Bacterial safety of commercial and handmade enteral feeds in an Iranian teaching hospital

This study aimed to investigate and compare the bacterial safety of handmade and commercial ready-to-use enteral feeding formulas used in an Iranian teaching hospital. In this experimental study, a total number of 70 samples [21 handmade formulas sampled at two sampling times, i.e. the time of preparation and 18 h after preparation, and 28 commercial ready-to-use formulas] were studied. Total count of viable microorganisms, coliform count and Staphylococcus aureuscount for all samples were conducted. Out of 42 handmade samples, 16 samples [76%] had total viable counts greater than 103 CFU/g in the first sampling time and 17 samples [81%] had total viable counts greater than 103 CFU/g in the second sampling time. Also, 11 [52%] had coliform contamination in the first sampling time which reached 76% [16 samples] in the second sampling time. Regarding contamination with S. aureus, 5 samples [24%] were contaminated in the first-and 13 samples [62%] were contaminated in the second-sampling time. Out of 28 commercial formulas, 27 samples [96%] had total viable counts greater than 103 CFU/g. Also, 24 samples [86%] were contaminated with S. aureus and 27 samples [96%] were contaminated with coliforms. In order to compare these two formulas, the results of Mann-Whitney test showed that contamination of ready to use formulas in all three microbiological samples was significantly more than that for handmade samples. The results of the present study indicate that the microbial safety of enteral feeding solutions in this hospital is much lower than standard values, demonstrating that the development of protocols for clean techniques in the preparation, handling and storage of both commercial and handmade enteral feeds is necessary

[Effect of dyslipidemia on noise induced hearing loss]

Hearing is one the most important senses of human. Hearing loss is one of the greatest chronic disabilities. Noise induced hearing loss [NIHL] is a common occupational disorder and several factors affect its intensity. One of these factors is individual differences. The aim of present study is the assessment of dyslipidemia's effect on NIHL. This study was conducted to evaluate association between dyslipidemia and noise induced hearing loss. This was an analytic-descriptive study which was conducted in 2010. The factory workers of Rasht industrial city with the following inclusion criteria were selected: environmental noise above 85dB, age below 55 years, no otologic disease or surgery, and no history of usage of ototoxic drugs. A total of 298 workers were assessed. After physical examination and audiometry, we measured the level of serum cholesterol, triglyceride, high and low density lipoprotein of participants. The results were analyzed with the SPSS version 17.0. The p value < 0.05 is considered significant statistically. In this study, 250 men and 48 women were assessed. The mean age of participants was 35.8 years. The participants had high noise exposure of 11 years on average [1-26years]. Ninty five of them had NIHL [31.8%]. The frequency of serum cholesterol, triglyceride, high and low density of this group were 31.5%, 10.8%, 53.2% and 14.3%, respectively. These levels in the group without NIHL [203 workers] were 38.9%, 12.6%, 58.9% and 21.1%, respectively. There was no statistical significance between these levels in the two groups. By backward logistic regression method, we observed that the duration of employment and gender increased the hearing threshold of 4 KHz frequency in the NIHL group. The odd ratio of hearing loss in male gender was 3.36 [95% confidence interval: 1.61-8.95, p= 0.004]. The other effective factors on the hearing threshold of 4 KHz frequency had statistical, but no clinical significant difference in two groups. We observed no statistical significance of dyslipidemia frequency between two groups. In addition to duration of employment, male gender was the other observed related factor with hearing loss in the two groups. This effect may be due to protective effect of estrogen on the hearing level. Studies with more sensitive approaches on a larger sample is advised

[Results of radiofrequency tonsillotomy in adults with recurrent tonsillitis]

Tonsil reduction by use of radiofrequency waves is one of the newest therapeutic modalities, especially for obstructive large tonsils. The aim of this study was comparing short term and long term results of radiofrequency tonsillotomy and traditional cold dissection tonsillectomy in adult patients with recurrent tonsillitis. a prospective randomized clinical trial on 72 adults with recurrent tonsillitis was performed in a tertiary referral university hospital. Traditional tonsillectomy in 34 cases and radiofrequency tonsillectomy [RF] by use of Radiofrequency Induced Thermotherapy [RFITT] probes in 38 cases were performed under general anesthesia. Time of surgery, amount of intraoperative bleeding, recovery time, post-surgical pain, dysphagia, weight loss, and time of return to normal diet and activity were measured. All the patients were followed for 24 months for recurrence of tonsillitis episodes. Statistical analysis was performed using SPSS version 16, chi square and Mann-Whitney U tests. Mean time of surgery [16.89 vs. 46.07 minutes] and recovery [14.32 min vs. 17.11 min], and amount of intraoperative bleeding [15-20 cc vs. 250-300cc] were significantly less in the RF group than the traditional tonsillectomy group [p<0.005]. There was no difference between the two groups in the recurrence of tonsillitis episodes after 24 months. Tonsillotomy with RF is a simple, rapid, and effective method in adult patients with recurrent tonsillitis

Human papillomavirus genotype as a major determinant of the course of cervical cancer

Introduction: Certain types of human papillomavrus [HPV] are associated with cervical intraepithelial neoplasia [CIN] and squamous cell carcinoma [SCC]. The aim of the observations reported here was to determine whether the prognosis for invasive cancers of the uterine cervix is related to the type of human papillomavirus asociated with the tumor

Material and Methods: Twenty Patients with invasive cervical cancer were prospectively registered from 2000 to 2001. HPV typing was performed by insitu hybridization [ISH] on DNA extracted from frozen, formal in-fixed, paraffin-embedded tumor specimens. The specimens mostly represented classifications SCC Stage 1 and Stage 2 of the International Federation of Gynecology and Obstetrics [Table 1]. HPV- DNA was detected by insitu hybridization, using three different DNA Probes: types 6/11, 16/18 and 31/33/51

Results: HPV DNA was detected in the nuclei of SCC tumor cells in 13[65%] of 20 cases. Of the 13 HPV-DNA positive cases three reacted only with the HPV 31/33/51 probe, two reacted only with the 16/18 probe, three showed strong hybridization for both 31/33/51 and 6/11probes, four showed 6/11 and 16/18 genotypes and one case reacted with 31/33/51,6/11 and 16/18 probes

Conclusion: The prognosis for invasive cancers of the uterine cervix is dependent on the oncogenic potential of the associated HPV type. HPV typing may provide a prognostic indicator for individual patients and is of potential use in defining specific therapies against HPV harboring tumor cells. These findings are consistent with the hypothesis that HPV infection is the primary cause of cervical neoplasia. Furthermore, they support HPV vaccine research to prevent cervical cancer and efforts to develop HPV DNA diagnostic tests