Yafteh

Background: Klebsiella pneumoniae is one of the important cases of community acquired infections and hospital infections. Increasing the emergence of multidrug resistance among hospital isolates of Klebsiella pneumoniae has limited treatment options for the treatment of infections caused by this bacterium. The aim of this study was to determine the frequency of oqxA and oqxB genes in Klebsiella pneumoniae clinical isolates.
Materials and Methods: In this study, samples consist of all persons who were referred to the hospitals in Khorramabad during the last 6 months. Laboratory samples were evaluated in a differential and biochemical way and their antibiotic susceptibility were evaluated by disc diffusion method. DNA was extracted by boiling and the genes were identified by specific primers using PCR.
Results: Out of 100 samples, 63 (63%) were male and 37 (37%) were female. The highest resistance was respectively to cefotaxime, amikacin, tetracycline and the highest sensitivity was related to levofloxacin, and ceftazidime. In all isolates, 57 isolates were resistant; among those the prevalence of oqxA and oqxB genes was 26.3% and 56.1%, respectively.
Conclusion: The results of this study showed that the prevalence of oqxB gene was higher than oqxA gene and it was found that there was increased resistance to fluoroquinolones in the studied isolates.

Background: One of the major problems presented to health care systems is the increasing prevalence of antibiotic-resistant bacterial infections. Today, natural substances, such as essential oils with antimicrobial properties, are increasingly used as an alternative to antibiotics. The present study aimed to assess the effect of chitosan nanogels containing essential oil of peppermint (Mentha Piperita) on clinical isolates of Acinetobacter baumannii in vitro.
Materials and Methods: In this cross-sectional study, Acinetobacter baumannii were isolated from selected hospitals in Khorramabad. After preparing nanogels containing peppermint essential oil (Mentha Piperita), the minimum inhibitory concentration of chitosan nanogels on Acinetobacter baumannii isolates was determined by micro broth dilution method in a 96-well plate according to Clinical & Laboratory Standards Institute instructions.
Results:  The mean minimum inhibitory concentrations of nanoparticles without essential oil of peppermint, containing peppermint, and gentamicin were 47±496, 48±301, and 25±25, respectively. This is indicative of the high sensitivity of the assessed strains to gentamicin, in comparison with the other two groups (P≤0.001) and the more effective performance of Menthapiperita in the inhibition of the growth of Acinetobacter baumannii isolates, as compared to nanoparticles without peppermint essential oil (P≤0.001).
Conclusion: The obtained results of the present study pointed to the effective ability of chitosan nanogels containing peppermint essential oil to inhibit the growth of Acinetobacter baumannii isolates, in comparison with non-essential nanoparticles (Mentha Piperita).
 

Background: Bacterial meningitis is an acute infection of the meninges requiring immediate diagnosis and treatment. Clinical, laboratory, and epidemiological findings of meningitis are of utmost importance for rapid diagnosis and treatment. The present study aimed to evaluate patients with meningitis based on their epidemiological, clinical, and laboratory findings and compare these variables between patients with septic and aseptic meningitis.
Materials and Methods: In this retrospective cross-sectional descriptive study, all children with suspected meningitis in Shahid Madani Hospital in Khorramabad in 2014-2015 were examined for spinal fluid culture, age, gender, seasonal distribution, and antibiogram results.
Results:  Among 63 patients with meningitis, 30 (47.6%) cases had septic meningitis, and 33 (52.4%) subjects had aseptic meningitis. Out of 30 patients with septic meningitis, 4 (13.3%) patients had positive microbial culture. Among patients with septic meningitis, only four bacterial isolates were isolated by the microbial culture method, out of which Streptococcus pneumoniae was the most common bacterium and the prevalence was higher in autumn and winter. The most effective antibiotics were cotrimoxazole and vancomycin with a sensitivity of 100%; nonetheless, there was relatively high resistance to cloxacillin, erythromycin, and clindamycin. The number of white blood cells (WBCs), sugar, and protein in cerebrospinal fluid (CSF) in septic meningitis were compared with aseptic meningitis, and a significant difference was observed between the two groups. There was also a significant difference between gender and septic meningitis, and male patients were more likely to suffer from septic meningitis.
Conclusion: The prevalence of aseptic meningitis was higher than that of septic meningitis. Microbial tests are very effective in the correct diagnosis and treatment; however, the level of WBC, glucose, and protein in CSF can also be of great help in diagnosing different types of meningitis, especially septic meningitis.

Background: Prediabetes is an important risk factor for developing type 2 diabetes and cardiovascular diseases. The current study aims to investigate the changes in miR-204 and serum glucose following eight weeks of high-intensity interval training (HIIT) in the men with prediabetes.
Materials and Methods: In this quasi-experimental study with a pre-test/post-test design, 24 middle-aged men (aged 40-50 years) with prediabetes (Fasting blood sugar= 110-125 mg/dL) were randomly assigned to the training and control groups. The training group performed the HIIT (High Knee, Butterfly, Burpee, Kettlebell Snatch, and Scott Goblet) with an intensity of 80-90% of heart rate for eight weeks (three sessions in the first four weeks and four sessions in the second four weeks). The blood samples were taken from the subjects 48 hours before and after the last training session to analyze the level of miR-204, lipid profile, and the serum glucose level. Data were analyzed by using paired t-test and ANCOVA in SPSS v.25 software, considering a significance level of P˂0.05.
Results: The eight weeks of HIIT significantly reduced the serum levels of miR-204 (P=0.001), Triglyceride (P˂0.001), Cholesterol (P˂0.001), low-density lipoprotein (P˂0.001), and glucose (P=0.031) compared to the control group. Furthermore, after HIIT, a significant increase in the serum high-density lipoprotein level was observed (P˂0.001).
Conclusion: It seems that miR-204 is an appropriate indicator for regulating the blood glucose level in both diabetic and pre-diabetic men. Furthermore, HIIT can reduce the lipid profile by altering the expression of miR-204 and, subsequently, reducing the glucose level.                                 

Background: Klebsiella pneumoniae is one of the essential types of human pathogenic bacteria. The emergence of antibiotic resistance has caused numerous treatment problems for its elimination. The present study aimed to assess the antibiotic resistance pattern of K. pneumoniae bacteria in patients admitted to the intensive care unit (ICU) of Shahid Rahimi Hospital in Khorramabad in 2022.
Materials and Methods: This cross-sectional descriptive study was conducted on 120 patients admitted to the ICU of Shahid Rahimi Khoramabad Hospital in 2022. After collecting K. pneumoniae isolates, the antibiotic resistance pattern of all isolates was evaluated. Thereafter, the relationship between antibiotic resistance and different variables was analyzed using SPSS software (version 25).
Results: In this study, the mean age of patients participating was 55.09±26.44 years. The most isolated strain of K. pneumoniae was obtained from urine samples (48.3%). The highest rate of antibiotic sensitivity was to amikacin (65.8%), gentamicin (50.8%), and ciprofloxacin (49.2%), while the highest rate of antibiotic resistance pertained to cefixime (68.3%), cefotaxime (66.7%), and ceftriaxone (60.8%). The pattern of antibiotic resistance showed a significant relationship with inpatient ICU, surgical ICU, general ICU, internal ICU, emergency ICU, and pediatric ICU (P < 0.05).
Conclusion: By specifying the pattern of antibiotic sensitivity in the ICU in the investigated area and reporting it to the doctors, the obtained results can be taken into account in experimental treatments, which in itself causes a better response from the patients to the received medicine and a reduction in antibiotic resistance in ICUs.

Background: COVID-19 infection initially results in respiratory complications; however, it may be associated with a hypercoagulable state, leading to arterial and venous thromboembolism. Thus, this study aimed to investigate the frequency of thromboembolism in COVID-19 patients admitted to Shahid Rahimi Hospital in Khorramabad.
Materials and Methods: In this cross-sectional (analytical) study, all patients with COVID-19 were admitted to Shahid Rahimi Hospital in Khorramabad from October 2020 to the end of September 2021. Laboratory and clinical variables of patients with positive polymerase chain reaction tests were collected. The incidence of thromboembolism was investigated in patients with radiological reports, and then the data were analyzed using SPSS25 software. The significance level was considered at < 0.05.
Results: Out of 3,612 patients with COVID-19, 19 had pulmonary thromboembolism. Diabetic patients accounted for 2.5%, patients with a history of hypertension accounted for 1.8%, and patients with a history of heart disease accounted for 1.5% of pulmonary thromboembolism cases. Patients with a smoking history constituted 0.5%, deceased patients represented 0.8%, and discharged patients also accounted for 0.5% of pulmonary thromboembolism cases. Patients who received at least one dose of the vaccine made up 0.4%, and patients with a previous COVID-19 infection accounted for 0.5% of pulmonary thromboembolism cases. There was a significant correlation between diabetes, hypertension, age, and a previous history of COVID-19 with the incidence of pulmonary thromboembolism (P<0.05).
Conclusion: Diabetes and high blood pressure increase the risk of pulmonary embolism in COVID-19. Therefore, those suffering from underlying diseases need more care regarding COVID-19.