IRANIAN SOUTH MEDICAL JOURNAL (ISMJ)
Year:2009 | Volume:12 | Issue:1|Papers Count:17

Background: Patients with low or intermediate TPMT enzyme activity are at increased risk to develop severe hematopoietic toxicity after taking standard doses of thiopuring medications. The aim of this study was to determine the frequency of four allelic variants of the TPMT gene in an Iranian population. Methods: In this cross sectional study, samples were obtained from 127 Iranian volunteers in Shariati hospital and were analyzed using PCR-RFLP and Allele Specific PCR techniques to determine the presence of common TPMT Polymorphisms in this population. Results: Mutant TPMT alleles were found in 11.8% of subjects (15 out of 127). Nine had TPMT*2, 4 TPMT *3C and 2 TPMT*3A. Conclusions: Our data showed the necessity of TPMT polymorphisms assessment before administration of thiopurine drugs.

Background: Various assays have been used to identify of enterotoxins produced by Staphylococcus aureus and because of antigenic similarities among enterotoxins, serological assay may not always be practical. The aim of this study was to detect of S. aureus enterotoxins (SEA, SEC and SEQ) genes by multiplex PCR assay. Methods: Of 150 strains obtained from nasal carriers, 95 S. aureus were confirmed by biochemical test. Multiplex PCR assay for the detection of genes encoding staphylococcal enterotoxins A, C and Q genes (sea, c and q) S. aureus was used. The nuc gene, which encodes thermonuclease was used as a target DNA to identify S. aureus.Results: DNA amplification fragments for the staphylococcal nuclease gene (nuc) was 397 bp, 552 bp for staphylococcal enterotoxin A gene (sea), 271 bp for staphylococcal enterotoxin C gene (sec) and 122 bp for staphylococcal enterotoxin Q gene (seq). S. epidermidis used as negative control and did not yield a PCR product. Among the 95 healthy human isolates from nasal carriage, forty one isolates (43/1%) were diagnosed as sea, sec or seq-positive. Twenty four (25/3%) isolates were sea gene, nine (9/5%) isolates were the sec gene and eight (8/4%) isolates were the seq gene and 54 (56/8%) of them were other se genes. Conclusion: Because Staphylococcus aureus was isolated in nasal healthy carrier, so the PCR assay could be useful in the routine direct detection of staphylococcal enterotoxin A, C and Q genes.

Background: Application of continuous cell lines has got a special place in the virological researches. These cells are immortal and their chromosomes are aneuploid. Therefore, they can be passage without any limitation. The aim of this research was to choose the best way of producing clone of cells. Methods: in this study, Bovine Kidney (BK) cell line was used to be cloned through limiting dilution method in which Vero cells were used as feeder layer. Vero cells were first cultured in DMEM supplimented with 7% heat inactivated calf serum and after a monolayer were formed, their growth was arrested by Mitomycin C. The cloned cells after incubation were separated and cultured in a new flask. After several experiments different clones were obtained and cultured for further studies. Results: Karyotype of clone cells were determined and compared with original cells. It was shown that cloned cells were more homogenous in early passages and their karyotypes showed less variability than original ones. Cloned and original cells were inoculated with HSV-1 and Parainfluenza virus 3 in order to evaluate its biological abilities. Tissue culture of infectious dose 50 (TCID50) of each virus was calculated and it was shown that there was no significant different between the HSV-1 titers before and after cloning whereas the titer of the Parainfluenza virus 3 was significantly higher in the original cells. Conclusions: Cloned cells of BK showed more stable karyotype and were less sensitive to parainfluenza type-3 virus infection than original BK cells.

Background: Low anterior rectal resection is an option for low rectal cancer. The aim of this study was to assess the clinical and manometric findings before and after low anterior resection in patients with rectal cancer. Methods: In a before-after prospective experimental study, 29 patients with colon cancer who were candidate for elective low anterior resection surgery in Imam Khomeini hospital were enrolled. In preoperative period, the data regarding the anorectal function were gathered and all the patients were assessed by an eight channel rectal manometer. After the surgery, patients were evaluated regarding current anorectal function and underwent rectal manometry for the second time. Results: The mean of defecation time was significantly higher in postoperative period compared with preoperative period (2.48±0.78 vs. 0.94±0.36 time per day). In postoperative period, gas incontinence was significantly higher in comparison to the preoperative period (27.59% vs. 0%). However, the fecal incontinence rates were comparable. Compared with preoperative period, max resting pressure was significantly reduced in postoperative period (53.20±17.45 vs. 64.32±17.33 mmHg). The same was true about max squeezing pressure (140.21±35.50 vs. 150.37±33.16 mmHg). Urgency also increased in postoperative period (48.28% vs. 0%). Conclusions: The results of this study revealed that following low anterior resection surgery for patients with rectal cancer, the defecation time, gas incontinence and urgency increase but max resting and squeezing pressure decrease.

Background: fluconazole is one of the systemic anti-fungal agents and clotrimazole vaginal cream is a topical agent against Candida Albicans. In this study, comparison between of the two regimes (Fluconazole with and without vaginal clotrimazole) in recurrent Candida albicans was assessed .with that of sequential dose of fluconazole for the treatment of Candida vaginitis, this evaluation was done. Methods: A double blind randomized clinical trial was carried out on 80 married women (20-45 years old) having chronic vaginal Candidiasis. The patients were divided in to two groups (40 in each). The first groups received two doses of fluconazole at two different timing (Zero and 72 hours) along with clotrimazole vaginal cream 1% ( for 7 days ). The second group recived only two doses of fluconazole (Zero time and 72 hours later). Then the patients were examined at 2 and 6 weeks after the treatment. Results: The signs and symptoms of disease (itching, erythema, excoriation, edema and fissure) in both groups were significantly decreased after two weeks of the treatment (P = 0.00). The final examination of both groups also showed that the treatment was more effective in the first group compared to the second group. The difference was significant statistically (P<0.05). Conclusion: the data shows that adding topical clotrimazole in treatment of patients with recurrent Candida vaginitis Is more effective.

Background: Diagnosis of tuberculosis pleurisies is difficult because of its nonspecific clinical presentation and insufficient traditional diagnostic methods. We investigated the use of adenosine deaminase (ADA) activity in tuberculosis pleurisies. Methods: A number of 85 patients were analyzed with exudative pleural effusions. Using the ROC curve, we determined the optimal cutoff for TB pleurisy. Results: A number of 58 exudative samples were nontuberculous (non-TB) and 27 were tuberculosis (TB). There was statistically significant difference (p<0.0001) between the means of pleural fluid ADA levels among the TB and non-TB populations. The prevalence of TB pleurisy in the studied population was 31%. Using the cutoff point equal to 35 for diagnosing TB effusions the sensitivity and specificity 70.3% and 91.3%, respectively. The positive predictive value (PPV) was 79.1% and the negative predictive value (NPV) was 86.8%. A pleural fluid ADA value <19 IU/L suggests that a tuberculosis effusion is highly unlikely. Conclusion: Pleural fluid total ADA assay is a sensitive and specific test suitable for rapid diagnosis of TB pleurisy.

Background: In the vast majority of patients with chronic urticaria , the etiology is unknown. It has been noted that in one third of such patients it has an autoimmune base. Autologous serum skin test (ASST) is currently the best in vivo test for the detection of such patients. Our aim was to identify the prevalence of positive ASST among patients with chronic idiopathic urticaria (CIU) and to compare features of ASST + and ASST – groups. Methods: this study was done on 79 patients with CIU. Samples of 0.05ml of autologous serum and normal saline were separately injected intradermaly into the volar aspect of right and left forearm respectively. ASST Was deemed to be positive if a serum induced weal had a diameter bigger than a sailin induced response by < 1.5 mm was seen at 30min. Also we compare the clinical and laboratory parameters of ASST + and ASST - groups.Results: Out of 79 patients with CIU, 39 patients (39%) had positive ASST and it was found that the frequency of attacks was higher in these patients (P=0.04). Conclusion: Significant percent of patients with CIU showed positive response to ASST which is most likely an autoimmune source for them. ASST can be used as a simple and cost - effective test for the detection of these patients, which has proven to be a therapeutic challenge to the treating physician.

Background: Hemoglobinopathies such as thalassemia and sickle cell disease are common genetic disorders. The aim of this study was to determine the prevalence of hemoglobinopathies and their associations with HbA, HbA2, HbS and HbF in the preuniversity students of Bushehr. Methods: Overall, 498 blood samples was collected in EDTA tubes. Hematological parameters including RBCs, Hb, MCV and MCH were determined by automatic analyzer. Measurement of HbA1, HbF, HbA2 and S band were done using Cellulose acetate electrophoresis. Samples with MCV< 80 fl and/ or MCH< 27 pg and/ or HbA2> 3.5% or HbF> 2% were diagnosed as Beta-thalassemia. Samples with positive sickle cell prep and had S band were diagnosed as SCA trait. Samples with HbA2 normal and low MCV or MCH were diagnosed as Iron deficiency or alpha thalassemia. Results: In our study, 74 samples had MCV< 80 fl and also 14.9% of female and 12% male had MCH<27 pg. Ninety-seven (19.7%) were diagnosed as Beta-thalassemia minor. There was no significant relationship between MCV and MCH with HbA2 (p>0.05). There was significant relationship between RBCs and HbA2 (p<0.05). Conclusion: Our study showed that the prevalence of hemoglobinopathies is 28.2% and therefore it suggests that health care authorities must take steps to reduce the complications.

Background: Dermatological disease affects quality of life in all ages specially children and adolescence. This study was aimed to determine quality of life in students with acne disease. Methods: Overall, 400 students of high school who had acne were selected. Data were gathered with two standardized acne quality of life questionnaire (CADI and CDLQI) analysis was used with chi-square and spear mans rho test. Results: The mean age of the students was 15.8±1 and 48.4 % and 51.6% of them were male and female, respectively. 31.2% of responders had high level aggression and13.7% had problems in their social activities. In addition, 30.8 % said they had depression feeling because of acne. The relation between sex and QOL wasn’t significant. But the relation between parents’ education and QOL was significant, statistically (p=0.001). Conclusion: Acne can affect social, educational, recreational and psychological functions.

Introduction: This study evaluated the relationship between social support, mental health and also demographic factors in health staffs of Bushehr oil industry in 2006. Methods: This cross-sectional descriptive study enrolled all health staffs, except 9 subjects who refuse to participate (108 male and 41 female). Subjects were evaluated by demographic questionnaire, general health Questionnaire-28 and Social Support Scale. Statistical analysis was performed by two sample t test, ANOVA and Pearson correlation coefficient. Results: This study showed that female gender, 35-44 age range group, having college educations, marital status and families with 4-5 members have higher mental health and social support. Onshore shiftworker staffs in comparison with others have lower mental health and social support. Conclusion: Social support and mental health showed a direct and significant correlation. The changes of policies for promoting quality and quantity of supportive networks, especially for vulnerable staffs, can reinforce protective effects of social support.

Background: Enterobious vermicolaris (EV) is a short-lived, tiny, and white human nematode that has afflicted almost one billion people all over the world. The prevalence rate of this parasite varies in diverse regions and is more common among children. This study was aimed to determine the prevalence of EV in primary school students of Kouhdasht rural regions. Methods: The students' parents filled out the questionnaires the samples were coded and gathered in the morning and were sent to the laboratory. The positive and negative results were recorded in a questionnaire after the samples were examined microscopically. Results: Out of 598 samples from the students of Kouhdasht rural regions, 202 ones (33.8%) were found to be afflicted with Enterobious vermicolaris. The obtained results as well as the variables included in the questionnaires were analyzed using chi-square test. Significant differences were observed between the results in terms of different rural areas, using soap regularly to wash hands prior to eating and clinical signs such as thinness, sleep disturbances, irritability, and anal itching. Conclusion: Since the parasite is transferred directly, there is a close relationship between the prevalence rate and the hygienic condition of the society. The exact diagnosis can decrease and prevent the parasite contamination by coordinating health condition with health instructions, as well as by providing health facilities.

Background: Menopause is a physiological event that occurs in women's life and result in physical, emotional and social changes which affects their quality of life. Because of controversial finding in previous researches and lack of such study in kashan city, this study investigated the quality of life in menopausal women and its related factors. Methods: A cross - sectional study was performed on 700 menopausal women aged 40-60 in Kashan city with cluster sampling. Menopausal Specific Quality of life questionnaire (MENQOL) was used for estimation of QOL and related factor such as age, job, educational level, marital status, duration of menopause, child at home, income satisfaction, marital satisfaction, exercise, smoking and family smoking were examined with statistical tests. Results: The quality of life was high in 17.9%, intermediate in 68.9% and low in 13.3% of women. Most of women had intermediate quality of life at vasomotor domain (67.3 %), psychosomatic domain (67.4%), physical domain(46.3%) and sexual domain (51.6%). Also there was a significant difference between quality of life and educational level (P=0.004), income satisfaction (P=0.01) and exercise (P=0.0001). Conclusions: Educational level, exercise and income satisfaction are related with quality of life in menopausal women. Based on our findings, we emphasis on teaching about menopause, its symptom and adverse effects. Also emphasizes the necessity use of non pharmacological methods such as exercise and change in life style and diet to improve quality of life in menopausal women.