Iranian Journal of Medical Sciences
Volume:27 Issue: 3, Sep 2002

The production of nitric oxide (NO) is important in the final outcome of leishmaniasis in animal models. The efficacy of garlic therapy and a combination of garlic and vitamin A were compared with an antimonial drug (glucantime) to assess healing and regulation of NO release in mice infected with Leishmania major. The mice were subjected to 3´105 promastigotes and allowed to induce a lesion. The mice were treated with above compounds twice a day for 45 days. The diameter of the lesion was measured on days 1, 10, 20, 30 and 45. In a separate experiment, NO release by peritoneal macrophages was measured. The diameter of lesion was reduced by aqueous extract of garlic within 30 days of treatment. However, the maximum reduction was induced when mice were subjected to vitamin A for 10 days before the administration of the aqueous extract for 30 days. A significant correlation between healing and the amount of NO release was also found. A combination of aqueous extract of garlic and vitamin A can treat leishmanisis

Following WHO recommendation, HBV vaccination has been integrated into EPI program in Iran since 1996. To evaluate the immunogenicity and protective effect of HB vaccine (recombinant Heberbiovac, Cuba) in vaccinated children and adults. A total of 542 cases (340 children and 202 adults) were vaccinated using a three-doses schedule of zero, one and six month. Blood samples were collected before the last injection, one month, one and two years after vaccination. Sera were tested for anti-HBs as indicator of immune response. Seroconversion rates for anti-HBs after second dose was 97.9% in children and 87% in adults. After the third injection this response increased to 100% and 93.7% in children and adults respectively. The anti-HBs titer decreased after two years in both groups. General vaccination with Heberbiovac vaccine in Iran has been successful in provoking immune response and protection against HBV infection. It seems that the persistence of the produced immunity is higher in children than adults.

Fungal corneal ulcer is the most dangerous and challenging type of infective keratitis. Since most of the ophthalmic antifungal drops are scarce and expensive in developing countries, attempts have been made to study fungicidal property of some readily available antiseptic agents as a substitute. Povidone iodine (PI) and chlorhexidine gluconate (CHx) has been postulated to be effective against fungi. To study in vitro antifungal efficacy of PI and CHx. Fungi isolated from cases of keratomycosis were entered in a prospective study from June 2001 to March 2002. In vitro susceptibility of these fungi was tested by broth dilution method of NCCLS Standard to PI (1%, 2%, 5%, 10%) and CHx (0.04%, 0.1%, 0.2%) after 5 minutes, 1 hr, 24 hrs and 48 hrs exposure times. From a total of 16 culture-proven cases of fungal keratitis, the isolated fungi were 8 Aspergillus sp, 3 Fusarium sp, 2 sterile hyphae, 1 Candida sp, 1 Drechslera sp, 1 Rhodotorula sp. PI showed 100% fungicidal effect with all tested concentrations, after 5 minutes of exposure to all fungal species.CHx. 0.1% and 0.2% after ³1 hr exposure were as effective as PI (p>0.34). The fungicidal efficacy of CHx 0.1% and 0.2% was significantly less than PI after 5 minutes (p<0.001). Both PI and CHx have strong in vitro fungicidal effect. The kill rate of CHx, however, is less than PI. Since in vitro efficacy of topical ophthalmic preparations is affected by multiple factors, our study provides a good idea for further in vivo investigations about this subject.

Experience with vesicoureteral reflux (VUR) differs in different centers and there is plenty of controversies. To evaluate the outcome of primary VUR complications and the rate of recurrence of UTI. In a retrospective study, the medical charts of all infants and children with primary VUR who were followed up by one nephrologist were reviewed. During 16 years, 271 patients (226 females, 45 males) with 401 refluxing ureters were followed up as primary VUR. The patients’ age at diagnosis was 4 days to 16 years (Mean: 4.4 years) and the mean duration of follow-up was 4.2 years. Urinary tract infection (UTI) was the presenting symptom in 97% and fever was recorded in 30% of cases. Frequencies of different grades of VUR at initial investigation were 6.5%, 52%, 23.4% and 18.1% for grades I to IV, respectively. The responsible microorganism in 90% of the first episodes of UTI was E. coli. Scarring or small size kidney was present in 63 patients. Recurrence of UTI in VUR of grades I to IV, were 68.7%, 51%, 60.1% and 46.8%, respectively. Follow-up voiding cystourethrogram revealed resolution of VUR in 52%, improvement in 31%, no change in 11%, and deterioration in 6%. Complications such as chronic renal failure, hypertension and renal tubular acidosis were observed in 11, 10 and 9 patients, respectively. Symptomatic primary VUR is more common and has better prognosis in girls. Recurrence of UTI is not related to the grade of VUR.

Management of lymphedema is a challenging issue in surgery. A variety of operations have been used, albeit with little success. To investigate the efficacy of testicular patch as a lymphatic conduit. An incision was made on the inguinal area of 10 dogs and all lymph nodes of inguinal area were excised. The tunica albuginea and parenchyma near the hilum of testes were taken and transferred to the site of excised lymph nodes. Microscopic study showed neovascularization of lymphatic duct in 80% of samples. Testicular patch graft can be used as a lymphatic conduit and implemented in the management of lymphedema.

Passive cigarette smoking is a known cause of a variety of diseases. However, most of the studies done in this field have focused on its chronic effects on human health. Studies considering the acute effect of smoking on QT dispersion, on the other hand, with its known predictive role in the occurrence ventricular arrhythmia and sudden cardiac death are sparse. This study aims at determining possible relation between acute exposure to others’ cigarette smoke and QT dispersion in normal subjects. In this prospective study, 95 healthy male volunteers 16 to 62 years (meanًSD: 29. 8±9. 5) and normal baseline ECG were selected. Within 5 minutes of inhaling the smoke of one filtered cigarette burned at a distance of one meter a second ECG was obtained. We measured QT intervals in each of the 12 leads and corrected them according to the heart rate (QTc). Difference of maximum and minimum measured QT and QTc intervals amongst 12 leads (QT dispersion (QTd) and QTc dispersion (QTcd), respectively) were compared. Mean±SD QTd were 50. 8±17. 8 ms before and 73. 6±29. 2 ms after passive smoking. Mean±SD QTcd were also increased from 62. 2±20. 9 ms to 85. 2±30. 8ms (p<0. 001). Passive smoking may acutely affect myocardial vulnerability to arrhythmia by increasing QT dispersion. More strict rules against smoking in all public places are endorsed in order to decrease the incidence of this preventable cause of illness and death

Our results showed a high prevalence of PPT in women in Shiraz. This may be due to the transition from low to adequate iodine intake and participation of women in earlier postpartum period. The major difference compared to other studies is the high frequency of thyrotoxicosis. The clinical and biochemical prevalence of PPT were 33% and 11.4%, respectively (p<0.01). Hyperthyroidism was more frequent in early months of postpartum period and hypothyroidism was more frequent in later months. Thyrotoxicosis and hypothyroidism occurred in 34 (8.8%) and 10 (2.6%) mothers, respectively. Positive Anti-Tpo Ab was found in 80% of patients and in 38% of the control group (p<0.0001). Of 460 postpartum women from Shiraz 385 cases who had no history of any medical problem or signs of other autoimmune disorders were selected during 1-8 months of postpartum period, to fill a questionnaire about signs and symptoms of their possible thyroid dysfunction. TSH and Anti-Tpo Ab were measured and FT4 assay was done on samples with abnormal TSH. 100 women at reproductive age were randomly selected as control group. To determine the prevalence of PPT in healthy postpartum women in Shiraz, southern Iran.

Tumor necrosis factor-beta or lymphotoxin-alpha (LT-α), IL-4 and IL-10 are determining factors in immunity against BCG. Allelic polymorphisms in the regulatory regions of their genes affect the rate of cytokine production and therefore, the host’s ability in BCG containment. To study the prevalence of –590 (C/T) and –592 (C/A) allelic distribution of IL-4 and IL-10 promoter regions, respectively, and +282 (G/A) polymorphism in the first intron of LT-α in BCG vaccinees with lymphadenopathy comparing to those of controls. Polymorphisms in the promoter region of IL-4 and IL-10 were determined by primer induced restriction site PCR and the polymorphism in the first intron of LT-α was investigated using PCR-RFLP method. Forty patients with BCG adenitis and 42 healthy age-matched infants without reactions were included in this study. No significant differences existed between allele and genotype frequencies of IL-4 or LT-α genes from patients as compared to the controls. A significant difference in genotype distribution of the IL-10 –592 C-to-T polymorphism was observed between patients and controls (p<0.05). In this respect, the AA and AC genotypes with lower ability in IL-10 production were found more frequently in the control group. The lower frequency of AA genotype at position –592 of IL-10 promoter region in patients may have resulted in more IL-10 production leading to weaker immune response that allows bacterial burden and occurrence of lymphadenitis.

The mean age at natural menopause and its determinants among Shirazi women (southern Iran) was calculated. The data were obtained from a population- based cross-sectional study carried out in the year 2000. Interviews were carried out and observations made on 948 women who had incurred natural menopause. They were randomly chosen using postal zones housing sample framework of Shiraz.Mean±SD age at menopause in the studied group was 48.3±5.3 (95% CI: 48.0-48.6) years with a median of 49.0 years. Arm circumference, height, weight, BMI, place of birth, handedness, ancestry, family background, level of education, level of daily physical activities, smoking habit, history of abortion, age at first marriage, age at first full-term pregnancy, menstrual cycle interval/du­ra­tion, age at menarche, dysmenor­rhea, mid-cycle spotting, were rewrded. It was found that the number of pregnancies were not significantly related to age at menopause. Age at natural menopause significantly correlated with menstrual cessation pattern, age at last full-term pregnancy, consanguinity of marriage, place of birth, and use of hormones before menopause.

Inborn errors of amino-acids metabolism and other inherited Mendelian disorders are common in the Middle East. The number of diagnosed inborn errors of amino acid metabolism is growing constantly on account of and availability and improved of analytical techniques. The aim of this work was to determine a rough estimate of the incidence rates of phenylketonuria (PKU), tyrosinemia, and maple syrup urine disease (MSUD) in Fars Province, South of Iran. Using a high performance liquid chromatography, 1044 patients with signs and symptoms suggestive of PKU, tyrosinemia and MSUD were investigated between 1996 and 2001, for the presence of the disorders. Of 1044 patients, 43 cases (4.1%) with PKU, 15 (1.4%) with tyrosinemia and 6 (0.6%) with MSUD were diagnosed. The incidence rates of PKU, tyrosinemia and MSUD were found to be 27.2, 9.4, and 4.7 per 100,000 births, respectively. The incidence rates of PKU, tyrosinemia and MSUD in our region is higher than the rates reported from Europe presumably because of the relatively higher rates of consanguinity.

The significance of immunophenotyping is growing day by day. It provides basic information in regard to classification and prognosis of acute leukemia which helps the management of patients. This study was conducted to Identify CD markers in leukemic patients admitted to Tabriz, in northwestern Iran. Immunophenotyping of 60 patients with acute leukemia was determined. Patients with acute myelogenous leukemia (AML) were 42% of M2 type, 23.6% M3, 15.7% M4, 13% M1 and 5.7% M5. CD13 and CD33 were the most prevalent myeloid markers. T-lymphoid markers consisted mainly of CD7 and its occurrence was mostly in M2 and M4, and least in M3 subtypes. The most common lymphoid markers in patients with Tcell acute lymphoblastic leukemia (ALL) were CD2, CD3, CD7 and in those with B-cell ALL were CD10, CD19 and HLA-DR. The most prevalent myeloid markers in T-ALL were CD14, CD33 and CD13.

Human T-cell lymphotropic virus type-I (HTLV-I) was the first human retrovirus associated with malignancy. The prevalence of HTLV-I infection varies significantly in different regions of the world. In this study, the prevalence of HTLV-I infection among ethnic Jews living in Shiraz, South of Iran, was investigated. 286 blood samples were obtained. HTLV-1 antibody assay on serum samples was done by standard ELISA method. Western blot method was applied for confirmation of borderline results.None of the subjects was found HTLV-I seropositive using both ELISA and western blotting methods. Our preliminary results indicate that HTLV-I is not endemic in Jewish people living in Shiraz, the southwest of Iran.

Some beliefs suggest that garlic is an excellent natural antimicrobial drug that can be considered as an alternative form of treatment or prophylaxis in gastrointestinal infections. The purpose of this study is to determine quantitative antimicrobial activity of garlic against Shigella by detecting the MIC. Garlic extracts were obtained and dilution susceptibility assay was used to determine the antibacterial properties of these extracts. All tested isolates of Shigella were susceptible to garlic extracts, and no one showed resistance to garlic extracts. These and many other research works propose garlic as a strategy for a low-cost intervention with few side effects and complete lack of resistance for prophylaxis and remedy of shigellosis in populations at high risk, particularly where antibiotic resistance and the risk of reinfection are high.

Disseminated nocardiosis (DN), is an infrequent and severe infection due to Nocardia species and defined as infection in two or more discontinuous organs. Most infections occur in the immunocompromised host or in persons with underlying disease. DN occurs rarely in children. In this report, we describe an 11-year-old immune-compromised child with nocardiosis involving the lung, skin, brain and bone. No predisposing factor nor any underlying disease was found to explain his immune deficiency. Diagnosis of nocardial infection is often cumbersome, resulting at times in wrong initial clinical diagnosis such as cancer and other bacterial infections (e.g. tuberculosis). Therefore, it is important to consider nocardial infection in the differential diagnosis of children with combined brain and lung lesions.