Isolation, characterization, and genotyping of Ornithobacterium rhinotracheale isolated from broiler and broiler breeder flocks in Mazandaran province, Northern Iran.

Background: Ornithobacterium rhinotracheale (ORT) is one of the most important pathogenic bacteria which cause significant economic losses in poultry breeder countries every year. Aims: The present study was conducted to isolate and investigate the ORT isolates' biochemical, antibiotic resistance, and genotypic characteristics of in industrial poultry flocks with respiratory signs in northern Iran. Methods: After sampling from 60 different flocks and cultivation of the samples on a selective medium, suspected colonies were subjected to biochemical and molecular identification of ORT. Then, confirmed isolates were aimed to antibiotic resistance assay, hemagglutination test, detection of pOR1 plasmid, and DNA fingerprinting to survey the variability of the isolates. Results: A total of 13 isolates, including seven isolates from broiler flocks (19.44%) and six isolates from broiler breeder flocks (25%) were obtained. Almost all isolates showed similar results in terms of basically important biochemical tests. The most resistance rates among all ORT isolates were obtained for ampicillin, erythromycin, ceftriaxone, and penicillin (100%). The majority of ORT isolates were susceptible to furazolidone. The pOR1 plasmid was detected in only two isolates, and analysis of the DNA fingerprinting phylogenetic tree showed four specific genotypic clusters. Conclusion: According to the results, the isolates showed different antibiotic resistance profiles, and most of the strains proved multiresistant. This can indicate the circulation of various multi-drug resistant strains among poultry farms in northern Iran. Isolates from broilers and broiler breeders were grouped into different clusters by genotyping.

[Retrosternal goiter in thoracic surgical practice]. / Zagrudinnyi zob v torakal'noi khirurgicheskoi praktike.

OBJECTIVE: To evaluate and optimize surgical approaches to the management of retrosternal goiter. MATERIAL AND METHODS: A cohort retrospective single-center study included 56 patients aged 68.3±9.8 years with retrosternal goiter who underwent surgery between 2004 and 2019. Right-sided goiter was diagnosed in 16 cases, left-sided goiter in 21 patients, bilateral goiter in 19 patients. Palpable neck mass was found in 17 (30.4%), stridor in 16 (28.6%), thyrotoxicosis in 4 (7.1%) and recurrent laryngeal nerve palsy in 2 (3.6%) cases. X-ray signs of tracheal compression were detected in 43 (76.8%) patients, deviation in 26 (46.4%) patients. Resection through cervical collar incision was performed in 40 (71.4%) patients. Additional sternotomy was required in 11 (19.6%) patients, 1 (1.8%) patient required collar incision and right anterior mediastinotomy. Right-sided posterolateral thoracotomy without collar incision was performed in 1 (1.8%) patient with a suspected mediastinal teratoma. Three patients underwent median sternotomy only because of preoperative diagnosis of teratoma in one and thymoma in two patients. RESULTS: There was no perioperative mortality. Transient vocal changes occurred in 3 (5.4%) patients, recurrent laryngeal nerve palsy in 3 (5.4%), atrial fibrillation in 2 (3.6%), wound complications in 2 (3.6%), left phrenic nerve palsy in 1 (1.8%), transient hypocalcaemia in 1 (1.8%) and persistent hypothyroidism in 1 (1.8%) patient. Hospital-stay ranged from 2 to 12 (5.5±2.0) days. Multinodular goiter was found in 53 (94.6%) patients, diffuse goiter in 1 (1.8%), ectopic thyroid in 1 (1.8%) and oncocytic tumor in 1 (1.8%) patient. One (1.8%) patient underwent simultaneous resection of RSG via a collar incision and right-sided VATS upper lobectomy for primary lung cancer. One (1.8%) patient also underwent simultaneous resection of RSG via collar incision and right-sided VATS subcarinal lymph node biopsy for coexistent lymphoma. Mean vertical length of goiter in the collar incision group was 7.6 cm compared to 10.6 cm in the sternotomy group. Mean weight of specimens was 162.3 g in patients with collar incisions and 312.5 g in the sternotomy group. Sternotomy was required in 14 (25%) patients. CONCLUSION: Resection of retrosternal goiter is more commonly performed via cervical collar incision with mandatory availability of sternotomy. Radiological measurement of craniocaudal length may predict the need for sternotomy. Surgical outcomes are not affected by surgical approach. Simultaneous thoracic interventions for a coexistent pathology in patients with RSG may be considered. Further research of minimally invasive interventions for RSG resection is required.

Maternal and Fetal Outcomes in Iranian Patients with Systemic Lupus Erythematosus: A Five-Year Retrospective Study of 60 Pregnancies.

BACKGROUND: As a multisystem autoimmune disease, Systemic Lupus Erythematosus (SLE) mainly affects women during reproductive age. This retrospective study was designed to investigate the fetal and maternal outcomes of Iranian women with SLE. METHODS: Clinical and laboratory records of 60 pregnancies in 55 SLE patients who attended Hafez hospital, a tertiary referral center for high risk pregnancies and SLE patients affiliated with Shiraz University of Medical Science, were reviewed during April 2012 and March 2016. RESULTS: The mean age of the patients was 29.28±4.6 years and mean disease duration was 5.09±4.2 years. Live birth rate was 83.3% after exclusion of elective abortions. There were 50 live births, 3 neonatal deaths, 3 spontaneous abortions and 7 stillbirths. 9 (15%) women developed preeclampsia and there was 1 (1.6%) case of HELLP syndrome. Lupus flares occurred in 27 (45%) patients during pregnancy. Preterm delivery occurred in 11.6% of pregnancies. Skin and joints were the most frequently affected organs. Patients with previous lupus nephritis (n=18) were associated with a higher risk of maternal complication, but fetal outcomes were similar in both groups. Cesarean rate was about 66%, mostly related to fetal indications (50%). CONCLUSION: Pregnancies in most women with pre-existing SLE can now be managed with successful results although presence of previous lupus nephritis is still a major risk factor for adverse maternal outcomes. In our study, fetal outcome was not different between patients with lupus nephritis compared with the patients without nephritis who were under treatments. Hence, to achieve favorable long-term results, we recommend regular multispecialty treatment approaches and progestational counseling for women with SLE.

Genotyping of Mycobacterium tuberculosis isolates from northwest Iran for determination on the mechanism of transmission.

Planning to control tuberculosis requires identification of dominant strains in the region, transmission patterns and risk factors that are possible by using molecular genotyping techniques. The aim of this study is to determine the transmission of tuberculosis in the northwest of Iran in order to better understand the spread of disease in northwest of Iran. In this study, 194 positive mycobacterium cultivars in northwest of Iran were investigated using exact tandem repeat-variable number tandem repeats (ETR-VNTR) method. The ETR-VNTR method was identified 55 different patterns in 194 isolates, which contained 25 clusters and 30 unique patterns, and the largest cluster had 33 isolates, and discriminatory power of ETRVNTR method was determined 0.9322 in the examined samples. There are strains of Mycobacterium tuberculosis located in the northwest of Iran that infect people, and ETRVNTR method can be used as a first-line method to examine the dynamics of tuberculosis transmission.

Genotyping of Mycobacterium tuberculosis isolates from northwest Iran for determination on the mechanism of transmission

@#Planning to control tuberculosis requires identification of dominant strains in the region, transmission patterns and risk factors that are possible by using molecular genotyping techniques. The aim of this study is to determine the transmission of tuberculosis in the northwest of Iran in order to better understand the spread of disease in northwest of Iran. In this study, 194 positive mycobacterium cultivars in northwest of Iran were investigated using exact tandem repeat-variable number tandem repeats (ETR-VNTR) method. The ETR-VNTR method was identified 55 different patterns in 194 isolates, which contained 25 clusters and 30 unique patterns, and the largest cluster had 33 isolates, and discriminatory power of ETRVNTR method was determined 0.9322 in the examined samples. There are strains of Mycobacterium tuberculosis located in the northwest of Iran that infect people, and ETRVNTR method can be used as a first-line method to examine the dynamics of tuberculosis transmission.

Genetic diversity of the Dwarf honeybee (Apis florea Fabricius, 1787) populations based on microsatellite markers.

Apis florea is one of two species of small, wild honeybee. The present study was conducted to evaluate the genetic diversity of Apis florea honeybee from 48 nests (colonies) using microsatellite markers in the South of Iran. All honeybee samples were analyzed for six microsatellite loci (A88, A107, A7, B124, A113 and A35). The six loci had different numbers of alleles in the sampled colonies ranging from 7 (loci A107) to 3 (loci A7, A35). Gene diversity in Apis florea ranged from 0.491 to 0.595. This range probably reflects the spreading of nests in a large region with a varied climate. Phylogenetic tree showed two distinct clusters including a) Minab region samples and b) Bandar Abbas, Bandar Khamir and Qeshm Island regions. All of these regions are geographically rich, having varied vegetation and climate conditions. Our findings are an important contribution to the methods of studying distribution and conservation of Apis florea.

Value of transvaginal ultrasonography in endometrial evaluation of non-bleeding postmenopausal women.

OBJECTIVE: To investigate the value of transvaginal ultrasonography (TVU) in the evaluation of the endometrium in postmenopausal women without vaginal bleeding. METHODS: This was a prospective, cohort, observational study which included 259 consecutive, asymptomatic, postmenopausal women who were referred to the outpatient clinics of Shiraz University of Medical Sciences. All the participants underwent TVU by the same gynecologist at the same time as hysteroscopy and endometrial biopsy were performed. Both 3 mm and 5 mm were considered as cut-off values. Endometrial histopathology was considered the gold-standard diagnosis and the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of TVU were calculated on the basis of pathologic reports. RESULTS: The mean age of the patients was 54.2 ±â€Š7.46 years (range 36-79 years). The mean endometrial thickness was found to be 3.83 ±â€Š2.95 mm (range 1-25 mm); it was > 5 mm in 41 (15.8%) patients. The sensitivity, specificity, PPV and NPV were 62.2%, 93.9%, 68.3% and 92.2%, respectively. The receiver-operating characteristics curve showed an area under the curve of 0.853 (95% confidence interval 0.788-0.917), indicating a moderate accuracy. Conclusion TVU is a moderately accurate test in asymptomatic postmenopausal women. Due to its high false-positive rate, its positive results cannot be interpreted.

Distant metastases to nasal cavities and paranasal sinuses case series.

Metastatic tumors to the nasal cavity and paranasal sinuses are far less common than primary cancer in this location. Review of the 2004-2010 pathology records of patients with sinonasal malignancy, revealed three cases with distant metastases to this region from primary sites in kidney, prostate and breast. The clinical presentation, histopathological findings and clinical outcome is presented for each patient. Metastases to the nose and paranasal sinuses usually respond poorly to treatment and have a poor prognosis. This report highlights the importance of suspecting metastases in patients with a previous history of malignancy. Therefore, thorough history and clinical evaluation is mandatory in any known/treated case of cancer.

The impact of educating parents of leukemic children on the patients' quality of life.

BACKGROUND: The quality of life of children with leukemia is reduced by fear and anxiety of parents after diagnosis, lack of information about the disease, treatments, and care of the child. This study aims to evaluate the effect of educating parents of leukemic children on the patients' quality of life. METHODS: In this interventional study, sixty parents of ALL children who met inclusion criteria were selected using simple random sampling method, and assigned to the experimental and control groups. The study tool included a valid and reliable questionnaire (TNO-AZL), that was filled in through interview by parents before and two months after the intervention for both groups. The first part of the questionnaire included demographic items and the second part (7 dimensions, each with 8 sections) contained questions related to the quality of life. The scores could range between 56 and 280 and a higher score represented a better quality of life. The intervention included three one-hour classes composed of lecture and question-answer sessions which were held for groups of 4-6 participants, accompanied by a booklet. RESULTS: Before the intervention, the quality of life score in the experimental and control groups was 180.83±14.43 and 174.28±20.72, respectively; after the intervention, these figures changed to 226.9±11.76 and 174.41±20.42 respectively. Paired samples T-test proved a significant increase in the quality of life in the experimental group. CONCLUSION: Parent education successfully increased the quality of life of leukemic children; therefore, parental consultation sessions and educational programs are recommended.

Type A behaviour pattern: is it a risk factor for hypertension?

Type A behaviour pattern has been found to be associated with coronary heart diseases, but its association with hypertension is inconsistent. To investigate the association between type A behaviour pattern and hypertension, 221 known hypertensive patients and a control group of 221 non-hypertensive patients in Basra, Iraq, were interviewed for type A behaviour using to a special questionnaire. Blood pressure, height and weight were measured. The proportion with type A behaviour was significantly higher in hypertensive than non-hypertensive patients (57.5% versus 24.9%) and a highly significant association was found between type A behaviour and hypertension (OR 4.08, 95% CI: 2.72-6.11). Type A behaviour pattern was shown to be an independent risk factor for the development of hypertension.