Isolation of keratinophilic fungi from soil in Isfahanprovince, Iran

Objective. — To evaluate the epidemiology of keratophilic fungi in Isfahan province, Iran.Material and methods. — The present research has been conducted on soil samples collected from 16 townships of Isfahan province. For isolate geophilic dermatophytes and keratinophilic fungi, the keratin baiting technique has been applied. Results. — Of 800 soil samples examined, 588 (73.5%) keratinophilic fungi were isolated. The present studied recognized 727 isolates including 16 species of 11 genus, as follows: Chrysosporium keratinophilum (31.4%), C. pannicola (16.9%), C. tropicum (15.4%), Microsporum gypseum (12.4%), Chrysosporium spp. (9.9%), C. indicum (7%), Sepedonium spp. (3.3%), Malbranchia spp. (1%), Trichophyton terrestre (0.8%), T. ajelloi and Paecilomyces lilacinus (0.4%), Engyodontium album and Acremonium spp. (0.3%), Curvularia spp., Fusarium spp. and Ulocladium spp. (0.1%). In this study, E. album was isolated for the first time in this country (Iran). The frequency these keratinophilic fungi are discussed in relation to different agents such as soil pH. Conclusion. — This study contributes to the knowledge of keratophilic fungi in Iran. # 2011 Elsevier Masson SAS. All rights reserve

Social Accountability in Nursing Education: A Necessary Yet Neglected Issue

Background: Evidence-Based Practice (EBP) is one of the nursing professional roles that can lead them to provide the best and more effective care. However, no studies are available on nursing students’ competencies in EBP. Objectives: This study aimed to investigate the nursing students’ knowledge, attitude and intention to implement EBP and its related factors in two nursing and midwifery faculties in Tehran, Iran. Materials and Methods: In this cross-sectional study, 170 undergraduate nursing students were selected from two faculties of nursing and midwifery in Tehran, Iran. A census sampling method was applied and they were all before graduation in 2013. The Rubin and Parrish questionnaire was used to assess the students’ knowledge, attitude and intention to implement EBP as well as factors affecting the implementation of EBP. Students completed the instrument through self-report. Descriptive statistics, Independent sample t-test and Pearson correlation coefficient were used to analyze the data. Results: The students mean scores of knowledge, attitude and intention to implement EBP was 31.08 ± 5.77, 50.40 ± 9.58, 36.01 ± 4.64, respectively. The students’ age was inversely correlated with their scores of knowledge, attitude and intention to use EBP (P < 0.05). However, the students’ GPA was in direct association with their knowledge, attitude and intention to implement EBP (P < 0.05). No significant differences were observed between the males and females mean scores in the three subscales. However, significant differences were found between the students mean scores in the two subscales of knowledge and attitudes toward EBP in terms of familiarity with statistics and research methods (P < 0.05). Neither familiarity with research methods nor familiarity with EBP could significantly affect the students’ intention to implement EBP. Conclusions: The present study showed that nursing students have not a high mean score in the three subscales of knowledge, attitude and intention to implement EBP. It is essential for faculties and nurse managers not only to focus on education of EBP, but also to support nurses and nursing students to implement it in the process patient care

Pamphlet as a tool for continuing medical education: Performance assessment in a randomized controlled interventional study

Background: Pamphlet is a tool used for distance continuous professional development programs. In this study, we assessed the impact of an educational pamphlet on improving prescription writing errors in general physicians' performance. Methods: In this randomized controlled interventional study, we prepared a training pamphlet according to the most prevalent prescription writing problems. We randomized 200 participants among general physicians affiliated with Tehran Social Security Insurance Organization, and randomly divided them into intervention and control groups. Participants' prescriptions (N= 34888) were investigated over a month, and then the prepared pamphlet was sent out to the participants in the intervention group. After three months we examined their one-month prescriptions again (N= 30296) and investigated the changes in prescription errors. Results: There was no significant difference in the mean number of prescriptions in two groups before and after intervention (p= 0.076). Mean number of medicinal items reduced significantly in intervention group. Also mean number of prescriptions including injection drugs (p= 0.024), Corticosteroids (p= 0.036), Cephalosporin (p= 0.017) and non-steroidal anti-inflammatory drugs (p=0.005) reduced significantly. No significant differences were found for other errors. Conclusion: This study showed that use of an appropriate pamphlet has a considerable impact on improving general physicians' performance and could be applied for continuous professional development

Hydrodynamic instabilities in gaseous detonations: comparison of Euler, Navier–Stokes, and large-eddy simulation

A large-eddy simulation is conducted to investigate the transient structure of an unstable detonation wave in two dimensions and the evolution of intrinsic hydrodynamic instabilities. The dependency of the detonation structure on the grid resolution is investigated, and the structures obtained by large-eddy simulation are compared with the predictions from solving the Euler and Navier–Stokes equations directly. The results indicate that to predict irregular detonation structures in agreement with experimental observations the vorticity generation and dissipation in small scale structures should be taken into account. Thus, large-eddy simulation with high grid resolution is required. In a low grid resolution scenario, in which numerical diffusion dominates, the structures obtained by solving the Euler or Navier–Stokes equations and large-eddy simulation are qualitatively similar. When high grid resolution is employed, the detonation structures obtained by solving the Euler or Navier–Stokes equations directly are roughly similar yet equally in disagreement with the experimental results. For high grid resolution, only the large-eddy simulation predicts detonation substructures correctly, a fact that is attributed to the increased dissipation provided by the subgrid scale model. Specific to the investigated configuration, major differences are observed in the occurrence of unreacted gas pockets in the high-resolution Euler and Navier–Stokes computations, which appear to be fully combusted when large-eddy simulation is employed

The effect of intra-wound vancomycin powder application in reducing surgical site infections after total hip arthroplasty

Post-operative total hip arthroplasty surgical wound infections are associated with substantial morbidity, mortality, and economic burden. Intra-wound vancomycin powder application may prevent infections after hip surgery. The objectives of this study is to answer the question as to whether the application of 2 gram intra-wound vancomycin powder In patients undergoing total hip arthroplasty, lead to reduced rates of postoperative surgical site infections or not? From April 2013, 125 patients had consent prior to their hip surgery. These 125 patients had total hip arthtoplasty by three different surgeons at Imam Hossein hospital. All patients received either 2 grams of IV Cefazolin one hour prior to the incision or 1 gram of IV Vancomycin one hour prior to the incision in patient with a Penicillin allergy. Near the end of the procedure, the wound was thoroughly irrigated with normal saline. for All patients befor surgical wound closure 2 gram of Vancomycin powder was poured into the wound. Postoperatively, patients continued on intravenous antibiotics for twenty-four hours. All patients underwent routine postoperative surgical care including physical therapy, routine radiographs, and routine managment of pain medications. Laboratory tests include Hb , BUN, Cr and electrolits were done before surgery and postoperatively after 48 hours and 7 days. All patients were discharged within the first 3 days after surgery and follow-up at weeks 2 and 4 and one year after surgery was performed. During the course of follow up that has ranged from one months to one year, sixteen of patients experienced surgical site infection. 10 patients were lost to follow up. No allergic reactions or adverse outcomes were reported from the use of 2 gram of Vancomycin powder prior to closure. Although intra-wound application of Vancomycin is known to minimize infections in spinal surgery little previous studies reported if Vancomycin application will reduce surgical site infection in hip surgeries. This study demonstrates that intra-wound application of Vancomycin reduces surgical site infection in total hip arthroplasty without any adverse complications

Is the Wild Coast in eastern South Africa a distinct marine bioregion?

Abstract: The South African coastline can be divided into at least four temperature-defined marine bioregions, including the tropical north-east coast, the subtropical east coast, the warm-temperate south coast, and the cool-temperate west coast. There are also two biogeographical transition zones, the south-west coast and the south-east coast (or Wild Coast). The former is sometimes considered a distinct marine bioregion, but no such status has yet been suggested for the Wild Coast. Previous data on the distribution of a recently described but very common coastal crab, Hymenosoma longicrure, indicated that this species could be a Wild Coast endemic. If confirmed, this would be a first indication that this region harbours unique fauna, and that additional research is required to determine whether the Wild Coast constitutes a distinct bioregion that needs to be managed separately from other coastal regions. In the present study, we generated novel genetic data for H. longicrure and compared the species’ range with that of its southern African congeners. We found that H. longicrure occurs north of the Wild Coast, where its range overlaps with that of H. projectum. This finding rejects the idea that the Wild Coast harbours endemic fauna and suggests that the ranges of the two species may be linked to the subtropical and tropical bioregions, respectively, with some southward dispersal facilitated by the southward-flowing Agulhas Current. We conclude that there is as yet no compelling evidence that the Wild Coast is a distinct marine bioregion, and concur with previous biogeographical studies which have suggested that the Wild Coast is an area in which species from the subtropical and warm-temperate bioregions have overlapping ranges. Nonetheless, that fact that no biological information is available for the majority of the region’s estuaries highlights the necessity of comprehensively documenting the biodiversity of this understudied region to fully resolve this issue

Causes and risk factors of urinary incontinence: Avicenna's point of view vs. contemporary findings

Purpose: To extract the causes and risk factors of urinary incontinence from an old medical text by Avicenna entitled "Canon of Medicine" and comparing it with contemporary studies. Materials and Methods: In this study, etiology and risk factors of urinary incontinence were extracted from Avicenna's "Canon of Medicine". Commentaries written on this book and other old reliable medical texts about bladder and its diseases were also studied. Then the achieved information was compared with contemporary findings of published articles. Results: Urinary incontinence results from bladder dysfunction in reservoir phase. Bladder's involuntary muscles and voluntary external sphincter are two main components which are involved in this process. Urinary incontinence can exist without obvious structural and neuronal etiologies. According to Avicenna, distemperment of muscular tissue of bladder and external sphincter is the cause for urinary incontinence in such cases. Distemperment is the result of bothering qualities in tissue, i.e.: "wet" and "cold". They are the two bothering qualities which are caused by extracorporeal and intracorporeal factors. Interestingly, the positive associations of some of these factors with urinary incontinence have been shown in recent researches. Conclusion: "Cold" and "wet" distemperment of bladder and external sphincter can be independent etiologies of urinary incontinence which should be investigated

Psychometric properties of the Postgraduate Hospital Educational Environment Measure in an Iranian hospital setting

Background: Students’ perceptions of the educational environment are an important construct in assessing and enhancing the quality of medical training programs. Reliable and valid measurement, however, can be problematic – especially as instruments developed and tested in one culture are translated for use in another. Materials and method: This study sought to explore the psychometric properties of the Postgraduate Hospital Educational Environment Measure (PHEEM) for use in an Iranian hospital training setting. We translated the instrument into Persian and ensured its content validity by back translation and expert review prior to administering it to 127 residents of Urmia University of Medical Science. Results: Overall internal consistency of the translated measure was good (a=0.94). Principal components analysis revealed five factors accounting for 52.8% of the variance. Conclusion: The Persian version of the PHEEM appears to be a reliable and potentially valid instrument for use in Iranian medical schools and may find favor in evaluating the educational environments of residency programs nationwide