Zahedan Journal of Research in Medical Sciences
Volume:24 Issue: 4, Oct 2022

 Physicians, as the leading decision-makers of the health system, are affected by various clinical statuses.

 This study aimed to compare the clinical skills of medical students as future physicians with the educational standards of Zahedan University of Medical Sciences in 2020 - 2021.

 This study was performed on 107 medical students (53 stagers and 54 interns). After obtaining students' consent and recording their demographic and academic information, clinical skills were assessed using the Clinical Medical Skills Questionnaire. The obtained data were analyzed using SPSS software Ver. 20.

 The least trained skills in the surgical department were suprapubic puncture and thoracotomy with a needle in compressive pneumothorax. In the pediatric ward, no clinical skill training was in good condition, and only practical measures to monitor growth and development were adequately trained. In the internal ward, the least training skill was related to lumbar puncture and aspiration of knee joint fluid. In the gynecology ward, abortion evacuation with pairs of forceps in cases of life-threatening bleeding and postpartum hemorrhage were considered the least instructed clinical skills. Finally, in the emergency ward, nasal bleeding catheter, suprapubic sampling, and cricothyrotomy were the least instructed clinical skill.

 The results showed a low number of encounters of medical students with the minimum expected clinical skills in the investigated medical school, indicating the poor quality of clinical training. The medical programs should be modified so that learners can be equipped with “the must learn” clinical skills.

Retinoblastoma (RB) is a common neoplastic disease in children, leading to high mortality if not diagnosed and treated timely. Mutations in both versions of the Retinoblastoma1 (RB1) gene are responsible for this disease. A wide range of mutations has been reported throughout the RB1 gene.

The present study aimed to assess the concordance of paternal and maternal RB-1 gene mutation with clinical manifestation and disease staging in patients suffering from RB.

This cross-sectional study was performed on 23 patients with unilateral or bilateral RB. Paternal and maternal peripheral blood samples were extracted for genome analysis. Information related to clinical manifestations and disease staging was collected from the patients’ hospital records. Multiplex-ligation dependent probe amplification (MLPA) method or Sanger sequencing method was employed to assess the gene mutation and its genomic pattern.

No significant association was revealed between the presence of both maternal and paternal RB1 gene mutations and the disease staging, while the study could show a significant relationship between the presence and heterozygous pattern of RB1 gene mutation and the presence of disease-related clinical manifestations that bilateral involvement was strongly associated with the presence of a heterozygous pattern of gene mutation compared to unilateral involvement (P = 0.001).

This study showed a significant correlation between the presence of RB1 gene mutation and bilateral involvement in RB, but the association between the disease staging and gene mutation remains insignificant.

 Computers and other electronic devices are a requisite aspect of people’s lives globally for multiple purposes, including education, entertainment, and communication.

 This study investigated the bacterial contamination of desktop computer keyboards (as a reservoir of pathogens) in different departments of Mazandaran University of Medical Sciences, Sari, Northern Iran, from September 2018 to February 2019.

 In this descriptive cross-sectional study, samples were obtained from computer keyboards with sterile swabs and cultured on blood agar and eosin methylene blue agar. Standard microbiological methods were used to identify bacterial isolates. Then, the antimicrobial susceptibility testing of the isolates was performed using the Kirby-Bauer method based on the CLSI procedure.

 In total, 58 bacterial strains were isolated from the collected samples. The isolates included 23 (39.7%) Staphylococcus epidermidis, 15 (25.9%) Staphylococcus aureus, 14 (24.1%) Bacillus spp., 3 (5.2%) Klebsiella pneumoniae, 2 (3.4%) Pseudomonas aeruginosa, and 1 (1.7%) Escherichia coli. All Gram-positive bacteria were resistant to penicillin, whereas the most resistance rate among Gram-negative bacteria was observed against ciprofloxacin, ceftazidime, and cephalothin.

 Due to the presence of opportunistic pathogens on computer keyboards, personal hygiene and periodic cleaning of keyboards with disinfectants is necessary to prevent the further spread of these bacteria.

Calcitonin gene-related peptide (CGRP) and rat calcitonin (rCT) play critical roles in descending pain control systems.

The present research aimed to evaluate the effect of the intracerebroventricular (ICV) administration of CGRP and rCT on the mRNA expression of CGRP and rCT peptides in the periaqueductal gray (PAG) of healthy rats in the formalin test.

A total of 24 male Sprague Dawley rats were categorized into four groups (n = 6). One week after stereotaxic surgery, 1.5 nmol CGRP or rCT peptides were injected (ICV) once daily for 7 days. After 20 min from the last injection, the right foot of the animal was injected subcutaneously with 2.5% formalin. Pain-related behaviors were recorded immediately for 60 min. The PAG nucleus was then removed to assess the changes made in the mRNA expression of the CGRP and rCT.

ICV injection of CGRP or rCT reduced pain in the different phases of the trial. ICV injection of rCT induced the expression of rCT mRNA in the PAG area (P < 0.05). However, ICV injection of rCT had no significant effect on the CGRP mRNA expression in the PAG area. Moreover, following the ICV injection of CGRP, the expression of rCT mRNA increased in the PAG area (P < 0.05). It is noteworthy that the ICV injection of CGRP caused a significant effect on the CGRP mRNA expression in the PAG area (P < 0.05).

The ICV injections of CGRP and rCT peptides decreased pain in the formalin test. Higher mRNA expression of these peptides in the PAG might be a possible mechanism for this observation.

 Pulmonary hypertension (PH) is a serious problem with high mortality in children, so early diagnosis of this condition is critical. Echocardiography is a non-invasive hemodynamic assessment tool, which facilitates serial follow-ups for hypertensive patients.

 The aim of this study was to evaluate the importance of echocardiographic parameters in children with PH and their correlation with cardiac catheterization parameters.

 This cross-sectional study was performed on the records of 20 children with primary PH referred to the pediatric Cardiology Department and clinic of Imam Reza Hospital, Mashhad, Iran, during 2001-2016. The correlation between echocardiography and cardiac catheterization findings was assessed to determine the predictability of echocardiographic parameters in primary pulmonary hypertension.

 Based on the findings, the mean values of tricuspid regurgitation pressure gradient (TRPG) and peak early diastolic transpulmonary valve pressure gradient (PRPG) were 76.33 ± 22.8 and13.18 ± 44.2 mmHg, respectively. The mean of RA systolic pressure, RA diastolic pressure, RA mean pressure were 13.62 ± 4.43, 5.12 ± 2.1, and 6.77 ± 4.08, respectively. The analysis of data showed a significant correlation between systolic pulmonary artery pressure (PAP) and TRPG (r = 0.62; P = 0.008). We found no significant correlation between systolic PAP and PRPG (r = 0.58; P = 0.03). Additionally, diastolic PAP significantly correlated with TRPG (r = 0.67; P = 0.003) and PRPG (r = 0.64; P = 0.04). Moreover, a significant correlation was observed between mean PAP and TRPG (r = 0.66; P = 0.004) and PRPG (r = 0.64; P = 0.04).

 Echocardiographic approach is a safe and sensitive method for diagnosis of primary pulmonary hypertension. We found a strong correlation between mean PAP and two variables of TRPG and PRPG.

 Staphylococcus aureus is considered a normal flora by colonization in the nose and skin of humans, yet it is a major cause of nosocomial infections and a life-threatening pathogen. Among antibiotics, oxazolidinones and glycopeptides have activity against gram-positive pathogens.

 The present study aimed to determine the frequency and comparison of the minimum inhibitory concentration of tedizolid, linezolid, and vancomycin against extensively drug-resistant (XDR) S. aureus strains isolated from hospitalized patients.

 This descriptive-analytical study was performed on 58 S. aureus isolates collected from 164 hospitalized patients over the course of one year. The Kerby-Bauer test was used to identify XDR isolates. Broth microdilution test was used according to CLSI M100-S25 (2015) criteria to determine the minimum inhibitory concentration (MIC) of vancomycin, linezolid, and tedizolid.

 The frequency of XDR S. aureus clinical isolates was 28 (48.3%). Determining MIC showed that all XDR S. aureus isolates tested were susceptible to tedizolid (MIC, ≤ 2 μg/mL), while 92/8% (MIC, ≤ 4 μg/mL) and 60.70% (MIC, ≤ 2 μg/mL) of XDR isolates were categorized as susceptible to linezolid and vancomycin, respectively. The concentration of tedizolid that inhibited 90% of isolates (MIC90) was 2 μg/mL, 2-fold lower than linezolid (MIC90 = 4 μg/mL) and 64-fold lower than vancomycin (MIC90 = 128 μg/mL). There was a significant difference between the frequency of XDR isolates from the aspirate, trachea, and wound infections, so 22% of vancomycin-resistant isolates and all strains resistant to linezolid were isolated from hospitalized patients in the infectious ward (P = 0.04).

 We conclude that tedizolid has a beneficial effect on XDR isolates of S. aureus and possesses more potent in vitro activity than the rest agents.

In pregnancy, the body undergoes modulation of pro-inflammation responses to ensure fetal survival, and these adjustments may decrease maternal immune defenses and promote infections.

This study was conducted to determine interleukin 2 (IL-2), IL-10, and interferon gamma (IFN-γ) among pregnant women co-infected with HIV and Plasmodium falciparum in Edo State, Nigeria.

This study was conducted at the Central Hospital, Benin City, Edo State. A total of 200 participants were enrolled, consisting of 150 pregnant women co-infected with HIV and P. falciparum and 50 non-pregnant women (as controls) who were neither infected with HIV nor P. falciparum. Venous blood specimen was collected for P. falciparum detection, CD4 T-lymphocyte estimation, and IL-2, IL-10, and IFN-γ assays using standard methods.

Among HIV-infected pregnant women, IL-2 (P = 0.0070), IL-10 (P = 0.0179) and IFN-γ (P = 0.1564) values were lower in primiparous women compared with multiparous women. HIV-infected pregnant women who were married had significantly higher IL-2 (P = 0.0085) and IFN-γ levels (P = 0.0332) compared with single women, while marital status did not affect the IL-10 level of pregnant women infected with HIV. Only the IL-2 levels of the HIV-infected pregnant women increased significantly (P = 0.0012) with increasing trimester. The tested cytokine levels were lower in those with malaria compared with those without malaria among HIV-infected pregnant women.

The HIV status and not malaria infection affects the cytokine levels of pregnant women co-infected with HIV and malaria.

 In December 2019, a novel coronavirus (a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) emerged in Wuhan, China.

 The current research aimed to evaluate the clinical features of COVID-19 infection in pediatric patients and compare them with those of adult patients in Sanandaj, Iran.

 Retrospectively, 56 hospitalized cases, including 32 adult and 24 pediatric patients with COVID-19 from March 7th, 2020, to June 5th, 2020, were enrolled in this study. The clinical and laboratory findings of the pediatric patients with COVID-19 infection were analyzed and compared with those of the adult patients.

 The average number of fever days in adults was higher than that of pediatric patients (P = 0.04). Cough was more severe in adults than in pediatric patients (P = 0.03). Diarrhea was not statistically different between the two groups. Dizziness was far more common in adults than pediatric patients (P = 0.01). The percentage of blood oxygen saturation decreased in both groups, but there was no statistically significant difference between the two groups. C-reactive protein (CRP) was positive in many patients in both groups; however, there was no difference between the pediatric and adult patients. Lymphopenia was significantly higher in adults than in pediatric patients (P = 0.02). As in pediatric patients, an increase in liver enzymes was seen in adults. However, there was no statistically significant difference between the two groups.

 The present study showed that pediatric patients with COVID-19 infection have milder clinical symptoms than adults. However, according to the laboratory findings, pediatric patients need to be followed up as well as adult patients.

Coronavirus disease 2019 (COVID-19) is a rapidly spreading global emergency, causing significant damage to the global economy and health care. Knowledge and awareness are crucial elements in stimulating self-imposed preventive measures.

We evaluated the knowledge and awareness about COVID-19 and the practice of hygiene measures to prevent the spread of coronavirus disease.

A prospective observational study was conducted in Karachi, Pakistan, between March 01 and March 25, 2020, using a non-probability consecutive sampling technique. All individuals aged 18 years or above were included in the study. The individuals who had no formal education were excluded from the study. A self-reported questionnaire assessing knowledge, awareness, and practices was distributed among the participants.

The mean age ± SD of the study population was 29.11 ± 7.8 years. In our study, 424 (98.6%) participants knew that a virus causes COVID-19, and most were knowledgeable about the disease's transmission mode. Higher education status and the medical profession were associated with the better practice of preventive measures.

We recommend that knowledge about COVID-19 and preventive measures be spread across the country via electronic media.

The registry will provide adequate motivation for researchers to conduct various studies in numerous fields of medical and neuropsychological sciences.

Up to the present, no registry system for autism spectrum disorder (ASD) has been developed in Iran. Therefore, the present study aimed at the generation of the protocol to develop an informative system of ASD registry in Hamadan, one of the western cities of Iran.

Before conducting this protocol, screening of 18-month-old children for ASD was executed. A researcher-made questionnaire will be used for data collection. The Data Management website will keep under review all accomplished questionnaires through the registration process.

The developed registry system is a precious tool to survey ASD and accurately conceive the essence of the problem. In Hamadan, similar to other parts of Iran and on a larger scale worldwide, the number of children diagnosed with ASD is increasing.

The essential services and facilities will be provided for children with ASD and their affected families through the obtained information from this registry system. In addition, the obtained data from a large population by the registry system for ASD will induce researchers to discover environmental and genetic contributions to the etiological components of ASD.