Epidemiological study of drug intoxication in children

Unintentional drug intoxication is still a major cause of morbidity and mortality in young children. In order to study the epidemiological pattern of childhood drug poisoning in Golestan province, all cases diagnosed with poisoning from 1997 to 2002 in the only pediatric hospital in province were recruited. During this period 563 cases of poisoned children were hospitalized in Taleqani hospital, of these 305 cases were due to drug poisoning. Opium was responsible for more than half of the poisoning cases, and 91% of deaths, among drug intoxicated children. Metoclopramide, benzodiazepines, tricyclic antidepressants and anticonvulsants were among the other frequent causes of poisoning. Neurological symptoms were the most prominent symptoms of poisoning and more than 80% of cases showed some neurological symptoms. Mortality rate among the cases was 3.6% and of total of 11 deaths, 10 were poisoned with opium. About 61% of cases were hospitalized between 24-48 hrs. Most of the poisoning cases in young children were unintentional and in many cases, their parents played a critical role in their intoxication. This role specially is crucial in infants and children under one year of age. Parents in Golestan province use opium widely for symptomatic treatment of routine illnesses in their young children and overdose of opium may cause severe intoxication and even death of the child. © 2006 Tehran University of Medical Sciences. All rights reserved

The Frequency of MRSA carriers in health care workers in Gorgan, North of Iran

Methicillin resistant Staphylococcus aureus (MRSA) is one of the most important pathogen in hospitals. Healthcare personnel are the main source of nosocomial infections and identification and control of MRSA carriers can reduce incidence of infections. The aim of this study was to determine the frequency of methicillin resistant Staphylococcus aureus (MRSA) and their antibiotic susceptibility profile among healthcare workers in Gorgan located in northern Iran. Three hundred and thirty three of healthcare workers were participated in this cross-sectional study in 2010. Samples were taken with sterile cotton swabs from both anterior nares. Swabs were plated onto Mannitol salt agar. S. aureus were identified by Gram stain, Catalase, Coagulase and DNase tests. MIC (micro dilution broth) method was used to determine resistance of strains to methicillin. Antimicrobial susceptibility pattern to other antibiotics was performed by diffusion method. Frequency of S. aureus and MRSA carriers among healthcare workers was 24% (80.33) and 3% (10.33) respectively. MIC of isolates was varied between 0.5 and 65.31 (39%) of cases were showed MIC of intermediate that ranged between 4 and 8. Penicillin and Imipenem resistance were seen in 97.5% and 1.4% of isolated S. aureus strains, respectively. Frequency of S. aureus carriers in healthcare workers in our area was median in compare with other region in Iran but the MRSA carriage in healthy staff was lower than most part of Iran. It would be considering to monitor healthy carrier staff because of high rate intermediate MIC in this group to prevent conversion to MRSA

Discrimination of Entamoeba spp. in children with dysentery

Aim: The present study was performed in order to differentiate E. histolytica and E. dispar in children from Gorgan city, using a PCR method. Background: Differential detection of two morphologically indistinguishable protozoan parasites Entamoeba histolytica and E. dispar has a great clinical and epidemiological importance because of potential invasive pathogenic E. histolytica and non-invasive parasite E. dispar. Patients and methods: One hundred and five dysentery samples were collected from children hospitalized in Taleghani hospital in Gorgan city. The fecal specimens were examined by light microscopy (10X then 40X) to distinguish Entamoeba complex. A single round PCR amplifying partial small-subunit rRNA gene was performed on positive microscopy samples to differentiate E. histolytica/ E. dispar and E. moshkovskii from each other. Results: Twenty-five specimens (23.8%) were positive for Enramoeba complex in direct microscopic examination. PCR using positive controls indicated E. histolytica and E. dispar in two (2/25, 8%) and three (3/25, 12%) samples, respectively. Conclusion: There is a warrant to performing molecular diagnosis for stool examination at least in hospitalized children in order to prevent incorrect reports from laboratories and consequently mistreating by physicians. © 2014 RIGLD, Research Institute for Gastroenterology and Liver Diseases

Herpes Simplex virus meningitis in children in South East of Caspian Sea, Iran

Background: Herpes simplex virus (HSV) is a member of Herpesviridae and a leading cause of human viral diseases. Meningitis occurs as a complication of HSV-1 or HSV-2 primary infection. Objectives: We aimed to evaluate HSV meningitis in children in Gorgan province, Iran. Patients and Methods: Forty-five cerebrospinal fluid samples were taken from children referred with meningitis symptoms. Samples with negative bacterial culture results were tested for viral, biochemical and cytological assays. DNA extraction and PCR were performed. Results: HSV-1 detected in 4 (8.8%) samples without any HSV-2 infections. Cases with positive results had fever and CSF pleocytosis. Vomiting, headache and higher count of WBC were observed in 3, 2 and 3 cases respectively. The cerebrospinal fluid (CSF) glucose and protein levels were normal and 3 cases showed positive C-reactive protein (CRP) results. Also erythrocyte sedimentation rate (ESR) was higher than normal in all positive cases. Conclusions: Distribution of HSV types in children with meningitis in our area predominantly was type 1 compared with type 2, which has been reported more in other area. © 2014, Ahvaz Jundishapur University of Medical Sciences; Published by Kowsar Corp

Emergence of a new focus of visceral leishmaniasis due to Leishmania infantum in Golestan Province, north-eastern of Iran

Over the last decade, a few cases of visceral leishmaniasis (VL) have been reported in some districts of the province of Golestan, in north-eastern Iran. The aim of the present study was to investigate the prevalence of Leishmania infantum infection among humans and domestic dogs by using direct agglutination test (DAT) and PCR assays in the eastern zone of the province. Between 2011 and 2012, blood samples were randomly collected from 450 humans and 50 domestic dogs, in the eastern zone of Golestan Province including 7 villages from Marave-tappeh district where new cases of human VL had been recorded there. Each of these samples was tested for anti-Leishmania antibodies, in DAT, and for L. infantum kinetoplast DNA on whole blood, in PCR-based assays. A total of 450 human samples, 6 (1.33 %) were found seropositive and 13 (2.8 %) was found PCR-positive. Of the 50 dog samples, 16 (32 %) were found seropositive and 15 (30 %) were PCR-positive. All PCR-positive dogs were found seropositive except one as well as 6 (46.2 %) PCR-positive humans were also found seropositive. Moreover, the species of L. infantum was detected in all PCR-positive samples. The high prevalence of VL in the study areas offer it has emerged as an endemic focus in the province. Further investigations on the vectors, reservoirs and human population are recommended. © 2013 Indian Society for Parasitology

Does the Elderly’s Number of Prescribed Medications across Months Matter? National Cohort versus Single-Center Cohort

AbstractObjectivesTo investigate the monthly number of prescribed medication (NPM) patterns among different elderly populations and the factors associated with monthly NPM changes.MethodsThis retrospective cohort study was conducted using the databases obtained from National Health Insurance Research Databases and a 2000-bed academic medical center in Taiwan (i.e., single-center cohort). We compared the monthly NPMs, demographic characteristics, disease states, and health care contacts among the National Health Insurance elderly cohorts in 2006 and 2007, and for those elderly in the national and single-center cohorts who had outpatient visits from November to October in 2006 to 2007 and 2007 to 2008, respectively. Generalized estimating equation analyses of repeated measures were performed for monthly NPMs.ResultsThe average monthly NPMs among the National Health Insurance elderly cohort was 2.33 in 2006 and 4.39 in 2007, respectively. After controlling for other factors, the increment in the proportion of monthly NPMs among the older elderly patients, in certain months and for those patients with hypertension and dyslipidemia, was statistically significant among the single-center cohort but was not observed in the national elderly cohort. The proportional changes decreased significantly among patients who made visits to emergency rooms and who were hospitalized during a 1-year period.ConclusionsThere was an incremental trend of monthly NPMs among the national cohort from 2006 to 2007. Although acute exacerbations and hospitalization might be the protecting factors of increasing monthly NPMs, more attention should be paid toward high-utilization patients with specific diseases during certain months for different elderly cohorts

SME default prediction: A systematic methodology-focused review

This study reviews the methodologies used in the literature to predict failure in small and medium-sized enterprises (SMEs). We identified 145 SMEs’ default prediction studies from 1972 to early 2023. We summarized the methods used in each study. The focus points are estimation methods, sample re-balancing methods, variable selection techniques, validation methods, and variables included in the literature. More than 1,200 factors used in failure prediction models have been identified, along with 54 unique feature selection techniques and 80 unique estimation methods. Over one-third of the studies do not use any feature selection method, and more than one-quarter use only in-sample validation. Our main recommendation for researchers is to use feature selection and validate results using hold-out samples or cross-validation. As an avenue for further research, we suggest in-depth empirical comparisons of estimation methods, feature selection techniques, and sample re-balancing methods based on some large and commonly used datasets.publishedVersio