Expression of Efflux Pumps and Fatty Acid Activator One Genes in Azole Resistant Candida Glabrata Isolated From Immunocompromised Patients

Acquired azole resistance in opportunistic fungi causes severe clinical problems in immunosuppressed individuals. This study investigated the molecular mechanisms of azole resistance in clinical isolates of Candida glabrata. Six unmatched strains were obtained from an epidemiological survey of candidiasis in immunocompromised hosts that included azole and amphotericin B susceptible and azole resistant clinical isolates. Candida glabrata CBS 138 was used as reference strain. Antifungal susceptibility testing of clinical isolates was evaluated using Clinical and Laboratory Standards Institute (CLSI) methods. Complementary DNA-amplified fragment length polymorphism (cDNA-AFLP) technology, semi-quantitative RT-PCR, and sequencing were employed for identification of potential genes involved in azole resistance. Candida glabrata Candida drug resistance 1 (CgCDR1) and Candida glabrata Candida drug resistance 2 (CgCDR2) genes, which encode for multidrug transporters, were found to be upregulated in azole-resistant isolates (≥2-fold). Fatty acid activator 1 (FAA1) gene, belonging to Acyl-CoA synthetases, showed expression in resistant isolates ≥2-fold that of the susceptible isolates and the reference strain. This study revealed overexpression of the CgCDR1, CgCDR2, and FAA1 genes affecting biological pathways, small hydrophobic compounds transport, and lipid metabolism in the resistant clinical C.glabrata isolates.

Assessing validity and reliability of Dundee ready educational environment measure (DREEM) in Iran

BACKGROUND

If an institute is looking for improvement of its learning environment, a reliable and valid assessment tool is needed for measurement of the educational environment .The Dundee Ready Educational Environment Measure (DREEM) has been used in various studies to evaluate the educational environment. However, psychometric evaluations of the instrument seem necessary, for all known versions of the instrument. The aim of this study was to investigate the reliability and validity of Persian version of the DREEM in the major clinical wards in teaching hospitals affiliated to Iran University of Medical Sciences.

METHODS

This descriptive - analytical study, involved medical students (clinical stagers and interns) in 4 major clinical wards. In this study, DREEM questionnaire was reviewed in content, face validity and construct validity through confirmatory factor analysis. The reliability was calculated according to test - retest and the internal consistency was measured using Cronbach's alpha coefficient.

RESULTS

A total number of 267 questionnaires were completed by medical stagers (60%) and interns (40%) including 181 females and 82 males. The mean age of stagers and interns were 23.60 ± 1.27 and 25.45 ± 1.22 years, respectively. The total mean of the questionnaire was calculated as 96.15 (93.5375, 98.7547) out of 176, with 95% confidence interval. The face validity of the questionnaire was confirmed. The mean of content validity ratio (CVR) was calculated as 0.35, and 6 questions were omitted in this step. The content validity index (CVI) was 0.39. The reliability coefficient mean was 0.71. In confirmatory factor analysis five factors were confirmed that changed the orientation of some questions. The Cronbach's alpha coefficient of the whole questionnaire was obtained as 0.914.

CONCLUSION

The modified and validates DREEM questionnaire in Persian language with 44 items and appropriate psychometric attributes is capable of being used in assessment of clinical education environments in Iran.

Post graduate ESP curriculum: reading and writing needs

Assessing learners' needs is an integral part of any curriculum and course design , namely English for specific purposes (ESP), syllabus design, materials development, teaching methods and testing issues. Critical approach to needs analysis, which is a relatively recent approach, acknowledges the rights of different stakeholders including teachers, students and administrators in the process of needs analysis. However, there has been no formal need analysis for syllabus design at postgraduate level in Medical Universities affiliated to the Ministry of Health in Iran. This study, conducted in 2011, was an attempt to assess the reading and writing needs of postgraduate students in ESP courses on the basis of critical approach to needs analysis. The study population consisted of 67 people: 56 postgraduate students, 5 heads of departments, 5 ESP instructors and 1 executive manager at the Ministry of Health in Iran. Ethical and demographic forms, needs analysis questionnaires, and a form of semi-structured interview were the instruments of the study. According to the findings, there was a discrepancy between students' and instructors' perception of learners' needs and the assumed needs appearing in the syllabi prescribed by the Ministry of Health in Iran. This study showed that a call for critical needs analysis in which the rights of different stakeholders are acknowledged is necessary for meeting the requirements of any ESP classes especially at postgraduate level where the instructors and learners are fully aware of learners' needs.