HIV, HSV2 and syphilis prevalence in female sex workers in Kerman, South-East Iran; using respondent-driven sampling

We estimated the prevalence of HIV, sexually transmitted infections [STIs], and risky behaviors among female sex workers [FSW] in Kerman City, Iran. Women, 18 years or older, who reported selling sex for at least 6 months during their lifetime and had at least one sexual contact with a client in the recent 12 months were sampled using Responding Driven Sampling [RDS]. Participants were interviewed about their sexual behaviors and provided whole blood for HIV, syphilis, and Herpes simplex type 2 [HSV2] testing. Data were analyzed using RDSAT Version 6.0 software. Among samples of 177 FSW, we did not find any HIV positive cases. The weighted prevalence of syphilis and HSV2 were 7.2% and 18.0%, respectively. The reported STI syndromes for the proceeding year of the survey were 36%. Unprotected sexual contact was about 17-22% and link to injecting drug users through injection was about 18%. While this survey found no HIV, there were findings of risky sexual behaviors and STI, markers for potential infection for HIV. The prevalence of STI and sexual risk behaviors for HIV is considerably high in this subpopulation that alarming for an urgent public health preventive measures and national control-plan to be developed and implemented

Epidemiology and risk factors of 377 AIDS [HIV infected] patients

Oral manifestations of HIV infection are common and include oral lesions and novel presentations of previously known opportunistic diseases. Some risk factors are significantly contributed to probability of developing opportunistic infection of oral candidiasis. We have performed the current survey to evaluate their role in Iranian patients with HIV infection. Totally, 377 documented HIV infected patients were included. Oral candidiasis was investigated with clinical observation, direct smear, and culture. Meanwhile, CD4 count was determined at the first visit and following antiretroviral therapy. The study population included 316 males and 60 females with a mean age of 36.5 +/- 8.7 years. Patients were diagnosed for a mean duration of 2.9 years. The most common route of infection transmission was shared needles [117 cases or 31%]. In serologic tests, 11 cases [2.9%] were positive for HBsAg, 206 cases [71.5%] for HCV nucleic acid and 53 cases [14.1%] for tuberculosis infection. At the first visit 52 cases [13.9%] and following HAART 31 cases [8.2%] were revealed to have oral candidiasis. Mean CD4 count in patients with oral candidiasis was significantly less than other patients [193.8 vs. 349.7 cells, P=0.0001]; however, the difference was not significant at follow up. Prompt diagnosis and treatment of HIV infection may have a significant role in prognosis and clinical course of patients with HIV infection and could decrease the rate of opportunistic infections

Inter tester and intra tester reliability of eight sacroiliac joint static and dynamic and three pain provocation tests

The purpose of this study was to determine the inter tester and intra tester reliability of 5 static and 3 dynamic palpation tests, and three pain provocation tests used to diagnose sacroiliac joint dysfunction. Five static palpation tests, namely palpation and assessment of the levels of the 1] posterior superior iliac spine [PSIS] in standing position, 2] PSIS in sitting position, 3] anterior superior iliac spine [ASIS] in standing position, 4] Medial Maleolus [MM] in supine position, and 5] MM in long sitting position, and three dynamic [motion palpation] tests, 1] the Gillet test, 2] the standing flexion test, and 3] the sitting flexion test were performed on ten asymptomatic subjects by four examiners. Each test was performed four times by each examiner resulting in 1280 assessments in total. Pain provocation tests were posterior pelvic pain provocation test [PPPPT] or posterior shear test, patric test, and hip resisted abduction test. The Study included twenty women with chronic low back pain, aged between 20 to 30 years. Each of pain provocation tests were performed two times by two examiners. Reliability was determined using Kappa Statistic which allows assessment of observer agreement for more than two examiners and multiple examiners. Intra examiner agreement of static palpation tests revealed a range of reliability from slight to good. Kappa coefficient yielded intra examiner agreement that ranged between slight to good for the PSIS in standing position [0.18-0.75], slight to moderate for the ASIS [0.15-0.5], and slight to fair [0.1-0.35] for other static and all motion palpation tests. Inter examiner reliability of all the static and dynamic tests did not exceed slight reliability [0.0-0.2]. Kappa value for intertester reliability of posterior shear test, patric test, and hip resisted abduction test for right limb was 0.7, 0.7, and 0.6, and for left one was 0.7, 0.78, 0.34, respectively, and the mean value of kappa for intratester reliability was between 0.75 and 0.91. The results of this study suggest that the reliability of palpation and assessment of the levels of the PSIS, ASIS, and MM in static positions, and the gillet, standing flexion, and sitting flexion tests as indicators of sacroiliac joint dysfunction still remain questionable. Therapists should reconsider the usefulness of evaluation techniques that rely on the assessment of the anatomical symmetry of bony landmarks of the innominates in static and dynamic conditions. About pain provocation tests, the results showed that posterior shear and hip resisted abduction tests are reliable tests to diagnose the pathology in the sacroiliac joints. The reliability of patric test that commonly used to determine the sacroiliac joints pathologies is in under question

[Cloning, expression and purification of snap-25 proterin]

Clostridial neurotoxin inhibits neurotransmitter release by selective and specific intracellular proteolysis of synaptosomal associated protein of 25KDa [SNAP-25], synaptobrevin/VAMP-2 and syntaxin. SNAP-25 is one of the components that forms docking complex in synaptic ends. This protein is subtrate for botulinum neurotoxins types A,C, and E. Each of these toxin serotypes specifically cleaves SNAP-25 in a particular position and thereby block docking and synaptic vesicle membrane fusion and finally prevents neurotransmitter exocytosis and transition of neurotic signals. Recombinant production of SNAP-25 in the laboratory can be used as a subtrate for the detection of clostridium botulinum types A, and E neurotoxins. In order to use the protein as a subtrate for detection of different types of clostridium neurotoxins in-vitro the protein was produced by recombinant technique. The cDNA from SNAP-25 was synthesized from total RNA purified from frozen Rattus norvegicus brain. and amplified by RT-PCR The amplified fragment was cloned into pET32a expression vector. The identity of recombinant protein was confirmed by Western blot using specific antibody and finally the recombinant protein was purified through an affinity column chromatography [Ni-NTA]. The optimum conditions of expression of SNAP-25 were found to be IPTG[1mM] and incubation at 37°C for 5 hours. The recombinant protein was isolated and purified using Ni-NTA column with imidazole at a concentration of 25OmM. Using enterokinase to cut the fision at 37°C comparatively yielded better results than room temperature. The protein retained its structure during the purification process being suitable for cutting and further tests. The purified protein we obtained can be used as subtrate for detection of clostridium botulinum types A, and E toxins

[Immunological characterization of light chain recombinant protein of clostridium botulinum type A]

Botulinum neurotoxin type A, structurally consists of a 50KD light chain and a 100 KD heavy chain linked by a disulfide bond. The protein can further be divided into three functional domains of which catalytic domain corresponds to the light chain. In this research we aimed to produce recombinant catalytic domain in order to obtain a protective protein. Bacteria were grown in anaerobic conditions and genomic DNA was extracted by alkaline method. Following the gene coding a set of primers was designed and the catalytic domain was amplified through PCR. The PCR product was then cloned into three expression vectors namely pRSETA, pET28a and pET32a. The expressed protein was analyzed on SDS-PAGE and confirmed by ELISA and western blotting and then purified by affinity chromatography. In this research the maximum expression was obtained at 0.5 mM IPTG,OD[600]:0.6 and 15 hours of induction at 30§C. The protein so expressed was purified by affinity coulmn chromatography .The antibody raised against recombinant protein could protect the rats by 100 LD[50]. Though the expression of AT- rich genes in E.coli system is low, we could obtain an appropriate level of expression in this study. The purification of recombinant protein in the early stages was elusive in the extreme by affinity chromatography due to the weak binding of histidine N-terminal to the column, howerer 90% purification was achieved through modification of the technique. The antibody produced against this domain was less protective compared to that of binding domain

[Knowledge of intern and extern medical students of Boali and Amiralmomenin hospitals towards prevention and control methods of nosocomial infections]

Nosocomial infections are one of the most important causes of morbidity and hospital mortality rate in hospitalized patients. The infections that are usually occur 48 to 72 hours after admission are called nosocomial infections. These infections increase the duration of hospitalization for 1-30 days. In Iran, nosocomial infections were reported in 1.9% to 25% of hospitalized patients. This cross sectional study was conducted among 252 medical students [80 interns and 172 externs]. Questionnaires including 40 questions in the form of multiple choices were prepared and distributed randomly among medical students. The answer sheets were collected and corrected. Then, results were analysed using SPSS software. Totally, 33% of students had poor knowledge of nosocomial infections, while 50% and 17% had moderate and good [high] knowledge, respectively. There was no statistically significant relationship between gender and knowledge, however, extern's knowledge were significantly better than intern's. With respect to the poor knowledge of medical students towards nosocomial infection, we suggest a course dealing with nosocomial infections for medical students