TANAFFOS
Year:2004 | Volume:3 | Issue:11|Papers Count:14

The field of innate immunity has undergone an explosion over the past decade with the discovery of receptor families that are instrumental in the first line recognition of microbes by hosts, and the regulation of innate and adaptive immune responses. In particular, the Toll-like receptor (TLR) family acts to sense foreign microbial products, and initiates a cascade of events that include the secretion of proinflammatory cytokines, the maturation of dendritic cells, and the activation of B- and T- cells. Given their pivotal role in host defense, it is not surprising that recent studies have identified a role for TLR function in several important human diseases, including sepsis, immunodeficiencies, atherosclerosis and allergies.

Background: Lung cancer is the second common malignancy in human. Human papillomavirus (HPV) has a well established association with squamous cell carcinoma of anogenital region. This study was performed in Massih Daneshvari hospital, between 1999 and 2003 to evaluate association of human papillomavirus type 16 and 18 in squamous cell carcinoma of the lung among Iranian patients.Materials and Methods: Paraffin embedded block of pathology archive of Massih Daneshvari hospital with diagnosis of SCC were selected for determination of HPV DNA by semi-nested PCR. For each specimen, all hematoxyline-eosin stained slides were reviewed by two pathologists; if the initial slide was inappropriate, a new slide was prepared. All inadequate specimens were excluded from the study.Results: 18 out of 45 paraffin- embedded specimens with diagnosis of squamous cell carcinoma were selected. Six specimens were positive for HPV type 16, and 2 were positive for HPV type 18. None of the specimens was shown to have concurrent positivity of HPV types 16 and 18.Conclusion: The present study showed that high risk HPV was associated with squamous cell carcinoma of the lung and more prevalent type was HPV 16. We suggest further investigations to evaluate this relationship.

Background: Tuberculosis (TB) is one of the commonest infectious diseases of our era; it is the second cause of death due to infectious diseases after AIDS. Studies have shown the significant effect of leukocyte integrins such as LFA-1and ICAM-1 on the function of macrophages against TB bacilli; increasing their activity during the process of TB infection.The objective of this research is to evaluate the changes observed in serum levels of SICAM-1 in pulmonary TB patients that had received treatment.Materials and Methods: All new pulmonary TB cases that had not received any treatment ,did not suffer from any kind of co-existing or underlying disorders such as hepatitis, sarcoidosis , lung cancer, HBV, HCV and HIV infections, chronic renal failure, cirrhosis, malnutrition, collagen vascular disorders and had not consumed immunosuppressive agents, were enrolled in this study. The SICAM-1 levels of the cases were measured by ELISA method before and 2 months after treatment with standard anti-TB drugs (Isoniazid, Rifampin, Ethambutol and Pyrazinamide) at the same time. T-test was used to compare the two sets of values of SICAM-1 levels before and 2 months after therapy.Results: A total of 28 patients; 23 (82.1%) male and 5(17.9%) female cases were enlisted. Meanwhile, 50% of the patients were Iranian and the remaining had Afghan nationality. All of them were sputum smear and culture positive for Mycobacterium tuberculosis. Regarding the extent of pulmonary involvement as shown on lung CT-Scan, 68% demonstrated diffuse pulmonary involvement. The mean SICAM-1 level before the initiation of treatment was 554.17 ± 202.85 ng/ml. Considering age , sex ratio, ESR level, PPD test and severity of lung involvement, the SICAM-1 levels did not show any significant differences in different groups of patients. Among the patients enrolled in the study we were able to follow the seventeen patients (61%) who completed 2 months of treatment. The mean level of SICAM-1 before and after treatment in these patients were 573.9 ±204.4 and 481.2 ± 103.2 ng/ml, respectively (P<0.05).Conclusion: SICAM-1 is considered as one of the inflammatory mediators that undergoes fluctuations during TB disease; its level is very much related to the extent of lung involvement. Since the level of this marker declines after therapy, it could be used as a "Serum marker "in evaluating the therapeutic response observed during the follow- up.Abbreviations: SICAM: Soluble Intercellular Adhesion Molecule, ICAM: Intercellular Adhesion Molecule, LFA: Leukocyte Function Antigen.

Background: Major lung resection is one of the surgical procedures which its significant physiologic and hemodynamic effects on the right heart have been recently studied. This study has been implemented to review the effects of this surgery on the most important echocardiographic index of the right heart that is pulmonary artery pressure (PAP).Materials and Methods: 29 patients were consecutively studied during 2 years. Each patient underwent a single transthoracic echocardiography before the operation and another echo study within one week after the operation. Background variables (age and sex) and echocardiographic indices (EF for global left heart function and PAP) were recorded. Analysis of data after review of distribution was done by paired-t-test and Wilcoxon signed rank test.Results: In this study 18 men and 11 women with mean ±SD age of 52±21 were included. Mean ± SD of EF and PAP before the operation were 57.1±3.9 and 26.8±9.9 respectively. After the operation no significant changes in EF (p_1) was observed while PAP changed to 29.7±11.3 (p<0.086)Conclusion: The results showed that reduced pulmonary vascular bed after lobectomy and pneumonectomy did not affect left sided EF, while right sided index (PAP) was slightly elevated although not statistically significant. We can deduce that major lung resection does not affect cardiac outcome and PAP significantly; future studies with more patients and longer follow-ups will clarify this issue.

Background: Cigarette smoking is the first preventable death in the world. Presence of a positive attitude towards tobacco use in young adults is one of the effective factors in starting smoking.Since it seems that the age of starting smoking has decreased in our society, it is important to recognize the attitudes towards cigarette smoking in this period of life.Materials and Methods: Therefore, this research was conducted according to WHO questionnaire and Global Youth Tobacco Survey Project (GYTS) and 1119 high school students were chosen randomly from different educational districts of Tehran in the year 2003 and were questioned in this regard.Results: According to the results of this study 28.2% of students (25.2% female and 30.8% male) smoked occasionally and 4.4% of them (1.5% female and 6.06% male) smoked daily.44.9% of the students believe that smoker students have less friends (than others) and 41.1% believe that smoker students are less comfortable in the parties.77.7% of the students believe that there is no difference in attractiveness of smoker and non smoker students.41.1% of the students consider the smoker boy as a “looser” and 38% of them consider the smoker girl as “stupid”. 80.4% of students assume that quitting smoking is very easy.Conclusion: Although the results of this study show that the attitudes of students towards smoking are not positive but this attitude has not prevented them from smoking and more serious action must be taken. Also, there is no significant difference between the attitudes of smoker and non smoker students.

Background: Methicillin- Resistant Staphylococcus Aureus (MRSA) has become one of the highest – ranking hospital acquired pathogens throughout the world, capable of causing a wide range of hospital infections. Staphylococcus aureus is a major nosocomial pathogen that causes a range of diseases, including endocarditis, osteomyelitis, pneumonia, toxic shock syndrome, food poisoning, carbuncles, and boils.Materials and Methods: One hundred S.aureus isolates recovered from patients in Loghman Hakim hospital were included in this study. Minimum inhibitory concentration (MIC) of strains for methicillin was determined by broth macrodilution method as recommended by NCCLS. Antibiotic susceptibility was tested by using the “disk diffusion technique on Mueller-Hinton Agar”. Nineteen antibiotics were tested including Ampicillin, Penicillin, Cephalexin, Cefepime, Gentamicin,   Doxycycline, Erythromycin, Chloramphenicol, Tetracycline, Nitrofurantoin, Kanamycin, Amikacine, Cefotaxime, Clindamycin, Cefazolin, Amoxicillin, Sulfamethoxazole-trimethoprim, Vancomycin, and Ciprofloxacin.Results: The MIC range for methicillin was from 17g/ml to 10247g/ml. Ninety percent of the isolated strains had methicillin MIC< 167g/ml and were designated as resistant. Vancomycin and Chloramphenicol were the most effective antibiotics and only 7% and 14% of the isolates were resistant respectively. Forty-four percent hospital acquired MRSA strains were resistant to Co-trimoxazole. The high antibiotic resistance among MRSA strains could be originated due to widespread use of antibiotics.Conclusion: Out of 90 MRSA isolates characterized in this study, approximately half of them displayed resistance to one or more antimicrobial agents, including Penicillin, Cephalosporins, Tetracycline and aminoglycosides. These data are in accord with previous study suggesting use of these drugs was important in the emergence of antimicrobial resistance in MRSA. In addition, 66% of MRSA isolates were sensitive to Trimethoprim-Sulfamethoxazole (Co-Trimoxazole). Since this drug combination is recommended for treating a range of human infections, S.aureus isolates should be monitored for further emergence of Co-Trimoxazole resistance.

Background: The study aimed to help the National Tuberculosis Control Program in promotion of DOTS strategy in Egypt. The specific objectives were to calculate the annual costs per TB case treated and TB case cured at the chest dispensary service delivery mode.Materials and Methods: The study was conducted in El-Dakahlia governorate at 5 chest dispensaries and the crosssectional analytic research design was utilized to investigate the current research issue. As a prerequisite for the proper research design a survey of literature has been carried out and covered the various methodological approaches of epidemiological and health economics investigations. Also, an exploratory study was carried out during the research-planning phase. Four different types of data collection instruments were used (Clients’ Flow, Capital, Recurrent, and Outcome Questionnaires) to collect the required data.Results: Analysis of data revealed that the annual costs per treated TB case and cured TB case were LE 157±150 and 198±190 respectively. Conclusion: The study concluded that the implementation of DOTS strategy required more resources than the routinely managed chest cases at the studied units. Recurrent cost was the most important element in the calculation of the final cost per outcome ratios especially those of drugs and chemicals followed by the annualized capital and personnel costs. We recommended the decision makers to conduct more studies at the different geographical areas and service delivery modes to get the full picture of DOTS strategy implementation in Egypt for future development and improvement.

Background: According to the prevalence of tonsillectomy, this study was performed to evaluate the complications in patients that had referred between the years 1989 and 1998.Materials and Methods: This was an observational retrospective study performed on 4042 patients who underwent tonsillectomy during 10 years. (From those, 2708 cases underwent surgery in one center and the remaining 1324 cases underwent tonsillectomy in another center by otolaryngologists). Records of the patients in both groups were surveyed in regard to complications.Results: A total number of 113 (2.79%) patients had complications. Complications were mostly seen in the age group of 5-9 years. The most common complication was bleeding which occurred in 59 patients (1.46%). Other complications in order of prevalence were clot formation or hematoma in the tonsillar fossa, tongue and soft palate edema, airway obstruction, hoarseness, persistent vomiting, infection of the parapharyngeal space, dental complications, remaining of a broken needle in tonsillar fossa, and death.Conclusion: According to the high prevalence of tonsillectomy in our country and high rate of bleeding and its related risks which may even lead to death and also the role of skill and attention of the surgeon and anesthesiologist during surgery and postoperative care in recovery room and in the ward, it is recommended for the surgeon to consider all of the related cares and perform surgery after acquiring the necessary skill with the help of an expert anesthesiologist to minimize the complications.

Pleuropulmonary blastoma (PPB) is a rare and aggressive tumor that is emerging as a distinct entity of childhood disease .It is characterized by mesenchymal elements (including undifferentiated blastoma and often cartilaginous, rhabdomyoblastic, or fibroblastic differentiation) and epithelium-lined spaces. PPB may be exclusively cystic (type I), solid (type III) or both solid and cystic (type II).A 5-month-old boy presented with a history of fever and respiratory distress. Chest radiograph and subsequent CT scan showed a large soft-tissue density occupying the left chest cavity. Radical resection of the mass was achieved by lobectomy. Histologic examination revealed PPB (type II).