Background & Objective: Respiratory tract infections causes 4.5 million children death in the world annually that occur mostly in developing countries like Iran. Bacterial and viral pathogens are responsible for this event and Adenovirus is one of the major responsible agents. According to multiple survey, incidence of viral pathogens in different world region is different so local survey is needed to describe regional incidence of different viral pathogens. Rapid test for detection of respiratory pathogens help us to select appropriate treatment and avoidence of antibiotic overusage. So abuse the aim of this study was to evaluate incidence and clinical presentation of Adenovirus infection in children in Tehran with rapid test.

 Methods:�This study is a descriptive-cross sectional analysis. All 3 month to 15 year old children with upper respiratory tract infection that come to OPD of Rasol-e-Acram Hospital in one year(1385) are included.

  Direct smear of patient’s throat was evaluated by rapid chromatography test for adenovirus infection. SPSS software was used to analyse the data.

  Results: 160 children with upper respiratory tract infection with a mean age of 61.5 months were evaluated. 57.5% were boys and 42.5% were girls. 77.4% had fever, 66% had sore throat, 37.4% had cough, 27% pharyngeal exudate, 16.4% had abdominal pain, 15.7% had vomiting, 13.8% had cervical lymphadenopathy, 10% had diarrhea, 5.7% had petechea in palate and 1.9% had conjectivitis. They admitted 24% in spring, 14.1% in summer, 23.1% in fall and 38.5% in winter.

  Adenovirus infection was detected in 10(6.3%) cases, 4(40%) boys and 6(60%) girls with mean age of 83.7(SD=58.5). they were detcted 20% in spring, 30% in summer, 30% in fall and 20% in winter.

  Conclusion: Adenoviruses are responsible in 6.3% of upper respiratory infections in children. They become less prevalent with increasing age. Its prevalence did not obey seasonal pattern. Fever and sore throat are most common clinical signs and cervical lymphadenopathy is more prevalent in adenovirus infection than others.

  Background and objectives: Because of diminished inflammatory responses to microbial invasion, the identification and diagnosis of diabetic foot infections remains a complex problem. The aim of this study was to determine the bacterial agents of diabetic foot infection and their antimicrobial susceptibility pattern. Additionally the percent of infections that were lead to amputation was determined.

  Methods: This retrospective study was conducted on a cross sectional basis at two teaching hospitals. Documents belonging to patients with diabetic foot infections in stages III and IV were studied. All demographic information, clinical manifestations, culture results, outcome of infection and other necessary data were recorded in special data sheets. The SPSS 13 statistical software was used for analyzing data. Statistical significance was assayed by Student’s t-test and chi². The differences were considered to be significant at the p<0.05 level.

  Results: Fifty two patients were selected, 36 patients (69.2%) were male. The mean age of patients was 60±12.8 years, and the mean duration of diabetes was 17±10.6 years. Amputation was done in 29 patients, and a significant correlation was found between duration of diabetes and amputation (p=0.04). The most frequently isolated pathogens were Staphylococcus aureus (38.46%) E. coli (15.4%), coagulase negative staphylococci (13.5%), and proteus spp (13.5%). Antimicrobial susceptibility results showed that 55% of Staphylococcus aureus isolates were resistant to methicillin. All the Staphylococcus aureus and coagulase negative Staphylococci isolates were sensitive to vancomycin. 100% and 87.5% of E. coli isolates were resistant to ceftriaxone and ceftazidime respectively. All Pseudomonas aeruginosa isolates were sensitive to ceftazidime.

  Conclusion: More than half of patients with diabetic foot infection were under amputation and there was significant correlation between amputation and duration of diabetes, so prevention of foot ulcer is very important in those patients. The results showed that the most isolates were resistance against common antibiotics and antibiogram is the best way to choose appropriate therapy in these patients.

  Background & Objectives: Contrast media-induced nephrotoxicity is one of the most common causes of acute renal failure and promotes both increased morbidity and greater healthcare costs. several mechanisms by which contrast media induces renal injury. These include renal vasoconstriction and direct effect of the contrast agents and reactive oxygen metabolites production. L-carnitine facilitates the transfer of long-chain fatty acids into the mitochondria. By this mechanism carnitine maintains low pools of fatty acid (acyl)-coenzyme a compounds, which are potentially toxic. However some of the actions of L-carnitine may be opposite to the toxic effects of contrast media. This study examined wheter administration of L-carnitine ameliorates contrast media-induced renal injury in rats.

  Methods : Fifty Sprauge-Dawley rats, weighting 140-230 gr were assigned to one of five treatment groups: group A(control) rats were given normal saline injections daily for 4 consecutive days, group B rats were given contrast media(diatrizoate meglumine) 1cc/kg/d, group C rats were given meglumine 1cc/kg/d and carnitine 200mg/kg/d, group D rats were given meglumine 1cc/kg and carnitine 80mg/kg/d, and group E rats were given carnitine 200mg/kg/d. Four days after injections, the rat were killed and their kidneys and blood samples were prepared for pathological and biochemistry examination. Histological scoring of renal cortical pathology was performed.

  Results: In rats that were given meglumine and no carnitine, renal function tend to be lower than in control group (p=0.001). Among rats injected with meglumine, those given 200mg/kg/d of L-carnitine had higher creatinine clearances at day 4 than the rats not given carnitine (p=00.04). Renal cortical histopathology changes were milder with meglumine and L-carnitine, particularly at 200mg/kg/d.

  Conclusions: In rats receiving meglumine, daily L- carnitine injections, particularly at 200 mg/kg ameliorates the severity of renal cortical proximal tubular necrosis and maintain greater renal function.

  Background & Objectives: The diagnosis�of Helicobacter pylori infection is based on invasive and non-invasive methods. The present study was carried out to evaluate the accuracy of three non-invasive and one invasive methods either separately or in combination for detection of Helicobacter pylori.

  Methods: A total of 108 dyspeptic patients older than 12 years who had not previously been treated for H. pylori infection were selected for upper GI-endoscopy. Histology was considered as a gold standard diagnostic test. Urea breath test, histologic examination and rapid urease test were done in endoscopy unit. Serology and stool anigen detection test were done in hematology unit of Nour Laboratory using ELISA Method.

  Sensitivity, specificity, positive and negative predictive values were calculated. The tests results were compared using the McNemar test.

  Results: According to histologic method, 56 patients had H. pylori infection. Sensitivities and specificities were 89% and 71% for the rapid urease test, 94% and 52% for serology, 90% and 82% for the urea breath test, and 46% and 80% for the stool test respectively. The most accurate combination test was rapid urease test and urea breath test.

  Conclusion: Rapid urease test and urea breath test in combination showed excellent diagnostic reliability.

  Background and Aim: Birth in the 21^st century is characterized by interventions. That interventions increase the risk for mother and baby without improving outcomes. The aim of this study was to compare the effect of physiological birth and routine normal delivery on some of maternal and fetus outcomes.

  Methods: This quasi-experimental study was performed on 160 pregnant women. The participants were allocated in two groups of physiological birth (n=80) and routine normal delivery (n=80). Inclusion criteria were as following: Apgar score between one and five dilatation between three and four cm maternal age between 18-35 years gestational age between 37-40 weeks cephalic presentation and neonatal birth weight of 2500-4000 gr. Physiological birth care included labor begins on its own, freedom of movement throughout labor, continuous labor support, spontaneous pushing, no separation of mother and baby. Routine birth cares include routine interventions in labor or birth. Rate of cesarean, Apgar score and neonatal intensive care unit were evaluated in both groups. Data were analyzed by SPSS 16. The t-test, chi-square and Mann Whitney were the statistical tests of choice.

  Results: Rate of cesarean was significantly different between two groups (p=0.005). First minute Neonatal Apgar score was significantly different (p=0.011), but fifth minute Apgar was similar in both groups (p=0.470). The transmission to neonatal intensive care unit had also significant difference among two groups (p=0.029).

  Conclusion: The present study showed that the physiological birth is safe. It seems that the physiological birth decreases the rate of cesarean and transmission to neonatal intensive care unit, also improves the first minute neonatal Apgar scores.

  Background & objectives: Wound infection is a predominant cause of death in burned patients who are clearly at increased risk of nosocomial infections. Pseudomonas aeruginosa is the most common cause of burn infections and is difficult to treat because of having high level of resistance to antibiotics. The aim of this study was to perform isolation, identification and determination of antibiotics resistance pattern of P. aeruginosa strains isolated from wounds of hospitalized burn patient.

  Methods: Biochemical and molecular tests were used for identification of the P. aeruginosa and antibacterial susceptibility test was performed using disk diffusion (Kirby- Bauer) methods. Then, the minimum inhibitory concentration (MIC) was performed for four representatives of different groups of antibiotics.

  Results: Among 94 evaluated strains of P. aeruginosa, 83 isolates (88.3%) were multi drugs resistant. Based on Kirby-Bauer method, the most resistance was seen to cefepime (89.5 %) and among the antibiotics studied to determine the MIC, the most resistance was observed to ciprofloxacin (89 %).

Conclusion: These results indicate high range of resistance to different antibiotics among strains of P. aeruginosa isolated from burn wounds of patients. So, the fast and accurate measurement and evaluation of antibiotic resistance for appropriate antibiotic therapy of burned patients is imperative.

Background & objectives: Enterococci are among the normal microbial flora in human and animals digestive tract. The nosocomial pathogenicity of enterococci has emerged in recent years and has caused great concern due to developing resistance to many antimicrobial agents. The aim of this study was to investigate and identify the prevalence of VRE (vancomycin resistant enterococcus) within Enterococci isolates obtained from different parts of the hospital.

Methods: Putative Enterococci (n=120) were isolated on Membrane Filter Enterococcus Selective Agar Medium and supplemented with 2, 4 and 8 µgr/ml vancomycin in medical samples. A total isolates passed the standard biochemistry tests for the genus and species as well as their specific primers. The antibiotic susceptibility was determined by the disc diffusion method for 8 antibiotics. Microbiologically-influenced corrosion (MIC) of vancomycin was also done using Agar-dilution assay by CLSI recommendations.

Results: Results showed that 38 and 84 of the isolates were E. faecium and E.faecalis, respectively. According to antimicrobial susceptibility tests 45, 88, 103, 42, 83, 73, 54 and 95 of the isolates were resistant to vancomycin, tetracycline, gentamicin, chloramphenicol, ciprofloxacin, penicillin, ampicillin and erythromycin, respectively. MIC test on 70% of the isolates was>256 µgr/ml.

Conclusion: Despite the fact that the prevalence of VRE strains belongs to two species, E. faecium had high resistance to a broad range of antibiotics. The results of this study indicate the important role of medical samples as reservoirs of resistance elements. Early detection of VRE with their virulence trait will help in preventing the spread of vancomycin resistant enterococcus species and urgent infection control is required in hospital setting