Zahedan Journal of Research in Medical Sciences
Volume:17 Issue: 1, Jan 2015

Listeria monocytogenes is slowly becoming drug resistant, study on resistance of this pathogen is important to ensure effective treatment of human listeriosis. The aim of this work was evaluating the changes in susceptibility to antibiotics and cell survival of L. monocytogenes PTCC1297 (serotype 4a) after exposure to some stresses. In this descriptive-analytic study L. monocytogenes PTCC1297 subjected to sub-lethal environmental stresses including ethanol (5% v/v), sodium chloride (7% w/v), acid (HCl, pH=5.0), hydrogen peroxide (600 ppm) and heat (45ºC). After the stress treatments, antibacterial susceptibility and cell survival were determined. Exposing to hydrogen peroxide (600 ppm) and heat (45ºC) significantly (p<0.05) increased resistance to all selective antibiotics. But treating to stresses such as hydrochloric acid (pH=5.0), sodium chloride (7% w/v) and ethanol (5% v/v) decreased resistance (p<0.05) to antibiotics. L. monocytogenes PTCC1297 cell survival was decreased at 60ºC which is considered as lethal condition. Exposing to sub-lethal acid stress increased survival to high acidic conditions (pH=3.0). But upon increasing hydrogen peroxide the viability of cell decreased. Treating the cells with ethanol (14% v/v) and NaCl (20% w/v) increased cell survival. Adaptation to some stresses including hydrogen peroxide and heat increase resistance to antibiotics. Stresses such as ethanol, hydrochloric acid and sodium chloride act in adverse. Exposing to some sub-lethal stresses increased cell survival when lethal doses of the same stress such as acid, ethanol and sodium chloride were used. But, when we treating the cells to sublethal doses of H2O2 and heat the cell survival decreased.

The kidney by the way is an essential organ and part of the urinary system and serves as natural filter of blood and removal of wastes, among other functions. The objective of this research is to investigate the effect of caffeine on renal toxicity induced by diethylnitrosamine (DEN), in rats. In this experimental study, 40 female rats were divided into 4 groups with 10 animals in each group. Group I (control group), group II were injected with a single dose of DEN (200 mg/kg, i.p.), group III were injected i.p. caffeine (100 mg/kg), daily for 4 weeks, group IV received the same treatment as group 2 of DEN and received daily caffeine as group 3. After 30 days, blood was collected for analyzing level of creatinine and blood urea nitrogen (BUN). The mean serum BUN and creatinine levels were significantly higher in DEN treated control group in comparison to those of base line control. Again, these levels were significantly lower in caffeine pretreated and DEN treated group (groups II, III, IV) when compared to those of DEN treated group (group I). Caffeine may have some nephroprotective effect against DEN induced nephrotoxicity.

Cardiac resynchronization therapy (CRT) has been introduced as a promising therapeutic choice in heart failure (HF) patients with ventricular dyssynchrony, shown with a wide QRS. In previous study, we showed a positive effect of CRT on ejection fraction. This study aimed to evaluate the effect of CRT on the severity of mitral regurgitation (MR) quantitatively using the volumetric Doppler method in HF patients. In this prospective before-after survey, 22 HF patients with wide QRS (≥120 ms) and NYHA class III who were included. All patients were evaluated initially for QRS width, NYHA class, MR volume, MR fraction and mitral valve area (MV area). Biventricular pacing was done through cardiac-resynchronization device along with three pacing leads and same evaluations were done after CRT. The mean (SD) QRS width and NYHA class were significantly decreased after CRT in HF patients (p<0.001). Also MR volume (46.9±30.2 mL vs. 27.0±26.4 mL, p<0.001) and fraction (40.1±25.5% vs. 26.8±22.7%, p=0.002) were improved following CRT. The decrease of MV area after CRT was also significant (10.6±3.0 cm2 vs. 8.6±2.6 cm2, p<0.001). As MR is associated with morbidity and mortality in HF patients and the standard surgical therapy may not be practical for a majority of them, this novel treatment may improve their disease condition significantly.

Visceral larva migrant’s syndrome by toxocara affects mainly children between 2 and 5 years old، it is generally asymptomatic، and the seroprevalence varies from 3 to 86% in different countries; as well as، the secondary stage larvae cause ocular، respiratory and neurotic disorders. The aim of this study was to determine the incidence of anti-toxocara antibodies in children blood that showed chronic cough having eosinophilia in rural part of Shiraz، Iran. In a cross sectional study during a tuberculin survey rural area of Shiraz، a city in Southwest Iran، a number of 610 children were selected by randomized two-stage cluster sampling. Children with chronic cough were investigated for toxocariasis. Initially، the absolute eosinophil count was determined. Then، children having eosinophilia were tested by toxocara-IgG - ELISA kit (Ibl، Hamburg). Of total 80 children with chronic cough، 12 (15%) were eosinophilic، among them 6. 25% were hypereosinophilic، 9 (11. 25%) were toxocara ELISA-IgG positive. No correlation between intestinal parasites and toxocariasis was detected. There was also no significant interdependence between age، gender، and dwelling difference in toxocara antibody amount. Presence of eosinophilia and the risk factors evaluated in this population were frequently associated to human toxocariasis. Anti toxocara antibody was detected in more than half of children with chronic cough، thus، toxocariasis among children in schools should have been noticed in schools by both education and hygiene ministry.

Carpal tunnel syndrome is entrapment of the median nerve in carpal tunnel of the wrist. In severe cases of carpal tunnel syndrome, or those refractory to conservative treatment, surgery is performed. The main aim of this research was to determine the incidence of recurrent and persistent rates of carpal tunnel syndrome following open surgery. This descriptive cross sectional study was performed on 105 patients having open carpal tunnel release in the range of 5 to 60 months ago. These cases were operated at Shahid Beheshti hospital in Yasuj, Iran. Assessment of carpal tunnel syndrome after open surgical release of the median nerve was done by electrodiagnostic studies and MRI. If symptoms of carpal tunnel syndrome maintain after surgery, this condition is persistent and if reappearance of the syndrome 3 months or more following surgery this is recurrent. In cases of observing changes from severe to lower stages of the disease in electrodiagnostic studies, treatment is considered successful. All of 58.1% of patients had right severe carpal tunnel syndrome and 41.9 % had left severe carpal tunnel syndrome prior to surgery. The incidence of recurrent and persistent carpal tunnel syndrome following open transverse carpal release was 12.4% and 10.4%, respectively. The incidence of persistent and recurrent rates of carpal tunnel syndrome following open transverse carpal release was higher than the expected rate. These rates were dependant to the appropriate patient, the correct diagnosis and duration of symptoms before surgery.

To compare the efficacy of adding an opposite clear corneal incision (OCCI) on the steep meridian versus performing surgery on the steep meridian alone during phacoemulsification in reducing pre-existing corneal astigmatism in Alzahra ophthalmology center. This randomized clinical trial was performed on 40 eyes with corneal astigmatism undergoing phacoemulsification and divided randomly to two groups. In the first group 3. 2 mm phacoemulsification incision was made on steep meridian and in the other group after the procedure was completed the surgeon made 3. 2 mm incision opposite to the main incision. Patients were followed with refraction، keratometry at 1،، 12 weeks. Mean corrected astigmatism was greater in opposite clear corneal incision group than steep meridian incision phacoemulsification group. No significant change occurred in amount of astigmatism in two groups. Opposite clear corneal incisions achieve an enhanced effect over single clear corneal incisions in treating preexisting astigmatism in cataract patients.

Using sclerotherapy with foam has caused a great change in treatment of varicose veins. Although, it is more than a century that it is being used, no exact and comprehensive knowledge of its complications has been published yet with regard to the existing facilities in Iran. In this cross-sectional study, Patients with varicose veins of lower extremity referred to cardiology clinic of Razi hospital, Rasht were included in the study after doppler sonography and in case of presence of varicose veins with more than 2 mm diameter in lower extremities without inadequacy of saphenofemoral and saphenopopliteal valve. They then underwent sclerosing with foam treatment. The total number of patients was 156 who were examined 2 weeks and 3 months after sclerotherapy in terms of complications such as pain, pigmentation, recurrence, phlebitis, deep vein thrombosis and skin necrosis. Out of 156 patients, 47 were men and 109 women whose mean±SD age was 46.5±12.2 years. Two weeks after sclerotherapy, pain in 95 patients (65.1%), pigmentation in 79 patients (53.4%), recurrence in 5 patients (3.4%), necrosis in 8 patients (5.5%) and no phlebitis was witnessed. Three months after sclerotherapy, pain in 10 patients 6.8%), pigmentation in 52 patients (35.1%), recurrence in 13 patients (8.8%) and phlebitis in 1 patients (8.8%) were seen; however, necrosis was not observed Sclerotherapy with foam is an effective, safe and inexpensive method for treatment of varicose veins of lower extremities. Thus, in case of a careful selection of patients and conduction in an equipped center, few complications will be seen.

Trace elements such as manganese have an important role in the maintenance of the normal structure and physiology of cells. Manganese is involved in many biological processes. Therefore, an evaluation of the manganese in the atherosclerotic disease is important. In this cross sectional study, 334 subjects, without recent cardiac event and history of collagen vascular or infectious disease were investigated. All patients divided into 4 groups to evaluate severity of coronary artery disease according to Syntax scoring system. All groups were matched in cardiovascular risk factors. The serum level of manganese in normal coronary group was 1.47±0.23 μg/L and in total atherosclerotic groups was 1.06±0.37 μg/L. The serum level of manganese was significantly lower in total atherosclerotic groups than normal group (p=0.001) and significantly decreased with severity of atherosclerosis. The serum level of manganese was significantly lower in sever atherosclerosis patients than mild and moderate coronary artery disease groups (p=0.001). The finding indicated that the serum level of manganese is lower in atherosclerotic patients and it decreases with severity of atherosclerosis.

Carpal tunnel syndrome (CTS) is the most common focal mono-neuropathy of median nerve in carpal tunnel. Prevalence is 2.7-5.8% and is more common in female than male. The most important diagnostic method is electrophysiologic study of median nerve. This case-control study has done on 34 patients with CTS and 44 healthy cases underwent electrophysiologic study. The diameter of nerve was measured at site of compression and also at a more proximal site in patients. In CTS group increased significant distal latency in motor and sensory conduction and proximal motor latency of median nerve was noticed. The altitude of sensory median nerve and conduction velocity of median nerve in CTS group was decreased significantly. Thenar atrophy was seen without relation with severity of nerve compression. The nerve diameter was decreased in severe cases of CTS group without significant differences. In CTS severity of anatomic changes are not the same as changes in electrophysiologic study.

Influenza A (H1N1) imposed a considerable burden on our health community. This study was conducted to evaluate the clinical and paraclinical pattern of the disease in influenza A (H1N1) patients in Kashan. This descriptive study was carried out on 87 definite cases of pandemic influenza A (H1N1) diagnosed from July to January 2009 in Kashan. The clinical and paraclinical information were collected and analyzed by SPSS-13. The majority of patients were in age group 16-25 years and 50.6% of patients were male. The most common clinical symptoms were fever (92%), cough (78.2%) and dyspnea (54%). The most important paraclinical findings were: leokocytosis (41.3%) increased ESR (46.6%), positive CRP (48.7%). The mortality was seen in 8 patients (9.2%). Regarding to majority of death has occurred in patients with underlying disease, annual prophylaxis by influenza vaccine and early treatment to prevent of morbidity and mortality is recommended.

Mental disorders severely affect the quality of life of epileptic patients. Due to the lack of adequate research, in the present study we assessed psychiatric disorders in patients with idiopathic tonic-clonic seizure. This descriptive-cross-sectional research was conducted on 170 patients using the SCL-90-R questionnaire and the results were analyzed by t-test and χ2 test. The prevalence of psychiatric disorders in patients was 38.8%. In order, the highest frequency belonged to obsessive compulsive, depression and interpersonal sensitivity 46.5%. Mental disorders are present in a high percentage of epileptic patients, which shows the need for psychological evaluation.

Infantile-onset Pompe disease is a rare genetic and lethal disorder which is caused by the lack of acid alpha-glucosidase activity (GAA). The aim of our study was to identify the demographic and clinical characteristics, and natural history of these patients. In this retrospective study, clinical file of 15 patients diagnosed with infantile-onset Pompe disease whose symptoms started before the age of 12 months were studied. Diagnosis was based on clinical history, physical examination and diagnostic parameters in chest X-ray, echocardiogram, electrocardiogram and biochemical tests after rule out the other metabolic and neuromuscular disorders. Sixty percent of the patients were male and 40% were female. The mean age at the onset of symptoms was 78 days (range: 3-150 days). Most frequent clinical and paraclinical symptoms were cardiomegaly, hypotonia, hyporeflexia, macroglossia, failure to thrive, hepatomegaly, and feeding problems, respectively. The mean age at the time of death was 5.96 months (range: 4-8 months), and all patients died before one year of age. Muscle enzymes including AST, ALT, LDH, and CPK were elevated in all patients. Due to the lack of availability, enzyme replacement therapy was not possible for any patient. The study showed that despite the supportive measures and no specific treatment, the clinical course is not significantly different with similar studies and the overall prognosis of this form of disease is very poor and disappointing.

Finger amputation is a physical and mental trauma. It can disrupt individuals’ daily life. Numerous advances are made regarding the replantation of amputated fingers. These all owe to the advances of microscopic surgical methods and respective specialists’ understanding of hand traumas. Establishing arterial blood circulation and venous flow are taken to be the most important factors in successful finger replantation. Replantation of four fingers were carried out in three patients. Surgery was done without any additional surgical incision whether in distal fragment or in proximal fragment. Patients were between 18 to 54 years old. One case had smoking background of 15 years given up for 3 months from surgery. Hospital admission was 48 h. Mean surgery time was 5.5 h for each finger. In all cases, replantation was successful. Although our method is technically time-consuming, it can be promising with respect successful results.

Hydatid disease is still an important health problem in the world. It is prevalent in the most countries in Asia, Middle East, Australia, and Eastern Europe. Due to the vital cycle of the parasite, the liver is a more common site than other organs. However, multiple huge cysts of liver are rare, especially when it is observed with liver malignancy. Here in, we report a 33-year-old woman with comorbidity of multiple huge cysts and hepatocarcinoma.

Tracheal diverticulum is a rarely encountered entity usually diagnosed incidentally on CT scan. It may be asymptomatic or may present with recurrent respiratory infections or other symptomatology. Here we report a 59-year-old baker presented with shortness of breath, cough, and sputum production that had tracheal diverticulum in association with bronchiectasis on HRCT which has rarely been reported in the literature.

Acute mitral regurgitation accounts for 9% cases of cardiogenic shock following myocardial infarction and results from papillary muscle infarction. This complication occurs early following myocardial infarction. The etiologies of this devastating complication include left ventricular failure, right ventricular failure and acute mitral regurgitation that mitral regurgitation usually results from papillary muscle rupture. We reported a 41 year old male with first diagonal branch stenosis and dominant left circumflex and complete transaction of anterolateral papillary muscle that had not been reported in literature.