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Introduction: Staphylococcus Aureus is one of the most important pathogenes in human. Regarding the ability of this bacterium in nasal colonization, carriers can increase the incidence of many nosocomial infections. This study was designed to compare the efficacy of two antimicrobial regimens (topical nasal Mupirocin and oral Ciprofloxacin) in treatment of Staphylococcus Aureus carriers and its recurrence. Materials and Methods: This study is a triple blind clinical trial that was performed on 366 cases of Vali-e-asr hospital personnel. Nasal cultures were prepared from all these cases. Among them, 45 cases were carriers which were divided in two groups (A and B). Group A were treated by single dose of oral Ciprofloxacin (1500 mg) and Vit A+D ointment as placebo for 5 days (twice a day) and group B were treated by single dose of oral placebo and nasal Mupirocin ointmdent for 5 days (twice a day). After this period, nasal cultures were repeated in the two groups to evaluate the efficacy of treatment. Also after 5 weeks the last cultures were performed in order to determine the prevalence of reinfection. Results were analyzed using Chi-square test. Results: Results showed that, 12.9% of Vali-e-asr hospital personnels were nasal carriers of Staphylococcus Aureus. Also the efficacy of topical nasal Mupirocin regimen (89.5%) was significantly higher than single dose of oral Ciprofloxacin regimen (55%) (p=0.019). But there was no significant difference between prevalence of reinfection in topical (13.3%) and oral regiment (20%). Conclusion: According to the present data, it seems that topical Mupirocin therapy is more effective than single dose of oral Ciprofloxacin in treating Staphylococcus Aureus carriers. However there is no significant difference in the prevalence of reinfection between the two methods.

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Introduction: Delivery of immediate medical interventions appropriate to the severity of clinical status of patients is a main public expectation of emergency departments. Waiting time and length of stay are the key measures to asses the quality of care in emergency departments. This study is done to investigate the waiting time and length of stay of attendants to emergency department of Vali-e-Asr Hospital, Arak-Iran. Materials and Methods: This analytical cross-sectional research was conducted in a general emergency department of a teaching hospital in Arak to asses the waiting time and length of stay of patients. In the first stage of the study all attendants during a 6 weeks period were classified regarding to the severity of their clinical status by an educated nurse and a general practitioner using a three category scale (guideline) presented by ministry of Health and Medical Education (2001). Also waiting time for a general practitioner visit was measured and documented by the resident general practitioner. In the second stage, a sample of 100 documents of patients in group 1 and 2 admitted for specialist visit were assessed for the waiting time and length of stay in emergency department. Mean of waiting time according to patients clinical status and the specialty of the first physician were analyzed by t-test and ANOVA (p =0.05). Results: During a 6 weeks period, of 1963 patients, 179(9.1%) were categorized as emergent (category 1), 391(19.9%) urgent (category 2) and 1393 (71%) non urgent. The mean waiting time for general practitioner visit was 5 minutes. The median and mean of waiting time for specialist visit in group 1 and 2 of patients were 225 and 262±156, 220 and 227±153 minutes, respectively. The median and mean of length of stay was 1 and 2 days, respectively. No differences were found between waiting time of various specialties visit in patients of categories 1 and 2. Conclusion: Regarding the long waiting time for specialist visit, using triage in emergency departments is necessary. This needs planning and organization for the presence of specialists in the hospital, over the time. Also regarding the large number of nonurgent patients, 24 hours presence of a general practitioner is necessary.

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Background: Metronidazole has antibacterial and antiparasitic action. Therefore it can use for treatment inflammatory diseases as Crohn. The effect of metronidazole on human’s blood lipids to reducing levels of LDL and VLDL and increasing level of HDL is under investigation. Target of this research is consideration effect of metronidazole on hyperlipidemia case of death such as coronary artry disrase. Methods and Materials: This study is a triple blind clinical trial was done on 100 voluntaries between 25-65 years old. with hyperlipidemia. Samples divided in two equal groups. The first group received metronidazol, 500mg, BID, for 10 days, and control group received placebo with the same dose. Lipids of serum were measured before and after using drugs, then data analyzed by SPSS software. Results: In metronidazol group amount of total cholesterol, LDL and Triglyceride were significantly less than placebo group. HDL’s amount in metronidazole group was significantly more than placebo group. Conclusion: Significant effect of metronidazole on reducing harmful blood lipids and increasing useful blood lipids. It can be suggested a probable candidate in treatment of hyperlipidemia. Maybe it can use with this application. Although it needs to more study by meta analysis to validate this effect.

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Background: Pyelonephrities is the urinary tract infection. Using supplemental dugs may decrease duration of treatment and hospitalization. We studied the effect of vitamin C on the recovery of symptoms due to pyelonephrities Methods and Materials: In this clinical trial, double blind, study, 64 patients with uncomplicated pyelonephrities were assessed in 2 groups randomly. Case group took vitamin C capsules, and control group took placebo capsules. In both groups, primary treatment was ceftriaxon capsules during hospitalization and they took ciprofloxacin capsules for 14 days after discharging. Symptoms and Urinary analysis were assessed in the first day of administration and then on the 7th and 14th days after discharging. Data were analyzed with Chi-Square test. Results: Mean of fever duration in vitamin C group (1.130.34 SD day) and placebo group (1.560.62 SD day) significantly decrease (p=0.001). There was a significant difference in dysuria duration in vitamin C group 2.191.06 SD day with placebo group (2.971.06 SD day) (p =0.007). In flank pain, nausea and vomiting duration difference was not significantly (p≥ 0.05). Conclusion: It seems vitamin C, as a supplemental drug improves some pyelonephrities symptoms, such as fever and dysuria, decreases of the hospitalization period

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Background: Herpes simplex clinical manifestations are in the form of vesicular eruptions on erythemateus base. The virus can remain latent within sensory nerve ganglions following the initial infection and be reactivated in some cases such as intracranial surgery, dental surgery, stress and excitements. Systemic or disseminated infection occurs in immune-deficient patients and sometimes in healthy individuals. In Previous studies, in most of the disseminated infection cases, visceral organs involvement has been mostly observed while skin involvement has been reported just in one case. Thus, our patient was the second case with herpes simplex disseminated skin infection. Case: The patient was a 38 year-old man who underwent craniotomy surgery due to epidural hematoma following car accident and head trauma. Almost 10 days after the surgery, the patient developed disseminated vesicular eruptions in erythemathous base which initially appeared in the face, head, and then in body and extremities. Fever was detected 5 days before the development of eruptions. Other than anemia and leucocytosis, there were no other notable points in the systemic examination and lab tests. For patient skin biopsy was taken with an impression of herpes simplex, mulocum contagiosum and a lower probability for bullouse diseases. In the skin biopsy, intra-epidermal vesicles and extensive epidermal necrosis with multinucleated giant cells and intra-nuclear objects were observed. A plethora of neutrophilic cells inside the vesicles and inflammatory cell infiltration in the underlying debris were seen. Based on the pathology report, infection with herpes simplex hominis was confirmed. Conclusion: Disseminated skin infection with herpes simplex can be observed even in healthy people with no background.

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Background: Brucellosis, a zoonotic disease with worldwide spread, is a common disease in Iran and is endemic in Markazi Province. Brucella osteomyelitis, on the other hand, is a rare disease. Here we reported a case of brucella osteomyelitis of the tibia following trauma. Case: The patient was a 22 year old man referring with chronic draining tibia ulcer. He had a history of trauma of the tibia, dating back to 3 years ago, for which local prosthesis had been prescribed. Later on, the prosthesis had been removed due to infection. Staining of the tissue samples indicated the presence of gram-negative coccobacill and brucella growth in the culture of excretions. Conclusion: This case was reported because of rare presentation of brucella and the educational implications of the patient with respect to the possibility of brucella development in chronic ulcers or prosthesis. Although uncommon, brucellosis should be regarded as a potential cause of osteomyelitis in patients with a record of physical contact with animals.

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Background: Hydatid disease is a common infection caused by Echinococcus granulosus. Cerebral involvement is very rare and only occurs in 2% of all hydatidosis in endemic areas. We report a case of primary multiple cerebral hydatid cysts in a 23 years old patient. Case: A 23 years old female was admitted in our emergency ward with primary generalized tonic colonic seizure, left body and face hemiparesis and history of headache in last two months. Contrast enhanced CT and MRI showed a big well-defined, rounded, cystic lesion in the motor strip of right temporo-parietal region with mass effect causing midline shift which was diagnostic for brain hydatid cyst and several smaller cysts. There was no evidence of other organs involvement. The patient underwent the brain surgery. A big hydatid cyst (10cm in diameter) and some others adhering to brain parenchyma in different sizes were evacuated completely and without rupture using Dowling method. Patient received albendazole 400mg/two times a day for 2 months too. There was no cyst in patient’s MRI study in two years follow up.

Conclusion: Though low incidence, primary multiple cerebral hydatid cysts should be considered in endemic area using brain CT and MRI. Surgery is standard treatment of the disease.

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Background: Motivation is one of the most important tools to push faculty members to perform effectively and efficiently in the workplace is. This study is based on Herzberg's theory of motivating factors to consider requiring faculty at the University of Medical Sciences deals.

Materials and Methods: In this cross-sectional study, a total of 168 faculty members of Tehran University of Medical Sciences, 102 persons conducting a completely free and informed, a 40-question questionnaire based on Herzberg's two-factor theory, design, a questionnaire. Data using t-test and Mann-Whitney U and indicators of central tendency and dispersion were analyzed by SPSS 16 software.

Results: Response rate to the questionnaires, 7.60, respectively. 5.24% of the faculty in the basic sciences and 5.74% at the clinical level of activity. Of "communication" and "progress and development", the motivation faculty have the greatest impact. Factors "physical condition" and "salary" have been less effective. Between the ages of faculty motivating factors, "nature", "responsibility and career" and "supervision and monitoring", there was a significant correlation. The relationship between work experience and of "salary" and "job security" was also significant.

Conclusion: Communication is one of the most important factors in increasing the motivation of faculty members in the physical conditions of work and wages are minimal impact in this area. With an aging faculty, salary, supervision and monitoring, and job security are more important motivation. In other words, with increasing age and work experience, academic expectations of the management of change and the proper evaluation of the activities of the officials do not have the decision-making, and because the quality of activities, good participate Ndah encouraged do not motivate members to create good will.

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Background: Staphylococcus aureus is one of the important pathogens can cause infections in hospitals specially in intensive care units (ICU). It seems that nasal carriage is important risk factor for developing l infection at ICU units. This study was designed to investigate the frequency of S. aureus nasal carriage and its virulence in patients admitted to ICU units in Vali-Asr hospital at Arak university of medical sciences.

Materials and Methods: In this cross-sectional study, nasal swab samples were obtained from all the patients hospitalized in ICU unit of Vali-Asr hospital from July-December 2014 at admission. After identification, methicillin resistance and the frequency of pvl and acme genes determined by PCR. Demographic data were collected using questionnaire and were analysed using SPSS 20 software.

Results: Out of 390 patients, 81(20.8%) and 31(12.9) patients had been colonized with MSSA and MRSA, respectively. The result of culture was negative for 278 patients (71.3%). 77.4% of MRSA and 54.3% of MSSA isolates were positive for acme gene. Also, 11.11% of and 6.45% of MSSA MRSA isolates were positive for pvl gene.

Conclusion: The application of medical supportive devices like cv line, ventilator, history of surgery operation and antibiotic use significantly was associated with S. aureus nasal carriage. High prevalence of S.aureus shows that these bacteria settled in the hospital. Hence, infection control measures must be performed to reduce the risk of hospital infection.

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Introduction: The Symptoms of Omicron are still unknown. Primary data show that the Omicron symptoms are mainly related to the respiratory system, including runny nose, sore throat, headache, fatigue, and sneezing. Based on the need for more evidence about Omicron symptoms, this study was conducted to investigate the symptoms of this COVID serotype.
Methods: This descriptive-analytical cross-sectional study was performed for 6 months in Arak city on 160 definitively diagnosed patients with Omicron. For all patients who entered the study, the information evaluation checklist, including demographics and symptoms (24 symptoms), was completed. Disease diagnosis was done by PCR.
Results: The disease of 55% of people was mild, 35% moderate, and 10% severe. Fifty-one people (31.9%) mentioned a history of previous infection with COVID-19. Pulmonary involvement, the type of drug used, and anxiety at the time of infection were related to the severity of the disease (P < 0.05). The five most common symptoms of Omicron (%) were sore throat (86.3), cough (82.5), weakness and lethargy (76.3), headache (72.5) and dry mouth (62.5). There was also a relationship between old age with dry mouth and headache, underlying disease with sneezing, anxiety during illness with joint pain and chest pain, and smoking with abdominal pain (P < 0.05).
Conclusions: The most common symptoms included sore throat, cough, weakness and lethargy, headache, and musculoskeletal pain. However, reduced smell and taste, night sweats, fever, and joint pain, common in the previous serotypes, were among the less frequent symptoms of Omicron.