Background and Objectives: Culture of M. tuberculosis is the golden standard for the diagnosis of TB which is a much more sensitive test than Smear examination. There is a strong need to use the new assays in order to speed up diagnostic methods. The aim of this research was to determine the evaluation of Microscopic Observation Drug Susceptibility culture in pulmonary tuberculosis in comparison with Ziehl-Neelsen stain and Lowenstein-Jensen culture of sputum.Methods: The research method was a Cross-sectional (diagnostic test) and the technique was observational-interview type. If the patient's history revealed clinical criteria compatible with TB and the infectious specialist’s judgment was that of "TB suspected case, the patient was considered a pulmonary TB suspect. Then, in addition to sputum Ziehl-Neelsen stain and culture for Lowenstein-Jensen, we carried out MODS culture as well.Results: 100 patients (48 male, 52 female) with mean age of 52.9±21.83 were evaluated. During sputum examination, 40% were Ziehl-Neelsen stain positive while 30% had positive sputum culture for Mycobacterium Tuberculosis in Lowenstein-Jensen and 47% had positive MODS culture. In comparison with sputum smear and Lowenstein-Jensen culture, MODS had a sensitivity of 82.5% and 86%, specificity of 77% and 70%, positive predictive value of 70% and 55%, negative predictive value of 86% and 92%, respectively.Conclusion: MODS culture demonstrated faster recovery and higher negative predictive value than by Lowenstein-Jensen method; it could be a simple and rapid method in the diagnosis of pulmonary tuberculosis.

Background and Objectives: Ziehl-Neelsen stain is an initial route in diagnosis of pulmonary tuberculosis. Some studies show the sensitivity and specificity of the methods of liquid media culture in rapid diagnosis of the disease. In this study, we evaluated the correlation between Microscopic Observation Drug Susceptibility culture, Ziehl-Neelsen stain and Lowenstein-Jensen culture of sputum in suspected pulmonary tuberculosis patients.Material and Method: This was a descriptive study with the technique of observational-interview type. One hundred patients from Masih Daneshvari hospital were considered as pulmonary TB suspects. One early morning sputum sample was obtained from each patient and used for Ziehl-Neelsen stain, culture on Lowenstein-Jensen medium and MODS culture for drug susceptibility testing.Results: On sputum examination, 40% of patients were smear positive by Ziehl-Neelsen stain, while 30% had positive sputum culture for Mycobacterium tuberculosis in Lowenstein-Jensen medium and 47% had positive MODS culture. This research showed a significant and direct correlation between MODS culture with Lowenstein-Jensen media (r=+0.39, P<0.0001). There was a significant association and a significant and reverse correlation between MODS culture with pleural effusion (r=-0.23, P<0.05). Multidrug resistance was observed in 55% of patients. Prevalence of positivity of these diagnostic methods among MDR patients was lower. There was a significant and direct correlation between MDR diseases with MODS culture. (r=+0.96 P<0.0001).Conclusion: due to increasing of MDR tuberculosis, rapid determination of resistance pattern is very important which is possible by using MODS cul ture method. However, since lower positivity of MODS culture is obtained in MDR patients, Lowenstein-Jensen culture method should be done as complementary method in suspected pulmonary tuberculosis patients.

Background: Non-tuberculous mycobacteria (NTM) are widely associated with pulmonary diseases. Evidence is lacking on the transmission of NTM from one person to another. Hence, it has gained lower public health priority than tuberculosis. Objectives: We determined the prevalence and antibiotic resistance rate of NTM isolated from sputum samples of patients with pulmonary infections. Methods: A total of 375 duplicate sputum samples were collected from 375 patients on consecutive days. The NTM growth was assessed using BACTEC 960 mycobacterial growth indicator tubes. The GenoType Mycobacterium CM/AS line probe assay was used for the species-level identification of mycobacteria. Antibiotic susceptibility tests were performed using the auto-MODS assay. Results: The overall NTM prevalence rate was 34. 4%. Mycobacterium avium complex (24. 8%) was the predominant species identified, followed by M. kansasii (24%) and M. abscessus complex (20. 2%). Of the 129NTMisolates tested for antibiotic susceptibility, 62. 8% were resistant to rifampicin, 60. 5% to levofloxacin, 58. 1% to ofloxacin, 55. 8% to ethambutol, 49. 6% to isoniazid, 48. 1% to streptomycin, and 41. 9% to amikacin. Seventy-three (56. 6%) isolates were identified as multidrug-resistant (MDR) isolates. Conclusions: Mycobacterium avium complex was the predominant species identified, and the majority of the organisms were resistant to commonly used anti-tuberculosis drugs. The high prevalence of NTM and drug resistance towards the tested antibiotics suggests that NTM can no more be ignored as a contaminant, reiterating the need for periodic surveillance and species-specific treatment for effective management of diseases caused by NTM.

This paper evaluates moving objects database (MODS) data models and data structures by focusing on history management approach for MODS. MODS algorithms and their complexity are being discussed. By introducing benchmarks as conventional tools for comparison of MODS, we use queries and data utilized within Berlin Mod benchmark for evaluation and analysis. Finally, we propose methods to enhance queries performance.

Introduction: Observing the effects of high-volume hemofiltration (HVHF) treatment on the monocytes apoptosis, antigen presentation, and secretion function, this study investigated the mechanism of HVHF effect on immunity homeostasis in multiple organ dysfunction syndrome (MODS) in an animal model.Materials and Methods: Lipopolysaccharides were administered in 12 Beagle dogs in order to induce MODS. Six dogs were randomly assigned to receive HVHF treatment for 12 hours (HVHF group) and the rest did not receive any treatment (the MODS group).The expression of DLA-DR, apoptosis, and cytokine levels were measured at 7 time points: normal condition (T1), after operation (T2), and zero, 3, 6, 9, and 12 hours after endotoxin injection (T3 to T7, respectively).Results:Apoptosis of CD14+mononuclear cell increased in early and late stages gradually in the MODS group and began to decline gradually after the HVHF treatment. There was a significant difference between the two groups at time points T2 to T7 (P<.01).After HVHF, the impaired expression of dog leukocyte antigen-DR showed an improvement trend in the HVHF group, which was significant better at T5 and T7 than that in the MODS group (P<.05). Interleukin-4 secretion increased significantly with HVHF and was significantly higher at time points T4 to T7 as compared with the MODS group (P<.01).Conclusions: High-volume hemofiltration can alleviate the mononuclear cell apoptosis, improve antigen-presenting function and secretion function, inhibit the release of inflammatory factors, and maintain immune homeostasis, and consequently alleviate symptoms of MODS effectively.

Objective: The present investigation aims to determine the various possibilities in which using MODS could describe second tier FRBR.Methodology: A comparative method was employed in which the main and ancillary components, features and measures for MODS and also 2nd Tier FRBR entities were used Findings: Considering the possibilities, a person or corporation could be responsible as the creator, author or compiler of a work, or hold ownership or even be the borrower of a title. It may be used in construction of an arbitrary title or be preferred to other names or be considered as the topic for the resource in question. A person or corporation could be part of the working title or establish a metadata record. It seems that given the results obtained through superimposing of two schemes studied, it is very possible to describe the various roles of persons or corporations in various resources, within MODS using XML syntactical basis. One could deploy this syntactical basis to describe second tier entities in various descriptive levels.

Iran is a drought region which is located in middle meridian of earth. Especially in mountains, precipitations fall as snowfall and provide water supply for warm season.Therefore, it is so important for hydrologists and water resource engineers to determinate boundary of snow cover to be able to estimate water supply. In this study, snow cover area in Central Alborz mountains were deteeted using NOM-A VHRR and TERRA-MODIS data using threshold determination in near infrared band. Discrimination between snow and clouds is one of the important problems in snow mapping using satellite data.Clouds are very diverse and have high reflection in visible and NIR band but snow shows low reflectance in this band.In MODIS snow mapping algorithm, first using NDSI, snow pack detected but for discrimination between snow and other wet lands we utilized threshold in 1, 2, 4 and 6 bands. In NOAA-AVHRR algorithm were also used threshold for Albedo of band 1 and 3 and brightness temperature 3 and 4.Snow areas in AVHRR is 5303 square kilometers in March 27th 2004 and full snow, fractal snow and clouds areas in MODIS data were 994, 2570 and 2505 square kilometers in March 25th 2003, respectively.Finally, using interrelation between hydro-climatology parameters 2.9oC were calculated as minimum temperature of snowfall and height of corresponding 0o C were calculated for snow permanence height in Central Alborz.

Background: Procalcitonin (PCT) kinetics is a good prognosis marker in infectious diseases, but few studies of children sepsis have been performed.Objectives: The aim of our study was to examine kinetics of procalcitonin, to evaluate its relationship with severity and to analyze its usefulness in the prediction of multiorgan dysfunction syndrome (MODS).Patients and Methods: Prospective observational study in an 8-bed pediatric intensive care unit of a university hospital. Sixty-two children aged 0-19 years with systemic inflammatory response syndrome or septic states. The degree of severity was evaluated according pediatric logistic organ dysfunction (PELOD) score. Blood tests to determine levels of PCT were taken if the patients had the criteria of systemic inflammatory response syndrome or sepsis. The serum to determine levels of PCT in control group has been taken from patients undergoing elective surgery.Results: Higher values of PCT were identified in patients with PELOD score 12 and more compared to those with PELOD<12 (P=0.016). Similarly, higher PCT values were found in patients who developed MODS in contrast to those without MODS (P=0.011). According to ROC analysis cut-off value of 4.05 ng/mL was found to best discriminate patients with PELOD<12 and PELOD³12 with AUC=0.675 (P=0.035). Effect of procalcitonin levels on mortality was not demonstrated.Conclusions: Levels of procalcitonin from day 1 to day 5 are related to the severity and multiorgan dysfunction syndrome in children.

Background: Various studies have conducted to report the mortality rates and its risk factors in pediatric intensive care unit. This study aimed to determine the mortality prevalence and risk factors in PICU of Imam Hossein Children's Hospital in Isfahan, which is the main referral pediatric hospital in the center of Iran. Materials and Methods: This study was performed on 311 patients during a period of 9 months. The questionnaire which included age, gender, length of stay in the PICU and hospital, mortality, history of resuscitation in other wards and readmission, the causes and sources of hospitalization, pediatric risk of mortality (PRISM)-III score, respiratory supports, morbidities like nosocomial infections, acute kidney injury (AKI), multiple organ dysfunction syndrome (MODS) confirmed by pediatric sequential organ failure assessment score (P-SOFA) and glycemic disorders was filled out. Results: One hundred and seventy-seven (56. 9%) were males and 103 (33%) were belonged to the age group of 12–59 months. The most prevalent causes of hospitalization were status epilepticus (12. 9%) and pneumonia (11. 2%). Mortality rate was 12. 2%. The significant factors associated with mortality were readmission and history of resuscitation. PRISM-III index showed a significant difference between nonsurvivors and survivors (7. 05 ± 6. 36 vs. 3. 36 ± 4. 34, P = 0. 001). Complications like AKI, hypoglycemia, MODS and disseminated intravascular coagulation (DIC), length of mechanical ventilation significantly correlated with mortality. Conclusions: Mortality rate was less than that of other developing countries (12. 2%) and this was associated with some risk factors included readmission, history of resuscitation, PRISM-III Index,complications like AKI, acute respiratory distress syndrome (ARDS), DIC, mechanical ventilation duration, MODS, hypoglycemia, and P-SOFA index.

Background: Interleukin 6 (IL-6) functions as both a pro-inflammatory cytokine and an anti-inflammatory cytokine. Objective: To evaluate the levels of IL-6 in patients with multiple organ dysfunction syndrome (MODS). Methods: Level of IL-6 was assessed and recorded for 14 days subsequent to the injury in 161 multiple trauma patients. MODS were diagnosed using Marshal Score. Injury Severity Scoring (ISS) was measured for all patients. Results: The results of this study indicated that there was a significant relationship between the level of IL-6 and ISS on the post trauma days number one and two (P=0. 0001). The high level of IL-6 on the post trauma day number 2 was associated with high mortality rate. Conclusion: Our study suggests the second day as the golden time for measuring the serum levels of IL-6. These findings warn us to take more health care actions in patients with higher serum levels of IL-6 on the second day.