[ Case-Control study on the risk factors of IBD in 258 Iranian patients]

Ulcerative colitis [UC] and Crohn's disease [CD] are chronic inflammatory bowel diseases [IBD] with uncertain etiology thought to be triggered by interactions between various environmental, genetic and immunologic factors. Role of different factors in IBD are controversial. The aim of this study is to determine the possible risk factors in a group of Iranian patients with IBD. Ninety five consecutive cases of CD and 163 cases of UC were included. Age matched controls were randomly selected. A total of 489 controls for UC and 285 controls for CD were enrolled. A standard record concerning many variables was completed. Logistic regression analysis was used to evaluate potential confounding variables. A statistically significant protective effect for smoking in UC was found [OR=0.18 95% CI=0.064-0.504, p < 0.05]. The risk of UC increases with prolonged exposure to OCP [OR=0.99, 95% CI=0.98-0.99, p< 0.05]. In patients with CD, 15 cases [15.8%] reported a previous history of appendectomy compared with 19 controls [6.7%] [OR=2.6, 95% CI= 1.2-5.4, p < 0.05]. Tonsillectomy was reported by 16 patients [16.8%] with CD compared with 25 controls [8.8%] [OR= 2.1, 95% CI= 1.07-4.1, p < 0.05]. The logistic regression analysis showed that both appendectomy and tonsillectomy are risk factors in CD. No association with other variables was found for either disease. Current smoking was a significant protective factor in UC. We observed a relationship between duration of OCP use and UC. Duration of using OCP in UC cases was significantly more than controls. Both appendectomy and tonsillectomy were risk factors in CD in this study

Time trends of gastro-esophageal reflux disease [GERD] and peptic ulcer disease [PUD] in Iran

Epidemiology of diseases changes over time with changes in socio-economic status, culture and health care systems. Gastroesophageal reflux disease [GERD] and peptic ulcer disease [PUD] are among the diseases whose epidemiology has changed over the past few decades in the west. Studies addressing the trend of GERD and PUD occurrence in Iran are lacking. We aimed to look at the time trends of GERD and PUD in a referral endoscopy clinic in Tehran, Iran. All patients with dyspeptic symptoms who underwent upper GI endoscopy from 1993 to 2005 [inclusive] in a tertiary outpatient GI referral center in Tehran were enrolled. Erosive esophagitis [EE, used as a proxy for GERD as a whole], PUD, rapid urease test [RUT] status and demographic characteristics were recorded from the endoscopy reports according to the year the endoscopy was performed. Over a period of 13 years, 8,029 endoscopic examinations were performed. The most common endoscopic diagnosis was EE that occurred in 4,808 patients [59.8%] followed by duodenal ulcer in 2,188 [27.3%] and gastric ulcer in 88 [1.1%]. Over 13 years [1995-2005], the proportion of EE increased from 14.1% in 1993 to 75.1% in 2005 among dyspeptic patients in this referral clinic. The proportion of each grade of GERD according to the Los Angeles classification was as follows: GERD-A 76.0%, GERD-B 20.9%, GERD-C 2.8% and GERD-D 0.3%. RUT positivity decreased from 71.4% to 9.5% during the study period. This study shows a remarkable increase in EE with a concomitant decrease in PUD and RUT positivity among dyspeptic patients in Tehran over a decade. This change in trend is important for future health care planning

Digestive and liver disease statistics in Iran

Gastrointestinal and liver diseases [GILD] are among the most common causes of morbidity in Iran and constitute a substantial proportion of mortality which imposes enormous economic consequences. Our purpose is to collect information and report current statistics on physician visits, hospitalizations, and deaths due to common GILD in Iran. Data on the leading causes of death were obtained from the Iranian Ministry of Health, Office of Health Statistics. A total of 213,322 deaths were reported from March 2003 to February 2004 [excluding mortality from the Bam earthquake] which equaled 4.4 deaths per 1000 population. Of these, 36,575 were due to accidents. Causes of death were reported on the basis of the 10th revision of the International Classification of Diseases [ICD-10; 1992]. The leading causes of hospitalization were obtained from the database of the GILD ward in Shariati Hospital, one of the largest and best known gastroenterology referral hospitals in Iran. Similarly, leading causes of out-patient referrals were identified from a large multi-physician outpatient clinic in Tehran. The five leading gastrointestinal causes of death in order of frequency were: gastric cancer, hepatobiliary cancer, liver cirrhosis, esophageal cancer, and colorectal cancer. The five leading causes of hospitalization in the GILD ward of Shariati Hospital were: liver cirrhosis, hepatitis, peptic ulcer disease, cholycystitis and cholangitis, and colorectal cancer. The most common outpatient diagnosis was gastroesophageal reflux disease followed by irritable bowel syndrome [IBS], duodenal ulcer [DU], non-ulcer dyspepsia, and chronic hepatitis B [HBV]. Gastrointestinal and liver malignancy along with chronic liver disease constitute the main GILD reasons for hospitalization and deaths in Iran. Gastroesophageal reflux disease, IBS, and chronic HBV are the most common GILD outpatient diagnoses

[Effects of quinolones on biofilm formed by Staphylococcus epidermidis isolated from patients with urinary tract infection]

Bacterial cells of Staphylococcus epidermidis are naturally occurring on skin and human mucosal membranes. They also cause nosocomial infections. Capability of biofilm formation plays an important role in the bacterial virulence. Quinolones have been used to treat urinary tract infections caused by S. epidermidis for several years. Thus, resistance to this type of antibiotics has emerged among the strains of this organism. Since the bacterial cells residing within biofilm structures are more resistant than those in planctonic stage, we conduct this study to examine the effect of quinolones was the main goal of ones study of higher resistance of native biofilm producing strains is the goal of this project. In this research ten native isolates of S. epidermidis were obtained from patients with urinary tract infection. Also standard strain of S. epidermidis PTCC 1435 was used as a control. Identification of strains was confirmed using morphological and biochemical tests. Challenge tests against the isolated was performed using three quinolone antibiotics including Ciprofluxacin, Ofluxacin, Nalidixic acid, with two different procedures: kirby bauer disk diffusion test, and broth dilution test. Average of MICs of above mentioned antibiotics against ten isolated was obtained as follow: Ciprofluxacin [7/375 micro g /micro l], Ofluxacin [11/53 micro g /micro l], Nalidixic acid [2597 /2 micro g /micro l]. Experimental biofilm model of these bacteria showed much higher resistance to quinolone antibiotic, from 15 times in case of Nalidixic acid to 18 times greater resistance in case of Ciprofluxacin. Average of MICs among ten isolates against the three antibiotics also showed increased resistance as follow: Ciprofluxacin [128/4 micro g /micro l], Ofluxacin [177/8 micro g /micro l], Nalidixic acid [3942/4 micro g /micro l]. S. epidermidis showed increased resistance to different quinolone antibiotics in biofilm structure, comparing to those of planktonic form. Results obtained from this research is in agreement with those of other similar projects; and emphesize on applying of adequate doses of antibiotics against urinary infection caused by biofilmic Staphylococcus epidermidis

[In vitro anti-Helicobacter pylori activity of cumin [Cuminum cyminum L.] and tarragon [Artemisia dracunculus L.] extracts]

Helicobacter pylori [HP] infection is the most common gastrointestinal bacterial disease worldwide. It is known that HP could be eradicated by a combination of therapeutic agents, but sometimes the cure thus achieved is incomplete and undesirable side effects are certain to occur. On the other hand, the anti- Helicobacter pylori effect of traditional herbal medicines has not been extensively studied. Cumin and tarragon are plants that are native to Iran and it has been reported that they are beneficial in gastric problems. In this study their activity against HP was examined. Percolated methanol and aqueous extracts of plant leaves were tested against 45 clinical isolates of HP. Growth inhibition was determined by the filter paper disc diffusion method on modified egg yolk emulsion agar [EYE agar] compared with amoxicillin and metronidazole. The effect of both methanol extracts of cumin and tarragon were significantly better than their aqueous extracts [p<0.001]. Methanol extract of tarragon and aqueous extract of cumin exhibited the most and least anti-HP activity, respectively. The minimum inhibitory concentration [MIC] of methanol extract s of cumin and tarragon were 691 micro g/ml. Both of two methanol extracts preserved their anti-HP activity after autoclaving for 20 min. Preliminary phytochemical screening of the cumin methanol extract indicated the presence of saponins and in the tarragon methanol extract indicated presence of saponins and tannins. Screening among natural resources and plants, which are used in folk medicine for gastric problems could be beneficial. This study demonstrated that tarragon and cumin inhibited the growth of H. pylori strains in vitro

relation between third day FSH level and incidence of poor response in patients undergoing ART cycles

The number and the quality of oocyte are very important in ART cycles. The level of FSH on third day of menstrual cycle plays an important role in success ART cycles. To study the relation between third day FSH level and ovarian response in patients undergoing control ovarian hyperstimulation for IVF cycles. This was an analytical study in which 2200 files form patients referred to Royan institute between 1991 and 1999 were examined. The study group included 212patients whose serum FSH was measured for a maximum of six months before ovation stimulation with long protocol GnRHa. Exclusion criteria included endometriosis and pervious treatment with ART. The patients were divided into two groups on the basis of third day serum FSH levels. Group I included 36 patients with FSH >/= 151IU/L and group II included 176 patients with FSH<151IU/l. The data [age, number of mature follicles, infertility duration, infertility type, and the levels of FSH, LH and progesterone] were analyzed X[2], t-test and Fisher's exact test. Finding: There statistically significant differences between two groups in the number of mature follicles [3.3 +/- 3.3 vs. 5.2 +/- 2.9, respectively], number of oocytes [4.5 +/- 7.75 vs. 7.0 +/- 5.5]], number of transferred embryos [1.4 +/- 1.5 vs. 2.2 +/- 1.7], number of cancelled cycles [30.5% vs. 2.8%] and the level of serum LH [23.5 +/- 20.5 vs. 9 +/- 8.5]. The third day level of serum FSH can be relatively used as a predictor of ovarian reserve and success of ART cycles

Cloning of protective antigen gene from Bacillus anthracis into Bacillus subtilis

Protective antigen [PA] of Bacillus anthracis is used as anthrax vaccine. Cloning and expression of the PA gene in various strain such as E.coli and Bacillus subtilis was reported that most expression was in B. subtilis up to 160 microg/ml. The objectives of this study were: to clone the gene of PA in an expression vector [pWB980] and then transformation into the B. subtilis WB600 strain. The pXOl plasmid was separated from the strain stern of B. anthracis with alcalin method and the PA gene with 2.4kb sequence amplified by PCR. Then the amplified fragment was directly cloned into pTZ57R plasmid as T-vector and transferred into E.coli DH5 alpha using CaC12 method. After that the gene was separated from the T-vector by enzymatic digestion [Sa1I and KpnI]. Ligation between the purified gene fragment of the PA and the vector was carried out. Then it was transferred into B. subtilis WB600 by electroporation method in 1000 V. In this study we isolated PA gene from B. anthracis strain stern with PCR and was cloned into pTZ57R plasmid. The Presence of the gene was confirmed by restriction analysis, PCR and sequencing. Then the PA gene was cloned into pWB980 and B. subtilis and the presence of the gene in two kanamycin resistant colonies [AMN1 and AMN3] was confirmed by restriction analysis and PCR. We may conclude that by making modification in the methods used and using pWB980 expression vector, we were able to clone the PA gene into B. subtilis. This is the first research project in Iran that the PA gene is isolated and cloned and B. subtilis is used as host