سال:1390 | دوره: | شماره: |تعداد مقالات:12

Hepatitis B virus (HBV) infection, one of the major health priorities, accounts approximately for 350 million chronic cases and a global total of 33 million people were living with human immunodeficiency virus (HIV) in the world. Co-infection with HIV and the HBV presents a significant challenge to health care providers, with different prevalence rates in different parts of the world. It is important to screen all HIV infected individuals for HBV infection and reverse. Infection with HBV becomes more violent in patients co-infected with human immunodeficiency syndrome. HIV/HBV co-infected individuals are at increased risk of chronic hepatitis, cirrhosis, and hepatocellular carcinoma, and of experiencing HAART toxicity. In this review, the latest statistics on epidemiology of HIV, HBV and their co-infection has been presented along with prominent characteristics of HBV. Transmission routes which are the common between HBV and HIV are described and the most important ones are described according to the regional and age features. Also, there is a series of actions being performed once HBV infections occur to prevent HIV or to diagnose if the HBV-infected individuals are also infected with HIV. As in treatment case, some of the frequent treatment methods including applying interferon and using nucleoside and nucleotide analogues have been discussed. Finally, we would explain the new recommendations for treating patients who were co-infected with HBV and HIV, including staging HBV and HIV treatment, based on the stage of each disease. It also outlines the optimal treatment options, whether the patient is treated for HBV first, HIV first, or HIV and HBV together.

Background: Cutaneous leishmaniasis is still a health problem in many rural and urban regions of Iran and drug resistance has emerged as a major impediment in the treatment of leishmaniasis. This study aims to determine the drug resistance gene in cutaneous leishmaniasis by PCR in some endemic areas of Iran.Methods: Ninety seven samples were collected from ulcers of leishmaniasis patients from some endemic areas of Iran. The Giemsa stained samples were examined microscopically and cultured in NNN and RPMI 1640 mediums for parasite detection. After DNA extraction, PCR was done by a pair of specific primers. For detection of mutation in DNA, first PCR products were electrophoresed on CSGE gel. The suspected samples were compared by sequencing and RFLP results were demonstrated. Comparison of DNA derived from a wild type cell and mutant cell was undertaken by CSGE and sequencing methods.Results: Among 90 isolates (92.8%) examined for detection of mutation in gene with CSGE and RFLP, 10 (11.1%) revealed a disorder in sequencing selection for unresponsive to drug.Conclusion: Drug resistance in cutaneous leishmaniasis to sodium stiboglocanat is probably due to a mutation in a genome. A field study is needed to determine the distribution of drug resistance and other gene mutations involved in unresponsiveness to drugs in leishmaniasis endemic areas of Iran.

Background: In developing countries, Ilizarov or AO external fixator is usually used for treatment of tibial open fractures. The purpose of this study was to compare the efficacy of these two methods for treatment of tibial open fractures.Methods: From April 2002 to April 2010, 120 patients with open tibial fractures admitted to the Department of Orthopedics of Babol University of Medical Sciences entered this study. In each arm, 60 subjects randomly received Ilizarov or AO external fixator. All patients were followed at least for one year. These two groups were compared regarding non-union, malunion and cure rates.Results: The mean age of the patients in Ilizarov group was 32.35±11.28 and for AO were 31.3±10.99 years. Mean time for union in Ilizarov group was 5.25±1.85 and for AO external fixator was 5.85±2.13 months. Nonunion rate in Ilizarov group was 10% and for AO external fixator was 11.7%. Malunion rate in Ilizarov group was 10% and for AO external fixator was 18.3%. Totally, efficacy of treatment in the Ilizarov group was 81.7% and in AO external fixator was 65%.Conclusion: The efficacy of treatment in Ilizarov was higher than that AO external fixator in treatment of open tibial fractures.

Background: Otomycosis is a fungal infection of the external ear with bothersome symptoms. The aim of this study was to evaluate the prevalence of fungal agents, predisposing factors and characteristics of patients.Methods: Between May 2008 and April 2010, 171 patients with clinical suspicion of otomycosis were enrolled and the samples from their external ear were examined for any mycological infection.Results: Otomycosis was confirmed after mycological diagnosis in 69% of clinically suspected patients. The highest incidence of otomycosis was in autumn and in patients aged 21-40 years old. Working in dry dusty environment was a major predisposing factor. Pruritus was the most common symptom. Aspergillus flavus was the most common fungus in otomycosis followed by A. niger, Candida albicans, A. fumigatus, A. nidulans and C. parapsilosis.Conclusion: Clinical suspicion of otomycosis is important to prevent unnecessary use of antibiotics. Etiology of fungal pathogens in dry dusty regions is not similar to hot humid areas and this needs to be considered in future susceptibility tests and treatment of patients with otomycosis.

Background: Preterm birth (PTB) is one of the most important unsolved problems in reproductive medicine. This study aims to evaluate several maternal risk factors and outcome of pregnancies who were admitted for preterm spontaneous uterine contractions (PSUC).Methods: From September 2007 to February 2009, 327 cases who were admitted for PSUC were retrospectively studied. They were classified according to their fetal numbers and presence of true versus threatened preterm labor (PTL).Results: There were 297 (90.82%) singleton, 27 (8.25%) twin and 3 (0.91%) triplet pregnancies. Only 12 women (3.6%) fulfilled the ACOG criteria for PTL who delivered in a few hours and 315 cases (96.3%) were classified as threatened PTL and most of them were discharged undelivered from the hospital.103 cases were missed and 224 mothers and their 247 neonates remained.121 women from this cohort had PTB and delivered before 259 days (54%). Pregnancy outcomes including; the time interval between admission for PSUC and delivery, the mean gestational ages at birth, birth weights, number and duration of NICU admissions were evaluated in each group.Conclusion: Regular uterine contractions even in the absence of cervical changes should be considered as a potential risk factor for PTB. The most frequently associated maternal risk factors were history of abortion, infertility and previous PTB, and the most frequently associated complications were preterm rupture of membranes, vaginal bleeding and febrile diseases.

Background: In patients with ulcerative colitis (UC), the repeated cycle of injury and repair of intestinal mucosa has been reported to increase the risk of colon cancer. So, a safe and efficient therapy is required for the treatment and prophylaxis for the disease. This study aims to investigate the efficacy of Calendula officinalis extract in treatment of experimentally induced ulcerative colitis in dog animal model.Methods: During fall 2010, 10 out-bred female German dogs (1-2 years old; weighs of 20-25 kg) were enrolled. Ulcerative colitis was induced with 6% acetic acid as enema and method of treatment was retrograde (via enema) too by C. officinalis.Results: Loose stools, diarrhea, gross bleeding and loss of body weight happened after administration of acetic acid and crypt damage, loss of epithelium, infiltration of inflammatory cells and depletion of goblet cells were noticed histologically. C. officinalis could successfully resolve the damages of UC.Conclusion: Treatment with C. officinalis can broaden the current therapy options for UC.

Dear Editor: Kingella kingae, a short gram- negative rod, is part of the normal oropharyhgeal flora, but rarely, it has been implicated as a cause of clinical infection. In spite of significant differences between Moraxella sp. and Kingella kingae, it has been classified in the genus of Moraxellabut recent studies have prompted placement in a separate genus of Kingella. Kingella kingae is an infrequent cause of septic arthritis, particularly during childhood. In this report, we describe a child who had septic arthritis caused by this organism. The apparent rarity of documented case may be partly a manifestation of clinical unfamiliarity and the fastidious nature of the organism that made its identification difficult.

Background: Chronic supportive otitis media (CSOM) is one of the commonest illnesses in ENT practice. This study was conducted to find out the various aerobic microorganisms associated with CSOM and their current antimicrobial susceptibility patterns to commonly used antimicrobials.Methods: samples were collected from 117 clinically diagnosed cases of CSOM and processed according to standard protocols.Results: Out of 117 CSOM cases, 105 (86%) showed positive bacterial culture. The Staphylococcus aureus was the commonest aerobic isolate in CSOM. The sensitivity of Staphylococci spp. to commonly used antimicrobials varied from 27.2% for cefixime to 95.5% for gentamicin and coagulase positive. Pseudomonas isolates showed complete (100%) resistance to amoxicillin/clavulanate (co-amoxiclave), cloxacillin and cefixime, and high sensitivity to ciprofloxacin (95%) and cephalexin (90%).Conclusion: An appropriate knowledge of antibacterial susceptibility of microorganisms would contribute to a rational antibiotic use and the success of treatment for chronic supportive otitis media.

Background: In a significant number of the patients with hematochezia, colonoscopy turns out to be normal and therefore is unable to determine the cause of bleeding. This study investigates outcomes and possible necessity for further work up in cases of hematochezia with normal colonoscopy.Methods: Ninety-seven patients with normal colonoscopy were followed for at least one year from the time of colonoscopy by regular visits and phone calls. Mortality and recurrent bleeding were recorded as primary end points. Those with recurrent or continued hematochezia were invited for a new visit and further work up.Results: Among the ninety seven patients, nine cases (9.3%) were lost at follow ups, 10 experienced rebleeding (10.3 %), and the remaining 78 (80.4 %) were apparently healthy and had no further complaints. There were two mortalities during the follow up, one due to gastric cancer and the other due to cerebrovascular accident.Conclusion: It is unusual for the cases of hematochezia with a normal initial colonoscopy to have recurrent bleeding as a result of a significant missed lesion in the colon.

Dear Editor: Exercise-induced ST-segment depression, although the most common accepted criterion for detecting coronary artery disease (CAD) has limited sensitivity and is unable to localize ischemic territory. Recently ST-segment elevation in lead aVR has been studied for the detection of CAD.

Dear Editor: Low back pain (LBP) is one of the common disabling conditions experienced by individuals through the world and the lifetime prevalence of LBP was reported about 84%. A type of LBP which occurs in the absence of an identifiable cause, is called nonspecific LBP. Non-specific LBP is managed conservatively by physical therapy and in many cases by applying orthosis. A wide variety of orthotic designs, ranging from lumbosacral corsets to rigid thermoplastic thoracolumbosacral orthosis are used for controlling LBP.

Dear Editor: Dental caries and periodontal diseases are still considered the most frequent oral ailments and considered as public health problems, which could result in the loss of dental structures and its support. Although dentistry has experienced great advances, the prevention of dental caries and periodontal diseases are still the best form of treatment. Therefore, education of patients deserves the most attention in preventive dentistry. As children and teenagers are more receptive to new knowledge, they can respond to trainings with greater efficiency. However, when working with the children, the education methods must be attractive and arouse the children's attention.