مجله طب جنوب
سال پانزدهم شماره 2 (تابستان 1391)

Coagulase Negative staphylococci (CoNS) are nosocomial pathogens. The main objective of the study was to compare the performance of disk diffusion, E-test and agar screening methods with Real-time PCR technique for detection of methicillin resistance in coagulase negative staphylococci (MRCoNS), using Taqman® Real-time PCR for mecA as the “gold standard” comparison assay.

88 coagulase negative Staphylococcus isolates were identified out of 284 Staphylococcus isolates collected from Hajar and Kashani hospitals-shahrekod, Iran. Methicillin resistance strains were identified by several

Disk diffusion, Agar screening, E-test and Real-time PCR. The results of the tested methods were compared with those of the Real-time PCR by Chi square or Fisher’s exact tests.

Of the 88 coagulase negative Staphylococcus isolates tested, 46 isolates (52.3%) were mecA-positive and 42 isolates (47.7%) were mecA-negative. The results of all the tested methods had a statistically significant agreement with those of Real-time PCR. The E-test was 100% sensitive and specific for mecA presence. The sensitivity and specificity of oxacillin agar screen (6.0 μg/ml) method were 96% and 98%, respectively and the sensitivity and specificity of oxacillin Disk diffusion method were 91% and 90%, respectively.

In the present study, E-test is proposed as the best phenotypic method. In case economic issue matters, the oxacillin agar screening method (6.0 μg/ml), which is suitable for the detection of MRCoNS due to its accuracy and low cost, is recommended.

Given the longevity achievable with current prophylactic and therapeutic strategies for persons with HIV infection, quality of life (QOL) has emerged as a significant medical outcome measure, and its enhancement has an important goal. This review highlights the relevance and complexity of physical, psychological, and social factors as determinants of health-related quality of life in HIV-infected person in Bushehr province.

This cross-sectional study was conducted using a convenience sampling method on 54 patients living with HIV or suffering from AIDS on 2009. The method of data collection was summarized questionnaire of World Health Organization (WHO-QOL-Brief). The main measured outcome in this study was quality of life and some related demographic and clinical variables.

The majority of the patients were males (46/54) and unemployed (37).25 participants were married. The mean±SD age of the patients was 38.1+ _7.47 years. Employment, marital status, level of education, and clinical stage of the disease, had a significant effect on the quality of life of the patients. In multivariate analysis, the most important predictor of the quality of life was job.

The most important factors, association with decreased quality of life of the Patients in this study, were being separated or divorced, unemployment and being at severe stage of the disease. The relationship of these measures to treatment outcomes can and should be examined in clinical settings in resource-limited countries.

Appropriate location selection for health Services unites is a Strategic decision which is based on gathering information and also exact analysis of related alternatives. It's clear that result of this decision is really important and will led to long time improvement in all dimensions including economic, social, and etc. Otherwise, the most studies of location have done in background manufacturing rather than service area and there are just few articles which have focused in field of healthcare. This study attempted to solve this stock of researches.

By using an almost comprehensive literatures review, objective and subjective criteria are identified. After finalizing criterias, Are used from decision-makers’ assessments for collection data. Fuzzy Analytical Network Process is used for analyzing the data.

The finding indicates that the criteria's of proposed model are high validity and reliability for appropriate location selection of Health Centers.

The analyzing of data indicates that lamtar locate is selected appropriate location.

Uterine artery pseudo aneurysm is a rare cause of late postpartum hemorrhage following Cesarean or uncomplicated vaginal delivery, gynecologic surgery such as dilatation and curettage, hysterectomy and myomectomy. In this article a case of uterine artery pseudo aneurysm is introduced. Patient is a 27-year-old female, Gravida2; Para 2 who presented to the emergency department with episode of heavy vaginal bleeding after a cesarean section in 42 days ago. In clinical examination there was no pathological sign except paleness and agitation. In gynecological examination there was vaginal bleeding more than normal menstruation bleeding, cervix was dilated 1 centimeter and uterus was about 14 weeks of pregnancy. A diagnosis of pseudo aneurysm of the uterine artery was diagnosed by Doppler ultrasonography and Total abdominal hysterectomy was performed. The aim of presenting this case is emphasis on considering uterine artery pseudo aneurysm as one of the causes of late postpartum hemorrhage. In these situations Doppler ultrasonography is essential for diagnosis. Patient situation and hospital equipments determine treatment methods.