Developing a Questionnaire for Iranian Women's Attitude on Medical Ethics in Vaginal Childbirth

Background: Vaginal delivery is one of the challenging issues in medical ethics. It is important to use an appropriate instrument to assess medical ethics attitudes in normal delivery, but the lack of tool for this purpose is clear. Objectives: The aim of this study was to develop and validate a questionnaire for the assessment of women’s attitude on medical ethics application in normal vaginal delivery. Patients and Methods: This methodological study was carried out in Iran in 2013 - 2014. Medical ethics attitude in vaginal delivery questionnaire (MEAVDQ) was developed using the findings of a qualitative data obtained from a grounded theory research conducted on 20 women who had vaginal childbirth, in the first phase. Then, the validation criteria of this tool were tested by content and face validity in the second phase. Exploratory factor analysis was used for construct validity and reliability was also tested by Cronbach’s alpha coefficient in the third phase of this study. SPSS version 13 was used in this study. The sample size for construct validity was 250 females who had normal vaginal childbirth. Results: In the first phase of this study (tool development), by the use of four obtained categories and nine subcategories from grounded theory and literature review, three parts (98-items) of this tool were obtained (A, B and J). Part A explained the first principle of medical ethics, part B pointed to the second and third principles of medical ethics, and part J explained the fourth principle of medical ethics. After evaluating and confirming its face and content validity, 75 items remained in the questionnaire. In construct validity, by the employment of exploratory factor analysis, in parts A, B and J, 3, 7 and 3 factors were formed, respectively; and 62.8%, 64% and 51% of the total variances were explained by the obtained factors in parts A, B and J, respectively. The names of these factors in the three parts were achieved by consideration of the loading factor and medical ethics principles. The subscales of MEAVDQ showed significant reliability. In parts A, B and J, Cronbach’s alpha coefficients were 0.76, 0.72 and 0.68, respectively and for the total questionnaire, it was 0.72. The results of the test–retest were satisfactory for all the items (ICC = 0.60 - 0.95). Conclusions: The present study showed that the 59-item MEAVDQ was a valid and reliable questionnaire for the assessment of women’s attitudes toward medical ethics application in vaginal childbirth. This tool might assist specialists in making a judgment and plan appropriate for women in vaginal delivery management

Methicillin-resistant staphylococcus epidermidis in Iran: A systematic review and meta-analysis

Objective: Methicillin-resistant Staphylococcus epidermidis (MRSE) remains one of the most prevalent drug-resistant bacteria causing health care infections. Limited data are available about how the frequency of MRSE changed in Iran over the past years. The current study aimed at determining the frequency of MRSE in different cities of Iran. Methods: Databases including Web of Sciences, Scopus, Embase, Medline, and Iranian databases were searched to find studies addressing the frequency of MRSE in Iran published from Mar 2006 to Jan 2016. The data were analyzed using comprehensive meta-analysis version 2.2 (Biostat). Of the 139 records identified in the databases, 15 studies met the inclusion criteria. Results: The analyses showed that the frequency of MRSE infections was 73.9 95% confidence interval (95% CI) 61.4-83.4 among culture-positive cases of S. epidermidis in different parts of Iran. The frequency of MRSE was higher in the studies conducted from 2011 to 2015, based on further stratified analyses. Conclusions: The regular surveillance on antimicrobial susceptibility pattern and formulation of definite antibiotic policy may control high rate of MRSE associated infections in Iran. Moreover, rapid and reliable diagnosis of MRSE isolates and regular screening of the personnel and surfaces of hospitals in terms of MRSE are indispensable. © 2018, Archives of Clinical Infectious Diseases

The global prevalence of Daptomycin, Tigecycline, Quinupristin/Dalfopristin, and Linezolid-resistant Staphylococcus aureus and coagulase-negative staphylococci strains: A systematic review and meta-analysis

Objective: Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus (MRCoNS) are among the main causes of nosocomial infections, which have caused major problems in recent years due to continuously increasing spread of various antibiotic resistance features. Apparently, vancomycin is still an effective antibiotic for treatment of infections caused by these bacteria but in recent years, additional resistance phenotypes have led to the accelerated introduction of newer agents such as linezolid, tigecycline, daptomycin, and quinupristin/dalfopristin (Q/D). Due to limited data availability on the global rate of resistance to these antibiotics, in the present study, the resistance rates of S. aureus, Methicillin-resistant S. aureus (MRSA), and CoNS to these antibiotics were collected. Method: Several databases including web of science, EMBASE, and Medline (via PubMed), were searched (September 2018) to identify those studies that address MRSA, and CONS resistance to linezolid, tigecycline, daptomycin, and Q/D around the world. Result: Most studies that reported resistant staphylococci were from the United States, Canada, and the European continent, while African and Asian countries reported the least resistance to these antibiotics. Our results showed that linezolid had the best inhibitory effect on S. aureus. Although resistances to this antibiotic have been reported from different countries, however, due to the high volume of the samples and the low number of resistance, in terms of statistical analyzes, the resistance to this antibiotic is zero. Moreover, linezolid, daptomycin and tigecycline effectively (99.9) inhibit MRSA. Studies have shown that CoNS with 0.3 show the lowest resistance to linezolid and daptomycin, while analyzes introduced tigecycline with 1.6 resistance as the least effective antibiotic for these bacteria. Finally, MRSA and CoNS had a greater resistance to Q/D with 0.7 and 0.6, respectively and due to its significant side effects and drug-drug interactions; it appears that its use is subject to limitations. Conclusion: The present study shows that resistance to new agents is low in staphylococci and these antibiotics can still be used for treatment of staphylococcal infections in the world. © 2020 The Author(s)

Wound healing with alginate/chitosan hydrogel containing hesperidin in rat model

Skin damages have always been considered as one of the most common physical injuries. Therefore, many researches have been conducted to find an efficient method for wound healing. Since hydrogels have suitable characteristics, they are widely used for this purpose. In this study, based on the high efficiency of alginate and chitosan hydrogels in the wound healing, different concentrations of hesperidin were loaded to alginate and chitosan hydrogels followed by evaluating their morphology, swelling properties, release, weight loss, hemo- and cytocompatibility, antibacterial and toxicity properties. Finally, the therapeutic function of the prepared hydrogels was evaluated in the full-thickness dermal wound in a rat model. Our results indicated that the hydrogels have appropriate porosity (91.2 ± 5.33) with the interconnected pores. Biodegradability of the prepared hydrogel was confirmed with weight loss assessment (almost 80 after 14 days). Moreover, the time-kill assay showed the antibacterial properties of hydrogels, and MTT assay revealed the positive effect of hydrogels on cell proliferation, and they have no toxicity effect on cells. Also, the in vivo results indicated that the prepared hydrogels had better wound closure than the gauze-treated wound (the control group), and the highest wound closure percentage was observed for the alginate/chitosan/10 hesperidin group. All in all, this study shows that alginate/chitosan hydrogels loaded with 10 of hesperidin can be used to treat skin injuries in humans. © 2019 Elsevier B.V

Distribution of the most prevalent spa types among clinical isolates of methicillin-resistant and -susceptible Staphylococcus aureus around the world: A review

Background: Staphylococcus aureus, a leading cause of community-acquired and nosocomial infections, remains a major health problem worldwide. Molecular typing methods, such as spa typing, are vital for the control and, when typing can be made more timely, prevention of S. aureus spread around healthcare settings. The current study aims to review the literature to report the most common clinical spa types around the world, which is important for epidemiological surveys and nosocomial infection control policies. Methods: A search via PubMed, Google Scholar, Web of Science, Embase, the Cochrane library, and Scopus was conducted for original articles reporting the most prevalent spa types among S. aureus isolates. The search terms were "Staphylococcus aureus, spa typing." Results: The most prevalent spa types were t032, t008 and t002 in Europe; t037 and t002 in Asia; t008, t002, and t242 in America; t037, t084, and t064 in Africa; and t020 in Australia. In Europe, all the isolates related to spa type t032 were MRSA. In addition, spa type t037 in Africa and t037and t437 in Australia also consisted exclusively of MRSA isolates. Given the fact that more than 95 of the papers we studied originated in the past decade there was no option to study the dynamics of regional clone emergence. Conclusion: This review documents the presence of the most prevalent spa types in countries, continents and worldwide and shows big local differences in clonal distribution. © 2018 Asadollahi, Farahani, Mirzaii, Khoramrooz, van Belkum, Asadollahi, Dadashi and Darban-Sarokhalil

Effect of probiotics in poultry diet on microbial hazards of poultry meat

Probiotics are products from microbial cells that have useful influence on health and tranquility of humans. According to numerous studies, many valuable properties such as anti-mutagenic, anti-carcinogenic, boosting body immunity and resistance against enteric pathogens have been attributed to probiotics. Therefore the aim of this study is to specify the effect of probiotics use in the diet of broilers on microbial hazards of poultry meat. For this purpose, two groups of treatment and control each containing 40 broiler chicks were chosen and edible probiotic were given to the treatment group throughout the whole 55 days of the rearing period under the same conditions and following slaughter 100 grams of skin and breast meat samples were collected from each carcass and transferred to food hygiene laboratory of the veterinary faculty under sterile conditions. Total microbial count,    Staphylococcus aureous, fecal Streptococci, Clostridium perferingens, Coliforms counts and detection of Salmonella and E.coli were performedon the samples according to standard approaches of Iran. The results were analyzed using independent t-Test and Chi-square test. Comparison of the means of total microbial count, coliform, enteric streptococci and meat staphylococcus counts in the control and treatment group using independent t-Test showed a significant reduction (

Continuous Measurement of Matrix Suction and Degree of Saturation of Unsaturated Soils with a New Soil-Water Retention Curve Device

The relationship between matrix suction and degree of saturation within the soil is a fundamental parameter in studying many behavioral aspects of unsaturated soils and is referred to as the soil-water retention curve (SWRC). Due to difficulties associated with negative pore water pressure measurements in unsaturated soils, most SWRC measuring techniques benefit from suction controlling methods such as axis translation or osmosis techniques. These methods provide only a few data points on the matrix suction-degree of saturation relationship and cause a discrete measured soil-water characteristic curve. However, many SWRC elements like drying and wetting curve slopes, air entry, and air expulsion values are fundamental parameters in describing the hydro-mechanical behavior of unsaturated soils. Therefore, a realistic understanding of these parameters requires continuous measurement of the degree of saturation-matrix suction relationship at more points. To this end, this paper examines the performance of a new SWRC device developed for the continuous measurement of the soil-water retention curve of unsaturated deformable soils along drying paths. The new apparatus is equipped with new miniature tensiometers enabling direct measurement of soil suction without the need for an artificial increase in pore air pressure. The variation of the degree of saturation is calculated by contiguous weighing of soil samples along drying paths. The credibility of the new SWRC apparatus is examined to investigate the influence of initial compaction on the soil-water retention response of sandy soil along with drying. This was experimentally achieved by SWRC tests on compacted soil samples with a range of void ratios between maximum and minimum void ratios to examine the influence of compaction on the slope of SWRC along with drying and variation of air entry value. The results are thoroughly discussed and compared against other available data in the literature. Also, the results suggest the fast performance of newly developed tensiometers for direct measurement of soil suction with a minute without the need for the application of elevated pore air pressure, which leads to the continuous SWRC measurement of the soil samples within 3 to 5 days along drying paths. The credibility of the new SWRC device is also examined with additional suction measurement tests using conventional jet-fill tensiometers, showing consistent results

Effect of warm-smoking on total microbial count of meat products

The frankfurters are amongst the most famous and popular sausages in the world and beef and poultry meat are used in Iran for their preparation. The techniques of warm smoking at 42°c for two hours and then hot smoking together with steam cooking at 8°c for one hour are utilized in proportion of this product. In spite of its carcinogenic properties, smoke is used to create color, flavor and odor and to improve the preservative qualities of sausages. In this study, 14 sausage samples were taken from each of the stages of frankfurter production line including pre-smoking, post- warm smoking and post-hot smoking, their total microbial counts (aerobic mesophiles) determined and the means of the three stages compared using the ANOVA statistical test. The results indicated that the total microbial count increased significantly (

Study on the effect of dextrose, valine, glycine, thiamine and different temperatures on growth rate of Bifidobacterium bifidum in milk

The first step in utilizing appropriate microorganisms to produce probiotic milk products is to recognize their growth conditions in milk and the factors influencing them. In this research, the effect of dextrose, valine, glycine, thiamine and different temperatures on growth rate of Bifidobacterium bifidum in milk has been studied and for this purpose, fermented milk by B. bifidum has been used as stock culture in order to inoculate the milk samples. First 28, 35, 42, 49 and then 35, 38, 41 and 44°C incubators were used to choose the suitable incubation temperature for growth of the microorganisms and the acidity of milk samples were measured as a growth index of the microorganisms prior to and during incubation. Concentrations of 0 (control), 5, 10 and 15 ppm of thiamine; 0(control), 0.4, 0.6, 0.8 and 1% of dextrose; 0(control), 30, 60, 90 and 120 ppm of glycine and valine were used to evaluate their effects on the growth rate of B. bifidum and acidity of milk samples were measured before incubation and after 2, 4, 6 and 8 hours of incubation at 42°C. The rate of increase of acidity at 44°C and 41°C was significantly higher than the other temperatures (