Novel carotid surgery in an asymptomatic totally occluded common carotid artery.

We report the case of a 67 year old English woman with bilateral transient cerebral ischaemic attacks who was managed by unconventional surgery. Duplex ultrasound of the carotid bifurcations indicated complete occlusion of the left common carotid artery with retrograde flow from external to internal carotid artery and an ulcerated plaque at the external carotid artery origin. Following ligation of the external carotid artery origin to exclude the ulcerated plaque, the proximal external carotid artery was re-anastomosed to the internal carotid artery, preserving cephalad flow in the internal carotid artery. This case report provides additional insight into the cause of transient ischaemic attacks and offers an innovative surgical solution which preserves blood flow to the brain. It also emphasises the need for an open minded and innovative approach to vascular surgery.

Recent spread of a new strain (A-Iran-05) of foot-and-mouth disease virus type A in the Middle East.

This report describes the characterization of a new genotype of foot-and-mouth disease virus (FMDV) type A responsible for recent FMD outbreaks in the Middle East. Initially identified in samples collected in 2003 from Iran, during 2005 and 2006 this FMDV lineage (proposed to be named A-Iran-05) spread into Saudi Arabia and Jordan and then further west into Turkey reaching European Thrace in January 2007. Most recently A-Iran-05 has been found in Bahrain. To the east of Iran, it has been recognized in Afghanistan (2004-07) and Pakistan (2006-07). Throughout the region, this lineage is now the predominant genotype of FMDV serotype A sampled, and has appeared to have replaced the A-Iran-96 and A-Iran-99 strains which were previously encountered. In August 2007, a new A-Iran-05 sub-lineage (which we have called A-Iran-05(ARD-07)) was identified in Ardahan, Turkey, close to the border with Georgia. This new sub-lineage appeared to predominate in Turkey in 2008, but has, so far, not been identified in any other country. Vaccine matching tests revealed that the A-Iran-05 viruses are antigenically different to A-Iran-96 and more like A(22). These findings emphasize the importance of undertaking continued surveillance in the Middle East and Central Asia in order to detect and monitor the emergence and spread of new FMDV strains.

Frequency of Helicobacter pylori vacA genotypes in Iranian patients with gastric and duodenal ulcer.

Helicobacter pylori infection is a risk factor for developing chronic peptic ulcers and gastric cancer. The purpose of this study was to investigate the frequency of Helicobacter pylori vacA genotypes in patients with gastric and duodenal ulcer. A total of 100 biopsy specimens of patients with gastric (n=50) and duodenal (n=50) ulcer were collected. The specimens were cultured on selective media and incubated in a microaerophilic atmosphere at 37 degrees C for 5-10 days. The isolates were characterized to species level by conventional biochemical tests. The extracted DNA from isolates was used to perform a polymerase chain reaction based, simultaneous analysis of the cagA status, allelic variation of the signal regions (s1, s2) and the middle regions (m1, m2) of the vacA gene. H. pylori isolated from 50 specimens of patients and the vacA gene was detected in all isolates. Among vacA genotypes the s1/m1 was the most common in H. pylori isolates from patients with gastric ulcer (56%) and duodenal ulcer (68%). This study demonstrated that vacA slml is common genotype of H. pylori in patients with peptic ulcer and the vacA allele s1 of this bacterium is associated with ulcer.

Inhibitory effects of Sage extract on the growth of enteric bacteria.

Antibacterial activity of Sage extract at concentrations of 0.1, 0.05, 0.025, 0.0125, 0.00625, 0.003125, 0.00156, 0.0005 and 0.00025 g dL(-1) against Salmonella typhi, Shigella sonnei, S. flexneri, Proteus vulgaris, Staphylococcus aureus, ETEC Escherichia coli and Pseudomonas aeruginosa was evaluated. Susceptibility testing of bacterial strains against 18 antibiotics was also performed for comparison. The results showed that P. aeruginosa and ETEC E. coli were completely resistant to Sage extract even at concentration of 0.1 g dL(-1). Its antibacterial activity (0.1 g dL(-1)) against P. vulgaris, S. flexneri and S. sonnei was the same as nitrofurantoin and ampicilline respectively. Sage extract (0.1 and 0.05 g dL(-1)) exhibited the same effects as ampicilline and streptomycin against S. typhi. Its antibacterial activity (0.1, 0.05 and 0.25 g dL(-1)) against S. aureus was the same as ceftazidim, chloramphenicol, gentamycin, neomycin and nitrofurantoin and was more significant compared to streptomycin and vancomycin. The results suggest Sage can be considered as an alternative herbal in the treatment of infections caused by the above-mentioned bacteria.

The prevalence of cagA and cagE genes in Helicobacter pylori strains isolated from different patient groups by polymerase chain reaction.

The aim of this study was to investigate the prevalence of cagA and cagE genes in H. pylori strains isolated from different patient groups with Non-Ulcer Dyspepsia (NUD), Duodenal Ulcer (DU), Gastric Ulcer (GU) and Gastric Cancer (GC). The patients admitted to the gastroenterology unit at Sharyati hospital in Tehran in 2006 were included in this study. Gastric biopsy specimens were obtained from the antrum of the stomach from each patient then cultured for detection of H. pylori. Identification of H. pylori was performed according to the standard bacteriological methods. Genomic DNA was extracted using a commercially available Qia gene kit. PCR was done using primers cagA-F, cagA-R and cagE-F, cagE-R to detect the target genes cagA and cagE, respectively. Amplified products of target genes were confirmed by sequencing. The cagA and cagE were detected among 85 and 86% of H. pylori isolates, respectively. Prevalence of cagA and cagE genes in the patients with NUD, DU, GU and GC were 22 (64.7%), 28 (100%), 18 (90%), 10 (100%) and 25 (73.5%), 27 (96.4%), 19 (95%), 7 (70%), respectively. The current study demonstrated a significant correlation between peptic ulceration and the presence of H. pylori isolates carrying cagE and cagA genes in Iranian patients.

Study of bacterial infections among the patients with suspected cutaneous leishmaniasis.

The main objective of this study was to evaluate the prevalence of secondary bacterial infections in the patients with cutaneous lesions. The patients admitted to leishmaniasis laboratory of faculty of health, Tehran university of medical sciences from October 2004 to June 2005 were subjected in this study. Clinical samples were analyzed using standard bacteriological and parasitological methods. One hundred seventy three patients were subjected to this study and leishmania was found in 84 (48.5%) cases. According to bacteriological experiments, 47 cases (55.9%) had been also infected by bacterial infections. The most prevalent bacterial isolates included group D Streptococcus (19.1%), Enterococcus spp. (19.1%) and Staphylococcus aureus (12.7%). The findings of current study indicated that the bacterial infections are still an important problem in the patients with cutaneous leishmaniasis and should be considered in treating these patients.

Antibacterial effects of Eucalyptus globulus leaf extract on pathogenic bacteria isolated from specimens of patients with respiratory tract disorders.

The antibacterial activity of Eucalyptus globulus leaf extract was determined for 56 isolates of Staphylococcus aureus, 25 isolates of Streptococcus pyogenes, 12 isolates of Streptococcus pneumoniae and seven isolates of Haemophilus influenzae obtained from 200 clinical specimens of patients with respiratory tract disorders. MIC50s for these species were 64, 32, 16 and 16 mg/L, respectively; MIC90s were 128, 64, 32 and 32 mg/L, respectively; and MBCs were 512, 128, 64 and 64 mg/L, respectively. These results suggest that further studies to clarify the possible therapeutic role of E. globulus leaf extract in the treatment of respiratory tract infection are warranted.