Shiraz Emedical Journal
Volume:12 Issue: 1, Jan 2011

Milk has an outstanding nutritional quality but is also an excellent medium for bacterial growth and an important source of bacterial infection when consumed without pasteurization. The present paper reports the results of a cross-sectional survey aimed at obtaining information on the agents of milk-borne bacterial infections and the prevalence rates in raw milk, and the spatial distribution of the prevalence of foodborne pathogens in Raw Milk in Malayer city in Iran. Different geographical information system tools were used to plan the sampling procedures, to display the results as maps and to detect spatial clusters of bacteria in raw milk in the study area. A total of 100 raw milk samples collected in May 2009 from the cow sheds and milk centers were cultured and the isolated organisms identified by standard bacteriological methods. Overall, the organisms identified and their prevalence rates were Escherichia Coli, (75%), Staphylococcus aureus, (52%), Enterobacter, (42%), Klebsiella, (36%), Pseudomonas pyocyaneus, (25%), Proteus, (4%).The result has shown the spatial distribution and the isolation of six potential and opportunistic pathogens from the two different sources of collected raw milk samples in Malayer City. Milk suggested contamination from various sources, which may include animal, human, environment, and utensils in their presence.

Burn injury is one of the major causes of morbidity and mortality worldwide. In addition to the financial burden it inflicts on the health care system, it can lead to psychological, social and physical distress both to the patient and family members. The aim of this study was to determine the epidemiological parameters in hospitalized burn patient. In a cross-sectional study we evaluated data of 1073 hospitalized burn patients in Zahedan Khatam Al Anbia hospital from 2005-2008. All data were extracted from medical record and analyze by SPSS software. A P-value less than 0.05 was considered significant. Among 1073 patient with acute burn, 55.4% were male and 44.6% were female. The mean age was 20.94 year old and mean size of burn area was 49.11±29.65 total body surface area (TBSA). Total body surface area burned was significantly higher in those with self-burn (p=0.0001). In children younger than 15 year-old scalds (hot liquid) was the most frequent cause of burn (44%). There was a higher incidence of self-burning in women (p=0.0001) and the mean length of hospital stay was 6.32±5.27 days. The mortality rate in self-burn patient was 87.34 % and in total cases was 41.47 %. In the present study, most of the burns were noted in 16 to 20 years age group, and more in male than in female subjects. Burn was more frequent in children and adultness and they are considered high-risk groups with higher mortality and morbidity. This shows a need for comprehensive burn prevention programs.

Considering that BCG injection in newborns is part of TB control program in Iran many years ago, we aimed to compare prevalence of childhood BCG vaccination scar with previous study and asses influence of household crowding on TST result. Considering that over time there is likely to reduce the immune response, two groups of subjects were selected among young and middle aged.Methods and Material: This cross sectional study was conducted in Zia Abad of Qazvin (a province of Iran) during year 2008. 261 participants randomly were selected (139 asymptomatic children (12-16 y) and 122 adults (40-50 y)). A questionnaire was used to obtain prior histories of BCG vaccination, known exposure to tuberculosis, prior acquired of TB, symptoms of TB disease and household crowding. BCG vaccine scar was ascertained and all participants were tested with 5TU-PPD. Reactions of 10 mm or more were considered positive. Statistical analysis used: Using student t test, chi square and Fisher’s exact test, the collected data was analyzed. BCG scar was observed in 78.4% of participant (91.4% children vs. 78.6% adults) which the difference was significant. Twenty three (16.5%) of children and 24 (19.7%) of adults had tuberculin reactivity of ≥10 mm. In children and parent groups, positivity of TST had significant direct association with presence of BCG scar and crowding. Most vaccinated children had a scar. Our results demonstrate that a TST applied after BCG vaccination usually produces a reaction of <10 mm. In addition, there is a significant relationship between the tuberculin reactivity and both presence of BCG scar and crowding among children and adult groups.

Polycystic ovary syndrome, as a low-grade chronic inflammatory state, may stimulate the immune response, increasing inflammatory factors such as C-reactive protein (CRP) and Interleukin 6 (IL-6) on one hand and zinc, another effective anti-inflammatory agent, on the other. The aim of this study is to evaluate the effect of zinc on inflammatory markers in women with polycystic ovary syndrome.Patients and In a randomized, double-blind, and placebo controlled clinical trial, sixty patients with polycystic ovary syndrome were randomly divided into two groups, each group received one of the following daily supplement for eight weeks; group Zn: 50 mg elemental zinc (n = 30), and group P: Placebo (n =30). Fasting serum zinc levels, inflammatory markers, systolic-and diastolic blood pressure, anthropometric indices, and nutritional intake were measured at the baseline and the end of 8th week. Results indicate that after eight weeks of supplementation, mean value of nutritional intake, anthropometric indices, and systolic-and diastolic blood pressure did not change significantly in the two groups. Zinc supplementation had significant effects in increasing serum Zn (p < 0.05) and in decreasing serum hs-CRP and IL-6 levels (p < 0.05). There were no significant changes in the levels of these parameters in the placebo group. The findings of the present study indicate that zinc supplementation may be considered as an inexpensive adjunct to treatments in patients with polycystic ovary syndrome in the hope of reducing cardiovascular disease risk factors, particularly inflammation.

Surgery accompanies by high mortality and morbidity rates in diabetic patients. As this disease affects numerous systems diabetic patients require to be approached systemically and carefully. Stress of surgery stimulates catabolic hormones secretion. Perioperative assessments can help us to find the high risk diabetic patients and the patients need extra- management. Some diabetic patients need to improve blood glycemic control before surgery. Tight glycemic control is a goal in diabetic patients for developing a better outcome, while the optimal range is 110-180 mg/dl. Although a reduced protocol may be acceptable for minor surgeries in diabetic patients glucose-insulin-potassium injection should be considered for their major surgeries. Physicians’ involvement with diabetic patients’ management before surgery and successful perioperative management of hyperglycemia is a big challenge. A simple protocol can help physicians to develop a safe perioperative management.

Post surgical complications of esophageal atresia (EA) include anastomotic leak, anastomotic stricture, gastroesophageal reflux, tracheomalacia, and recurrent tracheoesophageal fistula (TEF). However, hypertrophic pyloric stenosis (HPS) is complicating EA which seems to be rare. The aim of this report is to emphasize on HPS as a possible complicating post operative course of EA, the diagnosis of this complicating disorder may be delayed. A 3000 gram male infant was born at 38 weeks gestation to a 21-year-old, gravid mother by cesarean section. He presented vomiting with profuse foamy discharge and salivation. Esophageal atresia was confirmed by looped orogastric tube in the upper pouch of esophagus in chest X-ray. He underwent surgical correction and was discharged with a good condition on 7th post operation day. Nevertheless three weeks later, he developed recurrent vomiting. The diagnosis of HPS was confirmed by ultrasonography and barium upper gastrointestinal (GI) series. Pyloromyotomy was done on him and He was discharged without any complication. At 3.5 months old, he developed regurgitation and chocking cyanosis. At this time esophageal stenosis was diagnosed by barium swallow. The stricture was treated by gastroduodenoscopy. Infantile HPS should be considered in any case of persistent vomiting and feeding intolerance after surgery for esophageal atresia. A high index of suspicion is required for diagnosis to avoid complication arising from a delayed diagnosis.

A 22-yr-old man with no history of disease and normal physical and Para clinical evaluations underwent a general anesthesia for internal fixation of femur fracture for 2 hours. After completion of the surgery and full reversal of neuromuscular blockade, extubation was performed. After a few minutes the patient developed Laryngospasm. With prompt suctioning and positive pressure ventilation, Laryngospasm resolved. When SPO2 was 98% the patient transferred to recovery room. After a few minutes at the recovery room the patient developed dyspnea and a rapid decrease in SPO2 occurred associated with a lot of dirty pink secretions. He was intubated again and with the diagnosis of pulmonary edema frosemide, morphin and low PEEP was administered. After 8 hours pulmonary edema was resolved and tracheal tube was removed.

Acinar cell carcinoma of pancreas is a rare tumor of pancreas which arises from acinar cells of the pancreas. We want to present nephrotic-range proteinuria and plasma cell dyscrasia in a case of acinar cell carcinoma of pancreas.