[Acinetobacter antibiotic resistance and frequency of ESBL-producing strains in ICU patients of Namazi Hospital [2008-2009]]

Acinetobacter is a gram-negative pathogenic bacterium and an important cause of nosocomial infections especially in immunocompromised patients in the intensive care units. Reports of multi-drug resistant isolates have increased during the last decade. As a result of extensive use of broad-spectrum antibiotics and high prevalence of ESBL producing bacteria especially in ICU ward, Acinetobacter infection is often difficult to treat. To determine the antibiotic resistance in Acinetobacter and detecting the prevalence of ESBL producing strains in ICU patients of Namazi Hospital in Shiraz [Iran]. This study was carried our on 147 clinical isolates of Acinetobacter collected from ICU patients at Namazi Hospital during October to December [2008-2009]. Antibiotic susceptibility test for isolated strains was performed using disk diffusion method. Also, isolation of ESBL Acinetobacter strains was accomplished using double disk synergy test. Findings: The highest antibiotic resistance among 147 Acinetobacter baumannii strains was found against ciprofloxacin, amikacin, and gentamicin. Regarding the results of initial screening tests, 44% of total samples were demonstrated to be ESBL positive Based on our data, the major reason for emergence of diverse ESBL strains was due to unjustified administration of broad spectrum cephalosporins. Accurate antibiotic susceptibility testing prior to administration of antibacterial agents for patients to reduce the high prevalence of ESBL strains is recommended

Comparison of four ways in treatment of acute conversion disorder

In spite of high prevalence of conversion disorder, there is no widely acceptable effective treatment for it. In this study, we compared four ways of treatment in acute conversion disorder and it's recurrent after one month. In a clinical trial study, we selected 80 patients with acute conversion disorder using simple sampling method. They were divided randomly into four treatment groups. [Suggestion, simple muscle relaxation, hypnosis, and diazepam injection] The speed of syndrome elimination, recovery frequency, and one month's recurrence were compared. The results were analyzed with chi-square, Fisher's exact test and ANOVA. Mean recovery time was significantly less in muscle relaxation group compared to the hypnosis and diazepam injection groups [P < 0.05]. In patients with co-morbidity, the mean recovery time was shorter than the mean recovery time in none co-morbidity [P < 0.05]. There was no significant relation between one month recurrent and way of treatment or other variables. All four ways of treatments bring significant recovery, but in muscle relaxation, recovery is faster than hypnosis and diazepam infusion

Role of routine preoperative ECG on anesthesia planning in elderly patients

ECG is a test which is used for diagnosis and confirmation of cardiovascular diseases. Many studies regarding the validity of this test in different age groups have been performed and different results were obtained. This study was performed to assess the role of ECG on anesthesia planning in elderly patients. One hundred elderly patients who referred to Nikocari hospital in Tabriz for eye surgery were enrolled in this study. Findings of clinical examination and medical history were compared with those obtained from the interpretation of ECG by anesthetists. The data were analyzed using descriptive statistical methods. Results showed that only 4% of the patients without positive findings in clinical examination had ECG abnormalities; 3% had RBBB; and 1% had T inversion in pre-cordial leads. It is noticeable that reported abnormalities are not so important on the basis of anesthesia care planning. According to the results obtained, it seems logical to pay more attention to selection of patients for ECG and ordering ECG test only for patients with positive clinical findings