Application of Real-Time PCR method for evaluation of measles vaccine heat stability

The Plaque Forming Unit[PFU] and Tissue Culture Infectious Dose50[TCID[50]] methods are used for evaluation of vaccine heat stability and effect of various stabilizers on thermal stability of vaccines. The aim of present study is using Real-Time PCRtechniquefor estimation of vaccine degradation rate and thermal stability of measles vaccines. Lyophilized measles vaccines containing three various stabilizers were reconstituted with distilled water. Three vial of each vaccine incubated at25 degree C for 0, 4 and 8 hours. Titer of virus in vaccines calculated by TCID[50] method. Also after RNA Extraction and cDNA synthesis, the RNA copy numbers of viruses in vaccines were estimated by absolute quantitative Real-Time PCRtesting. The data were analyzedby SPSS 19 and Sigma Plot 11 software.The result of this study showed there is a significant relationshipbetween vaccine degradation rate calculated with TCID[50] and Real-Time PCR method [p<0.05]. ThereforeReal-Time PCR is a good complement or appropriate replacement to traditional methods.Titration methods based on cell culture are gold tests for titration of viral vaccines and estimation of heat stability but Real-Time PCR technique can also be used for this goals. This method is faster, cheaper and easier than TCID[50]

Cytomegalovirus colitis in a 10 year-old girl after kidney transplantation

Cytomegalovirus is an important infection in kidney Transplantation. Isolation of the CMV virus or detection of its proteins or nucleic acid in any body fluid or tissue specimen is defined as [CMV infection]. A 10-year-old girl was admitted frequently for vomiting and colicky watery diarrhea starting one month after renal transplantation from a non-relative living donor. Cr, BUN, serum electrolytes and also liver function tests were normal. Anti CMV IgM titer was negative before and after transplantation. On colonoscopy large aphthous like lesions were detected in the colon. CMV PCR of the lesion was strongly positive [>2000 copies/ml]. The patient received Ganciclovir. Usually CMV infected patients present with renal dysfunction after renal transplantation but other organ involvements must not be ignored. We report a patient presenting only with intestinal signs and symptoms of CMV infection

relationship between zinc deficiency and febrile convulsion in Isfahan, Iran

Febrile convulsion [FC] is a common cause of seizure in young children, with an excellent prognosis. In addition to genetic predisposition and infections, FCs are generally thought to be induced by metabolic and elemental changes during fever such as Zinc [Zn] deficiency. Regarding the high prevalence of febrile convulsions and the role of Zn deficiency, we investigated the role of Zn in FC patients in Isfahan, Iran. In a controlled cross sectional study, 90 patients aged 9 months to 5 years were studied in a period of 12 months. They were assigned to three groups. Thirty patients were included in the Febrile Seizure group, thirty febrile children without convulsion or previous history of convulsion were included in the febrile group and thirty afebrile healthy ones were enrolled as controls. Venous blood was obtained and Zn concentration in serum was measured using Graphite Furnance Atomic Absorbance Spectrophotometering [GF-AAS]. Patients and the control groups had no difference in either mean age or sex distribution. No significant relationship was observed between serum Zn level and age or sex among patients in the FC group and two other control groups. Our findings showed that Zinc level was significantly lower in the febrile seizure group compared to two other groups. We tried to categorize various conditions in a more practical form. Also, Zinc is in close relationship with socioeconomic level of the individuals which was well considered in the current survey

Comprehensive assessment of the relative frequency of sleep disorders in migraine and non migraine in 6- to 14-year-old children

Headaches are common during childhood. In addition, sleep disorders are common problems in children, too. Although it is commonly thought that headache and sleep problems are related, there is not enough evidence to confirm this relationship. Finding evident relations between these problems would help practitioners a lot to make earlier diagnosis and plan treatment modalities for both problems as soon as possible. This study aimed to assess the relative frequency of sleep disorders in migraine and non migraine children. In a cross sectional study, 148 children were enrolled in migraine [60] and non migraine [88] groups. They were aged 6 to 14 years. Migraine group consisted of patients who had definite migraine according to HIS [International Headache Society] criteria. Ten sleep problems [snoring, nightmares, sleep walking, sleep talking, bedtime struggle, bruxism, sweating during sleep, excessive daytime sleepiness, insomnia in early or mid night and sleep apnea] were compared between 2 groups. Fisher exact and chi square tests were used for making comparisons. We found relationships between night sleep and daytime headaches. Some of these relationships were easy to explain but for some others, finding complicated explanations are necessary. Our findings showed that bruxism, sleep walking, early and midnight insomnia was significantly higher in migraine children. There was a common etiology for headache and sleep disorders. Also, parents and migraine children were well familiar with the effect of relaxation on decreasing migraine episodes. They provided appropriate facilities for night sleep for this reason. We found relationships between night sleep and daytime headaches. Some of these relationships were easy to explain but for some others, finding complicated explanations are necessary

[Usefulness of ultrasonography in the diagnosis of the etiology of congenital hypothyroidism comparing with radioisotope scanning]

Congenital hypothyroidism [CH] is the most prevalent preventable cause of mental retardation. Since it is impossible to determine the etiology of CH by biochemical tests per se, imaging modalities of thyroid gland are used to evaluate the morphology and function of this gland and among them radionuclide scanning is currently the gold standard. Considering the limitations of time and accessibility of radioisotope scanning and benefits and faults of ultrasonography in determination of etiology of CH, the aim of this study was to determine the usefulness of sonography as compared to the gold standard imaging method of scintigraphy, in the diagnosis of etiology of primary congenital hypothyroidism in the screening program of Isfahan. This study was conducted from May 2002-February 2007. In order to compare ultrasonography to thyroid scintigraphy for etiologic diagnosis of CH, 102 CH newborns examined by both thyroid scintigraphy and ultrasonography were included in this study. The ultrasonographic findings were compared with the standard-of-reference scintigraphic findings and the sensitivity, specificity of the ultrasonography were determined. According to results of the ultrasonography 63, 27, 3 and 9 infants had normal thyroid glands, agenesia, ectopia and hypoplasia respectively and based on scintigraphic results 57, 36 and 9 of them had normal thyroid gland, agenesia and ectopia respectively. Ultrasound detected sensitivity, specificity, positive predictive value, negative predictive value, LR+ and LR- were 86%, 86%, 90%, 90%, 6.1 and 0.16 respectively. The sensitivity and specificity of ultrasonography compared with thyroid scintigraphy in diagnosis of thyroid gland ectopia was 33% and 100% respectively. Although calculated sensitivity and specificity of this method was not equal to those of thyroid radioisotope scanning but had an acceptable range, thyroid ultrasonography is a relatively appropriate imaging tool for diagnosing thyroid dysgenesia. Hence ultrasonography can be used as the first imaging tool for diagnosing CH, especially when the family prefers not to have the infant scanned

[ comparative study of eradication of H. pylori infection in dyspepsy patients using a low dose and a high dose triple therapy with clarithromycin, amoxicillin and Omeprazole]

Helicobacter Pylori is a major cause of diseases of the upper gastrointestinal tract. Having considered the high prevalence of the infection, an ideal regimen has been a matter of debate by the scientists for many years. This study evaluates the efficacy of the more tolerable regimens in the eradication of the bacteria and the effect of the treatment on the gastric symptoms. This parallel randomized control trial study included 560 patients with dyspepsia admitted to Imam Reza Hospital, Kermanshah University of Medical Sciences between 2006-2007. Patients who were identified with dyspepsia based on Rome II and were candidate for endoscopy were examined for H. pylori infection through rapid urease test and histology. Those proven positive were assigned at random to one of the two groups of high dose [Omeprazole 20mg, Clarithromycin 500 mg, and Amoxicillin 1000 mg] and low dose [Omeprazole 20 mg, Clarithoromycin 250 mg, Amoxicillin 500 mg] treatment regimens. They all went under treatment every 12 hours for a period of seven days. 4 weeks after the therapy, eradication success rate and gastric symptoms were evaluated using the same protocol. Side effects were recorded through a questionnaire. From the total of 560, 480 were proven positive for H. pylori [85.7%]. Eradication success rate was the same for the two groups [87.5%]. History of pyrosis before the treatment was statistically associated with eradication failure at the end of the treatment. Symptoms such as pyroisis were significantly reduced. General well being was also improved but the improvement was not statistically significant. Mild side effects were observed in 11% of high and 8% of low dose treatment regimens. However they were well tolerated and did not result in drug withdrawal. Eradiation success rate of one-week low dose treatment regimen was within the acceptable level. Eradication also reduced pyrosis episodes. Symptoms were improved even when the therapy did not result in eradication

[Mutations in RAG1 and ADA genes in patients with severe combined immunodeficiency [SCID]: report of new mutations]

Severe combined immunodeficiency [SCID] is a rare and mortal disorder with X-linked and autosomal recessive inheritance. Many genes is related to the disease including ADA, RAG1, RAG2, Artemis, CD45, JAK3, IL7R which have different clinical presentation and T and B lymphocytes profile. In this study, we investigated gene mutations in suspected patients referred to the Children Medical Center Hospital, Department of Allergy and Clinical Immunology. Blood tests for patients showed T-B-profile, so we selected the genes that were responsible in T and B cell maturation [ADA, RAG1 and RAG2]. According to our possibilities, we studied ADA and RAG1 genes in patients. We did the test by PCR and Sequencing method. Also total ADA activity [tADA] and its isoenzymes [ADA1 and ADA2] were estimated in patients. Our investigation showed two mutations in ADA gene and three in RAG1 gene. In this study, we offer a new protocol for investigation of RAG1 gene. This is the first study on diagnosis of SCID patients through genetic investigation in Iranian patients

[Griscelli syndrome: report of an Iranian case]

In this study, we report a patient who was afflicted by Griscelli syndrome [GC] type II. GS II is an autosomal recessive disorder that is associated with silver-gray sheen of the hair and immunodeficiency. Mutation in RAB27A gene is responsible for this type of GS. The aim of this study is to investigate mutations in the RAB27A gene in a 3-year-old boy who was referred to our center with immunodeficiency, silvery gray sheen of the hair, fever and accelerated phase. He was the third child of consanguine parents. The first child is a 6-year-old healthy girl and the second one was a boy who had the same clinical features as the proband, and he died when he was 13-month-old. So far the most of Iranian patients have had mutation in exon 6 of RAB27A gene and this mutation we report has been seen just in Iranian patients

[Failure factors of exclusive breast feeding during the first 6 months of infants' life in Khorramabad]

There is further evidence of breast feeding benefits for mother and infant health. In some regions of the world the rate of exclusive breastfeeding during the first 6 months of infant's life has been decreased. The most important factors associated with the problem are socio-economic variables such as maternal age, mother's employment status, level of education, and infant's birth interval from previous or next child. This analytic cross-sectional study was conducted on 340 mothers and their 6-12 months old children referring to Khorramabad health centers to achieve their children primary health cares from March 21st, 2006 to March 21st, 2007. Variables such as maternal age, mother's employment status, delivery status, mother's education, child birth rank, infant's gender, and infant's birth interval from previous child were investigated. The association between the exclusive breastfeeding failure and the variables were tested by chi2, Fisher exact test, t-test, Mann-Whitney, Pearson coefficient, and Kruskal-Wallis test. Out of the 340 samples, 151 mothers [42%] had given birth with cesarean section, 57 of the cases were employed mothers compared with the 283 unemployed ones. In addition, 185 and 155 children out of the 340 samples were boys and girls respectively, and 10 were twins. The prevalence of exclusive breastfeeding for the first six months of life was 79.1% [268 cases] in comparison with the 20.9% who had failed to be exclusively breastfed. Statistically significant relationships were found between the failure of exclusive breastfeeding with mother's employment status, maternal education, and cesarean delivery. A reduction in child's growth was the main reason reported by the mothers for the exclusive breastfeeding failure. In this study, the failure of exclusive breastfeeding in the first 6 months of life was 20.9%. According to the findings, at least a 6-month period of maternity leave is suggested for employed mothers. Additionally, providing appropriate places for mothers to breastfeed their infants as well as a reducing their working hours are highly recommended

Determining and prioritizing admission criteria for talented students office in Isfahan University of Medical Sciences using analytical Hierarchy Process Model

Students' scores on university entrance exam [Conquer] or their average scores are not appropriate criteria to recognize them as talented students. There have been limited studies concerning the comparison analysis of factors for selecting medical students as talented. This study was done to determine and prioritize the selection criteria for admitting students to the talented students' office. A group of 5 physicians having experience in medical education was established. Renzulli model was selected as the best descriptive model, then using brain-storming, the features of a talented student were identified. Based on Analytical Hierarchy Process [AHP], the questionnaires were designed and distributed among 21 experts. Using hierarchical analysis formula and by Excel software, the weight of each criterion was calculated. To define the weights of the sub-criteria, the detailed features of each criterion were determined and then, the total score of each sub-criterion was calculated by multiplying the score achieved in the first hierarchical analysis by the score attained in the second one. Creativity had the maximum score [38%], being responsible and prominent, were in second place acquiring 31% of the total weight. The highest grades belonged to registration of invention [127], cooperation in writing books and articles [104], and having high rank in Olympiads [92], respectively. The educational status which previously was the only admission criterion was in the fourth position, after having high rank in Olympiads. The areas of creativity, responsibility and being prominent were the main criteria for talented students' admission and there was not any significant difference between their scores. The educational status had a less important role in the prioritization system of this study. It seems that a student is required to have the three main criteria to be recognized as talented

Seroprevalence of Varicella Zoster Virus in Children from Shiraz-Iran

Varicella-zoster virus [VZV] causes herpes zoster and varicella [Chicken-pox], usually a mild disease which is diagnosed clinically with few complications. However, in neonates and healthy adults it can have a severe presentation. Herpes zoster results from VZV reactivation later in life. To determine the seroprevalence of VZV in elementary school children aged 6-10 years in Shiraz, Iran. A cross-sectional seroprevalence survey was conducted on 270 healthy subjects. All serum samples were investigated for immunoglobulin G [IgG] antibody against VZV using a commercial enzyme linked immunosorbent assay [ELISA]. Among the studied population, 175 [64.8%] had no detectable antibody levels. The overall seroprevalence rate was 35.2%. A breakdown of seropositivity to VZV according to age was as follows; 10 years old, 50%, 9 years old, 48.2%, 8 years old, 27.3%, 7 years old, 32.1%, and 6 years old, 13.2%. As VZV susceptibility in the studied age groups was higher than the expected rate, therefore childhood VZV vaccination is recommended in our region