2In hospitals, healthcare-associated infections (HAI), also referred as nosocomial infections (NI), pose a significant challenge, leading to prolonged hospitalization, increased healthcare costs, and mortality. Pathogens can be transmitted through high-touched surfaces, healthcare worker hands, and contaminated medical equipment. These infections are often caused by Multi-Drug Resistance Organisms (MDROs), which are bacteria resistant to multiple antimicrobial agents. Patients with higher illness severity scores, older age, and longer ICU stays are at increased risk. The most common side effect of healthcare is nosocomial infections, which can happen in any setting. Bacterial, fungal, and viral infections are potential causes for them, spread through direct or indirect contact. MRDOs, such as Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant Enterococci (VRE), and bacteria that produce Extended-spectrum beta-lactamases (ESBLs), pose a significant problem because of their antibiotic resistance. Preventive measures such as air filtration, hand hygiene, and environmental cleaning are important. Enhanced hand cleanliness, implementing contact precautions, and surveillance are crucial in managing MDROs. It is essential to use antibiotics judiciously and implement appropriate clinical measures. Further research is necessary to combat the proliferation of resistant strains. In conclusion, nosocomial infections caused by MDROs have significant public health implications. Effective prevention, control, and diagnosis are crucial in managing these infections. Preventive measures and proper antibiotic use are essential in controlling the spread of resistant bacteria.

Background and Objective: Fixed drug eruption (FDE) is one kind of drug rashes that is characterized by re-appearance of the lesions on the same sites after re-exposure to the causative drug. This study was performed to evaluate the epidemiologic characteristics of FDE. Materials and Methods: This descriptive study was done on a series of 100FDE cases, whom were admitted at the outpatient dermatology clinic of Hazrat-e-Rasoul Hospital over a six-year period. The primary diagnosis of FDE was suggested according to clinical findings including a remaining hyperpigmentation at the site of healed skin lesion(s). Oral challenge test with a single low dose administration of the suspected drug was used to confinn the diagnosis. Recurrence of the lesion(s) at the same body area(s) was considered as positive result. Results: Most commonly causative agents were co-trimoxazole and codein, which were found in 88% and 3% FDE cases; respectively. The most common site of involvement was penile glans in 57.7% of male patients and trunk in 48.3% of females. In one patient, reaction to multiple drugs including co-trimoxazole, codein and tetracycline was observed and after re-challenge with each drug, re-appearance of the skin lesion at the same site was evident. Several patients reported concomitant acetaminophen intake, but there was no reaction to that drug. Conclusion: Co-trimoxazole is the most common cause of FDE.      

Introduction: Malaria is a public health problem for approximately 2.4 billion people, 40% of the world’s population, particularly in the tropical and subtropical countries. Countries in Asia, and Latin America, the islands of the South, West, and central Pacific Ocean are all affected. Drug resistance is the greatest challenge in combating against malaria. Drug resistance in malaria is now widespread and increasingly has sophisticated the treatment in many parts of the world. This review study was conducted to determine the present situation of malaria drug resistance.Chloriquine, the most valuable antimalaria, has been the drug of choice for treatment of malaria all over the country almost for half a century. It is well absorbed, well tolerated, and inexpensive. However, the first report of chloroquine-resistant flaciparum malaria was published by Edrissian two decades ago. Consequently, mosquitoes of the Anopheles species spread the drug resistant parasite strians throughout the malarious areas of Iran. As a result, both prevalence and intensification of resistance has increased. Recent study has located several mutated genes responsible for plasmodium falciparum resistance to chloroquine and sulfadoxine/pyrimethamine combination. Application of genetic information for early detection of resistance foci and further monitoring of drug resistant malaria is a useful epidemiological tool in comparison with traditional methods. There is much to be done in the research of malaria and its treatment.Conclusion: Education on the prevention of malaria is greatly needed. Treatment of malaria with a single drug should no longer be regarded as ethical. Combination of two antimalarial with independednt mode of action should replace the conventional treatment. Although, recently combination of chloroquine and fansidar has been introduced as the first line treatment in falciparum malaria, nevertheless experiences in other countries reveal that such a combination is not suitable. It is highly suggested that the present first line drug should switch to the newly formulated antimalarials, i.e. artesunate, a derivative of artemisinine, not only is able to diminish the problem, but also due to its brilliant therapeutic efficacy, resolves the patient’s symptoms rapidly and prevents treatment failures as well. Furthermore, gametocyte rate will decrease too.