mojgan forotan

Diabetic foot ulcer is one of the most common problems in diabetic patients, hospitalized in infectious ward. Given various side effects of many antibiotics, the precise determination of the type of antibiotic used with the least side effects has great clinical importance. In this regard, the present study was conducted to compare the effectiveness of injectable levofloxacin with that of injectable ciprofloxacin and clindamycin in the treatment of leg ulcer infection in diabetic patients, hospitalized in the infectious ward. This research was conducted on 46 patients with grade 2 diabetic leg ulcer in two groups of 23 patients, including a group treated with injectable levofloxacin (mono-therapy) and a group treated with combination of injectable ciprofloxacin and clindamycin (combined therapy). Blood and tissue samples were collected for serological and microbiological studies. Then, important treatment parameters, including reduction in oxidative secretion, pathogenic activity of the ulcer, reduction in the number of inflammatory cells duration of treatment, and cost of treatment and other cases were studied in two groups. All isolated bacteria were Gram positive and Staphylococcus species had the highest frequency. The level of reduction in oxidative secretion, the pathogenic activity of diabetic leg ulcer, and the reduction in the number of inflammatory cells in the ulcer in the mono-therapy group increased more than that in combined therapy. The rate of increase in tissue debridement and shrinkage of ulcer surface of diabetic patients were also higher in the mono-therapy group.
The rate of recovery in the ulcer of the diabetic patients was similar in both groups. The duration of antibiotic therapy in the mono-therapy group was reduced by 22.8% in mono-therapy group in comparison to that in the combined treatment group, which this difference was clinically highly significant. In clinical evaluations, the success and cost of treatment in the group treated with levofloxacin as mono-therapy were better than those in the group treated with combinition of ciprofloxacin and clindamycin.

The purpose of this study was to determine the efficacy of Heller myotomy for the treatment of achalasia in a referral center in Tehran, and investigate the clinical characteristics, manometric results and treatment responses among three achalasia subtypes in Iranian patients. Esophageal achalasia is an unusual swallowing disorder, characterized by high pressure in the lower esophageal sphincter (LES) on swallowing, failure relaxation of the LES and the absence of peristalsis in esophageal. Patients and In this cross sectional study, clinical symptom and esophageal manometry before and 2 months after treating with Heller myotomy in 20 patients with achalasia who were referred to Taleghani Hospital, Tehran, in 2013 were evaluated. Patients’ demographic, clinical features and response to treatment were analyzed using SPSS software (version 20, Chicago, IL, USA). All the diagnostic criteria measured after the treatment were significantly different (P<0.05) before and after the therapy. The average decline in the length of the esophagus was 1.8 cm and dysphasia score was 7.25 units. Also an average decline in LES Resting Pressure, LES Residual Pressure, PIP, and IRP were 23.2 mmHg, 14.3 mmHg, 3.4 mmHg and 17.8 mmHg, respectively. Results of this study showed that the Heller myotomy is highly effective in relieving dysphasia in patients with achalasia. Also, type II achalasia is the most common subtype of achalasia with a better response to Heller myotomy compared to the other types.