Cutaneous leishmaniasis in Bam: a comparative evaluation of pre- and post- earthquake years [1999-2008]

The recent devastating earthquake of December 26 in Bam, 2003 created various risk factors; caused a sharp increase in incidence of anthroponotic cutaneous leishmaniasis [ACL] cases and reached to an epidemic proportion. The objective of this study was to evaluate the status of ACL cases five years before the earthquake compared to the cases occurred five years after the earthquake [1999-2008]. Status of disease was assessed retrospectively for the five years before the earthquake and prospectively for the five years after the earthquake. Identification was confirmed by smear and polymerase chain reaction [PCR]. The mean annual incidence of ACL for the period from 1999 to 2003 was 1.9 per 1000 comparing to post earthquake period, which was 7.6 per 1000. Most of the infection was in individuals of <20 years, more frequently in females before the earthquake, whilst in contrast, there was a progressive rise in the number of cases, significantly in male individuals of >20 years [P< 0.0001] in post earthquake era. The anatomical distribution of lesions considerably changed during the two periods. Most of the cases were limited to three zones within the city prior to the earthquake, whereas it was spread throughout different zones after the earthquake. PCR indicated that the CL was due to Leishmania tropica in the city. The results strongly suggest that in natural disasters such as earthquakes various precipitating factors in favor of disease will be created, which in turn provide a suitable condition for propagation of the vector and the transmission of the parasite

[Effect of combined administration of estrogen and progesterone on brain edema and neurological outcome after traumatic brain injury in female rats]

Many studies have shown uncontrolled brain edema to be the cause of disabilities and deaths following head trauma. Current data also suggests that a single administration of estrogen or progesterone can have neuroprotective effects on brain injury. In this study we investigated the combined effect of estrogen and progesterone on brain edema and neurological outcomes following traumatic brain injury [TBI] in female rats This interventional-experimental study was performed on 8 groups of female rats as follows: 1- control, 2-Sham, 3-Ovarectomized trauma [TBI+OVX] 4-Vehicle 5-Physiologic dose of estrogen + physiologic dose of progesterone [E1+P1], 6- physiologic dose of estrogen+pharmacologic dose of progesterone [E1+P2] 7-Pharmacologic dose of estrogen+physiologic dose of progesterone [E2+P1] and 8-Pharmacologic dose of estrogen+pharmacologic dose of progesterone [E2+P2]. Hormones were injected i.p, half an hour after diffuse traumatic brain injury through marmarou model to 2 week old ovarectomized rats. Brain edema [via brain water content], blood-brain barrier permeability [via extra vascular evans blue dye] and neurological outcome [via veterinary coma scale] were measured in this animals The results showed significance decreases of 2.68% and 2.88% in water content in group 8 compared to the vehicle group and group 6 respectively and a significant decrease of 2.29% in water content in group 5 compared to group 6. Evans blue level showed significant decreases of 14.7% and 21.1% in groups 6 and 7 compared to the vehicle group. Neurological scores showed a significant increase of 2.5 and 2 in group 5 compared to the vehicle group and group 3, 1 hour after TBI respectively a significant increase was seen in all groups compared to group 3 at 4 and 24 hours after TBI. Scores showed a significant increase of 1.2 in groups 7 and 8 compared to the vehicle group at 24 hours following the TBI. Based on these results, it can be concluded that combined administration of estrogen and progesterone have beneficial effects on both the reduction of brain edema and the neurological outcomes, the improvement depending on what dose of estrogen is administered with progesterone

[Knowledge of Kerman general practitioners about Tramadol in 2004]

Tramadol is an opioid analgesic indicated for the management of moderate and severe pains. Its side effects, in parts are due to the activation of micro receptors and in parts to increasing central catecholamine and serotonin levels. In the case of long administration, tramadol has a potential to cause dependency, tolerance and also drug abuse. After prohibition of injective diclofenac, considering Iranian's tendency for rapid sedation of pain symptoms, tramadol has been prescribed widely. The aim of this study is to determine general practitioners knowledge about this new drug. This cross-sectional study was arranged by collecting data through a self-administrated questionnaire consisted of 25 questions related to different aspects of drug knowledge. Sample consisted of 244 general practitioners in Kerman and data analysis was performed by SPSS. Out of 173 general practitioners, 49.1% worked in clinics, 34.9% in private offices and 16% in Emergency Units. Mean knowledge score was 30.72 +/- 0.35 out of the maximum of [50]. From all subjects 49.7% had poor knowledge [Z<-1], while 39.3% had moderate knowledge [-11]. The poorest information was in regard to drug classification and pharmacokinetics, while in dosage and side effects subjects' knowledge was better. No correlation was observed between mean score and variables of job experience, duration, place and sex of practitioners. Considering serious side effects and drug interactions of tramadol and also the low level of knowledge of general practitioners about this drug, educational programs and limitation of distribution seems to be necessary