Bacterial etiology and antibiotic resistance pattern of septicemia in HIV and non-HIV patients admitted to tertiary care hospitals, Shiraz, South of Iran.

The present study aimed to determine the bacteriological etiology and antibiotic susceptibility pattern of sepsis in HIV infected and HIV uninfected patients, and related risk factors to introduce an appropriate therapy. This cross-sectional study was conducted from January 2014 to January of 2015 enrolling patients with sepsis associated with or without HIV infection admitted to Shiraz teaching hospitals, South of Iran. Blood and urine cultures were performed and standard microbiological methods were followed for isolation and identification of the bacteria. HIV antibody testing and CD4+ lymphocyte count were done for HIV-infected patients. Antimicrobial susceptibility tests were performed using the disk diffusion method in accordance with CLSI recommendations. Totally, 140 patients with sepsis including 30 HIV-positive, and 110 HIV-negative were enrolled. Our finding showed 26.7% and 20% blood and urine culture positivity in HIV-positive and 20.9% and 14.5% positivity in HIV-negative patients. Staphylococcus aureus, Salmonella spp. and coagulase-negative staphylococci (CoNS) each with frequency of 25% were detected as the most prevalent isolates in samples of HIV patients. In contrast, the main etiology for sepsis in HIV-negative patients was CoNS (47.8%), followed by Escherichia coli (17.4%). The median of CD4+ lymphocyte count and viral load in HIV patients were estimated 10.15 cells/mm3 and 68019.48 copies/mL, respectively. The results of the present study revealed that the main cause of sepsis in the studied hospitals was nosocomial pathogens. These findings highlighted the importance of infection control policies for preventing the emergence and spread of nosocomial infections.

Brucellosis as a neglected disease in a neglected population: a seroepidemiological study of migratory nomads in the Fars province of Iran.

This study assessed the seroprevalence of brucellosis and its risk factors in migratory nomads in the Fars province of Iran. Active brucellosis was defined as the combination of clinical symptoms, including fever, chills, night sweats, headache, low back pain, arthralgia, or myalgia, and positive laboratory testing, including either a serum agglutination test (SAT) ⩾1:80 with a 2-mercaptoethanol (2-ME) test ⩾1:40, or a SAT <1:80 combined with a positive Coombs Wright test (CWT) at a titre of at least threefold higher than SAT titre results. For the 536 participants, the female (316, 59%) to male (220, 41%) ratio was 1·4 and the participants' mean age was 32·4 ± 18·9 (range 1-96) years. Of all participants, 325 (60·6%) showed clinical symptoms; in symptomatic participants, the Rose Bengal plate test was positive in 33 (6·1%) cases, the SAT was positive in 18 (3·3%) cases, and the 2-ME test was positive in 30 (5·5%) cases. Positive SAT and 2-ME results were seen in 18 (3·3%) cases, but a negative SAT and a positive CWT were found in 36 (6·7%) cases. As a result, active brucellosis was detected in 54 cases, indicating a prevalence of 10% (95% confidence interval 8-12). In conclusion, we determined that brucellosis is a prevalent yet neglected disease in this nomadic population. Brucellosis control is not possible as long as these high-risk populations remain neglected.

Design, development and demonstration of an improved bird washing machine.

Since oil was first extracted, pollution of the seas and oceans or adjacent coasts has been an obstacle for the oil industry and environmental activists. The major concern is oil discharge into the water which may lead to birds' affliction or death, besides putting marine life in jeopardy. This paper presents the first description of the design and implementation of a new bird washing machine that can be utilized for cleaning of oil-coated birds with the minimum of stress. The machine is equipped with a pneumatic system comprised of 19 moving nozzles which evenly cover the bird's body and is designed to be used in contaminated environments where a vast number of birds are affected. Experimental trials show an improvement in operation efficiency compared to other methods in a reduction in washing time, energy consumption and a decrease in fatality rate of washed birds.

Pulmonary tuberculosis in migratory nomadic populations: the missing link in Iran's National Tuberculosis Programme.

OBJECTIVE: To detect pulmonary tuberculosis (PTB) in migratory nomadic populations in Fars Province, southern Iran. DESIGN: Cross-sectional study. RESULTS: In this study, 5506 (82.8%) of a total nomad population of 6650 from 1337 tents were screened for PTB. The mean age was 27.4 ± 18.2 years (range 1-109). Based on clinical symptoms, 141/5506 (2.6%) were identified as TB suspects. One male and three female adult new smear-positive PTB cases were detected, giving an incidence rate of 0.7/1000 population compared to 0.08/1000 in the general population of the region, and 28.4/1000 TB suspects. The median time to onset of symptoms in detected cases was 82.5 days. Tribal stigma against female TB patients was one of the main barriers to appropriate health-seeking behaviour. CONCLUSIONS: The incidence of smear-positive PTB among migratory nomads is approximately nine-fold higher than in the general population. Active screening of TB in migratory nomads should be integrated into Iran's national TB control programme. The issue of destigmatisation, particularly among female TB patients, should also be addressed.

Methanol poisoning: acute MR and CT findings in nine patients.

INTRODUCTION: Methanol poisoning is an uncommon but potent central nervous system toxin. We describe here the CT and MR findings in nine patients following an outbreak of methanol poisoning. METHODS: Five patients with a typical clinical presentation and elevated anion and osmolar gaps underwent conventional brain MRI with a 1.5-T Gyroscan Interna scanner. In addition nonenhanced CT was performed in another three patients with more severe toxicity. RESULTS: Bilateral hemorrhagic or nonhemorrhagic necrosis of the putamina, diffuse white matter necrosis, and subarachnoid hemorrhage were among the radiological findings. Various patterns of enhancement of basal ganglial lesions were found including no enhancement, strong enhancement and rim enhancement. CONCLUSION: A good knowledge of the radiological findings in methanol poisoning seems to be necessary for radiologists. The present study is unique in that it enables us to include in a single report most of the radiological findings that have been reported previously.

Serum leptin level in patients with functional dyspepsia.

UNLABELLED: BACKGROUND/GOAL: Previous studies have shown that leptin plays a major role in the amount of food consumption. Recently, leptin and its receptors have been found in the human gastric mucosa. The aim of this study was to seek any possible correlation between serum leptin level and subtypes and pathological findings in functional dyspepsia. MATERIALS AND METHODS: In a prospective study, we randomly select 44 patients as dysmotility-like and ulcer-like dyspepsia (according to ROME II criteria) in two equivalent groups and compared them with 22 healthy volunteers control group who matched the patients in relation to age, sex and body mass index. From each patient, a fasting blood sample for leptin level and two antral biopsies for evaluating the intensity of gastritis and Helicobacter pylori infection were provided and compared with the control group. RESULTS: Compared to the control group, serum leptin level was significantly higher in patients with dysmotility-like dyspepsia (P < 0.05). Leptin level were also significantly correlated with the presence of gastritis and H. pylori infection (P < 0.05). CONCLUSION: Leptin may have a role in the pathogenesis of the dysmotility variety of non-ulcer dyspepsia through mechanisms other than H. pylori infection. Further studies based on gastric leptin immunohistochemistry may need correlation between symptoms of functional dyspepsia and gastric leptin expression.