[Incidence of ventilator- associated pneumonia [VAP] and bacterial resistance pattern in adult patients hospitalised at the intensive care unit of Besat hospital in Sanandaj]

Among nosocomial infections, ventilator associated pneumonia [VAP] is very important which can lead to increased mortality rate in the patients. The aim of the present study was to determine the incidence of VAP and its bacterial resistance pattern at the intensive care unit [ICU] of Besat Hospital in Sanandaj. In a prospective descriptive study carried out between September 2007 and June 2008, 149 endotracheal samples were obtained from the patients after 48 hours of hospitalization in ICU units of Besat Hospital. The samples were sent to the microbiology laboratory of Besat Hospital. Bacteriologic diagnosis was performed by using Edward and Ewings standard methods and antibiotic susceptibility pattern was determined by CLSI system guidelines. Demographic data were collected and recorded in a check list. Data were introduced into SPSS software and analyzed by means of descriptive statistical tests. Among 149 samples from endotracheal tube of the patients, 48 were positive for VAP with an incidence rate of 32.2%. Mean standard deviation of duration of hospitalization was 23.4 +/- 10.2 days. Microorganisms isolated from endotracheal tube were essentially Enterobacteriacae and included Klebsiella spp, enterobacter spp, and E.coli. Acintobacter spp and Staphylococcus epidermidis, Pseudomonas spp and Staphylococcus aureus were detected from 3, 3, 2 and 1 samples respectively. The maximum and minimum antibiotic resistance by gram negative bacteria were 93.3% to cefalotin and 50% to amikacin. The VAP incidence rate of 32.2% needs serious attention. Clinical isolates in the present study had a high antibiotic resistance especially to the third generation of cephalosporins. Close attention to the standards of infection control for prevention of VAP is recommended

[ effects of aerobic exercises on coagulation and fibrinolytic factors in inactive aged men]

Blood coagulation and fibrinolysis are two main components of homeostasis. Lack of balance between activities of these systems and their controlling mechanisms can lead to bleeding and clot formation. There are controversial reports about the effect of physical activities on these systems. The effect of aerobic exercise on coagulation and fibrinolytic factors in inactive old men has not been determined in the previous studies and these factors have direct relationship with cardio vascular problems. In this study we evaluated the effect of this kind of exercise on some of the factors of these systems. This was an experimental study. Sampling method was convenient. For this purpose, 16 male volunteers with age range of 60-70 years were divided randomly into 2 groups: control and aerobic groups [n1=n2=8]. Aerobic group performed physical exercise with ergometer in the first 2 weeks with 65%HRmax intensity for 30 minutes, and the next 2 weeks with 75% HRmax intensity for 35 minutes. Blood samples were taken 24 hours before the first, and 24 hours after the last training sessions. Fibrinogen, prothrombin time [PT], partial thromboplastin time [PTT], platelet counts and D-dimer were measured in both groups before and after training. Differences between the above mentioned factors in each person, before and after training, and between test and control groups were analyzed by means of t-test. Data analyses showed that aerobic training induced significant decrease in fibrinogen, PTT, PT and platelets counts [p<0.05], and significant increase in D-dimer [p<0.05]. These changes were not observed in the control group [p>0.05]. According to the findings of this study we concluded that 12 sessions of aerobic training can decrease coagulation factors and increase fibrinolytic factors of the blood and can prevent vascular thrombosis