mohsen chitsaz

The growing strength of the BRICS countries over the past decades and the formation of this group in the last ten years, given the strategic, political and economic capabilities of this group, has seriously raised the possibility of changing the structure of the international system. In the meantime, the study of Russia's goals in the formation of this group and the process of its development during the years of BRICS formation is of special interest due to its key role in the establishment of BRICS and its relationship with the current international system.The main question of the article is whether the BRICS influence on the international system is pursued with the aim of changing the existing order? In answer to this question, the hypothesis of the article is that the BRICS group is aimed at moderating the existing order by synergizing among its members and influencing the current power structure in the international system. The findings of the article show that the outcome of the BRICS goals is in line with the goals of Russia as one of the main BRICS members, despite the differences between this country and other members, in order to achieve the multiplicity of multiple centers of power worldwide. The method used is descriptive-analytical.

The antiemetic efficacy of midazolam and ondansetron was shown before. The aim of the present study was to compare efficacy of using intravenous midazoalm, ondansetron, and midazolam in combination with ondansetron for treatment of nausea and vomiting after cesarean delivery in parturient underwent spinal anesthesia.

One hundred thirty two parturients were randomly allocated to one of three groups: group M (n = 44) that received intravenous midazoalm 30 μg/kg; group O (n = 44) that received intravenous ondansetron 8 mg; group MO (n = 44) that received intravenous midazoalm 30 μg/kg combined with intravenous ondansetron 8 mg if patients had vomiting or VAS of nausea ≥ 3 during surgery (after umbilical cord clamping) and 24 hours after that. The incidence and severity of vomiting episodes and nausea with visual analog scale (VAS) > 3 were evaluated at 2 hours, 6 hours, and 24 hours after injection of study drugs.

The incidence of nausea was significantly less in group MO compared with group M and group O at 6 hours postoperatively (P = 0.01). This variable was not significantly different in three groups at 2 hours and 24 hours after operation. The severity of nausea and vomiting was significantly different in three groups at 6 hours after operation (P < 0.05).

Our study showed that using intravenous midazolam 30 μg/kg in combination with intravenous ondansetron 8 mg was superior to administering single drug in treatment of emetic symptoms after cesarean delivery under spinal anesthesia.

Organisms producing CTX-M β-lactamases are emerging as a source of resistance to oxyiminocephalosporins such as ceftriaxone and ceftazidime. However, the laboratory detection of these strains is not well defined. In this study, phenotypic assay for screening of extended-spectrum β-lactamases producing strains and molecular assay for the identification of CTX-M β-lactamases genes was developed and used to investigate the prevalence of these enzymes among clinical isolates of Klebsiella pneumoniae in three general hospitals of Tehran, Iran. Phenotypic detection was used for screening of isolates by agar dilution method. A decrease of ≥3 doubling dilution in an MIC for either ceftriaxone or ceftazidime tested in combination with 4 mg/l clavulanic acid (prepared from Glasco Smith company) versus its MIC when tested alone, confirmed an ESBL-producing organism. The PCR assay consisted of four primer sets. In initial screening test, 117 (69%) from 168 clinical isolates were positive and 51 isolates (31%) were negative. From the positive isolates, 96 isolates were positive in phenotypic confirmatory test. Using molecular assay, 117 strains potentially producing extended-spectrum-β-lactamases were examined for the presence of CTX-M enzymes. 88 strains (75.2%) were positive for blactx-m group І genes, 1 strain (0.85%) was positive for blactx-m group ІІІ genes, and 2 strains (1.7%) were positive for blactx-m group ІV. The prevalence of extended-spectrum β-lactamases (ESBLs) are increasing significantly in hospitals of Tehran. In other side, we found that the CTX-M І group had the most prevalence than other CTX-M groups.

The widespread use of β -lactam antibiotic has lead to the development of resistance to this group of antibiotics in bacterial pathogens due to β -lactamase production. This study was undertaken to determine the AmpC β -lactamase production in pathogens isolated from hospitalized patients at selected university hospitals of Tehran. Non-repeat clinical isolates (154) from clinical specimens of selected hospital were taken. Disk agar diffusion and minimum inhibitory concentration (MIC) with β -lactam antibiotic included Ceftazidim, Ceftriaxon and Cefepim and Clavulanic acid as a β -lactamase inhibitor for detection of extended spectrum β -lactamase (ESBLs) producing organisms w ere done. In addition, the susceptibility of these organisms to Cefoxitin was examined. All isolates were examined by Multiplex PCR method for finding the different kind of gene family encoded AmpC β -lactamases Isolates had divided in three group included of P+, P+C+, P+C- based on ESBLs phenotypic test criteria with 57.15% (n=88), 53.9% (n=83) and 3.25% (n=5) respectively. Isolates that their result became P+C+ and P+C- were selected and the Multiplex PCR for them were done. The results of molecular testing showed that 5.7% of isolates, in the other hand 5 strains of E. coli were positive for AmpC β -lactamase. This is the first report of AmpC β -lactamase producing bacteria from Iran. If the type of β -lactamase produced by the pathogen could be detected along with antibiogram before administrating the β -lactamase drug to the patient therapeutic failure might be avoided. Because of significance of these organisms in produce nosocomial infection and in order to prevent them from spread, we need to more study for showing the actual prevalence of them.