Iranian Journal of Public Health
Volume:34 Issue: 2, Summer 2005

Abstract: The incidence of nosocomial fungal infections has increased dramatically during the past two decades as the consequence of continuous increase in the number of severely immunocompromised patients. This study was done to determine the presumptive sources of nosocomial fungal infections at the intensive care unit and transplant wards (in a university- based teaching hospital in Tehran) during a 10-month period. Totally 583 samples were obtained from the air, surfaces, health care workers and also from the patients at those wards. Mycological culture of the samples yielded growth of 25 different genus and species of fungi and the most common isolated fungi were Candida albicans, Penicillium spp., Aspergillus niger, and Cladosporium spp., respectively. It was noted that health care workers were carrying fungi on their hands (50 %), nasal mucosa (57.6%), in oral cavity (38.6%) and also by their shoes (92.3%) and uniforms (92.7%). Environmental fungal contamination was shown and it was more prominent at the intensive care unit. Hospitalization also had more significant effect on colonization of fungi in the patients at the latter ward. Therefore, the highly susceptible patients in present study were at the greatest risk of developing fungal infections and preventive measures were critical for prevention and control of these life-threatening fatal infections.

Abstract: Tuberculose has increased in the recent years. Use of a sensitive screening method, can be one of the influential parameters in reduction of pulmonary tuberculosis. Current screening method in the laboratories is based on observation of bacilli in stained smear by Ziel-Neelsen procedure. The aim of this research was to study the PCR efficiency in all confirmed patients of Hamadan province. Twenty eight patients were registered as having pulmonary tuberculosis by the tuberculosis comity of the Hamadan province. All these patients had positive results for staining and culture. Amonst these registered patients, we could access only to the 12 patients during the study. Sputums were collected from early stage of diagnosis and continued during treatment at the end of each month. All these patients were under the treatment by the DOTs protocols. All samples were tested by PCR and the results were compared with Ziehl-Neelsen staining method that is recommended procedure by WHO. Compared results showed none of the samples were positive by staining method at the end of second month up to the last month of treatment, while PCR changed to negative gradually. It was negative in 5 and 4 patients at the end of the third and forth month, respectively. Specimens of the three remanied patients were continuously positive up to the end of treatment period. Gradually changing PCR results to negative in three forth of studied patients means it can be applicable screening tools, but one forth remained positive cases needs more study for the evaluation of target gene role and efficiency of the test.

Abstract: H.pylori infection stimulates immune responses. These responses at the mucosal level are predominantly of IgA types, while circulating antibodies against this microorganism are predominantly IgG classes. IgM antibodies are rarely found and seem to be non-specific for this bacterium. In this research, water extract antigen, from three strains of H.pylori (isolated from patients with gastritis, duodenal ulcer and normal human) was investigated for the detection of serum IgG antibodies against H.pylori by an indirect ELISA technique. Antibody titers against H.pylori were measured in 72 patients of whom 64 cases were H.pylori positive and 8 cases were H.pylori negative (confirmed by culture and urease tests). In this test, those titers that were more than 1/6400 indicated the rising of IgG titers and serum positive, being in testee, and the titers, which were equal or less than 1/6400 indicated the serum negative, being in individuals. Our ELISA results indicated that between 64 H.pylori positive individuals, 61 cases were serum positive and between 8 H.pylori negative patients, 5 individuals were serum negative; thus, specificity, sensitivity, positive predictive value (PPV) and negative predictive value (NPV) of the test were, 62.5%, 95.31%, 95.31%, 62.5%, respectively. The high level of sensitivity is because of using 3 different strains for preparing of antigens. But the reasons of low specificity are probably using of semi purified antigen.

Abstract: Chlamydia trachomatis is the most common agent of urogenital infections in both men and women. Diagnosis of chlamydial infections is based on isolation of bacteria in tissue culture media that requires at least 48 to 72h. Polymerase chain reaction (PCR) is a sensitive and specific method for detection of small quantity of bacterial DNA in clinical samples. The first goal of this study was to perform a PCR testing for detecting of C. trachomatis from urine samples and after that to identify the frequency of C. trachomatis among cervicitis women and at the end, to identify the potential risk factors for chlamydial genital infection. From August to October 2002, a total of 122 consecutive women with cervicitis who attended Obstetric & Gynecology Clinic of Shoosh, Tehran-Iran were involved into the study. After DNA extraction from urine specimens, PCR tests were performed. C. trachomatis genome was detected in 14 of 94 (14/9%) urine specimens. The highest C. trachomatis cervical infection frequency was found in women with 28 to 38 years old group, elementary education level group, and in users IUD for contraception. The results of this study indicate that PCR technique is a useful method for detecting C. trachomatis in urine.

Abstract: This study was conducted to investigate hematophagic tendencies of the malaria vector based on a seasonal basis as well as by geographical region in a malaria endemic area in Kahnouj, southern Iran. This study was carried out for 14 months from Apr/ 2002 up to the end of May 2003. Female anophelines were collected from different shelters in hilly and plain regions of Kahnouj district and their blood meal was tested using ELISA test methods. The five vectors that were active in the study area consisted of An. fluviatilis, An. stephensi, An. dthali, An. culicifacies, and An. superpictus. The dominant Anopheline in hilly areas was An. fluviatilis sibling species T. This species was active during whole year and reached a peak in December. In contrast the dominant species in flat regions was An. stephensi which showed strongly endophilic behavior with two seasonal activity peaks. The anthropophilic index for An. fluviatilis and An. stephensi was estimated at 2.68% and 0.5%, respectively. The population of other species was too low and they did not show a propensity for human blood. The most malaria cases occurred in the hilly area where An. fluviatilis is the active dominant species. It seems that An. fluviatilis is responsible for transmission of malaria in hilly districts of Kahnouj. Thus malaria transmission in this study area is much influenced by resident’s rest habits while a wild vector, An. fluviatilis shows exophilic behavior and uses microclimate shelters with high incidence of human blood feeding. Thus, adapting people to use personal protection such as a bed net instead of residual spraying may be considered as an effective measure in malaria control in hilly regions.

Abstract: It is widely believed that pain has a profound effect on health related quality of life. This study was conducted to assess quality of life in patients suffering from different density of chronic low back pain. The sample consisted of 101 patients with chronic low back pain attending to the Rheumatology Research Center of Tehran University of Medical Sciences between July and September 2003. All patients were female, married, aged 18 years or over and underwent rheumatologic clinical examination. Data were collected by face-to-face interviews using the Iranian version of the Short Form Health Survey (SF-36). Relative to mean score of bodily pain, patients were divided into 2 groups: severe pain group (group 1) and mild pain group (group 2). Then, quality of life scores was compared between these two groups. Independent sample t-test was applied and the results showed that there were significant differences between quality of life scores among people with different intensity of low back pain in all dimensions but the role emotional and social functioning scales. The findings from this study confirm that quality of life in patients with low back pain depending on its intensity may vary.

Abstract: Acanthamoeba keratitis is a vision-threatening infection caused by pathogenic species of the genus Acanthamoeba. In this study, 13 Acanthamoeba keratitis cases were diagnosed among 52 keratitis patients. To confirm the identity of Acanthamoeba at the genus level, a PCR-based method was used, and their pathogenic potential was determined using in vitro cytotoxicity assays on human corneal epithelial cells. Twelve (92.3%) of Acanthamoeba keratitis patients were contact lens wearers; among them eleven (91.7%) wore soft contact lenses. 11/13 (84.6%) isolates were axenised in liquid culture medium, of which 10 (90.9%) isolates disrupted corneal cells. Nine (69.2%) isolates showed Acanthamoeba sp. group II, and four (30.8%) showed group III morphology. To our knowledge this is the first report of determination of Acanthamoeba pathogenicity in Iran. This study confirms the importance of determination of pathogenic potential of Acanthamoeba isolates for clinical purposes.

Abstract: The main vector of malaria in Europe and Palearctic region is Anopheles maculipennis complex. In order to determine the survival rate of An. maculipennis s.l. this study was carried out in Garaboteh (Zanjan province, Iran) in July 2003. In this study anophelines were sampled for 31 consecutive days from five fixed animal shelters and five light traps. Out of 24481 collected An. maculipennis s.l., 19703 (80.48%) were female. Relative density of female anopheline with 95% CI was 74.25-78.48 and 49.16-52.36 in light traps (LT) and pyrethrum space spray catch (PSC), respectively. A significant difference was in mean parous rate in LT (0.46) and PSC (0.50) samples (P< 0.01). Daily survival rate of anopheline mosquitoes in study area was 0.82-0.86. About 1.74% of female mosquitoes can transmit malaria after 10 d. In 4 d gonotrophic cycle, there was maximum correlation (>0.92) between parous and total females. Also there was significant correlation between nulliparous females and males in LT (r=0.96) and PSC (r=0.87) samples and with increasing anopheline abundance ratio of male/nulliparous significantly decreased (r=-0.35, P<0.05). Due to simplicity and feasibility of using graphical and parametric method, it can be placed in entomological surveys for monitoring parity, age structure and survival rate of vector anopheline in the world.

Abstract: Since about four years ago, total quality management (TQM) has been informally introduced into our integrated healthcare and medical education system. With the aim of getting feedback/ learning from the experiences of the universities/schools of medical sciences in setting the ground for TQM implementation, an assessment was done. The survey results show that out of 31 universities/ schools of medical sciences, 15(48%) had 50 to 59% readiness, 8 (26%) 60 to 70%, and the remaining 8 (26%) more than 70% readiness. Another finding was that, there was a discrepancy between top management teams, understanding of TQM and their actual actions in taking steps regarding its implementation. In conclusion, although the universities/ schools of medical sciences are taking steps toward setting the stage for TQM implementation, each one with its own pace, but the top management team must take more active role than the past in preparation for and implementation of TQM.

Abstract: Two-dimensional electrophoresis (2-D electrophoresis) is a powerful and extensively used method for analysis of complex protein mixtures extracted from cells, tissue, or other biological samples such as helminth parasites including, F. hepatica. Each spot on the resulting two-dimensional collection corresponds to a single protein species in the sample. This study was carried out to detect of GSTs isoenzyme spots map for collection of highly specific proteins. For this purpose, GSTs were purified from adult parasite of F.hepatica and sheep liver tissue as an enzyme pool by a glutathione affinity matrix using a wash-bath method and investigated for sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) pattern. For 2-DE, purified GSTs from F.hepatica and sheep liver tissue were resuspended in sample buffer and then run on a IPG strip in the first dimension and then on an Excel Gel SDS in the second dimension before protein spots staining with Coomassie blue. The obtaining spots in the gels were compared and GSTs protein spots were detected with similar molecular weight, 26 kDa. The protein spots which are recorded in this paper could be GSTs isoenzymes and are highly specific peptids. These findings may be considered for vaccination or chemotherapeutic targets in sheep and human fascioliasis.

Abstract: Glucoronoxylomannan (GXM) is the most important compound of polysaccharide capsule in Cryptococcus neoformans that causes infection in its recognition as a foreign agent by immune system. Because of its similarity with some naural compounds such as heparin and hyaloronic acid, this study was undertaken to determine the effect of polysaccharide compounds on blood coagulative process and renal performance in two groups of laboratory animals including Guinea pig and rat via interaperitoneal injection of cuture filtrate Cryptococcus neoformans’s var. gattii. The results of coagulation tests (PT, PTT, CT and BT) and the renal histopathological changes compared with control group. Insignificant difference between related tests in control and test groups were observed, therefore results of this research proposed capsular compounds have no effect on blood coagulative process and renal performance in persons who involved in cryptococcosis.

Abstract: Amblyomma lepidum (Donitz, 1909), collected on sheep from Gilan gharb, is reported for the first time from Iran. The species has been reported from Sudan, Ethiopia, Kenya, Egypt and Zanzibar as well. Male diagnosis: A small to medium – sized tick; scutum with characteristic ornamentations; postero- median stripe broad at the base, slightly knobbed at the anterior extremity, not reaching the falci- form stripe; postero- accessory stripes short, fairly close to the 3rd lateral spots, almost vertical; eyes small, dark coloured, hemispherical, orbited; festoons parti- coloured.