[Assessment of screening tests for methicillin - resistant staphylococcus aureus in patients undergoing surgery by molecular [PCR] and culturing methods]

Staphylococcus aureus is the main cause of surgical site infection, causing morbidity and mortality in patients undergoing surgery. Despite a lot of research on the best diagnostic method and Methicillin-Resistant Staphylococcus aureus [MRSA] screening in patients undergoing surgery, the most appropriate diagnostic method is still unknown. The question is whether Rapid Molecular [PCR] or the traditional microbial culture is the most suitable method? This study aimed at systematic reviewing of articles to evaluate molecular method in MRSA diagnosis and the necessity of screening patients before and after surgery to prevent infections and its subsequent outcomes e.g. mortality. Many searches in databases including the digital and medical inlm library and sites such as Science, JAMA,BMD, Springer were done since 2007 to August 2010. In total, 118 studies were selected regarding the following keywords; site surgical infection, Staphylococcus aureus, PCR, and culture. Two independent persons who selected the articles evaluated the designs of the studies and extracted the information using blinded method objectively. After a complete study of other articles, 50 articles were also eliminated, and 8 articles were finally entered the study. Data of culture diagnostic methods and PCR and the statistics of infection prevalence in surgical site were analyzed by Cumulative Pooled analysis. Eight randomized clinical trials of culture methods and PCR had been studied in MRSA diagnosis and screening in different surgeries. The average duration of study was 11.6 months in all articles. The relative risk of side surgical infection was 7.3% with MRSA in all articles and CI was 95% [0.969, 0.367]. The conformity between culture and PCR was 91%, PCR sensitivity 99.2% and PCR specificity 82.2%. The rates of MRSA infection before [0.65%] and after [0.35%] surgery were significantly different with screening. When screening was applied, the rate of infection with 0.95% CI decreased to 28.9% - 31%. Findings confirm the necessity of screening before surgery in order to determine the antibiotic prophylaxis preceding the surgery in those who carry MRSA. Thus, considering the specificity and sensitivity of PCR to microbial culture, molecular method is rapid and effective in diagnosis and screening of the patients who undergo surgery

Differences in cephalometric analysis measurements: a comparison of computerized versus hand - tracing methods

The aim of this study was to evaluate the accuracy of cephalometric measurements using computerized tracing in comparison with hand tracing of radiographic printouts. A sample was used, consisting of 90 standardized lateral cephalometric radiographs, obtaining from 10 year old male and female patients with normal skeletal and dental components. The radiographs were analyzed by two different observers. The first observer performed the manual and computerized tracing and then the procedure randomly rechecked by the second observer. A total of 13 anatomical landmarks of McNamara analysis were located and angular and linear measurements were obtained. Measurement reproducibility was evaluated by calculating intraclass correlation coefficients [ICC]. Differences greater than 0.05 were considered to be statistically significant. Significant differences were found between the methods for [Inferior Airway Space] in females. Cephalometric measurements of most parameters were reproducible for both methods. The study showed that confidence can be increased in tracings obtained from computer-assisted cephalometric analysis. As the discrepancies found between both manual and computerized, were mostly not statistically significant, any differences were minimal and clinically acceptable

Cystic lymphangioma of the small intestine in a young girl

We describe a case of a 12-year old girl who presented with abdominal pain. A large abdominal mass was discovered on physical examination. Preoperative studies including abdominal ultrasonography and CT scan were performed, but they could not accurately determine the nature of the tumor. At laparotomy, a large cystic tumor of the small bowel was found. Histopathologic examination revealed a tumor of cystic lymphangioma. Although lymphangiomas are rare, especially in the abdomen, they may sometimes present as abdominal pain and acute abdomen, causing complications that require emergent surgery

[Relative frequency of success and complications of vascular access in end stage renal disease [ESRD]]

Introduction: inability to establish a success vascular access or associated complications are major causes of morbidity and mortality in ESRD patients

Objective: Relative Frequency of Success and Complications of Vascular Access in End Stage Renal Disease [ESRD] in Razi Hospital [2007]

Materials and Methods: this descriptive-cross sectiom1I study was performed on ESRD patients in Razi Hospital. The data were collected based on interview and physical examination. Because of the probability or failure in access of any patient and need lo another access establishment, the access numbers was more than the patients number

Results: among total of 151 patients 59.6% of patients was man and 40.4% was woman. The mean age of patients was 54.22 +/- 14.39 years. Success rate of dialysis was 86.1% . 82.9% of vascular access was used less than 2 months of creation [mean=3 l-60 days]. 32 cases of complications [15.6%] were recorded which in 9 cases of false aneurysm, 9 cases of venous hypertension, 5 cases of infection, 4 cases of steal syndrome, 3 cases of true aneurysm and 2 cases of thrombosis. The most number of complications were happened in antecubital A VF

Conclusion: success rate of dialysis in this study is like that other studies. Because or patients don't refer in proper time; use of vascular access was performed in less than 2 months of creation. It can increase complications and decrease patency rate of vascular access. On the other hand, to decrease the cost, usage of grail is less than native AVF; it could be reason of increased presence of complications in native AVF

[ case report of abdominal pregnancy]

Abdominal pregnancy is a very rare condition of ectopic pregnancy with a high mortality rate for mother and fetus. It occurs when the gestational sac implanted outside the uterus, ovaries and fallopian tubes. Although this condition is potential life-threatening but often misdiagnoses of other variant ectopic pregnancy. Prompt detection in initial stage of pregnancy is necessary to prevention of dangerous complication. This present casereport was a patient who admitted in the Alzahra hospital during two decades. She was a 23-year old nulliparous woman with a history of primary infertility that underwent ovarian hyper stimulation with clomiphen citrate. She underwent transvaginal ultrasonography because of menstrual retardation, positive serum betaHCG test and spotting. It was diagnosed an incomplete abortion according to clinical symptoms and lack of gestational sac inside the uterus. Transvaginal ultrasonography was performed again for persistency the pregnancy symptoms after 4months. Diagnostic pelvic ultrasonography confirmed a 16-week intra-abdominal pregnancy. The ultrasonographic examination confirmed a 27-week intra-abdominal pregnancy. The woman was admitted immediately. The surgery was performed, without any complications. She recovered well and was discharged soon

[Catamenial pneumothorax: case report]

Catamenial pneumothorax is a rare clinical condition that was coined from a Greek root meaning monthly. It classically involves women in the 3[rd] or 4[th] decade of life. Since the first description in 1958, Just 229 cases of a unique entity of catamenial pneumothorax in women have been reported. The etiology of this disease is not clearly known. Endothoracic endometriosis or other unidentified problems make periodic spontaneous pneumothorax in this patients. The main presentations of this disease are dyspnea and chest pain within 48 to 72 hours from the onset of menstruation. In this paper we discuss etiology, clinical course, and thoracoscopic treatment of a 39 year old woman with catamenial pneumothorax. In addition, the world literature is reviewed

Comparison of efficacy of honey versus silver sulfadiazine and acetate mafenid in the treatment of contaminated burn wounds in piggies

Introduction: Heat injury, with creation of conclusive necrosis in skin layers, prepares an environment suitable for bacterial infection as a result of low tissue perfusion and high protein content. Gram negative bacteries especially Pseudomonas Auroginosa have been recognized as the main creative organisms of wound infection mortality. Mankind has been interested in remedial role of honey since long.Materials and Sixty Indian piggies were categorized in three equal groups. A part of their body, approximately 8.5cm2, was burned with water steam [3 degree of burn]. Then, a number of 108 microorganisms of Pseudomonas Auroginosa were inoculated in the wound area. Each group was treated with group-specialized drug for a period of one month. [Honey- silver sulfadiazine 1%-acetat mafenid 8.5%]. In special days, according to determined schedule, animals' weight, as well as burn condition and extent were recorded and quantitative and qualitative cultural specimens were prepared periodically. The results were analyzed by statistical software of Spss10. Out of three groups, the group of honey had the mortality at least equal with two other groups[30% with comparison of 40% and 45%], the most formation of granulation tissue in a time of 10 days [90% with comparison of 35% and 44%], the smallest remaining wound at the end of study[percent of dwindle in size 62% in honey group with comparison of 29% and 22%] and the least of contamination in prepared specimens[20% in 10th day of burn with comparison of 95% and 100%]. Utilization of topical honey in treatment of deep and infectious burn in piggies not only accelerates the healing procedure but has antimicrobial effect at least equal to valuable acetate mafenid drug