Study of drug wastage rate and knowledge of operating room employees toward drug wastage in Ayatollah Kashani Hospital in Shahrekord, 2012-2013

زمینه و هدف: امروزه به علت افزایش هزینه اثر بخشی مراقبت های بهداشتی توجه قابل ملاحظه ای به هزینه های داروها شده است. این پژوهش با هدف تعیین میزان دور ریز برخی داروهای رایج مصرفی در اتاق عمل چشم، گوش و حلق و بینی (ENT) و همچنین بررسی آگاهی کارکنان اتاق عمل بیمارستان آیت اله کاشانی شهرکرد در خصوص دور ریز داروها انجام گردید. روش بررسی: در این مطالعه مقطعی، میزان دور ریز برخی داروهای رایج اتاق عمل بیمارستان آیت اله کاشانی شهرکرد طی یک دوره سه ماهه بصورت روزانه بررسی و هزینه مالی آن ها برآورد گردید. همچنین آگاهی 100 نفر از کارکنان شاغل در اتاق عمل این بیمارستان در خصوص دور ریز دارو با استفاده از پرسشنامه محقق ساخته بررسی گردید. یافته ها: در این مطالعه در دسته آمپول ها، قطره ها و سرم ها به ترتیب آمپول پروپوفول با 4/22، قطره پیلوکاربین با 9/94 و سرم مانیتول با 3/59 بالاترین درصد دور ریز را به خود اختصاص دادند. کمترین درصد دور ریز متعلق به آمپول آتروپین (9) بود. از نظر مالی بیشترین بار مالی به ازای هر بیمار متعلق به پروپوفول (21000 ریال) و کمترین متعلق به آتروپین (1066 ریال) بود. نمره آگاهی آزمودنی ها در خصوص دور ریز دارو 82 برآورد گردید. نتیجه گیری: با توجه به وجود دوزهای متفاوت داروئی و روش های مختلف مصرف، این میزان دور ریز گزارش شده در این مطالعه قابل توجیه نمی باشد، لذا مسئولین علاوه بر توجه به مقوله تولید و تهیه دارو می بایست به مقوله مصرف نیز توجه بیشتری نمایند

An automatic system for classification of breast cancer lesions in ultrasound images

Breast cancer is the most common of all cancers and second most deadly cancer in women in the developed countries. Mammography and ultrasound imaging are the standard techniques used in cancer screening. Mammography is widely used as the primary tool for cancer screening, however it is invasive technique due to radiation used. Ultrasound seems to be good at picking up many cancers missed by mammography. In addition, ultrasound is non-invasive as no radiation is used, portable and versatile. However, ultrasound images have usually poor quality because of multiplicative speckle noise that results in artifacts. Because of noise segmentation of suspected areas in ultrasound images is a challenging task that remains an open problem despite many years of research. In this research, a new method for automatic detection of suspected breast cancer lesions using ultrasound is proposed. In this fully automated method, new de-noising and segmentation techniques are introduced and high accuracy classifier using combination of morphological and textural features is used. We use a combination of fuzzy logic and compounding to denoise ultrasound images and reduce shadows. We introduced a new method to identify the seed points and then use region growing method to perform segmentation. For preliminary classification we use three classifiers (ANN, AdaBoost, FSVM) and then we use a majority voting to get the final result. We demonstrate that our automated system performs better than the other state-of-the-art systems. On our database containing ultrasound images for 80 patients we reached accuracy of 98.75% versus ABUS method with 88.75% accuracy and Hybrid Filtering method with 92.50% accuracy. Future work would involve a larger dataset of ultrasound images and we will extend our system to handle colour ultrasound images. We will also study the impact of larger number of texture and morphological features as well as weighting scheme on performance of our classifier. We will also develop an automated method to identify the "wall thickness" of a mass in breast ultrasound images. Presently the wall thickness is extracted manually with the help of a physician

Frequency of Self-Medication and Knowledge about Out-of-Counter Drugs during the COVID-19 Pandemic in a Group of Iranian Dental Students

Objective: To study the frequency of self-medication and knowledge about out-of-counter drugs during the COVID-19 pandemic in a group of Iranian dental students. Material and Methods: A descriptive cross-sectional study was conducted among dental undergraduates from September 2021 to November 2021 after receiving ethical clearance from the Kerman Medical University Ethical Committee. A valid and reliable questionnaire, consisting of demographic data and questions about self-medication and knowledge about out-of-counter drugs, was sent to participants via E-mail. Data was analyzed by SPSS 26 software by using a t-test. The P-value was considered at a 0.05% significant level. Results: A total of 88 students participated in the study with a mean age of 21.39±3.71 years. Prevalence of self-medication was found in 53.4%. The most common cause for self-medication was headache. Acetaminophen was the most commonly used medicine for self-medication. Females had more self-medication than males, but there was no significant differences. There was no significant differences between entering year to university and self-medication. Younger students had significantly more self-medication (p=0.007). Knowledge about out-of-counter drugs was moderate. Conclusion: Moderate self-medication as noticed. The out-of-counter drugs were the most used. Although out-of-counter drugs seem relatively safe, their improper use can cause serious side effects. Dental students need to be educated regarding appropriate safe medication and out-of-counter drugs

Determination of CTX-M genes in enterobacteriaceae producing extended-spectrum beta-lactamase using PCR method

زمینه و هدف:بتالاکتاماز وسیع الطیف گروه CTX-M در سراسر جهان به عنوان یک مکانیسم مهم مقاومت در مقابل سفالوسپورین در پاتوژن های گرم منفی شناخته شده و به سرعت در حال افزایش اند. هدف از این مطالعه تعیین ژن CTX-M در سویه های انتروباکتریاسه مولد بتالاکتامازهای وسیع الطیف ایزوله شده از بیمارستان های آموزشی شهرکرد به روش واکنش زنجیره ای پلی مراز (PCR) بود. روش بررسی: در این مطالعه توصیفی تحلیلی، 325 ایزوله انتروباکتریاسه از نمونه های ادرار، خون و زخم جداسازی و با آزمون های بیوشیمیایی تعیین هویت شدند. مقاومت باکتری ها نسبت به دیسک های سفوتاکسیم، سفتازیدیم، سفتریاکسون و آزترونام به روش دیسک دیفیوژن تعیین شد. ایزوله های مقاوم به آنتی بیوتیک های فوق بوسیله تست تاییدی دیسک های ترکیبی سفوتاکسیم-کلاولانیک اسید و سفتازیدیم-کلاولانیک اسید بررسی شدند. سپس در سویه های مولد بتالاکتامازهای وسیع الطیف، وجود ژن CTX-M با روش PCR بررسی شد. یافته ها: در تست فنوتیپی تاییدی 28 ایزوله ها بتالاکتامازهای وسیع الطیف تولید می کردند و فراوانی ژن بتالاکتاماز CTX-M در کل انتروباکتریاسه های فنوتیپ مثبت 5/50 در ایزوله های اشرشیاکلی، انتروباکتر و کلبسیلاپنومونیه به ترتیب 7/19، 4/15 و 4 بدست آمد (05/0

Prevalence of TEM-1 type beta-lactmase genes in Pseudomonas aeruginosa strains isolated from burn infections using Duplex PCR in Shahrekord, 2008

Background: Existence of extended spectrum B-lactamase (ESBL) genes plays an important role in spreading B-lactam antibiotic resistance in the producing strains of these enzymes. The resistance of gram-negative bacteria, such as Pseudomonas aeruginosa, to different antimicrobial agents, especially B-lactam and carbapenem, has increasingly been reported. This study was conducted to determine the prevalence of TEM-1 beta-lactamases in Pseudomonas aeruginosa isolates through Duplex PCR. Materials and Methods: In this descriptive-analytic study, 175 Pseudomonas aeruginosa isolates collected from burn patients were subjected to bacteriological tests. The samples were cultured and identified according to standard methods. Then the frequency of ESBL producing strains was determined via the combined disk method. Using boiling method, DNA was extracted and examined for the existence of TEM-1 gene by Duplex PCR. Results: Out of the 175 Pseudomonas aeruginosa isolates, 66 (37.7%) were ESBL positive, 15.15% of which were positive for TEM-1 B-lactamases resistance gene. Conclusion: Noticing the increasing rate of the ESBLs producing strains, using the appropriate treatment protocol based on the antibiogram pattern of the strains is highly recommended

A comparison between Recurrent Neural Networks and classical machine learning approaches In Laser induced breakdown spectroscopy

Recurrent Neural Networks are classes of Artificial Neural Networks that establish connections between different nodes form a directed or undirected graph for temporal dynamical analysis. In this research, the laser induced breakdown spectroscopy (LIBS) technique is used for quantitative analysis of aluminum alloys by different Recurrent Neural Network (RNN) architecture. The fundamental harmonic (1064 nm) of a nanosecond Nd:YAG laser pulse is employed to generate the LIBS plasma for the prediction of constituent concentrations of the aluminum standard samples. Here, Recurrent Neural Networks based on different networks, such as Long Short Term Memory (LSTM), Gated Recurrent Unit (GRU), Simple Recurrent Neural Network (Simple RNN), and as well as Recurrent Convolutional Networks comprising of Conv-SimpleRNN, Conv-LSTM and Conv-GRU are utilized for concentration prediction. Then a comparison is performed among prediction by classical machine learning methods of support vector regressor (SVR), the Multi Layer Perceptron (MLP), Decision Tree algorithm, Gradient Boosting Regression (GBR), Random Forest Regression (RFR), Linear Regression, and k-Nearest Neighbor (KNN) algorithm. Results showed that the machine learning tools based on Convolutional Recurrent Networks had the best efficiencies in prediction of the most of the elements among other multivariate methods

Comparison of agar screen and duplex-PCR in determination of methicillin resistant Staphylococcus aureus (MRSA) strains isolated from nose of personnel in Hajar hospital of Shahre-kord, 2007

Introduction: Methicillin resistant staphylococcus aureus strains are the most important agents of nosocomial infections. The conventional antibiotic susceptibility methods such as disk diffusion are not suitable for detection of these strains due to their heteroresistancy. Therefore, in this study, agar screen and duplex-PCR were compared in determination of methicillin resistant Staphylococcus aureus (MRSA) strains isolated from nose of personnel in Hajar hospital of Shahre-kord, 2007. Materials and Methods: In this experimental study a total of 204 nasal swabs from personnel of Hajar hospital over a period of 6 months were collected. The specimens were cultured on mannitol salt agar for primary isolation and identification of Staphylococcus aureus strains and their susceptibility pattern to oxacillin was assessed using agar screen method. Finally, using duplex PCR, the isolates were tested for the presence of mecA gene. Results were compared and sensitivity and specificity of the method was determined. Results: In this study, 23 of the 52 (44%) Staphylococcus aureus isolates were resistant to oxacillin using agar screen method. However, mecA gene was detected in 27 of the 52 strains (52%). Our results showed that the sensitivity and specificity of agar screen method in determination of MRSA strains were 81.5% and 96%, respectively comparing with PCR. Conclusion: Oxacillin agar screen, comparing PCR, is an inexpensive, applied and phenotypical method with low false positive and suitable for screening of MRSA. However, due to its relatively high false negative results is not appropriate for screening of MRSA strains isolated from hospital-employed nasal carriers

Clinical and bacteriologic correlates of the papG alleles among uropathogenic Escherichia coli strains isolated from cases of adult urinary tract infection

Objectives: To study the distribution of papG gene in uropathogenic Escherichia coli (E.coli) strains isolated from adult urinary tract infection (UTI) and the relationship between the different classes of papG gene and patients, sex, hospitalization and their clinical forms of UTI Design: Laboratory study Setting: Inpatient and outpatient settings with laboratory investigation Subjects and Methods: Genotyping of papG, the adhesin gene of E. coli P fimbriae, may predict clinical outcomes of UTI. A total of 182 urinary E.coli strains were analyzed by multiplex PCR method for detection of papG gene. Patients, sex, hospitalization and their clinical forms of UTI were also evaluated. Intervention: The distribution of papG gene in uropathogenic E.coli strains and the relationship between papG gene and clinical features of the patients Main Outcome Measures: Multiplex PCR method was performed for detection of papG gene in uropathogenic E.coli strains isolated from adult urinary tract infections Results: The prevalence of pap operon in the uropathogenic isolates was 36.2. The prevalence of papG gene classes II and III in uropathogenic isolates was 23.1 and 6.6 respectively. None of the isolates had class I genotype. PapG classes II and III were predominant in patients with pyelonephritis and cystitis respectively. There was no significant relationship between the presence of papG alleles, sex and hospitalization of the patients. Conclusions: PapG gene is likely to play an important role in pathogenesis of uropathogenic strains of E.coli in adult nosocomial UTIs. Detection and genotyping of this gene may contribute to improving the management of UTI