Expression and purification of recombinant mycobacterium tuberculosis [TB] Antigens, ESAT-6, CFP-10 and ESAT-6/CFP-10 and their diagnosis potential for detection of TB patients

One of the most widely used methods to detect tuberculosis [TB] infection is the tuberculin skin test [TST]. The completion of Mycobacterium tuberculosis [M. tuberculosis] genome sequence has led to identification of several antigens that can be utilized for accurate diagnosis and control of TB. The aim of this study was to purify the recombinant M. tuberculosis antigens for the evaluation of their potential in TB diagnosis. The recombinant secretory antigens, ESAT-6, CFP-10 and ESAT-6/CFP-10 were produced by PCR and cloning methods. To investigate antigen specific responses of these recombinant antigens in detection of TB, ex vivo enzyme linked immunospot [ELISPOT] test in 30 clinically diagnosed TB patients was evaluated. The selected M. tuberculosis antigens were cloned, expressed and purified in Escherichia coli [BL21]. ELISPOT assay for detection of TB showed the sensitivity of 93, 90 and 100% for recombinant ESAT-6, CFP-10 and ESAT-6/CFP-10 proteins respectively, which is significantly higher than conventional TST. The recombinant antigens of ESAT-6, CFP-10 and ESAT-6/CFP-10 can be used as an accurate means of detecting TB in Iran

Association between PPD and quanti FERON gold TB test in TB infection and disease among HIV-individuals in southern Iran

Tuberculosis is one of the most common diseases among HIV-infected patients. A person with a positive tuberculin skin test [TST] acquiring HIV infection has a 3-13% annual risk of developing active tuberculosis. The diagnosis of TB in HIV infected patients may be difficult. QuantiFERON-TB Gold [QFT-G] test is a novel method as an aid for diagnosis of Mycobacterium tuberculosis infection. We evaluated the association between TST and QFT-G test in latent TB infection [LTBI] and TB in HIV-infected patients. One hundred and seventy six HIV-infected subjects from Shiraz Consultation and Behavioral Modification Center [SCBMC] entered our study. The individuals were screened for TST, using 5TU purified protein derivative [PPD]. Also, blood sample was provided for QFT, measuring INF-gamma response to M. tuberculosis antigen. Of 176 participants, 98.3% returned for evaluation of TST results. Among them, 63% and 37% were negative and positive for TST, respectively. All the participants returned for QFT-G sampling. Of them, 64.8% and 27.8% were respectively negative and positive for the test and 7.4% showed undetermined results. The agreement between PPD and QFT-G in their negative results was 39.9% and 8.1% in their positive results and the overall agreement was 50%. Disagreement of TST-/QFT[+] was noticed in 19.7% of the subjects and TST[+]/QFT- disagreement in 24.9%. CD4[+] count <100 mm[3] was seen in 5.9%, >/= 100 and < 200 mm[3] in 17.1% and CD4[+] T cell count >/= 200 mm[3] in 76.9% of subjects. As the agreement rate between QFT-G and TST in HIV-infected patients was fair, a strategy of simultaneous TST and QFT-G testing would maximize the potential for LTBI diagnosis in HIV-infected subjects

[ study of hematologic, hepatic and renal side effects of intramuscular injection of meglumine antimoniate [glucantime] on patients with cutaneous leishmaniasis]

Cutaneous leishmaniasis is an endemic disease in many countries that is caused by different species of Leishmania. Nowadays, standard medication for leishmaniasis is pentavalent antimony compounds that are used intramuscular or intralesional. Though, they are drugs of choice, there are limitations such as hematologic, hepatic, renal and cardiac side effects. This study reviewed hematological, hepatic, and renal side effects of glucantim. The present work was a pre- and post- treatment study on 35 patients with cutaneous leishmaniasis referred to Dermatology Department, Imam Reza Hospital, Mashhad. Their disease was confirmed by direct smear. The patients were treated with intramuscular glucantime 60mg/kg daily for 20 days. Complete blood count [CBC, diff], serum glutamic oxaloacetic transaminase [SGOT], serum glutamic pyruvic transaminase [SGPT], blood urea nitrogen [BUN], creatinine[Cr] were evaluted at 3 times: before treatment, on the 20[th] day of treatment course [last day of injection], and a month after the end of treatment. Demographic, laboratory and treatment results, and drug complications were recorded in a questionnaire. Data were analyzed by descriptive statistics. Of 35 patients in this study, 26 completed the course. Red blood cell count, hemoglobin and hematocrit levels significantly reduced [P<0.05], but no significant difference was shown in white blood cell and platelet count. The increase of serum SGOT and SGPT levels were considerable [P<0.05]. Elevated serum levels of Cr and BUN observed in 11.5% and 34.6% of patients, respectively; and renal side effects were more common in females than in males [64% in females VS 10% in males]. Systemic glucantime is associated with hematologic, hepatic, and renal side effects. Therefore, evaluation of hematologic, hepatic and renal statement in patients receiving glucantim, before and during treatment is suggested

Normal serum prostate specific antigen levels in men in Yasuj province, Islamic Republic of Iran

We assessed serum prostate specific antigen [PSA] levels in 650 men over 40 years referred to 3 Yasuj hospitals for blood cell count in 2003/2004. Men affected by prostate cancer, prostatitis or transurethral instrumentation were excluded. PSA was determined by an immunoassay technique. PSA levels in different age groups were: 40-49-year-olds-mean = 0.7 ng/dL, normal = 0-1.35 ng/dL; 50-59-year-olds-mean = 0.9 ng/dL, normal = 0-1.85 ng/dL; 60-69-year-olds-mean = 1.6 ng/dL, normal = 0-3.2 ng/dL; >/= 70-years-olds-mean = 2.3 ng/dL, normal = 0-4.4 ng/dL. Normal PSA levels in our society were lower than those in the United States, Europe and Japan

Effects of local injection of bupivacaine and dexamethasone on postoperative pain of adenotonsillectomy

Adenotonsillectomy is a common surgical operation which is frequently associated with complications such as pain, hemorrhage and laryngospasm. For reduction of the possibility of postoperative bleeding and agitation, pain control is important. The opioid drugs are now being used for pain control, but their inconvenient side effects such as apnea may worry physicians. Therefore, the aim of this study was to compare the effect of local application of bupivacaine and dexamethasone with that of placebo on postoperative pain of adenotonsillectomy. This double-blind and case-control study was performed on 90 patients subjected to tonsillectomy operation with 3-30 years old, during spring and summer of 2005 in Kashani hospital, Shahrekord, Iran. The patients were randomly divided into three equal groups of A, B and C. The individuals in group A [cases] received a local injection of 2 ml of 0.5% bupivacaine, group B received a local injection of and group C [control] received a local injection of 2 ml of normal saline. Six, 12 and 18 hours after the operation, using McGill questioners, pain intensity was evaluated. Data was analyzed using X[2] test. Mean age was not significantly different among the 3 groups. 45.6% of the patients were male and the rest were female. Six hours after the operation, pain intensity in group received bupivacaine was more than that of in group received placebo [p<0.05]. However, 12 and 18 hours after the operation there was no statistically significant difference in pain intensity among the groups. Bupivacaine and dexamethason with dosage used in this study had no effect on pain intensity in these patients

Recurrent abdominal pain and chronic appendicitis

Background: the question of whether chronic appendicitis can give rise to chronic abdominal pain has always been a matter of controversy. The main purpose of this study was to find a means of diagnosing chronic inflammation of appendix through clinical and histopathological procedures

Methods: a group of 18 patients complaining of frequent pain attacks in their RLQs were involved in our study. The patients' history, clinical and lab findings were closely evaluated. All the patients underwent appendectomy and all their appendices were histopathologically examined. Chronic appendicitis was ruled in with a positive pathology report confirming chronic inflammation. All the patients referred for their follow-up visits in a period of one year

Results: histopathology reports confirmed chronic appendicitis in 16 of the cases [88.8%]. From them 93.7% expressed complete pain relief in the follow-up visits. 62.5% of our patients were women and the rest were men. The patients were categorized into three age groups as those less than 15 years [18.75%], between 15 and 25 years [31.25%] and older than 25 [50%]

Conclusion: it seems as if chronic appendicitis could be blamed for recurrent abdominal pain attacks. The disease is easily cured via appendectomy

new way in diagnosis of acute mesenteric ischemia

Background: despite advances over the past few decades in operative techniques and perioperative managements, acute mesenteric ischemia [AMI] is astonishingly associated with high mortality rate [around 75 to 90 percent]. The diagnosis of mesenteric ischemia remains a challenge. Presently, there is no quick and easy test [or combination of tests] which are available, with few side effects, high positive and negative predictive values, which can be early indicative of acute bowel ischemia. In our study we suggest intestinal serosal color change as an early diagnostic sign

Methods: this experimental single blinded study was done on 16 male rabbits. Every day we operated five rabbits with one of them as control. In case group superior mesenteric artery was ligated and thirty minutes later, observers who did not know the control and cases, inspected and scored the color changes of intestinal loops in rabbits. All of cases, which were reported as cyanotic or pale, supposed to be ischemic. The time from the ligation to color change was recorded

Results: superior mesenteric artery was ligated in 12 rabbits [cases]. Three rabbits were used as controls. Color changes indicative of AMI [pale or cyanosis] appeared in nine case rabbits [75 percent of cases], 2 were pale and 7 were cyanotic. There were no false positive in our study and all of controls were true negative. Therefore sensitivity was about 75% and specificity was 100 percent. Intestinal serosal color change appeared in 1 hour after occlusion and infarction occured after 6 hours

Conclusion: the result of this study shows that serosal color change is an indicator of occlusion of superior mesenteric artery in rabbits. Considering the similarity between human and rabbits with respect to intestinal loops, data regarding the time profile and color changes can be extrapolated to human as an indicator of occlusion and a diagnostic test of superior mesenteric ischemia for early diagnosis of this pathology

Estradiol antagonistic effects of winter cherry extract on pituitary and hypothalamic GOPD activities

Intraperitoneal administration of an aqueous extract of winter cherry fruits [Physalis alkekengi] to adult cycling female rats diminished pituitary glucose 6-P dehydrogenase [G6PD] activity by 35% and that of the basomedial hypothalamus [BMH] by 23%. Daily doses of 1.88, 3.75, 7.5, and 15 micro g beta-estradiol administered to such animals for a period of 6-9 days increased pituitary G6PD activity by 16,30,60, and 94% and that of BMH by 14,19,30, and 52%, respectively. Combined administration of a given dose of the aqueous extract along with the above doses of beta-estradiol for 8-9 days reduced G6PD inhibitory effect of the aqueous extract on both the pituitary and BMH. In this manner the pituitary enzyme was inhibited by 14% [1.88 micro g beta-estradiol], 7% [3.75 micro g estradiol] and activated by 37% [7.5 micro g estradiol] and 62% [15 micro g estradiol]. Corresponding values for the hypothalamic enzyme were inhibitions of 21% [1.88 micro g estradiol], 18% [3.75 micro g estradiol], 7% [7.5 micro g estradiol] and activation of 2% [15 micro g estradiol]. The estrogen antagonistic effect of this aqueous extract on the brain is discussed in terms of its possible action on the inhibition of the hypothalamic gonadotropin releasing hormone and the pituitary luteinizing hormone release, thus affecting ovulation and pregnancy