Ventilator-associated pneumonia in a teaching hospital in Tehran and use of the Iranian Nosocomial Infections Surveillance software

Ventilator-associated pneumonia is the most common health-care-associated infection in the intensive care unit [ICU] and computer-assisted diagnosis and surveillance is called for. The frequency of ventilator-associated pneumonia was assessed prospectively during a 6-month period in the ICUs of a teaching hospital in Tehran, Islamic Republic of Iran. To determine the accuracy of the Iranian Nosocomial Infections Surveillance [INIS] system, patient data were input to the software and compared with physicians'judgement. The frequency of ventilator-associated pneumonia was 21.6%, or 9.96 episodes per1000 ventilator days. The duration of admission to the ICU, duration of mechanical ventilator and number of re-intubations were significantly higher in patients who developed pneumonia. The INIS system identified 100% of cases, with no false-positive or false-negative results. Compared with developed countries, the frequency of ventilator-associated pneumonia was high in our ICUs, and INIS software was accurate in diagnosing nosocomial infection

[ effect of intra abdominal wall infiltration with bupivacaine in reducing postoperative diclofenac need in elective cesarean sections]

Considering the side-effects of opiums and NSIADS drugs such as respiratory depression, apnea and GI effects, today it has been paid more attention to intra abdominal wall infiltration of local anesthetics for this purpose. The aim of this study is to determine the effect of intra abdominal wall infiltration with bupivacaine to reduce post operative diclofenac need in elective cesarean sections. In this double- blind, placebo-controlled trial, 60 healthy women with single term pregnancy underwent spinal anesthesia were randomized into two groups. Patients, then received a combination of 30cc of bupivacaine with 1.5cc of epinephrine as intra abdominal wall infiltration or equal volume of saline in cesarean section at the time of abdominal closure. Pain was assessed using a visual analogue scale 1, 2, 3, 4,8 and 12 h after the operation. Also mean diclofenac consumption was assessed during 12 h after the operation. The final analysis was done with statistical tests by SPSS [P<0.05 was considered significant]. Mean pain scores at 1 and 2 h after the operation was significantly lower in bupivacaine group than placebo [p<0.05]. Mean diclofenac consumption was lesser in bupivacaine group than placebo [p<0.05]. Also the time we prescribed diclofenac in bupivacaine group was later [p<0.05]. Intra abdominal wall infiltration with 30cc of 0.25% bupivacaine leads to less paid and less diclofenac consumption at the first hours after cesarean section

[Survey the knowledge attitude and practice on papsmear in nurses and midwives]

Despite the easy of detection of cervical cancers in the pre-cancer stage, it is still one of the most common cancers in Iran and the world. The responsibility of womens education about this safe and unexpositive screening test is for nurses and midwives. Survey the knowledge, attitude and practice on Popsmear in nurses and midwifes in Alzahra Maternity Hospital. In this cross-sectional study, 80 Nurses and midwives of Alzahra maternity Hospital were studied. Data collection tool was a questionnaire designed in 5 section to determine their knowledge, attitude and practice. Chi- square, Mann- Whitney - U, Fishers exact test, Kruskal-Wallis and T - student test SPSS ver14 were used for statical analysis. Knowledge of 91.3% of participations was scored as "Good" and it was significantly different between nurses and midwives. 83.8% of them has "positive" attitude toward the test. There was no significant relationship between attitude, age, duration of occupation and marital status of two groups. Nurses and midwives were matched in terms of age; marital status and duration of occupation.42/9% were remarked to have [good] practice. With regard to Knowledge role of nurses and midwives in performing papsmear screening test it is necessary to improvement their education and compare their attitude and practice

Fetal laceration injury during cesarean delivery

The rate of cesarean delivery has increased in last decade, whereas it has some complications. This study was conducted to determine the incidence of fetal laceration injury in cesarean delivery in Al-Zahara teaching maternity hospital [Rasht, June1999-October2000]. It was a retrospective study using records of all neonates delivered by cesarean section during a 16 months period in Al-Zahara teaching maternity hospital. Maternal and neonatal records were reviewed in those cases with documented fetal laceration injuries. Lacerated and non-lacerated neonates were compared for maternal and neonatal characteristics. There were 21 lacerated neonates [approximately%o. 4] out of 5289 neonates delivered by cesarean section during the study period. The incidence of laceration appeared to be higher in breach presentation and fetal distress when the indication of cesarean was considered [1.1% and 1%; p=0.045 and p=0.0026, respectively]. Fetal laceration injury is a rare complication of cesarean delivery in cases of breech presentation and fetal distress