Seroprevalence of acanthamoeba antibodies in rheumatoid arthritis patients by IFAT, Tehran, Iran 2007

This preliminary study was conducted to discriminate the prevalence of Acanthamoeba antibodies in rheumatoid arthritis [RA] patients and healthy controls to analyze the correlation between these two groups. From October 2006 to August 2007 a total of 121 serum samples from RA patients attending the Rheumatolgy Department at Shariati Hospital in Tehran were obtained and stored at -20°C until using by indirect fluorescent-antibody test [IFAT]. RA was diagnosed according to the American Collage of Rheumatology classification criteria. The organism used in this study was isolated from various water resources in Tehran, Iran cultured axenically and then went on a PCR assay based on 18S rRNA to identify the genus Acanthomoeba. Indirect immunofluorescence antibody [IFA] staining of serum samples was carried out to detect anti Acanthomoeba antibodies. In culture, out of 22 samples, 13 [59%] were grown in xenic but only two in axenic medium. PCR amplified a 904bp fragment, specific for Acanthamoeba. Of examined serum samples, Acanthamoeba antibodies were present in 70 [57.8%] and 52 [41.2%], respectively. The highest titer of antibodies [1:320] was detected in one patient with RA. Our study supports the hypothesis that some parasitic microorganisms can involve and contribute toward the development of rheumatoid syndromes

Rapid detoxification of opium dependent patients via opioid antagonist

This project was conducted to assess the feasibility and outcome of rapid detoxification method. 41 opium dependent patients [37 males, 4 females] with mean age of 29.1 years [17-44] who had been consecutive admitted to Iran Psychiatric Center during one year period were detoxified with subcutaneous naloxone [11 patients] or oral naltrexone [30 patients]. Finally the detoxification was completed with the consumption of 50 mg of oral naltrexone. The required time for this method of detoxification was less than 72 hours. Except for two cases, all patients completed the treatment [95%].Among all serious side effects, delirium was seen in two subjects [5%]. The advantageous of this method of detoxification included little side effects, short period of treatment, significant efficacy, lower cost, and feasibility to provide the treatment to larger group of patients. Therefore, controlled study to replicate these findings is suggested

Rapid and clonidine detoxification in opium dependent patients

This project was conducted to compare two programs of treatment, the rapid [naltrexone/clonidine] and the conventional [clonidine] detoxification. 54 opioid dependent patients referred to the clinic of Iran Educational Psychiatric Center participated in the study; they were randomly placed in two groups. 28 patients in group A [naltrexone/clonidine] and 26 patients in group B [clonidine] were studied. Data were collected via clinical interview based on DSM-IV criteria and a questionnaire appraising demographic in- formation and drug use patterns. For statistical evaluations, descriptive tests, t-test, and X2 were used. Both groups were similar in terms of demographic information, pattern of drug use, and the rate of attrition in the one-month follow up. The severity of withdrawal symptoms was the same in the two groups and assessed generally at the moderate level. There was no difference in the rate of treatment completion between the two groups [94% for group A and 96% for group B]. However, the length of hospitalization was significantly lower in group A than group B [five days. vs. nine days]. There were no major side effects observed in the two groups. There were no significant differences in terms of maintaining in treatment and rate of relapse in the one month follow up. Relapse rates were 50% and 46% respectively in groups A and B. As an effective method, rapid detoxification with naltrexone combined with clonidine is recommended considering its moderate severity of withdrawal symptoms, short period of detoxification, lack of severe adverse effects, as well as the possibility of rapid commencement of treatment with naltrexone for maintenance treatment

[Comorbidity of psychiatric disorders in psychiatric outpatient clinic]

This project was conducted to appraise the comorbidity of psychiatric disorders in a psychiatric outpatient clinic. This was a descriptive-retrospective study. Out of 4000 patients of Tehran Psychiatric Institute's Clinic during the years of 1996-2000, a total of 648 cases diagnosed based on DSM-IV criteria were selected systematic randomly. The cases were further evaluated via a demographic questionnaire. Data were analyzed by descriptive-statistical methods.35.6% of patients had the comorbidity of psychiatric disorders.The diagnoses of simultaneous disorders on axis I, according to diagnostic categories,included mood and anxiety disorders [34.6%] and mood and substance-related disorders [6.9%]. The comorbidities according to disorders within each of diagnostic categories included major depressive and obsessive-compulsive disorders [16.0%], major depressive and dysthymic disorders [7.8%], dysthymic and obsessive-compulsive disorders [5.6%], and finally obsessive-compulsive disorder and social phobia [3.9%]. The diagnosis of simultaneous disorders on axis II, according to clusters A, B, and C, included A and C [0.4%]. The particular comorbidities according to disorders within each of the clusters A, B, or C included histrionic with borderline [0.9%] and paranoid with obsessive-compulsive [0.4%]. The simultaneous diagnoses on axis I and II included mood disorders with personality disorders in general [7.8%] and mood disorders with cluster B of personality disorders in particular [14.7%], anxiety disorder with personality disorders in general [12.6%] and anxiety disorder with cluster C of personality disorders in particular [8.7%],major depressive disorder with cluster B of personality disorders [4.3%], and finally obsessive-compulsive disorder with cluster C of personality disorders [3.9%]. The level of comorbidity detected in this project is less than other studies