[Survey of nosocomial infection and accompanied factors in neonatal intensive care unit]

Neonatal Intensive Care Unit [NICU] is considered a major problem regarding nosocomial infection control. Considering the importance of this subject and this point which this study has never performed in this province is necessity of performance of this research. To determine Nosocomial infections and accompanied factors in neonatal intensive care unit [NICU] at 17-Shahrivar hospital of Rasht, 2008-9. This study was a descriptive research and data were collected prospectively through a questionnaire and a checklist. Questionnaire was included demographic characteristic and treatmental factors. Structural and personnal factors were assisted by the checklist. In this study, samples were the same as study population and all neonates who had the characteristics of the research samples were included. Inclusion criterions consist of all of neonates that aged up to 30 days, suffering from prematurity, low weighting, hyaline membrane disease [HMD], respiratory distress syndrome [RDS], congenital anomalies and also neonates who required surgical treatment that manifested clinical infection signs after 48 hours of admission. All neonates that had clinical infection signs on admission time and suffering sepsis, meningities, pneumonia, urinary tract infection and other infections or the ones who were in incubation period were excluded from research. Nosocomial infection was diagnosed by focal point physician based on the National Nosocomial Infection Surveillance system [NNIS]. Data was analysed by using SPSS and by means of frequency distribution tables and graphs. During the study period, 270 neonates were hospitalized, among them 44 cases [16.29%] had nosocomial infection. Most of them [70.5%] were male, weight of them was under 2Kg and age of them was between 1-3days. Also most of them [73%] were preterm and were born by cesarean section method. Assessment of the research based on treatmental factors showed that majority of patients were premature and had respiratory distress. The most common isolated pathogens were entrobacter [57%], klebsiella [9%] and E-coli [2%]. Assessment of Structural factors showed that there are physical space problems in spite of adequate equipments and instruments. Regarding personality situations, it is clear that educational programs have been provided for prevention of infection. It is recommended to pay more attention in personal hygienic, especially hand washing and using stril gloves and sterilization rules regarding in IV cathetering. Also it is advised to control and prevent infections with suitable distribution of staffing, providing standard rules in physical structures and promoting knowledge in physicians and NICU personels

Penetrance of BRCA1/BRCA2 specific gene mutations in Iranian women with breast cancer

To estimate the penetrance of breast cancer genes 1 and 2 BRCA1/BRCA2 specific gene mutations in Iranian women with breast cancer. We conducted this study in the Department of Biostatistics, Tarbiat Modares University, Tehran, Iran between January and May 2008. The information was collected from the referral database of the Cancer Clinics, Day General Hospital, Tehran, Iran. We estimated the penetrance of breast cancer in carriers of BRCA1/2 specific gene mutations based on the modified kin-cohort method. Three hundred and forty-five probands were examined for specific mutations of BRCA1/2 genes. The estimated penetrance for the age groups among BRCA1/2 carriers was 31.9% < 50 years and 46.2% >/= 50 years. The reliable information of penetrance is considered important in genetic counseling. The low value of the estimated penetrance in this study might be attributed to the rare mutation in Iranian patients. Establishment and use of a kin-cohort gene databank is proposed as a solution for the preparation of the screening programs and the estimation of the penetrance to help reduce the risk of cancer

[Anthrax: a rare cause of periorbital cellulitis and cicatricial ectropion]

Abstract Introduction: Among the three human forms of anthrax [cutaneous, inhalational, and gastrointestinal], the cutaneous form is the most common disease [95%]. Cutaneous anthrax is a rare cause of periorbital [preseptal] cellulitis, therefore, diagnosis and initiation of treatment may be delayed. On the other hand, without correct diagnosis and appropriate treatment, periorbital anthrax may result in sever local complications such as blindness and airway obstruction, or dissemination of the disease like bacteremia and meningitis. In this research was introduced a child with periorbital anthrax to present the clinical manifestation and progression of the disease and remind physicians to interest contagious cause of periorbital cellulitis

Case Report: A 2.5 years old boy from a rural area of Guilan who was suffered of a small erythematous papule in his right lower eyelid 5 days prior to admission. Then, the lesion progressed to a necrotic ulcer with a black central eschar, edema and erythema at the area around. Sever swelling of eyelids and edema occurred all over the face. Fever wasn't observed. The child had repetitious contacts with domestic herbivores. CT scan of the orbit and paranasal sinuses showed soft tissue swelling only. Gram-positive rods were seen in the smear of exudate taken from cutaneous lesion but culture result showed negative. Treatment with intravenous ciprofloxacin, penicillin, and clindamycin resulted in clinical improvement but due to cicatricial ectropion formation, oculoplastic intervention was considered to be done

Conclusion: Physicians must consider it to be anthrax if any of the following symbols exists: a history of contact with domestic herbivores and animals, similar lesions in the family members, cutaneous necrotic ulcer with the characteristic black eschar and edema of the area around, and observing Gram-positive rods in scraped material taken from beneath the eschar edge or exudate of cutaneous lesions. Although anthrax of the eyelids is not common disease, it must be consider as in the differential diagnosis of periorbital cellulitis