[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 cutaneous leishmaniasis by PCR in some endemic areas of Iran

Cutaneous leishmaniasis is still a health problem in many rural and urban regions of Iran and drug resistance has emerged as a major impediment in the treatment of leishmaniasis. This study aims to determine the drug resistance gene in cutaneous leishmaniasis by PCR in some endemic areas of Iran. Ninety seven samples were collected from ulcers of leishmaniasis patients from some endemic areas of Iran. The Giemsa stained samples were examined microscopically and cultured in NNN and RPMI 1640 mediums for parasite detection. After DNA extraction, PCR was done by a pair of specific primers. For detection of mutation in DNA, first PCR products were electrophoresed on CSGE gel. The suspected samples were compared by sequencing and RFLP results were demonstrated. Comparison of DNA derived from a wild type cell and mutant cell was undertaken by CSGE and sequencing methods. Among 90 isolates [92.8%] examined for detection of mutation in gene with CSGE and RFLP, 10 [11.1%] revealed a disorder in sequencing selection for unresponsive to drug. Drug resistance in cutaneous leishmaniasis to sodium stiboglocanat is probably due to a mutation in a genome. A field study is needed to determine the distribution of drug resistance and other gene mutations involved in unresponsiveness to drugs in leishmaniasis endemic areas of Iran

[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

Study on ITS1 gene of Iranian Trichomonas vaginalis by molecular methods

Trichomoniasis is a worldwide protozoan parasitic disease and metronidazole is a choice drug for its treatment. Because of disease importance in public health and its controversial ideas about the prevalence of drug resistance, this study was carried out. Fifty-two suspected vaginal samples were collected from 2006 to 2007 in Gynecology Maryam Hospital, Tehran, Iran. All isolates were examined by microscopic, culture and PCR techniques. The PCR products were analyzed by RFLP and CSGE methods and two suspected samples were sequenced. Trichomonas vaginalis was identified from all 52 samples. Of 52 isolates, 45 samples were successfully cultured and amplified by PCR except one. Seven were positive only by PCR. Finally, ITS1 fragment was successfully amplified in 51 of 52. CSGE analysis and PCR products digestion by MspI followed by sequencing showed nucleotide mutation at position 209 [C209T] of the ITS1 fragment in two [3.9% of them. The results showed mutation in ITS1 fragment of T. vaginalis in two [3.9%] of Iranian isolates which may be related to metronidazole resistance

Diagnosis of myopathies using histology, histochemistry, immunohistochemistry and electron microscopy: a single center experience

Skeletal muscle biopsy is important for the diagnosis of motor unit disorders, systemic diseases and metabolic disorders. In some cases, routine histopathologic methods are not conclusive and histochemistry, immunohistochemistry and even an electron microscopic study are required. In this study, we describe our experience in the diagnosis of myopathies, considering all of the above-mentioned methods. During a period of 18 months, 43 specimens of patients with the impression of myopathy were submitted to the Pathology Department and were evaluated with H and E and histochemical stainings [PAS, Oil red O, ATPase, NADH-TR, Gomori Trichrome], immunohistochemistry [IHC] for dystrophin and electron microscopy. Three specimens were excluded from the study because there were only adipose tissues and no adequate muscle was present for evaluation. Twenty three [57.5%] males and 17 [42.5%] females with a mean age of 34 years were evaluated. The results were as follows: Becker's muscular dystrophy [5 cases, 12.5%], Duchenne's muscular dystrophy [3 cases, 7.5%], fascioscapulohumeral dystrophy [3 cases, 7.5%], limb girdle dystrophy [2 cases, 5%], polymyositis [6 cases, 15%], dermatomyositis [2 cases 5%], McArdle's disease [1 case, 2.5%], hypothyroidism myopathy [1 case, 2.5%], type 2 atrophy secondary to drugs and systemic diseases [2 cases 12.5%], congenital myopathy [2 cases 5%], McArdle [1 case 2.5%], unclassified myopathy [2 cases, 5%], and normal muscle biopsy [8 cases, 20%]. Although a genetic study was not available to confirm the diagnosis of cases such as fascioscapulohumeral myopathy, the diagnosis was made after putting all of the findings together including clinical presentation, family history, NCV, EMG, etc. In the cases with no definite diagnosis by the histology, histochemistry and IHC, we should perform an EM study to find out the distinct ultra-structural changes which can be diagnostic for some muscle disorders. EM study in conjunction with light microscopy of muscle biopsy could be very helpful in establishing the diagnosis of some types of myopathies

[Case report Surgical treatment of choledochal cyst]

Choledochal cysts are congenital cystic dilatation of the extrahepatic and / or intrahepatic billiary tree. Treatment of choice is surgery which varies according to the type of choledochal cysts. The present case was a woman with abdominal pain, jaundice, nausea, vomiting and pruritus, underwent surgery at Shahid Rajai Hospital in Qazvin. Intraoperative finding was choledochal cyst [Type V]. The extrahepatic cysts were excised and Roux- en-y hepaticojejunostomy, end to side jejunojejunostomy and cholecystectomy was performed which was accompanying with a good response

[Investigation of knowledge and attitudes of patients referring to Kerman dental school about AIDS, [spring 2006]]

The yearly incidences of AIDS continue to grow in Iran. The only way to preclude the outbreak of AIDS virus is promoting the society's awareness about the disease. However, to implement an effective health educational program, the first step is to have an appropriate correct understanding of the society's knowledge about this disease. The aim of this study was investigation of the knowledge and attitudes of patients in clinics of Kerman dental school about AIDS in 2006. In this study, 328 patients [aged 15 years or over] referred to oral medicine department were selected. To gather the data, a questionnaire including demographic data and questions on knowledge and attitude toward AIDS was prepared. SPSS [13.5] program, Chi-Square, t-test and variance analyze were used for data analysis. From 328 patients, 36.00% were male and 64.00% were female [mean ages of cases was 31.74 +/- 12.212 years]. The mean knowledge score was 69.31%. Most of the cases [67.7%] were informed of HIV/AIDS by TV programs. The level of knowledge of women about AIDS was significantly higher than men [p =0.031]. In addition, there was a significant relationship between the level of knowledge and education [p=0.0001].86.9% were concerned about AIDS transmission in the dental offices. 48.5% of the cases asked for diagnostic trials for AIDS before any dental treatment for all of the patients, and 48.2% asked for isolation of patients who carry the HIV/AIDS virus. The results stress the importance of providing information about AIDS by media more frequently and with higher quality. Another important factor is having good infection control standards in dental practices

Iron status in febrile seizure: a case-control study

Data on the relationship between iron deficiency anemia and febrile convulsions are controversial. The aim of this study was to determine the association between iron deficiency anemia and febrile convulsions among children. This case-control study was conducted during 2006-2007, on 90 children with febrile seizures [case] and 90 febrile children without seizures [control] referred to the Amirkola children hospital [a referral hospital in the north of Iran]. Two groups were matched for age and sex. In all children hemoglobin [Hb] level, hematocrit [Hct], mean corpuscular volume [MCV], mean corpuscular hemoglobin [MCH] and plasma ferritin [PF] were determined and the data collected were analyzed statistically using the t-test. The mean PF and TIBC levels were not significantly different in the febrile seizure compared to the reference group; neither were differences in Hb levels statistically significant between two groups. However MCV and MCH were significantly higher in the febrile seizure group [p<0.05] compared to reference group. Plasma ferritin levels were not significantly lower in children with febrile seizures in comparison with the children in control group. It seems that iron insufficiency does not play a role in pediatric febrile seizures

Community survey of knowledge about oral cancer in Babol: effect of an education intervention

A study in Babol, Islamic Republic of Iran, used a questionnaire to gather information on knowledge about oral cancer and its risk factors and to evaluate the efficacy of an educational brochure. From a community sample of 400 people, 76.0% had no knowledge of oral cancer. Mean knowledge score before the education intervention was 1.47 [standard deviation 3.40] out of 10. Knowledge about oral cancer was not associated with age, sex or education level but urban residents had better knowledge than rural residents. Mean knowledge score improved significantly by 5.92 [SD 3.30] at 1 month after the intervention among the 226 respondents who had read the brochure

effects of clinical rounds on patients in internal wards of hospitals affiliated to Isfahan University of medical sciences: the viewpoints of clinical care team

Clinical rounds as one of the clinical teaching methods, may cause adverse effects on patients and the medical team is able to report such problems. The purpose of this study was to determine the effects of clinical rounds on patients from medical teams' points of view. This descriptive cross-sectional study was conducted on 150 members of clinical care team including clerkship and internship students and nurses who were selected through convenient sampling method in educational hospitals affiliated to Isfahan Medical University. A questionnaire containing demo-graphic features, items asking the medical team's viewpoint about the method of running medical rounds, the list of events experienced by the patient, and medical team opinions regarding the patients' feelings toward the manner of clinical round was distributed as self-administered. The data was analyzed by SPSS software using frequency distribution, mean and standard deviation, and the comparisons were made by ANOVA. The medical team believed that patients had the most satisfaction from performing procedures by interns and residents, precision and follow up in therapeutic affairs, general outcome of hospitalization, and the duration of visits. Their least satisfaction was about the number of examiners, the duration of patient's encounter with the main physician, explanation about the disease and taking the patient's opinion into account in decision making. Based on the medical team's opinion, the current method of clinical rounds may cause dissatis-faction in patients and result in undesirable consequences. Revision and reforming the current situation of rounds can lead to the improvement of this process

[Incidence of acute mountain sickness in south and north-east pathways of Damavand]

Background: to determine the incidence and risk factors of acute mountain sickness [AMS] in trekkers in different pathways of Damavand. Although it is well known that Iranian trekkers suffer from acute mountain sickness [AMS] in south pathway of Damavand, not much is documented about the incidence of AMS in the other pathways of Damavand Mountain, trekkers that go to high altitude from different pathways and their related contributing factors

Material and Methods: this study was a descriptive cohort study. During a four weeks [in summer 2006] a population of trekkers was studied. AMS symptoms, were assessed by an extensively used standard questionnaire [Lake Louise], applied at 2900 m above sea level, and during descent from summit Damavand [about 4200m] at south and north east pathways of Damvand in Iran Alborz Mountain

Results: the overall incidence of A.M.S. was 53.5%. The mean age of trekkers was 35.08 [+/-11.88] and 85.8% of the study population was men. Men did not differ significantly higher rate of AMS from women. The incidence being increased in those who begin climbing from south pathway [P=0.001], amateur climbers [P=0.000], a previous AMS experience or high altitude illness [P=0.031], a history of upper respiratory infection during last week [P=0.017], begging hour of ascent [P=0.02] and sleep in high altitude [P=0.01]. There was not any relation between AMS and age and descending rate [P<0.05]

Conclusions: data show a strong relation between experiences mountaineer, history of AMS, pathway of climbing and the incidence of acute mountain sickness at Damavand Mount that didn't report previously

histopathological study of esophageal cancer in western side of caspian littoral from 1994 to 2003

Esophagus cancer [EC] accounts for a considerable proportion of carcinomas of the upper gastrointestinal tract in the Caspian Littoral. The global histologic pattern of the disease has changed recently. The intent of this study was to determine the incidence of EC over the past decade in Eastern Azerbaijan, a northwestern province of Iran, in western side of the Caspian Littoral and to assess the alteration of the histological pattern of the disease. In a retrospective study, all of 1792 pathologically documented EC of all registered cancer, surgery, pathology, and radiotherapy centers of the province over a period of 9 years [from March 1994 to March 2003] were enrolled in the study. The data concerning demographic characteristics, EC risk factors, and histological findings were recorded. The incidence and relative incidence of pathological subtypes in indigenous population of the province [excluding immigrants] were determined. The interaction of main risk factor and tumor histology of the patients were assessed over the years of study. The average incidence of EC was 7 cases per 100,000 persons per year. Adenocarcinoma and SCC account for 12.8% and 86.9% of cases. The proportions of different genders and histological types remained unchanged during these years. The frequency of nonsmoker patients has increased compared to smokers over the years. In nonsmoker subgroup of patients the relative incidence of adenocarcinoma as compared with that of squamouscell carcinoma has increased over the last 5 years of study. Esophageal cancer incidence rate in western side of Caspian littoral is as high as its western side. The frequency of nonsmoker patients has increased compared to smoker patients and the proportion of adenocarcinoma cases is increasing in this subgroup

[Osteoporosis in chronic liver disease: a mathematical method to screen high-risk patients based on clinical findings]

Patients with chronic liver disease [CLD] have an increased prevalence of osteoporosis but it is unclear which patients are at high risk for developing bone disease. The goal of this study was to evaluate the bone mineral density [BMD] among Iranian CLD patients and to compare it with healthy controls. We have also established a mathematical method, which can be used to determine high-risk patients based on clinical findings. A total of 65 patients [36 male, 29 female mean age 51.1years] with chronic liver disease were recruited over a 1-year period. BMD measurements were done using dual energy X-ray absorptiometry in the lumbar spine [LS] and femoral neck [FN]. Osteoporosis and osteopenia were defined by WHO criteria and BMD of patients was compared with the BMD of 65 age and sex matched normal individuals as controls. Finally we constructed a mathematical function to identify CLD patients who are at high risk for decreased BMD. The overall prevalences of osteopenia and osteoporosis in both sites were 47/7% and 23/1% respectively. BMDs at LS and FN were significantly lower in CLD patients than BMD in controls [p<0.005 and p<0.05, respectively]. BMD at LS and FN among women and BMD at LS among men was significantly lower in patients compared to controls [p<0.005 for all]. Increasing age was inversely correlated to BMD of females at LS and BMD of males at FN when the effect of BMI was controlled [r=-0.43 and rs=-0.5, respectively]. BMI was also correlated to BMD of females at LS and FN and BMD of males at FN when the effect of age was controlled [r=0.37, r=0.44 and rs=0.4, respectively]. At FN, BMD in Women with autoimmune, idiopathic and cholestatic liver disease was lower than BMD in viral hepatitis. Osteoporosis was more frequent in women with ascites and decreased [p<0.05]. Longer duration of CLD was correlated with lower BMD in women [p<0.05]. Women with Child C liver disease had higher abnormal BMD frequency compared to Child A [p<0.05] in men, no statistically significant correlation was found. Two functions were built based on sex, age, BMI and presence or absence of ascites, which could predict the abnormal BMD with sensitivity and positive predictive values of 85% and 87% respectively, which is significantly better than purely by guessing[p<0.05]. Osteoporosis is fairly common in CLD. We could screen high-risk patients by clinical indices as sex, age, BMI and presence of ascites so diagnostic and preventive measures could be instituted earlier in the course of the disease

Frequency of medical symptoms in Iranian Skiers

Some skiers suffer from medical symptoms during or after skiing, especially downhill skiing. However, there has been no investigation on medical problems in skiers. In this study, our main objective was to evaluate the frequency of medical symptoms during or after ski among Iranian skiers. This cross sectional descriptive study was performed in winter of the year 2005, at Dizin piste [Iran]. We evaluated demographic data and medical history of skiers, as well as the frequency of medical symptoms during ski using a questionnaire. The relations between sex, medical and drug history, smoking habits, and symptoms were assessed by chi-squared and fisher's exact test. The relation between age, duration of skiing, history of previous skiing [in years] and symptoms was analyzed by means of independent t- test. P <0.05 was considered significant. Out of 1448 skiers, 74% were male and the mean age of subjects was 25.2 [ +/- 8.4] years. A total of 1208 skiers wore medical glasses or lenses during skiing, and visual disorders were found in 15.2% of skiers. Among all subjects, one medical symptom was found in 20.1% and two medical symptoms or more in 3.6%. The most common clinical profile was headache, nystagmus and true vertigo. Occurrence of symptoms had significant association with wearing glasses or lenses during routine life, habit of smoking and previous ski injury. Alcohol consumption was seen in 31.2% skiers, and it had a borderline relation with incidence of symptoms. There was not any association between incidence of symptoms and sex, age, duration of skiing, wearing glasses or lenses during skiing, and history of motion sickness. There were at least two symptoms in 3.6% of skiers. This finding shows ski sickness is different from other altitude sicknesses

Evaluating correlation between neutrophil and congestive heart failure

Acute myocardial infarction [MI] with inflammatory response is a result of tissue necrosis due to leukocytosis and increased number of peripheral blood neutrophils. To investigate the relationship between neutrophils and congestive heart failure [CHF]. This cohort study was performed on 100 patients affected by acute MI who had two points out of three standard criteria [physical examination, enzyme and EKG findings] during the last 6 months of 2002 in Yahyanezhad hospital, Babol, Iran. CHF was detected through physical examinations, medical history, chest X-ray, and echocardiography using a CFG 750 VinG Med Instrument at the fourth day of admission. Ejection fraction 0.05] when the age of patients taken into account. Our data show that the neutrophilia of admission time correlates significantly with heart failure as an early onset of acute MI. This could be useful both in detection of high-risk people and also diagnostic and therapeutic measures

[ in-vitro effects of Hinosan and Diazinon on human sperm parameters]

Hinosan and Diazinon are organophosphorate pesticides with contacting and penetrating effect that are used in agriculture against rice blast. Therefore, with regard to high use of these pesticides in the north of Iran, their harmful effects and high rates of infertility that are increasing every year in Mazandaran province. This study was performed to determine the effects of Hinosan and Diazinon on sperm parameters. This experimental study was performed on sperm samples of subjects who referred for semen fluid analysis [SFA]. The sperms were affected by Hinosan and Diazinon [0.001 and 0.0001 concentration]. The sperm number, motility and grading at the times of 0, 1, 2 and 4 were recorded. Data were analyzed by repeated measurement and compared with normal condition. Hinosan and Diazinon can reduce sperm motility by time [P<0.05], but the increase of dose had not significant effect on sperm motility decreasing. During the study, changes in increasing of grade I and grade II was statistically significant [P<0.05], but these changes were not significant in grade III. According to the findings, Hinosan and Diazinon can exert their reducing effects on number and motility of sperm as a time dependent profile. These effects are not dependent to the dose of the materials

Comparison of Nanofiltration and GAC Adsorption Processes for Chloroform Removal from Drinking Water

In this research, the Chloroform [CHCl3] removal effectiveness of two water treatment systems including membrane technology and granular activated carbon [GAC] adsorption were studied. Two bench-scales were designed and set up: 1] Nanofiltration [NF] spiral-wound modules and 2] GAC adsorption column. Chloroform was considered as trihalomethanes [THMs] basic indicator compound. The inlet and outlet CHCl3 concentrations were detected by gas chromatography [GC] with electron capture detector [ECD]. The study was carried out for the two cases of spiked deionized water with CHCl3 and chlorinated Tehran tap water. Flow rate, CHCl3 and total dissolved solids [TDS] concentrations were considered in both treatment systems and the transmembrane pressures for membrane pilot, as the basic variables affecting removal efficiencies. Results showed that CHCl3 rejection coefficients for NF 300 Da, NF 600 Da and GAC Column, with various operation conditions had a range of 55.2% to 87.8%, 78% to 85% and 41.4% to 74.1%, respectively. It was found that removal efficiencies for NF 600 Da were lower than those of NF 300 Da and GAC column. The obtained data were analyzed by SPSS and non-parametric Kruskal-Wallis method. Results showed a positive correlation between the flow rate, CHCl3 concentration and chloroform rejection coefficients and the TDS concentration had no significant effect on chloroform removal efficiencies

Removal of chloroform [CHCL3] from Tehran drinking water by GAC and air stripping columns

The harmful substances, defined as trihalomethanes [THMs], were found to be formed during the disinfection of drinking water when chlorine was used as the disinfectant. In this research, the effectiveness of granular activated carbon [GAC] and air stripping [AS] packed column for the removal of chloroform [CHCL3] [as THMs basic indicator compound in many resources] in range of 50 to 300 micro g/L, from drinking water was studied. Pilots of GAC and air stripping columns were designed and set up. The study was carried out for the two cases of deionized and chlorinated Tehran tap water. Also the effects of flow rate, chloroform and TDS concentrations were considered in both treatment systems. Gas chromatography [GC] with electron capture detector [ECD] was used for determination of chloroform concentration in inlet and outlet samples. The obtained data were analyzed by SPSS and non-parametric KruskaI-Wallis method. Results showed a positive correlation between the flow rate and chloroform concentration, and removal efficiencies. The average of variations of removal efficiencies for AS and GAC columns with deionized water samples were, 89.9%, 71.2% and for chlorinated Tehran tap water were 91.2% and 76.4%, respectively. The removal of feed residual chlorine in these columns with 0.5, 0.8 ppm was 100%, respectively and re-chlorination for finishing water was recommended. Results showed AS to be considered more effective in chloroform removal for conventional water treatment plants as a finishing process