The pattern of antimicrobial utilization in patients of pediatric wards in Hajar hospital, Shahrekord, Iran in 2009-2010

زمینه و هدف: در بسیاری از کشورها، آنتی بیوتیک ها در حدود 30 تا 50 از داروهای تجویزی در بین عوامل درمانی را شامل می شوند. در اغلب مطالعات نشان داده است 60-30 موارد تجویزی نادرست و یا نامناسب بوده است. هدف این مطالعه بررسی منطقی بودن الگوی مصرف آنتی بیوتیک ها در یک بخش کودکان می باشد. روش بررسی: این مطالعه توصیفی-تحلیــلی در طی یک مقطع زمانی یک ساله در سال 1389-1388 انجام شد. الگوی مصرف آنتی بیوتیک در 265 نفر از کودکانی که در طول یک سال در 7 روز اول هر ماه از طریق درمانگاه یا از طریق بخش اورژانس بیمارستان در بخش کودکان و نوزادان پذیرش شدند و ظرف مدت بستری در بیمارستان آنتی بیوتیک دریافت نمودند، بررسی شد. داده های مطالعه پس از جمع آوری با کمک نرم افزار SPSS و استفاده از آزمون های تی و کای اسکویر تجزیه و تحلیل شدند. یافته ها: در این مطالعه حدود 37 موارد مصرف آنتی بیوتیک ناصحیح بود که با توجه به رقم 20 مصرف ناصحیح آنتی بیوتیک در کشورهای صنعتی این رقم بسیار بالا و قابل توجه است. شایع ترین آنتی بیوتیک مصرف شده سفتریاکسون بود. تجویز آنتی بیوتیک با وجود ارسال کشت های مختلف از بیماران، 99 به صورت تجربی بود و به نظر می رسد ارسال کشت در انتخاب نوع آنتی بیوتیک تاثیری نداشته است. نتیجه گیری: الگوی مصرف آنتی بیوتیک در بررسی ما از الگوی استاندارد و پروتکل درمانی مورد تأئید پیروی نمی کند. از این رو لازم است تمهیدات لازم در مورد مصرف منطقی آنتی بیوتیک ها اندیشیده شود

Preferences of Iranian patients about style of labelling and calling of their physicians

Objective: To document the performance of patients regarding label styles of their doctors and modes of addressing them. Methods: In this descriptive survey, 400 patients, at two teaching hospitals - Hajar and Kashani - with a mean age of 40.5 +/- 19.5 years were enrolled. Their demographic data, disorder type and duration were recorded. Photos demonstrating different label and attire styles based on Iranian culture were shown to the patients and they were asked to mark their performances about the necessity of wearing name badge. They were also requested to nominate the way they preferred to be addressed by the doctors. Results: Of the participants, 180 (45%) were men; 307 (76.8%) were married; and the mean duration of hospitalisation was 2.5 +/- 2.1 days. Most of the patients, (n = 320; 80%) stated that the doctor should always wear a name badge; 301 (75.3%) preferred to call their physicians by title; and 227 (56.8%) preferred to be called by their surnames. Patients preferred to have female physicians wearing white coat, shirt and trousers as the preferred dress code. Conclusion: Patients in the study preferred to have the physicians professionally attired, with the only difference being the dark veil for female physicians. Name badge and white coat were also preferred by the patients

Changes of trend of antibiotic susceptibility in isolated bacteria from culture of ICU patients of Shahrekord Ayatollah Kashanani Hospital, I.R. Iran

زمینه و هدف: بخش های مراقبت های ویژه (ICU) به طور روزافزونی با افزایش باکتری های مقاوم به آنتی بیوتیک ها مواجه هستند که می تواند باعث مرگ بیماران شود. این مطالعه با هدف تعیین الگوی مقاومت میکروارگانیسم های عامل عفونت های بیمارستانی بخش ICU به آنتی بیوتیک های رایج و مقایسه این الگو با فاصله زمانی 12 ماهه بعد است. روش بررسی: در این مطالعه توصیفی -تحلیلی در طی دو دوره (نیمه اول 1386 و نیمه دوم 1387)، 322 کشت (شامل نمونه های ادرار، ترشحات تراشه، Chest tube، زخم پوستی، خون و مایع مفصلی) از 205 بیمار بخش ICUبیمارستان آیت اله کاشانی شهرکرد بررسی شد. بیمارانی که علائم حاد التهابی را داشتند وارد مطالعه و بقیه حذف شدند. باکتری های جدا شده با دیسک های سفتریاکسون، سفتی زوکسیم، سفتازیدیم، سپیروفلوکساسین، کاربنی سیلین، نورفلوکساسین، جنتامایسین، آمیکاسین و کوتریموکسازول تحت آنتی بیوگرام به روش Disk diffusion method قرار گرفتند. یافته ها: بیشترین کشت از، ترشحات تراشه (6/58) و کمترین آن مایع مفصلی (3/0) بود. در کل 5/24 از کشت ها مثبت شدند که 2/58 از ترشحات تراشه و 3/0 از مایع مفصلی بود. کلبسیلا و پسودوموناس شایع ترین باکتری های جدا شده طی یک دوره دوازده ماهه بودند. مقاومت به سفتی زوکسیم، سپیروفلوکساسین و کاربنی سیلین به ترتیب از 5/62، 19 و 100 به 88، 55 و 71 تغییر یافت (05/0

Phytotherapy with hordeum vulgare: A randomized controlled trial on infants with jaundice

Jaundice is one of the most common causes of admission to hospital in newborns which is often associated with several complications. Aim: The present study was conducted to evaluate the effect of H. vulgare in reducing jaundice. Materials and Methods: In this double-blind, randomized controlled trials 70 term infants hospitalized due to jaundice in 2014 were enrolled. Control group was treated with full-time phototherapy alone using LED except when the infants were breastfed and case group with phototherapy, as per the protocol in the control group, along with and topical H. vulgare seed flour three times a day. Data were analysed using and analysis of covariance (ANCOVA) and paired t-test in SPSS version 16.0. Results: There was a significant difference in mean indirect bilirubin level between the two groups p0.05. Conclusion: H. vulgare flour can cause decrease in indirect bilirubin. Because the rate of decrease in indirect bilirubin can be effective in preventing severe complications due to bilirubinemia, H. vulgare can be used as a complementary therapy to treat jaundic

Prevalence and molecular characterization of rotaviruses as causes of nosocomial diarrhea in children

Rotaviruses have been confirmed as causative agents of nosocomial gastroenteritis in children, but limited data exist concerning the epidemiology of nosocomial rotavirus gastroenteroentritis in Iran. The aim of this study was to determine the prevalence and molecular characteristics of rotavirus in children less than five years old with nosocomial diarrhea in Shahrekord (southwest of Iran). This cross-sectional study was conducted between December 2010 and October 2011. The study population consisted of children aged 6 to 60 months who were hospitalized in the pediatric ward of Hajar Hospital in Shahrekord, Iran, due to diseases other than diarrhea. Nosocomial diarrhea was defined as that occurring more than 48 hours after admission to the hospital for non-diarrheal causes. Rotavirus and G genotypes were determined by seminested reverse transcriptase polymerase chain reaction in 100 stool samples. In these 100 samples, the prevalence of rotavirus infection was 30%; the most common genotyes were G1 (20%) and G9 (20%). According to the findings of the study, genotyping of rotavirus is necessary to monitor changes in strain prevalence. Identifying strains over time could affect future vaccine strategies and detect any regional differences of genotype prevalence

Prevalence of Nosocomial Diarrhea Due to Adenoviruses 40 and 41 in a Paediatric Ward in Iran.

BACKGROUND Enteric adenoviruses 40 (Ad40) and adenovirus 41 (Ad41) have been shown to be a significant cause of paediatric gastroenteritis worldwide, but no data are available for nosocomial diarrhea due to adenovirus in Iran. AIM The present study was performed to determine the incidence of Ad40 and Ad41 in children less than five years with nosocomial diarrhea in Shahrekord, southwest Iran. MATERIALS AND METHODS Adenovirus was detected by polymerase chain reaction (PCR) in stool samples collected during one year (2010-2011) from children less than five years with nosocomial diarrhea admitted to a paediatric center in Shahrekord, Iran. Nosocomial diarrhea was defined as those occurring more than 72 hours after admission to hospital for non-diarrheal causes. PCR technique was used for investigation of Ad40 and Ad41. RESULTS In total of 100 samples, Ad40 and Ad41 DNA was found to be positive in 14/100 (14%), and 8/100 (8%) of diarrheic patients less than five years, respectively. CONCLUSION Ad40 and Ad41 are important causes of nosocomial diarrhea in less than five-year, hospitalized Iranian children

Study of changes in rs2283265 polymorphisms in dopamine receptor D2 and rs27072 in dopamine transporter gene (SLC6A3) in patients with attention-deficit hyperactivity disorder

ObjectivesAttention-deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in children that lead to numerous complications. This study examined the changes in rs2283265 polymorphisms in the dopamine receptor D2 (DRD2) and rs27072 in the dopamine transporter gene (SLC6A3) in ADHD patients.Materials & MethodsThis descriptive-analytical study was performed on children aged 4-12 years with ADHD. In this study, 100 patients in the ADHD group (according to DSM-IV-TR criteria and diagnosed by interview by a child and adolescent psychiatrist) and 100 children in the control group (including patients referring to the pediatrician without hyperactivity) were enrolled.Two polymorphisms rs2283265 and rs27072 in two groups were comparatively investigated using PCR-RFLP method and restriction enzymes. Data were analyzed using SPSS 17. ResultsThere was a significant correlation between gender and ADHD, and the disease was more common in boys (P=0.021). In this study, there was no significant relationship between ADHD types and frequency distribution of rs2283265 (DRD2) and rs27072 (SLC6A3) polymorphism genotypes (P<0.05). However, there was a significant correlation between distribution of rs2283265 (DRD2) and rs27072 (SLC6A3) polymorphisms and ADHD (P<0.05). ConclusionIt seems that the changes in DRD2 and SLC6A3 genes are associated with ADHD, and study of these genes can be helpful in diagnosis and genetic screening

Protective effects of hydroalcoholic extract of Ferulago angulata against gentamicin-induced nephrotoxicity in rats

Gentamicin can lead to acute tubular injury and kidney dysfunction. This study aimed to evaluate the effect of Ferulago angulata on kidney function and other markers in rats with gentamicin-induced nephrotoxicity. Materials and Methods. Forty-eight male Wistar rats were divided into the following groups: group 1, the controls; group 2, rats receiving gentamicin (120 mg/kg body weight per day, intraperitoneal) for 7 days without treatment; groups 3, 4 and 5, rats receiving gentamicin for 7 days and oral treatment with 200 mg/kg, 400 mg/kg, and 800 mg/kg body weight per day of Ferulago angulate extract, respectively. Measurements included serum levels of creatinine, urea, uric acid, lipids, ferric-reducing antioxidant power, and protein carbonyl; kidney and serum levels of malondialdehyde; and serum and renal levels of tumor necrosis factor-α. Histopathology of kidney tissue was examined as well as renal catalase, superoxide dismutase, and vitamin C. Results. Compared to treatment with gentamicin only, treatment with Ferulago angulata resulted in a significantly higher high-density lipoprotein cholesterol, ferric-reducing antioxidant plasma, renal catalase, superoxide dismutase, and vitamin C levels. It was also associated with significantly lower serum levels of creatinine, urea, uric acid, malondialdehyde, protein carbonyl, tumor necrosis factor-α, total cholesterol, triglyceride, low-density lipoprotein cholesterol, and very low-density lipoprotein cholesterol. Ferulago angulate was linked with a lower renal gene expression of tumor necrosis factor-α. Conclusions. The present study suggests that Ferulago angulate extract has protective effects against nephrotoxicity due to gentamicin