[Investigation of the risk factors for congenital hypothyroidism in the newborns in Kurdistan Province]

Congenital hypothyroidism is one of the important preventable causes of mental retardation in newborns. Incidence of congenital hypothyroidism in Kurdistan province is more than its mean Incidence in Iran and in the world. The present study was performed to identify the risk factors for congenital hypothyroidism in Kurdistan province. This case - control study included all the newborns with TSH screening tests >10 mIU/l in Kurdistan Province. Another group of neonates were selected as our control group. Analysis was performed by means of chi-square, t- test and logistic regression. Our study included 105 patients, 66 [62.9%] boys and 39 [37.1%] girls. There were no significant differences between the 2 groups in regard to weight, height, head circumference, mother's BMI and maternal parity. Univariate analysis revealed that family history of thyroid diseases had a significant relationship with congenital hypothyroidism in the newborns [P= 0.019]. However multivariate analysis showed no significant association between the factors in our study and risk of congenital hypothyroidism. A history of thyroid disease among family members may be associated with congenital hypothyroidism. Therefore, family history of thyroid diseases should be regarded as a risk factor and included in the maternal control program

[Incidence of ventilator- associated pneumonia [VAP] and bacterial resistance pattern in adult patients hospitalised at the intensive care unit of Besat hospital in Sanandaj]

Among nosocomial infections, ventilator associated pneumonia [VAP] is very important which can lead to increased mortality rate in the patients. The aim of the present study was to determine the incidence of VAP and its bacterial resistance pattern at the intensive care unit [ICU] of Besat Hospital in Sanandaj. In a prospective descriptive study carried out between September 2007 and June 2008, 149 endotracheal samples were obtained from the patients after 48 hours of hospitalization in ICU units of Besat Hospital. The samples were sent to the microbiology laboratory of Besat Hospital. Bacteriologic diagnosis was performed by using Edward and Ewings standard methods and antibiotic susceptibility pattern was determined by CLSI system guidelines. Demographic data were collected and recorded in a check list. Data were introduced into SPSS software and analyzed by means of descriptive statistical tests. Among 149 samples from endotracheal tube of the patients, 48 were positive for VAP with an incidence rate of 32.2%. Mean standard deviation of duration of hospitalization was 23.4 +/- 10.2 days. Microorganisms isolated from endotracheal tube were essentially Enterobacteriacae and included Klebsiella spp, enterobacter spp, and E.coli. Acintobacter spp and Staphylococcus epidermidis, Pseudomonas spp and Staphylococcus aureus were detected from 3, 3, 2 and 1 samples respectively. The maximum and minimum antibiotic resistance by gram negative bacteria were 93.3% to cefalotin and 50% to amikacin. The VAP incidence rate of 32.2% needs serious attention. Clinical isolates in the present study had a high antibiotic resistance especially to the third generation of cephalosporins. Close attention to the standards of infection control for prevention of VAP is recommended

[ comparison of serum CRP levels measured by a highly sensitive method in healthy subjects and asthmatic patients]

C- reactive protein [CRP] is a plasma protein which is a marker of inflammation. Recently it has been shown that the increased level of CRP is associated with increased risk of MI, IHD, DM and hypertension. There are plenty of published articles in regard to the role of CRP in the pathogenesis of COPD. Also a potential role for CRP in the pathogenesis of asthma has been proposed. The local inflammation is an established pathology in the asthma however, little is known about role of systemic inflammation. We compared serum levels of highly sensitive CRP between steroid inhaling asthmatic patients and non asthmatic healthy controls. This case-control study, based on standard criteria, included fifty known cases of asthmatic patients who met the inclusion criteria and fifty non asthmatic subjects. Serum levels of CRP were measured and compared with each other in both groups by ELISA method. All asthmatics were at the same stage of treatment. The mean age of the asthmatic patients was 46.9 +/- 9.8 years and that of control group was 44 +/- 14.35 years. Durations of pulmonary symptoms were <3 years in 20%, 3-5 years in 36%, 6-12 years in 24% and >13years in 20% of the patients. HS-CRP levels were significantly higher in asthmatic patients than in control patients [34.79 mg/dl versus 12.8 mg/dl respectively] [P=0.001]. HS-CRP levels had no significant relation with age, gender and duration of asthma. In asthma inflammation is not limited to airways and like COPD, evidence of systemic inflammation such as increased CRP can be detected

[Suicide attempt and related factors in Kurdistan province]

Suicide is one of the most important community health problems which is related to many different factors in different communities. This was a case-control study and patients with suicide attempt admitted in Sanandaj hospitals were regarded as the case group. Control group was selected and matched for age. Data were introduced into SSPS 12.0 software and were analyzed by means of x2 test. Suicide attempt was more frequent in females [71.1%], in those with age of 20-24 years [31.1%] and in those with high school education [56.1%]. There was a significant relationship between number of family members and life events with suicide attempt [P=0.01, P<0.05 respectively]. No significant relationship was found between suicide attempt and marital status. The most common ways for suicide attempt were by using drugs and poisons. 6.7% of patients attempted suicide by selfburning. Self-burning was more frequent in married women and had 100% mortality. High frequency of suicide attempts in young women calls for attention to mental health in this group. Preventing suicide attempts by self-burning, particularly in married women indicates the importance of public education as well as reassessing marital condition, and family life training and education about handling interpersonal problems within families

[Risk factors of rectal colonization of vancomycin-resistant enterococci in Shiraz Namazi Hospital]

Risk factors for Vancomycin-resistant Enterococci [VRE] colonization are patient-related factors such as underlying disease or amount of prescribed antibiotics, and hospital-related factors such as duration of hospitalization, type of performed therapeutic procedures, and antibiotic prescription. This nested case control study was performed to determine risk factors of rectal VRE colonization at Shiraz Namazi Hospital. During December 2003 to July 2004 serial rectal swabs were yielded from all hospitalized patients every 5 days. Susceptibility of detected Enterococci was tested by Minimum Inhibitory concentration dilution method. More than 1000 rectal swabs were taken. A total of 99 of 700 patients [14%] were colonized with VRE [cases] and 59 patients were colonized with Vancomycin-sensible strains [VSE], serving as controls. In the univariate analysis, history of antibiotic use [P=0.04], underlying disease [P=0.01], renal failure due to dialysis [P=0.03], use of vancomycin [P=0.04], use of third generation Cephalosporins [P=0.04], and duration of vancomycin therapy [>7 days] [p=0.02] showed statistically significant differences between the two groups. In the multivariate analysis [logistic regression], presence of underlying disease [OR, 2.43; 95% CI, 1.2 - 4.9; P=0.013] and duration of Vancomycin use [>7 days] were independently associated with VRE colonization. This study, which was the first study on the prevalence of VRE in Iran, demonstrated that VRE prevalence is high in Shiraz, and confirmed earlier observations regarding risk factors for VRE in other countries and determined risk factors that may be considered in interventional strategies for the control of VRE