The impact of public partnership to identify patients with tuberculosis in Darashar, Iran

Background and objective: Participation of community-based services in the National Tuberculosis Control Programme is (NTCP) necessary to identify and treat all patients with tuberculosis (TB). We developed a novel model to encourage family members and relative to participate in the RNTCP in Darahshar city. Methods: This community-based intervention was included of two groups of community (relatives of patients and schools). They were trained to identify and refer of patients to allocated health centers. Case finding indices were compared initially and one year intervention. The exponential distribution and logarithmic of incidence were used to compare the incidence of tuberculosis after the intervention with other cities of the province. Results: The incidence of smear positive cases increased from 5.1/100,000 to 35.2/100,000 (p <001). There was a statistically significant difference between incidence of smear positive cases in Darehshar city and other cities in Ilam province (p <001). During the intervention, 408 suspected patients was identified, it showed about 297 percent increased in case finding (cases in the previous year of the intervention were 137 cases) (p <001). Conclusion: It seems that community-based intervention could be an effective method to enhance of identify and control of patients with tuberculosis

Addressing uncertainty in atomistic machine learning

Machine-learning regression can precisely emulate the potential energy and forces of more expensive electronic-structure calculations, but to make useful predictions an assessment must be made of the prediction's credibility.</p

Prevalence of metallo-beta-lactamase enzyme and patern of antibiotic resistance in Klebsiella pnomoniae isolated from patients with urinary tract infection in Qom city during 2013-2014

Bachground: Klebsiella pnomoniae is one of the most important etiologic agents of urinary tract infection (UTI). An increasing occurrence of antimicrobial resistance among uropathogenic bacterial isolates has complicated the treatment process. The aim of this study was to determine antibiotic susceptibility patterns and prevalence of the metallo-beta-lactamase enzyme of K. pneumoniae isolates collected from UTI. Materials and Methods: This cross-sectional study was conducted on patients with complicated UTI reffered to hospitals in Qom city, Iran. A total of 1807 culture positive samples of pathogens were collected from the patients, among which 457 isolates were K. pneumoniae. The isolates were tested for antimicrobial susceptibility by the disc-diffusion method recommended by the guidelines of Clinical and Laboratory Standards Institute (CLSI 2013). In addition, the dubble disk synergy test was used to detect the K. pneumoniae isolates of metallo-beta-lactamase enzyme. Results: The prevalence of UTI infection due to K. pneumoniae was 25.3. Among 1807 positive urine cultures, 62.4 were from females and 37.6 from males. Results of antimicrobial susceptibility showed that the highest antibiotic resistance was seen for trimetoprium-sulfametoxazole (98.5) and the lowest resistance levels were seen for amikacin (9.4), meropenem (22.8) and imipenem (25.6). The results of the imipenem-EDTA combined disk showed that 93.2 imipenem resistance isolates were positive for the metallo-beta- lactamase enzyme. Conclusion: Carbapenem resistance and production of the metallo-beta-lactamase enzyme in K. pneumoniae uropathogenic are increasing. However, amikacin is still effective against these bacterial infections and its effectiveness should be maintained

Comparison of culture and microscopic methods by PCR for detection of Mycobacterium tuberculosis in sputum

Background: It is difficult to diagnose Mycobacterium tuberculosis infection due to a lack of rapid, sensitive, and specific tests. Newer methods, which are easy and reliable, are required to diagnose TB at an early stage. Our aim is to evaluate the polymerase chain reaction (PCR) technique, using primers directed against the IS6110 gene, for the detection of M. tuberculosis in the sputum samples, and calculate the sensitivity and specificity of PCR. Patients and methods: A total of 248 sputum samples from patients suspected of mycobacterial diseases were studied. DNA was extracted by boiling method. IS6110 PCR method by a specific pair of primers designed to amplify 123bp and 245bp sequences of the insertion sequence, 6110, in the M. tuberculosis genome was used to analyze sputum samples. Results: Totally, 32 (12.9) samples had positive culture. PCR yielded a sensitivity of 93.8 and specificity of 99.1 for the diagnosis of TB, when diagnosis was confirmed by culture. There were 2 out of 32(6.3) PCR-positive cases among the patients with non-TB disease. Conclusion: We concluded that the performance of an IS6110 PCR assay is valuable in the rapid diagnosis of tuberculosis. © 2009 IDTMRC, Infectious Diseases and Tropical Medicine Research Center

Detection of VIM-1 and IMP-1 genes in Klebsiella pneumoniae and relationship with biofilm formation

Klebsiella pneumoniae is an important human pathogen that is considered in recent years due to nosocomial infections resistant to treatment as well as the ability to form biofilms particularly in patients with urinary tract infection in ICU or hospital. The aim of this study was to evaluate the prevalence of VIM1, IMP1 genes and their ability to form biofilm in K. pneumoniae strains isolated from patients with urinary tract infection. In the study, using culture and biochemical methods, 1807 K. pneumoniae samples were isolated from patients with urinary tract infection hospitalized or referred to hospitals in Qom in 2013–2014. For isolation of MBL producing isolates, Double Disk Synergy Test (DDST) was used. Then MBL positive isolates were examined for the presence of VIM1, IMP1 genes using PCR method. Furthermore, all strains were investigated for biofilm formation by phenotypic microplate method. From 3165 urine samples cultured, 1807 isolates of K. pneumoniae were isolated and 109 strains (93.2%) were positive for MBL enzymes production. PCR results showed that the prevalence of VIM1 and IMP1 genes are 15.6 and 6.4%, respectively. The Phenotypic method indicated that 91.2% of isolates formed biofilm. Biofilm formation in K. pneumoniae isolates is high and there is a significant relationship between strong biofilm formation and prevalence of VIM1 and IMP1 genes. Also due to the presence of MBL genes in K. pneumoniae and horizontal transfer of genes to other bacteria, and to control the indiscriminate use of antibiotics, the hospital infection control methods must be considered

ATTRIBUTION OF MENTAL DISORDERS IN SUICIDE OCCURRENCE

The present study aimed to determine attribution of mental disorders in suicide occurrence. By a cross-sectional study, all suicide records (n = 5188), between 1993 and 2009 in Ilam province, were investigated. Multiple logistic regression analysis was adopted. Totally, 27.5 of the suicides occurred due to mental disorders. This was significantly higher in males (29.3), individuals born in 1996(44) and 1990s (30.3), those aged 30 years and above (33.2) and suicide attempters (28.3), respectively and separately. The risk of suicide due to mental disorders was observed for females (OR = 0.85, CI = 0.74-0.97), those born in 1994 (OR = 2.82, CI = 1.27-6.24), completed suicides (OR = 0.81, CI = 0.68-0.97) and the age group 25 to 29 years old (OR = 0.82, CI = 0.66-1.01). Suicide due to mental disorders was higher among males compared to females, the rate of which was directly proportional to attempted suicide and age. It is therefore recommended that health educations be seriously carried on targeted groups

Modeling of Whole Genomic Sequencing Implementation using System Dynamics and Game Theory

Biomarker testing is a laboratory test in oncology that is used in the selection of targeted cancer treatments and helping to avoid ineffective treatments. There exist several types of biomarker tests that can be used to detect the presence of particular mutations or variation in gene expression. Whole Genome Sequencing (WGS) is a biomarker test for analyzing the entire genome. WGS can provide more comprehensive diagnostic information, but it is also more expensive than other tests. In this study, System Dynamics and Game Theoretic models are employed to evaluate scenarios, and facilitate organizational decision making regarding WGS implementation. These models evaluate the clinical and economic value of WGS as well as its affordability and accessibility. The evaluated scenarios have covered the timing of implementing WGS using time to diagnosis and total cost.Comment: The IISE Annual Conference & Expo 202