Iranian Journal of Public Health
Volume:39 Issue: 1, Spring 2010

Zoonotic cutaneous leishmaniasis (ZCL) is an expanding disease and public health problem in Iran. In the current study, natural Leishmania infection rate and seasonal fluctuation of the infection in Rhombomys opimus population of a hyperendemic focus of ZCL in Iran was investigated. The study was conducted from October 2006 to October 2008 in Esfahan Province, central part of Iran. An extensive sampling of rodents using Sherman traps was done in different seasons. Nested PCR assay was used for detection and identification of Leishmania species and the results were confirmed using PCR-RFLP. Leishmania infection rate was 58.6% (34 of 58) using nested PCR. 44.8% of the gerbils were infected only with L. turanica and 1.7% with L. gerbilli alone. A mixed natural infection with L. major and L. turanica was seen in 12.1% of the rodents. L. major infection alone was not seen in R. opimus population in the study area. The highest and lowest Leishmania infection rates were observed in fall and spring respectively. L. turanica infection was observed throughout the year whereas mixed infections with L. major and L. turanica was not seen in spring. It is concluded that in the study area, L. major, L. gerbilli and L. turanica circulate in the population of R. opimus. Leishmania major infection usually accompanied by L. turanica in naturally infected gerbils with the highest rate in fall. It is recommended that the role of L. turanica in the epidemiology and transmission of ZCL be revisited.

Staphylococcus aureus has been recognized as a major human pathogen and is the major cause of nosocomial infections. Gamma-toxin, leukocidin and other bi-component toxins are a family of proteins encoded by the hlg and luk-PV, respectively. Panton-Valentine leukocidin (PVL) is an example of these toxins and causes leukocyte destruction and tissue necrosis. The aim of this study was to determine the prevalence of bi-component leukocidin in Methicillin - Resistant Staphylococcus aureus (MRSA) isolates in staphylococcal infections. Collectively, 143 isolates of S. aureus were obtained from Tehran University of Medical Sciences hospitals and confirmed with biochemical tests. Then polymerase chain reaction was used to detect luk-PV loci and luk-E/D. Coagulase gene was used as internal control. The antibiotic susceptibility patterns of isolates were determined using disk diffusion method. Out of 149 S. aureus isolates 24.2% were luk-PV positive and 73.8% were luk-E/D positive. There was PVL-positive MRSA isolates with high prevalence in evaluated hospitals. The diseases from these bacteria are with extensive necrosis, leucopenia and even death. We desire that, prevent from progress and death by diagno­sis and right treatment.

Exercise can change the release of numerous cytokines and modulate their receptor systems. Dietary ω-3 lipids may decrease the levels of inflammatory cytokines and prostaglandins (PGs). Therefore, in this study, we investigated the effects of exercise and eicosapentaenoic acid (EPA) supplementation, with or without vitamin E, on the blood levels of IL-2, TNF-α, catalase, glutathione reductase, and MDA in male basketball players. Thirty-four well-trained male basketball players were enrolled into the study. Venous blood samples were obtained from all subjects between 5:00 and 6:00 p.m., after intensive endurance exercising for 2 hours, at the baseline and after intervention. Subjects received 2g EPA and/or 400 IU vitamin E or placebo depends on their groups for 6 weeks. There were significant fall (paired t-test) in TNF-α in group1(P< 0.05), and in MDA in group 3 (P<0.05), whereas there were significant increase in glutathione reductase in groups1 and 3 (P< 0.05), and in MDA in group2 (P< 0.05).There were significant differences (Tukey) in glutathione reductase between groups 2 and 3 (P< 0.05), and in IL-2 between groups 1 and other groups (P< 0.01), but there were no significant differences in MDA, CAT, and TNF-α, among groups after 6 week of intervention. Six weeks of EPA+vitamin E supplementation enhances the plasma levels of IL-2 and erythrocytes glutathione reductase, whereas it reduces TNF-α, and 6 weeks of EPA supplementation alone enhances only the serum level of MDA.

GB virus C (GBV-C) is a flavivirus that was characterized in 1995. The prevalence of GBV-C RNA in HIV-in­fected subjects has not been previously studied in Iran and was therefore determined. We have investigated serum samples of 80 patients from Imam Khomeini Hospital, Tehran, Iran, whose HIV in­fection was confirmed in our laboratory by Western-blotting. We used nested-PCR to detect GBV-C/HGV RNA in their sera. GBV-C/HGV RNA was detected in 15 (18.8%) of 80 patients. There was no significant difference in GBV-C/HGV RNA preva­lence between males and females, in different age groups and HIV viral loads groups. The prevalence of GBV-C RNA was high in HIV-infected patients. There was no association between GBV-C RNA prevalence and specific gender, age, and HIV viral loads groups.

The purpose of this study was to describe the knowledge and attitude of pregnant women in Qazvin Province, central Iran, Relating to oral Hygiene. The study group comprised of 760 pregnant women living in Qazvin, center of Iran in 2004. The questions were formulated to evaluate information without the need for dental examination. The age groups between 17-41 years old were randomly selected and a question was given to woman in three family planning center. Statistical analysis was done by SPSS. 94.4% responded the questionnaire and participated in statistical procedure. 73.1% of the patients used to brush their teeth at least twice a day and also 70.3% used to brush their teeth after meal. Health authorities should strengthen the implementation of community- based oral disease prevention and health promotion programmes. More importance must be given to oral health care center in family planning centers.

Although in the last few years there has been an increasing attention to the problem of landmines, to date, the implications of women being victims of landmine has not been duly dealt with in the world including Iran, which is estimated to be the second most landmine infested country in the world. Still, provinces by the west border of Iran, 18 years after cessation of Iraq-Iran war suffer from the burden of vast areas, highly infested with landmines. This study aimed to provide a gender focused insight into landmine accidents in Iran. In this retrospective study, women with documented deaths or injuries due to landmine and/or unexploded ordnances (UXO) explosions as documented in their medical records between Jul 1988 (after ceasefire) and Feb 2003 were studied in 5 western provinces of Iran. Data was analyzed by SPSS for Windows Version 11.P value under 0.05 was consid­ered statistically significant. During the 14-year study period, 252 women from 5 western provinces of Iran were reported to have injuries or death due to landmine and UXOs. All of the victims were civilians and the majority of them (47.6%) had one or more amputations. Most of them were injured in the period between1994 and 1998. The majority of the patients were young. Women who should take care of themselves as well as their families are more prone to sufferings inflicted by landmines and UXO.

Recent circumstantial evidences are suggesting that an increasing number of Iranian patients with cu­taneous leishmaniasis are unresponsive to meglumine antimoniate (Glucantime®). Pistacia atlantica is native plant in Iran (central, western, and eastern regions). Gum obtained Pistacia atlantica has been reported to possess consid­erable in vitro antimicrobial activity. In this study, we aimed to investigate antileishmanial activity of P. atlantica. Male BALB/c mice were inoculated subcutaneously 2×106 L. major Promastigotes (MHROM/IR/75/ER) at the base of tail in 2007. Mice were randomly divided into 3 groups. in group 1 Glucantime® was administered to the BALB/c mice in regimen of 60 mg per kg of body weight for 28 days by intraperitoneal injections per day, in group 2 the gum of P. atlantica var. Kurdica were tested by rubbing of local lesions for 28 days, group 3 infected but non-treated. Comparisons of treated groups and untreated group were done by two-way analysis of variance (ANOVA). Topically rubbing administration of gum obtained P. atlantica var. kurdica daily for 28 days like Glucan­time® decreased skin lesion size in the BALB/c mice infected with L.major compared with that in the control (P< 0.01). Treatment BALB/c mice with gum obtained P. atlantica var. kurdica and Glucantime® causes decrease num­ber of parasitologicaly positive mice (P< 0.05). Our results show that gum obtained P. atlantica var. kurdica can be used for controlling cutaneous leishmaniasis caused by L.major and inhibiting development of cutaneous leishmaniasis lesions

Atopic dermatitis is a public health problem worldwide. Increment of reactive oxygen species (ROS) produc­tion may be one of the contributing factors of tissue damage in atopic dermatitis. The present study was designed to deter­mine the effect of vitamins E and/or D on erythrocyte superoxide dismutase and catalase activities in patients with atopic dermati­tis. In a randomized, double blind, placebo controlled clinical trial 45 atopic dermatitis patients were divided into four groups. Each group received one of the following supplements for 60 days: group A (n=11) vitamins E and D placebos; group B (n= 12) 1600 international unit (IU) vitamin D3 plus vitamin E placebo; group C (n=11) 600 IU synthetic all-rac-α toco­pherol plus vitamin D placebo; group D (n=11) 1600 IU vitamin D3 plus 600 IU synthetic all-rac-α tocopherol. Erythro­cyte superoxide dismutase (SOD) and catalase activities, serum 25 (OH) D, plasma α-tocopherol were determined. The data were analyzed by analysis of variance (ANOVA) and paired t-test. After 60 days vitamin D and E supplementation, erythrocyte SOD activities increased in groups B, C and D (P= 0.002, P= 0.016 and P= 0.015, respectively). Erythrocyte catalase activities increased in groups B and D (P= 0.026 and P= 0.004, respectively). The increment of erythrocyte catalase activity was not significant in group C. There was a positive signifi­cant correlation between SOD activity and serum 25 (OH) D (r= 0.378, P= 0.01). It is concluded that vitamin D is as potent as vitamin E in increasing the activities of erythrocyte SOD and cata­lase in atopic dermatitis patients.

Policy making in health is largely thought to be driven by three ‘I''s namely ideas, interests and institutions. Recent years have seen a shift in approach with increasing reliance being placed on role of evidence for policy making. The present arti­cle ascertains the role of ideas and ideologies in shaping evidence which is used to aid in policy decisions. The article dis­cusses different theories of research-policy interface and the relative freedom of research-based evidence from the influence of ideas. Examples from developed and developed countries are cited to illustrate the contentions made. The article high­lights the complexity of the process of evidence-based policy making, in a world driven by existing political, social and cul­tural ideologies. Consideration of this knowledge is paramount where more efforts are being made to bridge the gap be­tween the ‘two worlds'' of researchers and policy makers to make evidence-based policy as also for policy analysts.

To identify the most important expectations that patients have from their physicians. We collected data from 199 hospitalized and 201 ambulatory patients (response rates 88% and 93% respectively). We used random sampling for selection of hospitalized patients and systematic sampling for the ambulatory ones. The questionnaire consisted of 18 different expectation items categorized in 5 domains. The participants scored each item from 1 to 9 using a VAS scale and ranked domains based on their importance. We analyzed the data using univariate and regression analyses. Among the ambulatory patients, the mean±standard error of the most important expectations was as follows: com­petency (8.9±0.01), courteousness (8.8±0.04), consultation in case of need (8.8±0.4), clear explanation of the disease (8.8± 0.05) and attentiveness (8.8±0.04). In hospitalized patients, the following items were the most important: competency (8.4± 0.08), courteousness (8.4±0.09), availability of physician (8.4±0.09), consultation in case of need (8.2±0.11), setting follow­ing appointments (8.2±0.1), and disease follow-up (8.2±0.09). In both groups, the most important domain of expecta­tions was "competency and quality of care" followed by "availability" in hospitalized and "giving information and patient auton­omy" among ambulatory patients. Our findings are similar to what reported in the literature from other countries and cultures. In addition to physician expertise and knowledge, patients value giving information and efficient doctor-patient relationship.

The medical and economic problem of thalassaemia are considered to be a vast public health problem in the thalas­saemia belt countries, emphasizing more on prenatal diagnosis as the solution of the problem. A cross-sectional descriptive study was conducted in the Institute of Haematology & Transfusion Medicine lo­cated in Medical College, Kolkata, India to assess the socio-demographic profile, clinical presentation, expenditure for treat­ment of thalassaemia patients and awareness about cause and prevention of the disease. Thalassaemia patients attended the Govt. setting were mostly from lower socioeconomic status with low level of liter­acy. Annual expenditure for treatment of thalassaemia ranged from $ 108 to 432; depending on type of treatment with av­er­age cost per transfusion was $ 5.2±2.2. Average 18.5%±14.3 of the total annual income was spent on the treatment for tha­lassae­mia. Average man days or school days lost for the patients was 29.87±18.5 and 19.07±12.7 for the accompanying persons. Blood transfusion and carrier screening facilities should be decentralized to decrease the expenditure for treat­ment and alleviate the harassment of the families. Folate and calcium tablets, hepatitis B vaccination can be made available at government setting free of cost

Alkyl hydroperoxide reductase (AhpC) of Helicobacter pylori is considered as a diagnostic antigen. There­fore, this antigen can be used to detect H. pylori infection by stool immunoassays such as ELISA. The aim of this study was to simplify the AhpC protein purification procedures. For whole cell protein extraction, the bacterial cells were ruptured by octly-β-D glucopyranoside. The isolation and purification of AhpC protein were attempted by various techniques including ammonium sulfate precipitation, dialysis, preparative sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and electroelution.A simple method was used for protein purification AhpC protein. One-dimensional preparative gel electrophoresis allows a single and short purification step; the high resolution capacity of this technique leads to a high level of purity of the protein. Moreover, it avoids contamination by other non-specific proteins which often appear during protein purification by column chromatography. The present method is simple, rapid and makes it possible to preparate AhpC from H. pylori

Oyan reservoir, South-West Nigeria was constructed in 1984 to generate electricity but has altered the exist­ing physical, biological and socio-economic environment of the people. This study, carried out between October 2006 and March 2008, aimed at investigating the current status of Schistosoma haematobium infection around the reservoir. Urine samples from 536 participants in five communities were examined for haematuria using reagent strips and S. haematobium ova was detected using sedimentation by gravity method. The participants were drawn from Abule Tuntun (n= 115), Ibaro (n= 156), Imala Odo (n= 88), Imala (n= 103) and Apojula (n= 74) communitie. Prevalence rates by haematuria were (Abule Tuntun- 33.04%; Ibaro- 73.07%; Imala odo- 60.22%; Imala- 7.77%; Apojula - 39.19%) and by presence of parasite ova were (Abule Tuntun- 39.13%; Ibaro- 83.97%; Imala Odo- 62.5%; Imala- 20.39%; Apojula- 54.05%). S. haematobium transmission has been sustained in the reservoir since the outbreak was first reported in 1988. Mass treatment with praziquantel was conducted 8 years ago (2001) in two of the communities. However, the infection has persisted due to lack of pipe borne water and safe waste disposal system.

Inflammatory bowel disease, coronary artery disease, cerebrovascular disease, hypertension, diabetes, tumours, are exam­ples of chronic degenerative diseases that have a high prevalence in developed nations. These chronic-non-communicable dis­eases have multifactorial aetiologies that considered to be caused by the interaction of environmental risk factors with multi­ple predisposing genes. Genetic researches on these diseases have traditionally focused on investigation aimed at identify­ing disease-susceptibility genes. Recent evidence suggests that somatically acquired DNA mutations may also contrib­ute significantly to the pathogenesis of these disease states such as coronary artery disease indicating a similarity be­tween the atherosclerotic and carcinogenic processes. The high incidences and prevalence of these chronic diseases in the West­ern World in comparison with the East and changing trends in disease incidence (seen in many countries) provide strong evidence that those environmental factors as playing a major influence in disease- expression. There is an ample reason to be­lieve that environmental factors have contributed to inducing alterations in genetic code in precedent generations, which were subsequently inherited and further modified by modern life style activities. Consequently, we now see the appearance of chronic degenerative diseases and their higher incidences in the Western nations as compared with the Eastern ones.

Oculocutaneous albinism type1 (OCA1) is characterized by the absence of melanin pigmentation. The muta­tion on TYR gene makes OCA1 as an autosomal recessive genetic disorder. In this study, we delineated the genetic analysis of an Iranian family with four members affected with OCA1. Clinical exams and paraclinical test were performed for all patients of the case family, also proband, her husband, and her parents. Pedigree chart was drawn too. We extracted the genomic DNA from the leukocytes of seven members of the family. Haplotype analysis at the TYR locus was done and informative microsatellite markers were employed. In order to amplify the entire coding region of the TYR gene, for bidirectional direct sequencing mutation analysis, eight sets of prim­ers were used. Our patients were diagnosed as affected with Oculocutaneous albinism type1a. Analysis of pedigree pattern showed an autosomal recessive inheritance. Analysis with different markers in chromosomes 5, 6, 9, 11 and 15 showed that cause of albinism in our case family was on chromosome 11 (D11S1887 marker was informative). The results offered a more developed method of diagnosis for OCA1 carrier identification and genetic counsel­ing for OCA1 affected families as well; also submit a sample of mutation involved with oculocutaneous albinism in Iran. Genetic analysis is necessary for determining the type of albinism in an individual patient.

The significant increase in the number of human subcutaneous dirofilariasis in recent years, suggests the appear­ance of a new health problem in the old world with most cases reported from Mediterranean countries. Besides the pre­sent case, eleven cases of human subcutaneous dirofilariasis have been detected in Iran, three of which belong to Gilan Prov­ince, northern Iran. We present an autochthonous case of subcutaneous Dirofilaria repens infection in a 39-year-old woman from Kouches­fahan district of Gilan Province, manifest as an itching and highly erythmatous subcutaneous tender nodule on her right thigh. The nodule was excised by a dermatologist as a suspected case of cutaneous fascioliasis. Microscopic examination of the excised nodule revealed the presence of D. repens. Since Gilan Province is the endemic region for human fascioliasis and several cases of cutaneous fascioliasis have been detected in the province during last two decades, we propose the physicians and pathologists to take in to account sub­cutaneous dirofilariasis as an emergent zoonosis causing dermal and visceral lesions which may sometimes misdiagnose as malignant tumors, and also as differential diagnosis of cutaneous fascioliasis.