Accuracy of dipstick urinalysis as a screening method for detection of glucose, protein, nitrites and blood

This study determined the reliability of dipstick urinalysis for detection of protein, glucose, blood and nitrites in non-random urine samples from 300 people aged > 50 years attending a health centre for check-up. The gold standards were fasting blood glucose for glucosuria and the sulfosalicylic acid method for urine protein. Microscopic examination of urinary sediment and urine culture were also performed for positive dipstick results for haematuria and nitrites. The sensitivity, specificity and positive and negative predictive values of the dipstick test for detection of protein were 80.0, 95.0, 22.2 and 99.6 and for glucose were 100, 98.5, 87.0 and 100 respectively. Dipstick urinalysis can be a reliable screening method for diagnosis of urinary tract infection and diabetes mellitus but not for proteinuria

Prevalence of asymptomatic bacteriuria and associated host factors in women with type 2 diabetes in shahre-kord, Iran; 2005

Objective(s): Asymptomatic bacteriuria (ASB) is common among diabetic women. The aim of this study was to determine the prevalence and risk factors for ASB in women with diabetes. Design: Prospective cross-sectional study Setting: Chahar-Mahal province, Iran Subjects and Methods: One hundred women with type 2 diabetes and 100 normal women (control) who had no abnormalities of the urinary tract were recruited. Demographic data and information regarding previous history of urinary tract infections (UTIs), duration of diabetes and presence of pyuria was collected. Baseline serum creatinine and fasting blood sugar levels (FBSL) were measured. Main outcome measure(s): Prevalence and risk factors for ASB in normal and type 2 diabetic women. Intervention: The prevalence of ASB and related risk factors in the two groups and the rate of ASB progressing to symptomatic UTI in a six-month period were evaluated. Results: The prevalence of ASB was 20 in diabetics and 4 in control group (p < 0.05). Pyuria was present in 80 of diabetics with ASB. Symptomatic UTI in previous year was the only risk factor for ASB (p < 0.05). During a follow-up of six months, 40 diabetics with ASB developed to symptomatic UTI. Conclusions: The prevalence of ASB is increased in women with diabetes. We recommend screening for detection and treatment of ASB in diabetic women

The antibacterial properties of Allium cepa (onion) and Zingiber officinale (ginger) extracts on Staphylococcus aureus Pseudomonas aeruginosa Escherichia coli and Candida albicans isolated from vaginal specimens

زمینه و هدف: مطالعه حاضر با هدف بررسی خاصیت ضد باکتری عصاره خام، آبی و الکلی پیاز و زنجبیل در برابر استافیلوکوکوس اورئوس، پسودوموناس ائروژینوزا، اشرشیاکلی و کاندیدا آلبیکانس (چهار میکروارگانیسم عامل عفونت های دستگاه ادراری تناسلی) جدا شده از ادرار انجام گردید. روش بررسی: در این مطالعه تجربی آزمایشگاهی ابتدا ارگانیسم های مورد نظر از نمونه های ادرار افراد مبتلا به عفونت های مجاری ادراری –تناسلی جدا و کشت خالصی تهیه گردید. همچنین عصاره های خام، الکلی، آب ســـرد و آب گرم از پیاز و زنجبیل تهیه شد و سپس آزمایش بررسی اثرات این عصاره ها بر روی ارگانیزم ها با استفاده از روش Disk diffusion مورد مطالعه قرار گرفت. یافته ها: نتایج نشان داد که عصاره الکلی زنجبیل نسبت به بقیه عصاره ها بطور وسیع تری از رشد ارگانیسم های مورد آزمایش ممانعت می کند. پسودوموناس ائروژینوزا نسبت به سایر ارگانیسم ها، حساسیت بیشتری به عصاره پیاز و زنجبیل نشان داد. فعالیت آنتی باکتریال دو گیاه بر روی باکتری های گرم منفی بوده و بر باکتری گرم مثبت تاثیری نداشتند. عصاره های زنجبیل اثر بازدارنده مشخصی را نسبت به عصاره پیاز روی ارگانیسم های مورد آزمایش ایجاد کرد. نتیجه گیری: این یافته ها نشان داد که زنجبیل بخاطر اثر ضد باکتریایی و خاصیت بازدارندگی بیشتر نسبت به پیاز می تواند در طب سنتی علیه میکروارگانیسم های مورد آزمایش کاربرد وسیع تری داشته باشد

Genotypic and phenotypic characteristics of vancomycin-resistant enterococcus isolated from clinical specimens of patients in shahrekord

Background and purpose: Enterococci are important agents of endocarditis and urinary tract infections. They acquire resistance against antimicrobial agents which causes difficulty in their treatment. This study aimed to determine the antimicrobial susceptibility of strains resistant to vancomycin and identification of resistance genes vanA and vanB Enterococcus strains isolated from teaching hospitals in 2014. Material and methods: Hundred and fifty isolates of Enterococcus were isolated from hospitals and the genus and species composition were identified using different biochemical methods. Antibiogram tests were also conducted. The minimum inhibitory concentration was conducted applying broth micro dilution. Finally the strains containing vanA and VanB genes were identified. Results: The antibiogram test showed 10 strains with VanA and VanB phenotype. All strains were resistant to ciprofloxacin. VanA and VanB genes were detected in all 10 isolates of vanA phenotype and two strains of vanB phenotype. VanA and VanB genes were proliferated by PCR in two strains of the10 strains that were VanA phenotype. Conclusion: Among Enterococcus species E. faecium and E. faecalis isolates were detected in teaching hospitals. The highest rate of resistance was to erythromycin and tetracycline and the lowest resistance rate was to vancomycin

Determination of the carbapenem resistance in Escherichia coli isolated from samples obtained from Shahrekord hospitals and determination of their minimum inhibitory concentration

Background and aims: Carbapenems are the final-line treatments for multidrug-resistant, gram-negative infections. The patterns of resistance to carbapenems among hospital bacterial pathogens vary widely across different hospitals in a country. Considering that Escherichia coli is one of the most important causes of nosocomial infections, it is essential to study its drug resistance. Methods: In this descriptive-analytical study, a total of 80 samples of E. coli isolated from inpatients with urinary tract infections (UTIs) were collected in different wards (i.e., women, urology, infectious, and ICU) of Shahrekord hospitals. After the diagnosis and confirmation of bacteria by standard bacteriological methods, their sensitivity to imipenem and meropenem was investigated by the antibiogram (diskdiffusion) method. Then, the minimum inhibitory concentration (MIC) was determined by the E-test strip according to the Clinical and Laboratory Standards Institute (CLSI) standard. Results: In this study, resistance to meropenem and imipenem by antibiogram (disc diffusion) was observed in 21 (25.26%) and 20 (25%) of the isolates, respectively. Twenty isolates had MIC ≥4 μg/mL for meropenem, 13 isolates demonstrated MIC≥4 μg/mL for imipenem, and 14 isolates had 1≤MIC<4 μg/mL and were semi-sensitive. Conclusion: In general, E. coli had significant resistance to carbapenems. Therefore, rapid and accurate identification of these strains can be a major step to the treatment and control of these strains and prevention of the spread of the resistance Keywords: Escherichia coli, Carbapenems, Meropenem, Imipenem, Minimum inhibitory concentratio

Prevalence of nasal carriage of S.aureus among the wards staff of three teaching hospitals in Shahrekord and the antibiogram pattern of the isolated strains

In this study, nasal carriage of S.aureus among the wards staff of three teaching hospitals (Kashani, Hajar and Ali-Asghar hospital) in Shahrekord and the antibiotic sensitivity of the isolated strains was investigated. For this reason, 197 swab samples were collected from the anterior nare of the ward staff and cultured for identification of S.aureus. The control samples (100) were collected from the normal population. In general, most of the staff carry bacteria in their nose and the highest carriage rate was seen in dialysis ward in contrast emergency ward of the Kashani Hospital had the lowest rate. The rate of carriers in the other hospital wards, was also significant. Carriage rate in general population was about 28%. Most of the S.aureus strains were resistant to Penicillin (Resistance rate-99%) but most of them were sensitive to Rifampin (92%). Further more, the sensitivity rate of bacteria to the other antibiotics was as follows: SXT (64%), Cephalexin (51%) and Cloxacillin (28%). This study showed that the nasal carriage rate among the ward’s staff was significantly higher than that of the control

Rate of satisfaction and evaluation of medical students (interns and externs) from the quality of clinical education in the Shahre-kord university of medical sciences-2005

Introduction: Revolution of information in medical sciences as one of the important parts of knowledge has made the attention to medical education more critical. This study was performed to evaluate the satisfaction of Shahre-kord university medical students (interns and externs) from the quality of education in clinical courses. Materials and Methods: In this descriptive-analytical study, the rate of satisfaction of 77 medical students (interns and externs) from the quality of education in Shahre-kord university clinical courses was evaluated using a locally standardized questionnaire. The findings were classified as: high, moderate and low. Data were analyzed using SPSS software (version 11). Results: A total of 77 students completed the questionnaire. The high rate of satisfaction from the quality of education in different clinical clerkship periods was reported as follows: Internal medicine 25/7, surgery (general surgery and orthopedic) 27/4, pediatric medicine 17/5, gynecology 6/3, infectious disease 54/5, neurology 36/5, ENT 54/5, ophthalmology 47/5, poisoning 21/2, psychiatry 37/7, urology 6/3, health science 17/6. In addition, high rate of satisfaction from professional skills teaching was reported by 17.4 of the students. The most satisfaction rate in internal and pediatric courses was from morning reports and in surgery clerkship period, from outpatient clinic and theory courses. In gynecology period the lowest rate of satisfaction was reported from outpatient clinic and theory courses. High rate of satisfaction in minor clerkship periods was reported from ENT, infectious disease, psychiatry, and neurology periods respectively. Conclusions: In major clerkship periods, the students were unsatisfied from teaching rounds, outpatient clinic and theory courses. In contrast, high rate of satisfaction was belonged to morning report programs. Due to the low rate of satisfaction from gynecology, poisoning and urology courses and also un-satisfaction from CPR and labor management teaching, reviewing the educational programs by teaching managers is recommended

Bacteriologic study of 50 patients with deep neck infections, Shahrekord, 2001

زمینه و هدف: عفونت های عمقی گردن به عنوان عفونت های نسبتاً شایع و دارای عوارض و مرگ و میر قابل توجه شناخته می شوند. در این مطالعه نوع باکتری ایجاد کننده این عفونت ها و الگوی حساسیت این عوامل نسبت به آنتی بیوتیک ها مورد بررسی قرار گرفت. روش مطالعه: در این مطالعه از50 بیمار مراجعه کننده به بیمارستان های کاشانی و رسالت شهرکرد با تشخیص ابتـــلا به عفونت عمقی گردن نمونه گیری و آزمایش های باکتریولوژی از نظر جدا سازی باکتری های هوازی و بی هوازی انجام گرفت. همچنین تست حساسیت نسبت به آنتی بیوتیک های پنی سیلین، آموکسی سیلین، جنتامایسین، آمیکاسین، سفالوتین، کلرامفنیکل، سفتی زوکسیم، وانکومایسین، کلوگزاسیلین، تتراسیکلین وکوتریموکسازول، در مورد سویه های باکتروئید و فوزوباکتریوم از مجموعه باکتری های بی هوازی و استافیلوکوک های کواگولاز مثبت و استافیلوکوکوس های اپیدرمیدیس ازمجموعه بی هوازی های اختیاری انجام گرفت. نتایج: از مجموع 66 نوع میکرو ارگانیسم مجزا شده از بیماران، 35 مورد (54) را باکتری های بیهوازی اجباری و تعداد 31 مورد (46) را باکتری های بیهوازی اختیاری تشکیل دادند و هیچ باکتری هوازی اجباری مجزا نگردید. از بین گونه های مختلف باکتریهای بیهوازی باکتروئیدها و فوزوباکتریومها بیشترین موارد، و از بین باکتریهای بیهوازی اختیاری استافیلوکوک های کواگولاز منفی بیشترین موارد را تشکیل دادند. در تست آنتی بیوگرام بعمل آمده مشخص گردید که آنتی بیوتیک های کلوگزاسیلین، سفتی زوکسیم و کلرامفنیکل بیشترین تاثیر را بر روی باکتریهای بیهوازی داشتند. در مورد استافیلوکوک های کواگولاز مثبت بیشترین حساسیت در برابر سفتی زوکسیم، کلرامفنیکل و سفالوتین و در مورد استافیلوکوکوس اپیدرمیدیس بیشترین حساسیت در برابر سفتی زوکسیم و کلرامفنیکل موجود بود. نتیجه گیری: در مجموع با توجه به ماهیت این گونه عفونت ها که مخلوطی از باکتریهای هوازی و بی هوازی را شامل می شود و بر اساس نتایج این تحقیق توصیه می گردد داروهای سفتی زوکسیم، کلرامفنیکل و کلیندامایسین با توجه به حساسیت مطلوب باکتری های عامل عفونت به این داروها، جهت درمان عفونت های مزبور مورد استفاده قرار گیرند

COMPARING THE EFFECT OF CLOFIBRATE AND PHENOBARBITAL ON THE NEWBORNS WITH HYPERBILIRUBINEMIA

The aim of treating hyperbilirubinemia is preventing the serum bilirubin to reach neurotoxic levels, which is done by phototherapy or blood transfusion. However, pharmacological treatments still remain vague. Therefore the effects of adding either clofibrate or phenobarbital on treatment outcomes was evaluated in icteric non-hemolitic newborns. Ninety neonates were divided in three groups. Two groups were prescribed 100 mg/kg clofibrate or 5 mg/kg phenobarbital orally as single dose on arrival, in addition to phototherapy. The control group only received phototherapy. Serum bilirubin was evaluated at the reception and 12, 24, 48 and 72 hours after beginning of drug therapy. Total bilirubin levels decreased in treated groups compared with the control group in all samples taken (12, 24, 48 and 72 hours). Clofibrate effect in decreasing bilirubin level was more prominent (14 % and 32 % after 12 and 72 h respectively). In addition duration of hospitalization and length of phototherapy decreased in clofibrate and phenobarbital groups compared with control group (1.5, 2 days respectively, vs. 2.6 days). Therefore using clofibrate and phenobarbital in icteric neonates are supportive not only by decreasing the serum bilirubin level, but also by lessening the duration of hospitalization and phototherapy. Thus in addition to cost benefits for the patient these drugs can reduce the risks of transfusion, and clofibrate seems more promising in this regard

The prevalence of methicillin-resistant Staph. Aureus strains producing enterotoxin A and B

Background: Staphylococcus aureus is a gram positive coccus which is able to cause different kinds of infection in certain condition. The function of this bacteria is to provide the conditions for the invasion of it to the host with the secretion of different sorts of toxins such as Staphylococcus aureus enterotoxin, including important virulence factors that super antigens are all factors digestive inconvenience. Staphylococcus aureus enterotoxin-secreting toxins such conditions provides invasion of host genes. There are different types of SE, but type A enterotoxin (SEA) and type B enterotoxin (SEB) are the most important types. Therefore, in this study, the prevalence of Staphylococcus aureus toxin-producing enterotoxin genes (SEB, SEA) in clinical strains isolated from patients in teaching hospitals of Shahrekord city, Iran, were studied. Methods: This cross-sectional and descriptive study, which was conducted from May 2014 to December 2014. A hundred and ten isolates of Staphylococcus aureus from patients collected over a period of 8 months and were first identified using standard biochemical methods and laboratory. Using standard methods and laboratory tests were identified and compared with the antibiotic oxacillin minimum inhibitory concentration were determined by broth micro dilution, and then they were assessed by polymerase chain reaction (PCR) technique. Results: The results indicated that, 110 samples of dairy products infected by Staphylococcus aureus were detected. Two cases (1.8%) of these infected samples were carrying both enterotoxin A and enterotoxin B genes. The frequencies of enterotoxin A genes were twenty-six cases (23/6%) and The frequencies of enterotoxin B genes were two cases (1/8%), respectively. Conclusion: The detection of enterotoxin A and enterotoxin B genes, shows the most important role they have in bringing about superinfection. The detection of enterotoxin A and B genes, shows the most important role they have in bringing about superinfection. Enterotoxins SEA and SEB are heat stable; therefore heating has no effect on dairy products contaminated by enterotoxins and gastritis may occur in a short period of time. As PCR is a rapid, sensitive, specific and inexpensive method, we suggest that it can be replaced to traditionally assays for detecting Staphylococcus aureus enterotoxin. © 2016, Tehran University of Medical Sciences. All rights reserved