Journal of Kerman University of Medical Sciences
Volume:14 Issue: 2, 2007

Cutaneous leishmaniasis is an important public health problem in many tropical and sub-tropical countries including Iran. In Iran, it presents in two forms of anthroponotic CL (ACL) and zoonotic CL (ZCL). Bam is one of the oldest foci of ACL and the earthquake of 2003 December, 26th made a significant change in the population and environmental factors and subsequently in epidemiological feature of the disease. The objective of this study was to assess the prevalence of CL in school children and treatment of patients. The results of this study can be used for prevention and planning future control programs in the district of Bam. The survey was conducted as a cross-sectional descriptive study during spring 2006. A total of 4931 children from 30 primary schools (6-10 years), elementary schools (11-14 years) and high schools (15-18 years) were selected randomly and examined physically in Bam and Barawat. The suspected CL cases were referred to the CL clinic. Smear scrapings were taken from the active lesions for direct microscopic examination and treatment of the confirmed cases. A questionnaire was completed for each case, indicating demographic and medical aspects. SPSS software was used for data entry and further analysis. The x2 test was used to determine any significant difference in disease prevalence. In whole, 4.9% of the school children had active lesions and there was a significant difference between boys (6.3%) and girls (3.6%) in this regard (P<0.01). Lupoid lesions were significantly more in boys comparing to girls (80.9% versus 19.1%, P<0.005). The prevalence rate of scar in students was 14.9% and there was a significant difference in this regard between elementary schools children and the children in two other levels (P<0.05). In whole, 74.5% had one lesion, 17.3% had two lesions and 8.2% had three or more lesions. Hand was the most frequent site of involvement (47.8%), followed by face (33.8%), legs (14.9%) and other body parts (3.5%). The present study indicated that the epidemiological features of CL have changed significantly as compared to the previous reports. The main differences are higher prevalence rate of the disease, particularly in boys than girls and significant higher rate of lupoid lesions in boys rather than girls. Moreover, the number and location of lesions and the clinical features of the disease have been changed significantly. These findings emphasize further researches on epidemiological aspects especially on causative agent, host and suspected accidental hosts for future planning and implementation of suitable control programs.

Despite improvements in the diagnosis and treatment of lung cancer in the past two decades, it has remained the most common cause of death from cancer worldwide. Among all genes that are mutated in lung cancer, TP53 located on chromosome 17P13/1 has a significant diagnostic and prognostic value. TP53 mutations have been extensively studied in lung cancer and TP53 mutational spectra have been used for finding the origin(s) and mechanisms of these mutations in lung cancer development. The present study was conducted to investigate the TP53 mutations in patients with Non- small cell lung cancer hospitalized during 1997-2005 in Afzalipour Hospital, Kerman, Iran. Formalin- fixed, Paraffin- embedded tissues from lung cancer patients undergone surgery between 1997 to 2005 were evaluated. The mutational status of the TP53 gene (exons 5 & 8) was screened by polymerase chain reaction (PCR) analysis followed by sequencing. Of all cases of squamous cell carcinoma, 73 mutations were found in Exon 5 (in 18 cases) and 47 mutations in Exon 8 of TP53 gene (in 15 cases). we identified mutation hot spot at codons 6, 14, 25 of exon 5 and codons 2, 27, 35 of exon 8 of TP53 gene. Tansversions (G to T, A to T and G to C) and deletion mutations were the most in both exons 5 and 8. The incidence of G to T transversion mutations did not significantly differ between Exons 5 and 8. Higher prevalence of mutations in TP53 gene in the present study comparing to previous studies may be due to genetic, environmental and some epidemiological factors such as diet and life style of studied subjects.

Fluoroquinolones are potent inhibitors of bacterial topoisomerase II. They can also inhibit eukaryotic topoisomerase, and may confer antitumoral properties. In this study the antitumoral activity of a new series of N-substituted piperazinyl- fluoroquinolones against a panel of human tumor cell lines was determined by MTT assays. Among the tested compounds N-[2- (5-bromo-2-thienyl)-2-oxoethyl] (C1,N1,E1), N-[2- (5-bromo-2-thienyl)-2-(hydroxyimino) ethyl](C2,N2,E2) and N-[2-(5-bromo-2-thienyl)-2-(phenylmethoxyimino) ethyl] (C3,N3,E3) piperazinyl quinolones exhibited the most cytotoxic activities (mean IC50s = 2.5 to 3 μg/ml), comparable to that of the Etoposide (mean IC50= 1.7μg/ml). Replacement of the 5- bromo-2-thienyl with 4- fluorophenyl or 2,6- difluorophenyl rings leads to variable inhibition activity. The quinolone activity was enhanced by the presence of a chlorine and two fluorine atoms at the benzyl and phenyl groups, especially against ACHN renal adenocarcinoma cell line. These data suggest that these series of quinolones provide good models for the further design of potent antitumor compounds.

Internal derangement (ID) of TMJ is the most common type of temporomandibular disorders after muscle disorders and includes all disorders related to incoordination and dislocation of disc and condyle. Anterior disc displacement without reduction or closed lock will happen if the disc or condyle displaces severely or if the disc traps in the space in front of the condyle accompanied with reduction in maximum mouth Opening. The purpose of this study was to evaluate reliability of clinical diagnosis of disc displacement without reduction (closed lock) by using magnetic resonance imaging as the Gold standard. This cross-sectional study was carried out on 10 patients who had referred to Dental school of Mashhad University with the symptoms of ID and were assigned a clinical diagnosis of disc displacement without reduction. Sagital and coronal MR images were obtained with 0.5 Tesla magnetic resonance system, with the jaw in closed and maximum opening position subsequently to establish the corresponding diagnosis of disc-condyle relationship. The data analysis included kappa statistic and calculation of positive predictive values and sensitivity. The overall diagnostic agreement for disc displacement without reduction was 0.22 with a corresponding kappa value. The predictive value for clinical diagnosis of disc displacement without reduction was 20% and the sensitivity was 100%. According to the results, clinical diagnostic criteria for disc displacement without reduction is not reliable and patients assigned clinical TMJ-related diagnosis of disc displacement without redaction may need to be supplemented by evidence from MRI to determine the functional disc – condyle relationship.

Homocysteine is an aminoacid yielded from methionin to cysteine metabolism. Normal plasma concentration of homocysteine in human is between 5-15 μmol/l and an increase more than 5 μmol/l can increase the risk of cardiovascular diseases, atherosclerosis and thrombosis. On the other hand in dialysis patients due to some reasons such as uremia, genetic factors, dialysis related factors and vitamin B group deficiency, the plasma level of homocysteine increases. This study was done to evaluate Plasma vitamin B12, Folic acid and homocysteine levels in kerman hemodialysis patients in comparison to healthy persons. In this cross-sectional study performed in two hemodialysis units of kerman-Iran, 25 hemodialysis patients and 25 healthy persons were studied. Blood samples were drawn prior to the dialysis session. The samples were centrifuged and the plasma was kept frozen at -20°C until analysis. Homocysteine level was determined by Gas-Chromatography and vitamin levels analysis were determined by radio assay method. Mean homocysteine level in hemodialysis patients (19.7±8.8 μmol/l) showed significant difference (P=0.024) with healthy persons, homocysteine level (15.3±3 μmol/l). There were no relationship between the time passed since the first dialysis (p=0.188) and patients, age (p=0.419) with homocysteine levels. Plasma vitmin B12 and folic acid levels in hemodialysis patients were 4672±2379 pg/ml and 47±17 ng/ml respectively. These values were much more than those in healthy persons (959±409 Pmol/L and 14±12nmol/L respectively). Although homocysteine level in our patients was more than healthy persons, but it was lower than that of hemodialysis patients in other countries. This difference may be related to some factors such as genetic factors and administration of daily oral folic acid and Intravenous injection of B12 and B Complex after each dialysis session. Therefore this procedure is recommended in hemodialysis patients.

HESA-A is an active natural compound with herbal and marine origin. It contains inorganic, organic and aqueous fractions, and has shown antioxidant, cytotoxic and anticancer effects. In this study, the teratogenic effects of HESA-A in mice have been evaluated. Several doses of HESA-A were administered orally to pregnant mice on days 6 to 14 of gestation. Various parameters in pregnant mice and embryos during and after pregnancy were evaluated and recorded. At the end of pregnancy, embryos were sectioned out and studied for external morphological abnormalities and by specific skeletal staining for skeletal malformations. Weight gain of pregnant mice showed that only the highest dose (800 mg/kg) caused gain retardation. Also, only the highest dose led to reduction of uterus weight, number of viable embryos, and weight and crown-lump length of embryos. Increase in fetal resorption by the highest dose of HESA-A was another important observation. Low and medium doses of HESA-A did not cause any significant external or skeletal abnormalities. However, higher doses caused embryo malformations such as short limbs, spinal abnormalities, dermal cysts, microphtalmia, and cleft palate. According to this study, only high doses of HESA-A, which are many times higher than the usual therapeutic doses, may cause embryonic toxicity. Mechanisms of these abnormalities are not clear and need to be determined.

Cutaneous leishmaniasis (CL) is an increasing public health problem in several parts of Iran. In southern parts, the incidence of CL has been doubled over the last decade. This epidemiological study was done for determination of reservoir(s) and vector(s) of cutaneous leishmaniasis in rural regions of Marvdasht, Fars province, southern Iran during 2003 and 2004.

A total of 126 rodents were collected from three villages using live traps and their Giemsa-stained smears were studied for leishmania infection. After DNA extraction from positive smears, Nested-PCR was used for the identification of parasite species. In another procedure, 200 sand flies were collected by aspirator and after species identification DNA extraction and PCR was done.

The collected samples included Meriones libycus (75.4%), Cricetulus migratorius (14.3%) and Microtus arualis (10.3%). Eight out of 95 Meriones libycus (8.4%) were found to be infected with Leishmania major. None of the other species were positive. Among the collected female sandflies 75% were identified to be Phlebotomus papatasi and 2.7% of them were found with L.major infection.

Only 2.7% of Phlebotomus papatasi were found naturally infected with Leishmania major. This is the first report of detection of L.major by Nested-PCR in P.papatasi as a proven principal vector of zoonotic cutaneous leishmaniasis in Fars province, south of Iran.

Primary and metastatic bone tumors are rare in patella bone. Chondroblastoma and giant cell tumor have been reported in patella more frequently than others. Treatment and post surgical knee function depend on the type of tumor and surgical procedure. Regarding the scarcity of patellar tumors there are little reports about it. In this retrospective cross-sectional study, 13 patients with patella tumor treated from 1995-2006 were studied. Radiologic findings, clinical symptoms, pathologic reports and surgical outcomes were obtained from patients’ profiles. The frequency of patella bone tumors and their symptoms as well as surgical outcomes were evaluated in a long term follow up. The most frequent patella tumor was chondroblostom (5 cases of 13) followed by giant cell tumor (3 cases), metastasis (2 cases), aneurism small bone cyst (2 cases) and simple bone cyst (1 case). Knee pain and effusion were the most common symptoms. Knee range of motion and quadriceps strength and function were better in patella saving procedures comparing to total patellectomy. There was one case of recurrence in patients underwent patella saving operation. In our patients, chondroblastoma and giant cell tumor were respectively the most frequent patella tumors. Since knee range of motion and quadriceps strength and function have been better in patella saving procedures compared to patellectomy cases, this procedure is recommended in the treatment of patients with patella tumors.

Our great leader fatwa allowing abortion in the case of fetal disorders created fundamental change in therapeutic abortion. The aim of this study was to study therapeutic abortion licences being issued by Kerman legal medicine office in 2005 and comparing them with last years issued licences in order to increase the medical team information about the indications of therapeutic abortion and its appropriate time. This is a non interventional and periodical study and the sample group was pregnant women referring to legal medicine office in 2005 in order to get the abortion licence. All relevant data were recorded in a questionnaire and analyzed by SPSS software. Therapeutic abortion licence has been given to 24 out of 47 who has been referred during one year. From 24 issued lincences, 68% has been issued due to fetus diseases or abnormalities and 32% has been issued because of mother’s illnesses. The most important fetus problem was major β– thalasemia and the main problem in mothers was cardiovascular diseases. Mean age of mothers at the time of abortion was 29 years and that of fetus was 17 weeks. Increase in the rate of therapeutic abortions can decrease the rate of illegal abortions and this in turn increases the pregnant women’s health. Therefore, women health can be improved by increasing medical team information about the circumstances under which therapeutic abortion is permissible and its rules as well as criminal abortion punishments. Moreover, it can reduce the gynecologists’ problems in this regard.