Comparative study evaluating efficacy of sufentanil versus midazolam in preventing myoclonic movements following etomidate

Background and Aims: Myoclonus is a major side-effect following etomidate injection requiring use of medical intervention. Material and Methods: In this double-blinded clinical trial, 50 consecutive patients, randomly received sufentanil 0.2 μg/kg or midazolam 0.015 mg/kg, 90 s before induction of anesthesia with etomidate (0.3 mg/kg). Then, the patients were monitored for any myoclonic movements during anesthesia. Results: The incidence of myoclonus was 28% in the sufentanil group and 84% in the midazolam group. The frequency and intensity of myoclonus were significantly higher in the midazolam group, compared to the sufentanil group (P < 0.001). Myoclonus duration in the sufentanil and midazolam groups were 5.8 ± 13.2 and 69 ± 47.8 s, respectively (P < 0.0010). Conclusion: The frequency, intensity and duration of myoclonus in the midazolam group, were significantly more prevalent than the sufentanil group

Cluster of Middle East Respiratory Syndrome Coronavirus Infections in Iran, 2014

During January 2013–August 2014, a total of 1,800 patients in Iran who had respiratory illness were tested for Middle East respiratory syndrome coronavirus. A cluster of 5 cases occurred in Kerman Province during May–July 2014, but virus transmission routes for some infections were unclear

Implementation of a National Measles Elimination Program in Iran: Phylogenetic Analysis of Measles Virus Strains Isolated during 2010–2012 Outbreaks

<div><p>Measles virus (MV) causes small and large outbreaks in Iran. Molecular assays allow identifying and the sources of measles imported from neighboring countries. We carried out a phylogenetic analysis of measles virus circulating in Iran over the period 2010–2012. Specimens from suspected cases of measles were collected from different regions of Iran. Virus isolation was performed on urine and throat swabs. Partial nucleoprotein gene segments of MV were amplified by RT-PCR. PCR products of 173 samples were sequenced and analyzed. The median age of confirmed cases was 2 years. Among all confirmed cases, 32% had unknown vaccination status, 20% had been vaccinated, and 48% had not been vaccinated. Genotypes B3 and D8 (for the first time), H1 and D4 were detected mainly in unvaccinated toddlers and young children. Genotype B3 became predominant in 2012 and was closely related to African strains. H1 strains were also found in small and large outbreaks during 2012 but were not identical to Iranian H1-2009 strains. A majority of the Iranian D4 strains during 2010–2012 outbreaks were linked to the D4 strain identified in the Pakistan in 2007. We identified a single case in 2010 belonging to D8 genotype with 99.7% identity to Indian isolates. Although the vaccination program is currently good enough to prevent nationwide epidemics and successfully decreased measles incidence in Iran, the fraction of protected individuals in the population was not high enough to prevent continuous introduction of cases from abroad. Due to increasing number of susceptible individuals in some areas, sustained transmission of the newly introduced viral genotype remains possible.</p></div

Measles, number of cases by age group and vaccination status, Iran, 2010–2012 (n = 173).

<p>Measles, number of cases by age group and vaccination status, Iran, 2010–2012 (n = 173).</p

Phylogenetic analysis of all Iranian H1 strains (C-terminus of N gene) during 2010–2012 with the H1 reference sequence and other wild-type measles genotype H1 detected in other countries.

<p>Bootstrap values (1,000 replicates) >70% are indicated. 2012- Iranian H1 strains are indicated by dark rhombic. 2009- Iranian H1 strains are indicated by dark circle. Reference strains are shown by dark triangles. Scale bar indicates base substitutions per site.</p

Phylogenetic tree of the C-terminus of N gene sequences of 63selected wild-type measles isolates from Iran compared to the reference sequences for each genotype.

<p>The Iranian sequences are belonged to B3, D8, D4 and H1 genotypes during 2010–2012. Bootstrap values (1,000 replicates) >70% are indicated. Closely related reference sequences to the Iranian strains are shown by dark rhombic. Scale bar indicates base substitutions per site. Accession numbers of WHO reference sequences are: Genotype A (U01987), B1 (U01998), B2 (U01994), B3.1 (AJ232203), B3.2 (L46753), C1 (AJ232203), D3 (U01977),D4 (U01976), D6 (L46750), D8 (AF280803), D9 (AF481485), D10 (AY923185), E (X84879), F(X84865), G1(U01974), G2(AF171232), G3(AY184217), H1(AF045212), H2(AF045217).</p

Age distribution of measles cases related to geographical location, Iran, 2010–2012 (n = 173).

<p>Age distribution of measles cases related to geographical location, Iran, 2010–2012 (n = 173).</p