Tehran University Medical Journal

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Background: Infectious diseases are problematic in all around the world especially in the developing countries and early diagnosis of infections and one etiologic agents has a major role in the treatment of one patients. There are some culturing methods consist of conventional, semiautomatic and automatic. One of automatic methods is BACTEC system worked by fluorescent technology and Co2 production of organisms in culture media.
Methods: This study is based on observational-descriptive method with simple convenient sampling. We analyzed 262 samples of body sterile fluids of patients admitted in pediatric and internal wards of a university (Rasol- Acram) Hospital. They are consisting of 150 blood, 46 synovial, 32 CSF, 24 pleural, and 10 peritoneal samples.
Results: There were no differences between two sex in BACTEC and Conventional methods. Average age of patients with positive and negative culture in two methods had not differences. 72 (27.5%) samples were positive that 32 (12.2%) samples only in BACTEC method, 4 (1.5%) in conventional method and 36 (13.7%) in two methods had statistical differences (p=0.003). That means positive cultures are seeing in BACTEC more than Conventional method. Comparison of two methods in positive blood culture samples had statistical differences (p=0.02) but no statistical differences in other body fluids were seen. i. e. positive cultures were seen in BACTEC more than Conventional method. Positive culture in these two methods had statistical differences in antibiotic utilization (p<0.001). Positive culture in antibiotic utility were seen in BACTEC more than Conventional method. The average time of culture to become positive were 17.5+ 5.88 hours in BACTEC against 62.36+ 13.98 hours in Conventional method. Contamination was seeing in 4 samples in BACTEC and 2 in Conventional method that had no significant differences.
Conclusion: According to these data organism detection in BACTEC culture media from body sterile fluids overall and specially from blood is more successful than Conventional method. It is a better method in antibiotic utilization. BACTEC can isolate organism in shorter duration than Conventional method. BACTEC can facilitate early and accurate diagnosis of infectious etiology, shorten duration of hospital stay and decrease mortality and morbidity and cost.

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Background: Gross difference in return to work exists in pilonidal sinus patients operated by primary and secondary repair. This survey was to evaluate the results of surgical management of pilonidal sinus with primary or secondary closure.
Methods: In a randomized clinical trial, patients with pilonidal sinus referring to the surgical clinic of Shariati Hospital in Tehran, Iran between March 2007 and March 2009 were underwent either excision with midline closure (primary, n=40), or excision without closure (secondary, n=40). The recorded outcomes were hospital stay, healing time, time off work, postoperative pain, patient's satisfaction and the recurrence rate.
Results: Majority of the patients were male (87.50%). There was no significant difference in the hospital stay. Time off work (8.65±1.73 Vs. 11.53±2.33 days, p=0.001) and healing time (3.43±0.92 Vs. 5.3±0.79 days, p=0.001) were shorter in primary group but, there were no significant differences in hospital stay and number of visits. Intensity of postoperative pain in the 1^st (37.75±6.5 Vs. 43.63±5.06, p=0.001), 2^nd (26.75±6.66 Vs. 34.63±5.48, p=0.001), 3^rd (18.25±6.05 Vs. 27.88±6.88, p=0.001), and 7^th (8.45±3.85 Vs. 17.88±6.19, p=0.001) days were lower in primary closure group. There was not significant difference in complication rates in groups. Patients' satisfaction was higher in primary group (4.15±0.53 Vs. 3.6±0.5, p=0.001).
Conclusion: According to this study excision and primary closure is the preferred procedure in patients with pilonidal sinus. It has the advantages of shorter time off work earlier wound healing, lesser postoperative pain, higher patients satisfaction and comparable complication and recurrence rates with excision and open wound.

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Background: Early detection of fetal gender can provide an alarm for parents who complicated by genetic disorders. Moreover, the invasive tests are used for detecting any sex-specific genetic syndromes before 12 weeks of gestation. This study was de-signed to discover any association between placental location and fetal gender between 11 to 13+6 weeks of gestation. Methods: A cross-sectional study was conducted on 200 singleton pregnant women. They were referred for Down syndrome screening sonography to prenatal clinic, Imam Khomeini Hospital a tertiary referral university affiliated hospital, Ahvaz, Iran, in 2013. Women were included if they are singleton and at 11 to 13(+6) weeks gestational age. Exclusion criteria were multifetal, ectopic pregnancies, or dead fetus. Information about placental location (upper, middle, below, anterior, posterior), gravidity, and fetal gender were recorded. All participants of our study were evaluated by one trained gy-necologist in ultrasound examinations during nuchal translucency (NT) examinations. Ultrasonography was performed using the Accuvix V10 OB/GYN ultrasound. All patients were followed-up till delivery for confirming the predicted gender. Information regarding gender of newborn were collected using medical chart review or by phone contact. Results: Among 200 placenta which had been assessed, 103 (51.5%) were anterior and 97 (48.5%) were posterior. Our results showed that 75 (72.8%) from girl cases had an anterior placenta, while just 28 (27.2%) from boy cases had an anterior placenta (P< 0.001). In addition, there was significant association between placental location regard-ing below, middle, and upper and fetal gender. Conclusion: According to our results, an anterior and posterior positions of the placen-ta had significant relation with fetal gender. Our findings are consistent with previous studies regarding prediction of fetal gender using placental location. We suggest that more research with large sample size is required as well as investigations with more de-tails about placental locations.

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Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorders in reproductive age women. These women confer with complications of pregnancy such as gestational diabetes, pregnancy-induced hypertension, preeclampsia and neonatal complications such as small for gestational diabetes (SGA) are more prevalence in women with PCOS. The aim of this study was to evaluate the incidence of complications associated with PCOS in pregnant women.

Methods: This was an observational and prospective study which recruited 205 pregnant women with PCOS from Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences (AJUMS) between 2013 and 2014. Inclusion criteria were women with PCOS and gestational age over 20 weeks. The demographic and clinical variables including mother's age, body mass index (BMI) and conditions of pregnancy including pregnancy-induced hypertension, preeclampsia, gestational diabetes and overt diabetes and neonatal complications such as preterm labor (PTL), SGA and intrauterine fetal death (IUFD) were recorded.

Results: The prevalence of hypertension disorders, preeclampsia, gestational diabetes and overt diabetes were observed in 44 (21.5%), 18 (8.8%), 29 (14%) and 22 (11%) patients, respectively. The history of familial diabetes was shown in 28 patients (13.6%). In addition, the history of pregnancy induced hypertension was reported in 25 patients (12.1%). Only 6 patients (2.9%) had history of gestational diabetes. Among neonatal complications due to PCOS, SGA with 15.3% and then PTL with 12.6% had highest prevalence. IUFD was shown only in 2 patients.

Conclusion: Pregnant women with PCOS are at the higher risk for pregnancy and neonatal complications. Specifically, these women should be evaluated for pregnancy induced hypertension during pregnancy than others.

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