To study the prevalence of resistant strains of S. aureus isolated from surfaces, beds and various equipment of an Iranian hospital emergency ward. Methods: Two hundred swab samples were collected from the surfaces, beds, trolleys, surgical equipment and diagnostic medical devices in emergency ward. Samples were cultured and those that were S. aureus-positive were confirmed using polymerase chain reaction (PCR). Antimicrobial resistance pattern was analyzed using disk diffusion method. Results: Nine of 200 samples (4.5 %) collected were positive for S. aureus. Surfaces (8.8 %), beds (5 %) and trolleys (5 %) were the most commonly contaminated. S. aureus isolates exhibited varying levels of resistance against antibiotics with the following being the highest: tetracycline (88.8 %), penicillin (88.8 %) and ampicillin (77.7 %). The prevalence of resistance against methicillin, oxacillin and azithromycin were 44.4, 33.3 and 33.3 %, respectively. There was no pattern of resistance against imipenem. Conclusion: Efficient disinfection of surfaces, beds, trolleys and surgical instruments should be performed periodically to reduce colonization of resistant strains of S. aureus in various areas of emergency health care centers.
Since some military exercises can be harmful, the occurrence of proteinuria and hematuria after physical exercise and military training were studied in soldiers participating in the morning exercise. The results showed that the 0.9% of individuals (1 person) before the study, and 2.7% (3 cases) after the study had hematuria. There was a significant difference (p = 0.027) between hematuria before and after exercise. 11% of individuals (11 cases) had proteinuria before exercise and 27.3% of individuals (30 cases) after. A statistically significant difference (p = 0.00) was observed in terms of the incidence of proteinuria before and after exercise. There was a significant relationship (p = 0.3) between the underlying disease and the occurrence of proteinuria after exercise. So that 100% of individuals with Renal calculus (2 cases), burns (1 cases), cold (3 cases), and 50% of individuals with a history of fracture were developed proteinuria after exercise. But there was not statistically significant difference (p = 0.99) between the underlying disease and hematuria. The incidence of proteinuria and hematuria has many factors. One of the major reasons can be hard physical and morning exercises, therefore, it is necessary to implement some appropriate measures to reduce the physical stresses on personnels. Hard physical exercises can lead to proteinuria and hematuria and their side effects. To alleviate clinical problems from hard activities in military bases, the individuals must be managed in terms of physiological characteristics and the appropriate exercises should be given them based on the individuals' physiology.
Background: Surgical treatment of lumbar intervertebral disc herniation is a critical procedure due to the proximity of the operation field to neural structures. Providing a bloodless field and optimizing surgeon vision is of high value in this regard. Total intravenous anesthesia with propofol and inhalation anesthesia with isoflurane are both used in spine surgeries. Both of these agents have vasodilator properties that could be benefited in inducing controlled hypotension as a blood sparing technique. We sought to compare propofol and isoflurane anesthesia in terms of intraoperative bleeding and hemodynamic changes. Methods: After obtaining ethics approval and informed consent, 88 Iranian patients with American society of anesthesiology score 1 and 2 were randomly divided into two groups. The ISO group received isoflurane and the PRO group received propofol as the main anesthetic agent. Hemodynamic changes, intraoperative bleeding, urinary output, and surgeon satisfaction score were recorded. Results: The two groups were similar in demographic characteristics (for age P = 0.072; for gender P = 0.286). The ISO group had significantly lower blood pressure after 30 minutes of anesthesia (P = 0.01). Intraoperative bleeding in terms of qualitative and quantitative measures was lower in the ISO group (P = 0.001). Isoflurane anesthesia was also associated with a higher surgeon satisfaction score (P = 0.01). Conclusions: Our findings showed that isoflurane as a volatile agent provides a bloodless field better than does propofol through TIVA.
In patients with paroxysmal supraventricular tachycardia (PSVT), adenosine is administered through a peripheral vein by which the initial dose of 6mg of adenosine is effective in up to only 58% patients and many need a second dose of 12 mg. The aim of this study is to compare the effectiveness of antecubital vein with external jugular vein as routes of administration of adenosine. We conducted this randomized controlled trial at the Emergency Department of a university hospital, Tehran, Iran between 2009 and 2012. Forty-sixPatients were randomized to receive adenosinefrom either the route of antecubital vein (n=25) or external jugular vein(n=21). In the antecubital vein group, 14 (56%) patients were treated successfully with the first dose of adenosine which was significantly lower than 20 (95%) patients in the external jugular vein group (p=0.003). we suggest that the external jugular vein route of administration of adenosine is a safe, dose saving and cost effective approach in treating patients with PSVT.
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