Heme oxigenase 2 gene polymorphisms as genetic risk factor in atherosclerosis in Iranian patients

Heme oxygenase 2 [HMOX2] is an important antioxidative stress enzyme found in the endothelial cells of blood vessels and adventitial nerves. This enzyme in collaboration with heme oxygenase 1 metabolizes heme molecules into ferrous iron, carbon monoxide [CO] and biliverdin while the later is further converted to bilirubin. Both biliverdin and bilirubin are potent antioxidants, reducing the chance of atherosclerosis. HMOX2 also induces endothelial relaxation by synthesizing CO. Heme oxygenase 2 gene mutations were studied in 137 patients with atherosclerosis and in 100 normal controls. Pairs of primers were designed to amplify 2[nd], 3[rd] and 5[th] exons of HMOX2 gene. These products were analyzed by single strand conformation polymorphism [SSCP] analysis and the shifted fragments were separated from SSCP polyacrylamide gel for further sequencing. Two sequence variations were observed among 13 patients with atherosclerosis, consisting of C to A substitution in codone A70D [GCC to GAC] which was reported for the first time and A to G substitution in codone K89E [AAG to GAG]. A significant association was noticed between A to G mutation in codon K89E of hemoxygenase 2 gene and the risk of atherosclerosis was supported with p=0.01 and chi[2]>6.82. However, no significant associations were observed among C to A substitution in codon A70D, p=0.11 and chi[2]>2.97 and the risk of atherosclerosis. Our findings denoted to the importance of K89E mutation in the development of atherosclerosis in Iranian cases. Further studies are required to show the importance of hemoxygenase 2 gene mutation in other populations

Impaction of laparoscopic ovarian electrocautery on doppler indices of stromal blood flow in women with polycystic ovary syndrome

Polycystic ovary syndrom [PCOS] is characterized by infertility, oligomenorrhea, and hyperandrogenism. Clomiphene citrate [CC], an antiestrogen, is first-line treatment for PCOS, if CC fails to induce ovulation, laparascopic electrocautery of the ovaries is offered. In this prospective controlled study, 52 women with clomiphen-resistant PCOS [group 1] and 46 women with regular menstrual cycles as a control group [group 2] were included. Hormonal profile and doppler blood flow changes within the ovarian stroma befor and after laparascopic ovarian electrocautery [LOE] in women with clomiphen- resistant polycystic ovary syndrome assessed and compared between groups. The doppler indices [pulsatility index and resistance index] of ovarian stromal blood flow were significantly lower in group 1 befor LOE than in group 2. The serum levels of testosteron [T] and LH were significantly reduced in group 1 after LOE compared with in group 1 befor LOE [P < 0.05]. Doppler indices [pulsatility index and resistance index] of ovarian stromal blood flow were significantly increased after LOE. Laparascopic electrocautery reduced serum T and LH and reduced ovarian blood flow velocities, which may explain the reduction of ovarian hyperstimulation syndrome in women with PCOS after LOE. Laparascopic electrocautery of the ovaries is now accepted as the preferred first-line treatment of women with PCOS who are resistant to clomiphen citrate. All affected women could be considered for this treatment

Resistance to vancomycin in enterococcus faecium and faecalis clinical isolates

The aim of this study was to investigate antibacterial resistance among enterococci species isolated in Tehran Baghyatallah Hospital. It consisted of 126 isolates of E. faecalis [86%], E. faecium [9%] and other Enterococus Spp. [5%] isolated from urine [34.92%], blood [27.77%], wound swabs [19.84], stool [5%] endotracheal secretions [3.37%], abscess [3.4%], dialysis fluids [1.7%] and catheter [4%]. Twelve [9.5%] isolates were resistant to vancomycin. The VRE isolates were resistant to ampicillin [75%], erythromycin [50%], tetracycline [58%], ciprofloxacin [41.6%], chloramphenicol [33.3%] and gentamicin [41.6%]. Two [16.66%] of VRE isolates were multidrug resistant. Eight [66.6%] of the vancomycin-resistant strains and all of the MDR strains carried the vanA phenotype and genotype. The MIC of VRE isolates were between 32-512 micro g/ml. Our results show that most glycopeptide resistant E. faecalis and E. Faecium carried vanA. It is also possible that frequency of infections caused by glycopeptide-resistant enterococci will increase in our geographical area