فهرست مطالب علیرضا جهانبخش

Ventilator-associated pneumonia is a common, serious and costly disorder in intensive care units (ICUs) that rank first in hospital infections. So, appropriate interventions are needed to prevent this condition. Eucalyptus is a plant with antibiotic properties, therefore, current study aimed at investigating its effects on prevention of endotracheal tube-associated pneumonia in ICU. A double-blind clinical trial was performed in 100 patients with endotracheal tube and on ventilator in ICU in Kermanshah Imam Reza Hospital, Iran. The patients were divided into two groups. In intervention group (n=50) 4 cc of 2% eucalyptus solution was mixed with 6 cc distilled water and in control group (n=50) 10 cc distilled water was given three times daily through a nebulizer kit connected to mechanical ventilation devices. Data on the rate of early and late pneumonia were compared based on CPIS criteria applying t-test and Chi-square. The incidence of early and late pneumonia was lower in intervention group compared to that of the controls. The decrease was significantly more in onset of late pneumonia (P=0.01). The onset of pneumonia due to mechanical ventilation was significantly higher in intervention group than that of the control group (P=0.01). Eucalyptus was found to be an effective prophylaxis that could delay the development of pulmonary infection in patients on ventilation. Therefore, it is suggested in ICUs in patients with tracheal tubes.

About 70 percent of the planet Earth is covered by water. Healthy marine and coastal ecosystems provide many valuable services including food security, resources for economic growth, beach tourism and coastline protection. Also marine ecosystem is recognized as crucial reservoir of biodiversity. Considering the islands, Iran has about 5800 kilometers of coastline. In Iran, the marine resources are strategically important due to energy, shipping and trade, fishing and tourism. Health and conservation of the resources in marine ecosystem is the consequence of recognizing the challenges, sustainable planning and management, so that the marine ecosystem results in economic, social and environmental benefits. In this article, firstly, the importance of Marine Planning in the event of Sustainability is presented, then the global and local policies in Marine Planning are studied. Analyzing the current situation and global approaches, a suggested plan in sustainable marine management in format of the Sixth Plan is submitted.

Linguatula serrata is a cosmopolitan organism belonging to the Phylum Pentastomida. Humans may act as an intermediate (Halzoun syndrome) or accidental definitive host of this parasite، manifesting the nasopharyngeal or visceral form. Linguatulosis occurs accidentally in human by ingestion of raw or undercooked visceral tissues of sheep، goat، camel، and other herbivores. This is the first report of Halzoun syndrome in Kermanshah province. In this case report، a 34-year-old man، from Salas-o-babajani district infested with this parasite was presented. Clinical signs and symptoms included pricking sensation in throat، coughing، sneezing and nasal discharge، which started 2-3 hours after eating undercooked goat liver. An organism in about 8 mm length was isolated from his pharyngeal discharge. The sample was examined in the pparasitology llaboratory of Kermanshah school of medicine. The results of analysis showed that this organism was the nymph of L. The serrata had a mouth surrounded by four hooks and a segmented body with small hooks. The patient was treated using oral anti histamines and gargling and nasal washing with saline solution. So، it is recommended that physicians consider L. Serrata infestation in patients with complaints such as pharyngitis accompanied by pharyngeal pain، coughing، sneezing and vomiting.

Sepsis is a common clinical diagnosis. Knowing the outcome of these patients is very important because it alerts the physicians. The goal of this research is to find an easy, inexpensive and accessible way for this purpose and to study the correlation between thyroid hormones and Cortisol levels and the outcome of patients in sepsis. In this study 55 sepsis patients were examined. Their 8 a.m. blood samples were studied in their first day admission for TSH, T3, T4, T3RU and Cortisol. Criteria for the outcome of these patients were the mortality in 28 days of admission and death was inappropriate and life was appropriate outcome. The hormones level of these two groups’ was compared. Findings were analyzed using SPSS version16, Χ2 test was employed for qualitative analysis of data and Leven and independent T-test were used for quantitative analysis of the data. Among 55 sepsis patients under study 17 patients died during 28 days and 38 patients remained alive. Cortisol level was higher in inappropriate outcome patients and there was a statistically significant correlation between worsening outcome of sepsis patients and their increasing hormone level (p<0.001). However, there was no statistically meaningful relationship between thyroid hormone levels, TSH and T3RU and outcome of sepsis patients. Measurement of blood Cortisol level could be worthy for predicting the outcome of sepsis patients.