Antibiotic resistance of isolated bacteria from urban and hospital wastewaters in Hamadan City

Widely use of antibiotics as therapy and uncontrolled discharge of them to receiving waters increased the percentages of antibiotic resistant bacteria in various environments which may cause problems in therapy. The aim of this study was to investigate the antibiotic resistance of E. coli, K. pneumoniae and P. aeruginosa bacteria isolated from urban and hospital wastewaters. Nine antibiotics namely Chloramphenicol, Ciprofloxacin, Trimethoprim Sulfamethoxazol, Gentamycin, Ceftizoxime, Nalidixic Acid, Ceftazidime, Ceftriaxon and Cefalexin were investigated in this study. Through a cross-sectional descriptive study the isolation of bacteria from hospital and urban wastewater samples was performed by microbiological identification techniques. The resistance to nine antibiotics was tested by application of the standard disc diffusion technique and zone-size interpretation chart of Kirby-Baeur. Non-parametric Mann-Whitney test was used to assessing two environments differences. The resistance percentage of E. coli to studied antibiotics was significantly less [ranged from 1.81 to 51.02%] than the resistance percentage of R aeroginosa [ranged from 3.57 to 61.76] and K. pneumoniae [ranged from 6.45 to 91.83%]. the highest resistance to antibiotics studied was for K. pneumonia in comparison with others. E. coli, K. pneumonia and P. aeroginosa bacteria showed the highest resistance to CAZ, SXT and CN, respectively. The study showed the resistance rate in hospital wastewater is more than urban wastewater. Easy access and uncontrolled usage of antibiotics cause discharge of antibiotics to wastewaters and consequently diminish the drugs' effectiveness. High concentration of antibiotic and diversity in wastewater of hospital in comparison with urban wastewater causes to transfer resistant agents between bacteria and increased the multiple resistances

[Teaching minimum learning essentials to orthopedic interns in Isfahan University of Medical Sciences]

The prevalence of musculoskeletal and orthopedic diseases is high in outpatient visits and emergency ward. Meanwhile, evidences show that there is no appropriate and sufficient education in this regard, in the educational programs of medical students and especially orthopedic interns. The aim of this study was to determine the accomplishment of minimum learning essentials by interns in orthopedic ward of Isfahan University of Medical Sciences. This descriptive study was conducted in educational hospitals of Isfahan Medical School in April and June 2006. A 14 item questionnaire including determined minimum learning essentials in 4 fields of surgery room, emergency, ward, and clinic was developed. Forty orthopedic interns, who at least had passed 3 months of their internship course, completed the questionnaire as self-administered. The data was analyzed by SPSS software using frequency distribution. All participants in this study performed the assessment of the "signs of the compartment syndrome" and "sutures" by themselves. Not all of the interns had received the needed education for casting and splint, doing different kinds of bandages, suturing open wounds and doing intra-articular injections. Interns could not achieve minimum learning essentials in orthopedic ward which was in accordance with previous studies. Therefore, it is necessary to implement a complete revision in educational programs of orthopedic interns such as extending the course duration, determining the task descriptions, and providing externship course

[ prevalence rate of congenital hypothyroidism in Kerman/Iran in 2005-2007]

Congenital hypothyroidism [C.H] is one of the most common infants' endocrine diseases and the cause of mental retardation in newborns. This study was performed to determine the prevalence of C.H and it's relation with neonatal's sex, birth weight and height and mothers' age, gestational age, parents' educational level, past medical history of thyroid disease in mother and family and consumption of Iodine salt by mother. A Total of 3000 neonates aged 2-5 days were screened from November 2005 to July 2006. Specimen collection and transportation to lab were performed according to NCCLS and Wisconsin newborn screening program guidelines. Thyroid stimulating Hormone [TSH] concentration in dried blood spot was determined quantitatively using ELISA technique. From 3000 neonates, 23 cases [0.8%] had TSH >/= 20 mIU/L that were recalled for verification of C.H. Of them, 13 cases [56%] were male and 10 cases [44%] were female. All of 23 infants were detected during 1-2 months after birth and 3 of them had serum TSH >/= 10 mIU/L. According to the protocol of kit they were considered as hypothyroidism cases and were referred for treatment. Considering the importance of congenital hypothyroidism in mental retardation, neonatal screening programs are of high importance. In this study, the prevalence of the disease was 1 in 1000 that is more than that in developed countries. Therefore, it should be considered as one of the hygienic priorities in our country

[Skin diseases in prisoners]

Prisoners are susceptible to dermatological diseases due to their communal life in prison, high-risk behaviours and being under stress. The aim of our project was to investigate the prevalence of dermatological diseases in an Iranian prison. In this observational-cross sectional study 1404 prisoners were randomly selected and examined by two dermatologists. All the examinees were male prisoners. Their average age was 34 +/- 11.2 and average time of imprisonment was 1.9+/- 2.8 years. 7% of cases [97] complained of generalized itching and 10% [140] had a localized itching. Tattoos were seen on the body of 261 prisoners [19%]. 783 person [56%] [CI 95%: 53-59%] had a dermatological disorder and 621 [44%] were totally healthy. Truncal Acne Vulgaris was the most common disorder that was seen in 184 cases [13%]. 158 cases [11.2%] had Tinea Versicolor. Other diseases were Facial Acne Vulgaris in 78 cases [5.5%], Dry Skin in 75 cases [5.3%] and Hand Eczema in 55 cases [4%]. The average age of patients with Facial and Truncal Acne was lower. However, Acne was seen more in the patients with history of addiction. Scabies was more prevalent in crowded rooms. The most prevalent skin diseases were truncal Acne and tinea versicolor; our finding revealed that scabies prevalence is meaningfully related to duration of imprisonment. It is recommended that all the prisoners should be examined before entering the prison and also periodically during their imprisonment in order to receive suitable treatment and decrease the risk of transmitting contagious diseases in prison

[Lower limb amputation in Iranian veterans of the imposed Iraq-Iran war]

Back ground: Despite their frequency, few reports exist concerning the long-term consequences of battle-injured lower limb amputations in Iranian Veterans of the Imposed Iraq-Iran War most of whom were young and otherwise healthy troops. Purpose of this study was to evaluate how well these patients function years after their injury

Methods and Materials: The study consisted a throughout assessment, examination and review of the history and wartime medical records of 168 Iranian Veterans who had undergone lower lime amputation at the time of the Imposed Iraq-Iran War [1980-1988]. The comprehensive survey consisted of a detailed questionnaire. Informations were analyzed and compared with few limited similar reports in the literature. In order to compare, we used the chi-square test

Results: Tripping a land mine or booby trap caused 60.7% of the injuries. The average age at the time of injury was 23.06 years old and 41.55 years old at the time of follow up. The average years of follow up was 17.36 years. The most common level of amputation was below knee [75.1%].The major complaints of the patients included symptoms such as phantom sensation [76%], phantom pain [30.9%] and stump pain [47.6%]. In addition, the prevalence of low back pain and contralateral hip or knee pain were 59.5% and 38.6%, respectively. Ninety patients [53.5%] had an occupation, 168 [100%] were married, 162 [96.4%] had children and 60 [35.7%] received psychological cares and services. Although, the prevalence of phantom sensation, phantom pain and stump pain was high in our patients, it was significantly lower than those seen in the veterans of other wars

Conclusion: Ours study showed better conditions of Iranian veteran amputees in the field of family status [marriage and having children] and psychological needs, but lower rate of occupation or employment in comparison with few counterpart studies in other countries