Internal Medicine Today
Year:2008 | Volume:13 | Issue:4|Papers Count:11

Acquired immunodeficiency syndrome (AIDS) is caused by a lenti virus named human immunodeficiency virus (HIV).HIV was first discovered in 1981 and since then millions of people worldwide have died from the disease. In Iran thousands of people are found to be HIV+ and the number is growing up every day. The major cause of mortality among AIDS patients are opportunist infectious agents and different types of cancer due to severely deficient immune system. Advances in molecular biology within last two decades have lead to a better understanding from molecular structure and pathogenicity of HIV, which promises efficient therapeutic ways to cure the disease in near future. In present article, first we discuss molecular structure and biology of HIV, its genome, life-cycle and pathogenicity. Then we go through molecular details of immune system responses against the virus and mechanisms by which HIV suppresses immune system: like evasion from antibody, cytotoxic T lymphocytes, antibody- mediated neutralization, reduction of major histocompatiblity complex (MHC), and destruction of CD4+ helper T cells.

Background and Aim: The incidence of diabetes is increasing and the prevalence of diabetes is approaching epidemic proportion in many developing countries in Middle East including Iran. The prevalence of type 2diabetes in Iran is 4-4.5% and in population aged above 30 years is greater than 14%.The aim of this study is determine the quality of life of diabetic patients.Materials and Methods: This was a quasi experimental study, that the subjects in the present study were type 2diabetes patients with range 25-75 years old. 120 individuals were randomly selected from the list of the referee patients of the Diabetic Research patients of Yazd. They were divided into two groups: case group (60persons) and control group (60 persons). The health related quality of life was measured with SF-20 questionnaire. The education as intervention factor was performed using face- to- face and group teaching methods to case group. All data which were collected before and after intervention (two months after education) were transferred directly into SPSS. For data analysis, ANOVA, t test and were used.Results: The mean duration of diabetes of patients was 9.87±7.2 years. 8.3% patients the quality of life of 32.46% of samples was low, QOL of 32.46%of them was medium and QOL of35.08was high. There was significant difference between the job, sex, education and having the neuropathy, retinopathy in case group, before and after intervention (P<0.017) .But there was not significant difference between those variables in control groups, before and after interventionConclusion: Diabetes requires the patients to self-manage their disease and is a life-time struggle to maintain and increase QOL. Treatment plans that inherently improve or include strategies to enhance patients' QOL may increase compliance, thereby improving these patients' metabolic status .Using a standard questionnaire that can determine the needs of patients is best methods for controlling of disease and reduce their disabilities.

Background and Aim: In recent years, fungal systematic infection due to pathogenic yeast have been considered as the most important causes of dead . Current antifungal therapies using routine antifungal drugs have not completely effective,. .In last decade, different formulations of combined antifungals have tested against some pathogenic fungi which shown good synergistic effects. In present work, antifungal effects of some azoles e.g .fluconazole (flu). Itraconazole (it) and ketoconazole (kcz) were studied in intact forms and also in combinations to each other against some pathogenic yeast including Candida albicans PTCC5057,Candida dubliniensis CD36,Cryptococcus neoformance CNE1 and Malassezia furfur MF1, invitro.Materials and Methods: In present work, antifungal effects of some azoles e.g .fluconazole (flu). Itraconazole (it) and ketoconazole (kcz) were studied in intact forms and also in combinations to each other against some pathogenic yeast including Candida albicans PTCC5057,Candida dubliniensis CD36,Cryptococcus neoformance CNE1 and Malassezia furfur MF1,invitro. The microdilution method was used for assessing antifungal susceptibility of above-mentioned compouneds in two culture media sabouraud dextrose broth (for all fungi except M.furfur) and modified Dixon broth (for only M.furfur). MIC and MFC values were calculated for each compound based on comparing colony counts of test and control samples.Results: On the basis of obtained results, all drugs were inhibited the growth of all fungi tested in a dosedependent manner. MIC ranges of Flu,It and Kcz for C.albicans(1-256,0.5-16,0.5-64microgram/ml),Candida dubliniensis (0.5-32,0.125-8,0.5-8 microgram/ml), C. neoformance (0.5-64,0.125-32,0.25-64 microgram/mL) and M. furfur (1-128,1-64,0.5-32 microgram/mL) were obtained, respectively.Results: Our results showed that the most effective drugs against Candida dubliniensis were Itraconazole and Fluconazole in intact forms and in combination to each other. Fluconazole and Ketoconazole in combination to each other are the most effective drugs against Malassezia furfur and Cryptococcus neoformans. Also Ketoconazole and Itraconazole in combination to each other are the most effective drugs against Candida dubliniensis, Cryptococcus neoformans and Malassezia furfur (P<0.05).

Background and Aim: Opioids consumption during pregnancy increase abortion. But the mechanisms that opioids increase abortion have been remained as a question. One of the mechanisms that may be caused to increase abortion is placental histological changes during pregnancy. The aim of this study was to determine histological changes after morphine consumption.Materials and Methods: Forty intact adult female Balb/c mice with two months-age, weighing 30-35 gr were used in this study. The animals were maintained at the animal house under controlled conditions (12 h light and dark cycle, 21oC and 50% relative humidity). Then they were mated overnight with 20 fertile males of the same strain. The day on which spermatozoa were found in vaginal smear was designated as embryonic day 0(E0). The pregnant mice were divided in 4 groups (2 experimental and 2 control groups). Experimental group 1 was received daily 10mg/kg morphine for 10 days and Experimental group 2 was received daily 10mg/kg morphine for 15 days. In Control grope, mice were injected 10mg/kg normal saline parallel to experimental grope as a placebo. After this, in both control and experimental gropes, mice were anesthetized and placentae were removed from the body. Then they were fixed in formalin for 48 hours. After routine histological processing and embedding in paraffin, all the specimens were cut in to 5 mm thickness sections and stained by Hematoxylin-Eosin. Then specimens were observed by light microscopy and photographs were taken.Results: In experimental group1, two pregnant mice were died and one abortion was occurred. In experimental group 2, four mice were died and also two abortions were occurred. In control groups neither die nor abortion occurred. In experimental group 1 disruption of the placental villi was irregular and fibroblast cells were increased. In experimental group 2, intensive necrosis was seen.Conclusions: Our research was showed that abortion; histological changes in placenta and significant neonate mortality rate and nervous system defect may be occurred after morphine consumptions.

Background and Aim: Leishmaniasis caused by compulsory intercellular parasite of leishmania. Suitable immunity for this infection is cellular immunity that depends on CD4+ T cell. Vaccination is a suitable way for controlling the disease and autoclaved leishmania major is a suitable choice for preparation of vaccine against this disease.Particulate drug delivery systems such as microspheres increase the immune response against encapsulated antigen and have immunoadjuvant potential. Alginate microspheres have been used for vaccination in several imunisation studies. Saponins have also shown high immune stimulation potential both for Th1 and Th2. CpG-ODN can be used as an immunity adjuvant for vaccines for increasing the immune responses.Materials and Methods: In this investigation various formulations of ALM (free or encapsulated in microsphere) with saponin and CpG-ODN adjuvants have been studied to find the best formulation for leishmaniasis vaccine. Also various formulations of ALM (free or encapsulated in microspheres alone or with CpG-ODN or saponin) were injected to balb/c mice. S.C. immunizations were repeated three times in three weeks intervals. For challenge test, after the last immunization, 106 live promastigotes were injected to the left foot pad of mice and foot pad thickness was recorded until 70 days. Serum antibody titers were determined three weeks after the last immunization by an ELISA method. For cytokine assay, the spleen lymphocytes were incubated with recall antigens and IFN-g and IL-4 titers were determined in culture supernatant with a sandwith ELISA method.Results: Results of this investigation showed that saponin and CpG have immunoadjuvant property in leishmania vaccine.(ALM)+SAP showed better result in immunostimulation (P<0.001). Addition of saponin and ALM in microsphere (ALM+SAP) increased the concentration of IFN-g but didn’t have significant effect on concentration of IL-4 (P>0.05). Encapsulation of ALM and CpG in alginate microspher showed higher concentration of cytokines than CpG solution (P<0.001).Conclusion: So that we can not choice one of these adjuvants is better by results of this investigation and investigation must be continue for better result and selection one of this adjuvant.

Background and Aim: The high rate of domestic violence is the obvious answer for new researches in this case. So this study was to examine possible correlations between domestic violence during pregnancy, and maternal complications, types of delivery and birth weight.Materials and Methods: 400 women without a history of psychological or medical disorder or medial and accident injuries delivering their babies at Zainabieh and Hafez hospitals, Shiraz University of Medical Sciences were asked to complete a questionnaire consisting of questions in regards to demographic characteristics, history and complications of previous and current pregnancy and domestic violence questions.Results: The rate of psychological, physical, social, economical, and sexual violence were 47.5%, 22%, 13.5%, 23% and 22.3%, respectively. There were significant correlations between such violence, and vaginal bleeding, hospitalization, preterm delivery, emergency cesarean section and low birth weight.Conclusion: The findings indicate that domestic violence might led to complications of pregnancy and low birth weight. Therefore measure to reduce such violence is vital to pregnancy and its outcome..

Background and Aim: At present, a high percent of older adults (86%), have at least one chronic conditions and functional decline caused by them could increase falling that leads to functional decline and psychosocial consequences. This study aimed to determine the prevalence of fallings in older adults and it's relation with chronic conditions in Khoramabad.Materials and Methods: The sample size of this cross-sectional study was 400 people aged 60 or older, living in Khoramabad in 2007. Sampling was done by multi-stage clustering method. The structured questionnaire was applied for data collection; contains demographic data, having chronic conditions and falling in recent year and was completed by reporter. Data was analyzed using SPSS 15 using descriptive statistics, Chi- square test and Mann- Whitney test.Results: The prevalence of falling for older people living in Khoramabad was 24.8%. In the other words, one out of four experiences a fall during a year. The findings suggested that the most common chronic diseases in Khoramabadian elders were arthritis, vision impairments (glasses) and hypertension respectively. Also, we found chronic conditions such as arthritis, stroke, vision impairments (glasses), disorientation, depression and chronic obstructive pulmonary disease, (urinary and fecal) incontinence increase the risk of falling.Conclusion: The findings of this study suggested that the effects of chronic diseases can increase the risk of falling. At last, modifying environment according with physical and mental status, using suitable assisted devices, cognition of older people that may be at risk, using hip protectors, family/patient education about strategies of preventing of falls and the ways of decreasing risk of falling are important. Also community based social services should be provided.

Background and Aim: One of the indicators of development in a country is allocation of pure percent than impure production to research. The purpose of this study is to determine the reasons why the results and findings of nursing researches have not been applied effectively.Materials and Methods: This survey is an analytical-descriptive research intended with methods include a questionnaire for demographic information associated with the executing of the research project together with a questionnaire for evaluating the problems existing in preparing and creating research proposals and a checklist for working on the nursing dissertations in order to make them practical. The research units in this survey consist of 40 nursing professors from Nursing colleges as well as 40 dissertations done by M.S. nursing students between 1992- 2001.The research fields were Nursing Faculties of Tehran University, Shahid Beheshti University, Iran University, Sabzevar University and referral of the subjects to the research field and sampling was performed by 40 of the professors.Results: The samples were 17.5% male and 82.5% female with age 43.38 year that 72.5% were Instructor School of Medical Sciences. Average work was 15 years in education, 5 years in research and 7 years in hospital. The main problems in this case included lacking a comprehensive and sufficient description of the findings obtained from nursing research and do not delivering them to the relevant authorities (85.5%), deficiencies and shortages in team research (80%), lack of funds because of costly and time-consuming nature of this type of research (80%).Conclusion: Conclusions showed that the main challenge is research priorities which are not defined and researchers who do not know how to do all practical researches. So it proposed to the strategy council for practical researches associated with governmental and non-governmental institutions to solve this challenge and to plan essential policies.

Background and Aim: To consider the importance of self esteem on students and knowing that self esteem is the causes of transaction with others, also it causes positive self imagination and a good self concept which causes student successfulness, this study with the aim of measuring the effectiveness of enhancing self esteem.Materials and Methods: In this semi-experimental study which was designed on 2006, random sample selection methods and educational intervention of "Enhancing Self Esteem" applied. Sample included of girls students of one of the school selected randomly from western areas of Tehran city. Case group included of all the students of a class (29 students) and another class as a control group (31 students). Pretest conducted with the all students in the beginning and after 9 weeks interviewed. Then the educational program in 18 sessions and in 9 weeks included of theoretical and workshop education to show the correct behaviors in the areas of appreciating yourself, control anger and taking responsibility carried out. After 6 months, post test performed and the data analyzed by SPSS soft ware and statistical test such as t, chi-square and logistic regression applied (P=0.05).Results: Statistical analysis of pre and post test showed that education significantly improved self esteem of the students (P<0.05). The differences between the growth rate of self esteem in control group during half a year was 1.1± 3.6 and in case group during educational intervention 4.3±3.7 and this is statistically significant (P<0.000). Case group in compare with the control group have had a positive and successful increase.Conclusion: To conclude research results show the effective and positive role of educational intervention on improving self -esteem of the grade one students.

Background and Aim: Infertility is a significant cause of anxiety among couples at the beginning of their life. This problem is not only a disappointing agent but also a destroying one that is effective on male or female personality evolution and their identification. This is to study the prevalence of women infertility, both primary and secondary in rural and urban areas of Gonabad and some demographic factors in a given population of women.Materials and Methods: An interview-questionnaire was used in this cross- sectional study in 2006. Our samples were 380 married women in age (15-49) who lived in Gonabad city. Method of women selection was in two stages, at first stage stratified sampling and at the second stage systematic method was used. The analysis of data was performed by SPSS. (p£0.05)Results: Among the 380 women contacted, (88.1%) reported no difficulties in having children. The prevalence of infertility was 11.9%. 6.5% women had primary infertility and 5.4% had secondary infertility. The prevalence of infertility in Gonabad city was 12.8% and in rural area it was 11.4%. There was not a significant difference between demographic data of women and period of menstruation.Conclusion: The prevalence of infertility in Gonabad city was 11.9% which is different with other studies, so it is necessary to survey in the case of etiology and other infertility factors.