Changes in antibiotic use in a general surgery unit over a 5-year period

Concerns have been expressed about the overuse of antibiotics in inpatient settings. We compared the pattern of antibiotic use in 2010 in a surgical unit of a university hospital in the Islamic Republic of Iran with similar data from 2006. Defined daily doses per 100 bed-days [DBD] were calculated. Overall use of antibiotics in our surgical unit increased significantly from a mean of 4.9 [SD 5.1] DBD in 2006 to 7.7 [SD 10.3] DBD in 2010. This increase was mainly due to increases in the use of antibiotics for treatment of infections; the prophylactic use of antibiotics did not show a significant increase. There was an increase in the consumption of ceftriaxone, imipenem, cefalotin, metronidazole and vancomycin, a decrease in the use of erythromycin and ceftazidime and no change in the use of ciprofloxacin and clindamycin. Ceftriaxone showed the greatest increase [5.1-fold] and erythromycin the sharpest decrease [8-fold] in use

case of perosomus elumbis concurrent with visceral abnormalities in a Holstein calf

Perosomus elumbis is an occasional congenital anomaly of cattle, swine, sheep, and dogs with unknown etiology. This congenital abnormality occurs in both sexes. A dead Holstein calf characterized by musculoskeletal and external genitalia abnormalities was referred to the large animal hospital of University of Tehran. Radiographic evaluation and subsequent dissection revealed that the vertebral column was truncated at the level of first lumbar vertebra [L1]. Moreover, L2-L5, sacrum and coccygeal vertebrae were absent. The dorsum of the lumbosacral region contained only soft tissues. Urogenital tract was incomplete, and it contained agenesis of the ovaries, uterine tubes, cervix, and vulva concurrent with unilateral umbilical artery agenesis. Small and large intestine contained blind-ended sacs. No testes, scrotum, and penis were found. The intact ureter was attached to a thin-walled fluid fill sac. The laboratory finding showed that the pH of the fluid was 6 and contained hemoglobin, white blood cells, bacteria, a few red blood cells, oxalate crystalline, and epithelial cells. It was concluded that the collected fluid was urine. This is the first report of perosomus elumbis in a Holstein calf having a lot of visceral abnormalities in Iran

Transcriptional effects of metal ions on the bovine oxytocin and the thymidine kinase-ERE promoter through the estrogen receptor alpha in MDA-MB 231 breast cancer cell line

Some of metal ions as environmental pollutants show estrogenic activity. This xenostrogenic compounds can be caused carcinogenicity in organs. The mechanism of carcinogenicity of metal ions is not clarified. In this study, we investigated the Transcriptional effects of variety of metal ions on the bovine oxytocin and the thymidine kinase-ERE promoter by estrogen receptor alpha in MDA-MB 231 breast cancer cell line. Cells were plated into flask [75cm[2]] at 1.3 density or into 12- well plates [Nunc] at a density of 100000 cells per well and were transfected with a total of 3 micro g of plasmid DNA using calcium phosphate coprecipitation. Oestrogen and some metal ions were used for stimulation of transfected cells. Our results showed that copper and cadmium ions activating specifically the oxytocin promoter, and cobalt and possibly, mercury ions activating specifically the ERE-controlled promoter and the majority of the ions did not affect transcriptional activation significantly. The study revealed that some metal ions show estrogenic activity by classical or non-classical mechanisms as well as some metal ions exhibit estrogenic activity by undetermined mechanisms in transfected MDA-MB 231 cell line

Ovulatory response of different GnRH analogues and subsequent corpus luteum lifespan in the presence of norgestomet in Holstein heifers

This study investigated the effect of GnRH analogues on inducing ovulation of dominant follicle [DF] and subsequent corpus luteum [CL] lifespan in the presence of norgestomet implant in Holstein heifers. On day 6 to 8 of the estrous cycle [day 0 of the experiment], all heifers [n=15] received norgestomet implant followed by prostaglandin injection on days 0 and 1. On day 4, group 1 [n=4] and 2 [n=4] heifers received 12.5 and 25 microg Alarelin, respectively. Heifers in group 3 [n=3] received 10 microg Buserelin. Heifers in control group [n=4] did not receive any further treatment. Norgestomet was removed on day 8 in the treatment group and kept throughout the experiment in control group. From day 0, blood sampling and ultrasonography were performed. Heifers were monitored after inducing ovulation for 2 consecutive estrous cycles. DF ovulated within 33 h after GnRH injection. Progesterone started to rise on day 3 and declined on day 7.45 +/- 0.28 after GnRH injection. Heifers in treatment groups displayed estrus 7.73 +/- 0.24 days after GnRH injection followed by spontaneous ovulation. The lifespan of CLs were 5.36 +/- 0.28 and 16.9 +/- 0.37 days after inducing ovulation of DF in the presence of norgestomet and following spontaneous ovulation, respectively [P<0.05]. In conclusion, the half dose of Alarelin induced ovulation of DF and the presence of single norgestomet implant after ovulation may be associated with short luteal lifespan

[Evaluation of 4-Amino salicylic acid chelating effect on healing of manganese induced intoxications in male Wistar rat's liver]

Manganese related jobs [Mn miners] may cause Manganism, a Parkinson like disease. Chelators are suggested to reduce these effects. This study was carried out to investigate the effect of 4-Amino Salicylic acid chelating effects. This experimental study was done on 20 adult male Wistar rats. The rats were classified into four groups, 5 in each group, as follows: one control and three experimental groups. In two phases the groups received Salin-Salin, Manganese-Salin, Salin-4-Amino acid and Manganese -4-Amini acid, respectively. Eight mg/kg of manganese chloride i.p. injection for 1 week and 1.5g/l of PAS s.c injection five-day in a week for four weeks, were used for intoxication and treatment, respectively. Serum and liver tissues were separated. Data were analyzed using ANOVA and Tukey's tests. Biochemical factors showed cholesterol increment in group 2 compared with group 1 and decrement of cholesterol level in the blood of group 4 compare with group 2 [P<0.01]. Also increasing the direct billirubin in the Mn and PAS groups was more significant compared with control group [P<0.05]. Billirubin was observed in the urine of the Mn, PAS, Mn+PAS groups and urobilinogen declining was decreased in the urine of these groups [P<0.05]. There was a significant increase [P<0.05] of OT, PT enzymes in the serum of PAS and ALP in the Mn and Mn+PAS groups compared with control group. PAS can play a significant role in reducing destructive effects of Mn, especially on liver but has different side effects, like other chemical drugs

[Success rate in basic medical sciences national exam among graduates and students applying for transfer to Iran]

In recent years, many Iranians have made educational travel to countries to study in the field of medical sciences. Considering the different educational systems and lack of comprehensive exams in some countries, the present study was attempted. To determine the success rate in basic medical sciences national exam of graduates and students applying for transfer to Iran. In this descriptive study 2621 students from Ukraine, Armenia, Azerbaijan, Russia, Romania, Belarus, Tajikistan, Kazakhstan, and Philippine, who participated in the medical basic sciences national exam during 1998 to 2008, were evaluated and the success rate calculated. The highest and lowest success rates for countries with more than 100 participants were 48.6% and 27.4% for Armenia and Romania, respectively. Regarding the countries with less than 100 participants, the highest and lowest success rates were 55.6% for Belarus and 8% for Kazakhstan. Based on the field of study, the lowest success rate was associated with pharmacy [15.8%] and the highest with dentistry [38.9%]. The success rates obtained for students from different countries evaluated were much lower than those for domestic students. The reason for this difference is likely due to inappropriate style of national exam with the training methods used for these students or the students' poor educational performance to successfully pass the national medical exam

Validation and use of the HFIAS questionnaire for measuring household food insecurity in Varamin-2009

Measuring food insecurity has been an ongoing challenge to researchers. This study was carried out to assess the validity of the Household Food Insecurity Access Scale [HFIAS] in measuring household food insecurity in an urban area of Varamin in 2009. In this cross-sectional descriptive study, 400 households from different parts of Varamin, a city south of Tehran, were selected by the multi stage cluster sampling method. Household food security was measured by the 9-item HFIAS questionnaire that asks whether a specific condition associated with the experience of food insecurity ever occurred during the previous 30 days. Based on the HAFIAS questionnaire score, households were categorized in 4 groups according to access to food; food secure, mildly, moderately and severely food insecure access. In the second stage of the study, 30 households were selected from each group. Food security was observed in 21% of households. Mildly, moderately and severely food insecure access was 46.5, 25 and 7.5%, respectively. Based on the responses to the 9 questions of the HFIAS questionnaire, perceptions that food is of insufficient quality [72%], two main factors emerged from the rotated principal component factor including: 1] Insufficient food quality and 2] Insufficient food intake. Both factors explained 77.5% of the total variance. HFIAS has good internal consistency [Cronbach's a= 0.95]. Food insecurity was observed in households in this urban area of Varamin. The HFIAS measurement instrument shows acceptable validity and reliability in measuring food insecurity among households

Evaluating success of no-scalpel vasectomy by ligation and excision with fascial interposition in a large prospective study in Islamic Republic of Iran

The aims of this prospective, non-comparative study were to determine time to azoospermia and vasectomy success rate based on the results of semen analysis. A total of 334 men seeking vasectomy at a clinic in Urmia city, Islamic Republic of Iran were followed bi-weekly up to 24 weeks after vasectomy or until azoospermia was confirmed via semen analysis. The cumulative life table rate for azoospermia was 93/100 men [95% Cl: 88.1 to 97.9]. The median time to azoospermia was 10 weeks. By week 24 of follow-up, 3.3% of participants had failed to achieve azoospermia. One pregnancy was reported during the study period and attributed to user failure. The results suggest that men can begin to rely on vasectomy for contraception 12 weeks after no-scalpel vasectomy using fascial interposition performed by an experienced surgeon

effect of sodium arsenite in induction of protein stress in chicken embryo model

Arsenic is one of the most important current environmental toxicants. Arsenic is one of the biggest protein stress inducer in several organs and systems. One of the basic and sensitive criteria for following protein stress is assessing carbonyl and thiol groups of proteins. Therefore, we assessed protein stress that produced by sodium arsenite in chicken embryos by measuring carbonyl and thiol proteins. After 4 days of incubation, 36 fertilized eggs were candled. The eggs that had alive embryos received a single injection of 0.1 and 0.5 ppm arsenite sodium in two separate groups of 12 eggs and the rest 12 [control group] received 0.5 ml saline into the yolk sac. After 20 days of incubation, teratogenicity and external defects in embryos were investigated, one ml of embryo blood was analyzed for assaying protein thiol and carbonyl as well. Data were analyzed by SPSS [version 16] with ANOVA test [tukey]. The mean of carbonyl protein was in 0.1 ppm group 0.835, 0.5 ppm group 0.844 and control group 0.804 and this change was significant and dose dependent. In addition, the mean of thiol protein was in 0.1 ppm group 0.053, 0.5 ppm group 0.014 and control group 0.054 and this change was also significant and dose dependent. The carbonyl and thiol protein alterations in serum of embryos exposed to arsenite sodium, suggest the embryotoxicity of this agent induction of plasma carbonyl and thiol protein stress

[Comparison of the percentages of peripheral blood CD4+ CD25+ T lymphocytes in recurrent abortion and normal pregnancy]

Background and Aims: Recent evidences indicate that parts of the immunoregulation system such as CD4+CD25+Tcells [Treg] and Th2 cells and Th1 cells, play very important roles in the maintenance of pregnancy. The deficiency in proper recognition of fetal alloantigen by the maternal immune system is associated with recurrent pregnancy failure. Here, we investigate the proportional changes of CD4+CD25+Tcells in peripheral blood of women with unexplained recurrent spontaneous abortion in comparison to women with normal pregnancy by using flowcytometry

Methods: The case group was comprised of 24 women who had at least three successive miscarriages with unexplained etiology. They had normal karyotypes, anticardiolipin and prolactin and their husbands had normal spermograms. The percentages of TCD4+CD25+cells in peripheral blood of these patients were compared with those of 21 women who had normal pregnancy with no history of pregnancy loss. Anti-CD4, anti-CD25 and anti-CD3 antibodies were added to lymphocytes isolated from peripheral blood. Then samples were incubated, centrifuged and washed. Finally cells were analyzed using FACS Caliber system and data of the two groups were compared

Results: Mean percentage of CD4+CD25+bright T cells in peripheral blood in case group was significantly lower compared to the control group [P=0.000]. Mean percentage of CD4-CD25 bright cells in the CD4+Tcell peripheral blood was significantly higher in case group campared to the control group [P=0.021]

Conclusion: Decrease of CD4+CD25 bright T cells plays a major role in tolerating conceptus antigens and cytokine and might contribute to the maintenance of pregnancy. Inadequate CD4+CD25+Tcells or their functional deficiency may link with miscarriage. Therefore, alteration of CD4+CD25+T cells can be used as an immunologic marker for monitoring of patients with unexplained recurrent spontaneous abortion

Qualitative study on nutritional knowledge of primary-school children and mothers in Tehran

The nutritional education demands of primary-school children in Tehran were evaluated in a qualitative study, through 20 focus group discussions, 16 for children and 4 for mothers, among 128 children aged 6-11 years and 32 mothers in 8 primary schools in Tehran. Children knew about the advantages of different food groups, including helping digestion, growth and increasing intelligence. They obtained their knowledge mainly from their parents and television, as well as books, teachers and friends. Mothers thought the sources that had most effect on children's nutritional knowledge were television advertisements, parents and classmates. Most of the children claimed that they preferred to learn about nutrition from their parents and television, e.g. children's programmes and advertisements

[Diagnostic value of sonography in discriminating benign from malignant liver space occupying lesions]

Sonography is a non-invasive, well stablished and low complication technique, which renders the determination of benign and malignant focal liver masses. In this study, diagnostic value of sonography in discriminating liver space occupying lesions and its related factors was evaluated and compared with clinical and pathological results. In this descriptive and diagnostic study, 102 patients with hepatic tumor admitted in Shaheed Sadoughi hospital in Yazd between March 2001 and April 2004 were studied. Patients' age, sex, clinical diagnosis, and pathologic and sonographic results were entered in a questionnaire. Data were analyzed by SPSS software with chi-square and Fisher exact tests. 102 patients with mean age of 52 +/- 18.7 years [range: 4 months- 87 years] were studied. 54 [53%] were male and 48 [47%] female. Of 102 liver mass, Sonography detected 36 benign and 66 malignant tumors, while clinical diagnosis reported 42 benign and 6n malignant tumors. Of 64 malignant tumors diagnosed by pathologic studies, sonography reported 51 malignant and 13 benign tumors. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of sonography in discriminating benign and malignant liver masses were 79.69%, 60.53%, 77.27%, 63.89 and 75.56%, respectively. Regarding the high sensitivity and accuracy of sonography in discriminating benign from malignant liver masses, it can be helpful for evaluation of hepatic tumors. However, sonographic results should confirm by pathologic studies

[Qualitative and quantitative dietary assessment of primary school children in Tehran]

Most of our food habits and preferences originate during childhood. Following an adequate and balanced diet from childhood is one of the most important factors in preventing degenerative diseases in adulthood. Thus, determining children's food consumption patterns is a high health priority. The present study was initiated to determine meal and snacking patterns of primary school children during 2003-2005 in Tehran. A total of 761 male and female primary school children [378 grade 1, 383 grades 2 to 5] from all the 19 Educational Areas in Tehran, selected by multistage cluster sampling, were included in the study. General information was collected in 2 parts, by interviewing [1]. the students, and [2]. the students' mothers or caregivers. For collecting information on food consumption during the previous month the 24-h-recall technique and a snack-frequency questionnaire were used. Results are reported as means +/- standard deviations and frequency distributions. The mean daily intakes of energy among the first and other grade students were 1910 +/- 551 and 2014 +/- 539 kcal, respectively. As compared to RDA, energy intake [95% RDA for grade 1 and 91% for other grades] and iron intake [86% for other grades] were inadequate, while the intakes of other nutrients were adequate. The mean intakes of energy, protein and some of the B vitamins among girls were higher than among boys

[Malocclusion in subjects with beta-thalassemia major]

Beta-thalassemia major is a hemolytic anemia. If these patients are not treated, bone marrow hyperplasia will happen. Hematopoiesis in the jaw results in mandibular and/or maxillary enlargement. To our knowledge, there are few studies about frequency of malocclusion in these patients. Therefore, this study was designed to investigate the frequency of malocclusion in betathalassemia patients and compare it to healthy control group. This research was a cross sectional study. Seventy beta-thalassemia patients and 70 healthy controls [age and sex matched] were examined for malocclusion using Angle classification, WHO malocclusion classification, determination of overjet and overbite. If crossbite, spacing, openbite, crowding and mouth breathing were observed in clinical examination they were recorded. Statistical analysis was done using Chi-square and Variants analysis. Beta-thalassemia patients showed class II malocclusion [angle classification] and grade 2 [WHO classification] more than healthy control group. There were significant differences in angle and WHO malocclusion classification between two groups [P<0.05]. Increased overjet and mouth breathing were seen in patients more than healthy control group. There were significant differences in overjet and mouth breathing between two groups [P<0.05]. There was a positive correlation between WHO malocclusion classification and serum ferritin levels, but not between angle malocclusion classification, overjet and serum ferritin levels. Beta-thalassemia major is associated with increased malocclusion and these anomalies will occur if the patients are not treated early. Patients with malocclusion should be visited and followed up by a dentist for dental problems. Fortunately, as a result of new treatments these patients live longer than before. Therefore, it is important to pay attention to their functional and esthetical problems

Presence of Epstein- Barr virus in oral Lichen planus and normal oral mucosa

Oral lichen planus [OLP] is a chronic immunologic disease. The etiology of OLP is unknown, viral antigens [for example Epstein-Bar virus] have been proposed as etiologic agents. OLP may get transformation to malignancy so research on the presence of EBV in OLP lesions seems to be necessary. The aim of this study was to ascertain if EBV acted as etiologic factor in pathogenesis of OLP. Tissue specimens of 22 patients with clinical diagnosis and histopathological confirmation of OLP were used as case group. And that of 22 persons without OLP served as control group. Polymerase Chain Reaction [PCR] method was used. Each sample was tested twice. All biopsy specimens from patients and controls were negative for EBV presence. In spite of the fact that the presence of EBV in OLP in these two small groups of Iranian population was not confirmed with PCR method, but due to different ideas and reports in this field, proving or disproving of presence or etiological role of EBV in OLP is continuously a question and needs to be examined in further studies

[Differential diagnosis of myoxid lesions in head and neck area with special staining of mucin]

Background and aim: myoxid histological pattern is of nonspecific features that is seen in most of benign and malignant lesions occupying a great mass of them. Thus, histopathologic diagnosis depends on a careful and precise investigation. The aim of this study was to differentiate between mucins in myoxid tissues through histochemical staining

Materials and Methods: archives of three important educational pathology departments [Faculty of Dentistry of Tehran University, cancer institute of Imam Khomeini hospital and Amir Alam hospital] were investigated and information on head and neck tumors with myoxid histopathologic pattern were worked out, then slides and paraffin embeded blocks were studied. Tissue slides of 5,um thickness were stained with PAS/Alcian blue technique and studied under light microscope. The notable standard was the predominant stain of mucin in histological field

Results: the study of 41 histologic slides containing: malignant fibrous histocytoma [MFH][n=4], Rhabdomyosanvma [n=6], Chondrosar coma [n=6], Schwannoma [n=7], Neurofibroma [n=8], Pleomorphic adenoma [n=4] and Odontogenic myxoma [n=6], revealed that neurologic derived lesions and Rhabdomyo sarcoma and MFH had notable red field [neutral mucin nature] where as chondrosarcoma, pleomorphic adenoma and odontogenic myxoma had notable blue field [acidic mucin nature]

Conclusion: despite limited cases, the results showed that different nature of mucins in different lesions can be considered as a good criteria for differential diagnosis, however, more detailed studies are recommended

Diagnosis of primary cardiac tumors: report of 30 cases

Between 1981 and 1993,30 cases of primary cardiac tumors were diagnosed at the Imam Khomeini Hospital. 20 patients were female and 10 were male, with an average age of 32 years [ranging from 17 days to 65 years of age]. The mean duration of symptoms before diagnosis was 6 months, with dyspnea and palpitation being the most common symptoms [60%] and cardiac murmurs the most usual signs [84%]. The diagnosis of cardiac tumors was made by echocardiography in all patients. Transesophageal echocardiography and cardiac catheterization were performed in 8 and 9 patients respectively for more precise localization of the tumor and evaluation of the coronary arteries. The left atrium was the only site of tumor in 60%. 4 patients had tumors in more than one chamber. 27 patients underwent surgery without mortality while 3 patients did not undergo surgery. Pathological examination revealed benign myxoma in 23 patients, fibroma [1 patient], round cell sarcoma [I patient], chondrosarcoma [1 patient], liposarcoma [1 patient], and undifferentiated sarcoma [1 patient]

Plasmocytoid myoepithelioma of minor salivary glands: ultrastructural analysis of four cases

In general, myoepithelioma is a rare salivary gland tumor. Four cases of plasmacytoid myoepithelioma of the minor salivary glands, with ultrastructural confirmation, are reported. Clinical examinations of these cases revealed gradually growing, protruding masses. The main site of involvement was the hard palate [2 cases]

Rhino-orbital mucormycosis: report of a successfully treated patient

A patient with diabetic ketoacidosis and rhino-orbital mucormycosis is presented. The clinical diagnosis of mucormycosis was made within 24 hours after the onset of symptoms, and therapy consisted of intravenous amphotericin B, surgical debridement and correction of diabetes mellitus. Direct microscopic examination of the black brownish crust obtained from her nasal passage and sinus material as well as their histology revealed no mycelium but culture of the same materials obtained separately revealed mucorales species mycelia. Early diagnosis and prompt institution of therapy contributed to this patient's survival despite complete visual loss in the involved eye. We believe that radical orbital treatment must be performed only in extensive and progressive forms of orbital mucormycosis, without insisting on blindness as an adequate criteria for performing orbital exenteration or enucleation