Feyz Medical Sciences Journal
Year:2007 | Volume:11 | Issue:1 (SERIAL 41)|Papers Count:14

Background: Gene therapy is an important technique in clinical research which offers new visions for the treatment of genetic deficiencies. Gaucher disease caused by genetic deficiency of glucocerebrosidase (Gba) enzyme has attracted special consideration in gene therapy. The aim of this project is cloning and transferring of glucocerebrosidase enzyme gene to HEK cell line by enhanced lentiviral vector.Materials and Methods: The cDNA of glucocerebrosidas enzyme gene was synthesized, amplified with specific primers by PCR methods, cloned in non-expressing vector and sequenced. The recombinant gene was sub cloned in enhanced lentiviral vector by GFP reporter gene. After culturing the HEK cell line, the recombinant lentiviral vector was transferred to them and the transfer of Gba gene was examined by GFP reporter gene. Results: The amplification and cloning of glucocerebrosidase enzyme gene was confirmed by restrictive enzymes. The sequence of Gba gene was compared correctly by its reported sequence. Sub cloning of Gbagene in lentiviral vector was confirmed by different restrictive enzymes. The transfer of Gba recombinant gene was confirmed by reporter gene with flurecent proteins.Conclusion: This project is a part of gene therapy protocol performed by the transferring of mouse glucocerebrosidas enzyme gene to HEK cells by lentiviral vector.

Background: Cesarean Section (C/S) is one of the most common surgical procedures in the world for which intrathecal anesthesia is a method of choice. This study was carried out to evaluate the effect of Midazolam in quality and duration of analgesia in SIC.Material and Methods: This was a double blind randomized trial study in which 124 women with C/S were divided into 2 groups. In the first group Bupivacain plus normal saline was used (control group) and in the second one Bupivacain plus intrathecal Midazolam was injected (interventional group). The beginning and the end of sensation block, severity of pain before and after operation, vital signs (VIS), time of requesting the first analgesic and morbidity in both groups were evaluated and recorded. Independent t-test, k 2, Mann-Withny and Fisher exact test were used to analyze the data. Results: This study showed that the duration of analgesia, 142.18±55.19 minutes (M) in the control group and 178.06±77.33 M in the case group, was significantly different. The severity of pain 15M after operation was 1.2±1.32 in the control group and 0.45±1.11 in the intervention group. 120M after operation it was 4.97:t2.1 in control group and 2±1.64 in the intervention group representing a significant reduction in pain perception (p<0.007). Sensory block started 1.72±0.052M faster in the intervention group. Vital sign changes were not significantly different between the two groups. Nausea and vomiting were more frequent in the interventional group.Conclusion: Intrathecal Midazolam plus Bupivacain is a suitable drug to decrease pain and increase the duration of analgesia in C/S.

Background: Vitrification is a simple and ultra rapid technique for the conservation of fertility. In this study, we compare the in vitro development of preantral follicles obtained from fresh specimens with vitrified-warmed mouse ovaries.Materials and Methods: This experimental study was carried out on 20, 14-day-oldfemale mice (NMRI). Ovaries were vitrified with a solution containing ethylene glycol, ficoll 70 and sucrose in PB1 (EGFS40) for 5 min, and transferred directly into liquid nitrogen and stored for one week. Fast warming was done by descending sucrose at room temperature.Preantral follicles with 100-130 mm in diameter were mechanically isolated from fresh and vitrified-warmed ovaries and cultured in a-minimum essential medium (a-MEM) supplementedwith5% fetal bovine serum (FBS), 100 mIU/ml rFSH, 1%ITS, and 20ng/ml mrEGF in vitro for 10 days. Diameter of follicle, and, survival rate and number of antral follicles in both groups were compared using t-test and chi-square test, respectively.Results: Isolated follicles from the vitrified and no vitrified groups survived and grew in vitro culture. On the day 6 survival rates in the vitrified and fresh control groups were 72.1% and 78.6%, and, on the day 10, they were 66.9% and 72.6%, respectively. Follicle antrum formation was 37.5% in the vitrified group while it was 43.5% in the fresh group in the 10th day. On the day 2, the mean diameters of fresh and vitrified follicles were 158.11±11.23 and 155.48±8.35 and on the day 4, they were 201.56±9.87 and 193.42±8.46, respectively. There was no significant difference between the control and vitrified groups in these variables (p>0.05).Conclusion: Taken together, cry preservation of the ovary by vitrification seems to be a promising method to preserve ovarian follicles.

Background: Type 2 diabetes mellitus is one of the most common health problems. Garlic (Allium sativum) has been the focus of serious clinical attention because of its beneficial effects on the reduction of serum blood glucose. This study was designed to evaluate the effects of garlic on serum glucose level in patients with type 2 diabetes mellitus.Materials and Methods: This 3-month randomized and double blind clinical trial was conducted on 60 new cases of type 2 diabetes referred to diabetes center of Kashan. The effect of garlic on their blood sugar and HbA1C was assessed Thirty patients were given 2 tablets of garlic 3 times per day (each tablet containing 400 mg dry garlic powder and over 1000mg Allicin) and 30 patients (controls) received vitamin B1 tablets. Both groups were given the same diet and exercise programs. Before and after the treatment fasting blood sugar (FBS) and gelycated hemoglobin were measured andanalyzed with t-test.Results: The mean age in the garlic and control groups was 46.3±3 and 45.7±10 years, respectively. There was no significant difference in age, sex, and other diseases between the two groups. After 3 months, the garlic-treated group showed a significant reduction (49.5 mg/dl) in FBS (P<0.001) when compared with the control group. The garlic-treated group also had a significant reduction (1.5%) in gelycated hemoglobin (P<0.003) compared with the control group.Conclusion: Garlic significantly reduced FBS and HbAlC in type 2 diabetic patients. Hence, it may be a candidate drug in the treatment of diabetes mellitus.

Background: Preeclampsia is one of the most important risk factors for maternal mortality in the world. The immune maladaptation theory suggests that the tolerance to paternal antigens, resulting from prolonged exposure to sperm, protects against the development of preeclampsia. Due to controversies in this regard the present study was conducted with main objective to determine the relationship between the extent of exposure to sperm, before pregnancy, and the risk of preeclampsia in pregnant women referring to Shabih-Khani maternity Hospital of Kashan during 2005-2006.Materials and Methods: A case-control study was carried out on 150 mothers with preeclampsia (case group) and 150 mothers without preeclampsia (control group).Preeclampsia was determined by blood pressure³140/90 and proteinuria³±1 by dipstick testing. The duration of sperm exposure prior to pregnancy, and the frequency and duration of the use of barrier method contraception before pregnancy were compared in the two groups. All results were analyzed using X2, Hest, and Mann-Whitney U statistical test.Results: There was no significant difference between the two groups in confounding variables. The mean duration of sperm exposure prior to pregnancy in the case and control groups was 11.4±14 and 12.4±13.8 months, respectively. Mann-Whitney U test showed that this difference was not significant. X2 statistical test appeared no significant difference between the two groups in barrier methods contraception (80 and 88 women in the case and control groups, respectively). Also Mann-Whitney U test showed that regarding duration of using barrier method contraception no important variation is evident between the case and control groups (25.8±21.9 and 28.7±23.7 months, respectively).Conclusion: We concluded that pre exposure to sperm, frequency and duration of using barrier contraception are not effective in the etiology of preeclampsia.  

Background: Diabetes accompanies over 8% of all pregnancies. It is associated with increased risk of complications of pregnancy and prenatal mortality. This study was conducted to determine the disadvantages of gestational diabetes on mother and new born in order to prevent neonatal and marital unpleasant outcomes.Material and Methods: The present historical cohort study includes 420 mothers referring to Shiraz hospitals in 2006. Seventy cases were suffering from gestational diabetes. Data were pooled by questionnaires and analyzed by t-test and fisher exact tests in SPSS.Results: The recurrence rate of gestational diabetes was 72.4%. There was a significant difference between the two groups in dead fetus (RR= 8.87), macrosommia (RR= 7.38), respiratory distress (RR= 5.16), hypoglycemia (RR= 13.38), neonatal jaundice (RR= 3.28), need to respiratory rehabilitation (RR= 3.17), anomalies (RR= 7.28) and cesarean delivery (RR= 1.96) (p<0.05). However, no statistical difference was appeared in intrauterine growth retardation, shoulder dystocia, breach labor, need to insulin, meconium problems, induction of labor, episiotomy and placenta disorders (p>0.05).Conclusion: This study showed that dead fetus, macrosomia, respiratory distress, hypoglycemia, and neonatal jaundice are more common in women with gestational diabetes than in other women. There fore, diabetes preventive practices are especially essential in pregnant women because of the unfavorable effects on labor and newborn baby.

Background: Assisted hatching techniques are utilized to facilitate the embryo escape out of the zona pellucida and increase the pregnancy rates in IVF centers. The objective of this study was to evaluate if assisted hatching improved the rates of pregnancy for in-vitro fertilization, in Isfahan Infertility Center.Materials and methods: This case-control study was carried out on 296 infertile patients. Patients with assisted hatching were 131 (case group) and non-treated patients were 165 (control group). Patients' age, number of oocytes aspirated, number of oocytes fertilized, and numbers of embryos transferred were matched. The pregnancy was determined by positive b-HCG, 14 days after transfer; and implantation was defined as presence of gestational sac in uterus on sonography. Statistical analysis was done with the student t-test and X2 test. A Pvalue of less than 0.05 was considered statistically significant.Results: No significant difference was noted in the mean age of patients, the number of oocytes aspirated, the number of oocytes fertilized, and the number of embryos transferred between the case and control groups. In addition, no significant difference was observed in the rates of pregnancy between the hatched and control groups (22.9% versus 20.6%, respectively).Conclusion: Assisted hatching has no significant impact on pregnancy rates in the patients population studied. Further data are needed to determine if assisted hatching has beneficial effect on pregnancy rate.

Background: Hepatitis virus infections are common in patients suffering from human immunodeficiency virus (HIV) infection due to similar transmission routes of these viruses.Hepatitis virus infections lead to impaired survival in HIV positive patients. In contrast to the expectations, some studies indicate that HGV infection slows down the progression and eventually death of AIDS patients. The aim of this study was to estimate the frequency of active HGV infection among HIV infected patients in Tehran.Material and Methods: Flow cytometric analysis of lymphocyte subpopulations was performed on blood samples of 103 patients with HIV infection referring to the central laboratory of Iranian blood transfusion organization. Their plasma samples were analyzed for the presence of HGVRNA by RT-PCR. HGV Positive cases were confirmed by PCR-ELISA.Results: Of 103 HIV-positive patients, 16 (15.5%) were HGV RNA-positive. It was apparent that the frequency of HGV in patients with CD4 count above 500 cell/ml is higher.Conclusion: Such frequency is not high compared with those found in other studies. The high frequency of active HGV infection in patients with asymptomatic HIV infection may be due to the loss of active HGV infection in patients with advanced HIV infection.

Background: Prolonged pregnancy influences different aspects of maternal and neonatal health. Although it is accepted that drug intervention is necessary before labor in prolonged pregnancy but there is debate about the termination time of the pregnancy. Considering the importance and prevalence of this entity we studied the labor indices in the hospitalized women with prolonged pregnancy in Kashan, in 1382-1383.Material and Methods: This descriptive study carried out on 450 women with gestational age of more than 40 weeks (based on their LMP or sonography before30 weeks) admitted for termination of pregnancy by induction. They had no medical or obstetrical problem. Labor indices including dilatation and effacement at the time of admission, number of inductions, duration of hospitalization, dystocia and type of delivery, as well as mother's age, history of prolonged pregnancy, and number of parturitions were recorded and then on the base of gestational age categorized in 4 following groups: 40w to 41w and 3days, 40w and 4 days to 41w, 41w and 1 days to 41 w and 3 days and 41w, 4 days or more.Results: Data showed that 131 women(%29.1) have terminated in 40 to 40w and 3 days of gestation and 130 women (%28.9) in 40w and 4days to 41w, 150 women (%33.3) in 41w and 1 days to 41w and 3 days and only 39 women(%8.7) after 41w and 3 day; 12(2.7%) of which were more than 42 weeks. There wasn't significant difference between women in dilatation and effacement on admission, dystocia and type of delivery; but there was significant difference in the number of induction and duration of hospitalization.Termination of pregnancy in lower gestational age causes increased number of inductions and duration of hospitalization. The most frequent reason for cesarean section was lack of response to drug interventions and induction in lower gestational age.Conclusion: We recommend no intervention for termination of delayed pregnancy up to 41.5 weeks in women with out problem.

Background: This study was carried out in the Iranian Tissue Bank Research and Preparation Center to evaluate the effective ness of an antibiotic cocktail used for sterility of the cardiac valves and aseptic preparation method utilized for graft from March2001 to February 2006.Materials and Methods: This is a descriptive study of existing data on 848 cardiac valve specimens received and processed for graft at the Iranian Tissue Bank Research and Preparation Center. From two small pieces of cardiac valves dissected, one piece was directly cultured on blood agar and Methylene blue agar. The other was put in a test tube containing an antibiotic cocktail and then was cultured. The cultured media was incubated at 3ic for 24 hours. The isolated bacteria were identified by standard biochemical tests. The results were analyzed statistically by the Chi-square test.Results: The overall contamination rate for cardiac valves in the intact and treatment groups was 37.7% (320 out of 848) and 5.4% (46 out of 848), respectively (P<0.001).Gram negative bacilli were the predominant isolates. Enterobacter sp. in 19.4% (62 out of 320), Streptococci in 17.2% (55 out of 320), and Klebsiella sp. in 14.1% (45 out of 320) were the most common isolated gram negative bacilli from the intact samples. Total of 46 samples from antibiotic treatment group were contaminated, and Klebsiella sp. Isolated from previous sample was the most common i.e. 80.4% (37 out of 46).Conclusion: Klebsiella sp. is the most common bacterial agent isolated from the treated cardiac valves; then, further studies are necessary for antibacterial susceptibility tests and selection of the appropriate antibacterial components of the cocktail.

Background: Occupational accidents are major health problems in both developed and developing countries. The most important aspect is death leading to loss of years of life and work. The objective of this study is evaluation of human costs of fatal occupational accidents in the insured employees by Human Capital method in Tehran.Materials and Methods: Data for this study were collected through specific checklists filled in by referring to the branches of the Social Security Organization. Human costs were calculated by determination of the lost years of life, years of active economic function as well as annual income of the deceased people.Results: In the three years of the study 7552 years of life and 3656 years of work have been lost because of the occupational accidents. Findings also showed that human cost for each occupational accident was 3.36 billion Rials. Human costs of fatal occupational accidents for each year of study were found to be equal to 0.03 percent of Iran's GDP.Conclusion: Very high expenses of occupational accidents mandate more attention to the occupational health and safety services.

Background: Considering the high prevalence of brucellosis and lack of definite data about its situation in our district this study was conducted to update our in knowledse and determine the frequency of clinical manifestations of hospitalized brucellosis patients in Beheshti Hospital of Kashan University of Medical Sciences during 1996-2003.Materials and Methods: This descriptive study was carried on the existing data in medical records of 380 hospitalized patients with brucelosis in Beheshti Hospital of Kashan University of Medical Sciences (KAUMS).The subjects were the patients with symptoms Compatible with brucellosis and Wright titer³1.160. Demographic, clinical and laboratory Findings were extracted and the collected data analyzed.Results: 59% of the patients were male and 41% female. Most of the patients (80=21%) were in the age range of 10-19. The most common chief complaint of the patients was fever (19.2%) followed by low back pain (14.6%). The most common general complaints were fever (75%), arthralgia (70%), sweating (59.7%), anorexia (33.6%), and weight loss (14.7%). The wright, coombs wright, and 2 ME were positive in 94.8%, 100%, 92.2% of cases, respectively.Conclusion: Because of the high frequency of fever, low back pain and arthralgia in our patients, brucellosis must be considered in differential diagnosis of any prolonged febrile disease with low back pain and arthralgia. Wright test was positive in most of the patients (94.8%), so it can be used as a reliable and sensitive test for the diagnosis of brucellosis.