Research in Medicine
Year:2016 | Volume:40 | Issue:1 |Papers Count:10

Background: The World Health Organization (WHO) has recommended the cell culture based rabies vaccines have no significant side effects. PVRV is a type of cell culture based vaccine, which is used for human rabies vaccination in Iran.Because PVRV is produced by a single source provider; other cell-culture derived vaccines, PCECV, has recently been used for vaccination.Methods: In this double blind clinical trial study 1449 people bitten by animals (279 females) were recruited from 4 different cities of Iran and randomly assigned to receive PVRV and PCECV vaccine in 5-dose regimen. The local and systemic adverse reactions to both of two vaccines were reported by the patients and confirmed by a physician.Results: The most common local adverse reaction in both groups was pain at the injection site (4%). Most of the reported systemic adverse reaction was headache (2.5%) and fever (1.9%) in PCECV and PVRV group, respectively.The percentage of subjects had itching after vaccination was fewer In PCECV group than PVRV group (0.1% vs.1%) (p<0.05). There was no significant difference between two groups in systemic adverse reaction. None of the subjects hospitalized due to vaccination.Conclusion: The result of the present study indicated that PCECV administered to people bitten by animals associated with fewer itching at the injection site. There was no significant difference between PCECV and PVRV vaccine considering local and systemic adverse reaction. Therefore, the PCECV vaccine can be administered instead of PVRV, when the country encounters serious challenges in PVRV vaccine supply.

Background: Diabetes is frequently along with hyperlipidemia. Glycemic control could improve this condition and including statins and fibrates is the best option to facilitate this amelioration. Noting the importance of diabetes in terms of its multiple complications and the load of its huge cost on the shoulders of the health system of our country, this study aimed to compare the efficacy of fenofibrate and gemfibrozil in improving lipid profile in patients with type II diabetes.Methods and materials: In this experimental setting, a total of 60 diabetic patients with serum low-density lipoprotein (LDL) in the target (p<0.001) range but with increased serum triglyceride were randomized in to 30-patient groups, receiving either fenofibrate (200 mg/day) or gemfibrozil (450 mg/day) for 3 consecutive months. Lipid profile changes at the endpoint were compared between the two groups with t-test Results: It seems except post treatment serum triglyceride level variations observed in two groups, which occurred to be significant. There was no significant difference in other analyzed parameters but there was a better improvement in serum lipid level in fenofibrate group.Conclusion: The efficacy of fenofibrate in improving serum lipid profile in diabetic patients is marginally better than that of gemfibrozil.

Background: Given the high prevalence of bacterial infections, particularly the E. coli in the semen of infertile men compared to fertile men and according to the controversial reports on the association of E. coli with male infertility herein, the prevalence of this bacterium in the semen of infertile men and its possible association with parameters determining sperm fertility was evaluated.Methods: In this case-control study and in a convenient sampling manner in 2014, semen specimens were collected from infertile and fertile men and were cultured on eosin methylene blue medium, and then, gram staining and biochemical tests were used to identify the E.coli bacteria. Sperm morphology and motility and other related parameters such as; fast, slow and non-progress motility was investigated according to the World Health Organization protocol. Finally, the sperm characteristics were compared between fertile and infertile E. coli-positive groups.Results: the prevalence of E. coli in the semen of the infertile group was significantly higher than that in the fertile group (p<0.001). Also, there was statistically significant differences between fertile and infertile E. coli-positive men in terms of mean age, percentage of normal sperm morphology and all the characteristics of sperm motility (p<0.01).Conclusion: despite the high prevalence of E.coli bacteria in the semen of the infertile compared to the fertile men, it seems that this bacterium is not responsible for alterations in morphology and motility properties of sperm. However, it suggested that in individuals with E.coli infection, along with increasing the age, the association between this bacterium and sperm quality becomes much more tangible.

Background: Students are the main clients for educational system and their opinions can improve service quality. Thus, determination of educational gap based on their viewpoints can trigger quality promotion programs. This project was performed to evaluate educational service quality based on viewpoints of medical students of Mashhad University of Medical Sciences in 2015.Methods: This cross-sectional study was carried out on 216 medical students of Mashhad University of Medical Sciences. Multi-stage random sampling method was used to gather post third grade students. The evaluation tool was the standardized SERVQUAL questionnaire which had demographic (4 questions) and 27 paired question for measuring service quality in 5 dimensions: assurance, accountability, empathy, confidence and physical with5 point Likert scale. SPSS 22 with p<0.05 was used for data analyses.Results: Age was 2.9±22.7 years. Sixty-four percent (139) were female. There were significant differences between desired and existing situation in all items and dimensions. Total service gap was -0.98±0.50 out of which, accountability had the highest (-1.22±0.74) and physical had the lowest (-0.79±0.62) educational gap. Gender, educational level and students' situation were not related to educational gap.Conclusion: Negative gap in all dimensions of educational services shows that students' expectations are not met. Some of these gaps can easily disappear by proper management and reconstruction of presenting services.

Backgroundm: Staphylococcus aureus is a fastidious pathogen of global concern. S. aureus can not only cause a wide range of serious infections, but it can also colonize healthy individuals. Nosocomial-associated S. aureus infection is a major concern for healthcare facilities. Recent increases in antibiotic resistance and communityacquired infection highlight the need for improved understanding for prevention and treatment of this pathogen.This study aimed to determine the antibiotic susceptibility pattern of Staphylococcus aureus (SA).Materials and Method: This cross sectional study was performed during April 2013-April 2015 in Khatam-Ol-Anbia general hospital among 62 samples (blood, urine, wound, etc) of community acquired S. aureus minimal inhibitory concentration (MIC) for various antibiotics (vancomycin, linezolid, teicoplanin, rifampin, oxacilline and ceftazidine organisms was determined by E-test method and statistical analysis was prepared by SPSS ver 13.Result: Overall, 62 patients (including 25 women and 37 men) were included in the study. Sensitivity percentage of organisms based on break point used in CLSI M7A6 (Clinical & Laboratory Standard Institute) for various antibiotics. Highest sensitivity was noted to Linezolid (100%) and highest resistance was noted against Oxacillin (96.1 %).Conclusion: Staphylococcus aureus still is a dangerous human pathogen with considerable morbidity and mortality. Methicillin-resistant staphylococcus aureus (MRSA) is one of the main causes of nosocomial infections acquired in the community. In recent years, the prevalence is increasing. Today, fewer drugs, more expensive with more complications are available for treatment resistant cases.

Background: Immunoglobulin G (IgG) is the most abundant antibody in serum. The amount of serum IgG is associated to severity of some diseases like immunodeficiencies and infections. Therefore, IgG has high diagnostic value. For precise measurement of IgG, diagnostic tools such as IgG-epitope specific monoclonal antibodies are needed.Immunoinformatic is a branch of immunology helps in more exact diagnosis of diseases using the computational biology. According to the significance of assessment of IgG level in some diseases such as immunodeficiency and infections and also efficacy of immunoinformatic methods for epitope mapping to develop monoclonal antibodies for diagnostic tests, this study was conducted for epitope mapping of human IgG by immunoinformatic.Methods of study: In this descriptive study, the amino acid sequence and third structure of reference human IgG was found in PDB database. The second IgG structure was determined by Phyre 2 software and the IgG linear epitopes were determined by Ellipro and IEDB immunoinformatic softwares.Results: Linear epitopes were located in 160-175 and in 350- 360 amino acid sequences of light and heavy chains respectively as was determined by IEDB software. Eleven linear epitopes were located to constant domains of human IgG, one in constant domain 1 (CH1) and others in constant domains 2 and 3 (CH2 and CH3) of IgG heavy chain as were determined by Ellipro.5 Main epitopes are located in CH3 domain.Conclusion: In this study a lot of linear epitopes located on human IgG were determined by two immunoinformatic softwares. These epitopes are useful tools for producing specific monoclonal anti-IgG antibodies, epitope mapping of IgG, production of specific diagnostic tools for human IgG and phylogenic studies. It seems that immunoinformatic is a useful tool for mapping of linear epitopes of human IgG. Experimental studies would be valuable for confirming the immunoinformatic results in epitope mapping of human IgG.

Background: Although several studies confirm long-term serum protection and immune memory of infantile-hepatitis B vaccination, but the duration and time of the loss of immunity is still unknown. We assessed antibody persistence and immunological memory to hepatitis B, 18 years after vaccination during infancy in freshman students of Tehran University (2012-2013).Material and Methods: This study was conducted on 395 students with a history of 3 times infant HB vaccination (first week, 1-3 months, 6-9 months, 10 μg recombinant HBV vaccine) 18 years ago (in accordance with the national vaccination program). Antibody against HBs Ag (anti-HBs) was measured and participants who had not a serum protection (anti-HBs<10 mIu/mL) were given a booster dose (20μg recombinant HBV vaccine) and the immune response was evaluated 10 to 14 days after injection.Increased antibody titer (³10 mIu/mL) was considered as an enhanced response (anamnestic response); which is suggestive for immunological memory.Results: Anti-HBs seropositivity rate was 79.2% (n=313). The number of seronegative participants was 82 (20.8%) that 40 of them were not willing to cooperate and the remaining 42 received a booster dose and anamnestic response observed in 92.9% (n=39). After the booster dose geometric mean (GMCs) and range of anti-HBs antibodies were 216.8 and 1084.3 respectively (n=42). The mean antibody concentration was significantly different after the boost than before (3.07±1.37 vs.517.97±435.75, p=0.000).Conclusion: Although the findings of this study show that 79.2% of participants had serum protection and immunological memory of infantile HBV immunization retained for 18 years in 92.9% of seronegative participants who received a booster dose, but still the time of deterioration of immunization is unclear.Therefore, we recommend that further studies be conducted with larger sample size in older people in different regions of the country.

Background: The increasing emergence of antimicrobial resistance among gram negative bacteria especially Enterobacteriaceae has become a global problem. Klebsiella pneumoniae is an opportunistic pathogen, which recently due to causing broad spectrum of disease and antibiotic resistance has been lionized. Efflux pumps are one of the antibiotic resistance mechanisms, which were introduced in this bacteria. Therefore, the aims of this study were detection of oqxA, oqxB, acrA and acrB genes, evaluation of expression level of oqxA and acrA genes and determination of antibiotic resistance patterns among Klebsiella pneumoniae isolated at Tehran hospitals.Materials and Methods: In this descriptive study 83 Klebsiella pneumoniae were collected from patients attending to three hospitals in Tehran. Antibiotic susceptibility test was performed by disk diffusion method. The presence of oqxA, oqxB, acrA and acrB resistance genes was detected by PCR. The CCCP was used as efflux pump inhibitor and the oqxA, acrA genes expression level was analyzed by using real-time PCR.Results: The most of strains showed to have OqxAB (96%) and AcrAB (97%) pumps. The use of efflux pump inhibitor showed different results for ciprofloxacin MIC. Real-time PCR assay showed higher expression level of OqxAB (2.3 folds) and AcrAB (4 folds) pumps in resistant strains.Conclusion: The existence of antibiotic resistance genes, increasing of Klebsiella pneumoniae strains, which become resistant to common antibiotics and nosocomial infections, highlights the need for particular detection, prevention and control of spread of resistant bacteria.