Razieh Amirfakhrian; Atieh Yaghobi; Roya Saddat Ghaderi; Seyed Isaac Hashemy; Kiarash Ghazvini
Abstract
Introduction: In recent decades, the inappropriate use of antibiotics and the existence of transferable resistant elements have caused the emergence of multidrug-resistant (MDR) gram-negative organisms. Antimicrobial resistance is becoming one of the major challenges to public health and has caused morbidity ...
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Introduction: In recent decades, the inappropriate use of antibiotics and the existence of transferable resistant elements have caused the emergence of multidrug-resistant (MDR) gram-negative organisms. Antimicrobial resistance is becoming one of the major challenges to public health and has caused morbidity and mortality worldwide. The purpose of this study was the assessment of the prevalence and frequency of colistin resistance among gram-negative bacilli (Enterobacteriaceae, Acinetobacter spp., and Pseudomonas spp.) in Iran and around the world. Methods: For this systematic review and meta-analysis, we searched international and national databases, including PubMed, Google Scholar, SID, and Magiran, from 1998 to 2018 for articles and abstracts describing colistin resistance among gram-negative bacilli. We have included 92 studies that met our inclusion criteria, and the outcomes were combined using a random-effects model to derive the event rate of colistin resistance among gram-negative bacilli. Data were analyzed by the Comprehensive Meta-Analysis Software (V2), and the heterogeneity of the studies was assessed using the I2 index. Results: Out of the 11050 papers identified, 92 studies met the strict inclusion criteria and were finally included. The overall event rate of colistin resistance among gram-negative bacilli (GNB) was about 6.6%, while the event rate of colistin resistance among Acinetobacter spp. (n = 18504) was 2.8% (summary: 95% confidence interval (CI): [0.02, 0.041], P = 0.001, I2 = 70, df (Q) = 36, Q-value = 121.924). The colistin resistance among Pseudomonas spp. (n = 15094) was 3% (95% CI: [0.022, 0.041], P = 0.001, I2 = 68.3, df (Q) = 25, Q-value = 85.648), and the colistin resistance among Enterobacteriaceae spp. (n = 44772) was 0.8% (95% CI: [0.004, 0.014], P = 0.001, I2 = 87.6, df (Q) = 15, Q-value = 71.291). Therefore, the event rate of resistance to colistin among GNB was relatively low (6.6%). Conclusion: The event rate of resistance to colistin among GNB was low. Therefore, this antimicrobial agent can still be administered as a suitable option against GNB that are resistant to other antibiotics such as carbapenems.
Kazem Saeedi; Ali Taghipour; Ehsan Mousa-Farkhani; Nasrin Milani
Abstract
Introduction: Diabetes is the most common metabolic disorder during pregnancy. Given the importance of the screening and treatment of gestational diabetes for the prevention of maternal and fetal complications, the present study aimed to evaluate the prevalence of gestational diabetes mellitus in the ...
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Introduction: Diabetes is the most common metabolic disorder during pregnancy. Given the importance of the screening and treatment of gestational diabetes for the prevention of maternal and fetal complications, the present study aimed to evaluate the prevalence of gestational diabetes mellitus in the pregnant women covered by Mashhad University of Medical Sciences, Iran.Methods: This study was conducted on the women with pregnancy intention or confirmed pregnancy, referring to the health centers affiliated to Mashhad University of Medical Sciences during March 2017-September 2018. The patients with gestational diabetes mellitus were identified based on the latest WHO criteria in 2013. Data were collected on the conducted experiments and recorded in the integrated health information system (SINA). Data analysis was performed in SPSS version 25 using Chi-square and logistic regression.Results: During the study period, 2,710 women (4.3%) were diagnosed gestational diabetes mellitus. The mean age of the patients was 28.5656.379 years. In terms of the influential factors, significant correlations were observed between gestational diabetes mellitus and family history of diabetes (OR=4.278; P<0.0001), history of gestational diabetes mellitus (OR=3.880; P<0.0001), body mass index (OR=2.302; P<0.0001), history of macrosomia (OR=1.656; P<0.003), history of recurrent miscarriage (OR=1.759; P<0.007), and preeclampsia (OR=1.914; P<0.045). Conclusion: According to the results, the prevalence of diabetes in Mashhad city (4.3%) seems to be slightly lower than other areas. Special attention must be paid to the pregnant women with the influential factors of gestational diabetes mellitus through selective screening based on the risk factors of the disease.
Marzieh Rahimzadegan; Farshid Abedi; Seyed Abodolrahim Rezaei; Reza Ghadimi
Abstract
Human T-lymphotropic virus (HTLV-1) is an ancient pathogen for human being but arising and recognized recently. The routes of transmission are vertical (mainly by breastfeeding), unsafe sexual contacts and through contaminated blood components specially in whom need frequent and repeated blood ...
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Human T-lymphotropic virus (HTLV-1) is an ancient pathogen for human being but arising and recognized recently. The routes of transmission are vertical (mainly by breastfeeding), unsafe sexual contacts and through contaminated blood components specially in whom need frequent and repeated blood transfusions such as permanent anemia due to blood loss in hemophilia and major thalassemia. Patients who should undergo hemodialysis in their lifelong are another instance for increased risk of HTLV-1 exposure. The main HTLV-1-associated diseases are tropical spastic tetraparesis (HAM/TSP), an inflammatory myelopathy and adult T-cell leukemia (ATL). Although HTLV-1 is scattered around the world, only in endemic areas where prevalence rate is more than 1%, viral burden of infection have accumulated. Japan, Southern and Central parts of Africa, Caribbean basin and Iran are examples of endemic areas of HTLV-1. In this article, a rapid and brief review of HTLV-1 virology, immunology and pathogenesis have emerged. In addition, a short debate has driven about current statues of HTLV-1 in Iran.