KOWSAR MEDICAL JOURNAL
Year:2006 | Volume:11 | Issue:1|Papers Count:23

Objective: Rapid molecular detection of salmonella typhi the causative agent of typhoid. Material and Methods: For rapid and specific detection of salmonella typhus we studied the efficiency of multiplex PCR technology. We used the sets of 6 PCR primers for O, H, and vi antigen genes (invA, tyv, prt) located on chromosomes. Genomic DNA was extracted from standard and clinical isolates and analyzed by different primers. Specificity of the assay was evaluated by different gram- negative and gram- positive. The sensitivity of assay was measured by colony count and DNA concentration. To reduce detection time we performed several optimization reactions and PCR programs.Results: This test was able to differentiate typhoid fever agents from other family of salmonella like: Salmonella thyphimorum, Salmonella paratyphoid A, Salmonella Paratyphoid B, Salmonella paratyphoid C, Salmonella infantis, Salmonella Havana and Salmonella entritideise by combinations of the different size bands produced. Standard and clinical isolates of Salmonella were examined and were accurately identified by this assay. Different gram negative and gram-positive bacteria evaluated specificity of the assay. The sensitivity of the assay revealed that this test was able to detect 1-10 copy number or CFUS of bacteria. By optimization of PCR program with standard thermocycler used in research laboratories (Gradient Ependorf Thermocycler) we were able to shorten the PCR time from 2.5 hrs to 35 minutes in 20 cycles comprising of 7 seconds of denaturation, annealing and extension times.Conclusion: By the methods described here it is possible to rapidly detect and identify Salmonella typhus bacteria within 90 minutes of arrival of specimens in the diagnostic microbiology laboratory. Other interesting findings of this study were the possibility of distinguishing between S. infantis and S. Havana. Sequences from this study are registered in the Gene Bank under accession numbers: AY771363, AY771362 and AY771364.

Objective: To evaluate the effect of P1/P2 ratio on fertilization and embryo quality and developmental rate in intra cytoplasmic sperm injection (ICSI) and in vitro fertilization (IVF) patients.Material and Methods: During this study P1/P2 ratio of 71 patients referring for IVF and ICSI were evaluated by protein extraction, gel-electrophoresis and western blot. Results: Increase in P1/P2 results in a reduction in fertilization rate and decrease in embryo quality in ICSI patients.Conclusion: It can be concluded that altered P1/P2 ratio affects fertilization rate and embryo quality, which subsequently effect implantation and pregnancy outcome.

Objective: This study evaluates its efficacy of long-term low-does Erythromycin in symptomatic improvement of Sulfur Mustard (SM) exposed patients.Material and Methods: Low-dose Erythromycin (EM) in doses of 400-600 mg/day was administered in 43 patients with documented history of SM exposure for 6 months.All patients were refractory to the bronchodilators and corticosteroids. Dyspnea, sleep disturbances, cough and hemoptysis were evaluated by a questionnaire beginning and at the end of the study period.Results: The intensity and frequency of Dyspnea, sleep disturbance due to Dyspnea, cough and hemoptysis were all reduced significantly after treatment (p<0.05).Conclusion: The results of this preliminary study show that low- dose EM may improve respiratory symptoms in SM injured patients, and randomized double-blinded, placebo-controlled clinical trials are indicated to prove this. Given the suggestive diagnosis of bronchiolitis obliterans (BO) in SM exposed patients, the results imply that EM maybe helpful in management of BO.

Objective: The aim of this study was to isolate mesenchymal stem cells from bone marrow NMRI Mice of and determine their growth characteristics in vitro.Materials and Methods: 4-8-week old NMRI mice were killed by cervical dislocation and their tibia and femur were dissected and cleaned from the soft tissues. Bone marrow was then flushed out of the bone and primary cultures were none. One week after culture, the first passage was performed and the cells were seeded with a very low density on wells of 6-well plate. The culture was maintained until a population of fibroblastic cells emerged. At this point the next passages were carried out and the cells were expanded by four passages and frozen for further examination. To prove the mesenchymal nature of the isolated cells, differentiation into bone and adipocyte were carried out. To determine the best fetal bovine serum concentration and initial cell density supporting the maximum cell proliferation, different concentration of (fetal calf serum) FCS and cell density were evaluated the colonogenic potential of the isolated cells were tested by colony forming unit- fibroblast assay (CFU-F).Results: The cells in primary culture were morphologically heterogeneous ranging from round cells to star and spindle- shaped cells. Two weeks after the first passage a population of fibroblastic cells with high proliferation potential dominated the culture. These cells readily differentiated to osteoblasts and adipocytes. The isolated cells had a maximum proliferation in a medium with 15% FCS and initiation of culture with 100 cell/cm2 resulted in high-fold increase in cell number. Mesenchymal stem cells isolated in this study, showed high colonogenic activity.Conclusion: Mesenchymal stem cells from NMRI mice can be isolated by low densityvculture conditions. These cells may have maximum proliferation when cultured with 100cell/cm2 in a medium with 15% FCS.

Objective: Vibrio cholera O1 is the causative agent of a severe secretary diarrhea and has historically been considered the cause of cholera epidemics. Recent epidemics of cholera in various parts of the world have emphasized the urgent need for rapid and reliable methods for detection of Vibrio cholera O1. Classical and conventional microbiological techniques that are sensitive and specific require several days to complete. Therefore, in this study a new technique for detection of vibrio cholera O1, using PCR-Enzyme-linked Immunosorbent assay (PCR-ELISA) was developed.Material and Methods: After amplification of a 375-bp sequence of a gene that codes for the synthesis of cholera toxin B subunit, the digoxigenin-labeled amplified product was captured on PBS buffer, coated on micro titer plates and detected by using an antidigoxigenin Fab-peroxidase conjugate. The specificity of the PCR was determined using 5 strains of others bacteria including salmonella paratyphoid C, Klebsiella, shigella dyscentriae, Enterobacter and Pseudomonas aeruginosa. The PCR product obtained was hybridized with biotin labeled probe and ELISA using streptoavidin observed the result.Result: The sensitivity of the PCR-ELISA test for genomic DNA as a template was 0.5 -0.6pg of DNA whereas it was 5 cells when lyses bacteria were used as a DNA source.Conclusion: The PCR-ELISA showed an analytical sensitivity higher than that of ethidium bromide staining and that obtained by conventional PCR assay. The PCR-ELISA technique seems to be a practical and reliable tool for the diagnosis of vibrio cholera O1.

Objective: Assessment of Metabolic and developmental condition of mouse embryonic stem cells (ESC)-derived cardiomyocytes in Mice based on kinetic properties of Creatine Kinase (CK) compare with neonatal cardiomyocytes.Materials and Methods: ESCs were differentiated into beating cardiomyocytes spontaneously, and neonatal cardiomyocytes were isolated from 2-4 day old pulp mice.Total protein were extracted by sonication and centrifugation for determining kinetic properties of creatine kinase with spectrophotometer methods.Result: Specific activity of CK for CrP was 3.26±0.26 and 5.67±0.35 mM and its km was 50.25±2.21 and 43.48±2.04µmol min-1mg-1 in ESC-and neonatal-derived cardiomyocytes respectively. Optimum pH of CK activity was 7 for ESC-derived cardiomyocytes and 6.5 for neonatal-derived cardiomyocytes. The optimum temperature of CK activity was 45°C for both enzyme preparations.Conclusion: This data showed ESC-derived cardiomyocytes displayed a model that seems to resemble the in vitro development of cardiomyocytes.

Objective: The aim of this study was to examine the short-term (4-8 weeks) and subchronic (12 weeks) lead poisoning on the levels of nitrite and nitrate (NOx) and vascular reactivity Material and Methods: Male Sprague-Dawley rats were divided to lead-treated and control groups. The lead-treated group was subdivided to 3 groups, in witch their drinking water contained lead acetate (100 ppm) for 4, 8, and 12 weeks. Blood pressure was monitored using rat tail electro sphygmomanometer in each group. Vanadium chloride (VCl3) was used to reduce nitrate to nitrite, followed by spectrophotometer analysis of total nitrite using Greiss reagent. In vascular reactivity experiments thoracic aorta was removed and after stabilization in organ bath, effects of contractile (phenylephrine, clonidine) and relaxant (isoproterenol) agents in the absence and presence of relative antagonists was evaluated.Results: Short-term lead administration was accompanied by significant elevation of blood pressure and reduction in level of serum NOx. At the end of subchronic lead poisoning the trend of decrease in NOx was reversed despite further increase in blood pressure. Both short-term and subchronic lead administration resulted in significant changes in vascular reactivity with respect to either vasoconstrictor (phenylephrine) or vasodilator (isoproterenol) agents.Conclusion: Altogether, it can be concluded that blood pressure increases even in the earliest phases of lead poisoning. Probably, the same mechanisms involved in chronic phases of lead poisoning such as nitric oxide pathway and vascular adrenergic system are also operative in short-term and subchronic phases of lead poisoning.

Objective: This study was done to survey hemodynamic effects of Dihydroergotamine (DHE) during spinal anesthesia and detection of the optimal IV dose.Material and Methods: In this clinical study the hemodynamic effects of three dose of DHE (5, 10,15mcg/kg) were evaluated in 90 patients who were schedule for elective inguinal herniorraphy under spinal anesthesia. Patients were randomly divided in 3 groups. All were in class land 2 ASA and aged 40-60 yrs. Non-invasive diastolic and systolic blood pressure and heart rate of patients, before and after spinal anesthesia and after IV injection of DHE every 3 minutes were recorded. During this period the patients did not received IV fluid.Results: All three dose of DHE treated diastolic and systolic hypotension due to spinal anesthesia, (p<0.0001). A dose of 5mcg/kg increased blood pressure near to that before spinal anesthesia. A dose of 10 mcg/kg increased diastolic and systolic pressure up to 7% and 8% baseline respectively. A dose of 15mcg/kg increased diastolic and systolic pressure up to 13% and 15% baseline respectively (p<0.0001).Conclusion: According to the above findings DHE is effective for treatment of hypotension during the spinal anesthesia and this effect is not dependent on Iv fluid administrationa dose of 5-10 mcg/kg is suggested.

Objective: The goal of this study was to investigate the efficacy and outcome of patients with spondylolisthesis who were treated via a posterior surgical approach with pedicle screw fixation.Materials and Methods: In this retrospective study, 48 patients with a diagnosis of spondylolisthesis who underwent pedicle screw fixation with a Cotrel-Dubousset (C.D.) screw at the Neurosurgery Department of Baqiyatallah (a.s.) Hospital between 2000-2003, were evaluated to relieve their symptoms after surgery (e.g. back pain, radicular pain and claudication) and surgical complications (e.g. screw fracture, malpositioned screw, wound infection and need for re operation) with a of 3 –year follow-up.Results: All cases were managed according to the same protocol. Back pain, radicular pain and claudication were relieved in 68.8%, 75% and 77.1% of patients respectively.Screw fracture was seen in three patients (6.3%), one screw (2.1%) was malpositioned and one patient (2.1%) needed re operation. None patient had postoperative infection. Most listheses were degenerative in L4-L5 region in women between 31-50.Conclusion: These results support the use of pedicle screw fixation with C.D. as an effective and safe procedure for spinal fusion with minimal complications and good outcomes.

Objective: This study reports the effect of radial artery harvesting on forearm blood flow in operated patients.Materials and Method: Thirty patients who had radial artery grafts taken and used for myocardial revascularization were selected. Brachial, ulnar and right radial artery diameters and blood flow velocity and resistance index (RI) were measured using plus wave color Doppler.Results: Mean diameter and blood flow velocity of the left ulnar and brachial arteries were consistently greater then right forearm (p<0.05). Also RI for above arteries was reduced significantly as compared to right (p<0.05) side.Conclusion: Harvesting of radial artery does not affect forearm blood flow to a clinically significant degree. Compensatory increase of ulnar blood flow is adequate to meet the physiologic demands of hands.

Objective: Lymphoproliferative disorders are among the most serious and potentially fatal complications of chronic immunosuppressants in organ transplant recipients.Post-transplantation lymphoproliferative disorders (PTLD) however, is not an uncommon complication after renal transplantation; we conducted a study to evaluate characteristics of patients with PTLD.Materials and Methods: In this cross- sectional study from June 1994 to March 2004 at the Labbafi Nejad Hospital, 2117 renal transplant recipients were enrolled. Patients with neoplasm were evaluated with regard to type of neoplasm, demographic data and survival time.Results: Overall 46 renal transplant recipients had different types of neoplasm. Among these most common types were skin neoplasm (24 cases, 52.2%; Kaposi's sarcoma 15 cases, 32.6%) and PTLD (14 cases, 30.4%). Mean (SD) age of PTLD patients at the time of transplantation was 37.86±9.67 years and 42.8 percent were females. Median and mean (SD) time from RT to PTLD diagnosis was 38.5 and 50.35±41.7 months, respectively (from 1 to 146 months). Types of PTLD in these patients were: kidney (14.3%); GI (14.3%), brain, tonsil, palatine, Hodgkin's, lymphoma and ALL (each 7.1%) and 28.6% were defined as unspecific type. The one, five and ten year survival after transplantation was 71.4, 51.4, 44.3 percent, respectively. Despite discontinuing the immunosuppressive therapy of PTLD patients (6 of 14), in 5 survival patients, the graft was active up to mean time of 105.4±57.6 months after transplantation.Conclusion: Our findings show that the prevalence of PTLD after RT is less than other reports in western countries. The course of lymphoproliferative diseases in Kaposi's sarcoma after transplantation is more aggressive.

Objective: The aim of this study was to assess the incidence and causa factors of UTI in school-age girls in one of Tehran's suburbs.Material and Methods: In this cross-sectional study all girl students (1216 cases) in an age range of 6-11 years (mean 8.51±1.24) were enrolled. Urine samples were collected and assessed through screening methods using a tape test. From all examines, nitrite positive cases were sent to a laboratory for culture. Laboratory results indicated 14 cases with over 100000 / ml colony count who were advised to receive treatment. Also, to examine the cause factors, the case control students were compared by use of questionnaires.Results: Statical analyses demonstrate that UTI prevalence was 1.15% which is consistent with previous reports that indicate a 0.9-3.6% prevalence of UTI in among elementary school girls. Also the results showed that cause factors in UTI included improper washing methods after defecation, low daily water consumption, lack of underwear washing, history of dysuria, frequency and flank pain.Conclusion: Considering the incidence of asymptomatic UTI in children specially school-age girls, and its probable complications, screening with the dipstick method, proper diagnosing and suitable treatment protocols are needed. Also a train student to prevent the UTI is necessary.

Objective: This study to investigated the correlation of helicobacter pylori Helicobacter pylori (HP) infection with liver enzymesin dyspeptic patients.Material and Methods: This cross-sectional study obtained blood samples for liver enzymes was obtained from all eligible dyspeptic patients referring to Baqiyatallah Hospital. Then they Linder went endoscopy and two biopsy specimens were taken for rapid urease test and the result was reported within 24 hrs.Results: A total of 475 patients (272 men) were enrolled in the study and 403 out of 475 patients had positive urease tests and the remaining 72 had negative results. Body mass index was identical in both groups. The mean value for AST, ALT and Alkaline Phosphates in the urease positive group was 25.8±2.08, 28.75±3.6, 192.2±81, respectively and in the urease negative group was 23.76±2.8, 32.11±9.8, 197.1±85, respectively which show no statistical difference.Conclusion: Although the role of HP infection on chronic liver disease has been reported, the mechanism and the process of liver injury have not yet been defined. This study indicates that there is no relationship between HP infection and serum liver enzyme levels in dyspeptic patients.

Objective: In this study we evaluated the effectively of local anesthesia versus spinal anesthesia, for the internal Sphincterotomy.Material and Methods: In a randomized clinical trial, 62 patients with chronic anal fissure allocated in local anesthesia and spinal anesthesia groups. Patients informed about benefits and risks of each technique, and an informed consent obtained from patients who were agree to participate in the study. Injection site pain, intra-operative pain, pain 24 hour after operation, pain during the first defecation, and one week after operations were assessed by visual analog scale (VAS). Post-operative nausea, vomiting, headache, urinary retention and amount of analgesics administered, assessed in both groups. Statistical analyses were made by SPSS package, using chi-square, Fischer and T-tests. P-values less than 0.05 considered significant. Results: The average score of injection site pain in spinal anesthesia group was 1.61 and in local anesthesia group was 2.92 (p=0.012). Intra-operative pain and pain 1 hour following operation were not statistically different between two groups (P<0.05). The pain 6 hours and 24 hr post operation and also during first post-operative defection were respectively 3.77, 1.65 and 4.29 vs. 1.9, 0.9 and 2.94 in spinal anesthesia group (p<0.05). The amount of intravenous opioid analgesics in local anesthesia group was lower than spinal anesthesia group (p< 0.05). Occurrence of urinary retention and headache were greater in spinal anesthesia group (respectively, 19.4% and 25.8% vs. 0% and 3.2% with significant p-value). No major complication was seen in both studied groups.Conclusion: Spinal and local anesthesia are both safe for Sphincterotomy, but local anesthesia has less complications, such as headache and urinary retention, has less postoperative pain, and patients can be discharged earlier.

Objective: This project was designed to determine the frequency of documented procedures by nurses and to compare their correlation of that with indicators: kind of ward, measure of personnel works hours, work shift and number of patients of confined to bed.Materials and Methods: We studied in a cross-sectional design with the aim of frequency determination of documented nursing procedures and the relation to the selected indexes. Nursing procedures are included the whole of nursing performances that were related to nursing job. These procedures can include types of dressing, injections, serum therapy, and sampling, care designs and etc. Document able procedures (95 procedures) were determined by coordination of head nurses and nurses of research environment. 978 discharged files were analyzed which recorded the performance nursing procedures had recorded in them, in the course of two months by nurses.Results: Performance of 93 procedures was documented 82638 times. The most of samples (238 files) have taken in men cardiac ward but generally procedures have documented greater in ward, which its personnel are women (P=0). There was no significant correlation between measure of personnel work hours, numbers of confined to bed patients and measure of procedures documentation. The most of procedures numbers have documented in morning shift and the least have documented in evening shift (P=0).Conclusions: some of measured indexes don't have any relation with frequency of documented nursing procedures, but quantity of nursing procedures is measurable by cooperation of nurses continually. In addition using of this method recommends for evaluation of nursing servants.