Dispersed Solidified Fine Droplets Based on Sonication of a Low Melting Point Deep Eutectic Solvent: a Novel Concept for Fast and Efficient Determination of Cr(VI) in Urine Samples

Cr(VI) has carcinogenic effects, so determination of trace amount of chromium in human body such as urine has a great deal of importance. In this work, a novel microextraction method was developed based on solidification of dispersed fine droplets (SDFD) of a low melting point deep eutectic solvent (DES), produced with the aid of sonication, for fast and efficient determination of Cr(VI) in urine samples. Cr(VI) contents of the human urine samples were first complexed using 1,5-diphenylcarbazone at pH ≈ 2.0 and then extracted by the method. A cloudy solution was achieved by the sonication of a microliter volume of a new water-immiscible DES consisting of benzyltriphenylphosphonium bromide (BTPPB) and phenol. Low freezing point of DES makes it possible to use simple, precise, and fast collection of the extraction phase by solidification and the subsequent centrifugation. Finally, the sedimented phase was diluted with methanol and analyzed by electrothermal atomic absorption spectrometry (ETAAS). The influences of the main factors on the efficiency of the procedure were investigated by a four-factor central composite design (CCD). Under the optimum conditions, the calibration curve was linear within the range of 10-1000 ng L^-1. The intra- and inter-day RSD% values of 2.6 and 4.7% were obtained at the concentration of 50.0 ng L^-1, respectively. The limits of detection (LOD) and quantification (LOQ) were calculated as 2.0 and 7.0 ng L^-1, respectively. Moreover, compared to the other approaches, the proposed method presented better or comparable analytical performance and provided accurate, precise, and reliable results for trace analysis of Cr(VI) in urine samples.

Deep eutectic liquid organic salt as a new solvent for carrier-mediated hollow fiber liquid phase microextraction of lead from whole blood followed by electrothermal atomic absorption spectrometry

In the present work, for the first time, a new carrier-mediated hollow fiber liquid phase microextraction (CM-HFLPME) technique was applied for the determination of lead in whole blood samples by means of ETAAS.

Toxoplasmosis in Iran: A guide for general physicians working in the Iranian health network setting: A systematic review

BACKGROUND

Human toxoplasmosis is an important zoonotic infection worldwide which is caused by the intracellular parasite Toxoplasma gondii (T.gondii). The aim of this study was to review briefly the general aspects of toxoplasma infection in in Iranian health system network.

METHODS

We searched published toxoplasmosis related articles in English databases including Science Direct, Pub Med, Scopus, Google Scholar, Magiran, Iran Medex, Iran Doc and Scientific Information Database (SID) for toxoplasmosis.

RESULTS

Out of 1267 articles from the English and Persian databases search, 40 articles were suitable with our research objectives and so were selected for the study. It is estimated that at least a third of the world human population is infected with T.gondii, suggesting it as one of the most common parasitic infections through the world. Maternal infection during pregnancy may affect dangerous outcome for the fetus, or even cause intrauterine death. Reactivation of a previous infection in immunocompromised patient such as drug induced, AIDS and organ transplantation can cause life-threating central nervous system infection. Ocular toxoplasmosis is one of the most important causes of blindness, especially in individuals with a deficient immune system.

CONCLUSION

According to the increasing burden of toxoplasmosis on human health, the findings of this study highlight the appropriate preventive measures, diagnosis, and management of this disease.

Prevalence and treatment outcome of pulmonary and extrapulmonary pediatric tuberculosis in southwestern Iran

BACKGROUND

Knowledge about childhood tuberculosis (TB) in Iran is limited. This study aimed to determine the proportion of tuberculosis in children living in Khuzestan in southwest of Iran and its treatment outcomes.

METHODS

In this retrospective study, the child's medical records registered in national TB program (NTP) unit of Khuzestan Health Center (KHC) for TB treatment from 2005 to 2010 were studied. Data including demographic, clinical presentation, laboratory test results, and treatment outcomes were extracted from the files and were analyzed.

RESULTS

Of total 4104 new TB cases registered in KHC, 203 (4.9%) were children. The mean age was 10.7±4.3 years, and 75.7% of them were females. More than 84% of TB children cases were 10 years or older, whereas, young children (< 5 years old) accounted for 5.6%. Of the total studied cases, 57.1% were pulmonary TB and 42.9% were extra pulmonary, 91.7% were successfully treated and 8.3% had poor treatment outcome. The main risk factors for poor treatment outcome were: age <5 years (OR: 0.17, 95% CI, 0.04-0.76), low body weight (OR: 0.08, 95% CI, 0.01-0.60), household contact with cases of TB treatment failure (OR: 0.13, 95% CI, 0.03-0.52), and exposure to cigarette smoke odor inside the home (OR: 0.17, 95% CI, 0.05-0.56).

CONCLUSION

The proportion of pediatric TB in the region was lower than expected. The treatment success rate was higher than the rate defined in NTP. Special attention should be given to children aged less than five years, low body weight, contact with TB treatment failure cases, and exposure to cigarette smoke.

Antibiotics use patterns for surgical prophylaxis site infection in different surgical wards of a teaching hospital in ahvaz, iran

BACKGROUND

Despite the effectiveness of prophylactic antimicrobials to prevent surgical site infection the use of antibiotic prophylaxis is often inappropriate.

OBJECTIVES

The current study aimed to determine the pattern of prophylactic antibiotic use in a teaching hospital affiliated to Jundishapur University of Medical Sciences, Ahvaz, Iran.

PATIENTS AND METHODS

The current descriptive study included 8586 patients who received prophylactic antibiotics before surgery from April 2011 to March 2012, in Razi Hospital affiliated to Jundishapur University of Medical Sciences. Indications for antibiotic use, proper or inappropriate antibiotics, an antibiotic or combination of antibiotics, dosage and length of treatment for each patient based on the infectious disease textbook (Mandel's Principle and practice of infectious diseases) definitions were administrated.

RESULTS

Of the total 8586 patients who took antibiotics for preventive purposes, 4815 (56%) required antimicrobial prophylaxis, and 3771 (44%) patients did not. Of the 4815 patients who received prophylaxis, 86.9% received it appropriately, 13.1% received it inappropriately; 8.2% received inappropriate dosage, and 9.5% received antibiotic longer than 24 hours.

CONCLUSIONS

The current study revealed that 44% of those who received prophylaxis did not need it. In the patients who received antibiotics, the most common mistakes were antibiotic selection followed by prolonged prophylaxis (> 24 hours) and excess dose.

Treatment of brucellosis: a systematic review of studies in recent twenty years

BACKGROUND

The treatment of human brucellosis is controversial. The purpose of this study was to search published clinical trial papers to provide a simple and effective treatment in brucellosis.

METHODS

Many studies on brucellosis treatment in a twenty- year span from 1993 to 2012 were searched in PubMed, Web of Science (ISI), Scopus, Google Scholar, Magiran, Iranmedex and SID. The studies that were searched and classified in groups according to combination therapy and monotherapy and their results in treatment outcome were compared. Regimens with lower treatment failure or relapse were considered as more suitable for brucellosis treatment.

RESULTS

The comparison of combined doxycycline and rifampicin (DR) with a doxycycline plus streptomycin (DS) favors the latter regimen. The combined doxycycline/cotrimoxazole (DCTM) showed similar effect with DR. The treatment with the combined regimen including quinolones was similar to DR but with higher relapse rates. Higher relapse rate was searched in monotherapy (13% vs. 4.8%) and in short-term (less than 4 weeks) treatment regimen (22% vs. 4.8%), respectively. Although in children, clinical trials were limited but showed cotrimoxazole plus rifampin for six weeks was the best treatment regimen.

CONCLUSION

In uncomplicated brucellosis in adult patients, doxycycline-aminoglycoside combination is the first choice with doxycycline- rifampin and doxycycline-cotrimoxazole should be the alternative regimens. The other oral regimens including quinolones may be considered as alternatives. Cotrimoxazole plus rifampin for six weeks may be the regimen of choice for the treatment of patients younger than 8 years old. Gentamicin for 5 days plus cotrimoxazole for six weeks may be a suitable alternative regimen.

Influenza A virus among the hospitalized young children with acute respiratory infection. Is influenza A co infected with respiratory syncytial virus?

BACKGROUND

Both influenza A virus (IAV) and respiratory syncytial virus (RSV) cause acute respiratory infection (ARI) in infants and young children. This study was conducted to determine Influenza A virus and its co infection with RSV among the hospitalized children with ARI.

METHODS

A total of 153 throat samples of the hospitalized young children aged between below one year and 5 years with the clinical signs of ARI were collected from the different hospitals in Khuzestan from June 2009 to April 2010. The samples were tested for Influenza A viruses by real time PCR. Positive IAV samples were tested for influenza A sub type H1N1 and for RSV by the nested PCR.

RESULTS

In this study, from the total 153 samples, 35 samples (22.9%) including 15 (42.8%) females and 20 (57.2%) males were positive for influenza A viruses. From the 35 positive samples for IAV, 14 were positive for swine H1N1 subtype. All the positive samples for influenza showed negative for RSV infection which revealed no coinfection with RSV. The prevalence of influenza A among age/sex groups was not significant.

CONCLUSION

Influenza A is a prevalent viral agent isolated from young children with ARI. Influenza A subtype H1N1 was accounted for the 40 percent all laboratory-proven diagnoses of influenza in 2009. No evidence of coinfection of influenza A and RSV has been observed in the present study.

Treatment of toxoplasmic lymphadenitis with co-trimoxazole: double-blind, randomized clinical trial

BACKGROUND

Lymphadenitis is one of the presenting signs of toxoplasmosis. Co-trimoxazole (CTM) has a good therapeutic effect on ocular and cerebral infections caused by Toxoplasma gondii. Since this infection is endemic in Ahvaz and because of the lack of investigations into the therapeutic effects of CTM in toxoplasmic lymphadenitis (TL), this study was performed from 2005 to 2007 to determine the therapeutic effects of CTM on TL in Ahvaz.

METHODS

Forty-six patients with TL were enrolled in this randomized, double-blind, placebo-controlled trial study. Diagnosis was based on clinical examination, serological tests (chemiluminescent), and histopathological examinations. Palpable lymph nodes, IgM >8IU, and follicular hyperplasia were defined as positive findings. Patients were randomly assigned to the comparison groups (23 patients in each group). The CTM patients were treated with 48 mg/kg/day CTM divided into two doses, for 1 month. The placebo patients were treated with placebo for 1 month. The primary endpoint for treatment response was 1 month. Follow-up with physical and serological examinations occurred at 6 months. The secondary endpoint was at 6 months. Clinical response was defined as no palpable lymph nodes and serological response as IgM <6IU; a patient was cured if the lymph nodes were no longer palpable and IgM was <6IU. Results were analyzed using SPSS software and the Chi-square test.

RESULTS

At the end of treatment, a clinical response was observed in 15 (65.2%) in the CTM group and five (21.7%) in the placebo group. A serological response was seen in 65.2% of the CTM group and 13.0% of the placebo group. The cure rate was 65.2% in the CTM group and 13.1% in the placebo group. There was a significant difference in therapeutic effect between the two groups (52.2%, 95% confidence interval 32.1-72%, p<0.001). There was no difference in the site of infection between the two groups (p>0.05).

CONCLUSION

CTM has a good therapeutic effect in TL and may be used in selected patients for whom treatment is required.

Outbreak investigation of needle sharing-induced malaria, Ahvaz, Iran

BACKGROUND

Humans acquire malaria from the bite of infected anopheline mosquitoes. Malaria is very rarely acquired by needle sharing among intravenous drug users (IVDUs). The aim of this report is to describe the role of injecting drug usage in malaria outbreaks occurring in malaria-free regions.

MATERIALS AND METHODS

This investigation was conducted to control a febrile illness occurring in IVDUs in a camp near Ahvaz, a city in the southwest of Iran, during the summer of 2000. All 98 men (mean age 25 years) in this camp took part in the study. A questionnaire was completed for data collection. Peripheral blood smears were examined for Plasmodium by Wright and Giemsa staining. Those who were positive for Plasmodium were treated with chloroquine 600 mg immediately on day 1, with a 300 mg follow-up dose 6h later; this was followed by 300 mg doses on days 2 and 3.

RESULTS

Twenty-seven patients (27.6%) were positive for Plasmodium falciparum, and all of them had shared needles and syringes in the days before their illness. One of the men had been transferred into the camp from Bandar Abbas two weeks previously . There were no anopheline mosquitoes in the camp environment and none within a 1-km radius. There had been no report of malaria transmission previously in this camp, nor among the population living within the 1-km radius. All of the cases (100%) were negative for P. falciparum at follow-up examination.

CONCLUSIONS

With regard to increasing injecting drug addiction and the presence of malaria in some parts of Iran, malaria should be included in the differential diagnosis of IVDU cases with fever.

Epidemiology of animal bites and stings in Khuzestan, Iran, 1997-2006

OBJECTIVES

To determine the incidence and characteristics of the injuries caused by animals among the population of Khuzestan region, Iran admitted to teaching hospital emergency departments.

STUDY

Retrospective study.

PLACE AND DURATION OF STUDY

From 1997 to 2006 in teaching hospitals in Ahvaz, Iran.

METHODOLOGY

The medical records of 894 patients admitted to hospital with animal bites or stings were studied. Data including epidemiological aspects, clinical findings and outcomes of treatment were analyzed using descriptive statistics and the chi(2) test.

RESULTS

Of 894 patients 62.0% were male, and the median age of males and females was 24.4 years and 26.2 years, respectively. Dogs, scorpions, mice and snakes were the most commonly involved animal species, causing injuries with a frequency of 69%, 12.5%, 8.8% and 4.4%, respectively. Feet (58.1%) and hands (30.6%) were the most commonly affected body parts, followed by the face and other parts. Infectious complications were seen in 127 patients, among them 94 soft tissue infections (74.1%), 28 cases of sepsis (22.0%) and five of endocarditis (3.9%). Thirty-five cases (3.9%) died following animal bites and stings, among them 28 (80%) due to scorpion stings, four (11.4%) related to dogs and three (8.6%) from snake bites. No cases of rabies were observed in these patients.

CONCLUSION

Animal bite is a major public health problem in Khuzestan, with a high frequency, a high percentage of hospitalization and considerable mortality.