Journal of Kermanshah University of Medical Sciences
Volume:28 Issue: 1, Mar 2024

Vaccination is one of the most cost-effective ways to prevent the spread of COVID-19.

The present study aimed to determine the prevalence of vaccine acceptance, side effects, and factors encouraging/disincentivizing vaccination among healthcare workers.

A descriptive-analytical cross-sectional study was conducted on 315 health workers at Imam Reza Hospital, Kermanshah, Iran, in 2021. The samples were selected through a simple random sampling method. The data collection tool was a researcher-made questionnaire, and the collected data were analyzed in STATA-17 software.

The vaccine acceptance rate was 84.1% (n = 265), and the vaccine refusal rate was 15.9% (n = 50). The most injected vaccines were Sinopharm (n = 112, 42.3%) and Sputnik (n = 88, 33.2%), respectively. The most common side effects after vaccine injection were fatigue (34.8%, n=39) and myalgia (14.3%, n = 16). Being in a high-risk place (n = 199, 75.2%) and fear of contracting COVID-19 (n = 88, 33.5%) were the most important reasons for encouraging vaccination. About 36.7% (n = 18) of blood clotting, 26.5% (n = 14) cardiac arrest, short-term safety, and distrust were the essential factors for not accepting the vaccine.

Based on the results, the prevalence of vaccine acceptance among health workers was high. However, a small percentage did not want to accept the vaccine due to negative news and a lack of trust in the vaccine. Therefore, it is necessary to establish strong educational and awareness-raising associations that transmit knowledge of the COVID-19 vaccine by focusing on false information.

Variation in the hemagglutinin (HA) of influenza A/H3N2 can affect antigenicity and virulence, potentially leading to the emergence of vaccine escape variants and antigenic shift viruses. This study aimed to evaluate the genetic variation of the HA gene to enhance global influenza virus surveillance.

The primary objectives of this research included molecular characterization and phylogenetic analysis of the influenza A/H3N2 HA gene. Therefore, this research aimed to contribute valuable insights to influenza surveillance efforts on a global scale by identifying the variants associated with vaccine escape and antigenic shift.

RNA extraction was performed on 300 nasopharyngeal swab samples from patients with influenza-like illness using a commercial kit. The presence of influenza A/H3N2 was determined using qRT-PCR. Subsequently, positive samples underwent HA gene amplification through RT-PCR using the Sanger method. Variability in HA immunological sites was compared with reference sequences, and genotype/subtype was determined. Alignment and phylogenetic analyses were conducted to construct a tree utilizing an optimal nucleotide substitution model

Among the 300 samples, 22 (7.33%) tested positive for influenza A/H3N2, with a male distribution of 13 cases. The mean age of the participants was 35 ± 2.40 years. The analysis of antigenic site mutations revealed significant variations (A, B, D, and E) in the HA gene, with major mutations at positions 140 and 186. Noteworthy mutations such as S159Y and the previously undocumented K83R substitution at antigenic site E. Phylogenetic analysis classified the A/H3N2 strain into clades 3C.2a and 3C.3.

The identified mutations in the HA gene suggest potential changes in antigenicity, emphasizing their relevance to vaccine development and surveillance strategies. It is recommended that ongoing molecular investigations be conducted for effective influenza control; also, the ongoing need to monitor influenza viruses is suggested to be highlighted. This research provides valuable insights necessary for maintaining efficient influenza control measures globally.

Evidence indicating the effect of vitamin D supplementation on improving the clinical outcomes of COVID-19 is limited.

This study aimed to examine the effect of high-dose vitamin D on mortality and hospital length of stay in ICU patients with COVID-19.

A single-center, double-blind, placebo-controlled, randomized clinical trial study was conducted on 61 patients with moderate to severe COVID-19 hospitalized in the ICU of Golestan Hospital, Kermanshah, Iran. Participants were randomly divided to receive a single dose of 300 000 IU vitamin D3 intramuscularly (n = 31) or placebo (n = 30). The primary outcomes were the length of hospital stay and in-hospital mortality. Secondary outcomes were the length of stay in the ICU, the number of patients requiring mechanical ventilation, and the serum level of 25-hydroxyvitamin D.

Out of 61 randomized patients, 44 patients with a mean age of 53.49 ± 13.2 years, body mass index of 29.80 ± 5.0 kg/m2, and serum vitamin D level of 24.36 ± 4.47 mg/dL were included in the study for primary analysis, of whom 31 (70.5%) cases were men. Median (interquartile range), the length of hospital stay between the vitamin D group (5.0 [6.0 - 11.0] days), placebo group (11.0 [6.0 - 17.0] days) (log-rank P = 0.23; unadjusted hazard ratio [HR] for hospital discharge, 3.4 [95% confidence interval [CI], 0.4 - 28.05]; P = 0.25; adjusted HR, 0.04 [95%CI, 11.52 - 0.0001]; P = 0.27) and mortality (unadjusted odds ratio [OR], 0.63 [95% CI,0.09 - 4.21]; P = 0.63; adjusted OR, 0.46 [95%CI, 0.03 - 6.55]; P = 0.57) showed no significant difference between the two groups before and after the adjustment of confounding factors. No significant difference was observed between the two groups regarding the need for mechanical ventilation (unadjusted OR for intubation = 2.1 [95% CI, 0.17 - 25.01]; P = 0.55), adjusted OR = 1.16 [95%CI, 0.04 - 27.57]; P = 0.92), and the length of stay in ICUs (log-rank = 2.49, P = 0.114; unadjusted HR for ICU discharge, 6.28 [95%CI, 0.5 - 78.42]; P = 0.15; adjusted HR = 21.48 [95%CI, 0.12 - 3677.48]; P = 0.24).

Based on the results, A high dose of vitamin D did not significantly reduce mortality and hospital length of stay in ICU patients with COVID-19.

Escherichia coli O157:H7 is a significant pathogen responsible for causing diarrhea in humans. Oxadiazoles are known for their diverse range of biological activities.

This study aimed to assess the anti-E. coli O157:H7 effects of 1, 3, and 4-oxadiazole derivatives.

Compounds containing an oxadiazole central core were synthesized anew. In vitro assays, including agar well diffusion, minimum inhibitory concentration, and minimum bactericidal concentration, were conducted. The molecular structures of the oxadiazole derivatives were optimized using the mm2 methodology with Chem3D v20.1.1.125 software. The ligand’s inhibitory potential against the active sites of stx-1 and stx-2 was assessed using Autodock Vina software. The results were analyzed using Discovery Studio v16.1.0 software.

The findings indicated that compound C ((2E)-3-(3,4-difluorophenyl)-2-(5-(hydroxy(pyridin-2-yl)meth yl)-1,3,4-oxadiazol-2-yl)-N-methylacrylimidic acid) exhibited more potent anti-E. coli O157:H7 effects compared to other compounds and the control sample. Furthermore, in silico results demonstrated that compound C exhibited inhibitory effects against stx-1 and stx-2 by forming hydrogen bonds for inhibition.

Compounds featuring a fluorophenyl structure with a 1, 3, and 4-oxadiazole core have the potential to serve as anti-E. coli O157:H7 agents for the development of therapeutic drugs.

Sleep disorders are a public health problem, and sleep studies among ethnic groups are few. Therefore, this study aimed to evaluate sleep quality and sleep problems among Iranian people.

This cross-sectional study was conducted on 4748 young people aged 18 to 35 (average: 27.58 years) in western Iran during the COVID-19 pandemic. In addition, 60.4% of the participants were men. The data were collected using the Pittsburgh Sleep Quality Inventory (PSQI), the Insomnia Severity Index (ISI), and the Demographic Information Questionnaire and analyzed with SPSS software version 22.

About 44.4% of the participants had unfavorable sleep quality and had sleep problems. Besides, the mean score of sleep problems (measured with PSQI) reported by the participants was 5.68±2.67. The logistic regression analysis showed that the participant’s age, education, marital status, occupation, drug abuse, alcohol consumption, use of mobile phones and the internet, and a history of previous sleep problems accounted for sleep problems during the COVID-19 pandemic.

Based on the results, there was a high prevalence of sleep problems among Iranian young people during the COVID-19 pandemic.

Pseudomonas aeruginosa is a ubiquitous bacillus responsible for severe infections in inpatients, especially nosocomial and intensive care unit (ICU) infections.

This study aimed to determine the antibiotic susceptibility of clinical isolates from inpatients in three referral hospitals in Isfahan, Iran.

Standard tests identified the organism and antibiotic susceptibility testing. Stratification was performed by place of infection (community, hospital), admission ward (ICU, non-ICU), and age group (< 20 versus > 20 years).

P. aeruginosa showed high susceptibility to colistin (100%) and amikacin (81.8%) followed by tobramycin (69.2%), ciprofloxacin (68.5%), meropenem (67.2%), cefepime (65.7%), ceftazidime (64.3%), and imipenem (63.3%). Community-acquired strains were significantly more susceptible to meropenem (81.6%), ciprofloxacin (77.1%), cefepime (77.1%), imipenem (74.3%), and ceftazidime (72.2%) than nosocomial strains. Non-ICU isolates were more susceptible to carbapenems. P. aeruginosa isolates had higher antibiotic susceptibility in less than 20 years.

Based on the results, a combination of colistin and amikacin would be appropriate for the empiric treatment of suspected P. aeruginosa infections in severe cases, nosocomial infections, or patients admitted to ICU. Ceftazidime, cefepime, ciprofloxacin, meropenem, or imipenem would be suitable for mild to moderate infections, especially in community-acquired infections.

Ralstonia pickettii is a rare environmental gram-negative bacterium that causes nosocomial infection due to its robust quorum-sensing system and constitution of biofilm in medical equipment and hospital instruments.

According to various case reports, Ralstonia is associated with catheter-related bacteremia, pneumonia, osteomyelitis, hemoperitoneum infection, meningitis, neonatal sepsis, endocarditis, and peritoneal fluid infection after internal surgery.

In this study, rare cases of nosocomial R. pickettii bloodstream infection were reported in hospitalized patients with uterus and cervical cancer with metastatic squamous cell carcinoma to the colon under surgery and blood transfusion.

A 46-year-old woman was admitted to the general surgery department of the target teaching hospital for the chief complaint of abdominal pain, nausea, and vomiting. Before admission, she was under hysterectomy, colectomy, colostomy, and chemotherapy three weeks ago. She received packed red blood cells twice during hospitalization and surgery. In addition, two consecutive blood cultures were positive for R. pickettii using the BD BACTEC™ FX Instruments and confirmation by bioM´erieux API 20NE. According to antibiogram test reports, Meropenem (1gr/Q8h/IV) was prescribed, and fortunately, blood culture results were negative after 14 days. In addition, the patient received pantoprazole (I.V. 40 mg) and octreotide (100 mcg/mL) during hospitalization.

R. pickettii is responsible for bloodstream infection and sepsis in cancer departments, especially during common surgical operations, and blood transfusions, especially for cancer patients. Hence, recognizing the source of infection can be helpful in appropriate infection control and successful treatment.