مجله دانشکده پزشکی اصفهان
پیاپی 312 (هفته اول بهمن 1393)

In recent years, many studies have been conducted on infantile complication related to delivery type and researchers have also tried to determine the amount, importance and role delivery type. This study aims to use meta-analysis in order to integrate the different studies and investigate the impact of delivery type on infantile complication This meta-analysis uses approach's Howitt and Cramer. For this purpose 62 out of 45 studies which were acceptable in terms of methodology selected and meta-analysis conducted on them. Research instrument was a checklist of meta-analysis after summarizing the results of the studies, effect size were calculated manually and combined based on meta-analysis and interpreted in accordance with Cohen’s table. After data collection, results showed that the effect size of cesarean delivery was on infantile physical complication 0.35 (P ≤ 0.001), respiratory morbidities 0.43(P ≤ 0.001), breastfeeding 0.34 (P ≤ 0.001), jaundice 0.29 (P ≤ 0.09) and others 0.27(P ≤ 0.001). According to Cohen’s table, the effect size was evaluated moderate for cesarean delivery on infantile physical morbidities.

In some studies, high intraocular pressure as a risk factor for ocular disorders such as diabetic retinopathy and optic nerve atrophy is discussed. In some studies, diabetes risk factor for increased intraocular pressure is raised. Given that previous studies regarding theme an intraocular pressure in diabetic patients compared with normal subjects is not available. Also notice to due to the increasing prevalence of diabetes, especially in our society and the role of intraocular pressure control in reducing complications, this study aimed to determine the relationship between intraocular pressure in patients with type II diabetes mellitus duration of grace referred to in 1390-1391was performed. In a descriptive analytical study, patients records with type 2 diabetes who admitted to Feyz hospital during 2013-2014 were studied and Demographic characteristics with the intra ocular pressure and duration of diabetes of patients were collected and analyzed by SPSS software. The mean ± standard deviation of duration of diabetes was 12.2 ± 5.6 (range: 1.25) years and the mean ± standard deviation of IOP in OD and OS was 15.6 ± 3.5 and 15.5 ± 3.5 respectively. Between duration of diabetes and IOP was significantly correlated with the rate of 8%, which was statistically significant (P = 0.006). Intraocular pressure in diabetic patients depend on many factors including age, sex, duration of diabetes and related disease. Also due to lack of proper control of diabetes, different parts of the body, especially the eyes are exposed to the destructive effects of diabetes and impaired performance. Because despite all the progress that has been made in the treatment of diabetic retinopathy, but prevention, is still the most appropriate way. Thus Sugar and blood pressure control, proper nutrition and regular physical activity can reduce the risk of diabetic retinopathy.

Absence of increase in heart rate in response to exercise indicates poor prognosis. Inflammatory factors as C-reactive protein (CRP) are associated with atherosclerosis. In this study, these two factors were compared in patients with and without metabolic syndrome.

203 individuals without and 123 individuals with metabolic syndrome were selected randomly from Isfahan Cohort Study and their demographic data, wait circumference, height and weight were recorded. Also, serum triglyceride (TG), fasting blood sugar (FBS), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), and high-sensitivity CRP (hs-CRP) levels were measured. Heart rate reserve (HRR) was determined through exercise test carried out according to the Bruce standard protocol. The age-adjusted data was analyzed by generalized linear regression and student's t test.

The mean ages of individuals without and with metabolic syndrome were 54.16 ± 8.61 and 54.29 ± 7.60 years, respectively (P = 0.890). The mean LDL levels in subjects without and with the metabolic syndrome were 116.17 ± 24.04 and 120.12 ± 29.55 mg/dl while mean TG levels were 140.38 ± 61.65 and 259.99 ± 184.49 mg/dl and mean FBS levels were 81.81 ± 9.90 mg/dl and 107.13 ± 48.46 mg/dl, respectively; all the differences were statistically significant. The mean systolic blood pressure was 116.06 ± 13.69 mmHg in persons without metabolic syndrome and 130.73 ± 15.15 mmHg in patients with the syndrome. The values for mean diastolic levels in the two groups were 76.52 ± 6.69 and 82.84 ± 8.7 mmHg, respectively. Hs-CRP level in the metabolic syndrome group was significantly higher than the other group (P = 0.02) while HRR did not show significant difference in the two groups (P = 0.27).

In our study, no relationship was documented between HRR and the metabolic syndrome. However, elevated levels of hs-CRP were recorded in patients with metabolic syndrome.

Acinetobacter baumannii, is a gram negative, non-fermenting cocobacill or cocci, which is mostly found in soil, different water sources, and many healthcare environments. A.baumannii is intrinsically resistance to many antibiotics. Nowadays carbapenem as MDR Acinetobacter baumannii is the last drug therapy to be used for the treatment of infection. Carbapenem resistance in Acinetobacter baumannii strains are also expanding and in turn the Acinetobacter baumannii drug resistance among strains is setting grounds for a crisis. The aim of this article is to study the frequency of metallo-β-lactamase and Antimicrobial Resistance patterns of Acinetobacter baumannii in Carbapenem-resistant Isolates in Intensive Care Units. In a cross sectional study during one year period (2012-2013), Acinetobacter baumannii isolates from clinical specimens of patients hospitalized in the intensive care unit (ICU) were identified by genetic and biochemical methods. The Susceptibility of isolates was determined by standard disk diffusion method according to CLSI. MBL-producing isolates were DDST method. 100 isolates were determined as Acinetobacter baumannii by phenotypic and molecular testing of clinical specimens were obtained. The antimicrobial patterns of isolates showed that 62% of isolates were resistant to amikacin, 88% to tetracycline, 92% to ceftazidime, 96% to imipenem and meropenem, 93% to ampicillin-sulbactam and 98% to ciprofloxacin trimethoprim sulfamethoxazole and cefepime. By examining DDST, Acinetobacter baumannii strains which were non susceptible to imipenem of 96 (95 strains), 9/97% were found to produce MBL. In order to prevent the spread of nosocomial infections caused by Acinetobacter baumannii in ICU, rapid and accurate report of MBL enzymes seems necessary in order to monitor better and more accurate tracking of multiple resistance Acinetobacter baumannii in hospital laboratories.

Due to the development of drugs and With regard to this matter that customers of health services are unable to assess the clinical and financial aspects of medical technologies, evaluation the clinical efficacy of drugs is avery important. The Study aim was to evaluate the clinical efficacy of zoledronic acid in the prevention and treatment of postmenopausal osteoporosis. This study was a systematic review. Cochrane, PubMed and Google scholar databases were searched using keywords: “Bone mineral density, Male Osteoporosis, Zoledronic acid postmenopausal women osteoporosis”. Inclusion criteria were all menopausal women at risk of osteoporosis or suffering from it that have been used zoledronic acid at least once for the prevention or treatment of osteoporosis. Desired outcomes include reduced bone fractures, bone resorption and bone turnover markers, increase bone density, significant improvement in health-related quality of life in patients who have had a fracture. The designs of included studies were randomized clinical trials and their languages were English. The use of zoledronic acid significantly increased BMD at the total hip, lumbar spine, femoral neck, hip trochanter, the distal radius, reduced the incidence of hip fractures, morphometric vertebral fractures, vertebral fractures, any clinical fracture, clinical vertebral fractures, risk of nonvertebral fracture and decreased bone turnover markers in the intervention group compared with the control group. According to safety and clinical effectiveness of zoledronic acid, using this medication in the prevention and treatment of osteoporosis in postmenopausal women is recommended.