Background:Methicillin-resistant Staphylococcus aureus (MRSA) is a frequent cause of infections. The changing epidemiology of MRSA became evident in the 1990s when CA-MRSA cases were first reported. Nasal carriage of CA-MRSA is associated with an increased risk for development of infections in various populations.Materials and Methods:Anterior nares culture for the presence of methicillin-susceptible Staphylococcus aureus (MSSA) and MRSA was taken from 345 children attending kindergartens, who didn’t have any known risk factor for MRSA colonization. Also, children demographic variables were recorded. Identification of SA and community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) with standard microbiological test was performed. Finally, the susceptibility of isolated to various antibiotics determined. The data were analyzed with Whonet 5.6 software.Results:Of 345 children, 20 children (5.8%) were colonized with CA-MRSA, 86 children (24.9%) with MSSA and 239 cases (69.3%) didn’t have SA colonization. The highest rate of MSSA and MRSA colonization was obtained at the age of 6 years. The frequency distribution of SA (MSSA and MRSA) colonization prevalence didn’t have any significant differences based on age, gender and the admission time (P > 0.05); but it was significantly different in the urban areas (P < 0.001). The lowest resistance rate of CA-MRSA isolates, with a frequency of 10%, was detected with gentamicin, rifampin, and trimethoprim-sulfamethoxazole.Conclusions:In summary, CA-MRSA colonization was observed in child care centers remarkably. Therefore, by facing various infections due to SA especially in areas of low socio-economic status, it must be considered. Based on antibiogram test, empirical treatment with rifampin, gentamicin and ciprofloxacin is recommended during CA-MRSA infections.
Background:The efficacy of steroid administration in the prevention of postextubation complications in critical care remains controversial. The purpose of this study was to determine whether administration of nebulized budesonide in critically ill patients reduces the occurrence of postextubation airway complications.Materials and Methods:This was a prospective, randomized, double-blind, placebo-controlled study. We prospectively followed up 70 adult patients in the intensive care unit who were intubated for more than 48 h. Patients received either nebulized budesonide (1 mg every 12 h; n = 35) or placebo (normal saline; n = 35) until 48 h after extubation. Then, the postextubation complications were assessed and recorded within 48 h of extubation.Results:The incidence of respiratory distress was lower in budesonide group (8.6% vs. 31.4%, P = 0.017). Reintubation with mechanical support was necessary in 8.6% (3.35) of patients in the budesonide group and 31.4% (11.35) of patients in the placebo group (P = 0.017).Conclusion:Nebulized budesonide after extubation is effective in reducing the incidence of reintubation and respiratory distress in adult patients.
Mustard gas as a chemical weapon causes devastating effects on different tissues of the body and there is no perfect antidote against it. This gas is a very strong and nonspecific alkaline agent that is capable of causing inflammation as well as increase of immunoglobulins in the patients. This gas causes irreparable and sever damage to all the body tissues; so finding of effective medicines to treat the mustard gas-exposed patients is of great importance and is the main purpose of this study. This study was conducted as double-blind intervention during 2 months. The population society was consisted of 40 mustard gas-wounded patients. Their illness had previously been approved by Foundation of Oppressed and the Crippled and other valid government agencies. These patients were referred as OPD for treatment to pulmonary clinic related to Shiraz University of Medical Sciences (Motahari, Imam Reza and Shahid Faghihi Clinics). The studied patients in this study were divided into two groups: 1-The placebo group that included 20 patients who did not receive colchicine and simvastatin. 2-The medication group included 20 patients who received simultaneously colchicine and simvastatin with daily dosage of 1 mg/d and 10 mg/d, respectively. Then blood samples were obtained from the under studied patients and the concentration of serum immunoglobulins IgG, IgE, IgM and IgA was measured by PFT method and using Prestige 24i automate analyzer device in before and after the beginning of the treatment. The results showed that there is no significant relationship between the concentrations of IgG, IgE, IgM and IgA before and after receiving the medicines and placebo (p value: 1). The obtained results from this study indicates that both colchicine and simvastatin are not effective in patients with mustard gas toxicity and thereby it will be possible to cut the treatment with both medicines in these patients and to reduce by this way the costs related to the treatment of these patients and to ignore the continues of an useless treatment.
Background:This study attempted to determine the effects of long-term use of Vitamin C on vascular endothelial function.Materials and Methods:During a pilot clinical trial study conducted at Imam Hussein Hospital (Isfahan) in 2014–2015, a total of forty diabetic patients were selected and then assigned randomly into two twenty-subject groups receiving Vitamin C and placebo tablets. The patients were treated with Vitamin C or placebo for 6 months. All patients were examined through echocardiography in terms of cardiac function before and after treatment. To evaluate the endothelial function (flow-mediated dilatation [FMD], intima-media thickness), they underwent arterial Doppler. Moreover, the chemical indices of vascular function were tested through intercellular adhesion molecule and vascular cell adhesion molecule (VCAM). Finally, the results were compared between the two groups.Results:Based on the results, the mean left ventricular mass significantly reduced after the intervention in the group treated with Vitamin C (from 76.35 ± 25.6–68.62 ± 22.66; P = 0.015) while there was no significant difference observed in the control group (from 67.58 ± 25.38–71.63 ± 26.84; P = 0.19) but no statistically difference between the two groups-based repeated measures ANOVA test (P = 0.6). In addition, the mean of VCAM changes was significantly difference between the two groups (P < 0.001).Conclusion:Long-term use of Vitamin C in diabetic patients can improve certain echocardiographic parameters such as ejection fraction, fractional shortening, and FMD, which in turn enhances vascular endothelial function.
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