancomycin, respectively.

    Conclusion

    Due to the variable nature of antibiotic susceptibility patterns and pathogens causing burn wound infection, continuous evaluation, detection of dominant bacterial infections and sensitivity patterns to locally available antibiotics in burn wound patients in order to modify the drug regimen for proper antibiotic treatment is important and seems reasonable.

    Keywords: Antimicrobial resistance pattern, Bacterial infection, Burn patients
  • Shokoufeh Hosseini, Masoumeh Yousefi Varazgaei, Maryam Ebrahimi* Pages 151-155
    Background and Objective

    Gestational trophoblastic disease (GTD) is a type of disease which is characterized by increased production of B-HCG by placental cells. Increased β-HCG production is due to increased proliferation of beta cells and lack of apoptosis. If left untreated, it can lead to malignancy. Almost 30-50 of GTD progresses to gestational trophoblastic neoplasia (GTN) in women over 40 years old. This study aimed to evaluate the effect of vitamin A doses (100,000 IU and 200,000 IU) on the decrement of β-HCG levels.

    Materials and Methods

    The study included three groups: two patients and one control, and each group contained 22 individuals. Two groups of patients (A and B) received 100,000 IU and 200,000 IU doses of vitamin A, respectively, in addition to suction curettage. β-HCG levels were then measured by radioimmunoassay (RIA).

    Results

    The β-HCG drop-in group B, which received 200,000 IU of vitamin A, was higher than that of group A. It was significant in the third and fourth weeks after the treatment compared to the control group. There was also a significant relationship between the three groups in terms of Gravid (P<0.001). All the patients were followed up for 6 months.

    Conclusion

    Considering that in the long run, the dose of 200,000 IU compared to the dose of 100,000 IU of vitamin A did not significantly reduce the B-HCG, therefore, in order to prevent the complications of high doses, the single dose of 100,000 IU was used for GTD patients.

    Keywords: Gestational trophoblastic disease (GTD), β-HCG, Gravid, Parity, Vitamin A
  • Hossein Rahimi*, Nasim Mehrpooya, Seyyed Abolfazl Vagharseyyedin Pages 156-165
    Background and Objective

    Cancer is one of the most prominent public health issues. It can put the patient’s hope and quality of life (QOL) at risk. The purpose of this study was to determine the effect of dignity therapy on the hope and quality of life of cancer patients.

    Materials and  Methods

    This trial was conducted in 2019. The sample included 76 cancer patients who were randomly divided into an experimental group (n=38) and a control group (n=38). Data were collected using a demographic questionnaire, the Herth-Hope questionnaire (1991), and the EORTC QLQ-C30 scoring (1988). The intervention group received a dignity therapy protocol. The control group received no intervention. The questionnaires were completed again four weeks after the intervention. Data were analyzed by SPSS 16 and several tests (Chi-square, Kolmogorov-Smirnov, independent t-test, paired t-test, Wilcoxon, and Mann-Whitney). The significance level was set at P-value<0.05.

    Results

    Mean scores for hope and quality of life before the intervention were not significantly different between the experimental and control groups (P=0.11). Four weeks after the end of the intervention, the mean scores of hope in the intervention group (26.88±2.90) were significantly higher than those of the control group (24.60 ± 4.26) (P=0.03). Also, after the intervention, the mean scores of quality of life in the intervention group (69.61±12.71) were significantly higher than those of the control group (50.64 ±12.15) (P<0.001).

    Conclusion

    Dignity therapy can be an effective intervention method for increasing hope and improving the quality of life among cancer patients.

    Keywords: Cancer, Dignity therapy, Hope, Quality of life
  • Mohammad Abdi, Mehran Tahrekhani, Mohammadreza Zeraati* Pages 166-170

    Necrotizing mediastinitis is the most lethal type of mediastinitis and is caused by neck fascia, esophageal, and mediastinal infections. Therefore, its early diagnosis is crucial. This report presents the case of a 49-year-old man who was suffering from necrotizing mediastinitis due to prolonged esophageal rupturing after rabbit bone ingestion diagnosed using infection assessments and imaging. After right lateral posterior thoracotomy, the mediastinal abscess was debrided and drained. The rabbit bones were then removed from the esophagus. Two drainage tubes and two thoracotomy tubes were inserted into the mediastinal and pleural spaces, and a jejunostomy tube was inserted. Varied clinical manifestations makes the diagnosis hard and time-consuming. If early diagnosis, antibiotic therapy, thoracic surgery, proper monitoring, CT-scan imaging for differential diagnosis, and intervention are not initiated promptly, mediastinitis resulting from DNM can be lethal.

    Keywords: Esophageal foreign body, Necrotizing mediastinitis, Septic shock
  • Forough Nokhostin, Mehrdad Dargahi Malamir, Sara Tutunchi, Hadi Rezaeeyan* Pages 171-174

    The Coronavirus infectious disease 2019 (COVID-19) has recently emerged as a pandemic and has endangered the lives of thousands of people worldwide. No specific treatment has been identified so far. However, the identification of diagnostic and prognostic factors in patients can be valuable for the application of preventive strategies. Increased platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), prothrombin time (PT), and D-dimer indices have been found in patients with increased inflammation and thrombosis and can lead to heart disease. Also, an increase in these indices is accompanied by worsening of the disease and impairment of the respiratory tract, which necessitates ventilation for the patients eventually. The evaluation of NLR, PLR, and coagulation parameters can be useful for identifying high-risk individuals who need to be intubated. Patient survival will improve by the timely identification and the use of appropriate treatment strategies.

    Keywords: COVID-19, Diagnosis, Inflammation, Lymphocyte, Neutrophil, Platelet