In recent years, in spite of medical advancement, tuberculosis (TB) remains a worldwide health problem. Although many laboratory methods have been developed to expedite the diagnosis of TB, delays in diagnosis remain a major problem in the clinical practice. Because of the slow growth rate of the causative agent Mycobacterium tuberculosis, isolation, identification, and drug susceptibility testing of this organism and other clinically important mycobacteria can take several weeks or longer. During the past several years, many methods have been developed for direct detection, species identification, and drug susceptibility testing of TB. A good understanding of the effectiveness and practical limitations of these methods is important to improve diagnosis. This review summarizes the currently-used advances in nonmolecular and molecular diagnostics.
Diagnosis* ; Mycobacterium tuberculosis ; Pathology, Molecular ; Tuberculosis ; Tuberculosis, Multidrug-Resistant ; Tuberculosis, Pulmonary*

PURPOSE: To compare the macular retinal thickness of moderately to severely amblyopic eyes with non-amblyopic eyes as controls. METHODS: This case control study was conducted on 56 children aged 4 to 10 years old (64.3% female subjects). Twenty-eight children had unilateral amblyopia (28 amblyopic eyes as cases and 28 normal fellow eyes as internal controls) and 28 children had normal visual acuity in both eyes and were considered as external controls (n = 56 eyes). Among our cases, 14 had strabismic amblyopia and 14 had anisometropic amblyopia. Macular retinal thickness was measured using optical coherence tomography at the center and in 1-, 3-, and 6-mm rings. RESULTS: Best-corrected visual acuity of the amblyopic eyes was less than that of the internal and external controls, and the best-corrected visual acuity of their fellow eyes was also less than that of the external controls. Thickness of the central macula and a 1-mm ring area in the amblyopic eyes was higher than that of both internal and external controls. Difference of central macular thickness ≥20 µm between two eyes of the amblyopic children was significantly more than non-amblyopic subjects. CONCLUSIONS: Based on the results of this study, the macular retinal thickness was significantly higher in moderate to severe amblyopic eyes compared to their fellow eyes and external controls. This might be due to macular developmental disorders in amblyopic eyes. Therefore, optical coherence tomography imaging is recommended if subtle macular abnormalities are suspected in moderate to severe amblyopic eyes.
Amblyopia* ; Case-Control Studies ; Child ; Female ; Humans ; Retinaldehyde ; Tomography, Optical Coherence ; Visual Acuity

BACKGROUND: In many developing countries, shigellosis is endemic and also occurs in epidemics and treatment of multidrug-resistant (MDR) isolates are important. The aims of this study were to determine the antimicrobial susceptibility, prevalence of class 1 and 2 integrons and the clonal relatedness of isolates. MATERIALS AND METHODS: Antimicrobial susceptibility tests were performed by disc diffusion method. Polymerase chain reaction (PCR)-sequencing technique was employed for detection and characterization of integrons. The genetic relatedness was evaluated by using enterobacterial repetitive intergenic consensus (ERIC) PCR. RESULTS: There was a high percentage of resistance to trimethoprim-sulfamethoxazole (TMP/SMX) (93.7%), ampicillin (AMP) (87.3%), streptomycin (STR) (84.5%) and tetracycline (TET) (78.9%). Multidrug resistant phenotype was seen in 95.1% of total isolates. Most common MDR profile was TMP/SMX/STR/AMP resistant pattern. Among the 142 Shigella spp. analyzed in this study, 28 isolates were positive for class 1 integron with two types of gene cassette arrays (dfrA17/aadA5 = 31.7% and dfrA7 = 3.8%). The class 2 integron was more frequently detected among the isolates (94.7%) with dfrA1/sat1/aadA1 (69.4%) and dfrA1/sat1 (30.6%) gene cassettes. ERIC-PCR results showed 6, 5, 4 and 3 main genotypes among S. flexneri, S. sonnei, S. boydii and S. dysenteriae isolates, respectively. CONCLUSIONS: Our findings revealed that multidrug resistant Shigella species with high prevalence of class 2 integron were very common in Iran. In addition, ERIC-PCR patterns showed limited variety of clones are responsible for shigellosis in the region of the study.
Ampicillin ; Clone Cells ; Consensus ; Developing Countries ; Diffusion ; Dysentery, Bacillary ; Genotype ; Integrons ; Iran* ; Methods ; Phenotype ; Polymerase Chain Reaction ; Prevalence ; Shigella* ; Streptomycin ; Tetracycline ; Trimethoprim, Sulfamethoxazole Drug Combination

BACKGROUND: In many developing countries, shigellosis is endemic and also occurs in epidemics and treatment of multidrug-resistant (MDR) isolates are important. The aims of this study were to determine the antimicrobial susceptibility, prevalence of class 1 and 2 integrons and the clonal relatedness of isolates. MATERIALS AND METHODS: Antimicrobial susceptibility tests were performed by disc diffusion method. Polymerase chain reaction (PCR)-sequencing technique was employed for detection and characterization of integrons. The genetic relatedness was evaluated by using enterobacterial repetitive intergenic consensus (ERIC) PCR. RESULTS: There was a high percentage of resistance to trimethoprim-sulfamethoxazole (TMP/SMX) (93.7%), ampicillin (AMP) (87.3%), streptomycin (STR) (84.5%) and tetracycline (TET) (78.9%). Multidrug resistant phenotype was seen in 95.1% of total isolates. Most common MDR profile was TMP/SMX/STR/AMP resistant pattern. Among the 142 Shigella spp. analyzed in this study, 28 isolates were positive for class 1 integron with two types of gene cassette arrays (dfrA17/aadA5 = 31.7% and dfrA7 = 3.8%). The class 2 integron was more frequently detected among the isolates (94.7%) with dfrA1/sat1/aadA1 (69.4%) and dfrA1/sat1 (30.6%) gene cassettes. ERIC-PCR results showed 6, 5, 4 and 3 main genotypes among S. flexneri, S. sonnei, S. boydii and S. dysenteriae isolates, respectively. CONCLUSIONS: Our findings revealed that multidrug resistant Shigella species with high prevalence of class 2 integron were very common in Iran. In addition, ERIC-PCR patterns showed limited variety of clones are responsible for shigellosis in the region of the study.
Ampicillin ; Clone Cells ; Consensus ; Developing Countries ; Diffusion ; Dysentery, Bacillary ; Genotype ; Integrons ; Iran* ; Methods ; Phenotype ; Polymerase Chain Reaction ; Prevalence ; Shigella* ; Streptomycin ; Tetracycline ; Trimethoprim, Sulfamethoxazole Drug Combination

BACKGROUND/AIMS: A recent study revealed increasing incidence and prevalence of inflammatory bowel disease (IBD) in Iran. The Iranian Registry of Crohn's and Colitis (IRCC) was designed recently to answer the needs. We reported the design, methods of data collection, and aims of IRCC in this paper. METHODS: IRCC is a multicenter prospective registry, which is established with collaboration of more than 100 gastroenterologists from different provinces of Iran. Minimum data set for IRCC was defined according to an international consensus on standard set of outcomes for IBD. A pilot feasibility study was performed on 553 IBD patients with a web-based questionnaire. The reliability of questionnaire evaluated by Cronbach's α. RESULTS: All sections of questionnaire had Cronbach's α of more than 0.6. In pilot study, 312 of participants (56.4%) were male and mean age was 38 years (standard deviation=12.8) and 378 patients (68.35%) had ulcerative colitis, 303 subjects (54,7%) had college education and 358 patients (64.74%) were of Fars ethnicity. We found that 68 (12.3%), 44 (7.9%), and 13 (2.3%) of participants were smokers, hookah and opium users, respectively. History of appendectomy was reported in 58 of patients (10.48%). The most common medication was 5-aminosalicylate (94.39%). CONCLUSIONS: To the best of our knowledge, IRCC is the first national IBD registry in the Middle East and could become a reliable infrastructure for national and international research on IBD. IRCC will improve the quality of care of IBD patients and provide national information for policy makers to better plan for controlling IBD in Iran.
Administrative Personnel ; Appendectomy ; Colitis ; Colitis, Ulcerative ; Consensus ; Cooperative Behavior ; Data Collection ; Dataset ; Education ; Feasibility Studies ; Humans ; Incidence ; Inflammatory Bowel Diseases ; Iran ; Male ; Mesalamine ; Middle East ; Opium ; Pilot Projects ; Prevalence ; Prospective Studies