رحیم براری سوادکوهی

Beta-thalassemia major is a genetic disorder with known globin defect that leads to chronic hemolytic anemia. Due to the need for recurrent blood transfusion, the risk of infectious diseases such as hepatitis is higher in these patients.

This cross-sectional study recruited 518 patients with thalassemia major in Amirkola Thalassemia Center, 2013-2014 who were selected via census sampling. Patients' blood samples were analyzed for HBsAb, HBsAg, and HCVAb by ELISA test. Data were analyzed in
SPSS V22.

The patients included 268 (51.7%) females and 250 (48.3%) males with the mean age of 27.93±9.88 years. The study showed that 5.79% of patients with thalassemia major were infected with HCV, including 11 (4.4%) males and 19 (7.1%) females and only one male patient was found to be HBsAg positive.

The study showed lower incidence of hepatitis C compared to previous reports from Amirkola Thalassemia Center. In current study the prevalence of HBsAg was also found to be low.

Nowadays mobile phone is one of the most essential tools in social and professional life of individuals. The patients, visitors and staff of health care and physicians in hospitals are also the users of mobile phones. This can make mobile phones a reservoir for transmission of pathogens and nosocomial infections. The aim of this study was to investigate the bacteria on cell phones of physicians and staff of health-care in teaching hospitals of Babol University of Medical Science hospitals, Babol, Iran. In this cross-sectional study, 192 cell phones of health care staffs and other non-clinical employees of Babol University of Medical Science hospitals were randomly chosen and sampled using sterilized cotton swabs. After placing the samples into the transferring mediums, they were fast transferred to the laboratory of Amirkola hospital. Then they were cultured on blood agar and McConkey medium. They were incubated at 37?C of temperature for 24 hours. Microorganisms were isolated by appropriate biochemical tests and the bacteria positive and negative cases were compared for different variables by logistic regression model. Of all 192 studied cases, 130 (67.7%) were positive for bacterial infection that 9 cases were infected with more than one bacterium. The most frequent isolated bacteria were Bacillus subtilis (45 cases, 23.6%) and Staphylococcus epidermises (25 cases, 13.1%) respectively. Of 62 samples that had not bacterial infections, 16 (8.4%) samples were completely negative and 46 samples contaminated with yeast. In comparison among sex, type of activity, hospitals and prevalence of bacterial contamination of cell phone, there was a significant difference between the level of education and prevalence of bacterial contamination of cell phone. There was the lowest rate of cell phone contamination in medical students and residents. According to results of this study, the mobile phones have significant microbial contamination. It seems that the increase in educational level can reduce the rate of contamination of cell phone.

Croup is a common respiratory problem presenting to emergency department and there are many treatment methods for this disease. The aim of this study was to determine the effect of dexamethasone and dexamethasone with nebulised L-epinephrine in treatment of croup. In this clinical trial study، patients with mild to moderate croup enrolled in two groups by random sampling. Forty nine patients received intramuscular dexamethasone and normal saline nebulizer (3ml normal saline) and 48 patients received intramuscular dexamethasone (at a single dose of 0. 6mg/kg) and nebulized epinephrine (0. 5ml and 1ml of 1:1000 solution in 3ml normal saline for less and more than 10kg weight، respectively. We used Geelhoed scoring for croup scoring in this study. Before treatment and 30 and 60 minutes after treatment، croup score and respiratory rate per minute has been calculated for each patient and age، gender، duration of stay in the emergency ward and hospitalization status were recorded. (IRCT: 201105264396N2) Mean age of patients in the dexamethasone+ normal saline nebulizer group was 27. 8±19. 7 months and in the dexamethasone group+ epinephrine nebulizer was 24. 6? 18 months (p=0. 412). There was no significant difference in sex distribution of children in both groups (p>0. 05). Significant difference between the two treatment groups at baseline was not found for croup score but significant differences between croup score at 30 (p=0. 006) and 60 min (p=0. 031) in the two treatments. Respiratory rate before and after treatment showed no significant difference between the two groups. The average reduction rate at 60 min after treatment in compared to before treatment in epinephrine + dexamethasone group was 5. 6? 1. 1 and in dexamethasone + placebo group was 3. 7? 0. 2. Risk of hospitalization in the two groups was not significant. Results showed that adding nebulized epinephrine to croup treatment with dexamethasone had better response for this disease.

Medical records consist of documents evidencing a patient's health status at a moment of life. There is a close relationship between disease progress and daily physician orders issued in medical records. Each order in fact reflects the patient's medical status and his/her disease progress. In this study, while keeping the previous progress page in the records, a column of brief disease progress was included in physician order sheets to increase the quality of records and promote the education of learners. In this cross-sectional controlled interventional study, medical records of all patients admitted to super specialty wards of Amirkola Children Hospital during the first quarters of 2009 and 2010 were included. From a total of 3462 records, 150 records were studied each year. Each indicator of disease progress, which was recorded based on subjective, objective, assessment, and plan (SOAP) note, was given a score. Finally, if only three indicators were mentioned in the record, it was considered as poor. Scores 4-5 represented moderate and scores 6-7 were considered as good. The scores of the records were then compared using statistical tests including t-test, paired t-test, Pearson's correlation coefficient, chi-square test, Fisher's exact test, and Kappa coefficient. P values less than 0.05 were considered as significant. The mean number of physician orders in records during the first quarters of 2009 and 2010 were respectively 9.15 ± 10.8 and 8.45 ± 6.80 cases. Good scores had the highest frequency in the new brief disease progress form. The highest average of results in the studied groups was observed in brief disease progress notes of 2010. Comparison of mean scores revealed statistically significant differences (P < 0.05). Adding a new column named "brief disease progressive note" in physician order sheets significantly promoted the recording of disease progress and reasons for medical orders based on SOAP note. Therefore, it is recommended to include this column in physician order sheets.

The widespread use of antibiotics for prophylaxis or treatment of bacterial infections leading cause of resistance in bacteries. so recognition of this bacteries and bacterial resistance patterns is one of the most important factors in treatment of bacterial infections. it seems that due to widespread use of Ciprofloxacin, Imipenem, Ceftriaxone and Cefotaxime bacterial resistance for this antibiotics have been increased. So the present study was designed to determined antimicrobial resistance in bacteries that growth in culture of admitted patients in amirkola pediatric hospital. In this cross-sectional study between 1389-1390 all positive culture of patients sample was collected. Bacterial resistance pattern was determined by minimum inhibitory concentration according to CSLI-2006 protocol. All data has been analyzed by spss 18. The most frequent microorganism isolated in this study was E.cloi(68.7%), staph areus (6.1%), klebsiella, Shigella and staph saprophyticus(5.1%), streptococcus(4%), pseudomonas and entrobacter (3%). Based on the result of antimicrobial testing susceptibility to Ciprofloxacin, Imipenem, Ceftriaxone and Cefotaxime were 90.9%, 72.2%, 91.9% and 60.6%. E.coli had the most resistance rate to Ciprofloxacin (16.2%)and the most susceptibility rate to Cefotaxime(97.1%). Kellebsiela was susceptible to all antibiotics. In this study the most rate of susceptibility was seen in cefotaxime and the most rate of resistance was seen in ciprofloxacin.

Background and Malta fever is an infectious disease caused by brucella bacteria in humen and animals and it is one of the endemic diseases in Ïran which can causes different clinical manifestations and sever complications like meningitis, endocarditis, nephritis and pancytopenia specially in children. Çansidering the incidence of malta fever in Ïran, specially in our region, we performed this study in children under 12 years of age on the bases of clinical findings, methods of laboratory findings and appopriate line of treatment. This case series descriptive study was conducted on the bases of data collected from 100 admitted patients with positive clinical sign,and specific blood culture or positive serological tests in the form of census from Tehran children medical center and Âmirkola children hospital in babol. 93% of the patients had 10 years old of age or less. The male to female ratio was1.6. Fever & knee pain was seen in 97% and 72% of them respectively. 56% noted a history of dairy products usage. ËSR was less than 50 unit in 96%. Ât last 96% of the patients improved by therapeutic regimen of cotrimoxazole(6wks) and Gentamicin (2wk). Çonclusion: Âccording to our results, the disease is common under 10 year-old and is seen in the boys more than the girls. Fever & knee pain are of the most common clinical manifestations. More than half of the patients noted the history of dairy products usage. So Malta fever have to be considered as a differential diagnosis for the patients with these manifestations and low ËSR rate. Âny way,the patients had a good respons to cotrimoxazol and gentamicin regimen.

Background and Nowdays tuberculosis is wide spreed and is the main cause of mortality in the world. Ânnually, there are 1300000 TB patients, of which 450000 infected children die. This research was designed in order to study clinically and para clinically the T.B. infected children referred to Âmir Kola pediatrics hospital in the years 1994-98. This is a descriptive cross sectional study, evaluated by referring to the files of 18 TB. patients with clinical symptoms and laboratory confirmed diagnostic tests admitted to Âmir Kola pediatrics hospital from Ôctober 1994 to march 1998. The ratio of male to female patients was 1:95, and 44.5% of the patients were in the group of under 3 years. No relevance was observed between the prevalence of the disease and the season. 39.9% of the patients were rural and 60.1% were urban citizens the main cause of referring was coughing 77.7%. Ïn 77.7% of the patients ËSR was more than normal. ÇRP was positive in 94.5%. chest X-ray confirmed TB in 88%. Ïn this study 72.2% of the patients were infected with. pulmonary tuberculesis and 27.8% with arthritis and osteomyelitis. Ïn all the patients, treatment with four drugs combination was successful. Çonclusion: Ïn most of the cases, the result was same as given by other workers. Knowledge of the patients on different clinical pictures of TB mould help in early diagnosis. Ïf a child is living in contaminated areas, and having cough for more than three weeks, persistant fever, weight loss, sweating at night, or any other symptoms, should be tested for tuberculosis.