Iranian Journal of Medical Sciences
Volume:28 Issue: 1, Mar 2003

Acid phosphatase (ACP) is suggested to be one of the virulence factors in leishmania and a correlation has been reported between Leishmanial acid phosphatase (ACP) activity and the severity of the disease in all types of leishmaniasis including zoonotic cutaneous leishmaniasis (ZCL), which is a polymorphic disease. Characterization of leishmania and its correlation with the severity of the skin lesions in zoonotic cutaneous leishmaniasis. Promastigotes were isolated from 30 patients with scaly flat ulcers (LP1), volcano-shaped lesions (LP2) and papular forms (LP3) of ZCL. The Km and Vmax values of ACP in the supernatant of lysed promastigotes were calculated in presence and absence of the enzyme inhibitors, fluoride, tartarate, phosphate and salicylate. The Michaelis-Menten substrate saturation kinetics exhibited Km values of 12.5, 16.0, 26.6 mM and Vmax values of 8.78, 5.26 and 1.51 mM/min/mg protein for LP1, LP2 and LP3, respectively. In all isolates, the ACP was inhibited by all four inhibitors but the percentage inhibition was different and each inhibitor showed a particular inhibition pattern for each promastigote preparation. ACP content of LP1 was more sensitive to all four inhibitors and fluoride was more potent inhibitor of the enzyme in three isolates. The differences in ACP kinetics may be interpreted as being consistent with the severity of the skin lesions in Leishmania major infection.

At the present there is no growth reference for Iranian children, and cross-sectional studies indicate that Iranian children grow at a lower percentile curve than Western children. The present longitudinal study was undertaken: 1. To establish a growth standard for Iranian children and, 2. To compare their growth with Western norms. Weight, length, height, and head circumference were measured from birth to maturity in 180 boys and 180 girls living in Shiraz in socioeconomic conditions similar to high income groups in Western Europe and USA. Raw data and smoothed distance curves are reported here. The 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles of the measurements were not significantly different from London and NCHS standards. 1. These data can be used as standard for the growth of Iranian children. 2. The growth potential for Iranian children is similar to that of West European and US children. 3. Data from cross-sectional studies performed in developing countries should not ideally be used as standards.

The prevalence of food allergy is different in different parts of the world. Identification of the most common food allergens is a priority in any population to provide effective preventive and curative measures. The aim of this study was to determine the most common food allergens in Iranian children. One hundred and ninety children with skin, respiratory or gastrointestinal symptoms, thought to be due to food allergy, were studied. The total serum IgE and eosinophil count tests were measured in all patients. Allergy to 25 food allergens was determined according to the patient’s history, skin prick tests, RASTs (Radioallergosorbent Test) and open food challenge tests. The most common food allergens were cow’s milk, tomato, egg white, egg yolk, beef and almond, respectively. The order of common food allergens in this study was different from other reports; this might be due to the different food habits and /or ethnic diversities.

QT dispersion (QTd) especially after ischemic heart disease and myocardial infarction is a prognostic predictor of mortality, in adult medicine. This study was undertaken to determine the correlation between QT dispersion and neonatal stress. Neonates were divided into 3 groups: normal term (30 cases), normal preterm (30 cases) and sick neonates (36 cases), born between October 2001 and June 2002 in Hafez and Nemazee Hospitals affiliated to Shiraz University of Medical Sciences. Electrocardiogram (12 leads) was obtained and QTd was calculated. QT dispersion in sick neonates was significantly higher than normal neonates. The mean QTds in normal term group were 52.4± 24.47 ms in normal preterm, 69.3 ± 17.94ms and 100.8 ± 29.01ms in sick neonates. In sick neonates, QTd correlated with the incidence rate of mortality. It is concluded that QTd might be a prognostic factor for estimation of neonatal mortality.

Measuring peak expiratory flow rate has been suggested as an important tool in asthma management by all international guidelines. Studies on various populations have shown considerable variations in normal values of peak expiratory flow rate. Since reference standards for Iranian children are not available, the present study was performed to establish these standards. This study was conducted on 1535 normal schoolchildren (767 female, 768 male), aged 6-14 in Tehran. A mini Wright peak flow meter was used to measure peak expiratory flow rates. The highest of the three readings was taken as the correct value. Regression analysis was used to calculate the predicted normal values of peak expiratory flow rate and also to assess its relationship to age, weight, height, and surface area. Peak expiratory flow rate values increased with age and were in strong correlation with the studied anthropometric measurements. Except for the 145-159 cm interval, the male children showed significantly higher values (P<0.01) of peak expiratory flow rate in comparison to female children. The peak expiratory flow rates for Iranian schoolchildren were similar to some of those reported from other countries and could be used by Iranian physicians for proper management of paients.

Nasal polyps, a common clinical problem, are characterized by eosinophilic and mast cell inflammation. The role of allergy and IgE in pathogenesis of nasal polyps is still unclear. IgE receptors are important components of the immunological pathway in allergic and inflammatory diseases. To determine if the low affinity IgE receptor (CD23) is presented on nasal polyp tissues as a marker of local allergy or inflammation. Twenty patients who had undergone polypectomy enrolled into the study. Polyp tissues were stained by hematoxylin-eosin and acid-fast methods for histopathologic study. Immunohistochemical staining was performed with monoclonal antibody to leukocyte surface CD23. Polyp tissue fluid was extracted by slicing and centrifuging. Total serum IgE and tissue fluid was measured by ELISA. Thirteen of 20 polyp tissues were positive for CD23. Moderate to large number of eosinophils were observed in 5 patients. Serum IgE level was elevated (>70 IU /ml) in 13 patients and polyp IgE level was elevated in 8 patients. No significant correlation was found between CD23, serum and polyp tissue IgE, and eosinophil infiltration. CD23 may act as non-IgE dependent inflammatory marker in the pathogenesis of nasal polyps.

Plasmapheresis is a well-recognised method for harvesting plasma. It was introduced in the 1950s and is currently employed worldwide. This method has been in use in Iran since 1979. To evaluate the efficacy of donor safety program used at the Iranian Blood Transfusion Organization. A comparison is made of the protein concentrations between the first-time and long-term plasmapheresis donors, using protein gel electrophoresis. The effect of vaccination for collection of hyper-immune plasma was also studied.Results/ Our data comprising a 10-year evaluation of the current programmes, demonstrates no significant difference between the groups studied. This indicates safety of the plasmapheresis procedures in plasma procurement.

Background/ Development of a new enzyme-linked immunosorbent assay (ELISA) for screening human blood serum and plasma for antibodies to human immunodeficiency virus type 1 (HIV1) and type 2 (HIV2) as HIV1/2REC ELISA diagnostic kit based on E. coli derived soluble recombinant proteins. Polypeptides corresponding to HIV1 gp41 and HIV2 gp36 immunodominant regions and HIV1 gag were expressed in E. coli in fusion with thioredoxin (Trx) to obtain a highly purified (>98%) soluble refolded proteins, which was used as solid phase antigens for ELISA. The sensitivity and specificity of anti-HIV1/2 antibody detection were evaluated with representative panels of positive and negative sera. Positive panels included HIV1-positive Western-blot (WB)-confirmed specimens collected in Iran, Russia, and Uganda. Commercially available HIV1 and HIV2 seroconversion low titer and performance panels were also used. Negative panel was collected from random volunteer blood donors, risk group members, HCV-infected patients and individuals with non-HIV related conditions potentially influencing test results. The sensitivity of antibody detection with new kit was determined to be 100%. Specificity was determined to be 99.82%. It was shown than thioredoxin (Trx) did not change the immunodominant epitopes of HIV. These fusion proteins are recognized by human native antibodies. In addition, thioredoxin (Trx) would help natural refolding of HIV proteins by E. coli. These characteristics of the new assay are comparable to those of majority of FDA-licensed and officially approved European diagnostic kits, which are currently available in the United States and Europe.

Fascioliasis is a health problem in several countries including the Islamic Republic of Iran. In a review of the medical publications during 1990-2002, only 22 cases of biliary tract obstruction by fasciola hepatica have been reported. Herein, we are adding a new case of fasciola hepatica causing bile duct obstruction and presenting with intermittent colicky pain, eosinophilia and bile duct dilatation. This condition was diagnosed by endoscopic retrograde cholaogio-pancreatography (ERCP) and was treated by extemporaneous papillotomy. This case report confirms that in endemic areas, fascioliasis should be included in the list of the differential diagnosis for colicky abdominal pain, eosinophilia and bile duct dilatation. The condition could be concurrently diagnosed and treated by ERCP.

Myiasis is an infestation of tissues with larval stage of dipterous flies. This condition most often affects the skin and may also occur in certain body cavities. It is mainly seen in the tropics, though it may also be rarely encountered in non-tropical regions. Herein, we present a case of cutaneous furuncular myiasis in an Iranian male who had travelled to Africa and his condition was finally diagnosed with observation of spiracles of larvae in the lesions.

Herein we report a case of primary leiomyosarcoma of testis, which was believed to originate from normal testicular structures. It contained smooth muscle cells, blood vessels and contractile cells of the seminiferous tubules. No evidence of tumor spread was found.Treatment consisted of orchiectomy with high ligation of the spermatic cord. The patient received no adjuvant therapy and there was no evidence of tumor 30 months after the operation. Pertinent literature is reviewed and the differential diagnosis is discussed.