Internal Medicine Today
Volume:29 Issue: 2, Spring 2022

Nosocomial infections have always been a serious threat to hospitalized patients, and in recent years, the emergence of antibiotic-resistant isolates has aggravated the severity of this problem. The type and rate of bacteria causing nosocomial infection can vary across different geographical areas; therefore, it is of utmost importance to periodically check the type of infection and variations in the antibiotic resistance pattern of bacteria. Therefore, this study aimed to assess the variation in antimicrobial resistance patterns in bacteria isolated from patients with nosocomial infection hospitalized in Allameh Bohlool Gonabadi Hospital from 2017-2020.

The present cross-sectional descriptive study was conducted on 392 patients with nosocomial infection admitted to Allameh Bohllol Gonabadi Hospital from 2017-2020. The age and gender of the patients, the hospital department, the type of hospital infection, the cause of the infection, and the pattern of antibiotic resistance were extracted from the patient's files. Finally, all the data were analyzed in SPSS software (version 21) using descriptive statistical tests, and the variation in antimicrobial resistance pattern in bacteria isolated from patients with nosocomial infection was investigated.

Out of 44,204 examined patients, 392 cases had nosocomial infections. The rate of nosocomial infection was 0.88%. Ventilator-related pneumonia (32.14%), urinary infection (27.55%), and surgical site infection (20.15%) were the most common nosocomial infections. The highest rate of nosocomial infections was related to the intensive care unit. E. coli (17.6%), Klebsiella (12.2%), and Acinetobacter (10.9%) were the dominant pathogens causing nosocomial infections. The results regarding the variation in antibiotic resistance pattern demonstrated that the rate of antibiotic resistance and the frequency of isolates with multidrug resistance increased over four years. All the isolates showed 100% resistance to ampicillin. Gentamicin and amikacin were the most effective antibiotics used for gram-negative bacilli.

As evidenced by the obtained results, there was a significant increasing trend in the resistance of isolates to all studied antibiotics during these four years; moreover, the frequency of multidrug-resistant strains was also increasing. Furthermore, the marked increase in antibiotic resistance among isolates causing nosocomial infections in recent years is a serious risk. Therefore, a thorough knowledge of antibiotic resistance patterns can be of great help to physicians in selecting more appropriate antibiotics for treatment and preventing the development of antibiotic resistance.

The present study aimed to assess the survival of patients with malignant pleural effusion (MPE) and identify factors that impact prognosis. It is crucial to identify these factors and provide appropriate treatment for patients with lower survival rates in MPE.

This study analyzed the survival of patients with MPE in oncologic clinics in Yazd from 2011-2021. It was a descriptive cross-sectional study that utilized Kaplan-Meier analysis for survival analysis. The survival time was measured from pathological diagnosis to death. The data were analyzed in SPSS software (version 21).

The study involved 135 patients (mean age: 54.24; range: 22-65). Most patients were in their 6th and 7th decades, and only 6.7% of cases were under 40 years old. Regarding gender, 63 cases were male, and 72 subjects were female. The main causes of metastasis in MPE patients were lung cancer, breast cancer, and adenocarcinoma of unknown origin. Chemotherapy, followed by combination therapy, was the common treatment approach. Out of 135 patients, 109 cases passed away during the study. The average survival time was 21.67 months, with a 30% chance of 2-year survival and a 10% chance of 5-year survival. The study found no significant relationship between survival rate and gender or cause of the disease (mesothelioma or metastasis); nonetheless, age, treatment type, and malignancy type exhibited a significant relationship.

Timely diagnosis and appropriate treatment are crucial for improving patient survival, especially in the first two years. It is essential to prioritize screening, diagnosis, and treatment of low survival rate cancers, such as lung cancer, adenocarcinoma of unknown origin, and renal cell carcinoma.

Alzheimer’s disease is one of the most common dementias, which is initially characterized by synaptic damage and subsequently accompanied by neuronal loss and cognitive impairments, such as anxiety and depression. Urolithins are natural phenolic compounds found abundantly in the human diet and are catabolized from the hydrolysis of ellagitannins by the gut microbiota. They possess anti-inflammatory and antioxidant properties and have been found to be effective in brain disorders, particularly memory dysfunction. This study aimed to investigate the effect of Urolithin A and B administration on learning and memory impairments as well as anxiety-like behaviors in adult male rat models of Alzheimer’s disease.

In this experimental study, 70 adult male Wistar rats were randomly divided into 10 groups of seven, including the healthy control group, the Sham group: received streptozotocin solvent (ascorbic acid 0.1% in saline) as intracerebroventricular (ICV) injection and urolithins solvent (DMSO) as intraperitoneal (IP) injection, Positive control group: received streptozotocin as ICV injection and memantine as IP injection, Negative control group: received streptozotocin as ICV injection, Treatment groups 1 to 6: received streptozotocin as ICV injection and urolithin A and urolithin B as IP injection for 14 days. After the treatment period, the learning and memory of the rats were measured by the passive avoidance test, and the elevated plus maze test measured anxiety-like behaviors.

The results of statistical analysis using one-way variance test (ANOVA) and Tukey's post hoc test, performed in R software, showed that in the passive avoidance test, streptozotocin caused a significant impairment in learning and memory in the negative control group (P<0.01), while the treatment with urolithin A and B significantly improved memory performance, much better than the standard treatment (memantine) (P<0.05). Furthermore, the results of the elevated plus maze test also indicated a significant increase in anxiety-like behaviors in the negative control group compared to the control group (P<0.001), while the treatment with urolithin A and B significantly reduced these behaviors (P<0.01).

The results of this study indicated that urolithin A and B, probably due to their antioxidant and anti-inflammatory properties, protected the brain against the effects of streptozotocin injection, and consequently, improved learning and memory performance and reduced anxiety-like behaviors.

Skin cancers are among the most prevalent skin diseases across the globe. In recent years, we are witnessing an increasing rate of skin cancer. Therefore, the present study aimed at epidemiological evaluation of basal cell carcinoma (BCC) in patients referring to the dermatology clinic of Allameh Bohlool Gonabadi Hospital from 2016 to 2019.

The present retrospective cross-sectional study was conducted on patients with suspected BCC referring to the skin clinic of Allameh Bohlool Gonabadi Hospital from April 2015 to September 2018. Their skin biopsy samples were sent to Allameh Behlool Gonabadi Hospital Pathology Laboratory for diagnosis. Based on the research criteria, 149 completed pathology reports were examined, and BCC was on the list of clinical differential diagnoses of skin lesions. Data were analyzed in SPSS software (version 20). A p-value less than 0.05 was considered statistically significant.

In the present study, the prevalence of BCC was calculated at 36.2%. Based on the location of the BCC lesion, the most affected area was the face. A statistically significant relationship was found between age and the prevalence of BCC. Nonetheless, the prevalence of BCC displayed no statistical relationship with gender and place of residence.

As evidenced by the obtained results, old age and male gender increase the probability of facial BCC. This finding can be ascribed to more prolonged contact of the face with direct sunlight or carcinogenic substances; therefore, screening programs are recommended for the diagnosis of this disease in its early stages.

Aims :

Pain and altered motor control are consequences of chronic low back pain (LBP). The present study aimed to assess the effects of a six-week Swiss ball core stabilization program on pain levels and lumbopelvic motor control in patients suffering from nonspecific LBP.

Materials & Methods :

This randomized clinical pilot study involved 24 participants (12 females and 12 males) who were diagnosed with nonspecific chronic LBP (mean age=42.08±7.05 years). Participants were randomly assigned to two groups: experimental (n=12) and control (n=12). The experimental group underwent a six-week intervention of core stability exercises, while the control group received routine physical therapy. The primary outcome measured was pain intensity using a visual analog scale ranging from 0-10. Secondary outcomes included lumbopelvic motor control, which was assessed using various tests, such as the knee lift abdominal test, bent knee fall-out test, Waiter's Bow test, sitting knee extension test, and transversus abdominis test. Evaluations were conducted at three time points: baseline, the end of a six-week intervention, and after one month of follow-up.

Findings :

The core intervention resulted in a significant increase in motor control during the post-test (P<.001; Cohen's d=6.04), although this effect did not persist in the follow-up assessment. Moreover, a significant decrease in pain intensity was observed both during the post-test (P<.001; Cohen's d=3.31) and follow-up (P<.001; Cohen's d=2.98) periods. Furthermore, significant differences were identified between the two groups in all outcome measures following the intervention (P<.05).

Compared to routine physical therapy, the six-week core stability exercises on the Swiss ball resulted in marked improvements in pain intensity and lumbopelvic motor control in patients with nonspecific chronic LBP.

Urinary tract infection (UTI) is the most common urinary system disease, which is considered a contributing factor to renal failure. The present study aimed to evaluate the significance of hyponatremia in the diagnosis and treatment of hospitalized patients with UTI at Allameh Bohlol Gonabadi Hospital in Gonabad City, Iran.

This cross-sectional study was conducted on 384 collected samples from patients diagnosed with UTI from 2013 to 2017. Demographic and clinical data of the patients were recorded using a checklist. The samples were divided into two groups: hyponatremia and non-hyponatremia, and variables including leukocyte count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and duration of fever were examined. After sample collection, the data were analyzed using the SPSS (version 20) software and Chi-squared and Mann-Whitney statistical tests.

In this study, 384 individuals with febrile UTI were examined, of which 71.6% were female and 28.4% were male. Hyponatremia was present in 57.6% of individuals with UTI. No significant correlation was found between age, gender, and hyponatremia (P=0.189 and P=0.238, respectively). Patients with hyponatremia had increased leukocyte count, elevated ESR, and positive CRP. A significant association was observed between hyponatremia and CRP, ESR, leukocyte count, and duration of fever (P<0.001).

The results demonstrated that hyponatremia may serve as a marker in the diagnosis of febrile renal infections, and its presence at the time of diagnosis suggests a likelihood of pyelonephritis and severe inflammation.

Septic shock, a complication characterized by altered tissue perfusion. Renal resistive index (RRI) reflects changes in intrarenal perfusion. The present study aimed at investigating changes in RRI during resuscitation of patients with septic shock and evaluating its relationship with perfusion parameters.

The present prospective observational study was performed on all patients diagnosed with septic shock from July 2018 to September 2019. Demographic characteristics of the study subjects were recorded and their hemodynamic, paraclinical, and RRI values were measured at three time points of on arrival, and 30 and 120 minutes and six hours after admission, by ultrasound.

A total of 109 subjects entered data analysis; their mean age was 67.62 ± 14.67 years, of which 65 (59.1) were male. The RRI values were 0.71 ± 0.27, on arrival, at 30  and 0.70 ± 0.1 on 60 minutes, at six hours after treatment onset, respectively, showing that RRI values decreased during the study (P-value= 0.00).

A decrease in RRI value during resuscitation is associated with an increase in MAP in patients with septic shock. RRI can be used as an indicator of tissue perfusion in the treatment process and volume assessment of patients with septic shock.

Hospitals and medical staff play a major role in managing the COVID-19 pandemic. The present study aimed to evaluate the psychological resilience of the staff and the organizational climate of Allameh Behlool Hospital in Gonabad and the relationship between the two during the COVID-19 pandemic.

The present cross-sectional study was conducted in Autumn 2021 with 300 employees of Allameh Behlool Hospital in Gonabad. Connor-Davidson Resilience Scale and Lyle Sussman and Sam Deep’s Organizational Climate Questionnaire were utilized for data collection. Multiple linear regression was used to estimate the association between organizational climate and psychological resilience. The data analysis was conducted using Stata 15.

Based on the obtained findings, the Mean (SD) age of participants was 34.05 (7.50) years, and their work experience averaged 9.22 (6.94) years. Psychological resilience and organizational climate had a Mean (SD) score of 66.04 (11.92) and 53.83 (14.72), respectively. A significant positive correlation was found between age, work experience, and psychological resilience. The multiple linear regression analysis showed that after controlling for the effects of age and work experience, there was a significant positive association between the organizational climate and the psychological resilience of the hospital staff.

This study found a significant positive association between organizational climate and psychological resilience among the hospital staff. Specifically, factors such as clarity of goals, role clarity, satisfaction with rewards, effective communication, and agreement on procedures contributed to greater resilience. These findings underscore the importance of adopting an integrated approach that considers the dimensions of organizational climate to enhance the resilience of the hospital staff, ultimately improving the hospital management to better prepare for crises.