Distribution and Antibiotic Resistance Pattern of Bacteria Isolated from Patients with Community-acquired Urinary Tract Infections in Iran: A Cross-sectional Study

Background: Urinary tract infections (UTIs) remain the common infections diagnosed in outpatients as well as hospitalized patients. Multi-drug resistance (MDR) and extensively-drug resistance (XDR) in bacteria is an alarming problem in the world. The aim of this study was to detection of etiologic agents associated with community-acquired urinary tract infections (CA-UTIs) and investigation of antibiotic susceptibility patterns.Methods: This study was performed from September 2014 to March 2015 on outpatients, which referred to Labbafinejad Hospital Clinic, Tehran, Iran. The bacterial pathogenic diversity identified by standard laboratory methods. The antimicrobial resistance rates were performed by Kirby Bauer disc diffusion methods.Results: A total of 303 patients were enrolled in this study, from which 204 (67.3%) were female and 99 (32.5%) were male patients. Escherichia coli was the dominant species (69%), followed by Enterococcus faecalis (12.8%) and Klebsiella pneumoniae (4.6%). High resistance rate to nalidixic acid (73.8%), trimethoprim/Sulfamethoxazole (54.3%), ciprofloxacin (54.3%) in E. coli,  and tetracycline (89.7%) in E. faecalis strains and high susceptibility rate to meropenem (96.6%), imipenem (95.2%), amikacin (90.4%), cefoxtin (87.6%), and  nitrofurantoin (82.8%)  in E. coli,  and nitrofurantoin (100%)                                                                                                                                                                                                                                                                                                                                                                      in E. faecalis strains were observed. In addition, 43.5% of the strains were multidrug-resistant (MDR).Conclusions: This study showed that E. coli was the predominant uropathogen of CA-UTIs in this geographical area. It also demonstrated the empirical treatment of urinary tract infections may be difficult due to high resistance to commonly used antibiotics. Continuous monitoring of MDR organisms and drug resistance patterns are needed to prevent treatment failure and reduce selective pressure. These findings suggest the use of nitrofurantoin, cefoxitin, and amikacin in this area of the country

Distribution and Antibiotic Resistance Pattern of Bacteria Isolated from Patients with Community-acquired Urinary Tract Infections in Iran: A Cross-sectional Study

Background: Urinary tract infections (UTIs) remain the common infections diagnosed in outpatients as well as hospitalized patients. Multi-drug resistance (MDR) and extensively-drug resistance (XDR) in bacteria is an alarming problem in the world. The aim of this study was to detection of etiologic agents associated with community-acquired urinary tract infections (CA-UTIs) and investigation of antibiotic susceptibility patterns.Methods: This study was performed from September 2014 to March 2015 on outpatients, which referred to Labbafinejad Hospital Clinic, Tehran, Iran. The bacterial pathogenic diversity identified by standard laboratory methods. The antimicrobial resistance rates were performed by Kirby Bauer disc diffusion methods.Results: A total of 303 patients were enrolled in this study, from which 204 (67.3%) were female and 99 (32.5%) were male patients. Escherichia coli was the dominant species (69%), followed by Enterococcus faecalis (12.8%) and Klebsiella pneumoniae (4.6%). High resistance rate to nalidixic acid (73.8%), trimethoprim/Sulfamethoxazole (54.3%), ciprofloxacin (54.3%) in E. coli,  and tetracycline (89.7%) in E. faecalis strains and high susceptibility rate to meropenem (96.6%), imipenem (95.2%), amikacin (90.4%), cefoxtin (87.6%), and  nitrofurantoin (82.8%)  in E. coli,  and nitrofurantoin (100%)                                                                                                                                                                                                                                                                                                                                                                      in E. faecalis strains were observed. In addition, 43.5% of the strains were multidrug-resistant (MDR).Conclusions: This study showed that E. coli was the predominant uropathogen of CA-UTIs in this geographical area. It also demonstrated the empirical treatment of urinary tract infections may be difficult due to high resistance to commonly used antibiotics. Continuous monitoring of MDR organisms and drug resistance patterns are needed to prevent treatment failure and reduce selective pressure. These findings suggest the use of nitrofurantoin, cefoxitin, and amikacin in this area of the country

The genoprotective effect of Naringin by mifepristone on human blood lymphocyte

Introduction: According to a study conducted by mifepristone, it is a potent anti-progesterone compound that can lead to abortion and abnormalities in the fetus. Therefore, due to the presence of high antioxidant flavonoids, such as Naringin, and the frequency of this compound in the country, we have determined the protective effect of Naringin against cytogenetic damage caused by mifepristone on blood lymphocytes with micronucleus method; a high dose causes abortion and genetic abnormalities. Methods and Results: With 5-cc heparin syringe, blood samples were collected from 5 healthy and non-smoker volunteers and blood samples were incubated for 1 hour after incubation with 100 μM of toxic dose of mifepristone and various concentrations of Naringin for 24 hours. Then to evaluate the production of micronucleus in binucleated lymphocytes, the slides were prepared and were evaluated by optical microscopy. The mean values were compared using the Spss software and the Anova test (posttest: Tukey). That p <0.05 has been made as meaningful. Incubation of blood samples with mifepristone induces genotoxicity in lymphocytes and the adjacency of cells with Naringin significantly reduces the number of micronucleus (p<0.05). The results of this study have shown a significant role of Naringin as the protective factor against the genotoxicity of mifepristone. Conclusion: In this study, Naringin was found to be a protective agent against the DNA damage caused by mifepristone, and since Naringin alone has no genetic disorder; it can be used as a protective agent against the toxic effects of mifepristone

Comparing Two Methods of Rectal Diclofenac Administration for Pain Management in Second Trimester Abortion: A Randomized Clinical Trial

Background & Objective: Pain is the most common side effect of induced medical abortion. However, the optimal analgesia method remains as a clinical challenge. This study aimed to compare the efficacy of two methods of administration of diclofenac as a prophylactic or a therapeutic in pain management in induced second-trimester medical abortion. Materials & Methods: This randomized clinical trial study was conducted upon pregnant women who were candidates for induced medical abortion and referred to a tertiary educational hospital between October 2019 and December 2020. Participants were divided into two groups based on the mode of diclofenac administration, which was either simultaneously with the first dose of misoprostol or after beginning of the pain. Pain severity, induction-to-abortion time interval, total misoprostol dosage, Hemoglobin concentration, length of hospitalization, and size of retained pregnancy products by ultrasound, and the cumulative dose of opioid usage were compared between the groups. Results: The severity of pain which was measured by a visual analog scale (VAS), residual of conceived products, hospitalization days, and the total misoprostol dosage were significantly lower (P\u3c0.05) in the prophylaxis compared to the treatment group. Conclusion: Simultaneous administration of diclofenac with misoprostol as prophylactic method of pain management may be an optimal method in induced medical abortion in the second trimester

First detection of efrAB, an ABC multidrug efflux pump in Enterococcus faecalis in Tehran, Iran

Enterococcus faecalis is one of the most significant pathogen in both nosocomial and community-acquired infections. Reduced susceptibility to antibiotics is in part due to efflux pumps. This study was conducted on 80 isolates of E. faecalis isolated from outpatients with urinary tract infection during a period of 1 year from April 2014 to April 2015. The antibiotic susceptibility patterns of isolates were determined by the disk diffusion method and presence of efrA and efrB genes was detected by PCR and sequencing. Minimum inhibitory concentrations (MICs) to ciprofloxacin (CIP) were measured with and without carbonyl cyanide 3-chlorophenylhydrazone (CCCP) by broth microdilution. The highest resistance rate was observed to erythromycin (83.3%) and the prevalence of efrA and efrB genes in all E. faecalis isolates was 100%. This study showed that 9 out of 13 (69.2%) ciprofloxacin-resistant isolates became less resistant at least fourfolds to CIP in the presence of efflux pump inhibitor. Our result showed that CCCP as an efflux inhibitor can increase effect of CIP as an efficient antibiotic and it is suggested that efrAB efflux pumps are involved in resistance to fluoroquinolone

A review of acrylamide toxicity and its mechanism

Acrylamide (AA) is an important industrial chemical agent that is mainly used in the production of polymers and copolymers. Recently it has been attention because of its production in the diet at high-temperature (>120 ºC) processes such as cooking, frying, toasting, roasting or baking of high carbohydrate foods. According to high exposure to acrylamide, recognition of its toxic effect is necessary. Neurotoxicity, reproductive toxicity and immunotoxicity of AA were observed in several studies. There isn’t a clear mechanism that justifies this toxicity. In this study we reviewed the mechanisms of AA toxicity especially oxidative stress and apoptosis. AA can cause neurotoxicity, reproductive toxicity and genotoxicity on animal models. It showed neurotoxicity in human. We suggested the oxidative stress is the main factor for inducing of acrylamide toxicities. We advised that modifying of food processing methods can be as a good way for decreasing of AA production in foods

The effect of voluntary exercise on MANF level in the brainstem of Parkinsonian rats induced by 6-Hydroxydopamine

Background and Aim: Mesencephalic astrocyte-derived neurotrophic factor (MANF) is one of neurotrophines’ family which improves the dopaminergic cells survival and activity. The purpose of the current study was to investigate the protective effects of 12 weeks of voluntary exercise on MANF level in the brainstem of parkinsonian rats against the destruction of substansia nigra’s dopaminergic cells using 6-hydroxydopamine. Materials and Methods: In this experimental study, twenty-five male rats were divided into three groups: Base (healthy control, n=9), control-Parkinson (n=9), and voluntary exercise-parkinsonian (n=7). The voluntary exercise control group/ healthy group (n=9) were housed in individual cages geared with running wheels and had activity for 12 weeks. To induce parkinson in the second group (n=9), 250 microgram in 5 microliter 6-OHDA (dissolved in saline) was administered intracerebroventricularly (ICV) using a stereotaxic apparatus.The third healthy exercise group only had voluntary exercise for the same period. Finally, MANF levels in the brainstems were measured by means of ELISA. The obtained data was analyzed using one-way variance analysis (ANOVA) and Tukey post hoc. Results: Mean running distance of the subjects was 5384±764/16 meter per day. In this study MANF levels between exercise group and Parkinson control had significant differences (P=.001). In other words, decrease in MANF levels was prevented in the exercise group (P=.001). MANF levels in the exercise group remained almost at the same level as the Base group (healthy control), P=0.615) Conclusion: voluntary exercises cause the amplification of MANF against oxidative damage induced by 6-OHDA toxicity and have a protective role against parkinson

Synergism effects of pioglitazone and Urtica dioica extract in streptozotocin-induced nephropathy via attenuation of oxidative stress

Objective(s): Hyperglycemia promotes oxidative stress that plays a crucial role in the pathogenesis of Diabetic nephropathy (DN). In this study, we investigated the synergism effects of hydroalcoholic extract of Urtica dioica and pioglitazone (PIO) on the prevention of DN in streptozotocin induced-diabetic mice. Materials and Methods: Forty-two mice were divided into six groups as follows: non-diabetic control group, DMSO group (as solvent), diabetic group and four treatment groups which received U. dioica, pioglitazone, U. dioica plus pioglitazone and vitE. Diabetes was induced by a single dose of streptozotocin (STZ) (200 mg/kg body wt, IP) diluted in citrate buffer (pH= 4.6). After 4 weeks treatment, all animals were anaesthetized and blood was collected for serum urea and creatinine levels assessment in plasma and kidney tissue were excised for evaluation of oxidative stress markers. Results: Treatment with U. dioica significantly inhibited increase in serum urea and creatinine in plasma that were observed in diabetic mice. Furthermore, the elevated level of oxidative stress markers (glutathione oxidation, lipid peroxidation (LPO), protein carbonyl) in renal supernatant of diabetic mice was inhibited by U. dioica treatment.  Interestingly, U. dioica promoted beneficial effects of PIO in reducing STZ-induced hyperglycemia, renal damage and oxidative stress markers. Conclusion: Our findings showed that PIO plus U. dioica have synergism protective effects against STZ-induced nephropathy that can be a candidate as a therapeutic approach in order to treatment of DN

The Relationship between Sensory Processing Disorder and Quality of Sleep in Children with Autism Spectrum Disorder and Learning Disorder from 6 to 14 Years' Old

Introduction: Sensory problems can affect the functioning of individuals in a variety of daily activities in different aspects. One of these aspects of daily activity is the quality and quantity of sleep. Sensory processing perhaps is the most basic psychological element that determine how individuals perceive and respond to environmental stimuli. Given this, this study aimed to investigate the effect of sensory processing disorder on sleep quality of children with autism spectrum disorder and learning disorder. Materials and Methods: The present study was a descriptive cross-sectional study. The study was performed on 23 children with autism spectrum disorder and 20 children with learning disorder from 6 to 14 years' old. Two Child Sleep Habits Quality (CSHQ) and Sensory profile 2 questionnaires were used for data collection. Data were analyzed by Mann-Whitney U test in SPSS 22 software. Results: The results of data analysis showed that children with ASD have lower sleep quality than children with specific learning disorder (P=0/033). Children with autism also received higher scores on sensory profile 2 subtests except visual and olfactory processing than children with specific learning disorders. In children with ASD the highest scores are related to Sensory Sensitivity (45.83) and sensory registration (45.17) and lowest score is related to visual processing (10.96). However, children with specific learning disorders have highest score in sensory registration (43.40) and lowest score in body position processing (8.55). Conclusion: The findings of the study emphasized children with poor sleep quality had sensory processing disorder and sleep quality were reduced. There was a significant relationship between sensory registration (P=0.005) and sensory sensitivity (P=0.012) with sleep quality. Therefore, it seems necessary to support children in considering proper sensory diet and taking measures to resolve their sensory problems and thus improve their sleep patterns. Keywords: Autism Spectrum Disorder; Learning Disorder; Quality of Sleep; Sensory Processing Disorde

Prediction of underweight, short stature, and microcephaly based on brain diffusion-weighted imaging sequence in neonates with stage.2 of hypoxic-ischemic encephalopathy: A follow-up study

Background: Hypoxic-ischemic encephalopathy (HIE), caused due to reduced oxygenation and brain blood flow, occurs in 1-8 per 1000 live full-term births in developed countries and up to 26 per 1000 live in the developing world. The growth status of survivors of birth HIE has not been evaluated sufficiently. Objective: This study evaluated, the growth parameters (weight, height, and head circumference) of neonates with Sarnat stage 2 of HIE at 6, 10, and 12 months and its relationship with findings of neonatal brain diffusion-weighted imaging (DWI) sequence. Materials and Methods: Medical records and growth parameters of 35 neonates with gestational age > 34 wk who were admitted with stage 2 of HIE in Neonatal Intensive Care Unit of Shahid Sadoughi hospital, Yazd, Iran from March 2021-March 2022, and its relationship with neonatal brain DWI sequence finding was evaluated. Results: 15 girls and 20 boys with a mean birth weight of 2880.3 ± 221.8 gr were evaluated. Conventional magnetic resonance imaging and DWI were found to be abnormal in 6 (17.1%) and 18 neonates (51.4%). The most abnormal finding of DWI was high signal in basal ganglia/thalamus in 9 neonates (25.7%). Abnormal DWI is more frequent in neonates with seizures and low birth weight. Hospital stay days were more prolonged in neonates with abnormal DWI. Microcephaly at 12 months was more frequent in children with abnormal DWI. Conclusion: In survivors of moderate neonatal HIE, abnormal brain DWI sequence might predict inappropriate head growth, and need close medical and nutritional interventions for growth improvement. Key words: Hypoxic ischemia encephalopathy, Magnetic resonance imaging, Diffusion weighted imaging, Microcephaly, Underweight