Wait-and-see policy versus cholecystectomy after endoscopic sphincterotomy for bile-duct stones in high-risk patients with co-existing gallbladder stones: a prospective randomised trial

Endoscopic sphincterotomy [ES] is one of the most important advances in the treatment of common bile duct [CBD] stones. However, the use of ES to remove CBD stones in high-risk patients without cholecystectomy is still debatable. The aim of this study was to compare the efficacy of a wait-and-see policy versus cholecystectomy after ES for CBD stones in high-risk patients with co-existing cholelithiasis. A total of 162 patients after undergoing ES with the clearance of CBD stones were randomised after informed consent to cholecystectomy or conservative management of their gallbladder stones. The results indicated that cholecystectomy after ES for CBD stones significantly reduced the biliary complications in high-risk patients. Every patient who has both CBD stones and gallstones with significant co-morbid illnesses, after clearance of CBD stones by ES, should undergo early cholecystectomy

Radical scavenging and antibacterial activity of Arnebia benthamii methanol extract

OBJECTIVE@#To evaluate in vitro antioxidant and antibacterial activity of methanolic extract of Arnebia benthamii (A. benthamii) whole plant.@*METHODS@#Plasmid damage was analyzed by agarose gell electrophoresis. Calf thymus DNA was monitored by TBARS formation. DPPH, reducing power and lipid peroxidation was evaluated by using standard procedures. Antibacterial assay was monitored by disc diffusion method.@*RESULTS@#DPPH radical scavenging and hydroxyl radical scavenging potential of the plant revealed that the extract to be active radical scavenger. Reducing (Fe(3+)-Fe(2+)) power and lipid peroxidation inhibition efficiency (TBARS assay) of the extract was also evaluated and the extract showed promising activity in preventing lipid peroxidation and might prevent oxidative damages to biomolecules. The extract offered a significant protection against plasmid and calf thymus DNA damage induced by hydroxyl radicals. The extract was also evaluated on different bacterial strains and the maximum antibacterial activity was exhibited against Escherichia coli (E. coli) when compared with standard drug.@*CONCLUSIONS@#These findings demonstrate that the methanol extract of A. benthamii has excellent anti-oxidant activities and could be considered as a potential source of lead molecules for pharmaceutical industries.

[Immunostimulatory and growth stimulation effects of Ergosan, Levamisole and herbal extracts in Cyprinus carpio]

Enhancement of the immune system seems to be the most promising method of preventing fish diseases and increasing growth rate. Biodegradable and biocompatible immunostimulants obtained from natural sources [particularly herbal extracts] have received great attention for fish. In this study the immunostimulatory and growth stimulation effects of herbal extracts [Echinacea purpurea, Boswellia thurifera, Zataria multiflora], Ergosan and Levamisole were evaluated in common carp. 450 fish [11.12 +/- 1.22 g] were randomly divided into 6 groups in triplicate and fed with experimental diet for 6 weeks. Fish in groups I to 5 were fed by food supplemented with E. purpurea, B.thurifera, Z.multiflora, Ergosan and Levamisole, respectively. Group 6 was fed with basal food without supplementation. The Growth performance indices were evaluated at the end of study and blood samples were collected from 6 fish in each group. Packed cell volume, haemoglobin concentration, red blood cell counts, white blood cell counts mean corpuscular hemoglobin, mean corpuscular volume and mean corpuscular hemoglobin concentration were compared among the groups. In each group, thirty fish were challenged with live Aeromonas hydrophila on day 42 and mortality rate was studied. Mortality rate showed no significant difference among groups [p>0.05]. Specific growth rate [SGR] and food conversion rate [FCR] showed significant increase in all groups except [Zataria multiflora] compared to the control. Post challenge mortality rate decreased in all groups except [zataria multiflora] compared to the control [p<0.05]. WBC values in Ergosan, E.purpurea and levamisole groups were 7830 +/- 590, 7750 +/- 500 and 7380 +/- 810 per mL respectively which, showed significant [p<0.05] increased compared to the control goup [6380 +/- 123mL], However no significant changes were seen in the other haematological parameters [p>0.05]. It can be concluded that extract of E. purpurea and B.thurifera have immunostimulatory and growth stimulation effects in common carp which are comparable with the effects of two well documented fish immunostimulants, Ergosan and Levamisole

Seroepidemiological study of visceral leishmaniasis in Booyerahmad district, south-west Islamic Republic of Iran

Visceral leishmaniasis [VL] is endemic in parts of Islamic Republic of Iran. A cross-sectional seroprevalence study was carried out in children in Booyerahmad district in the south-west of the country. Serum samples were taken from 1628 children up to 10 years old from different areas in Booyerahmad in 2005-06. Anti-Leishmania antibody was detected in 50 out of 1628 children [3.1%] by direct agglutination test [antibody titre > 1:3200]. There was no significant difference in seropositivity between the sexes [2.8% males and 3.3% females]. The highest rate of infection [5.2%] was in the age group 10 years. Further studies are needed to explore the reservoirs and vectors of the disease in this region

[Effects of eucalyptus globules labill essential oil on some immunological variables of common carp [cyprinus carpio]]

Influence of both dietary and bath administration of Eucalyptus globules labill was evaluated on some immunological variables of common carp [Cyprinus carpio] under temperature less than optimum in order to determine stimulatory effect of the essential oils. Fish weighing 30-35 g were bathed or fed with different doses of 30, 60 and 120 micro/L or mg/kg feed for a period of 8 days. Serum lysozyme activity, bactericidal activity, total white blood cells, total protein, globulin and albumin were measured on days 1, 2, 8, 15 and 23 after the essential oils administration. On day 23 post administration the remaining fish from each group were intraperitonealy injected with killed Aeromonas hydrophila [6x10[8] cells/ml] and antibody titer was measured 3 weeks later. The obtained results showed that Eucalyptus globules had a limited immunostimulatory effect on these immunological variables although antibody titers and total white blood cells in some test groups were significantly [p<0.05] higher than the control one. The reduction of the immunological factors is probably related to the lower water temperature, inappropriate administrating dose and duration of essential oils administration

Study on distribution of infectious hematopoietic necrosis [IHN] in five major provinces producing rainbowtrout [oncorhynchus mykiss] fry in Iran by indirect fluorescence antibody [IFAT] and nested -RT- PCR techniques

Distribution of infectious hematopoietic necrosis[IHN] was studied in five major provinces producing rainbow trout[Oncorhynchus mykiss]fry in Iran by indirect fluorescence antibody IFAT and nested-RT-PCR techniques. Also the effect of time duration was examined on some positive samples after 8 months post sampling. Samples of kidney, liver and spleen of rainbow trout fries collected from 27 trout farms were processed and examinated. Fourteen trout hatcher is located in all provinces were identified to be contaminated with IHNV tested by both techniques. The obtained results also showed that nested-RT-PCR is more sensitive than IFAT test particularly if samples are stored for a longer time

[Prevalence of hepatitis B antibodies in health-care workers in Yasuj Hospitals]

Hepatitis B is a common infection in the world and one of the main health problems in our country. Over 350 million people are infected with Hepatitis B virus in the world and are chronic carriers of this infection. Health care workers are at risk of infection with blood born viruses including hepatitis B [HBV]. This study was conducted to find out the rate of anti-HBs antibodies among the health-care workers [HCW] in Yasuj hospitals, Southwest of Iran. This is a cross sectional descriptive study in which 212 staff was randomly selected from different wards of the hospitals in Yasuj. Blood samples were taken from each individual and tested for hepatitis B surface antibody [anti-HBs] by ELISA. Those who had anti-HBs titer > 10 IU/ml were considered as positive. Collected data were analyzed by SPSS software using descriptive data analysis and chi-square test. 61.3% of the subjects were female and 38.7% were male. 93.9% of the subjects had a history of one to three doses of hepatitis B vaccination. Results of this study showed that 185 [87.3%] of the staff have anti hepatitis B antibodies [Anti-HBs]. Among the staff that was negative for anti-HBs antibody, 12 had a history of hepatitis B vaccination [at least one dose]. Female employees were more positive than males [93% vs. 78%] and this difference was statistically significant [p<0.05]. Moreover, a positive correlation was found between the titer of antibody and sex where females had a higher titer of antibody in comparison with males [p<0.05]. No correlation was found between the workplace of HCW and positive anti-HBS. Result of this study indicates that more than 85 percent of the health-care workers in Yasuj have reasonable immunity against hepatitis B infection. A small proportion of HCWs had no immunity against HBV. The second course of hepatitis B vaccine should be delivered to those who had no immunity against hepatitis B despite their receiving the first course of vaccination

[Case series report of renal cell carcinoma with inferior vena cava involvement [surgery techniques and results in 8 patients]

Renal cell carcinoma can be presented with extension of thrombosis to renal vein and inferior vena cava. Management of these patients consists of radical nephrectomy and thrombectomy. In this study we reviewed approach to these patients. This is a case series report. During 1379 to 1384, 148 patients diagnosed with renal cell carcinoma [RCC] limited to Gerota's fascia [stage T3 or less] were admitted to Hasheminejad hospital. Fourteen patients had inferior vena cava [IVC] involvement. Radical nephrectomy as well as thrombectomy was performed in 8 patients. This investigation is done on these 8 patients. Patients' average age was 51.4 years. Six patients were male [75%] and 2 female [25%]. The most common symptoms were flank pain [75%], gross hematuria [62.5%] and structural symptoms [50%]. All patients had tumors limited to Gerota's fascia without any distant metastasis. Infrahepatic involvement of IVC was seen in 6 patients and in 2 patients thrombosis extended above the hepatic vein [infrahepatic]. No perioperative mortality was seen. Postoperative complications were atelectasia in 2 patients and deep vein thrombosis in one which was treated with conservative management. By skillful surgical approach in patients with RCC and IVC involvement, thrombosis can be completely excised without increasing the rate of complications and long term survival could be expected

Risk factors and laboratory diagnostics for post renal transplant tuberculosis: a case-controlled, country-wide study on definitive cases

Tuberculosis [TB] is a common cause of morbidity and mortality in renal transplant recipients. It is usually misdiagnosed because of lack of medical awareness and its infrequency in renal transplant recipients. 44 cases [0.3%] with post-transplant TB out of 12820 patients who had renal transplants performed between 1984 to 2003 were found from the hospital records of 12 major kidney transplantation centers in Iran. These cases were compared with 184 healthy transplant subjects whose transplants were performed by the same surgical team as the controls. The mean age of cases and controls was 37.7 [13-63] and 35.6 [8-67] years [p=0.3], respectively. The mean duration of pre-transplantation hemodialysis was 30.3 [3-168] months in cases and 18.2[1-180] months in controls [p=0.03]. A past history of tuberculosis was detected in 2 cases and 1 control [p=0.3]. The mean doses of initial and maintenance immunosuppressive drugs in cases and controls were not significantly different. A total of 25 cases [56.8%] and 60[32.6%] controls had rejection prior to diagnosis of TB [p=0.004; OR=2.7, CI95%: 1. 3-5.6]. To our knowledge, this is the first study that demonstrated increasing risk of post-transplant TB by extending the duration of pre-transplant hemodialysis and the number of post-transplant rejection episodes. Further study is needed to clarify our new findings specifically in respect of different immunosuppressive regimens

results of grade IV cystocele repair using mesh

To evaluate the results of grade IV cystocele repair by 4-corner bladder and bladder neck suspension technique, using prolene mesh. Thirty-one women with a median age of 61 years and severe anterior vaginal wall prolapse [grade IV cystocele] were treated by 4-corner bladder and bladder neck suspension technique, using prolene mesh. Of these, 3 had associated uterine prolapse, rectocele, and enterocele, one had rectocele and enterocele, and 18 had rectocele only. In these cases, pelvic floor defects were also repaired simultaneously and in 3, vaginal hysterectomy was done. Twelve patients had a previous failed cystocele repair. In a 32-month follow-up, the patients were evaluated with vaginal examination and upright cystography. Urinary continence during increased intraabdominal pressure was also assessed, based on subjective symptoms. None of the patients had cystocele recurrence. Urinary continence during increased intra-abdominal pressure was seen in all of the patients. Intraoperative rectal or bladder injury did not occur. Transfusion was not required in any of the cases. Early complications [6 to 8 weeks postoperatively] included irritative urinary symptom in 17 patients, of whom, 8 had documented urinary tract infection that were treated successfully. Late complications were spotting in 3 cases [two were treated with topical estrogen and vaginal mucosal repair was done in one], dyspareunia in 4 sexually active patients, changes in urination pattern in 28 [improved significantly with behavioral therapy], long-term urge incontinence [>8 weeks] in 5 [medical treatment was successful in these patients], and prolonged intermittent catheterization in 1. Pelvic abscess and migration of mesh were not observed. According to our findings, using mesh in patients with grade IV cystocele, who had a previous failed surgery or weakness in supportive pelvic tissue, is an appropriate treatment modality

[Comparison of physical properties of zinc contained restorative dental cements made in Iran with world standard]

Background: Zinc contained cements are commonly important cements used in restorative dentistry. Therefore, cements that are used must be tested and assured

Objective: to measure compressive strength, setting time and solubility and disintegration of Iranian zinc contained cements included zinc oxide - eugenol, zinc phosphate and zinc polycarboxylate

Methods: an Iranian company dental products, used as prototypes and a German company dental products as proof samples. For compressive strength test, 11 samples provided from each types of cements. For setting time test, 16 samples provided from zinc oxide - eugenol cement and 11 samples from two others. For solubility and disintegration 11 samples provide from zinc oxide - eugenol cement. A Hypothesis test with confidence interval of 95% was used for means estinating

Findings: the means of zinc oxide - eugenol, phosphate and polycarboxylate cements are: 12.58, 37.21 and 35.86 MPa. Setting time are: 49.04, 5.41 and 2.5 minutes. Solubility and disintegration of zinc oxide - eugenol cement is 8.44%

Conclusion: by comparision of results and standards, it's concluded that none of Iranian cements are standard and not recommended for use