Research in Medicine
Year:2004 | Volume:28 | Issue:3|Papers Count:14

Background: TT virus is a newly described DNA virus that was first detected in the blood of patients with elevated serum aminotransferases following transfusion who were tested negatively for all known hepatitis viruses. This study aimed to elucidate the significance of TTV infection in Iranian patients with autoimmune hepatitis.Materials and methods: Sera from 90 patients with autoimmune hepatitis and 90 healthy controls were assayed for TTV DNA using a semi-nested polymerase chain reaction. Moreover, demographic and paraclinical features of patients were evaluated.Results: TTV DNA was detected in ten (11.1%) of patients with autoimmune hepatitis, versus four (4.4%) in control group, however, no significant difference was found between two groups (NS).Conclusions: According to our results, although the prevalence of TTV positivity in patients with autoimmune hepatitis was more than the healthy control group, the difference did not reach statistical significance, thus, our data did not provide enough evidence for TTV as a pathogenic organism in autoimmune hepatitis.

Background: While tamoxifen has been shown to alter concentration of many hormones and their binding globulins, there have been conflicting results on its effects on the thyroid function tests. We attempted to clarify these effects by studying subject in an uncontrolled clinical trial.Materials and methods: We evaluated 64 women with breast cancer who had participated in a nonrandomized pretest posttest study. They were given 20 mg tamoxifen orally daily at least for 12 months. Measurement of thyroid stimulation hormone (TSH), free thyroxin index (FTI), thyroxin (T4) and three idothyronin (T3) were made for each subject before and after 6 and 12 months of treatment.Results: Results revealed that T4 level has significantly increased 6 months, but not 12 months, following the therapy (p<0.0001). Meanwhile, T3 and TSH levels remained unchanged during the follow up period (NS). FTI results showed a significant increase in the mean value within the normal range after one year (p<0.005).Conclusion: Tamoxifen may induce increased level of FTI within the first year of treatment, however, this change is within the normal level. Moreover, T4 increased during the first 6 months but return within the normal range after 12 months.

Background: Non-ulcerative dyspepsia is common clinical problem. There are controversies regarding the role of helicobacter pylori infection on gastric emptying in non-ulcerative dyspeptic patients, thus, the present study was designed.Materials and methods: Fifty patients with non-tlcerative dyspepsia referring to Endoscopy unit of Taleghani hospital were included. Initial data including demographic and clinical data were gathered. Four biopsy samples were taken during endoscopy to assess helicobacter pylori infection (rapid urease test, culture and direct observation). Scintigraphy (solid phase) was used to detect gastric emptying disorders.Results: The study population included 20 males and 30 females. Flatulence was the most common chief complaint. Other clinical manifestations were distention, abdominal pain, and fullness. Two-third of patients with abdominal pain had noted epigastric pain. Thirty-five (70%) patients had H. pylori infection and 23 (46%) had reduced gastric emptying. We have found no statistically significant difference in gastric emptying between infected and non-infected dyspeptic patients.Conclusion: Results revealed that helicobacter pylori has no effect on gastric emptying in non-ulcerative dyspeptic patients.

Background: To assess the economic aspects of HBV (hepatitis B virus) transmission prevention for premarriage individuals in a country with cultural backgrounds like Iran and intermediate endemicity of HBV infection. Materials and methods: A cost-effectiveness analysis model was used from the health care system and society perspectives. The effectiveness was defined as the number of chronic HBV infections averted owing to one of the following strategies:1) HBsAg screening to find those would-be couples one of whom is HBsAg positive and putting seronegative subjects on a protection protocol comprising HBV vaccination, single dose HBIG and condom protection.2) HBsAg screening as above, in addition to performing HBcAb screening in the HBsAg negative spouses of the HBsAg positive persons and giving the protocol only to HBcAb negative ones. Sensitivity and threshold analyses were conducted.Results: The cost of each chronic infection averted was 202$ and 197$ for the strategies 1 and 2, respectively. Sensitivity analysis showed that strategy 2 was always slightly cheaper than strategy 1. The discounted threshold value for the lifetime costs of chronic liver disease, above which the model was cost saving was 2818$ in strategy 1 and 2747$ in strategy 2.

Background: The long-term effects of Ramadan fasting during pregnancy on the brain development of the fetus are still not clear. The aim of this study was to evaluate the effects of maternal fasting during Ramadan on the intelligence quotient of their progeny.Materials and methods: A historical cohort study conducted on 191 children aged between 4 to 13 years and their mothers. Of these, 98 mothers fasted throughout Ramadan when they were pregnant (case group) and 93 mothers did not fast during pregnancy (control group). The children were selected from 15 schools via a questionnaire filled out by their mothers. Detailed demographic, medical history, and socioeconomic status data were collected by interviewing the mothers. All children aged between 6 to 13 years were administered the Wechsler Intelligence Scale for Children-Revised (WISC-R), and those aged between 4 to 6 were administered Wechsler Preschool and Primary Scales of Intelligence (WPPSI), and intelligence quotient was estimated.Results: Cases included 47 boys and 51 girls with the. mean (± standard deviation) age of 8.5±2.5 years and controls included 44 boys and 49 girls with the mean age of 8.7±2.5 years. There was no significant difference in sex and age. Among background and confounding variables, caesarian section percentage and breast-feeding duration were significantly different between case and control groups; 29% caesarian section in cases vs. 45% in controls (p<0.05) and 17.7±9 months of breast-feeding for cases vs. 14.5±9 months for controls (p<0.05). There was no significant difference in socioeconomic status of families between the groups whereas socioeconomic status accounted for approximately 17% of the variances in the average of full-scale intelligence quotient scores. Adjusted mean and standard deviation of full-scale intelligence quotient scores, performance and verbal were 111±10,109±11 and 110±11 for the case group and 112±10, 110±11 and 110±11 for the control group respectively. No significant differences were observed between the intelligence quotient scores of the two groups.Conclusion: Maternal fasting during pregnancy did not adversely affect child's intelligence quotients.

Background: Giardia lamblia is a major cause of diarrheal disease among children and adults with a worldwide distribution. With respect to the wide usage of metronidazole for multiple types of infection and risk of drug resistance as well as its side effects, initiation of new therapies seems inevitable. We attempted to compare the therapeutic effects of albendazole with metronidazole in patients with giardiasis.Materials and methods: Having completed an informed consent, 120documented cases of giardiasis, residing in Hamadan, were assigned randomly in two equal groups. The first and second groups received albendazole (400 mg daily as single dose, for 5 days) and metronidazole (250 mg, 3 times a day, for 5 days) respectively. A parasitologist who was blind to the type of therapy, assessed the trophozoites in the samples and check all iodine-stained wet stool preparations before and after the therapeutic intervention. Data analysis was performed using SPSS 9.01 (SPSS Inc. Chicago, IL, USA) using chi square and independent student t tests. Type 1and 2 errors were considered as 0.05 and 0.2 respectively.Results: After the whole course of the therapy, in 6 (10 %) patients of the first group and 14 patients from the second group, failure of treatment was seen and a significant difference between the two groups was found (p<0.05). Response to the therapy was observed in 54(90%) and 46 (76.7%) of patients of the first and second group, respectively (p<0.05). Drug side effects were more likely reported in metronidazole group. Conclusion: Albendazole is a quite safe and effective drug for the treatment of giardiasis and can be easily used in the treatment of giardiasis.

Background: Rotavirus infection, a frequent cause of death in developing countries is also known to be the leading cause of acute gastroenteritis requiring hospitalization in infants and young children in the developed world. In this study, the most prevalent serotypes of rotavirus in Tehran and seasonal distribution in a year were investigated.Materials and methods: Fecal samples were collected from a total of 180 infants and children with acute gastroenteritis in two children's hospitals in Tehran. The samples were tested by ELISA. Serotyping investigation of viral specimens was performed, using 7 serotypes monoclonal antibodies (G1-G2-G3-G4- G6-G8-09) in ELISA tests. Results: Rotavirus type A was detected in 66 samples (37%). G1 and G4 serotypes were the most common serotypes found in infected children and infants in Tehran. The peak of rotavirus infection prevalence occurred during the cold months of the year. Conclusion: This study underlines the importance of these serotypes in the etiology of severe diarrhea in children. 01 and 04 serotypes were the most common serotypes.

Background: Hepatocellular carcinoma is the most common primary malignant tumor of the liver. The effect of some genes especially those involved in cell cycle regulation have been shown in the development of this cancer in several studies but there are some controversies about them yet.Materials and methods: The paraffin-embedded tissue samples of 25 patients (18 males and 7 females) with hepatocellular carcinoma were collected from 22 pathology centers in Tehran during a period of 2 years (2000-2001). Using inununohistochemistry method (avidin-biotin-peroxidase), they were stained for detection of p53, cyclin D1, RBl, c-fos and N-ras proteins.Results: The mean (±SD) age of the subjects was 60.56±12.52 years. Six (24%), 5(20%), 12(48%) and 2(8%) were positive for p53, cyclin D1, C-fos and N-ras, respectively. Twenty-two (88%) samples had alterations in the D1 cell-cycle checkpoint proteins (RBl or cyclin D1). P53 positive cases showed a higher (9 times) risk of being positive for RBI gene comparing with p53 negative samples. RB1 loss of expression in association with pS3 over-expression has been observed in 4(66.7%) of samples. Loss of expression of RBl was seen in all cyclin D1 positive, 20(90.9%) N-ras negative, and 11(50%) C-fos positive cases. Comparing cyclin D1 positive cases with the negative ones, the former group showed a higher (2.85 and 4.75 times) risk of being positive for c-fos and N-ras genes.Conclusions: The development of mutation in p53, RB1 and c-fos genes appear to have a key role in the carcinopathogenesis of HCC in Iran. Also a significant association between simultaneous mutations of these genes during development of HCC is likely.

Background: Listeria monocytogenes may be the cause of meningitis and sepsis. It is transmitted via food products. Precise detection of this organism would undoubtedly play a significant role in prevention of this infection.Materials and methods: Polymerase chain reaction method was developed for detection of Listeria monocytogenes in milk samples after enrichment culture. It consists of culturing samples in Listeria enrichment broth, followed by DNA extraction and detection of the organism using PCR.Results: Dilutions of Listeria monocytogenes in milk were subjected to PCR amplification after enrichment culture. When determining the sensitivity of the method, it was found to be possible to detect 37 colony forming unit of the bacterium in milk. When this PCR method was applied to extract of DNA from different bacteria no PCR products were observed.Conclusion: The method was assessed as a sensitive, specific and time-saving way of detecting L. monocytogenes in milk samples.

Background: Car accidents are among the first 10-leading causes of death worldwide that impose large expenses on societies. Variety of factors including alteration in traffic pattern or observation of traffic rules in Ramadan may influence the frequency of car accidents. The present study was conducted to compare car accidents in Ramadan with other months during a 4-year period (1997-2000).Materials and methods: Frequency of car accidents was extracted from related files of Police Office in Tehran and stratified according to the months. Then frequency of car accidents was estimated in Ramadan and compare with other months.Results: Totally 5283, 5671, 07047, and 9412 car accidents occurred in Ramadan monthof1997, 1998, 1999, and 2000, respectively. The related percentage of car accidents in Ramadan was 8.5, 8.6, 9.2, and 10.4%, respectively. The mean (±SD) of car accidents was 6853±1866.Conclusion: Car accidents in Ramadan did not significantly differ from other months.