Prevalence rate of cytomegalovirus infection in individuals with and without systemic lupus erythematosus

Background: The role of cytomegalovirus (CMV) infection in triggering or exacerbating systemic lupus erythematosus (SLE) remains a subject of debate. The aim of this study was to compare the prevalence rate of CMV infection between individuals with and without SLE. Materials and Methods: This cross-sectional comparative study recruited 52 consecutive patients with SLE (based on the criteria determined by the Systemic Lupus Collaborating Clinics, 2012) and 52 healthy subjects. The exclusion criteria were immunodeficiency and other background diseases. CMV infection was assessed according to serology (enzyme-linked immunosorbent assay) and polymerase chain reaction (PCR). Results: Immunoglobulin G (IgG) was positive in all participants. Immunoglobulin M (IgM) was positive in eight SLE patients (15.4%) and none of the controls (p = 0.003). The PCR was positive in four SLE patients (7.7%) and none of the controls (p = 0.041). IgM level was not related to age, gender, literacy, marital status, family history, SLE disease activity index (SLEDAI), or duration of the disease (p > 0.05). Conclusion: According to this study, CMV infection was higher in SLE patients but was not related to the type of organ involvement, type of immunosuppressive drug, or SLEDAI. &nbsp

Assessing the efficacy of 10% oral dextrose in reducing pain in infants during venipuncture: A randomized controlled clinical trial

Background: Available evidence on the efficacy of sweet solutions for reducing pain in infants is insufficient. This study aimed to assess the effects of 10% oral dextrose on the pain of infants during venipuncture. Methods: This randomized controlled clinical trial was done on 60 infants undergoing venipuncture. Eligible infants were randomly assigned into an intervention and control group. Two minutes before venipuncture, 2 ml of 10% oral dextrose solution and 2 ml of water were given to the intervention and control groups, respectively. The infants' pain intensity during the procedure was measured by two independent experts based on the Face, Legs, Activity, Cry, and CONSOL ability Behavioral Pain Scale. Data were analyzed using independent t-test and ANOVA tests. A P-value of ≤0.05 was considered statistically significant. Results: The mean (±standard deviation) age of infants in the intervention and control groups were 6.37 (2.96) and 9.03 (3.10) months, respectively (P0.05). In addition, the standardized mean difference in pain score between the two groups was -0.2 (95% confidence interval: -0.30 to 0.71). Despite a significant difference (P=0.003) in the pain score between females and males, the effect of intervention after gender effect correction was not statistically significant. Conclusion: Using 2 ml of 10% oral dextrose 2 minutes before venipuncture has a weak and non-significant effect on the pain of infants. Based on the effect size and 95% confidence interval, conducting further trials with a larger study population is recommended

Serum Inflammatory Markers in the Elderly: Are They Useful in Differentiating Sepsis from SIRS?

Differentiating sepsis from other noninfectious causes of systemic inflammation is often difficult in the elderly. The aim of this study was to evaluate the ability of C-reactive protein (CRP), Erythrocyte Sedimentation Rate (ESR), procalcitonin (PCT), and Interleukin-6 (IL-6) to identify elderly patients with sepsis. In this single center prospective observational study, we included all consecutive elderly patients admitted with suspected sepsis and systemic inflammatory response syndrome (SIRS) in an emergency department. Blood samples for measuring CRP, PCT, IL-6, ESR and white blood cells (WBC) count were taken at first day of admission. Sensitivity, specificity, positive and negative predictive values were calculated for each inflammatory markers being studied. A total of 150 elderly patients aged 65 and older, 50 with sepsis and 50 with SIRS, and fifty individuals in a normal health status were included. CRP exhibited the greatest sensitivity (98%) and negative predictive value (98.6%) and performed best in differentiating patients with sepsis from those with SIRS. In a receiver operating characteristic curve analysis, IL-6 performed best in distinguishing between SIRS and the control group (AUC 0.75, 95% CI). On the other hand, both CRP and ESR appeared to be a more accurate diagnostic parameter for differentiating sepsis from SIRS among elderly patients

Design of primers for pertussis diagnosis by Real Time PCR and determination of its sensitivity and specificity in comparison with commercial kits.

Background and Aim: Pertussis vaccination in this country has been going on for many years and active infection or vaccination will provide immunity in 85% of cases. However, every 2-5 years outbreaks in unprotected adults creates an epidemy for children and infants. Based on conserved genomic sequences, Real time PCR could be an easy, cost- benefit, fast and highly sensitive method for pertussis detection. Materials and Methods: A total of 170 nasopharyngeal swabs of infants with history of cough for more than 2 weeks were collected. In the first stage, Bordetella pertussis bacteria detection was performed by culture and followed by Real time PCR using a commercial kit and then repeated with newly designed primers. Results: Performance of our home made primers for detecting pertussis using Real Time PCR in comparison with those by commercial kit was acceptable based on diagnostic classical guidance (WHO) and the (CDC). Conclusions: Real time PCR test with new primers in comparison with culture techniques is more suitable, high sensitivity and can provide more informative values for pertussis detection

Need assessment of medical school curriculum for MOOCs: perspectives of instructors and students of Shiraz University of Medical Sciences

Abstract Introduction Designing, developing, and implementing a course without assessing and prioritizing instructional needs may result in inefficiency due to the disregard for the actual needs of the target population. The present study aimed to determine and prioritize medical students’ instructional needs regarding Massive Open Online Courses (MOOCs) at Shiraz University of Medical Sciences. Methods This survey study was carried out in three stages (2020–2021) using the Delphi technique. Purposive and snowball sampling methods were used to select the instructors. The students were selected through simple random sampling. The first round of the Delphi technique involved a questionnaire consisting of one open-ended question, completed by 49 basic/clinical faculty members and 47 senior medical students. In the second round, a 5-point Likert scale-based questionnaire was used to prioritize the instructional needs. The reliability of the questionnaire was verified by Cronbach’s alpha coefficient. In the third round, a focus group was used. A total of six expert faculty members and one senior medical student were invited to the focus group session to prioritize the needs. Data were analyzed using Friedman’s non-parametric ranking test in SPSS version 26. Results Ten instructional needs priorities were extracted, including common pharmacotherapies (antibiotics and narcotics), prescriptions, physiology, anatomy, physical examination, electrocardiography interpretation, radiography, computed tomography scans, serum electrolyte disorders, and cardiovascular and internal (endocrine and metabolic) diseases. The chi-squared calculated value (715.584) indicated a significant difference in the importance of the questionnaire’s questions (P < 0.001). These questions did not have equal value, and the importance, from the respondent’s point of view and the observed distribution of ranks, was not the output of a random factor. Conclusions The findings of this study can be used to design MOOCs, revise instructional programs, and adapt the curriculum to meet the needs of general practitioners, which will, in turn, help meet the medical needs of the general population