Comparison of the effectiveness of continuous versus intermittent cefazolin for the prevention of infection after off-pump coronary artery bypass graft

Surgical site infection is known as a common complication after cardiac surgery, and Cefazolin is the best prophylactic antibiotic to prevent this complication. The goal of this study was to evaluate the effect of continuous and intermittent Cefazolin for the prevention of superficial surgical site infection following off-pump coronary artery bypass [OPCAB]. This prospective randomized clinical trial study was conducted on 141 patients candidated for OPCAB and divided into two groups. This study was performed between February 2011 and February 2012 in the Iranian city of Yazd. Patients in both groups received 2 g of Cefazolin as a starting dose and at 30 minutes before incision. Definition of surgical site infections was according to the Centers for Disease Control and Prevention Criteria [CDC-criteria]. In the continuous infusion group [n = 74], 3 g of Cefazolin was infused over a 2 4-hour period after surgery. In the intermittent group [n = 67], 1 g of Cefazolin was administered at 3, 11, and 19 hours after the starting dose. Hyperlipidemia, diabetes, hypertension, smoking, history of heart disease, and incidences of superficial infection were compared between the two groups. Duration of follow- up was 4 weeks. The mean age of the patients was 60.49 +/- 10.63 years. The patients were 30.5% female and 69.5% male. There were no significant differences in age, body surface area, duration of operation, number of distal grafts, number of proximal grafts, and duration of hospital stay before heart surgery between two groups. The incidence of infection in intermittent group was [7.5%] and in continuous groups was [2.7%]. There was no significant difference in the incidence of infection between the two groups [p value = 0.26]. Our findings in this study showed no significant differences between continuous and intermittent Cefazolin for the prevention of superficial surgical site infections after OPCAB

Can preoperative serum level of creatinine predict new-onset atrial fibrillation in non-diabetic male patients undergoing open heart surgery? A retrograde view

Renal dysfunction is a risk marker in patients who candidate for coronary artery bypass graft [CABG]. Renal disorder is associated with prolonged stays in intensive care unit and hospital, morbidity and mortality. Aim of this study is specific evaluation of association between preoperative creatinine [Cr] with atrial fibrillation [AF] after elective off-pump CABG in non-diabetic male patients with normal ejection fraction. Two hundred non-diabetic male patients with normal ejection fraction undergoing elective off pump CABG surgery enrolled in this cross-sectional study and were stratified by present or absence of postoperative atrial fibrillation: patients with postoperative new-onset atrial fibrillation [n=100] as group 1 and patients without new-onset postoperative atrial fibrillation as group 2 [n=100]. Preoperative serological test of the participants, such as serum creatinine, were recorded in their medical dossiers. Data were analyzed in SPSS-16 software and tested for association between atrial fibrillation with creatinine level by using student t test, chi-square test or logistic regression. Cr level in patients with and without AF three days before surgery were 1.8 +/- 0.3 and 1.0 +/- 0.4 respectively [P value for Cr=0.00]. On surgical day, mean Cr level in patients with and without AF were 1.6 +/- 0.2 and 1.1 +/- 0.5 respectively [P value for Cr = 0.00]. Of the 100, male patients with postoperative AF, duration and frequency of recurrence of AF were not associated with Cr at three days before surgery and on surgical days [P>0.05]. Patients with postoperative AF had unsuitable status of renal function compare to patients without AF; however, preoperative serum creatinine cannot associate with duration and frequency of recurrence of AF

[Physical activity and factors influencing it among the personnel of a military center in Iran]

Considering the importance of sufficient physical activity in military personnel, this study was designed to determine the levels of this activity and factors influencing it among personnel of a military center in Iran. This cross-sectional method on 191 individuals randomly selected from entire staff working in a military center. A self-report valid and reliable questionnaire was applied to collect the data. The collected data was analyzed using SPSS software, descriptive and analytical statistics. According to the findings of the study prevalence of low, moderate and high levels of physical activity by study population was 35.1%, 19.4% and 45.5% respectively. A significant positive association was seen between levels of physical activity with both knowledge [P=0.001] and gender [P=0.022]. However, the association between, physical activity, with other studied factors such as age, job, and level of formal education was not significant. The most important factor of physical inactivity among participants was lack of enough free-time. On the other hand, accessibility to facilitates, organizational exercise, providing physical equipment's in job settings, and having free-time were the most important factors to promote the levels of physical activity, mentioned by the subjects. On the basis of the findings, especially considering the prevalence of the low level activity, 35.1%, and other documents supported this finding, one may conclude that performing educational program about to physical activity among military personnel seems necessary. To develop and promote enough equipment's and facilitates to increase the chance of sufficient physical activity among personnel is very important.

Honey with coffee: a new finding in the treatment of persistent postinfectious cough

Persistent postinfectious cough [PPC] is a cough that persists longer than 3 weeks or perhaps for many months after a common cold oran upper respiratory tract infection [URTI]. PPC has poor response to routine treatment modalities, so it can be a vexing problem for the patient and the physician alike. Our hypothesis was that honey and/or coffee have some beneficial effects in the treatment of PPC. The aim of this study was to evaluate the therapeutic effects of coffee and/or honey in the treatment of patients with PPC. This was a double blind randomized clinical trial, conducted on adult patients during a 6-year period from 2003 to 2009. Included in this study were 84 adult participants that had experienced PPC longer than 3 weeks. All of them had the history of several referrals to different physicians and despite treatment, their cough had persisted. Patients with other causes of chronic cough, or systemic disease or with abnormal routine laboratory tests were excluded. All the included 84 participants were distributed into three groups. For all the participants, a jam-like paste was prepared. Each 600 grams of the product consisted of "70 grams original instant coffee" in the first regimen, "500 grams of honey" in the second regimen and "70 grams of instant coffee plus 500 grams of honey" in the third regimen. These participants were told to dissolve 25 grams of the prescribed product in about 200 [CC] of warm water [under 60° Degree[C]], and drink this solution every 8 hours for one week. All the participants were evaluated before and at the end of the first week of their treatment, to measure the frequency of their cough. In addition they were under observation for the first month. Comparing the effectiveness of all three treatment regimens, this study found "honey with coffee" as the most effective treatment modality for PPC[P< 0.001]. Combination of honey and coffee can successfully treat the PPC at a short time. Thus, it is recommended for the treatment of PPC

Prevalence of readmission for hyperbilirubinemia in healthy newborns

The aim of this study was estimation of prevalence of jaundice readmission and observes neonatal jaundice risk factors in singleton infant with birth weight more than 2500 gr. This study was done among women who delivered a normal singleton infant with birth weight of >/= 2500 gr in Najmieh Hospital, Tehran, from 2004-2005. Maternal age, race, blood group and Rh, drug consumption during pregnancy, oxytocin consumption during labour, rupture of membranes together with neonatal sex, weight, maturity, gravity and length of nursery stay were recorded. The infants were followed during neonatal period to see if they were readmitted, and the reason of admission. The prevalence of readmission for neonatal jaundice was assessed and the risk factors for neonatal jaundice were compared between the icteric and non-icteric babies. The prevalence of readmission because of jaundice was 12.6%. The maternal data recorded from all mother-baby pairs were not significantly different except for maternal race, Rh group and drug consumption during pregnancy. Arab mothers compared with other race groups had more icteric babies [P=0.001]. Rh-negative mothers had more icteric infants [17.9%] compared with Rh-positive mothers [12%] [P=0.01]. Premature infants were hospitalized significantly more than mature babies [20.3% versus 12.1%, P=0.04]. The length of primary nursery stay differed significantly between two groups [mean [SD] 27 [9.8] hours for icterics versus 30 [2.5] hours for non-icterics, P < 0.001]. The mean age of readmission was fifth postnatal day. We conclude that infants, especially infants of Arab or negative Rh group mothers and premature babies, discharged early from the nursery should be advised to visit a pediatrician within the next 48-72 hours of birth to avoid complications of severe jaundice

frequency of skin allergens in patients with contact dermatitis

Eczema is one of the most widely spread inflammatory skin disorders. Contact dermatitis is an eczematous dermatitis that is produced as a result of contact with a substance in the environment. The substance can act as an irritant or allergen. Every country has allergens particular to itself. Determining the frequency of skin allergens in patients with contact dermatitis in Tehran. In this cross-sectional descriptive study, all the data about the patients with chronic contact dermatitis who were visited in a dermatology clinic in Tehran from the year 1993 to 2003 and patch tested with 23 allergens of European Standard Series [ESS] were analyzed. In this study 222 patients were surveryed. The mean age of the patients was 33.5 Years [SD=13.8]. 66.5% of the patients were females. The most common site of involvement [49%] was their hands. The mean duration of the disease was 54 months [SD=62]. Clinical diagnosis included: 59% allergic contact dermatitis, 24% irritant dermatitis, 10% atopic dermatitis, and 7% other types of dermatitis. One-hundred and forty five [65.3%] of them had at least one positive reaction. The most common allergens were: nickle sulfate 22.6%, cobalt chloride 14.5%, and fragrance mix 13.6%. Nickel was the most common contact allergen among the patients surveyed