Epidemiology of infective endocarditis in patients referred to Ardabil city hospital, 2010-2015

Background: Infectious endocarditis is caused by bacterial or fungal infections of the endocardial surface of the heart, with high morbidity and mortality. Information on infective endocarditis is low in a developing country, and in Iran, the situation is similar, and so far no accurate research on the epidemiology of endocarditis has been carried out. The aim of study is to epidemiological evaluation of Infective endocarditis.Methods: This cross-sectional study was done on 32 patients with infectious endocarditis who referred during 2011-20166 in Ardabil city Hospital. Data from blood culture, urine test, and other diagnostic procedures were extracted from the records. Information on age, sex, the most common cause of referral, culture and positive culture, mitral valve, tricuspid and pulmonary valve involvement, underlying condition of injecting drug addiction, duration of hospitalization, clinical symptoms, type of treatment, response to Treatment, status of hospital discharge and mortality rate of patients were collected and then analyzed.Results: Of all patients, 14 (43.75%) were male and 18 (56.25%) were female. The mean age of patients was 55.6±9.4 years with a range of 21-72 years old. Patients were treated at an average of 2.2±1.4 weeks. 9 patients (28.12%) had skeletal-muscular manifestations. 26 patients (81.25%) had fever. The most prevalent microorganism was klebsiella with 71.87% that was sensitive in 13 patients (56.5%) to methicillin.Conclusions: Fever with musculoskeletal manifestations in young men with a history of injectable addiction is a common manifestation of infectious endocarditis

Efficacy of orlistat in the treatment of patients with non-alcoholic fatty liver

Background: Nonalcoholic fatty liver disease (NAFLD) is a reversible condition of fat accumulation that is associated with liver inflammation and can disrupt the normal activity of the liver. People with a diagnosis of NAFLD have a higher risk of all- cause mortality than the general population. The purpose of the present study was to determine, the efficacy of orlistat in the treatment of patients with NAFLD.Methods: This semi-experimental study was performed on 45 fatty liver patients of the gastroenterology clinic of Imam Khomeini Hospital in Ardabil city in April 2016 to April 2017. Data was collected by a checklist which included demographic and clinical data such as age, sex, body mass index (BMI), alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglyceride (TG), cholesterol and result of ultrasound before and after orlistat consumption.Results: The mean decrease in the variables examined was as follows: weight 8.3 kg, BMI 3.5 kg/m2, ALT 31.6 U/l, AST 18.1 U/l, cholesterol 15.5 mg/dl and TG 33.1 mg/dl. All of the upper indexes were decreased significantly following received drug.Conclusions: Orlistat therapy was associated with significant decreases in ALT, AST, TG and cholesterol level. Orlistat is effective in weight loss, body mass index reduction and can be used to treat non-alcoholic fatty liver disease

Seroprevalence of SARS-CoV-2 antibodies and its risk factors in the north-west of Iran: A population-based cross-sectional study

Background: The aim of this study is to determine the prevalence of SARS-CoV-2 seropositivity and to examine the risk factors for seropositivity among the people of Ardabil, in the northwestern part of Iran. Methods: A community-based survey was carried out involving 1013 participants (690 from urban and 323 from rural areas), who were selected based on the cluster sampling method. Iran’s FDA-approved Pishtaz Teb SARS-CoV-2 ELISA kits were used to assess the presence of SARS-CoV-2-specific immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies in serum samples. Weighted seroprevalence, the number of infections, infection to case ratio (ICR), and infection fatality ratio (IFR) were estimated after adjusting for survey design and serial test performance. The factors associated with IgG/IgM positive were determined using logistic regression. Results: Between May 20 and June 7, out of 1013 survived people, 123 (12.11%) were IgG positive, 49 (4.8%) were IgM positive and 122 (12.04%) were having both IgG and IgM antibodies. The highest frequency of positive test for IgG and IgM antibodies was found in people with diabetes, followed by people with obesity and heart disease, respectively. Multivariate logistic regression showed old age (2.04, 95% CI: 1.02 to 11.74), male sex (1.52, 95% CI: 1.15 to 2.13), urbanization (1.40, 95% CI: 1.02 to 3.22), higher family number (9.44, 95% CI: 1.69 to 52.13), obesity (2.14, 95% CI: 1.11 to 5.86), NCDs (1.22, 95% CI: 1.01 to 2.16), having symptoms (3.02, 95% CI: 1.64 to 8.61), traveling (2.70, 95% CI: 1.76 to 10.8), history of contact with infected patients (2.38, 95% CI: 1.08 to 7.03), as factors associated with IgG/IgM positive test. Conclusion: Around the mid of May 2020, SARS-CoV-2 seroprevalence was low among Ardabil's adult population. Several factors have been found to be associated with SARS-CoV-2 seroprevalence, which should be considered by policymakers to set policies against the SARS-CoV-2 pandemic

BIOTECHNOLOGICAL PRODUCTS AND PROCESS ENGINEERING EGFP reporter protein: its immunogenicity in Leishmania-infected BALB/c mice

Abstract Optical reporter genes such as green fluorescent protein (GFP) and luciferase are efficiently and widely used in monitoring and studying the protective/therapeutic potential of candidate agents in leishmaniasis. But several observations and controversial reports have generated a main concern, whether enhanced GFP (EGFP) affects immune response. To address this issue, we studied the immunogenicity of EGFP in vivo by two lines of stably transfected parasites (Leishmania major EGFP or L. major EGFP-LUC ) in BALB/c model and/or as a recombinant protein (rEGFP) produced in vitro by bacteria in parallel. Disease progression was followed by footpad swelling measurements and parasite burden in draining lymph nodes using microtitration assay and real-time PCR, and immune responses were also evaluated in spleen. EGFP-expressing parasites generated larger swellings in comparison with wild-type (L. major) while mice immunized with rEGFP and challenged with wild-type parasite were quite comparable in footpad swelling with control group without significant difference. However, both conventional and molecular approaches revealed no significant difference in parasite load between different groups. More importantly, no significant inflammatory responses were detected in groups with higher swelling size measured by interferon-γ (IFN-γ), interleukin (IL)-10, IL-5, and nitric oxide against frozen and thawed lysate of parasite as stimulator. Altogether, these results clearly revealed that EGFP protein expressed in prokaryotic and eukaryotic hosts is not an immunological reactive molecule and acts as a neutral protein without any side effects in mice. So, EGFP expressing Leishmania could be a safe and reliable substitution for wildtypes that simplifies in situ follow-up and eliminates the animal scarification wherever needed during the study

Community based needs assessment in an urban area; A participatory action research project

<p>Abstract</p> <p>Background</p> <p>Community assessment is a core function of public health. In such assessments, a commitment to community participation and empowerment is at the heart of the WHO European Healthy Cities Network, reflecting its origins in health for all and the Ottawa Charter for Health Promotion. This study employs a participation and empowerment plan in order to conduct community assessment.</p> <p>Methods</p> <p>The method of participatory action research (PAR) was used. The study was carried out in an area of high socio-economic deprivation in Ardabil, a city in the northwest of Iran, which is currently served by a branch of the Social Development Center (SDC). The steering committee of the project was formed by some university faculty members, health officials and delegates form Farhikhteh non-governmental organization and representatives from twelve blocks or districts of the community. Then, the representatives were trained and then conducted focus groups in their block. The focus group findings informed the development of the questionnaire. About six hundred households were surveyed and study questionnaires were completed either during face-to-face interviews by the research team (in case of illiteracy) or via self-completion. The primary question for the residents was: 'what is the most important health problem in your community? Each health problem identified by the community was weighted based on the frequency it was selected on the survey, and steering committee perception of the problem's seriousness, urgency, solvability, and financial load.</p> <p>Results</p> <p>The main problems of the area appeared to be <it>the asphalt problem</it>, <it>lack of easy access to medical centers</it>, <it>addiction among relatives </it>and <it>unemployment of youth</it>. High participation rates of community members in the steering committee and survey suggest that the PAR approach was greatly appreciated by the community and that problems identified through this research truly reflect community opinion.</p> <p>Conclusions</p> <p>Participatory action research is an effective method for community assessments. However, researchers must rigorously embrace principles of mutual cooperation, respect for public ideas, and a robust belief in community empowerment in order to pave the way for responsible and active citizen participation in the various stages of research.</p

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Clinical and Epidemiological Characteristics of Patients with HIV in Ardabil City during 2005-2014

Background & objectives: Human immunodeficiency virus (HIV) is a globally widespread infection that spreads mainly through sexual contact, mother to child and intravenous drug use. The disease can vary from an asymptomatic state to advanced immune deficiency and AIDS-related opportunistic infections and complications. Patients may be diagnosed at different stages of the disease. In this study, we aimed to analyze the clinical and epidemiological characteristics of patients with HIV and its consequences during the past 10 years (2005-2014) in Ardabil city. Methods: In this descriptive and case series study, patients with HIV (including live and dead patients) referring to the Ardabil behavioral counseling center were included during 2005-2014 years. The checklist containing demographic data, modes of transmission, time of diagnosis, clinical and therapeutic problems during this period, etc. was prepared for each patient. In dead patients, the causes of death as well as the interval between diagnosis and death were investigated. Results: In this study, 60 patients with HIV were evaluated, the mean age was 42.96 years, 76.7% of patients were male and 48.2% were intravenous drug users. In 39.7% of cases, patients have probably been infected through intravenous injection and 33.3% by sexual contact. The mean CD4 + lymphocyte cell count of patients was 252 cells per ml. The most common early symptoms of the disease were fever (63.33%), aphthous stomatitis (35%) and diarrhea (28.33%). In 7 cases (50%), tuberculosis was the most common opportunistic infection. 6 patients (10%) had coinfection with hepatitis B or C. 28 patients (46.6%) died within&nbsp;the time of study. The median time from diagnosis to death was 44.84&plusmn;39.65 months and cardiorespiratory failure was the most common cause of death among patients. Conclusion: This study showed that most patients were middle-aged and intravenous drug use was the most common risk factors for HIV. The most common way of transmission was intravenous injection and hepatitis C and tuberculosis were the most important comorbidities, respectively. Raising community awareness about the disease, early diagnosis and appropriate care during illness are basic measures to deal with this global problem

Microbiological Profile and Antibiotic Resistance Pattern of Uropathogens in Diabetic and Non-Diabetic Patients

Background & Aims:  Urinary tract infection (UTI) is one of the most common human infections which is more prevalent especially in patients with diabetes mellitus. The aim of this study was to compare the uropathogens isolated from the urine culture of diabetic and non-diabetic patients and their antibiotic resistance pattern in patients admitted to Imam Khomeini Hospital in Ardabil from 2012 to 2013. Materials & Methods: In this descriptive cross-sectional study, the medical records of all patients admitted to Imam Khomeini University Hospital in Ardabil province from the beginning of 2012 to the end of 2014 were reviewed and the required information including age, sex, or the absence of diabetes was recorded. Results: E. coli was the most common uropathogens isolated from both diabetic (58.1%) and non-diabetic (53.6%) patients followed by yeast (19.4%) in both groups. Other common organisms in diabetic and non-diabetic patients were Staphylococcus aureus (8.4%) and coagulase negative Staphylococcus (7.1%), respectively. Among diabetic patients, E. coli had the highest sensitivity to polymyxin (100%), tetracycline (100%), and amikacin (88.9%). In non-diabetic patients, E. coli had the highest sensitivity to amikacin (90.4%), nitrofurantoin (86%), cefoxitin (85.3%), and gentamicin (82.1%). Conclusion: Our findings indicated that susceptibility profiles of uropathogens are different in diabetic and non-diabetic individuals, therefore, empirical treatment for diabetic and non-diabetic patients will be different

Effectiveness of teaching cognitive-behavioral techniques on locus of control in hemodialysis patients

Background: Many of the cognitive behavioral models and therapeutic protocols developed so far for psychological disorders and chronic diseases have proved effective through clinical research. Objective: This study aimed to determine the effectiveness of teaching cognitive-behavioral techniques on locus of control in hemodialysis patients. Methods: This controlled clinical trial study was conducted in 2015 with 76 patients selected by census and treated with a hemodialysis machine in the dialysis department of Vali-Asr Hospital in the city of Meshkinshahr. A total of four patients were excluded because of their critical conditions while the rest, who were recruited, were randomly divided into two equal groups of 36 patients as the intervention and control groups. First, the locus of control was measured in both groups through a pretest, and cognitive-behavioral techniques were then taught to the intervention group during eight 45 to 90-minute sessions. The locus of control in patients of both groups was finally re-measured through a posttest. Data were collected using Rotter's Locus of Control Inventory. The Wilcoxon test and Mann–Whitney U test were respectively used in SPSS18 for data analysis. Results: In the pretest and posttest stages respectively, 4.8% and 14.3% of samples in the control group as well as 14.3% and 33.3% of samples in the intervention group enjoyed internal locus of control. The difference between the pretest and posttest scores of internal locus of control in the intervention group was significant (p=0.004), which indicates the positive effect of cognitive-behavioral psychotherapeutic intervention on internalization of locus of control in this group. Conclusions: Given the external locus of control in most of the study patients and also the positive significant effect of cognitive-behavioral psychotherapy on internalization of locus of control in this group of patients, it appears necessary to have a psychology resident present in the hemodialysis department to teach the necessary cognitive-behavioral techniques to internalize the locus of control. Trial registration: The trial was registered at the Thai Clinical Trial Registry (http://www.clinicaltrials.in.th) with the TCTID: TCTR20170707003. Funding: The authors received no financial support for the research, authorship, and/or publication of this articl

Three-Year Trend of Antimicrobial Resistance of A. baumannii: A Retrospective Study from Ardabil, Northwestern Iran

Background & Aims:  Acinetobacter baumannii is one of the most important pathogenic bacteria causing nosocomial and opportunistic infection with the high rate of antibiotic resistance. The aim of the present work was to study the antimicrobial resistance pattern of Acinetobacter isolates recovered from patients admitted to Imam Khomeini Hospital and identifying the related risk factors. Also, in this study, the efficacy of different combined antimicrobial therapy against A. baumannii was evaluated. Materials & Methods: In this retrospective study, a total of 108 medical records related to patients admitted to Imam Khomeini Hospital in Ardabil province from 2011 to 2013 was entered into the study. For each patient, demographic, bacterial culture, and antibiogram data were obtained and analyzed. Results: Results indicated that pulmonary infections were the most common clinical source of Acinetobacter infection. The highest rate of resistance (100%) was related to ceftizoxime, chloramphenicol, furazolidone, nitrofurantoin, cephalothin, cephalexin, ticarcillin, piperacillin, amoxicillin, and aztreonam followed by ceftazidime, imipenem, co-trimoxazole, ceftriaxone, cefotaxime, and cefixime (80%). The lowest rate of resistance was seen against polymyxin B, ampicillin/sulbactam and meropenem. Our results indicated that 86.9 % and 91.7% of isolates were resistant to ceftriaxone and imipenem, respectively. Since carbapenems are the drug of choice and the last-resort agent for the treatment of MDR strain of A. baumannii , this high resistance level would be a serious concern. Conclusion: The epidemiological survey will be helpful in controlling infections in hospital environment and prescribing proper antimicrobial agents