We examined electrolyte imbalance and blood sugar levels in patients with COVID-19 who had no underlying disease. This cross-sectional study in a clinical center was performed in Kermanshah, west of Iran. All patients who had a record of magnesium (Mg 2+ ), potassium (K + ), sodium (Na+), and fasting blood sugar (FBS) tests in their clinical files at the time of admission to the hospital from April 21 to July 12, and didn't have a history of an underlying disease, were included in the study. Patients were divided into outpatient (as less severe COVID-19) and intensive care units (ICU) (as severe COVID-19). For statistical analysis of collected data, the SPSS software (version 16) was used. Among a total of 134 patients, 58 cases (24 ICU and 34 outpatients) were included in the study. The mean and median age was 56 and 62 years, respectively. From all included, 33 men (57%), 25 women (43%), 52 urban (89.7%), 6 rural (10.3%), 41 alive (70.7%), and 17 died (29.3%) were recorded. From all included patients, 49.1% hyperglycemia, 38% hyponatremia, 7.3% hypokalemia, and 32% hypomagnesemia were observed. Unlike the mean of age and the level of K+, there was a statistically significant difference between the outpatient and ICU groups in terms of Mg 2+ , Na + , and FBS (p < 0.05). Hyperglycemia and electrolyte imbalance in COVID-19 patients is feasible. Therefore, notice to measuring these cases and monitoring the patient can be effective in the treatment process and prevent the serious complications of the disease.

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Despite a Mycobacterium tuberculosis control programme and anti-tuberculosis drugs, drug-resistant tuberculosis (DR-TB) is one of the most serious public health issues worldwide. Rapid laboratory diagnosis of M. tuberculosis is needed for the diagnosis of multidrug-resistant (MDR) TB and to find the optimal treatment protocol. The purpose of this study was to detect resistance to rifampicin in new cases of TB using the GeneXpert MTB/RIF (M. tuberculosis/rifampicin) assay and the standard proportional method in west and northwest Iran. In this descriptive cross-sectional study, sputum samples were enrolled and screened for M. tuberculosis using Ziehl–Neelsen stain and mycobacterial culture. Samples from individuals with smear-positive TB were cultured on Lowenstein–Jensen medium; afterwards, the presence of resistance to rifampicin was examined by the GeneXpert MTB/RIF and standard proportional methods. A total of 400 new cases of suspected TB were collected, 162 (40.5%) of which were smear- and culture-positive for M. tuberculosis. The frequencies of rifampicin resistance in new smear-positive TB cases were 3.1% and 4.3% for GeneXpert and standard proportional method, respectively. Sensitivity and specificity of GeneXpert were 71% and 100%, respectively, compared with the proportional method. GeneXpert can be a quick and helpful method for the diagnosis of rifampicin-resistant TB in regions with high rates of DR-TB or MDR-TB. GeneXpert MTB-RIF assay must be used as an early diagnostic method whose results must be confirmed by the standard proportional method. The GeneXpert and proportional methods complement but do not replace each other.

Background: Urinary tract infection (UTI) is a very common medical complication of pregnancy. The aim of this study is to determine the incidence of UTI in preeclamptic pregnancies and its association with severity of this disease.Methods: This cohort study was performed on 71 women with mild preeclampsia (PE), 70 women with severe PE, and 98 healthy pregnant women from October 2012 to April 2014 in the west of Iran. Mean diastolic pressure and level of proteinuria were used as indicators of disease severity. The main criteria for diagnosis of UTI was microbial count of higher than 10 4 cfu/ml. Results:The prevalence of the UTI in severe PE patients was significantly higher than mild PE patients and non-hypertensive pregnants. 12 out of 70 women with severe PE (17.1%) and 7 out of 98 controls (7.1%) had UTI (P<0.05), also 8 out of 71 women with mild PE (11.3%) had UTI (P>0.05). Conclusions:Our data shows a significant increase in UTI in severe PE pregnancy. Thus, we can consider UTI as one of the risk factors for developing severe PE; so by screening UTI in the first visit of the pregnant women and repeating it at the second and third trimester of pregnancy we could decrease adverse effects of UTI such as severe PE in pregnant women.

BACKGROUNDNeonatal sepsis is a disease process, which represents the consequences of systemic response to bacteria entering the blood stream during the first 28 days of life. Platelet count (PLT) and indices, including mean platelet volume (MPV), platelet distribution width (PDW) and Platelet larger cell ratio (P-LCR) are considered as markers of production rate and platelet activation. They are readily available via blood tests. However, their prognostic value in neonatal sepsis has not been fully clarified and several studies reported contradictory results. This study evaluated the changes of platelet count and indices in neonatal sepsis. METHODSThis study was performed on 20 neonates with culture proven sepsis and 20 neonates with the similar age and weight but without any infectious disease served as the control group from February 2013 to June 2017 in the west of Iran. PLT, MPV, PDW, P-LCR and other infection markers (white blood cell count [WBC], erythrocyte sedimentation rate [ESR], and neutrophil percentage were also determined. This data was compared between patients and control group. RESULTSIn sepsis group, MPV, PDW and P-LCR were significantly increased (p= 0.024, p= 0.006 and p= 0.005 respectively), but WBC, Neutrophil percentage and PLT were not significantly different compared to controls. There was no significant difference in the platelet count and indices between Gram-negative and Gram-positive sepsis. CONCLUSIONSDiagnostic value of platelet indices is higher than that of WBC and neutrophil percentage. Therefore, platelet indices as inexpensive and easily available tests can be routinely performed for all neonates suspected to be in sepsis.

A 46-year-old male patient referred to Department of Oral Medicine, with the primary chief complaint of a painless swelling in the right side of mandibular. A panoramic radiograph revealed a well-defined, multilocular radiolucent bony lesion with thin and straight septa in the right side of mandible extending from distal of canine to mesial of third molar. Histological examination showed a solid proliferation of atypical plasmacytoid cells, which was indicative of plasmacytoma. A systemic workup for the final diagnosis was performed to rule out multiple myeloma.

Background: Hospital patients who are nasal carriers of methicillin-resistant Staphylococcus aureus (MRSA) are a high-risk potential threat to themselves and other hospitalized patients. The high antibiotic resistance of these isolates renders the treatment of related infections difficult.Objectives: The present study, for the first time investigated the prevalence of MRSA isolates in nasal carriers in Imam Reza Hospital in the western province of Iran.Materials and Methods: Nasal samples from 1269 hospitalized patients were tested for S. aureus. The sensitivity of these isolates to various antibiotics was evaluated by the disk diffusion method and E-test oxacillin strips. After determining the MIC and inducible clindamycin resistance, the mecA gene was investigated by PCR.Results: 17.57% (223) of patients were HA-SA nasal carriers, with 82 isolates (36.8%) being resistant to methicillin (MRSA). The infant ward had the highest rate of carriage (80%). The difference in the sensitivity of MRSA and MSSA isolates to several antibiotics was significant (P< 0.05); furthermore, 80.5% of MRSA isolates and 2.8% of MSSA isolates were multi-drug resistant (MDR). A lower resistance was observed against clindamycin (58.5%), rifampicin (19.5%), and chloramphenicol (7.3%).Conclusions: The high prevalence and antibiotic resistance of HA-MRSA isolates in western Iran indicates the necessity of continuous monitoring of hospital patients in the country for the presence of MRSA, particularly in infant wards

Background: Human Papillomavirus (HPV) plays a necessary etiological role in cervical cancer, it is logical to use HPV as a marker for the early detection of cervical cancer and precancerous. Prevalence of HPV infection and HPV genotypes vary among different regions. Objectives:The aim of the present study was to investigate the frequency of HPV and its genotype distribution in cervical specimens of the patients who had attended to the pathology laboratories of Kermanshah, Iran. Methods: Cervical swaps, genital, and skin biopsy were obtained from each participant. DNA of HPV specimens were extracted using a genomics extraction kit. PCR amplification and genotyping were employed to investigate the presence of High-risk (HR) and Low-risk (LR) genotypes and also the types of HPV. Results: Human Papillomavirus was found in 62.1% of the samples obtained from the patients. Among the HR and LR types, HPV-6 was the major genotype 64.8%. Type 16 and 18 were the most frequent HR-HPV types (presented in 26% of the patient), followed by type 50s (24.7%), 45, 30s, and 11 (1.8% from each). Multiple HPV infections were presented in 40.7% of the positive genotyping specimens. Conclusions:In comparison with previous surveys done in other parts of Iran, we noticed higher frequency of HPV among the collected isolates and also the higher prevalence of HPV types 6, 16, 18, and 50s in this region of Iran. It seems that HPV vaccination as well as an organized prevention program can be safe and efficient to reduce HPV types.