Detection of magA Gene in Klebsiella spp. Isolated from Clinical Samples

Objective(s): Klebsiella infections are caused mainly by K. pneumoniae and K. oxytoca. In the last two decades, a new type of invasive Klebsiella pneumoniae which contains mucoviscosity-associated gene (magA) has emerged. The aim of this study was to investigate the prevalence of magA gene and to detect antimicrobial susceptibility patterns of Klebsiella   spp. isolated from clinical samples.     Materials and Methods:   Klebsiella isolates were collected from patients admitted to referral hospitals of Hamadan, Iran, during a 12-month period from 2007 to 2008. The samples were analyzed by conventional microbiological methods and polymerase chain reaction (PCR). The hypermucoviscosity (HV) phenotype of Klebsiella   isolates was characterized by formation of viscous strings >5 mm as a positive test. The susceptibility of isolates to routine antibiotics was assessed by agar disk diffusion method.   Results: Out of 105 Klebsiella isolates, 96.2% was identified as K. pneumoniae and 3.8% as K. oxytoca by PCR. magA gene was detected in 4 (3.8%) isolates of K. pneumoniae. The isolates of K. oxytoca contained no magA gene. From 4 isolates with positive magA gene, two of them were HV+ and two were HV- phenotype. Overall, sixty-four isolates (60.95%) of K. pneumoniae   showed an HV positive phenotype and all isolates of K. oxytoca were HV-phenotype. The most effective antibiotics against the isolates were tobramycin (79.05%), ceftazidime (79.05%), ceftizoxime (78.09%), ciprofloxacin (76.19%), ceftriaxone (76.24%) and amikacin (74.29%).     Conclusion: The results suggest that there is also magA associated serotype of the K. pneumoniae in this region. In addition, the presence of HV+ phenotype may not be associated with magA   .    

Trend analysis of medicine consumption based on therapeutic categories in Iran: 2000–2016

Objective: Iranian healthcare system cost has been remarkably growing during the recent decades. Drug shortages and the economic effects of the sanctions have also exposed the pitfalls and shortcomings of the pharmaceutical system. Moreover, the pharmaceutical system is a major expenditure source for the health system. Pharmaceutical market trend analysis serves as a reliable tool to gather and analyze market and consumption data to take account of the past policies and forecast the future of the market and disease trends. Methods: The present work tries to quantitatively describe and analyze past 17 years of Iranian pharmaceutical market sales data from 2000 to 2016. The anatomical therapeutic chemical-classified drug utilization data obtained from the Iranian Food and Drug Administration were used to analyze the market trends for each therapeutic class and categorize them. Findings: The size of Iranian pharmaceutical market has grown dramatically during the last 5 years reaching to $5.183 billion in 2016 from$3.847 billion in 2011 with a compound annual growth rate of 6.14%. Antidiabetics and antineoplastic agents were one of the most prominent market growth drivers. Introduction of new drug molecules to the market has also contributed to the trend. However, the noncommunicable diseases are gaining momentum in the national disease burden. Conclusion: The market growth necessitates policies to prevent the overwhelming cost burden on the healthcare system which in turn requires well-informed decision-making. Pharmaceutical market trend analysis tries to supply the evidence feed for informed policy-making to forecast, prioritize, and contain the cost burden imposed on the healthcare system by the pharmaceutical sector

The effect of wet cupping on serum levels of interferon-gamma in laboratory rats with the disease brucellosis

Background: Brucellosis is a systemic infection caused by gram-negative coccobacilli and facultative intracellular bacteria of the genus brucella. Brucellosis is a bacterial disease common to humans and livestock. Infection with Brucella spp. continues to pose a human health risk globally despite strides in eradicating the disease from domestic animals. The humoral and cellular immunity plays an important role in brucellosis. The effect of phagocytosis and cellular immunity has been demonstrated in brucellosis. The effect of cupping as a therapeutic method on bacterial diseases has been demonstrated. By considering this fact that cupping is an effective method on host immune system functions and has potential effect to regulate the inflammatory reactions. Methods: This experimental study was carried out on 48 rats in 6 groups (48 rats were divided into 6 groups) during the first 6 months from January 2015 to July 2016 in the laboratory of microbiology and animal of Hamedan University of Medical Sciences. The rats were infected through the injection of Brucella melitensis with plenty 5×105 (cfu/ml) of bacteria. After a week, in order to approve the accuracy of the infection in the studied rats inoculated with coombos Brucella melitensis, Wright test, 2-Mercaptoethanol test and Coombs' Wright test were used. The rats were then treated with cupping method in their sacral area. IFN-γ was measured using enzyme-linked immunosorbent assay. And the study of tissues using hematoxylin and eosin (H&E) Staining. Results: The results of this study showed that cupping leads to an increase in the mean serum level of interferon-gamma. The histopathological study of liver tissue showed that the radial arrangement was not observed in the infected group with brucellosis and the cells were acidophilus. While, the radial arrangement was observed in treated rats with cupping, but it was not complete. The number of enlarged sinusoids were reduced. But, cell infiltration was observed. Conclusion: This study showed that cupping can increase serum level of IFN-γ, and thus help to the clearance of disease and improvement of injury in the brucellosis animals lab

The Association Between Computerized Tomography Findings and Ocular Trauma Score in Open Globe Injury: The Prognostic Value of Imaging

PURPOSEThe aim of this study was to evaluate the association between CT findings and Ocular Trauma Score (OTS) in open globe injury. METHODSIn 182 eyes with open globe injury, CT findings were categorized into 5 major types: scleral irregularity with decreased globe volume, dislocation of the crystalline lens, abnormal vitreous density, thickening of the chorioretinal layer, and intraocular foreign body/air. Association between different types and number of CT findings with OTS stages were evaluated through a multivariate analysis. RESULTSMean age of the patients was 38 ± 8.5 years. The most common CT findings were severe scleral irregularity or globe collapse (71.9%) and abnormal vitreous density (56%). The most common OTS stages were II (44.5%) and I (30.7%). In multivariate analysis, abnormal vitreous density (odds ratio [OR] = 2.11, p < 0.001), chorioretinal thickening (OR = 1.89, p < 0.001), and intraocular foreign body/air (OR = 1.58, p = 0.001) were associated with more advanced OTS stages (I or II). Mean OTS in eyes with 1, 2, and 3 CT findings were 66 (stage III), 47 (stage II), and 37 (stage I), respectively (p value = 0.008). Presence of 2 (OR = 2.46, p < 0.001) and 3 (OR = 2.92, p < 0.001) CT findings were associated with more advanced OTS stages (I or II). CONCLUSIONSThe type and number of CT findings may help to predict the OTS stage and visual prognosis in eyes with open globe injury

Condensation heat transfer and pressure drop characteristics of Isobutane in horizontal channels with twisted tape inserts

The enhancement of heat transfer rate in heat exchangers has been considered a major concern. In this research, the impacts of inserting twisted tapes in horizontal two-phase flow heat exchangers are discussed, and different values of vapor qualities (in the range of 0.1 to 0.7) and mass velocities (in the range of 119 to 367 kgm−2s−1) are considered during forced convective condensation of R600a (Isobutane). The test case is a pipe made from copper with an inner diameter of 8.1 mm and a length of 1000 mm. Furthermore, three twisted tape inserts with various twist ratios (defined as the ratio of the twisted tape pitch to the test pipe inner diameter) of 4, 10, and 15 are used. The results illustrated that installing twisted tapes results in the increment of pressure drops and the rate of heat transfer in comparison to the smooth case. Furthermore, the pressure drops and heat transfer rates augment as the refrigerant mass velocity and vapor quality increase. Depending on the inserts type and operating conditions, the performance factor (a criterion to assess the performance modification compared to the primary test case) between 0.39 to 1.05 was obtained. It was also observed that there exists an optimum amount of the refrigerant mass velocity at which the performance factor is higher. Results showed that generally using twisted tapes in heat exchangers is not instrumental unless when the main concern is to improve the heat transfer rate or when the augmented power consumed by pump can be justified