Clinical microbiology study of diabetic foot ulcer in Iran; pathogens and antibacterial susceptibility

The aim of this study was to investigate microbial pathogens and their antibiotic susceptibility profile in infected diabetic foot ulcers in Iranian patients. This was a one-year cross sectional study on diabetic patients with infected diabetic foot ulcer at Shariati Teaching Hospital, Tehran, Iran. Grade of ulcer was determined by Wagner's criteria. Specimens were obtained from the base of ulcer, deep part of the wound or aspiration and were tested with gram staining and antibacterial susceptibility was determined with both disk diffusion and E-Test methods. Total of 546 pathogens were isolated from 165 ulcers of 149 patients. Gram positive aerobes including Enterococcal species and methicillin resistant Staphylococcus aureus (S. aureus) (21.4 and 19.4%, respectively) were identified as the most common pathogens followed by Gram negative isolates including Escherichia coli and Pseudomonas-aeruginosa (12.6 and 5.4%, respectively). The majority of wounds were classified as Wagner grades 2 and 3 (15.7 and 75.7%). Appropriate empiric treatment to cover both these Gram positive and Gram negative pathogens is crucially important

Ebola Hemorrhagic Fever as a Public Health Emergency of International Concern; a Review Article

Ebola hemorrhagic fever (EHF) was first reported in 1976 with two concurrent outbreaks of acute viral hemorrhagic fever centered in Yambuku (near the Ebola River), Democratic Republic of Congo, and also in Nzara, Sudan. The current outbreak of the Ebola Virus was started by reporting the first case in March 2014 in the forest regions of southeastern Guinea. Due to raising infection rates of over 13,000% within a 6-month period, now is considered as a global public health emergency and in August 8, 2014 the World Health Organization (WHO) has declared the epidemic to be a Public Health Emergency of International Concern. With more than 5000 involved cases and also nearly 3000 deaths, this event has turned to the largest and most dangerous Ebola virus outbreak in all around the world. Based on above mentioned, the present article aimed to review the virologic characteristics, transmission, clinical manifestation, diagnosis, treatment, and prevention of Ebola virus disease

Pregnancy Screening before Diagnostic Radiography in Emergency Department; an Educational Review

Radiation exposure during pregnancy may have serious teratogenic effects to the fetus. In modern medical practice, there is an increasing dependence on imaging techniques in most medical specialties. Therefore, checking the pregnancy status before imaging women of child bearing age is essential. Lack of international regulations and standard protocols exposes the patient to unexpected fetal radiation effects and the health professionals to medicolegal suits. Recently, the American Academy of Radiology and the European community of Medical Ionizing Radiation Protection released national guidelines regarding pregnancy screening before imaging potentially pregnant females. However, different methods of pregnancy screening exist among different radiology centers. This review aims to discuss the most recent guidelines for imaging females of childbearing age and highlight the need for an international regulation to guide pregnancy screening before radiological exposure

The Risk of Venous Thromboembolism with Different Generation of Oral Contraceptives; a Systematic Review and Meta-Analysis

Introduction: Oral contraceptives (OCs) are considered as one of the most common risk factor of venous thromboembolism (VTE) in child bearing age. Some of the recent researches indicate that the odds of VTE may be even higher with newer generations of OCs. The present meta-analysis was designed to evaluate the effect of different generation of OCs on the occurrence of VTE. Methods: Two researchers independently ran a thorough search in Pubmed, ISI Web of Science, EMBASE, CINAHL and Scopus databases regarding study keywords including thromboembolic event, thromboembolism, embolism, thromboembolic, thrombotic and thrombosis, combined with oral contraceptive. The outcomes were the incidence of diagnosed thromboembolism, such as deep vein thrombosis, pulmonary embolism and cerebral venous thrombosis. Based on the heterogeneity of the studies, random effect model was used and pooled odds ratio was reported. Results: Three cohort and 17 case-control studies with 13,265,228 subjects were entered into meta-analysis. Analysis showed that the odds of VTE in women taking OCs are more than three-fold (OR=3.13; 95% CI: 2.61-3.65). The risk of VTE in women taking first-, second- and third-generation OCs are 3.5 fold (OR=3.48; 95% CI: 2.01-4.94), 3 fold (OR=3.08; 95% CI: 2.43-3.74) and 4.3 fold (OR=4.35; CI: 3.69‒5.01), respectively. Conclusion: It seems that the risk of VTE is not same between different generations of OCs, so that third-generation has highest risk. Taking second and third-generation OCs increases the risk of VTE up to 3 and 4.3 fold, respectively. The researchers of the present study suggest that more clinical trials be designed in relation to the effect of newer generations of OCs in different communities.

An environmentally friendly soil improvement technology for sand and dust storms control

Background: Dust storms occur when unchecked, strong, or turbulent winds combine with exposed loose and dried soil surfaces. Sand and dust storms have a significant impact on society, economy, and environment at local, regional, and global levels. The environmental and health hazards of such storms cannot be permanently reduced, however, by taking appropriate measures, its impact can be reduced. The present study aimed to investigate the effects of microbial precipitation of calcium carbonate (CaCO3) as a biocompatible agent on soil stabilization and control of dust storms using ureaseproducing bacteria (UPB) as a biological improvement technique, which were isolated, identified, sprayed on the soil surface. Methods: For this purpose, the erosion of bio-cemented soil samples was investigated experimentally in a wind tunnel under the condition of wind velocity of 0 to 98 km.h-1 in two soil types with sandy and silty texture in a completely randomized design with three replicates. Results: The investigation of the threshold wind velocity of soil particles showed that soil particles began to move at velocity of 8 and 10 km.h-1 in silty and sandy soils, respectively, but in all biological samples (MICP), particles did not move until the wind speed reached 97 km.h-1. It was also revealed that the weight loss of all MICP-treated samples at different wind velocities was significantly reduced compared to the control group. Differences in the amount of soil loss among bio-cemented samples and control treatments were even superior at higher velocities, so that at velocities more than 57 km.h-1, soil losses increased significantly in the control group, while in soils treated with bacteria, soil loss was very low (about 2.5 kg.m-2.h-1). Comparison of the bacteria used in this study also showed that Bacillus infantis and Paenibacillus sp3 had high efficiency in controlling dust storms. Conclusion: The formation of abrasion-resistant surface layers on soil samples treated by biocementation showed that cementation by biological methods could be an effective way to stabilize surface particles and control sand and dust storms. Keywords: Urease, Dust storms, Bio cement, Soil loss flu

Estimation Of Saxophone Alternate Fingerings’ Configurations

A method to estimate the saxophone fingerings’ configurations is presented. This is not solely a problem of pitch detection since a sounding pitch can be produced by multiple fingering configurations. The widely used spectral envelope technique in similar problem of speech analysis as a vocal tract impulse response is not sufficient to solve the problem because a player can alter the envelope by controlling the reed vibration through embouchure and blowing pressure. Motivated by Saxophone playing technique, a theoretical model is proposed based on sub harmonics’ and main harmonics’ positions to identify fingerings by measuring the similarity of the input sound spectrum peaks’ positions and models. The proposed method has achieved the accuracy of 73% on a dataset of Bb tenor saxophone recordings, the result has been improved to 87% with combination of pitch as a complementary feature

Eucalyptus species trial on sandy dunes of Khuzestan province (Iran)

There are about 350,000 hectares of sandy dunes and sandy lands in Khuzestan. During the past 40 years, different Physical, chemical and biological operations were applied to stabilize these lands and the results were all satisfied. The aim of the study was to determine the most tolerant species of Eucalyptus to drought and heat for biological fixation of sand dunes. Three species and one provenance of Eucalyptus, including E. camaldulensis 9616, E. camaldulensis, E. microtheca and E. sargentii were planted in 1992 under rainfed condition and statistical design of randomized complete blocks, with three replicates at 3*3meter spacing and against dominant wind direction. In this study, a mulch cover was applied to stabilize the sandy dunes against wind erosion. The measured Eucalyptus characteristics were: survival, height and diameter. After seven years, the data were analyzed, using ANOVA and Duncan tests. The results showed that E. camaldulensis 9616 was the most promising species due to its highest value of survival (73%), mean height (9.66m) and mean diameter at breast height (10 cm)

Social media; resolving tunnel vision in practicing medicine

Background: With the emergence of social media, physicians who use social media, including emergency medicine physicians, have shared their experiences with their colleagues instead of working alone and keeping their experiences to themselves. Objective: This study aimed to evaluate the rate and type of use of electronic online sources and social media, in order to improve learning and education among emergency medicine residents. Methods: This was a cross-sectional study carried out from September 2015 until August 2016 on emergency medicine residents of two main medical universities of Tehran, Iran. A questionnaire was prepared by reviewing the existing studies and asking emergency medicine professors inside and outside Iran for opinions. Census sampling method was applied and all emergency medicine residents were included. The gathered data were analyzed using statistical tests of chi square, Independent-samples t-test and Pearson’s correlation coefficient via SPSS version 21. Results: Seventy three residents with the mean age of 34.2±5.2 years participated in this study (60.3% female). Smart phone is the most important tool they use for connecting to the Internet. About 30% use the Internet for about 1-2 hours a day. In half of these participants less than 25% of this time is spent on something related to their academic field of study. The correlation of sex (p=0.034) and age (p=0.049) with extent of using social media related to the academic field of study were significant. Other analytical analyses were not statistically significant (p>0.05). Conclusion: In summary, the findings of current study showed that despite sufficient access to proper technology, use of social media and online sources by high majority of the studied EM residents regarding improvement of their learning and educational level is very limited

تقسیم بندی علل لنگش حاد کودکان مراجعه کننده به بخش اورژانس؛ یک مقاله مروری

Unusual walking and non-weight bearing on one side of the body is called limping. The incidence of this complication, as an acute complaint in children, is among the causes of emergency department visits and considered as one of the medical challenges in this unit. It is safe to claim that in emergency department, finding the exact cause is not a priority; conversely, it is more important to know that it is not caused by a serious condition. In other words, in the emergency department, ensuring that the cause does not threaten the patient’s life or limb is prioritized over reaching the final diagnosis. Emergency medicine specialists play an important role in detection, diagnosis, and proper referral of these patients. The current manuscript was written in order to facilitate clinical decision-making regarding treatment of children with acute limping visiting emergency department. راه رفتن یک حرکت هارمونیک و منظم می باشد که از دو فاز ایستایی و آویز تشکیل می شود. هرگونه تغییر در این حرکت هارمونیک را لنگش می نامند. بروز این عارضه به صورت حاد در کودکان از جمله علل مراجعه به بخش اورژانس بوده و یکی از چالش های پزشکان در این بخش می باشد. شاید بتوان ادعا کرد که در بخش اورژانس اینکه علت دقیقا چه هست اواویت ندارد و در مقابل اینکه علت چه مواردی نباشد بیشتر مد نظر قرار دارد. به بیانی دیگر در بخش اورژانس رد تشخیص های افتراقی تهدید کننده حیات و یا عضو به نسبت رسیدن به تشخیص نهایی در الویت قرار دارد. متخصصین طب اورژانس نقش بسیار مهمی در شناسایی، تشخیص و ارجاع صحیح این بیماران برعهده داشته و مطالعه حاضر در جهت تسهیل روند تصمیم گیری بالینی در برخورد با کودک دچار لنگش حاد مراجعه کننده به بخش اورژانس نگارش شده است