Effects of metronidazole therapy on preterm labor in women with bacterial vaginosis

Regarding to prevalence of preterm labor and its consequences, there are different reports on relationship between bacterial vaginosis and preterm labor. This study was performed to evaluate the effect of metronidazole therapy on preterm labor in women with bacterial vaginosis. This randomized clinical trial was performed on 120 women suffering from bacterial vaginosis at 20-34 weeks of pregnancy, to evaluate the therapeutic effect of metronidazole to delay preterm labor in Shabih Khani maternity hospital in Kashan, Iran in 2002. Bacterial vaginosis was diagnosed based on clinical and laboratory findings. The patients were randomly divided into two groups. The patients in the case group received 500 mg metronidazole BID for 7 consecutive days, but the control group did not receive it. The demographic characteristics of the patients such as, pregnancy age, educational level and job of the spouse were similar at both case and control groups. Double-blind follow up of the patients at the whole stages of parturition and after delivery with respect to the delivery method, infection, and fever was done by other practitioner besides the main researcher. The results were analyzed statistically by chi-square, and Fischer's exact tests. 420 patients entered the study, of whom 120 (28.6) had bacterial vaginosis. The antibiotic and control groups were not significantly different for maternal age, job of the spouse, and education. No difference was observed in spontaneous preterm birth before 37 weeks of gestation in antibiotic-treated compared with control group. Treatment with metronidazole in symptomatic women with a bacterial vaginosis in the late second trimester does not decrease the incidence of preterm delivery. © 2009 Tehran University of Medical Sciences. All rights reserved

Corrigendum to �Cauda equine syndrome due to Brucella spondylodiscitis and epidural abscess formation: A case report� (Interdisciplinary Neurosurgery: Advanced Techniques and Case Management (2019) 17 (42�44), (S2214751918302676), (10.1016/j.inat.2019.01.011))

The authors' regret: Acknowledgements must be deleted because it is not related to our manuscript. The authors apologise for any inconvenience caused. © 201

Evolution of Preprofessional Pharmacy Curricula

Objectives. To examine changes in preprofessional pharmacy curricular requirements and trends, and determine rationales for and implications of modifications. Methods. Prerequisite curricular requirements compiled between 2006 and 2011 from all doctor of pharmacy (PharmD) programs approved by the Accreditation Council of Pharmacy Education were reviewed to ascertain trends over the past 5 years. An online survey was conducted of 20 programs that required either 3 years of prerequisite courses or a bachelor’s degree, and a random sample of 20 programs that required 2 years of prerequisites. Standardized telephone interviews were then conducted with representatives of 9 programs. Results. In 2006, 4 programs required 3 years of prerequisite courses and none required a bachelor’s degree; by 2011, these increased to 18 programs and 7 programs, respectively. Of 40 programs surveyed, responses were received from 28 (70%), 9 (32%) of which reported having increased the number of prerequisite courses since 2006. Reasons given for changes included desire to raise the level of academic achievement of students entering the PharmD program, desire to increase incoming student maturity, and desire to add clinical sciences and experiential coursework to the pharmacy curriculum. Some colleges and schools experienced a temporary decrease in applicants. Conclusions. The preprofessional curriculum continues to evolve, with many programs increasing the number of course prerequisites. The implications of increasing prerequisites were variable and included a perceived increase in maturity and quality of applicants and, for some schools, a temporary decrease in the number of applicants

Antibiotic resistance pattern and distribution of Vietnamese extended-spectrum- β lactamase (VEB-1) gene in Acinetobacter baumannii isolated from hospitalized patients in Kashan Shahid Beheshti hospital during 2013-2014

Background: Acinetobacter baumannii are widely distributed pathogens in hospitals. They have the ability to have various mechanisms of resistance. Multiple drug resistant (MDR) strains of A. baumannii have created therapeutic problems worldwide. The aim of the present study was to determine the antimicrobial susceptibility and detection of blaOXA51 and VEB-1 genes of A. baumannii isolated from clinical specimens in teaching hospital. Materials and Methods: A descriptive cross-sectional study was performed on 124 A. baumannii strains isolated from patients in Beheshti hospital, Kashan, Iran, during 2013-2014. At the species level, the isolates were identified by conventional biochemical tests and then confirmed by the Microgen kit (GNA). An antibiotic susceptibility test was performed for 17 antimicrobial agents according to the CLSI guidelines. Multiple drug resistant was defined as presence of resistance to three or more classes of antibiotics. The presence of blaOXA51 and VEB-1 genes was investigated using the polymerase chain reation. Results: Acinetobacter baumannii isolates demonstrated the highest resistance to ceftriaxone, ceftazidime and cefotaxime. All isolates were sensitive to colistin and polymyxin. All isolates were positive for blaOXA51. Thirty-two isolates (25.8) were positive for the VEB-1 gene. Conclusion: This study highlights the high frequency of MDR isolates. The VEB-1 gene, which produces extended spectrum beta lactamase enzymes and inactivates third generation cephalosporins, was positive in more than 25 of the samples

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

Sensitivity of levofloxacin in combination with ampicillin-sulbactam and tigecycline against multidrug-resistant Acinetobacter baumannii

Background and Objectives: The selection of alternative treatment options with antibiotic combinations may be used for successful managing of multidrug-resistant Acinetobacter baumannii. The aim of this study was to determine the synergistic effects of ampicillin-sulbactam combined with either levofloxacin or tigecycline against MDR A. baumannii. Materials and Methods: A total 124 of A.baumannii isolates collected from clinical samples of hospitalized patients which assessed for antibiotic susceptibility using disk diffusion method. E-test was used on 10 MDR A. baumannii isolates to determine the minimum inhibitory concentration (MIC) of ampicillin-sulbactam, levofloxacin and tigecycline. Any synergistic effects were evaluated at their own MIC using E-test assay at 37°C for 24 hours. Synergy was defined as a fractional inhibitory concentration index (FICI) of ≤0.5. Results: Levofloxacin plus ampicillin-sulbactam combination was found to have synergistic effects (FIC index: ≤0.5) in 90% of the isolates, but there was no synergistic effect for ampicillin-sulbactam/tigecycline and tigecycline/ levofloxacin combination. The antagonist effect in 50% of isolates (FIC index: >2) showed in combination of levofloxacin/tigecycline. Conclusion: The emergence of multidrug A. baumannii isolates requires evaluating by combination therapy. The combination of levofloxacin plus a bactericidal antibiotic such as ampicillin-sulbactam is recommended. Results should be confirmed by clinical studies. Keywords: Acinetobacter baumannii, Etest Methods, Microbial Drug Resistance, Synergistic effec

Antibiotic susceptibility pattern and the prevalence of Staphylococcus aureus isolated from skin and soft tissue in Tehran Razi skin hospital (2014-15)

Background: Staphylococcus aureus (S. aureus) is the most common cause of skin and soft tissue infections. This study aimed to determine the prevalence of S. aureus isolated from skin and soft tissue and antibiotic susceptibility pattern among the patient hospitalized in Razi skin hospital (Tehran-Iran). Materials and Methods: This cross-sectional study was conducted on patients (n=400) with skin and soft tissue infections in Razi skin hospital. Sterilized swabs were used to collect the skin infection samples. S. aureus isolates were confirmed using biochemical tests (gram staining, catalase, coagulase, DNase test and manitol fermentation tests). Result: 51.3 ( 205 out of 400) of isolates were S. aureus. Ninety six (46.8) of isolates were methicillin and penicillin-resistant S. aureus. All of the isolates showed sensitivity to vancomycin, linezolid. 98 of the isolates were susceptible to daptomycin. One-hundred sixteen (56.6) isolates were multi- drug resistant. Conclusion: More than half of the skin and soft tissue infections were caused by S.aureus. More than 46 percent of the isolates were methicillin resistant. The highest resistance to penicillin was observed

Cauda equnia syndrome due to Brucella spondylodiscitis and epidural abscess formation: A case report

Brucellosis is an infection with a widening clinical disease spectrum, has been reported as the causative agent of lumbar spine complications but rarely accompanying CES Injury. We report a female patient with Brucella spondylodiscitis affecting the lumbosacral region resulting in CES due to epidural abscess formation. Brucella spondylodiscitis should be suspected in patients with unexplained neurological features and low back pain in endemic regions. © 201