The frequency of fimbriae genes papA, fimH, kpsMT, papEF and ibeA in Escherichia coli isolated from children urinary tract infection

زمینه و هدف: سویه های اشریشیاکلی عامل مهمی در بروز عفونت ادراری بوده و به گروه اشریشیاکلی بیماری زای خارج گوارشی تعلق دارند. اشریشیاکلی یوروپاتوژنیک فاکتورهای حدت مختلفی را بروز می دهند. این فاکتورها در ایجاد کلونیزاسیون، تهاجم و متعاقب آن کاهش پاسخ دستگاه ایمنی میزبان می شوند. هدف از این مطالعه بررسی فراوانی ژن های حدت fimH،papAH ، ‏papEF، ‏kpsMT و ibeA از جدایه های اشریشیاکلی ایزوله شده از کودکان مبتلا به عفونت ادراری و تعیین حساسیت آنتی بیوتیکی آن بود. روش بررسی: در مجموع 60 جدایه اشریشیاکلی از نمونه های ادراری اخذ گردید. جدایه ها بر اساس تست های بیوشیمیایی و باکتریولوژی استاندارد تشخیص داده شدند. جدایه های تأیید شده به منظور تعیین ژن های papAH، ‏fimH، ‏kpsMT، ‏papEF‏ و ‎ ibeA‏‏توسط روش Multiplex-PCR مورد بررسی قرار گرفتند. آزمون حساسیت آنتی بیوتیکی جدایه ها علیه 9 عامل ضد میکروبی صورت گرفت. یافته ها: ژن حدت fimH دارای بیشترین فراوانی (75) بود. سایر ژن ها شامل‏ ‏kpsMT، ‏papEF‏ و papAHبه ترتیب در 6/21، 6/11 و 10 جدایه ها شناسایی شدند. بیشترین میزان مقاومت به آنتی بیوتیک های پنی سیلین و آمپی سیلین به ترتیب با 3/96 و 2/87 فراوانی و بیشترین میزان حساسیت به ‏آنتی بیوتیک کوآموکسی کلاو با 6/94 فراوانی گزارش شد. نتیجه گیری: نتایج مطالعه حاضر نشان می دهد ژن fimH دارای بیشترین فراوانی در بین سویه های اشریشیاکلی جداسازی شده از عفونت اداری مربوط به کودکان می باشد و عامل مهمی در بیماری زایی این باکتری می باشد

Configuration of soft-tissue sarcoma on MRI correlates with grade of malignancy

The aim of the study was to assess whether the configuration of primary soft-tissue sarcoma (STS) on MRI correlates with the grade of malignancy. 71 patients with histologically proven STS were included. Primary STS were examined for configuration, borders, and volume on MRI. The tumors were divided into high-grade (G3), intermediate-grade (G2) and low-grade (G1) STS according to the grading system of the French Federation of Cancer Centers Sarcoma Group (FNCLCC). 30 high-grade, 22 intermediate-grade and 19 low-grade primary STS lesions were identified. High- and intermediate-grade (G3/2) STS significantly most often appeared as polycyclic/multilobulated tumors (p < 0.001 and p = 0.002, respectively). Low-grade (G1) STS mainly showed an ovoid/nodular or streaky configuration (p = 0.008), and well-defined borders. The appearance of high-, intermediate- and low-grade STS with an ovoid/nodular configuration were mainly the same on MRI. All streaky G3/2 sarcoma and 17 of 20 patients with polycyclic/multilobulated G3 sarcoma showed infiltrative borders. High-grade streaky and polycyclic/multilobulated STS are larger in volume, compared to intermediate- and low-grade STS. . Configuration of STS on MRI can indicate the grade of malignancy. Higher-grade (G2/3) STS most often show a polycyclic/multilobulated configuration, while low-grade STS are mainly ovoid/nodular or streaky. Infiltrative behavior might suggest higher-grade STS in streaky and polycyclic/multilobulated STS

The Role of Immune System Dysfunction in Co-Existence of Neurological Disorders in Psoriasis

No Abstrac

A Guideline for Early Diagnosis of Autoimmune Epilepsy Based on Clinical Manifestations and Common Para-Clinical Tests

No Abstrac

The chemical composition and in vitro digestibility evaluation of almond tree (Prunus dulcis D. A. Webb syn. Prunus amygdalus; var. Shokoufeh) leaves versus hulls and green versus dry leaves as feed for ruminants

The current study aimed to evaluate the chemical composition and in vitro digestibility of almond tree (Prunus dulcis D. A. Webb syn. Prunus amygdalus; var. Shokoufeh) leaves versus hulls, and green versus dry leaves as feed for ruminants. The fresh green almond hulls (GAH) and leaves (GAL) were harvested and spread under a shade to dry. Dry almond leaves (DAL) were collected from under the trees where as dry almond hulls (DAH) were collected 4 weeks after harvesting the fresh samples. The chemical composition of substrates was determined using standard approaches and the metabolisable energy (ME), in vitro dry matter (DMD) and in vitro organic matter (OMD) digestibility were measured using the in vitro gas production (GP) technique. The GAL contained 81 g crude protein (CP) kg-1 DM while DAH contained 103 g CP kg-1 DM. The CP was higher (P = 0.0003) in dry (leaves and hulls) than in green (leaves and hulls) samples. The ash content ranged from 99.2 to 181.5 g kg-1 DM in DAH and DAL, respectively, (P = 0.0041). The ether extract content ranged from 27 for DAH to 65 g kg-1 for DAL (P = 0.0018). The acid detergent fibre and neutral detergent fibre content ranged from 185 to 304 and 444 to 620 g kg-1 DM (P = 0.04), for GAL and DAH, respectively. The DAH had the highest (P = 0.0001) GP24 and GP96. The DAH had the highest (P = 0.0001) potential GP (i.e., b), while the GP rate was highest for GAL and GAH (P = 0.034), ME was highest for DAH (P = 0.0001), and in vitro OMD was highest for DAH (P = 0.0001). The highest DMD (P = 0.0001) values were obtained with DAH followed by GAL, DAL and GAH, respectively. It can be concluded that almond hulls and leaves have a good nutritional potential to cover the maintenance nutrient requirements of small ruminants. Almond hulls and leaves can also be used as supplement to low quality mature pasture and/or crop residues. However, more studies are warranted to better characterize these feeds in in vivo animal feeding trials

The chemical composition and in vitro digestibility evaluation of almond tree (Prunus dulcis D. A. Webb syn. Prunus amygdalus; var. Shokoufeh) leaves versus hulls and green versus dry leaves as feed for ruminants

Almond, (Prunus dulcis D. A. Webb syn. Prunus amygdalus) is a species belonging to the Rosaceae family (Sfahlan et al. 2009). The state of California in the USA is the major producer of almond; however, its production is widely distributed (Wijerante et al. 2006) and there is increasing interest to produce almond and its by-products worldwide. Approximately 2,112,815 metric ton of almonds with shell is produced globally with Iran contributing about 110,000 metric ton (FAO 2007). Almond is a midsize tree with fruit that can grow up to ten meters tall (Chen et al. 2010). The fruit is made of hulls, shell and kernel. Drying almond hulls results in approximately (kg-1 DM) 250 g nut, 500 g hulls and 250 g shell (Aguilar et al. 1984; Fadel 1999).The current study aimed to evaluate the chemical composition and in vitro digestibility of almond tree (Prunus dulcis D. A. Webb syn. Prunus amygdalus; var. Shokoufeh) leaves versus hulls, and green versus dry leaves as feed for ruminants. The fresh green almond hulls (GAH) and leaves (GAL) were harvested and spread under a shade to dry. Dry almond leaves (DAL) were collected from under the trees where as dry almond hulls (DAH) were collected 4 weeks after harvesting the fresh samples. The chemical composition of substrates was determined using standard approaches and the metabolisable energy (ME), in vitro dry matter (DMD) and in vitro organic matter (OMD) digestibility were measured using the in vitro gas production (GP) technique. The GAL contained 81 g crude protein (CP) kg-1 DM while DAH contained 103 g CP kg-1 DM. The CP was higher (P = 0.0003) in dry (leaves and hulls) than in green (leaves and hulls) samples. The ash content ranged from 99.2 to 181.5 g kg-1 DM in DAH and DAL, respectively, (P = 0.0041). The ether extract content ranged from 27 for DAH to 65 g kg-1 for DAL (P = 0.0018). The acid detergent fibre and neutral detergent fibre content ranged from 185 to 304 and 444 to 620 g kg-1 DM (P = 0.04), for GAL and DAH, respectively. The DAH had the highest (P = 0.0001) GP24 and GP96. The DAH had the highest (P = 0.0001) potential GP (i.e., b), while the GP rate was highest for GAL and GAH (P = 0.034), ME was highest for DAH (P = 0.0001), and in vitro OMD was highest for DAH (P = 0.0001). The highest DMD (P = 0.0001) values were obtained with DAH followed by GAL, DAL and GAH, respectively. It can be concluded that almond hulls and leaves have a good nutritional potential to cover the maintenance nutrient requirements of small ruminants. Almond hulls and leaves can also be used as supplement to low quality mature pasture and/or crop residues. However, more studies are warranted to better characterize these feeds in in vivo animal feeding trials

Pathophysiological mechanisms of post-myocardial infarction depression: a narrative review

Myocardial infarction (MI) can have significant physical and mental consequences. Depression is a prevalent psychiatric condition after MI which can reduce the quality of life and increase the mortality rates of patients. However, the connection between MI and depression has remained under-appreciated. This review examines the potential connection between depression and MI by overviewing the possible pathophysiologic mechanisms including dysregulation of the hypothalamic-pituitary-adrenal axis and autonomic nervous system, coagulation system dysfunction, inflammation, environmental factors, as well as, genetic factors. Furthermore, depression can be an adverse event of medications used for MI treatment including beta-blockers, statins, or anti-platelet agents. The need for early detection and management of depression in patients with MI is, therefore, crucial for improving their overall prognosis. Adherence to treatments and regular follow-up visits can ensure the best response to treatment

Neurological manifestations as the predictors of severity and mortality in hospitalized individuals with COVID-19: a multicenter prospective clinical study

BACKGROUNDS: The reports of neurological symptoms are increasing in cases with coronavirus disease 2019 (COVID-19). This multi-center prospective study was conducted to determine the incidence of neurological manifestations in hospitalized cases with COVID-19 and assess these symptoms as the predictors of severity and death. METHODS: Hospitalized males and females with COVID-19 who aged over 18 years were included in the study. They were examined by two neurologists at the time of admission. All survived cases were followed for 8 weeks after discharge and 16 weeks if their symptoms had no improvements. RESULTS: We included 873 participants. Of eligible cases, 122 individuals (13.97%) died during hospitalization. The most common non-neurological manifestations were fever (81.1%), cough (76.1%), fatigue (36.1%), and shortness of breath (27.6%). Aging, male gender, co-morbidity, smoking, hemoptysis, chest tightness, and shortness of breath were associated with increased odds of severe cases and/or mortality. There were 561 (64.3%) cases with smell and taste dysfunctions (hyposmia: 58.6%; anosmia: 41.4%; dysguesia: 100%). They were more common among females (69.7%) and non-smokers (66.7%). Hyposmia/anosmia and dysgeusia were found to be associated with reduced odds of severe cases and mortality. Myalgia (24.8%), headaches (12.6%), and dizziness (11.9%) were other common neurological symptoms. Headaches had negative correlation with severity and death due to COVID-19 but myalgia and dizziness were not associated. The cerebrovascular events (n = 10) and status epilepticus (n = 1) were other neurological findings. The partial or full recovery of smell and taste dysfunctions was found in 95.2% after 8 weeks and 97.3% after 16 weeks. The parosmia (30.9%) and phantosmia (9.0%) were also reported during 8 weeks of follow-up. Five cases with mild headaches and 5 cases with myalgia were reported after 16 weeks of discharge. The demyelinating myelitis (n = 1) and Guillain-Barré syndrome (n = 1) were also found during follow-up. CONCLUSION: Neurological symptoms were found to be prevalent among individuals with COVID-19 disease and should not be under-estimated during the current pandemic outbreak

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

Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019 : a systematic analysis from the Global Burden of Disease Study 2019

Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Findings In 2019, 273 center dot 9 million (95% uncertainty interval 258 center dot 5 to 290 center dot 9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 center dot 72% (4 center dot 46 to 5 center dot 01). 228 center dot 2 million (213 center dot 6 to 244 center dot 7; 83 center dot 29% [82 center dot 15 to 84 center dot 42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global agestandardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 center dot 21% [-1 center dot 26 to -1 center dot 16]), similar progress was not observed for chewing tobacco (0 center dot 46% [0 center dot 13 to 0 center dot 79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 center dot 94% [-1 center dot 72 to -0 center dot 14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Summary Background Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control. Methods We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. Findings In 2019, 273 & middot;9 million (95% uncertainty interval 258 & middot;5 to 290 & middot;9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 & middot;72% (4 & middot;46 to 5 & middot;01). 228 & middot;2 million (213 & middot;6 to 244 & middot;7; 83 & middot;29% [82 & middot;15 to 84 & middot;42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global age standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 & middot;21% [-1 & middot;26 to -1 & middot;16]), similar progress was not observed for chewing tobacco (0 & middot;46% [0 & middot;13 to 0 & middot;79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 & middot;94% [-1 & middot;72 to -0 & middot;14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Copyright (c) 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe