History of treated pulmonary tuberculosis will also be an underlying symptom of opportunistic aspergillosis by Aspergillus flavus: A case report

AbstractIntroductionAspergillus species as cosmopolitan fungi with remarkable virulence factors were found to be agents of pulmonary aspergillosis in patients with impaired immunity. The formed cavity of some previously treated lung diseases, such as tuberculosis, sarcoidosis and pneumoconiosis, is usually predisposed to the development of aspergillosis.Pulmonary aspergillosis (PA) is an uncommon disease which is characterized by hemoptysis, malaise, fever, cough, weight loss and nonspecific radiographic manifestations, including an oval or round mass with a radiolucent halo or crescent of air, a focal consolidation, and cavitary lesions.Case presentationThis study presents the case of a 54-year-old woman with dyspnea alongside a history of treated pulmonary tuberculosis (PTB) by ATT 2years ago. X-ray confirmed the presence of a rounded mass in a surrounding cavity in the lung. Tracheobronchial and chest CT images of the patient showed cavities with tuberculous nodules. Clinical symptoms of the patient were fever, malaise, anorexia, weight loss, chest pain, cough and dark mucus sputum. Aspergillus sp. was detected primarily as branching hyaline hyphae in direct examination of the sputum by calcofluor-white staining. The sample was positive with culture as well. Aspergillus flavus was identified in culture and confirmed by polymerase chain reaction (PCR) and sequencing of the ITS region of rDNA and β-tubulin of fungus. The patient signed an agreement for reporting her case as a medical document in journals or in conferences.ConclusionThe importance of tuberculosis (TB) in the development of aspergillosis, even after treatment, has been highlighted by multiple studies. Microbiological and molecular evaluation are needed to detect PA quickly and accurately. The WHO reported about 8.8million new cases of TB in 2010. Therefore, it is essential to focus more on monitoring of diagnosis and treatment of PA

Clinimetrics of the Freezing of Gait Questionnaire for Parkinson Disease During the "off" State

Introduction: Freezing of gait, a common PD motor symptom, could increase the risk of falling. This study aimed to investigate the clinimetric attributes of the Freezing of Gait Questionnaire (FOGQ) for people with Parkinson disease in the "off" state. Methods: A total of 115 patients with Parkinson disease (PD; mean age, 60.25 years) were included. Acceptability, internal consistency (by the Cronbach alpha, and test-retest by Intraclass Correlation [ICC]), and reliability of the Persian-translated version of the FOGQ were examined. Dimensionality was estimated by Exploratory Factor Analysis (EFA). Fall efficacy scale-international, unified Parkinson disease rating scale-II, Berg balance scale, functional reach test, and Parkinson disease questionnaire-39 were applied to determine the convergent validity. Diagnostic accuracy for obtaining optimal cutoff point, separating faller and non-faller groups, was analyzed by Receiver Operating Characteristics (ROC) curve analysis and Area Under the Curve (AUC). All tests were carried out in an "off" state. Results: The Cronbach alpha was high (α=0.92). The test-retest showed high reliability (ICC=0.89). The FOGQ was unidimensional according to the EFA and had acceptable convergent validity with moderate to high correlation with other clinical scales. The optimal cutoff point to discriminate fallers from non-fallers during the "off" state was 9/10, with an AUC of 0.92. Conclusion: Our results suggest that the FOGQ has appropriate reliability, validity, and discriminative ability for measuring FOG in patients with PD during the "off" state.S

The effect of involved Aspergillus species on galactomannan in bronchoalveolar lavage of patients with invasive aspergillosis

PURPOSE: The detection of galactomannan (GM) in bronchoalveolar lavage (BAL) fluid is an important surrogate marker for the early diagnosis and therapeutic monitoring of invasive aspergillosis (IA), regardless of the involved species of Aspergillus. Here, we utilized the Platelia Aspergillus GM enzyme immunoassay (Bio-Rad) to evaluate the GM index in BAL fluid samples from patients with proven, probable or putative IA due to Aspergillusflavus versus Aspergillusfumigatus. METHODOLOGY: In a prospective study between 2009 and 2015, 116 BAL samples were collected from suspected IA patients referred to two university hospitals in Tehran, Iran. KEY FINDINGS: According to European Organization for Research and Treatment of Cancer and Mycoses Study Group and Blot criteria, 35 patients were classified as IA patients, of which 33 cases tested positive for GM above 0.5 and, among these patients, 22 had a GM index >/=1. Twenty-eight were culture positive for A. flavus and seven for A. fumigatus. The GM index for A. flavus cases was between 0.5-6.5 and those of A. fumigatus ranged from 1 to 6.5. The sensitivity and specificity of a GM index >/=0.5 in cases with A. flavus were 86 and 88 % and for A. fumigatus patients were 100 and 73 %, respectively. CONCLUSION: Overall, the mean GM index in patients with A. fumigatus (3.1) was significantly higher than those of A. flavus (1.6; P-value=0.031) and the sensitivity of GM lower for A. flavus when compared to A. fumigatus. This finding has implications for diagnosis in hospitals and countries with a high proportion of A. flavus infections

A Kinetics Study on the Thermal Degradation of Starch/Poly (Vinyl Alcohol) Blend

Abstract The thermal degradation of starch/poly (vinyl alcohol) (PVA) blend was studied by using TG in air atmosphere. Thermo-analytic investigations on pure starch film and starch/PVA blend film were carried out to evaluate the thermal stability and the respective activation energy of the materials. Experiments in air atmosphere and under non-isothermal and isothermal condition carried out. The Kissinger and Flynn-Wall-Ozawa methods were used to calculate the activation energy of non-isothermal degradation of starch and starch/PVA blends. The results show that these two methods were suitable and effective to describe the thermal degradation of starch and starch/PVA blends. These results are shown that starch/PVA blend was thermally less stable than pure starch and thermal stability of films decreased with increasing PVA content

OXAZIRIDINE (C-CH3NO), C-CH2NO RADICALS AND CL, NH2 AND METHYL DERIVATIVES OF OXAZIRIDINE; STRUCTURES AND QUANTUM CHEMICAL PARAMETERS

Oxaziridine [c-CH3NO (X1A)], c-CH2NO (X2A) radicals and Cl, NH2 and methyl derivatives of oxaziridine structures have been optimized via DFTB3LYP level of theory using 6-311++G (d, p) basis set. Population analysis had been carried out. Vertical ionization energy (VIE) and adiabatic ionization energy (AIE), Fukui indices and some quantum chemical parameters were calculated. N-O bond was determined as weakest bond in oxaziridine triangle. The effect of electron withdrawing and electron donating groups on stability of weakest bond were assessed

OXAZIRIDINE (C-CH3NO), C-CH2NO RADICALS AND CL, NH2 AND METHYL DERIVATIVES OF OXAZIRIDINE; STRUCTURES AND QUANTUM CHEMICAL PARAMETERS (Supplementary material)

Supplementary material contains Tables S1 to S9 and Figures S1 to S4

Evaluating Environmental Health Students\' Attitudes toward their Discipline and Future Career in Hamedan University of Medical Sciences in 2008

Introduction: The raise of medical sciences graduates is counted to be on of the problems in public, as concern about the discipline and future career is evidently seen in students. This study was performed with the aim of determining environmental health students' attitude toward their discipline and future career carried out in Hamedan University of Medical Sciences in 2008. Methods: All environmental health students of Hamedan University of Medical Sciences studying morning courses of first semester of academic year 2008-2009 in associate, BS, and MS degrees were entered into this descriptive cross sectional study through census (n=115). The data gathering tool was Minnesota University questionnaire including 20 questions based on Likert scale. Data was analyzed by SPSS software using statistical t-test. Results: Mean and standard deviation of students' attitude toward their future career attained to be 56.6 and 11.2 respectively out of 96 questionnaires. Regarding the score of 60 as the mean score of the test, the attained mean score is lower than expected. Conclusion: The mean score for attitude of population under investigation toward their future career was lower than acceptable level which demonstrates lack of desirable attitude toward future career among students. It is while they have an acceptable attitude toward their discipline. Adjusting the number of students accepted, proper distribution of human resources, informing students about university disciplines before they take the entrance examination, and supporting the students financially may prove helpful in improving their attitudes

In vitro antifungal susceptibility of Candida speciesisolated from diabetic patients

Abstract INTRODUCTION This study aims to evaluate the antifungal susceptibility of different species of Candida isolated from diabetic patients against eight antifungal agents. METHODS Susceptibility testing of 111 clinical isolates of Candida species was performed against 8 antifungals using the M27-A3 protocol of the Clinical and Laboratory Standards Institute (CLSI). RESULTS Voriconazole, lanoconazole, and caspofungin showed the highest in vitro activity against all the isolates of C. albicans. Resistance against the tested antifungals was only observed in the C. albicans isolates. CONCLUSIONS Our finding revealed that resistance against amphotericin B, itraconazole, ketoconazole, posaconazole, and fluconazole can be observed in C. albicans