Shiraz Emedical Journal
Volume:11 Issue: 2, Apr 2010

Lamivudine therapy for chronic hepatitis B (CHB) is associated with resistance. This study aimed to analyze the response, the incidence of LAM resistance, and different viral mutational patterns of Lamivudine therapy. Study design: CHB patients (n=31) who had not previously received interferon or a nucleoside analogue, received Lamivudine once daily for a minimum of ≥12 months and followed. All patients were tested for presence of mutation in YMDD motif of viral polymerase gene at the end of the first year of treatment, and if indicated in rising alanine aminotransferase (ALT) or HBVDNA titer. Polymerase chain reaction along with restriction fragment length polymorphism (PCR-RFLP) method was used to detect mutations in YMDD motif. The mean age of patients was 45.2 (SD 13.5) years. The mean follow-up period of patients was 45.5 (21.9) months. Seventeen patients (54.8%) had mutations, and 45.2% of subjects were sensitive to LAM. Mean time of mutation detection after treatment was 45.5 (SD 25.3) months. The distribution of YMDD status was: 32.3 % YIDD, 3.2% YSDD, 12.9% YVDD, and 6.5% YVDD/ YIDD. The mean age, pretreatment HBeAg negativity, and high HBVDNA titer at time of mutation had significant statistical association with occurrence of YMDD mutants (PV= 0.009, 0.032, 0.049), respectively. Lamivudine-resistant mutation is common in CHB patients. Regarding different mutant strains as identified in this study, is necessary for develop more useful treatment strategies, especially in patients without YMDD mutation and high HBVDNA titer, analysis for possible new mutants should be performed.

Osteomyelitis is a progressive infection of bone that results in inflammatory destruction of the bone. The aim of this study was to detemine etiological agents of osteomylitis and management of it in Iraqi Patients admitted in an Iranian Hospital. This study carried out by Doctors without Borders (MSF group) in Imam Hussein Hospital of Mehran with cooperation of Milad Hospital. Surgical debridement, bone graft, fixation and antibiotic therapy were the major management programe and. The most prevalent organisms isolated from patients included Staphylococcus aureus, E.coli and Klebseilla pneumonia. The majority of these microorganisms were resistant to third generation of cephalosporins. Colistin was the sole antibiotic which most of gram-negative rods were susceptible to it. Nearly 34 % isolates of S.aureus were resistant to methicillin. All isolates of S.aureus were susceptible to vancomycin.

Evaluation of outcome of surgeries has shifted to self-evaluation. Health outcome should be defined for each case and be measured by valid and standardized tools. The aim of this study is to evaluate the effect of THA on various aspects of patients’ life, including their social, familial, and psychological activities, as well as their physical performance. This study evaluated 220 patients who underwent total hip arthroplasty because of hip joint osteoarthritis in Baqhiatallah university hospitals, Tehran and Kashani hospital, Isfahan from 1998 to 2008. Control group included 220 patients of the same age group admitted in hospitals and orthopedic clinics because of hip joint osteoarthritis and have not undergone arthroplasty until now. Patients were evaluated thoroughly by “Short form of general health status” (SF-36), “The Disease Specific Symptom (WOMAC)” Questionnaire, the “Arthritis Patient Preference Disability” Questionnaire. Mean scores of SF-36 and Womac questionnaires were 53.07 ± 18.43 and 63.02 ± 17.42 respectively for control group, while the determined scores for control group were 81.3± 16.31 and 42.53± 18.73, respectively.The scores obtained from these two questionnaires showed a 23.3% improvement in general health status and an 18.1% improvement in specific symptom of the disease in case group. The two groups had a significant difference considering these two parameters (P< 0.001). Total hip arthroplasty increased quality of life,improved function and produced great satisfaction in the majority of cases in our society

Back ground: Delusional disorder is a rather an uncommon psychotic disorder. This study is designed to describe condition of such patients in our community and investigate possible role of cultural effect on features of delusional disorder in our community. This cross sectional study investigated admitted patients during 1999-2002. Demographic statistics (e.g. age, gender, occupation, educational and marital status) and clinical features in patients and response to therapy are described. Sixty eight patients were enrolled. From the total of 68 patients, 54 (79.5%) were male and 14(20.5%) were female (M/F ratio: 3.8). These patients were 0.4% of all admitted patients. Persecutory delusion was the most common while grandiose and erotomanic subtypes were rare. Six patients (8.8%) had insight to the disorder in some extents. Auditory hallucinations, depressed mood and homicidal thoughts were common established symptoms. Loose of job and legal problems were common complications. Following treatment with new anti psychotic drugs; 4.5% had complete response and 84% had relative response. Clinical symptoms of the disorder in our community are similar to other populations, but we noticed low fraction of female patients to be admitted. Delusional disorders as a condition which may lead to serious problems will be controlled promptly with assistance of an aware family.

This study evaluates the coverage efficacy of the tetanus immunization programme in Jos University Teaching Hospital (JUTH), Nigeria and certain factors that affect the efficiency of maternofoetal transfer of tetanus toxoid (TT) IgG antibodies.

Sera from 43 mother-baby pairs selected randomly in JUTH were investigated for TT IgG antibodies using enzyme linked immune-sorbent assay (ELISA) technique. TT IgG antibodies were detected in 36 and 38 mothers and babies respectively.

Thirty-six (83.7%) and 38 (88.4%) mothers and babies respectively were found to be seropositive (equivalent to or greater than 0.151IU/ml of TT IgG antibodies). Three (7.0%) seronegative mothers had seropositive babies. One (2.3%) seropositive mother had a seronegative baby. A highly significant correlation was observed between maternal and fetal TT IgG antibodies level (r=0.905). Twenty-one (58.3%) of the 36 seropositive mothers had concentrations lower than their respective babies. The ratio of the mean concentrations of the TT IgG antibodies of cord blood to maternal blood (C/M ratio) was less than one. Maternofoetal transfer of TT IgG antibodies was found to be unrelated to the baby’s gender, weight and the mode of delivery.

The study underscores the need to improve on the current immunization programme in JUTH and for further studies to understand how maternal characteristics affect the maternofoetal transfer of TT IgG antibodies in JUTH.

Nicolau syndrome also known as livedo-like dermatitis or embolia cutis medicamentosa is a rare adverse reaction of a still largely unidentified pathogenesis at the site of intramuscular and intra-articular drug injection.Case report: herein we report a 7-year-old boy, a known case of cerebral palsy received a penicillin injection in the left buttock due to upper respiratory tract infection and one day later developed an echymotic, ischemic and necrotic area in the site of injection which extended to the left leg, thigh and foot gradually. Nicolau syndrome was diagnosed and the patient received prednisolone, pentoxyphyllin and was heparinized. In the follow up, the lesion began to improve. There is no specific therapy for Nicolau syndrome other than prevention.Correct Intramuscular injections may prevent these conditions. This case is the second report of Nicolau syndrome from Iran after the case of Beheshti-rooy et al.

Gaucher’s disease is rare and is the most common lysosomal storage disease. There are only a few case reports that show association between Gaucher’s disease and lymphoproliferative disorders. Psudo-Gaucher’s cells are reported in patients with leukemia and lymphomas. Here we present a case of adult type 1 Gaucher’s disease associated with lymphoma.