Iranian Journal of Public Health
Volume:35 Issue: 4, Winter 2006

Cryptosporidium is an apicomplexan parasite of humans and a wild range of domestic as well as wild animals. An 833-bp fragment of the 18S-rRNA gene was used to identify Cryptosporidium spp. recovered from children and adult patients, in human immunodeficiency virus (HIV) positive and negative patients in Iran. Initial identification of cryptosporidiosis was carried out by Ziehl-Neelsen acid-fast staining method of stool samples. The samples, then, were identified specifically by nested PCR, targeting the most polymorphic region of the 18S-rRNA gene. The genotype encountered was detected by restriction endonuclease digestion of the nested-PCR product. Among 17 analyzed isolates, two different genotypes of Cryptosporidium were identified; 24% of the isolates belonged to C. parvum human genotype, and 76% to the potentially zoonotic species of C. parvum bovine genotype. The results of the present study showed that in contrast to HIV negative individuals, HIV positive individuals were more likely to be infected with zoonotic genotypes of the parasite; it was also confirmed the fact that zoonotic transmission of the parasite in Iran was as frequent as the transmission of anthroponotic origin. These outcomes are helpful for researchers to establish the corresponding prevention and treatment measures.

A high quality of work life (QWL) is essential for organizations to continue to attract and retain employees. QWL is a comprehensive program designated to improve employee satisfaction. This research aimed to provide insights into the positive and negative attitudes of Tehran University of Medical Sciences (TUMS) Hospitals’ employees from their quality of life. A cross- sectional, descriptive and analytical study was conducted among 908 TUMS hospitals’ employees by questionnaire at 15 studied hospitals. A stratified random sampling technique was used to select respondents as nursing, supportive and paramedical groups. The results showed that the majority of employees were dissatisfied with occupational health and safety, intermediate and senior managers, their income, balance between the time they spent working and with family and also indicated that their work was not interesting and satisfying. TUMS hospitals’ employees responding to this survey have a poor quality of work life. We suggest more training and educations for TUMS hospitals’ managers on QWL issues are planned.

Endo-derived nitric oxide (NO) is synthesized from L-arginine by endothelium nitric oxide synthase (eNOS). Since reduced NO synthesis has been implicated in the development of coronary atherosclerosis; we hypothesized that polymorphisms of NOS gene might be associated with increased susceptibility to this disorder and coronary artery disease (CAD). We studied the 27 base pair tandem repeat polymorphism in intron4 of the endothelial nitric oxide synthase (eNOS) gene in 141 unrelated CAD patients with positive coronary angiograms in Shahid Rajaee Heart Hospital and 159 age matched control subjects without a history of symptomatic CAD. The study protocol was approved by the Iran University of Medical Sciences Ethics Committee. The eNOS gene intron4a/b VNTR polymorphism was analyzed by polymerase chain reaction. The plasma lipids levels and other risk factors were also determined. The genotype frequencies for eNOS4b/b, eNOS4a/b and eNOS4a/a were 68.8, 29.1 and 2.1% in CAD subjects, and 81, 18.4 and 0.6 % in control subjects, respectively. The genotype frequencies differed significantly between the two groups (χ²= 6.38 P= 0.041). The frequency of the allele was 16.7% in CAD subjects and 9.8% in control subjects and was significantly higher in the patients (χ²= 6.18 P= 0.013, odds ratio=1.84). Plasma lipids, except HDL-C were also remarkablely increased in CAD group.

Brucella transmission and epidemiology depend on infecting species and biovar. Therefore, exact identification of the Brucella is important to design correct control and treatment strategies. In this study, we examined presence of other Brucellae in Isfahan. One hundred twenty Brucella isolates were collected and genomic DNA was extracted from them. omp2a fragment of all isolates were amplified using a pair of specific primers and the PCR products were electrophoresed and stained with EtBr. These PCR products were then restricted using PstI restriction endonuclease. The PCR products of all isolates had the same size of 1100bp. The banding pattern of PCR-RFLP for all of the isolates were similar to banding pattern of the Brucella melitensis biotype 1 except for 5 samples that demonstrated banding pattern similar to B. abortus. Based on our results, it is clear that biotype 1 of the B. melitensis is not the only Brucella present in Isfahan and now B. abortus is also present in our area. These results are very important in planning for the control of the disease as well epidemiology and even treatment of the patients.

The emergence of Plasmodium vivax in Dashte Moghan in northwestern Iran has become a major concern for Iranian''s health officials. Knowledge of genetic make up of the P. vivax populations in this area would give us an insight into the origin of the prevalent infections and the possible routes they are introduced. This paper reports the analysis of a variable region between the two interspecies conserved blocks (ICBs) of 5 and 6 of MSP-1 gene in 18 isolates from Dashte Moghan. The results revealed that all the 18 isolates were similar to an Azari Belem-like type with 21 glutamine (Q) in the repeated residues. Our results may give a clue that the resurgent malaria in Dashteh Moghan might have primarily been introduced from Azerbaijan. However, much more molecular and epidemiological evidence are needed to confirm this hypothesis.

High prevalence of HBV and HCV infections in prisoners suggests them as one of the main infection source in community. Preventive measures can possibly decrease their rate of infection and infectivity. We evaluated prevalence of HBV and HCV infections and their relation to dangerous behavior in addict prisoners. This was a cross-sectional study included prisoners of central provinces of Iran who were evaluated for HBV and HCV in 2003. All of 1431 prisoners filled out questionnaires that were evaluated for HBsAg and HCV antibody. There were 51 prisoners (3.5%) who were HBsAg positive and 513 prisoners (35.8%) had HCV antibody. Odd`s ratio for HBV and HCV were 10.3 and 9.6 for IVDA, respectively. This study showed that the HBV and specially HCV infection had high prevalence among prisoners. In comparison to rate of HBsAg and HCV infection in general population of Iran, this study showed that the HBsAg was 2 times and HCV infection was 70 times more frequent in prisoner than in general population of Iran. The education for dangerous behavior is strongly recommended to control this persistent infection source for hepatitis B and C in the community.

Trichophyton rubrum (T. rubrum) is an anthropophilic dermatophyte that is distributed worldwide and causes common cutaneous disease such as mycosis. Although several properties of this fungus have been investigated so far, however a few studies were carried out in the field of molecular biology of this fungus. In the present study we tried to identify its molecular characterization of the goanosin three phosphat (GTP) binding protein gene. Pairs of 21 nt primers were designed from highly conserved regions of the gene in other fungi. The primers were utilized in PCR by using isolated genomic DNA template as well as cytoplasmic RNA of T. rubrum and the PCR and RT-PCR fragments were then sequenced. About 645 nucleotides have been sequenced which encodes a polypeptide with 214 amino acids. Nucleotide sequence comparison in gene data banks (NCBI, NIH) for both the DNA and its deduced amino acid sequence revealed significant homology with GTP binding protein genes and proteins of other eukaryotic cells. The amino acid sequence of the encoded protein was about 64% identical to the sequence of GTP binding protein from other fungi. In summary, we have cloned the first GTP binding protein of dermatophytes and characterized it as a member of this gene family in other eukaryotic cells.

Shigellosis is an acute gastroenteritis caused by Shigella species. The purpose of this study was to determine plasmid profile, antibiotic resistance and phenotypic virulent by Congo red between S. flexneri strains. The isolated bacteria were identified by standard bacterial and biochemical methods. Plasmids were isolated by alkaline lysis method. Antibiotic susceptibility test was performed according to”kirby-Bauer” method. Serological reactions were carried by slide agglutination tests with both polyclonal and monoclonal antiserum kits. Virulent strains were isolated on a TSA plate contained Congo red dye concentration. From 350 isolated Shigella species, 142 (40.57%) were S. flexneri. Eleven distinct plasmid profile patterns were identified. Of S. flexneri isolates, 95% were resistant to tetracycline, 85.6% to SXT and 75.3% to ampicillin. All the isolates were sensitive to ciprofloxacin. Our results showed that 39% were serotype II. 45.56% of S. flexneri were Congo red positive. Antibiotic resistant determination in each case may prevent drug resistance increase. Since Congo red binding test is cheap and simple it can be used to determine virulence properties of S. flexneri.

Lack of vaccination and modern health care facilities in many countries including Iran let meningococcemia to remain as a serious challenging disorder especially among children and in spite of improved diagnosis and earlier treatment its prognosis is still dismal. This study describes 68 cases (54.4% male) of proved meningococcemia hospitalized since 1992 up to the end of 2002 in Children Medical Center Hospital, Tehran, Iran. Infants of 6 to 12 month old were a major concern in number (14.7%) and severity of disease. 5.9% of the cases have had at least two hospitalization history for meningococcal septicemia and 19.1% of the patients had Systemic Lupus Erythematosus (SLE), nephrotic syndrome or chronic liver disease in their past medical history. Meningeal irritation signs were seen in 55.9% and cerebrospinal fluid (CSF) smear was positive in 71.4% and culture was positive in 48.5% of patients. Meningococcal septicemia ended in shock (38.2%), Disseminated intravascular coagulation (DIC) (7.4%), thrombocytopenia (10.3%), arthritis (4.4%),ocular complications (2.9%), pericarditis (2.9%) and seizure (8.8%) in 51 of the cases, and death occurred in 7 patients. This study shows that the manifestation of the disease is similar to those described elsewhere except for lower pneumonia and no seasonal variations.

Hepatitis C is a major cause of liver related morbidity and mortality worldwide and represents a major public health problem. Depending on genomic organization, the virus is divided into six genotypes and a number of subtypes. Different genotypes are seen in different parts of the world. Genotype one is difficult to treat, while genotypes 2 and 3 are easy to treat. Therefore, identification of HCV genotype in patients is necessary to begin and follow up the treatment. In this study, viral genomic materials of 214 patients’ sera were detected by nested-RT PCR. Based on genomic differences among different genotypes, the PCR products were digested with proper enzymes and studied by RFLP. Except for one, sequencing of 14 samples, representative of all genotypes, confirmed the results of PCR-RFLP. The results of PCR-RFLP were as follows: 1a (52.88%), 1b (14.01%), 3a (27.57%), 2a (2.1%), 4 (3.44%). This indicates that a high percentage of HCV infected patients in Iran are infected with 1a or 3a genotypes. These findings reveal that the pattern of HCV genotypes in Iran differs from those of other middle-eastern countries

Soil is well known to support the transient or ongoing existence of kerathophilic fungi and potential sources of infection for humans and animals. Fifty soil samples were collected from various areas of forests and farmyards at Golestan Province in the north part of Iran to determine the prevalence of keratinophilic fungi and dominant species. A total of 357 fungal colonies including 13 genera with 11 species were isolated as follows: Anixiopsis stercoraria (16.24%), Arthroderma cuniculi (12.04%), Reniospora flavissima (9.24%), Fusarium oxysporum (9.24%), Aspergillus flavus (8.68%), Chrysosporium keratinophilum (8.40%), Trichophyton vanbreuseghemii (7.84%), and other fungi (37.56%). McNemar’s test showed that non-keratinolytic fungi were dominant in this investigation (P< 0.05). Anixiopsis stercoraria (16.24%) was the most prevalent and dominant keratinophilc fungus (P< 0.05). It can be concluded that soils from forest and farmyards of Golestan Province are rich in keratiophilic fungi including dermatophytes.

Snail transmitted diseases are one of the major group of helminth parasitic diseases which have been established by trematode parasites. The larvae of trematodes (cercariae) use the snails as host. The purpose of the present study was to identify of cercariae released from Melanopsis spp. (M. doriae, M. costata, M. praemorsa, and M. nodosa) and evaluate their medical importance. Accordingly, 2, 266 Melanopsis spp. (fresh water snails) were collected from various agriculture canals in the central area of Khuzestan Province in the south west of Iran. 72 (3.1%) infected Melanopsis spp. snails were isolated and the cercariae were obtained by emerging or crushing methods. Subsequently, measurement and drawing were made on cercariae specimens and recognized. In some cases experimental infections were established in the animals for further identification. A total of 4 cercarial families and 1 cercarial group were identified as follows: Heterophyidae: Haplorchis pumilio, H. taithui, Stellantchasmus falcatus and Centrocestus formosanus; Echinostomatidae: Echinochasmus milvi; Cyathocotylidae, Philophthalmidae and Monostome group cercariae (probably Notocotylidae). These results have been recorded for the first time and these cercariae are of medical and veterinary importance.

Since work-related musculoskeletal disorders (WMSDS) have a high prevalence in different industries, in order to quantify the prevalence of WMSDS of the upper limbs in of exposed group and find a relationship between exposure indices and effect indicators, this research was carried out. A total of 404 male exposed and of 120 male non-exposed workers of Qaemshahre (northern Iran) weaving factory located in the north of Iran were studied. Regarding the quantification of exposure, use was made of the Occupational Repetitive Actions (OCRA). Also the Concise Damage Index (CDI) was calculated for any job and then statistically significant relationships between CDI and OCRA exposure indices were surveyed. It was considered that there were significant associations between OCRA and an effect indicators (CDI) represented by the prevalence of all the WMSDS of the upper limbs (R2= 0.85, P=0.001). When a logarithmic conversion of the relative exposure (OCRA) and injury indices was carried out, a simple and multiple linear regression model resulted that seems to provide a satisfactory and truly predictive performance of the risk of WMSDS of the upper limbs based on the exposure index, length of time, lack of recovery periods, and etc.

Neonatal bacterial sepsis is one of the major cause of morbidity and mortality in neonates. This retrospective study was performed to determine the incidence of bacterial sepsis with focus on Gram negative organisms in neonates admitted at Beheshti Hospital in Kashan, during a 3-yr period, from September 2002 to September 2005. Blood culture was performed on all neonates with risk factors or signs of suggestive sepsis. Blood samples were cultured using brain heart infusion (BHI) broth according to standard method. From the 1680 neonates 36% had positive blood culture for Pseudomans aeruginosa, 20.7% for Coagulase negative Staphylococci, and 17% for Klebsiella spp. Gram-negative organisms accounted for 72.1% of all positive cultures. The overall mortality rate was 19.8% (22 /111) of whom 63.6% (14 /22) were preterm. Pseudomona aeruginosa and Klebsiella spp. showed a high degree of resistance to commonly used antibiotics (ampicillin, gentamicin) as well as third generation cephalosporins. Continued local surveillance studies are urged to monitor emerging antimicrobial resistance and to guide interventions to minimize its occurrence.