Report of Health Care
Volume:1 Issue: 1, Autumn 2015

Nosocomial infections are primarily caused by Klebsiella bacteria, which lead to an increase in healthcare costs and the mortality rate. Concerning the alarming increased antibiotic resistance of Klebsiella species, the purpose of this study was to compare the frequency and determine the antibiotic resistance pattern of Klebsiella species isolated from nosocomial infections using Kirby Bauer method.

This study was done on 80 specimens of Klebsiella isolates from 480 hospitalized patients in three different units of Khorramabad Shohadaye Ashayer hospital. After determining the bacterial species, antibiotic-resistance test of Klebsiella species was performed for 15 antibiotics using the disk diffusion method. The results were recorded based on Clinical and Laboratory Standards Institute (CLSI) standard guidelines.

The frequency rates of Klebsiella species were determined as follows: Klebsiella pneumoniae (91%), Klebsiella oxytoca (5%), Klebsiella rhinoscleromatis (3%), and Klebsiella ozaenae (1%). The frequency of Klebsiella species on the basis of sources of infection and type of sample respectively were: urine (42%), lung and sputum (36%), wound (15%), blood (6%), and cerebro-spinal fluid (CSF) (1%). The resistance of all Klebsiella species to studied antibiotics were respectively as follows: ceftriaxone (92%), ciprofloxacin (82%), nitrofurantoin (80%), ofloxacin (75%), cefotaxime (70%), imipenem (67%), ticarcillin (66%), nalidixic acid (60%), gentamicin (52%), azithromycin (40%), cefepime (31%), polymyxin B (22%), colistin (17%), amikacin (7%), and meropenem (1%).

According to the obtained results, meropenem and amikacin with the lowest resistance are the most effective antibiotics against all Klebsiella strains, and although ceftriaxone antibiotic does not help in the treatment of Klebsiella infections, but it may cause antibiotic resistance.

Selenium oxyanions are toxic to living organisms at excessive levels. Selenite can interfere with cellular respiration, damage cellular antioxidant defenses, inactivate proteins by replacing sulfur, and block DNA repair. Microorganisms that are exposed to pollutants in the environment have a remarkable ability to fight the metal stress by various mechanisms. These metal-microbe interactions have already found an important role in bioremediation. The objective of this study was to isolate and characterize a bacterial strain with a high potential in selenite bioremediation.

In this study, 263 strains were isolated from wastewater samples collected from selenium-contaminated sites in Qom, Iran using the enrichment culture technique and direct plating on agar. One bacterial strain designated QW90, identified as Bacillus sp. by morphological, biochemical and 16S rRNA gene sequencing, was studied for its ability to tolerate high levels of toxic selenite ions by challenging the microbe with different concentrations of sodium selenite (100-600 mM).

Strain QW90 showed maximum Minimum Inhibitory Concentration (MIC) to selenite (550 mM) and the maximum selenite removal was exhibited at 30 degrees C, while the activity was reduced by 20% and 33.8% at 25 and 40 degrees C, respectively. The optimum pH and shaking incubator for the removal activity were shown to be 7.0 and 150 rpm at 50.7% and 50.8%, respectively. Also, the concentration of toxic sodium selenite (800 μg/ml) in the supernatant of the bacterial culture medium decreased by 100% after 2 days, and the color of the medium changed to red due to the formation of less toxic elemental selenium.

This study showed that the utilization of enrichment culture technique in comparison to the direct plating on agar leads to better isolation of selenite resistant bacteria. Bacterial strain was resistant to high concentrations of selenite and also it reduced selenite to red elemental selenium. Therefore, this microorganism could be further used for bioremediation of contaminated sites.

Diabetes is a chronic disease that produces serious disabilities, complications, and effect all features of a patient’s life. One of the important parts of diabetes care is the patient’s active participation in the care plan. This patient-centered approach is called empowerment program, which its philosophy is enabling the patient to play an active role in planning and making decisions in health-related activities. With the failure of traditional methods in patient education, checking efficacy of new methods sounds essential. The purpose of this study was to estimate the effect of empowerment program on psychosocial self-efficacy in type 1 diabetic patients. In this semi-experimental research, 40 type 1 diabetic patients were randomly divided into two equal intervention and control groups. Diabetes empowerment scale, after obtaining content validity and reliability by the calculation of Cranach’s alpha, was used for data collection. Both groups completed the questionnaire. Then the empowerment program according to a former prepared protocol during six sessions and 90 minutes in length was held for the intervention group. Two months after intervention, both groups completed the questionnaire again. SPSS software was used for data analysis. Findings did not show any significant difference in psychosocial self-efficacy before the intervention (P> 0.05), but the difference was significant after the intervention (P= 0.000) in the intervention group. The implementation of empowerment program had a significant effect on psychosocial self-efficacy for type 1 diabetic patients and caused positive changes in total psychosocial self-efficacy scale and its subscales. Therefore, using similar programs can improve self-efficacy and enhance stress management. It also helps decision making for diabetes, facilitates the recognition of suitable and achievable goals, overcomes the barriers, and finally improves patient’s health status.

Medication errors are considered as important threatening challenges for health systems in all countries. They are also perceived as one of the most threatening factors for patient safety. Health education centers are intensively predisposed to a spectrum of medical errors occurrence due to students who learn in these centers. Therefore, this study was conducted to survey the reasons for not reporting errors regarding nursing students and nurses.

In this descriptive-analytical comparative study 94 nursing students and nurses who worked in Khatamolanbia hospital of Zahedan participated in 2014. Data were collected using the questionnaire of not reporting medical errors. SPSS software was used for the analysis.

The results showed that the mean score for being afraid to report consequences, management factors reporting, and medication errors were (73.28±7.58), (14.30±3.38), and (8.63±2.49) for nursing students respectively, in addition, the scores of (34.9±9.84), (12.9±3.59), and (8.82±2.52) were obtained for nurses respectively. The results of parametric T-test regarding the two groups showed that there was a statistically significant difference between both groups (P≥0.05).

Medical errors are considered as one of the most important issues in health care environments. So, the use of these methods depends on adopting a systematic approach to survey predisposition factors and removing them as well as designing a system to increase error reporting rate by nursing students and nurses to decrease and control such errors.

Brucellosis is one of the most common zoonotic diseases that is especially important for its side effects on human in terms of health and economy. It appears that an important reason for the incidence of brucellosis and its consequent disabilities is lack of knowledge about its transmission routes and prevention. Hence, the present study aimed to determine the effect of training on the knowledge of Shahr-e Babak Azad University students about the prevention of brucellosis. This experimental study was conducted with 108 students assigned to the experimental and control groups by random stratified sampling from Shahr-e Babak Azad University in 2013. First, students’ knowledge of brucellosis and its prevention was assessed using a valid and reliable researcher-made questionnaire. Then a training program including two sessions of group training, questions and answers, and discussion was implemented and an educational pamphlet was distributed among the experimental group. One month later, the post-test was given. Data were analyzed using descriptive and inferential statistics in SPSS software. Knowledge score of students before the intervention was not significantly different in the experimental and control groups, while the difference of mean score was significant after the intervention. None of the demographic variables had a significant impact on the mean score of knowledge after training. The significance level was set at P The results showed that training can improve participants’ knowledge about brucellosis prevention. Training is an appropriate and necessary method to increase health information.

Surveying and diagnosing patient safety culture is a key step to improve the health and patient safety culture, which generally is provided by surveying of providers and measuring globally. So the present study aimed to survey and evaluate patient safety culture among nurses in hospitals affiliated to Zahedan university of medical science. This descriptive-analytical, cross-sectional study was conducted in 2014. In order to collect data, a questionnaire was developed to survey patient safety culture on 400 nurses in hospitals related to Zahedan university of medical sciences. The results were analyzed using SPSS software. The required tests such as T-test, ANOVA, and Spearman correlation coefficient were used. The results of the present study showed that the score of patient safety culture for each aspect of it was low. Findings also showed that items such as general perception to patient safety, management support, and organizational learning and permanent promotion in Khatam ol Anbia, Ali Ibn Abi Taleb, and Bu Ali hospitals had the highest scores, while hospital patient transfer and exchange of information, manager’s actions, expectation to promote patient safety, and related issues to staffs had the lowest scores Patient safety care is necessary for providing an appropriate and efficient healthcare. So the organizations which provide healthcare services must establish a comprehensive and regular system based on the processes of patient safety promotion to decrease errors. They should also be responsive to injured people through establishing a patient safety culture and maintaining appropriate organizational mechanisms.

We argue that the field of medicine ought to think over the definition of medical professionalism and the challenges that doctors face in everyday practice. Although there are a diversity of definitions revolving around medical professionalism, but the most recent and revalidated definition should be taken into account. In addition, we highlight four barriers threatening professionalism: 1) doctors’ of self-interest; 2) doctors’ temptation to deviate from the standards of medicine; 3) market incentives (financial conflicts of interest); and 4) peer pressures. We conclude with suggestions for remedies to overcome these threats, e.g. selection criteria of medical students, and stringent rules and guidelines.

Glucose-Galactose Malabsorption (GGM) is one of the rare autosomal recessive disorders of intestinal transport of glucose and galactose/Na+cotransport system (SGLT1) that leads to osmotic watery diarrhea, dehydration, failure to thrive, or early death. It is caused by mutations in the gene coding for the intestinal brush border of sodium-glucose co-transporter. More than 30 different mutations in this gene have been found to cause abnormalities in the transporter. Because of the wide number of mutations known today, genetic testing for defects is difficult, leaving clinicians to rely on clinical testing, including the glucose or galactose hydrogen breath test as a diagnostic test of choice. Treatment includes the elimination of glucose and galactose from diet. We report a male infant with suspected GGM with acidosis and diarrhea.