[Detection of the YMDD motif mutations rate in chronic hepatitis b patients treated with lamivudine]

Lamivudine is the first nucleoside analogue licensed for the treatment of chronic hepatitis B patients which is effective in suppressing virus replication and results in reduced disease activity. However the most important problem of lamivudine treatment is the emergence of lamivudine resistance strains with amino acid substitution in the YMDD motif of the DNA polymerase during the treatment. The aim of this study was to evaluate the frequency of YMDD motif mutations in chronic hepatitis B patients treated with lamivudine. 56 chronic hepatitis B patients who had not previously received interferon and/or a nucleoside/nucleotide analogue, received lamivudine for a minimum of 6 months were examined in this study. HBV DNA was extracted from serum samples, and YMDD mutations in the HBV DNA polymerase gene was determined using PCR-direct sequencing. HBV DNA quantification was determined using real-time PCR. 56 patients 39 [69.6%] male and 17 [30.4%] female with mean age of 34.12 +/- ] 13.6 [were evaluated. YMDD motif mutations were observed in 15 out of 56 patients [26.7%]. 8 of these mutations [14.2%] were in the form of YIDD and the remaining 7 [12.5%] in YVDD form. Serine mutation at YMDD motif was not found in this study. YMDD motif mutations leading to lamivudine resistance is common in our chronic hepatitis B patients. Molecular diagnosis of YMDD motif mutations using methods such as direct DNA sequencing can detect upcoming viral resistance in chronic hepatitis B patients

[Zinc plasma level in patient with human immunodeficiency virus infection that come to high risk behavior consult center or admit in infectious disease ward in Imam Khomeini hospital and compare to HIV negative group in 2005]

Zinc is one of the essential micronutrients and its role in immune system function is an interesting matter for researchers. HIV/AIDS as an immune system disorder, presents with impairing in elements of immune system. This study was designed for assessment of zinc level of serum in a group of HIV[+] patients and compare with non-HIV people. Determining relationship between zinc level of serum and count of immune cells was another aim of this study. This cross-sectional study was conducted with 96 people in 2 groups: 48 HIV[+] and 48 HIV[-]. HIV negative group was divided in 2 subgroups: IV Drug Users [IDUs] and non- IDUs. Zinc level of serum was measured with atomic absorption method and statistical analysis was conducted with SPSS for Windows. Levels of zinc were compared in different groups. Overall means of main groups had significant differences, and HIV[+] group showed a significant difference with 2 other groups too. In addition, 2 groups of HIV[-] had significant difference. There was a relationship between count of CD4 cells and zinc level of serum. Zinc showed lowest level in HIV[+] IDUs, then HIV[-] IDUs and finally HIV[-] non-IDUs. The results demonstrate zinc level impairment in HIV[+] cases and its association with decrease in determinant parameters of survival such as count of CD4 cells

[Zinc plasma level in patient with human immunodeficiency virus infection that come to high risk behavior consult center or admit in infectious disease ward in Imam Khomeini Hospital and compare to HIV negative group in 2005]

Background: zinc is one of the essential micronutrients and its role in immune system function is an interesting matter for researchers. HIV/AIDS as an immune system disorder, presents with impairing in elements of immune system. This study was designed for assessment of zinc level of serum in a group of HIV+ patients and compare with non-HIV people. Determining relationship between zinc level of serum and count of immune cells was another aim of this study

Materials and Methods: this cross-sectional study was conducted with 96 people in 2 groups: 48 HIV+ and 48 HIV-. HIV negative group was divided in 2 subgroups: IV Drug Users (IDUs) and non- IDUs. Zinc level of serum was measured with atomic absorption method and statistical analysis was conducted with SPSS for Windows. Levels of zinc were compared in different groups

Results: overall means of main groups had significant differences, and HIV+ group showed a significant difference with 2 other groups too. In addition, 2 groups of HIV- had significant difference. There was a relationship between count of CD4 cells and zinc level of serum. Zinc showed lowest level in HIV+ IDUs, then HIV- IDUs and finally HIV- non-IDUs

Conclusions: the results demonstrate zinc level impairment in HIV+ cases and its association with decrease in determinant parameters of survival such as count of CD4 cells

Myeloperoxidase deficiency in neutrophils of diabetic patients with and without infectious diseases

Myeloperoxidase [MPO], an iron-containing protein, is found in the azurophilic granules of neutrophils [PMNs], and catalyzes the conversion of hydrogen peroxide and chloride ions [Cl] into hypochlorous acid, which plays an important role in oxygen-dependent bacterial killing. The enzyme was first isolated in 1941, and deficiency of MPO was first described in 1954. Fewer than 5% of patients with MPO deficiency contract severe infections, which are usually fungal infections in diabetes mellitus [DM] patients. Besides the disorder in antifungal activity, diminished rate of bacterial [S. aureus] killing, and carcinogenesis, it seems that MPO deficiency is also related to atherosclerosis, degenerative neurologic diseases, as well as other disorders. In this study, we compared the levels of the MPO enzyme in the peripheral neutrophils of infected and non-infected DM patients at Imam Khomeini Hospital during 2005-2006. We compared these two groups the prevalence of MPO deficiency in each group, in order to then determine any correlations this may have with infection. In this case-control study, 50 patients were in the infected group [case group] and 50 were in the control group. Patients were chosen using simple sampling methods. Data was gathered from blood samples, using a qualitative test to determine MPO deficiency [Kaplow stain], laboratory results [BUN, Cr, PMN, HbA1c], interviews and completion of a questionnaires, as well as hospital records. Data were analyzed with SPSS software using T test and chi-square test, with a confidence index of 0.05. In spite of differences seen in stained slides, the MPO enzyme was positive in all of the patients, and no differences were seen between the two groups. The average patient age and the duration of DM in the case group were more than those of the control group. No statistical differences in the type of DM and glycosylated hemoglobin [HbA1c] levels were found between the two groups. Body mass indexes [BMI] and PMN counts were higher in the case group. The most prevalent infections were in the skin and soft tissue, bones and joints, as well as chronic respiratory infections [TB], pneumonia, urinary infections, CNS infections, gastrointestinal and intra-abdominal infections, mucormycosis, and sepsis. We found no correlation between MPO enzyme deficiency and age, sex, type or duration of DM, HbA1c levels and BMI

Haematological manifestations of brucellosis

Brucellosis is a major health problem in many parts of the world, particularly in the Mediterranean and Middle East. Very few data on the frequency and diversity of haematological abnormalities occurring in brucellosis have been reported. In the present study 85 patients with brucellosis in Imam Khomeini Hospital during 1997-2002 were investigated retrospectively to determine the haematological changes during the active course of this infection. Inclusion criteria included a compatible clinical picture with either a positive blood culture or bone marrow culture for brucella organism or a brucella antibody titre of 1/80 [Wright agglutination test], and 2MB [2-mercaptoethanol] of 1/40 or coomb's Wright with any titre. Anemia was detected in 43.5% patients, leukopenia in 13.6%, thrombocytopenia in 12.5% and pancytopenia in 2.4% of patients. Unusual complications were detected in two patients, one with mouth bleedings, the other with purpuric skin lesions of the lower extremities, both patients had endocarditis. As brucellosis is common in our region it may be considered in patients whose blood picture reveals haemolytic anemia, leukopenia, thrombocytopenia or pancytopenia, particularly when the disease is epidemiologically suspected

[Community-acquired pneumonia: a comparison between elderly and nonelderly patients]

Community-acquired pneumonia could be a life-threatening condition especially in elderly patients. The factors influencing the outcome in elderly patients are thought to be different from those in young adults. We compared the clinical and paraclinical profiles in elderly and nonelderly patients with community-acquired pneumonias. In this cross-sectional study, seventy nine patients who were hospitalized with community acquired pneumonia over a period of one year were included. Patients' medical records were reviewed; and data related to comorbid conditions, signs and symptoms, laboratory and radiographic findings were gathered using a checklist. The clinical features, laboratory parameters and complications from pneumonia were almost similar in 41 elderly [group I, age