[ frequency of toxigenic strains of Clostridium difficile in hospitalized patients with diarrhea in Tehran/Iran by PCR method, 2010]

Clostridium difficile has been identified as a pathogen in antibiotic associated diarrhea [AAD], pseudomembranous colitis and also nosocomial diarrhea. The present study was performed to find the prevalence of toxigenic strains of C .difficile isolated from diarrhea patients hospitalized in Tehran hospitals. A total of 98 fecal samples obtained during July to December 2010 were studied. Samples were rapidly cultured on the CCFA medium and incubated at the anaerobic conditions. Then ELISA was done to detect toxin A and B in the stool. Molecular identification of C.difficile was done by cdd3 universal primer and toxin A gene [tcdA], toxin B gene [tcdB] and binary toxin profiles were determined by PCR method. From a total of 98 fecal samples, 15 samples [15.3%] were positive of which, 12 strains [21.2%] were A+B+, 2 strains [2%] were A+B-, and 1 strain [1%] was A-B+. This study showed that Clostridium difficile is an important pathogen in the development of nosocomial diarrhea. Therefore, routine detection of C.difficile in suspected cases is recommended

Prevalence and associated factors of insomnia syndrome in the elderly residing in Kahrizak nursing home, Tehran, Iran

As insomnia is common, especially among the elderly in the nursing homes, we aimed to estimate insomnia prevalence among the elderly residing in nursing homes as well as to determine factors associated with insomnia in the elderly. This cross-sectional study was carried out in 2009 on 112 elderly residents at Kahrizak Nursing Home, Tehran Iran. The information was gathered through 5-part questionnaires by interviewing either the individuals or the nurses in charge and also reviewing the subjects' medical files. Eventually, the necessary data were analyzed using oneway AN OVA and Chi-square tests. The mean age of the participants was 76.8 +/- 8.05 years [range, 65 to 107 years]. Based on the results, 303 [39.2%] of the elderly, including 86 [34.7%] men and 217 [41.1%] women, had insomnia syndrome. 433 [56.1%] participants complained of difficulty initiating sleep, 357 [46.2%] of disrupted sleep, 362 [46.9%] of early morning awakening, and 313 [40.5%] of non-restorative sleep. Our findings also showed that age [P= .004], number of diseases [P = .019], motility status [P = .017], sleep environment satisfaction [P < .001], cognitive status [P = .023], and functional autonomy [P= .003] were significantly associated with insomnia. Insomnia is a prevalent disorder amongst the nursing home elderly population, especially elderly women, and several pharmaceutical and nonpharmaceutical factors may trigger its occurrence. However, to prevent this problem, further studies are required in Iran and Middle Eastern region to establish a reliable understanding about insomnia patterns, causes, and cures

[Homeopathy treatment and pemphigus vulgaris: case series]

Pemphigus vulgaris is a chronic vesicular and autoimmune disease that involves the skin and mucosal membranes. The prevalence is low and drugs used for treating pemphigus have a lot of side effects. It has been suggested that homeopathy may be helpful in treating pemphigus conditions. The aim of this study was to evaluate the role of homeopathy in treatment of pemphigus vulgaris patients. A total of 12 new patients were identified over 1.5 year period. Those who did not used any drug for treatment of their pemphigus. Seven patients volunteered to be treated by homeopathy. Homeopathy treatment was applied for four weeks during the waiting period until biopsy confirmation report was received. No drug was used over this period in order to evaluate the efficacy of homeopathy alone. By the end of homeopathy treatment, patients were evaluated regarding the number of lesions, amount of pain and their wellness. According to the findings, two patients had prominent remission and six of them reported feeling better and had less pain. It seems that homeopathy does not have the expected efficacy of conventional therapy in controlling pemphigus conditions, but it may be used together with conventional treatment in order to reduce pain, dosage of corticosteroid medication used and also facilitates patients' recovery. In conclusion, further studies are required in order to determine the value of homeopathy more accurately when treating pemphigus conditions