Journal of Advances in Medical and Biomedical Research
Year:2012 | Volume:20 | Issue:80|Papers Count:17

Background and Objective: Pseudomonas aeruginosa is an opportunistic pathogen that causes severe and lethal infections in immunocompromised individuals. This bacterium possesses a single polar flagellum. Flagellum and its subunit Flagellin play important roles in the pathogenesis of P. aeruginosa. Flagellin induces immune responses by interaction of its N-terminal domain with TLR-5. Our main aims of this study were cloning and expression of N-terminal domains of flagellin and evaluation of antibodies raised against it on motility inhibition of P. aeruginosa.Material and Methods: The DNA sequence coding for the first 161 amino acids of flagellin was PCR amplified and cloned into a pET-28a expression vector. Recombinant protein was over expressed in BL-21(DE3), and purified by Ni-NTA resin. The immune reactivity of recombinant truncated flagellin was evaluated by Western blotting. The recombinant protein was injected into a rabbit and antibodies raised against it were evaluated for the cell motility inhibition of P. aeruginosa 8821M.Results: The N-terminal domain of Flagellin was successfully overexpressed in Escherichia coli BL-21(DE3) host strain. Anti-native and anti-N-terminal flagellin antibodies reacted with the recombinant protein. Motility inhibition assay demonstrated that polyclonal antiserum against N-teminal flagellin is able to inhibit the motility of P. aeruginosa 8821M.Conclusion: The N-terminal domain of flagellin may be used for development of a new recombinant vaccine against P. aeruginosa infections.

Background and Objective: Brucellosis is an endemic disease in Iran that has a worldwide spread and is associated with chronic disabilities in humans. Combination therapy of brucellosis leads to recovery of symptoms, shortening of the symptomatic intervals, and decrease in the rate of relapse and drug resistance. Considering the use of rifampin in the treatment of tuberculosis, and the necessity for an alternative treatment in regions endemic for both tuberculosis and brucellosis, in this study we compared the efficiency of the WHO's standard regimen of rifampin-doxycycline (RD) versus ciprofloxacin-doxycycline (CD) for the treatment of brucellosis.Materials and Methods: This randomized controlled trial was performed on 90 patients, affected with brucellosis, who were referred to the Infectious Disease Clinics at Arak University of medical sciences. The patients were randomly divided into two groups: the DR group, received 100 mg of Doxycycline twice a day and 300 mg of rifampin Bid daily for eight weeks; and the CD group, received 100 mg of doxycycline plus 500 mg of ciprofloxacin twice a day for eight weeks. The patients were analyzed for the relief of symptoms, drug side effects, and laboratory findings during the treatment.Results: In this study, the rate of symptom relief and laboratory findings in both groups were similar. The relief of symptoms was seen in 93.2% and 83.9% of the patients for the DR and CD groups, respectively (P=0.182). The side effects of the drug were not significant in either groups, with no significant difference, and did not lead to discontinuation of the therapy.Conclusion: Due to the similar efficacy of CD and DR regimens in the treatment of brucellosis and considering the usage of rifampin in regions with high prevalence of tuberclusis, the CD regimen is recommended as an appropriate treatment.

Background and Objective: Subsequent to spinal cord injury (SCI), many pathological changes may occur that could lead to inappropriate conditions for repair. The most important of such changes include the death of neurons, cyst formation, glial scar, and ineffectiveness of monocytes. Adult stem cells and monocytes may provide new strategies to treat SCI. Among various types of candidate cells, bone marrow stromal cells (BMSC) and monocytes are promising because of their potential for neuronal differentiation and repair. In this study, we aimed to compare the effects of BMSC versus monocyte treatments in a rat SCI model.Materials and Methods: Rats were divided randomly into three groups of six. The SCI was inflicted usingthe weight dropping method. The BMSCs and monocytes were injected on the 4th day of post SCI. Group one included rats receiving normal saline, group two received BMSCs, and group three received monocytes. Following the injections, a Basso, Beattie and Bresnahan (BBB) score test was performed for a period of four weeks. Two weeks before the end of BBB, biotin dextran amine was injected intracerebrally followed by tissue staining at the end of the fourth week.Results: There was not a significant difference in the BBB scores between the groups. There were significant differences in axon counting between group one and other groups (p<0.0001). However, there were not significant differences in axon counting between groups two and three.Conclusion: BMSCs and monocytes are promising candidate cells for the repair of SCI. In this study, the scoring was carried out for 4 weeks. It might be better to continue the evaluation for a longer period.

Background and Objective: Gastric cancer is a common cancer in East-Azerbaijan (Northwest of Iran). In a community with high rates of gastric cancer, dyspepsia may be a symptom of a serious problem. The main aims of this study were to evaluate the gastric mucosal changes in dyspeptic patients from Azerbaijan and to compare it with similar patients from Hormozgan (a community with low rates of gastric cancer in the South of Iran).Materials and Methods: In this analytic-descriptive setting, 191 patients with dyspepsia were evaluated at the Tabriz Liver and Gastrointestinal Diseases Research Center. Upper endoscopy was done in all patients and biopsies were obtained from 5 different points of the stomach, followed by histopathological assessments.Results: A total of 101 patients from Azerbaijan (so-called Azari) and 90 patients from Hormozgan (so-called Bandari) were enrolled. Endoscopically determinable lesion was significantly more frequent in the patients from Hormozgan (68.3% case vs. 81.1% control x2test; P=0.03). HP infection was determined in 69.3 and 84.1 percent of the patients from Azarbayjon and Hormozgan, respectively. Active chronic and chronic gastritis were found in 72.3% and 23.8% of Azari group and 73.6% and 25.3% of Bandari group. In those patients with gastritis, corpus predominant or pangastritis was more common in the Bandari group (64.1% Azari vs. 83.3% in the Bandari). Chronic gastritis (Mean scores 10.96±2.8 Bandari v 8.5±3.2 Azari, P<0.001, u=2494) and active gastritis (Mean scores 7.6±5.7 Bandari vs. 3.4±3 Azari, P<0.001, u=2572) were severe in the Bandari group. No cases of displasia and adenocarcinoma were detected.Conclusion: Our findings show that endoscopically determinable lesion, HP infection, chronic and active chronic gastritis of gastric mucosa, and the corpus predominant or pangastritis were more common in the patients from Hormozgan.

Background and Objective: Gastric cancer (GC) is one the most common causes of death worldwide. Despite the decreasing rate for GC in the world during recent years, it remains the most common cancer in our country, especially among men. This study aimed to assess the survival of the patients with GC and to determine the risk factors involved.Materials and Methods: A total of 400 patients with GC in the Cancer Institute of Imam Khomeini Hospital, were entered in the study during 2003 - 2007. Patients were followed up through periodical referrals and hospital visits and/or phone calls. The survival time was considered as the time period from diagnosis to either death or the end of study. The effects of various risk factors such as gender, age at diagnosis, tumor site, pathologic stage, type of treatment, and tumor size were evaluated by Cox Proportional Hazard (PH) model. Data were analyzed using SPSS16 statistical software.Results: Of the total of 400 cases studied, 303 (75.8%) were males. About one third of the patients (130; 32.5%) experienced death. The survival mean and median were 41.8±3.1 and 26 months, respectively. The percentages of one-, three-, and five-year survivals were 74%, 31% and 23%, respectively. Gender, age at diagnosis, pathologic stage, and tumor size appear to be the most significant factors affecting the survival rate among GC patients.Conclusions: The majority of the risk factors, affecting the survival rate in this study, were related to the delayed diagnosis. Therefore, it seems that if the cancer is diagnosed at early stages, it may lead to better prognosis.

Background and Objective: Photodynamic therapy is a treatment that uses photosensitizer and intense visible light. When photosensitizers get exposed to a specific light wavelength (preferentially in the red region), they produce reactive oxygen species that are toxic to cells. Recently, attention has been focused on porphyrins and their analogs as photosensitizers. Zn (II) tetrapyridinoporphyrazin complex is a water-soluble photosensitizer that has a good potential for application in photodynamic therapy. In this study, phototoxic effect of this complex on HeLa cancer cell line has been investigated.Materials and Methods: HeLa cell cultures were treated with different concentrations of Zn (II) tetrapyridinoporphyrazin. The cytotoxic effects were measured both in the presence and absence of light using the MTT assay. The light source was a 150W tungsten halogen lamp equipped with a red filter.Results: Our data indicate that porphyrazine’s photocytotoxicity is remarkably more significant than its cytotoxycity in the dark. Statistical analysis showed the effective dose (ED50) values in the dark and light conditions were 8.6 and 4.2 mM, respectively. In addition, the results imply that in the range of 0-12 mM, the increase in the complex concentration correlates with the increase in the cytotoxicity effect. However, the cytotoxicity decreases at the higher concentration (50mM), which is likely due to aggregation of the complex.Conclusion: Our results show that Zn (II) tetrapyridinoporphyrazin complex may be a promising photosensitizer for innovative photodynamic therapy and may have a high potential application in cancer treatment. Furthermore, it seems to have more benefits compared to other known photosensitizers.

Background and Objective: Epidemiological studies indicate that not only the incidence of fungal infections is dramatically on the rise, especially in the immunocompromised hosts, but also the sensitivity of etiological agents to antifungal drugs shows a remarkable reduction. Therefore, early detection at the species level is critically important for proper clinical management. Because standard diagnostic procedures are time consuming, expensive, and less sensitive, PCR-based molecular techniques have been developed. In the present study, we aim to describe a rapid and sensitive technique based on the rolling circle PCR amplification for accurate and fast identification of Cladophialophora carrionii vs. C. yegresii.Materials and Methods: Specific padlock probes were designed based on a single nucleotide polymorphism (SNP) difference in the internal transcribed spacer (ITS) rDNA region of Cladophialophora strains to differentiate between C. carrionii and C. yegresii. The probe sequences are complementary to the target DNA leading to the linker position that after hybridization with the target DNA will be joined together by DNA ligase, form a closed molecule and hybridize to the target DNA for replication at single-temperature conditions.Results: We successfully amplified the target fungi DNA at the species level without any false and negative cross reactivity. The RCA product was visualized on 1.5% agarose gel to clarify the specificity of the probe DNA template binding.Conclusion: These results demonstrate that RCA is a powerful and accurate tool for discrimination and identification of pathogenic fungi.

Background and Objective: Aggressive periodontitis is a destructive disease that leads to a quick and extensive periodontal tissue loss. Mast cells are known to play important roles in allergic reactions, host defense against bacterial infections, local homeostasis, inflammation, and angiogenesis. The aim of the present study was to evaluate the relationship between mast cell numbers and aggressive periodontitis.Materials and Methods: A descriptive analytical and blind study was designed and gingival specimens from 19 moderate to advanced aggressive periodontitis sites (case group) and 18 gingivitis sites (control group) was taken during flap and crown lengthening surgeries. Toluidine blue and Hematoxylin Eosin staining were done for mast cell counting and inflammation assessment, respectively. Inflammatory and mast cells in 5 micron sections were assessed by two trained observers utilizing light microscopy. ANOVAs and T test with an alpha error level less than 5% were used to analyze the data.Results: The mean values of the mast cell numbers were 7.6±10.8 and 9.8±13.0 in aggressive periodontitis and gingivitis sites, respectively. There were no statistically significant differences among the mast cell counts, clinical attachment loss, or pathologic inflammation (P> 0.05).Conclusions: The present study indicates that mast cell numbers were not significantly different between aggressive periodontitis and gingivitis. Further studies are required to evaluate dynamic aspects of host defense.

Background and Objective: The high levels of sensitivity and job stress for nurses require a necessity of voluntary extra-role behavior known as customer oriented citizenship behavior (COCB). The aim of this research was to examine the influence of the most important factors on COCB in nurses.Materials and Methods: In this cross-sectional study, data were gathered by a questionnaire from 198 employee nurses at Imam Reza Hospital in Mashhad, Iran. In order to test the relationship, the structural equation method was used.Results: Our results were in agreement with the significant impact of procedural justice, distributive justice, job satisfaction, and organizational commitment on external representation and internal influence, as the two elements of COCB. The effect of interactional justice on internal influence and the third element of COCB, service delivery, were also approved.Conclusion: In comparison to other dimensions of organizational justice, the procedural justice has the highest impact on job satisfaction and organizational commitment and through them on COCB. Therefore, organizational policies and procedures should be devised in a way that nurses find them fair and indiscriminating.

Background and Objective: Caesarean sections are the most common surgery in obstetrics and gynecology. However, like any other surgical procedures, they have some disadvantages. Nowadays, unfortunately, Caesarean sections are not carried out necessarily to save the mother and/or the baby, and due to excessive applications they have become a problem worldwide. The aim of this study was to determine the related causes of Cesarean delivery in Zanjan.Material and Methods: In this descriptive cross-sectional study, a total of 697 mothers were selected through random sampling. A questionnaire was completed by each participant and the collected data were analyzed using descriptive statistical methods, including chi-square test, Fisher exact, ANOVA, and multivariate logistic analysis.Results: According to our analysis, the recent rate of the Cesarean in Zanjan was about 43%, out of which 43% were elective. The majority of the cases (57.8%), were repeated Cesarean sections and most mothers chose Cesarean because of either fear of pain or for termination of the pregnancy (43.3%). In the present study, the Cesarean section rate correlated significantly with the level of education in mothers (P<0.0001) and family financial status (P=0.01).Conclusion: According to our analysis, promoting public awareness and also efforts towards applying Cesarean sections in only necessary cases could reduce the rate of cesarean in general.

Background and Objective: Childbirth is an important event during a woman’s life and the second stage of labor is extremely painful. There are disagreements regarding the most appropriate position during this phase. The main aim of this study was to compare the effects of different positions during the second stage on the length of labor.Materials and Methods: A randomized clinical trial was designed for women who were referred to the Taleghani Hospital in Arak between the years 2009-2010 for delivery. The inclusion criteria were set as women being primiparous and singleton, within the gestational age of 37-42 weeks. Demographic data and BMI forms were completed for the participants, and after signing the consent forms, they were randomly allocated to three groups: group1, lithotomy position (n=49); group2, squatting position (n=49); and group3, kneeling position (n=50). All participants were laid in their respective positions after full dilatation and effacement until the crowning stage of the fetus. The times between full dilatation and effacement until the crowning stage were measured by chronometer and Apgar score.Results: A total of 148 women with the mean age of 24.35±3.36 years participated in the study. We found no significant differences in the mean duration of the second stage of labor among the 3 groups: 49.02±26.31, 50.97±25.68, and 52.71±26.52 minutes for lithotomy, squatting, and kneeling positions, respectively). The rates of the cesarean sections in lithotomy, squatting, and kneeling position groups were 5.76%, 7.54%, and 9.1% respectively. These differences were not statistically significant. There were also no significant differences in 1- and 5-minute Apgar scores between the 3 groups.Conclusion: Although in contrast to some other studies, we did not find a significant correlation between different labor positions and the duration of the second stage of labor, it seems advisable to select the most comfortable position per case basis so that women feel the least pain and are provided with the maximum comfort and calm possible.

Background and Objective: Patients with idiopathic scoliosis often have hypokyphosis in their spines, but some patients may exhibit an increase in kyphosis instead. The aim of this study was to define the effect of the kyphosis on the flexibility of scoliotic curves.Materials and Methods: A total of 100 cases of idiopathic scoliosis were studied with standing posteroanterior and lateral radiographies of the entire spine. Based on the degree of kyphosis, cases were classified into two groups and compared statistically.Results: Group 1 included 61 cases with less than 50 degrees of kyphosis, and group 2 included 39 cases with equal or more than 50 degrees of kyphosis. The average of scoliosis in group 1 was 57.5 degrees compared with 51.3 degrees in group 2, and the averages of the flexibility index were 57.1 vs. 52.7, respectively. The two groups were also compared according to the standing and supine bending scoliosis, flexibility index, and the correlation between kyphosis and flexibility index. There was neither a significant correlation between the kyphosis and scoliosis curves (P>0.05; r<0.5) nor in the flexibility of scoliosis curves between the two groups (P=0.23).Conclusion: In our study, the presence of kyphosis seems to have no impact on scoliosis curves in patients with idiopathic scoliosis.