Angiotensin- converting enzyme insertion/deletion polymorphism and its association with coronary artery disease in an Iranian population

The study of the association between genotype and phenotype is of great importance for the prediction of many diseases and pathophysiological conditions. The relationship between angiotensin-converting enzyme [ACE] gene insertion/ deletion [I/D] polymorphism and pathological processes such as coronary artery disease [CAD] has been investigated previously with discordant results. This study was designed to determine the association between ACE gene I/D polymorphism and CAD in an Iranian population. A total of 1050 individuals who were referred to Tehran Heart Center for coronary angiography were recruited. Six hundred seventy-six CAD-positive patients [documented by coronary angiography and Gensini scores higher than 6] and 374 CAD-negative patients were evaluated for ACE gene I/D polymorphism via the Polymerase Chain Reaction Amplification method. The patients' age, sex, smoking status and its duration as well as familial history of CAD, hypertension, and diabetes mellitus were recorded. Five hundred four [74.6%] of the CAD-positive patients were male, and the mean age of this group was 60 [60 +/- 10]. In the CAD-negative individuals, the mean age was 56 [56 +/- 10] and 196 of them were male [52.4%]. After the analysis of all the groups and gender subgroups, neither genotype nor allele frequency was significantly different between the CAD-positive and CAD-negative groups [p values for genotypes and allele frequencies were 0.494 and 0.397, respectively]. ACE gene I/D polymorphism was not associated with an increased risk of CAD in an Iranian population

Increasing antibiotic resistance among uropathogens isolated during years 2006-2009: impact on the empirical management

Urinary tract infections (UTI) are one of the most common infections with an increasing resistance to antimicrobial agents. PURPOSE: Empirical initial antibiotic treatment of UTI must rely on susceptible data from local studies. MATERIALS AND METHODS: Retrospective analysis of isolated bacteria from children with UTIs was performed at the university hospital during years 2006-2009. The findings were compared with data collected in a similar study carried out in 2002- 2003. RESULTS: A total of 1439 uropathogens were isolated. Escherichia coli (E.coli) was the leading cause, followed by Enterobacter, and other gram negative bacilli. It was observed resistance of E.coli to ceftriaxone, cefexime, amikacin, gentamycin, and nalidixic acid; Enterobacter to cefexime; and the resistance of gram negative bacilli to gentamicin and cefexime increased significantly. The highest effective antibiotic was Imipenem, ciprofloxacin, and amikacin with 96.7%, 95% and 91% sensitivity rates , respectively, followed by ceftriaxone 77.2%, gentamicin 77%, nitrofurantoin 76.4%, nalidixic acid 74.3% and cefexime with 70%. CONCLUSION: The use of nitrofurantoin or nalidixic acid as initial empirical antibacterial therapy for cystitis seems appropriate. For cases of simple febrile UTI, the use of initial parenteral therapies with amikacin or ceftriaxone followed by an oral third generation cephalosporin also seemed appropriated, and in cases of severely ill patients or complicated UTI, imipenem as monotherapy or, a combination of Ceftriaxone with an aminoglycoside, are recommended.

[Viral hepatitis and prevention-current status and future prospects]

Viral hepatitis is the most common cause of liver disease in the world. In the past 30 years, highly effective vaccines have become available for two of the five hepatitis viruses, and where implemented, vaccination has become a key component of hepatitis prevention. To provide a current review and critical analysis of the viral hepatitis, A [HAV] and B [HBV] prevention by immunization has been presented in this article.Review of medical articles obtained from Medline 2000 to 2007 and Iran Medix [1377 to 1386] database. There are signitificant differences regarding epidemiology of hepatitis A and B viruses' infection between countries. A zero prevalence rate was highly correlated with sanitation and socio-economic conditions. Dramatic vaccine-induced declines in the incidence of both hepatitis A and B and have occurred in countries where HAV and HBV vaccines were integrated into universal childhood immunization. Improved sanitation and living conditions leads to a decline in the average HAV zero prevalence rates. Planning for large-scale immunization programs against HAV should involve careful analysis of the cost-benefit and sustainability in different appropriate hepatitis A prevention strategies. Due to the grave impact of universal infant HB vaccination on prevalence of HBV infections, continued universal infant HB vaccination is recommended. Moreover, this is to ensure continued success of hepatitis B immunization. The need for booster doses to preserve vaccine-induced immunity should be evaluated regularly as vaccinated cohort age