Background: Stress ulcers are common in mechanically ventilated patients. They are the most common cause of gastrointestinal bleeding and are primarily associated with increased the consumption of non-steroidal anti-inflammatory drugs. Despite advanced treatment, it has a high in-hospital mortality rate. This study assessed the effect of fenugreek (Trigonella foenum-graceum L.) seeds on gastrointestinal bleeding in mechanically ventilated patients.Methods: In this double-blind, randomized controlled clinical trial, 60 mechanically ventilated patients hospitalized in intensive care units were equally distributed into intervention and control groups. The intervention group received 3 mg fenugreek seeds powder twice daily with a gavage solution for five days, in addition to routine treatment. The control group received only the gavage solution and routine treatment. The gastrointestinal bleeding and abdominal pain at admission and during the five days were assessed. Data were analyzed using SPSS software V. 16, and the significance level was set at 0.05. Results: Gastrointestinal bleeding at admission was similar in both groups. The number of mechanically ventilated patients with gastrointestinal bleeding decreased on the third, fourth, and fifth days, but the difference was insignificant. The Cochran test results showed that the rate of stress-induced gastroin-testinal bleeding in the control group increased significantly (P =.04). The decrease in gastrointestinal bleeding in the intervention group was not statistically significant (P=.08). Conclusion: The use of this drug reduces the gastrointestinal side effects of ventilated patient. Despite this, reducing gastrointestinal bleeding and similar mechanical ventilation complications in patients entirely dependent on the treating team is an important achievement.

Objective: To check biofilm formation by Acinetobacter baumannii (A. baumannii) clinical isolates and show their susceptibility to different antibiotics and investigate a possible link between establishment of biofilm and multidrug resistance. Methods: This study was performed on clinical samples collected from patients with nosocomial infections in three hospitals of Tehran. Samples were initially screened by culture and biochemical tests for the presence of different species of Acinetobacter. Identifications were further confirmed by PCR assays. Their susceptibilities to 11 antibiotics of different classes were determined by disc diffusion method according to Clinical and Laboratory Standards Institute guidelines. The ability to produce biofilm was investigated using methods: culture on Congo red agar, microtiter plate, and test tube method. Results: From the overall clinical samples, 156 specimens were confirmed to contain A. baumannii. The bacteria were highly resistant to most antibiotics except polymyxin B. Of these isolates, 10.26% were able to produce biofilms as shown on Congo red agar. However, the percentage of bacteria with positive biofilm in test tube, standard microtiter plate, and modified microtiter plate assays were 48.72%, 66.66%, and 73.72%, respectively. At least 92% of the biofilm forming isolates were multidrug resistant. Conclusions: Since most of the multidrug resistant strains produce biofilm, it seems necessary to provide continuous monitoring and determination of antibiotic susceptibility of clinical A. baumannii. This would help to select the most appropriate antibiotic for treatment.