Scientific Journal of Kurdistan University of Medical Sciences
Year:2022 | Volume:27 | Issue:4 (121)|Papers Count:13

Background and Aim: Klebsiella pneumoniae is one of the most common causes of community-acquired and nosocomial infections and has acquired numerous resistance mechanisms over time. The aim of this study was to evaluate the antibiotic resistance pattern of clinical isolates of K. pneumoniae and investigate the mutations in Ompk35 porin as one of the most important mechanisms of resistance to beta-lactam antibiotics. Materials and Methods: In this cross-sectional correlation study, 100 urinary isolates of K. pneumoniae from the patients admitted to Milad Hospital were evaluated. Antibiotic susceptibility testing was performed using disk diffusion method. Using PCR method, ompK35 genes were detected, sequenced and the mutations were identified by use of Mega software (version 3. 7. 3). SPSS software version 20 and Chi-square test were used for data analysis. Results: The highest resistance rate belonged to amikacin (74%) followed by levofloxacin (69%). Resistance rates to cefepime, gentamicin, ciprofloxacin, meropenem, and ceftriaxone were 62, 58, 53, 41, and 35%, respectively. The highest sensitivity rate belonged to imipenem (80%). Numerous mutations were observed in the Ompk35 porin encoding genes. Among the isolates, 70% harbored mutations in Ompk35 protein and two isolates had five mutations simultaneously. There was no significant relationship between resistance to the antibiotics and gender in our study (P>0. 05). Conclusion: Our findings indicated a high prevalence rate of antibiotic resistance and high frequency of porin mutations among K. pneumoniae isolates. Also, the presence of similar mutations in the isolates suggests that they may have a common origin.

Background and Aim: HOTAIR is a long noncoding RNA, that is transcribed from the antisense strand of the homeobox C gene and acts as an oncogene. The aim of this study was to assess the association of HOTAIR (rs920778 C>T) gene polymorphism with the risk of thyroid cancer in the northwest of Iran. Materials and Methods: In this case-control study we investigated association of HOTAIR (rs920778 C>T) gene polymorphism with thyroid cancer susceptibility in a statistical population consisting of 109 patients and 198 healthy controls by PCR-PFLP. Statistical analysis was performed using javastat online statistics package and SPSS V. 26. Results: The frequency rates of TT, CC, and TC genotypes were 46. 78%, 29. 35%, and 23. 85% in the case group, and 38. 88%, 20. 20%, and 40. 90% in the control group respectively. Statistical analysis showed a significant association between TC genotype (p-value=0. 003) (OR=0. 452, CI 95%=0. 268-0. 764) and thyroid cancer risk. Also, C and T allele frequency rates, were 41. 28% and 58. 71% in the case group and 40. 65% and 59. 34% in the control group respectively. There was no significant relationship between T (p-value=0. 088) and C (p-value=0. 088) allele frequency rates and thyroid cancer risk in the northwest of Iran. Conclusion: These findings suggested that rs920778 C>T polymorphism may be associated with increased susceptibility of thyroid cancer in the northwest of Iran. There was no significant association between rs920778C >T polymorphism and patient’, s pathological characteristics consisting of age, tumor grade, lymph node involvement, side involved, tumor size, tumor stage and type of thyroid tumor.

Background and Aim: Nowadays, there are many challenges in the treatment of head lice infestation and the efficacy of anti-lice products is a very important factor. The aim of this study was to determine the effectiveness of using vinegar before and after application of permethrin shampoo for the treatment of head lice infestation in the elementary school students in Qom Province. Materials and Methods: Our study inclueded 200 female students infested with head lice referring to two comprehensive urban health centers of Qom University of Medical Sciences from September to February 2020. The patients were between 13 and 17 years of age. Using blocked randomization with randomly selected block sizes, the patients were treated with either application of vinegar before or after using 1% permethrin shampoo. Removal of adult human head lice, nymphs, and nits were considered as the outcome of the treatment methods. Results: The current standard treatment method proposed by the Ministry of Health (use of vinegar after applying permethrin shampoo 1%) resulted in the treatment of the infestation in 45% of cases. But the experimental treatment method (using vinegar before applying permethrin shampoo 1%) led to successful treatment of 79% of the participants and showed a high Odds Ratio (OR = 4. 6 CI = 2. 5-8. 5 p =. 000). Conclusion: This study did not approve the current standard treatment method of the Ministry of Health (use of vinegar after consuming permethrin shampoo 1% for removal of head lice infestation). Therefore, we recommend application of vinegar before using permethrin shampoo 1%.

Background and Aim: Fam83h Protein is a non-secretory protein that interacts with Casein Kinase1Alpha1(CSNK1A1) through its N-terminal. Materials and Methods: In this study, the C-terminal domains of Fam83h in human and mouse were modeled using the I-TASER software for prediction of protein structure and function. The molecular dynamics (MD) simulations were performed by GROMACS version 5. 0. 2 to investigate their temporal behavior. FEL analysis was done for each model after MD. Protein-protein docking was done by PIPER to investigate the interaction of Fam83h C-terminal with cytoskeletal keratins5 as a cellular keratin model. Results: The results showed that the human protein is more stable and compact than the mouse protein. Assessment of the interaction between the C-terminal of the mouse Fam83h and Keratin-5 proteins showed the residues Arg378, Pro391, Ser663, Glu710, Arg923 in mouse Fam83h protein made hydrogen bonds with Leu474, Arg417, Tyr453, Glu 397, Gln 396 and Glu 390 of the chain A and B of mouse keratin-5, respectively. Human Fam83h and keratin 5 form hydrogen bonds via residues of Thr433, His447 and Arg477 and Leu473, Gly476, Glu420 and Arg407. Conclusion: According to the previous experimental reports, Fam83h can interact with keratin cytoskeleton and has a role in cancer progression. It can be concluded that Fam83h protein can directly interact with keratin filaments through its C-terminal. Therefore, our hypothesis based on in-silico study is: non-sense mutation in C-terminal of Fam83h protein may lead to truncated protein and subsequently disruption of keratin cytoskeleton bundling which can be regarded as a mechanism involved in cancer progression.

Background and Aim: Lichen planus (LP) is a skin-mucosal disease that can affect skin, hair follicles, mucosa and nail. Oral mucosa is a common site of involvement. The aim of this study was to evaluate blood sugar levels and its relationship with demographic and clinical features in the patients with LP. Materials and Methods: This was a descriptive-analytical cross-sectional study. Fifty-eight patients with LP were included from 2016 to 2019. For data collection, we used database of the patients with LP of Kurdistan University of Medical Sciences. Results: The mean age of the patients was 43. 69 ±,15. 08 years and the mean duration of the disease was 1. 32±, 2. 4 years. 55. 2% of the patients were female and most of the patients were housewives (44. 8%). The most common presentation was involvement of multiple sites which was encountered in 41. 4% of the patients followed by involvement of the foot (24. 1%). 31% of the patients had a history of other diseases, 8. 6% had a family history of LP, and 25. 9% had a history of use of medications. The most commonly used drug was losartan (6. 9%). Conclusion: The results showed that patients' blood sugar levels had no statistically significant relationship with gender, occupation, location of lesions, family history of LP, and stress, but there was a significant relationship between mean blood sugar levels of the LP patients with history of other diseases.

Background and Aim: The fifth wave of Covid-19 occurred in Iran and lasted from the beginning of July to the end of August 2021. Unlike the previous waves, which lasted mainly 3-4 weeks, the fifth wave in the country, especially in Kurdistan province, was longer than 4 months. This study aimed to identify the causes of prolongation of the fifth covid-19 wave in Kurdistan Province. Materials and Methods: In this qualitative study, the views of 52 medical professionals who were directly or indirectly involved in the surveillance and treatment of COVID-19 were obtained using semi-structured interviews. Data analysis was performed using the framework analysis method. Results: Low coverage rate of vaccination, false beliefs and lack of confidence in regard to the effectiveness of vaccines used, incomplete effects of the vaccines, vaccination during incubation period or illness, non-compliance with health protocols especially use of masks by vaccinated people, lack of correct and consistent use of standard masks, insufficient medical services and facilities, use of outpatient treatment approach and rapid discharge of the patients regardless of the disease transmission period, insufficient attention to the education of the patients and their families, weakness in contacts tracing of infected people, lack of seriousness in implementing government decisions, especially insufficient government support for vulnerable people and businesses, community exposure to a new strain of the virus (Delta strain), increased risk of transmission of the disease in the community due to cold weather in the province were the most important reasons for the prolongation of the fifth covid-19 peak in Kurdistan Province. Conclusion: Based on the results, various factors such as vaccination, behavior of community members, government decisions, and response rate of health system were involved in the prolongation of the fifth corona wave in Kurdistan Province. It seems necessary to consider these factors in dealing with the next waves and peaks.

Background and Aim: General anesthesia (GA) is commonly used for spine surgery but this operation can be performed under regional anesthesia. The advantages of regional anesthesia (RA), as compared to GA in regard to the optimum choice of anesthesia for spine surgery have been a matter of controversy. The aim of this study was to compare GA with RA in regard to the intraoperative events, incidence of postoperative complications, and the recovery time in the patients undergoing spine surgery. Material and Methods: This prospective comparative study included 80 patients in ASA 1 and 2 who had referred to Kwosar Hospital in Sanandaj for spinal and lower thoracic surgery. After random allocation of the patients into two equal groups, general anesthesia or epidural anesthesia was adminstered in the same manner to the patients of each group. Demographic characteristics, vital signs, the severity of pain, agitation, urinary retention, nausea, and vomiting, number of times needed to administer analgesics, the time of request for the first dose of analgesia, the time to start walking, and the time of discharge from the hospital were recorded in the patients ׳,records. Using SPSS software version 23, data were analyzed by average statistical test, standard deviation, independent ttest, and chi-square test. Results: There was no significant differences between the two groups in terms of gender, age, and type of surgery (P >0. 05). The severity scores of pain based on the VAS scale at 2, 4, and 6 hours after surgery in the GA group were higher than those in the epidural group (P <0. 05). The highest average score of pain intensity in the GA group was in the second hour after surgery (8. 6). RASS-based restlessness scores were also higher in the GA group at the 2nd and 4th hours after surgery than in the epidural group (P <0. 05). The incidence rates of nausea and vomiting were higher during recovery time in the GA group (P <0. 05). Also, the time to first analgesic request in the GA Group was shorter. The incidence of urinary retention, the time to start walking, and hospital discharge were not significantly different between the two groups (P <0. 05). Conclusion: Based on our results, use of epidural anesthesia seems to be a suitable alternative to general anesthesia with fewer complications for spinal surgery.

Background and Aim: Pain and restlessness are common problems in the intensive care unit. Sensory stimulation is one of the non-pharmacological methods of pain control. Dyang sensory stimulation includes visual, auditory, olfactory, tactile, and motor-sensory stimulation. In this study we investigated the effects of Dyang sensory stimulation on the level of consciousness, pain, and restlessness in the unconscious patients. Materials and Methods: This clinical trial included 60 patients under mechanical ventilation. The patients were divided into two groups. The intervention group received Dyang sensory stimulation. Sensory stimulation was performed for one hour in the evening and at night for six consecutive days. Fifteen minutes after sensory stimulation, the level of consciousness, pain, and restlessness were measured using GlasgowComa Scale, BPS (Behavioral Pain Scale), and Rass (Richmond Agitation Sedation Scale), respectively. Results: The mean values for level of consciousness of the patients in the two groups before the intervention were below 7. The mean values for pain intensity (p=0. 684) and restlessness (p=0. 739) did not show any significant differences between the two groups before the intervention. After sensory stimulation on the second day, the level of consciousness of the patients in the intervention group increased compared to that in the control group (p=0. 016). However, there were no significant differences between the two groups in terms of pain intensity and restlessness on all days of the study (p>0. 05). Conclusion: Dyang sensory stimulation can increase the level of consciousness. Therefore, this multidimensional stimulation method can be used in the patients under mechanical ventilatation.

Background and Aim: Genome editing is an efficient and accurate method in biological and medical studies. Among the wide range of genome editing techniques, clustered regularly interspaced short palindromic repeats (CRISPR) is one of the simplest and yet promising methods. The CRISPR system consists of two key components,an endonuclease enzyme called Cas9 and guide RNA (gRNA), ensuring that Cas9 enzyme cuts at the right point in the genome. Although CRISPR genome editing is one of the useful methods to modify the genome, there are still multiple challenges in the technique steps. Materials and Methods: sgRNAs were designed and ordered accordingly on the basis of the target site and vector of interest. Cloning procedures were performed and confirmed by sequencing as a gold standard. The list of high efficient sgRNAs for the LAMP-2 gene was prepared based on the available outstanding databases by analyzing and comparing the specificity and functionality as two main characteristics. Results: In this study, we tried to evaluate the main challenges in the process of preparing CRISPR/Cas9 popular vectors (pX330/pX459). A list of high efficient sgRNAs for an autophagy gene is also prepared as an example for clarification of the sgRNA design procedures. Conclusion: This study tried to depict problems that may be encountered during sgRNA design and plasmid preparation, followed by giving appropriate recommendations.

Background and Aim: The most common form of violence against women is domestic violence, with the highest probability of repetition and the highest social, psychological and economic consequences, which often occur by the closest people in the family. This study aimed to develop a model for the role of difficulty in emotion regulation and intolerance of anxiety in domestic violence against women considering the mediating role of marital conflict in couples referring to counseling centers in Sanandaj City. Materials and Methods: This was a fundamental stady based on descriptive methods. The stady population included all women referring to counseling centers in Sanandaj between 1398 and 1399. Using converience sampling method a total of 300 women were entered into the study. For data collection we used, Domestic Violence Questionnaire against Women by Mohseni Tabrizi et al. (2010), Simmons and Gahr Distress Intolerance Questionnaire (2005), Emotional Regulation Difficulties Questionnaire, and Barati and Sanaei Marital Conflict Questionnaire (1996). Using PLS-3 software, data were analyzed by structural equation model. Results: The results showed the direct effects of emotion regulation difficulty (8. 202), anxiety intolerance (4. 081) and marital conflict (641. 64) on domestic violence against women. The results also showed indirect effects of emotional regulation difficulty through marital conflict (4. 347) and intolerance of anxiety through marital conflict (4. 798) on domestic violence against women. Conclusion: The results showed that marital conflict acts as a mediator. In fact, it is considered a motivating factor for commiting violence against women.

Background and Aim: There are several methods for genotyping single nucleotide polymorphisms (SNPs). Polymerase chain reaction with confronting two-pair primers (PCR-CTPP) is an inexpensive, quick, reliable, time saving and cost effective method that is applicable for SNPs genotyping compared to other related methods. In the PCRCTPP technique, allele-specific products of the genes are selectively amplified by adding two pairs of four primers and ordinarily prepared PCR mixture in a single PCR tube. Four allele-specific primers are F1 (sense) and R1 (antisense) primers for one allele that R1 has an anti-sense nucleotide at the 3′,end and F2 (sense) and R2 (antisense) for the other allele that F2 has a sense nucleotide at the 3′,end. PCR-CTPP produces three products with different sizes which can make possible genotyping of SNP by gel electrophoresis. To increase the reproducibility and accuracy of the PCRCTPP results, it is better to optimize protocol before sample genotyping. The aim of this study was to review the currently used strategies for optimum application and determination of advantages and disadvantages of the PCR-CTPP method in SNPs genotyping. Materials and Methods: The articles related to the PCR-CTPP method were searched from databases such as ISI Web of science, Science direct, Pubmed, Google Scholar, SID, and Scopus. Results: For more efficiency and reproducibility of the PCR-CTPP method, we should consider the specificity and similarity of melting temperatures of the designed primers by using algorithms and specific primer design softwares. Conclusion: Strategies for optimizing the concentration ratio of internal and external primers, adding amplification additives to the PCR reaction mix, and use of the touchdown program are also recommended.

Background and Aim: Anomalous origin of the right coronary artery from the left anterior descending artery is extremely rare. It is usually asymptomatic but can be associated with a risk of myocardial ischemia and sudden death. Case presentation: This paper presents the case of an elderly male with exertional dyspnea. He underwent diagnostic measures including coronary artery angiography which showed severe stenotic three-vessel disease and right coronary artery anomaly. He underwent coronary artery bypass grafting and discharge home in good condition. Conclusion: Although the abnormal origin of the right coronary artery from the left anterior descending artery is a rare anomaly, due to causing chest pain and the possibility of sudden death, it is considered important. For a definite diagnosis of this anomaly coronary angiography is useful.