High infection of Anaplasma and Ehrlichia spp. among tick species collected from different geographical locations of Iran

Objective: To ascertain the prevalence of the Anaplasma/Ehrlichia infections in tick population within four provinces of Iran. Methods: A total of 384 tick specimens were collected from domestic animals inhabiting in four provinces (East Azerbaijan, Gilan, South Khorasan and Yazd). Specimens were identified based on morphological analysis. The detection of Anaplasma spp./Ehrlichia spp. within tick samples was carried out by nested PCR amplification of the 16S ribosomal RNA gene accompanied by DNA sequencing and analysis for verification. Results: A total of 10 tick species were identified as follows: Ornithodoros lahorensis (O. lahorensis) (44.8), Hyalomma dromedarii (15.6), Dermacentor marginatus (13.5), Hyalomma anatolicum (11.2), Hyalomma asiaticum (5.7), Hyalomma marginatum (4.9), Rhipicephalus sanguineus (2.3), Hyalomma detritum (1.0), Dermacentor niveus (0.5) and Argas persicus (0.3). The percentage distribution of Anaplasma/Ehrlichia was 55.5 (213) across 384 studied ticks. Conclusions: To the best of our knowledge, this is the first report of Anaplasma ovis infection in O. lahorensis in Iran. We also conjecture the prevalence of Ehrlichia spp. in Yazd Province based on sequencing results; also, it is suggested that O. lahorensis is a potential vector in the studied area. This survey highlights the importance of Argasidae family to verify and correlate their threat in causing anaplasmosis and other diseases in animals. © 2016 by the Asian Pacific Journal of Tropical Disease

Construction of an Interface Terminology on SNOMED CT Generic Approach and Its Application in Intensive...

Objective: To provide a generic approach for developing a domain-specific interface terminology on SNOMED CT and to apply this approach to the domain of intensive care. Methods:The process of developing an interface terminology on SNOMED CT can be regarded as six sequential phases: domain analysis, mapping from the domain con - cepts to SNOMED CT concepts, creating the SNOMED CT subset guided by the mapping, extending the subset with non-covered concepts, constraining the subset by removing irrelevant content, and deploying the subset in a terminology server. Results:The APACHE IV classification, a standard in the intensive care with 445 diagnostic categories, served as the starting point for designing the interface terminology. The majority (89.2%) of the diagnostic categories from APACHE IV could be mapped to SNOMED CT concepts and for the remaining concepts a partial match was identified. The resulting initial set of mapped concepts consisted of 404 SNOMED CT concepts. This set could be extended to 83,125 concepts if all taxonomic children of these concepts were included. Also including all concepts that are referred to in the definition of other concepts lead to a subset of 233,782 concepts. An evaluation of the interface terminology should reveal what level of detail in the subset is suitable for the intensive care domain and whether parts need further constraining. In the final phase, the interface terminology is implemented in the intensive care in a locally developed terminology server to collect the reasons for intensive care admission. Conclusions: We provide a structure for the process of identifying a domain-specific interface terminology on SNOMED CT. We use this approach to design an interface terminology on SNOMED CT for the intensive care domain. This work is of value for other researchers who intend to build a domain-specific interface terminology on SNOMED CT

Characteristics of AIDS patients in Dutch intensive care units

Perioperative Medicine: Efficacy, Safety and Outcom

Mental illness, poverty and stigma in India: a case-control study

OBJECTIVE: To assess the effect of experienced stigma on depth of multidimensional poverty of persons with severe mental illness (PSMI) in Delhi, India, controlling for gender, age and caste. DESIGN: Matching case (hospital)–control (population) study. SETTING: University Hospital (cases) and National Capital Region (controls), India. PARTICIPANTS: A case–control study was conducted from November 2011 to June 2012. 647 cases diagnosed with schizophrenia or affective disorders were recruited and 647 individuals of same age, sex and location of residence were matched as controls at a ratio of 1:2:1. Individuals who refused consent or provided incomplete interview were excluded. MAIN OUTCOME MEASURES: Higher risk of poverty due to stigma among PSMI. RESULTS: 38.5% of PSMI compared with 22.2% of controls were found poor on six dimensions or more. The difference in multidimensional poverty index was 69% between groups with employment and income of the main contributors. Multidimensional poverty was strongly associated with stigma (OR 2.60, 95% CI 1.27 to 5.31), scheduled castes/scheduled tribes/other backward castes (2.39, 1.39 to 4.08), mental illness (2.07, 1.25 to 3.41) and female gender (1.87, 1.36 to 2.58). A significant interaction between stigma, mental illness and gender or caste indicates female PSMI or PSMI from ‘lower castes’ were more likely to be poor due to stigma than male controls (p<0.001) or controls from other castes (p<0.001). CONCLUSIONS: Public stigma and multidimensional poverty linked to SMI are pervasive and intertwined. In particular for low caste and women, it is a strong predictor of poverty. Exclusion from employment linked to negative attitudes and lack of income are the highest contributors to multidimensional poverty, increasing the burden for the family. Mental health professionals need to be aware of and address these issues

A randomized, prospective open labeled study of oral amoxicillin-clavulanate and levofloxacin with intravenous ceftriaxone and amikacin in chemotherapy induced low risk febrile neutropenia

Background : We compared the efficacy of oral antibiotics with intravenous antibiotics in low risk febrile neutropenia. Design : A prospective, randomized study Methods: Between April 2004 - December 2005, 55 patients with low risk febrile neutropenia (expected neutropenia duration &#60; 7 days with no co-morbid features) between 15 and 75 years of age, were randomized to receive either oral amoxicillin-clavulanate 625mg twice daily and levofloxacin -500mg once daily OR intravenous (i.v.) ceftriaxone 2g and amikacin 15mg/kg once daily. Most patients were treated on out patient basis. The primary end point was response to therapy, defervescence of fever within 72 hours with improvement in any clinical manifestation of infection and no recurrence of fever for 48 hours without use of antipyretics. Use of growth factors was not permitted except in treatment failure. Results: A total of 64 febrile episodes were recorded (mean 1.20 ); 33 in the IV group and 31 in the oral antibiotics group. Both groups were equally matched for age (median 25 years in the IV group and 19 years in the oral group), gender, type of cancer, baseline absolute neutrophil count (median 200/cmm in both arms) and duration of neutropenia (5 days and 4 days in the IV and oral groups, respectively). A focus of infection was identified clinically in 15% of episodes and microbiologically in 11% of episodes; 57% of which were Gram positive organisms and the rest Gram negative. 72% in the IV arm and 77% in the oral arm responded to therapy (p=ns). One patient in IV group had one episode of seizure. Non-responding patients received second line IV antibiotics. There was no mortality in either group. Age &#62; 60 years, neutropenia lasting &#62; 7 days after the onset of fever and positive blood culture were predictors for lack of response to antibiotics on multivariate analysis. Conclusion: Oral antibiotics have comparable efficacy as IV antibiotics in the management of low risk febrile neutropenia

Immunization Evaluation of Type III Secretion System Recombinant Antigens and Shiga Like Toxin Binding Subunit of E. coli O157:H7

BACKGROUND AND OBJECTIVE: Escherichia coli enterohemorrhagic (EHEC) causes diarrhea, hemolysis colitis, and uremic hemolytic syndrome. Due to the dangers of antibiotic treatment in the EHEC O157: H7 infection, vaccines offer a promising way to prevent infection. The purpose of this study was to investigate the immunity of recombinant proteins Intimin, EspA and Stx2b against infection of E. coli O157 H7. METHODS: In this research study, expression of recombinant Intimin, EspA and Stx2b proteins E.coli BL21 DE3 was induced with IPTG. Recombinant proteins were examined by Western Blot and purified using the affinity Ni-NTA chromatography. Subcutaneous and intraperitoneally immunization of mice was performed and the antibody titer was determined by ELISA. The mice were orally infected with bacteria and the bacterial loss and mortality of the mice were examined. FINDINGS: SDS-PAGE analysis showed expression of proteins with 11,17 and 34 kDa molecular weight. The recombinant proteins were confirmed by Western Blot. ELISA end point titer for humoral response to EspA, Intimin and Stx2b was 25600. The loss of bacteria in mice was 102 cfu / ml and mortality rate were reduced to 60 Percent. CONCLUSION: The results showed that immune response against EspA, Intimin and Stx2b proteins protects animals against challenges using E. coli O157: H7

The Effect of Educating the Use of Developmental Positions of Premature Infants on the Clinical Performance of Neonatal Intensive Care Unit Nurses

BACKGROUND AND OBJECTIVE: One of the early interventions in neurodevelopmental disorders in neonatal intensive care units is providing proper conditions for infants. Premature infants have lost their last three months of life in the uterus, and as a result, have not reached a collapsed status, which is a developmental position that indicates brain growth in the infant. Considering the importance of the neonatal position in developmental positions and achievement of better neural evolution, this study was conducted to implement educational intervention to improve the performance of nurses in order to properly implement the developmental positions of premature infants in neonatal intensive care unit. METHODS: This interventional study was carried out among 85 neonatal intensive care unit nurses in Shahid Akbar-Abadi and Ali Asghar Hospitals in Tehran in three stages. First, the nurses' performance was evaluated regarding the supportive developmental positions of the premature infants in the neonatal intensive care unit through a neonatal assessment tool (IPAT with a maximum score of 12 and a minimum score of 3). Then, nurses were educated by slides and face to face and the performance of nurses was evaluated and compared after the first week after training and two months after the training. FINDINGS: Demographic data showed that the education level of most nurses (98.8%) was bachelor's degree and most nurses (48.2%) were older than 30 years of age. The highest work experience of nurses (42.4%) was in the range of 5–10 years. In addition, the nurses' performance score regarding the supportive developmental position of premature infants in the pre-training stage (5.84±0.03), the first week after training (8.35±1.42) and two months after training (8.71±1.16) had a significant difference (p<0.001). CONCLUSION: Based on the results of this research, educating the use of developmental positions of premature infants has positive effects on the clinical performance of neonatal intensive care unit nurses

Effect of vowel auditory training on the speech-in-noise perception among older adults with normal hearing

Introduction: Aging reduces the ability to understand speech in noise. Hearing rehabilitation is one of the ways to help older people communicate effectively. This study aimed to investigate the effect of vowel auditory training on the improvement of speech-in-noise (SIN) perception among elderly listeners. Materials and Methods: This study was conducted on 36 elderly listeners (17 males and 15 females) with the mean±SD of 67.6±6.33. They had the normal peripheral auditory ability but had difficulties in SIN perception. The samples were randomly divided into two groups of intervention and control. The intervention group underwent vowel auditory training; however, the control group received no training. Results: After vowel auditory training, the intervention group showed significant changes in the results of the SIN test at two signal-to-noise ratios of 0 and -10 and the Iranian version of the Speech, Spatial, and Qualities of Hearing Scale, compared to the control group (P<0.001). Regarding the Speech Auditory Brainstem Response test, the F0 magnitude was higher in the intervention group (8.42±2.26), compared to the control group (6.68±1.87) (P<0.011). Conclusion: This study investigated the effect of vowel auditory training on the improvement of SIN perception which could be probably due to better F0 encoding and receiving. This ability enhancement resulted in the easier perception of speech and its more proper separation from background noise which in turn enhanced the ability of the old people to follow the speech of a specific person and track the discussion. © 2020 Mashhad University of Medical Sciences. All rights reserved