Centers In Shiraz Research Articles

Does Physical Activity Could Moderate Perceived Wellness of Health Providers?

Background Sufficient levels of physical activity are an issue for health, quality of life, and more importantly for healthcare providers. This study aimed to determine the status of physical activity and its relationship with perceived wellness in healthcare workers.Methods This study included about 254 health personnel who work in urban health centers in Shiraz. The IPAQ and PWS self-administered questionnaires were used to collect information. This study was approved by the ethic and council committee of the Shiraz University of Medical Sciences. Additionally, moral considerations (confidentiality and informed consent) was observed, and data were analyzed with SPSS V.19.IBM.Results About 46% of the participants had moderated to severe physical activity. The results indicated a strong relationship between physical activity, perceived health and all its dimensions, except for social health and mental health. Furthermore, perceived health was significantly associated with age (ρ = 0.039, β = 0.61) and gender (ρ = 0.002, β = 9.33).Conclusions Regarding the staff’s insufficient physical activity, the strong relationship between physical activity and health. Their impact on the organization’s direct and indirect costs, health promotion programs and policies have to be designed focusing on the staff’s physical activity.

Quality of Life and Its Influencing Factors of Couples Referred to An Infertility Center in Shiraz, Iran

BackgroundInfertility adversely affects quality of life (QoL). The present study aims to evaluate QoL and its associated factors among infertile couples.Materials and MethodsIn this cross-sectional study, the Fertility QoL (FertiQoL) instrument was used to measure QoL among 501 volunteer couples who attended the Infertility Clinic at the Mother and Child Hospital, Shiraz, Iran. We used an additional questionnaire to assess participants’ demographic and clinical characteristics. The relationship between the scores of QoL to the sociodemographic and treatment data was analysed.ResultsThe subjects with lower income levels had lower relational, mind/body, emotional, and total core scores. Female participants without academic education had lower scores in the emotional subscale, while the male participants showed lower scores in emotional, mind/body, relational, social, and total QoL domains. Subjects who had undergone any type of treatment, including pharmacological treatment, intrauterine insemination (IUI), intra-cytoplasmic sperm injection (ICSI), and in vitro fertilization (IVF) showed significantly lower scores in the environmental domain. Participants with lower infertility duration obtained significantly greater QoL scores. Finally, tolerability, emotional, and environmental domains were significantly more desirable when the infertility problem was related to a male factor.ConclusionInfertile couples with shorter duration of infertility and male etiology have higher QoL. Lower academic education, lower income levels, or prior unsuccessful treatments are associated with lower QoL.

Social support among the elderly in Iran

Aim of the studyAim: One of the factors affecting the life of the elderly is the extent of social support by the people around them. The present study was designed to determining social support among the elderly, in Shiraz at 2015.Subject or material and methodsMaterials and Methods: This study was a cross – sectional analytical research with a sample size of 143. To collectthe required data, Social Support Questionnaire (SSQ) was used. Linear Regression was used to analyze the data, and SPSS version 19 was applied for analysis.ResultsResults: Among 143 elderly participants, 43 were male (30.1%) and 100 were female (69.9%). Results of the multivariate analysis indicated that among the factors studied, age, education and previous job (self-employed and housewife) were significantly relatedto both social networks and social satisfaction (p-value <0.00).DiscussionDiscussion: This study aimed to investigate the demographic factors associated with social support for the self-introduced elderly in care centers in Shiraz. After controlling the possible impact of confounding variables, findings of our study showed that age, education, and previous job (self-employed and housewife) were significantly associated with both social network and satisfaction.ConclusionsConclusions: The findings of this study indicated that among the factors studied, age, occupation and education of the elderly people had the greatest roles in social support.

The Prevalence of Alzheimer’s Disease; its Risk and Protective Factors Among the Elderly Population in Iran

Objectives: This study aimed at evaluating the prevalence of the Alzheimer disease, and its risk and protective factors in the elderly people referred to health centers in Shiraz, Iran. Methods: The current descriptive, analytical study was conducted on 2000 elderly by the randomly selection method. Mini-mental state exam (MMSE) and geriatric depression scales (GDS) were applied to gather the data. Afterwards, the cases with cognitive deficit went through the psychological and neurological examinations. All statistical computations were conducted by SPSS software, version 22. Results: Of the total number of studied people, 7.85% were identified with cognitive impairment. However, the prevalence of Alzheimer disease was 2.3%. The results indicated that listening to music daily, weekly visits by friends, and the daily consumption of vitamin E were the protective factors, while depression was one of the risk factors in developing the Alzheimer disease. Conclusions: The findings suggested a unique opportunity for early diagnosis and preventive interventions.

Effects of atorvastatin on brain contusion volume and functional outcome of patients with moderate and severe traumatic brain injury; a randomized double-blind placebo-controlled clinical trial

The aim of the current study was to investigate the effects of atorvastatin on brain contusion volume and functional outcome of patients with moderate and severe traumatic brain injury (TBI). The study was conducted as a randomized clinical trial during a 16-month period from May 2015 and August 2016 in a level I trauma center in Shiraz, Southern Iran. We included 65 patients with moderate (GCS: 9–13) to severe (GCS: 5–8) TBI who had brain contusions of less than 30cc volume. We excluded those who required surgical intervention. Patients were randomly assigned to receive daily 20mg atorvastatin for 10days (n=21) or placebo in the same dosage (n=23). The brain contusion volumetry was performed on days 0, 3 and 7 utilizing spiral thin-cut brain CT-Scan (1-mm thickness). The outcome measured included modified Rankin scale (MRS), Glasgow Outcome Scale (GOS) and Disability rating Scale (DRS) which were all evaluated 3months post-injury.There was no significant difference between two study group regarding the baseline, 3rd day and 7th day of the contusion volume and the rate of contusion expansion. However, functional outcome scales of GOS, MRS and DRS at 3-months post-injury were significantly better in atorvastatin arm of the study compared to placebo (p values of 0.043, 0.039 and 0.030 respectively). Even though atorvastatin was not found to be more effective than placebo in reducing contusion expansion rate, it was associated with improved functional outcomes at 3-months following moderate to severe TBI.

Can breast ultrasound reduce patient’s level of anxiety and pain?

Breast pain is one of the most common complaints of women attending a gynecology clinic and general practitioners. This pain can cause anxiety and, consequently, reduce the woman's quality of life. The objective of this study was to assess the severity of pain and anxiety in patients with breast pain and normal examination, before and after breast sonography. Among the patients with breast pain and normal examination who came for breast sonography in three centers in Shiraz during 2011-2012, 51 patients agreed to cooperate in this project. These patients filled out the questionnaire for evaluation of pain and anxiety before and after breast sonography. Sonography findings indicated that 88% of patients have normal sonography without any finding. The average amounts of pain severity before and after sonography were 3.3 and 2.4, respectively (p < 0.005). The average amounts of anxiety severity in patients before and after sonography were 51.9 and 37.9, respectively (p < 0.005). This study shows the severity of pain and anxiety after ultrasonography decreased significantly. It can be concluded that ultrasound findings, which reassure the patients that they do not have specific pathology, can reduce the pain and anxiety by its impact on psychological status of the patient.

Sleep Quality in Patients Undergoing Long-term Hemodialysis Using the Pittsburgh Sleep Quality Index

Background: Sleep disturbances are common among uremic patients. However, limited data are available on predictors of the quality of sleep in this population. Objectives: This study aimed to assess the quality of sleep in patients undergoing hemodialysis and investigate its predictors. Methods: In this cross-sectional study, 197 patients on maintenance hemodialysis were consecutively included from three medical centers in Shiraz, southern Iran. They completed the Pittsburgh sleep quality index. Serum calcium, phosphorus, and hemoglobin levels were checked. We also assessed the neck circumference, dialysis shift, dialysis plan, diabetes history, body mass index (BMI), age, and sex. Results: From a total of 197 patients, 124 cases were men. The mean age of the patients was 54.46 ± 14.84 years. Poor quality of sleep was frequent in 90.86% of the cases. Age, BMI, a history of diabetes mellitus and the product of calcium and phosphorus were independent factors affecting the quality of sleep. Serum calcium and phosphorus levels, hemoglobin, sex, dialysis shift, dialysis plan, neck circumference and dialysis quality showed to have no significant effect on the quality of sleep. Conclusions: Poor quality of sleep is very frequent in patients on maintenance hemodialysis. Further studies are required for better understanding of risk factors associated with the poor quality of sleep to find possible treatments for these patients.

Epidemiological and clinical characteristics of scorpionism in Shiraz (2012-2016); development of a clinical severity grading for Iranian scorpion envenomation

Background: Scorpionism is a public health problem in some provinces in Iran. The present study aimed to assess the clinical manifestations of scorpion envenomation in Shiraz and determine a clinical severity grading for Iranian scorpion envenomation in order to suggest a treatment guideline for emergency physicians. Methods: In this analytic retrospective study, all medical charts of patients with scorpion sting admitted in the adult medical toxicology center in Shiraz during July 2012 to July 2016 were assessed. Data regarding the patient's age, gender, sting site, month of envenomation, time of sting, clinical manifestations, vital signs, presence of blood or hemoglobin in urine analysis, duration of admission, color of scorpion, received treatments, and administration of scorpion antivenin were recorded. Results: The scorpions in Shiraz and its suburban area were classified into two groups: yellow scorpions ( Mesobuthus eupeus, Mesobuthus caucasicus , and Compsobuthus matthiesseni) and Hottentotta scorpions (Hottentotta jayakari and Hottentotta zagrosensis). A total of 126 cases of scorpion stings were assessed. About 59% (n=74) were males. The patients aged 8-63 years (mean age, 33.8±11.5 years). About 38.4% (n=48) of the stings occurred during summer. More than 40% of patients (n=51) referred to the emergency department (ED) at night. Localized pain was the most frequent presenting complaint (76.2%). The most frequent general symptom was nausea (6.3%). The most prevalent envenomation site was the lower extremities followed by upper extremities (43.5% and 41.9%, respectively). Based on the clinical severity grading for Iranian scorpion envenomation, 65, 43, and 18 patients (51.6%, 34.1%, and 14.3%) were classified in the grades I, II, and III, respectively. Eighty-one (73%) patients stayed in the ED from 1 to 6 hours, and 30 (27%) patients stayed for >6 hours for observation. Severe localized pain was more prevalent in stings with Hottentotta scorpions than yellow scorpions (P=0.01). The season of envenomation with Hottentotta scorpions was summer in all cases, but envenomation with yellow scorpions was seen throughout the year. All patients received symptomatic treatment, and five were given scorpion antivenin. No death was reported. Conclusion: Hottentotta jayakari is recommended to be listed among the medically important scorpions in Iran. Moreover, scorpion-stung patients in geographical regions where Hemiscorpius lepturus and Androctonus crassicauda are not prevalent may be treated in outpatient departments. The presented grading system can be used for treating patients with scorpion envenomation.

The Effect of Self-Management Education Program on Disability of Elderly Patients with Knee Osteoarthritis Referring to Elderly Care Clinic of Imam Reza (AS) Treatment Center in Shiraz, 2015-2106

The Effect of Self-Management Education Program on Disability of Elderly Patients with Knee Osteoarthritis Referring to Elderly Care Clinic of Imam Reza (AS) Treatment Center in Shiraz, 2015-2106

Cytogenetic Analysis in Infertile Male Patients with Oligospermia and Azoospermia in the Southern Region of Iran, Shiraz

Background: Infertility was found to affect approximately 10%-15% of the couples, worldwide. Male factors are responsible for at least 50% of the infertility cases. The chromosomal abnormality is more common in infertile men than in fertile men. However, the aim of this study was to evaluate the frequency and type of major chromosomal abnormalities in the infertile men with problems in their sperm count, who had been referred to cytogenetic center in Shiraz, the main referral center in southern Iran. Materials and Methods: A total of 433 infertile males, with azoospermia [169(31%)] and oligospermia [264(69%)], were included in this prospective observational study. Samples were retrospectively collected from the infertile males, and examined by karyotype analysis. Results: The findings revealed that there are 17.3% chromosomal problems, in which 14.3% and 3% of all cases exhibited numerical and structural abnormalities, respectively. Among the 433 infertile patients, 57(33%) exhibited a numerical sex chromosome abnormality, including 49 (11.3%) subjects with typical Klinefelter syndrome, 4 (2.95%) ones with structural sex chromosome and 11 (4.4%) ones with the autosomal chromosome abnormality. Conclusion: The results from this study demonstrated that chromosomal abnormalities are common in the infertile men with a higher frequency of sex chromosomal abnormality, especially those with the numerical type. This highlights the importance of karyotype findings to make appropriate decisions regarding the management of the patients in infertility clinics.

Epidemiological Study of Legal Abortion due to Fetal Defects in the Files Referred to Fars Province Forensic Medicine Centers from 2007 to 2013

Background: Sometimes the fetus suffers some abnormalities that damage its physical and mental growth. There have already been some indications for legal abortion and in fact, since 2005, some other conditions have been added in the Islamic republic of Iran under certain conditions. Objectives: This study was aimed to study the fetal causes of legal abortion referred to the Fars province forensic medical centers from 2007 to 2013. Methods: This is a descriptive-analytic retrospective study. The subjects included are the cases referred to the forensic medicine centers in Shiraz, Iran, during the years of 2007 and 2013. There were 1,664 samples in total and the sampling was done upon census. The variables of demography, midwifery, mother’s disease, fetal disease and reasons for abortion were considered in the checklist of the questionnaires. The gathered data was analyzed by SPSS, version 16. Results: The highest frequency of abortion was observed and 31.5% related to mothers between the ages of 25-30. In 79.6% of the cases, abortion certificates were issued for fetal causes, 35.25% for thalassemia major and 23.4% for neural system congenital disorders. Consanguineous marriage accounted for 60.8% of abortion cases and 83.42% had an abortion before the fourth month of their pregnancy. Furthermore, in about16.58% of the cases, an abortion certificate was issued for mother’s distress and constrictions. Approximately 36.75% of the couples had a family history of thalassemia and 17.65% of them already had a child with congenital abnormality. Conclusions: The most frequent causes of fetal abortion licenses were due to the thalassemia and congenital malformations of the nervous system.

GW27-e0096 Overweight and obesity and their associated factors in adult women referring to medical and health centers in Shiraz, Iran

GW27-e0096 Overweight and obesity and their associated factors in adult women referring to medical and health centers in Shiraz, Iran

Impact of Education on Awareness Towards Reproductive Health in Women With Beta-Thalassemia Major

Objectives: This study aimed to investigate the effect of nursing educational programs on the awareness of females with β-thalassemia major (β-TM) regarding their disease and reproductive health. Methods: Thirty-nine consecutive female patients with β-TM (age range between 20 and 32 years) participated in this interventional pre-post study. All patients attended the Thalassemia Clinic of Dastgheib hospital, a referral governmental center in Shiraz, Southern Iran. Awareness of patients regarding reproductive health was evaluated by a designed questionnaire. The intervention consisted of nursing educational program regarding important issues related to reproductive health of female patients with beta-TM. Knowledge of patients was revaluated and compared with their knowledge before education. Data were analyzed using SPSS software v.21 using Paired t-test, Pearson correlation test and Mann-Whitney test. Results: Total awareness score significantly increased after education (mean ± standard deviation (SD): 16.12 ± 1.67 vs. 13.69 ± 2.35, P < 0.001). Increased knowledge of patients after the intervention was not significantly associated with educational level or with age of the patients (P = 0.058 and P = 0.395, respectively). Conclusions: An educational program can be helpful in increasing awareness of females with β-TM regarding their disease and reproductive health issues resulting in increased life expectancy and quality of life.

Logistic Regression Modeling for Evaluation of Factors Affecting Trauma Outcome in a Level I Trauma Center in Shiraz

Background: Since injury-related mortality is preventable, identifying factors that inversely affect trauma outcome are important initial steps towards reducing injury burden. Objectives: This study aims to determine independent risk factors of early/late in-hospital mortality among adult trauma victims with equal injury characteristics and severity at Shahid Rajaee (Emtiaz) Hospital during 2013 and 2014. Patients and Methods: A cross-sectional study of adult trauma patients (age ≥ 15 years) sustaining injury through traffic accidents, violence, and unintentional incidents was conducted. Information was retrieved from three hospital administrative databases. Data on demographics, injury mechanisms, injured body regions, injury descriptions, outcomes of hospitalization, and development of nosocomial infections were recorded. Injury severity score was calculated by cross walking from international classification of diseases (ICD-10) injury diagnosis codes to abbreviated injury scale (AIS-98) severity codes. Two multiple logistic regression models were employed to reflect the partial effect of each covariate on early (within 48 hours) and late (beyond 48 hours) deaths. Results: There were 47,295 hospitalized patients (male/female ratio: 2.7:1.0) with a median age of 30 years (interquartile range 23 - 44 years). A crude mortality rate of 1% (454 cases) was observed and 52% of deaths occurred within 48 hours of hospital arrival. One percent developed a nosocomial infection in the course of admission. After adjusting for covariates, sustaining a thoracic injury (OR 8.5, 95% CI [4.7 - 15.2]), ISS over 16 (OR 6.4, 95% CI [3.6 - 11.4]) and age over 65 years (OR 5.1, 95% CI [3.0 - 8.8]) were the most important independent risk factors of early trauma death. Presence of a hospital-acquired infection (OR 12.7, 95% CI [8.9 - 18.1]), age over 65 years (OR 7.4 95% CI [4.5 - 12.1]), and ISS of more than 16 (OR 14.6, 95% CI [6.2 - 34.3]) were independent predictors of late death. Conclusions: Age, injury severity, injured body region, and hospital-acquired infections are important determinants of trauma outcome in our center. Timely recognition of factors affecting trauma mortality is crucial for monitoring changes of trauma quality of care. Our findings suggest the need to allocate resources for trauma prevention along with a potential focus on reducing in-hospital complications.

Detection of Hepatitis E Virus Genotype 1 Among Blood Donors From Southwest of Iran.

BackgroundInfection with hepatitis E virus (HEV) is endemic in developing countries and reveals significant regional differences. Several studies have reported virus transmission via blood transfusion. To date, however, no cases of HEV RNA detection in blood donors have been reported from Iran.ObjectivesThe aim of this study was to determine the presence of HEV RNA in plasma samples of blood donors referred to a blood transfusion center in Shiraz in the southwest of Iran. The HEV genotypes were also investigated using nucleotide sequencing.Patients and MethodsBlood samples were collected from 700 blood donors who were referred to Fars blood transfusion organization from January to March 2014. Plasma samples were screened for the presence of HEV IgG and IgM antibodies by standard enzyme immunoassay. Samples seroreactive to anti-HEV were further tested for the presence of HEV RNA using nested polymerase chain reaction (PCR) with universal primers for detection of all four HEV genotypes. Positive PCR samples were then subjected to DNA sequencing for further analysis.ResultsFifty (50, 7.1%) out of 700 plasma samples tested positive for anti-HEV antibodies. HEV RNA was detected in 7/50 (12%) of the antibody-positive samples, the majority of which were IgM positive. Sequence analysis of seven isolates of the HEV RNA ORF 2 gene region revealed > 80% similarity with genotype 1.ConclusionsThe analysis indicates that the HEV isolated from blood donors in the southwest of Iran belongs to genotype 1. However, more samples from other geographic regions of Iran are needed to confirm these findings. Because transmission of HEV by administration of blood or blood components is likely to occur, it may be sensible to screen donor blood for HEV to eliminate transfusion-transmitted HEV infection when the recipient is immunocompromised.

Physical and Mental Health of Patients Immediately After Discharge From Intensive Care Unit and 24 Hours Later.

Background:Monitoring the health status of patients discharged from intensive care units is a crucial method of service evaluation.Objectives:This study aimed to assess the physical and mental health status of patients immediately after discharge from the ICU and 24 hours later.Patients and Methods:This descriptive comparative study was conducted on 104 patients discharged from the ICUs of a referral trauma center in Shiraz, Southwest Iran. Physical parameters, including respiratory rate, need for supplemental oxygen, heart rate, blood pressure, and need for cardiac monitoring, were assessed. Hospital anxiety and depression scale (HADS) was used for mental health evaluation. The mental and physical status of patients were assessed before ICU discharge and 24 hours later; data were recorded in information forms and were analyzed using SPSS statistical software version 17.Results:At the time of discharge, the respiratory rate of 28% of the participants was more than 24 minutes, and 95.2% received supplemental oxygen. However, after 24 hours these values decreased to 10% and 21.6%, respectively. The mean heart rate and systolic blood pressure were within the normal range at both time points. Additionally, 63% of the patients had anxiety scores above 11 at both time points, reflecting high anxiety. The number of patients who reported depression increased from 58.7% at ICU discharge to 69.6% after 24 hours.Conclusions:Despite the considerable improvement in most of the patients’ physical condition in the first 24 hours after discharge from ICU, a significant number of them remain at risk for the development of adverse effects from this transition. The high prevalence of mental health disorders in these patients reveals the necessity to conduct follow-up consultations.

Analyzing the long-term survival of the patients undergoing peritoneal dialysis in the peritoneal dialysis center in Shiraz, 2002-2011.

One of the advantages of peritoneal dialysis (PD) compared to hemodialysis is it can be performed at home. The present study aims at determining the long-term survival of patients and technique survival and investigates the risk factors affecting the mortality rate in PD patients. The study was conducted on 290 patients undergoing PD in the main PD center in Shiraz, Iran, between April 2002 and March 2012. The patients' survival rate and the factors affecting their survival were assessed using the Kaplan-Meier method. Besides, log-rank method was used to compare survival among different levels of the categorized variables. Cox regression model was used for introducing the risk factors affecting the patients' survival. The mean of the patients' survival at the end of the follow-up period was 15.42 ± 13.97 months. The patients' 1-, 2-, 3-, and 5-year survival rates were 85%, 72%, 57%, and 22%, respectively, and the median survival time was 11.64 months. Forty-three patients (14.8%) changed their treatment method to hemodialysis. The patients' 1-, 2-, 3-, and 5-year technique survival rates were 90%, 81%, 72%, and 47%, respectively. Age and hemoglobin level were the most significant factors in the patients' survival. Hemoglobin level was the most important factor in technique survival.

Demographic and Clinical Features of Pediatric Uveitis at a Tertiary Referral Center in Iran.

Purpose:To determine the clinical features and distribution of uveitis in the pediatric age group at a referral eye care center in Shiraz, South Iran.Materials and Methods:All new cases of uveitis in patients 18-year-old or younger referred from January 2007 to December 2013 were enrolled in this study. The patient underwent a complete history of systemic and ocular diseases, comprehensive ophthalmic examination. Patients were classified according to the International Uveitis Study Group definitions. The definitive diagnosis was based on clinical manifestations and laboratory investigations.Results:Seventy-seven eyes (54 patients) comprised the study sample. The mean age at the onset of uveitis was 12.5 years. The female-to-male ratio was 1.25. Anterior uveitis was the most frequent anatomical location (40.7%), followed by intermediate uveitis (33.3%), posterior uveitis (18.5%), and panuveitis (7.5%). Seventy-four percent of patients presented with chronic uveitis. Noninfectious uveitis (81.5%) was the most frequent etiology. Thirty-seven percent of patients had a specific diagnosis for uveitis, and 63% were classified as idiopathic cases. Toxocariasis was the most common infectious cause. Associated systemic diseases were present in 14.8% of patients. The most frequent systemic disease was juvenile idiopathic arthritis in 9.2% of patients. Complications occurred in 66 (85.5%) of affected eyes. The most common complications were posterior synechia (20.7%), cataract (18.8%), and cystoid macular edema (12.9%).Conclusions:Uveitis in the majority of children had an insidious onset and was chronic. Over half the patients had a specific diagnosis. Idiopathic cases were more common in the intermediate uveitis group.

Health care associated infections, antibiotic resistance and clinical outcome: A surveillance study from Sanandaj, Iran.

To study the antibiotic susceptibility patterns of gram-negative healthcare associated bacterial infections at two tertiary hospitals in the Sanandaj city, Kurdistan Province, Iran. From January 2012 to December 2012, all positive cultures from potentially sterile body fluids were gathered. They sent to professor Alborzi clinical microbiology center in Shiraz for further analysis and susceptibility testing. The antibiotic susceptibility was determined using the Kirby-Bauer method (disk diffusion technique). The Results were interpreted according to Clinical and Laboratory Standards Institute guidelines against a series of antimicrobials. World Health Organization definitions for Healthcare associated infections were followed. Seven hundred and thirty-two positive cultures were reported from both hospitals. Seventy-nine isolates/patients fulfilled the study criteria for health-care associated gram-negative infections. The most frequent bacterial cultures were from the pediatric wards (52%). Serratia marcescens (S. marcescens) (38%) Escherichia coli (E. coli) (19%), Klebsiella pneumoniae (K. pneumoniae) (19%), Acinetobacter baumannii (6%), Enterobacter species (6%), Serratia odorifera (4%) and Pseudomonas species (5%) were the most frequently isolated organisms. The susceptibility pattern of common isolates i.e., S. marcescens, E. coli and K. pneumoniae for commonly used antibiotics were as follows: Ampicillin 3.3%, 6.7%, 20%; gentamicin 73.3%, 73.3%, 46.7%; ceftazidim 80%, 73.3%, 33.3%; cefepim 80%, 86.7%, 46.7%; piperacillin/tazobactam 90%, 66.7%, 86.7%; ciprofloxacin 100%, 73.3%, 86.7%; imipenem 100%, 100%, 100%, respectively. The most effective antibiotics against gram-negative healthcare associated infections are imipenem followed by ciprofloxacin. The resistance rate is high against ampicillin and cephalothin. The high mortality rate (46.1%) associated with S. marcescens is alarming.

Epidemiologic Study of Trauma Patients Admitted to a Level 1 Trauma Center in Shiraz: One Year Survey

Background: Traumatic injuries exert significant burden on human populations around the world. Iran as a developing country is at top 5 deadliest countries regarding injuries; however, few studies have examined the descriptive epidemiology of trauma in Iran. Objectives: To describe injuries regarding age, gender and injury mechanism and also time trend in emergency departments of Shahid Rajaee Trauma Center affiliated to Shiraz University of Medical Sciences. Patients and Methods: This descriptive cross-sectional study was carried out on all trauma patients (n = 21542) admitted to Shahid Rajaee Trauma Hospital (level I trauma referral center in Shiraz) between March 2011 and March 2012. Data were analyzed separately by age, gender, month of admission, and injury mechanisms (motorcycle collision, car-pedestrian accidents, car-car accidents, fall from height, stab wounds and gunshot injuries). Results: With a mean age of 36.0 ± 17.2 years, a total number of 21542 patients were visited, 16524 (76.7%) of whom were male. The male to female ratio was 3.3:1 with injured men being significantly younger than women (mean age 33.7 + 16.6 and 43.6 ± 19.2 years, respectively). There were 1492 trauma victims older than 60 years accounting for the smallest proportion of the population (6.92%). On admission, 1699 patients (7.9%) required cardiopulmonary cerebral resuscitation (CPCR) with a sex ratio of 2:1. Among those requiring CPCR, falling down was the major cause (45.24%) of injury in elderly (patients over 60 year) and car accident in those under 60 year (43.94%). Conclusions: Injuries affect all age groups; however, the disproportionately at risk population is the productive youth. Preventive strategies should focus on reducing trauma incidence among young men at population level. Considering the higher number of incidents occurring in mid spring and late summer, authorities should devise preventive plans mainly through alteration of traffic rules in this period.