Clinical Presentation and Microbial Analyses of Contact Lens Keratitis; an Epidemiologic Study

Introduction: Microbial keratitis is an infective process of the cornea with a potentially and serious visual impairments. Contact lenses are a major cause of microbial keratitis in the developed countries especially among young people. Therefore, the purpose of the present study was to evaluate the frequency and microbiological characteristic of CLK in patients referred to the emergency department (ED) of teaching hospitals, Babol, Iran. Methods: This is a cross-sectional study of all patients with contact lens induced corneal ulcers admitted to the teaching hospitals of Babol, Iran, from 2011- 2013. An ophthalmologist examined patients with the slit-lamp and clinical features of them were noted (including pain, redness, foreign body sensation, chemosis, epiphora, blurred vision, discomfort, photophobia, discharge, ocular redness and swelling). All suspected infectious corneal ulcers were scraped for microbial culture and two slides were prepared. Data were analyzed using SPSS software, version 18.0. Results: A total of 14 patients (17 eyes) were recruited into the study (100% female). The patients’ age ranged from 16-37 years old (mean age 21.58±7.23 years). The most prevalent observed clinical signs were pain and redness. Three samples reported as sterile. The most common isolated causative organism was pseudomonas aeroginosa (78.6%), Staphylococcus aureus 14.3%, and enterobacter 7.1%, respectively. Treatment outcome was excellent in 23.5%, good in 47.1%, and poor in 29.4% of cases. Conclusion: Improper lens wear and care as well as the lack of awareness about the importance of aftercare visits have been identified as potential risk factors for the corneal ulcer among contact lens wearers. Training and increasing the awareness of adequate lens care and disinfection practices, consulting with an ophthalmologist, and frequent replacement of contact lens storage cases would greatly help reducing the risk of microbial keratitis

Umbilical cord serum procalcitonin, as an early diagnostic marker of early neonatal sepsis

Background and Objective: The prognosis of early neonatal sepsis is significantly associated with rapid diagnosis and appropriate antibiotic therapy. Since blood culture has been reported positive in less than 16 of neonatal sepsis cases, various biochemical markers have been evaluated. This study was performed to evaluate the umbilical cord blood procalcitonin (PCT) as an early diagnostic marker of early neonatal sepsis. Methods: This cross-sectional study included 100 neonates in two groups of case and control. The case group consisted of three separate groups, including proven, suspected and clinical sepsis groups. The PCT level of umbilical cord blood was measured by immunoluminoassay method, and PCT 0.5-2ng/ml, 2-10 ng/ml and >10ng/ml were considered weakly positive, positive and strongly positive, respectively. Sepsis screening tests and a culture taken from blood or other sterile fluids were studied in the case group. Findings: The PCT mean was 1.39±1.52 and 0.17±0.05ng/ml in the case (sepsis) and control groups, respectively. Finally, the PCT level was significantly higher in all cases in the proven sepsis group than in other sepsis groups. Conclusion: The result of this study showed that the mean value of PCT level in umbilical cord blood was higher in the sepsis group, and it was higher in the proven sepsis group than in the other two groups of sepsis

Audit nursing reports in intubated neonates admitted in neonatal intensive care unit of Ayatollah Rouhani Hospital, Babol, Iran

Background: Accurate and complete documentation of nursing records is one of the preconditions of the evidence-based cares and is considered as one of the most important professional tasks in nursing. The aim of the present study was to audit the nursing reports in intubated neonates admitted in neonatal intensive care unit of Ayatollah Rouhani hospital, Babol. Methods: In this cross-sectional study, 100 nursing reports were randomly selected from the neonatal intensive care unit. Data were collected by a researcher using a checklist which was developed in accordance with the standard and indicators of nursing documentation in national and international reliable sources and then compared after determining the content validity and reliability (observers' agreement coefficient). Data were analyzed using SPSS20, and statistical methods of Man-Whitney and Kruskal-Wallis were used at a significant level of p<0.05. Results: The quality of 93%, 1% and 6% of nursing records was good, moderate and poor, respectively. Overall, the quality of nursing records was desirable in terms of content and structure and there was no significant difference in nursing documentation record in dimensions of structure and content according to overtime (P=0.92 and P=0.11), work experience (P=0.61 and P=0.16) and age group (P=0.09 and P=0.76). Conclusions: The quality of nursing records in neonatal intensive care unit of Ayatollah Rouhani Hospital of Babol has been improved according to the Accreditation of Health Care Centers. In addition, the increase of nurses' knowledge about legal and professional issues has also been effective on improving the quality of the documentation

Pure Red Cell Aplasia as a Presenting Feature in Systemic Lupus Erythematosus and Association with Thymoma, Hypothyroidism and Hypoparathyroidism: a Case Report and Literature Review

This paper presents a 54-year-old female with lupus whom severe anaemia due to pure red cell aplasia (PRCA) was the first manifestation. There was seven years interval between PRCA onset and diagnosis of lupus. Thymectomy due to thymoma had been carried out six years before but anaemia sustained. Hypothyroidism and hypoparathyroidism were other associated diseases. Severe anaemia and the need for monthly blood infusions were resolved following treatment with Prednisolone, Hydroxychloroquine and Levothyroxine

Effects of exogenous enzymes addition to wheat-based diets on growth and meat performance of male (Ross 308) broiler chickens

The objective of this study was to evaluate the effect of adding four commercial multi-enzymes on growth performance, meat yield, water intake, litter moisture, jejunal digesta viscosity, and characteristics of the gastrointestinal tract of chicks fed wheat-based diet in comparison with control and corn-based diets. Two hundred and thirty four, one-day-old, Ross 308, male chicks were distributed into pens in a randomized complete block design with six treatments each with three replicate of 13 birds. In all of rearing periods, average daily feed intake, average daily gain, feed conversion ratio, and related parameters were not significantly (P >0.05) affected by enzyme supplementation, exception following cases. The relative weight of the breast as proportion of live weight was significantly (P <0.05) decreased by fed diets included enzymes B, C, and D and corn diet in comparison with control diet. The relative weight of the abdominal fat as proportion of live weight at 28 and 42 days of age was significantly (P <0.05) increased by fed diet included enzyme B and corn diet, and diet included enzyme A and corn diet, respectively, in comparison with control diet. Therefoie, these results led to the conclusion that it is possible to use high levels of some varieties of wheat (with low-non-starch polysaccharides) instead of corn in broiler diets without enzyme supplementation

Designing an artificial neural network for prediction of pregnancy outcomes in women with systemic lupus erythematosus in Iran

Background: Pregnancy in women with systemic lupus erythematosus (SLE) is still introduced as a major challenge. Consulting before pregnancy in these patients is essential in order to estimating the risk of undesirable maternal and fetal outcomes by using appropriate information. The purpose of this study was to develop an artificial neural network for prediction of pregnancy outcomes including spontaneous abortion and live birth in SLE. Methods: In a retrospective study, forty-five variables were identified as effective factors for prediction of pregnancy outcomes in systemic lupus erythematosus. Data of 104 pregnancies in women with systemic lupus erythematosus in Shariati Hospital and 45 pregnancies in a private specialized center in Tehran from 1982 to 2014 in August and September, 2014 were collected and analyzed. For feature selection, information of the 149 pregnancies was analyzed with a binary logistic regression model in SPSS software, version 20 (SPSS, Inc., Chicago, IL, USA). These selected variables were used for inputs of neural networks in MATLAB software, version R2013b (MathWorks Inc., Natick, MA, USA). A Multi-Layer Perceptron (MLP) network with scaled conjugate gradient (trainscg) back propagation learning algorithm has been designed and evaluated for this purpose. We used confusion matrix for evaluation. The accuracy, sensitivity and specificity were calculated from the confusion matrix. Results: Twelve features with P<0.05 and four features with P<0.1 were identified by using binary logistic regression as effective features. These sixteen features were used as input variables in artificial neural networks. The accuracy, sensitivity and specificity of the test data for the MLP network were 90.9%, 80.0%, and 94.1% respectively and for the total data were 97.3%, 93.5%, and 99.0% respectively. Conclusion: According to the results, we concluded that feed-forward Multi-Layer Perceptron (MLP) neural network with scaled conjugate gradient (trainscg) back propagation learning algorithm can help physicians to predict the pregnancy outcomes (spontaneous abortion and live birth) among pregnant women with lupus by using identified effective variables

Punica granatum peel supplementation attenuates cognitive deficits and brain injury in rat by targeting the Nrf2-HO-1 pathway

The critical role of nutrition to prevent neurodegenerative disorders is well documented. Punica granatum fruit is identified as a highly nutritional food for alleviating various ailments. The ameliorating properties of P. granatum peel on memory dysfunction and the possible roles of oxidative stress, acetylcholinesterase (AchE), and nuclear factor erythroid 2-related factor 2 (Nrf2)-heme oxygenase (HO)-1 pathway in the scopolamine-treated rats were assessed. The hydroethanolic extract was standardized using high-performance liquid chromatography (HPLC). The animal groups were as follows: Control, scopolamine (2 mg/kg), and treatment groups (the extract at doses of 200–800 mg/kg). The behavioral performance was evaluated using the Morris water maze (MWM) and passive avoidance equipment. Various biochemical parameters were then measured. Rats received the extract properly found on the platform location, indicated by a shorter traveling time and distance during 5 days of learning MWM. Moreover, the extract increased the delay and light time, while decreasing dark time and the frequency of entries to the dark in the passive avoidance test. The extract also exerted a significant increase in superoxide dismutase activity and thiol content, while decreasing AchE activity and lipid peroxidation in the brain of scopolamine-injured rats. Our results demonstrated the neuroprotective effects of P. granatum peel in minimizing scopolamine injury possibly through targeting the Nrf2-HO-1 pathway