Zahedan Journal of Research in Medical Sciences
Year:2015 | Volume:17 | Issue:6|Papers Count:12

Dear Editor: Stimulant medications such as methylphenidate and dextroamphetamine are used to treat children with symptoms of hyperactivity disorder and attention deficit; these treatments have some unknown side effects such as irritability, flurry, insomnia, having nightmares, loss of appetite and weight loss.

Background: Urinary tract infection is one of the common clinical sequelae of diabetes mellitus.Objectives: This study aimed to determine the effect of poor glycaemic control as determined by glycated hemoglobin (HbA1c) levels on the prevalence of urinary tract infections among diabetic women.Materials and Methods: In this cross-sectional descriptive study, 50 non-pregnant diabetic women attending the diabetes clinic of Nena hospital, Abuja, Nigeria were included as subjects and 25 age and sex-matched apparently healthy individuals were included as controls.Results: Mean HbA1c levels in diabetic women were significantly higher than in healthy controls (7.29±2.4% vs. 4.5±1.8%) (P<0.001). The prevalence of poor glycaemic control was high; 19 (38%) and UTI was significantly more prevalent in DM patients with poor glycaemic control than in subjects with good glycaemic control 14 (77.8%) vs. 4 (22.2%) (P<0.001).Conclusions: HbA1c values showing poor glycaemic control may be a proxy indicator for screening for UTI among women with diabetes mellitus.

Background: Coxiella burnetii is an obligate intracellular bacterium that causes the zoonotic disease Q fever with a worldwide distribution. Also C. burnetii is classified as a bioterrorism agent. In order to management, prevention and control of Q fever the fast and accurate detection of C. burnetii is necessary. However, the isolation of this strain is very difficult and dangerous.Objectives: The aim of the study was to evaluate the sensitivity of PCR using different primers for the detection of C. burnetii in milk samples.Materials and Methods: In this cross-sectional study 70 bovine bulk milk samples were collected randomly from dairy herds in Jahrom, Iran in 2010. All the samples were analyzed for the presence of C. burnetii by PCR targeting 3 different genes (Trans, OMP, Coc). The PCR products were examined by electrophoresis using an agarose gel.Results: The frequency of C. burnetii in the evaluated samples using Trans-PCR, OMP-PCR and Coc-PCR were 17.14%, 10% and 10%, respectively.Conclusions: The results of this study show that Trans-PCR is highly sensitive and useful for the direct detection of C. burnetii in milk samples. This technique is a one-step and fast process in comparison to the other assays.

Dear Editor: In 2011, an estimated 524 million people (8% of the world’s population) were aged 65 or older. Until 2050, this number is expected to nearly triple to about 1.5 billion, representing 16% of the world’s population. Between 2010 and 2050, the number of older people in less developed countries is projected to increase more than 250%, compared with a 71% increase in developed countries.

Background: Seronegative Spondyloarthropathies (SNSAs) are referred to a group of diseases with same clinical and genetic features.Objectives: Due to lack of data about HLA-B27 prevalence in patient with SNSA in Kashan this study was conducted to determine the status of HLA-B27 in these patients.Patients and Methods: This cross sectional study was conducted on 294 patients suffered from SNSA. Presence or absence of HLA-B27 was checked by serological method using Greener kit. Results were analyzed with SPSS-16 software using t-test and χ2 test.Results: Of all 26.5% of subjects were HLA-B27 positive. HLA-B27 was significantly more frequent in male patients (34.1% vs. 16.5%, P<0.001). Prevalence of HLA-B27 was 69% in ankylosing spondylitis, 31.5% in psoriatic arthritis, 18.2% in entropathic arthropathy, 17.9% in undifferentiated spondyloarthropathies, 16.1% in reactive arthritis and 12.5% in juvenile rheumatoid arthritis (P<0.001).Conclusions: HLA-B27 has highest prevalence in ankylosing spondylitis and least prevalence in juvenile rheumatoid arthritis. HLA-B27 prevalence was in relation with gender, type of disease, family history, peripheral, and axial joints engagement.

A 67-year-old woman presented with dysphagia, odynophagia and hoarseness. In her chest X-ray, there was evidence of consolidation associated with loss of volume in the upper lobe of the left lung. Acid-fast bacillus was not seen at the direct smear of the throat exudates. In laryngoscopy, bilateral edema of the arytenoids and exophytic lesions at the posterior commissure were detected. In the biopsy sample of these lesions, acid-fast bacilli were seen. Finally, the patient was treated by anti-tuberculosis drugs.

Background: One of the most challenging isolates in nosocomial infections is Acinetobacter baumannii which is rapidly changing towards multi-drug resistant. Resistance to the last resort antibiotics, carbapenems, is reported around the world. In particular, metallo-b-lactamases (MBL) are responsible and detection of MBLs is of interest.Objectives: In this study we have evaluated the prevalence of MBLs in A. baumannii isolated during 2012 by two feasible described methods.Materials and Methods: In this cross sectional study, during 2012, 40 A. baumannii non-replicate isolates gathered from clinical and environmental specimens from Afzalipur hospital of Kerman. Isolates were characterized by conventional biochemical tests as A. baumannii-calcoaceticus complex (ABC). For antimicrobial susceptibility testing, 17 different antibiotics were sought by agar diffusion method. Phenotypic MBL detection was assessed by double disk test and Modified Hodge test for carbapenem resistant isolates.Results: During the study 40 isolates of ABC were collected. Of which, 23 (57%) isolates were resistant to carbapenems. Phenotypic MBLs detection was negative by two methods.Conclusions: The rates of resistance of the isolated ABCs in our clinical setting were at high level. Though, carbapenems were the most efficient antibiotic, but, there was a pronounced rate of resistant. MBL genes were not responsible for carbapenem resistance in under study clinical setting.

Background: Congenital toxoplasmosis (CT) is the result of maternal infection if acquired during gestation, an infection that most often is clinically unapparent.Objectives: This study was conducted to determine acute and chronic toxoplamosis in pregnant women and its complications in newborn.Patients and Methods: In this cohort study, 798 pregnant women were tested for Toxoplasma IgG/IgM by ELISA. PCR and IgM were performed on 4 newborns of acute and 5 chronic maternal infections; they were followed for 1 year. Data were analyzed by SPSS-11.5 and χ2 test.Results: Five (0.63%) and 341 (42.7%) were positive for acute and chronic infections. A 400 bp band was seen in 3 newborns of acute maternal infections. The incidence of neonatal toxoplasmosis was 3.7 per 1000. Only one neonate of the acute maternal toxoplasmosis had jaundice.Conclusions: The rate of maternal and neonatal toxoplasmosis, were higher than the world. Jaundice was only sign in newborn with Toxoplasma gondii infection.

Background: There is a growing trend toward avoidance of intubation and mechanical ventilation for preterm neonates. Noninvasive ventilation can be provided by a variety of ways including nasal cannula.Objectives: This study was conducted to compare the efficacy and safety of Humidified high Flow Nasal Cannula (HFNC) and nasal CPAP for respiratory support after surfactant administration in preterm newborn infants with respiratory distress syndrome.Patients and Methods: In this randomized controlled clinical trial, 85 preterm newborn infants with birth weight of 1250- 2000 grams and gestational age of 30 - 34 weeks who received surfactant replacement therapy were enrolled. Patients were randomly allocated in two groups; NCPAP group (43 neonates) and HFNC group (42 neonates).Results: The mean gestational age of patients was 32.07±1.48 weeks in NCPAP and 32.24±1.7 weeks in HFNC group and their birth weight was 1885±417 and 1905±464 grams in NCPAP and HFNC groups, respectively. Demographic characteristics of patients were similar in the both groups. Although the rate of re-intubation, pneumothorax, intra-ventricular hemorrhage and bronchopulmonary dysplasia were higher in NCPAP group, the differences were not statistically significant. Nasal mucosa injury was determined in 27 (62.8%) neonates in NCPAP group and 14 (33.3%) infants in HFNC group (P=0.007).Conclusions: In our study, HFNC was as effective as NCPAP for respiratory support in preterm infants after surfactant administration and extubation. Nasal mucosal injury rate was lower in HFNC group. It is recommended to perform future studies with larger number of patients before routine use of HFNC in post extubated preterm infants.

Background: Urinary Tract Infection (UTI) is one of the most common reasons for human to seek medical advice and is also one of the most frequently occurring nosocomial infections. Nosocomial UTIs are almost exclusively complicated with a broad spectrum of etiological pathogens. Escherichia coli remains the predominant uropathogen (80%) isolated in community-acquired infections.Objectives: The aim of this study was to determine the local incidence of UTIs, identification of Uropathogenic E. coli (UPEC), serotyping and strains antimicrobial resistance of E. coli isolated from these patients.Patients and Methods: In this prospective cross-sectional study, in order to isolate and identify bacterial agent (UPEC) causing UTI and to identify it’s sex and age distribution, a total 150 urine samples through simple random sampling method were analyzed for identification of bacterial isolates. Lactose fermenting colonies on MacConkey’s agar were processed and identified as E. coli by standard biochemical tests. Antibiotic susceptibility tests were performed with disk diffusion tests using Kirby-Bauer method on E. coli isolated from 110 cases with UTI aged from 1 year to 85 years and serotyping achieved by slide agglutination method. All data analyzed using SPSS-21 software.Results: Majority of UPEC belonged to serotype O1, O2, O4, O20, O25, O44, O64 and O78. Majority of the isolates were resistant to routinely used antibiotics amoxicillin, cotrimoxazole, tetracycline and gentamicin. Most of the isolates were sensitive to nalidixic acid, ciprofloxacin, nitrofurantoin and ceftazidime.Conclusions: The present study revealed that serotype O25 was isolated with maximum frequency followed by O2, O6, O1, O78, O44, O20 and O64 respectively.

Background: Carpal tunnel syndrome is one of the most common entrapment neuropathy. Recent studies suggest that this syndrome may be more frequent in some specific sleep positions.Objectives: The aim of this study was evaluation of sleep position in patients with carpal tunnel syndrome.Patients and Methods: This cross-sectional study was conducted on 220 patients with carpal tunnel syndrome. The diagnosis was confirmed with electromyography. The sleep position in the patients was assessed via the questionnaire. The sleep position of the patients was compared with the sleep position of 320 healthy persons. The χ2 test was used for statistical analysis.Results: Carpal tunnel syndrome was more frequent in women. About two thirds of the patients had moderate to severe carpal tunnel syndrome. The prevalence of carpal tunnel syndrome was more frequent in patients who slept on their sides than who slept in other positions (P<0.01). There was no significant relationship between the severity of carpal tunnel syndrome and sleep position.Conclusions: Our study showed that carpal tunnel syndrome was more frequent in some sleep positions, however, no significant relationship was found between the sleep position and the severity of this syndrome.

Background: Fleas are wingless insects belonging to the Siphonaptera order (named because of their siphon-like mouthparts).Objectives: The aim of this study was to evaluate the abundance and fauna of the fleas that are the carrier pathogen in the South of Khorasan-e-Razavi province.Materials and Methods: In this cross-sectional study, for catch the fleas of cow and sheep were used 3 methods such as: light trap, sticky trap, and human bite.Results: A total number of 580 fleas from Gonabad and Bajestan cities were collected that all species were Pulex iritans. Thirty five percent fleas were collected from cow and 65% from sheep.Conclusions: Considering that fleas are carrier pathogens and tend to feed on human blood, which is offered periodically at different seasons, barn spraying with appropriate insecticide was performed.