[Identification of mutation for drug resistance gene in cutaneous leishmaniasis]

Cutaneous leishmaniasis is a common parasitic disease and one of the health problems world wide. The pentavalent antimonial drugs [e.g. pentostam and Glucantime] are the first line treatment for leishmaniasis, and resistance to these drugs is a serious problem. Using PCR method, this study was carried out to identify the mutation for sodium stibogluconate resistance gene in cutaneous leishmaniasis cases referred to different health centers during 2006-8. This descriptive study was conducted on 150 isolates of leishmania major and leishmania tropica to identify the mutation in drug resistance gene. Promastigote clones were cultured in enriched RPMI 1640 medium and then the genomic DNA was isolated and using a pair of primers, a 400 bp of the gene was amplified. Finally, the PCR products were screened by conformation sensitive gel electrophoresis [CSGE] method and then the mutation was confirmed using RFLP with Sdu1 enzyme. Screening using CSGE and RFLP methods showed that 6.3% of the samples carried a mutation for drug resistance gene. Results showed a resistance for cutaneous leishmania against sodium stibogluconate. Further studies are required to determine the biochemical mechanism of this resistance

[Detection of drug resistance gene in trichomonas vaginalis by PCR]

Trichomoniasis is a worldwide protozoan parasitic disease. Considering the importance of the disease in public health and the controversial ideas about the prevalence of drug resistance, this study was designed to determine the prevalence of metronidazole resistance gene in trichomonas vaginalis [T. vaginalis] with PCR-RFLP method in Tehran and in Kashan. In this descriptive study 140 samples of T. vaginalis in patients with T. vaginalis infections were collected and assessed microscopically. Then they were isolated and examined by culturing in dorset's medium, DNA extraction and PCR amplification. The PCR products were analyzed using RFLP and suspected samples were sequenced. All but 7 samples were T. vaginalis positive by PCR. Sixty-two samples [44.4%] were examined by microscopic, culture and PCR techniques; 12 samples [8.5%] by microscope and PCR, 56 samples [40%] by culture and PCR and other 3 samples [2.1%] were positive only by PCR. Two samples [1.5%] were also examined for detection of mutation in 18S rRNA gene with RFLP in Tehran. This study shows that T. vaginalis infections in the female population living in Tehran are metronidazole-resistant. Since metronidazole is considered as the drug choice for T. vaginalis infections, more studies are recommended for identification of the drug resistance mechanisms and prevention of the disease

Nitric oxide acts through different signaling pathways in maturation of cumulus cell-enclosed mouse oocytes

Nitric oxide [NO] have a dual action in mouse oocyte meiotic maturation which depends on its concentration, but the mechanisms by which it influences oocyte maturation has not been exactly clarified. In this study different signaling mechanisms which exist for in vitro maturation of meiosis was examined in cumulus cell-enclosed oocytes [CEOs] after injection of pregnant mare's serum gonadotropin [PMSG] to immature female mice. The CEOs were cultured in spontaneous maturation and hypoxanthine [HX] arrested model. Sodium nitroprusside [SNP, an NO donor, 10mM] delayed germinal vesicle breakdown [GVBD] significantly during the first 5 hrs of incubation and inhibited the formation of first polar body [PB1] at the end of 24 hrs of incubation. SNP [10-5M] stimulated the meiotic maturation of oocytes significantly by overcoming the inhibition of HX. Sildenafil [a cGMP stimulator, 100 nM], had a significant inhibitory effects on both spontaneous meiotic maturation and HX-arrested meiotic maturation. Forskolin [an adenylate cyclase stimulator, 6 micro M] and SNP [10mM] had the same effects on GVBD. Forskolin reversed the SNP [10-5M] stimulated meiotic maturation. These results suggest that differences in pathways are present between SNP-inhibited spontaneous meiotic maturation and SNP-stimulated meiotic maturation in mouse oocytes

[Prenatal outcomes in high risk pregnancies according to biophysical profile without non-stress test]

Introduction: the biophysical profile is one of the best methods of assessment of fetal well-being and prediction of adverse prenatal outcomes. Non stress test is a part of biophysical profile which had a high rate of false positive and decreased the score of biophysical profile that resulted to increase cesarean rate due to early intervention for termination of pregnancy

Objective: prenatal outcomes in high risk pregnancies with abnormal biophysical profile score without Non stress test

Materials and Methods: this c ross-sectional descriptive study was performed on 1000 women with high risk pregnancy who was admitted in Alzahra hospital for delivery. Information about variables were found according the contents of their files such as maternal age, gestational age, parity, cesarean rate, 1 and 5 minutes Apgar score <7, fetal heart abnormalities rate, meconium passage, low birth weight, fetal and neonatal death, and preterm labour. The score of biophysical profile 6-8 was considered normal and score <6 were considered abnormal. Data were analyzed by SPSS 11.5 and chi-square and Fisher Exact Test. P<0.05 was considered significant

Results: 1000 pregnant women with high risk pregnancy were evaluated in this study. 24.9% of them had biophysical profile score less than 6 which had considered abnormal. The comparison of the two groups showed that the rate of cesarean section, 1 and 5 min Apgar score < 7, fetal heart abnormalities rate, preterm delivery, and neonatal mortality rate were higher than in abnormal group [P<0.001]. But there weren't statistical significant differences between low birth weight, meconium passage, and fetal death in two groups

Conclusion: the biophysical profile without non stress test can be predicted poor prenatal outcomes in high risk pregnancies

Assessment of health belief model structures along with HbAlC in diabetic patients with optimum and unfavorable diabetes control

Nowadays implementing educational models for identifying reasons of rejecting health issues in the treatment process is increasingly concerned. One of the models which has been a matter of concern in recent years is health belief model. The objective of this study is assessing the structures of this model along with HbAIC in diabetic patients. In this cross-sectional study 76 [insulin dependent and non-insulin dependent] diabetic patients who referred to diabetes clinic of Hormozgan University of Medical Science during July and August 2006 and had been detected as diabetic at least one year prior to recruitment, entered the study after filling consent form. Data collection was performed via 3 questionnaires including demographic information, health belief model and self-efficacy questionnaires. HbA1C was calculated by calorimetry and body mass index [BMI] were calculated. Data by SPSS software, using t-test and pearson's correlation coefficient. 46 women [60.5%] and 30 men were studied. Data analysis revealed that there is no significant difference between HbA1C and the following factors: amount of perceived barriers according to sugar control, amount of perceived self-efficacy based on sex, rate or perceived self-efficacy on the basis of literacy and sensitivity rate perceived by the number of years inflicted with diabetes. Diabetes control is not satisfactory in patients despite long term medication and prejudiced diets. The level of health belief model structures in patients with unfavorable diabetes control is lower than those with optimum control. Hence, a precise educational program based on health belief model is necessity for excelling severity and sensitivity perceived by patients, increasing the perceived benefits and removing perceived barriers

[Survey of prevalence, etiology and associated factors of heart murmurs and extrasounds in the first-grade students in Rasht, 2006-7]

Abstract Introduction: Heart murmurs are common findings of physical examination of children, but most of them are innocent. Recognizing the etiology and associated factors with heart murmurs can help us in differential diagnosis of them. In attention to high prevalence of heart murmurs and low prevalence of congenital heart diseases in children, diagnosis of the innocent murmur with pathologic murmur is important

Objective: Determine the prevalence of heart murmurs and extra sounds, etiology and associated factors in the heart of the first-grade students in Rasht, 2006-7

Materials and Methods: This cross-sectional study was performed on 4080 first-grade students in Rasht. At first, all students were examined by educated physicians and the cases with positive findings in cardiovascular examination were referred to the clinic of pediatric cardiology hospital. Echocardiography, Electrocardiography and if it was necessary Chest X ray, Angiography and Laboratory evaluations were performed for the students with a murmur and heart extra sound who were examined by pediatric cardiologist. Following the determination of definitive diagnosis and complementary history from the parents of the children, all collected data were analyzed by SPSS 15

Results: Among 4080 students [2055 boys,2025girls], 320 students [7.8%] had a heart murmur and extra sound that among of them 292 students [7.15%] had a murmur and 52 students [1.27%] had a extra sound. The prevalence of innocent and pathologic murmurs in the girls were [4.88% and 2.12%] and in the boys were [4.91% and 2.38%], respectively. The prevalence of congenital heart diseases [except MVP] were 1.8%, including MR [0.93%], TR [0.51%], TVP [0.147%], VSD [0.12%], PS [0.12%], ASD [0.07%], PI [0.07%], AS [0.02%], PDA [0.02%], PPH [0.02%] and Ebstein anomaly [0.02%]. The prevalence of MVP was 2.38% and in the girls it was 1.2 times more than in the boys [p<0.05]. The most frequency of pathologic murmurs were in the children which their mothers were 35-39 years old [51%]. The relative frequency of pathologic murmurs in the children, which their mothers used ranitidine and NSAID in the pregnancy, were higher than in other groups. The relative frequency of pathologic murmurs in the children, which their mothers used hair dyes during pregnancy [37%] was higher than the other group [28%]

Conclusion: The present study confirms previous studies, which murmurs are most common finding in children and most of them are innocent. There is no requirement for diagnostic and therapeutic modality. On the other hand, children with pathological murmurs ought to be referred to a pediatric cardiologist for evaluation and treatment

[Comparison the prevalence of varicocele in first degree relatives of patients and kidney donation volunteers]

Introduction: Varicocele is an abnormal tortuosity and dilatation of the testicular veins within the spermatic cord. Varicocele is approximately found in 15% of the general population, despite of the high relatively prevalence of varicocele in the general population, and its association with impaired spermatogenesis and steroid genesis, the paucity available of information and majority of studies were centralized on pathophysiology, methods and results of Varicocele reparation. Regarding to the potential inheritance pattern, we desided to perform this study

Objective: Evaluate the hereditary behavior of varicocele through comparison of prevalence of disease in firstdegree relatives of patients with known varicocele and normal healthy kidney donation volunteers

Materials and Methods: This is a cross-sectional study; Sixty-two patients with known varicocele who were admitted for surgery in Razi hospital between September 2005 and October 2006 were enrolled in the study. Their healthy available first -degree relatives [N=88] were asked to refer and examin. A group of 100 men who were refered for voluntary kidney donation were selected as control group and were assessed for varicocele

Results: Among the 88 first -degree relatives of patients with a known varicocele, 40 cases [45.4%] and 11 cases [11%] of 100 men in control group had a clinically palpable varicocele on physical examination. There was a statistically different. Between two groups among the first-degree relatives, 32 cases [55.1%] of 58 brothers, 8 cases [26.6%] of 30 fathers had palpable varicocele

Conclusion: Clinical varicoceles are more prevalent among first-degree relatives [particularly brothers] of patients with known varicoceles and may be an indicator of hereditary behavior of the disease and necessity of screening for male family members

[ evaluation of the survival rate and motility of freeze-thawed mouse sperm -frozen in and out of the epididym]

Direct contact between a sperm cell and cryopreservation solution has detrimental effects on the cell. In this study the role of the epididymal tissue in the preservation of direct contact between sperm cell and cryopreservation solution during a freeze-thaw process was studied by assessing motility and vitality of the sperm. About 30 male mice were killed and the right caudal epididymis were removed and placed in cryo-preservation solution for two minutes. The samples were exposed to liquid nitrogen vapor for ten minutes and then immersed in liquid nitrogen. The left caudal epididymis were similarly removed and placed in T6 medium. In order to extract sperm, samples were needled and incubated for 1 hour at 37°C. Subsequently, sperm motility and vitality were assessed as control group and then the remaining solution was transmitted into a tube containing cryopreservation solution. For thawing, samples were picked up from a liquid nitrogen tank and kept in room temperature for 20 seconds and then immersed in warm water [37°C] for 2 minutes. Thereafter, sperm motility and vitality were assessed. The survival rates of the three groups [control, outer and inner epididym] were 78.75 +/- 13.01, 34.67 +/- 7.86 and 9.97 +/- 7.08, respectively. The statistical analysis has shown that the difference between the inner and outer epididym was significant [P<0.05]. The progressive motility of sperms in the three groups was 30.29 +/- 15.33, 3.29 +/- 3.55 and 0.00 +/- 0.00, respectively. The progressive motility of sperms in the inner and outer epididym was less than the control group [P<0.05], but there was no significant difference between the inner and outer groups [P=0.344]. The non-progressive motility of sperms in the three groups was 34.72 +/- 12.21, 29.21 +/- 10.37 and 6.78 +/- 4.94, respectively. The statistical analysis has shown that the difference between the control and outer groups and also between the control and inner groups was significant [P<0.05] but the difference between the inner and outer groups was not significant. The quality of cryopreserved-thawed sperm in the outer epididym group was significantly better than in the inner epididym group. In this study we can conclude that the epididym has no protective effect on sperm during cryopreserved processing

[Relation of iron deficiency anemia with first febrile convulsion in 6 month to 5 year old children]

Introduction: There are form studies about possible relation between iron deficiency anemia and febrile convulsion. But these results have not shown a definite and convincing answer yet. In attention to high prevalence of anemia and febrile convulsion in children population and its importance that has a preventable nature this study aims to further survey its possible relation

Objective: This study was carried out to determine the relation of iron deficiency anemia with first febrile convulsion in 6 month to 5-year-old children admitted to Hefdah Shahrivar Hospital, in Rasht in 2006

Materials and Methods: Degree of iron sufficiency parameters including Hemoglobin [HB], Mean Cell Volume [MCV], Mean Cell Hemoglobin [MCH], Plasma Ferritin, Fe and Total Iron Binding Capacity [TIBC] were prospectively measured in 200 children with first FC [FFC] and compared with 200 controls matched regarding age and sex with febrile conditions without convulsion

Results: In our 400 participant febrile children, 233 were boys [58.2%] and 167 were girls [41.8%]. Out of 200 children who had febrile convulsion, 118 were boys [59%], and 82 were girls [41%]. In convulsion group mean HB [10.48 +/- 1.16], MCV [77.5 +/- 6.6], and MCH [25.3 +/- 2.78] were higher than control group but without any statistically significant differences. Mean Fe 58.55 +/- 35.35 [P=0.003], Ferritin 100.23 +/- 114.3 [P=0.005], TIBC 320.89 +/- 49.4 [P=0.002], were higher in convulsive group with no statistically significant differences. From 184[46%] anemic children, 96[52.1%] were without convulsion and 88 children [47.9%] had convulsion, with no statistically significant differences regarding febrile convulsion and iron anemia and with odds ratio = 1.175 shows anemia doesn't have any protection for FFC

Conclusion: We found that there was no relation between iron deficiency anemia and First Febrile Convulsion

[ effects of hyaluronan on fertilization capability of mouse sperm before cryopreservation and after thawing]

Freezing and thawing induce a number of insults to the sperm cells, such as low motility and low fertilization capability. For evaluation of hyaluronan [HA] supplementation on sperm characteristics, we investigated the effect of hyaluronan [HA] on mouse sperm before freezing and after thawing. For this purpose we removed cauda epididimes from 24 male mice with aseptic method and freezed the semen in 1.8ml cryotubes with%18 raffinose and%3 skim milk cryoprotectant solution.We had 4 groups: group 1[fresh control] group 2 [freeze control] group 3[supplemented 750 micro g/ml HA to sperm before freezing] and group 4[supplemented 750 micro g/ml HA to sperm after thawing]. Fertility rate evaluated after routine IVF by counting two-cell stage embryos. HA supplementation [750 micro g /ml] after thawing improved fertilization capability parameters but supplementation before freezing had no effect on mentioned characteristic. Acording to data of present study the hyaluronan supplemen- tation [750 micro g /ml] after thawing has the greatest effect on the fertility rate of sperms

[Ultrastractural study of cells involved in the healing of the parietal bone defects after implantation of octacalcium phosphate [OCP] combined with bone matrix gelatin [BMG] in rat]

This study was designed to identify the cells involved in the healing of the parietal bone defects after implantation of octacalcium phosphate [OCP] combined with bone matrix gelatin [BMG]. Sixteen young male Sprague Dawley rats [5-6 weeks age] were used. A full thickness standardized trephine defects, 5mm in diameter, was made in the rat parietal bone and OCP combined with BMG [in 1/4 ratio] was implanted into the defect. No OCP/BMG particles were implanted in control group that was otherwise treated identically. Cellular identification was carried out on days 7th and 14th after implantation, by light and transmission electron microscopy. Ultrastractural identification of cells involved in the healing of the defects in experimental group on day 7th after implantation, showed full secretory chondroblasts and also showed the integration of newly formed matrix with the defect margins. On day 14th after implantation the results revealed the typical osteoblasts that are active in the defect margins. In experimental group, bone defects were healed through intramembranous ossification route

[Effect of adenotonsillectomy on serum IgA, IgM, IgG levels in patients under 15 years]

Introduction: Surgical removal of adenoid and tonsils is the most common operation in ENT HandN surgery that principally is operated on patients under 15 years. These tissues are arranged as mucosal defense system that is first defense against different organisms and their Ig[s] productions are quite known. Then, this surgery may have an effect on serum Ig[s] levels

Objective: The purpose of the study was to determine whether adenotonsillectomy actually affected on serum Ig[s] levels

Materials and Methods: This study was an experimental-like type that investigated 300 patients under 15 years at Amiral Momenin Hospital in Rasht that needed these operations. Serum Ig[s] levels were measured immediately before and one month after operation. Ig[s] of serum were measured with SRID [Single Radiation Immune Diffusion]. Adenoid and tonsils were removed with curette and adenotome and incision blunt dissection snare respectively

Results: Serum IgG levels of all patients were the same pre and post-operations. Preoperative serum IgM levels of 289 cases were normal, but 278 ones had normally postoperative levels. In 11 patients, serum IgM levels decreased post operation in 11 patients. IgM levels that were low preoperations in 4 patients were changed to normal levels postoperatively. In 296 patients, serum IgA levels were normal pre and post-operation. In 2 of 4 patients, IgA levels reached normal range postoperatively

Conclusion: Adenotonsillectomy has no significant effect on serum Ig[s] levels

Differential sensitivity of male and female neuronal cells may play a role in onset of neuronal diseases

Due to the worldwide increase in the number of older people in both developed and developing countries, there is a public health concern for dealing with age related diseases such as neurodegenerative diseases. There is little known about the difference in neuronal cell responses between genders. Our understanding of the neuronal cell response regarding genders, will be useful for developing more efficient therapies for these diseases such as Alzheimer's disease. To investigate gender differences in neuronal cell response against cell death inducers, we examined the percentage of cell death in male and female mouse primary cortical neuronal cultures. Our findings indicate that there is a difference in cellular response to ethanol [a cell death inducer] that may be the basis of how they behave in vivo of what may be seen in adults, as they age. These observation support this idea that genetic factors, most likely governed by X or Y chromosomes

Two case reports of emphysematous cystitis in two diabetic patients with related literature review

Emphysematous cystitis is a rare form of acute infection of the bladder is which most cases are seen in diabetic patients. Most infections are due to E.coli and Klebsiella species. Predisposing factors are diabetes mellitus, recurrent urinary tract infections, bladder outlet obstruction and neurogenic bladder. CT-scan is the most sensitive method of diagnosis that detects air whithin intramular of bladder that is pathogonomonic of the disease. In this case report we reported two cases of emphysematous cystitis. The first case was a 73 years old diabetic woman who was admitted due to acute renal failure after cholecystectomy. During hospitalization, after remission of renal function, she developed fever, abdominal pain, hematuria and progressive abdominal distention. In physical examination she had generalized abdominal tenderness with dominance in the lower abdomen without rebound tenderness which with observation of air in intramural bladder by CT-scan, diagnosis of emphysematous cystitis was confirmed and the patient was treated and improved. The second case was a 37 years old diabetic woman. She was refered to the hospital because of nausea, recurrent vomiting and abdominal pain. In physical examination she had severe hypotention, generalized abdominal tenderness that was dominant in the lower abdomen and abdominal mass in suprapubic area. Suspicious to emphysematous cystitis, pelvic CT-scan was ordered. By observation of air in intramural bladder, emphysematous cystitis was confirmed. Patient was treated with antibiotic, insertion of fouly catheter and was improved. Undiagnosing or delaying in initiating appropriate treatment can lead to peritonitis secondary to intraperitoneal perforation of the bladder, septisemia and ultimately death of the patient. Timely diagnosis and aggressive therapy are important for the survival of these patients

[Assessment of prevalence and risk factors associated with early post- partum hemorrhage in cesarean deliveries]

Introduction: one of the most important cause of mortality in parturients is early postpartum severe hemorrhage that accounts for 28% of maternal death

Objective: the aim of this study was to determine prevalence of postpartum hemorrhage in cesarean section and requirement of blood transfusion during 24 hours after operation

Materials and Methods: this was a cross sectional study that performed among patients who underwent cesarean section at Alzahra Hospital in Rasht in 2000. Selection of 1600 records out of 3200 records by systematic Randomization was the base of this study. Of these, 100 records were omitted because of poor information and the rest [1500 records] were considered with these variables: blood transfusion requirements, kind of anesthesia, amnionitis, kind of uterine incision and labor abnormalities. Test of chi-square has been used for making a comparison between two groups, namely those requiring blood transfusion and those who didn't need it

Results: our study showed that incidence of early postpartum hemorrhage in cesarean deliveries was 2.26 percent and it was similar to other studies and the risk factors associated with early postpartum hemorrhage were pre-eclampsia, labor abnormalities and general anesthesia

Conclusion: considering the results obtained, women with preeclampsia or labor abnormalities or receiving general anesthesia, were at higher risk of early severe hemorrhage after cesarean section. Thus, the hospital should be well- equipped in dealing with such high- risk patients

subacute effects of cadmium on sex hormones in female rats

Toxic effects of trace elements upon the hypothalamic- pituitary- testicular axis and sex hormones have been reported in recent years. It is generally considered that CdCl2 poisoning causes histopathological changes in the testicles of male rats. Little attention had been drawn to the possible toxic effects of CdCl2 on the ovary and female sex hormones. The purpose of the present study was to determine the subacute poisoning effects of CdCI2 [10 mg/kg I.P. for 15 days] on the female gonadotropins and sex hormones such as FSH, LH, progestrone, estradiol and prolactin. Female wistar rats 12 weeks of age [approximately 300g] were divided into two groups [10 in each group], one group received CdCl2 and the other received saline as a control. Serum hormones were measured by radioimmunoassay. In contrast to male animals, CdCl2 injection did not affect serum FSH and LH concentration in female rats, whereas serum prolactin concentration was significantly elevated compared with that of control animals [p<0.05] after CdCl2 injection. This effect is not similar to the effect of CdCl2 on the prolactin of male rats which was reported by Chandler and coworkers. No marked differences were observed between the control and experimental values of serum estradiol and progestrone concentrations