Yafteh

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Background : Identification of Nocardia spp. in routine medical laboratories is based on phenotypic methods that is often time- consuming. The objective of this study was to diagnose Nocardia agents by PCR technique in BAL samples of patients with suspected tuberculosis admitted to hospitals in Tehran. Materials and Methods: In this study, 116 BAL samples of patients admitted in Baqiyatallah, Imam Khomeini and Shariati hospitals were collected within 8 months. Nocardia DNA was extracted by phenol-chloroform protocol. In Duplex PCR, primers NG1 and NG2 were used to amplify a Nocardia genus- specific 598-bp fragment of 16S rRNA gene. BetF and BetR primers were used as housekeeping gene to amplify 204-bp fragment. Gel-purified PCR products were sequenced. Results: Using Duplex PCR, 7 (%6.03) samples were positive for Nocardia spp. . Sequencing results showed that the species identified were N.cyriacigeorgica (6 case) and N. otitidiscaviarum (1 case). Conclusion: In the present study, DNA extracted from Nocardia Spp. in BAL specimens by manual method during minimum time which had not previous record in Iran. The study also was carried out on patients with suspected tuberculosis which restricted work has already been done on them. In this study, N. cyriacigeorgica was dominant species that has been introduced during recent years, which should be considered in clinical laboratories and research centers.

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Background: Sleepiness that occurs at inappropriate or undesirable times or that interferes with daytime activities is generally considered excessive daytime sleepiness. Obstructive Sleep Apnea (OSA) is one of the most common causes of excessive daytime sleepiness. The aim of this study is to finds out the most important nocturnal polysomnographic parameters influencing daytime sleepiness in patients with OSA. Materials and Methods: Considering the inclusion and exclusion criteria, 112 patients referred to Baqiyatallah subspeciality sleep clinic in Qom city were selected. Patients, demographic and Epworth Sleepiness Scale (ESS) data were gathered and then comparison among ESS with polysomnography and anthropometric parameter was performed. Chi-square was used for analysis of qualitative parameters. Data analysis was done by SPSS v.18. P value was significant (˂0.05). Results: The mean age of the cases was 55.07 with male frequency 58.9% and female 41.1%. Body mass index was 34.34, apnea hypopnea index 43.62, mean Arousal Index 30.64 and mean ESS was 12.83. There was significant relationship among ESS>10 with arousal index (p=0.009) and mean O2 saturation (p=0.029), But we didn’t detected correlation between ESS>10 with other polysomnographic parameters. Conclusion: According to the data, the most important parameters of sleepiness in obstructive sleep apnea patients were sleep fragmentation and mean O2 saturation.

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Background: Escherichia coli is one of the most common causative agent of urinary tract infection. In recent years, resistance to cephalosporins has been considerably on the rise due to production of extended spectrum beta-lactamases (ESBLs.( This study was aimed to determine the survey of CTX-M, SHV, TEM, OXA-1, PER-2, and VEB-1 which are the most famous ESBL genes in E. coli isolated from outpatients with UTI in Guilan.
Materials and Methods: A total of 2267 urine samples were collected from outpatients suffering from UTIs. After primary biochemical and differential tests like MRVP, Lysin dacarboxilation in LIA medium, Urea hydrolysis test, TSI and Simon citrate test, samples containing E. coli were identified. Antibiotic susceptibilities were determined by disk diffusion. Double disk tests using Cephtriaxon, Amoxiclave and Cephtazidime-clavolonate were performed for phenotypic ESBL production assay. ESBL-producing genes were evaluated by PCR.
Results: Among the 2267 urine samples, 167 E. coli cells were isolated. From these E. coli isolates, 38.9% were shown to be ESBL producers by the Double disk method. Based on the molecular analysis, the frequency of ESBL-producing genes were, CTX-M (70.32%), TEM (9.64%), SHV (4.88%) OXA-1 (57.2%), and PER-2 (12.1%). VEB-1 was not detected in the analyzed samples. Also, some of the isolates had more than one ESBL-producing gene. Statistically, there was a direct correlation between gender and age with the infection.
Conclusion: In this study, more than half of the isolated bacteria were ESBL-producers. As the resistance-inducing genes are carried on mobile genetic elements, rapid detection of resistant species is of major importance to prevent their dissemination.

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