[The effect of educational intervention on the attitudes and behaviors of family caregivers caring for children with intellectual disability]

Introduction: having an intellectually disabled child imposes many physical, mental, and social predicaments on the family. Appropriate interventions to improve attitude and create constructive caring behaviors can greatly support those families and provide them a healthier quality of life. This study conducted to determine the effect of the educational intervention on the attitudes and behaviors of family caregivers caring for children with intellectual disability

Method: this study is a randomized, controlled, intervention study conducted in Narges rehabilitation center, Miyaneh in 2013. A total of 64 caregivers of children with intellectual disabilities aged 6-18 years were randomly divided into two groups. Intervention group received training classes [6 sessions] but control group did not receive any intervention. Data were collected based on the researcher made, behavior and attitude questionnaires at beginning and the end of the study. Data were analyzed using SPSS version 21, paired t-test, t-test, and chi square

Results: mean score of attitude and behavior in both groups was not statistically significant before the intervention. However, 90 days after the intervention, attitude and caring behavior of caregivers in the intervention group increased significantly [P<0.05]

Conclusion: educational intervention improved attitudes and behaviors of family caregivers significantly. Therefore, authors recommend further studies to evaluate the effectiveness of this model on other chronic conditions

Effects of bleaching and remineralising agents on the surface hardness of enamel

Statement of Problem: Home bleaching is a common method for whitening the teeth. However, bleaching may lead to a decrease in the hardness of the enamel

Purpose: The purpose of this study was to investigate the effects of two different concentrations of carbomide peroxide [CP] on the hardness of the enamel and also to evaluate the effects of the remineralising agents on the hardness of bleached enamel

Materials and Method: Crowns of 100 intact extracted human anterior teeth were resected from their roots and mounted in acrylic resin in a way that the buccal surface was parallel to the floor [horizontal]. The samples were then divided into 10 groups. The baseline hardness in the middle of the buccal surface was measured through Vickers Micro-hardness test and at a load of 500 gram per second. Then five groups were bleached with 10% carbomide peroxide and other five groups with 22% carbomide peroxide. The bleaching was performed for 21 days and was applied 4 hours each day. The samples were kept in distilled water in the interval time between the applications of bleaching agents. In the next phase the enamel micro-hardness was measured and different demineralising agents were used for each group. The Tooth Mousse [TM] paste; MI paste plus [MI]; and Crest fluoridated toothpaste was applied for 4 hours to the surface of the enamels in three groups. In the forth group, samples were embedded in fresh cow milk for the same period and the fifth group was kept in distilled water as a control group. Then, the final hardness was measured and the collected data were analyzed by t-test, paired sample t-test and One-way ANOVA test

Results: Bleaching with the aforementioned concentration of CP had no effects on enamel microhardness. In the groups with a 10% CP, none of the demineralising agents had any effect on the hardness value. However, the application of milk increased the hardness. In the groups with a 22% CP, TM paste reduced the enamel microhardness value while Crest, increased it. MI paste and milk didn't have any effect on it

Conclusion: The use of TM paste results in lower hardness of the bleached enamel. It seems that the high concentration of fluoride in MI paste may be responsible for increased microhardness of enamel. Milk and fluoridated toothpaste have propensity to increase the enamel hardness

[Antibiotic-resistance patterns of helicobacter pylori isolates obtained from patients in Kerman- 2009]

Background and Aims: Based on serological studies the prevalence of Helicobacter Pylori infection in Iranian adults is up to 80%. Gastritis, peptic ulcer and gastric adenocarcinoma are common clinical outcomes of this infection in Iran. Since antibiotic resistance patterns of Helicobacter pylori are different geographically, local studies are highly required

Method: From April to December 2009, 63 isolates of Helicobacter pylori were obtained From 191 patients referred to the endoscopy unit of Afzalipour hospital in Kerman. Demographic features including age, gender, symptoms, were recorded before the sampling and sensitivity to six common antibiotics used for the treatment of H.pylori infection was determined. Modified disk diffusion test was used to evaluate antibiotic resistance pattern. Data analysis was done through SPSS 16 and using Pearson chi-square test

Results: The patterns of antibiotics resistance were as below: metronidazole 55.5%, clarithromycin 30.1%, tetracycline 3.1%, amoxicillin 26.9%, ciprofloxacin 7.9% and no resistance to furazolidone was detected. While 12.7% of the isolates were susceptible to all the six antibiotics, 55.6% were resistant to one antibiotic, 25.4% to two antibiotics, 6.3% to three antibiotics and there was no resistance to more than three antibiotics at the same time

Conclusion: According to the obtained antibiotic resistance rates in this study, performing antibiogram tests before starting the treatment is necessary

Simultaneous spectrophotometric determination of paracetamol, phenylephrine and chlorpheniramine in pharmaceuticals using chemometric approaches

The linear multivariate calibration models such as principal components regression [PCR] and partial least squares regressions [PLS1 and PLS2] due to the mathematical simplicity and physical or chemical interpretability are sufficient and generally preferred method for analysis of multicomponent drugs. In this study, simultaneous determination of paracetamol, phenylephrine and chlorpheniramine in pharmaceuticals using chemometric methods and UV spectrophotometry is reported as a simple alternative technique. Principal components regression [PCR] and partial least squares regressions [PLS 1 and PLS2] were used for chemometric analyses of data obtained from the spectra of paracetamol, phenylephrine and chlorpheniramine between wavelengths of 200 to 400 nm at several concentrations within their linear ranges. The analytical performance of these chemometric methods were characterized by relative prediction errors and recoveries [%] and compared with each other. PCR, PLS1 and PLS2 were successfully applied to a tablet formulation, with no interference from excipients as indicated by the recovery. However, the PLS1 shows better results due to its flexibility and mathematical principals. The proposed methods are simple and rapid requiring no separation step, and can be easily used as an alternative in the quality control of drugs

Recombinant SAG1 antigen to detect Toxoplasma gondii specific immunoglobulin G in human sera by ELISA test

Although some serological tests for the detection of Toxoplasma gondii-specific immunoglobulin are commercially available, better diagnostic tools are needed. The aim of present study was to evaluate the usefulness of the recombinant Toxoplasma gondii SAG1 antigen for the recognition of toxoplasmosis by ELISA. This study was conducted in Cellular and Molecular Biology Research Centers, Shahid Beheshti University, M.C., Tehran, Iran in 2008-2009. Surface antigen 1 [SAG1], a tachyzoite stage-specific protein, was subcloned into an expression vector and was subsequently transformed into BL21 [DE3] pLyss competent bacterial cells. After inducing expression of the recombinant antigen, the protein product was purified using Ni-affinity chromatography. The immunoreactivity of recombinant SAG1 [rSAG1] was analyzed by SDS-PAGE and western blotting. The reactivity of the rec-SAG1 protein was evaluated using an ELISA. Sensitivity and specificity of the generated recombinant-ELISA [rec-ELISA] compared to a commercially available ELISA [com-ELISA] were 88.4% and 88%, respectively. Recombinant SAG1 produced in E. coli is a promising antigen that can be used in diagnostic assays for the detection of specific antibodies against T. gondii

[Effectiveness of oral n-acetyl-cystein in reduction of pulmonary complications in smokers undergoing coronary artery bypass surgery]

Up to 12% of patients undergoing coronary artery bypass graft have pulmonary complications. Smoking can cause a six-time increase in pulmonary complication after major surgery. The most common pulmonary changes after CABG are decrease in FRC, VC and atelectasis. In this study, the effect of oral N-acetyl-cystein in reduction of severity of hypoxemia and atelectasis in current smokers who smoked more than 10 packs/year and had undergone CABG was evaluated. In the study, 54 current smoker patients were selected randomly and allocated to two drug and placebo groups. In the study group, 300mg N-acetyl-cystein [ACC long] containing vitamin C was prescribed two times a day from 4 days before operation up to 3 days after surgery and in control group, effervescent vitamin C tablet was prescribed as placebo. Patients with body mass index more than 35, NYHA class IV, those who needed intra aortic balloon pump and those who needed reoperation due to bleeding were excluded from the study. In all patients, spirometry was done in the preoperative visit and FEV1/FVC was determined. Induction and maintenance of anesthesia was similar in all patients. Arterial blood gas samples were obtained immediately after anesthesia induction and 4 to 6 hours after extubation. Chest X ray was taken before, 6 to 10 hours after extubation and 3 rd postoperative day. Severity of atelectasis was also measured. Quantitative and qualitative data was analyzed by ANOVA and Chi-square tests, respectively. P value <0.05 was considered as statistically significant. Both groups were similar with respect to demographic data including ejection fraction, NYHA class, FEV1/FVC, cigarette smoking and Lima harvesting. The ratio of arterial oxygen pressure to fraction of inspiratory oxygen Pao2/FIo2 was not significantly different after induction but this difference was strongly significant [P value<0.005] after extubation. Duration of mechanical ventilation was significantly shorter in patients who had N-acetyl-cystein, but duration of ICU stay was similar. Linear and segmental atelectasis was significantly less in the study group. N-acetyl-cystein can improve oxygenation and ventilatory parameters in pathological lungs, but further studies with different doses and different situations are needed

[Evaluation of the second fraction of excreted/secreted antigens from toxoplasma gondii by ion exchange chromatography for serodiagnosis of toxoplasmosis in rat]

According to the previous studies, Toxoplasma gondii excreted/secreted antigens [E/SA] appear to be suitable marker for serodiagnosis of toxoplasmosis. Most of the previous studies used whole E/SA. The present study was carried out to evaluate the ELISA method using E/SA components from Toxoplasma gondii for the diagnosis of toxoplasmosis. Components obtained by incubation of tachiziotes at RPMI-1640 culture medium were purified by Ion exchange chromatogeraphy and fractions were analyzed by native-PAGE electrophoresis. Forty noninfected rats were injected as IP with 4x106 Toxoplasma tachyzoites and their serum samples were collected at 8, 15, 22 and 60 days after infection then were tested by dye-test. Based on these results the sera of 15 and 60 days were selected and tested by ELISA using E/SA. Second fraction of chromatography was selected as antigens. The cut-off point of ELISA with 99% confidence was found to be 0.41. Optical density of all sera samples of 15 and 3 of 60 days after infection and 2 negative sera were over the test cut-off. Therefore sensitivity and specificity of the method were determined to be 100% and 91% respectively. These results indicated that the second fraction of Ion exchange chromatography of Toxoplasma E/SA under these conditions may be useful tool for the serediagnosis and differentiation of acute and chronic phases of toxoplasmosis

Prevalence of helicobacter pylori infection in subjects with gastric cancer surgery

To determine the prevalence of helicobacter pylori [H. Pylori] infection in patients with gastrectomy for gastric cancer. Samples from 95 [69 males, 26 females] consecutive patients who had undergone surgery for gastric cancer were included in this study. Histologic examination of tumor obtained at the time of surgery yielded the diagnosis and then the specimens were stained with haematoxylin and eosin and Giemsa for the assessment of tumor and H.pylori infection. All patients did H.pylori immunologic and urease test. From 95 patients with gastric cancer, 83 patients [87.36%] were positive for H. pylori infection. Histologic type of tumors was intestinal in 61 patients and diffuses in 7 patients. The prevalence of H. pylori was 93.2% in intestinal type carcinoma and 28.5% in diffuse type [P- value=0.0002]. No significant difference was found in sex, smoking and staging between H.pylori positive gastric cancer and H.pylori negative cases. This study reconfirmed a high prevalence of H. pylori infection in patients suffering from gastric cancer and provided that evaluation for H. pylori infection might confer additional benefit in identifying the population that is at greater risk for this tumor

Comparison of antifungal and antibacterial and lralwex effects of persica with Chlorhexidine mouthwashes [an in vitro study]

Global approach to the herbal medicine has resulted in research activities to be focused on the findings of scientific documents in this field. The aim of this study was to investigate the antibacterial and antifungal effects of three herbal mouth washes [Persica, Matrica, Iralwex] and two chlorohexidine - based commercially available mouth washes. The microbial ssp tests were performed using catalase, optochin, bacitracin and gram staining. Cellular suspensions with a concentration of 0.5 Me Farland were prepared. The inhibition zone was assessed by Disk diffusion method. The minimum inhibitory concentration [MIC] of each mouth wash for each micro-organism was determined by using Dilution Tube Technique. The results were analyzed and compared using ANOVA at a significance level of [p<0.05]. The results showed that the effect of the herbal mouth washes on the micro- organism was less than the two other chlorhexidine-based mouth washes [P<0.01]. The antibacterial effect of the herbal Matrica compared to the two other herbal mouth washes was more but not significant. The comparison between the herbal and chlorehexidine-based mouth washes showed that the antibacterial etfect of the herbal Matrica compared to the two other herbal mouth washes was more but not significant. More research is needed for improvement of the herbal mouth washes

[Designing of ELISA kit for diagnosis of anti-toxoplasma specific IgG, using exerted/secreted antigens and its diagnosis potency]

Many studies report that Toxoplasma gondii excreted / secreted antigens [E/SA] appear to be a suitable marker for toxoplasmosis serodiagnosis. Most of these studies have used E/SA, obtained from supernatant of Toxoplasma cell culture, or by incubating tachyzoites in cell free media [RPMI-1640]. The present study for the detection of Toxoplasma IgG in human serum was evaluated, using the components of peritoneal fluid of infected mice [as another source of E/SA]. Peritoneal fluids of mice infected by interaperitoneal [IP] inoculation of Toxoplasma tachyzoites were collected after 3 days and centrifuged at 750 x g for 15 minutes. Then the supernatant was precipitated with ammonium sulphate solution [40% saturated] and used as components encompassing E/SA. Forty [40] none- infected [without anti- toxoplasma antibodies] and thirty- two [32] positive [with IgG to toxoplasma] human serum samples were selected [all sera were first tested by standard method for detection of IgG antibodies anti-T. gondii] then, the sera were tested by ELISA using E/SA. The cut-off point with 95% confidences was found to be 0.78. Moreover, sensitivity and specificity of the method were determined to be 84% and 92%, respectively. The present results indicate that peritoneal exudates from mice infected with T.gondii, may be used as a source of anti-genic material for the detection of Toxoplasma-specific IgG. Furthermore, it may be valuable for the development of new tools in the serodiagnosis of toxoplasmosis

Antagonistic effects of Lactobacillus casei subspecies casei on Helicobacter pylori

Helicobacter pylori is a gram negative curved bacterium, inhabited in gastric mucosa where it remains for years. It causes several diseases such as gastritis and peptic ulcer. Its conventional treatment is antibiotics therapy; however there are other methods under investigation by probiotic micro organisms like Lactobacilli. It is reported that Lactobacilli supernatant inhibits H. pylori growth. In the present study, inhibitory effects of a subspecies of Lactobacillus genus, L. casei casei, on H. pylori growth in a mix culture was investigated. The study was performed in 2002, using a gel stabilized system. This system consisted of two layers including a solid PYS [peptone yeast extract salt solution] medium containing 1.5% agar plus 2% glucose at the bottom and a semi-solid PYS medium [0.75% agar without glucose but certain number of washed bacterial cells] on the top, all in a 30 ml tubes. In this system, L. casei casei and H. pylori were cultivated alone and in mix cultures. Samples from cultures were taken by sterile cork borers, each core was sectioned into smaller size, on which viable counts, pH, glucose concentration and optical density were determined and compared to each other. The investigating organism in this system produced growth band in the semi-solid layer. The growth position [growth bands], number of viable cells, optical density and pH in the mix culture of H. pylori plus L. casei casei were similar to those in the culture of H. Pylori alone. Conclusions: The results indicated that, L. casei casei can not prevent H. pylori growth in the mix culture and is not a good candidate as a probiotic against H. Pylori

Creatinine, blood urea nitrogen and thyroid hormone levels before and after haemodialysis

A study was carried out on 57 patients with chronic renal failure in a hospital in Kerman city, Islamic Republic of Iran. Blood samples were taken before and after haemodialysis to measure blood urea nitrogen and serum creatinine, triiodothyronine [T3] and thyroxine [T4] levels. Findings revealed that before dialysis T4 in 11 cases and T3 in 29 cases were lower than the normal range, but after haemodialysis only 3 cases for T4 and 15 cases for T3 were lower than normal levels. The remaining cases reverted to normal state. We suggest that a feedback relationship exists between the major end catabolic products [creatinine and blood urea nitrogen] and thyroid hormone serum levels

[Antagonistic effects of lactobacillus against helicobacter pylori in a gel stabilized glucose - gradient system]

Helicobacter pylori is a gram-negative bacterium inhabits the gastric mucosa and may remains there for a long period. It causes gastritis and ulcer. Recently, antibiotics are widely used to treat the infections caused by Helicobacter pylori but other means of treatment such as Probiotic [using live organisms such as Lactobacilli] can be considered. Therefore in this study antagonistic effects of two species of Lactobacillusagainst Helicobacter pylori under the laboratory condition are investigated. In this study a gel stabilized system was used. This system consisted of two phases solid layer [10 ml peptone yeast extract salt solution plus 1.5% agar and 2% glucose] at the bottom and a semi layer [10 ml PYES plus 0.75% agar and 1.5 x 10[7] washed bacterial cell /ml] at the top in 30 ml screw test tubes. Lactobacilli and Helicobacter pylori were used as pure and mixed in the upper phase of the above system. After incubation at 37[degree]C for different time intervals, samples were withdrawn from the semisolid layer using sterilized steel corkscrew and sectioned. The bacterial population, optical density, pH and glucose concentration of the medium were measured at the various depths. All bacteria had a condensed band of growth in the special places of semisolid. Growth appearance [growth band] viable count, optical density, pH in the mixed culture of Lactobacillus plantarum and Helicobacter pyloriwere like the pure culture of Lactobacillus plantarum. However, mixed culture of Lactobacillus casei and Helicobacter pylori was similar to that of pure culture of Helicobacter pylori. Regarding the results of this study Lactobacillus plantarum inhibited the growth of Helicobacter pylori in the mixed culture. This may be due to possible production of organic acids like lactic acid and bacteriocins, but Lactobacillus casei could not inhibit the Helicobacter pylori's growth. Therefore, Lactobacillus plantarum has antagonistic effect against Helicobacter pylori under in vitro condition and it can be a good choice for the probiotic purposes against Helicobacter pylori infections for in vivo investigations

[Carotid artery sonography findings in 291 patients undergoing CABG]

Doppler ultrasonography [DUS] is the most preferable method for screening of carotid artery disease in patients undergoing CABG. The purpose of this study was to investigate the frequency of carotid artery disease and determine the relation between known risk factors of atherosclerosis and rate of carotid artery narrowing in order to identify high-risk groups among patients scheduled for isolated elective coronary artery bypass grafting [CABG] procedures. Two-hundred ninety-one patients [222 males and 69 females] undergoing isolated coronary artery bypass grafting were preoperatively evaluated by carotid artery Doppler ultrasomography and the morphology of carotid artery was determined. Age, sex, cervical bruit, diabetes mellitus [DM], hypertension, hyperlipidemia, smoking, history of cerebrovascular event [CVE] and coronary angiographic findings were investigated to define the high-risk group for carotid artery disease. Data were analyzed by SPSS software and P<0.05 was considered significant. Patients ages ranged from 35 to 95 years [mean of 57.6 +/- 10.4 years]. Eleven patients [3.8%] had history of cerebrovascular events [CVE]. 13 patients [4.5%] had cervical bruit. Left main coronary artery involvement was observed in 19 patients [6.4%]. In 127 patients [43.6%] carotid scanning was normal, fifty nine patients [20.4%] had less than 50% stenosis [mild stenosis], ninty seven patiens [33.3%] had 50-70% stenosis [moderate stenosis], and eight patiens [2.7%] had more than 75% stenosis [severe stenosis]. Calcified plaque was observed in 109 patients [37.5%]. Previous cerebral ischemic events [P=0.297], diabetes mellitus [P=0.467], hypertension [P=0.110], hyperlipidemia [P=0.08], smoking [P=0.401], age >60 years [P=0.84], female sex [P=0.730], and left main coronary disease [P=0.390] were not identified as high-risk factors for carotid artery stenosis greater than 50%. But positive MI history [P=0.025], and cervical bruit [P=0.002], were significantly related to 50% carotid artery stenosis. Based on the results of this study, we can not suggest DUS as a routine screening method in all patients undergoing CABG, except for patients with history of MI and cervical bruit. Another important finding was that 56.4% of patients posted for CABG had different degrees of carotid artery stenosis which requires a long term CVA prophylaxis program

In vitro comparison of the effect of Iranian nystatin and chlorhexidine mouthwashes with foreign samples on standard and local isolated strains of Candida albicans

Chlorhexidine is a mouthwash with known antibacterial effect but its antifungal effect is not clear. The aim of this study was to compare the antimicrobial effects of nystatin and chlorhexidine mouthwashes [one Iranian product and the other, commercial] on Candida albicans under in vitro condition. In this experimental study, the strains of Candida albicans used consisted of one standard strain [PTCC 5027] and ten local isolates. The latter were obtained from patients referred to different dental clinics in Kerman city. The specimens were taken from the gum and palate area by sterile swabs and dipped into Stewards transport medium, transferred to the laboratory within one hour, and cultured on Sabauraud dextrose Agar. Colonies showing the characteristic appearance of Candida were further cultured and routine differential tests including germ tube formation were performed to confirm the diagnosis of C.albicans. These were used to prepare a microbial cell suspension of 0.5 Mc Farland concentration. Each cell suspension was inoculated over duplicate plates of SDA and 4 wells of 5 mm diameter were made using sterile cork borers. Each previously coded mouthwash was placed in corresponding well and incubated for 24-48 hours and the diameter of inhibition zone was measured with ruler. The minimum inhibitory concentration [MIC] of each mouthwash for each isolate of Candida albicans was determined using dilution tube technique. Data were analyzed by SPSS package using proper statistical tests with P<0.05 as the limit of significance. There was a significant difference between the antimicrobial effects of the four tested mouthwashes. The results indicated that Iranian nystatin mouthwash had the greatest effect and the average inhibition zone from the highest to the lowest was associated with Iranian nystatin, foreign nystatin, Iranian chlorhexidine and foreign chlorhexidine respectively. The MIC determination revealed that generally nystatin was more effective than chlorhexidine. No statistical difference was seen between the Iranian and foreign samples. Despite the antifungal effects of chlorhexidine, more investigations on different strains of C.albicans is required before recommending its cilinical application

[Efficacy of propranolol and amiodarone on prevention of atrial fibrillation after CABG]

Atrial fibrillation is the most common arrhythmia following CABG. This complication can cause palpitation, significant hemodynamic instability and thromboembolic events. This prospective randomized study evaluate prophylactic effects of propranolol low dose amiodarone and high dose amiodarone in patients candidate for CABG. Three hundred consecutive patients undergoing elective CABG were randomly categorized into three groups [each group contains 100 patients]. Patients in group1 [control group] received 10mg/TDS propranolol per oral [P.o], preoperatively. Patients in group 2 received 10mg propranolol TDS, P.o plus 350mg/24h amiodarone. Patients in group 3 received 10mg propranolol TDS P.o plus 1000mg/24h amiodarone 24 hours before operation. Atrial fibrillation occurred in 12 patients [12%] in group 1, four patients [4%] in group 2 and 10 patients [10%] [P=0.035] in group 3. AF occurred in 10.36% of men and 3.84% of women. There was no AF in off- pump groups and 9.73% in on-pump groups This study suggested the combination of propranolol plus low dose amiodarone for post CABG atrial fibrillation prophylaxy

Survival and chemotactic behavior of H pylori at different media pH

Background: H pylori is a human gastric pathogen. Chemotaxis is an essential factor in colonization of H pylori, but very little is known about its chemotactic responses at different pH conditions, especially in acidic environment of stomach as its natural habitant

Methods: we first determined survival of H pylori under various pH conditions in the presence and absence of urea. Chemotaxis was then assayed in three strains of H pylori by modified Adler's procedure, in which potassium bicarbonate was used as an attractant for estimating the chemotactic activity which was compared with phosphate buffer as an inert reagent

Results: H pylori cannot withstand pH 1, but in the presence of urea, it survives in solutions with pH values of 2 to 9 and remains viable at pH of 3 to 9, irrespective of presence of urea. Maximum chemotactic activity occurred at pH values of 5.5 to 6.5, whereas no chemotaxis was found in solutions with pH 3. Chemotactic activities are increased at pH 3 to 5.5 and reduced at pH 6 to 9, beyond which no chemotaxis was observed

Conclusion: in view of the fact that chemotaxis is severely affected by media pH, it is concluded that the antrum of the stomach is most suitable for colonization of H pylori for which maximum colonization occurs at neutral pH