Rising cesarean sections rate

Objective: To identify cesarean section [CS] rate in Bahrain and evaluate the reasons for the rise of CS rate

Design: A Retrospective Cross-Sectional Analysis

Setting: Salmaniya Medical Complex, Kingdom of Bahrain

Method: All CS performed from 1 May 2011 to 31 October 2011 were included

The following patients' characteristics and clinical data were documented: age, nationality, maternal weight, parity, gestational age, number of gestation, birth weight and presentation. In addition to primary or repeat CS, indications of the procedure, uterine incision, type of anesthesia provided and immediate complications were documented

Result: One thousand five hundred thirty-five women had CS. Five hundred fifty-eight CS who had complete data were included in the study. The mean maternal age was 32 years +/- [SD 5.8]. Three hundred seventeen [56.8%] patients were Bahrainis

The mean gestational age was 37.1 weeks +/- [SD 2.7] with a mean neonatal birth weight of 3,012 grams +/- [SD 0.750]

One hundred sixty-one [28.9%] were primiparous and 397 [71.1%] were multiparous. Forty-six [8.2%] were performed for multiple gestations

Two hundred eighty-six [51.3%] were primary CS and 272 [48.7%] were repeat CS

The main indications for the procedure were repeat CS in 176 [31.5%], failure to progress in 104 [18.6%], non-reassuring fetal heart rate in 100 [17.9%] and breech presentation in 80 [14.3%]

Conclusion: CS rate is increasing in Bahrain; more than 30% of deliveries in Bahrain are by CS. Physicians should aim to reduce CS rate by lowering primary CS and allowing trial of scar in patients with previous CS

Biodiesel Fuel Production from Palm, Sunflower Waste Cooking Oil and Fish Byproduct Waste as Renewable Energy and Environmental Recycling Process.

Significant of the Study: Biomass is renewable, organic, plant and animal derived source of biomaterial that can be converted into different forms of biofuel, bioplastic, bio-solvent, and bioenergy using different biotechnological procedures. Biomass derived bio-fuel is biodegradable, nontoxic, sustainable and substitute for fossil fuel as well as capable to reduce greenhouse gas emission. It is renewable and outstanding energy resource for the creation of steam and electricity, transportation fuel, manufacturing industries. Biomass derived from animal and plants like, fruits, vegetable, crops, fish, chicken and other animal byproducts or waste biomass which can be used for bioenergy production like biofuel and nano-catalyst for biofuel. Aim: The purpose of this study was to compare and investigate the suitable biodiesel properties produced from waste fish byproducts, palm and sunflower oil which were more economically viable. Results: There was a total of 7, 5 and 4 types of fatty acid methyl esters presence in the fish, palm and sunflower biodiesel, respectively. The quality of biodiesel such as viscosity, total acid number, fuel consumption and emission rate was evaluated. The kinematic viscosity was maintained ASTM standard in case of all produced biodiesel. However, sunflower biodiesel was slightly viscous compared to palm and fish biodiesel. Metal elements such as phosphorus, magnesium, and calcium were present moderately in all biodiesel but it was limited range in fish oil. In the engine tests, the emissions of unburned hydrocarbons, oxides of nitrogen and carbon monoxide were lower in palm biodiesel than in sunflower and fish biodiesel. Fuel consumption was higher in palm biodiesel. Fish biodiesel had the lowest fuel consumption than that of palm and sunflower biodiesel. Conclusion: It can be concluded that waste palm oil and fish oil can be considered as a great potential source for commercial biodiesel.

Prevalence of sleep-related accidents among drivers in Saudi Arabia

The prevalence of sleepy driving and sleep-related accidents [SRA] varies widely, and no data exist regarding the prevalence of sleepy driving in Saudi Arabia. Therefore, this study was designed to determine the prevalence and predictors of sleepy driving, near-misses, and SRA among drivers in Saudi Arabia. A questionnaire was developed to assess sleep and driving in detail based on previously published data regarding sleepy driving. The questionnaire included 50 questions addressing socio-demographics, the Epworth Sleepiness Scale [ESS], driving items, and the Berlin Questionnaire. In total, 1,219 male drivers in public places were interviewed face-to-face. The included drivers had a mean age of 32.4 +/- 11.7 years and displayed a mean ESS score of 7.2 +/- 3.8. Among these drivers, 33.1% reported at least one near-miss accident caused by sleepiness. Among those who had actual accidents, 11.6% were attributed to sleepiness. In the past six months, drivers reported the following: 25.2% reported falling asleep at least once during, driving and 20.8% had to stop driving at least once because of severe sleepiness. Young age, feeling very sleepy during driving, and having at least one near-miss accident caused by sleepiness in the past six months were the only predictors of accidents. Sleepy driving is prevalent among male drivers in Saudi Arabia. Near-miss accidents caused by sleepiness are an important risk factor for car accidents and should be considered as a strong warning signal of future accidents

Sleep medicine services in Saudi Arabia: The 2013 national survey

We conducted this national survey to quantitatively assess sleep medicine services in the Kingdom of Saudi Arabia [KSA] and to identify obstacles that specialists and hospitals face, precluding the establishment of this service. A self-administered questionnaire was designed to collect the following: General information regarding each hospital, information regarding sleep medicine facilities [SFs], the number of beds, the number of sleep studies performed and obstacles to the establishment of SFs. The questionnaire and a cover letter explaining the study objectives were mailed and distributed by respiratory care practitioners to 32 governmental hospitals and 18 private hospitals and medical centers in the KSA. The survey identified 18 SFs in the KSA. The estimated per capita number of beds/year/100,000 people was 0.11 and the per capita polysomnography [PSG] rate was 18.0 PSG/year/100,000 people. The most important obstacles to the progress of sleep medicine in the KSA were a lack of trained sleep technologists and a lack of sleep medicine specialists. The sleep medicine services provided in the KSA have improved since the 2005 survey; however, these services are still below the level of service provided in developed countries. Organized efforts are needed to overcome the identified obstacles and challenges to the progress of sleep medicine in the KSA

Sleep estimation using BodyMedia's Sense Wear armband in patients with obstructive sleep apnea

We aimed to evaluate the validity of the BodyMedia's SenseWear Armband [BSA] device in estimating total sleep time [1[st]] in patients with obstructive sleep apnea [OSA]. Simultaneous overnight recordings of in-laboratory polysomnography [PSG] and BSA were performed on [1] 107 OSA patients [mean age of 45.2 +/- 14.3 years, mean apnea hypopnea index of 43 +/- 35.7/hr and [2] 30 controls matched with OSA patients for age and body mass index. An agreement analysis between the PSG and BSA scoring results was performed using the Bland and Altman method. There was no significant difference in OSA patients between BSA and PSG with regard to TST, total wake time, and sleep efficiency. There was also no significant difference in the controls between BSA and PSG with regard to TST, total wake time, and sleep efficiency. Bland Altman plots showed strong agreement between TST, wake time, and sleep efficiency for both OSA and the controls. The intraclass correlation coefficients revealed perfect agreement between BSA and PSG in different levels of OSA severity and both genders. The current data suggest that BSA is a reliable method for determining sleep in patients with OSA when compared against the gold standard test [PSG]. BSA can be a useful tool in determining sleep in patients with OSA and can be combined with portable sleep studies to determine TST

Sleep architecture of consolidated and split sleep due to the dawn [Fajr] prayer among Muslims and its impact on daytime sleepiness

Muslims are required to wake up early to pray [Fajr] at dawn [approximately one and one-half hours before sunrise]. Some Muslims wake up to pray Fajr and then sleep until it is time to work [split sleep], whereas others sleep continuously [consolidated sleep] until work time and pray Fajr upon awakening. To objectively assess sleep architecture and daytime sleepiness in consolidated and split sleep due to the Fajr prayer. A cross-sectional, single-center observational study in eight healthy male subjects with a mean age of 32.0 +/- 2.4 years. The participants spent three nights in the Sleep Disorders Center [SDC] at King Khalid University Hospital, where they participated in the study, which included [1] a medical checkup and an adaptation night, [2] a consolidated sleep night, and [3] a split-sleep night. Polysomnography [PSG] was conducted in the SDC following the standard protocol. Participants went to bed at 11:30 PM and woke up at 7:00 AM in the consolidated sleep protocol. In the split-sleep protocol, participants went to bed at 11:30 PM, woke up at 3:30 AM for 45 minutes, went back to bed at 4:15 AM, and finally woke up at 7:45 AM. PSG was followed by a multiple sleep latency test to assess the daytime sleepiness of the participants. There were no differences in sleep efficiency, the distribution of sleep stages, or daytime sleepiness between the two protocols. No differences were detected in sleep architecture or daytime sleepiness in the consolidated and split-sleep schedules when the total sleep duration was maintained

Molecular and seroepidemiological survey of visceral leishmaniasis among humans and domestic dogs in Mazandaran province, north of Iran

New cases of visceral leishmaniasis [VL] have been reported recently in some parts of Mazandaran Province, north of Iran where the first human case of VL was reported in 1949. This study aimed to determine the present status of Leishmania infantum infection among humans and domestic dogs using serological and molecular methods in central parts of Mazandaran Province. In this cross-sectional study, blood samples were randomly collected from 402 humans and fortynine domestic dogs throughout 2009 and 2010 in the central part of Mazandaran Province including Semeskadeh and Kiakola districts where recent cases of human visceral leishmaniasis had been reported there. All the collected samples were tested by direct agglutination test [DAT] for the detection of anti- Leishmania infantum antibodies as well as convenience PCR assay on whole blood samples for detection of leishmanial infection and identification of Leishmania species. None of 402 collected human [402] and dog [49] blood samples showed anti Leishmania infantum antibodies at titers 1:3200 and 1:320 as cut-off values of DAT, respectively but only 2 of domestic dogs [4.1%] were found PCR-positive corresponding to L .infantum. This study confirms the circulation of L. infantum at least among domestic dogs and highlights the sporadic pattern of VL in the studied areas. Further investigations regarding to sand flies fauna and wild canines as reservoir hosts of the disease, are recommended

Phytoremediation of Phenanthrene from soil by Sorghum

Contaminated lands around oil fields, especially soils contaminated by Polyaromatic hydrocarbons [PAHs] Are the common problem in these areas. PAHs such as Phenanthrene, Naphthalene, Benzo-a-pyrene are the major pollutant in the fields around petroleum refineries and arise largely as a result of coal and oil burning andother refineries activities. This causes an actual or potential threat to the environment and human, so removing them from polluted soil and water is necessary. In this regard, biological methods including "phytoremediation", as a new approach, are effective and economical. The aim of Phytoremediation in Contaminated lands is using the ability of plants to uptake, accumulate, degrade and removing toxic substances. This is a promising technology for the clean-up of petroleum contaminated soils, especially in the tropical area where climatic conditions favor plant growth and microbial activity and therefore the financial resources can be limited. Grass species are excellent candidates for Phytore mediation due to their extensive fibrous root system, which allow for more interaction between the rhizosphere microbial community and the contaminant. The present study was conducted to investigate the role of a warm season grass type, Sorghum vulgare Pers. Sudananse, in Phenanthrene, a major pollutant in soils around oil and gas fields, removal. The experiment was done in a green house scale with climatic conditions similar to mentioned region, in 16 weeks growth period. Physicochemicalparameters of agricultural soil were determined by standard methods as follows. pH and EC determination in saturated extract of soil. Micro and macroelement determination. Organic carbon content. Soiltexture by soil particle size determination. Field capacity 98% Phenanthrene from Aldrich chemical company was used as contamination source. Studies showed that contaminant limits, in the region is in the range of 13-17 mg/kg, so three concentrations of Phenanthrene, 10-15-20 mg/kg, was added to soil. Spiked soil was placed in 30 kg capacity blocks with 110x 46 cm dimensions and then Sorghum seeds were planted in 4-5 cm of surface. Treatments were as follows: Control :[Planted samples in non polluted soils]. Unp[l,2,3] Unplanted contaminated soil[10-15-20 mg/kg respectively]. P[1,2,3]: Planted contaminated soil[10-15-20mg/kg respectively] Phenanthrene content in soil and plant tissues was extracted to determine pollutant concentration in different times. The fate and presence of PAHs in plant root and rhizosphere may be predicted from their K[ow] or octanol-water partition coefficient which is characteristic for each organic compound and indicates their water solubility. Partitioning of compounds to the root surface from the soil solution is directly proportional to know values and inversely proportional to solubility

Prevalence of symptoms and risk of sleep apnea in middle-aged Saudi women in primary care

To assess the prevalence of symptoms and risks of obstructive sleep apnea [OSA] in a sample of middle-aged Saudi women in a primary care using a validated questionnaire. In this cross-sectional study, trained medical students administered the Berlin Questionnaire to a consecutive random sample of Saudi women in the age group 35-60 years, attending the primary health care center in King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia, between January and July 2007. Based on the questionnaire, individuals were classified into high-risk and low-risk groups for OSA. Four hundred women with a mean body mass index of 31.3+7.2 kg/m[2] were surveyed in this study. Among the study group, 40.8% reported snoring [everyday in 15%, 3-4 times a week in 7.5%, and one-2 times a week in 9.8%]. Breathing pauses more than 3 times per week was present in 22.5%. Hypertension was present in 24.8%. Based on the Berlin Questionnaire stratification for risk of OSA, 39% were considered as high-risk patients for OSA. In the primary care setting, the prevalence of symptoms of OSA among middle-aged Saudi women is very high. Almost 4 out of 10 middle-aged Saudi women are at risk for OSA, and may benefit from proper evaluation for OSA

Evaluation of critical thinking skills in Isfahan university of medical sciences' students and its relationship with their rank in university entrance exam rank

Are the education students receive prior to entering the university, based on critical thinking skills? Are their scientific abilities associated with this thinking style? This study was designed with the aim of evaluating critical thinking skills and its relationship with the achieved rank in university entrance exam in the students of Isfahan University of Medical Sciences. In a descriptive study, critical thinking skills of 89 randomly selected students who entered Isfahan University of Medical Sciences in the academic year of 2006-2007, and were spending their first semester was evaluated. Data was gathered using California standard test of critical thinking skills [form B] which was run officially. The attained scores were regarded as students' critical thinking skills criteria and were investigated considering its relationship with the students rank in university entrance exam. The data was analyzed by SPSS software using t-test and Pearson correlation coefficient. The mean and standard deviation of students' scores in critical thinking skills was 12.48 +/- 3.23 There was no significant relationship between the rank in university entrance exam and the total score of critical thinking. Among domains of critical thinking, there was just a significant relationship between the domain of inference and student's rank in the university entrance exam, with a relatively low correlation. In two groups of doctorate [professional doctorate] and bachelor students, only in doctorate students and in the domain of deductive reasoning, there was a significant correlation between university entrance exam rank and critical thinking scores. It seems that students' critical thinking scores at the time of their entrance to the university are not so desirable and their rank in the university entrance exam is not related to these skills. Therefore, it is necessary to consider teaching and promoting critical thinking skills in the university educational planning

[Community-acquiured methicillin-resistart Staphylococcus aureus: prevalence and risk factors]

Methicillin-resistant Staphylococcus aureus [MRSA] is resistant to most antibiotics and is an important pathogen of nosocomial infections. Colonization with MRSA is no longer limited to hospitalized patients or persons with predisposing risk factors and at present there are several strains of community-acquired MRSA [CA-MRSA]. The aim of this study was to determine the prevalence of community-acquired methicillin-resistant Staphylococcus aureus and also the colonization-associated risk factors. This cross-sectional study was conducted through random sampling of 1083 patients admitted to Qazvin hospitals from 2004 to 2006. Nasal swabs were obtained at admission and cultured on mannitol salt agar. Oxacillin-screening plate was used to demonstrate methicillin-resistance strains of SA [according to NCCLS guidelines]. Demographic and specific information were collected by questionnaire. Data were analyzed by Chi square test. The participants' age group ranged between 2 to 94 years [mean 42.24] among those, 468 [43.2%] were males and 615 [56.8%] females with 613 [56.6%] living in urban areas. Of 1083 individuals, 56 [5.2%] were SA carrier, 51 [4.7%] colonized with MSSA and 5[0.5%] with MRSA strains. Several factors such as occupation, family size, previous hospitalization, history of antibiotic therapy within the previous 2 months, and also the presence of chronic diseases were assessed, however, no significant relationship with MRSA colonization was found [p > 0.05]. This study confirmed the presence of CA-MRSA in Qazvin. There was no significant relationship between the prevalence of CA-MRSA strains and the risk factors

mathematical model to predict nickel concentration in Karaj river sediments

The contamination of surface waters through human activities has been intensified over the past years as population density has increased. Nickel is a metallic element and fuel combustion, nickel mining, refining waste, sewage sludge, and incineration are the major sources of nickel propagation. Nickel from various industrial wastewaters and other sources finally are disposed into water bodies. In this work, Karaj river was considered from 50° to 50° 14' longitudes and 35° 45' to 35° 58' latitudes and the presence of nickel was also assessed in this area. Sixteen stations were randomly selected and sediment samples were collected in polyethylene containers. Some water quality parameters such as pH, temperature, dissolved oxygen, electrical conductivity, were determind by direct on-site measurements. To measure COD, 16 water samples were collected in dark bottles and transferred to laboratory spatial parameters such as slope and distance from start point were also calculated by ARCGIS 9.2. The relation between Ni concentration with spatial parameters and water quality parameters were obtained by multivariate analysis. Results showed that there was a significant relation between Ni concentration in sediments and distance from start point and electrical conductivity

N-acetyl-beta-D-glucosaminidase and inflammatory response after cardiopulmonary bypass

To determine the changes in activity of plasma N-acetyl-Beta -D-glucosaminidase, a marker for inflammation as well as renal, pulmonary and cardiac damage and proinflammatory cytokines in patients undergoing coronary artery bypass grafting and find out the relationship between their plasma levels with clinical outcome of patients. Cross-sectional study. The Aga Khan University, Karachi, from January to June 2003. N-Acetyl-Beta -D-glucosaminidase [NAG] activity and concentrations of tumor necrosis factor-alpha of [TNF alpha], interleukin 6 [IL-6], interleukin 8 [IL8] and granulocyte-macrophage colony stimulating factor [GM-CSF] were monitored in plasma samples of 12 angina patients undergoing coronary artery bypass grafting [CABG], before, immediately after and 5 days post-surgical procedure. Serum glucose concentrations were also monitored in those patients. Patient`s clinical condition was monitored during this time period. No significant increase was observed in plasma NAG activity [a marker of inflammation] or in plasma levels of TNF alpha, IL-6, IL-8 and GM-CSF immediately after surgery, indicating that cardiopulmonary bypass itself does not produce any significant amount of inflammation immediately after CABG. However, 5 days post surgery, there was a significant increase in plasma NAG activity [p=0.001], TNF alpha [p=0.047] and GM-CSF [p=0.045]. There was no relationship between plasma NAG activity and clinical outcome because various parameters of renal, cardiac and pulmonary functions, though slightly affected, remained within the normal limits. Increased levels of NAG and TNF alpha did not affect clinical outcome. However, data suggest that NAG can be a potential marker for inflammation and end organ damage following CABG. An increase in GM-CSF on day 5 following CABG indicates enhanced body`s defense mechanism against infection

Osteochemonecrosis of jaws: our cases and management

There have been many reports from different centres of possible associations between osteochemonecrosis of jaws and use of bisphosphonates. A number of cases have been referred to our unit with osteonecrosis of jaw with the history of bisphosphonate use. In the view of our experience and recent publications, our cases and their management is discussed

[Comparison of serological methods for diagnosis of brucellosis]

Introduction: Brucellosis is one of the most prevalent infectious diseases in Iran. Clinical signs are not specific and laboratory methods are necessary for definite diagnosis. Isolation of microorganism from clinical samples is the most definitive methods, but its succession depends on many factors that can not be used in all cases. Standard agglutination test [SAT] and recently Enzyme Linked Immunosorbant Assay [ELISA] are the most important serological tests for diagnosis of brucellosis

Objective: In this study we compared these two diaghostic methods in patients suspected of brucellosis in Sari in 1381

Materials and Methods: In this descriptive study, all patients suspected of brucellosis who referred to health centers of Sari city from 1381/2/1 to 1381/8/1 were chosen regardless of age, sex and condition. Their sera were collected and tested by SAT, 2ME [according to WHO standard methods with Pasteur institute antigen] and Elisa [IBL Hamborg]. 1/80 titer in SAT consider as positive and 2 dilution difference between 2ME and SAT consider as positive IgM

Results: Overall the sera of 276 patients [183 female and 93 male] were tested for IgG and IgM antibodies against brucella. 12 samples were positive for IgG + IgM with both SAT and Elisa methods. IgG detected in 98 samples by Elisa method while 27 samples were positive for IgG by SAT. Elisa detected IgM in 6 samples while SAT and 2ME were negative and SAT and 2ME detected IgM in 3 samples while Elisa was negative

Conclusion: In diagnosis of acute brucellosis [IgM + IgG ] both technique were the same but in diagnosis of subacute and chronic disease [ IgG without IgM or visevera ] two methods were very different

[Serological survey of anti-Toxoplasma gondii antibodies in goats, sheep and cattle in slaughter houses of Mazandaran province, Iran]

Toxoplasmosis is a widespread zoonosis caused by Toxoplasma gondii. In addition to economic losses, this disease is transfer able to human and regarding the special ecological conditions of this parasite in nature of Mazandaran province, it is necessary to determine the situation of the disease. The purpose of this study was to determine the frequency of antibodies against T. gondii in cattle, sheep and goats slaughtered in official slaughterhouses in Mazandaran province, in 2004. To determine the prevalence of toxoplasmosis in slaughtered animals, in a descriptive cross-sectional study, 639 blood samples were obtained from cattle, sheep and goats between December 2004 and April 2005, from the three main geographical zones of Mazandaran province, Iran. Nine slaughterhouses were randomly selected in Western, Central and Eastern regions. Sera were extracted from 5mL venous blood samples, by centrifugation at 2000xg for 10 min, and were stored at -20°C prior to testing. Sera were screened for T. gondii antibodies by immunofluorescence antibody test [IFAT] and serum samples showing a titre of 1:16 were further diluted to determine the end point. Data were analyzed using Chi-square [X[2]] test. Of the 639 serum samples examined, 27.5% [176/639] showed positive titers equal or higher than 1:16 by IFAT. The highest frequency of antibody titres [1:16 titre] were found in sheep and the least in cattle [9%]. The highest infection rates in cattle were seen in western region with 5.5% antibody titres of 1:16. In three regions, 35% of sheep sera showed positive titers with high frequency of 1:16 antibody titre [17.3%] in Western region. Thirty percent of goat sera in 3 regions were seropositive and the highest infection rate was seen in 1:16 titre [18.5%] in Western region. The results of this study show that the presence of T. gondii specific antibodies for sheep and goats in Northern Iran is high, and the consequent risk of acquiring toxoplasmosis from human consumption of sheep and goat meat may be greater in this region

[Intestinal parasite infections in cattle breeders in rural regions of Babol town during 2003]

Parasitic infections, particularly of intestinal protozoan are very important for hygienic and medical points of views specially in the north of Iran in different ages and professional groups. The aim of this study was to determine intestinal parasitic infection in cattle breeders from rural areas of Babol town. In this descriptive study, stool samples were collected from 181 persons who were in contact with cattle [sheep and cows], lasted for one years. Samples were taken from each person under study and examined. Data were collected and analyzed by Chi-square and T-test statistically. this study indicated that the highest rate of infection was observed in persons aged 41-60 years and 62.4% of the cases were man. Rate of contamination to 13 species parasites in total samples were 57 [31.5%]. Highest rates of infection in infected persons were B. hominis and E. coli and G. lamblia. Rate of infection in both sexes to intestinal parasites especially intestinal protozoans in infected persons was different. Highest rate of infection to intestinal parasites was observed in illiterate persons. Infection with different types of pathogenic and non-pathogenic protozoan, particularly to blastocystosis and giardiasis indicating the significance of these infections for the health of the cattle breeders in rural regions of North of Iran. At present attention must be paid to protozoan as infection agent, which is having significant role in intestinal disorder

[Measurement of biochemical components of liver Hydatid cyst fluids in human, sheep, goat, cattle and camel; Mazandaran; 2004]

Different strains of Echinococcus Granulesus have been found in endemic areas of Iran. This variation has a significant aspect in the field of medical parasitology and veterinary and also in epidemiology, pathology, control and prevention of Hydatid cyst infection. Morphology, epidemiology and biochemical studies can be carried out to determine Hydatid cyst strains in human and animal origins as host. This study was done to measure different biochemical compositions of liver Hydatid cyst fluids in human, sheep, goat, cattle and camel in 2004.In a cross sectional-analytical study, 112 samples of Hydatid fluids were collected from the liver cysts of different hosts: 16 sheeps, 64 catties, 12 goats and 10 camels in slaughter houses of Sari and Ghaemshahr and 10 human in Imam hospital. All cyst fluids were centrifuged at 4500 rpm at 4°C for 45 minutes and the supernatants were analyzed for various biochemical parameters.Quantitative differences were observed in the levels of Sodium, Glucose, Urea, Alanin Aminotransferase [AST] in liver cystic fluids obtained from different hosts, although these differences were not statistically insignificant. However, differences in the levels of Potassium, Calcium, Triglycerides, Cholesterol, Uric acid, Creatinin, Albumin, Gamma Glutamyl Transferase, Aspartat Aminotransferase [AST] and Creatinine Phosphokinase [CPK] in different Hydatid cyst fluids were statistically significant [P<0.05].Differences in biochemical composition of different Hydatid cyst fluids suggest the possible existence of more than one strain of Echinococcus Granulosus in human and other intermediate domestic animal hosts in Mazandaran

Evaluation of blood cultures in Sari Hospitals

The aim of this study was to determine the rate of blood culture contamination, to describe and compare the epidemiologic, clinical and microbiological characteristics of hospital-and community - acquired blood stream infections. In this survey during one year [2002-2003] all patients over 18 years of age admitted in different hospitals for whom blood culture were drawn, were included. In the cases that positive blood cultures were drawn more than 72 hours after the patient had been admitted to the hospital or if the patients had been recently discharged from the hospital the infection was classified as hospital-acquired. If the cultures were drawn within 72 hours after admission to the hospital, the infection was classified as community-acquired. Severity of illness was categorized as non-fatal, ultimately-fatal, and rapidly-fatal according to McCabe and Jackson groups. For determining the susceptibility of isolated bacteria to the used antibiotics in the hospitals, Kirby-Bauer disk diffusion test was used and. the results were reported. The rates of positive blood cultures associated with significant bacteremia and contamination were 43.4%, and 21.7% respectively. Of the 168 episodes of bacteremia, 70.8% were hospital - acquired, and 29.2% were community - acquired. The most commonly isolated microorganisms were Staphylococci [49.6%], Escherichia coli [19.3%] and Klebsiella [16%] in hospital - acquired infection, and Pneumococci [24.5%], Brucella spp [20.4%] and Escherichia coli [16.3%] in community-acquired episodes. Mortality rate was 26.5% in hospital acquired and 17.2% in community-acquired infections. Fatal underlying diseases, severity of illness, severe sepsis, bladder and intravenous catheters, previous usage of antibiotics, previous surgery and tracheal intubation were found to be associated. with death in hospital-acquired infections. Nosocomial infections are more severe than others and antibiotic resistant bacteria will continue to challenge all who care for patients with bloodstream infections