Journal of Studies in Medical Sciences
Volume:35 Issue: 5, 2024

Acinetobacter baumannii, as one of the causes of hospital infection, causes the death of many patients every year. Due to the high antibiotic resistance, controlling the infections has faced a challenge. In addition, no effective vaccine has been produced for this bacterium. Therefore, in the present study, using immunoinformatics tools, OmpA protein as a vaccine candidate was used to investigate the immune responses in different time points of administration so that in addition to introducing a vaccine candidate, the best timing of its administration was also provided.

In this study, The Acinetobacter baumannii OmpA protein was chosen and the epitopes of T and B lymphocytes were predicted using immunoinformatics servers. Then, the antigenic properties, non-allergenicity, non-toxicity, physical and chemical properties, and binding ability to innate and adaptive immune receptors were evaluated. Finally, the ability to induce immune responses in five different injection programs was investigated.

The results showed that OmpA is an antigenic, safe, hydrophilic protein with good solubility. This protein can bind to innate and adaptive immune receptors and can induce humoral and cellular immune responses in three-time and four-time injections.

In total, this study shows that OmpA, in addition to its immunogenic properties, as a vaccine candidate, can induce immune mediators by administering it three times, however, four times administrations of this protein create a stronger immune response.

Despite the reduction of tuberculosis globally, new cases of this disease continue to be reported in Iran, although skin tuberculosis is uncommon and constitutes a small portion of new cases. The presentation of skin ulcers caused by cutaneous tuberculosis can mimic other systemic diseases, leading to clinical uncertainty. Cutaneous tuberculosis is classified into two types: the true type, characterized by the presence of bacilli in the affected skin, and the tuberculoid type, resulting from an allergic reaction.This case report highlights a situation where a skin nodule, initially identified as cutaneous tuberculosis, was later confirmed through a lung biopsy guided by CT scan. It emphasizes the significance of medical history, physical examination, and considering the potential risk of disease spread during needle sampling procedures guided by CT scans.

The foundation of medical care is rooted in respect for human dignity. Preserving the dignity of elderly patients is one of the most fundamental aspects of their care. This study aimed to investigate the social dignity of elderly patients hospitalized in hospitals affiliated with Abadan University of Medical Sciences in 2022.

This cross-sectional study was conducted among a sample of 167 elderly patients admitted to hospitals affiliated with Abadan University of Medical Sciences in 2022. A 77-question questionnaire was used for data collection. For data analysis, descriptive statistics and univariate analyses, including two-sample t-tests, Mann-Whitney, ANOVA, and Kruskal-Wallis tests, were performed. Multivariate analyses using multiple linear regression were also conducted. All analyses were performed using SPSS version 24 software at a significance level of 0.05.

The study examined the social dignity of the elderly in terms of age, gender, occupation, education, income, place of residence, ethnicity, type of hospitalization, and hospitalization department. The results showed that only the income level had a statistically significant average difference. In other cases, the observed differences were not statistically significant.

The results of this study indicated that the social dignity of patients admitted to public hospitals affiliated with Abadan University of Medical Sciences was average. Policymakers in the health system need to pay serious attention to the components of the social dignity of hospitalized elderly patients. Although the economic aspect did not significantly impact the dignity of these patients, neglecting this issue could lead to future problems. Therefore, the researchers emphasize the importance of strengthening community support, employee support, and reducing social and economic burdens to enhance the social dignity of elderly patients in government hospitals.

More than three years after the outbreak of the new SARS-CoV-2 virus, it remains a health concern for certain populations, including pregnant women. The purpose of this study is to investigate the rate of premature birth and low birth weight in pregnant women with COVID-19 infection and compare it with the population of non-infected mothers.

In this cohort study, 511 pregnant women whose COVID-19 infection was confirmed by a positive SARS-CoV-2 RT-PCR test or with clinical signs and symptoms of COVID-19 pneumonia, as well as 1018 pregnant women without infection, were included. Retrospectively, basic characteristics and data related to maternal and neonatal outcomes were collected from patient records and analyzed using SPSS v.26 software.

The average gestational age at the time of delivery for pregnant women with COVID-19 infection and healthy pregnant women was 37 ± 4 days and 38 ± 2 days, respectively. The rate of cesarean delivery among pregnant women with COVID-19 was significantly higher than that of healthy pregnant women (P < 0.001). No statistical difference in neonatal outcomes was observed in terms of NICU admission rate, neonatal death, or Apgar score. Babies with low birth weight were more common in pregnant women with COVID-19 compared to healthy pregnant women (P < 0.001).

Pregnant mothers infected with COVID-19 have a higher risk of preeclampsia, cesarean delivery, premature delivery, ICU hospitalization, maternal death, and low birth weight of the baby. Additionally, there is a significant correlation between COVID-19 infection and these adverse outcomes. However, we did not observe a significant difference in Apgar scores, NICU admissions, or perinatal mortality. It seems that pregnant mothers with COVID-19 should be given special attention regarding the possibility of preeclampsia and the risk of premature birth.

Acute limb ischemia remains a significant cause of emergency vascular surgery. Given the severe complications associated with this condition and the need for more effective treatments, this study was conducted to evaluate the impact of beta-alanine on clinical outcomes in patients with acute upper or lower limb ischemia following surgery.

This single-blind clinical trial enrolled 40 patients with acute limb ischemia without gangrene or mottling and who required amputation. Patients were randomly assigned to a beta-alanine group (n=20) or a placebo group (n=20). The intervention group received 4 grams of oral beta-alanine before surgery and 4 hours postoperatively, while the placebo group received a matching placebo. Primary outcomes included limb loss frequency and extent, while secondary outcomes were mortality and laboratory findings.

A total of 9 patients (22.5%) experienced limb loss. Of these, only 1 patient (5%) was in the beta-alanine group, compared to 8 patients (40%) in the placebo group (p=0.02). In the beta-alanine group, the affected limb was the right lower extremity. In the placebo group, one patient lost the right upper limb, two lost the right lower limb, four lost the left upper limb, and one lost the left lower limb. There was no significant difference in mortality between the groups (5% in the beta-alanine group versus 15% in the placebo group; p=0.61).

The frequency of limb loss was significantly lower in patients treated with 4 grams of oral beta-alanine compared to the placebo group. Therefore, beta-alanine may be considered an effective adjunctive therapy in reducing the risk of limb loss in patients with acute limb ischemia.

Resistant starch (RS) is a form of starch that human digestive enzymes cannot access, and it is fermented in the lower intestinal tract, modifying microbiota and producing short-chain fatty acids. Although numerous studies have investigated the impact of RS on human health, its exact mechanisms and effects on human health and diseases are not yet fully understood.

This review study was conducted using relevant keywords and electronic searches in Scopus, PubMed, and Web of Science databases.

Resistant starch type 2 (RS2), a high amylose starch (HAM-S), cannot be completely digested in the gastrointestinal tract due to its specific structure. Consequently, RS2 affects satiety, obesity, and other metabolic variables in a dose-dependent manner. Additionally, a diet rich in HAM-S may have beneficial effects on gastrointestinal health and kidneys by altering gut microbiota and reducing nitrogenous waste in the body. However, several studies have shown that the intake of high amylose supplements has no positive effects on cardiometabolic variables.

This study reviewed some of the main effects of resistant starch type 2 (RS2) on obesity, gut health, chronic kidney diseases, and cardiometabolic health. Due to the beneficial effects of RS2 on human health and the absence of significant side effects from its consumption, it is probably helpful to consider HAM-S as part of daily carbohydrate intake.

Today, endoscopic procedures are considered as a key method in early diagnosis and treatment of gastrointestinal diseases. However, the quality of performance and patient satisfaction is one of the most important issues in endoscopy. This study aimed to determine the effect of promethazine on sedation and quality of upper esophageal and gastro endoscopy.

In this double-blind clinical trial study, 22 patients were randomly divided into two groups: promethazine (intervention) and placebo. Patients in the intervention group received 30 cc of promethazine hydrochloride syrup dissolved in 70 cc of drinking water one hour and placebo group received 50 gr of glucose solution dissolved in 50 cc of drinking water before the procedure. The outcomes of the study including endoscopist and patient satisfaction, patient anxiety, and Wilson sedation scale were measured and compared between the two groups.

The results showed that the endoscopist satisfaction in 3. 27% of patients in the intervention group and 1.9% in the placebo group were excellent and good and the average frequency of endoscopist satisfaction in the intervention and placebo groups was 5.54% and 7.27%, respectively. In the intervention group, 1.9% of patients were completely satisfied with the procedure. For the Wilson Sedation Scale, 100% of patients were aware in the placebo group, while 7. 27% were fully aware in the intervention group. The percentage of severe and high anxiety in the patient during endoscopy in the intervention and placebo groups were 7. 27% and 8.81%, respectively. None of the studied outcomes showed statistically significant differences between the two groups (p <0.05).

The use of promethazine as a premedication compared with placebo did not have a significant effect on the quality of endoscopy and patient sedation.

Escherichia coli and Klebsiella pneumoniae are important bacteria that cause hospital-acquired infections and have become resistant to beta-lactam antibiotics through the acquisition of beta-lactamase-encoding plasmids. Resistance to disinfectants has also been observed in these strains. Therefore, the aim of this study was to investigate the antimicrobial effect of the disinfectant chlorhexidine on multidrug-resistant strains of Escherichia coli and Klebsiella pneumoniae.

Clinical samples were collected from the intensive care unit of Qazvin hospital. All isolates were analysed by phenotypic method. Finally, the combined effect of chlorhexidine and EDTA on the collected strains was performed.

45% of the 70 Escherichia coli isolates were MDR and 83.3% of the 74 Klebsiella pneumoniae isolates. All samples were equally sensitive to chlorhexidine. EDTA showed no synergistic effect with this substance.

The results of our study show that chlorhexidine can effectively destroy Escherichia coli and Klebsiella pneumoniae producing and non-producing biofilm strains. Therefore, this disinfectant can be used at low concentrations to control antibiotic resistance in multidrug-resistant Escherichia coli and Klebsiella pneumoniae bacteria in hospital-acquired infections.