Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Teaching practical medical bacteriology accommodate with job analysis

Introduction: In routine procedure, education of practical medical bacteriology is not related with job analysis. The aim of this study was designing and performance of practical medical bacteriology education based on job analysis. Methods: This interventional study was performed in second semester in 1388-1389 in the practical course of bacteriology for 40 second-year medical students. The students randomly were divided to two groups (control, case) and education was performed according to routine and new process and evaluated with questionnaire and posttest. Data analysis was done by SPSS. Results: The mean of exam results in case group shows an increase of 8.5% comparing with control group According to questionnaire results all of the students were agree with necessity of change in educational program of practical bacteriology (63 and 91 in case and control group respectively). At the end of course, more than 70% of students in the case group achieved to the aims of the course (this was 9% in control group). Conclusion: The results of this study showed this method cause to more co-operations, interesting, and learning in practical courses. This new procedure is more related with job analysis comparing with routine methods. Students expect to learn issues that are more practical while common teaching methods address basic subjects regardless of the professional needs of students

Mandibular Flexure in Anterior-Posterior and Transverse Plane on Edentulous Patients in Mashhad Faculty of Dentistry

Introduction: Angle and internal position of lateral pterygoid muscle leads to contraction over two half of the mandible in maximum opening and protrusion position so it can affects impression prosthetic procedures. The aim of this study was to evaluate the mandibular flexure in two transverse and antro-posterior dimensions. Methods: Seventy edentulous patients at Mashhad Faculty of Dentistry as the main group and 50 dentulous patients as the control group were selected. In these patients, transverse dimensions between second molar areas and also canine eminence from one side to another side, and longitudinal dimensions based on the distance between canine to second molar area at centric occlusion and maximum mouth opening were measured. Dimensional differences as the mandibular flexure were measured. Results: The mandibular dimensions in maximum opening and closed mouth were different. Average reduction in transverse dimension on second molar region at maximum mouth opening and closing position were almost equal to -0.0787 mm for target group and 0.7512 mm for control group. On anterior side, averages of these changes were equal to 0.3069 mm for target group and were 0.2254 mm for control group. Conclusion: Transverse dimensions in anterior region at maximum opening position are smaller than the same dimension at closed mouth in edentulous and dentulous patients

Assessment of the Relationship Between Stress and Oral Lichen Planus: A Review of Literature

Background and Aim: Oral lichen planus (OLP) is a chronic inflammatory lesion. Psychological stress occurs when someone senses that environmental demands exceed his/her adaptive capability. Stress, anxiety, and depression have frequently been mentioned as possible factors related to the development of OLP, although this association remains controversial. In most studies, a positive correlation was found between psychological stress and OLP, although some found no significant association. In this review, we assess the possible role of psychological stress in the etiopathogenesis of OLP. Materials and Methods: The methodological approach of this study was to search major databases from 1985-2014, using "oral lichen planus"," stress", "anxiety", "depression" and "psychological disorder” as search terms. Results: A total of 45 scientific papers and abstracts in English were reviewed, and 10 articles met the necessary requirements. Stress evaluation methods of these articles were questionnaire, genetic polymorphisms at DNA level, measurement of body substances like hormones, and effect of drug therapy of psychiatric disorders on OLP patients. In order to include a study, OLP in patients must have been proven by clinical and histopathological criteria. Exclusion criteria were not explicit stating the OLP diagnosis, an inadequate number of the test subject in experimental and control groups, discrepancy (inconsistency) in sex and age between the case and control groups, and unreliable method of stress measurements. Conclusion: Higher levels of stress in patients with OLP were confirmed. Reducing psychological stress and well-being of patients is an important factor that should be considered in the treatment of OLP

Adult onset of xanthelasmoid mastocytosis: Report of a rare entity

Xanthelasmoid or pseudoxanthomatous mastocytosis is an extremely rare variant of diffuse cutaneous mastocytosis. Herein, we describe an adult male with cutaneous mastocytosis showing multiple widespread yellowish ovoid papules like eruptive xanthoma. A 60-year-old male visited our outpatient clinic with a 1-year history of generalized yellowish, ovoid, and skin color papular eruption located on the trunk, groin, extremities, with the modest pruritus. Vital signs were stable, and Darier′s sign was negative. No other subjective and objective signs were detected during the examination. No abnormality was detected in his diagnostic laboratory tests. Skin biopsy was taken, and histopathologic examination revealed proliferation of mast cells with ovoid and spindle nuclei with distinct cytoplasm borders around the capillaries, which was compatible with mastocytosis. Antihistamine was prescribed for pruritus control which was successful, but eruptions were persistent, and even 1-year phototherapy was not useful

Phylogenetic analysis of human bocavirus in children with acute respiratory infections in Iran

Human bocavirus (HBoV) was first characterized in nasopharyngeal aspirates from young children with acute respiratory infections. It is prevalent among children with acute wheezing. This study was carried out in order to analyze the infection frequency and coinfection rates of HBoV with respiratory syncytial virus (RSV) and to perform phylogenetic analysis of HBoV in samples of children with acute respiratory infection in Isfahan, Iran. During the time period 2016–2017, altogether 75 respiratory samples from children hospitalized with acute respiratory infection were collected. The samples were first screened for RSV by direct immunofluorescence method and then subjected to detect HBoV DNA by PCR. Genotyping of HBoV-positive samples was conducted by direct sequencing of PCR products using NP and VP1/VP2 genes. Out of 75 respiratory samples, 20 (26.7%) and 10 (13.3%) were positive for RSV and HBoV, respectively. The coinfection rate was 40% (p = 0.048). Considering the seasonal distribution, winter has the highest extent outbreak (p = 0.036). Sequence analysis of positive samples exhibits that all of the isolated HBoV were related to genotype 1 (HBoV-1) with minimal sequence variations. Increasing frequency of HBoV suggests that the virus is related to acute respiratory infection in children. A single genetic lineage of HBoV1 seems to be the major genotype in Iran

Isolation of toxigenic Clostridium difficile from ready-to-eat salads by multiplex polymerase chain reaction in Isfahan, Iran

Background: Since 2003, the incidence of community associated Clostridium difficile infection (CA-CDI) has increased; different types of food have been supposed to be the vectors of C. difficile strains. The purpose of this study is to investigate the occurrence of C. difficile strains in ready-to-eat salads distributed in food services. Materials and Methods: A total of 106 ready-made salad specimens were sampled from different restaurants and food services located in Isfahan, in the center of Iran. Positive isolates of C. difficile were identified and confirmed for the existence of three genes including tpi, tcdA and tcdB by multiplex PCR. Results: A total of six (5.66%) samples were positive for C. difficile strains. Of which, one strain (16.6%) was positive for A and B toxins. Conclusion: The existence of toxigenic C. difficile in ready-made salads could be a caution for public health. Further investigation is required to assess the relationship between the isolated strains in our study and those from diarrheic patients through molecular typing

Identification of Non Tuberculous Mycobacteria Isolated from Isfahan Different Water Sources Using Phenotypic Characterization Tests

In recent decades, by increasing immunocompromised patients, disease related to nontuberculous mycobacteria, previously known as environmental opportunistic pathogen, has been raised. In this study, 85 water samples from different sources in Isfahan were evaluated for the presence of NTM. Phenotypic tests were used to identify NTM species. Twenty one out of 85 (24.7%) collected water samples had at least one NTM. Of these, 23.8% (5 isolates) and 14.3 % (3 isolates) were M. furtuitum and M. smegmatis, respectively.  Two cases for each isolates (9.5%) were identified as M. chelonae like organisms, M. terrae complex, M. gordonae and M. mucogenicum. One cases for each isolates (4.8%) was determined as M. avium complex, M. phlei, M. xenopi, M. fallax, and M. flavescence. The results showed the incidence of different species of NTM in this geographical region in Iran. Because of increasing immunocompromised disease in communities, and high frequency of NTM in different geographical regions, understanding the NTM distribution in environment would help clinicians to manage proper treatment strategy