Introduction: Testicular torsion is a surgical emergency which requires early diagnosis and prompt surgical management to avoid testicular damage. The aim of this study is to survey the clinical findings and outcome o...Introduction: Testicular torsion is a surgical emergency which requires early diagnosis and prompt surgical management to avoid testicular damage. The aim of this study is to survey the clinical findings and outcome of the patients treated for testicular torsion in a university hospital in Babol, northern Iran. Methods: In this cross sectional study, a retrospective survey of all cases presenting with acute scrotum and primarily diagnosed as testicular torsion was conducted during 2001 and 2012 in Babol, northern Iran. All 103 cases were reviewed and several clinical data, including duration of symptoms and operative findings were collected. Findings: Of 103 patients who presented to the emergency department with acute scrotum, the median age of the cases was 16.0 years. Thirty four percent of the patients presented emergency unit less than 6 hours from symptom exposure. Pain (95.1%) was the major symptom in all patients. Surgery revealed that 72 (70.9%) cases were diagnosed firmly as testicular torsion that 23 patients underwent orchidectomy for a necrotic torsed testis. There were significant differences between orchiectomized versus non-orchiectomized torsion cases in affected side, symptom presentation to operation time. Conclusion: According to our results more than half of the cases presented more than in the golden time. Late presentation to hospital was the major cause of delay leading to orchidectomy in patients with testicular torsion. Greater effort in health education and direct or selfreferal to hospital may reduce this delay.展开更多
Introduction:The occurrence of congenital anomalies is one of the serious challenges in the world.Therefore,identifying related factors to reduce it is of particular importance.This study aimed to determine the incide...Introduction:The occurrence of congenital anomalies is one of the serious challenges in the world.Therefore,identifying related factors to reduce it is of particular importance.This study aimed to determine the incidence and factors related to congenital anomalies.Methods:An epidemiology study was conducted on 1567 infants and their parents in Kermanshah,Iran.The required information was extracted from the ffles of mothers in health centers.The data collection tool was a researcher-made checklist of 39 questions.The data was statistically analyzed with the STATA version 14 software.Result:The incidence of congenital anomalies was 2.9%(n=45).Brain anomalies(n=10)and pulmonary anomalies(n=8)were the most common congenital anomalies in newborns.The results showed that parents’age(p=0.001),place of residence(p=0.022),mother’s occupation(p=0.010),hemoglobin level(p=0.002),blood pressure disorders(p=0.001),bleeding during pregnancy(p=0.001),infection during pregnancy(p=0.001),multivitamins(p=0.002)and women’s previous birth records such as previous abnormal birth history(p=0.015),abortion history(p=0.001),stillbirth history(p=0.001),birth history of infant less than 2500 g(p=0.001)was found to have a statistically signiffcant relationship with congenital anomalies.Conclusion:The incidence of congenital anomalies was high in Kermanshah city.Considering the identiffcation of risk factors and preventive factors related to congenital anomalies,it is suggested that interventions be carried out in health centers to increase awareness among pregnant women to reduce the incidence of anomalies.展开更多
Objective:To evaluate the efficacy and safety of QL1206(a denosumab biosimilar to Xgeva■)in breast cancer patients with bone metastasis(BM)through subgroup analysis of a randomized,double-blind phaseⅢtrial(No.NCT045...Objective:To evaluate the efficacy and safety of QL1206(a denosumab biosimilar to Xgeva■)in breast cancer patients with bone metastasis(BM)through subgroup analysis of a randomized,double-blind phaseⅢtrial(No.NCT04550949).Methods:This subgroup analysis included patients with BM from breast cancer enrolled in a phaseⅢtrial.Patients were randomized(1:1)to receive either three cycles of QL1206 or denosumab(120 mg subcutaneously every 4 weeks).Subsequently,they received 10 cycles of QL1206(120 mg)over 40 weeks,followed by a 20-week safety follow-up.The primary endpoint was the percentage changes from baseline to week 13 in urinary Ntelopeptide corrected for creatinine(u NTx/Cr).Results:The breast cancer cohort consisted of 311 patients.Vertebral involvement(66.4%)was the most prevalent BM site at enrollment,while 27.7%of patients presented with≥3 metastatic bone lesions.At week 13,QL1206 demonstrated a median u NTx/Cr reduction of-69.9%(range:-98.1%-568.0%)vs.-74.3%(range:-97.7%-386.3%)for denosumab.The analysis of covariance revealed comparable least-square means for log-transformed changes:-1.416[95%confidence interval(95%CI):-1.736 to-1.096]vs.-1.501(95%CI:-1.824 to-1.178),yielding an between-group difference of 0.085(90%CI:-0.062-0.232;P=0.343).After a 53-week treatment period,83.6%achieved bone density improvement/disease stabilization.Safety profiles were comparable between groups.Conclusions:QL1206 demonstrated similar efficacy and safety to the reference denosumab in patients with BM from breast cancer,supporting QL1206 as a new option for management of BM from breast cancer.展开更多
Objective:To determine the efficacy of tranexamic acid(TXA)in the management of acute upper gastrointestinal(GI)bleeding.Methods:A total of 70 patients with acute upper GI bleeding were included in this double-blinded...Objective:To determine the efficacy of tranexamic acid(TXA)in the management of acute upper gastrointestinal(GI)bleeding.Methods:A total of 70 patients with acute upper GI bleeding were included in this double-blinded randomized controlled clinical trial from September 2018 to December 2018.Patients were divided into the control group(received fluid therapy and intravenous infusion of pantoprazole,35 cases)and the TXA group(received intravenous TXA besides the treatment of control group,35 cases).Rebleeding,admission duration,and need for blood transfusion were compared between the two groups.Results:Fifteen patients(42.9%)in the TXA group and 10 patients(28.6%)in the control group stayed in hospital for more than 3 days during their admission(P=0.21).Rebleeding occurred in 8 patients(22.9%)and 5 patients(14.3%)of the TXA group and the control group,respectively(P=0.35).More patients in the TXA group(21 cases,60%)received blood transfusion than the control group(8 cases,22.9%)(P=0.02).Conclusions:TXA did not improve the outcome of patients with acute upper GI bleeding.展开更多
Objectives:The present study was conducted to evaluate the clinical competence and its related demographic factors among critical care nurses in Kermanshah,Iran.Methods:In this cross-sectional study,155 Iranian nurses...Objectives:The present study was conducted to evaluate the clinical competence and its related demographic factors among critical care nurses in Kermanshah,Iran.Methods:In this cross-sectional study,155 Iranian nurses were selected by stratified random sampling.The data collection tools included a personal information form and the"Nurse Competence Scale".Data were analyzed using descriptive and analytical statistics.Results:The mean score of nurses'clinical competence was equal to 76.14±1.59 out of 100,which was at a"very good level".The mean score of using clinical competence in practice was equal to 70.38±15.25 out of 100,which was at a"good level".Among the subscales of clinical competence,the highest mean score was related to"managing situation".The mean score of"using clinical competence in practice"was related to the subscale of"therapeutic interventions".There was no statistically significant difference among the score of clinical competence of nurses varying with different gender,age,academic degree,and work experience.Conclusions:The clinical competence of critical care nurses in Kermanshah was at a"very good"level,and the use of clinical competence in practice was at a"good level."Given the importance of clinical competencies in practice,nurses'clinical competence should be evaluated objectively and positive measures should be taken to promote the application of their clinical competence.展开更多
Drug abuse by pregnant women is one of the significant problems for mothers and their neonates.This study aimed to investigate the effects of maternal substance use disorder during pregnancy on neonatal developmental ...Drug abuse by pregnant women is one of the significant problems for mothers and their neonates.This study aimed to investigate the effects of maternal substance use disorder during pregnancy on neonatal developmental criteria.In a case-control study,clinical records of 90 neonates diagnosed with neonatal abstinence syndrome who were admitted to NICU in one of four hospitals affiliated with Shahid-Beheshti University of Medical Sciences in Tehran,Iran between 2017 and 2020 were compared to 90 neonates without neonatal abstinence syndrome(control group).Demographic information and data for neonatal developmental characteristics and complications were extracted from the clinical records of this convenience sample.Data for the type and method of maternal substance use during pregnancy were collected through a telephone call with mothers.Our data showed that the prevalence of drug addiction was 1.8%among pregnant women,and the most common drugs used by mothers were opium(n=45%,50%),amphetamine(n=30%,33%),and methadone(n=14%,16%).Neonates with abstinence syndrome had a higher prevalence of transient tachypnea of the newborn(TTN)(P=0.004),and a prevalence of being admitted to NICU(P=0.05)and for a longer duration(P<0.001).Their mothers had a higher prevalence of having pre-eclampsia(P=0.010).Using morphine vs.amphetamine showed no difference based on their effects on mothers and neonates.Substance use during pregnancy increased the prevalence of pregnancy complications(pre-eclampsia)and neonatal complications(TTN and prevalence and duration of hospitalization).Therefore,planning for the development of health policies to raise awareness among women and more broadly,all members of the community,is important to prevent the tendency to engage in this potentially high-risk behavior.展开更多
Background:Complementary medicine is an interesting field for extracting bio-active compounds from various plant and animal sources.The hepatoprotective effect of the methanolic extract of a species of sea cucumber ca...Background:Complementary medicine is an interesting field for extracting bio-active compounds from various plant and animal sources.The hepatoprotective effect of the methanolic extract of a species of sea cucumber called Holothuria leu-cospilota in an animal model of liver cancer caused by dimethyl nitrosamine(DMN)was studied.Methods:Wistar female rats were randomly divided into five groups(n=12):control(intact),positive control(received 1%DMN[10 mg/kg/week,intraperitoneally]for 12 weeks),and three treatment groups(received 50,100,and 200 mg/kg/day H.leu-cospilota extract orally for 12 weeks along with intraperitoneal administration of 1%DMN[10 mg/kg/week]).In all groups,ultrasound was performed on the liver every week to check its density.Blood sampling and liver isolation were performed on three occasions,at 4,8,and 12 weeks,to check liver enzymes and the histopathological condition of the liver tissue(every week,four animals from each group were randomly selected).Results:Liver density changes were evident from the eighth week onward in the positive control group.Histopathological results indicated pathologic changes in the positive control group after 4 weeks.The increase in liver enzymes in the posi-tive control group was significantly different from that in the treatment and control groups.Conclusions:We demonstrated the hepatoprotective effect of H.leucospilota on DMN-induced liver damage in rats using biochemical and histological parameters and ultrasonography.More additional research(in silico or in vitro)is needed to find the exact mechanism and the main biological compound in H.leucospilota.展开更多
Objective:To evaluate thyroid dysfunction prevalence and its consequences in high-risk pregnant women and their children.Methods:In this retrospective cohort study,data from high-risk pregnant women who were referred ...Objective:To evaluate thyroid dysfunction prevalence and its consequences in high-risk pregnant women and their children.Methods:In this retrospective cohort study,data from high-risk pregnant women who were referred to a governmental referral hospital in Qom,Iran from March to August 2022 were collected.The thyroid disorders were determined according to the 2017 American Thyroid Association guidelines.The predictors of a mother's hypothyroidism and its fetal and maternal consequences were assessed.Independent t-test,Chi-square test,and logistic regression were used for bivariate and multivariate analysis.Results:293 women were included.The prevalence of hypothyroidism and hyperthyroidism based on the thyroid stimulating hormone classification was 32.5%and 2.0%.The prevalence of subclinical and overt hypothyroidism was 6.1%and 4.1%,and the prevalence of subclinical and overt hyperthyroidism was 2.4%and 1.4%,respectively.Family history of thyroid disorders was the most important predictor of hypothyroidism during pregnancy(OR=2.6,95%CI=1.0-6.6,P=0.002),while preterm delivery(OR=2.2,95%CI=1.3-6.8,P=0.220)and elevated neonate thyroid stimulating hormone(OR=1.2,95%CI=1.1-1.3,P=0.041)were the most important consequence of hypothyroidism.Conclusions:Hypothyroidism is a highly prevalent thyroid disorder in high-risk pregnant women.Thyroid function screening should be performed in all pregnant women to increase the detection of subclinical and overt hypothyroidism during pregnancy.展开更多
Brucellosis is a common global zoonotic disease, which is responsible for a range of clinical manifestations. Fever, sweating and musculoskeletal pains are observed in most patients. The most frequent complication of ...Brucellosis is a common global zoonotic disease, which is responsible for a range of clinical manifestations. Fever, sweating and musculoskeletal pains are observed in most patients. The most frequent complication of brucellosis is osteoarticular involvement, with 10% to 85% of patients affected. The sacroiliac(up to 80%) and spinal joints(up to 54%) are the most common affected sites.Spondylitis and spondylodiscitis are the most frequent complications of brucellar spinal involvement. Peripheral arthritis, osteomyelitis, discitis, bursitis and tenosynovitis are other osteoarticular manifestations, but with a lower prevalence. Spinal brucellosis has two forms: focal and diffuse. Epidural abscess is a rare complication of spinal brucellosis but can lead to permanent neurological deficits or even death if not treated promptly. Spondylodiscitis is the most severe form of osteoarticular involvement by brucellosis, and can have single-or multifocal involvement. Early and appropriate diagnosis and treatment of the disease is important in order to have a successful management of the patients with osteoarticular brucellosis. Brucellosis should be considered as a differential diagnosis for sciatic and back pain, especially in endemic regions. Patients with septic arthritis living in endemic areas also need to be evaluated in terms of brucellosis. Physical examination, laboratory tests and imaging techniques are needed to diagnose the disease. Radiography, computed tomography, magnetic resonance imaging(MRI) and bone scintigraphy are imaging techniques for the diagnosis of osteoarticular brucellosis. MRI is helpful to differentiate between pyogenic spondylitis and brucellar spondylitis. Drug medications(antibiotics)and surgery are the only two options for the treatment and cure of osteoarticular brucellosis.展开更多
BACKGROUND Platelet-rich plasma(PRP)and hyaluronic acid have been shown to be useful in the treatment of knee osteoarthritis.However,investigations comparing the efficacy of these two drugs together are insufficient.A...BACKGROUND Platelet-rich plasma(PRP)and hyaluronic acid have been shown to be useful in the treatment of knee osteoarthritis.However,investigations comparing the efficacy of these two drugs together are insufficient.AIM To compare the outcomes of PRP vs hyaluronic acid injections in three groups of patients with bilateral knee osteoarthritis.METHODS This randomized controlled trial study involved 95 patients.Thirty-one subjects received a single injection of PRP(group PRP-1),33 subjects received two injections of PRP at an interval of 3 wk(group PRP-2)and 31 subjects received three injections of hyaluronic acid at 1-wk intervals(group hyaluronic acid).The patients were investigated prospectively at the enrollment and at 4-,8-and 12-wk follow-up with the Western Ontario and McMaster Universities Arthritis Index(WOMAC)and Visual Analogue Scale questionnaires.RESULTS Percentages of patients experiencing at least a 30%decrease in the total score for the WOMAC pain subscale from baseline to wk 12 of the intervention were 86%,100%and 0%in the groups PRP-1,PRP-2 and hyaluronic acid,respectively(P<0.001).The mean total WOMAC scores for groups PRP-1,PRP-2 and hyaluronic acid at baseline were 63.71,61.57 and 63.11,respectively.The WOMAC scores were significantly improved at final follow-up to 42.5,35.32 and 57.26,respectively.The highest efficacy of PRP was observed in both groups at wk 4 with about 50%decrease in the symptoms compared with about 25%decrease for hyaluronic acid.Group PRP-2 had higher efficacy than group PRP-1.No major adverse effects were found during the study.CONCLUSION PRP is a safe and efficient therapeutic option for treatment of knee osteoarthritis.It was demonstrated to be significantly better than hyaluronic acid.We also found that the efficacy of PRP increases after multiple injections.展开更多
Objective:To examine whether the platelet index would be applicable for the diagnosis of community-acquired pneumonia(CAP).Methods:In this study,64 CAP patients(the case group)and 68 healthy children(the control group...Objective:To examine whether the platelet index would be applicable for the diagnosis of community-acquired pneumonia(CAP).Methods:In this study,64 CAP patients(the case group)and 68 healthy children(the control group)were included from 2017 to 2018.Baseline variables were recorded including total white blood cells,neutrophils,lymphocytes,red blood cells,platelet,mean platelet volume,platelet distribution width,erythrocyte sedimentation rate,and C-reactive protein,and compared between the case group and the control group.The cutoff value,sensitivity,and specificity of neutrophil-to-lymphocyte ratio,platelet,neutrophils,lymphocytes,and platelet larger cell ratio were calculated by receiver-operating characteristic curves.Results:The median platelet count of the case group and the control group were(411.09±67.40)mm3 and(334.48±78.15)mm3,respectively(P=0.000).The median neutrophil count of the case group was higher than that of the control group,while the lymphocyte level of the case group was lower.Differences in other variables including the mean platelet volume,platelet distribution width,C-reactive protein,and erythrocyte sedimentation rate were not statistically significant between the two groups.Conclusions:Due to the different levels of platelet,neutrophil and lymphocyte indices in the case and the control group,these indices can be used simultaneously for the diagnosis of CAP.展开更多
Ischemic heart disease(IHD) is known as the leading cause of death in both genders. Moreover, significant sex differences were found in cardiac structure, function, pathophysiology, presentation, treatment, and outcom...Ischemic heart disease(IHD) is known as the leading cause of death in both genders. Moreover, significant sex differences were found in cardiac structure, function, pathophysiology, presentation, treatment, and outcome of IHD. The presence of unique risk factors such as exposure to menarche and pregnancy, more anemia, hypertension, and autoimmune disorders in women have recently received attention. Ischemic symptoms are more indefinite and vague in women compared to men as well as a delay in diagnosis, treatment, and worse outcomes compared to men. Women usually receive less evidence-based treatment and intervention, with less concern on preventive health care. Clinical trials primarily recruit male patients and women are underrepresented. Without any correct diagnosis, treatment, and prevention, these problems are accumulated and continue up to older age. Accordingly, with the belief of longer life in women and the increased prevalence of IHD with aging, it will become an important public health problem and concern in the future. This narrative review aimed to provide an overview of some of the differences between the two genders in terms of IHD with paying more attention to practical points.展开更多
To investigate the best treatment option for large upper ureteral stone,percutaneous nephrolithotomy or laparoscopic ureterolithotomy.We searched three key word of upper ureteral stone,laparoscopic ureterolithotomy,pe...To investigate the best treatment option for large upper ureteral stone,percutaneous nephrolithotomy or laparoscopic ureterolithotomy.We searched three key word of upper ureteral stone,laparoscopic ureterolithotomy,percutaneous nephrolithotomy in PubM ed,Scopus and Ebsco.We found approximately twenty suitable articles about this subject since January 1980 until January2014.All articles studies and reviewed meticulously and brief review of these articles was written and some Ideas of experts was added.In many studies,it is suggested that success rate and complications of laparoscopic ureterolithotomy and percutaneous nephrolithotomy are the same,but percutaneous nephrolithotomy has less hospital stay time,duration of surgery and it is more cost effective.Overall it seems that percutaneous nephrolithotomy for treatment of upper ureteral stones is preferable rather than laparoscopic展开更多
Objective: To investigate the diagnostic value of platelet parameters in acute appendicitis. Methods: This retrospective case-controlled study was performed among 200 healthy people and 200 patients with a primary dia...Objective: To investigate the diagnostic value of platelet parameters in acute appendicitis. Methods: This retrospective case-controlled study was performed among 200 healthy people and 200 patients with a primary diagnosis of acute appendicitis between October 2017 and June 2018. The patients were classified into three groups: the acute complicated appendicitis (suppurative and gangrenous) group, acute non-complicated appendicitis group and the control group. Red blood cell, white blood cell, lymphocyte, monocyte and platelets count, red blood cell distribution width, hemoglobin, hematocrit, mean platelet volume, platelet distribution width, and C-reactive protein were compared between the groups. Results: Thirty-nine (19.5%) patients with acute appendicitis had no complication and 161 (80.5%) developed a complication. The white blood cell count, neutrophil count and C-reactive protein serum levels were significantly higher, whereas the mean age, lymphocyte count, monocyte count, red blood cell distribution width and platelet count were significantly lower in acute appendicitis patients with and without complications compared with the control group. Moreover, combined analysis of best diagnostic parameters (white blood cell, neutrophil and lymphocyte counts) showed that combined parallel sensitivity and specificity were 98.7% and 42.7%, respectively. Conclusions: White blood cell, lymphocyte counts and neutrophil count could be used for diagnosis of acute appendicitis. More over the utility of mean platelet volume for differential diagnosis might be overestimated.展开更多
Objective:To evaluate the effectiveness and safety of ivermectin in patients with mild and moderate COVID-19.Methods:This study was a single-center,randomized,open-label,controlled trial with a 2-arm parallel-group de...Objective:To evaluate the effectiveness and safety of ivermectin in patients with mild and moderate COVID-19.Methods:This study was a single-center,randomized,open-label,controlled trial with a 2-arm parallel-group design on 68 patients with COVID-19.According to the 1:1 ratio between the study groups(ivermectin group and standard treatment group),patients were randomly admitted to each intervention arm.Results:The mean age of the participants in the ivermectin group was(48.37±13.32)years.Eighteen of them were males(54.5%)and the participants in the control group had a mean age of(46.28±14.47)years,with nineteen of them being males(59.4%).As a primary outcome,after 5 days of randomization,there was no significant difference between the ivermectin group and the control group in the length of stay in the hospital(P=0.168).ICU admission(P=0.764),length of stay in ICU(P=0.622),in-hospital mortality(P=0.427),adverse drug reactions,and changes in the mean difference of laboratory data had not any significant difference between the two groups(except for urea change).In addition,the radiologic findings of the two groups of patients were not significantly different.Linear regression analysis showed that for every 10 years increase of age,0.6 day of hospitalization duration was increased.There was no statistically significant association between other variables and clinical outcomes.Conclusions:Among adult hospitalized patients with moderate to severe COVID-19,there was no significant relationship between the administration of ivermectin single dose in a five-day course and clinical improvement,and mortality of the participants.展开更多
EVER since the first patie nt was diag no sed with co ro no virus disease 2019(COVID-19),many epidemiologic reports tried to present signs日nd symptoms of patients infected with SARS-CoV-2(Severe acute respiratory syn...EVER since the first patie nt was diag no sed with co ro no virus disease 2019(COVID-19),many epidemiologic reports tried to present signs日nd symptoms of patients infected with SARS-CoV-2(Severe acute respiratory syndrome coronavirus 2).For instance,in a review article pub-lished by Jiang et al,respiratory symptoms including cough and dysp nea,are the comm on in itial fin dings in such patients after fever.[1]This Very contagious disease involves lower respiratory system and can lead to coronavirus pneumonia and rapidly progressive acute respiratory distress syndrome(ARDS),[2]and if the respiratory failure occurs,patients need intubation and protective mechanical ventilation.展开更多
Objective: To evaluate the effect of doxorubicin and its pegylated liposomal formulation(Doxil, Caelyx) on in vitro susceptibility of promastigote and amastigote stages of Leishmania major. Methods: Throughout in vitr...Objective: To evaluate the effect of doxorubicin and its pegylated liposomal formulation(Doxil, Caelyx) on in vitro susceptibility of promastigote and amastigote stages of Leishmania major. Methods: Throughout in vitro assays the IC50 was calculated in the promastigotes and amastigotes forms in J774 macrophage cell line. Also as cytotoxicity in J774 cell line macrophages. Results: Doxorubicin and Doxil showed the same activity against promastigote form with IC50 values of 10.49 μg/m L and 9.63 μg/m L, respectively. Similarly, the amastigote stage was susceptible at concentration of at least 1 μg/m L when compared to positive control(P<0.000 1). Also, cytotoxicity assay against macrophage revealed no toxicity on the host cells at IC50 concentrations. Conclusions: Our findings demonstrated the efficacy of both doxorubicin and its pegylated liposomal formulation on Leishmania major at low concentrations. Further researches are needed for evaluating the safety of drugs in animal model particularly as topical formulation.展开更多
Objectives:To determine changes in the distribution of uropathogens and their antimicrobial resistance in pediatric patients in a children's hospital from 2005 to 2016.Methods:A cross-sectional analysis of uropath...Objectives:To determine changes in the distribution of uropathogens and their antimicrobial resistance in pediatric patients in a children's hospital from 2005 to 2016.Methods:A cross-sectional analysis of uropathogens and their antimicrobial resistance within inpatient children was performed over the 11-year period,2005 to 2016,in Ali Asghar children's hospital.The rate of antibiotic resistance among patients was evaluated according to demographic data including age,sex,urinary tract abnormities and history of antibiotic consumption.Results:In total,958 female and 349 male positive cultures were analyzed.Escherichia coli(E.coli)(77.6%)was the most common causative agent of urinary tract infection(UTI)in children and Klebsiella pneumoniae(10.4%),Pseudomonas aeruginosa(2.4%),and Enterococcus spp(2.4%)were less frequent isolated bacteria.The resistance rates of E.coli isolates were increased against amikacin,ceftriaxone,ceftazidime,ciprofloxacin,cotrimoxazole and imipenem from 2005 to 2010.However,we observed a decreasing trend for some of antibiotics including amikacin,gentamicin,imipenem,ceftazidime and cotrimoxazole during 2014-2016.The rate of antibiotic resistance was greater in boys than in girls against many antibiotics.The rate of resistance to amikacin,gentamicin,nitrofurantoin and cotrimoxazole in patients aged<1 year was higher than other age groups(p<0.001).A higher antibiotic resistance rate was observed in patients with anatomical abnormality and those who have had a history of antibiotic consumption.Conclusion:The study indicated the significant decrease in E.coli antibiotic resistance in the last 3 years.An effective empirical treatment regime should be based on local epidemiology and antimicrobial susceptibility testing.展开更多
SARS-CoV-2 is the causative agent of COVID-19.Since its outbreak in December 2019,COVID-19 has swept the globe.By 17 July 2020,the World Health Organization(WHO)had confirmed 13?119?239 cases and 573?752 deaths,and th...SARS-CoV-2 is the causative agent of COVID-19.Since its outbreak in December 2019,COVID-19 has swept the globe.By 17 July 2020,the World Health Organization(WHO)had confirmed 13?119?239 cases and 573?752 deaths,and the numbers are still rising.Current evidence shows that COVID-19 is lower than severe acute respiratory syndrome and Middle East respiratory syndrome in terms of severity and mortality risk,although the infections are particularly more severe in patients with underlying medical conditions.The bulk of COVID-19 patients had close contact with confirmed cases,but an exact origin and specific transmission for COVID-19 are still unknown.As there is no approved antiviral treatment for COVID-19 infection,proper prevention and control practices are essential to control the infection.To have an insight view of COVID-19,we summarized and compared the etiology,clinical manifestations,diagnosis,treatment,and prevention measures of COVID-19,severe acute respiratory syndrome,and Middle East respiratory syndrome.展开更多
Objective: To compare Quanti-FERON-TB Gold In-Tube (QFT-GIT) test and tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection in children. Methods: In this cross-sectional study, 64 participants ...Objective: To compare Quanti-FERON-TB Gold In-Tube (QFT-GIT) test and tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection in children. Methods: In this cross-sectional study, 64 participants who were between 3 months and 14 years old and had close contact with smear-positive pulmonary tuberculosis were included. Both QFT-GIT test and TST were done and the results were analyzed by SPSS software and Kappa test. Results: The distribution of gender and age according to QFT-GIT and TST results were matched (P>0.05). Overall agreement between QFT-GIT and TST for diagnosis of latent tuberculosis infection in children was 75%. In addition, the contingency coefficient was 0.257, and the Kappa measure of agreement was 0.246 (P=0.034). Conclusions: Compared to TST, QFT-GIT shows no apparent advantage for diagnosis of latent tuberculosis infection in children.展开更多
文摘Introduction: Testicular torsion is a surgical emergency which requires early diagnosis and prompt surgical management to avoid testicular damage. The aim of this study is to survey the clinical findings and outcome of the patients treated for testicular torsion in a university hospital in Babol, northern Iran. Methods: In this cross sectional study, a retrospective survey of all cases presenting with acute scrotum and primarily diagnosed as testicular torsion was conducted during 2001 and 2012 in Babol, northern Iran. All 103 cases were reviewed and several clinical data, including duration of symptoms and operative findings were collected. Findings: Of 103 patients who presented to the emergency department with acute scrotum, the median age of the cases was 16.0 years. Thirty four percent of the patients presented emergency unit less than 6 hours from symptom exposure. Pain (95.1%) was the major symptom in all patients. Surgery revealed that 72 (70.9%) cases were diagnosed firmly as testicular torsion that 23 patients underwent orchidectomy for a necrotic torsed testis. There were significant differences between orchiectomized versus non-orchiectomized torsion cases in affected side, symptom presentation to operation time. Conclusion: According to our results more than half of the cases presented more than in the golden time. Late presentation to hospital was the major cause of delay leading to orchidectomy in patients with testicular torsion. Greater effort in health education and direct or selfreferal to hospital may reduce this delay.
文摘Introduction:The occurrence of congenital anomalies is one of the serious challenges in the world.Therefore,identifying related factors to reduce it is of particular importance.This study aimed to determine the incidence and factors related to congenital anomalies.Methods:An epidemiology study was conducted on 1567 infants and their parents in Kermanshah,Iran.The required information was extracted from the ffles of mothers in health centers.The data collection tool was a researcher-made checklist of 39 questions.The data was statistically analyzed with the STATA version 14 software.Result:The incidence of congenital anomalies was 2.9%(n=45).Brain anomalies(n=10)and pulmonary anomalies(n=8)were the most common congenital anomalies in newborns.The results showed that parents’age(p=0.001),place of residence(p=0.022),mother’s occupation(p=0.010),hemoglobin level(p=0.002),blood pressure disorders(p=0.001),bleeding during pregnancy(p=0.001),infection during pregnancy(p=0.001),multivitamins(p=0.002)and women’s previous birth records such as previous abnormal birth history(p=0.015),abortion history(p=0.001),stillbirth history(p=0.001),birth history of infant less than 2500 g(p=0.001)was found to have a statistically signiffcant relationship with congenital anomalies.Conclusion:The incidence of congenital anomalies was high in Kermanshah city.Considering the identiffcation of risk factors and preventive factors related to congenital anomalies,it is suggested that interventions be carried out in health centers to increase awareness among pregnant women to reduce the incidence of anomalies.
文摘Objective:To evaluate the efficacy and safety of QL1206(a denosumab biosimilar to Xgeva■)in breast cancer patients with bone metastasis(BM)through subgroup analysis of a randomized,double-blind phaseⅢtrial(No.NCT04550949).Methods:This subgroup analysis included patients with BM from breast cancer enrolled in a phaseⅢtrial.Patients were randomized(1:1)to receive either three cycles of QL1206 or denosumab(120 mg subcutaneously every 4 weeks).Subsequently,they received 10 cycles of QL1206(120 mg)over 40 weeks,followed by a 20-week safety follow-up.The primary endpoint was the percentage changes from baseline to week 13 in urinary Ntelopeptide corrected for creatinine(u NTx/Cr).Results:The breast cancer cohort consisted of 311 patients.Vertebral involvement(66.4%)was the most prevalent BM site at enrollment,while 27.7%of patients presented with≥3 metastatic bone lesions.At week 13,QL1206 demonstrated a median u NTx/Cr reduction of-69.9%(range:-98.1%-568.0%)vs.-74.3%(range:-97.7%-386.3%)for denosumab.The analysis of covariance revealed comparable least-square means for log-transformed changes:-1.416[95%confidence interval(95%CI):-1.736 to-1.096]vs.-1.501(95%CI:-1.824 to-1.178),yielding an between-group difference of 0.085(90%CI:-0.062-0.232;P=0.343).After a 53-week treatment period,83.6%achieved bone density improvement/disease stabilization.Safety profiles were comparable between groups.Conclusions:QL1206 demonstrated similar efficacy and safety to the reference denosumab in patients with BM from breast cancer,supporting QL1206 as a new option for management of BM from breast cancer.
基金financial support from Kermanshah University of Medical Sciences,Iran(Grant Number.97101).
文摘Objective:To determine the efficacy of tranexamic acid(TXA)in the management of acute upper gastrointestinal(GI)bleeding.Methods:A total of 70 patients with acute upper GI bleeding were included in this double-blinded randomized controlled clinical trial from September 2018 to December 2018.Patients were divided into the control group(received fluid therapy and intravenous infusion of pantoprazole,35 cases)and the TXA group(received intravenous TXA besides the treatment of control group,35 cases).Rebleeding,admission duration,and need for blood transfusion were compared between the two groups.Results:Fifteen patients(42.9%)in the TXA group and 10 patients(28.6%)in the control group stayed in hospital for more than 3 days during their admission(P=0.21).Rebleeding occurred in 8 patients(22.9%)and 5 patients(14.3%)of the TXA group and the control group,respectively(P=0.35).More patients in the TXA group(21 cases,60%)received blood transfusion than the control group(8 cases,22.9%)(P=0.02).Conclusions:TXA did not improve the outcome of patients with acute upper GI bleeding.
基金This work was supported by the Kermanshah University of Medical Sciencesgrant numbers 96566
文摘Objectives:The present study was conducted to evaluate the clinical competence and its related demographic factors among critical care nurses in Kermanshah,Iran.Methods:In this cross-sectional study,155 Iranian nurses were selected by stratified random sampling.The data collection tools included a personal information form and the"Nurse Competence Scale".Data were analyzed using descriptive and analytical statistics.Results:The mean score of nurses'clinical competence was equal to 76.14±1.59 out of 100,which was at a"very good level".The mean score of using clinical competence in practice was equal to 70.38±15.25 out of 100,which was at a"good level".Among the subscales of clinical competence,the highest mean score was related to"managing situation".The mean score of"using clinical competence in practice"was related to the subscale of"therapeutic interventions".There was no statistically significant difference among the score of clinical competence of nurses varying with different gender,age,academic degree,and work experience.Conclusions:The clinical competence of critical care nurses in Kermanshah was at a"very good"level,and the use of clinical competence in practice was at a"good level."Given the importance of clinical competencies in practice,nurses'clinical competence should be evaluated objectively and positive measures should be taken to promote the application of their clinical competence.
文摘Drug abuse by pregnant women is one of the significant problems for mothers and their neonates.This study aimed to investigate the effects of maternal substance use disorder during pregnancy on neonatal developmental criteria.In a case-control study,clinical records of 90 neonates diagnosed with neonatal abstinence syndrome who were admitted to NICU in one of four hospitals affiliated with Shahid-Beheshti University of Medical Sciences in Tehran,Iran between 2017 and 2020 were compared to 90 neonates without neonatal abstinence syndrome(control group).Demographic information and data for neonatal developmental characteristics and complications were extracted from the clinical records of this convenience sample.Data for the type and method of maternal substance use during pregnancy were collected through a telephone call with mothers.Our data showed that the prevalence of drug addiction was 1.8%among pregnant women,and the most common drugs used by mothers were opium(n=45%,50%),amphetamine(n=30%,33%),and methadone(n=14%,16%).Neonates with abstinence syndrome had a higher prevalence of transient tachypnea of the newborn(TTN)(P=0.004),and a prevalence of being admitted to NICU(P=0.05)and for a longer duration(P<0.001).Their mothers had a higher prevalence of having pre-eclampsia(P=0.010).Using morphine vs.amphetamine showed no difference based on their effects on mothers and neonates.Substance use during pregnancy increased the prevalence of pregnancy complications(pre-eclampsia)and neonatal complications(TTN and prevalence and duration of hospitalization).Therefore,planning for the development of health policies to raise awareness among women and more broadly,all members of the community,is important to prevent the tendency to engage in this potentially high-risk behavior.
文摘Background:Complementary medicine is an interesting field for extracting bio-active compounds from various plant and animal sources.The hepatoprotective effect of the methanolic extract of a species of sea cucumber called Holothuria leu-cospilota in an animal model of liver cancer caused by dimethyl nitrosamine(DMN)was studied.Methods:Wistar female rats were randomly divided into five groups(n=12):control(intact),positive control(received 1%DMN[10 mg/kg/week,intraperitoneally]for 12 weeks),and three treatment groups(received 50,100,and 200 mg/kg/day H.leu-cospilota extract orally for 12 weeks along with intraperitoneal administration of 1%DMN[10 mg/kg/week]).In all groups,ultrasound was performed on the liver every week to check its density.Blood sampling and liver isolation were performed on three occasions,at 4,8,and 12 weeks,to check liver enzymes and the histopathological condition of the liver tissue(every week,four animals from each group were randomly selected).Results:Liver density changes were evident from the eighth week onward in the positive control group.Histopathological results indicated pathologic changes in the positive control group after 4 weeks.The increase in liver enzymes in the posi-tive control group was significantly different from that in the treatment and control groups.Conclusions:We demonstrated the hepatoprotective effect of H.leucospilota on DMN-induced liver damage in rats using biochemical and histological parameters and ultrasonography.More additional research(in silico or in vitro)is needed to find the exact mechanism and the main biological compound in H.leucospilota.
基金funded financially by the Vice Chancellor for Research and Technology Development at Qom University of Medical Sciences.
文摘Objective:To evaluate thyroid dysfunction prevalence and its consequences in high-risk pregnant women and their children.Methods:In this retrospective cohort study,data from high-risk pregnant women who were referred to a governmental referral hospital in Qom,Iran from March to August 2022 were collected.The thyroid disorders were determined according to the 2017 American Thyroid Association guidelines.The predictors of a mother's hypothyroidism and its fetal and maternal consequences were assessed.Independent t-test,Chi-square test,and logistic regression were used for bivariate and multivariate analysis.Results:293 women were included.The prevalence of hypothyroidism and hyperthyroidism based on the thyroid stimulating hormone classification was 32.5%and 2.0%.The prevalence of subclinical and overt hypothyroidism was 6.1%and 4.1%,and the prevalence of subclinical and overt hyperthyroidism was 2.4%and 1.4%,respectively.Family history of thyroid disorders was the most important predictor of hypothyroidism during pregnancy(OR=2.6,95%CI=1.0-6.6,P=0.002),while preterm delivery(OR=2.2,95%CI=1.3-6.8,P=0.220)and elevated neonate thyroid stimulating hormone(OR=1.2,95%CI=1.1-1.3,P=0.041)were the most important consequence of hypothyroidism.Conclusions:Hypothyroidism is a highly prevalent thyroid disorder in high-risk pregnant women.Thyroid function screening should be performed in all pregnant women to increase the detection of subclinical and overt hypothyroidism during pregnancy.
文摘Brucellosis is a common global zoonotic disease, which is responsible for a range of clinical manifestations. Fever, sweating and musculoskeletal pains are observed in most patients. The most frequent complication of brucellosis is osteoarticular involvement, with 10% to 85% of patients affected. The sacroiliac(up to 80%) and spinal joints(up to 54%) are the most common affected sites.Spondylitis and spondylodiscitis are the most frequent complications of brucellar spinal involvement. Peripheral arthritis, osteomyelitis, discitis, bursitis and tenosynovitis are other osteoarticular manifestations, but with a lower prevalence. Spinal brucellosis has two forms: focal and diffuse. Epidural abscess is a rare complication of spinal brucellosis but can lead to permanent neurological deficits or even death if not treated promptly. Spondylodiscitis is the most severe form of osteoarticular involvement by brucellosis, and can have single-or multifocal involvement. Early and appropriate diagnosis and treatment of the disease is important in order to have a successful management of the patients with osteoarticular brucellosis. Brucellosis should be considered as a differential diagnosis for sciatic and back pain, especially in endemic regions. Patients with septic arthritis living in endemic areas also need to be evaluated in terms of brucellosis. Physical examination, laboratory tests and imaging techniques are needed to diagnose the disease. Radiography, computed tomography, magnetic resonance imaging(MRI) and bone scintigraphy are imaging techniques for the diagnosis of osteoarticular brucellosis. MRI is helpful to differentiate between pyogenic spondylitis and brucellar spondylitis. Drug medications(antibiotics)and surgery are the only two options for the treatment and cure of osteoarticular brucellosis.
基金Supported by Vice Chancellor for Research and Technology of Babol University of Medical Sciences,No.970568
文摘BACKGROUND Platelet-rich plasma(PRP)and hyaluronic acid have been shown to be useful in the treatment of knee osteoarthritis.However,investigations comparing the efficacy of these two drugs together are insufficient.AIM To compare the outcomes of PRP vs hyaluronic acid injections in three groups of patients with bilateral knee osteoarthritis.METHODS This randomized controlled trial study involved 95 patients.Thirty-one subjects received a single injection of PRP(group PRP-1),33 subjects received two injections of PRP at an interval of 3 wk(group PRP-2)and 31 subjects received three injections of hyaluronic acid at 1-wk intervals(group hyaluronic acid).The patients were investigated prospectively at the enrollment and at 4-,8-and 12-wk follow-up with the Western Ontario and McMaster Universities Arthritis Index(WOMAC)and Visual Analogue Scale questionnaires.RESULTS Percentages of patients experiencing at least a 30%decrease in the total score for the WOMAC pain subscale from baseline to wk 12 of the intervention were 86%,100%and 0%in the groups PRP-1,PRP-2 and hyaluronic acid,respectively(P<0.001).The mean total WOMAC scores for groups PRP-1,PRP-2 and hyaluronic acid at baseline were 63.71,61.57 and 63.11,respectively.The WOMAC scores were significantly improved at final follow-up to 42.5,35.32 and 57.26,respectively.The highest efficacy of PRP was observed in both groups at wk 4 with about 50%decrease in the symptoms compared with about 25%decrease for hyaluronic acid.Group PRP-2 had higher efficacy than group PRP-1.No major adverse effects were found during the study.CONCLUSION PRP is a safe and efficient therapeutic option for treatment of knee osteoarthritis.It was demonstrated to be significantly better than hyaluronic acid.We also found that the efficacy of PRP increases after multiple injections.
文摘Objective:To examine whether the platelet index would be applicable for the diagnosis of community-acquired pneumonia(CAP).Methods:In this study,64 CAP patients(the case group)and 68 healthy children(the control group)were included from 2017 to 2018.Baseline variables were recorded including total white blood cells,neutrophils,lymphocytes,red blood cells,platelet,mean platelet volume,platelet distribution width,erythrocyte sedimentation rate,and C-reactive protein,and compared between the case group and the control group.The cutoff value,sensitivity,and specificity of neutrophil-to-lymphocyte ratio,platelet,neutrophils,lymphocytes,and platelet larger cell ratio were calculated by receiver-operating characteristic curves.Results:The median platelet count of the case group and the control group were(411.09±67.40)mm3 and(334.48±78.15)mm3,respectively(P=0.000).The median neutrophil count of the case group was higher than that of the control group,while the lymphocyte level of the case group was lower.Differences in other variables including the mean platelet volume,platelet distribution width,C-reactive protein,and erythrocyte sedimentation rate were not statistically significant between the two groups.Conclusions:Due to the different levels of platelet,neutrophil and lymphocyte indices in the case and the control group,these indices can be used simultaneously for the diagnosis of CAP.
文摘Ischemic heart disease(IHD) is known as the leading cause of death in both genders. Moreover, significant sex differences were found in cardiac structure, function, pathophysiology, presentation, treatment, and outcome of IHD. The presence of unique risk factors such as exposure to menarche and pregnancy, more anemia, hypertension, and autoimmune disorders in women have recently received attention. Ischemic symptoms are more indefinite and vague in women compared to men as well as a delay in diagnosis, treatment, and worse outcomes compared to men. Women usually receive less evidence-based treatment and intervention, with less concern on preventive health care. Clinical trials primarily recruit male patients and women are underrepresented. Without any correct diagnosis, treatment, and prevention, these problems are accumulated and continue up to older age. Accordingly, with the belief of longer life in women and the increased prevalence of IHD with aging, it will become an important public health problem and concern in the future. This narrative review aimed to provide an overview of some of the differences between the two genders in terms of IHD with paying more attention to practical points.
文摘To investigate the best treatment option for large upper ureteral stone,percutaneous nephrolithotomy or laparoscopic ureterolithotomy.We searched three key word of upper ureteral stone,laparoscopic ureterolithotomy,percutaneous nephrolithotomy in PubM ed,Scopus and Ebsco.We found approximately twenty suitable articles about this subject since January 1980 until January2014.All articles studies and reviewed meticulously and brief review of these articles was written and some Ideas of experts was added.In many studies,it is suggested that success rate and complications of laparoscopic ureterolithotomy and percutaneous nephrolithotomy are the same,but percutaneous nephrolithotomy has less hospital stay time,duration of surgery and it is more cost effective.Overall it seems that percutaneous nephrolithotomy for treatment of upper ureteral stones is preferable rather than laparoscopic
文摘Objective: To investigate the diagnostic value of platelet parameters in acute appendicitis. Methods: This retrospective case-controlled study was performed among 200 healthy people and 200 patients with a primary diagnosis of acute appendicitis between October 2017 and June 2018. The patients were classified into three groups: the acute complicated appendicitis (suppurative and gangrenous) group, acute non-complicated appendicitis group and the control group. Red blood cell, white blood cell, lymphocyte, monocyte and platelets count, red blood cell distribution width, hemoglobin, hematocrit, mean platelet volume, platelet distribution width, and C-reactive protein were compared between the groups. Results: Thirty-nine (19.5%) patients with acute appendicitis had no complication and 161 (80.5%) developed a complication. The white blood cell count, neutrophil count and C-reactive protein serum levels were significantly higher, whereas the mean age, lymphocyte count, monocyte count, red blood cell distribution width and platelet count were significantly lower in acute appendicitis patients with and without complications compared with the control group. Moreover, combined analysis of best diagnostic parameters (white blood cell, neutrophil and lymphocyte counts) showed that combined parallel sensitivity and specificity were 98.7% and 42.7%, respectively. Conclusions: White blood cell, lymphocyte counts and neutrophil count could be used for diagnosis of acute appendicitis. More over the utility of mean platelet volume for differential diagnosis might be overestimated.
基金Hormozgan University of Medical Sciences,Bandar Abbas,Iran(grant No.990238)。
文摘Objective:To evaluate the effectiveness and safety of ivermectin in patients with mild and moderate COVID-19.Methods:This study was a single-center,randomized,open-label,controlled trial with a 2-arm parallel-group design on 68 patients with COVID-19.According to the 1:1 ratio between the study groups(ivermectin group and standard treatment group),patients were randomly admitted to each intervention arm.Results:The mean age of the participants in the ivermectin group was(48.37±13.32)years.Eighteen of them were males(54.5%)and the participants in the control group had a mean age of(46.28±14.47)years,with nineteen of them being males(59.4%).As a primary outcome,after 5 days of randomization,there was no significant difference between the ivermectin group and the control group in the length of stay in the hospital(P=0.168).ICU admission(P=0.764),length of stay in ICU(P=0.622),in-hospital mortality(P=0.427),adverse drug reactions,and changes in the mean difference of laboratory data had not any significant difference between the two groups(except for urea change).In addition,the radiologic findings of the two groups of patients were not significantly different.Linear regression analysis showed that for every 10 years increase of age,0.6 day of hospitalization duration was increased.There was no statistically significant association between other variables and clinical outcomes.Conclusions:Among adult hospitalized patients with moderate to severe COVID-19,there was no significant relationship between the administration of ivermectin single dose in a five-day course and clinical improvement,and mortality of the participants.
文摘EVER since the first patie nt was diag no sed with co ro no virus disease 2019(COVID-19),many epidemiologic reports tried to present signs日nd symptoms of patients infected with SARS-CoV-2(Severe acute respiratory syndrome coronavirus 2).For instance,in a review article pub-lished by Jiang et al,respiratory symptoms including cough and dysp nea,are the comm on in itial fin dings in such patients after fever.[1]This Very contagious disease involves lower respiratory system and can lead to coronavirus pneumonia and rapidly progressive acute respiratory distress syndrome(ARDS),[2]and if the respiratory failure occurs,patients need intubation and protective mechanical ventilation.
基金financially supported by Vice Chancellors for Research and Technology of Mazandaran University of Medical Sciences(project number:1919)
文摘Objective: To evaluate the effect of doxorubicin and its pegylated liposomal formulation(Doxil, Caelyx) on in vitro susceptibility of promastigote and amastigote stages of Leishmania major. Methods: Throughout in vitro assays the IC50 was calculated in the promastigotes and amastigotes forms in J774 macrophage cell line. Also as cytotoxicity in J774 cell line macrophages. Results: Doxorubicin and Doxil showed the same activity against promastigote form with IC50 values of 10.49 μg/m L and 9.63 μg/m L, respectively. Similarly, the amastigote stage was susceptible at concentration of at least 1 μg/m L when compared to positive control(P<0.000 1). Also, cytotoxicity assay against macrophage revealed no toxicity on the host cells at IC50 concentrations. Conclusions: Our findings demonstrated the efficacy of both doxorubicin and its pegylated liposomal formulation on Leishmania major at low concentrations. Further researches are needed for evaluating the safety of drugs in animal model particularly as topical formulation.
文摘Objectives:To determine changes in the distribution of uropathogens and their antimicrobial resistance in pediatric patients in a children's hospital from 2005 to 2016.Methods:A cross-sectional analysis of uropathogens and their antimicrobial resistance within inpatient children was performed over the 11-year period,2005 to 2016,in Ali Asghar children's hospital.The rate of antibiotic resistance among patients was evaluated according to demographic data including age,sex,urinary tract abnormities and history of antibiotic consumption.Results:In total,958 female and 349 male positive cultures were analyzed.Escherichia coli(E.coli)(77.6%)was the most common causative agent of urinary tract infection(UTI)in children and Klebsiella pneumoniae(10.4%),Pseudomonas aeruginosa(2.4%),and Enterococcus spp(2.4%)were less frequent isolated bacteria.The resistance rates of E.coli isolates were increased against amikacin,ceftriaxone,ceftazidime,ciprofloxacin,cotrimoxazole and imipenem from 2005 to 2010.However,we observed a decreasing trend for some of antibiotics including amikacin,gentamicin,imipenem,ceftazidime and cotrimoxazole during 2014-2016.The rate of antibiotic resistance was greater in boys than in girls against many antibiotics.The rate of resistance to amikacin,gentamicin,nitrofurantoin and cotrimoxazole in patients aged<1 year was higher than other age groups(p<0.001).A higher antibiotic resistance rate was observed in patients with anatomical abnormality and those who have had a history of antibiotic consumption.Conclusion:The study indicated the significant decrease in E.coli antibiotic resistance in the last 3 years.An effective empirical treatment regime should be based on local epidemiology and antimicrobial susceptibility testing.
文摘SARS-CoV-2 is the causative agent of COVID-19.Since its outbreak in December 2019,COVID-19 has swept the globe.By 17 July 2020,the World Health Organization(WHO)had confirmed 13?119?239 cases and 573?752 deaths,and the numbers are still rising.Current evidence shows that COVID-19 is lower than severe acute respiratory syndrome and Middle East respiratory syndrome in terms of severity and mortality risk,although the infections are particularly more severe in patients with underlying medical conditions.The bulk of COVID-19 patients had close contact with confirmed cases,but an exact origin and specific transmission for COVID-19 are still unknown.As there is no approved antiviral treatment for COVID-19 infection,proper prevention and control practices are essential to control the infection.To have an insight view of COVID-19,we summarized and compared the etiology,clinical manifestations,diagnosis,treatment,and prevention measures of COVID-19,severe acute respiratory syndrome,and Middle East respiratory syndrome.
文摘Objective: To compare Quanti-FERON-TB Gold In-Tube (QFT-GIT) test and tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection in children. Methods: In this cross-sectional study, 64 participants who were between 3 months and 14 years old and had close contact with smear-positive pulmonary tuberculosis were included. Both QFT-GIT test and TST were done and the results were analyzed by SPSS software and Kappa test. Results: The distribution of gender and age according to QFT-GIT and TST results were matched (P>0.05). Overall agreement between QFT-GIT and TST for diagnosis of latent tuberculosis infection in children was 75%. In addition, the contingency coefficient was 0.257, and the Kappa measure of agreement was 0.246 (P=0.034). Conclusions: Compared to TST, QFT-GIT shows no apparent advantage for diagnosis of latent tuberculosis infection in children.
