Comparison of Genetic Patterns of E. coli Strains Isolated from Patients with Cystitis and Pyelonephritis, Using Pulsed Field Gel Electrophoresis

Abstract: Background & Aims: Urinary tract infection (UTI) is one of the most frequently acquired bacterial infections caused by a large genetically heterogeneous group of Escherichia coli which are called uropathogenic E. coli (UPEC). Cystitis and pyelonephritis are two most common symptoms seen in patients with UTI. The genetic diversity of this organism has hampered the identification of UTI strains and it is unclear whether all UPEC isolates are capable of causing both cystitis and pyelonephritis. Therefore, Careful selection of appropriate genotyping methods is mandatory. The most popular method is Pulsed Field Gel Electrophoresis (PFGE) that is used in the present study to evaluate the genetic patterns of UPEC. Methods: In this cross-sectional study a total of 90 E. coli strains consisting of 48 isolates causing pyelonephritis and 42 isolates causing cystitis in children were analyzed by PFGE and their corresponding patterns were compared. Results: Sixty six PFGE profiles were obtained from the genome of E. coli strains by this genotyping method. Most strains exhibited twelve and thirteen bands and the patterns with eight or nineteen bands had the lowest rate. Genome size of strains was between 1610-4170 kbp. Conclusion: According to these results, it can be suggested that in some cases the strains causing pyelonephritis or cystitis have common patterns and different clinical symptoms could be attributed to different gene factors. Keywords: Escherichia coli, Pyelonephritis, Cystitis, Pulsed Field Gel Electrophoresis » XM

The Prevalence of Needle sticks injuries among health care workers at a hospital in Tehran

ABSTRACT Needle stick injuries (NSIs) are one of the most significant and preventable hazards in relation to Healthcare workers (HCWs). Such injuries have been shown to be of high prevalence within developing countries. To determine the prevalence and circumstances pertaining to the occurrence of NSIs among HCWs employed at a special hospital. The study conducted was a cross-sectional study on HCWs and was carried out in one of Tehran's special hospitals in the year 2012. In this study, in order to identify and determine hazardous potential due to needle stick, HFMEA method was chosen. This resulted in the collection of 240 valid and reliable questionnaires. The validity and reliable nature of the questionnaires was confirmed by experts and by means of the test re-test method. The gathered data was analyzed with SPSS software, version 16.From the analysis of the data it was shown that, a total of 97 (40.42%) HCWs had suffered NSIs in the last year. The patient ward showed the highest prevalence of NSIs (47.42%) in the hospital. Nurses had the highest risk of suffering NSIs (56.7%) in comparison with the other occupational groups. All in all 175 NSIs occurred for the 240 HCWs trialed during the selected period of clinical practice. Of those that received injuries, only roughly 1 in 3 (38.14%) reported it to their infection control officer. Just over a quarter (26.80%) of the injured HCWs used post exposure prophylaxis (PEP) against HIV. Almost all (88.75%) of the HCWs had received a safe injection course. In general, NSIs and their subsequent underreporting are commonplace among hospital healthcare professionals. Significantly, more than two-thirds of the injured HCWs did not use post-exposure prophylaxis (PEP) against HIV. Improved prevention and reporting strategies are needed if the occupational health and safety of healthcare workers is to improve

Helicobacter species are associated with possible increase in risk of biliary lithiasis and benign biliary diseases

<p>Abstract</p> <p>Background</p> <p>Hepato-biliary tract lithiasis is common and present either as pain or as asymptomatic on abdominal ultrasonography for other causes. Although the DNA of <it>Helicobacter </it>species are identified in the gallbladder bile, tissue or stones analyzed from these cases, still a causal relationship could not be established due to different results from different geographical parts.</p> <p>Methods</p> <p>A detailed search of pubmed and pubmedcentral was carried out with key words <it>Helicobacter </it>and gallbladder, gallstones, hepaticolithiasis, cholelithiasis and choledocholithiasis, benign biliary diseases, liver diseases. The data was entered in a data base and meta analysis was carried out. The analysis was carried out using odds ratio and a fixed effect model, 95% confidence intervals for odds ratio was calculated. Chi square test for heterogeneity was employed. The overall effect was calculated using Z test.</p> <p>Results</p> <p>A total of 12 articles were identified. One study used IgG for diagnosis while others used the PCR for Ure A gene, 16 S RNA or Cag A genes. A couple of studies used culture or histopathology besides the PCR. The cumulative results show a higher association of <it>Helicobacter </it>with chronic liver diseases (30.48%), and stone diseases (42.96%)(OR 1.77 95% CI 1.2–2.58; Z = 2.94, p = 0.003), the effect of each could not be identified as it was difficult to isolate the effect of helicobacter due to mixing of cases in each study.</p> <p>Conclusion</p> <p>The results of present meta analysis shows that there is a slight higher risk of cholelithiasis and benign liver disease (OR 1.77), however due to inherent inability to isolate the effect of stone disease from that of other benign lesions it is not possible to say for sure that <it>Helicobacter </it>has a casual relationship with benign biliary disease or stone disease or both.</p

National and subnational mortality effects of metabolic risk factors and smoking in Iran: a comparative risk assessment

<p>Abstract</p> <p>Background</p> <p>Mortality from cardiovascular and other chronic diseases has increased in Iran. Our aim was to estimate the effects of smoking and high systolic blood pressure (SBP), fasting plasma glucose (FPG), total cholesterol (TC), and high body mass index (BMI) on mortality and life expectancy, nationally and subnationally, using representative data and comparable methods.</p> <p>Methods</p> <p>We used data from the Non-Communicable Disease Surveillance Survey to estimate means and standard deviations for the metabolic risk factors, nationally and by region. Lung cancer mortality was used to measure cumulative exposure to smoking. We used data from the death registration system to estimate age-, sex-, and disease-specific numbers of deaths in 2005, adjusted for incompleteness using demographic methods. We used systematic reviews and meta-analyses of epidemiologic studies to obtain the effect of risk factors on disease-specific mortality. We estimated deaths and life expectancy loss attributable to risk factors using the comparative risk assessment framework.</p> <p>Results</p> <p>In 2005, high SBP was responsible for 41,000 (95% uncertainty interval: 38,000, 44,000) deaths in men and 39,000 (36,000, 42,000) deaths in women in Iran. High FPG, BMI, and TC were responsible for about one-third to one-half of deaths attributable to SBP in men and/or women. Smoking was responsible for 9,000 deaths among men and 2,000 among women. If SBP were reduced to optimal levels, life expectancy at birth would increase by 3.2 years (2.6, 3.9) and 4.1 years (3.2, 4.9) in men and women, respectively; the life expectancy gains ranged from 1.1 to 1.8 years for TC, BMI, and FPG. SBP was also responsible for the largest number of deaths in every region, with age-standardized attributable mortality ranging from 257 to 333 deaths per 100,000 adults in different regions.</p> <p>Discussion</p> <p>Management of blood pressure through diet, lifestyle, and pharmacological interventions should be a priority in Iran. Interventions for other metabolic risk factors and smoking can also improve population health.</p

Algorithms for enhancing public health utility of national causes-of-death data

<p>Abstract</p> <p>Background</p> <p>Coverage and quality of cause-of-death (CoD) data varies across countries and time. Valid, reliable, and comparable assessments of trends in causes of death from even the best systems are limited by three problems: a) changes in the <it>International Statistical Classification of Diseases and Related Health Problems </it>(ICD) over time; b) the use of tabulation lists where substantial detail on causes of death is lost; and c) many deaths assigned to causes that cannot or should not be considered underlying causes of death, often called garbage codes (GCs). The Global Burden of Disease Study and the World Health Organization have developed various methods to enhance comparability of CoD data. In this study, we attempt to build on these approaches to enhance the utility of national cause-of-death data for public health analysis.</p> <p>Methods</p> <p>Based on careful consideration of 4,434 country-years of CoD data from 145 countries from 1901 to 2008, encompassing 743 million deaths in ICD versions 1 to 10 as well as country-specific cause lists, we have developed a public health-oriented cause-of-death list. These 56 causes are organized hierarchically and encompass all deaths. Each cause has been mapped from ICD-6 to ICD-10 and, where possible, they have also been mapped to the <it>International List of Causes of Death </it>1-5. We developed a typology of different classes of GCs. In each ICD revision, GCs have been identified. Target causes to which these GCs should be redistributed have been identified based on certification practice and/or pathophysiology. Proportionate redistribution, statistical models, and expert algorithms have been developed to redistribute GCs to target codes for each age-sex group.</p> <p>Results</p> <p>The fraction of all deaths assigned to GCs varies tremendously across countries and revisions of the ICD. In general, across all country-years of data available, GCs have declined from more than 43% in ICD-7 to 24% in ICD-10. In some regions, such as Australasia, GCs in 2005 are as low as 11%, while in some developing countries, such as Thailand, they are greater than 50%. Across different age groups, the composition of GCs varies tremendously - three classes of GCs steadily increase with age, but ambiguous codes within a particular disease chapter are also common for injuries at younger ages. The impact of redistribution is to change the number of deaths assigned to particular causes for a given age-sex group. These changes alter ranks across countries for any given year by a number of different causes, change time trends, and alter the rank order of causes within a country.</p> <p>Conclusions</p> <p>By mapping CoD through different ICD versions and redistributing GCs, we believe the public health utility of CoD data can be substantially enhanced, leading to an increased demand for higher quality CoD data from health sector decision-makers.</p

Toxicity assessment of chemical contaminants;transition from in vitromethods to novel in vitro methods

Exposure to occupational and environmental contaminants is a major contributor to human health problems. Despite significant achievements in the risk assessment of chemicals, the toxicological database, particularly for industrial chemicals, remains limited. Considering there areapproximately 80, 000 chemicals in commerce, and an extremely large number of chemical mixtures, in vivo testing of this large number is unachievable from ethical, economical and scientific perspectives. Therefore, increasing the number of available industrial chemicals andnew products has created a demand for alternatives to animal methods for better safety evaluation. Recent toxicity studies have demonstrated that in vitro methods are capable of rapidly providing toxicity information. In this review, current toxicity test methods for risk evaluation of industrial chemical contaminants are presented. To evaluate the potential applications of  more recent test methods developed for toxicity testing of chemical contaminants are discussed. Although  to be considered more broadly for risk assessment of human chemical exposures. In vitro methods,in vitro toxicology methods cannot exactly mimic the biodynamics of the whole body, in vitro  relationships (QSARs) and physiologically based toxicokinetic (PBTK) models have a potentialtest systems in combination with the knowledge of quantitative structure activity

Astudy on relationship between production link worker's safety attitude and their safe act in of arak metal industry

Background and aims   Unsafe attitude are the offset of occurring an accident. Although conducting few studies regarding to systematic measurement on requirement and attitude in the  field of safety in organization. One of the critical factors in order to make attempts to provide some programmers increasing safety behaviors is acknowledging the safety climate of working  environment. In this study we are intending to evaluate the relationship between safety climate and safe behaviors and the relationship between these two variables and personal factors as well as.   Methods   Safety climate is measured by questionnaire and in order to determine the rate of safe behaviors the direct observation has been used. This survey has been conducted on 178 workers of a production line a certain industry j.e.metalic heavy industry.   Results   In trying to specify the reliability of questionnaire the internal consistency was measured. The rate of a crombach was reched to 91% to determine the structure of safety climate the factor analysis method was used. The analysis resulted a 4 factor answer which defines  60/30% of the total variance. There was a clear correlation between factors consisting the safety  climate and safe behaviors.   Conclusion   In general, there was no clear correlation between the factor climate and personal factors. There was a clear correlation between safe behaviors and two personal factors, e.g. age and work experience. There was no clear correlation between safe behaviors and educational   degrees.

Evaluation & Identification of Hazards for Employees in Oil Exploration Seismic Operations with Job Safety Analysis Method

Background and aims   Global -and local (Iran)- accident fact sheets show that increasing development of products, changing in technology and materials & new instruments appliances  have resulted more injuries and fatalities in various industries. Job Safety Analysis (JSA) is one of  the various methods to identify and evaluate the hazards.   Methods   This case study was carried out in Abadan seismic field. Data gathering and completion  of the JSA worksheets were carried out through one-to-one observations, interviews,  photography, video tape recording, historical data and checklists.   Results   Ten tasks, 55 steps, 155 hazards and 301 corrective and prevention actions were identified during this study to be eliminated.   Conclusion   Based on findings¡ an Emergency Response Plan and 10 safe operation procedures were developed. It is revealed that in outdoor environment, unsafe conditions are focused more in JSA