Effects of Intraluminal Vancomycin in Decreasing Central Venous Catheter Infection

Background: Central venous catheters (CVC) are important intravenous routes, that nowadays they can be used for various reasons including resuscitation management, intravenous feeding, chemotherapy drugs, and blood transfusions. Due to the special importance and increasing usage of these catheters lengthening the duration of these catheters are very important. Infections are the most common cause of removal of this catheter.Methods: In this prospective study (cohort), 80 patients with central venous catheter were divided into two groups. In the first group Vancomycin once per day injected inside catheter equal to their intraluminal volume and remained for 2 h, then catheter was aspirated and washed. But in control group catheter was washed only with normal saline. Finally, catheter infection rates in the two groups were compared.Results: In the group that used intraluminal Vancomycin, catheter infection was ‎observed in 3 cases and was confirmed by blood culture, but in none of them ‎catheter infection agent was not Gram-positive cocci.‎ In control group, 18 cases of catheter infection were confirmed by culture that in 16 cases were caused by Gram-positive cocci that in 14 cases catheter was removed, and in 2 cases of catheter infection, infectious agent was Staphylococcus epidermidis which catheter maintained with appropriate antibiotics.Conclusions: Use of the intraluminal Vancomycin significantly reduces the rate of infection and thus increase the survival rate of CVC

Epidemiological study on sand flies in an endemic focus of cutaneous leishmaniasis, Bushehr city, southwestern Iran

Cutaneous leishmaniasis is the most important health problem in the city of Bushehr, southwestern Iran. The objective of the study was to determine some ecological aspects of sand flies in the city during 2010-2011. Sand flies were collected monthly from outdoors and indoors by sticky traps at four selected districts of the city. They were also dissected and examined by nested-PCR for identification of the parasite during August-September of 2011. A total of 1234 adult sand flies were collected and 6 species including 3 of Genus Phlebotomus and 3 of Genus Sergentomyia were identified. Four species including P. papatasi (3.98%), P. sergenti (1.14%), S. tiberiadis (87.18%), and S. baghdadis (7.7%) were found indoors. Six species including P. papatasi (3.47%), P. sergenti (3.17%), P. alexandri (0.1%), S. tiberiadis (77.74%), S. baghdadis (15.41%), and one female of S. clydei (0.11%) were collected from outdoors. Sand flies started to appear from March and disappear at the end of January. There was only one peak in the density curve in July. The study revealed that S. tiberiadis and S. baghdadis could enter indoors which 89 and 81.8% of them were found blood-fed, respectively. Moreover, P. papatasi, S. tiberiadis, and S. baghdadis were active indoors and outdoors in most months of the year. Nested-PCR of P. papatasi females was positive against kinetoplast DNA of L. major and L. turanica and also mixed natural infections were found by L. gerbilli and L. turanica. Moreover, mixed infections by L. major and L. turanica were observed in this species. Sergentomyia clydei and S. tiberiadis were found to be negative to any DNA of Leishmania species. Phlebotomus sergenti females were found infected with DNA of L. turanica and this is the first report of natural infection and detection of the parasite from this sand fly species in worldwide

Basal Cell Carcinoma of Vermilion Mucosa of Upper Lip: a Rare Case Report

Although basal cell carcinoma (BCC) is a common skin tumor, very rare cases of BCC arising from upper vermilion mucosa of lip have been reported previously. This tumor basically, originates from pillar structures and the involvement of the vermilion lip contrasts this concept so it is devoid of hair follicles and sweat glands. The exact pathogenesis of vermilion lip BCC is not clear but it has been postulated that the neoplasm originates from the pluripotential epithelial cells of the oral mucosa and epidermis. On the other hand, some authors consider their origin from ectopic sebaceous glands. Herein, we report a 34- year-old man with an asymptomatic ulcerated lesion on the upper left lip vermilion mucosa .The diagnosis of BCC was confirmed with histopathological examination after incisional biopsy of the mucosal neoplasm. After surgery of lip lesion, no recurrency was seen after 3 months follow-up the patient

Adult Variant of Self-healing Cutaneous Mucinosis in a Patient with Epilepsy

A 52-year-old woman was admitted with a 3 weeks history of periorbital edema and lips swelling. She developed several subcutaneous firm erythematous papules and nodules on the face, scalp and two indurated plaques on the upper back and left forearm. These lesions grew rapidly. The patient had a positive history of epileptic seizures since childhood. General examination was normal. There was a mild pitting edema on her hands and feet. Laboratory data were within normal limits. Histopathological examination revealed a well circumscribed accumulation of mucin in the dermis. Alcian blue stain was positive. Clinical and histopathological findings followed by spontaneous resolution of the lesions within a period of 4 months was compatible with diagnosis of self-healing cutaneous mucinosis. Herein we report the first case of self-healing cutaneous mucinosis associated with epilepsy

A Feasibility Study on Using the Facilities of Health Centers for Developing a Laboratory Network on Vectors and Reservoir Hosts of Cutaneous Leishmaniasis in Iran

Background: Cutaneous leishmaniasis is an ancient endemic disease in Iran and continues to be a growing health threat to community development and the environment. This paper explains how to use the facilities of health centers for developing a laboratory network on vectors and reservoir hosts of cutaneous leishmaniasis in Iran. Methods: A literature search was performed of the relevant multiple databases to include studies on vectors and reservoirs of cutaneous leishmaniasis in Iran. A team of experienced experts was performed. After holding several meetings, field visits and organizing workshops, the activities of laboratories were determined at three levels. Results: Entomological studies showed that 5 species of the genus Phlebotomus and 10 species of the genus Sergentomyia are active in the south, 4 species of the genus Phlebotomus and one species of the genus Sergentomyia in the central part and 5 species of the genus Phlebotomus and 2 species of the genus Sergentomyia in the north east. Reservoir hosts were identified in the study areas. The tasks of laboratories were regulated at different levels. Conclusion: The Iranian Ministry of Health and Medical Education should prioritize the employment of capable persons in the field of Medical Entomology and Vector Control. The survival of this laboratory network depends on hiring and employing interested and persistent people. The universities of Medical Sciences that have the facilities to set up this network will be a very effective partner in the control of the disease in high risk areas. The results can be used in neighboring countries.Fil: Reza Yaghoobi Ershadi, Mohammad. Tehran University of Medical Sciences; IránFil: Akhavan, Amir Ahmad. Tehran University of Medical Sciences; IránFil: Reza Shirzadi, Mohammad. Iranian Ministry of Health and Medical Education; IránFil: Zohreh Hosseini, Seyedeh. Tehran University of Medical Sciences; IránFil: Salomón, Oscar Daniel. Secretaria de Gobierno de Salud. Instituto Nacional de Medicina Tropical. Instituto Nacional de Medicina Tropical - Sede Tucumán; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste; ArgentinaFil: Hanafi Bojd, Ahmad Ali. Tehran University of Medical Sciences; IránFil: Rassi, Yavar. Tehran University of Medical Sciences; Irá

A survey of reservoir hosts in two foci of cutaneous leishmaniasis in Kerman province, southeast of Iran

In the Old World, cutaneous leishmaniasis (CL) is zoonoses and natural vertebrate hosts of CL parasites are mammals. This study was carried out on natural infection rates of Leishmania parasites in reservoir hosts in one new focus of zoonotic cutaneous leishmaniasis (ZCL) and in suspected reservoir in an old focus of ACL in Iran. The sampling of rodents using Sherman traps was carried out and PCR technique was used for detection and identification of Leishmania species in Bahreman district, Kerman province, southeast of Iran. In addition, the smears were taken from suspicious lesions in stray dogs in the city of Kerman, the center of Kerman province. Simultaneously, pieces of lesion (1 9 191 cm) were taken for further histopathological examination. Overall, 25 rodents were collected and identified, including Meriones libycus and Rhombomys opimus. Amastigotes were observed in 33 % of the R. opimus by microscopic examination and indentified as Leishmania major by PCR technique. Four suspicious dogs out of 391 stray dogs showed no Leishmania species. To the best of our knowledge, this is the first isolation and identification of L. major from R. opimus in Kerman province, where ZCL has been present in recent years. Therefore, R. opimus is considered as the main animal reservoir host in Bahreman ZCL focus. In ACL focus such as the city of Kerman, dogs had no role in CL infection as reservoir host

A Feasibility Study on Using the Facilities of Health Centers for Developing a Laboratory Network on Vectors and Reservoir Hosts of Cutaneous Leishmaniasis in Iran

Background: Cutaneous leishmaniasis is an ancient endemic disease in Iran and continues to be a growing health threat to community development and the environment. This paper explains how to use the facilities of health centers for developing a laboratory network on vectors and reservoir hosts of cutaneous leishmaniasis in Iran. Methods: A literature search was performed of the relevant multiple databases to include studies on vectors and reservoirs of cutaneous leishmaniasis in Iran. A team of experienced experts was performed. After holding several meetings, field visits and organizing workshops, the activities of laboratories were determined at three levels. Results: Entomological studies showed that 5 species of the genus Phlebotomus and 10 species of the genus Sergentomyia are active in the south, 4 species of the genus Phlebotomus and one species of the genus Sergentomyia in the central part and 5 species of the genus Phlebotomus and 2 species of the genus Sergentomyia in the north east. Reservoir hosts were identified in the study areas. The tasks of laboratories were regulated at different levels. Conclusion: The Iranian Ministry of Health and Medical Education should prioritize the employment of capable persons in the field of Medical Entomology and Vector Control. The survival of this laboratory network depends on hiring and employing interested and persistent people. The universities of Medical Sciences that have the facilities to set up this network will be a very effective partner in the control of the disease in high risk areas. The results can be used in neighboring countries.Fil: Reza Yaghoobi Ershadi, Mohammad. Tehran University of Medical Sciences; IránFil: Akhavan, Amir Ahmad. Tehran University of Medical Sciences; IránFil: Reza Shirzadi, Mohammad. Iranian Ministry of Health and Medical Education; IránFil: Zohreh Hosseini, Seyedeh. Tehran University of Medical Sciences; IránFil: Salomón, Oscar Daniel. Secretaria de Gobierno de Salud. Instituto Nacional de Medicina Tropical. Instituto Nacional de Medicina Tropical - Sede Tucumán; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste; ArgentinaFil: Hanafi Bojd, Ahmad Ali. Tehran University of Medical Sciences; IránFil: Rassi, Yavar. Tehran University of Medical Sciences; Irá

Evaluation of susceptibility status of Phlebotomus papatasi, the main vector of zoonotic Cutaneous Leishmaniasis, to different WHO recommended insecticides in an endemic focus, Central Iran

Background: Among neglected zoonotic diseases, leishmaniases caused by Leishmania parasite through infected female sand fly bite, are a group of diseases found in 98 countries and territories representing a critical burden of disease worldwide. Vector management plays a crucial role in reducing the burden of vector-borne diseases by WHO’s global plan. The objective of the current study was to assess the susceptibility status of wild phlebotomine sand flies from Esfahan Prov- ince, central Iran, to the recommended insecticides by WHO. Methods: Sand flies were collected by mouth aspirator in Matin Abad desert Eco-resort and were tested using WHO adult mosquito test kit against Dichlorodiphenyltrichloroethane (DDT) 4%, Deltamethrin 0.05%, Malathion 5% and Propoxur 0.1%. The number of knockdown sand flies were recorded during exposure time in ten minutes interval for DDT and Deltamethrin and they were allowed to recover for 24 hours. Knockdown Time50 (KD50) and KD90 were generated for them using Probit software. They were mounted and identified by valid keys. Results: Among the tested insecticides against female Phlebotomus papatasi, DDT, Deltame- thrin, and Malathion recorded the highest mortality rate of 100%, followed by Propoxur with 92.2% mortality for a one-hour exposure. For DDT, KD50 and KD90 were calculated 21.87 and 42.93 and for Deltamethrin, they were 23.74 and 56.50 minutes respectively. Total sand flies ex-posed with DDT and Deltamethrin shed their leg(s). Conclusion: It is concluded that Ph. papatasi from central Iran is susceptible to DDT, Deltame- thrin, Malathion, and Propoxur

Outpatient Transurethral Cystolithotripsy of Large Bladder Stones by Holmium Laser

Introduction: To assessment of the efficacy and safety of transurethral cystolithotripsy of large bladder stones by holmium laser in the outpatient setting.Methods: In a prospective study, 48 consecutive adult patients with large bladder stones, were enrolled for transurethral cystolithotripsy. Patients older than 18 years, with bladder stones larger than 2 cm were enrolled. Urethral stricture, active urinary infection, and any anesthetic contraindications for operation, were the exclusion criteria. Demographic characteristics of patients, outcomes and complications related to operation and post operation period, were recorded.Results: Patients mean age was 46 ± 7.3 years. Male to female ratio was 45/3. Mean body mass index of patients was 28.5 ± 3.5. Mean stone size was 3.7 ± 1.6 cm. Mean operation time was 43.5 ± 15.5 minutes. Nearly complete stone clearance (98.5%) was achieved in all patients. Mean hospital stay was 6.5 ± 1.3 hours. No major complications were seen. Mean visual analog pain score (VAS) was 4.2 ± 2.1 and 1.4 ± 0.6, during and 1 hour after operation, respectively. During follow up of 22.4 ± 12.5 months, recurrence of bladder stone was not seen. No case of urethral stricture was detected.Conclusion: Transurethral holmium laser lithotripsy is an effective and safe alternative in selected patients with large bladder stones. This procedure can be easily performed in the outpatient setting