مجله دانشکده پزشکی اصفهان
پیاپی 702 (هفته دوم اسفند 1401)

Assessments of the position and area of the vertebral artery (VA) may be particularly important especially preoperatively. Here, we aimed to investigate the relationship between the area and position of the vertebral artery with the transverse foramen (TF).

This is a cross-sectional study that was performed during 2020-2021 in Al-Zahra hospital in Isfahan. At the first step, 100 patients were randomly selected to performing Color-Doppler ultrasound imaging. The dominant artery was identified by measuring blood flow volume in the two vertebral arteries and data were collected. Patients were then undergoing CT-angiography of the cervical arteries. The area of vertebral artery and transverse foramens as well as vertebral artery position inside transverse foramen at C4 level were measured.

significantly larger than the opposite side. The ratio of vertebral artery to transverse foramen (VA/TF) was significantly higher on the dominant side than on the non-dominant side. We found no significant difference between the types of centrality in the dominant and non-dominant side, but in both sides the position of the vertebral artery inside the transverse foramen was significantly paracentral, especially anteromedial.

area of the vertebral artery and the transverse foramen and the ratio of VA/TF were significantly higher on the dominant side than the non-dominant side.

Ventilator-associated pneumonia is the most common nosocomial infection that is responsible for increasing the mortality of patients admitted to the intensive care unit. The aim of this study was to evaluate the frequency of MBL and ESBL genes and to determine the patterns of antibiotic resistance in gram-negative bacilli isolated from ventilators in the ICU of Imam Reza Hospital in Kermanshah.

After collecting samples and identifying the bacteria by standard biochemical and microbial culture methods, 152 bacterial isolates were identified. ESBL and MBL genes were identified by phenotypic DDCT method and molecular PCR method using specific primers.

The most common microorganism isolated from ventilator-associated pneumonia (VAP) patients was Klebsiella pneumoniae (2.56%). In total, the frequency of ESBL and MBL genes was 113 (74.34%) and 8 (5.26%). The antibiotic resistance pattern showed that 36.53% of the isolates were resistant to ceftazidime, cefotaxime and imipenem. The blaSHVOS gene with a frequency of 75 (49.34%) had the highest genotypic frequency. The blaVIM gene was not found in any of the isolates.

The high resistance of Acinetobacter baumannii and Klebsiella pneumoniae isolates to the mentioned antibiotics and the high prevalence of ESBL-producing genes in Klebsiella pneumoniae isolates is a significant alarm in the ICU of different wards of Imam Reza Hospital. The emergence of the blaPER-1 gene in patients with VAP has raised another worry in patients with VAP in the intensive care unit.

Diabetes is one of the most common co-morbidities and is associated with worse results in patients with coronavirus disease 2019 (COVID-19). The results showed that mortality was reduced among diabetics taking metformin compared with those not taking metformin. Therefore, the present study was conducted with the aim of providing reliable and up-to-date evidence about the effects of metformin drug in diabetic patients suffering from concomitant infection with COVID-19.

In this review, we searched PubMed, Embase, Cochrane and Google Scholar databases starting in December 2019 to find studies. We carried out a systematic search of English texts using the keywords "metformin" or "biguanides" and "coronavirus disease 2019" or "COVID-19". After reviewing the titles, summaries and complete texts, 28 studies were eventually included in the study.

The review found that most studies showed reduced mortality among metformin users compared to non-users among diabetics with COVID-19. In addition, the results indicate that metformin may inhibit viruses by increasing insulin susceptibility. However, some studies do not support the impact of metformin on mortality reduction.

Results from this study show that metformin use in diabetic patients with COVID-19 is associated with decreased mortality. Of course, randomized controlled trials are necessary to confirm this outcome.