Sesamum indicum (sesame) enhances NK anti-cancer activity, modulates Th1/Th2 balance, and suppresses macrophage inflammatory response

Objective: To evaluate the potential immunomodulatory effects of an aqueous extract of Sesamum indicum seeds with regard to splenocyte proliferation, Th1/Th2 balance, macrophage function, and the cytotoxic activity of natural killer (NK) cells. Methods: Splenocyte proliferation was measu red by [3H]-thymidine incorporation. Griess assay was performed to evaluate the production of nitric oxide by macrophages. The levels of cytokines secreted by splenocytes and macrophages were measured by ELISA. JAM assay was performed to examine the cytotoxic activity of NK cells againstYAC-1 tumor cells. Results: Sesamum indicum significantly enhanced splenocyte proliferation in a dose-dependent manner. Sesamum indicum also increased and suppressed the secretion of Th1 and Th2 cytokines, respectively, by splenocytes. The secretion of key pro-inflammatory mediators (IL-6, TNFα, and nitric oxide) by primary macrophages was significantly inhibited by Sesamum indicum. Moreover, Sesamum indicum increased the cytotoxic activity of NK cells againstYAC-1 tumor cells. Conclusions: Sesamum indicum shows potent immunomodulatory, anti-inflammatory, and anti-cancer effects. Constituents of Sesamum indicum may be used as effective therapeutic agents in regulating immune reactions implicated in various infectious and non-infectious conditions including cancer.

BMI and breast cancer in upper Egypt

Background and aim: BMI may be an important factor affecting breast cancer outcome

Materials and methods: The present study included 100 patients who were newly diagnosed with breast cancer a tAssiut University Hospital. Their BMI was measured, and the relation of BMI to the stage of breast cancer and age was determined

Results: Patients' ages ranged from 27.0 to 72.0 years. Overall, 45% of the patients were between the ages of 50 and 60 years, and their mean age was 50.6 years. Stage I, II, III, and IV breastcancer were diagnosed in 14, 64, 12, and 10% of the patients, respectively. Around 29% ofthe patients were overweight and 35% of them were obese. There was a significant positive correlation between age and BMI [P = 0.000]. In addition, there was a significant positive relation between BMI and the stage of breast cancer at diagnosis, with a statistical significant difference[P < 0.05]

Conclusion: Overweight and obese breast cancer patients were more often older, and this was significantlyassociated with later stages at diagnosis

[Antimicrobial effect of zataria multiflora and rosemarinus officinalis on antibiotic-resistant staphylococcus aureus strains isolated from food]

Staphylococcus aureuse is one of the important pathogens which transmitted by food and has majority of habitant in human and animal community as a pathogen and normal flora. Antibiotic resistant among Staphylococcus aureuse strains is a global health challenge. Regarding to the different therapeutic and antimicrobial effect of Shirazi Zataria multiflora and Rosemarinus officonalis in present work the antibacterial effect of this extract and its synergistic effect with routine antibiotics was investigated. In this in vitro study the antimicrobial effect of Shirazi Zataria multiflora and Rosemarinus officonalis extract on methicillin resistant Staphylococcus aureus [MRSA] and other antibiotic resistant strains to tetracycline, erithromycine, trimethoprim, sulfamethoxazol, together with its MIC and MBC were determined. Also synergistic effect of these extracts with these antibiotics was investigated by paper disc method. Shirazi zataria multiflora, had a significant antibacterial effect against MRSA, and other Staphylococcus aureus resistant strain to tetracycline, erithromycine, trimethoprim, and sulfametoxazol, isolated from food. Production of a suitable herbal medicine with few side effects will give rise to a promising outlook in the treatment of infections caused by antibiotic resistant strains of Staphylococcus aureus

[ trend of drug resistance in toxin and non-toxin producing Shigella Spp. isolated from stool of children with diarrhea]

Diarrhea is recognized as one of the main causes of morbidity and mortality in developing countries. Gastrointestinal diseases can lead to death of many children of less than 5 years of age. The aim of this study was to evaluate the drug resistance pattern in Shigella toxin and non-toxin producing strains in children. In this descriptive analytic study a total of 80 Shigella strains, 60 strains isolated from stool samples of children with diarrhea from Loghman, Emam and Tebi Koodakan Centre Hospitals, and 20 national collection strains isolated and reserved during the last years. The isolates were evaluated for cytotoxin production by using cell culture technique [Hela cell]. Our study included 54 strains of S. flexneri, 14 strains of S.sonnei, 10 strains of S. boydii and 2 strains of S. dysenteriae. Data were analyazed by means of chi-square and Fisher's exact test. Of 80 strains 9 [11.25%] showed cytotoxic effect. Chi-square test showed no significant difference between the isolated and national collection strains [P >/= 0.05].There was no correlation between the cytotoxic activity and clinical symptoms such as abdominal pain, nausea, and frequency of passing stools / day, but other symptoms like fever and presence of blood in the stool had correlation with cytotoxin production. The results of this study showed that there was no significant difference in the antimicrobial resistance pattern between toxin and non-toxin producing Shigella strains isolated from the clinical samples and the standard national collection

Air pollution and low birth weight: a historical cohort study from Tehran

This historical cohort study was designed to clarify the association between air pollution and low birth weight [LBW] amongst women referred to Tehran hospitals in 2007. In total, 225 eligible pregnant women who lived within 5 km of an air pollution monitoring station during their pregnancy were selected for the study. Data were collected via interview and hospital records. Exposure to each pollutant was estimated for each woman individually throughout her pregnancy and for each trimester. Exposures were modelled as categorical variables using inter-quartile ranges in a logistic regression model. The results showed a significant association between exposure to CO and LBW [OR = 2.08, 95% CI: 1.70-4.60], particularly during the second trimester [OR = 3.96, CI: 1.83-12.5. We conclude that exposure to air pollution during pregnancy may be associated with LBW

[Effect of immobilization stress on scratching behavior in male rat]

Background and aim: Stress is one of the most psychological disorders that can lead to many health problems, including vascular diseases of heart and brain, cancers and immunity suppression. Since it has been reported that there is a relationship between stress and skin inflammation in one hand, and inflammation and scratching on the other hand, in the present study the effect of immobilization stress has been investigated on skin scratching

Methods: In this experimental study, 26 male rats were randomly divided into control and case groups. Stress was induced in the case animals, two hours daily for five days. After inducing stress in each day, animals were observed for one hour and their scratching behavior was determined. The weight and scratching behavior were assessed before and 24 hour after the experiment. At the end of the examination, WBC counts were evaluated

Results: The mean frequency of scratching in days 1 and 2 was higher in the case group than the control group, but this difference was not found significant. However, in case group, mean frequency of scratching was significantly higher on day 3 [P<0.05], day 4 [P<0.01] and day 5 [P<0.001] compared to the control group

Conclusion: Our data showed that immobilization stress may lead to increase in skin scratching

[Effect of designed health education program on knowledge, attitude, practice and the rate Pediculosis Capitis in female primary school students in Chabahar city]

Background and aim: Pediculosis Capitis is one of the important health problems in students which cause physical, mental and social complications. The aim of this study was to determine the effect of designed health education program on knowledge, attitude, practice and Pediculosis Capitis rate among female elementary students in Chabahar city during 2008 and 2009

Methods: This research was a quasi-experimental [case -control] study. Data gathering tools were questionnaire, check list and head examination. Two schools were randomly selected among female primary schools in Chabhar and 153 students were divided into case and control groups. After collecting the data, an educational program was designed and performed in case group and was evaluated after 2 months. Data were analyzed using Chi-square, Wilcoxon-Mann Whitney, and McNemar tests

Results: Results showed a significant difference in knowledge, attitude and practice of the students in the case group before and after the educational program [P<0.001], however, it was not significant in the control group [P>0.05]. The infestation rate was 69.3% in the case group before education and 82.1% in the control group which decreased to 26.7% in the case group after the education [P<0.001]. However, it was not significant in the control group [P>0.05]. Significant relationship was observed between infection and the variables such as father's level of education, number of bedrooms, number of individuals per room, existence of continuous water at home, type of hair, history of infection in students and infected cases in the family [P<0.05]

Conclusion: The health education program had a positive effect on the reduction of Pediculosis Capitis among students. Therefore, performing and evaluating educational programs for students and their parents is suggested

[Effects of education on the knowledge and self-efficacy of health volunteers about the necessity of moldy bread separation from other bread waste]

Bread waste is consumed as a food in the livestock, and can cause considerable harm to human and animal beings if they are moldy. Since health volunteers can convey health knowledge to people in a simple and intelligible language, the present study was conducted to evaluate the knowledge of health volunteers about the necessity of moldy bread separation from other bread waste and the effect of education on their knowledge in the Abkooh Sugar Factory of Mashhad. In this interventional experimental study, 39 active health volunteers at the health center of Abkooh Sugar Factory of Mashhad, Iran participated and were recruited by non-probability convenient sampling, and were randomly assigned into the experimental group [n=21] and control group [n=18]. Relevant data were collected through questionnaire and training was performed by providing a CD [educational video] for the experimental group. After a two-month training period, data were collected again. Data of before and after training were analyzed in SPSS 16 using paired t-test and mean +/- SD [p < 0.05]. After training, the scores of volunteers in the intervention group raised from 22.86 +/- 4.8 to 26.36 +/- 4.9; and paired t-test showed a significant difference between their scores before and after education [p=0.03]. Also, their perceived self-efficacy on the necessity of separation of moldy bread from other bread waste was significantly different across the two groups [p=0.023]. The results indicated the effect of education on the knowledge of health volunteers about the necessity of moldy bread separation from other bread waste

Serum prohepcidin, iron and hepatic iron status in chronic hepatitis C in Egyptian patients

Patients with chronic hepatitis C [CHC] often have increased liver iron. Hepcidin has recently emerged as a key regulator for iron homeostasis. Therefore, we aimed to study the relationship between serum prohepcidin, serum iron indices, hepatic necro-inflammation, fibrosis and hepatic iron density and to determine the predictors of advanced fibrosis in these patients. Fifty CHC treatment naive patients and 20 healthy controls were enrolled in this study. Complete blood count, liver function tests, serum iron indices and serum prohepcidin were assayed. Liver biopsy was performed for all patients for assessment of necro-inflammatory activity, fibrosis and liver iron density. Thirty-four patients [68%] had mild fibrosis [stage 0, 1,2] and sixteen [32%] had advanced fibrosis [stage 3, 4]. All cases were positive for liver iron stain [68% mild, 32% advanced]. Mean serum prohepcidin level was significantly lower in CHC patients than healthy controls. In univariate analysis, prohepcidin was significantly associated with necro-inflammatory activity [P<0.05] and advanced fibrosis [P<0.05]. Multivariate analysis revealed that necro-inflammatory activity and liver iron density arc independently associated with stage of fibrosis. No significant correlations were found between prohepcidin and serum iron indices or liver iron score. Scrum prohcpcidin is reduced in CHC which may be one -not the only- factor leading to iron overload in these patients. Histological grading and hepatic iron density are independent predictors of advanced fibrosis. Further studies are needed to clarify the role of viral and host genetic factors in hepatic iron deposition

Can serum fibrosis markers predict medium/large oesophageal varices in patients with liver cirrhosis?

Non-invasive predictors of medium/large oesophageal varices [LOVs] could reduce the number of screening endoscopies. As portal hypertension is a consequence of liver fibrosis, serum fibrosis markers were evaluated together with other variables as possible non-invasive predictors of medium OV/LOV. A total of 154 cirrhotic patients with splenomegaly and 30 healthy control subjects were recruited in a prospective study in two gastroenterology centres in Upper Egypt. Clinical parameters assessed included Child-Pugh class, liver size and ascites. Laboratory parameters included complete blood count, liver function tests, and aspartate aminotransferase [AST]/platelet ratio. Transforming growth factor-p! [TGF-beta [1]], alpha2 macro globulin [A[2]M] and hyaluronic acid [HA] were assayed. Ultraso-nographic examination was done for assessment of liver span, portal vein diameter and detection of minimal ascites. Oesophageal varices were diagnosed and graded by oesophagogastroduodenoscopy. Fifty-four patients [35%] had no or small varices and 100 [65%] patients had medium OV/LOV by endoscopy. On multivariate analysis, the independent predictors of medium OV/LOV were the presence of ascites [beta = 0.258, p = 0.047] and serum HA [beta = 0.449, p = 0.009]. The receiver operating characteristic curve for HA showed the area under the curve to be 0.916. The sensitivity, specificity, positive and negative predictive values and diagnostic accuracy of HA at a cut-off value of 207 micro g T[1] were 94%, 77.8%, 88.7%, 87.5% and 88.3%, respectively. The presence of ascites and serum HA level higher than 207 micro g T[1] can predict the presence of medium OV/LOV in cirrhotic patients. This would help physicians to identify patients who would most likely benefit from screening endoscopy and thus, reduce costs and discomfort from unnecessary endoscopic procedures

[Family system and its effect's on HIV/AIDS high risk behaviors: a qualitative study]

The statistics of HIV/AIDS patients are increasing in the world and Iran. Since previous studies indicated that family structure and communication had an important role in high risk behaviors engagement, Assessing role of family system in high risk behaviors would be help to explore solving problem and prventing high risk behaviors. To determine the effect of family on high risk behaviors. This thematic analysis study with qualitative approach was done during 10 months in Behavioral Counseling Clinic of Imam Khomeini Hospital and West Clinic in Tehran. The participated patient were selected by purposeful sampling and data was obtained from in dept and semi-structured interview with open end questions. Total interview was recorded and typed word to word. For analysies the results review of transcripts, themes gained from data and coded categorized were done. Among 61 HIV/AIDS patients 45cases were HIV positive and 16 cases were AIDS patients with range age 21-42 years old with average age of 29.7 +/- 4.86. There were 62.3% males and 37.7 were females. Majority of them was single with secondary and high school educational level. Themes consisted of: 1- defect in family function 2- vulnareble structure of family 3- risky family norms. This study showed that core variable was inadequate support of family. Then increasing support of family in adolescents and family base intervention can reduce high risk baheviors and HIV/AIDS incidence

[Antibacterial effects of Rosmarinus officinalis on methicillin - resistant Staphylococcus aureus isolated from patients and foods]

Methicillin-resistant Staphylcoccus aureus [MRSA] is considered a major problem in the world. This strain colonizes nose and causes increased incidence of nosocomial infections, mortality and morbidity. Rosemary [Rosmarinus officinalis] is a herbal medicine widely used all over the world. The aim of this study was to evaluate the in vitro antimicrobial activity of rosemary essence on MRSA isolated from patients and food. 200 strains of MRSA, 100 from patients and 100 from food samples, were collected and analyzed in Tehran, during the last year. 28 MRSA strains and multi drug resistant [MDR] strains were isolated. The antimicrobial activity of the rosemary essence against different isolates of the microorganism was evaluated by disk diffusion and macro broth dilution methods. MRSA isolates belonged to 25% and 60% of food and clinical samples, respectively. The results showed effective and similar antimicrobial activity of Rosmarinus officinalis on broth clinical and food samples with an inhibition zone of 20mm in diameter. The minimum inhibitory concentration [MIC] and minimum bactericidal concentration [MBC] in our study were 1.40 mg/ml and 2.81 mg/ml, respectively. Overuse of antibiotics has led to extensive bacterial resistance to antibiotics, which demonstrates the need for use of new antimicrobial agents. Considering increasing prevalence of MRSA strains and the beneficial effect of rosemary essence on these strains, this essence can be recommended for the treatment of MRSA infections

[ effect of health education program on knowledge, attitude and performance in male primary school students regarding Tinea capitis in Chabahar]

In many parts of the world Tinea Capitis is a public health problem, especially in primary school children. The control of the disease is dependent on patients' education for increasing their knowledge and health. The aim of this study was to evaluate on knowledge, attitude and performance in male primary school students regarding Tinea Capitis in Chabahar in 2007-2008. In this quasi-experimental [case - control] study, 115 primary school students were randomly selected from two primary school in the city of Chabahar. Students were assigned into two groups. Tools and data collection methods were included: questionnaire, check list and laboratory samples of scalp and hair. At the beginning of the research, a pre-test was performed on the students and according to the data obtained, an educational program were prepared and was performed for experimental group. Post-test was done after two months. Data was analyzed using chi-square, Mann-Whitney, Wilcoxon and McNemar tests. The findings showed a significant increase in the knowledge, attitude, performance in experimental group [P<0.001]. In addition, experimental group demonstrated a significant decrease in Tinea Capitis [P<0.01]. The results of this study showed that there is a significant relationship between Tinea Capitis and weight, type of skin and parents' education [P<0.05]. The results of this research show that the risk of Tinea Capitis transmission is a public health problem and health education is a suitable response to this problem

[Correlates of unwanted pregnancy among pregnant women attending medical and health centers in Semnan, Iran]

Unwanted pregnancy is one of the most important causes of mother and child mortality. It may end up to illegal abortion and result in inevitable physical and psychological consequences. This study aimed to determine the correlates of unwanted pregnancy among pregnant women attending medical and health centers in Semnan. In this cross-sectional study, we recruited 229 pregnant women using random sampling. Women with at least one alive child were recruited. Data were gathered using a questionnaire and analyzed using descriptive and analytical statistical tests. The mean age was 30.7. The mean age at marriage was 19.7. Of all women, 32.3% had unwanted pregnancy. The results showed that there were significant relationships between age of marriage [P<0.05], current age of women [P<0.05], level of education [P<0.05], No. of children [P<0.01], employment [P<0.05], and income [P<0.01] with unwanted pregnancy. The prevalence rate of unwanted pregnancy was high in the studied population. Educational programs regarding correct methods of contraceptive usages are required

Alterations in thyroid gland size and functions in cirrhotic patients: relationships with splanchnic haemodynamics

Thyroid dysfunction has long been reported in liver diseases. But limited informations are available on thyroid size and the involvement of thyroid hormones in the haemodynamic alterations of cirrhosis. To 1] study changes in thyroid gland volume and functions in different grades of liver cirrhosis. 2] Investigate the relationship of thyroid hormone levels to changes in the hepatic and splenic haemodynamics in cirrhotic patients. Thirty-six cirrhotic patients with different disease severity were chosen according to Child- Pugh classification [12 Child class A, 12 Child Band 12 Child C]. Twelve healthy controls were included in the study. For all subjects, serum levels of FT3, FT4 and TSH levels were measured. An ultrasound scan of the thyroid was done for measuring thyroid volume. A colour Doppler ultrasound scan of the abdomen was performed for measuring portal vein diameter [PVD], cross sectional area, maximal velocity [PV V max], mean velocity [PV V mean], blood flow rate [PV BFR] and congestion index [CI]. Hepatic and splenic arteries resistive indices [HA RI, SA RI] were also studied. Total thyroid volume was increased in patients compared to healthy controls and it significantly increased with progression of the disease from Child A to C. Mean serum levels of free T3 [FT3], free FT4 [FT4] and TSH were significantly decreased in patients compared to healthy controls. However, they were not correlated to thyroid volume. FT4 had a significant negative correlation with PVD, PV BFR and CI, while FT3 had a significant positive correlation with PV V max. Total thyroid volume showed a significant negative correlation with PV V max and positive correlations with both CI and HA RI. Thyroid volume is increased in cirrhotic patients independently from thyroid hormones status. Low FT4 values of cirrhotic patients may participate in arterial vasoconstriction present in hepatic and splenic arteries. FT4 levels are directly correlated with Doppler parameters of portal hypertension

effect of childbirth preparation classes on childbirth fear and normal delivery among primiparous women

There has been an increase in the number of women willing to have a caesarean birth because of their fear of childbirth. It seems the childbirth preparation educational class is a good way to remove or alleviate fears associated with pregnancy and childbirth.This research designed to identify the effect of childbirth preparation classes on childbirth fear on the primiparous women. The present study is a clinical trial which was carried out in 2007 at Milad Hospital, with 100 nulliparous pregnant women. Childbirth fear was measured by childbirth attitudes questionnaire. Normal pregnant women in the second trimester with childbirth fear score was 28 or more were randomly selected and dirided into experimental and control group with 50 subject in each qroup. The experimental group attended nine childbirth preparation class sessions and control group received routine antennal care. The mean scored fear of childbirth in case and control group were 39.35 +/- 6.96 and 40.71 +/- 6.23 respectively. There was not significant difference between two groups. After the sessions, comparing childbirth fear score between two groups in third trimester showed the mean score of childbirth fear among experimental group was lower than control group [29.82 +/- 7.18 compare to 38.03 +/- 9.27], and the differences statistically was significant [p < 0.001]. Mode of delivery was significantly different between the two groups. Primiparous women attended childbirth preparation classes acquired lower score of childbirth fear in compare to women received routine prenatal care. The results of this research showed relaxation training decreased childbirth fear and increased normal vaginal delivery

Endothelial cell dysfunction and inflammatory process in type 1 diabetic patients with-and without micro vascular disease

Endothelial cell dysfunction results in altered production of cell adhesion molecules [CAMs] that may be involved in the pathogenesis of diabetic microvascular disease. Increased circulating cytokines may also be involved in this process. The aim of the present study was to evaluate levels of some CAMs and cytokines in children and adolescents with type 1 diabetes. It was also aimed to assess these parameters in relation to microvascular complications and certain risk factors. The study included 45 cases with type 1 diabetes aged 8-22 years of whom, 30 cases had evidence of microangiopathy [retinopathy or nephropathy] and 15 cases had not. Fifteen apparently healthy matchable subjects were included as controls. Cases were subjected to full history taking and physical examination. Direct ophthalmoscopy and fluorescein angiography were used to diagnose retinopathy, while nephropathy was diagnosed by detection of microalbuminuria. Level of glycated hemoglobin [HbA[1c]] and serum levels of sVCAM-1 and sE-selectin as well as IL-6 and TNF alpha were assessed for all patients and controls. The results showed that diabetic patients as a whole had significantly higher serum levels of sVCAM-lt sE-selectin, IL-6 and TNF alpha than controls. Post pubertal age, long duration of illness, obesity and high HbA[1c] level were significant risk factors for higher levels of CAMs. Significant positive correlations were found between levels of HbA[1c] and each of serum levels of sE-selectin and IL-6. Also significant positive correlations were found between each of serum levels of sVCAM-1 and sE-selectin, and IL-6 and TNF alpha. Patients with evidence of microangiopathy had significantly higher level of sVCAM-1 than cases without, and the latter group had significantly higher level of sE-selectin than controls. It is concluded that young patients with type 1 diabetes had significant markers of endothelial cell dysfunction particularly in those with microvascular disease. Screening of diabetic patients with E-selectin may help early diagnosis of endothelial dysfunction. Strict glycemic control and new therapeutic targets are mandatory to improve diabetic outcome in such cases

Comparative study of different methods of diagnosis of invasive fungal infection in immunocompromised patients

Fungal infection is still a major cause of morbidity and mortality in cancer patients. Our study was conducted on 50 patients attending Al-Hussein university hospital complaining from different types of cancer were suffering from low grade fever, night sweat, weight loss, lassitude and easy fatigability. The cases were matched with 10 healthy controls of the same age and sex. Blood samples were collected and cultured to isolate fungal pathogens using conventional methods and BACTEC system. Positive cases were subcultured on Sabouraud dextrose Agar [SDA]. We describe a multiplex polymerase chain reaction [PCR] based approach to the detection and identification of pathogenic fungi which has potential for the diagnosis of invasive mycoses. PCR allowed the detection [universal PCR] and identification [species-specific PCR] of a fungal pathogen within 6 h from blood samples. Fungal isolates detected and identified using conventional and confirmatory methods were 7 cases [14%], while fungal isolates detected using PCR were 8 cases [18%]. Sensitivity and specificity of conventional methods in relation to PCR was; sensitivity [87.5%] and specificity [98.1%]. In our study Candida species were the only fungal pathogens with different frequency; Candida albicans [4 isolates], Candida tropicalis [2 isolates], Candida glabrata [1 isolate] and Candida parapsilosis [1 isolate]

Waiting time for emergency surgeries in a tertiary care public hospital - a performance audit

To find out the waiting time for emergency surgeries and to identify causes responsible for this delay in a tertiary care public hospital.Settings: Surgical Unit IV, Civil Hospital, Karachi.Patients and Patients admitted through emergency for immediate emergency operations during the month of November and December, 2003 were included in the study. For data collection a proforma was made which included diagnosis, operation performed, time of planning immediate surgery, time of surgery, causes responsible for delay apart from demographic information.Main outcome measures: Waiting time for emergency surgeries, different causes responsible for the delay. A total of 45 patients were enrolled in the audit study. Majority of patients 14 [31.1%] were suffering from acute appendicitis. 33 [73.3%] of patients had to wait for more than 3 hours before their emergency surgery. Major cause of this delay in 33.6% of patients was due to surgical team doctor's inefficiency. In 7 [21.2%] patients surgery was delayed due to late night admission and in 6 [18.1%] due to non-availability of cross matched blood. In 5 [15.1%] patients surgery was delayed due to unavoidable causes like busy theatre and arrival of more serious patients. A substantial number of patients needing emergency surgery waited too long for the surgical management. Majority of delays were due to causes which can be addressed to improve the patients care

Prevalence of clostridium difficile- associated diarrhean in hospitalized patients with nosocomial diarrhea

Clostridium difficile is a frequently identified cause of nosocomial gastrointestinal disease. It has been proved to be a causative agent in antibiotic-associated diarrhea, antibiotic-associated colitis, and pseudomembraneous colitis. This study was aimed to determine the prevalence of C.difficile- associated diarrhea in hospitalized patients with nosocomial diarrhea. The 942 hospitalized patients stool samples with nosocomial diarrhea were collected at three hospitals in Tehran from Dec 2002 to Feb 2004.All the stool samples were cultured and in 97 [prevalence: 10.9%] samples grew C.difficile that 57 [prevalence: 6.1%] isolates were toxigenic by cytotoxicity assay and so 57 patients had C.difficile- associated diarrhea. Results of statistical analysis showed significant difference between the rate of C.difficile associated diarrhea and the patients ages [P<0.05]