[Clostridium difficile toxin infection among the patients admitted to valiasr hospital of Arak, Iran, from 2013 to 2014]

Background and Objectives: Diarrhea is one of the most common complications of antibiotic usage. And clostridium difficile is the most common cause of Antibiotic-Associated Diarrhea [AAD]. This study was aimed to investigate the infection with Clostridium Difficile Toxin [CDT] and Clostridium Difficile-Associated Diarrhea [CDAD] among hospitalized patients

Materials and Methods: This cross-sectional descriptive study was conducted on 195 patients admitted to different wards of Valiasr Hospital in Arak, Iran in the summer of 2013, by simple random sampling and considering inclusion and exclusion criteria. Demographic and clinical information of the patients was recorded using questionnaires

Results: Among 195 patients, the prevalence positive toxin and CDAD were calculated as 14.4% and 4.1%, respectively. Incidence of CDAD had a significant relationship with antibiotic consumption history [p<0.05]. Though the prevalence of positive toxin cases was more in female patients [p=0.001] and having significant relationship with diarrhea [p=0.036], no other significant relationship was found between the age, the type of hospital wards, the reason for hospitalization and antibiotic use with the results of CDT test

Conclusion: The CDT infection and CDAD were highly frequent in the hospital under our study. Therefore, it is suggested to implement care programs to decrease prevalence of the toxin of this organism in the patients admitted to hospitals and the related CDAD

Evaluation of vaginal group B streptococcal culture results after digital vaginal examination and its pattern of antibiotic resistance in pregnant women

Group B streptococcus [GBS] colonizes the gastrointestinal and genitourinary tract of 10-40% of pregnant women and it is a major cause of neonatal morbidity and mortality. This study was to evaluate whether vaginal GBS culture results alter after digital vaginal examination or not. Antibiotic resistance pattern of this specie has been also assessed. A total of 186 pregnant women with gestational age of 37 weeks were enrolled to the study. Two vaginal swaps were taken before and immediately after digital vaginal examination, then third swap was taken after 48 hours of examination. The cultures were evaluated for bacterial growth and the isolated bacteria were assessed for antimicrobial drugs sensitivity. Positive culture of GBS was seen in 16.1%. Initially negative GBS result was found not to change immediately after examination. But positive cultures were negative in 1.6% of women after digital vaginal examination. After 48 hours 2.7% of initially negative GBS was positive and no one with initially positive GBS had negative culture. Sensitivity to penicillin and vancomycin was 100%, erythromycin 74%, ampicillin 65%, cefazolin 62.8%, cefotaxime 54.2% and ceftizoxime was 40%. The present investigation showed that the vaginal GBS culture result is minimally affected by digital vaginal examination. Drug of choice for GBS eradication is penicillin; vancomycin could be the choice in the case of penicillin hypersensitivity

Evaluation of the effect of Islamic fasting on lung volumes and capacities in the healthy persons

To evaluate the changes in pulmonary volumes during and after Islamic fasting. It is a cohort study conducted on 117 healthy subjects selected on a random basis from employees, professors and students of Iran University of Medical Sciences, Tehran, Iran, between December 1999 and January 2000. All of them underwent spirometry 10 days prior to Ramadan, 2 times during Ramadan, and one time 10 days post-Ramadan. In first visit, in addition to spirometry they underwent medical examination to make sure they are healthy. All of their spirometries and background information were collected. Repeated measurements analysis of varience method was used to compare the measurements. Approximately 69% of subjects were male and the mean age was 23.9 years. Mean fasting time was 27.8 days. The mean difference in forced expiratory volume in 1 second [FEV1%] was significant between the 4 visits [P=0.01]. The mean FEV1% increased both during fasting and after Ramadan [P=0.017]. The mean vital capacity and peak expiratory flow rate values increased during Ramadan significantly [p=0.043, P<0.001]. Although the mean maximum mid-expiratory flow decreased in the beginning of Ramadan and significantly increased subsequently [P=0.02], MEF50% [P=0.004] and MEF75% [P=0.047] increased in the beginning of Ramadan and decreased subsequently. As a whole, fasting increases lung volumes and might improve pulmonary function. This finding seems to be relevant to the changes in weight during Ramadan