[In vitro antimicrobial drug-resistance of urinary tract pathogens in patients admitted to Vali-E-Asr Hospital Wards]

Extensive use of antibiotics in medicine has led to resistance of microorganisms in urinary tract infection [UTI] in both children and adults. Therefore, conducting studies on antibiotic susceptibility is needed for selection of antibiotics based on regional studies. During the year 2006 urine samples from all symptomatic patients admitted to neonatal, pediatrics, obstetric and neurologic wards were collected through midstream clean-catch, catheterization, or urine bags. An antibiogram test was performed for all 118 urine samples which were culture positive. The most common organisms found in neonatal urine culture were klebsiella pneumoniae [44/5%] followed by Escherichia coli [33/5%]. Escherichia coli was the most common organism in pediatrics [41%], obstetric [46%], and neurologic wards [73%]. Resistance to ampicillin [82/6%] and cefixime [73/6%] was significant in all samples. Ciprofloxacine was the most effective drug against E.coli and klebsiella pneumoniae in all wards [resistance rate: 24/1%] followed by nitrofurantoin [resistance rate: 41/4%], ceftriaxone [resistance rate: 44/8%] and amikacin [resistance rate: 51/9%]. Vancomycin was the most effective drug against staphylococcus epidermidis [resistance rate: 37/1%] followed by cephtasidim [resistance rate: 40/1%] and ciprofloxacine [resistance rate: 48/5%]. Unfortunately due to irrational use of antibiotics, high resistance to ampicillin, cefixim, gentamycin, cotrimoxazol, and some other drugs was observed. Continuous studies regarding the drug resistance are recommended for better assessment in the future

[Evaluation of theraputic effect of desmopressin on enuresis in children aged 5-14 years]

Nocturnal enuresis, the involuntary passing of urine during sleep after the age at which bladder control would normally be anticipated, is a widespread and potentially disabling disorder of children. Treatment of enuresis includes non-pharmacologic and pharmacologic procedures. Imipramine, anticholinergics, and desmopressin are appropriate drugs for treatment. Desmopressin is a synthetic analogue of vasopressin, which decreases urine output. Since efficacy and side effects of desmopressin-therapy differ in various studies, this research was conducted to evaluate the efficacy of desmopressin in enuretic children in Zanjan. In this quasi-experimental study, 126 children aged 5-14 suffering from primary nocturnal enuresis, referring to pediatric nephrology clinic were entered into the study during 2002-2006. Following the written consent a questionnaire concerning the personal data and physical examination was completed for each patient. Clinical tests including U/A, U/C, Cr and serum electrolytes were carried out and after rejecting the secondary causes of enuresis 10-20 micro-g intransal desmopressin was prescribed according to the age and weight of the children. The effect and complications of the drug were followed up monthly for six months. Of 126 children, 56 [44.4%] obtained full recovery, and 48 [38.1%] partial recovery from nocturnal enuresis. The total recovery was 82.5%. 22 patients [17.4%] did not respond to the drug. No significant difference was observed between age, gender, existence of stress, and effect of the drug on child enuresis. Children with familial history of nocturnal enuresis responded better to the drug. No complications were observed in patients. Desmopressin is an effective drug against nocturnal enuresis of children. The drug is more effective in children with familial history of primary nocturnal enuresis