Journal of Kerman University of Medical Sciences
Volume:17 Issue: 4, 2010

Dry type localized cutaneous Leishmaniasis due to Leishmania tropica is one of the most prevalent cutaneous parasitic infections in Kerman province. It seems that cellular immune response and the nature of immune inflammatory cells comprising the inflammatory background play a determinant role in this infection. Skin biopsies of 53 patients with acute(<2 years duration), nonlupoid chronic(≥2 years duration) and lupoid chronic (new lesions around old scar) types of cutaneous leishmaniasis due to Leishmania tropica were studied by hematoxylin-eosin staining for evaluation of inflammatory cells and epidermal and dermal changes. Immunohistochemical staining was used to determine immunophenotypic patterns (CD1a, CD68, CD3, CD8, CD4, CD20) and to evaluate host immune response at tissue level, the correlation between the presence and concentration of certain cell types, and the clinical presentation and duration of disease. Mean percentages of epidermal and dermal Langerhans cells CD1a+ were higher in lupoid than in acute lesions. Also, the predominant T lymphocyte in acute, chronic and lupoid leishmaniasis was T CD8+. It seems that Langerhans cells CD1a+ are responsible for the suppression of the inflammatory response against L.tropica infection and by providing Leishmania antigens in a steady state induce tolerance to the Leishmania antigens and consequently cause cutaneous chronic lupoid leishmaniasis. This study also suggests that T CD8+ play an effective role in parasite elimination and in the process of healing of cutaneous leishmaniasis due to Leishmania tropica.

Cutaneous leishmaniasis (CL) has been endemic in Bam district for many years and several epidemics have already occurred. Following a silent period, another outbreak of CL occurred after the earthquake in 2003. This study was performed to find the trend of CL during 20 years (1988-2007) in Bam district. In a retrospective study, data of 29395 CL patients were collected from medical records of Center for CL Control and Treatment and also from previous published studies and analyzed. Before the earthquake there were three periods of outbreak, control and silent. The highest prevalence (8.3%, 6734 cases) was in 2000, whereas the lowest (0.2%, 215 cases) was in 2003 just prior to the earthquake. Again, in 2006 CL prevalence increased to an epidemic level (2.6%, 2880 cases). During these 20 years, age of patients has increased and after the earthquake males infected more than females. Lesion sites has changed from face to hands and legs. The causative agent and the vector have been Leishmania tropica and phlebotomus sergenti, respectively. Epidemiology of CL varies with environmental changes and due to the immunity after infection, the incidence rate becomes equivalent to the birth rate. Increase in the prevalence of CL after the earthquake is mainly due to the immigration of non–immune individuals to this area. In endemic areas with frequent natural disasters such as earthquake, it is very essential to consider preventive programs in advance.

This study was performed to compare the effects of open and closed chain terminal knee extension exercises on onset latency of vastus medialis obliques (VMO) and vastus lateralis (VL), pain and function in subjects diagnosed with patellofemoral pain syndrome (PFPS). In a pretest and posttest 5-week intervention study, 26 subjects diagnosed with PFPS and 13 healthy subjects were studied. Subjects diagnosed with PFPS were divided into two groups. One group (n=13) participated in a 5-week rehabilitation program consisted of open chain terminal knee extension exercise and the other group’s program (n=13) consisted closed chain terminal knee extension exercise. Electromyographic onsets of VMO and VL collected during step up and step down tasks performed during the pretest and posttest. A Visual analog scale (VAS) and Lysholm questionnaire were administered at pretest and posttest. Analysis of variance was used to compare the three groups. T-test and paired t-test were also used for statistical analysis. VMO and VL onsets timing in PFPS groups were significantly more than those in the control group at the base line (P<0.05). VMO and VL onset timing differences (VL electromyographic onset minus VMO electromyographic onset) significantly decreased and VAS and Lysholm scores significantly improved for subjects diagnosed with PFPS after intervention (P<0.05). There was no significant difference between the outcomes of two intervention programs in patients with PFPS. Subjects diagnosed with PFPS responded favorably and quickly to therapeutic exercises program that incorporated open and closed chain exercises.

Licorice (Glycyrrhia glabra L.) is an important herbal medicine that its root extract has long been used for the treatment of various diseases. The essential component of its root is glycyrrhizin. This study was performed to determine the percentage of the extract and glycyrrhizin content of the roots of Glycyrrhiz glabra grown in different areas of Kerman province and some samples in Fars province. Twenty six samples from the roots of Glycyrrhia glabra grown in various areas of Kerman province and 2 samples from Fars Province (a total of 28 samples from 8 regions) were collected and extracted by using ethanol and distilled water (for 5 samples). The percentage of glycyrrhizin in the extracts was determined by High Performance Liquid Chromatography (HPLC) technique. Mean percent of extracts from the samples of Fasa and Shiraz in Fars province (18.25 ± 1.06%), Sirjan (17.29 ± 0.90%) and Bardsir (16.33 ± 5.62%) were higher than other areas (P<0.05). Glycyrrhizin contents of samples of Bardsir (5.09 ± 0.02%), Sirjan (4.94 ± 0.75%), Zarand (4.46 ± 3.34%) were non significantly higher than Glycyrrhizin content of Fars samples (3.65 ± 0.59%). The percentage of the extract and glycyrrhizin were higher in ethanol extract compared to the aqueous extract (P<0.05). Samples with yellow root color had higher percentage of glycyrrhizin than those with brown color and samples of relatively cold and high altitude areas had higher glycyrrhizin content (P<0.001, P<0.05 respectively). Overall, it is concluded that the percent of extract and glycyrrhizin content of licorice root in the most areas of Kerman is relatively high. Appropriate measures for using this root in the country and for exporting purposes and also industrial growing in potential areas of the Province are recommended.

Asthma is a chronic inflammatory disease of the airways which is associated with the triad of cough, wheezing and dyspnea. Allergic asthma is often associated with a personal or family history of allergic diseases and mostly begins at early childhood. Mold is one of the most common irritants of asthma and allergic rhinitis. In the last 20 years there has been 30% increase in the prevalence of molds-related asthma. In this study the prevalence of mold allergy in asthmatic patients of less than 18 years old who refrred to Semnan allergy clinic during 2007-2008 was determined. Skin prick test with standard mold allergens was performed and sensitivity to the most prevalent molds like Alternaria, Penicillium, Aspergillus, cladosporium and mucor was evaluated. From 220 studied subjects, 35% (95% Confidence Interval: 28.7-41.3%) were shown to be sensitive to at least one mold. The prevalence rates of sensitivity to molds were as follow: Alternaria14.5%, Aspergillus 12.7%, Cladosporium 13.2%, Penicilium 12.7% and Mucor 2.7%. There was a significant relationship between sensitivity to molds and the grade of asthma (P<0.05) and episodes of admissions (P<0.05), but mold sensitivity showed no significant relationship with age, gender, personal or family history of other allergic diseases and the duration of asthma. Association between grade of asthma and episodes of admissions with the number of sensitizing molds was significant (P<0.05).Conclussion: Since asthma is the most common childhood disease and molds especially Alternaria and Cladpsporium are among the most important triggers of asthma and its progression, detection of this type of allergens and warning patients to avoid them could be an effeicient way to prevent and control the disease progress

Fungi are among the most important biological agents in air pollution. Textile factories are known as high risk places for contamination with fungal spores and metabolites. Since Yazd is one of the most important textile industry centers, this study was conducted to determine the concentration and types of airborne fungi in Yazd textile factories. A total of 235 indoor air samples from 30 randomly selected Yazd textile factories in 2007 were collected using air sampler pumps with appropriate filters. The concentration and types of isolated fungi were determined according to NIOSH standard technique for isolation of biologic agents. Data were analyzed based on the survey objectives, using statistical tests. Overall, 958 colonies from 16 different genera of fungi were isolated and among them Penicillium, Aspergillus and Cladosporium were known as the most prevalent isolated fungi. The fungal contamination rates were higher in the small factories than bigger factories and also in few factories, which usually used natural based fiber compared to those used synthetic fiber (P=0.0001). The finishing areas had more contamination than the other parts and working areas with the topical air conditioner had lower contamination (P= 0.034). There was a direct relationship between the amount of moisture and air fungal contamination (P=0.046), but there was no significant correlation between the whole fungal contamination rates and temperature. The results showed a high rate of contamination to fungal viable cultivable spores in Yazd textile factories. The presence of opportunistic fungi in these places, especially in summer is hazardous for immunosuppresed workers or those with malignancies or diabetes.

Despite advantages of exercise most employees in various countries do not exercise adequately. Transtheoretical model has been identified as a comprehensive model for behavior change and self efficacy is regarded as a fundamental structure of this model. Hence, in this study, the situation of exercise in comployees of Yazd according to the Transtheoretical Model and its relation with self efficacy have been evaluated. In this cross-sectional study, 220 employees of Yazd offices were selected by two-stage cluster sampling. In order to gather information a questionnaire with acceptable validity and reliability consisting of demographic data and constructs of model and self efficacy was used. Data analysis was performed with SPSS. In whole, 152 males and 68 females with mean age of 34±8.68 years were participated. From 220 cases, 44 ones were in precontemplation stage, 88 ones in contemplation, 30 ones in preparation stage, 16 ones in action stage and 42 ones were in maintenance stage. There were significant differences between self efficacy and variables of stages of change (P=0.0001), sex (P=0.01), and education (P=0.005) According to this study, self efficacy plays an important role in exercise behavior and any improvement of self efficacy level requires support of the related institutions such as the Physical Education Organization and universities.

Brucellosis is a public health problem in many developing countries, including Iran. Diagnosis is based on history, clinical manifestations and positive serum agglutination test (SAT) or Wright test. The purpose of this study was to evaluate the diagnostic value of SAT in pediatric Brucellosis. In this prospective study, during 2 years, 52 patients with clinical features of Brucellosis were studied. Sera were obtained from all patients. Assuming that patients with active Brucellosis in our area have SAT ≥1:80, all blood samples were tested by SAT and blood culture with BACTEC system. Of 52 patients with clinical presentation of brucellosis, in 26 patients, the diagnosis was confirmed according to positive blood culture and/or SAT (≥1:80). Brucella spp were isolated in 10 patients (38.4%). SAT was found positive in 25 samples (96.1%). Blood culture and SAT both were negative in 26 cases and the final diagnosis of this group was a disease other than brucellosis. The sensitivity, specificity, positive and negative predictive value of the test were 90%, 62%, 36% and 96.2%, respectively. Wright test can be used as a reliable, convenient and cost – effective test in the diagnosis of pediatric brucellosis in our population

Glutamate is extensively and relatively uniformly distributed in the central nervous system (CNS) and its effects mediated by two distinct groups of receptors including Ionotropic and metabotropic glutamate receptors. Concentration of glutamate in the nervous system is much higher than in other tissues. Glutamate receptors play an important role in synaptic transmission, neural plasticity and neural development. Although glutamate has various neural physiological effects, it is a strong neurotoxin and high concentration of glutamate in synaptic milieu and extra cellular space plays a critical role in neurodegenerative diseases like ischemia, acute neural trauma and many other CNS disorders. Selective ligands for glutamate receptors have made considerable advances in the identification of the physiological and pathological roles of these receptors in the nervous system. Furthermore, advances in animal models of neurodegenerative disorders have lead to the application of many glutamatergic compounds in clinical studies. These compounds consist of ionotropic glutamate receptor antagonists that examined in clinical tests for disorders including epilepsy, ischemic stroke, etc. The purpose of this review is to describe ionotropic glutamate receptors and their possible roles in excitotoxicity and nervous system disorders. Then we will discuss briefly about transporters for glutamate and their association in the pathology of CNS disorders. Finally, involvement of ionotropic glutamate receptors in neurological disorders including schizophrenia, Alzheimer's disease and epilepsy will be explained.

Neonatal thrombocytosis is a very rare phenomenon in infants born to addict mothers. It can be due to opioids withdrawal and occurs a few days after delivery. The etiology is unknown and it is eradicated gradually without any complication. The reported neonate was born to a heroin addict mother who has used methadone during pregnancy. The neonate was admitted in 14th day of life in neonatal intensive care unit (NICU) with the diagnosis of withdrawal syndrome and supportive care was administered for him. Thrombocytosis was detected in routine lab tests. There was not any reason for it except his mother’s addiction. The platelet count was 1,168,000 in the first day and decreased gradually during 28 days to 739,000. There was not any complication and no special treatment was administered. This case indicates that thrombocytosis may happen as a part of neonatal abstinence syndrome and is eradicated without any complication