Orlando’s nursing process application on anxiety levels of patients undergoing endoscopy examination

Background and aims: Anxiety is a common reaction when people encounter new problems where they do not know what expect. The nurses are responsible for assessing the patient and helping them with the procedure of endoscopy. This study investigates differences in anxiety level of patients who receive nursing process of Orlando's theory prior to endoscopy examination compared to a control group. Methods: A Quasi -experimental research design was used in this study. Samples were 60 adult patients who were randomly assigned to two groups (30 patients each). Patients in the study group receive nursing process of Orlando's theory by the researcher plus the routine hospital intervention, while the control group only received the routine hospital intervention. The Spielberger State-Trait Anxiety Inventory (STAI scale) is administering to both groups before and after endoscopy examination. STAI, a self-reporting psychometric test, is used to assess state anxiety levels. STAI has demonstrated reliability and validity in previous studies. Results: Statistically significant difference was evident between the 2 groups regarding the mean of anxiety level of patients after the intervention. Before the intervention, the mean of anxiety level in the control and study groups were 47±9 and 58 ±11 and after the intervention were: 41±7, 35±7, respectively. Conclusion: Intervention groups have the lower mean of anxiety level after the intervention. Female patients in this study experienced low level anxiety compared to male patients after Orlando nursing process. The data suggest that endoscopy unit personnel and the referring physician should consider the patient’s perception of the procedure. Detailed information on the procedure and training in relaxation techniques should be given. Positive re-appraisal and information on sensations to be anticipated, rather than procedural details, will be more successful in alleviating stress and anxiety

High level of resistance to metronidazole and clarithromycin among Helicobacter pylori clinical isolates in Qazvin province, Iran

resistance. We aimed to investigate the prevalence and mechanism of antibiotic resistance to metronidazole and clarithromycin in H. pylori isolates collected from patients with gastrointestinal symptoms in Qazvin, Iran. In this cross-sectional study, antibiotic susceptibility testing to clarithromycin and metronidazole was performed among 80 clinical strains isolated from H. pylori-positive dyspeptic patients referred to Qazvin hospital from July 2018 to November 2018. Polymerase chain reaction (PCR) and sequencing tests were performed to determine the type of mutations in the rdxA gene in metronidazole-resistant isolates, and the 23SrRNA gene in clarithromycinresistant isolates. Thirteen (40.6%) and Twenty-one (65.6%) isolates were resistant to clarithromycin and metronidazole, respectively. 37.5% and 59.4% of clarithromycin and metronidazole resistant isolates had MIC>256. In clarithromycin-resistant isolates, mutations in the 23SrRNA gene was seen at A2143G (15.6%), A2142G (9.4%), C2195T (6.3%), C2244T (3.1%), and G2212A (3.1%) locations. In one isolate, three simultaneous mutations were recorded in locations A2143G, G2110A, and C2121T. Mutations in the rdxA gene in metronidazole-resistant isolates, were missense. High resistance to metronidazole and clarithromycin antibiotics were seen in H. pylori isolates in Qazvin province. This is the first report of new mutation sites G2212A, G2110A, and C2121T on the 23SrRNA gene in clarithromycin-resistant isolates. It is necessary to evaluate the current situation in terms of resistance and identify the mechanisms involved in its occurrence for the successful treatment of infections caused by this organism

Global incidence of helminthic contamination of vegetables, cucurbits and fruits: A systematic review and meta-analysis

Accidental ingestion of infective stages of helminths through consumption of contaminated vegetables and fruits causes a wide range of food-borne diseases in humans. This systematic review and meta-analysis evaluated the global incidence of helminthic contamination of vegetables, cucurbits and fruits. Several databases (Science Direct, Web of Science, PubMed, Scopus, and Google Scholar) were searched for literature published prior to November 2020. Overally, 184 articles (32 countries) met the inclusion criteria. Among these, 137 studies documented helminthic contamination in vegetables, 46 in cucurbits and 9 were in fruits. The pooled incidence (95% confidence interval) was 31% (26%–37%) for vegetables, 20% (14%–27%) for cucurbits and 20% (8%–37%) for fruits. The highest incidence rate was found in the Western Pacific WHO region (54%; 9%–95%). The most prevalent parasitic agents were Ascaris lumbricoides eggs (12%; 9%–15%) and Strongyloides stercoralis larvae (12%; 8%–16%) in vegetables, S. stercoralis larvae (10%; 5%–15%) and Toxocara spp. eggs (10%; 3%–21%) in cucurbits, and Trichuris trichiura eggs (9%; 1%–22%) in fruits. The highest incidence rate was found to be associated with lower-middle income countries (34%, 28%–41%) and regions with a tropical rainforest climate (50%, 10%–91%). The potential role of vegetables, cucurbits, and fruits in the spread of helminthic parasites was revealed. Utilizing clean water for irrigation, proper washing and cooking of vegetables and improved sanitary practices can decrease the public health hazard regarding the consumption of vegetables, cucurbits, and fruits

The prevalence of human trichuriasis in Asia: a systematic review and meta‑analysis

Trichuriasis is one of the most common soil-transmitted helminth (STH) infections, affecting populations globally. The condition is particularly prevalent in tropical and subtropical areas with low levels of sanitation and poor living conditions. The objective of this systematic review and meta-analysis was to evaluate the prevalence of Trichuris trichiura infection in Asia at the country and region level. Multiple databases/academic search engines (Web of Science, PubMed, ProQuest, Scopus, and Google Scholar) were searched for literature on T. trichiura prevalence in Asia published through January 2021. Pooled prevalence was determined using the meta-package in R (version 3.6.1). Out of 13,836 articles, 226 studies (5,439,500 individuals) from 26 countries met the inclusion criteria. Of the 226 studies, 151 were community-based studies that included individuals across the age spectrum, while 75 studies focused on school children (typically in the 5–16 years age range). The overall T. trichiura pooled prevalence was 15.3% (95% CI: 12.4–19.1%), with a pooled prevalence of 13.3% (95% CI: 10.0–17.1%) for the community studies and 20.9% (95% CI: 14.7–27.9%) for the studies only including school children. For studies including all age groups, individuals in the 1–15 years age group had the highest pooled prevalence at 23.4% (95% CI: 1.7–49.4%). There was a significant difference found in overall pooled prevalence by sex (p < 0.001) and community type (rural versus urban) (p < 0.001). Although prevalence appears to be decreasing, study findings suggest that T. trichiura infection continues to be a public health problem in Asia. Therefore, control programs focused on at-risk individuals in endemic areas are needed

Global prevalence of intestinal protozoan contamination in vegetables and fruits: A systematic review and meta-analysis

Environmental contamination of vegetables and fruits with intestinal protozoan trophozoites, cysts and oocysts is a means of transmitting parasitic agents of public health importance. The purpose of this systematic review and meta-analysis was to determine the global prevalence of intestinal protozoan parasite contamination in vegetables and fruits. Several databases (Web of Science, PubMed, Scopus, ProQuest and Google Scholar) were searched for literature published up to August 2021. Pooled prevalence was determined using the meta-package in R (version 3.6.1). Out of 90,404 publications, 189 articles (202 datasets) met the inclusion criteria. Among these, 183 investigations documented protozoan contamination in vegetables and 20 in fruits. The pooled prevalence (95% confidence interval) was 20% (16%–24%) for vegetables and 13% (7%–21%) for fruits. The highest pooled prevalence was found in South-East Asian WHO region 37% (6%–76%). The most prevalent protozoan parasite in vegetables was Cryptosporidium spp. (11%, 7%–15%). As well, Entamoeba histolytica was the most common agent found in fruits (9%, 4%–14%). Furthermore, the unwashed samples had the highest pooled prevalence of contamination (22%, 3%–49%). Our data suggest a possible risk of protozoan infection in humans via unwashed vegetables and fruits. Accidental ingestion of protozoa occurs through consumption of contaminated vegetables and fruits that have been improperly washed and prepared under poor sanitation. Using sanitary irrigation water, consuming properly cleaned and cooked vegetables, and practicing good hygiene can all assist to reduce the risk of protozoa infection

Molecular survey of aminoglycoside-resistant Acinetobacter baumannii isolated from tertiary hospitals in Qazvin, Iran

Aminoglycoside-modifying enzymes (AMEs) and 16S rRNA methylases (16S RMTase) are two main resistance mechanisms against aminoglycosides. This study aimed to evaluate the frequency of AMEs and 16S rRNA methylase genes among aminoglycoside nonsusceptible Acinetobacter baumannii isolates and to assess their clonal relationship using repetitive extragenic palindromic-PCR (rep-PCR). In this cross-sectional study, a total of 192 A. baumannii isolates were collected from the patients hospitalized in Qazvin, Iran (January 2016 to January 2018). Identification of isolates was performed by standard laboratory methods and API 20E strips. Antimicrobial susceptibility was determined by Kirby–Bauer method followed by examination of the genes encoding the AMEs and 16S RMTase by PCR and sequencing methods. The clonal relationship of isolates was carried out by rep-PCR. In total, 98.4% of isolates were nonsusceptible to aminoglycosides, 98.4%, 97.9% and 83.9% of isolates were found to be non-susceptible against gentamicin, tobramycin and amikacin, respectively. The frequencies of aph(30 )-VI, aac(60 )-Ib, aac(3)-II, aph(30 )-Ia and armA genes were 59.3%, 39.2%, 39.2%, 31.7% and 69.8%, respectively, either alone or in combination. Rep-PCR results showed that the aminoglycoside non-susceptible isolates belonged to three distinct clones: A (79.4%), B (17.5%) and C (3.2%). The findings of this study showed a high frequency for AMEs with the emergence of armA genes among the aminoglycoside non-susceptible A. baumannii isolates. Rational administration of aminoglycosides as well as using an appropriate infection control policy may reduce the presence of resistance to antibiotics in medical centres