Comparison of cytotoxic and apoptosis-inducing effects of MTA, propolis, and propolis-MTA on immature dental pulp stem cells.

BACKGROUND: Pulpotomy is a treatment option for the preservation of pulp vitality in primary teeth with extensive caries. Propolis is a natural resinous substance with optimal antimicrobial, anti-inflammatory, and immune-regulatory properties. Thus, this study aimed to compare the cytotoxic and apoptosis-inducing effects of mineral trioxide aggregate (MTA), propolis, and MTA-propolis on immature dental pulp stem cells (IDPSCs). METHODS: In this in vitro, experimental study, primary IDPSCs were exposed to propolis, MTA, and MTA-propolis for 24 and 72-h. The cytotoxicity and apoptosis-inducing effects were evaluated using the methyl thiazolyl tetrazolium (MTT) assay and flow cytometry, respectively. Data were analyzed using ANOVA and Tukey's test at 0.05 level of significance. RESULTS: The cytotoxicity of MTA and MTA-propolis was higher than that of propolis alone at both 24/48 h. In addition, all tested concentrations showed higher biocompatibility at 72-h compared with 24-h (P < 0.0001). In the assessment of apoptosis, propolis-MTA showed higher cell viability compared with other materials (P < 0.0001). CONCLUSION: Propolis-MTA showed higher biocompatibility than MTA. Addition of propolis to MTA improved cell proliferation in the first 24-h. Also, the cytotoxicity of propolis was lower than other materials in the first 24-h. Thus, propolis may serve as a promising pulp capping agent given that its other properties are approved.

Pyrethroid-linked resistance allelic mutations by molecular analysis in wild human head louse (Phthiraptera: Pediculidae) populations from schoolgirls of South Iran.

Background: Human head louse, Pediculus humanus capitis De Geer, 1767 (Anoplura: Pediculidae), is one of the most frequent ectoparasites infesting Homo sapiens worldwide. Reduced sensitivity to treatment due to genetic mutations, in particular knockdown resistance (kdr) (or target site insensitivity) allele, has led to this infestation prevalence. Molecular characterization of this resistance has a crucial impact on selecting appropriate treatment protocol. The aim of this study was to investigate kdr gene mutations on voltage-sensitive sodium channel (VSSC) among wild head lice samples from Fars province, southern Iran. Methods: Head lice were collected using plastic detection combs on girls enrolled in public schools from 10 counties in Fars province. The specimens were screened in 10 pools (each pool per county containing 35 specimens), with three pools (30%) being positive. Following species identification with valid entomological keys, 350 (68%) out of 514 randomly collected adult head lice were analyzed after their somatic genomic DNA extraction using Sinaclon kit. Samples were investigated by polymerase chain reactions (PCR), and the amplicon was subsequently sequenced. Results: Sequence analysis showed that the sodium channel genes in the pooled ectoparasites had two intron and three exon regions. Single (L840F), double (I836L, E837K), and triple novel point mutations (V875L, Q876P, S879V); the last involving two concomitant allelic substitutions; were discovered in the second and third exon regions of head louse DNA on chromosome II from three (30%) counties. Other exon or intron regions remained non-mutated from the remaining seven counties. Conclusions: The detection of six amino acid substitutions from 30% of examined head lice among infested schoolgirls reveal that mutants are minutely developing. These findings provide further incentive to recapitulate the legitimacy of current control measures and resolve dynamics of resistance in human head louse populations.

Probing nanoliposomes using single particle analytical techniques: effect of excipients, solvents, phase transition and zeta potential.

There has been a steady increase in the interest towards employing nanoliposomes as colloidal drug delivery systems, particularly in the last few years. Their biocompatibility nature along with the possibility of encapsulation of lipid-soluble, water-soluble and amphipathic molecules and compounds are among the advantages of employing these lipidic nanocarriers. A challenge in the successful formulation of nanoliposomal systems is to control the critical physicochemical properties, which impact their in vivo performance, and validating analytical techniques that can adequately characterize these nanostructures. Of particular interest are the chemical composition of nanoliposomes, their phase transition temperature, state of the encapsulated material, encapsulation efficiency, particle size distribution, morphology, internal structure, lamellarity, surface charge, and drug release pattern. These attributes are highly important in revealing the supramolecular arrangement of nanoliposomes and incorporated drugs and ensuring the stability of the formulation as well as consistent drug delivery to target tissues. In this article, we present characterization of nanoliposomal formulations as an example to illustrate identification of key in vitro characteristics of a typical nanotherapeutic agent. Corresponding analytical techniques are discussed within the context of nanoliposome assessment, single particle analysis and ensuring uniform manufacture of therapeutic formulations with batch-to-batch consistency.

Comparison of desmoglein 1 and 3 enzyme-linked immunosorbent assay and direct immunofluorescence for evaluation of immunological remission in pemphigus vulgaris.

BACKGROUND: Drug withdrawal is the ultimate goal in the management of patients with pemphigus. Direct immunofluorescence (DIF) has long been considered the gold-standard test to predict immunological remission in pemphigus vulgaris (PV); however, there have been no comparisons between DIF and antidesmoglein (anti-Dsg) ELISA. AIM: To compare anti-Dsg ELISA with DIF in patients with PV for evaluation of immunological remission. METHODS: The study enrolled 46 patients with PV who had absence of any lesion, and had a daily prednisolone dosage of ≤ 10 mg without adjuvant drug treatment in the preceding 6 months. Biopsy specimens were taken from patients and processed for DIF. Intercellular deposition of IgG and/or C3 was considered positive. Serum samples were also collected for anti-Dsg1 and anti-Dsg3 ELISA, and an ELISA index value of > 20.0 was considered positive. RESULTS: DIF and anti-Dsg ELISA were positive for 11 (23.9%) and 18 patients (39.1%), respectively. Anti-Dsg ELISA had a sensitivity of 100%, a specificity of 80%, a positive predictive value of 61.1% and a negative predictive value of 100%. CONCLUSIONS: The high sensitivity of anti-Dsg ELISA proves that this simple serological test is a good substitute for DIF for evaluation of immunological remission in PV. As none of the DIF-positive patients was anti-Dsg-negative, it is possible that during the course of immunological remission, results for DIF may become negative before the results for Dsg ELISA do so.

Non-syndromic multiple odontogenic keratocyst: a case report.

Odontogenic keratocyst (OKC) is a common developmental odontogenic cyst affecting the maxillofacial region. Multiple OKCs are usually seen in association with nevoid basal cell carcinoma syndrome (NBCCS) but approximately 5% of patients with OKC have multiple cysts without concomitant syndromic presentation. This report represents a case of multiple OKCs in a non-syndromic patient.

Psychological issues in inflammatory bowel disease: an overview.

Inflammatory bowel disease (IBD) including Crohn's disease (CD) and ulcerative colitis (UC) is a chronic and disabling disease with unknown etiology. There have been some controversies regarding the role of psychological factors in the course of IBD. The purpose of this paper is to review that role. First the evidence on role of stress is reviewed focusing on perceived stress and patients' beliefs about it in triggering or exacerbating the course of IBD. The possible mechanisms by which stress could be translated into IBD symptoms, including changes in motor, sensory and secretory gastrointestinal function, increase intestinal permeability, and changes in the immune system are, then reviewed. The role of patients' concerns about psychological distress and their adjustment to disease, poor coping strategies, and some personality traits that are commonly associated with these diseases are introduced. The prevalence rate, the timing of onset, and the impact of anxiety and depression on health-related quality of life are then reviewed. Finally issues about illness behavior and the necessity of integrating psychological interventions with conventional treatment protocols are explained.

Trucut biopsy of breast lesions: the first step toward international standards in developing countries.

UNLABELLED: The new concept in breast cancer diagnosis and treatment is based on a less invasive, more accurate and effective strategy, with a multidisciplinary approach in a specialised breast unit. When indicated, conservative surgery has replaced mastectomy with sentinel-node biopsy substituting routine axillary dissection. But the key factor in respect of these new standards is to confirm the cancer before going to the operating room. Trucut biopsy is performed instead of incisional or excisional biopsy and frozen section. The technique is reliable, simple, and reproducible, and not at all expensive; it can be adapted even for low-income developing countries. MATERIALS AND METHODS: Between March 2006 and June 2010, 764 patients under clinical suspicion of cancer and/or with BIRADS (Breast Imaging Reporting and Data System) III-V in imaging in one university and one private hospital in Tehran, Iran underwent trucut biopsy (60% palpable and 40% non-palpable lesions). Cancer was found in 30.8% of the cases. In benign pathology, in concordance with clinical and imaging suspicion, surgery was omitted with short-term follow-up. For palpable symptomatic benign lesions surgery was performed to relieve the patient's symptoms. When the pathology report was not in concordance with clinical/imaging suspicion (1.8%), and in the presence of moderate and severe hyperplasia with or without atypia, in lobular and papillary lesions (4.9%) open biopsy was done to rule out cancer (10 added cancers, 1.3%; total cancers 32.1%). Cancer surgery was done as a single procedure in 89.8% of cases. CONCLUSION: Trucut biopsy for breast lesion assessment is the first step toward a new concept in breast cancer care. It is simple, reduces the number of surgeries (no surgery for non-symptomatic benign lesions and one surgery for cancer), and avoids diagnostic errors with full respect for the patient's rights. We insist on its routine use to extend international guidelines while decreasing the total cost of this common disease in all low-resource countries.

First microscopical and molecular-based characterization of Leishmania major within naturally infected Phlebotomus salehi (Diptera; Psychodidae) in Fars province, southern Iran.

Zoonotoc cutaneous leishmaniasis is endemic in several parts of Iran. Jahrom district is one of the most important endemic foci of leishmaniasis located in Fars province, southern Iran. To identify the vectors of leishmaniasis in this area, a total of 349 sandflies were collected during May to August 2009. They were caught from outdoors in five regions of Jahrom district including villages of Mousavieh, Ghotb-Abad, Heydar-Abad, Fath-Abad and Jahrom County. Eleven species of Phlebotomine (three Phlebotomus spp. and eight Sergentomyia spp.) were detected. To determine the sandflies naturally infected by Leishmania spp., 122 female sandflies were dissected and evaluated microscopically using Giemsa-stained slides. Natural infection of 2 out of 38 (5.26%) P. papatasi and 1 out of 8 (12.5%) P. salehi to Leishmania major was confirmed in the region. Sequencing and nested polymerase chain reaction-based detection of Leishmania were carried out to confirm the microscopic findings. Five (13.16%) P. papatasi and two (25%) P. salehi were positive in nested polymerase chain reaction assay. All positive samples were shown 72-76% similarity with L. major Friedlin. On the basis of our knowledge, this is the first molecular detection of L. major within naturally infected P. salehi in this region in southern Iran.

The PCR-based detection and identification of the parasites causing human cutaneous leishmaniasis in the Iranian city of Ahvaz.

In Iran, Leishmania major or L. tropica cause almost all of the human cutaneous leishmaniasis (CL). Unfortunately, the detection methods frequently used for CL (the microscopical examination of direct smears or the culture of biopsies) are not very sensitive and the Leishmania species causing each case of CL in Iran is usually only tentatively identified from extrinsic factors, such as the case's clinical manifestations and region of residence. Recently, however, a nested PCR that targets the parasites' kinetoplast DNA has been used in the city of Ahvaz (the capital of the province of Khouzestan, in south-western Iran) to confirm the microscopical diagnosis of CL and to identify the causative parasites, to species level. Smears from the lesions on 100 suspected cases of CL were fixed, stained with Wright's eosin-methylene blue, and checked for amastigotes under a light microscope. Scrapings from the same smears were then tested for leishmanial DNA, using a nested PCR that allows the DNA from L. tropica to be identified and distinguished from that of L. major. The 100 smears investigated were all found amastigote-positive by microscopy and PCR-positive for either L. major DNA (97 smears) or L. tropica DNA (three smears). The predominant species causing CL in Ahvaz is therefore L. major.

Behavioural and emotional problems in Iranian children four years after parental death in an earthquake.

BACKGROUND: Although previous research has established a direct impact of natural disasters on child mental health, there is limited knowledge on the underpinning mechanisms, particularly when there has been the loss of a parent. AIMS: To establish: (a) the rates of behavioural and emotional problems of school-aged children who had lost their parents in the 2003 earthquake in Iran, compared with children from intact families who attended the same schools; (b) the relationship between the psychopathology of the surviving parents' and children's behavioural and emotional problems; and (c) whether this relationship was compounded by socioeconomic factors. METHODS: Eighty six children of 7-13 years who had lost a parent in the earthquake four years earlier were compared with 80 matched children from intact families. The teacher and parent versions of the Strengths and Difficulties Questionnaire (SDQ) were used as measures of behavioural and emotional problems. Parents' psychopathology was established by the Self Report Questionnaire (SRQ). RESULTS: Behavioural and emotional problems were significantly higher in children who had suffered parental loss than in the control group. There was a significant association between parent-rated SDQ and SRQ scores. Parental death was found to interact with socioeconomic variables in predicting children's behavioural and emotional problems and surviving parents' mental health problems. CONCLUSIONS: After natural disasters, bereaved children and their surviving parents are at risk of developing mental health problems, and social adversities increase this risk.

Comparison of three methods for diagnosis of cutaneous leishmaniasis.

BACKGROUND: Leishmaniasis is one of the infectious parasitic diseases of highest incidence in the world. Cutaneous Leishmaniasis (CL) has long been reported in Shiraz, Southern Iran. There is a need to find a sensitive and specific method for treatment and control of the disease. METHODS: We have compared the sensitivity of the conventional methods microscopy and cultivation of lesion scrapes against PCR amplification of parasite kinetoplast DNA from these samples. The samples (n=219) were obtained from the patients clinically suspected of CL. The smears were stained with Giemsa for microscopy and cultured in Novy-Nicolle-McNeal (NNN) blood agar for promastigote growth. For PCR, the dry smears were scraped off the slides and DNA was extracted. RESULTS: The positive rates from 219 specimens were 76.71%, 50.68%, and 93.61% for microscopy, cultivation, and PCR, respectively. The highest correlation was found between PCR and microscopy method (P=0.014). In PCR assay, 95.61%, 3.9%, and 0.49% of the samples were identified as Leishmania major, L. tropica, and dermatropic L. infantum, respectively. CONCLUSION: The PCR method appears to be the most sensitive for the diagnosis of CL and is valuable for identifying the other species of Leishmania with confusing dermatropic signs.

Inguinal hernia and occurrence on the other side: a prospective analysis in Iran.

BACKGROUND: Indirect inguinal hernia (IH) is the most common type of hernia. Routine contralateral inguinal exploration, without clinical evidence of a hernia is still controversial especially in children. The purpose of our study was to determine incidence of contralateral IH. METHODS: This is a prospective study of 301 patients during a one-year period. History of groin mass, positive findings, demonstrable hernia, or communicating hydrocele were our criteria for diagnosis. RESULTS: Our study includes 301 infants and children, 270 (89.7%) males and 31 (10.3%) females with mean age of two years and 40.9% under six months. In the follow-up period, we found 33 new IH in our patients. 23 (12%) of 196 patients less than two years old underwent contralateral herniorrhaphy in the follow-up period (P = 0.02). Six patients of 30 premature children underwent contralateral herniorrhaphy (P = 0.03). CONCLUSION: The incidence of contralateral hernia is approximately 10% and in our study it is approximately 1.7%. There is a significant difference between the occurrence of contralateral hernia in preterm compared with term infants (P = 0.03). We think that the incidence is still too low to recommend routine contralateral exploration.

Chrysomya bezziana as a Causative Agent of Human Myiasis in Fars Province, Southern Iran.

Myiasis is the invasion of body tissues of humans or animals by the larvae of the Diptera or two-winged flies. The various forms of myiasis may be classified from clinical or entomological point. This study describes the existence of Chrysomya bezziana (Diptera: Calliphoridae) cases as a causative agent of myiasis in 18 and 87 year-old men in two different regions in Fars Province. To our knowledge, this is the first observation of mentioned species in this province.

Asymptomatic human carriers of Leishmania infantum: possible reservoirs for Mediterranean visceral leishmaniasis in southern Iran.

Over the last decade, the incidence of visceral leishmaniasis (VL) has increased in many districts of the province of Fars, in southern Iran. Recent epidemiological reports indicate that asymptomatic human infections with Leishmania infantum (the causative agent of VL throughout the Mediterranean basin) occur more frequently in Iran than was previously believed. Between 2004 and 2006, blood samples were collected from 802 apparently healthy subjects from communities, in the north-west and south-east of Fars province, where VL cases had been recorded. Each of these samples was tested for anti-Leishmania antibodies, in direct agglutination tests (DAT), and for L. infantum kinetoplast DNA, in PCR-based assays. Of the 426 subjects from north-western Fars, eight (1.9%) were found seropositive and 68 (16.0%) PCR-positive. The corresponding values for the 376 subjects from south-eastern Fars were lower, with five (1.3%) seropositive and 32 (8.5%) PCR-positive. Of the 100 PCR-positive subjects, 18 (18.0%) each lived in a household in which there had been a case of VL, and six (6.0%) had had VL themselves (in each case, more than a year before the blood sampling for the present study). Although 21 of the PCR-positives have now been followed-up for at least 18 months, none has developed symptomatic VL. Since positivity in the PCR-based assay probably indicated the presence of L. infantum amastigotes in the peripheral blood of 12.5% of the subjects, it is clear that asymptomatic human carriers of L. infantum are quite common in the study areas and probably act as reservoirs in the transmission of the parasite, to humans and to dogs, by sandflies.

Rodent infection with Leishmania in a new focus of human cutaneous leishmaniasis, in northern Iran.

The incidence of zoonotic cutaneous leishmaniasis (ZCL), which is endemic in several parts of Iran, has recently increased in the rural areas of the northern district of Damghan, in Semnan province. Between 2001 and 2004, as part of an investigation of this worrying trend, wild rodents in this region were caught and checked, by the microscopical examination of liver and spleen smears, for leishmanial infection, to see which species were acting as 'reservoir' hosts. Overall 298 Nesokia indica, 29 Meriones libycus, 10 Mus musculus and two Microtus socialis were caught. Most of the N. indica (61%) and Me. libycus (52%) but none of the other rodents were found smear-positive for leishmanial amastigotes. When PCR was used to test scrapings from 50 of the smears (of which 25 had been found to harbour amastigotes, by microscopy), 29 (58%) of the smears were found positive for the kinetoplast DNA of Leishmania major; none was found positive for any other Leishmania species. Nesokia indica and Me. libycus are therefore incriminated as the main 'reservoir' hosts of L. major in Damghan.

Association of HTLV1 infection and esophageal squamous cell carcinoma.

BACKGROUND: Both esophageal carcinoma and HTLV-1 (Human T cell lymphotropic virus 1) have high prevalence in northeastern of Iran. OBJECTIVE: To assess the presence of HTLV-1 genome in esophageal cancerous tissue and in tissues from non cancerous individuals. METHODS: Eighty five patients with esophageal squamous cell carcinoma and 48 non-cancerous control patients that underwent esophagogasteroscopy for other reasons were included in this study. All selected subjects are residing in northeastern part of Iran. All specimens were studied histopathologically by H&E staining and were evaluated for HTLV-1 by PCR method. In PCR, the presence of tax, pol, env and LTR segments of HTLV-1 genome were detected. RESULTS: Male to female ratio in the case group was 3 to 5. Average age and standard deviation in case and control group were 56 +/- 17 and 54 +/- 21 years, respectively; which did not have any significant differences. All the patients came from the same area in the northeastern part of Iran. HTLV-1 genome was found in two subjects with esophageal cancer and in one subject in the control group. Statistical analysis showed no significant differences between the two groups (chi square = 0.26, Fisher exact test P value = 0.7, Odd ratio = 1.13 [0.08

Multidisciplinary intervention for reducing malnutrition among children in the Islamic Republic of Iran.

A multidisciplinary intervention to reduce protein-energy malnutrition among children in rural areas was piloted in 3 provinces of the Islamic Republic of Iran. Based on an initial situation analysis, a range of interventions were implemented through local nongovernmental organizations, including nutrition, health and literacy education for mothers, improved growth monitoring and fostering rural cooperatives and income generation schemes. Malnutrition before and after the intervention (in 1996 and 1999) was assessed using anthropometric measurements of random samples of children aged 6-35 months in control and intervention areas. Three years into the intervention, all indicators of malnutrition had consistently decreased in all intervention areas and the prevalence of underweight and stunting was significantly lower. Control areas showed a mixed pattern of small increases and decreases in malnutrition indicators.

Multidisciplinary intervention for reducing malnutrition among children in the Islamic Republic of Iran

A multidisciplinary intervention to reduce protein-energy malnutrition among children in rural areas was piloted in 3 provinces of the Islamic Republic of Iran. Based on an initial situation analysis, a range of interventions were implemented through local nongovernmental organizations, including nutrition, health and literacy education for mothers, improved growth monitoring and fostering rural cooperatives and income generation schemes. Malnutrition before and after the intervention [in 1996 and 1999] was assessed using anthropometric measurements of r and om samples of children aged 6-35 months in control and intervention areas. Three years into the intervention, all indicators of malnutrition had consistently decreased in all intervention areas and the prevalence of underweight and stunting was significantly lower. Control areas showed a mixed pattern of small increases and decreases in malnutrition indicators

The PCR-based detection of Leishmania major infections in Meriones libycus (Rodentia: Muridae) from southern Iran.

Cutaneous leishmaniasis (CL) is an increasing public-health problem in the countries of the Mediterranean region. In southern Iran, for example, the incidence of CL has more than doubled over the last decade. As part of an investigation of this worrying trend, the leishmanial infections of the wild rodents that may act as reservoir hosts were investigated in the Iranian province of Fars. Overall, 82 rodents, 56 of them Libyan jirds (Meriones libycus), were collected, in live traps, from a new, hypo-endemic focus of zoonotic CL. When Giemsa-stained smears of ear tissue or any lesions on the rodents were prepared and checked under a light microscope, amastigotes were found in the smears from six of the rodents, all M. libycus. None of the other rodents investigated was found to be infected. The infected rodents were encountered in two of the three areas studied. In PCR-based assays, the amastigotes seen in the ear smears and those from two recent human cases of CL from the focus were all found to be identical to a reference strain of L. major. It therefore seems that M. libycus is the main active reservoir host for ZCL in the focus.

Typing of human papillomavirus by pyrosequencing.

The possibility of using a new bioluminometric DNA sequencing technique, called pyrosequencing, for typing of human papillomaviruses (HPV) was investigated. A blinded pyrosequencing test was performed on an HPV test panel of 67 GP5+/GP6+ PCR-derived amplification products. The 67 clinical DNA samples were sequenced up to 25 bases and sequences were searched using BLAST. All of the samples were correctly genotyped by pyrosequencing and the results were unequivocally in accordance with the results obtained from conventional DNA sequencing. Pyrosequencing was found to be a fast and efficient tool for identifying individual HPV types. Furthermore, pyrosequencing has the capability of determining novel HPV types as well as HPV sequence variants harboring mutation(s). The method is robust and well suited for large-scale programs.