Comparison of fine-needle aspiration with fine-needle capillary cytology in thyroid nodules

INTRODUCTION

High false-negative results have been reported for fine-needle aspiration (FNA) cytology in thyroid nodules. Fine-needle capillary (FNC) cytology is an alternative technique that prevents aspiration, reducing tissue damage. This study aimed to compare FNA and FNC in assessing thyroid nodules and in terms of their predictive role in the appropriate diagnosis of malignancy.

METHODS

This is a comparative prospective study conducted on 486 patients. FNA was performed in 235 patients during 2016 and 2017 and FNC in 251 patients during 2018 and 2019. The quality of cytological specimens was compared and then correlated with the final histopathological findings of 39 patients who underwent thyroidectomy.

RESULTS

Both groups were statistically similar regarding age and sex distribution. The FNA technique yielded significantly higher adequate specimens compared with FNC (p<0.001). Abundant blood in the background was found more frequently in the FNA technique (p<0.001). The sensitivity and specificity of FNA for malignancy diagnosis were both 100%, compared with 83.3% and 57.7% for FNC, respectively.

CONCLUSIONS

The two methods, FNA and FNC, did not differ in terms of overall quality. FNA was superior regarding consistency with the histopathological results and the ability to diagnose malignancy.

Evaluating the antibiotic resistance and frequency of adhesion markers among Escherichia coli isolated from type 2 diabetes patients with urinary tract infection and its association with common polymorphism of mannose-binding lectin gene

The present paper aims to determine the frequency and antibiotic resistance patterns of pathogenic bacteria, the virulence factor profile of Escherichia coli and mannose-binding lectin (MBL) gene polymorphism in individuals with diabetes mellitus (DM) and urinary tract infection (UTI). The population under study was 130 individuals with type 2 diabetes mellitus (T2DM) and UTI. The patients' clinical characteristics and urine and blood samples (5 mL) were collected. Antibiotic resistance was determined using a disc diffusion method, and the results were interpreted according to CLSI. The presence of virulence genes was detected by multiplex PCR. To detect the MBL gene polymorphism, PCR and restriction fragment length polymorphism methods were applied. The predominant Gram-negative and Gram-positive bacteria included E. coli and Streptococcus spp.viridans group, respectively. Women were more susceptible to the incidence of UTI than men. The E. coli isolates showed a high level of resistance to amoxicillin-clavulanic acid (87.35%), and nitrofurantoin and ceftizoxime were the most effective antimicrobial agents for E. coli. Cefotaxime and ceftizoxime were the most effective antimicrobial agents for Enterobacter spp., norfloxacin and ciprofloxacin were the most effective antimicrobial agents for Staphylococcus epidermidis and Staphylococcus saprophyticus. papGII (52.87%) and papEF (1.14%) had the highest and lowest frequency among examined genes in E. coli isolates, respectively. The GG genotype had the highest frequency among patients with T2DM and UTI. Results showed that the detection of E. coli in individuals with an AA genotype, codon 54 of the MBL gene, can play an important role in the molecular diagnosis and timely treatment of bacterial infections in individuals with diabetes.

Clonal relatedness and resistance characteristics of OXA-24 and -58 producing carbapenem-resistant Acinetobacter baumannii isolates in Tehran, Iran

AIMS

The present study was conducted to investigate the mechanism of carbapenem resistance and the molecular epidemiology of carbapenem-resistant Acinetobacter baumannii (CRAB) isolates collected from two nearby hospitals in Tehran, Iran.

METHODS AND RESULTS

A total of 180 CRAB isolates were studied. Antimicrobial susceptibility testing was performed using disk diffusion and Epsilometer tests. The detection of OXA-23, -24 and -58 was implemented for all isolates using polymerase chain reaction. Subsequently, isolates harbouring OXA-24 and -58 were investigated for the presence of resistance determinants of Ambler class A, metallo-β-lactamases (MBLs), and carbapenem-hydrolysing class D β-lactamases, ISAba1, and the genetic relatedness between them was analysed using pulsed-field gel electrophoresis (PFGE). All isolates were found to be resistant to imipenem with a MIC of ≥8 µg ml^-1 and were susceptible to colistin with a MIC of ≤1·5 µg ml^-1 . Sixty percent of the isolates had OXA-23. OXA-24 and -58 were detected in 31 of 180 CRAB isolates. These chosen isolates were devoid of MBLs and bla_SHV , bla_{C TX-M} , bla_VEB ESBL genes. The PER determinant was detected in 38% of isolates as the most common extended spectrum β-lactamases (ESBLs). Of these isolates, 51·6% had OXA-23, and ISAba1 was found to be upstream of OXA-23 and OXA-51 in 16 and 8 isolates, respectively. The band patterns produced by PFGE showed nine clonal pulsotypes distributed between the two hospitals.

CONCLUSION

The findings showed that the refractory CRAB isolates were transmitted intra- and inter-hospital, particularly in the ICU due to shortcomings in infection control surveillance.

SIGNIFICANCE AND IMPACT OF THE STUDY

Carbapenem resistance is a substantial threat in the treatment of infections caused by A. baumannii due to limitations in the therapeutic options.

Susceptibility of herpes simplex virus type 1 to monoterpenes thymol, carvacrol, p-cymene and essential oils of Sinapis arvensis L., Lallemantia royleana Benth. and Pulicaria vulgaris Gaertn

In recent years, with increased the prevalence of viral infections and having no specific for  their treatment  and also the continuous appearance of resistant viral strains, the finding of novel antiviral agents is necessary. In this study, monoterpenes of thymol, carvacrol, p-cymene and essential oils from Sinapis arvensis L., Lallemantia royleana Benth. and Pulicaria vulgaris Gaertn. were screened for their inhibitory effect against herpes simplex virus type 1 (HSV-1) in vitro on Vero cell line CCL-81-ATCC using a plaque reduction assay. The antiviral activity of three monoterpenes (thymol, carvacrol and p-cymene) and three essential oils were evaluated by cytotoxicity assay, direct plaque test. In addition, the modes of antiviral action of these compounds were investigated during the viral infection cycle. Results showed that the inhibitory concentrations (IC50) were determined at 0.002%, 0.037%, &gt;0.1%, 0.035%, 0.018% and 0.001% for thymol, carvacrol, p-cymene, S. arvensis oil, L. royleana oil and P. vulgaris oil, respectively. A manifestly dose-dependent virucidal activity against HSV-1 could be exhibited for compounds tested. In order to determine the mode of the inhibitory effect, compounds were added at different stages during the viral infection cycle. At maximum noncytotoxic concentrations of the compounds, plaque formation was significantly reduced by more than 80% when HSV-1 was preincubated with p-cymene. However, no inhibitory effect could be observed when the compounds were added to the cells prior to infection with HSV-1 or after the adsorption period.

CONCLUSION

These results indicate that compounds affected HSV-1 mostly before adsorption and might interact with the viral envelope. Thymol exhibited a high selectivity index and seems to be a promising candidate for topical therapeutic application as antiviral agent for treatment of herpetic infections.

The link between intergenic distances and controls exerted on the transcriptional regulation; an inferential approach

The position of genes along the genome is an important evolutionary factor for organizing gene regulation. Hence, transcriptional regulatory network have been studied much more extensively from gene distributions rather than other viewpoints. The systematics of intergenic distances, therefore, should be taken into account as an important source of information on the controls exerted on gene expression by various biological mechanisms. Here we study a collection of features including, intergenic and interoperonic distances, distances between isolated genes, distances between regulatory genes and distances between isolated and regulatory genes/operons in order to provide a more informative picture of gene distributions via firstly discovering the statistical model of these features. We find that all these features significantly follow the lognormal distribution. Then we test a few important biological hypotheses particularly in relation to controls exerted in the transcriptional regulatory network in a completely inferential approach using generalized p-value based on the discovered model. We find that mean distances of isolated genes significantly is less than that of regulatory genes.  These findings are consistent with the previous evidences that many biological variables, especially in relation to systems biology, follow lognormal distribution. furthermore, our results inferentially support the crucial hypothesis on the two distinct logical types of control, namely digital control (i.e. control mediated by specific transcription factors) and analog control (i.e. control mediated by distribution of supercoiling energy and based on gene neighborhood) previously proposed by studying expression patterns.

Impact comparison of ketamine and sodium thiopental on anesthesia during electroconvulsive therapy in major depression patients with drug-resistant; a double-blind randomized clinical trial

BACKGROUND

Electroconvulsive therapy (ECT) is one of the available and the most effective therapies for the treatment of resistant depression. Considering the crucial role of seizure duration on therapeutic response in patients treated with ECT, this study aimed to compare the effect of ketamine and sodium thiopental anesthesia during ECT for treatment of patients with drug-resistant major depression (DRMD).

MATERIALS AND METHODS

In a double-blind randomized clinical trial, 160 patients with DRMD were selected consequently and were assigned randomly into two groups including ketamine 0.8 mg/kg and sodium thiopental 1.5 mg/kg. The seizure duration, recovery time, and the side effects of anesthesia were evaluated after 1-h after anesthesia. Data of recovery time and complication collected in 2 nd , 4 th , 6 th , and 8 th ECT. Depression was assessed by Hamilton depression scale.

RESULTS

The results indicated that ketamine and sodium thiopental had a significant effect on the reduction of depression scores in patients with DRMD (P < 0.05). Complications such as a headache, nausea, pain at the injection site, short-term delirium, and long-term delirium were higher in ketamine group (P > 0.05). But ketamine was more effective in improvement of depression score and increasing systolic and diastolic blood pressure (P < 0.05). The mean of seizure duration showed a decreasing trend and was significant between two study groups (P < 0.05).

CONCLUSION

Anesthesia induced by ketamine during ECT therapy increased blood pressure and seizure duration. Therefore, due to lower medical complication and attack rate of seizure, ketamine is an appropriate option for anesthesia with ECT in patients with DRMD.

Evidence for biological roots in the transgenerational transmission of intimate partner violence

Intimate partner violence is a ubiquitous and devastating phenomenon for which effective interventions and a clear etiological understanding are still lacking. A major risk factor for violence perpetration is childhood exposure to violence, prompting the proposal that social learning is a major contributor to the transgenerational transmission of violence. Using an animal model devoid of human cultural factors, we showed that male rats became highly aggressive against their female partners as adults after exposure to non-social stressful experiences in their youth. Their offspring also showed increased aggression toward females in the absence of postnatal father-offspring interaction or any other exposure to violence. Both the females that cohabited with the stressed males and those that cohabited with their male offspring showed behavioral (including anxiety- and depression-like behaviors), physiological (decreased body weight and basal corticosterone levels) and neurobiological symptoms (increased activity in dorsal raphe serotonergic neurons in response to an unfamiliar male) resembling the alterations described in abused and depressed women. With the caution required when translating animal work to humans, our findings extend current psychosocial explanations of the transgenerational transmission of intimate partner violence by strongly suggesting an important role for biological factors.

P01-340-Title: comparing of psychiatric co- morbidity disorders in primary school students with adhd subtypes (attention deficit, hyperactivity, combined) in academic year of 2009–2010 in arak-iran

Introduction

ADHD is one of the most prevalent psychiatric disorders in children.

Objective

ADHD have co-morbidity with many other psychiatric disorders.

Aims

Aim of this study was Comparing of prevalence of three subtypes of ADHD with psychiatric Co- morbidity in primary school students of Arak-Iran.

Methods

This study was a descriptive analytic, cross- sectional one, which carried on 2000 (960 girls and 1040 boys)primary school students in 1st state of Arak in academic year of 2009–2010, which screened by Intelligence Raiven scale and 48 Canner’s questionnaire (parents and teachers)and if there were existed of any subtypes of ADHD, we have done K-SADS-E questionnaire(Schedule for Affective disorder and Schizophrenia -epidemiological version)for them, then data were analyzed by using descriptive- statistical methods and Logistic- regression for obtaining R. R.

Results

2.3, 3.5 and 2.7 percent of children have one of the subtypes of ADHD. The findings showed that prevalence of hyperactivity and attention deficit subtypes decreased while combined type increased by increasing age. The prevalence of two subtypes of hyperactivity and attention deficit in boys and girls were not significantly different but combined type was significantly different. Finally, there were differences between ADHD subtypes and Co morbidity of psychiatric disorders such as conduct, depressive,enuresis, tic, schizophrenia, oppositional, obsessive- compulsive, manic and social phobia, but these differences were not significant between girls and boys.

Conclusions

Prevalence of subtypes of the ADHD were different between age and gender but there were not significant differences between Co morbidity of ADHD subtypes and psychiatric disorders.

Comparison of psychiatric disorders between opium dependent and non dependent families in Arak-Iran in 2010

Introduction

Opium dependence is a worldwide problem, that has developed beyond the health - care border line.

Objective

There are a lot of foreign studies about psychiatric disorders in the opium dependent families. But those are a few in our culture and geographic area.

Aims

The aim of this study is comparing of psychiatric disorders between opium dependent and non dependent families in Arak-Iran in 2010.

Materials & method

This is a case - control study that carried on 230 families of 87 opium dependent subjects attending to the withdrawal clinics as case group and 420 families of 174 opium nondependents as control group who attended to the blood transfusion center in Arak -Iran by using SCL-90 Questionnaire. Then analyzed data by using Spss 15 in order for comparing different psychiatric disorders in them.

Result

Depression, Generalized anxiety disorder, hostility and paranoia were significantly different in three pathological types such as borderline, disorder and combined disorders (Pvalue < 0.05) in opium dependent and non-dependent families, but there were not Significantly different between other disorders such as somatization, Obsessive-compulsive, interpersonal disturbance, phobia and psychotic disorder in that questionnaires SCL90-R were measured (P value > 0.05). Psychiatric disorders as overall were significantly differences in opium dependent and non-dependent families (p < 0.05).

Conclusion

According to our finding a number of psychiatric disorders are more common in opium dependent families.Therefore further studies in this area and families with other substance dependence subjects were suggested.

Comparison of the Effect on 8 weeks Treatment with Fluoxetine and Imipramine on Fasting Blood Sugar of Major Depressive Patient

Background:

There is a lot of interference between depression and diabetes - mellitus and vice versa. Therefore, control of blood glucose levels in depressive patients and also to knowing the effect of antidepressants on blood glucose levels is important.

This study was performed to determine the effect of 4 and 8 weeks treatment with Fluoxetine and Imipramine on the fasting blood sugar (FBS) of patient with major depressive disorder.

Material and method:

This study was a parallel randomized clinical trial that was performed in 2006 on out - patients, of the psychiatric ward of Hashemi Senejani Hospital of Arak - Iran, for major depression treatment; there were 40 subjects in each group. These patients had their F.B.S. tested three times, before beginning and 4 and 8 weeks after treatment, respectively.

Results:

There were not significant statistical differences between first and second time mean F.B.S. values in group A, but we had a significant decrement in first and third times mean F.B.S. values (p < 0.05). There was also a significant increment in second and third times mean F.B.S. values versus first time mean F.B.S. values in group B (p > 0.05).

Conclusion:

In this study, we have found that there is a decrement in F.B.S. mean value after 8 weeks of treatment with Fluoxetine and increment in FBS after 4 and 8 weeks of treatment with Imipramine. Therefore, we recommended Fluoxetine for hyperglycemic depressive patients and Imipramine for hypoglycemic one.

Laparoscopic cholecystectomy using 2-mm instruments

Today, laparoscopic cholecystectomy is the method of choice for treatment of symptomatic gallbladder disorders. It minimizes effects of the operation that are independent of the gallbladder, such as trauma to the abdominal wall and other soft tissue. The surgical wounds were even smaller when 2-mm trocars were used. Laparoscopic cholecystectomy using 2-mm instruments was performed in a consecutive series of 14 patients with symptomatic gallstones. The procedure was completed in 12 cases, with conversion to open surgery in two cases. Intraoperative cholangiography was always performed. The postoperative course was always uneventful. The cosmetic effect was highly satisfactory. The procedure using 2-mm instruments could be indicated in selected patients with uncomplicated gallstone disease.