Comparison of resistant and susceptible strains of Trichomons vaginalis to metronidazole using PCR method

Metronidazole is drug of choice recommended by WHO for treatment of trichomoniasis, however, some reports claims drug resistance in Trichomonas vaginalis isolates recently. The objective of this study was to determine the minimum lethal concentration [MLC] of metronidazole in resistant and sensitive strains, as well as genetic patterns of these stains by PCR method. From February 2006 to March 2007, in a cross sectional study, clinical and wet mount examination of vaginal smear along with culture were performed on 683 women attending to public and private outpatient clinics in Hamadan. Trichomoniasis marked based on major clinical symptoms. Diagnosis confirmed using wet mount microscopically and culture in Diamond medium. A serial concentration of metronidazole was provided and all isolated Trichomonas strains [resistant and sensitive] tested by standard method. Finally, all sensitive and resistant strains examined by PCR technique. Only 15/683, [2.2%] of patients clinically diagnosed trichomonal vaginitis were positive for T. vaginalis by wet smear and culture. The minimum lethal concentration [MLC] for clinically sensitive isolates was 25 micro g/ml; however, this concentration for resistant isolates was 200 micro g/ml after 24 h and 100 micro g/ml after 50 h. The results of PCR examination of DNA from sensitive and resistant isolates had same pattern. The lanes appeared by two primers were 98 bp and 261 bp for both clinically sensitive and resistant strains. Resistance to metronidazole in T. vaginalis has not relation to genetic variations and might be related to some physiologic pathways of organism

Prevalence of trichomonas vaginalis infection in Hamadan city, Western Iran

Infection with Trichomonas vaginalis is one of the most common sexually transmitted diseases [STDs] in humans. The prevalence of infection in Iran has been reported between 2 to 8%, depending on deferent socio-cultural conditions. This study aimed to determine the prevalence of T. vaginalis in women referred to gynecologic clinics in Hamadan city, West of Iran. This descriptive cross-sectional study was conducted on 750 women who referred to Gynecologic clinics in Hamadan from November 2010 to July 2011. Vaginal samples were obtained from them and examined by wet mount and culture methods for the detection of T. vaginalis. Sixteen out of 750 vaginal swab specimens [2.1%] were culture positive for T. vaginalis and 13 of these positive specimens [1.7%] were wet mount positive. Only 12 of 42 patients who were clinically diagnosed as having T. vaginalis infection, confirmed by culture method. Five hundred and fifty of the participants women [73.3%] had at least one of signs and symptoms of trichomoniasis. No statistical correlation was observed between clinical manifestations and parasitological results [p>0.05]. This study showed low prevalence of T. vaginalis infection in the study population. Since clinical signs of trichomonal vaginitis are the same of other STDs, a confirmatory laboratory diagnosis is necessary. Wet smear as well as culture are sensitive for detection of T. vaginalis

[Frequency of musculoskeletal complications among the diabetic patients referred to Kashan diabetes center during 2009-10]

Diabetes Mellitus is one of the most common metabolic disorders causing pathophysiologic changes in multiple organs. Considering the burden of diabetes and its complications, this study aimed to evaluate the frequency of musculoskeletal complications in diabetic patients. This cross-sectional study was performed on 327 diabetic patients referred to Kashan diabetes center during 2009-10. Age, the type of diabetes and clinical manifestations such as arthralgia, paresthesia, and limited joint movements were obtained from the hospital medical records of patients and then musculoskeletal complaints [e.g., adhesive capsulitis, carpal tunnel syndrome, dupuytren's contracture, trigger finger, and limited joint movements] were diagnosed and recorded by a rheumatologist. The mean ages of type II and I diabetic patients were 54.6 +/- 12.61 and 29.7 +/- 10.36 years, respectively. Carpal tunnel syndrome [49.8%], knee osteoarthritis [45%], sclerodactyly [27.2%], dupuytren's contracture [14.1%], trigger finger [11.9%], adhesive capsulitis [11.9%], limited joint movements' syndrome [8%] and Charcot joint [0.6%] were seen in patients. There was a significant relationship between the type of diabetes and knee osteoarthritis [P<0.003; OR=1.86; CI=1.05-3.30] and also carpal tunnel syndrome [P<0.045]. A significant relationship was also seen between duration of disease and trigger finger, dupuytren's contracture [OR=3.76; CI=1.9-7.41] and limited joint movements. The findings of this study indicated that type of diabetes and also its duration [over 15 years] may increase the risk of musculoskeletal complications. Hence, careful periodic examinations of all diabetic patients are recommended

[ comparison between touch cytology and histology method in diagnosing Helicobacter pylori infection]

Touch cytology is one of the sensitive ways of diagnosing Helicobacter pylori in stomach biopsies. The current study was designed to compare touch cytology with histology method in the diagnosis of Helicobacter pylori infection. This study was performed on 150 dyspeptic patients undergoing upper gastrointestinal endoscopy in Kashan Shahid Beheshti Hospital. Antrum samples [2-4] were taken from each of 150 patients. One biopsy sample was considered for touch cytology and the remaining biopsy samples were studied for histological examination. Eighty-three out of 150 patients [55.3%] were men with the mean age of 46.63 +/- 5.93 years. The sensitivity, specificity, positive predictive value and negative predictive value in the touch cytology method were 95.65%, 100%, 100% and 66%, respectively, while in the histology method they were 84.78%, 100%, 100% and 36.36%, respectively. The sensitivity of the touch cytology was more than that of the histology method [P<0.001] in the diagnosis of H. pylori. Since the cytology method is more sensitive with equal specificities in relation to histology method, when the histological information is not necessary, the cytology method can be considered more reliable for diagnosing Helicobacter pylori

[Relevance of serum vitamin D level and the disease activity in rheumatoid arthritis]

Rheumatoid arthritis [RA] is one of the most prevalent autoimmune diseases in the world. Some of the researches have suggested that the serum vitamin D level may relate to disease activity. The current study was designed to identify the correlation between serum vitamin D level and the disease activity index [DAI]. In this sectional study, 108 patients [diagnosed based on the American Committee of Rheumatology criteria] were enrolled. In all cases after determining the serum vitamin D level and ESR, complete joint examination were done. The normal range of vitamin D was 47.7-144 nm/lit. Then, the specified disease activity form [DAS-28] and visual analog scales [VAS] were filled out. The correlation between disease activity index, [based on VAS, tendered or swelled joints and ESR] and serum vitamin D was analyzed using Chi square, Mann Whitney and t-tests. Seventy nine [73.14%] out of 108 patients had normal serum vitamin D and 29 [26.86%] had low serum vitamin D level. The mean age of patients with normal and low serum vitamin D level were 52.22 +/- 11.6 and 48.48 +/- 12.51, respectively [P=0.075]. The mean DAI in normal and low vitamin D patients were 3.75 +/- 1.37 and 5.19 +/- 1.56, respectively [P=0.00]. The mean number of swollen joints in normal and low vitamin D patients was 1.24 +/- 1.39 and 3.65 +/- 3.3, respectively [P=0.001]. The mean number of tender joints in normal and low vitamin D patients were 6.84 +/- 4.41 and 9.44 +/- 3.62, respectively [P=0.042]. The mean ESR in normal and low vitamin D patients were 19.40 +/- 12.40 and 37.91 +/- 21.72, respectively [P=0.002]. Moreover, the mean VAS in normal and low vitamin D patients was 23.29 +/- 19.42 and 50.68 +/- 30.78, respectively [P=0.003]. The more active the RA, the less serum vitamin D level

Seroepidemiology of toxoplasmosis in primigravida women in Hamadan, Islamic Republic of Iran, 2004

We determined the prevalence of Toxoplasma antibodies in 576 primigravid women randomly selected from health houses in Hamadan. The relationship between positivity and some risk factors was assessed. Data were collected by questionnaire and blood samples examined for Toxoplasma antibodies by indirect fluorescent antibody test. Of the 576 women, 193 [33.5%] were positive for Toxoplasma antibodies [titre >/= 1:20]. Age, consumption of fresh undercooked meat and frequent consumption of raw vegetables were statistically significantly associated with higher infection rates. Educational level, touching cats, handling raw meat, farming, method of washing vegetables and consumption of raw milk and eggs were not associated with infection