Journal of Kermanshah University of Medical Sciences
Volume:24 Issue: 1, Mar 2020

Waterborne and foodborne diseases are considered to be major public health issues, which are associated with significant mortality each year worldwide. Viruses and most noroviruses (NoVs) are important causes of gastrointestinal infections.

The present study aimed to evaluate the gastroenteritis outbreak in Eslamabad-e Gharb in Kermanshah, Iran for the epidemiological, clinical, and laboratory assessment of the disease.

This descriptive, cross-sectional study was conducted with an emphasis on the outbreak of waterborne gastroenteritis in Eslamabad-e Gharb in Kermanshah province in 2016. The sample population included 3,362 patients referring to the public and private centers, who completed the linear list. In addition, 87 water microbial samples, 205 chlorine assessment samples, and 293 human samples were examined. Data were collected using the linear list of the patients, and data analysis was performed in Excel and SPSS version 21 using chi-square.

Among 3,362 patients, 57.1% were female, and 42.9% were male. Most of the patients (21.1%) were aged 20 - 29 years, with the mean age of 26.8%. In total, 73.4% of the patients had diarrhea, while 3.2%, 73%, 50%, 48.8%, 29.1%, and 30.6% had bloody diarrhea, vomiting, nausea, abdominal cramps, fever, and headaches, respectively. None of the microbial water samples (n = 87) collected from the rural and urban regions of the city were infected with thermotolerant coliforms. Moreover, the chlorine assessment demonstrated that 7.8% of the samples were unfavorable and above the limited range. In total, 10 blood and 10 fecal samples were evaluated in Alebouyeh Laboratory. Furthermore, six out of 10 fecal samples had non-pathogenic E. coli, while three samples were positive for the NoV molecular test of real-time polymerase chain reaction.

According to the results, NoV was the main cause of the disease outbreak in the studied region, and the clinical and epidemiological characteristics of the sample population, season, and environment were consistent with the diagnosis. Some of the factors that should be considered in the prevention and control of similar outbreaks include the development of a comprehensive and practical crisis management model in the epidemics, conservation of drinking water supplies and pipelines, and highlighting the importance of health education.

Currently, no potent tools are available to differentiate diagnose between patients with benign prostatic hyperplasia (BPH) and newly diagnosed prostate cancer patients (NDPCa) based on increased serum prostate-specific antigen (PSA) as the value may increase in both conditions. Therefore, finding new biomarkers is considered to be a major issue in this regard.

The present study aimed to differentiate BPH and NDPCa patients and evaluate serum and urine sarcosine levels as reliable markers.

This study was conducted on 67 patients with NDPCa and BPH and healthy controls. PSA evaluation was performed on all the patients, and the serum and urine levels of sarcosine were measured using the ELISA assay. In addition, the serum and urine sarcosine levels were assessed using the receiver operating characteristic (ROC) curve analysis.

The mean serum and urine sarcosine levels in the healthy controls were 3.0 ± 2.0 and 6.0 ± 2.0 ng/mL, respectively, while they were 9.0 ± 1.0 and 8.0 ± 1.0 ng/mL in the patients with BPH, respectively. The serum and urine sarcosine levels in the patients with NDPCa were 21.02 ± 2.0 and 15.0 ± 2.0 ng/mL, respectively. Significant differences were observed in the serum and urine sarcosine between the patients with BPH and NDPCa (P < 0.001). In addition, the serum sarcosine content increased in the patients with NDPCa and BPH compared to the healthy controls. The serum and urine levels of sarcosine had the following order: healthy controls < patients with BPH<patients with NDPCa.

According to the results, the serum and urine sarcosine contents might provide beneficial evidence for PCA diagnosis, while differentiating the patients with BPH and NDPCa. Furthermore, sarcosine levels may be valuable markers for PCA with clinical significance compared to PSA

Acinetobacter is a gram-negative coccobacillus that performs an essential role in nosocomial infection. Antibiotic resistance as a major problem in hospitals has increased in recent years. ICU-admitted patients have a high mortality and morbidity risk of disease with this organism.

This study was carried out to establish Acinetobacter’s pattern of antibiotic resistance in ICU wards.

In this analytical-descriptive study, Acinetobacter isolates from patients, staff, and equipment of ICU ward in Imam Reza Hospital, Kermanshah, Iran were identified using bacteriologic and biologic methods during six months in 2017. Then the pattern of antibiotic susceptibility was determined for ten different antibiotics using the Disc-Diffusion-Agar-Method.

Acinetobacter bumanii isolates were completely resistant to cefepime, ciprofloxacin, ampicillin, ceftriaxone, ceftazidime, cefazolin, trimethoprim, gentamycin, pipracilin, and imipenem.

This study revealed that Acinetobacter bumanii was highly resistant to various antibiotics. Although the methods in our study were not as reliable as E-test, regarding this agent’s potential role as a virulent pathogen in nosocomial infections, proper treatment with potent and effective antibiotics and infection control policies is needed to prevent the spread of this agent in ICU.

Staphylococcus aureus is a common commensal bacterium of the human body and a potential pathogen, causing public health hazards. Due to various virulent factors and growing antibiotic resistance, bacteria could cause various infections, ranging from minor skin infections to life-threating sepsis.

The present study aimed to evaluate the prevalence rate of S. aureus and determine its antimicrobial sensitivity profile in the secondary school students in Duhok City, Iraq.

Samples were collected from the anterior nares of 492 volunteers aged more than 16 years in different cities, including Akre, Amedye, Bardarash, and Duhok. Conventional laboratory tests were performed for the identification of the bacterial isolates. In addition, the antimicrobial sensitivity test was carried out in accordance with the Clinical and Laboratory Standards Institute (CLSI).

Out of 492 subjects, 185 cases (37.6%) were carriers of S. aureus, including 57/185 (30.8%) males. The oxacillin resistance rate was estimated at 41.08%, while the resistance rate against tetracycline, fusidic acid, ciprofloxacin, gentamicin, vancomycin, clindamycin and rifampicin was 27.02%, 19.46%, 9.19%, 8.65%, 7.56%, 3.78%, and 1.08%, respectively. All the isolates were susceptible to teicoplanin.

According to the results, the prevalence rate of S. aureus was high, and the species were more common in females. Therefore, further investigations are required to monitor the S. aureus antimicrobial profile and implement proper plans to manage the associated issues.
Keywords

Sports activities may alter the parameters of plantar pressure distribution while walking.

The present study aimed to compare the peak pressure, maximum force, contact area, and contact time between the right and left foot and their correlations with height and weight in elite weightlifters.

This study was conducted on 12 elite weightlifters with the mean age of 23.2 ± 2.26 years. The parameters of plantar pressure distribution were measured using the Emed platform during barefoot walking. In addition, the AutoMask software was used to divide the sole into 10 anatomical regions. The parameters of peak pressure, maximum force, contact area, and contact time in each region were also estimated using the MultiMask evaluation software. Data analysis was performed using paired t-test and Pearson’s correlation-coefficient (P ≤ 0.05).

Significant differences were observed in the peak pressure parameter in the third region (medial midfoot) and maximum force parameter in the ninth region (9th toe) between the right and left foot. Moreover, positive, significant correlations were denoted between height and weight with the peak pressure, maximum force, contact area, and contact time (P < 0.01). In the left foot, an inverse, significant correlation was observed between the maximum force and height in the fifth region (first metatarsal bone) (P < 0.05).

According to the results, the functional demand for both feet is very close in weightlifting. Therefore, insole designers must pay special attention to the reduction of the load on the third to fifth metatarsal bones in order to prevent complications such as metatarsalgia in athletes in the long run.

Cardiovascular diseases are the leading cause of mortality across the world. Coronary artery bypass grafting (CABG) is frequently performed on patients with cardiac diseases, the outcomes of which are closely associated with lifestyle modification, especially physical exercise.

The present study aimed to evaluate the impact of aerobic exercises on the cardiac function and inflammatory markers of male patients with heart failure after CABG.

This clinical trial was conducted on 20 male patients with heart failure after CABG, who were randomly divided into the intervention and control groups (10 per each). In total, 24 aerobic exercise sessions were performed in the form of three 60-minutes weekly sessions with 60% - 70% maximal heart rate (MaxHR). Cardiac function was evaluated, and the levels of interleukin 6 (IL-6) high‐sensitivity C‐reactive protein (hsCRP) were measured before and after the intervention. Data analysis was performed in the PRISM software using independent and Paired t-test.

After the intervention, left ventricular ejection fraction significantly increased in the intervention group, while no changes were observed in the control group (P = 0.0039). However, no significant changes were observed in the diastolic function of the groups after the intervention (P > 0.05). IL-6 had no significant changes in the control group, while it significantly reduced in the intervention group (P = 0.002). Furthermore, the hsCRP significantly decreased in the intervention group (P = 0.036), while no significant changes were observed in the control group in this regard (P < 0.05).

According to the results, aerobic exercises could improve systolic cardiac function and decrease IL-6 and hsCRP in the patients with cardiac failure. Therefore, these exercises are recommended following CABG.

Rituximab is an anti-CD20 monoclonal antibody, which is used for the treatment of various autoimmune diseases. Owing to its marked effect on B cells, rituximab has also been used in the treatment of fulminant multiple sclerosis. The present study aimed to describe the case of a patient with fulminant radiological presentation, which was effectively controlled using rituximab. A 21-yearold woman initially presented with vertigo, which resolved spontaneously. TheMRI indicated extensive periventricular involvement with multiple enhancing lesions. The patient was hospitalized and received pulse methylprednisolone (1 g) daily for five days. Afterwards, she was administered with ZytuxTM (1 g; rituximab, AryoGen Pharmed) for two weeks.