Shiraz Emedical Journal
Volume:10 Issue: 4, Oct 2009

Hepatitis C virus (HCV) infection creates a significant burden to health care system. The epidemiological characteristics and risk factors for transmission vary across countries. A literature review of published scientific reports on HCV epidemiology in Iran and summarize of findings of some countries was performed. Prevalence of hepatitis C in Iran ranges from 0.5% to 0.97% in blood donors, 19.3% in patients with thalassemia, 19.6% in patients on maintenance hemodialysis, 31.5% of drug abuser inmates in a prison of Hamadan, 45.4% of inmates and 88.9% of intravenous drug abusers of a prison in Guilan were HCV antibody positive. The risk of infection related to injection drug use and health care serving are the most important for still growing number of infected persons. Expansion of harm-reducing interventions for drug users, and educating preventive programs in targeted high-risk behaviors populations will improve infection spread in our country. Design appropriate public health strategies by involvement of regional health agencies for education, supervising addiction control and establish policies for the appropriate use of injections, sterile principles in healthcare-related procedures, and improvement in blood transfusion safety in countries with high drug trafficking and insufficient health and social resources is needed. Control of HCV transmission requires continuous monitoring, surveillance and prevention.

BCR/ABL fusions in hematopoeitic cells are known to induce resistance to apoptosis and cell changes in response to cell-cell and cell-matrix interactions, on the other hand, patients with TEL/AML1 gene fusions respond differently to treatment, depending on therapeutic protocols. We conducted a prospective cohort study to investigate how these translocations affect a person’s quality of life, and to evaluate their responses to bone marrow transplantation therapy.Methods and Materials: TEL, AML1, ABL and BCR probes were applied to cells during interphase, using cytogenetic techniques and FISH analysis to obtain the karyotype of 100 patients, which included genes involved in fusion, signal distributions, age, sex, positive familial background, and responses to therapies. After BMT was performed in 25 patients, all of the above data was collected once again and the results were compared. In our study, 46% of child patients demonstrated an abnormal FISH pattern (23% with fused ABL/AML1, 3% with deletion, 7% with a gain in TEL gene, and 3% and 10% with deletion and a gain in AML1 genes, respectively. In adults, 27% had an abnormal FISH pattern, while 3% had fused TEL/AML1 genes and other abnormalities, as was evident in children. A gain in gene copy occured twice as often as a loss in gene copy, except for child ALL patients with t(12;21), where in 58% of cases, lost TEL gene children with t(12;21) had longer survival periods, while adults with t(9;22) had shorter ones. Post BMT revealed that 65% of BM cells karyotyped normal, compared to 24% pre-BMT. WBC count increased positively with the onset of ALL, although an increase in WBC count decreased survival time. A relationship between positive familial background and ALL was also seen. FISH is the better method for diagnosing genetic disorders in ALL patients compared to other methods.

Zinc deficiency may aggravate the effect of oxidative stress on RBC (Red Blood Cell) of chronic uremia. In this study, there is an attempt to show the relationship between the plasma zinc level and RBC osmotic fragility in hemodialysis patients. Patients and Thirty five patients with low level of serum zinc (serum zinc level<70) participated in the trial. RBC osmotic fragility, Hb (hemoglobin) and BUN (blood urea nitrogen) were checked. The patients received zinc supplement (zinc sulfate) (250 mg/day). Plasma level of zinc, Hb, BUN and osmotic fragility rechecked after 6 weeks. The mean serum zinc concentration among the participants increased and it was statistically significant (p<0.05). Erythrocytes at day 0 (59+/_ 3.5) were significantly (P < 0.05) more fragile in hypotonie saline than those at day 43(38+/_ 2.9), (at NaCl 40%). No significant changes were noted in the level of Hb In this trial, oral zinc supplementation caused a significant rises in the plasma zinc level after 6 weeks. Although Hb concentration was not changed during the trial the level of osmotic fragility in red cells reduced significantly.

Differentiating and typing clinical and environmental isolates of Aspergillus strains are necessary for epidemiological studies and could contribute to the solution of several pertinent clinical problems. We investigated the utility of the RAPD-PCR technique for typing twenty-six strains of Aspergillus fumigatus and ten additional clinical and environmental Aspergillus fumigatus and Aspergillus niger isolates. Fungal genomic DNA was extracted using glass bead disruption and RAPD analysis was performed by using a six individual (R108, R151, UBC90) and combined (R108+R151, R108+UBS90, R151+UBC90) primer set. Primer pair R108+UBC90 demonstrated the highest discriminatory power with collection strains, whereas primer R151 displayed the highest degree of discrimination power with clinical and environmental isolates. Both primer sets detected seven types of strains.It was found that primer R151, on its own and in combination with primer UBC90, shared a relative relationship between clinical and environmental A. fumigatus isolates. We found that although RAPD-PCR analysis can be applied as a simple, rapid, and very effective method for differentiating Aspergillus strains, selecting the best primers is a critical step to reach the desirable discriminatory power.

We studied markers of both neonatal and maternal hemodynamic condition in preeclamptic patients receiving spinal anesthesia for cesarean section and evaluated primary neonatal outcome with Apgar scores. 44 preeclamptic patients randomized into two groups of 22 patients were enrolled in this trial in Tabriz Alzahra Hospital. The trials were conducted from December 2005 to August 2006. In group A, spinal anesthesia was performed with 6mg of bupivacaine and 3.3 μg of sufentanyl, while Group B received 12mg of bupivacaine alone. Hypotension was treated with intravenous ephedrine boluses of 2.5-5 mg, up to maximum of 50 mg. After delivery, 1st and 5th minute Apgar scores were evaluated and umbilical arterial blood gas samples were drawn and analyzed. All patients had satisfactory anesthesia. Five of 22 patients in group A required 5mg of ephedrine, while 17 of the 22 patients in group B required ephedrine. There was no significant between group differences for 1st and 5th minute Apgar scores (P=0.760, P=0.349) and umbilical arterial blood gas markers (p>0.05). A 6mg dose of bupivacaine in combination with 3.3 μg of sufentanyl provided satisfactory spinal anesthesia for cesarean section in preeclamptic patients, and caused substantially less hypotension than 12 mg of bupivacaine alone. There was no difference in immediate neonatal outcome, as assessed by Apgar scores and neonatal pH and base deficit.

Halothane is a halogenated inhalation anesthetic. Its three trace elements are fluoride, chloride and bromide. Fluoride is well known by biochemists to be an inhibitor of enzymes. Fluoride forms a strong hydrogen bond with the amide group, and thus has the potential to interfere with fundamental life-processes involving the shape and function of both proteins and nucleic acids. Patients with halothane hepatitis or severe hepatic damage due to other halogenated anesthetics produce antibodies against several liver trifluoroacetylated microsomal proteins. Other studies suggest that molecular mimicry of N6-trifluoroacetyl-L-lysin by lipoic acid, or the impairment thereof, might play a role in the susceptibility of individuals for the development of halothane hepatitis. The spectrum of disease differs from aminotransferase elevation either without symptoms or with mild, self-limited symptoms to severe hepatitis or acute liver failure. More investigation is needed to understand the mechanisms of halothane hepatotoxicity. The aim of our report is to prevent, recognize and manage the complications of hepatitis associated with halothane administration.

GIS provides an excellent means for visualising and analysing epidemiological data, revealing trends, dependencies and inter-relationships. It can acquire, store, manage, and geographically integrate large amounts of information from different sources, programmes and sectors. GIS serves as a common platform for the convergence of multi-disease surveillance activities. Standardised geo-referencing of epidemiological data facilitates structured approaches to data management. Once the basic structure is ready, it is easy to convert it to a surveillance system for any other disease. Public health resources, specific diseases and other health events can be mapped in relation to their surrounding environment and existing health and social infrastructures. GIS helps generate thematic maps that depict the intensity of a disease or vector. GIS can identify catchment areas of health centres and also locate suitable sites for a new health facility. GIS allows interactive queries of information contained within the map, table or graph. It permits a dynamic link between databases and maps so that data updates are automatically reflected on the maps. Dynamic maps published on the Internet assist patients in locating the most convenient health services easily.

Aggressive angiomyxoma (AAM) is a rare vulvovaginal mesenchymal neoplasm with a marked tendency for local recurrence, but usually does not metastasize. We describe a case of (AAM) in the left labium majus in a 35 year-old woman.