Internal Medicine Today
Year:2014 | Volume:19 | Issue:5 (SUPPLEMENT)|Papers Count:11

Aims: Urinary tract infection is one of the most common bacterial infections and coagulase negative staphylococci are a common cause of this disease based on some reports. Due to increasing the resistance resulting from antibiotics consumption, this study was performed to determine the antibiotic resistance pattern of the coagulase negative staphylococci isolated from urinary tract infections in Gonabad, Iran. Methods: This cross-sectional study was performed on 264 coagulase negative staphylococci isolated from patients who were referred to Jahad Daneshgahi Laboratory due to urinary tract infection in Gonabad city. Identification of bacterial strain was performed by classical identification methods and antimicrobial susceptibility testing was carried out on Mueller-Hinton agar (merck-Germany) using disk diffusion (Kirby Bauer›s) technique.Results: Out of 264 isolates, the most frequent species of coagulase negative staphylococci (CNS) isolates were Staphylococci epidermidis (84%) followed by Staphylococcus saprophyticus (14%). Based on antibiotic resistance pattern, ››Penicillin›› (56.43%) showed the highest resistance followed by "erythromycin" (46.21%), and "nitrofurantion" (42.42%) in order. However, CNS showed the highest susceptibility to "ciprofloxacin" (82.57%), "vancomycin" (78.03%) and "Amikacin" (74.24%).Conclusion: The findings showed that the use of ciprofloxacin and vancomycin, as the first choice in empirical treatment of Urinary Tract Infection (UTI) in the region, should be reconsidered.

Aims: Cardaria draba plant is a perennial plant from Brassicaless ordert. Tincture and essence of Cardaria draba was used in traditional medicine to treat various diseases. While its antioxidant effect of Cardaria draba is indicated, its anti-bacterial effects haven’t been checked. In this study, we investigate the antibacterial effect of Cardaria draba essence against some bacterial food borne pathogens in vitro.Methods: This experimental study Having collected the leaves of this plant in spring, we extracted the essence. Also, there are different concentration rates for the essence (like 40, 20, 10, 5, 2.5, 1.25) which have been produced by microdilution Broth method in BHI medium and culturation in Mueller Hinton Agar medium. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) have been determined with two methods of visual monitoring and optical density (OD) for the bacteria Escherichia coli, Salmonella typhymurium, Staphylococcus aureus, Lysteria monocytojenese, and Bacillus cereus with the use of Elisa Reader. The results were statistically analyzed by ANOVA and post hoc Duncan tests.Results: The results showed that the essence of Cardaria draba with minimum inhibitory concentration of 2.5mg/ml was found effective on staphylococcus aureus and the minimum bactericidal concentration of 40 mg/ml was effective on this bacterium. With different essence concentrations of this plant, no effects of inhibitory or bactericidal on Escherichia coli, Salmonella typhymurium, Lysteria monocytojenese, and Bacillus cereus were found.Conclusion: Through the results of the study, we found that the essence of Cardaria draba has relatively weak inhibitory effect on Escherichia coli, Salmonella typhymurium, Staphylococcus aureus, Lysteria monocytojenese, and Bacillus cereus. We suggest that there is more room for investigation on the effective particles of the extracts of this plant.

Aims: Hypochondrias is a kind of psychiatric disorder that refers to a person who, despite having physical health, always complains of pain. The present study investigated the prevalence of Hypochondrias and its effective factors in population of 20-50 years old in Gonabad city.Methods: This study was performed on 400 persons randomly selected from population of 20-50 years old in Gonabad city. Persons with a known previous psychiatric or medical disorder or defectiveness were excluded from the study. All the samples filled the demographic questionnaire and Evans hypochondrias questionnaires including 36 items. Then, the data were analyzed using appropriate descriptive statistics and analytic tests such as independent t-test and ANOVA.Results: In the present study, the prevalence of hypochondrias among the populations of 20-50 years old was 39.2% at the borderline level and 28.8% at the disorder level. 28% of the cases with hypochondriac disorder showed mild symptoms while 8% had moderate symptoms. This disorder was significantly more prevalent in the age groups under 30 than that in other group (P=0.01). Hypochondriasis was significantly prevalent in people with divorce problems (P=0.05). However, there was no significant relationship between hypochondriasis and variables such as sex (P=0.77), education (P=0.11) and job (P=0.08).Conclusion: The present study demonstrated a higher prevalence of hypochondrias in population of 50-20 years old in Gonabad city compared to those on global statistics. Of course, it should be mentioned that a questionnaire was used for data collection. Therefore, it is recommended that, in future studies, its prevalence be investigated through diagnostic adaptation with mental examination.

Aims: Urinary incontinence is a common health problem in women and its most common type is urinary stress incontinence. The disease has a significant impact on various aspects of life and leads to reduced quality of life for women. One way of improving health level is focusing on life quality level in individuals. So, in this study, the impact of family-centered empowerment model on quality of life in women with stress urinary incontinence is discussed. Methods: This study is a clinical trial. After sampling through convenience method, the subjects (N=64) were divided into experimental and control groups, using blocked random method. For the experimental group, the interventions based on family-centered empowerment model which included four stages (perception of threat, efficacy promotion, self-esteem and evaluation) were performed using group discussion, representation, and training participation. Research instruments included questionnaires of demographic and disease basic information, assess quality of life in patients with urinary incontinence (IQOL), knowledge, self-esteem, and health behaviors. The questionnaires were completed before and after the intervention. The data were analyzed with SPSS version 20 using descriptive statistics and analytical tests.Results: The statistical tests showed that the two groups of experimental and control were matched in terms of demographics and severity of incontinence. Moreover, based on independent t-test, there was no significant difference between the mean score of quality of life, knowledge, self-esteem and health behaviors in the two groups before the intervention (P>0.05), while there was a significant difference between the two groups with respect to these variables after the intervention (P<0.001). Also, Chi-square test showed a significant difference in the occurrence of urinary incontinence before and after the intervention in the experimental group (P<0.001).Conclusion: Family-centered empowerment health model can be used by nurses for the management of behavioral techniques, as the first level of provided intervention to improve the stress urinary incontinence. Moreover, it can increase the life quality of women with stress urinary incontinence who are not hospitalized and reside in the community.

Aims: Alexithymia is a personality trait that demonstrates inability in emotional expression. This trait emerging from emotion disregulation has an effective role in etiology of psychosomatic illnesses. Psychosomatic patients, due to somatic illness and also difficulty in emotion regulation, experience anxiety and depression symptoms that exacerbate each other in a cycle with dermatologic illnesses.Methods: In this post-hoc, cross-sectional and correlational study, Toronto Alexithymia Scale-20 (TAS-20) and the Hospital Anxiety and Depression Scale (HADS) were administered to all 215 patients who were referred to psychodermatology clinic of Isfahan University of Medical Sciences from autumn 2010 to autumn 2012. The final sample consisted of 140 patients. To analyze the data, we used SPSS software V.18.Results: The results showed that the frequency of high alexithymia, anxiety and depression in psychodermatologic patients were 41.8%, 51.2% & 40%, respectively. Assessing the relationship between alexithymia and its subscales with anxiety and depression showed that there were significant positive correlations between alexithymia and difficulty in identifying and describing feelings with anxiety and depression (p<0.001). The results of regression analyses of alexithymia on anxiety and depression showed that difficulty in identifying and describing feelings predicts depression; and difficulty in identifying feelings predicts anxiety in patients. Conclusion: Alexithymia predicts anxiety and depression of psychodermatology patients and a complete treatment of these patients should be considered.

Aims: Medication errors as a global problem can lead to serious injury and even the patients’ death. The errors will have a negative impact on patients, medical personnel and organizations, resulting in decreased quality of care. This study aimed to determine the factors associated with drug error and barriers of their reporting. Methods: In this descriptive and analytic study, 150 medical staff with a minimum experience of 6 months in the hospitals affiliated to Gonabad University of Medical Sciences were selected by census sampling in 2011. The data were collected by a demographic form and medication error questionnaire which included occurrence and report of errors, related factors, and barriers in reporting them. Content validity and Cronbach›s alpha coefficients (a=0.81) were used for validity and reliability, respectively. The data were analyzed by SPSS software V.16 using descriptive and inferential statistical methods. Results: The mean age of participants and their work experience were 30.63 and 6.5 years, respectively. Majority of them were women (70%), married (82%) and nurses (78%) with a mean error reporting 1.15. Most factors associated with the occurrence of errors were the altered doctor›s orders, high workload, and lack of staff. Further, the barriers of reporting of errors included lack of clear guidelines for reporting errors, barriers of staff, and management barriers.Conclusion: According to the importance of patient safety, it is recommended that managers provide interventions to reduce errors in health care workers; and if errors occur, they should offer a recording system for reporting them without fearing of the consequences.

Aims: Various diseases in the elderly and consumption of items with more drug-related physiological changes of aging increase medical complications and the problems related to drug therapy in the elderly. The purpose of this study is to investigate the pattern of medicine consumption and its effective factors on the elders in Gonabad city. Methods: This cross-sectional study was conducted on 323 elderly people who were selected by multi stage sampling method in 2011. The data were collected through interview by visiting households with elderly using a questionnaire consisting of three parts: demographic characteristics, patterns of drug use, and factors influencing the pattern of drug use. The obtained data were analyzed employing descriptive statistics and analytical tests of Chi-square and ANOVA.Results: Among the samples, 72.1% was taking medication. The mean of taking drug was 4.06±0.3 during the day. The simultaneous use of four drugs was observed in the 56.6% of the samples. 53.3% of elderly were the irrational user of medicine. Most medications among the participants included cardiovascular drugs (67.8%). ASA, atenolol, and ranitidine were the drugs used most by the elderly. There was no significant relationship between the use of self-medication and age.Conclusion: Due to the risk of several diseases simultaneously on the part of the elderly, drug therapy and irrational use of medicine are often some of the main issues requiring serious attention in that period.

Aims: Marital adjustment represents the strenght and efficiency of the family system. The family health depends on the existence of healthy and mature communications of couples; and if the family foundation is not strong enough, its outcome will be some kind of physical and mental problems. This study objective is to determine the predictive role of spiritual intelligence and coping strategies in marital adjustment of teachers in Gonabad city in 2012-2013.Methods: In this correltional study, 330 teachers (160 males and 170 females) were selected using Morgan table through stratified sampling. They completed the spiritual intelligence, coping strategies, and marital adjustment questionnaires, and the collected data were analyzed through SPSS V.11.5 employing Pearson correlation coefficient and multiple regression.Results: The resluts indicated that there was a significant correlation between spiritual intelligence, and marital adjustment (r=0.656, P=0.001), but there was no significant relationship between coping strategies and marital adjustment (P=0.58) and also between coping strategies and spiritual intelligence (P=0.074). However, there was a negative and significant correlation between spiritual intelligence and emotion oreinted syle (r=0.39, P<0.001) from among 3 coping styles of problem oriented, emotion oriented and avoidant styles. According to the results of regression analysis, only spiritual intelligence predicts marital adjustment.Conclusion: According to the findings, it is recommended that expert staff provide the younger individuals with strategies which increase spiritual intelligence including teaching the spiritual intelligence.

Systemic lupus erythematosus is a rheumatic disease which involves critical organs such as the central and peripheral nervous system and leads to detrimental neuropsychiatric impairments. A 10-year-old girl with seizures and mood disorders lasting more than one year was referred to pediatric rheumatology department and admitted. She was resistant to anticonvulsive drugs and also had some hematologic abnormalities. After clinical and laboratory evaluation, she fulfilled the criteria of systemic lupus erythematosus and the treatment led to good responses. Unexplained neuropsychiatric presentations such as headache, depression or seizures in an adolescent girl should raise the suspicion of systemic lupus erythematosus.

The most common and effective surgical technique for cataract extraction is phacoemulsification. One of proposed mechanisms of phacoemulsification is the direct mechanical effect named jackhammer theory. Close mechanical contact between the tip and the nucleus is one of important factors which determine the efficacy of jackhammer effect.Clockwise turning of stainless steel screw, slightly larger than the inside diameter of a standard phaco tip 1 mm behind the tip boarder, causes internal clockwise grooves. On the external surface, one row of counterclockwise grooves with 1 mm in length was made.The designed tip in vitro and immersed in salin solution was examined to evaluate the efficiency of emulsifying chestnut particles and mature human lens. In vitro effective phaco time (EPT) was less for the double-threaded tip compared with internally grooved tip. The anti-directional design of internal and external grooves could improve mechanical adherence. Important consideration with this design is the fact that these grooves create more cavitation.This tip seems useful especially for stony hard nuclei. Future in vivo and clinical studies are needed to better discover features of this design.