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Kasiri F, Soltani R, Khorvash F, Ataei B, Nasirian M, Hakamifard A. Evaluation of Synbiotics in the Prevention of Ventilator-Associated Pneumonia: A Randomized, Triple-Blind, Placebo-Controlled Clinical Trial. Int J Prev Med 2023; 14:124. [PMID: 38264562 PMCID: PMC10803674 DOI: 10.4103/ijpvm.ijpvm_329_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 02/16/2023] [Indexed: 01/25/2024] Open
Abstract
Background Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections. The role of probiotics in preventing VAP is still questionable. This study aimed at evaluating the effect of synbiotic FamiLact 2plus on the prevention of VAP in patients admitted to the intensive care unit (ICU). Methods A total of 80 mechanically ventilated patients were included and divided into two groups of 40. Group 1 received FamiLact 2plus, and group 2 received placebo. The outcome variables were compared, including the incidence of VAP, the time interval between the onset of ventilation and VAP, the duration of mechanical ventilation, and the length of stay in the ICU. Results VAP is documented in four patients (10%) in group 1 and 11 patients (27.5%) in group 2 (P = 0.045). The length of stay in the ICU in group 1 was significantly shorter than in group 2, and the time interval between the start of intubation and the onset of VAP in group 1 was longer than in the placebo group. During the intervention, 15 patients in group 1 (37.5%) and 26 patients in group 2 (65%) developed diarrhea, which was a significant difference (P = 0.02). Conclusions Synbiotic is associated with a reduction in the incidence of VAP as well as a reduction in ICU stay and delayed VAP.
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Affiliation(s)
- Faranak Kasiri
- Department of Infectious Diseases, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasool Soltani
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzin Khorvash
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behrooz Ataei
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Nasirian
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Atousa Hakamifard
- Department of Infectious Diseases, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Shafiee F, Soltani R, Meidani M. Invasive fungal infections in hematologic malignancies: Incidence, management, and antifungal therapy. J Res Med Sci 2023; 28:73. [PMID: 38116484 PMCID: PMC10729687 DOI: 10.4103/jrms.jrms_1072_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 06/25/2023] [Accepted: 07/17/2023] [Indexed: 12/21/2023]
Abstract
The incidence of invasive fungal infections (IFIs) has increased in recent years as a result of increasing the incidence of hematologic malignancies (HMs). IFIs, as the opportunistic diseases, are the most important concern in these patients with a high mortality rate. These infections are one of the leading causes of morbidity and mortality in HM patients and an important factor in increasing the costs of patients' management because of the prolonged hospitalization and the inevitable need to use antifungal agents. Due to the changes in the pattern of organisms causing IFIs, unavailability of effective and safe antifungal drugs, and high rate of drug resistance as well as lack of fast and accurate diagnostic methods, these infections have become a serious and life-threatening problem necessitating effective prevention and treatment strategies using suitable antifungal agents, especially in high-risk patients. The aim of the present study was to review the pathogens causing various types of IFIs, diagnostic methods, and novel prophylactic and therapeutic antifungal regimens in HM patients according to the new published studies and clinical trials.
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Affiliation(s)
- Fatemeh Shafiee
- Department of Pharmaceutical Biotechnology, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohsen Meidani
- Department of Infectious Diseases, Imam Khomeini Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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Shahali A, Soltani R, Akbari V. Probiotic Lactobacillus and the potential risk of spreading antibiotic resistance: a systematic review. Res Pharm Sci 2023; 18:468-477. [PMID: 37842520 PMCID: PMC10568962 DOI: 10.4103/1735-5362.383703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/21/2022] [Accepted: 11/02/2022] [Indexed: 10/17/2023] Open
Abstract
Background and purpose Lactobacillus, the most popular probiotic, has recently gained more attention because it is a potential reservoir of antibiotic resistance. This review summarized and discussed the phenotypic-genotypic characteristics of antibiotic resistance. Experimental approach Google Scholar, PubMed, Web of Science, and Scopus were searched up to February 2022. The inclusion criteria were all studies testing antibiotic resistance of probiotic Lactobacillus strains present in human food supplementation and all human/animal model studies in which transferring antibiotic-resistant genes from Lactobacillus strains to another bacterium were investigated. Findings/Results Phenotypic and genotypic characterization of Lactobacillus probiotics showed that the most antibiotic resistance was against protein synthesis inhibitors (fourteen studies, 87.5%) and cell wall synthesis inhibitors (ten studies, 62.5%). Nine of these studies reported the transfer of antibiotic resistance from Lactobacillus probiotic as donor species to pathogenic bacteria and mostly used in vitro methods for resistance gene transfer. Conclusion and implications The transferability of resistance genes such as tet and erm in Lactobacillus increases the risk of spreading antibiotic resistance. Further studies need to be conducted to evaluate the potential spread of antibiotic resistance traits via probiotics, especially in elderly people and newborns.
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Affiliation(s)
- Ali Shahali
- Department of Pharmaceutical Biotechnology, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
- Department of Pharmaceutics, College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
| | - Vajihe Akbari
- Department of Pharmaceutical Biotechnology, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
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Hakamifard A, Soltani R. Reply to the letter to the editor regarding the study "The effectiveness of gabapentin and gabapentin/montelukast combination compared with dextromethorphan in the improvement of COVID-19-related cough: A randomized, controlled clinical trial". Clin Respir J 2023. [PMID: 37100403 DOI: 10.1111/crj.13619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/17/2023] [Accepted: 04/05/2023] [Indexed: 04/28/2023]
Affiliation(s)
- Atousa Hakamifard
- Department of Infectious Diseases, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rasool Soltani
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Talebi A, Soltani R, Khorvash F, Jouabadi SM. The Effectiveness of Silymarin in the Prevention of Anti-tuberculosis Drug-induced Hepatotoxicity: A Randomized Controlled Clinical Trial. Int J Prev Med 2023; 14:48. [PMID: 37351038 PMCID: PMC10284206 DOI: 10.4103/ijpvm.ijpvm_81_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 02/16/2023] [Indexed: 06/24/2023] Open
Abstract
Background Several animal studies have shown the protective effect of silymarin (the extract of Silybum marianum seeds) against anti-tuberculosis drug-induced hepatotoxicity (ATDH). However, the knowledge of ATDH of silymarin in humans is scarce. In this study, we aimed to clinically evaluate it. Methods During this randomized controlled clinical trial, 36 new cases of tuberculosis (TB) were enrolled to receive either silymarin 150 mg twice daily for two weeks along with a standard anti-TB therapeutic regimen (experimental group; n = 16) or standard anti-TB therapeutic regimen alone (control group; n = 21). Liver function tests (serum AST, ALT, ALP, and total bilirubin) at the end of weeks 1 and 2 as well as the rate of ATDH during the study were determined and compared between the groups. Results No significant differences between the experimental and control groups were observed at the end of the first week regarding liver function tests; However, at the end of the second week, the mean serum levels of AST (P = 0.03) and ALP (P = 0.04) were significantly lower in the experimental group. ALT (P = 0.016) and ALP (P = 0.027) levels in the experimental group significantly decreased during the study, while the changes in the control group were not significant. Two patients in the control group (9.5%) developed ATDH, while no one in the experimental group manifested this adverse effect. Conclusions Our study suggests that silymarin use has the potential for the reduction of anti-TB drug-induced hepatotoxicity.
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Affiliation(s)
- Ali Talebi
- Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Isfahan, Iran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzin Khorvash
- Department of Infectious Diseases, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Nosocomial Infections Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Mohsenzadeh A, Karimifar M, Soltani R, Hajhashemi V. Evaluation of the effectiveness of topical oily solution containing frankincense extract in the treatment of knee osteoarthritis: a randomized, double-blind, placebo-controlled clinical trial. BMC Res Notes 2023; 16:28. [PMID: 36869332 PMCID: PMC9984289 DOI: 10.1186/s13104-023-06291-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 02/16/2023] [Indexed: 03/05/2023] Open
Abstract
OBJECTIVE Pharmacological treatments of osteoarthritis (OA) have several side effects. Boswellia serrata resin (frankincense) is rich in boswellic acids that have antioxidant and anti-inflammatory effects; though, their oral bioavailability is low. The aim of this study was evaluation of the clinical effectiveness of frankincense extract in the treatment of knee OA. In a randomized double-blind placebo-controlled clinical trial, eligible patients with knee OA were randomly divided into two groups of drug (33 patients) and control (37 patients), to use oily solution of frankincense extract or placebo, respectively, on the involved knee three times daily for four weeks. WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), VAS (visual analogue scale; for pain severity), and PGA (patient global assessment) scores were determined before and after intervention. RESULTS For all evaluated outcome variables, there was a significant decrease from baseline in both groups (P < 0.001 for all). Furthermore, the end-of-intervention values for all parameters were significantly lower in drug group than placebo group (P < 0.001 for all), showing more effectiveness of drug compared to placebo. CONCLUSION Topical oily solution containing enriched extract of boswellic acids could decrease pain severity and improve the function in patients with knee OA. Trial Registration Trial registration number: IRCT20150721023282N14. Trial registration date: September 20, 2020. The study was retrospectively registered in Iranian Registry of Clinical Trials (IRCT).
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Affiliation(s)
- Afsaneh Mohsenzadeh
- Students Research Committee, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mansoor Karimifar
- Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. .,Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Valiollah Hajhashemi
- Department of Pharmacology and Toxicology, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Momenzadeh M, Soltani R, Shafiee F, Hakamifard A, Pourahmad M, Abbasi S. The effectiveness of colistin/levofloxacin compared to colistin/meropenem in the treatment of ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii: a randomized controlled clinical trial. Res Pharm Sci 2022; 18:39-48. [PMID: 36846731 PMCID: PMC9951781 DOI: 10.4103/1735-5362.363594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/10/2022] [Accepted: 10/28/2022] [Indexed: 12/25/2022] Open
Abstract
Background and purpose The treatment of ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii (CRAB) is still a great challenge. This study evaluated the effectiveness of the colistin/levofloxacin regimen compared to the usual colistin/meropenem regimen in the treatment of patients with VAP caused by CRAB. Experimental approach The patients with VAP were randomly assigned to experimental (n = 26) and control (n = 29) groups. The first group received IV colistin 4.5 MIU every 12 h + levofloxacin 750 mg IV daily, and the second group received IV colistin with the same dose + meropenem 1 g IV every 8 h for 10 days. The clinical (complete response, partial response, or treatment failure) and microbiological responses at the end of the intervention were recorded and compared between the two groups. Findings/Results The complete response rate was higher (n = 7; 35%) and the failure rate was lower (n = 4; 20%) in the experimental group than in the control group (n = 2; 8%, and n = 11; 44%, respectively), but the differences were not statistically significant. Even though the microbiological response rate was higher in the experimental group (n = 14; 70%) than in the control group (n = 12; 48%), the difference was not statistically significant. The mortality rate was 6 (23.10%) and 4 patients (13.8%) in the experimental and control groups, respectively (P = 0.490). Conclusion and implication The levofloxacin/colistin combination can be considered an alternative regimen to meropenem/colistin in the treatment of VAP caused by CRAB.
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Affiliation(s)
- Mahnaz Momenzadeh
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan, I.R. Iran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan, I.R. Iran,Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, I.R. Iran,Corresponding author: R. Soltani Tel: +98-3137927067, Fax: +98-3136680011
| | - Fatemeh Shafiee
- Deparment of Pharmaceutical Biotechnology, School of Pharmacy, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
| | - Atousa Hakamifard
- Department of Infectious Diseases, School of Medicine, Isfahan University of Medical Sciences, Isfahan, I.R. Iran,Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, I.R. Iran
| | - Morteza Pourahmad
- Department of Infectious Diseases, School of Medicine, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
| | - Saeed Abbasi
- Anaesthesiology Department, School of Medicine, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
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Salehi M, Khalili H, Seifi A, Davoudi H, Darazam IA, Jahangard‐Rafsanjani Z, Mohammadnejad E, Heydari B, Siahkaly SJM, Tabarsi P, Kalantari S, Menshadi SAD, Babamahmoodi F, Khorvash F, Davarpanah MA, Soltani R, Yaghoobi MH, Anari SAM, Khodadadi J, Aliramezani A, Hantooshzadeh S, Naderi HR, Hajiabdolbaghi M, Elyasi S, Firouzabadi D, Kasgari HA, Roshanzamiri S, Ebrahimpour S. Antibiotic use during the first 6 months of COVID-19 pandemic in Iran: A large-scale multi-centre study. J Clin Pharm Ther 2022; 47:2140-2151. [PMID: 36054303 PMCID: PMC9538430 DOI: 10.1111/jcpt.13761] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/21/2022] [Accepted: 08/02/2022] [Indexed: 12/24/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Although antibiotics are ineffective against viral infections, epidemiological studies have revealed that the COVID-19 pandemic resulted in the overuse of antibiotics and disruption of antimicrobial stewardship programmes. We investigated the pattern of antibiotic use during the first 6 months of the COVID-19 pandemic in Iran. METHODS A multi-centre retrospective study was designed to investigate the use of 16 broad-spectrum antibiotics in 12 medical centres. The rate of antibiotic use was calculated and reported based on the Defined Daily Dose (DDD) per 100 hospital bed-days. The bacterial co-infection rate was also reported. RESULTS AND DISCUSSION Totally, 43,791 hospitalized COVID-19 patients were recruited in this study. It was found that 121.6 DDD of antibiotics were used per 100 hospital bed-days, which estimated that each patient received approximately 1.21 DDDs of antibiotics every day. However, the bacterial co-infections were detected only in 14.4% of the cases. A direct correlation was observed between the rate of antibiotic use and mortality (r[142] = 0.237, p = 0.004). The rate of antibiotic consumption was not significantly different between the ICU and non-ICU settings (p = 0.15). WHAT IS NEW AND CONCLUSION In this study, widespread antibiotic use was detected in the absence of the confirmed bacterial coinfection in COVID-19 patients. This over-consumption of broad-spectrum antibiotics may be associated with increased mortality in hospitalized COVID-19 patients, which can be an alarming finding.
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Affiliation(s)
- Mohammadreza Salehi
- Infectious Diseases Department, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Hossein Khalili
- Department of Clinical Pharmacy, School of PharmacyTehran University of Medical SciencesTehranIran
| | - Arash Seifi
- Infectious Diseases Department, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Hamidreza Davoudi
- Department of Pharmaceutical Care, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Ilad Alavi Darazam
- Department of Infectious Disease, Loghman Hakim HospitalShahid Beheshti University of Medical SciencesTehranIran
| | | | - Esmaeil Mohammadnejad
- Department of Medical‐Surgical Nursing and Basic Sciences, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Behrooz Heydari
- Department of Clinical Pharmacy, School of PharmacyShahid Sadoughi University of Medical SciencesYazdIran
| | | | - Payam Tabarsi
- Department of Infectious Disease, School of Medicine, National Research Institute of Tuberculosis and Lung Diseases, Dr. Masih Daneshvari HospitalShahid Beheshti University of Medical SciencesTehranIran
| | - Saeed Kalantari
- Department of Infectious Disease, School of Medicine, Hazrat‐e Rasool General HospitalIran University of Medical SciencesTehranIran
| | - Seyed Ali Dehghan Menshadi
- Infectious Diseases Department, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Farhang Babamahmoodi
- Department of Infectious Diseases, Antimicrobial Resistance Research Center, Communicable Diseases Institute, Ghaem Shahr Razi HospitalMazandaran University of Medical SciencesSariMazandaranIran
| | - Farzin Khorvash
- Department of Infectious Diseases and Tropical Medicine, Nosocomial Infection Research Center, Al‐Zahra HospitalIsfahan University of Medical SciencesIsfahanIran
| | - Mohammad Ali Davarpanah
- Department of Internal Medicine, HIV/AIDS Research Center, Research Institute for Health, Namazi Teaching HospitalShiraz University of Medical SciencesShirazIran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical SciencesIsfahan University of Medical SciencesIsfahanIran
| | - Mojtaba Hedayat Yaghoobi
- Department of Infectious Diseases, School of MedicineAlborz University of Medical SciencesKarajAlborzIran
| | - Seyed Alireza Mosavi Anari
- Department of Infectious Disease, Infectious Diseases Research Center, Shahid Sadoughi General HospitalShahid Sadoughi University of Medical SciencesYazdIran
| | - Javad Khodadadi
- Department of Infectious Disease, Kamkar‐Arabnia HospitalQom University of Medical SciencesQomIran
| | - Amir Aliramezani
- Department of Microbiology, Shohadaye Tajrish HospitalShahid Beheshti University of Medical SciencesTehranIran
| | - Sedigheh Hantooshzadeh
- Department of Obstetrics and Gynecology, School of Medicine, Family Health Research Institute, Imam Khomeini HospitalTehran University of Medical SciencesTehranIran
| | - Hamid Reza Naderi
- Department of Infectious Disease, Surgical Oncology Research Center, Imam Reza HospitalMashhad University of Medical SciencesMashhadIran
| | - Mahboobeh Hajiabdolbaghi
- Infectious Diseases Department, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Sepideh Elyasi
- Department of Clinical Pharmacy, School of PharmacyMashhad University of Medical SciencesMashhadIran
| | - Dena Firouzabadi
- Department of Clinical Pharmacy, School of PharmacyShiraz University of Medical SciencesShirazIran
| | - Hamideh Abbaspour Kasgari
- Department of Clinical Pharmacy, School of PharmacyMazandaran University of Medical SciencesSariIran
| | - Soheil Roshanzamiri
- Department of Clinical Pharmacy, School of PharmacyShahid Beheshti University of Medical SciencesTehranIran
| | - Sholeh Ebrahimpour
- Department of Clinical Pharmacy, School of PharmacyAlborz University of Medical SciencesAlborzIran
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Soltani R, Nasirharandi S, Khorvash F, Nasirian M, Dolatshahi K, Hakamifard A. The effectiveness of gabapentin and gabapentin/montelukast combination compared with dextromethorphan in the improvement of COVID-19- related cough: A randomized, controlled clinical trial. Clin Respir J 2022; 16:604-610. [PMID: 35908849 PMCID: PMC9353294 DOI: 10.1111/crj.13529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/30/2022] [Accepted: 07/18/2022] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Cough is one of the most common presenting symptoms of COVID-19, which can persist for weeks or months. OBJECTIVE The goal of this study was to evaluate the effectiveness of gabapentin (GBT) alone and in combination with montelukast (MTL) for improving cough. METHODS In this open-label randomized controlled clinical trial, eligible cases were patients hospitalized with moderate to severe COVID-19 who had cough with a Breathlessness, Cough, and Sputum Scale (BCSS) score of at least 2 based on its cough subscale. The participants were randomly assigned to three groups including two experimental groups and one control group. The first and second experimental groups received GBT and GBT/MTL, respectively, whereas the control group received dextromethorphan (DXM). Treatment duration was 5 days in all groups. Before and after the interventions, the severity of cough was evaluated using BCSS scale and Visual Analog Scale (VAS). RESULTS A total of 180 patients were included; GPT, GPT/MTL, and DXM consisted of 76, 51, and 53 patients, respectively. There was no significant difference between the three groups in terms of age, gender, and comorbidities (P > 0.05). Regarding BCSS and VAS scores, there was significant reduction from the baseline values in all groups (P < 0.0001), with the change rate being significantly higher in DXM group. The amount of reduction of BCSS in the GPT/MTL group was significantly more than the GPT group, whereas there was no significant difference between the two groups regarding VAS score. Although the duration of hospitalization differed between the groups with the GPT/MTL group having the shortest duration, the difference was statistically significant only between the GPT and GPT/MTL groups (P < 0.0001). CONCLUSION GPT, both alone and in combination with MTL, improves cough frequency and severity in hospitalized patients with COVID-19, with the combination being more efficacious. This regimen may be useful in patients who cannot tolerate opioids.
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Affiliation(s)
- Rasool Soltani
- Infectious Diseases and Tropical Medicine Research CenterIsfahan University of Medical SciencesIsfahanIran,Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical SciencesIsfahan University of Medical SciencesIsfahanIran
| | - Sara Nasirharandi
- Department of Infectious Diseases, School of MedicineIsfahan University of Medical SciencesIsfahanIran
| | - Farzin Khorvash
- Nosocomial Infection Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Maryam Nasirian
- Department of Biostatistics and Epidemiology, School of HealthIsfahan University of Medical SciencesIsfahanIran
| | - Kian Dolatshahi
- Infectious Diseases and Tropical Medicine Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Atousa Hakamifard
- Department of Infectious Diseases, School of MedicineIsfahan University of Medical SciencesIsfahanIran,Infectious Diseases and Tropical Medicine Research CenterShahid Beheshti University of Medical SciencesTehranIran
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10
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Soltani R, Sajjadi S, Shirani K, Minaiyan M, Saghafi F. Drug Utilization Evaluation of Antibiotics in Burn Patients at a Referral Teaching Hospital. jpc 2022. [DOI: 10.18502/jpc.v10i2.9977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Nowadays, due to the irrational and excessive use of antibiotics, antimicrobial resistance has become one of the main concerns of the medical community. Patients with burns are more prone to infections due to the loss of the skin's defense barrier and a weakened immune system. Therefore, proper antibiotic treatment is essential in these patients. In the present study, the rational use of antibiotics in the burn hospital of Imam Mousa Kazem in Isfahan was evaluated.
Methods: This prospective cross-sectional descriptive study was performed on 102 hospitalized patients over 9 months (from January to September 2020). Adult burn patients who received at least one antibiotic were included in the study. All required information, including demographic data, the prescribed antibiotic, basis of administration (empiric vs. culture-based), dose and duration of use, microbial culture test, and treatment outcome were recorded in the data collection form by referring to patients’ medical profile and the hospital computer system. Judgments about the accuracy of the indication, dose, and duration of treatment, as well as the need for dose adjustment in renal or hepatic impairment were made using related guidelines and references.
Results: Among the 196 antibiotic prescriptions, cefepime (40.3%) was the most frequently used antibiotic, followed by vancomycin (17.9%) and meropenem (16.8%). Most prescriptions were empirical, while the antibiotics were administered based on the microbial culture results only in two cases (1.9%). The indication of use was correct in 52.6% of prescriptions (n = 103), of which 74.8% (n = 77) had correct dose. In addition, in 47 cases (45.6%), the duration of antibiotic therapy was correct. 6.8% of the patients died, 10.75 discharged with the patient's personal consent, and the rest of the them discharged in good condition.
Conclusion: Prescribing antibiotics in Imam Moussa Kazem Hospital is associated with many errors in various aspects, including indication, dose, de-escalation, and duration of treatment.
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Pourahmad M, Shahzamani K, Nikokar F, Saniei M, Saniei M, Soltani R. The effects of licorice mucoadhesive patches (Aftogel®) on the results of nasopharyngeal swab real-time PCR test of SARS-CoV-2: a randomized triple-blind placebo-controlled clinical trial. Immunopathol Persa 2022. [DOI: 10.34172/ipp.2022.31400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background and objectives: Up to present no efficacious antiviral medications have been discovered in order to eradicate SARS-CoV-2 in nasopharyngeal tract. In this article, the aim is to evaluate the effectiveness of a new herbal drug product called Aftogel patch, which contains licorice extract, in the eradication of this novel coronavirus in the nasopharyngeal secretions of the patients. Methods: In this triple-blind randomized clinical trial, 125 patients with positive real-time PCR for SARS-CoV-2 and in stage 0 and/or 1 of COVID-19 were studied in two separate groups, namely interventional and placebo, in which they used Aftogel and placebo patches, respectively. At the end of the study, the results of PCR test in aforementioned groups were assessed and compared. Results: Following the application of Aftogel, Real-time PCR was converted to negative in 53.97% of patients which was significantly higher than that of the placebo groups. (27.40%, P= 0.003). Conclusion: It seems that Aftogel mucoadhesive patch (Licorice extract) is effective in the eradication of SARS-CoV-2 which has colonized the nasopharyngeal area. Hence, this drug product has the potential for evaluation as a prophylactic agent against COVID-19.
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12
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Sadeghi H, Narimani T, Tabesh E, Shafiee F, Soltani R. Antibiotic resistance pattern of Helicobacter pylori strains isolated from patients in Isfahan, Iran. J Res Med Sci 2022; 27:39. [PMID: 35968205 PMCID: PMC9374139 DOI: 10.4103/jrms.jrms_829_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/06/2021] [Accepted: 01/31/2022] [Indexed: 11/04/2022]
Abstract
Background The objective of this study was to evaluate the antibiotic resistance pattern of Helicobacter pylori strains isolated from patients in Isfahan province. Materials and Methods Gastric antrum biopsy specimens of patients undergoing endoscopy were cultured. The samples with the growth of H. pylori underwent antibiotic susceptibility test by disk diffusion method. Reaults Of 96 samples, 50 samples (53%) were positive for H. pylori. The rates of antibiotic resistance were as follows: amoxicillin, 6%; azithromycin, 20%; furazolidone, 22%; levofloxacin, 16%; metronidazole, 20%; rifampin, 12%; and tetracycline, 22%. Conclusion H. pylori strains in our area have high rates of resistance to azithromycin, levofloxacin, metronidazole, tetracycline, and furazolidone.
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Affiliation(s)
- Hajarsadat Sadeghi
- Students Research Committee, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tahmineh Narimani
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elham Tabesh
- Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Shafiee
- Department of Pharmaceutical Biotechnology, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran,Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Rasool Soltani, Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Hezar-Jerib Avenue, Isfahan, Iran. E-mail:
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13
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Eshghinejad A, Panahandeh E, Memarfar M, Soltani R, Shafiee F. The Efficacy and Safety of Pentoxifylline in the Treatment of Recurrent Aphthous Stomatitis: A Systematic Review. jpc 2022. [DOI: 10.18502/jpc.v10i1.9127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Several evidence have shown the beneficial effects of pentoxifylline in the improvement of oral aphthous ulcers. However, the data in this regard are sparse. So, the efficacy and safety of pentoxifylline in oral route was systematically reviewed to elucidate its effects on the size and number of ulcers, as well as the healing time and recurrence frequency in Recurrent Aphthous Stomatitis (RAS) patients. PubMed (Medline), Web of Science, Scopus, ScienceDirect, Cochrane Library, ProQuest, and Clinicaltrial.gov were searched for related articles. The investigated outcomes were pain level, the size and number of ulcers, the frequency of recurrence, the healing time, and finally the pentoxifylline related side effects. Only 6 related study that investigate the efficiency of Pentoxifylline on RAS (n =107) were identified. Decreasing in the pain level, improving the ulcer size and number were established in approximately all studies. Pentoxifylline established its ability to shorten the healing time of this type of mouth ulcers. However, its potential to prevent the recurrence of the disease could not establish based the data presented here. In conclusion, this systematic review suggests pentoxifylline in RAS patients because it confirmed that RAS patients who received this agent as oral administration reported suitable response. However, conducting more clinical trials with larger sample size and long follow-up time especially to efficiently judge about its ability to the recurrence prevention still is necessary to develop clinical practice guidelines for management of RAS.
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14
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Shabib S, Soltani R, Khorvash F, Taheri A, Shahbazi Azad M. The Effect of Topical Cow's Milk on the Healing of Diabetic Foot Ulcers: A Randomized Controlled Pilot Clinical Trial. INT J LOW EXTR WOUND 2022:15347346221084788. [PMID: 35287509 DOI: 10.1177/15347346221084788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Diabetic foot ulcer (DFU) is a very serious side effect among the diabetic patients with substantial clinical and economic consequences. The aim of this study was to investigate the efficacy of cows' milk topical ointment, as an available and cost-effective natural product, on accelerating the healing of DFU. In this randomized controlled clinical trial, patients with grade 1 or 2 DFU were randomly divided into two groups of intervention (n = 50) and control (n = 49). For patients of intervention group, cows' milk 20% topical ointment was applied on the ulcer once daily for two weeks, while a type of novel dressing was used for control group with the same frequency and duration. Both groups received usual standard wound care measures. The percentage of change in the ulcer size and the number of cases with complete wound healing (>90% reduction in the ulcer size) were recorded in the both groups. The ulcer size significantly reduced in both groups on the seventh and 14th days of intervention; however, the percentage of reduction was significantly higher in the intervention (milk) group compared to control at both time points (44.64 ± 15.98 vs. 24.95 ± 12.78, P < .001; 67.67 ± 22.15 vs. 42.87 ± 19.74, P < .001). Furthermore, although more patients in the intervention group (n = 4, 8%) showed complete healing of the ulcer compared to control (n = 0), the difference was not statistically significant (P = .117). Cow's milk 20% topical ointment improves and accelerates the healing of diabetic foot ulcers. However, more clinical studies are required to confirm these effects.
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Affiliation(s)
- Somayeh Shabib
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, 48455Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, 48455Isfahan University of Medical Sciences, Isfahan, Iran
- Pharmaceutical Sciences Research Center, 48455Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzin Khorvash
- Nosocomial Infection Research Center, 48455Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azade Taheri
- Department of Pharmaceutics, School of Pharmacy and Novel Drug Delivery System Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Shahbazi Azad
- Nosocomial Infection Research Center, 48455Isfahan University of Medical Sciences, Isfahan, Iran
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15
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Ghanadian M, Soltani R, Homayouni A, Khorvash F, Jouabadi SM, Abdollahzadeh M. The Effect of Plantago major Hydroalcoholic Extract on the Healing of Diabetic Foot and Pressure Ulcers: A Randomized Open-Label Controlled Clinical Trial. INT J LOW EXTR WOUND 2022:15347346211070723. [PMID: 35044254 DOI: 10.1177/15347346211070723] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Aims: Diabetic foot ulcer (DFU) and pressure ulcer (PU) both are common types of ulcers worldwide. The wound healing effect of Plantago major leaves has been shown in a few animal studies. This study aimed to evaluate the clinical efficacy of P. major hydroalcoholic extract on DFU and PU healing. Methods: In this clinical trial, patients with DFU or PU who met the inclusion criteria were randomly assigned to drug (P. major) or control groups. For patients in the drug group, Plantago extract 10% topical gel was applied on the wound once daily concurrent with dressing and routine wound care for two weeks, while for the control group, an appropriate novel dressing was used along with routine wound care for the same duration. The percentage of wound size reduction at the end of the seventh and 14th days of intervention was recorded and compared between the groups. Results: Fifty and 44 patients in drug and control groups, respectively, completed the interventions. Plantago extract gel significantly resulted in more reduction in the wound size compared to control at the end of the first (64.90 ± 29.75% vs. 33.11 ± 26.55%; P < 0.001) and second week (86.85 ± 24.34% vs. 52.87 ± 32.41%; P < 0.001). Furthermore, the number of patients with complete wound healing in the drug group (n = 32, 64%) was significantly more than the control group (n = 9, 20.45%; OR: 3.129, 95% CI: 1.685-5.809, P < 0.001). Conclusion: The use of 10% topical gel of P. major leaf extract results in the acceleration of DFU and PU healing. Key points: Application of P. major topical gel results in the acceleration of diabetic foot ulcer and pressure ulcer healing. - P. major extract helps reducing the wound's erythema.- P. major leaf extract assists decreasing the wound size.- The number of patients completing wound healing process is higher among whom undergoing P. major dressing.
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Affiliation(s)
- Mustafa Ghanadian
- Department of Pharmacognosy, School of Pharmacy, 48455Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy, 48455Isfahan University of Medical Sciences, Isfahan, Iran
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Homayouni
- Department of Pharmaceutics, School of Pharmacy, 48455Isfahan University of Medical Sciences, Isfahan, Iran
- Research and Development Department, Goldaru Pharmaceutical Company, Isfahan, Iran
| | - Farzin Khorvash
- 48455Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Moein Abdollahzadeh
- Students Research Committee, School of Pharmacy, 48455Isfahan University of Medical Sciences, Isfahan, Iran
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16
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Tabatabaei M, Soltani R, Dorvashy G, Samsamshariat S, Meamar R, Sabzghabaee AM. Ampicillin-Sulbactam for the Treatment of Aspiration Pneumonia in Patients with Opioid Overdose: A Randomized Controlled Clinical Trial. IJMTFM 2022. [DOI: 10.32598/ijmtfm.v11i4.34657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Aspiration pneumonia is among overdose complications, requiring timely appropriate treatment. The present study aimed to evaluate the effects of ampicillin-sulbactam, compared to our usual regimen ceftriaxone + clindamycin on aspiration pneumonia in opioid-poisoned patients. Methods: In a randomized-controlled clinical trial, opioid-poisoned patients with aspiration pneumonia were randomly divided into the experimental and control groups to receive ampicillin-sulbactam 3 g Intravenously (IV) every 6 hours (experimental group) and ceftriaxone 1 g IV every 12 hours + clindamycin 600 mg IV every 8 hours (control group) followed by co-amoxiclav 625 mg orally every 8 hours and cefixime 400 mg once daily + clindamycin 600 mg orally every 8 hours in experimental and control groups, respectively, to complete a 7-day course of therapy. White blood cell count and temperature (axillary) at baseline and the third day of the intervention and the treatment outcome on the third day of the intervention, defined as either complete response, partial response, or failure, were evaluated and recorded for all patients. Results: Except for the number of cases of leukocytosis on the third day of the intervention, i.e., lower in the control group (5 patients, 26.30%) than the experimental group (13 patients, 68.40%) (P=0.020), no significant difference was observed between the study groups regarding other outcome variables. Clinical response was similar between the study groups; so that, 10.50% and 63.20% of patients in the experimental group and 21.10% and 47.4% of patients in the control group presented complete and partial responses, respectively (P=0.550). Conclusion: The obtained data suggested that ampicillin-sulbactam is an effective antibiotic for the treatment of aspiration pneumonia in patients with opioid overdose, in which case, it has the same efficacy as the two-drug regimen of ceftriaxone + clindamycin.
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17
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Ghanadian S, Soltani R, Saberi Z, Taheri A, Entezarhojjat A. The effectiveness of olibanum orally disintegrating tablet in the treatment of oral aphthous ulcers: A randomized, double-blind, placebo-controlled clinical trial. J Res Med Sci 2022; 27:8. [PMID: 35342437 PMCID: PMC8943586 DOI: 10.4103/jrms.jrms_247_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/13/2021] [Accepted: 07/26/2021] [Indexed: 11/15/2022]
Abstract
Background: Boswellia serrata oleo-gum-resin (frankincense; olibanum) has anti-inflammatory, analgesic, and antimicrobial effects. This study aimed to evaluate the clinical effectiveness of frankincense extract in the treatment of oral aphthous ulcers. Materials and Methods: In a randomized, double-blind, placebo-controlled clinical trial, patients with aphthous ulcers were randomly assigned to either experimental (Frankincense extract) or placebo groups to use orally disintegrating tablets (ODT) of frankincense and placebo, respectively, four times a day for 3 days. The size of aphthous ulcers and the pain severity by visual analogue scale were recorded at days 0, 2, and 4 and compared between the groups. Results: Twenty-five patients in each group completed the study. Olibanum extract ODT significantly reduced the ulcer size on the second (P < 0.001) and fourth (P < 0.001) days as well as the pain score on the second (P = 0.002) and fourth (P < 0.001) days of the intervention compared to placebo. Furthermore, at the end of the intervention, the number of patients with complete ulcer healing and pain relief in the experimental group was significantly more than the placebo group (5 vs. 0, P = 0.02; and 11 vs. 0, P < 0.001, respectively). Conclusion: Taking olibanum extract ODTs reduces the ulcer size and pain severity and accelerates the healing process in the oral aphthous lesions.
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18
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Fallah F, Shirani K, Khorvash F, Soltani R, Ataie B, Tarrahi M. The effect of Vitamin B 6 in the prevention of hematological adverse effects of linezolid in patients with chronic osteomyelitis: A randomized double-blind placebo-controlled clinical trial. Adv Biomed Res 2022; 11:67. [PMID: 36325173 PMCID: PMC9621342 DOI: 10.4103/abr.abr_274_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/02/2021] [Accepted: 11/02/2021] [Indexed: 11/06/2022] Open
Abstract
Background: Due to the contradictory results of the effects of Vitamin B6 in reducing the hematotoxic effects of linezolid, the present study aimed to investigate the possible role of Vitamin B6 administration in reducing linezolid-related hematological toxicities in patients with chronic osteomyelitis. Materials and Methods: In a randomized double-blind placebo-controlled clinical trial, patients with chronic osteomyelitis were randomly divided into two groups (n = 40 each): the intervention group received Vitamin B640 mg twice daily from the beginning of treatment with linezolid and the control group received placebo with linezolid, both for 21 days. Blood variables including hemoglobin (Hb), white blood cells (WBC), and platelets (PLT) were measured at baseline and at the end of the 1st, 2nd, and 3rd weeks (days 7, 14, and 21) of the intervention. Results: There was no significant difference between the groups regarding the count of WBC and PLT and level of Hb at evaluated time points. Furthermore, there was a significant decreasing trend in all parameters within both groups; however, the decreasing trend of both PLT and WBC was slower in the intervention (Vitamin B6) group compared to the placebo group. Conclusion: Vitamin B6 has no significant effect in the reduction of hematological adverse effects of linezolid in chronic osteomyelitis patients. However, it could retard the decreasing trend of WBC and PLT counts.
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Asgary S, Soltani R, Daraei F, Salehizadeh L, Vaseghi G, Sarrafzadegan N. The effect of lycopene on serum level of cardiac biomarkers in patients undergoing elective percutaneous coronary intervention: A randomized controlled clinical trial. ARYA Atheroscler 2021; 17:1-7. [PMID: 34703487 PMCID: PMC8519623 DOI: 10.22122/arya.v17i0.2194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/03/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Myocardial ischemia may recur in a significant subset of patients following percutaneous coronary intervention (PCI). Lycopene, a carotenoid with antioxidant activity, has evidence for beneficial effects on cardiovascular system. In the present study, we aimed to evaluate the possible preventive effect of lycopene against post-PCI myocardial damage by detection of cardiac biomarkers of ischemia. METHODS A total of 45 patients who planned to undergo elective PCI were randomly assigned to two groups to receive either lycopene (30 mg 12 hours before PCI as well as 15 mg just before and 8 hours after PCI) along with standard treatment (n = 23) or only standard treatment (n = 22). Standard treatment included aspirin, a statin, and a beta-blocker. The serum levels of creatine kinase-MB (CK-MB), troponin I, and high sensitivity C-reactive protein (hs-CRP) were measured 12 hours before and 12 hours after the procedure and were compared between the two groups. RESULTS The use of lycopene significantly prevented the increase of CK-MB following PCI compared to control (P = 0.048). However, it had not any significant effect on serum levels of troponin I (TnI) (P = 0.176) and hs-CRP (P = 0.186) compared to control. CONCLUSION Lycopene can prevent the increase of CK-MB following PCI. Therefore, it has the potential for prevention of post-PCI cardiovascular events. However, more studies are needed to confirm such an effect.
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Affiliation(s)
- Sedigheh Asgary
- Professor, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasool Soltani
- Associate Professor, Infectious Diseases and Tropical Medicine Research Center AND Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Daraei
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute AND Students Research Committee, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Leila Salehizadeh
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Golnaz Vaseghi
- Assistant Professor, Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Professor, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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20
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Badri S, Siberian L, Soltani R, Moghaddas A, Ataei S, Momenzadeh M. Nephrotoxicity induced by vascular endothelial growth factor inhibitors. J Nephropharmacol 2021. [DOI: 10.34172/npj.2022.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Vascular endothelial growth factor (VEGF) is a special mitogen for vascular endothelial cells, an essential endogenous angiogenic cytokine, and the principal controller of vascular growth that plays a fundamental role in therapeutic angiogenesis pathways. VEGF-targeted therapy is categorized into the group of angiogenesis inhibitors that inhibit the expression or the activity of VEGF. It comprises counteracting VEGF antibodies, VEGF receptors, VEGF-trap, and tyrosine kinase inhibitor (TKIs) with selectivity for VEGF receptors. The kidney is both a target and a source of VEGF. VEGF may be a vital mediator to restore some types of renal diseases (e.g., non-diabetic renal diseases) and harmful in some other diseases (e.g., diabetes and diabetes complications). Due to their ability to prevent angiogenesis, VEGF inhibitors have been found as a powerful tool to treat angiogenesis-dependent diseases, including cancer and diabetic retinopathy. VEGF preserves the renal structure and function in normal physiologic conditions. Therefore, all treatments that inhibit the VEGF pathway may lead to renal disorders, especially renovascular diseases such as hypertension, proteinuria, nephrotic syndrome, decreased glomerular filtration rate (GFR), and thrombotic microangiopathy (TMA). In the present study, we reviewed some related reports and associated mechanisms, especially for hypertension and proteinuria.
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Affiliation(s)
- Shirinsadat Badri
- Department of Clinical Pharmacy and Pharmacy Practice; Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences; Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azadeh Moghaddas
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences; Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sara Ataei
- Department of Clinical Pharmacy, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahnaz Momenzadeh
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences; Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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21
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Ashtari F, Soltani R, Shokouhi S, Rismanbaf A, Hajiahmadi S, Hakamifard A. Adverse reaction of methylprednisolone pulse therapy: Acute respiratory distress syndrome. Clin Case Rep 2021; 9:e04468. [PMID: 34295489 PMCID: PMC8283859 DOI: 10.1002/ccr3.4468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 05/26/2021] [Accepted: 05/31/2021] [Indexed: 11/08/2022] Open
Abstract
Methylprednisolone pulse therapy has significant anti-inflammatory effects in multiple sclerosis. Acute respiratory distress syndrome as a probable adverse effect of methylprednisolone pulse therapy in MS patients should be considered.
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Affiliation(s)
- Fereshteh Ashtari
- Isfahan Neuroscience Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy PracticeSchool of Pharmacy and Pharmaceutical SciencesIsfahan University of Medical SciencesIsfahanIran
| | - Shervin Shokouhi
- Department of Infectious Diseases and Tropical MedicineLoghman Hakim HospitalShahid Beheshti University of Medical SciencesTehranIran
- Infectious Diseases and Tropical Medicine Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Ali Rismanbaf
- Department of Clinical Pharmacy and Pharmacy PracticeSchool of Pharmacy and Pharmaceutical SciencesIsfahan University of Medical SciencesIsfahanIran
| | - Somayeh Hajiahmadi
- Department of RadiologySchool of MedicineIsfahan University of Medical SciencesIsfahanIran
| | - Atousa Hakamifard
- Infectious Diseases and Tropical Medicine Research CenterShahid Beheshti University of Medical SciencesTehranIran
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22
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Shafiee F, Naji Esfahani SS, Hakamifard A, Soltani R. In vitro synergistic effect of colistin and ampicillin/sulbactam with several antibiotics against clinical strains of multi-drug resistant Acinetobacter baumannii. Indian J Med Microbiol 2021; 39:358-362. [PMID: 33906750 DOI: 10.1016/j.ijmmb.2021.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE Nowadays, Acinetobacter baumannii is resistant to almost all available antibiotics. The evaluation of synergistic effects between the antibiotics against this pathogen is among the efforts to counteract its antimicrobial resistance. This study aimed to evaluate possible synergistic effect of colistin and ampicillin/sulbactam (separately) with several antibiotics against clinical isolates of multi-drug resistant (MDR) A. baumannii. METHODS Acinetobacter baumannii strains were isolated from biological samples of hospitalized patients with any type of nosocomial infection related to this pathogen. Only MDR strains (resistance to at least three classes of antibiotics including cephalosporins, fluoroquinolones, and aminoglycosides) were included in the study. After determining the minimum inhibitory concentration (MIC) of antibiotics against the isolates by broth microdilution test, the checkerboard method was used for evaluation of any possible synergistic effect of both colistin and ampicillin/sulbactam with several other antibiotics. RESULTS Twenty isolates underwent synergy test for colistin and 20 isolates for ampicillin/sulbacatam. Doxycycline (55%), azithromycin (35%), and co-trimoxazole (35%) had the most frequency of synergistic effect with colistin. On the other hand, amikacin and gentamicin (55%), doxycycline (50%), co-trimoxazole (45%), azithromycin (40%), and cefepime (40%) had the most frequency of synergistic effect with ampicillin/sulbactam. No antagonistic effect was observed for both antibiotics. CONCLUSION Colistin and ampicillin/sulbactam have substantial synergistic effect with several antibiotics especially doxycycline, co-trimoxazole, azithromycin, and amikacin (with ampicillin/sulbactam) against MDR strains of Acinetobacter baumannii.
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Affiliation(s)
- Fatemeh Shafiee
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Saeed Naji Esfahani
- Students Research Committee, School of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Atousa Hakamifard
- Department of Infectious Diseases, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran; Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Soltani R, Hakamifard A, Mousavi S, Amani Z. Drug Utilization Evaluation of Antibiotics in Intensive Care Units of a Referral Teaching Hospital. jpc 2021. [DOI: 10.18502/jpc.v9i1.6034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Drug Utilization Evaluation (DUE) studies are designed to assess drug usage appropriateness. This study aimed to evaluate the drug utilization of antibiotics in the intensive care units (ICUs) of a referral teaching hospital.
Methods: Patients hospitalized in ICU who received antibiotics were enrolled in this crosssectional study. Patients’ medical charts were reviewed and data including indication of antibiotics, dosing, dose adjustment, and culture sensitivity test were recorded in a predesigned data collection form. Related guidelines and references were used for judgement about the correctness of these parameters.
Results: Among 182 evaluated antibiotic prescriptions, 75.8% of the cases were prescribed empirically that for 31.88% of them microbial culture and sensitivity test were requested. Indication was appropriate in 51.6%. Fifteen patients needed antibiotic dose adjustment that was performed just for 4 patients. Doses of antibiotics were correct in 58.5% of cases. Meropenem (15.9%), Metronidazole (15.9%), and vancomycin (11.5%) were the most frequently prescribed antibiotics.
Conclusion: Use of antibiotics in ICUs of our hospital is associated with high rate of errors especially in the aspects of medical indication and dosage. J
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Bahrami S, Shafiee F, Hakamifard A, Fazeli H, Soltani R. Antimicrobial susceptibility pattern of carbapenemase-producing Gram-negative nosocomial bacteria at Al Zahra hospital, Isfahan, Iran. Iran J Microbiol 2021; 13:50-57. [PMID: 33889362 PMCID: PMC8043821 DOI: 10.18502/ijm.v13i1.5492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Bacterial antibiotic resistance is one of the most important threats for public health around the world. Carbapenemase-producing Gram-negative bacteria have resistance to most antibiotics including carbapenems complicating the treatment of infections. The aim of this study was to determine the antimicrobial susceptibility pattern of carbapenemase-producing nosocomial Gram-negative pathogens at a referral teaching hospital to reveal the best options for treatment of related infections. MATERIALS AND METHODS Gram-negative bacteria, isolated from hospitalized patients with nosocomial infections, underwent meropenem susceptibility test by disk diffusion method. Meropenem-resistant strains were evaluated for the presence of carbapenemase using Modified Hodge test (MHT). Finally, the antibiotic susceptibility test was performed to determine the sensitivity of each carbapenemase-positive strain against various antimicrobial agents according to the guidelines of Clinical and Laboratory Standards Institute (CLSI). RESULTS Over the study period, 155 carbapenemase-positive isolates were detected. Pneumonia was the most frequent related nosocomial infection (67.1%) followed by UTI (23.2%). Acinetobacter baumannii (53.5%) and Klebsiella pneumoniae (40%) were the most frequently isolated pathogens. The pathogens had high rate of resistance to all antibiotics. Colistin had the most in vitro effect against all pathogens. Also, K. pneumoniae had a co-trimoxazole sensitivity rate equal to colistin (30.6%). CONCLUSION Carbapenemase-positive Gram-negative bacteria causing nosocomial infections are common in our hospital and have high rate of resistance to most antibiotics. Improvement in the pattern of antibiotic use and infection control measures are necessary to overcome this resistance.
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Affiliation(s)
- Sima Bahrami
- Students Research Committee, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Shafiee
- Department of Pharmaceutical Biotechnology, School of Pharmacy and Pharmaceutical Sciences, Isfahan, University of Medical Sciences, Isfahan, Iran
| | - Atousa Hakamifard
- Department of Infectious Diseases, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Fazeli
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Soltani R, Mosayebi S, Shafiee F, Assarzadeh S, Hakamifard A. Evaluation of the effectiveness of n-acetylcysteine in the prevention of colistin-induced nephrotoxicity: A randomized controlled clinical trial. J Res Pharm Pract 2021; 10:159-165. [PMID: 35769842 PMCID: PMC9235367 DOI: 10.4103/jrpp.jrpp_90_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/20/2022] [Indexed: 11/04/2022] Open
Abstract
Objective: Methods: Findings: Conclusion:
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Hakimizad R, Soltani R, Khorvash F, Marjani M, Dastan F. The Effect of acetyl-L-carnitine, Alpha-lipoic Acid, and Coenzyme Q10 Combination in Preventing Anti-tuberculosis Drug-induced Hepatotoxicity: A Randomized, Double-blind, Placebo-controlled Clinical Trial. Iran J Pharm Res 2021; 20:431-440. [PMID: 34903999 PMCID: PMC8653653 DOI: 10.22037/ijpr.2021.114618.14953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Drug-induced liver injury (DILI) is one of the most serious adverse effects of anti-tuberculosis (TB) drugs. A suggested mechanism of this adverse effect is mitochondrial dysfunction (MDF). The purpose of this study was an evaluation of the possible preventive effects of the combination of acetyl-L-carnitine (ALCAR), alpha-lipoic acid (ALA), and coenzyme Q10 (CoQ10), as mitochondrial nutrients (MNs), against anti-TB DILI. In this clinical trial, patients who met the inclusion criteria were randomly assigned to either experimental (n = 44) or placebo (n = 43) groups. The experimental group received capsules containing CoQ10 (200 mg) + ALA (250 mg) + ALCAR (250 mg) orally twice daily for two weeks, and the placebo group received oral placebo capsules with the same interval and duration. The mean serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total bilirubin (TBil) at the end of the first and second weeks as well as the incidence of DILI during the intervention were recorded and compared between the two groups. At the end of the study, the mean serum levels of AST and ALT in the experimental group were significantly lower than the placebo group (36.27 ± 36.43 vs. 86.02 ± 97.23 and 28.41 ± 27.41 vs. 78.80 ± 118.28, respectively, P = 0.003 for both). Also, the incidence of anti-TB DILI was significantly lower in the experimental group than the placebo group (6.8% vs. 25.6%, P = 0.017). In conclusion, using the combination of ALCAR, ALA, and CoQ10 may provide an effective strategy in preventing anti-TB DILI.
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Affiliation(s)
- Reza Hakimizad
- Students Research Committee, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. ,Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. ,Corresponding author: E-mail:
| | - Farzin Khorvash
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Majid Marjani
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Farzaneh Dastan
- Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. ,Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Haghighipour S, Soltani R, Anjomshoa A. The protective effect of lycopene supplement against vancomycin-induced nephrotoxicity; a randomized double-blind placebo-controlled clinical trial. J Renal Inj Prev 2020. [DOI: 10.34172/jrip.2020.32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: It has been proposed that oxidative stress plays a crucial role in vancomycin-induced nephrotoxicity (VIN). Objectives: The present study aimed to investigate the nephroprotective effects of lycopene, as a powerful antioxidant, on VIN. Patients and Methods: In the present study, individuals who received vancomycin (VCM) for any indication were assigned to drug (n=28) and control (n=30) groups. The individuals in the drug group received 25 mg of oral lycopene daily for 10 days started concurrently with VCM and the patients in the placebo group received placebo tablets with VCM. Serum levels of creatinine (SCr) and blood urea nitrogen (BUN) as well as creatinine clearance (CrCl) were determined and recorded before the start of interventions, every other day during therapy, and 12 hours after the last dose of VCM in 10th day of treatment for all participants. Finally, the mean values of the measured parameters were compared between the groups. Results: The mean values of SCr were significantly lower in drug group compared to placebo at the 4th (0.85 ± 0.18 vs. 0.98 ± 0.22, P=0.016) and 6th (0.83 ± 0.18 vs. 0.95 ± 0.21, P=0.029) days. Also, CrCl was significantly higher in the drug group at the 4th day compared to placebo (105.82 ± 20.09 vs. 94.67 ± 20.53, P=0.041). Regarding VCM-induced AKI, no case was reported in any group. Conclusion: Lycopene has the potential for diminution of VCM-induced nephrotoxicity (VIN). However, more investigations with larger sample size are necessary to confirm this effect.
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Affiliation(s)
- Somayeh Haghighipour
- Infectious Disease and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Anjomshoa
- Department of Infectious Diseases, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Hakamifard A, Soltani R, Hajigholami A, Yaghoubi S. Acalculous Cholecystitis, Acute Hepatitis and Hemolytic Anemia Associated With Epstein-Barr Virus: A Case Report. ACTA 2020. [DOI: 10.18502/acta.v58i3.3776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Epstein-Barr virus (EBV) is a member of the herpes virus family and is characterized by fever, lymphadenopathy, and sore throat. In this report, we present a 20-year-old woman with a four-day history of fever, chills, nausea, vomiting, jaundice and abdominal pain, and a diagnosis of acalculous cholecystitis, acute hepatitis with hemolytic anemia due to infectious mononucleosis. After the confirmation of acute acalculous cholecystitis along with hemolytic anemia, prednisolone was initiated for the patient. Supportive measures resolved the symptoms of acalculous cholecystitis.
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Badri S, Soltani R, Sayadi M, Khorvash F, Meidani M, Taheri S. Effect of N-acetylcysteine against Vancomycin-Induced Nephrotoxicity: A Randomized Controlled Clinical Trial. Arch Iran Med 2020; 23:397-402. [PMID: 32536177 DOI: 10.34172/aim.2020.33] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 01/21/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND The proposed mechanism of vancomycin-induced nephrotoxicity (VIN) is indirect production of reactive oxygen species in the kidney tissue. This study aimed to investigate the effectiveness of N-acetylcysteine (NAC), an anti-oxidant agent, in the prevention of VIN. METHODS Patients who received vancomycin for any indication were randomly divided to drug (NAC) and control groups. The patients in the drug group received oral NAC 600 mg every 12 hours for 10 days, starting concurrently with vancomycin. Serum creatinine (SCr) levels and blood urea nitrogen (BUN) as well as creatinine clearance (CrCl) and 12-hour urine volume were recorded at baseline, every other day during the study, and 12 hours after the last dose of vancomycin on the 10th day. Furthermore, the cases of acute kidney injury (AKI; ≥ 0.5 mg/dL or at least 50% increase in serum creatinine from baseline) were recorded in the two groups. RESULTS Over the study period, 84 and 95 patients completed the study in drug and control groups, respectively. SCr and CrCl were significantly lower and higher, respectively, at all-time points (except for baseline) in the NAC compared to the control group. Furthermore, although not statistically significant, 12 cases of vancomycin-induced AKI were observed in the control group (12.63%), while 4 cases (4.76%) were reported from drug group (P = 0.066; relative risk [RR] = 0.377, 95% CI: 0.126-1.124). CONCLUSION NAC has the potential for reduction of VIN. However, more studies are necessary to confirm this effect.
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Affiliation(s)
- Shirinsadat Badri
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran.,Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mina Sayadi
- Students Research Committee, Faculty of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzin Khorvash
- Department of Infectious Diseases, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Nosocomial Infections Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohsen Meidani
- Department of Infectious Diseases, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahram Taheri
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Abstract
Background: The choice of appropriate antibiotics to treat nosocomial infections requires knowledge of antibiotic resistance pattern in the hospitals. The aim of this study was to determine antimicrobial resistance patterns of common pathogens of nosocomial infections (pneumonia, UTI, bloodstream infection, wound infection) in a referral teaching hospital.
Methods: This cross-sectional study was conducted over a 6-month period. The pathogens isolated from biological samples of hospitalized patients with nosocomial pneumonia, UTI, bloodstream infection, or wound infection underwent antibiotic susceptibility testing by Kirby-Bauer method (disk diffusion test).
Results: Over the study period, 442 cases of infection were recorded. Pneumonia (n = 204, 46.2%) and UTI (n = 118, 26.7%) showed the most frequency followed by BSI (n = 71, 16.1%) and wound infection (n = 49, 11%). Acinetobacter baumannii was the most common pathogen of nosocomial pneumonia infection that showed the most susceptibility to colistin (100%). Escherichia coli, the most common pathogen of urinary tract infections, showed the highest sensitivity to colistin (100%). Staphylococcus epidermidis was the most common bloodstream infection pathogen that showed the most sensitivity to vancomycin (100%). Enterococcus spp., the most common pathogens of wound infection, had the most susceptibility to linezolid (100%).
Conclusion: Nosocomial infections in our hospital have high rate of resistance to antibiotics representing the importance of improvement in antibiotic use and infection control.
J Pharm Care 2020; 8(1): 26-34.
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Soltani R, Khorvash F, Meidani M, Badri S, Alaei S, Taheri S. Vitamin E in the prevention of vancomycin-induced nephrotoxicity. Res Pharm Sci 2020; 15:137-143. [PMID: 32582353 PMCID: PMC7306246 DOI: 10.4103/1735-5362.283813] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 01/19/2020] [Accepted: 04/29/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND PURPOSE The use of vancomycin, as a key therapeutic choice for treatment of hazardous infections, may be associated with nephrotoxicity. The proposed mechanism is the indirect production of reactive oxygen species and oxidative stress. The purpose of this study was to investigate the effect of vitamin E as an antioxidant agent in the prevention of vancomycin-induced nephrotoxicity. EXPERIMENTAL APPROACH In a matched-groups interventional study, patients who received vancomycin for any indication were assigned to vitamin E (n = 30) and control (n = 60) groups. The patients in experimental group received 400 units of oral vitamin E per day for 10 days started concurrently with vancomycin, while the patients in control group received vancomycin alone. Serum level of creatinine, blood urea nitrogen (BUN), creatinine clearance (CrCl), and 24-h urine output were determined and recorded before the start of interventions, every other day during therapy, and 12 h after the last dose of vancomycin in 10th day of therapy for all patients. Also, the rate of acute kidney injury (AKI) in the two groups was recorded. Finally, the mean values of the measured parameters were compared between the groups. FINDINGS / RESULTS Treatment with vitamin E for 10 days resulted in a significant reduction of BUN (from 17.5 ± 7.8 mg/dL at baseline to 11.4 ± 4.8 mg/dL at the end; P < 0.001) along with slightly non-significant increase of CrCl (from 84.7 ± 18.9 mL/min at baseline to 91.3 ± 19.5 mL/min at the end; P = 0.301) in comparison to the control group. However, CrCl decreased significantly in the control group. Vitamin E had no significant effect on 24-h urine output. Regarding vancomycin-induced AKI, 12 cases were observed in the control group, while no case was reported in experimental group (P = 0.041). CONCLUSION AND IMPLICATIONS This study showed the beneficial effect of add-on therapy of vitamin E besides vancomycin in reducing AKI, which could be considered as a new potential prophylactic therapy for vancomycin-induced nephrotoxicity.
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Affiliation(s)
- Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
- Infectious Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
| | - Farzin Khorvash
- Department of Infectious Diseases, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
- Nosocomial Infections Research Center, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
| | - Mohsen Meidani
- Department of Infectious Diseases, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
| | - Shirinsadat Badri
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
| | - Sajedeh Alaei
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
| | - Shahram Taheri
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
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Asgary S, Soltani R, Barzegar N, Sarrafzadegan N. Evaluation on the Effects of Tamarindus Indica L. Fruit on Body Weight and Several Cardiometabolic Risk Factors in Obese and Overweight Adult Patients: A Randomized Controlled Clinical Trial. Int J Prev Med 2020; 11:24. [PMID: 32175064 PMCID: PMC7050219 DOI: 10.4103/ijpvm.ijpvm_558_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 10/14/2019] [Indexed: 11/14/2022] Open
Abstract
Background: Animal studies have shown the anti-obesity effects of Tamarindus indica L. (tamarind) fruit pulp. This study aimed to evaluate the weight-reducing effects of T. indica L. fruit as well as its blood pressure- and lipid-lowering effects in a clinical trial. Methods: In a randomized controlled clinical trial, obese and overweight patients were randomly and equally assigned to tamarind and control groups. Both groups were instructed proper diet and maintaining physical activity for 6 weeks. Furthermore, the participants of tamarind group were instructed to consume 10 grams of tamarind fruit pulp twice daily with meals for the same period. Body mass index (BMI), waist circumference, systolic blood pressure (SBP) and diastolic blood pressure (DBP), fasting serum levels of glucose (fasting plasma glucose, FPG), total cholesterol, triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were determined and recorded for all patients pre- and post-intervention. Results: Twenty patients in each group completed the study. Tamarind significantly reduced BMI, WC, LDL-C, SBP, and DBP compared to baseline. However, none of these effects were statistically significant compared to control group. Conclusions: Consumption of tamarind fruit pulp with daily dose of 20 g has no significant effects on body weight, waist circumference, serum lipid profile, blood glucose, and blood pressure.
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Affiliation(s)
- Sedigheh Asgary
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Najmeh Barzegar
- Student Research Committee, Faculty of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Soltani R, Alikiaie B, Shafiee F, Amiri H, Mousavi S. Coenzyme Q10 improves the survival and reduces inflammatory markers in septic patients. ACTA ACUST UNITED AC 2020; 121:154-158. [PMID: 32115970 DOI: 10.4149/bll_2020_022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study aimed to evaluate the effect of Coenzyme Q10 (CoQ10) administration to patients in the early phase of sepsis to determine its effect on the markers of inflammation and the clinical outcomes of septic patients. BACKGROUND Previous studies showed that CoQ10 levels were decreased in septic patients and worsening of mitochondrial dysfunction was observed. METHODS In this randomized controlled trial septic patients (n=40) received 100 mg CoQ10 twice a day for seven days added to standard treatment of sepsis. As a primary endpoint levels of Interleukin 6 (IL-6), Tumor Necrosis Factor-α (TNF-α), Glutathione peroxidase and malondialdehyde (MDA) were assessed at baseline, third and 7th day after the intervention. Secondary endpoints included assessment of clinical scores and in-hospital mortality. RESULTS There was no difference in baseline inflammatory and oxidative injury markers between the groups. TNF-α and MDA levels decreased significantly in the CoQ10 group on the 7th day of the study (P:0.003 for both). There was a significant difference in the in-hospital mortality in the CoQ10 group compared to the control group (P:0.01). CONCLUSION These findings suggest that CoQ10 has a positive effect on clinical parameters as well as mitochondrial dysfunction when administered in the early phase of sepsis (Tab. 2, Fig. 1, Ref. 38).
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Soltani R, Hakamifard A. Drug-induced Pseudochondritis: A Case Report. J Res Pharm Pract 2019; 8:226-227. [PMID: 31956638 PMCID: PMC6952760 DOI: 10.4103/jrpp.jrpp_19_50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 09/11/2019] [Indexed: 11/04/2022] Open
Affiliation(s)
- Rasool Soltani
- Department of Clinical Pharmacy, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Atousa Hakamifard
- Department of Infectious Diseases, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Abstract
In this study which was conducted in Alzahra University Hospital (Isfahan, I.R. Iran), the therapeutic drug monitoring of vancomycin focused on determining area under the concentration-time curve at dosing interval (τ) at steady state/minimum inhibitory concentration (AUCτ/MIC) was carried out in chronic kidney disease (CKD) patients. The study population was selected from patients with the history of CKD (stages 3 or 4) treated by intravenous vancomycin. To determine vancomycin AUCτ, blood samples were taken at four different occasions (trough-1, peak, random, trough-2) between the fourth and fifth doses of vancomycin. Drug concentration was determined by fluorescence polarization technique, and the E-TEST technique was used to determine the MIC. Nineteen patients were included. For 8 (42%), 7 (37%), and 4 (21%) patients, trough concentration levels were found to be less than 10 mg/L, 10-20 mg/L, and more than 20 mg/L, respectively. The mean value of AUCτ for studied patients was 470.7 ± 228.3 mg.h/L and the mean MIC values was 1.04 ± 0.43 mg/L. Ten patients (53%) and 9 patients (47%) had the AUCτ/MIC ratios above 400 and below 400, respectively, with the average of 519.4 ± 391.3 h. Vancomycin dosing based on patient glomerular filtration rate (GFR), as a traditional method, is not accurate enough to gain the most desired vancomycin concentration in patients with decreased or changing kidney function. Measuring drug concentration and observing its therapeutic effects accordingly is inevitable in susceptible populations receiving vital drugs such as vancomycin.
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Affiliation(s)
- Ahmad Khoei
- Isfahan Pharmacy Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
| | - Jaber Emami
- Department of pharmaceutical biotechnology and Isfahan Pharmaceutical Sciences Research Center, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
| | - Shirinsadat Badri
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, I.R. Iran.,Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
| | - Shahram Taheri
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
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Soltani R, Dalimi A. A Molecular Study on Hepatozoon canis Infection in Dogs in Tehran (Iran). Arch Razi Inst 2018; 73:257-263. [PMID: 31077115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 09/27/2017] [Indexed: 06/09/2023]
Abstract
Hepatozoonosis is a protozoal disease caused by various species of Hepatozoon. This parasite is transmitted from tick; the main vector of Hepatozoon canis is usually the brown dog tick (Rhipicephalus sanguineus). However, several species of ticks are disposed as the alternative vectors. Dogs are usually infected by eating the tick or a part of the tick organ infected by the mature oocysts containing infectious sporozoite. In the current study, a total of 145 blood samples were collected from the cephalic vein of pet, stray, and shelter dogs in Tehran. To conduct this study, first thin blood smears were prepared from all the samples and stained with the Giemsa method. Then, after extraction of DNA from the blood samples, in order to trace Hepatozoon canis, the 18S rRNA gene segment of the parasite was amplified using polymerase chain reaction (PCR). To confirm the PCR-positive results, five randomly selected PCR-positive samples were sequenced. According to the results, through direct observation of microscopic slides, no infection of H. canis parasite was observed, but according to the PCR results, 32 out of the 145 blood samples were found to be infected by H. canis. In this study, infection to H. canis in older dogs was higher than in young dogs, and more male dogs were found to be infected by the parasite compared to female dogs; but no significant difference was observed in this regard (P &gt; 0.05). Moreover, stray dogs showed a significantly higher rate of infection, compared to the pet and shelter ones (P &lt; 0.05).
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Affiliation(s)
- R Soltani
- Research Expert,Faculty of Industry and Agriculture,Department of Microbiology, Standard Research Institute (SRI),Standard squre, Karaj, Alborz
| | - A Dalimi
- Department of Parasitology and Entomology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
- Department of Parasitology and Entomology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Naderi P, Shirani K, Soltani R, Khorvash F, Naji Esfahani SS. Meropenem Utilization Evaluation in a Referral Teaching Hospital in Iran. J Res Pharm Pract 2018; 7:83-87. [PMID: 30050961 PMCID: PMC6036873 DOI: 10.4103/jrpp.jrpp_17_86] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: Inappropriate use of antibiotics is associated with detrimental effects including emergence of antibiotic resistance. This study aimed to evaluate the use of meropenem, an extended-spectrum antibiotic, in a referral teaching hospital to detect different types of errors in its prescription. Methods: In a cross-sectional study performed over a 6-month period (2014–2015), hospitalized adult patients who received meropenem for any indication were randomly selected. The collected data included the indication for prescription and its correctness, the basis of prescription (empirical or culture based), administered dose, duration of treatment, the status of demanding sample culture in the case of empirical prescription, the status of dose adjustment in the case of renal impairment, and the treatment outcome. Findings: Over the study period, 123 patients were evaluated. The most frequent indication for prescription of meropenem was pneumonia (31.7%) and soft-tissue infections (18.7%). Out of these prescriptions, 62.6% (77 prescriptions) were incorrect. All meropenem prescriptions were initially empirical. Furthermore, sample culture and antibiotic susceptibility test were requested for only 52% of patients (n = 66). Treatment duration was correct for 53.7% of patients. Seventeen patients (13.8%) received an inappropriate dose of the antibiotic. Furthermore, of 51 patients who needed meropenem dose adjustment because of renal impairment, 17 patients (33.33%) received unadjusted dose. Conclusion: High rate of errors exists in the utilization of meropenem in our hospital, especially in the rank order of selection for treatment (indication), dose adjustment, and treatment duration. Therefore, modification strategies are necessary to promote the rational use of meropenem in this center.
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Affiliation(s)
- Peyman Naderi
- Pharmacy Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kiana Shirani
- Department of Infectious Diseases, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzin Khorvash
- Department of Infectious Diseases, Isfahan University of Medical Sciences, Isfahan, Iran.,Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Karimifar M, Soltani R, Hajhashemi V, Sarrafchi S. Evaluation of the effect of Elaeagnus angustifolia alone and combined with Boswellia thurifera compared with ibuprofen in patients with knee osteoarthritis: a randomized double-blind controlled clinical trial. Clin Rheumatol 2017; 36:1849-1853. [PMID: 28349271 DOI: 10.1007/s10067-017-3603-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 03/03/2017] [Accepted: 03/13/2017] [Indexed: 10/19/2022]
Abstract
Osteoarthritis (OA) is one of the most common articular disorders. Many patients do not respond to acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs), the mainstay of pharmacotherapy for knee OA. The plants Elaeagnus angustifolia and Boswellia thurifera have anti-inflammatory and analgesic properties. This study aimed to evaluate the effect of E. angustifolia alone and in combination with B. thurifera compared with ibuprofen in patients with knee osteoarthritis. In a randomized double-blind controlled clinical trial, 75 patients with knee OA were randomly and equally assigned to one of three groups Elaeagnus (n = 23), Elaeagnus/Boswellia (n = 26), and ibuprofen (n = 26) to receive the capsules of Elaeagnus, Elaeagnus/Boswellia, and ibuprofen, respectively, three times daily with meals for 4 weeks. Pain severity based on VAS (visual analog scale, 0 to 10 scale) and the scores of LPFI (Lequesne Pain and Function Index) and PGA (patient global assessment) were determined pre- and post-intervention for all patients. All interventions had significant lowering effects on VAS, LPFI, and PGA scores (P < 0.001 for all parameters) with no significant difference between groups in terms of effects on all evaluated parameters. Consumption of E. angustifolia fruit extract either alone or in combination with Boswellia oleo-gum resin extract could decrease pain and improve function in patients with knee osteoarthritis comparable to ibuprofen.
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Affiliation(s)
- Mansoor Karimifar
- Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Valiollah Hajhashemi
- Department of Pharmacology and Toxicology, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sara Sarrafchi
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Soltani R, Hashemi M, Farazmand A, Asghari G, Heshmat-Ghahdarijani K, Kharazmkia A, Ghanadian SM. Evaluation of the Effects ofCucumis sativusSeed Extract on Serum Lipids in Adult Hyperlipidemic Patients: A Randomized Double-Blind Placebo-Controlled Clinical Trial. J Food Sci 2016; 82:214-218. [DOI: 10.1111/1750-3841.13569] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 10/12/2016] [Accepted: 11/01/2016] [Indexed: 12/30/2022]
Affiliation(s)
- Rasool Soltani
- Dept. of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences; Isfahan Univ. of Medical Sciences; Isfahan Iran
| | - Mohammad Hashemi
- Dept. of Cardiology, School of Medicine; Isfahan Univ. of Medical Sciences; Isfahan Iran
| | - Alimohammad Farazmand
- Dept. of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences; Isfahan Univ. of Medical Sciences; Isfahan Iran
| | - Gholamreza Asghari
- Dept. of Pharmacognosy, School of Pharmacy and Pharmaceutical Sciences; Isfahan Univ. of Medical Sciences; Isfahan Iran
| | | | - Ali Kharazmkia
- Dept. of Clinical Pharmacy, School of Pharmacy; Lorestan Univ. of Medical Sciences; Khorramabad Iran
| | - Syed Mustafa Ghanadian
- Dept. of Pharmacognosy, School of Pharmacy and Pharmaceutical Sciences; Isfahan Univ. of Medical Sciences; Isfahan Iran
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Torabi A, Soltani R, Hasanzadeh A, Hayati M, Sharifirad G. Prediction of Self-Efficacy and Behavioral Expectations with Consumption of Fruits and Vegetables in Elderly Patients with Functional Constipation. IAHS 2016. [DOI: 10.18869/iahs.3.3.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Asgary S, Soltani R, Mirvakili S, Sarrafzadegan N. Evaluation of the effect of Vaccinium arctostaphylos L. fruit extract on serum inflammatory biomarkers in adult hyperlipidemic patients: a randomized double-blind placebo-controlled clinical trial. Res Pharm Sci 2016; 11:343-8. [PMID: 27651815 PMCID: PMC5022383 DOI: 10.4103/1735-5362.189321] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Atherosclerosis is a chronic inflammatory condition. Many pro-inflammatory factors including interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and adhesion molecules including intercellular adhesion molecule (ICAM-1) and vascular cell adhesion molecule (VCAM-1) are expressed in atherosclerotic lesions. The plants of genus Vaccinium are rich in anthocyanins with anti-inflammatory effects. This study aimed to evaluate the effects of Vaccinium arctostaphylos fruit extract on the serum level of TNF-α, IL-6, ICAM-1, and VCAM-1 in adult patients with mild hyperlipidemia to detect its possible inhibitory effects on progression of atherosclerosis. In a randomized double-blind placebo-controlled clinical trial, eligible hyperlipidemic patients were randomly and equally divided in to two groups of study drug or placebo control to receive either the Vaccinium extract or placebo capsules, respectively, twice daily for four consecutive weeks. Each drug capsule contained 0.8 mg of anthocyanins. Serum levels of TNF-α, IL-6, ICAM-1, and VCAM-1 were measured before and after the interventions and finally were compared.A total of 8 men and 12 women in drug group as well as 11 men and 9 women in placebo group completed the study (P = 0.527). The use of Vaccinium extract significantly reduced only the IL-6 level (P = 0.037); however, this reduction was not significant compared to placebo (P = 0.062). Consumption of Vaccinium arctostaphylos fruit extract with the dose of 500 mg twice daily did not show any significant effect on serum levels of TNF-α, IL-6, ICAM-1, and VCAM-1 in adult hyperlipidemic patients. However, considering slight decrease in the level of IL-6, ICAM-1, and VCAM-1, the use of higher doses with longer duration might have significant effects on these factors.
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Affiliation(s)
- Sedigheh Asgary
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
| | - Saeide Mirvakili
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
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Asgary S, Soltani R, Zolghadr M, Keshvari M, Sarrafzadegan N. Evaluation of the effects of roselle (Hibiscus sabdariffa L.) on oxidative stress and serum levels of lipids, insulin and hs-CRP in adult patients with metabolic syndrome: a double-blind placebo-controlled clinical trial. J Complement Integr Med 2016; 13:175-180. [PMID: 26982618 DOI: 10.1515/jcim-2015-0030] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 01/20/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Roselle (Hibiscus sabdariffa L.) is a plant with antihyperlipidemic and antihypertensive effects. This study aimed to evaluate the effects of roselle calyces on the serum levels of lipids and insulin, inflammation, and oxidative stress in patients with metabolic syndrome (MetS). METHODS Forty adult patients with MetS were randomly assigned to receive either 500 mg of H. sabdariffa calyx powder or placebo once daily for 4 weeks. Systolic and diastolic blood pressures (SBP and DBP) and BMI (body mass index) as well as fasting serum levels of glucose (FPG; fasting plasma glucose), insulin, lipoproteins, triglycerides (TG), high-sensitivity C-reactive protein (hs-CRP), and malondialdehyde (MDA) were determined pre- and post-intervention and compared. RESULTS H. sabdariffa significantly reduced serum TG (p=0.044) and SBP (p=0.049) compared to placebo. All other variables were not significantly affected by the interventions. CONCLUSIONS Daily consumption of 500 mg of H. sabdariffa L. calyx powder can decrease SBP and serum TG in MetS patients.
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Eizadi-Mood N, Akouchekian S, Yaraghi A, Hakamian M, Soltani R, Sabzghabaee AM. Memory Impairment following Acute Tricyclic Antidepressants Overdose. Depress Res Treat 2015; 2015:835786. [PMID: 25649497 PMCID: PMC4310445 DOI: 10.1155/2015/835786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 11/29/2014] [Accepted: 12/02/2014] [Indexed: 11/26/2022]
Abstract
Background. Psychiatric consultation is necessary for all patients with intentional poisoning and its reliability depends on the proper function of patients' memory performance. This study aimed to determine the possible memory impairment following acute TCAs' poisoning. Materials and Methods. In this cross-sectional study, patients with acute TCAs poisoning were allocated to two groups of severe poisoning (with coma, seizures, cardiac arrhythmias, hypotension, and a wide QRS complex) and mild-to-moderate poisoning according to their clinical presentation at the time of hospital admission. All patients underwent memory performance test both immediately and 24 hours after their initial consciousness after admission, using Wechsler Memory Scale (WMS-IV). Results. During the study period, 67 TCA-poisoned patients (aged, 20-64 years) were evaluated, of which 67.2% were female. The mean memory scores of patients immediately and 24 hours after the initial consciousness were 31.43 ± 9.02 and 50.62 ± 9.12, respectively (P < 0.001). Twenty-four hours after the initial consciousness, memory score was statistically correlated with the amount of ingested drug and the intoxication severity. Conclusion. Following the recovery from somatic symptoms of acute TCA poisoning, patients may still suffer from memory impairment and it seems that this time is not suitable for performing a reliable psychiatric consultation.
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Affiliation(s)
- Nastaran Eizadi-Mood
- Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahla Akouchekian
- Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Yaraghi
- Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehrnazsadat Hakamian
- Department of Clinical Toxicology, Noor and Ali-Asghar (PBUH) University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Mohammad Sabzghabaee
- Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Soltani R, Khalili H, Shafiee F. Double-disk synergy test for detection of synergistic effect between antibiotics against nosocomial strains of staphylococcus aureus. J Res Pharm Pract 2014; 1:21-4. [PMID: 24991583 PMCID: PMC4076852 DOI: 10.4103/2279-042x.99673] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: Synergistic effect between commonly used antibiotics against nosocomial multidrug-resistant strains of Staphylococcus aureus, if present, could provide a viable option as an alternative therapy for infections due to this pathogen. The aim of this study was searching for any synergistic effect between several antibiotics against drug-resistant strains of S. aureus with nosocomial origin using double-disk synergy test and to determine the applicability of this test for such a purpose. Methods: Over a 6-month period, strains of S. aureus isolated from clinical specimens of hospitalized patients with documented nosocomial infection underwent disk diffusion test using antibiotic disks of oxacillin, cephalothin, clindamycin, ciprofloxacin, vancomycin, cotrimoxazole, rifampin, erythromycin, gentamicin and meropenem. Double-disk synergy test was performed for all isolates resistant to at least two of applied antibiotics. Combinations of all possible pairs of antibiotics (to which the microorganism was resistant) were tested by placing antibiotic disks at distance of 20 mm from each other (center to center). After 16- 20 hours of incubation, if synergistic effect was present among two antibiotics, an inhibition zone was formed between their disks. Findings: Among all of possible two-antibiotic combinations tested for 41 resistant isolates, only two cases of synergistic effect were detected; both effects were among rifampin and cotrimoxazole. Conclusion: The combination of rifampin and cotrimoxazole could provide a viable option for treatment of infections due to resistant strains of S. aureus; however, clinical trials are needed before any new recommendation. Also, double-disk synergy test seems to be capable of detecting the synergistic effect between antibiotics at in vitro level.
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Affiliation(s)
- Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Khalili
- Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Fateme Shafiee
- Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran
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Sabzghabaee AM, Abedi D, Fazeli H, Javadi A, Jalali M, Maracy MR, Soltani R, Karamyafti MJ. Antimicrobial resistance pattern of bacterial isolates from burn wounds in an Iranian University Hospital. J Res Pharm Pract 2014; 1:30-3. [PMID: 24991585 PMCID: PMC4076853 DOI: 10.4103/2279-042x.99675] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective: About 73% of death cases in the first 5 days after burning are due to infection complications. The aim of this study was to identify the causing agents of infections in burn patients and the sensitivity pattern of them to the commonly used antimicrobials in an Iranian Burn center University Hospital. Methods: In this cross-sectional study, patients who were admitted to one of the Iranian Burn center University hospitals in 2009 and had nosocomial infection due to burn wound, whom received antimicrobial agents for therapeutic reasons, with a hospitalization period of more than 48 hours were enrolled. Gram stain analyses were performed to help identifying growing colonies. Differential tests for identification of pathogenic bacteria species were performed following primary tests. E-test strips of each antimicrobial were placed on the culture medium plate in order to determine the minimum inhibitory concentration Studied antimicrobials for isolated Gram-negative bacteria were meropenem, piperacillin/tazobactam, ceftriaxone, cotrimoxazole, and for Staphylococcus aureus, vancomycin, piperacillin/tazobactam, cotrimoxazole, and cephalothin. Findings: Only 16% of Pseudomonas aeruginosa species were sensitive to meropenem, and 13% were sensitive to piperacillin/tazobactam. Ten out of 29 Klebsiella species (34%) were sensitive to meropenem and piperacillin/tazobactam. All isolated strains of Staphylococcus aureus were sensitive to vancomycine while they were all resistant to cotrimoxazole. Conclusion: Pseudomona, Klebsiella and Staphylococcoci are the most common species causing burn infection in this medical center. Results showed the importance of limiting irrational use of wide-spectrum antimicrobials and recommends strict management of infections in burn injury centers.
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Affiliation(s)
- Ali Mohammad Sabzghabaee
- Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Daryoush Abedi
- Isfahan Pharmaceutical Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Fazeli
- Department of Microbiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbasali Javadi
- Department of Infectious Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Jalali
- Department of Food Science and Technology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Reza Maracy
- Department of Community Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasool Soltani
- Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Soltani R, Ehsanpoor M, Khorvash F, Shokri D. Antimicrobial susceptibility pattern of extended-spectrum β-lactamase-producing bacteria causing nosocomial urinary tract infections in an Iranian referral teaching hospital. J Res Pharm Pract 2014; 3:6-11. [PMID: 24991629 PMCID: PMC4078647 DOI: 10.4103/2279-042x.132703] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE Gram-negative bacilli are the most important cause of nosocomial urinary tract infections (UTIs). The production of extended-spectrum β-lactamase (ESBL) enzymes is a common mechanism of resistance among these bacteria. The aim of this study was to determine the rate of ESBL producing Gram-negative bacteria causing nosocomial UTI in a referral hospital as well as their susceptibility pattern to the most commonly used antibiotics. METHODS In a prospective cross-sectional study performed over a 6-month period, urinary specimens obtained from hospitalized patients with documented culture-proved nosocomial UTI (age range of 1-87 years). Isolated aerobic Gram-negative bacteria underwent further microbiologic tests for detection of ESBL, as well as antimicrobial susceptibility test using Kirby-Bauer (disk diffusion) and E-test methods. FINDINGS During the study period, 213 urine samples were detected to have growth of Gram-negative organism. Escherichia coli was the most frequently isolated organism (61%). ESBL was detected in 102 isolates including 38.5% of E. coli, 39.5% of Klebsiella pneumonia, 88.5% of Pseudomonas aeruginosa, and 100% of Acinetobacter baumannii strains. Imipenem and meropenem were the most effective antibiotics on E. coli and K. pneumoniae strains. P. aeruginosa and A. baumannii strains showed high resistance to all tested antibiotics. CONCLUSION Large numbers of Gram-negative bacteria causing nosocomial UTIs produce ESBL with most being multidrug-resistant. Therefore, routine ESBL detection testing and subsequent antibiogram with disk diffusion method could be useful to determine the best treatment options for UTI.
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Affiliation(s)
- Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohsen Ehsanpoor
- Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzin Khorvash
- Department of Infectious Diseases, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Dariush Shokri
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Sabzghabaee AM, Ataei E, Kelishadi R, Ghannadi A, Soltani R, Badri S, Shirani S. Effect of Hibiscus sabdariffa Calices on Dyslipidemia in Obese Adolescents: A Triple-masked Randomized Controlled Trial. Mater Sociomed 2013; 25:76-9. [PMID: 24082826 PMCID: PMC3769081 DOI: 10.5455/msm.2013.25.76-79] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 03/25/2013] [Indexed: 12/14/2022] Open
Abstract
CONFLICT OF INTEREST none declared. OBJECTIVE We aimed to evaluate the effects of Hibiscus sabdariffa (HS) calices on controlling dyslipidemia in obese adolescents. METHODOLOGY In this triple blind randomized placebo-controlled clinical trial which was registered in the Iranian registry for clinical trials (IRCT201109122306N2), 90 obese adolescents aged 12-18 years with documented dyslipidemia were randomly assigned in two groups of cases who received 2 grams of fine powdered calices of Hibiscus sabdariffa per day for one month and controls who received placebo powder with the same dietary and physical activity recommendations and duration of exposure. Full lipid profile and fasting blood sugar measured before and after the trial. Data were analyzed using multivariate general linear model. FINDINGS Overall, 72 participants (mean age of 14.21±1.6, 35 boys) completed the trial. The two arms of the study (cases and controls) were not statistically different in terms of age, gender, weight, body mass index (BMI) and lipid profile before the trial. Serum total cholesterol, low density lipoprotein cholesterol and serum triglyceride showed a significant decrease in cases group but high density lipoprotein cholesterol level was not changed significantly. CONCLUSION It is concluded that Hibiscus sabdariffa calyces powder may have significant positive effects on lipid profile of adolescents which maybe attributed to its polyphenolic and antioxidant content. Further studies are needed on dose-response and formulation optimization.
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Affiliation(s)
- Ali Mohammad Sabzghabaee
- Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences , Isfahan, Iran
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Soltani R, Soheilipour S, Hajhashemi V, Asghari G, Bagheri M, Molavi M. Evaluation of the effect of aromatherapy with lavender essential oil on post-tonsillectomy pain in pediatric patients: a randomized controlled trial. Int J Pediatr Otorhinolaryngol 2013; 77:1579-81. [PMID: 23932834 DOI: 10.1016/j.ijporl.2013.07.014] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 07/12/2013] [Accepted: 07/16/2013] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the effect of aromatherapy with Lavandula angustifolia essential oil on post-tonsillectomy pain in pediatric patients. METHODS This was a randomized controlled prospective clinical trial. In this study, 48 post-tonsillectomy patients aged 6-12 years were randomly assigned to two groups (24 patients in each group). After tonsillectomy surgery, all patients received acetaminophen (10-15 mg/kg/dose, PO) every 6h as necessary to relieve pain. The patients of the case group also inhaled lavender essential oil. The frequencies of daily use of acetaminophen and nocturnal awakening due to pain, and pain intensity (evaluated using visual analog scale [VAS]) were recorded for each patient for 3 days after surgery. Finally, the mean values of variables were compared between two groups separately for each post-operative day. RESULTS The use of lavender essential oil caused statistically significant reduction in daily use of acetaminophen in all three post-operative days but had not significant effects on pain intensity and frequency of nocturnal awakening. CONCLUSION Aromatherapy with lavender essential oil decreases the number of required analgesics following tonsillectomy in pediatric patients.
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Affiliation(s)
- Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
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Sabzghabaee A, Khayam I, Kelishadi R, Ghannadi A, Soltani R, Badri S, Shirani S. Effect of Zizyphus Jujuba Fruits on Dyslipidemia in Obese Adolescents: a Triple-masked Randomized Controlled Clinical Trial. Med Arch 2013. [DOI: 10.5455/medarh.2013.67.156-160] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Sabzghabaee AM, Khayam I, Kelishadi R, Ghannadi A, Soltani R, Badri S, Shirani S. Effect of Zizyphus jujuba fruits on dyslipidemia in obese adolescents: a triple-masked randomized controlled clinical trial. Med Arch 2013; 67:156-159. [PMID: 23848030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
OBJECTIVE This study aimed to assess the effects of Ziziphus jujuba (ZJ) fruit on controlling dyslipidemia in obese adolescents. METHODS This triple-blind randomized placebo-controlled clinical trial comprised 86 obese adolescents aged 12-18 years with dyslipidemia, i.e. serum low density lipoprotein-cholesterol (LDL-C) or total cholesterol (TC) or triglycerides (TG) equal or more than the age- and gender-specific 95th percentile or high density lipoprotein- cholesterol (HDL-C) less than 5th percentile. They were randomly assigned into two groups of equal number Both groups received similar recommendations for dietary and physical activity habits. The case group received 5 grams of ZJ fruit powder three times a day for one month and controls took the same amount of a placebo powder. Fasting blood sugar, TC, LDL-C, HDL-C and TG were measured at the beginning and at the end of the trial. Data were analyzed using General linear method (multivariate) test. FINDINGS Overall, 70 participants (51% boys, mean age of 14 +/- 2) completed the trial. The two groups studied did not differ in terms of age, gender, weight and body mass index (BMI). After the trial, serum TC decreased significantly (19 +/- 37 mg/dl in controls vs. 170 +/- 29 mg/dl in cases, P = 0.007) reduction. The corresponding figure was also significant for LDL-C (114 +/- 38 mg/dl vs. 104 +/- 22 mg/dl, respectively, P = 0.004). The changes in BMI and other lipids were not significant. CONCLUSION This study suggest that ZJ's fruits is generally well tolerated and may have potential favorable effects on serum lipid profile. While healthy lifestyle is the mainstay of controlling childhood obesity, this nutraceutical may be considered as a complementary treatment. Key words: Zizyphus, dyslipidemia, adolescence, obesity.
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Affiliation(s)
- Ali Mohammad Sabzghabaee
- Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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