Sequence analysis of different domains of plasmodium vivax apical membrane antigen [PvAMA-1 gene] locus in Iran

Plasmodium vivax is responsible for approximately 80 million malaria cases in the world. Apical membrane antigen1 [AMA-1] is a type I integral membrane protein present in all Plasmodium species. AMA-1 interferes in critical steps of invasion of human hepatocytes by sporozoites and red blood cells by merozoites and is one of the most immunodominant antigens for eliciting a protective immune response in human. It is considered as a promising antigen for inclusion in a vaccine against P. vivax. Since more knowledge is needed to lighten the scope of such antigen we compared genetic variation in P. vivax AMA-1from an Iranian isolate with those reported from some of the other malarious countries so far. P. vivax genomic DNA was extracted from the whole blood of an Iranian patient with patent P. vivax infection. The nucleotide sequence for 446 amino acid [AA] residues [42-488 of PvAMA-1] was amplified by PCR and cloned in pUC19 vector for sequencing. Sequence analysis of the antigen showed a high degree of identity [99%] with strong homology to the PvAMA-1 gene of P. vivax S3 and SKO814 isolates from India and Korea [Asian isolates] respectively, and 96% similarity with P. vivax Sal-1 AMA-1 gene from El Salvador. We cloned and characterized three domains of PvAMA-1 gene from an Iranian patient. Predicted protein sequence of this gene showed some discrepancies in corresponding protein in comparing with similar genes reported from other malarious countries

[Evaluation of early oral feeding and traditional oral feeding in upper gastrointestinal surgeries]

Due to fears of postoperative complications following upper gastrointestinal surgeries [UGI], fasting before bowl function recovery is a traditional practice, but fasting following elective surgery is controversial. The aim of this study was to compare early oral feeding versus traditional oral feeding in patients who underwent UGI surgeries. Fifty two patients who underwent UGI anastomosis or surgery for various reasons were randomly divided into early oral feeding [EOF] group and traditional oral feeding [TOF] group. The nasogastric tube [NGT] removal time, tolerance of oral feeding, ileuses, nausea and vomiting, vital sign before and after surgery, postoperative stay, patients. satisfaction and complications were recorded. The mean time of NGT removal was 1.62 +/- 0.49 and 4.61 +/- 1.99 days in EOF group and TOF group respectively [p=0.0005]. The mean start time of oral feeding was 2.04 +/- 0.19 and 5.87 +/- 1.32 days in the EOF group and TOF group respectively [p=0.0005]. Tolerance of oral feeding was seen in 24 [92.3%] patients and 21 [91.3%] patients in the EOF and TOF groups respectively. Duration of hospital stay following surgery was 5.62 days in the EOF group and 8.04 days in the TOF group. 24[92.3%] out of 26 patients in the EOF group were satisfied with oral feeding that started in the second postoperative day. 13 patients [56.5%] complained of delay feeding in the TOF group. The results of the present study suggest that early oral feeding following upper gastrointestinal anastomosis or surgery is safe and can result in a shorter hospital stay and less cost

[Delay in diagnosis and treatment of gastric cancer from the begining of symptoms to surgery]

In developed countries diagnosis of gastric cancer is performed in early stages through screening and the 5 year survival rate has risen to 86%. Although the patients in developing countries have digestive symptoms for quite a while, they do not undergo early endoscopy. The patients refer to the physicians in developed stages. This research was conducted to determine the median time of delay from the beginning of symptoms to surgery. In this research 63 patients suffering from gastric cancer were investigated during 2004-2005. Research questionnaire was completed from patient's admission to endoscopy until surgery through interview with the patients. Mann- Whitney statistical test and SPSS software were used for data analysis. Out of 63 patients 48 [76.2%] were male and 43 [68.3%] rural esidents. The most common cancer area was cardia [31 patients] and the most common symptom was abdominal pain [28 patients]. The results showed of median total delay from the beginning of symptoms until surgery was 96 days, which the patient delays 8 days, from the first referring to endoscopy [General practitioner delay] 57 days, from endoscopy to pathology affirmation 12 days, and from pathology affirmation to surgery performance 7 days. Factors like place of residence, education, income and gender had no significant effect on the time of delay. Delay from referring to endoscopy performance and from performance of endoscopy to pathologic confirmation was higher than expected. Screening plan for timely referring of patients and performance of endoscopy seems essential. To reduce the time of delay cooperation of different units like medical education, hospital units, pathology and supply of necessary hospital equipment is highly recommended