Prevalence of nosocomial urinary tract infection in PICU of referral children hospital in Iran

To determine the prevalence of the occurrence, risk factors and microbiology for acquiring UTIs in the PICU of one of the main referral children hospital in Iran. A surveillance study was conducted among all children admitted to PICU in the Mofid children hospital in Tehran between July 2007 and July 2008. During the one year, 428 patients were admitted to PICU for 48 hours or more and a total of 31 [7.2%] acquired UTIs, yielding an overall incidence density, of 11 per 1000 PICU days. One bacteremic [4.3%] ICU-acquired UTIs occurred. Mean hospital staying in UTI patients was 22 days comparing with 7 days in other patients [P value<0.001] but mortality rate difference was not significant [P value=0.2]. The most common organisms isolated were Escherichia coli [30.4%], Kelebsiellapneumoniae[30.4%] and Candida a/b/cans[21.7%]. Monitoring of a PICU-acquired UTI is important in critically ill patients. The results of this study offer a reliable measure of the prevalence of nosocomial UTIs at hospitals in Iran and provide a baseline for future studies

Determining the topics and content of CME programs in five selected subjects: comparing the view points of experts and target group; a Tehran University of Medical Sciences experience

One of the most appropriate methods for needs assessment is to assess learners' needs and arrange the educational programs based on their viewpoints. The aim of this study was to determine the topics and content of Continuing Medical Education [CME] programs in five selected subjects by medical education experts and target group, based on the real needs of General Practitioners [GPs] in order to revise CME national programs. In this cross-sectional applied study, 700 GPs covered by Medical Sciences Universities in Tehran province were studied. A questionnaire consisting of two parts of demographic features and 80 scientific questions regarding their knowledge in five domains of clinical pharmacology, skin diseases, toxicology, emergencies, and forensic medicine was used. The questionnaires were delivered to physicians' offices by trained personnel using a list or by direct referral to offices and then gathered. Three topics in each subject and 15 standard educational contents in total were developed for the target group. There was almost a complete relationship between the opinion of experts and target group in forensic medicine. Some of the first five priorities of the two groups overlapped in skin diseases, forensic medicine, and emergencies. No common viewpoints were observed between experts and target group in pharmacology. In toxicology, there was no common viewpoint in the first three selections of the two groups. Real educational needs of GPs in receiving new information in order to promote their competencies and knowledge were different from those considered by experts. It is recommended to design the educational content for the target groups in the health care field based on their real deficiencies in knowledge and practice and by assessing their views and knowledge

[Comparing AVF ligature and transvenous endorrhaphy for AVF closure in hemodialysis patients]

Arteriovenous fistulae are the principal chronic hemodialysis access in patients with end stage renal disease. There is an increasing number of patients who need AVF closure because of serious complications or renal function retrieval by transplantation. Multiple open and endovascular techniques have been proposed for AVF closure. In this study, we are going to compare two surgical methods and select the preferred one as the standard technique for closure. A randomized controlled clinical trial was designed. 140 patients were randomly assigned into two matched groups. 70 patients underwent AVF ligature and the other 70 subjects underwent transvenous endorrhaphy. Each patient was followed for at least 6 months to monitor surgical results. Of 140 patients, 26 [18.6%] AVF closures were failed during 6 months of follow up. Of 26 failed cases, 24 had undergone AVF ligature. Thrill recurrence and closure failure was 37.1% in the ligature group and 2.9% in the endorrhaphy group. Transvenous endorrhaphy is associated with better AVF closure results. Therefore, we recommend this procedure as the standard technique of AVF closure