مجله دانشکده پزشکی اصفهان
پیاپی 552 (هفته چهارم دی 1398)

 Acinetobacter baumannii (A. baumannii) is an opportunistic pathogen with high antibiotic resistance and biofilm production capability in the patients with burn wound. The present study aimed to determine the antibiotic resistance pattern and frequency of the multidrug-resistant (MDR) strains, and evaluate biofilm formation potential in the burn wound infection isolates.

 Biochemical and molecular tests were used for identification of the 117 strains collected from Isfahan City, Iran, during one-year period. Antibacterial susceptibility test was performed using disk diffusion and interpreted in accordance with the standards of Clinical and Laboratory Standards Institute (CLSI). Biofilm formation was evaluated using microtiter plate assay.

 Of 117 clinical strains of A. baumannii, 114 (97.49%) were MDR. Strains showed maximum resistant to ceftazidime (99.14%) followed by ciprofloxacin (94.01%). 81.19% of isolates were able to form biofilm, 1.7% of strains were strong-biofilm producers, and 18.80% of them were notable biofilm producers. In this assessment, 42.73% and 36.75% were considered as moderate and weak biofilm-forming isolates, respectively.

 The high prevalence of A. baumannii in patients with burn wound, and the significant relationship between biofilm formation and resistance among the burn isolates indicate that antibiotic resistance is increasing rapidly, and soon many usable antibiotics will become ineffective medicines for treating patients. This needs an emergency actions and alternative ways to control these problems.

Patient package inserts (PPIs) are the most important and accessible source of information for patients which is expected to contribute with the safe and efficient use of medicines. However, the information in the PPIs is not always appropriate and complete, and may lead to medication errors. The purpose of this study was to evaluate the conformity of pediatric antibiotics’ PPIs with the standards of Iran’s Food and Drug Administration (FDA).

This descriptive cross-sectional study evaluated 51 PPIs related to 13 best-selling pediatric antibiotics in Iran based on the criteria approved by Iran’s FDA. Six categories of criteria as writing and formatting, drug description, warnings and precautions, side effects, interactions, and references were considered in evaluating the extent of conformity.

 In total, 2652 items from 51 PPIs were evaluated. The PPIs content was insufficient in various aspects of conformity with standards in each category (54.8%). Among the six categories, the best match was found in warnings and precautions with 359 items (70.3%). The lowest conformity was found in the reference category with 76 items (18.6%).

 The PPIs of Iranian pediatric antibiotics do not fully meet Iran’s FDA standards. It is strongly recommended that the drug leaflets must be updated based on the standards of Iranian Ministry of Health and Medical Education to overcome this problem.

Weight gain more than the recommended range by the Institute of Medicine (IOM) is one of the most common complications of pregnancy, which would be ended to gestational diabetes, preeclampsia, cesarean section, or maternal, and child obesity. Few successful studies in this area include nutrition and physical activity. We examined a simple, practical, and cost-effective solution as nutrition training based on the Pender’s model, because this is one of the most effective patterns for nutritional behavior.

This single-blind randomized controlled clinical trial study was performed on 192 nulliparous pregnant women. During training sessions, mothers of intervention group learned how to prevent excessive weight gain over healthy eating habits. Mothers’ weight, nutrients intake, and physical activity levels were estimated before, during, and after intervention.

The constructs of perceived benefits, perceived self-efficacy, behavior-related feelings, interpersonal influences, competing demands and preferences, and commitment to action increased significantly. In the intervention group, 58.6% gained weight within the recommended range compared to 50.0% in control group. Moreover, 28.7% in the intervention group versus 45.6% in the control gained weight more than the IOM limits while 12.6% in the intervention group and 4.4% in the control gained weight less (P = 0.020). The perceived self-efficacy and commitment to the plan constructs were associated with normal weight gaining.

Pender model-based nutrition education considering the national guideline prevented excessive gestational weight gain in pregnant women.