[ prevalence and antibacterial susceptibility pattern of enteropathogenic Escherichia coli [EPEC] strains isolated from less than 5 years old children with diarrhea hospitalized in Shahrekord Hajar hospital -2007]

Enteropathogenic Escherichia coli [EPEC] strains are among the most important diarrheagenic agents in developing countries. This study aimed to determine the common serotypes and antibacterial susceptibility pattern of EPEC strains isolated from less than 5 years old children with diarrhea hospitalized in Shahrekord-Hajar hospital in first six months of 2007. A total of 50 rectal swabs were collected from less than 5 years old children with diarrhea. In addition, 50 rectal swabs were obtained from outpatient children without history of diarrhea and gastroenteritis as control group. Stool samples were cultured on differential media EMB and Mac Conkey agar and incubated overnight in 35°C. Standard biochemical tests [IMVIC] were used for identification of bacteria. Confirmation of isolated bacteria as EPEC strains was performed with specific antisera [Bahar Afshan-Tehran] using slide agglutination method. Besides, antibacterial susceptibility pattern of 13 EPEC isolates against some common antibiotics: cephalotin, ampicillin, nalidixic acid, sulfamethoxazol- trimethoprim, gentamicin, ceftriaxone, ciprofloxacine and nitrofurantoin was evaluated using disk diffusion method. Data were analyzed using t-test, chi-square and logistic regression. EPEC strains were isolated from 26% of the children with diarrhea [13 patients] compared with 4% of children without diarrhea [2 cases]. Our data showed that fifty percent of the EPEC isolates were belonged to O44, O125, O126 and 0128 serogroups. In addition, 33.3% of the EPEC isolates were belonged to O20, O114 serogroups and finally, 16.6% were belonged to O26, O55 and O111 serogroups, Nitrofurantoin, ciprofloxacin and gentamicin were the most effective antibiotics against EPEC bacteria. The prevalence of EPEC demonstrates the important role of these strains in causing of acute diarrhea in children. Therefore, we suggest the application of routine diagnostic tests for identification and serogrouping of EPEC strains in bacteriologic laboratories

Evaluation of the laparoscopic adrenalectomy results

Laparoscopic adrenalectomy is the operation of choice for benign adrenal lesion. We report of our experience in laparoscopic adrenalectomy that were performed for first time in Tabriz. From September 2003 to September 2005, six patients with adrenal lesions underwent laparoscopic adrenalectomy through transperitoneal approach. Two of them were simultaneous bilateral adrenalectomy. Preoperative evaluation including CT Scan, MRI, MIBG scan, endocrine tests such as, cortisol, ACTH, mineralocorticoid, 17- hydroxy progesterone and VMA .The results were analyzed by SPSS. Six patients, [3 females and 3 males], underwent on laparoscoic surgery. Mean age was 40.2 [range 30-65] years. Lesion was located at right in 5 patients and 3 at left. Mean operative time was 180 +/- 30.62, [126-300], minutes. Mean hospitalization was 3.1 [3-5] days. Mean size of mass was 4.5 +/- 1.8 [4-8] cm. In one case, because of the adhesion of mass to the posterior side of venacava, convertion was necessary. No significant major intra or post operative complication and we didn't need to transfusion. At the 9 months following, hormonal tests and blood pressure were normal. The mean postoperative follow up time were 9 [range 3-24] months. Due to our limited experience on advanced urologic laparoscopy this study showed that transperitoneal laparoscopic adrenalectomy is an effective and safe approach in the treatment of adrenal disorders with the least morbidity