Iranian Journal of Public Health
Volume:32 Issue: 4, Winter 2003

Using mutation specific PCR assay and analysis of position 108 amino acid in dihydrofolate reductase-thymidilate synthase gene in 70 Plasmodium falciparum isolates of malarial patients from southern areas of Iran, showed 4 different situations: i-wild type (108-Ser) ii-mutant type (108-Thr) iii-mutant type (108-Asn) and iv-mixed wild and mutant type (108-Ser+Thr) with frequency of 58(82.8%), 2(2.9%), 8(11.4%) and 2(2.9%) respectively. Many studies have demonstrated that mutations in position 108 have key role for emerging resistance to anti-folate drugs in falciparum malaria so, the resistance to pyrimethamine and proguanil, presents in Plasmodium falciparum isolates from malarious endemic regions of Iran

Migraine is one of the common varieties of headache. It involves 4 to 6 percent of men and 13 to 16 percent of women under 30 years in more than 80% of cases. Some studies have shown that in 50% of patients serum magnesium level decreases during attacks of headache and using magnesium tablets and intravenous magnesium sulfate is more effective for treatment of migraine attack، than placebo. This is a cross sectional، analytical study on 50 patients referring to private neurology clinics and Shahid Beheshti Hospital of Kashan University of Medical Sciences (KAUMS). Serum magnesium level studied during the attack of headache and in remission in each of 50 patients. All predisposing factors such as age، sex، cigarette smoking، trauma and family history of migraine and so on were searched. Forty – five of 50 patients (90%) were female and 5 (10%) were male. Thirtyfour (68%) of cases were between 31 and 45 years old. In this age range 30 (60%) were female and 4 (8%) male. Seven (14%) had history of trauma. Five (10%) cigarette smoker، 44 (88%) had history of stress، and 30 (60%) had history of migraine in their family. Serum magnesium level was 2. 1 in remission phase، and 1. 7 during attack (P=0. 001)، although both are in normal range (N=1. 6 - 2. 7). Serum magnesium level decreases during the attacks of migraine headache، so using magnesium containing drugs may be useful in its control.

Conventional sand filtration which has become a common wastewater treatment technology to satisfy regulations appointed for effluent reuse، suffers from the disadvantage of high energy for backwashing. The subject of this study is application of downflow floating media prior to coarse sand filtration، which requires less water for backwash. Two pilots have been employed in two stages. For the first stage، a pilot of two columns was used، one was packed with plastic beads and the other with coarse sand. For the second، floating medium was placed on the sand in a unique column. The effluent of Ghods Treatment Plant was selected as the influent for the both pilots and a turbidity of 2NTU for the filter effluent has been specified as the breakthrough. Final results showed the good efficiency of the system in removing pollutants even in the case of using a unique column. Moreover، this system was determined to be able to meet the non potable reuse standards of water recycling in cities. The performance of the system in reducing chlorine demand was also drastic and results indicated a maximum of 66% and a minimum of 50% decrease in this regard.

To study the humoral immune response to Entamoeba histolytica infection، sera prepared from different cases of amoebiasis from gastroenterology ward of B. H. U hospital، including15 cases with amoebic liver abscess (ALA)، 10 cases with acute amoebic dysentery (AD) and 10 controls were examined by Enzyme Linked Immuno Sorbent Assay (ELISA)، using crude amoebic antigen prepared from Entamoeba histolytica NIH: 200 grown axenically and its three chromatographed fractions، i. e. fraction I (FI)، fraction II (FII) and fraction III (FIII). Efficacies of different antigens in detecting anti amoebic antibodies were compared. Estimation of immunoglobulin G (IgG)، immunoglobulin M (IgM) and immunoglobulin A (IgA) levels were also carried out employing Single Radial Immuno Diffusion (RID) technique. The results indicated that crude amoebic antigen and fraction I (FI) were more efficient in antibody detection while، potencies of fraction II (FII) and fraction III (FIII) were lower as antigens for serodiagnoses. On estimating different immunoglobulin levels، it was found out that there was significant increase in IgG level in amoebiasis group while، no significant increase was observed in IgA level. IgM level was increased only in amoebic liver abscess cases compared to negative controls.

Human visceral and ocular toxocariasis can occasionally be a serious or life-threatening condition, especially for children. The diagnosis and confirmation of the disease mostly based upon serological tests. The purpose of the present study was to evaluate somatic antigen with regard to its application in a routine diagnostic laboratory test. Using gel-filtration chromatography, fraction No.1 of Toxocara canis antigen (F1To) was obtained from somatic antigen of parasite, and was evaluated for the immunodiagnosis of human toxocariasis by enzyme-linked immunosorbent assay (ELISA) test. Of 30 patients with suspected clinical toxocariasis, all had anti-T. Canis antibodies (positive serological result) corresponding to a diagnostic sensitivity of 100%. The specificity of the test was calculated as 77%. In this regard the positive and negative predictive values were demonstrated as 65.2% and 100% respectively. In conclusion, the application of the test using somatic antigen, because of the low specificity is not recommended.

An outbreak of zoonotic cutaneous leishmaniasis caused by Leishmania major was identified in Ghanavat rural district, Qom province, central Iran, during 1999-2001. Among 1069 inhabitants examined in Dec. 1999, 5.14% showed evidence of active lesions and 12.44% had scar indicative of past infection. The most highly infected age group was 5-9 years old for ulcers with a rate of 6.56%. The incidence of the disease was calculated as 2.7% and 1.4% in 2000 and 2001 respectively. Meriones libycus (66.7%), Nesokia indica (27.3%) and Hemechinus aurithis (6%) were present around the district. No leishmanial infection was seen in the slides. Meriones libycus is the probable reservoir host of the disease in the area. Sixteen dogs appeared to be uninfected because examination showed no active lesion or scar. Most probably Phlebotomus papatasi is the vector because 81.53% of indoor sand flies were of this species. The active season of P.papatasi was from late April to early October in indoors. The occurrence of this outbreak of ZCL in the district seems to be the result of construction of buildings near colonies of rodents and also traveling to other infected foci of Iran

The emergence of multidrug resistant strains of Escherichia coli has complicated treatment decision and may lead to treatment failures. From April to November 2001 we prospectively evaluated the prevalence of resistance to trimethoprim-sulfamethoxazole (SXT)، gentamicin، cephalothin، ciprofloxacin، and nitrofurantoin in 220 Escherichia coli isolates from patients with urinary tract infections in kashan، Iran. To assess the current breadth of multidrug resistance among urinary isolates of E. coli. of total isolates، 10. 9% were resistant to three or more agents and considered multidrug resistant. Among the multidrug resistant isolates، 91. 7% were resistant to SXT، 75% to gentamicin، 58. 3% to cephalothin، 54. 2% to ciprofloxacin and 45. 8% to nitrofurantoin. The predominant phenotype among multidrug resistant isolates (29. 2%) included resistance to SXT، gentamicin، and cephalothin. Rates of multidrug resistance were demonstrated to be higher among males (13. 2%) than females (10. 4%). There was no significant association between gender and reduced susceptibility. Continued local surveillance studies are urged to monitor emerging antimicrobial resistance and to guide interventions to minimize its occurrence.

According to Environmental Protection Organization of Iran, maximum permissible concentration of residual phosphorus in treated municipal wastewater is 1 mg /l-P. The total average phosphorus concentration in raw municipal wastewater is about 8 mg / l; about 70 percent of the incoming phosphorus normally is discharged with secondary treatment plant effluents. In this research, the role of adding different kinds of coagulants on phosphorus removal efficiency of an electrochemical process was investigated. The research is a bench scale experimental type using batch system for elec. process with direct current. Samples were collected from an extended aeration effluent. The used electrode was steel type and its total effective area was 336 cm2. In each run 1500 ml of sample was placed in an electrolytic cell equipped with magnetic stirrer. The results show that phosphorus removal efficiency increases by increasing of DC and reaction time. Minimum rate of current/percentage of removal was obtained for 0.6amp current and under the same conditions minimum rate of reaction time/percentage of removal was provided in 15 min. In 6min reaction time and 0.6amp current, adding poly aluminum chloride (PAC) up to about 27 mg/l could improve the efficiency up to about 50%. But under the same condition, similar results were not observed in 12min reaction time. Besides, adding alum or ferrous sulfate showed similar behavior to PAC. Electrochemical treatment without addition of coagulants and thereby without any changes on the primary characteristics of the sample can remove the phosphorus up to about 93%. But in the case of sufficient reaction time for electrochemical process, adding coagulants can not improve the efficiency and in comparison to a chemical precipitation alone, the use of electrochemical treatment can not reduce the required doses of coagulants in short reaction time.

Repellet effect of extracts and essential oils of Citrus limon (L.) Burm.F., (lemon) and Melissa officinalis, (balm) were evaluated against Anopheles stephensi in laboratory on animal and human and compared with synthetic repellent, N,N-diethyl-3-methylbenzamide (Deet) as a standard. Results of statistical analysis revealed significant differences between oils and extracts (P< 0.05) against the tested species, thus oils were more effective than extracts. There was no significant difference between Deet and lemon oil, whereas the difference between lemon and melissa oils was significant. Relative efficacy of lemon oil to Deet was 0.88 whereas it was 0.71 for melissa oil. The results were found marginally superior in repellency for animals than human. Due to advantages of botanic compounds to synthetic compounds we recommend lemon essential oil as an effective alternative to Deet with potential as a means of personal protection against mosquito vectors of disease.

The aim of this study was to measure the alterations in serum zinc (Zn) copper (Cu) and iron (Fe) concentrations in patients with acute and chronic cutaneous leishmaniasis. Serum zinc and copper were measured by flameless atomic absorption spectrophotometer and serum iron concentration was measured by the Ferrozine method with commercial kits and assay was carried out by using an automatic analyzer. A total of 54 individuals were enrolled in this study: 18 patients with acute cutaneous leishmaniasis, 18 with chronic one and 18 healthy people who were not infected by Leishmania parasites. Serum Cu concentration was found to be significantly higher in the patients with acute (p<0.05) and chronic (p<0.05) cutaneous leishmaniasis than those of control group. However, Zn and Fe levels were lower in patients with acute (p<0.001) and chronic (p<0.001) cutaneous leishmaniasis than in the control group. There were no statistically significant differences in serum zinc, copper and iron levels in patients with acute and chronic cutaneous leishmaniasis. Our results showed that serum essential trace elements Zn, Cu and Fe concentrations have been changed in these patients. The changes may be a part of defense strategies of organism and are induced by the hormonelike substances.

Diabetes is characterized by a nitric oxide deficiency at the wound site. Diabetes is a factor that influences all stages of wound healing. In animals with acute experimental diabetes induced by streptozotocin (STZ)، the early inflammatory responses after wounding is impaired، fibroblast and endothelial cell proliferation is reduced as well as accumulation of reparative collagen and gain in wound breaking strenght. This study investigated whether exogenous nitric oxide supplimentation with nitric oxide donor DETA NONOate could reverse impaired healing in diabetes. The results suggest nitric oxide donor DETA NONOate can reverse impaired healing associated with diabetes (P<0. 001) and urinary nitrate (NO-3) output may reflect the extent of repair in this wound model (P<0. 001).

To determine the role of blood transfusion protocols on retinopathy of prematurity (ROP), a prospective cohort study on 57 premature infants under 1501 grams birth weight was performed. Fourteen day-old infants were divided into two groups randomly. Infants in group 1 (n=27) received packed red blood cell transfusion only if specific medical signs were met and their hematocrit level was under 30%. Infants in group 2 (n=30) received blood transfusion to maintain their hematocrit level > 40% regardless of their signs. All infants had an eye examination by indirect ophthalmoscopy from 28 to 40 days of life for detecting ROP. We did not find any significant difference in ROP incidence between both groups.

Since particulate matter (total suspended particles and particulate matter with median aerodynamic diameter less than 10 µm) is one of the important pollutants in the ambient air of Tehran, the capital of Iran, organic substances, inorganic substances and lead levels in TSP and PM10, correlation between TSP and PM10 concentrations, ratio among the two fractions and relation between TSP and PM10 concentrations with meteorological parameters (relative humidity and temperature) were studied. Twenty-four hour simultaneous sampling of TSP and PM10 has been carried out during the period of 22 December 2001 to 20 April 2002 in the ambient air of Shariati Hospital district. The results showed that inorganic substances were the most abundant component of TSP and PM10 (Approximately 76% and 68%, respectively); 0.21% of total mass for TSP and 0.26% of total mass for PM10 were lead particles; 64% of lead particles had a diameter less than 10 µm; 48% of TSP had a diameter less than 10 µm; while atmosphere relative humidity and temperature were in the range of 50% and 5-10○C respectively, specially on Saturdays in winter and more importantly in inversion conditions, the highest concentrations of TSP and PM10 would be expected.