Journal of Archives in Military Medicine Journal of Archives in Military Medicine J Arch Mil Med http://www.jammonline.com 2345-5071 2345-5063 10.5812/jamm en jalali 2017 6 27 gregorian 2017 6 27 3 3
en 10.5812/jamm.28959 A Review of Malaria Prevention and Control in War Areas A Review of Malaria Prevention and Control in War Areas research-article research-article Conclusions

This review paper recognizes and supports the IVM as an efficient method for malaria prevention and control in war areas.

Results

Fifty-five articles, including case reports, research papers, and review studies, were found but only 43 publications met the inclusion criteria. The reviewed publications were categorized into five major groups, viz. transmission, symptoms and diagnosis, chemical control, biological control, and environmental management.

Data Extraction

Information from the obtained studies was reviewed only according to the year of the publication and topics.

Study Selection

Forty-three papers were utilized in this review article. The selected studies were classified according to their relation to malaria, war areas, and vector-control methods.

Data Sources

For this review article, appropriate online databases, including PubMed, Wiley, and ScienceDirect were searched up to November 10th, 2014, using MeSH and free texts. Only English texts comprising research papers, reviews, and reports were included.

Objectives

This study intends to introduce the integrated vector management (IVM) for the control and prevention of malaria in war areas by employing an appropriate combination of environmental management techniques and other conventional methods of vector control.

Context

Soldiers are confronted with a variety of vector-borne threats and diseases during their missions in war areas. Among all threats, malaria holds an important place as a major health problem in tropical or hyperendemic areas. Malaria control in war areas has been deemed one of the most challenging goals of different armies throughout history.

Conclusions

This review paper recognizes and supports the IVM as an efficient method for malaria prevention and control in war areas.

Results

Fifty-five articles, including case reports, research papers, and review studies, were found but only 43 publications met the inclusion criteria. The reviewed publications were categorized into five major groups, viz. transmission, symptoms and diagnosis, chemical control, biological control, and environmental management.

Data Extraction

Information from the obtained studies was reviewed only according to the year of the publication and topics.

Study Selection

Forty-three papers were utilized in this review article. The selected studies were classified according to their relation to malaria, war areas, and vector-control methods.

Data Sources

For this review article, appropriate online databases, including PubMed, Wiley, and ScienceDirect were searched up to November 10th, 2014, using MeSH and free texts. Only English texts comprising research papers, reviews, and reports were included.

Objectives

This study intends to introduce the integrated vector management (IVM) for the control and prevention of malaria in war areas by employing an appropriate combination of environmental management techniques and other conventional methods of vector control.

Context

Soldiers are confronted with a variety of vector-borne threats and diseases during their missions in war areas. Among all threats, malaria holds an important place as a major health problem in tropical or hyperendemic areas. Malaria control in war areas has been deemed one of the most challenging goals of different armies throughout history.

Malaria Vector Control;Malaria Prevention;War Areas Malaria Vector Control;Malaria Prevention;War Areas http://www.jammonline.com/index.php?page=article&article_id=28959 Farshad Najafipour Farshad Najafipour Department of Epidemiology, AJA University of Medical Sciences, Tehran, IR Iran Department of Epidemiology, AJA University of Medical Sciences, Tehran, IR Iran Amir Norozi Amir Norozi Health Insurance Research Center, Armed Forces Insurance Organization, Tehran, IR Iran; Health Insurance Research Center, Armed Forces Insurance Organization, Tehran, IR Iran. Tel: +98-2166733608, Fax: +98-2166726909 Health Insurance Research Center, Armed Forces Insurance Organization, Tehran, IR Iran; Health Insurance Research Center, Armed Forces Insurance Organization, Tehran, IR Iran. Tel: +98-2166733608, Fax: +98-2166726909 Milad Darejeh Milad Darejeh Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, IR Iran Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, IR Iran
en 10.5812/jamm.29653 Importance of Cohort Study in Military Medicine: An International Overview Importance of Cohort Study in Military Medicine: An International Overview letter letter http://www.jammonline.com/index.php?page=article&article_id=29653 Milad Nazarzadeh Milad Nazarzadeh Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, IR Iran; Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, IR Iran. Tel: +98-5144419572, Fax: +98-5144445648 Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, IR Iran; Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, IR Iran. Tel: +98-5144419572, Fax: +98-5144445648
en 10.5812/jamm.30057 Assessment of Consensus-Based Pharmacological Therapies in Irritable Bowel Syndrome Assessment of Consensus-Based Pharmacological Therapies in Irritable Bowel Syndrome review-article review-article Conclusions

There is a need for new drugs in the setting of pharmacological therapy for the IBS. A new medical approach should include both novel and traditional drugs in order to reach to a desirable outcome for patients and improve their quality of life.

Results

The pathophysiology of the IBS has yet to be fully elucidated. Global medical attempts, including pharmacological therapy and herbal remedies, aim at curing and/or subsiding pain, flatulence, diarrhea, and constipation.

Evidence Acquisition

In the present study, data on the IBS were principally collected via Google Scholar and PubMed, followed by articles in journals and libraries.

Context

The irritable bowel syndrome (IBS) is a symptom-based gastrointestinal (GI) disease with the presence of symptoms such as abdominal pain and abnormal intestinal activities. It is a frequent GI problem encountered by physicians. The purpose of this paper was to review and assess some of the current and emerging pharmacological therapies for this syndrome.

Conclusions

There is a need for new drugs in the setting of pharmacological therapy for the IBS. A new medical approach should include both novel and traditional drugs in order to reach to a desirable outcome for patients and improve their quality of life.

Results

The pathophysiology of the IBS has yet to be fully elucidated. Global medical attempts, including pharmacological therapy and herbal remedies, aim at curing and/or subsiding pain, flatulence, diarrhea, and constipation.

Evidence Acquisition

In the present study, data on the IBS were principally collected via Google Scholar and PubMed, followed by articles in journals and libraries.

Context

The irritable bowel syndrome (IBS) is a symptom-based gastrointestinal (GI) disease with the presence of symptoms such as abdominal pain and abnormal intestinal activities. It is a frequent GI problem encountered by physicians. The purpose of this paper was to review and assess some of the current and emerging pharmacological therapies for this syndrome.

Diagnosis;Irritable Bowel Syndrome;Physiopathology;Pharmacotherapy Diagnosis;Irritable Bowel Syndrome;Physiopathology;Pharmacotherapy http://www.jammonline.com/index.php?page=article&article_id=30057 Seyed Reza Abtahi Seyed Reza Abtahi Department of Physiology and Pharmacology, School of Medicine, AJA University of Medical Sciences, Tehran, IR Iran; Department of Physiology and Pharmacology, School of Medicine, AJA University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188337909 Department of Physiology and Pharmacology, School of Medicine, AJA University of Medical Sciences, Tehran, IR Iran; Department of Physiology and Pharmacology, School of Medicine, AJA University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188337909 Parvin Zareian Parvin Zareian Department of Physiology and Pharmacology, School of Medicine, AJA University of Medical Sciences, Tehran, IR Iran Department of Physiology and Pharmacology, School of Medicine, AJA University of Medical Sciences, Tehran, IR Iran
en 10.5812/jamm.28306 The Effect of Low- Intensity Resistance Training with Blood Flow Restriction on Serum Cortisol and Testosterone Levels in Young Men The Effect of Low- Intensity Resistance Training with Blood Flow Restriction on Serum Cortisol and Testosterone Levels in Young Men research-article research-article Conclusions

Short term blood flow restriction (BFR) exercise stimulates cortisol hormones production in young men. However, this program seems too short to express any difference in testosterone change. Generally, it can be concluded that low-intensity resistance training can increase short-term BFR catabolic-anabolic hormones in young men.

Results

Serum cortisol level significantly increased after the exercise for both protocols compared to baseline (P < 0.05). After 3 weeks, serum cortisol level increased significantly in LIBFR and HIWBFR groups compared to control group (P < 0.001). At the end of the exercise protocols, serum testosterone level was higher in LIBFR group compared to HIWBFR group; however, this difference was not significant (P ˃ 0.49).

Patients and Methods

A total of 30 healthy young men (aged 19 - 24 years) were volunteered for this study. Subjects were randomly assigned into three groups: low-intensity blood flow restricted (LIBFR) (n = 15) resistance exercise group (3 sets of 15 repetitions at 20% of 1RM (one repetition maximum)), traditional high-intensity without blood flow restriction (HIWBFR) (n = 12) resistance exercise group (3 sets of 10 repetitions at 80% of 1RM), and a control group (n = 13). Both LIBFR and HIWBFR groups trained for front leg and squat exercises 3 days per week for 3 weeks. Fasting growth hormone cortisol and testosterone levels were measured in the morning before and after exercise sessions. Data were analyzed with paired t-test and One-way ANOVA at the significant level of P < 0.05.

Background

Based on the research evidence, the efficiency of resistance exercises depends on the changes in the hormones level to improve the muscle strength and mass.

Objectives

This study aimed to investigate the effect of a short course blood flow restricted resistance training on serum cortisol and testosterone levels in young men.

Conclusions

Short term blood flow restriction (BFR) exercise stimulates cortisol hormones production in young men. However, this program seems too short to express any difference in testosterone change. Generally, it can be concluded that low-intensity resistance training can increase short-term BFR catabolic-anabolic hormones in young men.

Results

Serum cortisol level significantly increased after the exercise for both protocols compared to baseline (P < 0.05). After 3 weeks, serum cortisol level increased significantly in LIBFR and HIWBFR groups compared to control group (P < 0.001). At the end of the exercise protocols, serum testosterone level was higher in LIBFR group compared to HIWBFR group; however, this difference was not significant (P ˃ 0.49).

Patients and Methods

A total of 30 healthy young men (aged 19 - 24 years) were volunteered for this study. Subjects were randomly assigned into three groups: low-intensity blood flow restricted (LIBFR) (n = 15) resistance exercise group (3 sets of 15 repetitions at 20% of 1RM (one repetition maximum)), traditional high-intensity without blood flow restriction (HIWBFR) (n = 12) resistance exercise group (3 sets of 10 repetitions at 80% of 1RM), and a control group (n = 13). Both LIBFR and HIWBFR groups trained for front leg and squat exercises 3 days per week for 3 weeks. Fasting growth hormone cortisol and testosterone levels were measured in the morning before and after exercise sessions. Data were analyzed with paired t-test and One-way ANOVA at the significant level of P < 0.05.

Background

Based on the research evidence, the efficiency of resistance exercises depends on the changes in the hormones level to improve the muscle strength and mass.

Objectives

This study aimed to investigate the effect of a short course blood flow restricted resistance training on serum cortisol and testosterone levels in young men.

Resistance Training;Cortisol;Blood Flow Restriction;Testosteron Resistance Training;Cortisol;Blood Flow Restriction;Testosteron http://www.jammonline.com/index.php?page=article&article_id=28306 Shahram Mohamadi Shahram Mohamadi Department of Sport Physiology, Faculty of Physical Education, Shahrood University, Shahrood, IR Iran; Department of Sport Physiology, Faculty of Physical Education, Shahrood University, Shahrood, IR Iran. Tel: +98-9187833088 Department of Sport Physiology, Faculty of Physical Education, Shahrood University, Shahrood, IR Iran; Department of Sport Physiology, Faculty of Physical Education, Shahrood University, Shahrood, IR Iran. Tel: +98-9187833088 Alireza Khoshdel Alireza Khoshdel Department of Epidemiology, AJA University of Medical Sciences, Tehran, IR Iran Department of Epidemiology, AJA University of Medical Sciences, Tehran, IR Iran Faezeh Naserkhani Faezeh Naserkhani Department of Sport Physiology, Faculty of Physical Education, Shahrood University, Shahrood, IR Iran Department of Sport Physiology, Faculty of Physical Education, Shahrood University, Shahrood, IR Iran Rahimeh Mehdizadeh Rahimeh Mehdizadeh Department of Sport Physiology, Faculty of Physical Education, Shahrood University, Shahrood, IR Iran Department of Sport Physiology, Faculty of Physical Education, Shahrood University, Shahrood, IR Iran
en 10.5812/jamm.28205 Economic Inequality and Infant, Under-5-Year-Old, Maternal, and Crude Mortality Rates Economic Inequality and Infant, Under-5-Year-Old, Maternal, and Crude Mortality Rates research-article research-article Conclusions

Per capita GDP, GNI, and per capita health expenditure played a significant role in creating disparities. Since per capita GDP and GNI are less variable, an increase in health expenditure can reduce inequality in mortality rates.

Results

The results showed that poorer countries had higher rates of infant, under-5-year-old, and maternal mortality. Among the economic indicators, per capita health expenditure, per capita GDP, and GNI had an important role in creating disparities, whereas the out-of-pocket index had no impact.

Patients and Methods

In this ecological study, data on 196 countries were obtained from the World Bank to assess the relation between economic inequality and mortality in 2013. Per capita gross domestic product (GDP), gross national income (GNI), out-of-pocket index, and per capita health expenditure were extracted as economic variables. Data analysis was performed using STATA, version 12.

Objectives

We sought to evaluate the association between economic inequality and infant, under-5-year-old, maternal, and crude mortality rates in the world.

Background

Mortality indices are among the most important health indicators in every country. On the other hand, mortality has an unequal distribution in different socioeconomic levels.

Conclusions

Per capita GDP, GNI, and per capita health expenditure played a significant role in creating disparities. Since per capita GDP and GNI are less variable, an increase in health expenditure can reduce inequality in mortality rates.

Results

The results showed that poorer countries had higher rates of infant, under-5-year-old, and maternal mortality. Among the economic indicators, per capita health expenditure, per capita GDP, and GNI had an important role in creating disparities, whereas the out-of-pocket index had no impact.

Patients and Methods

In this ecological study, data on 196 countries were obtained from the World Bank to assess the relation between economic inequality and mortality in 2013. Per capita gross domestic product (GDP), gross national income (GNI), out-of-pocket index, and per capita health expenditure were extracted as economic variables. Data analysis was performed using STATA, version 12.

Objectives

We sought to evaluate the association between economic inequality and infant, under-5-year-old, maternal, and crude mortality rates in the world.

Background

Mortality indices are among the most important health indicators in every country. On the other hand, mortality has an unequal distribution in different socioeconomic levels.

Socioeconomic Factors;Infant Mortality;Maternal Mortality;Child Mortality Socioeconomic Factors;Infant Mortality;Maternal Mortality;Child Mortality http://www.jammonline.com/index.php?page=article&article_id=28205 Amir Almasi Hashiani Amir Almasi Hashiani Department of Epidemiology and Biostatistics, School of Health, Arak University of Medical Sciences, Arak, IR Iran Department of Epidemiology and Biostatistics, School of Health, Arak University of Medical Sciences, Arak, IR Iran Erfan Ayubi Erfan Ayubi Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Noushin Fahimfar Noushin Fahimfar Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Ahmad Khosravi Ahmad Khosravi Center for Health-Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, IR Iran Center for Health-Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, IR Iran Nahid Karamzad Nahid Karamzad Nutrition Research Center, Department of Community Nutrition, School of Nutrition, Tabriz University of Medical Sciences, Tabriz, IR Iran Nutrition Research Center, Department of Community Nutrition, School of Nutrition, Tabriz University of Medical Sciences, Tabriz, IR Iran Saeid Safiri Saeid Safiri Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, IR Iran; Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, IR Iran. Tel/Fax: +98-413337374 Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, IR Iran; Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, IR Iran. Tel/Fax: +98-413337374
en 10.5812/jamm.30745 Iran Virtual Screening (IranVScreen): An Integrated Virtual Screening Interface Iran Virtual Screening (IranVScreen): An Integrated Virtual Screening Interface research-article research-article Results

The GUI provides the required data to other modules and displays the results to the user.

Conclusions

These results describe that IranVScreen provides a very intuitive all-in-one GUI to carry out multiple VS tasks in several mouse clicks with minimal requirement of skill. This software localized in Persian language surpasses the language barrier for novice users.

Materials and Methods

The software was developed using Microsoft’s Visual Studio 2012 in visual basic and C++. It integrates Open Babel and Autodock Vina platforms. The software includes an easy to use Persian localized GUI. IranVScreen is composed of three application layers: application layer, class interface layer and software entity layer. Application layer consists of three functional nodes. The software entity layer includes the external tools.

Objectives

In the present study, we have developed a VS software: IranVScreen, which is an easily operable tool for medicinal chemists and pharmacologists to carry out multiple practical virtual screening tasks.

Background

Virtual screening (VS), as a computational technique, is being used widely in drug discovery research. One of the widely used VS methods is based on the docking of every ligand structure in a specific macromolecule. Multiple popular VS tools do not provide a graphic user interface (GUI).

Results

The GUI provides the required data to other modules and displays the results to the user.

Conclusions

These results describe that IranVScreen provides a very intuitive all-in-one GUI to carry out multiple VS tasks in several mouse clicks with minimal requirement of skill. This software localized in Persian language surpasses the language barrier for novice users.

Materials and Methods

The software was developed using Microsoft’s Visual Studio 2012 in visual basic and C++. It integrates Open Babel and Autodock Vina platforms. The software includes an easy to use Persian localized GUI. IranVScreen is composed of three application layers: application layer, class interface layer and software entity layer. Application layer consists of three functional nodes. The software entity layer includes the external tools.

Objectives

In the present study, we have developed a VS software: IranVScreen, which is an easily operable tool for medicinal chemists and pharmacologists to carry out multiple practical virtual screening tasks.

Background

Virtual screening (VS), as a computational technique, is being used widely in drug discovery research. One of the widely used VS methods is based on the docking of every ligand structure in a specific macromolecule. Multiple popular VS tools do not provide a graphic user interface (GUI).

Software;Computational Intelligence;Mass Screening Software;Computational Intelligence;Mass Screening http://www.jammonline.com/index.php?page=article&article_id=30745 Majid Jafari Sabet Majid Jafari Sabet Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran; Razi Drug Research Center, Iran University of Medical Sciences, Tehran, IR Iran; Department of Pharmacology, AJA University of Medical Sciences, Tehran, IR Iran; Department of Physiology, AJA University of Medical Sciences, Tehran, IR Iran; Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2186703120 Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran; Razi Drug Research Center, Iran University of Medical Sciences, Tehran, IR Iran; Department of Pharmacology, AJA University of Medical Sciences, Tehran, IR Iran; Department of Physiology, AJA University of Medical Sciences, Tehran, IR Iran; Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2186703120 Ali Baratian Ali Baratian Department of Pharmacology, AJA University of Medical Sciences, Tehran, IR Iran; Department of Physiology, AJA University of Medical Sciences, Tehran, IR Iran Department of Pharmacology, AJA University of Medical Sciences, Tehran, IR Iran; Department of Physiology, AJA University of Medical Sciences, Tehran, IR Iran Mohammad Habibi Mohammad Habibi Department of Pharmacology, AJA University of Medical Sciences, Tehran, IR Iran; Department of Physiology, AJA University of Medical Sciences, Tehran, IR Iran Department of Pharmacology, AJA University of Medical Sciences, Tehran, IR Iran; Department of Physiology, AJA University of Medical Sciences, Tehran, IR Iran Farzin Hadizadeh Farzin Hadizadeh Department of Medicinal Chemistry, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, IR Iran Department of Medicinal Chemistry, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, IR Iran
en 10.5812/jamm.27862 Antibiotics Use Patterns in Intensive Care Units of Five Hospitals in Tehran During 2011 - 2012 Antibiotics Use Patterns in Intensive Care Units of Five Hospitals in Tehran During 2011 - 2012 research-article research-article Conclusions

Use of antibiotics was higher than expected in the studied ICU wards and the antibiotics use pattern was different from other countries. This problem should be addressed to correct the use pattern of antibiotics in ICUs. Implementation of antibiotic use and microbial resistance monitoring programs, continuous medical education for physicians and compilation of clinical practice guidelines and protocols could be effective in reduction of antibiotic use in hospitals.

Results

Antibiotic use in ICU2 ward of hospital C was significantly higher than hospitals A, D, E and ICU-Open Heart (ICUOH) of hospital C (P value ≤ 0.001). Use of antibiotic in ICU1 ward of hospital C was also higher significantly compared to hospitals D, E and ICUOH of hospital C (P value ≤ 0.001). Drug use 90% profile of hospitals’ ICUs showed that Beta-lactams, Cephalosporin and Vancomycin were the most antibiotics used in these wards.

Materials and Methods

This observational cross-sectional research aimed to evaluate antibiotic use patterns in ICUs of five hospitals in Tehran, Iran. Retrospectively, data related to antibiotic consumption in ICUs of five Military General Hospitals were collected from 20 March 2011 to 20 March 2012. The Anatomical Therapeutic Chemical classification system and the Defined Daily Dose used to evaluate consumption of antibiotics and drug use 90% was determined for all ICUs antibiotic consumption. Data was analyzed by SPSS software version 16 using one way ANOVA and Tukey post hoc tests to compare antibiotic consumption in ICUs between different hospitals.

Objectives

In this study, we aimed to evaluate antibiotics use pattern in ICUs of five hospitals in Tehran, Iran.

Background

Inappropriate use of antibiotics is one the most important challenges for health systems. In the hospital setting, intensive care unit (ICU) is a unique place in generating antibiotic-resistant pathogens. Irrational use of antibiotics is one of the main reasons of increasing the resistance of pathogens.

Conclusions

Use of antibiotics was higher than expected in the studied ICU wards and the antibiotics use pattern was different from other countries. This problem should be addressed to correct the use pattern of antibiotics in ICUs. Implementation of antibiotic use and microbial resistance monitoring programs, continuous medical education for physicians and compilation of clinical practice guidelines and protocols could be effective in reduction of antibiotic use in hospitals.

Results

Antibiotic use in ICU2 ward of hospital C was significantly higher than hospitals A, D, E and ICU-Open Heart (ICUOH) of hospital C (P value ≤ 0.001). Use of antibiotic in ICU1 ward of hospital C was also higher significantly compared to hospitals D, E and ICUOH of hospital C (P value ≤ 0.001). Drug use 90% profile of hospitals’ ICUs showed that Beta-lactams, Cephalosporin and Vancomycin were the most antibiotics used in these wards.

Materials and Methods

This observational cross-sectional research aimed to evaluate antibiotic use patterns in ICUs of five hospitals in Tehran, Iran. Retrospectively, data related to antibiotic consumption in ICUs of five Military General Hospitals were collected from 20 March 2011 to 20 March 2012. The Anatomical Therapeutic Chemical classification system and the Defined Daily Dose used to evaluate consumption of antibiotics and drug use 90% was determined for all ICUs antibiotic consumption. Data was analyzed by SPSS software version 16 using one way ANOVA and Tukey post hoc tests to compare antibiotic consumption in ICUs between different hospitals.

Objectives

In this study, we aimed to evaluate antibiotics use pattern in ICUs of five hospitals in Tehran, Iran.

Background

Inappropriate use of antibiotics is one the most important challenges for health systems. In the hospital setting, intensive care unit (ICU) is a unique place in generating antibiotic-resistant pathogens. Irrational use of antibiotics is one of the main reasons of increasing the resistance of pathogens.

Intensive Care Units;Antibiotics;Hospital Intensive Care Units;Antibiotics;Hospital http://www.jammonline.com/index.php?page=article&article_id=27862 Omid Adeli Omid Adeli Fajr Hospital, AJA University of Medical Sciences, Tehran, IR Iran Fajr Hospital, AJA University of Medical Sciences, Tehran, IR Iran Nader Markazi Moghaddam Nader Markazi Moghaddam Department of Public Health, School of Medicine, AJA University of Medical Sciences, Tehran, IR Iran; Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Department of Public Health, School of Medicine, AJA University of Medical Sciences, Tehran, IR Iran; Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Ramin Hamidi Farahani Ramin Hamidi Farahani Department of Infectious Diseases, School of Medicine, AJA University of Medical Sciences, Tehran, IR Iran Department of Infectious Diseases, School of Medicine, AJA University of Medical Sciences, Tehran, IR Iran Sanaz Zargar Balaye Jame Sanaz Zargar Balaye Jame Department of Public Health, School of Medicine, AJA University of Medical Sciences, Tehran, IR Iran; Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Public Health, School of Medicine, AJA University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188989129 Department of Public Health, School of Medicine, AJA University of Medical Sciences, Tehran, IR Iran; Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Public Health, School of Medicine, AJA University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188989129