Abstract aim: HAIs (Hospital-Acquired Infections) remain a major problem in ICUs. The purpose of this study is survey of HAIs and antibiotic susceptibility patterns of causative agent among patients admitted in ICUs. Methods: A retrospective study was conducted in three teaching hospitals related to Mazandaran University of Medical Sciences in 2012-2014. The incidence, clinical presentation, risk factors, causative agents and antibiotic resistance pattern of bacteria analyzed by SPSS (ver. 16) and Descriptive statistics were used. Results: The incidences of HAIs were 4.13%. The most common HAIs were respiratory infection 49.1%, wound infection 26.3%, UTI 16.7%, and blood Infection 7.9%. P. aeruginosa 42.1%, Acinetobacter spp. 21.05%, Enterobacteriaceae 19.29% and S. aureus 12.28% were the most bacteria isolated. We found that 35% ESBL and 14.58% carbapenemase-producer Pseudomonas spp. Also 60% of Acinetobacter spp were MDR and 14.28% of S.aureus was resistant to niVnmocnaV. Conclusion: This article suggests that the prevalence of HAIs in ICUs of teaching hospitals in northern Iran is false low. Diagnosing of NI in our area focused on physician diagnosis and clinical criteria for reporting HAIs, The rate of inappropriate administration of antibiotics is very high in our region also significant resistance in organisms such as Acinetobacter spp, P. aeruginosa, Enterobacteriaceae, S. aureus to the most commonly used antibiotics has been increasing. Infection control procedures must be implemented carefully and Antibiotic resistance patterns of organisms causing HAIs should be checked periodically to guide empirical antibiotic therapy.

Background:Schizophrenia is one of the most important mental disorders that in comparison with other mental disorders, leaves the most devastating effect on person’s life and social health. Objectives:In this research we determinerelationship between metacognitive beliefs and mild neurological symptoms with positive and negative symptoms of schizophrenia. Patients and Methods:This was a correlation type study conducted on80 patients with Schizophrenia were randomly selected among patients who referred to Fatemi and Isaar hospitals in Ardebil, Iran from 2013 to 2014.Meta-cognitive impairment and mild neurological soft sing were measured with meta-cognitive questionnaire test and neurological soft symptoms respectively and positive and negative symptoms of schizophrenia were measured with positive and negative symptoms of schizophrenia test too. Results:The average and standard deviation of meta-cognitive beliefs were x=74/54, SD=14/32 respectively, the average and standard deviation of mild neurological soft symptoms were x=19/93, SD=8/26 respectively, the average and standard deviation of positive symptoms were x=49/55, SD=7/27 respectively, and the average and standard deviation of negative symptoms were x=46/76, SD=6/34 respectively. Meta-cognitive beliefs with positive symptoms (R=0.41) and negative symptoms (R=0.33) has a meaningful positive correlation (p <% 1) but any meaningful relation between mild neurological symptoms and positive and negative symptoms was not found. Conclusions:The results of this study indicated that Meta cognitive beliefs with positive and negative symptoms of schizophrenia have a meaningful relation, but there is no relation between the weak neurological symptoms and positive and negative symptoms.

Objective; To evaluate the incidence of unexplained pulmonary hypertension (PH) in end- stage renal disease (ESRD) and to evaluate its possible relationship with some clinical and biochemical parameters. Patients and Methods; This study was conducted retrospectively at Prince Rashed Hospital (PRH), North of Jordan, on patients undergoing maintenance hemodialysis (HD) during August 2009 to August 2010.Demographic and clinical data were obtained from charts review and Patients themselves. 2Dimensional echocardiography (2DECHO) was performed in all patients. Blood samples were taken for parathormone (PTH) and other biochemical measurements. SPSS package was used for statistical analysis.Statistical significance was considered at p value < 0.05. Results; A total of 131 hemodialysis (HD) patients were included in the study, of them 76 (58, 9%) were men. The mean age of the study population was 53.7 + 16.2 yrs. Pulmonary hypertension (pulmonary artery pressure (PAP)=47+3, range 35-79mmHg) was detected in 52 patients (39.6%).The levels of PAP were positively correlated with serum intact parathormone (iPTH) levels, age, duration of HD, mean arterial pressure (MAP), interventricular septal (IVS) thickness, cardiac output(CO), and serum levels of phosphorus , creatinine, whereas the levels of PAP were inversely correlated with the levels of serum calcium and hemoglobin(Hb). Conclusion; Pulmonary hypertension is a frequent finding in end stage renal disease and mineral disorders together with secondary hyperparathyroidism (SHPTH), increased cardiac output and anemia may be involved in the pathogenesis of this abnormality. The early detection and treatment of pulmonary hypertension aiming to decrease its serious complications is mandatory.

Objectives:Asthma is one of the commonest chronic illnesses worldwide. Inhaled corticosteroids (ICS) are critical components in this disease therapy. Incompliance to prescribed treatment is a major factor leading to poor asthma control and many factors could be responsible for this issue.Our aim is to clarify the relation between adherence to treatment and level of asthma control and to evaluate the role of some factors affecting the compliance of asthmatic patients to prescribed inhaled corticosteroids (ICS). Subjects and methods;A prospective descriptive study was held at internal medicine, thoracic medicine, and pediatric clinics located at Prince Rashed Hospital (PRH), North of Jordan, on asthmatic patients over a period of six months starting from 15 July 2014. Factors that may affect adherence to therapy were studied. These factors included age, sex, residence; level of education, asthma education, Type of inhalation device, and combinations with long acting ß2 agonist (LABA).A structured questionnaire to collect the data was used. Adherence to ICS was determined according toModified Morisky Scale (MMS).Global Initiative for Asthma (GINA) 2011 guidelines were used to assess the level of asthma control. For statistical analysis SPSS window software was used. P- Value below 0.05 was considered as significant. Results:Total of 110 asthmatic patients, of them 50 (45%) males, were included in the study.53 patients (48%) were adherent and only 10patients (9%) have a fully controlled asthma. Adherent patients are more likely to have controlled asthma. Adherence was significantly promoted by increased level of education, being older, having asthma education, using dry powder inhaler (DPI), and using ICS and LABA by the same device. On other hand, sex and residence have no significant effect on adherence. Conclusion:Nonadherence to ICS is prevalent and it is significantly worsening the clinical outcome in asthmatic patients. National efforts are mandatory to improve the knowledge of general population about such chronic and correctable illnesses as bronchial asthma in order to increase the adherence to treatment and improve the outcome of these diseases.

Abstract In children with Down syndrome (DS) there is higher chance for concomitant congenital heart defects and organic disorders. However Epstein’s anomaly is a rare association of DS. We report a 2.5 months DS boy that referred to our hospital with tachypnea. In echocardiography the septal leaflet displaced downwardly toward the apex about 8.2 mm and displacement index was 27.3 mm/m2, Tricuspid regurgitation (TR) was moderate (VC=5.5mm) with 70 mmHg gradient also an ASD with bidirectional shunt and a membranous VSD were seen. catheterisation and angiography was done, pulmonary arterial pressure was subsystemic and a 2.5 mm size PDA was seen, in the levophase a medium size VSD was seen. The patient is under follow up with lanoxin, captopril and lasix now. As mentioned earlier Epstein’s anomaly is rare and it prevalence is about 0.5% of CHDs although 50% of patients with DS have CHD but its association with Epstein’s anomaly is very rare.

Background. Acute gastroenteritis is one of the most prevalent infectious illnesses in childhood and frequently associated with severe zinc deficiency. The objective of present study was to determine zinc status in 32 gastroenteritis girls and boys under 5 years old not on Zn supplementation at Reference health laboratory, Tehran-Iran. Materials &Method. Out of 32 gastroenteritis children six excluded and fasting serum samples of n=26 (10=girls & 16=boys) were collected. For analysis a Varian Spectra Flame Atomic Absorption was used. Results. Out of10 girls and 16 boys serum samples, [6(60%), 95%CL(38% - 60%) ] and [(11(68%), 95%CL (53% - 65%) ] had zinc level less than reference interval range (70-120 µg/dL). Results of Pearson correlation indicated significant correlation between Zn and age at p<0.05. Conclusion: The author concludes serum Zn determination is an important factor in gastroenteritis children under five years old. Although in developing countries, the role of zinc during acute diarrhea in children assess further future studies, conducting educational based programs could be useful to increase the community information on the impact of zinc during gastroenteritis and emphasize on the WHO recommendation , replacing 20 mg of elemental zinc per day for children above 6 months , to shorten the duration of acute gastroenteritis .

Abstract Orf or Ecthyma contagiosum is a zoonotic disease that is the result of a dermatophitic parapox virus infecting goats and sheep. The virus is transmitted to humans through contact with infected animals or fomites. Here in this paper, we reported eight patients infected with orf viruses and also tried to provide a relatively complete data of this disorder by reviewing of the literatures. Worthknowing about the disease may occur at any location, so all clinicians and researchers need to have this disease in mind as a differential diagnosis in patients who has a history of working with animals.