Multi-Drug Resistance Patterns in Bacteria Isolated from Various Sources upon Common Related Virulence Factors by PCR in Iran

Background: The current study was conducted to investigate the frequency of resistance in the bacteria isolated from various sources, in Shiraz, Iran. Acquisition of new resistance genes is an important factor in the increasing incidence of resistant strains. A critical feature of resistance gene transfer is their stability to adapt rapidly to a new host and make serious consequences. Methods: A total of 520 samples were chosen from human and animal sources in order to investigate the frequency of antibiotics resistance mobile genes using PCR assay. Results: The rates of 70%, 52%, 16.5%, 8.5%, 8%, 4%, 9.2% and 6.8% were confirmed for several genes including tetO, tetA, tetB, tetM, tetR, gyrA, blaz, and blaSHV, respectively. Our results have revealed a pool of mobile genetic elements in the bacteria isolated from various sources in Iran. Conclusion: Our findings indicated un-regulated use of antibiotics in the food production chains which require more investigation

The association between early maladaptive schemas and glycaemic control in patients with type 2 diabetes mellitus: A cross‐sectional study

Abstract Introduction Diabetes is a disease with high prevalence and causes heavy economic burden. Mental and physical health are tied together and their interaction determines one's health or sickness. Early maladaptive schemas (EMSs) are suitable indicators of mental health. We investigated the association between EMSs and glycaemic control in type 2 diabetes mellitus (T2DM) patients. Methods We conducted a cross‐sectional study in 2021 on 150 patients with T2DM. We used two questionnaires a demographic data questionnaire, and a Young Schema Questionnaire 2 – Short Form for gathering the data. We also performed laboratory tests on our participants and used the results of fasting blood sugar and haemoglobin A1c to evaluate glycaemic control. Results Most of our participants were females (66%). Most of our patients were 41–60 years old (54%). There were only three single participants, and 86.6% of our individuals did not have a university degree. Total mean ± SD for EMSs score was 192.45 ± 55.66; self‐sacrifice (19.09 ± 4.64) and defectiveness/shame (8.72 ± 4.45) had the highest and lowest EMSs scores, respectively. None of the demographic data had any significant impact on EMSs scores or glycaemic control, but generally, younger patients with higher levels of education had better glycaemic control. Participants with higher scores for defectiveness/shame and insufficient self‐control had significantly worse glycaemic control. Conclusion Mental and physical health are tied together, and paying attention to psychological aspects in prevention and management of physical disorders is crucial. EMSs, especially defectiveness/shame and insufficient self‐control are associated with glycaemic control of T2DM patients

Simultaneous endobronchial and mediastinal mucormycosis in a patient with Diabetes Mellitus and SARS-CoV-2: A case report and literature review

Background: Mucormycosis can be lethal in people with immunocompromising conditions, especially Diabetes Mellitus. Correction of the underlying disorders, instant initiation of antifungal therapy, and surgical resection are the main components of treatment. Herin, we present the successful medical management of Mucormycosis in a patient with Diabetic Ketoacidosis and positive SARS-CoV-2 test who presented with a less seen condition: the simultaneity of mediastinal mass on one side and an endobronchial mass on the other. Case presentation: An 18-year-old male with a history of insulin-dependent DM from 4 years ago presented to our hospital with sudden onset dyspnea, chest pain, sore throat, hoarseness, cough, and sputum. Also, we detected unilateral swelling in the neck and multiple lymph nodes in the neck. Lung auscultation revealed bilateral generalized wheezing. Primary laboratory tests detected high blood sugar, metabolic acidosis, positive urine ketone, high ESR, positive CRP, and leukocytosis; his polymerase chain reaction (PCR) for SARS-CoV-2 was positive. Chest X-ray showed left upper lobe consolidation. Computed tomography scan (CT-scan) of the chest revealed a large collapse consolidation in the left lung, mild left side pleural effusion, mediastinal lymphadenopathy, and distention in the esophagus. With suspicion of malignancy, we performed flexible bronchoscopy and endobronchial Ultrasound (EBUS) which revealed a creamy tumoral lesion in the right main bronchus. The biopsy was consistent with Mucormycosis. We successfully treated Mucormycosis with Amphotericin-B liposomal. Conclusion: Mucormycosis can mimic the clinical characteristics of malignancy, and emphasize the importance of considering appropriate differential diagnoses because timely diagnosis and treatment is potentially life-saving in Mucormycosis

Kawasaki disease in children: a retrospective cross-sectional study

Introduction Kawasaki disease (KD) is a systemic vasculitis, seen mostly in children. Epidemiology of KD is dependent on geographical location and seasonality. Although many years have passed since the first report of KD, multiple related factors are still unknown. Material and methods We investigated the clinical, paraclinical, and therapeutic aspects of KD in Kerman, Iran by performing a retrospective, descriptive, cross-sectional study on all children hospitalized due to KD between 2007 and 2020. Results A total of 340 patients with mean ±SD age of 29.83 ±22.55 months participated in the study. Most of our patients were two to five years old. The male : female ratio was ~ 1.4 : 1. A few of our patients had a family history of KD or vasculitis (0.3%, 1.7%). Typical KD was more common by a large margin (316 patients with typical KD). More than half of our patients had a duration of hospitalization of under ten days. All of our patients were febrile. Hand/foot and lip/mouth changes were the second and third most common clinical findings in more than 60% of our patients. Other manifestations were conjunctivitis in 40%, skin rashes in 34.8%, gastrointestinal manifestations in 33.9%, and lymphadenopathy in 25.3%. Echocardiography revealed abnormalities in 78.6% of the participants; coronary artery aneurysm (CAA) was the most frequent (22.5%) and follow-up echocardiography revealed that all of them regressed within 6 months after treatment. The two laboratory tests with the highest ratio of abnormality were erythrocyte sedimentation rate (95%) and hemoglobin (83.3%). C-reactive protein and liver function tests were also abnormal in most patients. All of our patients received intravenous immunoglobulin and acetylsalicylic acid. Conclusions Kawasaki disease must be considered in every febrile child, especially those with risk factors, because timely diagnosis and treatment are essential to prevent complications. Health policies should focus on appropriate diagnosis and treatment to prevent the occurrence of sequelae

Modified genome comparison method: a new approach for identification of specific targets in molecular diagnostic tests using Mycobacterium tuberculosis complex as an example

Abstract Background The first step of designing any genome-based molecular diagnostic test is to find a specific target sequence. The modified genome comparison method is one of the easiest and most comprehensive ways to achieve this goal. In this study, we aimed to explain this method with the example of Mycobacterium tuberculosis complex and investigate its efficacy in a diagnostic test. Methods A specific target was identified using modified genome comparison method and an in-house PCR test was designed. To determine the analytical sensitivity and specificity, 10 standard specimens were used. Also, 230 specimens were used to determine the clinical sensitivity and specificity. Results The identity and query cover of our new diagnostic target (5KST) were ≥ 90% with M. tuberculosis complex. The 5KST-PCR sensitivity was 100% for smear-positive, culture-positive and 85.7% for smear-negative, culture-positive specimens. All of 100 smear-negative, culture-negative specimens were negative in 5KST-PCR (100% clinical specificity). Analytical sensitivity of 5KST-PCR was approximately 1 copy of genomic DNA per microliter. Conclusions Modified genome comparison method is a confident way to find specific targets for use in diagnostic tests. Accordingly, the 5KST-PCR designed in this study has high sensitivity and specificity and can be replaced for conventional TB PCR tests