[Frequency of human papilloma virus genotypes among woman with genital lesions, in Sanandaj, Iran]

Background and Aim: genital wart is the most common sexually transmitted infection and its role in cervical cancer has been confirmed. The aim of this study was to determine the presence of human papillomavirus [HPV] and the frequency of its genotypes in the patients with genital lesions referring to the clinics in Sanandaj, Iran

Material and Method: this descriptive analytical study included 50 women with genital lesions referring to the clinics in Sanandaj City from February 2016 to February 2017. Biopsy samples were examined for four genotypes [HPV 16, 18 [high risk] and HPV 11, 6 [Low risk]] by PCR. Demographic information and risk factors were recorded in a questionnaire for every patient. Using spss v.20 software, data were analyzed by descriptive statistics. Fischer test was used to investigate the relationship between the risk factors and HPV infection

Results: the results showed that 28 cases [56%] were HPV positive. Among the four genotypes of HPV, HPV 6 was the most frequent [32%], followed by the types of 18 [12%], 16 [6%] and 11 [2%]. Co-infection of HPV-16 and 18 were found in 2 cases [7.1%].The mean age of the patients with HPV infection was 34.07 +/- 8.7 years and the mean age of the first sexual contact was 21.22 +/- 4.8 years. No significant association was found between the risk factors and HPV infection [P> 0.05]

Conclusion: considering the high prevalence of HPV infection and its asymptomatic course in many cases, early detection and treatment of the genital warts, especially HPV16 and 18, can lead to prevention of cervical cancer

[Investigation of the knowledge, attitude and performance of the physicians in regard to rational antibiotic prescription]

Background and Aim: excessive use or misuse of antibiotics leads to important consequences such as increased cost of treatment, bacterial resistance, treatment failure, drug toxicity and increased morbidity and mortality. Use of guidelines can result in increased knowledge of the physicians and decreased prescription of antibiotics with resultant change in the attitudes of the physicians towards this policy

Materials and Methods: this cross-sectional study included 356 physicians and was conducted in Sanandaj in 2015. The sampling method was census. The final questionnaire included 7 questions to assess knowledge, 18 questions to measure attitudes, [by means of a 5-point Likert Scale from very strong agreement to very strong disagreement], and 12 questions to assess performance. The reliability of the questionnaire was 54%. Using SPSS20 software, frequency and mean score of the questions were calculated

Results: among 356 questionnaires, 44.2% were filled out by specialists and 45.2% by the physicians who had graduated more than seven years ago. 56% of the physicians chose the correct answer for the questions on knowledge, and 25% of the physicians had knowledge about antibiotic resistance. 97.3% of the physicians agreed that antibiotics in our country have been used in excess. In this study, 233 [65.5%] physicians had high knowledge and selfconfidence and 19.7% expressed low or lack of self-confidence about antibiotic prescription. WHO guideline and antibiotic guideline had been considered useful by 56% and 54.5% of the participants respectively. 49.9% of the physicians had not participated in any training course on antibiotic prescription. The highest and lowest frequency rates about sources of knowledge on antibiotic prescription belonged to internet [63.2%] and information provided by pharmaceutical companies [30.3%] respectively

Conclusion: considering the average level of knowledge of the doctors on antibiotic prescription and lack of participation of half of the subjects in training courses on antibiotic prescription after, attention to training courses with proper planning is recommended

[Comparison of sputum induction and bronchoalveolar lavage methods in diagnosis of pulmonary TB in patients with negative smear or without spontaneous sputum]

Sputum smear is recommended for microbiological confirmation of diagnosis of pulmonary tuberculosis. It has been reported that sputum induction is a safe and non-invasive method for confirmation of microbiological diagnosis of tuberculosis in smear negative patients. This study deals with the comparison of the value of sputum induction with that of bronchoalveolar lavage [BAL] in the diagnosis of TB. 56 patients suspected to have tuberculosis were admitted in the infectious ward of Tohid Hospital and entered into this study. Sputum induction and BAL were performed for two consecutive days according to a standard procedure. Smears obtained from induced sputum and BAL contents were stained for acid fast bacilli. Exclusion criteria were severe asthma or severe chronic obstructive pulmonary disease and pregnancy. Of 56 tuberculosis suspects with negative or absent sputum production, sputum induction led to positives smears in 8 [14.3%] patients [5 previously smear-negative, 3 unproductive] and BAL had positive results in 7 [12.5%] patients which revealed a significant difference [p = 0.000]. Sputum induction is safer, easier to accomplish and more sensitive than BAL technique for diagnosis of pulmonary TB. Our study suggests that sputum induction with aerosolized hypertonic saline is a useful technique for better detection of cases of tuberculosis in patients with negative smears or non-productive cough