[Identification of Leishmania using microscopic and molecular methods in suspected patients of cutaneous leishmaniasis by targeting ITS-rDNA gene, Golestan province, Iran (2009-10)]

Zoonotic Cutaneous Leishmaniasis [ZCL] is a parasitic disease which caused by a protozoan belongs to the genus Leishmania. ZCL is of great public health importance in many countries and also in endemic parts of Iran. Leishmania major is the causative agent, Phlebotomus papatasi as the main vector and Rhombomys opimus is the most important reservoir of the disease. Species identification of Leishmania in a large scale of human samples is necessary to conduct a useful program for controlling the disease outspread. This study was done to identify the Leishmania using microscopic and molecular methods in suspected patients of Cutaneous Leishmaniasis by targeting ITS-rDNA gene, Golestan province, Iran. 121 smears collected from suspected patients of ZCL, in Eastern region of Golestan province, Iran during 2009-10, stained and examined under a light microscope. DNA of parasites extracted directly from smears and ITS-rDNA gene amplified. Positive samples digested with BsuRI restriction enzyme, according to RFLP method and subsequently the parasite was identified. After sequencing the ITS-rDNA gene, Molecular software was applied for verification of RFLP results. The achieved results were definitely approved by this procedure. 113 out of 121 and 92 out of 121 samples detected as Leishmania positive using microscopic examination and molecular method respectively. All 92 molecular positive samples digested with BsuRI endonuclease and 90 individuals identified as Leishmania major. In order to final verification, 8 samples of Leishmania major sequenced and confirmed by molecular software analysis. Unfortunately, sequences of two samples which were not Leishmania major were not readable, and consequently, these could not be identified. Comparison of obtained sequences of current study with Gene Bank sequences confirmed L.major in human from Northern Iran. Other species of Leishmania were not identified in this investigation but detection of two other samples, which were not L.major, could indicate the role of other Leishmania species causing infection in human in Eastern region of Golestan province, northern Iran. These findings should be considered to improve the disease control programs, which can be led to increase the rate of public health in Golestan province

[Using lms method in smoothing reference centile curves for lipid profile of iranian children and adolescents: a caspian study]

LMS is a general monitoring method for fitting smooth reference centile curves in medical sciences. They provide the distribution of a measurement as it changes according to some covariates like age or time. This method describes the distribution of changes by three parameters; Mean, Coefficient of variation and Cox-Box power [skewness]. Applying maximum penalized likelihood and spline function, the three curves are estimated and fitted and optimum smoothness is expressed by three curves. This study was conducted to provide the percentiles of lipid profile of Iranian children and adolescents by LMS. Smoothed reference centile curves of four groups of lipids [triglycerides, total-LDL- and HDL-cholesterol] were developed from the data of 4824 Iranian school students, aged 6-18 years, living in six cities [Tabriz, Rasht, Gorgan, Mashad, Yazd and Tehran-Firouzkouh] in Iran. Demographic and laboratory data were taken from the national study of the surveillance and prevention of non-communicable diseases from childhood [CASPIAN Study]. After data management, data of 4824 students were included in the statistical analysis, which was conducted by the modified LMS method proposed by Cole. The curves were developed with a degree of freedom of four to ten with some tools such as deviance, Q tests, and detrended Q-Q plot were used for monitoring goodness of fit models. All tools confirmed the model, and the LMS method was used as an appropriate method in smoothing reference centile. This method revealed the distributing features of variables serving as an objective tool to determine their relative importance. This study showed that the triglycerides level is higher and HDL-C level is lower in Iranian children and adolescents than their counterparts in Western countries. Future studies with larger sample size and with higher density at the end points and equal distribution of measurements in changing limits of covariates would hopefully reach more precise findings

[ frequency of cryptosporidiosis among gastroenteritic patients in western cities of Mazandaran Province [2007-2009][

Gastroenteritis is caused by parasitic and non-parasitic microorganisms. Cryptosporidiosis is one of the parasitic diseases leading to acute or chronic gastroenteritis caused by Cryptosporidium spp. Self-limiting gastroenteritis is observed in immunocompetent individuals, but in immunocompromised patients it causes a sever disease. High humidity, ecological conditions, water supplies, domestic and industrial animal husbandry and the rate of raining have made the Mazandaran regions as a province for transmission of parasites. The objective of this study was to determine the frequency of cryptosporidiosis among gastroenteritic patients in western cities of Mazandaran Province, during 2007-2009. This analytical study was conducted in cities of Chalus, Tonekabon, and Ramsar located in west Mazandaran province, northern Iran. Stool samples from patients with gastroenteritis and healthy individuals were collected, fixed and examined by direct method [DM] for the diagnosis of enteropathogenic and non-pathogenic parasites; acid-fast staining [AFS] and auramine phenol fluorescence [APF] for detection of Cryptosporidium oocysts and analysed using ANOVA and t-ests. The mean prevalence rate of parasitic infections in three cities was 2.38% with the highest rate of infection associated with Giardia lamblia [1.43%], Blastocystis hominis [0.71%], and Entamoeba coli [0.24%], respectively. No Cryptospordium sp. was observed among the test and control groups. Based on our data, a low rate of parasitic infection and also an absence of cryptospordiosis, compared to the previous studies, in western part of Mazandaran province were established. This may be associated with improvements in public health education, water treatment environmental sanitation, and low animal contacts during recent years

[Evaluation of Vibrio cholera distribution and its relation to the affected patients in different parts of Qom city]

True cholera with typical clinical features nearly always occurs by serologic groups O1 and O139 but the non-O1 group can produce a disease with same clinical characteristic sporadically. According to the important of climate and environmental conditions in the distribution and abundance of Vibrio cholera, in this study, the distribution of the serologic group was evaluated in different parts of Qom city with relation to the affected patients. In this study 5220 environmental specimens were taken from 12 parts of Qom city and during different seasons of the year 1325, 60 clinical specimens were taken from the patients and all were evaluated for Vibrio cholera with standard methods. The study was of Descriptive and cross sectional and the results were analyzed with statistical soft ware [Epi-info]. The most abundance of Nag strains were related to Emamzadeh Ebrahim and Sheikhabad parts and Shahed Street from Khak faraj and Niroogah area and the least abundance were related to Salariyeh area. The abundance distribution of Nag strain, 7 different specimens was most in hogwash, sewerage and vegetables and least in pipe water which reveal a significant difference [P< 0.05] according to statistical goodness of fit test. The frequency distribution of the patients in each part of area 4 with relevance to sex revealed that the most contamination percentage was attributed to Emamzadeh Ebrahim and Sheikhabad and Shahed from Niroogah area and no positive specimen was taken from Haftado-do-tan and Shahrdary areas. According to high occurrence of the disease in same areas, and results from other researchers based on increased frequency of non-O1 strains in the environment during the epidemic, so can release a connection between Vibrio cholera O1 strains and non-O1 strains to conclude. On the other hand, none of the clinical and environmental samples, Vibrio cholera O1 was isolated, so probably human carriers in Qom, not the main factor is the emergence of this disease

Molecular diagnosis of trichomoniasis in negative samples examined by direct smear and culture

Trichomoniasis is an extremely common sexually transmitted infection [STI] worldwide and is associated with important public health problems, including amplification of HIV transmission. This disease is in forms of symptomatic and asymptomatic in women and may depend on host as well as parasite variables. Most of the studies reported from females are based on examination of vaginal secretions and urine samples by direct smear and culture in modified Diamond's media. The aim of this study was checking the samples, which were negatively by direct smear and culture, with PCR technique. The urine samples and vaginal discharge of patients attending Gynecology Clinics of Mazandaran Province, Iran with different symptoms rechecked for Trichomonas vaginalis by PCR technique using primers targeting a conserved region of the beta-tubulin genes of the parasite. Data were analyzed by Epi Info software program. Out of 161 negative samples by direct smear and culture, seven samples [4.3%] were positive by PCR technique. Diagnosis of trichomoniasis by PCR is a sensitive and specific method that could play important role to help the physicians for properly treatment and control of infection

Nationwide report on the findings of integrated school health screening program in Iran

Screening of students' health problems could lead to timely prevention and control of many health disorders. This study aimed to determine the nationwide prevalence of common disorders through school health screening program in Iran. This cross-sectional national screening program was conducted in 2007-2008 among first-and third-grade-students in primary schools, first-grade-students of middle and high schools of all provinces in Iran. Data were obtained from 3,124,021 [81.9%] students reported from the whole country classified into 33 geographical zones. Of total students studied, 12.48% had weight abnormalities, 4.77% had visual disorders, 3.95% had head lice, 2.24% had behavioral disorders, and 0.6% had hearing disorders. Among students studied, 0.4%, 0.7%, 0.4% and0.8% had endocrine, psychological, neurological and genitourinary disorders, respectively. In addition, 2.1%, 1.9%, 1.8%, 0.8%0.5%, 0.3% and 0.3% of students had ear, nose and pharynx disorder, anemia, skin and hair, cardiac, abdominal, vertebral and lung problems, respectively. In elementary schools, 57.6% of first-grade-students with at least one disorder were managed in outpatient settings and 6% of them were hospitalized for more investigation. Among third-grade-students of elementary schools, these values corresponded to 13.2% and 1.1%, respectively. Among first grade students of middle and high schools, this prevalence was 58.5% and 44.6% and 1.2% and 0.3% of students were hospitalized for more investigation. This integrated school screening program revealed a considerably high prevalence of health disorders among school students. These results might help health policy makers to design future health promoting programs

Trichomoniasis in asymptomatic patients

Trichomoniasis is an extremely common infection worldwide and is associated with important public health problems, including amplification of HIV transmission. This disease is in forms of symptomatic and asymptomatic in women and may depend on host as well as parasite variables. Thus the aim of this study was to evaluate the patients attending gynecology clinic with different symptoms and checked them for Trichomonas vaginalis infection. The vaginal secretion and urine samples of the patients attending gynecology clinic, Imam Reza Hospital, Amol City, were checked by direct smear and cultured in TYI-S-33 culture media. Out of 853 samples collected, 8[0.9%] were positive for T. vaginalis and the number of asymptomatic patients for trichomoniasis were 1.3 times more than infected samples belong to symptomatic ones. Per speculum examination revealed that 75% of T. vaginalis positive subjects had normal appearance of vagina and cervix. According to the epidemiological aspects, these asymptomatic patients are very important as healthy carriers, and T. vaginalis infections are commonly associated with other STDs and are a marker of high-risk sexual behavior. Thus laboratories could play important role for diagnosis of infection and help the physicians for proper treatment

[Contamination rate of trichomonas vaginalis in females referring to Taamin Ejtemayi hospitals in Hamedan in 2005]

Trichomoniasis is a protozoan infection in lower urinary reproductive tract in males and females. It usually takes place in the fertility period in women and is transmitted through sexual inter course. To do this experiment, many females, referring to Taamin Ejtemayi hospital in Hamedan in 2005, were sampled among females for yearly cancer -test and smear, and then educated people under the supervision of the researchers examined the samples. In this study 400 females were selected in an improbable way and through simple sampling in the second half of 2005, and were examined by wet mount and culture procedure. Meanwhile, a questionnaire including questions pertaining to personal, social and hygienical status was administered and analyzed, using Epi 2000 statistical software. On prevalence rates, using wet mount and culture procedure were 2% and 3% respectively, and it was found that the highest percent of infection belonged to people aged 26-35, furthermore, rural areas were more infected than urban areas, however, it was not significant statistically. Among the women in the childbearing age, there was no statistically significant difference in terms of education and profession. It was also found that the number of pregnancies had no effect of on the rate of infection but using intravaginal contraceptive devices can increase the rate of infection. In this study, it was found that the prevalence rate in culture procedure is 1% more than direct procedure and that this procedure is more sensitive than direct procedure. Since proper diagnosis is the basis for correct treatment, it is recommended to use a culture procedure in cases, which a direct procedure turns out to be negative

[Evaluation the immunogenesity structure of HIV recombinant protein gp41-p24]

HIV recombinant proteins can be used as immunogen and inducer of immune system. The gag and env proteins are among the most important ones that are located on internal and surface sections, respectively. In this study, we considered the immunogenisity structure of HIV recombinant protein gp41-p24, which has not yet been studied in detail before. In the present study, the HIV recombinant protein gp41-p24 was prepared by cloning methods and kept as unfolded. Using the dilution procedure, unfolded protein was changed to refolded state. The molecular weight and concentration of protein [refolded and unfolded] was measured by electrophoresis and spectrophotometer methods. The measurement of refolded protein can be estimated by native gel and circular dichroism method [CD] based on secondary structure of the protein. Immunological activity and immunogenic structure of these two proteins, based on protein type and optical density was recorded by ELISA and western blot methods. Our results showed that molecular weight of each protein was 32 KD and also they were pure. The refolded protein was observed by native gel method. In the above protein compared with the unfolded one, increased content of helix and beta strand structures and decreased random form was shown. Immune reaction with the antibodies in the serum of HIV positive control patients was observed in the standard and refolded proteins. There was no significant difference based on the protein type. Our research indicated that the HIV recombinant protein gp41-p24, after refolding, has immunogenic activity and we suggest its application as an immunogen in immunization and stimulation of immune system

Evaluation of antibiotic resistant-Staphylococcous aureus in the operation room, Golpayegani Hospital, Qum

Staph aureus continues to be a major cause of community-acquired and health-care related infection worldwide. The emergence of high levels penicillin resistance Staph followed by the development and spread of strains resistant to the semi synthetic penicillin's has made the therapy of staphylococcal disease a global challenge. At present, vancomycin- intermediate and resistant Staph aureus has been spreading in some hospitals. The purpose of the present study was to determine the distribution of S. aureus at various sites of eye surgery room in pre and post operation and its antibiotic sensitivity at Golpayegani hospital. Common antibiotic against S. aureus used for antibiotic testing. The determination of MIC was performed with the agar dilution method according to the procedure outlined by NCCLS. This study was descriptive and was performed in Golpayegani hospital of Qum during the first semester of 2005. The statistical analysis was done by using T and paired T- Test. The frequency of Staph aureus was lower in preoperative setting during the Spring and Summer seasons. In preoperative sampling, most of the Staph aureus were isolated from broom and floor, while in postoperative sampling, most of the isolates were from broom, floor and anesthetic mask. All of the isolates revealed a totally different antimicrobial susceptibility pattern so that all of the isolates were susceptible to Vancomycin and Methicilin, however, postoperative isolates showed resistance to Carboxycilin, Tetracyclin, Cephazolin and Penicillin. According to the higher frequency of antimicrobial resistant isolates during warm months, probably insufficient disinfectant technique and temperature may play a major role in bacterial resistance. Thus, for effective removal of all bacteria, immediate application of antiseptic agents after surgery is recommended

[Prevalence of fungal infections among wrestlers in Tehran]

The management of skin infections in wrestlers and other athletes in sports involving skin-to-skin contact is challenging, from making an accurate diagnosis to determining eligibility for play. In recent years, skin diseases in wrestling have finally received the attention it deserves. Tinea corporis gladiatorum, caused most frequently by triclophyton tonsurans, infect wrestlers at alarming rates. To control the outbreak, we conducted an epidemiologic investigation. The purpose of this study is to determine the prevalence of tinea corporis gladiatorum in wrestlers club in Tehran. A study of dermatophytosis among wrestlers was carried out during March 2004 to December 2005 in 612 mycologically proven cases of dermatophytosis in wrestlers in Tehran. The wrestler mycologically examination consisting of direct microscopic observation and culture of pathologic material. Diagnosis was based on the macro-and microscopic characteristics of the colonies. Trichophyton tonsurans was the predominant dermatophyte, accounting for 92.6% of all tinea corporis gladiatorum isolates in each of the 2 years analyzed. Tinea corporis gladiatorum was found to be more frequent in 10-20 [72.7%] and follow 21-30 [22.4%] age groups. The wrestlers with tinea corporis gladiatorum were mostly from wrestler clubs in south and southeast of Tehran. Transmission of tinea corporis is primarily through skin-to- skin contact. Practicing wrestling can lead to direct and indirect exposures to transmission of dermatophytes. The rapid identification and treatment of tinea corporis gladiatorum is vital to minimize disruption in team practices and competition, are paramount. Since infection with dermatophytes can disqualify a wrestler from competing in matches, vigilant surveillance and rapid initiation of therapy can reduce the suspension of a team's practice and competition

Typhoid fever: an epidemiologic survey of suspected cases referred to diagnostic laboratories in Rasht, 2002-2003

Typhoid fever has been endemic in Iran throughout its history. This Study was conducted in response to the rising number of cases reported from Rasht [capital of Gilan province in northern Iran]. we performed a descriptive study on 2031 suspected cases referred to city's diagnostic laboratories in 2002 and 2003. A [definite] diagnosis was defined as Vidal test titers rising 80-fold or more over a period of one week, or a positive bacteriologic test. We completed questionnaires for the definite cases, and used the EPI-INFO computer package to analyze the data. The serologic prevalence was 3.94%, and 25% of the seropositive individuals had positive bacterial cultures. The geometric mean of the reciprocal titers [GMRT] was 1: 1 80. The prevalence was the same in both sexes and among all age groups. Factors showing a statistically significant relationship with prevalence include occupation [the greatest frequency was seen in housewives], education level, place of residence, and source of drinking water. We conclude that high prevalence rates coupled with the ecological conditions in this area could favor the occurrence of salmonellosis outbreaks: the issue requires more extensive research for further clarification

Comparison of validity of microlymphocytotoxicity and flow cytometry methods with PCR for HLA-B27 antigen typing

The Human Major Histocompatibility Complex [MHC] plays a crucial role in transplantation, transfusion, paternity test and assessment of susceptibility to some diseases associated with HLA-B27. Three of the most fashionable methods for determination of HLA antigens in clinical and research laboratories are microlymphocytotoxicity [MLCT], flowcytometry and polymerase chain reaction [PCR].The purpose of this study was to compare the sensitivity, specificity, and positive and negative predictive values of MLCT and flowcytometry methods with PCR as a gold standard method in determination of HLA-B27 antigen. In the present study, all three above-mentioned techniques have been used for 36 patients suffering from ankylosing spondylitis and 31 healthy volunteers. Specific antisera and monoclonal antibodies against HLA-B27, and allele specific PCR have been used in MLCT, flowcytometry and PCR methods respectively. The results show that sensitivity, specificity, positive and negative predictive values of MLCT method as compared with PCR technique were 83.3%, 100%, 100% and 88.1% respectively. Moreover, sensitivity, specificity, positive and negative predictive values of flowcytometry compared to the PCR technique were 100%, 94.6%, 93.8% and 100% respectively. Based on the results, the flowcytometry method in determination of HLA-B27 is more valid than MLCT in this regard, particularly in research programs. The similarity between the results of our study and those studies done in Europe suggests the probability of resemblance between HLA-B27 subtypes in Europe and in Iran