Journal of Ilam University of Medical Sciences
Year:2006 | Volume:14 | Issue:3|Papers Count:12

Introduction: Vancomycin resistance in Enterococci has become of great concern in public health, since the increase of prevalence of these organisms inside and outside the health care settings including urban sewage treatment plants have been documented. Materials & Methods: In this study, we isolated vancomycin resistant Enterococci strains from wastewaters. After identification and susceptibility testing of the isolates, PCR assays were used for detection of vanA, vanB, vanC1 and vanC2/3 resistant genes. Results: As a result, 53 VRE strains were isolated and identified as vancomycin resistant Enterococcus faecium. Antimicrobial susceptibility revealed that all the isolates were multidrug resistant and 98% of them had high level of vancomycin resistance. Molecular analyses revealed that all proved the presence of vanA gene, while vanB was detected only in 15%. But non of them had vanC1 and vanC2/3.Conclusion: Due to the possibility of resistance prevalence of van genes, more care should be taken to control the sewage systems and elimination of resistant organisms especially multi drug resistant VRE and prevent the transmission of their resistant genes to other Enterococci.

Introduction: Inspite the fact that applying high doses of chemotherapeutic drugs is a successful way to manage patients with cancer, this management reduces the level of immunity. Decrease in neutrophilic cells has caused serious infections and increased mortalities. Thus, This investigation was done to study the prevalence and etiology of fever in hospitalized patients with fever and neutropenia in Baqyiatallah hospital. Materials & Methods: This descriptive cross-sectional study was carried out on 95 hospitalized patients with fever and neutropenia in Baqyiatallah hospital in the decade from 1995 to 2005. Results: 44.2% and 60% of patients were documented microbiologically and clinically for infections. Most common sources of infection in patients were Pulmonary (17.9%) and urinary tract (10.5%) infections. In 29.5% and 7.4% of infectious cases, gram-negative and positive bacteria were isolated respectively.Conclusion: Unlike the most previous reports Mentioning gram-positive bacteria as a main cause of fever in these patients, in current study Escherichia coli proved to be the most common organism isolated.

Introduction: phosphatidate phosphohydrolase (PAP) catalyzes the dephosphorylation of phosphatidic acid to yield Pi and diacylglycerol. Two forms of PAP in rat hepatocyte have been reported. A cytosolic form (PAP1) that is responsible for glycerolipid metabolism and requires Mg2for its activity. Another form (PAP2) is primarily involved in lipid signaling pathways which dose not need Mg2+. It has two isoforms; PAP 2a and PAP2b. Little information is known about enzymological characterization of PAP2 especially its substrate. We investigated the enzyme behavior against Mg2+ structure- breaking agents (urea and guanidine HCl) with respect to its substrate. Materials & Methods: PAP2b was purified from rat hepatocyte membrane using a multi – stage chromatography. The enzyme activity was determined against La (lamellar) and HII (Hexagonal) forms of substrate in the presence of triton X-100. The effect of Mg2+ concentration and urea and guanidine HCl (structure- breaking agents) were examined on La to HII phase transition and enzyme activity. Results: PAP2b consumes La form of phosphatidate. Cations such as Mg2+ result in HII from La phase of substrate and therefore reduce enzyme activity. Urea and guanidine HCl increase enzyme activity due to prevention of HII formation. Both can also reduce the effect of cations on La to HII transition of phosphatidate.Conclusion: Since PAP2b consumes La form of substrate parameters can induce La to HII phase transition which result in low enzyme activity. In contrast, factors such as urea and guanidine HCl increase activity due to prevention of La to HII phase transition . As Mg2+ stimulates HII formation and the enzyme needs La form substrate, it can be concluded that, Not only does the enzyme need no Mg2+,but it is controlled by it too.

Introduction: Helicobacter pylori colonize in gastric mucosa and causes some disorders in upper gastrointestine. The clinical outcome of Helicobacter pylori infection may be associated with or without CagA. Materials & Methods: To investigate presence of CagA gene in Helicobacter pylori strains among patients with NUD, Peptic Ulcer and Gastric Cancer, 150 gastric biopsy specimens were taken. Biopsy samples were cultured on selective media under microaerophilic condition. After incubation period, the colonies were diagnosed by biochemical tests. Finally, using unique primers, CagA gene was investigated among the H.pylori strains. Results: Among the samples, H.pylori was isolated in 92 cases by culture method. After PCR method was done on culture positive samples,it was found that the prevalence of CagA gene in strains isolated from patients with NUD, Duodenal ulcer, Gastric ulcer and Gastric Cancer was 64.7% (22 from 34 cases ), 100% (28 from 28 cases), 90% (18 from 20 cases) and 100% (10 from 10 cases) respectively. In this study, there was a significant different between association of CagA gene in strains isolated from patients with peptic ulcer and gastric cancer (P<0.05), but this difference was not significant among strains isolated from NUD patients (P>0.05).Conclusion: According to the findings, it is suggested that presence of CagA gene in strains of Helicobacter pylori may play an important role in aggrovating disorders in Iran.

Introduction: Acinetobacters are non fermentative gram- negative bacteria involving in various nosocomial infections. These organisms as opportunistic pathogens are resistant to many antibiotics and cause various infections such as bacteremia, meningitis, pneumonia, urinary tract infections and surgical wound infections. Materials & Methods: During this study, 66 isolates of Acintobacter baumannii and 46 isolates of non- Acinetobacter baumannii were studied. After species were defined by chemical tests, antibiotic susceptibility of the isolates was tested by standard disk diffusion method. Results: The findings showed that all the Acinetobacter baumannii strains were resistant to Cefoprazone, Ceftizoxime, Ceftazidime, Ticarcillinl Clavulanic acid, Cephotaxime, Aztreonam, Meropenem, Cefixime, Ceftriaxone, Carbenicillin, Cephotaxime and Ticarcillin and sensitive to Colistin. Conclusion: It is concluded that clinical Acinetobacter isolates in general and Acinetobacter baumannii in particular enjoy high degrees of resistance to most the antibiotics, for example the third- generation cephalosporins and broad- spectrum penicillins.

Introduction: Physical methods such as combing, manual removal and haircut are old methods usually used to treat head lice. The current study was designed as a single blind, randomised, comparative clinical study to evaluate the curative rate of Themephus compared to that of GBHC which is a commonly used chemical insecticide to treat head lice, amongst the primary school children of Ham. Materials & Methods: We aimed to measure the effectiveness of these treatments under realistic conditions, as used by people in practice following the recommendations of the manufacturers. The participants were 50 school girls allocated in two groups of 25; each group received one medication compared to a group of 176 individuals as control group without any medication. The impact of insecticides on adult and nymphal lice was evaluated 24 hours post treatment while their ovicidal impact was assessed after one and two weeks respectively. Results: The cure rate of Themephus on adult and nymphal lice was 92 percent while that of GBHC was 100 percent. The ovicidal efficacy of GBHC was 84 and 68 percent one and two weeks post treatment respectively while that was 84 and 80 percent for Themephus. There was no significant difference between the two methods of treatment but a significant difference was found for case and control groups (P= 0.000). Conclusion: As no important side effects were found in treatment with Themephus and this chemical treatment was more effective in treating both the adult and nymphal lice over GBHC and since there is a probability of resistance to GBHC, Themephus could be an appropriate alternative for GBHC in treatment of head lice.

Introduction: Myocardial infarction is known as a complication of coronary artery disease which is the first leading cause of death among people of well- developed countries. In USA, nearly 1.0 million patients with suspected acute MI are admitted each year. This study was performed to determine the epidemiology and prevalence of risk factors and mortality of patients with acute MI. Material & Methods: This retrospective ,descriptive , analytic study was performed on the charts of 1466 patients admitted at Shahid Beheshti hospital of Kermanshah during 1998-1999 with a discharge diagnosis of acute MI. Infarction was established with new ECG changes along with increasing CPK and LHD level. The collected data was analyzed with descriptive statistical methods. Results: Of all the 1466 subjects, 1038 (%70.9) were men and 428 (%22.1) women: Acute MI was more common in men (71 %). Smoking was the first common risk factor ( 45% ) and hypertension was the second (33%) HLP %14 and NIDDM (%12). Antroseptal MI (49%)was the most common type of MI and total hospital mortality was 7/5% which is compatible with international statistics.Conclusion: Acute myocardial infarction is mostly associated with major risk factors of which smoking and hypertension are more common. Risk factor correction, life style modification and public education are strongly suggested as important factors in prevention of this fatal disease.

Introduction: As several parasitologic studies on normal population of Hamadan city during 1989-1999 indicated a high prevalence of Parastic infection in the area, this study was carried out to evaluate Parastic and Fungal infection of skin, digestive and reproductive tract in patients with mental disorders confined to bed in Sina hospital. Materials & Methods: To study parasitic infections, stool samples of 106 patients (78 males, 28 females) were collected and examined using direct and formol- ether methods.To evaluate skin fungal infections, samples of suspected lesions of 124 patients (31 females, 39 males) were gathered and tested using culture and direct methods. All the patients (124) were carefully examined for any infection with scabiei and pediculus humanus. Using swab sampling, 31 females were tested to be diagnosed if infected with parasitic and fungal infections. All the samples were tested through culture and direct methods. Results: The findings showed that 23.6% of the patients were infected with parasites, 4.71% with Ascaris, 2.73% with Trichuris trichiura and Iiymenolepis nana: 0.94%, Giardia lamblia: 7.49% and 3 cases of skin fungal lesions 2 cases of inguinal candidia, one case of onicomychosis. None of the cases were infected with trichomonas vaginalis, reproductive tract fungal infections, scabiei and pediculus humanus.Conclusion: The results of this study campared with the normal population of Humadan city show that the infection rate in psychiatric patients of Sina hospital (23.6%) is significantly less than the average rate of parasitic infection in normal population of Humadan city (50%). The important point regarding epidemiologic factors was the rate of infections that has a significant correlation with the patients period of confinement. So the rate of infection was relatively less in those who were confined to bed for a longer time.