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Showing 25 results for Drug
Mohammadhasan Namaei , Mohammad Nazem , Ali Sadeghian , Mahboobeh Naderinasab,
Volume 3, Issue 1 (4-2003)
Abstract
Background & Objective: Tuberculosis is a diseases which is severely threatening the individuals health and is spreading quickly. Moreover, the appearance of new strains resistant to drugs has complicated the issue. Since there is no information available regarding the present drug-resistance situation of patients suffering from tuberculosis in Mashhad, this study was conducted to determine the prevalence of this resistance in this city. Methods: To determine prevalence of anti-tuberculosis drug resistance in Mashhad, drug sensitivity of 75 M. tuberculosis strains isolated from patients with pulmonary and extra-pulmonary tuberculosis from 20 Feb. 2002 to 20 Aug. 2002 was studied using the indirect proportion method. Every strain was tested against Rifampicin (RMP), Isoniazid (INH), Ethambutol (ETM), and Streptomycin (STM). Medical records of the patients were reviewed. Patients with no or less than 1 month treatment were defined as new cases and those previously treated for more than 1 month were defined as previously treated cases. Results: Of 75 isolates, 70(93.33%) were from new and 5(6.66%) from previously treated cases. 68 patients (90.66%) were suffering from pulmonary and 7(9.33%) from extra-pulmonary tuberculosis. Of 75 isolates, 23(36%) were resistant to at least one anti-tuberculosis drug. The highest rate of resistance was observed to streptomycin. Three of the 75 strains (4%) were resistant to all four drugs. 1.43% and 40% of strains isolated from newly and previously treated patients respectively were multidrug resistant. Conclusions: In this study new cases with MDR-TB were less prevalent compared to other studies. Most drug resistance and MDR-TB were associated with previous treatment. Continual evaluation of drug resistance following DOTS implementation seems to be necessary.
Ziyaaddin Ghorashi , Hasan Sultani Ahari ,
Volume 3, Issue 3 (9-2003)
Abstract
Background & Objective: Most of the acute poisonings are mild with no complication but in some rare cases they can be life threatening. About 70% of acute poisoning happens in children. More than 90% of these toxic exposures are incidental and easily preventable. The factors leading to acute poisoning are variable based on cultural and socioeconomic differences among the population. The increasing production and distribution of new drugs and chemicals change the etiologic factors. This study was conducted to investigate common acute poisonings and their victims in Tabriz. Methods: In this retrospective study 306 cases of acute poisoning were reviewed from April 1999 to March 2002, in Tabriz Pediatric Medical Center. The factors that were considered included: age, gender, manner (incidental versus intentional), agents route of intoxication, residential area (rural versus urban), duration of admission, clinical presentation, date of first admission and mortality. Results: 306 patients (53.3% male and 46.7% female) were studied in this research. Most of the cases (31%) were 1-2 years old, and the fewest (1.3%) were under 6 months of age. About 95% of the cases were incidental, and 5% intentional suicide attempts among children above 10 years of age. 63% of the subjects were living in Tabriz, 29.5% of them were from rural areas and the rest (7.5%) were dwelling small towns. Poisons in the order of prevalence included: drugs (45.5%), hydrocarbons (26%), organo phosphates (7%), atropinic material and datura intoxication (6%), Rodenticides (3.6%), Opiates (2.9%), Carbon monoxide (2.2%) and alcohol, mushrooms, animal bites, acids & alkalines (6.8%). Average duration of hospitalization was 2 days and the total mortality rate was 3 cases. Conclusions: The most common etiologic factor was drug poisoning followed by hydrocarbons as the second most prevalent factor in this regard. It seems that mass media especially TV programs can play a key role to increase the public knowledge about this issue.
Zhinoos Bayatmakoo , Roshanak Bayatmakoo ,
Volume 4, Issue 1 (4-2004)
Abstract
Background & Objective: The emergence of multi-drug resistant salmonella strains h ave made t h e treatment of typhoid fever difficult all over the world. It is even more complicated w h en t h e hi g h cost of newly marketed antibiotics, their side effects and arising bacterial resistance to them are considered. Knowledge of antibiotic sensitivity and resistance of salmonella can make prevention of side-effects and emergence of resistance as well as the treatment measures more effective in this region. Methods : This descriptive study was performed in a 6-year period between 1992-97 on 397 patients who were culture positive (blood and stool) in terms of typhoid. The drug resistance was determined based on the anti-biogram of salmonella separated from blood and stool culture of the patients. Results: The total number of patients was 397 (237 males, 160 females). All of the subjects were above 12 years old. The resistance of strains of salmonella separated from the blood and stool culture to an antibiotic was 76.9 and 79.6 percent respectively. Resistance to ampicillin, amoxicillin, co-trimoxazole and chloramphenicol was highest among others. There were 60 strains with multi-drug resistance 34 of which (8.57% of all patients) were separated from blood culture and 26 (6.55% of all patients) from stool-culture. The amount of microorganisms multi-drug resistance separated from blood and stool was 6.55% and 8.57% respectively (15.12% in total). Conclusions : Using antibiotics without the knowledge of bacterial resistance and sensitivity can complicate the issue.
Khalil Rostami,
Volume 4, Issue 3 (9-2004)
Abstract
Serious vascular complications of IV drug abuse are being encountered with increasing frequency. These patients often present with cellulitis, abscess and endocarditic. Due to having viral infections these people can be a hazard to health care workers. Medical intervention is usually conducted after the emergence of one of the dreadful complications of IV drug abuse. The subject is a 40-year old male prisoner who referred to Emergency Department with 24 hours history of chill and fever, intermittent bleeding from a painful ulcerated lump in right groin along with hypotension and severe edema of right lower extremity necessitating packing and initial resuscitative measures. It was clinically diagnosed as ruptured infected pseudo aneurysm and urgent exploration was undertaken. Excision of common femoral artery was conducted by interpositioning of saphenous graft between external iliac and superficial femoral artery along with ligation of deep femoral artery drainage of abscess and debridment of necrotic tissue. The patient recovered with limb salvage except seroma on original site of vein graft.
Firooz Amani, Saeid Sadegie Ahari , Saedollah Mohammadi, Ahad Azami,
Volume 5, Issue 3 (9-2005)
Abstract
Background & Objectives: Opium addiction is a major social, psychological and health problem in the world. In past decades addiction to legal and illegal drugs has been widespread and over 1000 kinds of narcotics have been recognized, which are used in different ways including eating, smoking, injection and inhaling. Statistics published by international organizations such as UNDCP, WHO and UNSCO indicated an increasing trend in drug abuse worldwide. The countries are different only in the pattern of drug abuse. This study investigates the pattern of drug abuse in last 5 years in Ardabil. Methods : This is a descriptive, analytical and prospective study. To obtain the trend of substance abuse the records of all addicts in 1998 (684 cases) and 2002-2003 (341 cases) were studied. The collected data were analyzed by SPSS software (rel.11) using descriptive statistics. Results: The findings indicated that in the last five years the use of hashish, opium extract and other substances has decreased whereas the trend of heroin and opium use has increased. The use of opium has increased from 48.07% in 1998 to 67.4% in 2002-2003. Also the heroin use has increased from 8.5% in 1998 to 27.5% in 2002-2003. Moreover, the use of hashish, opium extract and other narcotics has decreased. The highest decrease (23.5%) belonged to opium extract and the highest increase (19%) to heroin. Conclusion : According to the results we could say that the pattern of substance abuse in Ardabil in the last five years has changed and heroin and opium consumption has increased.
Fariba Kahnamoie Aghdam , Firooze Asadzadeh Monir , Firooz Amani ,
Volume 7, Issue 1 (4-2007)
Abstract
Background and objectve: Hyper prolactinemia is a disorder which is presented in clinical forms of galatrrhea infertility, menstural disorder, hirsotism and PMS. Bromocriptin is agonist of dopamine and a drug for treatment of this disorder. Because of the necessity in continuous consumption of this drug (even for many years), the acceptance of the patients to the drug is important. In the present study the side-effects and acceptance level of patients to bromocriptin for the two forms of oral and vaginal use were studied. Methods: This study is a single-blinded clinical trial. Cases of study were patients referring Gynecology clinic with complaints of “Galactoria, Hirsotism, Menstural disorders and infertility.” The samples were 180 (two groups of 90 members each) and the length of study was two years. The samples were divided into two groups, (oral & vaginal). Before the start of the study, cases underwent, in terms of systemic and local complication, systemic and gynceologic examination to control systemic and local side effects. After health assurance of other systems, drugs were administered in two forms one group oral and the other group vaginal. The data was collected on the basis of questionnaire and analyzed by SPSS. Results: This study showed the side effects of Bromcriptin in oral-forms they were 100% and for vaginal-froms they were 43.2%. Most of the side effects in oral froms were nausea 38.9% and in vaginal from was vaginal itching (22.3%). Vertingo in oral forms was more than vaginal form (27.8% to 2.3%). Hypotension was seen in 11.2% of oral forms but not in vaginal form. About 51.2% of oral form group had more than two complications. In both groups the most complications were seem within the first ten days (37.8% and 66.7%). Severity of side effects in 31.2% of oral forms and 11% of vaginal forms were so tense that resulted to patients' discontinuation of the drug. Conclusion: There is a significant difference between severity, intensity and kind of complications in the forms of oral and vaginal use of Branocriptin and acceptance and duration of drug intake in vaginal forms is more than oral forms.
Vahed Alaei, Farhad Salehzadeh,
Volume 8, Issue 3 (9-2008)
Abstract
Background & Objectives: Identifying urinary tract infection, especially in infants and young children is very important from the viewpoint of start of treatment, and if it is delayed probably the children are affected by risk of failure to thrive, sepsis and chronic problems such as renal scars, increase of arterial blood pressure and renal failure. Increasing usage of antibiotics, result in AB resistance microorganism. This study was done because of bacterial differences in resistance in different regions and the change in the rate of resistance in UTI. Methods:This research is a descriptive-prospective study 510 children under the age of 12 as the study samples were chosen. These children were referred to clinics of Ardabil Aliasghar and Sabalan Hospitals in 2006. Their urine culture colony was above 100000. Data gathering was accomplished by their parents through questionnaire and interview's then gathered Data were analyzed by computer software programs of the SPSS and Excel. Results:Findings of research showed that symptoms of malodorous urine (54.7%) in children under 12 months, dysuria (58.9%) in 1-3 years age groups, frequency (54.8%) in 3-6 years old groups dysuria (49.2%) in 6 years old groups and above were most prevalent symptoms which were reported. From the viewpoint of gender differences UTI in girls was 4 times more than that of boys that this difference in 1-3 years old groups was highest range (4.8 to 1). About antibiotical resistancy of microorganisms, Ampicillin with 78.9% resistance, Co-trimoxazole with 66%, Cephalexin with 62.8% and cephazoline with 33.3% were most resistant antibiotics respectively. E-coli resistance against gentamicine was 15.8%, that compared with other microorganisms is very high and its resistance against ceftriaxon was 8%, which is low compared with other microorganisms. Conclusion: Findings of research showed the variety of UTI symptoms in children and also showed that drug resistancy against Ampicillin, Co-trimoxazole, Cephalexin and cephazoline is high.
Bahram Fatollahzadeh , Parviz Maleknejad, Abbas Bahador, Hadi Peeridogaheh,
Volume 10, Issue 1 (4-2010)
Abstract
Babak Mostafazadeh, Esmaeil Farzaneh,
Volume 10, Issue 1 (4-2010)
Abstract
Background & Objectives : One of the limitations in management of patients suffering from decreased level of consciousness due to drug poisoning is the inability to interview the patient. The aim of the study was to compare characteristics of the two subgroups of these patients those who had a suicidal attempt history with others. Methods: In this cross-sectional study, 19 patients with suicidal attempt history and 66 patients without this history were selected among patients who were admitted for drug poisoning to referral poisoning hospitals in Tehran, Iran, in August, September and October 2009. All of them had decreased level of consciousness due to unknown drug poisoning. Demographics, poisoning characteristics, past medical history and substance use history of the patients were recorded. Results: Different between previous history of suicide action with drug material decreased level of consciousness caused by poisoning, was significantly (p=0.04). Mental disease (p > 0.01), number of tablets consumed (p=0.02), interval between drug consumption and emergency forces to reach the place (p= 0.021), described in deliberate self poisoning patients (Self Poisoning) (p=0.001), decreased level of consciousness grade (p=0.046), U.S. fail initial level of consciousness after emergency measures (p=0.02) and the need for health care and advanced next (p= 0.013) in patients with decreased level of consciousness with a history of previous suicide compared with other group were higher. Significant difference between the two age groups (P> 0.05), gender and history of illegal drug use (P> 0.05) did not exist. Conclusion: According to these findings, when dealing with patients suffering from decreased level of consciousness due to unknown drug poisoning, paying attention to history of suicidal attempts in these patients can help medical professionals in determining more effective treatment options for them. Medical staff should also record previous suicide as a risk factor in the risk assessment to consider the disease.
Atefeh Ghanbari, Akramosadat Montazeri , Maryam Niknami , Zahra Atrkarroshan , Abdolrasool Sobhani, Behrooz Najafi,
Volume 10, Issue 4 (12-2010)
Abstract
Background and objectives: Chemotherapy-induced nausea and vomiting are the most important complications for cancer patients. Ginger is an effective herbal drug for the treatment of nausea and vomiting. It hasn’t any known side effects. In some countries, it is used for making of antiemetic drugs. The aim of this study was to determine the effect of ginger on the intensity of chemotherapy-induced nausea and vomiting in cancer patients . Method: This study is a randomized, cross-over, double – blinded, clinical trial that was done on 44 cancer patients undergone chemotherapy. In the first cycle of the study, patients were assigned by four block random allocation to receive one of the antiemetic regimens regimen A (routine and 1gr ginger) and regimen B (routine and 1gr placebo). After 28 days, in the next cycle of chemotherapy, another regimen was administrated A or B plus chemotherapy drugs., the severity of the nausea and vomiting was measured in 4h (1, 2, 3, 4) after second dose and at the end of the 24h after receiving the first dose by using VAS and kortila tools .The data were analyzed by independent student t - test and non-parametric test (Mann-Whitney U test) by using SPSS, version 16 software . Results: The results showed that the frequencies of nausea and vomiting in two regimen groups weren’t different, but nausea score was significantly decreased in ginger group, compared to placebo. Independent student t - test and Mann-Whitney U test also revealed a significant difference on nausea scores in 3rd and 24th hour post chemotherapy (p=0.06, p=0.01, respectively). Conclusion: In respect to low nausea score in ginger regimen, compared to placebo, it seems ginger using is a safe and simple method and it can be used as antiemetic drugs in patient undergoing chemotherapy
Firouz Amani, Sadollah Mohammadi , Afshin Shaker, Samira Shahbazzadegan,
Volume 11, Issue 3 (9-2011)
Abstract
Background & Objectives: Using of drugs arbitrarily leads to failure of treatment and causes side effects in prolonged time. The aim of this study was to survey prevalence of arbitrary drug use and the factors affecting it. Methods: Three hundred students participated in this cross-sectional and descriptive study in Ardabil (Islamic Azad, Mohhaghegh Ardabili, Payame-Noor and Medical Sciences Universities) during 2010. The samples were selected randomly from four universities and data were collected by questionnaire and then, analyzed by descriptive and analytical statistics such as chi-square test. Results: The average of students’ age was 20.64±2 years. 23.3% of them were married from whom 92.2% were non-medical students and 7.1% were medical students. 76.7% of all students were single. 83% of all students were using drugs arbitrarily. The highest mean score for student attitude was reflected to safety of used drugs. Lack of time to visit a physician, believing the safety of many drugs and selling of drugs without prescription were the most common causes in arbitrary drug use among students. Conclusion: Regarding to the high arbitrary drug use among students, it is necessary to make a new policy for education and correct informing of students in order to reduce self-treatment.
Hosein Douste Kami , Adalat Hosseinian , Effat Mazaheri, Naser Aslanabadi , Samad Ghaffari , Bahram Sohrabi , Eiraj Mohammadzadeh , Farhad Pourfarzi , Naser Moaiiednia ,
Volume 13, Issue 3 (10-2013)
Abstract
Background & Objectives: Coronary bifurcation lesions are important, complex lesions with different therapeutic strategies. In this study, patients with Coronary bifurcation lesions were treated and clinical results in these patients were followed during the nine-month period. Methods: This descriptive analytical study was performed between January 2007 to December 2008 at Tabriz Shahid Madani Cardiovascular Center. We have studied 96 patients (83 male and 13 female). Patients on the basis of one or two stents were placed in one group and the other groups were divided based on the use of Drug Eluting Stent and Bare Metal Stent. After diagnostic angiography if coronary bifurcation lesions were present based on Medina classification, appropriate angioplasty treatment was carried out. In a situations including chest pain, electrocardiographic changes or the objective evidence of ischemia and indication of angiography, appropriate diagnostic tests during follow up period were done. Clinical outcomes including acute coronary events were recorded. And result analyzed using SPSS version 16 . Chi-square ، Fisher and T tests were used to compare the relationship between variables. Results: In this study 86.5% was male and 13.5% female. The mean age of these patients was 56±9.9 years old. The most prevalent risk factor was HTN with 41.7% incidence and 55.2% of patient had chronic stable angina and 26% of them had history of acute myocardial infarction, 7.2% with history of PCI and 5.2% with history Of CABGS. Most prevalent site of bifurcation was ALD/diagonal with 65.5% incidence. The most prevalent complication was mild bleeding from puncture site with 10.4% and 5.2% of patients had mild hematoma. Among patients with two stents versus one stent presence of AMI presentation with CSA, ST Elevation in ECG was statistically significant. Also involvement of SB (side branch) lesions lengths at SB, kissing ballooning after implantation of two stents were statistically significant. Among patients with DES versus BMS usage of stent in RCA, LAD, lesion lengths at PMB (proximal main branch), DMP (distal main branch) and SB, procedure time, radiation dose, fluoroscopy time were statistically significant. Among two groups MACE (major acute coronary event) in two stents patient between 1-3 month and total MACE at first 6 month were statistically significant Conclusion: The age of patients treated with CBL was low, also more usage of BMS and stenting of BFLs with two BMS had weak results in this study but surprisingly total results of BMS and DES did not have significant difference after 9 months follow up between two groups.
Samira Sheikh Ghomi , Parisa Farnia , Mojtaba Darbouy ,
Volume 14, Issue 2 (7-2014)
Abstract
Background & objectives: The rapid identification of patients carrying resistant Mycobacterium tuberculosis (M.TB) isolates is important for effective tuberculosis therapy. Unfortunately, during the recent years considerable numbers of isolates showed resistant to Rifampin (RIF) and Isoniazid (INH). The aim of this study was to rapidly identify resistant MTB isolates using molecular method. For this reason, the comparison between real-time PCR based on Taqman and HRM AssayS in detection of rpoB, inhA and katG genes mutation in clinical isolates were performed and analyzed. Methods: The study carried out on Mycobacteriology Research Center (MRC) from 2012-2013. Classical susceptibility testing i.e., proportional method against INH and RIF was performed on eighty three M.TB isolates. Thereafter, multiplex and real-time PCR were performed on extracted DNA sample. The real-time PCR was based on Taqman and HRM assays. Mutation in genes rpoB, inhA and katG were detected. Results: In overall, based on proportional and multiplex PCR method, 47 and 35 isolates were resistant to RIF and INH, respectively. Thirty of strains were resistant to both RIF and INH. The agreement of real-time PCR using Taqman was 88% for resistant and 84% for susceptible isolates, whereas the agreement of HRM was 96% and 30%, respectively. The sensitivity and specificity of Taqman in comparison to multiplex were 84% and 88%, respectively. In addition, the sensitivity and specificity of HRM were 30% and 96%, respectively. Conclusion: Results documented that real-time PCR based on Taqman assay is more sensitive than HRM assay. Additionally, real-time PCR based on Taqman assay is a rapid, accurate and cost effective method in detection of Mycobacterium tuberculosis resistance.
Nasrin Fouladi , Farhad Pourfarzi , Jalal Tagizadeh, Hosein Alimohammadi , Raheleh Mohammadi,
Volume 14, Issue 4 (1-2014)
Abstract
Background & objectives: Addiction is one of the problems in world threating the social, economic and culture factors. It is essential to have an accurate knowledge about the characteristics of drug users in order to diminish the high-risk behaviors of intravenous drug addicts. This research has been done to assess relationship between individual characteristics and high risk behavior in intravenous drug addicts. Method: In this descriptive-analytic research, 360 drug users were selected from different places in Ardabil city and interviewed by a prepared questionnaire. The data were analyzed using descriptive and analytical tests including t-test, Pearson correlation and ANOVA with SPSS statistical software. Results: The results showed that the age, gender, material status, job position, age of addiction start, age of injection start, injection frequency, injection frequency per day, syringe supply place and the partner’s gender during recent few months had no significant difference compared to drug users with needle sharing and without needle sharing. The educational level of drug users with needle sharing was lower (P=0.037) and the number of new syringe usage per month was also lesser (P=0.001). They predicted to be more likely infected with AIDS (P=0.001) and had a less argument with their partner about using condom, also mostly have not used condom at their last sexual relationship (P=0.001). The average number of their partners during last three months was high (P=0.003) and there was a meaningful relationship between true sense of peril and using condom in drug users with needle sharing group (p=0.001). Conclusion: There is a significant relationship between the true sense of danger and the using condom. It is necessary to have an appropriate advertising to increase using condoms among injecting drug users.
Maryam Adabi, Mahshid Talebi Taher , Leila Arbabi, Mastaneh Afshar , Sara Fathizadeh, Sara Minaeian, Niloofar Moghadam-Marageh, Ali Majidpour ,
Volume 15, Issue 1 (4-2015)
Abstract
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.
M Parsian, K Hashemian, Kh Abolmaali, M Mirhashemi ,
Volume 15, Issue 2 (7-2015)
Abstract
Background & objectives: Substance abuse is one of the worst humanitarian issues in recent years which undermines the base and foundations of human society. Its prevention requires the application of multiple theories in various disciplines together with diverse methods and techniques. Several studies have been emphasized on the role of personal and familial variables as risk factors for substance use . However, this study was done in order to predict drug addiction attitude in adolescents according to the family training risk factors to prevent substance abuse and to design a model for the prevention of addiction .
Methods: This study is a descriptive and survey research performed on a sample of 373 male and female students selected randomly among the five high school students in Ghaemshahr city. Then a questionnaire including parenting styles, attitude to addiction and social problem solving skill as well as a socioeconomic questionnaire distributed among the students. For data analysis, the statistical method of descriptive statistics and path analysis has been used.
Results: Results of this study have shown that the component of parenting styles has a direct and positive impact on attitudes to drug addiction. In addition, there was a direct and positive non-significant relationship between the adaptive social problem solving skills and attitude to drug addiction and also direct and negative significant relationship between the non-adaptive social problem solving skills on this attitudes. A direct and negative significant relationship was also seen between parenting styles and attitude to drug addiction.
Conclusions: Based on the results of present study, the components of parenting styles have a direct and negative impact on attitudes to drug addiction. Also there is a direct and significant relationship between the components of non-adaptive social problem solving skills and the variable of social attitude in adolescents . But the component of adaptive social problem solving skill has a direct and non-significant impact.
Shadi Shahsavan, Abdolaziz Rastegar Lari , Bita Bakhshi, Parviz Owlia, Maliheh Nobakht ,
Volume 16, Issue 3 (10-2016)
Abstract
Background & objectives: Shigella spp. are gram negative bacteria that can cause shigellosis in human. It is important in young children as well as elderly and immunocompromised people. Threatening complications can occur in severe cases with multidrug resistance species. It has been observed that Shigella spp. have become resistant to antibiotics like other bacteria. Investigation of resistance to azithromycin, tetracycline and pattern of resistance are the objectives of this study.
Methods: Fifty isolates of Shigella spp. which have been collected from three hospitals in Tehran were studied. Isolates identified and confirmed as Shigella spp. by biochemical, serological and molecular methods (ipaH, wbgz, rfc genes). Antimicrobial susceptibility test was performed for ampicillin, azithromycin, ciprofloxacin, doxycycline, levofloxacin, minocycline, nalidixic acid, norfloxacin, streptomycin, trimethoprim-sulfamethoxazole and tetracycline by disc agar diffusion method. Minimal inhibition concentrations were performed for azithromycin and tetracycline.
Results: From a total of 50 Shigella spp. isolates, 16% of them were Shigella flexneri and 84% Shigella sonnei. The majority of isolates were multidrug resistant. The most resistance was seen to doxycycline, streptomycin, trimethoprim-sulfamethoxazole and tetracycline. Resistance to azithromycin was 6% and all of the isolates were susceptible to norfloxacin and levofloxacin. Nine patterns of resistance were revealed to these isolates.
Conclusion: High resistance to tetracycline was observed and resistance to azithromycin as an alternative treatment choice was also considerable.
Jafar Mohammadshahi , Shahram Habibzadeh, Mohammad Hosseinzadeh, Bita Shahbazzadeghan,
Volume 17, Issue 2 (7-2017)
Abstract
Background & objectives: Human immunodeficiency virus (HIV) is a globally widespread infection that spreads mainly through sexual contact, mother to child and intravenous drug use. The disease can vary from an asymptomatic state to advanced immune deficiency and AIDS-related opportunistic infections and complications. Patients may be diagnosed at different stages of the disease. In this study, we aimed to analyze the clinical and epidemiological characteristics of patients with HIV and its consequences during the past 10 years (2005-2014) in Ardabil city.
Methods: In this descriptive and case series study, patients with HIV (including live and dead patients) referring to the Ardabil behavioral counseling center were included during 2005-2014 years. The checklist containing demographic data, modes of transmission, time of diagnosis, clinical and therapeutic problems during this period, etc. was prepared for each patient. In dead patients, the causes of death as well as the interval between diagnosis and death were investigated.
Results: In this study, 60 patients with HIV were evaluated, the mean age was 42.96 years, 76.7% of patients were male and 48.2% were intravenous drug users. In 39.7% of cases, patients have probably been infected through intravenous injection and 33.3% by sexual contact. The mean CD4 + lymphocyte cell count of patients was 252 cells per ml. The most common early symptoms of the disease were fever (63.33%), aphthous stomatitis (35%) and diarrhea (28.33%). In 7 cases (50%), tuberculosis was the most common opportunistic infection. 6 patients (10%) had coinfection with hepatitis B or C. 28 patients (46.6%) died within the time of study. The median time from diagnosis to death was 44.84±39.65 months and cardiorespiratory failure was the most common cause of death among patients.
Conclusion: This study showed that most patients were middle-aged and intravenous drug use was the most common risk factors for HIV. The most common way of transmission was intravenous injection and hepatitis C and tuberculosis were the most important comorbidities, respectively. Raising community awareness about the disease, early diagnosis and appropriate care during illness are basic measures to deal with this global problem.
Reza Mamizadeh, Nima Razzaghi-Asl,
Volume 18, Issue 2 (7-2018)
Abstract
Background & objectives: the interaction of albumin- the most important plasma protein- with various drugs leads to variations in the pharmacokinetics of drugs. Since interaction of different pharmaceuticals with albumin is determinant in the estimation of dose and prediction of drug-drug and drug-food interferences, studying the binding ability of different drugs with albumin is an active area of research.
Methods: Docking studies were performed by Lamarckian Genetic Algorithm of AutoDock 4.2 program. The three-dimensional structures of albumin were obtained from Brookhaven protein data bank (2BXD & 2BXF; www.rcsb.org). Pre-processing of molecules was done using AM1 method and AutoDock Tools 1.5.4 software. AM1 optimization method was performed using Polak-Ribiere (conjugate gradient) algorithm with termination condition as RMS gradient of 0.1 Kcal/Å mol. Schematic representation of drug-albumin complexes were obtained by Ligplot.
Results: Oxiconazole and fenticonazole were top-ranked drugs in binding to site 1 (subdomain IIA) and 2 (subdomain IIIA) of albumin, respectively (∆Gb -9.01 and -9.89 kcal.mol-1). Leu238 and Ala291 were the key residues of site 1 due to hydrophobic contacts with all of the antifungals, while Ile388, Asn391 and Leu430 were the key residues of site 2. A few structure binding relationship rules could be extracted from the binding pattern of antifungal drugs.
Conclusion: It was found that antifungal agents might have higher affinity toward site 2 of albumin rather than site 1. Estimated high albumin affinities of antifungals provided the possibility of drug-drug or drug-food interactions. It seemed that hydrophobic contacts were more significant in binding antifungals to albumin.
Moien Zakavati, Shahram Habibzadeh, Saeed Sadeghieh, Perham Mohammadi, Sara Mostafalou,
Volume 19, Issue 1 (4-2019)
Abstract
Background & objectives: Nowadays, bacterial resistance and the increase in the therapeutic costs are considered as the most important global concerns of medical care system regarding complicated infections. Imipenem is a member of the carbapenem class of beta-lactam antibiotics prescribed mostly in our hospitals because of its broad activity against bacterial infections. Drug Utilization Evaluation (DUE) process is an official, ongoing and systemic program that collects information in order to identify and improve the adverse effect of drugs and the cost of medicalization. The objective of this study was to evaluate the administration and use of imipenem in the educational Imam Khomeini hospital in Ardabil in 2018.
Methods: In this prospective, descriptive, cross- sectional study, 110 hospitalized patients, who received imipenem from September to December of 2018, were included in this study. Patient's demographic data, dosing, dosage adjustment in renal failure and other co-prescribed antimicrobial drugs were extracted from current medical file of hospitalized patients and evaluated with medical guidelines.
Results: 64% of patients received imipenem in the first day of hospitalization and 75.5% of patients were empirically received imipenem while antibiogram test was ordered for only 24.5% of patients. Serum creatinine were ordered for most of the patients, but correct dose regimens for patients who get non-empiric antibiotic therapy were only 25.5%.
Conclusion: High rate of empiric prescription without considering the result of antibiogram test and immediate initiation of antimicrobial therapy at the time of admission were the most important aspects of irrational use of imipenem observed in this study. Paying more attention to sampling, culturing and sensitivity test and prescription of imipenem based on specific guidelines are recommended.
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