Investigating the Prevalence and Clinical Significance of Helicobacter pylori in Hospital-ized Patients Undergoing Endoscopy in Namazi Hospital, Shiraz

Background: Helicobacter pylori found in the gastric mucosa of more than 50% of the human popula-tion, and the risk of stomach cancer increases in infected individuals. Materials and Methods: In this retrospective study, the target population was patients admitted to Namazi Hospital in Shiraz during 2009-2018. For this purpose, 3099 records of patients were analyzed with regard to history of endoscopy, age, gender, chief complaint, reason for referral, initial clinical diag-nosis, pathology result, and presence of Helicobacter pylori.  Results: Among all the examined individuals, 776 (69.1%) of women and 1197 (60.9%) of men were in-fected with Helicobacter pylori. The most and the least affected individuals fell in the age group 59-36 years with 899 (0.29%) and 19-35 years with 573 (18.5%), respectively. Of the participants, 1380 (69.9%) had a history of endoscopy. The most common causes for patient's chief complaint or the reason for go-ing to the hospital or referring for hospitalization were burping (11.1%), vomiting (9.8%), hematemesis (9.8%), heartburn (9.7%) and dysphagia (9.6%). In terms of the initial clinical diagnosis, the most causes pertained to chronic gastritis (21.6%), atrophic gastritis (18.7%), gastric ulcer (16.8%) and intractable vomiting (14.0%). Conclusion: The results of this study showed that the prevalence of Helicobacter pylori has decreased in recent years and that being infected is related to gender and age

Ralstonia pickettii bloodstream infection in the patient with Guillain-Barre syndrome under plasmapheresis

Ralstonia pickettii is a rare Gram-negative opportunistic bacterium that causes rare infections such as bacteremia, neonatal sepsis, endocarditis, and meningitis in hospitalized or immunocompromised patients. In this study, we identified and reported bloodstream infection caused by R. pickettii in a 15 -year-old boy patient with an autoimmune disease, Guillain-Barré syndrome, under plasmapheresis and intravenous immune globulin (IVIG) therapy. He was referred for admission to the neurology center of the teaching hospital of Shiraz, Iran for inability to walk, and lower extremity muscle weakness. After he was treated with plasmapheresis once during hospitalization, and after severe fever besides shivering blood cultures using BACT/ALERT®3D instrument were positive for R. pickettii. According to antibiotic susceptibility test reports, Ciprofloxacin (5 μg) was prescribed. Fortunately, after starting antibiotic treatment, blood culture results reported no growth after 5 days. Indeed, the patient was infected with nosocomial hepatitis A and URSOBIL (300 mg/BID/Po) was administered. Hence, after reporting the infection occurrence to the hospital infection control unit, initial and possible measures such as device infection control, replacement of potentially polluted plasmapheresis fluids, disinfecting the environment and replacing old sterile washing water with new sources were carried out in plasmapheresis unit. In conclusion, R. pickettii is a rare nosocomial infection that is responsible for the contamination of medical equipment, especially in hemodialysis, plasmapheresis devices and sterile solutions. Also, it is suggested that the role and importance of rare environmental bacteria as the causative agents of human infections should not be ignored in medical centers

Production of egg yolk antibody (IgY) against a chimeric protein containing IpaD, StxB, and TolC antigens from Shigella: An investigation of its prophylactic effects against Shiga toxin (Stx) and Shigella dysenteriae in vitro and in vivo

Shigella is a major problem in developing countries. Immunoglobulin Y (IgY) can be used for prophylaxis and neutralize bacteria. The aim of this study was to produce IgY against the chimeric protein containing IpaD, StxB, and TolC antigens from Shigella, investigate its prophylactic and neutralizing effects against Stx and Shigella dysenteriae. The nucleotide sequence corresponding to the chimeric protein was cloned into pET28a plasmid and expressed in E. coli BL21 (DE3). Protein expression was confirmed by SDS-PAGE and the recombinant protein was purified by Ni-NTA affinity chromatography. The 150 μg of chimeric protein was mixed with Freund's adjutant and injected into laying hens (Leghorn). IgY was purified using PEG6000 precipitation. Antibody titer in the serum and egg yolk was evaluated by ELISA. IgY challenge against 1,10 and 50 LD50 of Stx and S. dysenteriae was investigated. A 60.6 kDa recombinant protein was confirmed by SDS-PAGE. ELISA showed that the antibody titer was significantly increased. MTT assay [3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide] showed that at 16 μmol/L, IgY protected HeLa cells against Stx. Treatment of mice with 1000 and 1500 μg IgY leads to complete survival of the mice against 1LD50 toxin and 4000 μg of IgY led to complete survival against 1LD50, also 70% and 30% survival against 10 and 50 LD50 S. dysenteriae. This study showed that IgY produced against Stx and Shigella virulence factors could cause high protective effects against bacteria and toxins

Antibacterial activity and mechanism of action of chitosan nanofibers against toxigenic Clostridioides (Clostridium) difficile Isolates

Background. Clostridioides difficile a Gram-positive, obliged anaerobic, rod-shaped spore-former bacterium, causes a wide spectrum of diseases, ranging from mild, self-limiting diarrhoea to serious diarrhea. Chitosan, a natural polysaccharide, is largely known for its activity against a wide range of microorganisms. Chitosan, in the form of nanofibrils (nanofibrilated chitosan), consists of separated fibers which can be suspended easily in aqueous media. Study design. This paper, for the first time, aims to evaluate the antimicrobial activity of chitosan nanofibers against C. difficile isolates. Methods. Chitosan nanofibers were characterized through scanning electron microscopy and atomic force microscopy. Minimum inhibitory concentration and minimum bactericidal concentration of chitosan nanofibers against toxigenic C. difficile isolates (with resistance gene: ermB, tetM and tetW) was determined by the standard broth microdilution method. Results. The Miniumum Inhibitory Concentration of chitosan nanofibers for two toxigenic isolates with resistance genes ermB, tetM and tetW, two toxigenic isolates ermB+ tetM+ and the standard strain ATCC 700057 was similar and equal to 0.25 mg/mL. The minimum bactericidal concentration for all isolates was 0.5 mg/mL. Conclusions. The results demonstrated that chitosan nanofibers exhibit potent antimicrobial activities against multiple toxigenic C. difficile isolates, and the antibacterial effect of chitosan nanofibers against C. difficile isolates with ermB, tetM and tetW resistance genes indicates that interfering with the synthesis of proteins is not the mechanism of action of chitosan nanofibers

Learning Styles of First Year Nursing and Midwifery Students in Ilam University of Medical Sciences

Introduction: Learners have very different learning styles depend on their preference, psychological preparedness as well as physical condition of their senses. Identification of proper learning styles plays an important role for choosing effective teaching methods, transferring concepts, and finally improving education quality. This study aimed to identify learning style of first year nursing and midwifery students in Ilam University of medical science. Methods: In this cross-sectional study, 50 first year nursing and midwifery students at Ilam University of Medical Sciences were studied, in 2009. Data collection was done using VARK questionnaire. Results: 56% of samples (n=28) were female. 44% (22 students) preferred a single learning style (Uni-modal) and 56% preferred multi-modal learning styles. Students, who preferred only one style, preferred reading/writing style to other styles. While other students who preferred more than one styles, used quad-modal. Conclusion: In this study, the preferred learning styles were reading/writing, aural, kinesthetic and visual, respectively. Determination of desired learning styles of first- semester students can be helpful for choosing appropriate teaching methods by educational groups and faculty members, which lead to achieving educational goals

Symptom Prediction and Mortality Risk Calculation for COVID-19 Using Machine Learning

Background: Early prediction of symptoms and mortality risks for COVID-19 patients would improve healthcare outcomes, allow for the appropriate distribution of healthcare resources, reduce healthcare costs, aid in vaccine prioritization and self-isolation strategies, and thus reduce the prevalence of the disease. Such publicly accessible prediction models are lacking, however.Methods: Based on a comprehensive evaluation of existing machine learning (ML) methods, we created two models based solely on the age, gender, and medical histories of 23,749 hospital-confirmed COVID-19 patients from February to September 2020: a symptom prediction model (SPM) and a mortality prediction model (MPM). The SPM predicts 12 symptom groups for each patient: respiratory distress, consciousness disorders, chest pain, paresis or paralysis, cough, fever or chill, gastrointestinal symptoms, sore throat, headache, vertigo, loss of smell or taste, and muscular pain or fatigue. The MPM predicts the death of COVID-19-positive individuals.Results: The SPM yielded ROC-AUCs of 0.53–0.78 for symptoms. The most accurate prediction was for consciousness disorders at a sensitivity of 74% and a specificity of 70%. 2,440 deaths were observed in the study population. MPM had a ROC-AUC of 0.79 and could predict mortality with a sensitivity of 75% and a specificity of 70%. About 90% of deaths occurred in the top 21 percentile of risk groups. To allow patients and clinicians to use these models easily, we created a freely accessible online interface at <ext-link ext-link-type="uri" xlink:href="http://www.aicovid.org/" xmlns:xlink="http://www.w3.org/1999/xlink">www.aicovid.net</ext-link>.Conclusion: The ML models predict COVID-19-related symptoms and mortality using information that is readily available to patients as well as clinicians. Thus, both can rapidly estimate the severity of the disease, allowing shared and better healthcare decisions with regard to hospitalization, self-isolation strategy, and COVID-19 vaccine prioritization in the coming months

Assessment of interpersonal communication skill levels in lecturers of Ilam University of medical sciences: A case study

Introduction: One of the most effective factors on quality of learning is using appropriate communication skills by faculty. Appropriate communicational foundation cause to pass information to students as well. The present study aimed to evaluation interpersonal communication skill levels in lecturers of Ilam University of Medical Sciences. Methods: In this descriptive-analytic study, 60 lecturers of Ilam University of Medical Sciences with randomly sampling were selected in 2009. Data collection was performed using a questionnaire of Interpersonal Communication skills test. The questionnaire has 34 questions and based on 170 scores. Data was analyzed using SPSS software ver.16 and t test and Pearson correlation. Results: Mean age ± standard deviation of participants was 36.03±7.86 years and 80% were male. Overall, 30% of participants were assistant professor and 45% had more than 5 years educational experiences. Mean score of communication skills of lecturers was 106.53 ± 8.59 that it was significantly associated with their gender (p<0.04). While, this relationship not found for age of lecturers, teaching experiences and their scientific ranking. Conclusion: Based on results, Interpersonal communication skill levels of lecturers study were evaluated average. Conducting of educational workshop on interpersonal communication for lecturers is one of the methods to improve their effective communications which can cause to increasing learning and promoting communicational skills of students