Archives of Clinical Infectious Diseases
Volume:8 Issue: 1, Jan 2013

We have previously reported on a premature stop codon in hepatitis B Virus (HBV) S gene among Iranian patients. This mutation may cause undetectable HBV by conventional ELISA methods.. In this study, we aimed to determine the presence of premature stop codon in HBV S gene from Middle Eastern countries with predominant HBV genotype D, subtype ayw2.. Submitted HBV sequences to NCBI genome database from Middle Eastern countries (Iran, Iraq, Turkey, Pakistan, Afghanistan, United Arab Emirates (UAE) and Yemen) were retrieved. The S genes of submitted HBV sequences were analyzed by the Bioedit software to evaluate the genotype and premature stop codon in the S gene.. Premature stop codon in the S gene was observed for all countries with appropriate sequences for analysis. The frequency of mutant strains to total evaluated sequences was 17/711, 1/2, 4/110 and 1/30 for Iran, Iraq, Turkey and Yemen, respectively. In other countries (Pakistan, Afghanistan and UAE), there were no submitted sequences or the submitted sequences were inappropriate for analysis. Moreover, this mutation in the S gene of HBV was derived from 2 blood donors.. Premature stop codon in the S gene was observed in all countries with evaluable HBV genome sequences. Co-existence of detectable hepatitis B surface antigen (HBsAg) and S gene premature stop codon was inconsistent with other studies. Investigations on yield truncated HBsAg are suggested to determine if they can affect ELISA HBsAg results..

Ventilator-associated pneumonia (VAP) is a type of nosocomial pneumonia which develops more than 48 hours after endotracheal intubation. Early recognition and treatment of VAP is important, since timely and appropriate management can be lifesaving.. This study aimed to determine the antimicrobial susceptibility pattern of microorganisms causing VAP in the intensive care units (ICU) of two university associated hospitals in the province of Mazandaran in Iran from 2008 to 2010.. This study was performed on VAP patients diagnosed with the clinical pulmonary infection score (CPIS) in ICU’s of two university hospitals. For each patient suspected of VAP, quantitative culture of endotracheal aspiration (QEA) was performed and minimum inhibitory concentration (MIC) was determined by a micro dilution test. Data was analyzed by the SPSS 17 software and a P < 0.05 was considered to be statistically significant.. In this study, the type and the frequency of the microbial agents causing VAP was as follows: coagulate negative staphylococci (23.3%), Escherichia coli (E. coli) (21.7%), Staphylococcus aureus (S. aureus) (18.3%), Pseudomonas aeruginosa (P. aeroginosa) (18.3%), Enterobacter spp (11.7%). and Klebsiella pneumoniae (K. pneumonia) (6.7%). 35.71% of coagulate negative staphylococci were sensitive to vancomycin. All of the isolated E. coli was resistant to ceftazidime, but 50% sensitive to gentamicin and meropenem. 54.54% of isolated S. aureus were resistant to vancomycin. All of the isolated P. aeroginosa cases were sensitive to imipenem while 50% were resistant to ceftazidime.. In patients with VAP, carbapenems had good activity against P. aeroginosa. Increasing resistance of S. aureus to vancomycin requires more attention and further studies..

Helicobacter pylori (H. pylori) is one of the most common pathogen affecting humans, which is approximately infecting 50% of the world population and remains as a significant cause of morbidity and mortality. Since the discovery of Helicobacter pylori in early 1980, many treatment regimens have been developed to effectively treat this infection. Despite the extensive research over the last 25 years the treatment of Helicobacter pylori remains a challenging clinical problem due to its antimicrobial resistance.. This study aimed to evaluate Clarithromycin, Amoxicillin and Omeprazole efficiency as a treatment for H. pylori..Patients and The patients with clinical features of H. pylori infection and positive serological and clinical test results were entered to the study. Whole of the patients enrolled in the study were given a full two weeks of effective treatment protocol of H. pylori consisted of Clarithromycin (20 mg PO bid), Amoxicillin (1 g PO bid) and Omeprazole (20 mg PO bid) together. Our variables in this study were blood IgG and CagA factor levels, which were collected using serological tests and the H. pylori stool antigen was another variable in the study which was taken from stool tests.. Results showed that the mean level of IgG and CagA of blood samples was lower in the study group than the control one. Moreover, the average level of H. pylori antigen in stool was lower after the treatment.. The result of our study showed that using Clarithromycin, Amoxicillin and Omeprazole for treatment of H. pylori infection can be useful. It is concluded from lower levels of IgG and CagA in blood and H. pylori antigen in stool after treatment compared to the amount of these factors before therapy. Considering all these data, it is obvious that there is an urgent need to found a better therapy and treatment for H. pylori infections in which it cause low bacterial resistance..

Prevalence of Helicobacter pylori (H. pylori) differs among populations worldwide. H. pylori has been correlated with gastritis, peptic ulcer and cancer. Considering the treatment failure due to antibiotic resistance, proper treatment of H. pylori infection is of great importance.. The aim of this study was to determine the prevalence of H. pylori infection based on age, sex and also to examine antibiotic resistance among patients referred to the endoscopy department of Shahid Beheshti University of Medical Sciences hospitals in Tehran from 2010 to 2011..Patients and In this descriptive study, biopsies were taken from 192 patients with dyspepsia who underwent endoscopic evaluation. For diagnosis of H. pylori infection and histologic assessment, samples were stained by Giemsa and hematoxylin-eosin (H & E) staining. Based on the Sydney system for classification of gastritis, extent of H. pylori infection and severity of gastritis were measured. To determine antibiotic resistance after culturing on Brucella agar medium, antibiogram test was done using modified disk diffusion method on Mueller-Hinton agar considering standard conditions. Data analysis was done by the SPSS 16.0 software, using the chi-square and T-test methods.. Overall prevalence of H. pylori was 83% among all patients and 90.3% among those with gastritis (CI 95% = 85.9% - 94.6%). There was no significant correlation between the extent of H. pylori infection and age (P = 0.182) and gender (P = 0.466). Yet, there was a significant correlation between H. pylori infection and severity of gastritis (P = 0.001). Rates of resistance to metronidazole, clarithromycin, amoxicillin, ciprofloxacin and tetracycline were 50%, 16.1%, 5.2%, 4.6% and 3.6%, respectively.. Prevalence of H. pylori infection in our patients was similar to that of developing countries. Severity of gastritis is correlated with the extent of H. pylori infection. Moreover, the antibiotic resistance rate observed in this study signifies the ever-growing importance of further antibiotic sensitivity studies to help with proper treatment regimens against H. pylori..

HIV positive drug addict are in need of extensive social support to be able to fight against the destructive effects of this disease including the resulting mental and physical problems.. The present research has been designed to study the effectiveness of cognitive-behavioral trainings with an emphasis on spirituality to improve the mental health of this group of individuals in the society..Patients and This research was semi-experimental with pre-test and post-test design and control group. The statistical population included all 300 HIV positive drug addicted males who had referred to the health center, located west of Tehran, during 2009. 30 out of 300 individuals were randomly selected as a sample group. They were divided into two groups: 15 in the experimental and 15 in the control. The experimental group participated in a cognitive-behavioral and spiritual training program (8 sessions each 90 minutes, per week). In order to study the effect of the treatment; a questionnaire of life quality measurement from the Medical Outcomes Study HIV Health Survey (MOS-HIV) was used. This questionnaire was validated (with one-month time interval) through a retesting method (Cronbach''s Alpha 0.70). The sample group completed the questionnaire at two stages, pre-education and post-education programs. The data was analyzed by the t-test to compare the mean differences of mental and physical health in experimental and control groups.. The result of the present research showed that cognitive-behavioral trainings with an emphasis on spirituality were effective for improving quality of life, regarding general aspects of mental and physical health, sub-scales of general health, physical performance, the performance of role, physical pain, social performance, energy, stress and, cognitive performance of HIV positive drug addicts (P < 0.01).. It can be concluded that cognitive-behavioral and spiritual training was effective for the improvement of mental health of HIV positive drug addicts..

Needle stick injuries (NSI) are major occupational hazards for health care workers.. This study aimed to determine the Epidemiology of needle sticks and sharp injuries among nurses of an Iranian Teaching Hospital.. This descriptive cross-sectional study was conducted in 2009 on 328 nurses in a health center in Tehran. Stratified random samples were selected among the staff. Data were collected through a questionnaire prepared for this study and were analyzed with the SPSS software version 15, by using descriptive and analytical statistical methods.. The results showed that 45.12% of the employees'' occupational injuries were caused by sharp objects. Regarding the type of device, needle and angiocath needle had caused the most serious injuries with a frequency of 43.91% and 29.05%, respectively. After the injury incidence, 41.87% of the health staff only washed the injury area with adequate soap and water and 76.82% of the nurses have received the hepatitis B vaccination. The injury mostly occurred in the emergency department due to the overcrowding in the ward and the staff fatigue. There were significant associations between the staff age as well as the ward with the extent of injuries.. Needle stick injuries are common among nurses and are often not reported. Improved standard infection control precautions (SICPs) policy and reporting strategies are needed in order to increase occupational safety for nurses..

Typhoid fever is a common infection in children in developing countries. Typhoid fever is a systemic illness which affects many organs. Isolated hepatitis, thrombocytopenia and acute renal failure complicating typhoid fever are well known. The potential of multiorgan involvement in typhoid fever - on rare occasions - may occur simultaneously in the same patient..