The effect of Bonyan-Method Experiential Marathon Structured Groups (BEMSG) on ego functions

The present research has studied Bonyan-Method Experiential Marathon Structured Groups' efficacy on the nonclinical populations' ego functions. This study was a quasi-experimental trial with a control group. The trial group participated in the marathon group on three consecutive days (36 hours) and weekly sessions for three weeks. Then the ego function evaluation questionnaire was simultaneously given to both groups. All ego functions in the trial group showed significant growth compared to the control group. Among these, the most remarkable statistical effect size was related to "Adaptive Regression in Service of the Ego" and "Stimulus barrier." The relationship between improving ego functions and mental health can be anticipated, and steps can be taken to promote the community’s mental health by using these groups

Effect of COVID-19 on Mortality of Pregnant and Postpartum Women: A Systematic Review and Meta-Analysis

Background. Based on what is known at this time, pregnant women are at an increased risk of severe illness from COVID-19 compared to nonpregnant women. Additionally, pregnant women with COVID-19 might have an increased risk of adverse pregnancy outcomes. To investigate the effects of coronavirus disease 2019 (COVID-19) on mortality of pregnant and postpartum women, we performed a systematic review of available published literature on pregnancies affected by COVID-19. Methods. Web of Science, SCOPUS, and MEDLINE- databases were searched for original studies concerning the effect of COVID-19 on mortality of pregnant and postpartum women published by July 10, 2020. Meta-analyses of proportions were used to combine data and report pooled proportions. Results. 117 studies with a total of 11758 pregnant women were included. The age ranged between 15 and 48 years. Most subjects were infected with SARS-CoV-2 in the third trimester. Disease severity was not reported in 1125 subjects. Maternal mortality was 1.3%. In 100% of fatal cases with adequate data, fever alone or with cough was one of the presenting symptoms. Also, dyspnea (58.3%) and myalgia (50%) were the most common symptoms. Sore throat (8.3%) and gastrointestinal symptoms (anorexia, nausea) (8.3%) were rare. The rate of comorbidities was 20% among COVID-19 deaths. The majority of COVID-19-infected women who died had cesarean section (58.3%), 25% had a vaginal delivery, and 16.7% of patients were not full term. Conclusion. COVID-19 infection in pregnant women was associated with higher rates (and pooled proportions) of cesarean section and mortality. Because new data are continuously being generated and published, the findings of this study can be complete and updated with new researches. The results of this study can guide and improve prenatal counseling of COVID-19-infected pregnant women

First report of Klebsiella pneumonia carbapenemase-producing Pseudomonas aeruginosa isolated from burn patients in Iran: Phenotypic and genotypic methods

Wound infection associated with carbapenem-resistant Pseudomonas aeruginosa in burn patients is a growing problem. One of the main mechanisms of resistance to carbapenem antibiotics is the ability of P. aeruginosa to produce carbapenemase enzymes. Klebsiella pneumonia carbapemenase (KPC) is an important type of carbapenemase which can hydrolyze carbapenem antibiotics. The Modified Hodge Test (MHT) and boronic acid as a KPC inhibitor are two phenotypic methods used for detection of carbapenemase. The sensitivity and specificity of these two phenotypic tests for the identification of KPC can be measured by PCR. In this study, 241 P. aeruginosa strains were isolated from wounds of hospitalized burn patients. Carbapenem-resistant P. aeruginosa isolates were determined by the disk diffusion method. KPC-producing carbapenem-resistant strains were examined using the Modified Hodge Test, followed by boronic acid. Further, strains with positive responses to MHT and boronic acid tests were analyzed with the PCR molecular method. One hundred eighty-six of 241 isolates were resistant to carbapenems and 75 were positive in the MHT. Three exhibited an at least 5-mm diameter difference when meropenem was combined with boronic acid vs meropenem alone in the boronic acid test. Two strains had a specific band with primer No.1 after gel electrophoresis. This study showed that MHT, despite excellent sensitivity, has variable specificity independent of bacterial species. Further, the use of KPC inhibitors such as boronic acid did not yield favorable sensitivity and specificity among the specimens from Iranian patients. Thus, it seems that sequencing after PCR should be considered the gold standard for the detection of KPC-producing P. aeruginosa

Nosocomial Infections in Burned Patients in Motahari Hospital, Tehran, Iran

Burn patients are at high risk of developing nosocomial infection because of their destroyed skin barrier and suppressed immune system, compounded by prolonged hospitalization and invasive therapeutic and diagnostic procedures. Studies on nosocomial infection in burn patients are not well described. The objective of the present study was to identify the causative bacterial of nosocomial infection and to determine the incidence of nosocomial infection and their changing during hospitalization in burned patients admitted to in the Motahari Hospital, Tehran, Iran. During the second part of 2010, 164 patients were included in this study. Samples were taken the first 48 hours and the fourth week after admission to Motahari Burn hospital. Isolation and identification of microorganisms was performed using the standard procedure. Of the 164 patients, 717 samples were taken and 812 bacteria were identified, 610 patients were culture positive on day 7 while 24 (17.2%) on 14 days after admission. The bacteria causing infections were 325 Pseudomonas, 140 Acinetobacter, 132 Staphylococcus aureus, and 215 others. The percentage of mortality was 12%. All of patients had at least 1 positive culture with Pseudomonas and/or with Acinetobacter. Hospitals suggest continuous observationof burn infections and increase strategies for antimicrobial resistance control and treatment of infectious complications

Distribution and Antibiotic Resistance Pattern of Bacteria Isolated from Patients with Community-acquired Urinary Tract Infections in Iran: A Cross-sectional Study

Background: Urinary tract infections (UTIs) remain the common infections diagnosed in outpatients as well as hospitalized patients. Multi-drug resistance (MDR) and extensively-drug resistance (XDR) in bacteria is an alarming problem in the world. The aim of this study was to detection of etiologic agents associated with community-acquired urinary tract infections (CA-UTIs) and investigation of antibiotic susceptibility patterns.Methods: This study was performed from September 2014 to March 2015 on outpatients, which referred to Labbafinejad Hospital Clinic, Tehran, Iran. The bacterial pathogenic diversity identified by standard laboratory methods. The antimicrobial resistance rates were performed by Kirby Bauer disc diffusion methods.Results: A total of 303 patients were enrolled in this study, from which 204 (67.3%) were female and 99 (32.5%) were male patients. Escherichia coli was the dominant species (69%), followed by Enterococcus faecalis (12.8%) and Klebsiella pneumoniae (4.6%). High resistance rate to nalidixic acid (73.8%), trimethoprim/Sulfamethoxazole (54.3%), ciprofloxacin (54.3%) in E. coli,  and tetracycline (89.7%) in E. faecalis strains and high susceptibility rate to meropenem (96.6%), imipenem (95.2%), amikacin (90.4%), cefoxtin (87.6%), and  nitrofurantoin (82.8%)  in E. coli,  and nitrofurantoin (100%)                                                                                                                                                                                                                                                                                                                                                                      in E. faecalis strains were observed. In addition, 43.5% of the strains were multidrug-resistant (MDR).Conclusions: This study showed that E. coli was the predominant uropathogen of CA-UTIs in this geographical area. It also demonstrated the empirical treatment of urinary tract infections may be difficult due to high resistance to commonly used antibiotics. Continuous monitoring of MDR organisms and drug resistance patterns are needed to prevent treatment failure and reduce selective pressure. These findings suggest the use of nitrofurantoin, cefoxitin, and amikacin in this area of the country

Distribution and Antibiotic Resistance Pattern of Bacteria Isolated from Patients with Community-acquired Urinary Tract Infections in Iran: A Cross-sectional Study

Background: Urinary tract infections (UTIs) remain the common infections diagnosed in outpatients as well as hospitalized patients. Multi-drug resistance (MDR) and extensively-drug resistance (XDR) in bacteria is an alarming problem in the world. The aim of this study was to detection of etiologic agents associated with community-acquired urinary tract infections (CA-UTIs) and investigation of antibiotic susceptibility patterns.Methods: This study was performed from September 2014 to March 2015 on outpatients, which referred to Labbafinejad Hospital Clinic, Tehran, Iran. The bacterial pathogenic diversity identified by standard laboratory methods. The antimicrobial resistance rates were performed by Kirby Bauer disc diffusion methods.Results: A total of 303 patients were enrolled in this study, from which 204 (67.3%) were female and 99 (32.5%) were male patients. Escherichia coli was the dominant species (69%), followed by Enterococcus faecalis (12.8%) and Klebsiella pneumoniae (4.6%). High resistance rate to nalidixic acid (73.8%), trimethoprim/Sulfamethoxazole (54.3%), ciprofloxacin (54.3%) in E. coli,  and tetracycline (89.7%) in E. faecalis strains and high susceptibility rate to meropenem (96.6%), imipenem (95.2%), amikacin (90.4%), cefoxtin (87.6%), and  nitrofurantoin (82.8%)  in E. coli,  and nitrofurantoin (100%)                                                                                                                                                                                                                                                                                                                                                                      in E. faecalis strains were observed. In addition, 43.5% of the strains were multidrug-resistant (MDR).Conclusions: This study showed that E. coli was the predominant uropathogen of CA-UTIs in this geographical area. It also demonstrated the empirical treatment of urinary tract infections may be difficult due to high resistance to commonly used antibiotics. Continuous monitoring of MDR organisms and drug resistance patterns are needed to prevent treatment failure and reduce selective pressure. These findings suggest the use of nitrofurantoin, cefoxitin, and amikacin in this area of the country

Association between Immunofluorescence Pattern and Mucosal Involvement in Patients with Bullous Pemphigoid

Bullous pemphigoid is an acquired autoimmune subepidermal blistering disease which is associated with mucocutaneous lesions. The type and amount of autoantibody deposition may have a role in mucosal lesions. We studied the association between mucosal involvement and direct immunofluorescence pattern in cutaneous lesions of patients with bullous pemphigoid. In this retrospective analytical cross-sectional study, we studied the demographic data, clinical presentations, and immunopathological findings of 69 patients with bullous pemphigoid admitted to our hospital 2008-2016. Patients were allocated into two groups on the basis of the mucosal involvement, and direct immunofluorescence patterns were evaluated. The data were analyzed using SPSS version18. The mean age of patients was 70.9±14.97 (mean ± Standard Deviation) years old. In our study, 56.5% of patients were women. All patients showed deposition of IgG and C3 in the dermoepidermal junction, with different severity. Patients with mucosal involvement (40.6% of cases) had a more prominent deposition of IgG, IgA, and C3 at the dermoepidermal junction compared with patients without mucosal involvement, which represented a statistically significant difference (P&lt;0.05). Logistic regression analysis showed that lower age, IgA, and C3 deposition (P&lt;0.05) were associated with mucosal involvement. Deposition of IgA and C3 (in addition to IgG) at the dermoepidermal junction seems to be a marker of mucosal involvement in patients with bullous pemphigoid. Attention to direct immunofluorescence pattern in patients with bullous pemphigoid may be helpful in prediction of mucosal involvement in these patients. </p

Prognostic Value of KI6 Biomarker in Predict Short Time Prognosis of Low Grade Cervical Intraepithelial Neoplasia in HPV Negative and Positive Patients

Screening of cervical cancer is the most common gynecologic cancer in developing countries. Despite being preventable, but we have still some problems with the screening of this cancer. Recently, many studies have been done on immunohistochemistry to improve screening of cervical intraepithelial neoplasia (CIN) as a precancerous lesion. But, the majority of the studies are based on cytological samples. The objective of this study was to analyze the correlation KI-67 biomarker and HPV infection in predict short time prognosis in CIN as an alternative or auxiliary method to the current screening method in a different geographic population. This descriptive cohort prospective study included 40 patients with a diagnosis of CIN based on cervical punch biopsy samples after colposcopy examination. They were referred to the department of gynecology and oncology of an academic hospital, Mashhad University of   2016 to 2017. All samples were investigated for HR- HPV DNA with Cobas test and immunostaining for KI-67 biomarker. Finally, after one year follows up, the prognosis for all patients was evaluated. Data were analyzed by SPSS software program version 23.0 and Mann-Whitney U test and Fisher's exact test. P<0.05 was considered significant. Significant difference was found between HR-HPV positive and negative tests in KI-67 expression (P<0.001), but no significant difference was observed in reactivity level (P=0.5), also no significant difference was found in KI-67 expression in the metaplastic and non-metaplastic epithelium (P=0.88). KI-67 biomarker is recommended as complementary screening tests not alternative for differentiating in high risks patients with CIN1. The patients with low KI-67 / HR-HPV positive test could be offered for a less aggressive follow-up protocol

First detection of efrAB, an ABC multidrug efflux pump in Enterococcus faecalis in Tehran, Iran

Enterococcus faecalis is one of the most significant pathogen in both nosocomial and community-acquired infections. Reduced susceptibility to antibiotics is in part due to efflux pumps. This study was conducted on 80 isolates of E. faecalis isolated from outpatients with urinary tract infection during a period of 1 year from April 2014 to April 2015. The antibiotic susceptibility patterns of isolates were determined by the disk diffusion method and presence of efrA and efrB genes was detected by PCR and sequencing. Minimum inhibitory concentrations (MICs) to ciprofloxacin (CIP) were measured with and without carbonyl cyanide 3-chlorophenylhydrazone (CCCP) by broth microdilution. The highest resistance rate was observed to erythromycin (83.3%) and the prevalence of efrA and efrB genes in all E. faecalis isolates was 100%. This study showed that 9 out of 13 (69.2%) ciprofloxacin-resistant isolates became less resistant at least fourfolds to CIP in the presence of efflux pump inhibitor. Our result showed that CCCP as an efflux inhibitor can increase effect of CIP as an efficient antibiotic and it is suggested that efrAB efflux pumps are involved in resistance to fluoroquinolone