Immunoasssay chromatographic antigen test for rapid diagnosis of Group A beta hemolytic Streptococcus pharyngitis in children: a cross/ sectional study

Group A beta-hemolytic streptococcus [GABHS] is an important pharyngotonsillitis etiologic agent in children. The objective of this study was diagnosis of streptococcal pharyngitis based on rapid antigen detection test and conventional pharyngeal culture. The rapid GABHS antigen detection test was compared to culture on blood agar, the gold standard for the diagnosis of this etiologic agent. Streptococcal antigen was detected in pharyngeal specimens of 34.5% of cases by rapid strip test. We detected group A Streptococcus in 17.2% of pharyngeal culture. There was no agreement between two methods [PV < 0.1]. The negative pharyngeal culture results are probably due to antibiotic usage in 43.2% of patients. Positive rapid test results in pharyngeal swab was age dependent [P < 0.05]. There was good correlation between observing the [petechia in pharynx of patients] and positive rapid test in pharyngeal swab [P < 0.004]. Throat culture results were relatated to previous antibiotic usage [P < 0.03]. The rapid test in pharyngeal swab is helpful for rapid diagnosis and treatment of GABHS pharyngitis. Diagnosis of GABHS pharyngitis based on soley clinical findings is misleading in the majority of cases. Petechia observed in pharynx of the cases was highly predictive of streptococcal pharyngitis

Viral infections detected by serology and PCR of perilymphatic fluid in children with idiopathic sensorineural hearing loss

The etiology of sensorineural hearing loss [SNHL] in children may be viral. This cross-sectional study aimed to determine the role of viral infectious agents in children with idiopathic SNHL Of 119 children with SNHL aged 3-168 months undergoing cochlear implant surgery at a hospital in Tehran, no cause could be established in 18 cases [15.1%]. Cytomegalovirus [CMV] and herpes simplex virus [HSV] active infections [detected by DNA-PCR, confirmed by serology] were found in the perilymphatic fluid of 16.7% [3/18] cases of idiopathic SNHL Serology was performed on blood samples from 11 of these cases: specific antibodies against CMV, Toxoplasmo spp., HSV and rubella were determined in all cases; acute T. gondii infection was detected in 7 cases and rubella IgG was found in only 1 case. Neonatal screening for CMV, HSV and T. gondii may be helpful in the Islamic Republic of Iran

[Determine of association quality of life and stress coping method among the caregiver of patient with multiple sclerosis; MS society, Ahvaz 2008]

Multiple sclerosis is a chronic disease that involves central nervous system. This disease which causes incapability in adult happens after traumatic accidents. 7000 cases are added annually to MS patient in Iran. This study was conducted to determine the quality of life and stress coping method among the family member and multiple sclerosis caregivers. 200 cases of family members and caregivers of patient with MS and dependent to Ahvaz MS society enrolled in this descriptive study. Three inanimate questionnaires were used to evaluate the cases. 108 male and 90 eligible female enrolled in this study. The quality of their life was normal physically, psychologically and socioeconomically. Generally, the quality of the males' life was better than the females', especially psychologically. Majority of male and female used normal and good coping method, and we also found a direct and statistically significant correlation between the level of education and the quality of life among the caregivers. Higher level of quality of life among the caregiver with higher level of education and use of suitable stress coping method among them, revealed the necessity of socio-economical supports and contour programs for educating family members and caregiver of patient with multiple sclerosis, especially for caregiver with lower level of knowledge and education

Outcome and characteristics of patients on the liver transplant waiting list: Shiraz experience

The only curative therapy for end-stage liver disease is transplantation but due to a shortage of available donor livers the waiting list mortality is high. This study aimed to evaluate the outcome and characteristics of patients on the waiting list for liver transplantation in Shiraz, southern Iran during the period from April 2004 to March 2007. Medical records of all chronic liver disease patients >/= 14 years that were on the waiting list for liver transplantation at the Nemazee Hospital Organ Transplant Center during April 2004 to March 2007 were reviewed. Hospital records were used to retrieve demographic, clinical and laboratory data. Records of the referring gastroenterologists provided information about the etiology and complications of liver disease. The patients were followed at the end of the study period by clinic visits or telephone contact. There were 646 patients on the waiting list for liver transplant during April 2004 to March 2007. Hepatitis B was the most common etiology of liver disease [31.2%]. Of those on the waiting list, 144 patients 22.3%] underwent liver transplant and 166 [25.7%] died while waiting for a transplant. The mean waiting period for transplant was 6.6 months. Receiving a transplant was correlated with the etiology of liver disease and Rh blood group [p<0.05] but had no significant association with gender or ABO blood type. Among non-transplanted patients, survival was lower in those who had a history of encephalopathy, SBP or uncontrolled ascites and in patients with a Child-Turcotte-Puph [CTP] class C and/or a Model of End-stage Liver Disease [MELD] score >/= 15. Hepatitis B virus is the most common cause of end-stage chronic liver disease amongst patients on the waiting list for liver transplant in Shiraz, southern Iran. Patients with a MELD score >/= 15 particularly those with a history of SBP, hepatic encephalopathy or uncontrolled ascites are recommended for waiting list enrollment

comparative study on Iranian libraries and librarians, and superior librarianship web logs

Web logs are the evident tools for the librarians. There are three main ways for applying web logs in librarianship fields, as follows: personal use by librarian to upgrade their personal information, as a source of information in case of libraries, and for their services. The aim of this research is to compare between Iranian libraries and librarians, and superior librarianship web logs. Present research has been achieved by descriptive method and comparatively studied a comparison between Iranian libraries and librarians, and superior librarianship web logs in 2006. Seventy-nine web logs from libraries and Iranian librarian and ten best librarianship web logs in the world in 2006 have been chosen as research community. We used direct observations and a check list -that its main factors came from Herring- and associated and based on observations and writer experiences, coaches' and weblog writers consultations for collecting data; and comparing with the best weblogs, other subjects have been added in this check list including overall identifications factors, writers identifications, date, and the level of the weblog activities, technical aspect, overall concept, linkage conditions, and opinion have been showed. Collected data have been presented and analyzed using descriptive statistics method. In terms of type, it showed that 67% of Iranian web log are filtrated and 14% are scientific, Communicating services in terms of the librarianship and its news%18, coordination and similarity and communication between librarian and services performance%9; and publishing scientific information, papers and translations 9%; are the main goal of the Iranian web logs. Evaluating different structural factors in Iranian librarian weblogs showed that in 40.5% of Iranian web log between 50% up to 75% of the writers identifications, 97.4% of them between 50% up to 75% of technical factors, 78.48% of Iranian weblog under 50% of overall technical factors, 64.55% of them under 50% overall containing, and 43.42% of them under 50% different type of the connections have been observed. In total 65.54% of the structural factors were in superior weblogs and 49.90% in Iranian web logs. Evaluation of the structural factors made the leveling Iranian librarian and libraries and superior libraries web logs based on gained scores. Iranian librarian group web logs achieved the first place by 80.95% points and non librarian web logs went down to 79 place by 17.26%;based on structural factors among Iranian web logs. Between the superior web logs The Academic Librarian was in first place by 82.14% and the Conservator in 10th place by 29.76%points. Some 58.23% of Iranian and 20% of world's superior web logs managed the structural factors in this grading

[Molecular diagnosis of B cell Non-Hodgkin Lymphoma by evaluation of immunoglobulin heavy chain gene rearrangement]

Rearrangement of V, D, and J segments of immunoglobulin heavy chain gene with inserted or deleted nucleotides within rearranged segments makes unique hypervariable regions [CDR-3]. These regions can be used for evaluation of B cell clonality for the purpose of molecular diagnosis of Non-Hodgkin Lymphoma [NHL] and for confirmatory diagnosis in suspicious cases. In this study, samples of 42 patients were collected from Taleghani, Baqhiyatalah, and Aliasghar hospitals; out of this number, there were 22 patients with diagnosis of B cell NHL, 10 with reactive hyperplasia, and 10 with malignant lymphoma. After DNA extraction from formalin fixed paraffin embedded tissues, PCR was done using consensus primers for amplification of CDR-3 region. PCR products were analyzed after heteroduplex analysis using polyacrylamide gel electrophoresis and silver stain. Results Clonal patterns in group 1 [B cell NHL], 2 [reactive and follicular hyperplasia], and 3 [morphological diagnosis without immunohistochemistry] were observed in 77.2%, 0%, and 70% of patients, respectively. Our findings are compatible with other international studies with minor differences. The diagnosis of B-cell lymphoid malignancy can frequently be substantiated by detecting clonal immunoglobulin heavy chain [IGH] gene rearrangement

[Stem cell transplantation into rat inner ear]

Recent advances in regenerative medicine and stem cell therapy has opened new horizons with promising results in treating diseases so far known as incurable. Therapy with stem cells has been considered in treating various disorders encompassing hematologic, cardiovascular, neurologic, dermatologic and orthopedic entities as well as diabetes. Stem cells transplantation has been lately evaluated in treating hearing impairments in experimental studies and it is expected to open its way in treating patients with sensori-neural hearing loss in future. The present study is a review of literature published in medical databases current as of July 2007. Authors in this article has highlighted important characteristics of this novel approach including basics of stem cell biology and its potential application in treating auditory disorders. Despite primary hopeful results from stem cells transplantation in treating hearing impairments in experimental research, there are many questions which should be answered before their being introduced in clinical trials. Finding a proper source for cellular isolation, method of differentiation, way of delivery to the target organ and the right dosing as well as the ethical issues and potential hazards confronted are such challenges which should be first overcome

Drill-and suction generated noise levels in mastoid surgery

It has been recognized that noise levels generated during ear surgery may cause sensorineural hearing loss. However, there is a controversy about the main factor that may cause such hearing threshold alternations: drilling, suction or both of them. The purpose of this investigation was to measure the air-conduction noise levels generated by common drills, burrs and suction irrigators in mastoid surgery. Our evaluations were carried out in two states: isolated temporal bones [cadavers] and intraoperative recordings. Preliminary drillings were made on 10 cadavers, and intensity and frequency analysis of common diamond and cutting burrs were performed. Then, the noise levels generated by drilling, suction irrigation and simultaneous drilling and suction irrigation were measured from 15 patients under radical modified mastoidectomy. Data were analyzed by SPSS II software and 0.05 value was regard as significant level. The average noise levels of drilling ranged from 83 to 95 dB SPL, varying with burr used. Cutting burrs were found to be up to more intense than diamond burrs. Mean suction irrigation noise levels ranged from 77.45 to 78.65 dB SPL. The average of "intraoperative drilling" and "simultaneous drilling and suction irrigation" generated noise levels were 87.14 and 86.26 dB SPL, respectively. The comparison of resultant noise levels between cadaver and under operation situations was not statistically significant. Our results showed that the main factor contributing the highest noise level is drilling which is predominately apparent in cutting burrs. Exposure to these noise levels may account for shifts in the hearing thresholds

Sensory hearing loss in children with mumps infection

Mumps infection is endemic in Iran and mumps parotiditis is a common disease in Iranian children. There has been a dramatic decrease in the worldwide incidence of mumps since the introduction and use in 1968 of the very effective and inexpensive mumps vaccine. In Iran probably due to a higher percentage of unvaccinated young persons <15yr, the incidence rate of mumps infection and its sequel are higher in comparison to corresponding data from developed countries prior to comprehensive vaccination programs. The aim of the study was to investigate the effects of the mumps virus on cochlear function and to determine the frequency of related Sensory Neural Hearing Loss [SNHL] in children. This descriptive case-series study was conducted in 94children, aged less than 14 years, hospitalized between 1999 and 2001, in the pediatric ward of the Hazrat Rasool Hospital in Tehran. All patients with documented mumps infection [specific mumps-IgM antibody] were evaluated twice for audiometeric function on the basis of diagnostic parameters for sensory neural hearing loss; the first evaluation was done on admission and the second three weeks later. 54 patients [age range 1-14y, mean age 4.83 +/- 3.93, male: female ratio30:24] were studied in two years. The highest incidence of mumps was seen in winter [37%] and spring [28%] and the lowest in summer [13%]. Specific IgM antibody for mumps virus was detected in 74 children. Comprehensive audiologic evaluation was done in 54 patients at admission and again 3 weeks later. SNHL was detected in 7.2% of patients; the 4.4% incidence of SNHL in this study was higher than in other studies in developed countries prior to comprehensive vaccination programs. Implementation of comprehensive vaccination programs in young Iranians could dramatically reduce the burden and costs imposed by the infection and its sequelae

[Neonatal hearing screening with TEOAE in Mashhad city]

Hearing loss diagnosis solely by using the classical methods in neonatal and infants seems to be difficult. Any delay in diagnosis results in reverse effects on speech, language and social cognitive developments. TEOAE and ABR tests are highly recommended to be performed at birth. The aims of this study were early diagnosis, intervention and prevention of linguistic delay that were performed in the three hospitals in mashhad city. This was a descriptive study and neonates in the first 24 hours were screened using the TEOAE test. The cases who failed the first time test were have been rescreened 3 weeks later. If the results in both sessions [screen and re-screen] failed in one or both ears the child would be referred for a complete diagnosis ABR test before 3 month of age. Confirming the presence of mono aural or biaural hearing loss using by the ABR test. Long term follow up and medical/rehabilitative interventions were been programmed and performed before the age of 6 month. From 10016 screened new born 9615 individuals [96%] passed the tests and 401 individual [4%] were referred to the next step. Of those who were referred, only 289 individuals showed up for the re-screening test. From these only 23[8%] newborns were referred to ABR test. In this population the presence of hearing loss was only confirmed in 13 individuals [56%]. Eight of them had profound hearing loss in cochlear, 2 of them had moderate hearing loss in Cochlea, and 3 newborn had sever conductive deficit. Because of the high prevalence of congenital hearing loss, the reverse effects on children development, the availability of accurate tests for diagnosis of hearing loss, and being cost effective, hearing screening of all the neonates are highly recommended at the birth

Effect of different glucose concentrations on PC12 cells apoptosis: role of bax and Bcl[2] proteins

In diabetics, hyperglycemia is associated with neuropathy, nephropathy, and retinopathy. However, direct toxic effects of glucose on neurons are still largely unknown. Firstly, cellular vital capacity was determined by MTT. Then, effects of different glucose concentrations and the role of Bax protein-induced apoptosis in PC12 cells was examined by Hoechst staining and western blotting techniques, respectively. During MTT, cells revealed to have a meaningful apoptosis at hours 48, 72, and 96 when compared with controls [p<0.01]. Apoptosis was induced suitably at a glucose concentration of 13.5mg/dl after 72 hours. Western blotting showed a significant expression of Bax protein in PC12 cells treated with increased glucose concentrations for 72 hours. Increment in glucose concentration may induce apoptosis in PC12 cells. This process occurred under the intense influence of Bax protein

[TT virus infection among Iranian blood donors: its prevalence and relationship to serum alanine aminotransferase [ALT] leve]

TT virus [TTV] is a DNA virus and is proposed as a potential cause of non-A to E hepatitis. We aimed to investigate, for the first time, the prevalence of TTV in Iranian healthy blood donors. Three hundred and twelve healthy Iranian blood donors were randomly selected and tested for TTV DNA by the seminested polymerase chain reaction method. Serum alanine aminotransferase [ALT] levels were determined in those infected and uninfected individuals that adequate serum were available. HBsAg or HCV antibody-positive subjects were excluded. Results: TT virus DNA was detected in 70 [22.4%] of the 312 subjects under study. ALT was elevated in 8 [18.2%] of the 44 TTV positive blood donors and in 8 [10.9%] of the 73 TTV negative blood donors. There was no significant difference between these two groups. TTV viremia is common among Iranian blood donors. Its prevalence in Iran is higher than US [1%] and most West-European countries and is comparable to China [28%] but lower than Thailand [37%] and Italy [42.4%]. Our data do not support the correlation between TTV viremia and elevated ALT level

[Human papillomavirus in squamous cell carcinoma of esophagus in a high-risk population]

The role of human papillomavirus [HPV] in the etiology of esophageal squamous cell carcinoma [ESCC] is not clear. Previous studies have found highly variable [from 0% to 67%] prevalence of HPV in ESCC tumor. However, prevalence of HPV in ESCC tumor seems to be higher in areas with high incidence of ESCC, such as China and South Africa. Iran is one of the areas of the world with the highest rates of ESCC. However, no previous study has reported the prevalence of HPV in ESCC tumor tissues from Iran. In this study, we compared the prevalence of a common marker for the presence of HPV [MY09/MY11 consensus primers] and two markers for the presence of HPV-16 and HPV-18 [respective E6 /E7 primers] in tumor tissues from 38 ESCC cases and normal biopsied tissues from 38 Iranian individuals. 14 out of the 38 ESCC [36.8%] samples, but only 5 out of 38 control samples [13.2%] were positive for the common marker of HPV presence; this difference was statistically significant [p=0.02]. Five ESCC samples [13.2%] but none of the control samples were positive for HPV16 E6 /E7 gene [p=0.05]. Three of the ESCC samples [7.9%] and five of the control samples [13.2%] were positive for HPV18 E6 /E7 gene. Our data are consistent with HPV DNA studies conducted in other high-risk areas for ESCC. HPV should be considered as a potential factor responsible for the increased incidence of ESCC in Iran and other high-incidence areas of the world

major patterns of inflammatory sinonasal disease in 77 cases of functional Endoscopic Sinus Surgery [FESS]

In the two past decade Functional Endoscopic Sinus Surgery [FESS] has appeared as a relatively benign surgical technique for treatment of chronic recurrent sinusitis. Coronal sinus CT Scan is the best method for properative evaluation. Identifying the major patterns of inflammatory sinonasal disese in CT scan is very helpful for planning the technique. These five major patterns are I] infundibular, II] ostomeatal unit or OMU, III] sphenoethmoidal recess or SER, IV] sinonasal polyposis or SNP and V] sporadic or unclassifiable. By identifying these patterns more tailored endoscopic sinus surgery is possible

In 77 Consecutive Patients [age: 12Y to 68 Y, mean 32Y] undergoing FESS for treatment of chronic inflammatory sinonasal disaese, coronal sinus CT scans reviewed for the major inflammatory patterns and anatomic variations may attribute to inflammatory disease. Infundibular pattern was identifed in 11[14%], OMU pattern in 42[55%], SER pattern in 32[42%], SNP pattern in 16[21%] and sporadic or undclassifiable pattern in 10[13%]. The OMU and SER patterns were seen simultaneously [pansinusitis] in 25 [35%]. Additional incidental sinonasal anatomic variations were frequently encountered including some degree of nasal septal deviation in 45[59%] and concha bullosa in 32[42%]. In patients with concha bullosa more severe patterns were seen with higher incidence

We found higher incidence of more severe patterns and higher incidence of anatomic variations specially septal deviation and concha bullosa in our study. Although our group was surgical but this seems not to be the only reason for dramatic high incidence of the most extensive inflammatory disease. This may perhapsbe due to delay in patients presentation in Iran

Cochlear implantation in Iran

Sound is transformed into small electrical currents which stimulate the auditory nerves in the cochlea and generate the hearing sensation. Cochlear implantation [CI] has become an increasing common procedure in the rehabilitation of selected cases of profound bilateral deafness. CI is a method which provides useful hearing and improves communication ability of adults and children with severe or profound bilateral sensorineural hearing loss. One hundred sixty patients [134 prelingual, 26 postlingual deaf] underwent cochlear implantation after full investigations in the Iranian Cochlear Implantation Center from 1992 to 1998. The majority of patients were 4 to 7 years old. The youngest patient was a 15-month-old child. Spontaneous reaction to environmental sound achieved in 87.3%. 71% of cochlear implanted deaf patients became able to use telephone and communicate with familiar speakers. Complication rate was as low as 3.75% and the most common complication was CSF gusher

Cochlear implantation in Iran

Cochlear implantation has become an increasingly common procedure in the, rehabilitation of selected cases of profound deafness. Patients should have profound total bilateral sensorineural hearing loss. Sound is transformed into small electric currents which stimulate the auditory nerves in the cochlea and generate the hearing sensation. The nucleus cochlear implant is the result of more than 20 years of research and development and has been used in more than 9000 patients worldwide to date. After two years of research in order to provide the cochlear implant in the Farsi [Persian] language, three out of 54 post lingual totally deaf patients up to now have undergone the cochlear implant operation with a 22-channel mini-system through a Lehnhardt incision, mastoidectomy, facial recess, and cochleostomy procedure. One month following the implant, these patients were undergoing speech education and auditory training by using innovative rehabilitation techniques for deaf people in the Persian language. This report deals with presenting three cases implanted by a cochlear implantation team in Iran and the results of rehabilitation following implant

Pendred's syndrome revisited

Pendred's syndrome is defined as a triad of congenital perceptive hearing loss, goiter, and abnormal perchiorate test. Three brothers with Pendred's syndrome [P.S] are reported. The oldest brother has hearing loss [he has been deaf and mute since childhood] and has a large goiter. A thyroid scan revealed euthyroid multinodular goiter and a perchlorate test was performed, and reported abnormal. His brother had the same manifestations but with less severity and after subtotal thyroidectomy, the pathology report revealed follicular carcinoma. The youngest brother had hearing loss since childhood but a normal sized thyroid. We report three patients and compare the frequency of their symptoms with that reported in the literature