Background: The emergence of healthcare-associated infections (HAIs) or superinfections in COVID-19 patients has resulted in poor prognosis and increased mortality. Methods: In a cross-sectional study, 101 respiratory samples were collected from ICU-admitted COVID-19 patients. The HAI rate, demographics, and antibiotic resistance were assessed. Results: The HAI rate was 83.16% (76.62% bacterial and 6.54% fungal). The prevalence of 3 major HAI-causing organisms included Klebsiella pneumoniae (41.5%), Acinetobacter baumannii (20.8%), and Staphylococcus aureus (4.9%). Mortality and intubation ventilation proportions of 90% (p = 0.027) and 92.2% (p = 0.02) were significant among patients with superinfection, respectively. Multiple logistic regression analysis showed SpO₂ pressure (odds ratio 0.842; 95% CI 0.750–0.945; p = 0.004) as a predictive factor in the association between antibiotic usage and mortality. More than 50% of patients received carbapenems. The resistance rates to at least one antibiotic of third-generation cephalosporins, aminoglycosides, quinolones/fluoroquinolones, tetracyclines, and β-lactam inhibitors were 95.2%, 95.2%, 90%, 57.1%, and 100% among A. baumannii isolates and 71.4%, 55%, 69%, 61.9%, and 59.5% among K. pneumoniae isolates, respectively. A proportion of 60% was recorded for methicillin-resistant S. aureus isolates. Conclusion: As a result, antibiotic treatment should be administered following the microbial resistance profile. Contact isolation and infection control measures should be implemented as needed.

Abstract: Objective: This study was conducted with four objectives in mind, including: (1) characteristics of selfmedication; (2) storage of drugs at home; (3) factors associated with storage of drugs at home; and (4) comparison of the level and sources of knowledge between over-the-counter (OTC1) and prescription-only (POM2) medication consumers. Methods: A cross-sectional survey was conducted in 2007 using a semi-structured questionnaire on 300 clients of 21 drugstores (from a total of 214 drugstores in the city of Tabriz, Iran). Results: The highest demand for drugs was for analgesics (from OTC drugs) and antibiotics (from POM drugs). Of 325 requests for medications by 300 customers of drugstores in Tabriz, aged 15 years or higher, 50.8% (165 requests) were for OTC drugs and 49.2% (160 requests) were for POM drugs, twenty-five cases requested both OTC and POM medications. There were 246 customers (82%) who reported that they stored drugs at home. Physicians were reportedly the most common source of information about medications, while the highest-quality information was obtained from pharmacists. Conclusion: The frequency of home storing of medications was very high in this study. Customers, especially the lower education groups, had very little information about the side effects of drugs and differentiation of OTC and POM medications. Wayward use of antibiotics was very high among the drugstore clients. It seems that the information provided by the pharmacists can be one of the most effective ways for advancing the level of knowledge among the consumers of medications.

Neonatal diabetes mellitus with hyperglycemia during the first 6 months of life is a rare disorder that can occur in all races and societies. In this study, we introduced an Iranian (Persian) 65-day-old patient with neonatal diabetes mellitus with novel homozygous mutation in the pancreatic and duodenal homeobox 1, PDX1, gene, which is also known as IPF1 gene, located in exon 2. This case was a newborn boy born in Vali-Asr Hospital, Tehran; he was diagnosed as having hyperglycemia on 28th day. Genetic analysis detected a homozygous mutation on PDX1 gene on chromosome 13. It is a novel homozygous mutation in the PDX1 gene (NM_000209.3), p.Phe167Val. This mutation was confirmed by Sanger sequencing. There was no evidence of agenesis of the pancreas. We reported a case of neonatal diabetes mellitus due to novel homozygous mutation in the PDX1 gene without exocrine pancreas manifestations.

Spirometry is an important measurement in detecting and monitoring of chronic obstructive pulmonary disease. The validity of the multi-ethnic Global Lung Function Initiative 2012 (GLI-2012) spirometric norms have been debated in some countries. The aim of the present study was to evaluate the applicability of the GLI reference norms in the Iranian population. A cross-sectional study was performed on 622 healthy non-smoker population (204 males and 418 females, age range: 4 ± 82 years) between July 16 and August 27, 2019 in Iran. Z-scores for spirometric data [FEV₁ (forced expiratory volume in 1 s), FVC (forced vital capacity) FEV₁/FVC, and FEF_25–75% (forced expiratory flow averaged over the middle portion of FVC)] were calculated. According to the agreement approved, a mean Z-score outside the range of ± 0.5 was considered clinically significant. The mean (SD) Z-score values of FEV₁, FVC, FEV₁/FVC and FEF_25–75% were 0.44 (1.21), 0.49 (1.14), 0.11 (1.03), and − 1.13 (0.99) in males and 0.61 (1.14), 0.89 (1.26), 0.17 (0.88) and − 0.49 (0.96) in females, respectively. The Z-score of FEV₁/FVC was below the lower limit of normal (LLN) in 3.43% of men and 2.01% of women (in ≥ 21 years), while these values were significantly higher in people under 21 years old (46.2% in boys and 40.0% in girls). The GLI reference values are not perfect for the Iranian population, especially in children below 10 years old. The use of the GLI reference values was appropriate in population above 21 years; however, they would overestimate the prevalence of airway obstruction in individuals below 21 years.

Key words: Sleep apnea, obstructive; Housing; Nutrition surveys; Snoring; United States