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Introduction: spp. is a growing global health concern due to increasing multiple drug resistance, commonly resulting in therapeutic failure. Integrons are gene expression systems run by integrase genes. The aims of this study were detection of class I, II and III integrons and assessment of antimicrobial resistance in spp. isolated from acute pediatric diarrhea patients.Materials and methods: From January to December 2015, were isolated from 310 non-duplicative diarrheal stool samples in Children’s Medical Center, Tehran, Iran. The isolates were analyzed for their antibiotic susceptibility using CLSI guidelines Multiplex PCR was used for amplification of I, II and III integron-associated integrase () genes.Results: Of 310 stool samples, 16 (5.2%) were positive for in 7 of them and in 9 of them were identified. Results of the antimicrobial susceptibility test showed that 6.2%, 50%, 31.2%, 6.2%, 81.2%, 56.2% and 31.2% of the isolates were resistant to gentamicin, chloramphenicol, nalidixic acid, ciprofloxacin, tetracycline, ampicillin and trimethoprim-sulfamethoxazole, respectively. Multiplex PCR results revealed that 6.2% (1/16), 31.2% (5/16), 50% (8/16) of isolates carried I, iII and both I/lI genes. No class were detected.Discussion: In this study, multidrug resistance was seen in isolates similar to that in isolates from other geographical areas. This is possible due to inappropriate use of antimicrobials. Furthermore, prevalence of multidrug resistance was significantly linked to the presence of integrin genes. Conclusion: A class 2 integron plays a role in presence of multidrug resistance in spp. It is vital to prevent the spread of antibiotic resistance through continuous monitoring.

Background To evaluate and compare the efficacy of urinary carbohydrate antigen 19-9 (CA19-9), neutrophil gelatinase-associated lipocalin (NGAL), and kidney injury molecule-1 (KIM-1) biomarkers as predictive factors to determine the surgery requirement in patients with ureteropelvic junction obstruction. Methods We obtained urine samples from 161 patients at diagnosis and evaluated their levels of the three biomarkers. The patients were under observation for 2 years; subsequently, they were divided into two groups based on their requirement of pyeloplasty. We determined the correlation between the urinary concentration of the biomarkers and surgical interventions, as well as the kidney function deterioration and sonography outcomes. Results The non-surgery group included 60 male and 22 female patients with mean age of 21 months. The surgery group comprised 58 boys and 21 girls with mean age of 26.9 months with no significant difference of age and gender between the two groups. The outcomes were indicative of higher efficacy of CA19-9 level with a sensitivity and specificity of 84.2% and 73.2% at the cutoff point of 59.09 U/ml. Also, a significant negative correlation was detected between the kidney function and the concentrations of CA19-9 and NGAL. Conclusions Our evaluations demonstrate the higher efficacy of CA19-9 to predict the requirement of surgical intervention in comparison with the other biomarkers, as well as a significant correlation between kidney function deterioration and urinary CA19-9 and NGAL. The outcomes of this investigation could pave the way for more extensive clinical application of these urinary biomarkers, besides future research determining the association between markers and kidney fibrosis., Author(s): Kiarad Fendereski [sup.1] , Amirreza Nabighadim [sup.1] , Maryam Seyedtabib [sup.2] , Seyedeh Sima Daryabari [sup.1] , Mohammad Taghi Haghi-Ashtiani [sup.3] , Abdol-Mohammad Kajbafzadeh [sup.1] Author Affiliations: (1) grid.411705.6, [...]

Background & Objective: Unnecessary pre-operative ordering of red blood cells (RBCs) in elective surgeries increases costs and waste of blood inventory. Maximum surgical blood order schedule (MSBOS) is a helpful strategy in the estimation of blood units needed for surgery and the prevention of overconsumption. In this study, an MSBOS for pediatric cardiac surgeries is designed. Methods: In this cross-sectional study, we included all pediatric patients who underwent elective cardiac surgery in Children's Medical Center in Tehran, Iran, from March 21, 2019, to September 22, 2019. Data consisted of the type of surgery and the number of blood units transfused and units cross-matched, based on which cross-match to transfusion ratio (CTR), the transfusion index (TI), and transfusion probability (T%) were calculated. Results: Overall 205 pediatric patients were included in the study. Four hundred and ten RBCs units were cross-matched, and 262 were transfused. The overall results of the CTR, T%, and TI for all the eight types of cardiac surgery were 1.56 (410/262), 76% (157/205), and 1.28 (262/205), respectively. The raw MSBOS for cardiac surgeries included ventricular septal defect, tetralogy of fallot, dextro-transposition of the great arteries, atrial septal defect, aortic coarctation, patent ductus arteriosus, pulmonary stenosis, and pacemaker insertion, which were 1.58, 1.03, 1.54, 1.66, 0.77, 0, 1.25, and 0 unit, respectively, and the figures were rounded up. Conclusion: Accurate MSBOS protocols reduce cross-match workload in laboratories, lead to the appropriate use of blood stocks with less wastage, save human and economic resources, and eventually, promote patient safety. [ABSTRACT FROM AUTHOR]

Background and Objectives: The human papillomavirus (HPV) is associated with more than 70% of the cervical neoplasm. The current study aims to evaluate the distribution of HPV genotypes in suspected women cytological specimens from Tehran, Iran. Materials and Methods: In the current cross-sectional study, HPV genotype prevalence was investigated in 433 subject women. DNA extraction was performed by High Pure Viral Nucleic Acid kit. A semi-automatically hybriSpot 24™ (HS24) setting was used for HPV typing and data interpreted by hybriSoft™ software according to instructions. Results: Pathologic data showed 181 (41.8%) had non-malignant lesions, 212 (49%) had inflammation and 40 (9.2%) reported LSIL in primary Pap-smear result. HPV was found in 143 (33%) specimens and the most comment high-risk and low-risk HPV types were HPV-16 and -6, respectively. Also, 62 (43%) were co-infected with multiple genotypes includes, 34 (24%) cases had co-infection with two HPV types, 17 (12%) cases had co-infection with three HPV types, 6 (4%) cases had co-infection with four HPV types and 5 (3%) cases had co-infection with five HPV types. There was statistically different domination on high-risk genotype in most of the co-infected samples (p<0.01). Conclusion: Current study indicates that the lesion pathology assessment was significantly associated with the HPV infection (p<0.01). Furthermore, the age group assessment shows that most of the HPV positive cases were 21 to 40 (p<0.01). The HPV infection prevalence in the current study was 33% and the most frequently reported high-risk and low-risk HPV types were 16 and 6, respectively. [ABSTRACT FROM AUTHOR]

Background: Head and neck masses are common in infants, children and adolescents. Etiologically, these masses are divided into three groups of inflammatory, congenital and neoplastic lesions. Their incidence rate has been variable in different parts of the world. This study aimed to determine the frequency of head and neck masses in Iranian children during a 21-year period. Methods: This retrospective, descriptive study was performed on medical files of patients between 2 to 12 years with pathological head and neck masses derived from the archives of the Pathology Department of Children's Medical Center of Tehran from 1995 to 2016. Age, gender, time of presentation, location of the lesions and final diagnosis were collected from patients' medical records and descriptively analyzed. Results: Of 594 children, 63.3% were males and 36.7% were females (male to female ratio of 1.7:1, P < 0.001). The mean age was 6.5 years (range 2 years and 2 months to 12 years). The highest prevalence belonged to inflammatory/reactive/infectious lesions (41.7%) followed by neoplastic lesions (35.7%) and congenital/developmental lesions (22.6%). In the neoplastic group, malignant and benign lesions had 26.6% and 9.1% prevalence, respectively. Lymphoma (22.4%; 16.3% Hodgkin and 6.1% non-Hodgkin), lymphadenitis (16.2%) and thyroglossal cyst (11%) were the most prevalent lesions. Conclusions: Based on the results, inflammatory lesions had the highest incidence among the head and neck masses in children. Malignant lesions were not uncommon among Iranian children. [ABSTRACT FROM AUTHOR]