Identification of Candida Species Associated with Blood Infection by Multiplex PCR and Phenotypic Characteristics

Background and Aim: The correct identification of Candida species is one of the most critical procedures in prognostic and therapeutic significance, allowing an early and appropriate antifungal therapy. This study aimed to evaluate multiplex PCR as a rapid diagnostic method and traditional phenotypic tests in identifying Candida species isolated from candidemia cases. Methods: In this study, 38 Candida spp were isolated from culturing of human blood obtained from patients suspected to candidemia. The isolated species were evaluated by phenotypic and molecular methods including carbohydrate assimilation test, colony colour on CHROMagar Candida, chlamydoconidia production, germ tube formation and Multiplex PCR. Multiplex PCR was performed using specific primers of 4 common species. The results of multiplex PCR were compared with those obtained from phenotypic tests. Results: According to multiplex PCR findings, the isolated Candida species were identified as C. albicans, C. parapsilosis, C. glabrata, and C. tropicalis. Phenotypic tests identified that 23 (60.52%), 8 (21.05%), 5 (13.15%), and 2 (5.26%) isolates belonged to C. albicans, C. parapsilosis, C. glabrata, and C. tropicalis, respectively, that were confirmed by multiplex PCR results. C. albicans and C. parapsilosis had the same carbohydrate assimilation pattern but were differentiated based on their colonies color on CHROMagar and the ability of C. albicans to produce chlamydoconidia and germ tube. C. glabrata (100%) and C. tropicalis (100%) assimilated trehalose and cellobiose, respectively. Conclusion: Our study showed that the both phenotypic and molecular techniques provide appropriate information for identification of Candida spp from blood samples. *Corresponding Author: Masoomeh Shams-Ghahfarokhi; Email: [email protected]; ORCID ID: 0000-0003-2562-965X Please cite this article as:  Fallah B, Shams-Ghahfarokhi M, Salehi M. Identification of Candida Species Associated with Blood Infection by Multiplex PCR and Phenotypic Characteristics.  Arch Med Lab Sci. 2023;9:1-9 (e1). https://doi.org/10.22037/amls.v9.3840

Impact of Ethical Leadership on Missed Nursing Care: A Cross‐sectional Study from Nurses\' Perspective

Background and Objective: Missed nursing care is a global concern. Nursing managers, using leadership skills, have a prominent role in preventing missed nursing care. Ethical leadership is one of the leadership approaches. The present study aimed to describe the impact of ethical leadership perceived by nurses on missed nursing care in 2021. Materials and Methods: In this descriptive correlational study, 230 nurses working in internal medicine and surgery units were selected through a stratified proportional sampling method from two hospitals affiliated with Yazd University of Medical Sciences, Yazd, Iran. Questionnaires on “ethical leadership in nursing” and “missed nursing care” were the data collection tools. Descriptive and inferential statistics were performed for data analysis using SPSS (version 16). Results: The mean score of missed nursing care and perceived ethical leadership was 47.54 ± 2.83 and 109.08 ± 10.75, respectively. The most missed nursing care, in the dimensions of assessment, individual needs, basic care, and planning, were "focused reassessment according to patient’s condition", "emotional support for patient/family", "supervision on feeding patient when the food is still warm", and "attending interdisciplinary care conferences", respectively. The results showed a significant inverse relationship between perceived ethical leadership and missed nursing care (P<0.05). The regression analysis revealed that among the dimensions of ethical leadership, the ethical-oriented dimension can be considered a negative predictor of missed nursing care. Conclusion: Implementing ethical leadership is one of the practical strategies to decrease missed nursing care. The participation and performance of nursing managers in this process are critical to a successful outcome

Churg-Strauss syndrome following cessation of allergic desensitization vaccination: a case report

<p>Abstract</p> <p>Introduction</p> <p>Churg-Strauss syndrome is a vasculitis of medium to small sized vessels. Diagnosis is mainly clinical with findings of asthma, eosinophilia, rhinosinusitis and signs of vasculitis in major organs.</p> <p>Case presentation</p> <p>We present a case of a 19-year-old Persian male who developed signs and symptoms of this syndrome related to hyposensitization treatments for allergy control.</p> <p>Conclusions</p> <p>No unifying etiology for the disease can be presented as it is found associated with environmental factors, medications, infections and is even considered a variant of asthma with predisposition to vasculitic involvement. Therefore, it is important to recognize this disease and be aware of underdiagnosis because of emphasis on pathologic evidence. Here, we present a case of allergic desensitization causing Churg-Strauss syndrome in the absence of other known factors.</p

Churg Strauss Syndrome after Polypectomy in Asthmatic and Allergic Patients

Churg Strauss Syndrome (CSS) is a form of primary vasculitis that is characterized by severe eosinophilia and often granulomatous inflammation as well as history of asthma or allergy. Previously, the association between cysteinyl leukotrien receptor antagonists (LTRAs), corticosteroid withdrawal or a sudden change in its used method and CSS had been established. We report three cases that have been referred because of dyspnea, wheezing and cough with a history of allergic rhinitis and nasal polypectomy. After polypectomy, disseminated skin purpuric rashes appeared on their forelegs, abdomen and all of them had experienced neuropathic signs in their extremities. Clinical findings, marked eosinophilia in blood and skin biopsies finally led to the diagnosis of CSS. The patients have been free of symptoms after receiving prednisolone; routine examinations and blood tests have rended regular results. Here, we report a probable occurrence of an association between nasal polypectomy and CSS on the basis of our findings. Further, extended researches are required to establish this correlation

A framework of antecedents for the development of rural cooperatives

Context and purpose. This study aimed to present the framework of rural cooperative development antecedents. Methodology/approach. The approach of the present research is mixed, based on the applied purpose and exploratory in terms of data collection. The statistical population in both of qualitative and quantitative stages include experts in the field of agriculture and rural cooperatives, including managers and experts of rural cooperatives as well as managers and active members of rural cooperatives. The sampling method is purposive in qualitative stage and convenient in the quantitative stage. In the qualitative stage, semi-structured interview tools were used and the interviews continued until the theoretical saturation (26 people) was reached and theme analysis technique has also been used to analyze the data. In the quantitative stage, a questionnaire was used to collect data so that 40 questionnaires were distributed among the statistical sample and the weighted average technique was used to prioritize the topics. Findings and conclusions. Findings show that the development background of rural cooperatives can be classified into four general dimensions: individual-cognitive development, inclusive institutional development, multiple capacity building and endogenous synergy. As a result and based on the research findings, the most important preconditions for the development of rural cooperatives include thirteen components: psychological development, collaborative space development, performance management, empowerment, institutional-government development, awareness and education, financial support, infrastructure-technical capability, systems upgrading, marketing and sales, supply chain management, local development And knowledge of the interior and surroundings.Originality. Previous studies mainly in the field of pathology of rural cooperatives

Palliative Care in Neonatal Intensive Care Units: Challenges and Solutions

Palliative care is a series of actions aiming to offer support to parents and their infants in order to improve their quality of life. Despite optimal outcomes, the provision of palliative care for infants and achieving these outcomes may be hardly feasible. The present study aimed to investigate the barriers to palliative care and gain insight into the solutions. Accordingly, the obstacles were identified and classified into three categories of parent-related barriers (parental request for continuing treatment, cultural background, and religious beliefs), barriers concerning healthcare providers (attitude toward palliative care, death, and life values, religious beliefs, knowledge and skills in palliative care, and ethical distress), and barriers within the healthcare system (unclear policies regarding the implementation of palliative care, inadequate support from caretakers, lack of educational programs, insufficient personnel, unprepared environment, lack of technological requirements, and lack of access to consultants). Each category was discussed, and relevant solutions were provided

Poisoning in children and adolescents in Kermanshah city, Iran

Abstract Background Poisoning among children and adolescents is a public health problem worldwide. To take preventive measures, the pattern of this problem should be determined. This study aimed to describe the demographic characteristics of poisoning in children and to investigate the relationship between the types of poisoning and demographic factors in children in Kermanshah province. Methods This cross-sectional, descriptive-analytical study was conducted on 250 children and adolescents under 18 years of age who were referred to Mohammad Kermanshahi Pediatric Hospital in Kermanshah province due to poisoning during 2019–2022. The demographic and epidemiological data of patients were extracted from their medical files and analyzed. Results Out of 250 cases of poisoning, 173 (69.2%) cases were unintentional, 96 (55.5%) of whom were boys. Further, 77 (30.8%) cases of poisoning were intentional, of whom 49 (63.6%) were girls. There was a significant difference between gender and intentional and unintentional poisonings (p-value = 0.005). The median age of unintentional poisoning was 3 (IQR = 2.5) and that of intentional poisoning was 14 (IQR = 2). Most cases of poisoning were in cities, 145 (83.8%) of them were unintentional and 66 (85.7%) were intentional. Most cases of intentional and unintentional poisonings occurred in spring 2017 (35.1%) and autumn 2016 (34.6%), respectively. The most common causes of poisoning were narcotics (n = 36, 34.3%) and drugs (n = 35, 33.3%) in the age group 0–3 years and drugs (n = 46, 66.9) in the age group 11–18 years. Conclusions The most common causes of poisoning were narcotics and drugs in children and drugs in adolescents. To prevent poisoning in children, parents are required to increase their knowledge of the safe storage of narcotics and drugs, such as not storing methadone in a water bottle. Targeted evaluation and preventive measures are also needed in adolescent poisoning

Comparison of clinicoradiologic manifestation of nonspecific interstitial pneumonia and usual interstitial pneumonia/idiopathic pulmonary fibrosis: A report from NRITLD

<b>Background: </b> Ever since Katzenstein and Fiorelli introduced the term nonspecific interstitial pneumonia (NSIP) to denote those cases of interstitial pneumonia that cannot be categorized as any of the other types of idiopathic interstitial pneumonias (IIP), there has been continuing debate on whether it is a real clinical entity or not. The American Thoracic Society/European Respiratory Symposium task group tried to identify idiopathic NSIP as a separate disease and exclude it from the category of IIP. However, it appears that the clinical presentation of NSIP and usual interstitial pneumonia (UIP) are the same. <b> Objective :</b> To show that the radiologic features of NSIP and UIP should be relied upon, instead of clinical presentation and pathologic findings, to differentiate between the two. <b> Materials and Methods:</b> Consecutive patients who had received a diagnosis of either NSIP or UIP on the basis of open lung biopsy between January 2001 and December 2007 were identified for inclusion in this retrospective review. The study included 61 subjects: 32 men and 29 women with a mean age of 59.39 &#x00B1; 14.5 years. Chest computed tomography images of all the cases were collected for a review. High resolution computed tomography (HRCT) and all pathologic specimens were also evaluated. A weighted kappa coefficient was used to evaluate whether radiology can be used instead of biopsy for the diagnosis of NSIP and UIP. Comparison of the mean ages and the time intervals (i.e., interval between symptom onset and the time of diagnosis) in the UIP and NSIP groups was done using the Mann-Whitney U test. Association between gender and biopsy result was evaluated by the Fisher exact test. Data were evaluated using SPSS, v.13. <b> Results :</b> Sixty-one patients were included in this study, 32 were male and 29 were female. On the basis of biopsy findings, 50 (82&#x0025;) patients had UIP and 11 (18&#x0025;) had NSIP. Thirty (60&#x0025;) of the 50 patients who had UIP were male and 20 (40&#x0025;) were female; 2 (18.2&#x0025;) of the 11 patients who suffered from NSIP were male and 9 (81.8&#x0025;) were female. Based on HRCT findings, 36 (60&#x0025;) patients were diagnosed to have UIP and 24 (40&#x0025;) were diagnosed with NSIP. When diagnosis was based on biopsy findings, the time interval in the UIP group was 13.59 &#x00B1; 8.29 months and in the NSIP group it was 7.90 &#x00B1; 4.18 months. When diagnosed on the basis of HRCT findings, the time interval in the UIP group was 14.22 &#x00B1; 8.94 months and in the NSIP group it was 10.54 &#x00B1; 5.78 months. When diagnosis was on the basis of biopsy, the mean age in the UIP group was 61.30 &#x00B1; 14.18 years and in the NSIP group it was 50.73 &#x00B1; 13.14 years. <b> Conclusion :</b> HRCT can be used instead of invasive methods like lung biopsy to differentiate between UIP and NSIP

The antagonistic effects of Candida parapsilosis on the growth of Fusarium species and fumonisin production

Background and Purpose: Fusarium species are avid producers of secondary toxic and carcinogenic metabolites such as fumonisin. Contamination of food and feed products with fumonisin can be hazardous to the health of humans and animals and may lead to agricultural loss. Accordingly, in this study, we aimed to evaluate the effects of Candida parapsilosis on the growth and fumonisin production of Fusarium species Materials & Methods: Mycelial growth rate of 26 Fusarium isolates, including F. verticillioides (n=6), F. proliferatum (n=18), F. solani (n=1), and F. oxysporum (n=1), in the presence of 42 C. parapsilosis strains was investigated by pourplate method. The decline in fumonisin production was measured in co-cultured fungi in coarsely ground maize after four weeks of incubation in the dark at 22&deg;C, using ELISA technique. For data analysis, paired t-test was performed, using SPSS version 20 Results: The mycelial growth and fumonisin production of Fusarium isolates significantly decreased in the presence of C parapsilosis in comparison with the control cultures (P<0.05). The percentage of mycelial growth inhibition ranged from 56.36% to 74.54%. The minimum and maximum decline in total fumonisin production was 12% and 78%, respectively F. oxysporum and F. solani were found to be minor fumonisin producers among the studied Fusarium species. On the other hand, a decline was reported in the growth of Fusarium species and fumonisin production in the presence of C parapsilosis Conclusion: C. parapsilosis showed notable inhibitory activities against Fusarium isolates. Therefore, this fungal species could be considered as a biocontrol agent against the growth and fumonisin production of toxigenic Fusarium species in the futur