449 research outputs found

    Determinants of healthcare utilisation and predictors of outcome in colorectal cancer patients from Northern Iran

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    We aimed to assess healthcare utilisation (HU), its determinants, as well as its relationship with survival in colorectal cancer (CRC) patients. This study was conducted on incident CRC cases from Northern Iran. Information on HU was collected using a valid questionnaire, considering eight diagnostic and four therapeutic services. The results were categorised as good and poor HU. Multivariate logistic regression analysis was used to assess the relationship between HU and other variables. Cox regression analysis was performed to determine major predictors of survival. In total, 227 new cases of CRC were enrolled. HU could be assessed in 218 subjects (96). Living in rural areas was the strongest variable related to poor HU (adjusted OR, odds ratio=2.65; CI, confidence interval: 1.30-5.40). The median survival time was 40.5months. The 1-, 3- and 5-year survival rates were 71, 52 and 44 respectively. Cox regression analysis showed a significant lower survival rate in patients with poor HU (HR=2.3; CI: 1.46-3.64). HU was an independent predictor of survival in our CRC patients. Patients' place of residence was a significant determinant of HU. Regarding its effects on patients' outcome, HU and its determinants should be considered in designing CRC controlling programmes in our region and similar high-risk populations. © 2016 John Wiley & Sons Ltd

    Ability of biofilm production and molecular analysis of spa and ica genes among clinical isolates of methicillin-resistant Staphylococcus aureus

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    Objective: This study aimed to evaluate the phenotypic and genotypic characterization of biofilm formation and spa and ica genes among clinical isolates of methicillin-resistant Staphylococcus aureus. Result: This cross-sectional study was performed on 146 Staphylococcus aureus isolates from hospitalized patients in Isfahan Province Hospitals. MRSA isolates were confirmed using disk diffusion test with oxacillin disk and amplification of mecA gene by PCR assays. Ability of biofilm production was evaluated targeting the icaA and icaD genes. Of 146 Staphylococcus aureus isolates, 24 (16.4) carried mecA genes and identified as MRSA strains. Strong ability of biofilm production was seen among 76.02 (111/146) S. aureus isolates and 87.5 (21/24) MRSA strains, respectively. Also, 75.0 (18/24) MRSA isolates carried icaA and icaD was not detected in these strains. Analysis of spa gene showed 70.83 (17/24) MRSA strains were spa positive. From which 14 and 3 strains identified with one band (150, 270, 300, 360, 400 bp) and two bands (150-300 bp), respectively. According to data obtained, the prevalence of MRSA isolates from Isfahan Province Hospitals is relatively high and a remarkable percentage of them show strong power in biofilm production. Also analysis of spa gene showed a fairly large diversity among MRSA strains. © 2020 The Author(s)

    Association between socio-demographic factors and diabetes mellitus in the north of Iran: A population-based study

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    Objective: This study considers the prevalence of DM and some related factors among adults in the Golestan province (north of Iran) in 2006. Methods: This is a Cross-sectional-Descriptive and population-based study, carried out among 1999 cases (1000 men and 999 women) between 25 and 65 years old. Participants were chosen by cluster and stratified sampling in urban and rural areas. Data on socio-demographic factors were collected using questionnaire, and anthropometric and biochemical indexes were measured. Fasting Blood Sugar (FBS) equal to or over 126 mg/dl was classified as type 2 DM. Results: Mean of age was 39.2 years and mean ± SD of FBS among men and women was 94.51 ± 32.91 and 98.2 ± 40.1 mg/dl, respectively. Prevalence of DM was 8.3% [(men = 6.8% and women = 9.7%), (urban = 10.5% and villages = 6.4%)]. Twenty-five percent of patients were undiagnosed as whole, 43% of patients were unaware of their problem, in men more than in women (48.5% versus 39.2%) and in rural area more than in urban area (35.1% versus 54.4%). We showed a positive and significant correlation between FBS and age, waist circumference and BMI (P = 0.01). Conclusion: DM was the one of the biggest health problems in the north of Iran, and half of them were unaware of their morbidity. DM was influenced by socio-demographic factors. © 2010 International Journal of Diabetes Mellitus. Published by Elsevier Ltd. All rights reserved

    Limits on Replenishment of the Resting CD4+ T Cell Reservoir for HIV in Patients on HAART

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    Whereas cells productively infected with human immunodeficiency virus type 1 (HIV-1) decay rapidly in the setting of highly active antiretroviral therapy (HAART), latently infected resting CD4+ T cells decay very slowly, persisting for the lifetime of the patient and thus forming a stable reservoir for HIV-1. It has been suggested that the stability of the latent reservoir is due to low-level viral replication that continuously replenishes the reservoir despite HAART. Here, we offer the first quantitative study to our knowledge of inflow of newly infected cells into the latent reservoir due to viral replication in the setting of HAART. We make use of a previous observation that in some patients on HAART, the residual viremia is dominated by a predominant plasma clone (PPC) of HIV-1 not found in the latent reservoir. The unique sequence of the PPC serves as a functional label for new entries into the reservoir. We employ a simple mathematical model for the dynamics of the latent reservoir to constrain the inflow rate to between 0 and as few as 70 cells per day. The magnitude of the maximum daily inflow rate is small compared to the size of the latent reservoir, and therefore any inflow that occurs in patients on HAART is unlikely to significantly influence the decay rate of the reservoir. These results suggest that the stability of the latent reservoir is unlikely to arise from ongoing replication during HAART. Thus, intensification of standard HAART regimens should have minimal effects on the decay of the latent reservoir

    Molecular assay on Crimean Congo Hemorrhagic Fever virus in ticks (Ixodidae) collected from Kermanshah Province, Western Iran

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    Background: Crimean-Congo Hemorrhagic Fever (CCHF) is a feverous and hemorrhagic disease endemic in some parts of Iran and caused by an arbovirus related to Bunyaviridae family and Nairovirusgenus. The main virus reservoir in the nature is ticks, however small vertebrates and a wide range of domestic and wild animals are regarded as reservoir hosts. This study was conducted to determine the infection rate of CCHF virus in hard ticks of Sarpole- Zahab County, Kermanshah province, west of Iran. Methods: From total number of 851 collected ticks from 8 villages, 131 ticks were selected randomlyand investigated for detection of CCHF virus using RT-PCR. Results: The virus was found in 3.8 of the tested ticks. Hyalommaanatolicum, H.asiaticum and Rhipicephalus sanguineus species were found to have viral infection, with the highest infection rate (11.11) in Rh. sanguineus. Conclusion: These findings provide epidemiological evidence for planning control strategies of the disease in the study area

    Refractive characteristics of keratoconus eyes with corneal Vogt's striae: A contralateral eye study

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    Purpose: The aim of this study was to assess and compare clinical characteristics of bilateral keratoconus patients with unilateral Vogt's striae. Methods: In this contralateral eye study, refractive status were evaluated in patients with bilateral keratoconus whose corneas had definite slit-lamp biomicroscopic evidence of unilateral Vogt's striae. All cases underwent a comprehensive ophthalmic examination. Some refractive errors components provided by autorefraction were converted to vectorial notation for power vector analysis. Finally, the outcomes were compared between keratoconus eyes with and without Vogt's striae. Results: Fifty patients aged 20 to 38 years (27.43 ± 5.5) were recruited in this study. The results showed a significant difference in uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), non-cycloplegic and cycloplegic autorefraction including sphere, cylinder, spherical equivalent, and J0, between keratoconus eyes with and without Vogt's striae (all P < 0.05), except for J45 (P = 0.518 in non-cycloplegic autorefraction and P = 0.574 in cycloplegic autorefraction). Comparison of cycloplegic and non-cycloplegic autorefraction in both study groups showed significant differences in the sphere and spherical equivalent (all P < 0.001), but no significant difference was found in cylinder, J0, and J45 between the study groups (all P > 0.05). Conclusions: Comparison of the cycloplegic and non-cycloplegic autorefraction in keratoconus eyes with and without Vogt's striae showed significant differences in UDVA, CDVA, and some refractive errors components provided by autorefraction between the two groups, with a worse condition in KCN eyes with Vogt's striae. © 2020 Spanish General Council of Optometr
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