Evaluation of prophylactic Effect of Remifentanil on Succinylcholine-Induced Myalgia in Humans

Purpose: To assess the efficacy of remifentanil in preventing succinylcholine-induced myalgia in humans.Methods: Sixty healthy adults scheduled for elective surgery under general anesthesia were enrolled in a double-blind study and randomly allocated to two groups of thirty patients. Patients in Group I (remifentanil group) were pretreated with remifentanil 1 ìg/kg one minute prior to induction of anesthesia, while patients in Group II (saline group) received an equivalent volume of saline. Anesthesia was induced in both groups with fentanyl 1 µg/kg, propofol 2.0 mg/kg and succinylcholine 1.5 mg/kg. Postoperative myalgia was assessed 12, 24, and 48 h after induction and graded as nil, mild, moderate, or severe.Results: Fifty nine patients completed the study. The demographic data for both groups were comparable (p > 0.05). Postoperative myalgia at 12, 24, and 48 h after induction were 34.5, 34.5 and 14.1 % in group I, and 60, 53.4 and 30 % in group II, respectively (p > 0.05).Conclusion: Prophylactic use of remifentanil 1 µg/kg intravenously is ineffective in the prevention of postoperative myalgiaKeywords: Remifentanil, Succinylcholine, Myalgia, Propofol, Prophylaxi

Oral Candidiasis amongst cancer patients at Qods Hospital

Background: Within the past two decades, Candida species have emerged as major human pathogens and are currently the fourth most common cause of nosocomial infection. Propose of this study was to determine the occurrence of oral Candidiasis among cancer patients at Qods hospitals in Sanandaj.Materials and Methods: Sixty cancer patients were examined for oral candidiasis. For all patients, the clinical diagnosis had to be confirmed microbiologically by the presence of yeasts and / or hyphae or pseudohyphae on potassium hydroxide–treated smears of oral swabs. Oral samples were obtained and cultured on Sabouraud's dextrose agar and CHROMagar.Results: 25 out of the 60 patients (41.7%) were males and 35 (58.3%) were females ranging in age from 15 to 79 years. Gastrointestinal cancer and Breast cancer were the most frequent cancer in the studied group, accounting for 65 % and 18.4 % respectively. The mean weight of the patients was 52.67 Kg (range, 38– 80 Kg). Similarly, the mean of hospital stay was 3.58 days (range; 1-9 days). From these patients, 19 Candida spp were isolated; C. albicans alone outnumbered other species and accounted for 73.68% episodes of trash. For C. albicans isolates, the MIC values ranges from 1 to 9 Z g / ml μg / ml for polyenes and from 0.03 to 16 Z g / ml for the azole antifungals. All the Candida albicans had closely related MFCs values.Conclusion: In conclusions, the finding of our study strongly suggest that oral candidiasis is a frequent complication among cancer patients, being C. albicans the main etiological agent.Keywords: Cancer, Oral candidiasis, Candida albicans, Antifungal agentsdoi: 10.4314/ajcem.v12i3.

Risk factors for acquisition of ventilator-associated pneumonia in adult intensive care units

Objective: Ventilator Associated Pneumonia (VAP) has an imperative place amongst nosocomial infections leading to increase morbidity and mortality rates. The present study aimed to determine risk factors for acquisition of ventilator-associated pneumonia in an intensive care unit (ICU). Methods: A nested case-control study was carried out from September 2007 to June 2008. All 183 patients hospitalized at the adult ICU ward in Be'sat Hospital, Sanandaj city western Iran over a 48 hour period were included. Bacteriologic diagnosis and antibiotic susceptibility patterns were performed based on Edward & Ewing's methods and CLSI system guidelines. Results: Of the 149 samples which were taken from endotracheal tubes of 183 patients, 48 cases were diagnosed for VAP with an incidence rate of 26.2. Mean duration of hospitalization was 23.4 +/- 10.2 days. The maximum and minimum antibiotic resistance for the gram negative bacteria was 93.3 for Cefalotin and 50 for Amikacin. The main risk factors for acquisition of ventilator-associated pneumonia were mechanical ventilation (Adjusted OR: 1.55, 95 CI: 1.37-1.74), history of antibiotic consumption (AOR: 8.92, CI: 1.16-66.66) and fever (AOR: 3.11, CI: 1.22-7.93). Conclusions: VAP is significantly related to ICU hospitalization, mechanical ventilation and history of antibiotics consumption. Cefalotin and Amikacin showed the highest and lowest antibiotic resistance against gram negative bacteria respectively

Epidemiology of metabolic syndrome among women of reproductive age in Abhar City in Western Iran

Objective: Metabolic syndrome is a set of metabolic disorders highly related with cardiovascular diseases and has high expansion among population. The present study aimed to assess the prevalence and characteristics of the metabolic syndrome amongst women of reproductive age. Methodology: A cross sectional study was conducted using a systematic randomized sampling method. Overall, 406 women of reproductive age living in Abhar city western Iran was recruited. Data was analyzed using T-test, Fisher exact test and chi-square. Results: The prevalence rate of metabolic syndrome was 28.1. This figure increased as the mean age and body mass index (BMI) of women increased. The common metabolic disorder was HDL < 50 (98.2). Majority of cases with metabolic syndrome were either overweight or obese (53.5). The most expansion of metabolic syndrome was observed in the age range of between 45 to 49 years (70.6). There was a significance relationship between having metabolic syndrome and patients' level of education and profession (p<0.01). Conclusions: Obesity and old reproductive age are the main risk factors associated with metabolic syndrome. Increased prevalence of metabolic syndrome in this part of the world is going to be a major public heath concern which indicates the necessity of applications for preventive programs based on national and international guidelines

Landmine victims in Iran Kurdistan; demographic features and accident characteristics

Objective: Iranian civilians living in border areas are still victims of un-neutralized war mines from the eight years war between Iraq and Iran. This cross-sectional study was aimed to determine demographic characteristics and features associated with the land mine injuries using data from a representative group of victims. Methodology: Overall, 300 civilian mine victims in Kurdistan Province western Iran between 1991 to 2005 were randomly recruited. The documentary data for those who lost their lives was gathered from the archives of local police, Red Crescent and War-disabled (Janbazan) Organization. Other survived mine-injured victims were interviewed for data collection using a validated check list. SPSS was used for all analyses. Results: Overall, 17.7 of victims (n=53) were killed immediately after explosion and 82.3 (n=247) were injured. Of those who survived, 40 (n=99) had an amputation surgery of lower limb in particular. Majority of victims were either farmers or shepherd. Amongst risk factors investigated, victims' job and age were significantly correlated with mine accidents in Kurdistan province after adjusting for other factors including gender, education level and socioeconomic status (Adjusted OR=2.1, 95 CI, 1.1-3.2, p < 0.01 and AOR=1.7, 95 CI, 1.1-2.5, p=0.04 respectively). Conclusions: Young civilians living in border areas between Iran and Iraq with certain jobs are still affected by un-neutralized war mines despite the valuable mine clearance activities in the area. Concerted efforts are required to avoid and minimize the adverse effects of mine explosions in border areas in west of the country and in Kurdistan in particular

Socioeconomic, psychiatric and materiality determinants and risk of postpartum depression in border city of Ilam, western Iran

Background. Postpartum depression (PPD) is considered as one of the mood disturbances occurring during 2-3 months after delivery. The present study aimed to determine the prevalence of PPD and its associated risk factors in border city of Ilam, western Iran. Methods. Through a descriptive cross-sectional study in 2011, overall, 197 women who attended Obstetrics & Gynecology clinics postpartumly in the border city of Ilam, western Iran, were randomly recruited. A standard questionnaire that was completed by a trained midwife through face to face interviews was used for data gathering. Results. Mean age ± standard deviations was 27.9 ± 5.2 years. Prevalence of PPD was estimated to be 34.8 (95 CI: 27.7-41.7). A significant difference was observed among depression scores before and after delivery (P ≤ 0.001). Type of delivery (P = 0.044), low socioeconomic status (P = 0.011), and women having low educational level (P = 0.009) were the most important significant risk factors associated with PPD. The regression analysis showed that employed mothers compared to housekeepers were more at risk for PPD (adjusted OR = 2.01, 95 CI: 1.22-2.28, P = 0.003). Conclusions. Prevalence of PPD in western Iran was slightly higher than the corresponding rate from either national or international reports. © 2013 Pegah Taherifard et al

Neonatal blood stream infections in tertiary referral hospitals in Kurdistan, Iran

Background: Bloodstream infection (BSI) is one of the most common causes of nosocomial infection in neonatal intensive care units (NICU). The aim of the present study was to determine bacterial agents and their susceptibility patterns to antibiotics and to investigate the risk factors associated with BSI. Methods: This was a nested case-control study carried out from September 2009 to June 2010 in the NICU wards in Sanandaj hospitals western Iran. Cases were patients with BSI and controls were other patients who had negative blood culture. Bacteriologic diagnosis and antibiotic susceptibility pattern was performed based on the Edward & Ewings and the National Committee of Clinical Laboratory (NCCL) Standards. Results: Of 472 patients who hospitalized in NICU, 6.4 had BSI (n = 30) including 17girls (56.7) and 13 boys (43.3). Enterobacter SPP was the predominant isolated bacteria from blood culture (36.7). The maximum antibiotic resistance and sensitivity were observed by Tetracycline and Ciprofloxacin respectively. Risk factors associated with BSI were age = 7 days (p = 0.001), previous antibiotic consumption (p = 0.013), and low birth weight (LBW), (p = 0.001). Conclusions: Gram negative bacteria and Entrobacter in particular are the most common pathogens. Improving prenatal health care, standards of infection control and choosing accurate antibiotics are recommended to avoid BSI in neonatal intensive care units

Workplace violence against physicians and medical students in west part of Iran

Purpose: The purpose of this paper is to survey the prevalence of exposure to workplace violence (WPV) including physical violence, verbal abuse, bullying as well as its related factors among physicians and medical students attending teaching hospitals of Kurdistan University of Medical Sciences (KUMS). Design/methodology/approach: This is a descriptive analytic as well as a cross-sectional study which was carried out on all physicians (general and specialists) and medical students attending teaching hospitals of KUMS in 2014. Overall, 400 participated in this study and data were gathered using a standard questionnaire. Then, data were analyzed using SPSS 20, � 2 and Fisher�s exact tests as well as univariate and adjusted logistic regression. Findings: The prevalence of physical violence, verbal abuse and bullying among medical students was reported 4.5, 59 and 0.8 percent, respectively. In addition, the prevalence of these violence among general practitioners was 6.9, 72.4 and 0 percent, respectively. Moreover, 11.5, 42.3 and 3.8 percent of specialists had experienced physical violence, verbal abuse and bullying, respectively. Patients and their relatives were the main sources of the violence. Based on the results of multivariate logistic regression, male sex (AOR=2.60, CI: 1.56�4.32) and having shift work (AOR=3.13, CI: 1.67�5.84) were the most significant risk factors for total WPV. Originality/value: The WPV experienced by physicians and medical students attending teaching hospitals of MUK is high. Health sector authorities should develop and implement proper strategies and interventions aiming at reducing or preventing from incidence of WPV. © 2018, Emerald Publishing Limited