Medical Journal of Mashhad University of Medical Sciences
Year:2010 | Volume:53 | Issue:3|Papers Count:15

Introduction: Cytokines are secreted as the molecular products of different cells in particular T-Lymphocyte which contribute in the processes of immune responses. Therefore, the study may provide valuable information regarding the function of cell-mediated immunity (CMI) in this disease.Materials and Methods: This study was performed in the medical centers of Mashhad University of Medical Science.40 Patients with brucellosis and 40 normal samples took part in this investigation. Diagnosis of the disease was based on case history clinical examination and serological tests.Results: The levels of TNF-a, IL-2, IFN-g, IL-4, and IL-10 in serum were measured using ELISA method. The levels of the random variables IL-2 and IL-10 were tested by Kolmogrov Smirnov test and shown to be normal (p<0.05). Other cytokines including IL-4, IFN-g, and TNF-a of patients serum were not normal. The results indicated that the levels of IL-10 in the sera of patients had increased (p<0.001). IFN-g level showed it has increased in patients (p<0.05). The level of IL-2 and IL-4 and TNF-a in the sera of patients did not show any appreciable difference with those of normal controls (p>0.1). Kruskal-Wallis test showed a significant difference in IFN-g in the two groups.Conclusion Our results would suggest a definite role of IFN-g, and IL-10 in sera of patients with arthritis and low bake pain brucellosis.

Introduction: Cutaneous leishmaniasis is a parasitic infection With an important health problem in many parts of Iran such as Sabzevar, in Khorasan Razavi province. Epidemiological and clinical findings aren’t sufficient for identification of parasites. Because the host sources are different an accurate identification and diagnosis is necessary before treatment. DNA of every parasite such as every organism is specific. This facilitates extensive use of DNA for diagnostic and identification of parasite species. Molecular methods such as PCR seem to be very useful for this reason. We decided to identify different species of leishmania parasites causing Cutaneous leishmaniasis by PCR in SabzevarMaterials and Methods: A Total of 86 patients, whom diseases were confirmed by direct smear, were recruited and samples were isolated and cultured in NNN medium, followed by sub-cultured in RPMI-1640. Then DNA was extracted using four DNA extraction methods. Extracted kinetoplastic DNA was amplified by PCR method using two specific primers. Electrophoresis patterns from each isolate were compared with reference strains of L.major, L.tropica and the markerResults: The related bands to amplified products were detected on agarose gel in all samples expected of DNA extracted by boiling method. The results of kDNA gene templets in Electrophoresis gel indicated the leishmania parasite species, causing Cutaneous leishmaniasis, in Sabzevar as 32 samples L.tropica and 54 samples L.major.Conclusion: L.tropica and L.major both are Etiologic agents ofCutaneous leishmaniasis in Sabzevar and PCR technique is a suitable tool for the leishmania species characterization in epidemiological studies. The phenol-chloroform based methods are as valuable as DNeasy mini kit (QIAGEN) but more cost effective than kit.

Introduction: Cutaneous Leishmaniasis (CL) is a common parasitic skin disease which is endemic in many parts of Iran, including Khorasan. Leishmanin Skin Test (LST) is used for clinical diagnosis of previous infection. The aim of this study was to determine the correlation between the result of LST with the clinical form of CL lesion and species of causative agent in patients referred to the Parasitology laboratory, Imam Reza hospital during 2007-2008.Materials and Methods: This study was undertaken over a 12 month period. Following confirmation of diagnosis of CL in 50 patients who obtained positive result by direct smear test, their demographic, clinical and laboratory information were recorded. LST was performed for each patient. PCR (polymerase chain reaction) was used to determine the species of parasite. The result of LST read after 24, 48 and 72 hours. The collected data were statistically analyzed using SPSS.Results: Among 30 persons with Anthroponotic Cutaneous Leishmaniasis (ACL), 60% had dry and 33% had infected moist lesions. Among 20 persons with Zoonotic Cutaneous Leishmaniasis (ZCL), dry and infected moist ulcers were observed in 30% and 65% respectively. The result of Positive LSTwas increased 48 and 72 hrs. After injection.Conclusion: There was a significant relationship between the clinical form of CL lesion and causative agent as the result of the LST; but no significant relationship was observed between causative agent & clinical form.

Introduction: By means of normal hearing system and appropriate auditory feedback, we can control acoustic parameters of voice such as phonation, quality of voice, pitch and intensity.Materials and Methods: The aim of this cross-sectional study was investigation and comparison of some acoustic parameters of voice including: mean of intensity range, frequency range, shimmer, and harmonic to noise ratio between 2 groups of children (17 hearing impaired and 17 normal children). These groups were matched with respect to age and sex. The mean of each parameters were calculated using collection of speech studio software and electrolaryngograph apparatus and were compared between two groups of children.Results: The mean of intensity range between two groups was not statistically different (P=0.462). The mean of frequency range between two groups was not statistically different either (P=0.277). The mean of Shimmer in children with hearing loss was higher than normal children (P=0.010). The mean of Harmonic to noise ratio (HNR) in children with hearing loss was lower than normal children (P=0.001).Conclusion: It can be concluded that most susceptible acoustic parameters of voice for improving by hearing aids and speech therapy services are frequency and intensity range. The higher mean of shimmer and lower mean of harmonic to noise ratio (HNR) in hearing impaired children in comparison with normal group is caused by excessive pressure that these children are bearing on the larynx and related structures.

Introduction: Helicobacter pylori infection has various clinical features. One of the most common presentations of this infection is upper abdominal pain. Complications such as gastritis, gastric ulcer, gastric carcinoma and MALT lymphoma mandate early diagnosis of H.P infection by a low cost and non invasive manner. The aim of this study was to evaluate the diagnostic role of H.P stool antigen detection as a simple and non invasive method for diagnosis of this infection.Materials and Methods: Upper endoscopy with gastric biopsy was done on all patients between 6 months to 18 years old with upper abdominal pain. Stool test was done by polyclonal anti-h.p antibody. Results of stool Test were compared with results of RUT and histologic examinationResults: Overall 110 patients (57 boys,53 girls) were studied, 32 patients were Helicobacter pylori positive and 78 patients were Helicobacter pylori negative based on RUT and histologic examination. Stool antigen testing was positive for 39 patients. Sensitivity and specificity of stool Ag were 100% and 91% respectivelyConclusion: Stool Ag test has high sensitivity and negatity predictive value for diagnosis of Helicobacter pylori infection.

Introduction: In Iran vaccination against Mumps (with Zagreb strain) has been started since 2005, and since that time the incidence of Mumps and its complications (like meningitis) has dramatically decreased. However during the 3 years after Mumps vaccination there have been frequent reports of Parotitis and Meningitis in the first few weeks after the shot. This article is the report of the authors experience about the probable adverse reactions of mumps vaccine.Materials and Methods: This was prospective cross sectional observational study in Pediatric wards of Imam Reza and Dr Sheikh hospitals from August 2004 up to July 2009. In this study children who developed Parotitis or Meningitis within 0ne to six weeks after MMR vaccination were considered as probable Mumps vaccine adverse reaction.Results: There were 24 cases of Meningitis (with or without Parotitis) and 16 cases of isolated Parotitis during 9 to 39 days after MMR vaccination. Male to Female ratio was 3/1 in Meningitis and 2/3 in Parotitis group. In the whole group %65 (26 ) of children were 4-6 years old and 30% of them (12 cases) were One year old, and in all of them this was the first shot of Mumps vaccine. We had a probable case of vaccine virus transmission from a 7 years old girl to her 14 years old brother.Conclusion: Meningitis is a common event during one to six weeks after Mumps vaccination with the current (Zagreb) strain.

Introduction: Relative differences in QOL between hemodialysis (HD) and peritoneal dialysis (PD) are not clearly known. The objective of this study was to compare QOL between HD and PD patients in Emam Reza and Ghaem hospital dialysis centers.Materials and Methods: We compared 40 patients (17male and23 female) on PD with 40 matched patients (20 male and 20 female) on HD. Health related 36 item short form questionnaire (SF-36) were used to assess the quality of life. For the SF-36, eight domain scores (physical functioning [PF], role limitations as a result of physical problems [RP], body pain [BP], general health perceptions [GH], social functioning [SF], role limitations as a result of emotional problems [RE], vitality [VT], mental health [MH]) were calculated. We also calculated summary Physical Component (PCS), Mental Component (MCS) and total scores of QOL.Results: This study included 80 patients treated with HD and PD. The worst score was for RP dimension in both groups, and the best score was for RE in PD patients and BP in HD patients. SF-36 domains of GH, RP, VT and PCS were all significantly higher in the PD patients as compared to the HD patients. The only domain for which significant differences favoured HD patients was BP. (P<0.05).Conclusion: This study provided evidence that patients in PD treatment modality were experiencing better quality of life in SF-36 domains of GH, RP, VT, PCS in comparison to HD patients

Introduction: To investigate the discriminative ability of contrast sensitivity (CS), color vision and log MAR visual acuity (VA) in detecting functional losses in diabetic participants with and without retinopathy comparing to the control group.Materials and Methods: In this cross sectional study in 1388 we examined 105 patients in Mashhad Khatam- Al-Anbia Eye Hospital including 70 diabetic patients (35 with retinopathy and 35 without retinopathy) with 35 control group. Contrast sensitivity was examined by means of CSV-1000 E at 3, 6, 12 and 18 cpd respectively. Color discrimination ability was measured with the Farnsworth D-15 test and log MAR VA by Snellen chart.Results: Contrast sensitivity was significantly lower in the diabetic eyes with retinopathy than in the normal eyes in all spatial frequencies. Comparing to the control group, there was a statistically significant CS loss in spatial frequencies of 3, 6, 18 cpd in the diabetic eyes without retinopathy (p<0.05). The mean log MAR VA and color vision abnormalities were significantly higher in the diabetic eyes with retinopathy than in the normal eyes or the diabetic eyes without retinopathy (p<0.001). The sensitivity and specificity of the CS test in 6 cpd were 71% and 82% which were significantly higher than other spatial frequencies. The sensitivity and the specificity of the color vision test and VA (log MAR ³0.05, Snellen £9/10) were 79% and 94% respectively.Conclusion: There was significant difference between the visual performance of those diabetics with retinopathy and those without. There was excellent agreement between the results of these three tests

Brucellosis, is a common zoonosis in developing countries, where it undermines animal health and productivity. Brucella organisms invade cells of Reticuloendothelial system. Cytokines play an important role in inflammation. Brucella organisms induce a variety of prointlamatory cytokines such as IL-1 Beta, IL-6, IL-12 and TNF alpha, Brucella organisms induce the production of IL-10, a cytokine with ability of down regulation pro inflammatory process or an anti-inflamatory cytokine. IFN-gamma a crucial cytokine involved in immunity of Brucella, a Th-1 cytokine with stimulation activity of Bactericidal function in Macrophages. Th 1 T.Cell production of IFN-gamma activates Macrophages to kill interacellular Bacteria. Th 2 cells produce IL-4, IL-5, IL-13, IL-9, IL 10 and IL-25.Brucella Organisms have evolved Mechanisms to escape Neutrophil and antibody- mediated Immune defenses. Phagocytic cells entering is the most effective escape mechanism and in this condition The host cell becomes a protective defencse against exatera cel1ular anti-Microbial defenses. In diagnosis of Brucel1a infection serologic test is not a gold standard diagnostic assay, Regarding false positive and false negative serologic tests. Blood and Bone marrow culture and tissue PCR are strong tests and have high specificity and sencibility values.

Introduction: Ulcerative colitis (UC) and Crohn’s disease (CD), collectively referred to as inflammatory bowel disease (IBD), present with different histology and cytokine profiles. While the precise mechanisms underlying the development of IBD are not known, sufficient data have been collected to suggest that it results from a complex interplay of genetic, environmental, and immunologic factors. An inappropriate mucosal immune response to normal intestinal constituents is a key feature, leading to an imbalance in local pro- and anti-inflammatory cytokines. Neutrophil and monocyte influx occurs with subsequent secretion of oxygen radicals and enzymes, leading to tissue damage.Case report: Here we report three patients with sever symptom of IBD after ovarian stimulation.Conclusion: Cytokine profile after ovarian stimulation may contribute to the altered intestinal permeability due to increase in systemic inflammatory cytokines and neutrophil or macrophage activation. In our hypothesis ovulation induction can induce inflammation in intestinal mucosa or exacerbate previous IBD by different cytokines.