Internal Medicine Today
Year:2006 | Volume:12 | Issue:3|Papers Count:14

Background and Aim: Urinary tract infection (UTI) is one of the most common infectious diseases diagnosed in patients. Escherichia coli (E.coli) has been documented to be the most important pathogen associated with symptomatic tract infections. The aim of this study was to determine the local prevalence of bacterial and strains antimicrobial resistance of E.coli isolated from patients with UTI by reason increasing use of antibiotic and antibacterial resistance.Material and Methods: In order to isolate and identify bacterial agents causing UTI and to indentify its sex and age distribiution, in a cross- sectional study, a total of 2101 midstream urine samples “through simple random sampling method” were analyzed for isolation and identification of bacterial isolates as per standard methods. Susceptibility tests were performed with disc diffusion tests using the Kirby-Bauer method on E.coli isolated from 233 cases with UTI aged from 3.5 month through 90 years with an average of 16.52±21.22 years. All data were analyzed with SPSS for windows.Results: Out of which 353 samples were found to be significant bacteriuria (105 Cfu/mL) and remaining 1748 samples were either non-significant bacteriuria or very low bacterial count or sterile urine. In the present study, out of 353 isolated uropathogens the most common isolate was E.coli (66%) followed by staphylococcus sp (21.8%) klebsiella pneumoniae (7.93%), proteus vulgaris (3.4%), pseudomonas aeruginosa (0.84%). The UTIs were found to most frequently in female (78.5%) than male (21.5%) (P=0.000). The isolated E.coli showed resistant to amoxycilin (100%), ampicillin (99.1%) and sensitive to ciprofloxacin (85%) and ceftizoxime (60.1%).Conclusion: This study suggests that in emergency cases before the result of antibiogrom test is determined, the best choices to begin empiric treatment are cipro floxacin and ceftizoxime. Amoxicillin and ampicillin are quite ineffective to treat these infections.

Background and Aim: Continuous evaluation of serum levels of hepatic transaminases' like AST and ALT can show the severity of cellular damage in chronic hepatitis B, also it can be helpful in follow up of hepatic disease progression. This study was designed to detect the relationship and correlation between serum level of enzymes with damage ranking in liver biopsy and inflammation in hepatic cells.Materials and Methods: In this analytic-descriptive study, all blocks of liver biopsy of patients with chronic hepatitis B, taken from 2000 to the first three months of 2004 (for 5 years) in the university hospital, had been overviewed. At first, all liver samples were ranked according to histopathological features, and then were classified according to the severity of inflammation in Knodell HAI score. Based on the patients' files, AST, ALT serum level, sonography report and B hepatitis serological markers like HBeAg, HBeAb and personal identity were registered.Initially, we reviewed clinical findings and analyzed data with statistical tests. Statistical analyses were performed and P value less than 0.05 was significant.Results: We reviewed 86 hepatic biopsies. Mean severity of hepatic inflammation base on Knodell HAI score was 5.13±3.31.Mean AST, ALT serum level were 86.74±44.93 and 105.44±50.39, respectively. Serological markers for B hepatitis, HBeAb were reported positive in 53 persons (61.6%). Meanwhile 39 persons (43.3%) were positive for HBeAg. There was noticeable relationship between grading according to Knodell HAI score and qualitative ranking. There was a significant relationship between AST, ALT serum levels and Knodell HAI quantitative score, too (P<0.05).Conclusion: Our findings suggest that serum levels of liver enzyme like AST and ALT are suitable markers for classification of severity of hepatic inflammation but they are not useful for evaluation of prognosis of the cirrhosis. To substitute them with liver biopsy, we recommend more study.

Background and Aim: Continuous evaluation of serum levels of hepatic transaminases' like AST and ALT can show the severity of cellular damage in chronic hepatitis B, also it can be helpful in follow up of hepatic disease progression. This study was designed to detect the relationship and correlation between serum level of enzymes with damage ranking in liver biopsy and inflammation in hepatic cells.Materials and Methods: In this analytic-descriptive study, all blocks of liver biopsy of patients with chronic hepatitis B, taken from 2000 to the first three months of 2004 (for 5 years) in the university hospital, had been overviewed. At first, all liver samples were ranked according to histopathological features, and then were classified according to the severity of inflammation in Knodell HAI score. Based on the patients' files, AST, ALT serum level, sonography report and B hepatitis serological markers like HBeAg, HBeAb and personal identity were registered.Initially, we reviewed clinical findings and analyzed data with statistical tests. Statistical analyses were performed and P value less than 0.05 were significant.Results: We reviewed 86 hepatic biopsies. Mean severity of hepatic inflammation base on Knodell HAI score was 5.13±3.31.Mean AST, ALT serum level were 86.74±44.93 and 105.44±50.39, respectively. Serological markers for B hepatitis, HBeAb were reported positive in 53 persons (61.6%). Meanwhile 39 persons (43.3%) were positive for HBeAg. There was noticeable relationship between grading according to Knodell HAI score and qualitative ranking. There was a significant relationship between AST, ALT serum levels and Knodell HAI quantitative score, too (P<0.05).Conclusion: Our findings suggest that serum levels of liver enzyme like AST and ALT are suitable markers for classification of severity of hepatic inflammation but they are not useful for evaluation of prognosis of the cirrhosis. To substitute them with liver biopsy, we recommend more study.

Background and Aim: Recently attentions to intensive care unit environments is essential because of multiplied disadvantages of undesirable environment in high risk newborn therefore determination and collection of standards for accurate practice in hospital and health centers.Materials and Methods: This research is a multiple triangulation done in years 2004-2006. First international standards were extracted from world wide webs. The using Delphi method, these standards as well as the view points of 15 clinical medical sciences experts were complied to set suggested standards in environmental health finding and in the third stage, 42 clinical medical sciences experts of the country were selected. And their suggestions were investigated regarding desirability and applicability of these standards to the executive and sociocultural situations in Iran through a descriptive survey method. The results of this stage were analyzed via descriptive statistics. Results: In the first stage standards were extracted of lo controls and states. The suggestions and assertions made by experts regarding the suitability and applicability to the environmental situations in Iran were studied and standards in environmental health were drafted and were finally approved by an 80-100 desirability percent rate.Conclusion: The findings of the third step of the research showed that most of the environmental health standards had either appropriate or fairly appropriate level. So necessary changes in final standards have been made based on subjects, viewpoint and suggestions facilities standards suggested for Iran. The findings of this research are hoped to contribute to the enhancement of the quality in Iran.

Background and Aim: The first step in implanting pacemaker is finding a suitable venous way. We can pass the lead through cutting down the cephalic vein or external jugular or even the internal jugular. It is also possible to locate a larger vein through skin and pass the lead though it after making a fissure in it. The aim of this study is comparing two methods of implanting pacemaker through subclavian vein and cutting down the cephalic vein in deltopectoral pathway concerning short-term side effects.Materials and Methods: From early 1997 up to the end of 2001, 352 patients were provided with permanent pacemaker. After the analysis of these patients they were divided into two groups: In group A including 164 patients (46.6%) the pacemaker was implanted through subclavian and in group B including 188 patients (53.4%), the cutting down cephalic vein method was used. The results were compared by statistical analysis of side effects of these two methods. Results: Pneumothorax was seen in one case of group A (0.6%) patients. There was injury infection in a patient from group A (0. 6%) and two patients from group B (106%). A case of generator displacement was also seen in each group. There was neither case of air embolism nor the damage to the veins.Conclusion: The study shows that although there is no remarkable statistical difference between the two groups concerning the individual side-effect, the subclavian vein method had more side effects than the cut down cephalic vein which is statistically remarkable when collective side-effects are concerned.

Background and Aim: Flotation involves separation of solids from the water phase by attaching the solids to fine air bubbles to decrease the density of the particles. Flotation including of tree type 1. Vacuum flotation, 2. Dispersed air flotation and 3.dissolved air flotation. In this research used from dissolved air flotation. Various industries produce many goods and marchandias and affects our environment. Vegetable oil manufacturing is one of these industries. The main pollutants in the east of this industry are chemical oxygen demand (COD), biochemical oxygen demand (BOD) and Oil. The aim of this assay is to study the reduction of pollution of vegetable oil manufacturing wastewater with "DAF" system.Materials and Methods: At first phase of these examinations, the optimum dosage of the coagulants was determined. The coagulants that used in this study were Alum and Ferric Chloride. The second phase was flotation. In this series of examinations, oil, COD, total solid, volatile solid, fixed solid and suspended solid measured in raw wastewater and the effluent of the DAF pilot.Results: Optimum value of "Ph" for Alum and Chloride ferric obtained 7.5 and 5.5 respectively. And optimum dosage for these obtained 30 and 32 mg/l respectively in this search. Mean moval for the parameters of oil, COD, total solid, volatile solid, fixed solid and suspended solid obtained 75.85%, 78.27%, 77.32%, 82.47%, 73.52% and 85.53% respectively.Conclusion: During pressure rising from 3 to 4 and 5atm removing rate of COD, total solid, volatile solid, fixed solid parameters reduced but oil and suspended solid have increase. In addition to, following increase of flotation time up to 120s all of the measured parameters have increase in removing rate. Optimum A/S for removal of COD, total solid, volatile solid, fixed solid parameters obtained 0.001 and for oil and suspended solid obtained 0.0015.

Background and Aim: Obesity is one of the most prevalent nutrition disorders which is associated with increase in mortality rate, hypertension, diabetics, cardiovascular diseases, and Cancer. The majority of the people in developing and developed countries are involved in obesity. It is also the most important nutrition disease and one of the social problems all over the world.Materials and Methods: The samples, consisting of 440 females of 15-65 years of age, were selected based on random cluster sampling method. Measurement of obesity was performed through BMI and WHR indices. The analysis of data was done through statistic tests- Regression, Pierson. Kendal- and variation analysis, etc. using SPSS software.Results: Based on BMI index 27.7% of the sample females suffered from overweight (BMI=25-29.9), 14.5%, from obesity (BMI³30) and 22% from abdominal obesity (WHR³0.85). Based on both indices, BMI and WHR, there is a significant relationship between the level of education and the prevalence of obesity: This relation is detected between obesity and the three variables of marital status, menopause and frequency of pregnancy. 26.6% of married females. Suffers from obesity while this percentage is reduced to only 2.5% in the case of single females. 64.8% of menopausal females suffer from obesity while this percentage is reduced to 13.8% in the case of no menopausal females. The prevalence of obesity associated with no pregnant females is 11.9% while, in the case of females with six pregnancies, it rises to 67.5%. Regression test also indicates a significant relationship between advance in age and obesity: the rate of obesity sours from 7.7% among females of 20-24 years of age to 72.7% among females of 55-65 years of age. The results of the research confirm the existence of a significant relation- ship between the parent's, especially the mother's, obesity and the daughter’s obesity. Conclusion: Spreading information about obesity and its Complications, urging people to change their eating habits and to do exercise and physical activities can be effective in decreasing the prevalence of obesity.

Background and Aim: Urinary tract infection (UTI) is one of the most common bacterial infections during pregnancy and it may cause important complication in mother and fetal if no treatment is conducted. This study conducted to present the most appropriate antibiotic among Cephalexin, Ampicillin, Amoxicillin and Cefixim in empirical treatment of cystitis.Materials and Methods: This study was performed in Dezyani Hospital, Gorgan University of medical sciences and private offices in 2003. It was a clinical trial that was performed on 128 pregnant women with symptomatic infection in the lower urinary tract. They were investigated in four different groups and every group had a treatment with special antibiotic. The results were compared with t and chi-square test. Results: The response rate to antibiotics was different. The highest response was due to Cephalexin (84.4%) and the lowest response was due to Ampicilline (56.3%) and there were no significant statistical differences between Amoxicillin (75%) and Cefixim (78.1%). Among patients (73.4%) had positive response to antibiotic therapy and among them، (34%) had relapse during the first month after treating.Conclusion: The results showed that the best antibiotic was Cephalexin, and the worst was Ampicillin; which probably was due to high resistance of E.coli (most common pathogen) to Ampicillin. Therefore, it is recommended to use Cephalexin or Amoxicillin in empirical treatment of cystitis in pregnancy, instead of Ampicillin and Cefixim for patients with frequent relapses.

In a cytogenetic study on the residents in the high level natural radiation areas of Ramsar, a woman had an acentric like C group chromosome showing the premature centromere separation in the peripheral lymphocytes. This unusual chromosome was identified as an X chromosome with Fluorescent In situ Hybridization (FISH) method. Analysis of the 2038 cells revealed that these unusual X chromosomes had ability to replicate. This replication was associated with non-disjunction leading to aneuploid cells. In this paper, induction of the premature centromere separation (PCS) in the aged women is discussed in relation to the effect of the chronic exposure to low dose.

Background and Aim: Knee in one of the commonest joints being injured in professional sports (specially football) and developed world, and accident being responsible for this. Injury to the anterior cruciate ligament (ACL) is very common. It causes instability of the knee. Rehabilitation and reconstruction of ACLs are the aims in active and athletic patients.Materials and Methods: Reconstruction of the ACL using bone patellar bone autograft is the gold standard In this study, we reviewed 400 patients who had knee arthroscopy. 22 patients with isolated ACL rupture were selected for reconstruction of ACL using bone patella tendon autograft, and fixation with interference screws.Results: Good results such as: stability, decreased pain, good range of motion, and return to previous activity was achieved in most of the patients. Conclusion: Thus, it is recommended that in selected patients, who have symptomatic ACL deficient knee reconstruction of anterior cruciate ligament using BPB autograft being performed.