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

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

[Determinants of fruit and vegetable consumption in type 2 diabetics in Tehran]

The world is facing a dramatic rise in the prevalence of diabetes, most of which is occurring in the low-and middle-income countries. This is having a major impact on the quality of life of hundreds of millions of people and their families. Furthermore, nutrition, especially intakes of fruit and vegetable have important effects on glycemic control and prevention of diabetic complications. The present study was designed to assess the fruit and vegetable consumption in type 2 diabetic patients and their relationship with socio-demographic factors in Tehran. A cross-sectional study was conducted on 367 type 2 diabetic patients. Fruit and vegetable consumption was determined, using 169-item food frequency questionnaire. Information on demography and socio-economic factors was obtained from related questionnaires. Results: Vegetable consumption was significantly lower in retired or jobless patients [p=0.04], and higher in patients who had children [p=0.003]. Also, fruit consumption was significantly higher in patients with 3 or less children. No significant association was observed between fruit or vegetable consumption and education levels, parents' job levels, household size, ethnicity, family income, food expense and duration of living in Tehran. Based on logistic regression, employment was significantly related to the consumption of vegetable [p=0.012]

Evaluation of urinary tract infection in newborns with jaundice in South of Iran

Neonatal jaundice is clinically presented in 60% of full-term newborns. About 8% of newborns with jaundice have urinary tract infection [UTI] without any other clinical signs in favor of UTI. In present study we evaluated clinical and paraclinical data that help to rapid and early diagnosis of UTI in apparently healthy newborns with jaundice. From February to August 2006, 51 apparently healthy full-term newborns with jaundice and UTI who had been admitted for management of jaundice in Motahary hospital, Jahrom [south of Iran], were studied and compared with 56 neonates with jaundice but without UTI. All the neonates had not any other symptoms such as fever or lethargy. At the time of admission, total and direct bilirubin, Coombs' test, mother and neonate blood group, urinalysis and urine culture were requested. There was no significant difference of gestational age, birth weight, age of admission, age at the time of starting jaundice, and total serum bilirubin between the two groups. There was significant difference of direct bilirubin level, mean of decrease serum bilirubin after 24 hours, gender, and blood groups. Male gender with mean decrease of bilirubin less than 2.2 mg/dl after 24 hours phototherapy and direct bilirubin more than 1.6 mg/dl ,during the first two weeks of neonatal period has about 7 times more risk for UTI. The presence of those three above mentioned factors had only 30% sensitivity and more than 94% specificity for suspicious of UTI in asymptomatic neonates with jaundice. Jaundice may be the only presenting sign of UTI in newborns, so according to high specificity for the presence of three below factors simultaneously, it seems better to evaluate newborns for UTI if they have high level of direct bilirubin [more than 1.6 mg/dl], slow decrease in serum bilirubin level with phototherapy [less than 2.2mg/dl/day] especially in male newborn with blood group B

Frequency of rotavirus infection in children with acute gastroenteritis in jahrom, south of Iran

Rotavirus is a major cause of acute diarrhea in children worldwide. It is an important cause of death among young children in developing countries. The aim of this study was to evaluate the prevalence of rotavirus infection in children less than five years old hospitalized for gastroenteritis in Jahrom. One hundred and two stool samples were collected from children less than 5 years old hospitalized for acute diarrhea during October 2006-February 2007 in Motahary hospital, Jahrom, south of Iran. All samples were tested for rotavirus antigen by commercial enzyme linked immunoassays [ELISA] and latex agglutination test. Sixty nine stool samples [67.6%] were positive for both ELISA and latex agglutination. The mean age of the patients was 14.38 months [range 2-60 months]. There was no significant difference between the patients with positive and those with negative tests for rotavirus in duration of admission, fever, vomiting, gender, and stool examination. Thirty-three percent of the patients had abnormal increased blood urea nitrogen that was normalized after hydration. Rotavirus was an important cause of acute gastroenteritis in young children less than 5 years old in our hospital. Dehydration, azotemia, and electrolyte disturbances were the major problems in those patients

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

Comparison of two therapeutic protocols: heparin with aspirin vs prednisolone with aspirin, in patients with recurrent miscarriages

The most common complication of pregnancy is abortion. The etiology of recurrent pregnancy loss is not completely known. There are few therapeutics and diagnostic strategies in recurrent abortion. The aim of this study was to compare the use of heparin with aspirin vs prednisolone with aspirin in patients with recurrent pregnancy loss [RPL]. This randomized clinical trial study comprised of 50 patients with RPL referred to Fatemieh Hospital, Hamadan. These patients were selected when beta-HCG test was positive and were divided into two groups [n=25 for each group]. Patients in the first group received subcutaneous heparin [5000 U twice a day] and oral microcoated aspirin [80 mg once a day] up to 20[th] week of pregnancy. Ultrasonography was repeated 3 times for these patients. Ca tablet was administrated in order to prevent osteoporosis. Antiphospholipid and anticardiolipin antibodies were checked for all patients. Neonates were visited by a neonatologist and followed up for one month. Finally, the data were analyzed by t-test and Fisher's exact test. The mean age of prednisolone with aspirin group were 31.8 +/- 3.3 years while, it was 30.7 +/- 3.2 years in heparin with aspirin group and, this difference was not significant [P>0.05]. The mean pregnancy loss number was 2.8 +/- 1.1 while 2.4 +/- 1 in prednisolone with aspirin and heparin with aspirin groups respectively, which was not statistically significant [P>0.05]. Anticardiolipin antibody was positive in 4 [8%] patients, and antiphospholipid antibody was also positive in 4 [8%] patients. Pregnancy loss with heparin + aspirin was significantly higher than prednisolone + aspirin [P<0.05]. There was not any case of complications in two groups. The results of this study showed that prednisolone with aspirin are more effective than heparin with aspirin in the management of recurrent pregnancy loss and are preferred to use in these patients

Epidemiologic pattern of vaginal colonization by group B streptococcus in pregnant women in Hamadan, central west of Iran

Group B Streptococcus [GBS] is a leading cause of serious neonatal infections. Although great progress has been made in preventing prenatal GBS, its colonization rate in different regions of Iran remains unknown. The objective of this study was to determine the colonization rate of GBS in pregnant women in Hamadan city, Central west of Iran. A group of 544 pregnant women were randomly selected after 20 weeks gestation. Vaginal specimens were examined by Gram staining and culture methods and GBS was identified using bacteriologic criteria. Of these cases, 145 [26.7%] were colonized by GBS. A significant relationship was found between the career of subjects and the related colonization rate. Parity, gestational age, and the number of children were unrelated to GBS colonization. The results are indicating that the relatively high colonization rate of GBS in pregnant women living in Central west of Iran, warrants a routine screening and prophylactic treatment of the infected women

[Comparing the painlessness effects of spinal [sufentanil] and epidural [bupivacaine plus lidocaine] analgesic methods in labour and delivery]

This study was designed in order to compare the effects of spinal and epidural analgesia on labour and also several maternal and fetal factors in vaginal delivery. The study was a randomized clinical trail and participatnts were 120 gravid 1 and gravid 2 women in the active phase of delivery, admitted to the labour room of Fatemieh Hospital in Hamedan in 1381-1382. Sixty patients were randomly divided into two groups of 30, analgesia was induced by single spinal sufentanil injection in one group and, bupivacaine plus lidocaine injection in the other group. Maternal vital signs and pain score were recorded [VAS] at 1, 5, 15 and 30 minutes after administration of analgesia and every 30 minutes thereafter. Fetal heart rate every 15 minutes, vaginal examination every hour, urinary output every 4 hours after delivery and the incidence of headache and back pain, one week after delivery were the variables under study. Both groups were matched regarding demographic, gravida and Parity factors. There was no significant difference between groups regarding pain score, [based on VAS],duration of the first and second delivery phase, the incidence of fetal distress, meconium excretion, apgar scores at 1 and 5 minutes after delivery, abnormal laboar, operative or assisted delivery. Average analgesic duration was longer in spinal analgesia than single epidural injection analgesia. Considering the difficulty of the technique, the need for anaestheticianHs supervision and injection repeatition in epidural analgesia, it seems that spinal analgesia is a suitable replacement which is more practical, less expensive, easy to perform and induces a desirable analgesia

[Comparison of effectiveness of Epley's and Semont's maneuver in tlze ti-eatmeizt of BPPV]

Benign paroxysmal positronal vertigo is the most common cause of vertgoin adults. The main treatments for this disease are Epley's and Semont's maneuver. Effectiveness of both maneuvers is high but the Acceptability of them was not evaluated. In this study, effectivness and acceptability of two maneuvers are compared. Between the Oct 2001 and Feb 2003 we identified 64 patients with typical form of BPPV in the clinic of otolaryngology head and neck surgery of Kermanshah University of medical science. They allocated randomly in two group of the Epley's and Semont's maneuver. Then evaluated objectively by Dix-hallpike maneuver and subjectively by using the history of patients. In addition the acceptability of two maneuver were assessed and all data analyzed by k-square and sPSS11.05. The effectiveness of Epley's and semont's maneuver was 94.5%, 84% [respectively]. Acceptability of epley's maneuver was 93% and it was 45% for semont's maneuver. Acceptability of Epley's maneuver for patient in the group of more than 55 years old was statistically significant. Epley's maneuver is effective treatment for BPPV. Although subjective results of two maneuvers were not significant but acceptability of Epley's maneuver is higher in-group of old patients

Kogan syndrome report of a case

Cogan syndrome is a rare autoimmune disease that is characterized by acute with Audiovestibular dysfunction. Bilateral and progressive profound sensorineural hearing loss is the most important sign of the disease. Delay diagnosis leads to deafness or death and atypical form has not complete response to therapy. The purpose of this case report is presenting the sign and symptom of syndrome and advancing knowledge for early diagnosis and reporting an exceptional case. The patients was a 51-y male with chief complaints of eye redness and then hearing loss and typical vertigo. Clinical and Para clinical data rule out is the main differential diagnosis of syndrome [sarcoidosis, syphilis] and finally the Cogan syndrome was the diagnosis. Treatment with early high dose corticosteroid was used and fortunately good response was observed. The diagnosis of Cogan syndrome is based on classic finding and rule out of differential. The main differential diagnosis of Cogan syndrome includes syphilis, sarcoidosis, [PAN] all causes of peripheral vertigo. Clinical and Para clinical findings lead to diagnosis of Cogan syndrome. Exceptional items in this case: 1- Cogan syndrome is the disease of young adults, but this case was 51 year old 2- Atypical from of Cogan has not good response to drugs. But our patient completely recovered by using high dose prednisolone. At end we have to say that complete knowledge about the symptom of inner ear autoimmune disease and early treatment led to better response even in the case of atypical form