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Byline: Mohammad. Barzegar, Amir Hossein. Rouhi, Mehdi. Farhoudi, Sara. Sardashti Although it is a sporadic disease, few studies have reported cases of Guillain Barre Syndrome (GBS) in families which postulate [...]

Aim: Documentation is a critical element in the function of the nursing team, and cannot be separated from high-quality, patient-centered care. The aim of this study was to compare the quality of nursing documentation in electronic and paper-based systems.Method: A retrospective descriptive study was designed to compare the quality of nursing documentation in electronic health records (EHR) versus paper-based documentation systems before and after the application of the electronic system.Results: Analysis of data found a significant difference in the quality of nursing documentation in the two hospitals both before and after the implementation of an EHR system (p < 0.001).Quality of nursing documentation in the electronic system was significantly better than that of paper-based documentation systems.Conclusion: Vocal-electronic systems help to improve quality of nursing documentation, suggesting this aspect may be essential to implementing a successful system in local settings. [ABSTRACT FROM AUTHOR]

Aims: High rates of negative microbiologic test results highlight the potential role of empiric antimicrobial agents in management of malignant otitis externa (MOE). This study investigates the clinical presentation, laboratory findings, and response to empiric treatment in a large group of patients admitted to a tertiary academic hospital in Tehran, Iran. Methods and Materials: We recruited 224 patients diagnosed with MOE in a prospective observation from 2009 through 2015. All patients received a 2-agent antibacterial regimen at baseline (phase I). Patients with no improvement within 10 days and/or nonresponders to a second course of antibacterials were switched to antifungals (phase II). Response to treatment was observed and documented in both groups. Results: All patients had physical symptoms for more than 12 weeks before admission. In total, 127 patients responded well to antibacterials. Eighty-seven out of 97 patients who were switched to antifungals had complete response to treatment; patients in the latter group had significantly higher A1C levels at baseline. Conclusion: Our findings provide evidence to develop clinical guidelines that accelerate diagnosis and treatment of MOE to improve patient outcomes. [ABSTRACT FROM AUTHOR]

The utilization of organic fertilizer is an effective method in production of medicinal plants because of its beneficial effects on soil structure, reduction of environmental problem and plant growth improvement. The experiment was conducted in a research field at the University of Zabol at the Zabol, Iran, to determine the effects of manure (without manure, 30 and 40 t ha-1) and light intensity (full sunlight, 80 % of sunlight, 60 % of sunlight, 40 % of sunlight and 20 % of sunlight) on peppermint yield and quality. The results showed that the treatments significantly affected all studied traits. The highest fresh and dry weight and leaf area obtained from 80 % of sunlight and 40 t ha-1 manure and the lowest amount of them obtained from 20 % of sunlight and 40 t ha-1 manure. The highest essential oil content was belong to 60 % of sunlight and 30 t ha- 1 manure and the lowest was belong to 20 % of sunlight and 40 t ha-1 manure. Among the essential oil compositions, the highest mentol content obtained from 20 % of sunlight and the highest content of menton obtained from 80 % of sunlight. It seems that rational application rate of manure (e.g. 30 t ha-1 manure) under suitable radiation conditions (60 % of sunlight) can maintain higher yield and essential oil content of peppermint. Therefore, the enough radiation with a rational manure application rate could be an important pathway toward sustainable production of peppermint. [ABSTRACT FROM AUTHOR]

Introduction: Evidences suggest that 9 to 20 percent of the patients with acute psychotic symptoms who attend emergency departments suffer from a general medical condition. This statistic highlights the significance of the complete medical workup before finalizing the diagnosis of non-organic psychiatric disorders. In this respect, a wide range of diagnoses should be taken into account, including physical traumas, the use of drugs and toxins, the failure of organs, structural brain lesions, nutritional deficiencies, and infections. For the majority of these patients psychiatrists are the last resort in diagnosing who may have been missed by other medical doctors. Methods: In this study, a case of the acute onset of psychosis is studied in a 35 year old woman. The patient was married with 3 children and had been on a 10-day trip to the central parts of Iran (Kashan city) before the development of the symptoms. The patient had experienced a sudden onset of disorientation, amnesia, and visual and auditory hallucinations as well as persecutory delusions two days prior to the first visit by the neurologist. As she had a generalized headache with no fever or chills, she was referred to the outpatient clinic. After undergoing a careful examination, the patient was referred to the general emergency department to rule out organic etiologies. The initial brain CT scan showed no intracranial lesions. Neutrophilia was observed in the complete blood count, and other tests were normal. Lumbar puncture was tried by internists and despite the presence of no sign of meningeal irritation, it failed due to the patient's non-compliance and probability of the vertebral deformity. The injection of acyclovir was initiated due to the patient's fluctuating level of consciousness. After 10 hours with no changes to the clinical picture and two other failed LP trials, ceftriaxone and vancomycin were prescribed. A dramatic improvement was observed in 24 hours. In a week, the mental status examination was performed with no abnormal findings. The patient had reported no prior psychiatric symptoms before the present illness; she was only reported to have been in touch with an adult with chronic ear infections on her last trip to Kashan. Conclusion: The sudden onset of the psychotic disorder should always provoke the diagnosis of organic causes .Even in absence of typical symptoms and signs of infectious diseases, atypical representations and life-threatening causes of psychiatric representations must be taken into account. [ABSTRACT FROM AUTHOR]

New World Health Organization guidelines recommend the initiation of antiretroviral treatment (ART) for asymptomatic patients with CD4+ T-cell counts of ≤ 500 cells/mm(3). Substantial reduction of human immunodeficiency virus (HIV) transmission is addressed as a major public health outcome of this new approach. Middle East and North Africa (MENA), known as the area of controversies in terms of availability of comprehensive data, has shown concentrated epidemics among most of it's at risk population groups. Serious challenges impede the applicability of new guidelines in the MENA Region. Insufficient resources restrict ART coverage to less than 14%, while only one fourth of the countries had reportable data on patients' CD4 counts at the time of diagnosis. Clinical guidelines need to be significantly modified to reach practical utility, and surveillance systems have not yet been developed in many countries of MENA. Based on available evidence in several countries people who inject drugs and men who have sex with men are increasingly vulnerable to HIV and viral hepatitis, while their sexual partners - either female sex workers or women in monogamous relationships with high-risk men - are potential bridging populations that are not appropriately addressed by regional programs. Research to monitor the response to ART among the mentioned groups are seriously lacking, while drug resistant HIV strains and limited information on adherence patterns to treatment regimens require urgent recognition by health policymakers. Commitment to defined goals in the fight against HIV, development of innovative methods to improve registration and reporting systems, monitoring and evaluation of current programs followed by cost-effective modifications are proposed as effective steps to be acknowledged by National AIDS Programs of the countries of MENA Region.