[Comparison between efficacy of ciprofioxacin-doxycycline and rifampin-doxycycline regimens in treatment of brucellosis]

Brucellosis is an endemic disease in Iran that has a worldwide spread and is associated with chronic disabilities in humans. Combination therapy of brucellosis leads to recovery of symptoms, shortening of the symptomatic intervals, and decrease in the rate of relapse and drug resistance. Considering the use of rifampin in the treatment of tuberculosis, and the necessity for an alternative treatment in regions endemic for both tuberculosis and brucellosis, in this study we compared the efficiency of the WHO's standard regimen of rifampin-doxycycline [RD] versus ciprofloxacin-doxycycline [CD] for the treatment of brucellosis. This randomized controlled trial was performed on 90 patients, affected with brucellosis, who were referred to the Infectious Disease Clinics at Arak University of medical sciences. The patients were randomly divided into two groups: the DR group, received 100 mg of Doxycycline twice a day and 300 mg of rifampin Bid daily for eight weeks; and the CD group, received 100 mg of doxycycline plus 500 mg of ciprofloxacin twice a day for eight weeks. The patients were analyzed for the relief of symptoms, drug side effects, and laboratory findings during the treatment. In this study, the rate of symptom relief and laboratory findings in both groups were similar. The relief of symptoms was seen in 93.2% and 83.9% of the patients for the DR and CD groups, respectively [P=0.182]. The side effects of the drug were not significant in either groups, with no significant difference, and did not lead to discontinuation of the therapy. Due to the similar efficacy of CD and DR regimens in the treatment of brucellosis and considering the usage of rifampin in regions with high prevalence of tuberclusis, the CD regimen is recommended as an appropriate treatment

Morphological and morphometrical description of trichostrongylus species isolated from domestic ruminants in Khuzestan province, southwest Iran

Genus Trichostrongylus [Nematoda: Trichostrongylidae] is one of the most important zoonotic nematodes with wide geographic distribution in the world. The purpose of the present study was to describe morphological and morphometrical characteristics of male Trichostrongylus species, currently prevalent in domestic ruminants of Khuzestan Province, southwest Iran. Gastro-inetstinal organs of 1600 sheep, goats, cattle, and buffalos, slaughtered in Khuzestan Province, southwest Iran, were examined for infectivity with Trichostrongylus species. For examination and measurements of helminthes, Azo-carmine staining was performed, followed by camera lucida drawings of morphological characters and measurements of morphometrical criteria with a calibrated microscope. Using valid nematodes systematic keys, almost all the parasites were identified at the level of species. Overall, 114 animals were found infected with at least one species of Trichostrongylus. Considering morphlogifcal characteristics of male Trichostrongylus, six species were identified including T. colubriformis, T. vitrinus, T. probolorus, T. capricola, T. longispicularis and Trichostrongylus sp.. Although, compared to the previous decades, currently Trichostrongylus is much less prevalent in the domestic ruminants of the study area, but still different species occur in these animals

[ study on waiting time and length of stay of attendants to emergency department of Vali-e-Asr Hospital, Arak-Iran]

Delivery of immediate medical interventions appropriate to the severity of clinical status of patients is a main public expectation of emergency departments. Waiting time and length of stay are the key measures to assess the quality of care in emergency departments. This study is done to investigate the waiting time and length of stay of attendants to emergency department of Vali-e-Asr Hospital, Arak-Iran. This analytical cross-sectional research was conducted in a general emergency department of a teaching hospital in Arak to assess the waiting time and length of stay of patients. In the first stage of the study all attendants during a 6 weeks period were classified regarding to the severity of their clinical status by an educated nurse and a general practitioner using a three category scale [guideline] presented by ministry of Health and Medical Education [2001]. Also waiting time for a general practitioner visit was measured and documented by the resident general practitioner. In the second stage, a sample of 100 documents of patients in group 1 and 2 admitted for specialist visit were assessed for the waiting time and length of stay in emergency department. Mean of waiting time according to patients clinical status and the specialty of the first physician were analyzed by t-test and ANOVA [p = 0.05]. During a 6 weeks period, of 1963 patients, 179[9.1%] were categorized as emergent [category 1], 391[19.9%] urgent [category 2] and 1393 [71%] non urgent. The mean waiting time for general practitioner visit was 5 minutes. The median and mean of waiting time for specialist visit in group 1 and 2 of patients were 225 and 262 +/- 156, 220 and 227 +/- 153 minutes, respectively. The median and mean of length of stay was 1 and 2 days, respectively. No differences were found between waiting time of various specialties visit in patients of categories 1 and 2. Regarding the long waiting time for specialist visit, using triage in emergency departments is necessary. This needs planning and organization for the presence of specialists in the hospital, over the time. Also regarding the large number of nonurgent patients, 24 hours presence of a general practitioner is necessary

Effect of metronidazole on amount of blood's lipids of hyperlipidemia people

Metronidazole has antibacterial and antiparasitic action. Therefore it can use for treatment inflammatory diseases as Crohn. The effect of metronidazole on human's blood lipids to reducing levels of LDL and VLDL and increasing level of HDL is under investigation. Target of this research is consideration effect of metronidazole on hyperlipidemia case of death such as coronary artry disrase. This study is a triple blind clinical trial was done on 100 voluntaries between 25-65 years old. with hyperlipidemia. Samples divided in two equal groups. The first group received metronidazol, 500mg, BID, for 10 days, and control group received placebo with the same dose. Lipids of serum were measured before and after using drugs, then data analyzed by SPSS software. In metronidazol group amount of total cholesterol, LDL and Triglyceride were significantly less than placebo group. HDL's amount in metronidazole group was significantly more than placebo group. Significant effect of metronidazole on reducing harmful blood lipids and increasing useful blood lipids. It can be suggested a probable candidate in treatment of hyperlipidemia. Maybe it can use with this application. Although it needs to more study by meta analysis to validate this effect