Tehran University Medical Journal

Background: Many of hospital acquired infections that cause so much morbidity and mortality and have great economical burden are transmitted via contaminated hands of health care workers (HCW).Prevalence of these infections can decrease up to 30% with hygienic measures. In this study we assessed the prevalence of careers and microbial spectrum of HCW,s hand and relation between detergent used for washing and reduction of microbial load of HCW, s hand.

Materials and Methods: This study was done in two part: Descriptive part (cross sectional) and analytical part (before –after). Cases were Consist of all staff Working in wards of center of pediatrics hospital (Including attends, residents, interns, nurses and workers). In first part ,we assess hand microbial spectrum and contamination load of 72 staff and in second part, we assessed and compared hand microbial spectrum and load before and after of washing with four detergent : plain soap (60 staff ), liquid soap (60 staff ) , betadin scrub in ward (60 staff ) and betadin scrub in operating room manner (26 staff).

Results: %87.5 of personnel had positive cultures-.The most prevalent bacteria were staph. epidermidis (%79.4), staph. oreus (%42.9), klebsiella (%12.7), E-coli (%12.7). The rate of reduction or negative cultures in groups used betadin were greater than the first two group (P-value <0/05).Thirty staff (10 with plain soap,10 with liquid soap and 10 with operating room betadin scrub ) dried their hands after washing. Forty percent of first, fifty percent of second and ninety percent of third group have negative culture after drying. Also 11 samples were drawn from faucets that all of them were positive.

Conclusion: Prevalence of careers is high among HCWS and drying of hands can an important role in hospital infection rate. Faucets have heavy contamination and can transmit bacteria to hands after washing. For theses reasons education and of staff to correct hand washing and drying before every contact with patients and used of faucets without direct hand touching can play a great role in lowering hospital infections.

Background: There are several million new cases of peptic disease annually. The disease has a various range of presentations. Gram negative helicobacter pylori bacilli is considered as an etiologic factor in this disease. Goal of treatment in peptic disease is eradication of the helicobacter pylori (HP). Combination therapy has been implemented in the treatment of this disease. Different modalities have been recommended up to now. In order to lower adverse effects, cost and drug resistance, researchers have introduced a new combination therapy in which honey is substituted for metronidazole.

Methods: A step II of clinical trial was designed. The sample size was 15 children. Diagnosis of HP infection was confirmed with histopathology. Treatment regimen consisted of omeprazole, amoxicillin, bismuth and honey. After a 3-4 week follow- up, eradication was evaluated.

Results: 15 children completed the follow- up period. Mean age of patients was 9.4 years. Treatment effectiveness was 80 percent.

Conclusion: Combination therapy with 3 drugs along with honey has significant effectiveness on HP eradication.

Background: Acute abdominal pain is a common complaint in an emergency setting. An immediate and precise diagnosis is necessary for reducing morbidity and mortality. Several studies have reported that CT scan increases diagnostic accuracy for patients with acute abdominal pain. This study was designed to evaluate the sensitivity, specificity and accuracy of spiral CT scan compared to that of abdominal ultrasound and plain radiography. 

Methods: We assessed the data of 91 consecutive patients, including 45 males and 46 females, ranging in age from 8 to 84 years (mean age 52.38 years) presenting to the emergency department of Sina Hospital, Tehran, Iran, with acute non-traumatic abdominal pain during the years 2003-2005. All patients underwent spiral CT scanning in addition, sonography and plain radiography were performed for 66 and 64 of the patients, respectively. The sensitivity, specificity and accuracy were calculated and compared, based on the final diagnosis, which was established with surgical, pathologic, and clinical follow-up. The data was analyzed by SPSS 13.0 software.

Results: Among the 91 patients examined, CT scan was reported to be normal in 15 patients (16.5%). The most common CT findings were aortic aneurysm (12.1%), pancreatitis (9.9%), ovarian cyst (7.7%), intestinal distension (7.7%), and hepatic cyst (7.7%). The overall sensitivity, specificity, and accuracy of unenhanced spiral CT were 92.2%, 92.86%, and 92.3%, respectively, whereas those of plain radiography were 13.2%, 72.7%, and 23.4%, respectively, and ultrasound 73.2%, 90%, and 75.7%, respectively.

Conclusions: This study suggests that plain radiography is an insensitive technique in the evaluation of nontraumatic acute abdominal pain presenting in the emergency department. Unenhanced spiral CT is accurate for adult patients with nontraumatic acute abdominal pain and should be considered as an alternative to radiography as the initial imaging modality.

Background: Preeclampsia is a disorder of pregnancy with increased maternal and perinatal morbidity and mortality. An imbalance between free radical induced lipid peroxidation and antioxidant system has been suggested as possible pathogenesis of preeclapsia. It has been shown correlation of some serum antioxidant agents (for example ceruloplasmin) with preeclampsia and its severity. The purpose of this study was to evaluate of this correlation.

Methods: In a analytic case-control study, in clinic and delivery unit of Mirza Koochak Khan university hospital, Tehran, we evaluated 90 pregnant women of 19-38 years old with gestational age higher than 20 weeks in two groups, case (preeclampsia) and control (healty mother). Case group was devided into two groups mild preeclampsia (n=30) and severe preeclampsia (n=30). Patients with preeclampsia (n=60) had either early (n=41) or late preeclampsia (n=19). Control group included 30 normotensive pregnant women. Serum Ceruroplasmin level was measured. Then relationship between this factor and preeclampsia was studied.

Results: The mean level of serum ceruloplasmin in women with severe preeclampsia (390.83mg/dl) and mild preeclampsia (319.43mg/dl) was higher than control group (212.7mg/dl). Likewise it was significantly higher in severe preeclampsia than mild (P<0.001) and higher in early (373.28mg/dl) than late preeclampsi (298.34mg/dl) (P<0.01).

Conclusions: Our data suggest that serum ceruroplasmin level may predict preeclampsia occurrance and its severity. Likewise antioxidant theryapy before the onset of preeclampsia in an attempt to decrease its frequency should be considered.