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Aspiration pneumonia is a critical disease and can result from a various causes. Epiphrenic diverticula is a rare disorder, which can cause aspiration of food material contained in it. Mediastinal tuberculosis can also cause traction diverticula at mid-esophagus, which usually are asymptomatic and induce no complication. In this article we describe a case, suffering of all these three disorders and after seven years of surgery and medical treatment any symptom was not found in the patient.

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Background and Objective: Mycoplasma pneumoniae bacteria, is one of the most important factor in causing of respiratory infections. Serological and molecular detection methods have their own limitation. Due to this limitation, the application of these methods in all diagnostic laboratories is not possible. Therefore this study was done to determine the rapid detection of Mycoplasma pneumonia by loop mediated isothermal amplification (LAMP). Methods: In this descriptive laboratory study, nasopharynx samples were collected from 92 patients with atypical pneumonia. DNA sample were extracted by boiling method. Six specific primer pairs were designed for LAMP technique by primer explorer ver 4 software. LAMP product identified by adding SYBR Green. Limit of detection and specificity tests have been done for optimizing LAMP test and optimized test carry out for each sample. Results: The LAMP test was optimized using the large Bst enzyme fragment at 66 degree temperature for 1 hour. The detection limit of the test obtained 1 CFU and the DNA replication does not observed in non of the examined pathogenic factors. Out of 92 clinical samples using LAMP technique, 73 cases were negative (80%) and 19 cases were positive (20%). Conclusion: The loop-mediated isothermal amplification technique is simple, convenient and available method for detection of Mycoplasma pneumoniae.

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Background and Objective: Extended-Spectrum Beta Lactamase enzymes (ESBLs) are the most important factor for antimicrobial resistance in Enterobacteriaceae The resistance to beta-lactam antibiotics is the main problem in the bacterial infections therapy. This study was done to determine the prevalence of Extended-Spectrum Beta Lactamase enzymes in clinical isolates of Enterobacteriaceae family.

Methods: In this descriptive study, 240 isolates of Enterobacteriaceae family were collected from clinical specimens obtained in Shohada, Rahimi and Madani hospitals in Khorramabad city, Iran. Antibiotic susceptibility of isolates was performed by disk diffusion method. ESBLs production in all isolates was determined using the combination disk method.

Results: Bacteria strains isolated in this study were Escherichia coli (76%), Klebsiella pneumonia (16.2%), Citrobacter (5.4%), Enterobacter spp. (0.83%) and Proteus (1.6%). The results of antimicrobial susceptibility of isolates showed that the highest rate of antibiotic resistance was toward Ampicillin (88%) and Cefotaxime (43%) and the lowest rate was observed to Amikacin (2.5%). According to the results of the phenotypic tests, 141(59%) isolates out of 240 Enterobacteriaceae were beta-lactamase producers.

Conclusion: ESBL producer isolates and antibiotic resistant due to of Enterobacteriaceae isolated from clinical samples from hospitals are high prevalence in Khorramabad city, Iran.

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Background and Objective: Hemoptysis is defined as the expectoration of blood from the lower respiratory tract. Bronchiolitis, bronchogenic carcinoma, and bronchiectasis are the most common causes of hemoptysis in developed countries, while infections caused by Mycobacterium tuberculosis are the most common cause in endemic countries. This study was conducted to determine the frequency of causes of hemoptysis and some related factors.
Methods: This descriptive-analytical study was done on 68 patients (37 men and 31 women, average age 56.85±17.27 years) who were referred to the Shahid Sayyad Shirazi Hospital in Gorgan, north of Iran during 2014-16 with the complaint of hemoptysis. Demographic information, cause of hemoptysis and history of illness or drug abuse were extracted from the patients’ records.
Results: Based on the results, 42.6%, 45.6%, and 17.6% of the patients had a history of smoking, drug abuse, and diabetes, respectively. The most frequent causes of hemoptysis were bronchiectasis (25%), pneumonia (20.6%), tuberculosis, and lung cancer (16.4%). Gender was determined as an independent risk factor for hemoptysis (P<0.05). The most common causes of hemoptysis were bronchiectasis, lung cancer and pneumonia in men, and tuberculosis and bronchiectasis in women. Age, drug abuse, smoking, and diabetes had no significant association with the occurrence of hemoptysis.
Conclusion: Bronchiectasis, tuberculosis, and lung cancer are the main causes of hemoptysis, and gender is an independent risk factor for hemoptysis in the study area.
 

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Background and Objective: Ventilator-associated pneumonia (VAP) is an important complication in intensive care unit (ICU) patients with endotracheal intubation. Finding potential early indicators of this condition can aid in reducing the disease burden. We aimed to investigate the relationship between VAP occurrence and serum levels of C-reactive protein (CRP), procalcitonin (PCT), and hemoglobin (Hgb) during ICU hospitalization of brain trauma patients.
Method: This descriptive-analytical study was carried out on brain trauma patients (99 male, 39 female), referring to the 5th Azar hospital in Gorgan, Iran, in the course of 2017. The patients were hospitalized in ICU with endotracheal intubation and mechanical ventilation. The diagnosis of VAP was confirmed by a 12-score rating based on chest radiographs, body temperature, white blood cell count, and sputum culture. After admission, serum CRP, PCT, and Hgb were documented daily for 6 days.
Results: According to the diagnostic criteria, VAP was confirmed in 41 patients (30%). Serum CRP and PCT levels on the 6th-day post-admission were significantly associated with VAP diagnosis, while Hgb levels did not differ significantly between VAP and non-VAP patients. Serum levels of CRP, PCT, and Hgb on the 6th day were not associated with age or sex.
Conclusion: Our results indicate that serum CRP and PCT levels are associated with the occurrence of VAP in ICU patients receiving mechanical ventilation. Therefore, these biomarkers could be utilized to warn physicians about the possibility of VAP, thereby reducing mortality rate and hospitalization length.