Identification and molecular epidemiology of nosocomial outbreaks due to Burkholderia cepacia in cystic fibrosis patients of Masih Daneshvary Hospital, Iran.

INTRODUCTION: B. cepacia complex have emerged as an important opportunistic pathogen in hospitalized and immunocompromised patients. Small hospital outbreaks are frequent and are usually due to a single contaminated environmental source. In this study we were going to investigate the role of B.cepacia complex in those patients suspected to involve with cystic fibrosis and evaluate responsible types in Masih Daneshvary Hospital. METHODS: One hundred specimens were collected from all admitted patients who were suspected to cystic fibrosis to Masih Daneshvary hospital during one year April 2011 till end of March 2012. All were culture and identified standard procedure. All samples were checked by API system (API20NE) and by specific PCR method for genus Bulkhorderia and Bcc as well. Identified strains were finally tested by PFGE system to identifying specific involving pulse-types. RESULT: . Isolation and identification methods revealed 5 specimens were B.cepasia, The frequency of the cystic fibrosis detected at this study was lower than other similar study previously reported. All these isolates showed similar pattern by PFGE standard protocol that may have spread from a single source and could not be attributed to cross infections from patient to patients. DISCUSSION: Application of PFGE and identification of pulse-type is a potential tool to enhance the investigation of apparent nosocomial outbreaks of B.cepacia. However it needs to be adjusted with environmental findings. Implementation of educational programs and adherence to infection control policies are obviously the main element for complete elimination of an outbreak.

The Effect of Service Quality on Patient loyalty: a Study of Private Hospitals in Tehran, Iran.

BACKGROUND: Service quality is perceived as an important factor for developing patient's loyalty. The aim of this study was to determine the hospital service quality from the patients' viewpoints and the relative importance of quality dimensions in predicting the patient's loyalty. METHODS: A cross-sectional study was conducted in 2010. The study sample was composed of 943 patients selected from eight private general hospitals in Tehran. The survey instrument was a questionnaire included 24 items about the service quality and 3 items about the patient's loyalty. Exploratory factor analysis was employed to extracting the dimensions of service quality. Also, regression analysis was performed to determining the relative importance of the service quality dimensions in predicting the patient's loyalty. RESULT: The mean score of service quality and patient's loyalty was 3.99 and 4.16 out of 5, respectively. About 29% of the loyalty variance was explained by the service quality dimensions. Four quality dimensions (Costing, Process Quality, Interaction Quality and Environment Quality) were found to be key determinants of the patient's loyalty in the private hospitals of Tehran. CONCLUSION: The patients' experience in relation to the private hospitals' services has strong impact on the outcome variables like willingness to return to the same hospital and reuse its services or recommend them to others. The relationship between the service quality and patient's loyalty proves the strategic importance of improving the service quality for dragging and retaining patients and expanding the market share.

Optimization of solid-phase extraction using developed modern sorbent for trace determination of ametryn in environmental matrices.

In recent years, there has been a significant increase in molecularly imprinted solid-phase extraction (MISPE) technique for the purification and clean-up of environmental samples. In this study, solid-phase extraction using the imprinted polymer has been optimized with the experimental design approach for a triazine herbicide, named ametryn with regard to the critical factors such as sample pH, sample concentration, sample flow-rate, sample volume, elution solvent, washing solvent and sorbent mass. These factors were evaluated statistically and also validated with spiked drinking water samples and showed a good reproducibility over six consecutive days as well as six within-day experiments. Also, in order to the evaluate efficiency of the optimized MISPE protocols, enrichment capacity, reusability and cross-reactivity of cartridges have been studied. Finally, a selective MISPE was successfully demonstrated for ametryn with a recovery of above 90% for spiked drinking water samples. It was concluded that the central composite design could prove beneficial for aiding the MIP and MISPE development.

Application of multivariate analysis to the screening of molecularly imprinted polymers (MIPs) for ametryn.

Among the solid-phase extraction (SPE) techniques, a novel system for a triazine herbicide named ametryn, has been developed based on a molecular imprinted polymer (MIP) phase. Through this method, the synthesis of the complementary to ametryn MIP was accomplished and the factors influencing its efficiency have been optimized. Through the optimization process, the type and the amounts of functional monomer and solvents, template amount, cross-linker, initiator as well as the polymerization temperature were considered to be evaluated. Based on the obtained results, the optimum conditions for the efficient polymerized sorbent, considering the recovery efficiency were solvent: acetonitrile, 6.41 mL; monomer: methacrylic acid, 5.41 mmol; template: 1.204 mmol; cross-linker: 27.070 mmol; initiator: 2.03 mmol; temperature: 40.86 degrees C. The optimum molar ratio among the template, monomer and cross-linker for ametryn was 1:4.49:22.48. The reversed-phase HPLC-UV was used for the ametryn determination, using an isocratic solvent delivery system (acetonitrile: H(2)O, 60:40), flow-rate of 0.8 mL min(-1) and a UV wavelength of 220 nm. In line with the obtained results, using central composite design (CCD) can increase the precision and accuracy of synthesis and optimization of MIP to ametryn and possibly other similar analogues.