Journal of Analytical Research in Clinical Medicine
Volume:3 Issue: 2, Spring 2015

The purpose of this research was to analyze blood-group antigen-binding adhesion (babA2) and sialic acid binding adhesion (sabA) genotypes status in Helicobacter pylori (H. pylori) isolates and their relationship with clinical outcomes.
Gastric biopsy specimens were homogenized and placed in Brucella agar medium supplemented with 5% sheep blood and 3 antibiotics and were cultured at 37 °C under microaerophilic conditions and incubated for 4-7 days. H. pylori was identified by typical morphology, gram-staining and urease tests, and babA2 and sabA genes were detected by polymerase chain reaction (PCR).
From a total of 100 H. pylori isolates; babA2 and sabA genes were detected in 23.0 and 26.4%, respectively. There was a significant relationship between these genes and clinical outcomes (P We found that the babA2 status was not related to clinical outcomes in Tabriz, Iran. However, sabA was a promoting determinant for disease, and multivariate analysis disclosed sabA to be an independent marker of non-ulcer diseases in our subjects.

Patients satisfaction includes the assessment of healthcare which she/he received. This study aims at assessment of mothers’ satisfaction with the care of maternal care in Specialized Educational-Medical Centers in obstetrics and gynecological disease in Northwest, Iran.
In an analytic-descriptive cross-sectional study, 1000 female patients who admitted in educational-medical centers of Northwest were studied during a 2 years period (2010-2012). They asked to fill a 34-item closed-answer questionnaire (ranking from very unsatisfied to very satisfied responses) following their discharge. Validity of the questionnaire was improved by gynecologist’s experts comments, and reliability of the questionnaire were assessed by test-retest methods (α = 0.946).
The satisfaction score (satisfied or very satisfied responses) were 61.2, 55.8, 61.8 and 59.5 percent for admitting process, primary care services, treatments and therapeutic interventions and overall, respectively. The satisfaction score for access to doctors was highest in the morning and lowest at the night shifts. The satisfaction score about the personnel’s behavior was lowest during the night shifts. The satisfaction score about the residents’ behavior was highest for the morning shifts. There was no significant difference between the three working shifts regarding psychological feelings, humanitarian respect, and issues like nutrition and private and public hygiene. There was a significant direct correlation between the mean score of satisfaction and patients’ age (Spearman’s rho = 0.117, P The satisfaction level of patients hospitalized in Northwest of Iran's Hospitals was intermediate. Planning new strategies in this regard with emphasis on the main limitations may improve the satisfaction rate in the future.

High risk of blood-borne infections is one of the problems of patients with chronic kidney disease (CKD), above which, there is hepatitis B. One of the ways to prevent this disease is vaccination against hepatitis B besides observing standard precautions. Lack of response to vaccine in uremic patients has been reported up to 33.0%. The aim of this study was to investigate the effect of levamisole as an adjuvant in improving vaccination response in patients suffering from CKD.
In this cohort study, 30 patients suffering from the chronic renal disease who had undergone levamisole plus hepatitis B vaccine were included in the study as exposed group (Group A). Then 30 equivalent patients who had just underwent hepatitis B vaccination were in the study as a unexposed group (Group B). Antibody titer against hepatitis B virus (HBV) was compared between two groups monthly, then data was analyzed.
Mean age of all investigated patients was 58.1 ± 14.9 years old, and it ranged from 26 to 82. 23 patients (38.3%) were female, and 37 patients (61.7%) were male. None of the patients in both groups had a history of previous hepatitis B vaccination. Mean antibody titer was higher in group A than that of the group B after the first and second stages of hepatitis B vaccination. However, the difference between two groups was not statistically significant (P = 0.14 and P = 0.46 respectively). Also, the mean antibody titer after the third stage was 98.8 ± 61 u/l in group A and 86.2 ± 49 u/l in group B where the difference between two groups was not statistically significant (P = 0.38). Side effects resulted from levamisole was not observed in any of patients in group A.
According to the results it is possible to express that levamisole pill could be used as a proper adjuvant in improving the response of hepatitis B vaccination in patients suffering from CKD. However, further studies in this field are recommended according to the lack of significant difference between two groups for confirming above mentioned point.

Human migration can transmit infectious disease like tuberculosis (TB) to recipient countries. The IS6110 is an insertion sequence used for strain differentiation of mycobacterium tuberculosis (MTB), epidemiological studies, and recent transmission. In this study, our aim was to investigate transmission TB from the Republic of Azerbaijan to Iran people.
Totally 119 isolates of MTB were collected from 14 patients from Republic of Azerbaijan and 105 patients from East Azerbaijan, Iran who referred to TB centers of the province. Isolates were analyzed by IS6110 restriction fragment length polymorphism (RFLP) typing. Isolates with identical RFLP patterns were considered a cluster.
93 distinct IS6110-RFLP patterns were revealed. 81 of these patterns were unique, and 12 were shared by 2-8 strains. 38 strains (31.9%) belonged to one of 12 clusters that were found among the total of 119 strains. One of these 12 clusters contained two Iranian patients with one Azeri patient.
Finding of the present study indicates that Azeri TB patients refer to TB centers of the province for treatment can transmit TB to East Azerbaijan people. Therefore, it needs to design a suitable program for TB control and decrease transmission of TB between these two countries.

Prevalence of depression in patients with diabetes is 2-3 times more than patients without diabetes. Hence, the aim of the current study was to evaluate the reliability and validity of Persian version of the 10-item Kessler Scale (K10) in assessment of mental health status among patients with type 2 diabetes in Ardabil, Northwest of Iran.
This cross-sectional methodological study was conducted in Ardabil on a total of 70 patients with type 2 diabetes. K10 was translated into Persian by backward-forward method, and content validity was evaluated by a panel of experts in the field of psychiatry, psychology and epidemiology. Concurrent validity examined by the correlation between K10 and general health questionnaire-12 (GHQ-12). The reliability and stability evaluated by Cronbach¢s alpha and intraclass correlation coefficient (ICC) (test-retest method). The total score was computed from 10-items, which were classified into four categories (well, mild, moderate and severe). The analysis was performed using SPSS the level of significance was set at 0.05.
The total average content validity ratio (CVR) and content validity index (CVI) were 0.88 and 0.95; correlation between K10 and GHQ-12 was significant (r = 0.63, P The Persian version of K10 is valid and reliable for evaluation of mental health status among patients with type 2 diabetes.

Trauma, due to stimulating stress responses like hormones, leads to increased blood sugar level (BS level), which worsens cerebrospinal and renal damages. Admission hyperglycemia associated with poor outcomes in severe traumatic injuries, therefore glucose control leads to improved outcomes and better prognosis of these patients. This study aims to analyze the impact of severity of spinal cord injury (SCI) (based on Frankel classification) on BS level in these patients. Furthermore, the effect of controlling the BS level in a normal range on improving the neurological outcomes [muscular force (MF)] was examined.
This is a cross-sectional study in which admission BS level of all SCI patient, were measured, and regular treatments were applied based on standard protocols. The recovery process of motor and sensory disorders was also examined in discharge and was evaluated with the primarily measured BS level. Besides, patients with high BS level (more than 200 mg/dl) underwent the insulin protocol, and the effects of glucose level control on the final outcome of SCI patients were evaluated.
Among the 380 patients enrolled in this study, 266 were male (70%) and 114 were female (30%). The mean age of patients was 35.84 ± 18-65 years old. The mean hospital length of stay was 5.98 days (from 3 to 14 days). The mean BS level in patients with MF of 0/5, 1/5, 2/5, 3/5, 4/5 and 5/5 were 169.8, 185.9, 177.3, 172.8, 117.5 and 118.0 mg/dl, respectively. The rate of MF changes was measured in hyperglycemic patients who underwent an insulin protocol.
As the SCI trauma becomes more severe, the BS level increases with a higher rate. Besides, there was a significant difference (P = 0.001) in MF of patients before and after the insulin protocol prescription.

Patients with Henoch-Shonlein purpura (HSP) have higher rates of Mediterranean fever (MEFV) mutations comparing general population. To our knowledge, there is no report in this regard among Azeri Turkish children. In this study, we evaluated the prevalence of MEFV mutations and their clinical and laboratory correlations in Azeri Turkish children with HSP.
In this case-control study, we included 40 unrelated patients from Azeri Turk origin diagnosed with HSP between January 2010 and March 2011. The control group consisted of 100 healthy unrelated subjects. Genomic deoxyribonucleic acid (DNA) was extracted from peripheral blood leukocytes using standard protocols. Each sample was initially analyzed for the five common mutations (M694V, M694I, M680I, V726A and E148Q).
From 40 patients with HSP, 10 patients (25.0%) had one MEFV mutation. Both patient groups (with and without mutation) were similar regarding clinical manifestations and age at the onset of disease. Frequency of female gender was higher in patients with the mutation. MEFV mutations were found in 26.0% of control group among them 19.2% had V726A and 80.8% had E148Q mutation. There was no significant difference in total mutations between patients and controls. Frequency of M680I mutation was significantly higher in HSP patients than controls (P = 0.020). E148Q mutation was much higher in the control group than HSP patients, but the difference was not statistically significant (P = 0.053).
There was no difference in the clinical spectrum of patients with and without MEFV mutation. M680I mutation may have a probable predisposing role for HSP.

Phenytoin (PHT) is used for seizure prophylaxis in patients with traumatic brain injury (TBI). However, levetiracetam (LEV) is emerging as an alternative. Hence in this study, we aimed to conduct a meta-analysis comparing these two drugs in patients with TBI.
A systematic search in electronic databases was performed. Studies consistent with our purpose (comparing LEV vs. PHT for the prevention of seizures in TBI patients) were selected for our meta-analysis. We extracted data of all eligible studies on a standard abstraction sheets. Extracted data included patient’s demographics, study type, intervention, and outcome. We defined seizures as primary outcome.
1184 unduplicated papers identified by our search of which 1106 were excluded by reading the abstract and titles. 72 papers were removed by reading the full text. Finally 6 studies (Cohort studies) were selected for analysis. There is no superiority of either these two drugs at preventing of seizures based on the point estimate’s odds ratio (OR) = 1.1 [95% confidence interval (CI) = 0.55-2.20].
PHT and LEV showed equal efficacy in prevention of seizures after TBI .

Vascularity of kidneys is very high, so these organs are potentially susceptible to be affected with toxins including snake venom. Hypersensitivity to snake venous could cause some neurological problem. Case Report: We present a 14-year-old boy with acute kidney injury (AKI) due to snake bite. After a few days, kidney failure with hematuria was developed. His serum creatinine level rose to 3 mg/dl and following 2 weeks gradually and decreased to normal level without any special treatment except for anti-venom, which was not prescribed inappropriate time (this type of AKI is not reported previously). He had seizure attacks, which were according to magnetic resonance imaging due to posterior reversible encephalopathy syndrome (PRES) (This neurologic complication has been seen in other kidney injuries but up to now it was not reported in snake bite victims). Sanke venom could cause PRES due to AKI and seizure could be one of the most important complications in snake bite.

In order to reduce behavioral risk factors in the 21st century accurate and valid information is required on these factors and also about protective factors during these so called stormy years. . Attention to life-long behavioral risk factors and protective factors provides an alternative paradigm. Indeed, efforts to improve adolescent and pre-adolescent health typically features interventions designed to address specific health risk behaviors, such as physical inactivity, tobacco use, alcohol and drug use, violence, unintentional injuries and early sexual activities .As we know, the Global School-based Student Health Survey (GSHS) was developed by the World Health Organization and conducted among adolescents, aged 13–17 years, at a country level to obtain accurate information on behavioral risk factors and protective factors, with 335 items in 10 core questionnaire modules addressing the leading causes of morbidity and mortality among children and adults worldwide, including alcohol and tobacco use, dietary behaviors, drug use, hygiene, mental health, physical activity, violence and unintentional injuries, sexual behaviors that contribute to HIV infection and other sexually-transmitted infections, unintended pregnancy and protective factors .We found that internal consistency (Cronbach's alpha) in 2 modules of dietary behaviors (0.25) and physical activity (0.22) had the lowest reliability in comparison with other items.This finding suggests that although the tool that uses GSHS is accurate, it is necessary to pay more attention to issues in adolescent health-related contexts and it seems essential to pay more attention to and exercise caution in interpretation of data regarding items about dietary behavior and physical activity in using this questionnaire despite transcultural adaptation and validation of the GSHS questionnaire in Persian.This school-based self-report survey provided critical information for implementation across culturally diverse adolescents; therefore, culturally sensitive and locally valid questionnaires are essential to local health behavior risk factors and concerns in the global context. In addition, comparative cultural data on dietary behavior and physical activity are necessary to map the causal pathways and identify contributions of other risk factors such as peer pressure.