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Background&Objective: Two enzymes have the ability to hydrolyze acetylcholine. One is acetylcholinesterase, which is called true cholinesterase, it is found in erythrocytes. The other cholinesterase is pseudocholinesterase, it is found in serum. Some chemical components of organophosphates group and carbamates affected cholinesterase activity. Determination of cholinesterase has application in diagnosis of liver disease, liver damage by insecticide and assessment of fatty liver. Pesticide factory workers are one group of peoples which are exposed of poisoning by pesticide. Materials&Methods: This research in 2005 performed in pesticide producers. In two stages (3 month interval) from 58 of personal blood was drown. Results: Mean of erythrocyte cholinesterase in first stage was 48.5±11.2 IU/gHb and second stage was 37.9±17.3 IU/gHb. Decrease of erythrocyte cholinesterase was significant differences (paired t test, P<0.05). Increase of serum AST was not statistically significant. Increase of serum ALT and Albumin was significant differences (paired t test, p<0.05). In 15 individual (25.9 %) cholinesterase decrease more than 35% and in 16 workers (27.6 %) erythrocyte cholinesterase decrease between 26-35%. Conclusion: Since in more than 26% of personnel cholinesterase decreased over than 35%, routine assessment of cholinesterase in similar factory, is recommended.

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Background and Objective: The vaccination against hepatitis B is a front line defence for all at-risk groups. Conventional methods of hepatitis B vaccination (0, 1 and 6 months) is considered a long process. But vaccination at shorter intervals (0, 10 and 21 days) is suggested to achieve rapid immunity. This study was carried out to compare for the protective antibody level against hepatitis B in accelerated and conventional vaccination. Materials and Methods: In this descriptive and analytical study 160 health personnel of Imam Reza hospital of Kermanshah, Iran with no history of vaccination against hepatitis B were selected and divided into two groups during 2009. The volunteers were received vaccination according to accelerated (0, 10 and 21 days) and convetional (0, 1 and 6 months) methods. The antibody titer measured two years after the final dose of vaccination. The acceptable level of antibody was considered higher than 10 IU/ml. Results: After two years the acceptable level of antibody was observed in 94.5% and 97.9% of subjects in accelarated and conventional methods, respectivley. This difference was not significant. Conclusion: This study showed that there is not significant differences between accelerated and conventional methods in antibody production against hepatitis B antigen.

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Background and Objective: The Detection of neurologic signs for topographical disorders in central nerves system can prevent unnecessary neuroimaging techniques such as MRI. This study was performed to determine the diagnostic value of physical examination for topographic detection of infratentorial lesions in patients with cerebrovascular syndromes. Methods: This descriptive study was done on 200 patients with cerebrovascular syndrome in Qaem Hospital in Mashhad, north-east Iran during 2011. Regarding to topographic physical examination, sensitivity, specificity, positive and negative predictive value and accuracy of signs of syndromes were compared to MRI as gold standard method. Results: The accuracy of tetraparesis and crossed syndromes for localization of brain lesion in brainstem was 79% and 83%, respectively. The accuracy of hemiataxia for localization of brain lesion in ipsilateral cerebellar hemisphere was 98%. The accuracy of Wallenberg syndrome for localization of brain lesion in posterolateral medulla was 98%. Conclusion: Using clinical neuro-examination skills and accurate topographic physical examination can prevent unwanted MRI technique for the diagnoses of cerebrovascular syndromes.

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Background and Objective: Bacterial resistance to Imipenem is increased in bacterial infections in Iran. In regard to the importance of Imipenem in the treatment of nosocomial infections and the key role of disc diffusion method as a major antibiotic susceptibility testing assay, this study was done to determine the prevalency of imipenem-resistant bacterial strains isolated from hospital and accuracy of Iranian imipenem disc product. Methods: In this descriptive-analytic study, 241 bacteria were isolated from patients in different wards of the Baqyatallah hospital in Tehran, Iran during 2013-14. After streaking of the organisms, identification was performed by all conventional biochemical tests. The bacterial resistance to imipenem was determined by disk diffusion method using Iranian and Mast imipenem discs. True imipenem-resistant isolates were examined for susceptibility to six different antibiotic including Ciprofloxacin, Gentamicin, Cephalexin, Azitromysin, Tetracycline and Ceftazidim, using disk diffusion method. Results: The most prevalent isolates organisms were gram-negative bacilli (Klebsiella, Escherichia coli, and Pseudomonas aeruginosa, respectively). The common clinical source was urine and wound samples, respectively. Resistant to Imipenem was 68 (25.7 %) and 19 (7.8 %) based on the results of Iranian and Mast Imipenem discs, respectively. False results for Iranian Imipenem discs was higher than Mast Imipenem discs (P<0.05). Among the 19 true Imipenem resistant isolates, 17 micro organisms were Pseudomonas aeruginosa. 57% of isolated resistant to Imipenem were isolated from ICU ward. The most resistance was seen to Gentamicin (84%) and the lowest was seen to Ciprofloxacin (63%). 84% of isolated samples were multi drug resistance. Conclusion: Although a small percentage of the isolates obtained as important nosocomial pathogens were resistant to Imipenem, but the rate of multiple resistance and high rate of isolates obtained from ICU was noticeable.

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Background and Objective: Wound infection treatment, particularly in chronic and bacterial poly cases, is difficult and entails heavy costs. This study was done to determine the prevalence of poly bacterial infection and antimicrobial susceptibility of wound samples from different wards. Methods: In this descriptive study, wound sampling was prepared from 336 patients admitted to different wards of Baqiatallah Hospital in Tehran, Iran. Identification was performed based on biochemical tests including oxidase test, TSI, IMVIC, lysine decarboxylase, phenylalanine deaminase, urea, motility, catalase, coagulase, mannitol fermentation, optochin sensitivity, susceptibility to bacitracin and sulfamethoxazole, growth in Bile esculin and DNase production. Antibiotic resistance pattern of isolates was determined using disk diffusion method for 14 important antibiotics. Results: 294 samples were positive for bacterial culture, from which 364 isolates including 11 different isolates were obtained. Out of 294 positive samples, 245 samples were mono bacterial and 54 were poly bacterial including two-bacterial (45 samples), three-bacterial (7 samples), and four-bacteral (2 samples). S. aureus (29.7%), Enterococci (15.6%), and E. coli (15.6%) were the most prevalent isolates. S. aureus-Enterococci pattern was the most common two-bacterial pattern (33%), and majority of polybacterial patterns belonging to gram negative bacteria was in surgery ward (32.5%). Antibiogram results showed high levels of antibiotic resistance in the isolates. Imipenem and amikacin were the most effective antibiotics against Gram negative isolates, and vancomycin for Gram positive isolates. Also, 71% of S. aureus isolates were resistant to oxacillin. Conclusion: Variation of bacterial isolates was similar to other studies. Most of poly-bacterial wound infections were due to common nosocomial pathogens and their high rates of antibiotic resistance are extremely alarming.