مجله دانشگاه علوم پزشکی شهید صدوقی یزد
سال هجدهم شماره 4 (پیاپی 75، مهر و آبان 1389)

The importance of scientific research in prevention of drug addiction is obvious. The main site of drug action is the brain. Mu receptor is the first place of drug action. In this study, the rate of mu receptor gene single nucleotide polymorphism (SNP) was compared in addicts and non-addicts. In this study AA, AG and AA polymorphism of mu receptor gene was investigated in 47 addicts and 30 non-addicts (controls). DNA was extracted by salting out method from peripheral blood and the PCR-Arms was performed. In control group, 66.7% had AA polymorphism while 68.1% of addict group showed this polymorphism. The AG polymorphism was 30% and 27.7% in control and addict groups, respectively. The GG polymorphism was 3.3% in control and 4.3% in addict group. There were no significant differences between the two groups. Our results indicated that there is no relationship between the mu receptor gene SNP and addiction. The other SNPs in this gene and other genes must be investigated. In addition, it seems that other factors such as environmental factors could play a role in addiction.

There are various ways to treat H.pylori infection, such as triple-therapy and quadruple therapy for two weeks. However, these treatments have some side effects and Helicobacter pylori easily become resistant to these antibiotics. Some studies have confirmed a relationship between consumption of garlic and reduction in Helicobacter pylori infection, whereas some others have rejected this relationship. Therefore, this present study was performed to determine the effects of garlic on Helicobacter pylori infection. This trial was performed in a randomized, case-controlled design on outpatients diagnosed with Helicobacter pylori infection. The patients in the case group took four grams of garlic powder daily (two tablets each containing two grams of garlic powder) whereas the patients in the control group took two placebo tablets (each containing two grams of white flour). In order to confirm the presence of Helicobacter pylori infection, urea breath test was taken, and in order to examine the presence of inflammation and/or ulcer in stomach, esophagus and duodenum, upper endoscopy was performed at the beginning and the end of the study. At the beginning of this study, all the patients had positive urea breath test. At the end of this study, the results of urea breat*- test showed that Helicobacter pylori infection was negative in 87% of the case group and 73% of control group showing eradication of Helicobacter pylori infection. However, this difference was not significant statistically when compared to the control group (P= 0.36). These findings suggest that taking garlic powder along with prescribed antibiotics can help in reducing Helicobacter pylori infection.

Alanine aminotransferase (ALT) is the most useful laboratory marker of hepatic necroinflammation that is used for diagnosis of liver diseases. Based on recent data, the investigators suggested a new upper limit of normal, which was based on patient's sex and BMI criteria. This prospective study was done to determine the normal range of serum alanine aminotransferase (ALT) in healthy normal population of Yazd from October 2008 to June 2009. In this study, 565 randomly selected apparently healthy people without any defined diseases were selected. Cases who had any history of hepatic diseases, history of hepatotoxic drugs or alcohol were excluded. Patients positive for HBsAg or HCV were also excluded. ALT measurements were performed by the the same laboratory method using Pars Azmon kit made in Iran. Healthy ranges for ALT levels were computed. Univariate and multivariate analyses were performed to evaluate associations between clinical factors and ALT levels. The 95Th percentile of ALT was 35.6 I.U for males and 31.2 IU for females and the mean ALT was 23.03±9.93 IU/dL. In this study, ALT levels were related to gender, age, BMI, FBS and cholesterol, but there was no relation with triglyceride levels. (Age, r=-0.100, BMI. r=0.13 FBS r=0.119, cholesterol r=0.142.) The 95Th percentile of ALT was, 35.6 IU/dL for males and 31.2 IU/dL for females. Serum ALT is related to gender, BMI, FBS, cholesterol but is not related to triglyceride levels. ALT is inversely related to age.

Determination of produced cytokines, especially interleukin 10, interleukin 12, interferon gamma and TNF-α is an important tool in the review of safety responses against inducers such as illnesses. The purpose of this study was to investigate the immune system status in patients with mycobacterium infections such as tuberculosis and non-tuberculosis as compared to healthy controls and find the relationship of these values with the diseases and their distribution. Blood sampling was performed on 87 infected patients with mycobacterium infection referring to the Mycobacteriology Research Center. Patients were divided into two groups of nontuberculosis mycobacterium (MOTT) (27 patients) and tuberculosis mycobacterium (60 patients). Also, 86 healthy controls were selected. Cytokines serum values were determined by ELISA test. In this study, the control group included 86 people, the tuberculosis mycobacterium group included 60 people and the MOTT group included 27 people. IL-10and IFN-γ levels were significantly more in infected people with mycobacterium tuberculosis and mycobacterium nontuberculosis infection as compared to the healthy controls, whereas the difference in serum TNF-α and IL-12 levels was not statistically significant. According to the results obtained in this study, increased serum values of IL-10 and interferon gamma are related with disease progression, while IL-12 and α-TNF serum values are not affected significantly in disease.

Diagnosis of infection based on blood culture alone is not a suitable method, but it is important to understand the clinical diagnosis for interpreting blood cultures. The goal of this study was to determine blood culture contamination and the type of microorganisms in false and real positive cases in patients admitted at Avicenna Hospital. This cross sectional study was done on all patients in the emergency and internal medicine departments from April, 2008 to October, 2008 and blood for blood culture was obtained (in response to clinicians order) at least 2 times from two separate sites. From 244 cases of blood culture, 62 cases (25%) were false positive, 31 cases (12%) were true positive and other cases are negative. Pseudomonas was the commonest organism in false positive cases followed by staphylococcus. There is a need for a close relationship between microbiology laboratory and clinical departments in order to avoid additional costs and also, cross- training for blood cultures.

Leukemia is a heterogeneous malignant disease in which progression at the level of CD34+ cells has a major impact in drug resistance and relapse. The multi-drug resistance gene product, P-glycoprotein is an inhibitor of apoptosis proteins (IAPs), such as Survivin that are expressed simultaneously with several putative drug resistance parameters in CD34+ leukemia cells. In fact, IAPs over-expression and their anti-apoptotic splice variants are associated with CD34 positivity, poor response to chemotherapy and reduced overall survival in leukemic patients. Recently, adenosine 5ʹ-triphosphate (ATP) has been reported to inhibit proliferation and induce apoptosis in several human cell lines. The K562 CD34+ human myeloid leukemia cell line has the unique feature of expressing significant functional IAPs and other drug-resistance genes. Thus, the efficacy of ATP in overcoming the resistance and expression profile of Survivin and its splice variants were examined in K562 cells in the present study. K562 cell were cultured and treated several times with different concentrations of ATP. Apoptosis was studied by fluorescent microscopy(Ao/EtBr double staining) and DNA fragmentation assay. The expression level of Survivin and its splice variants was studied by semiquantative RT-PCR method. The results showed that over-expression of Survivin and its anti-apoptotic splice variant, 3b splice variant were decreased after treatment by ATP in a time- and dose-dependent manner. The expression levels of other splice variants (ΔEx3, 2b, 2α and 3α) did not show significant difference between the control and the treated cells. The results showed that ATP attenuated expression of Survivin and its anti-apoptotic splice variant, meaning that this nucleotide can facilitate apoptosis in drug-resistant leukemia cells. In addition, combination of ATP with standard chemotherapies may be utilized for inhibition of drug-resistance in leukemia cells.

The G to A mutation in KCNJ11; the ATP-sensitive potassium channel subunit, results in glutamate (E) to lysine (K) substitution at codon 23, and the A allele is shown to have a relationship with type II diabetes in our previous study. Their role in coronary heart disease (CHD) is not exactly obvious. We hypothesized that the polymorphism would be associated with increased susceptibility to CHD. The E23K gene polymorphism of KCNJ11 gene was analyzed by PCR-restriction fragment length polymorphism (PCR-RFLP) methods in 55 controls and 73CHD patients. Serum lipids and Fasting Blood Sugar concentrations were measured in all subjects. Among the CHD patients, the frequency of the A allele was higher (34.9% vs. 26.4%, P<0.05) and the frequency of the G allele was lower (65.1% vs. 73.6%, P>0.05) than among controls. No significant differences were found in allele frequencies between CHD and controls (P>0.05). Also, there were no significant differences in GG and combined (GA+AA) genotypes frequencies (42.5% vs. 56.4%, and 57.5% vs. 43.6%, P>0.05). The E23K gene polymorphism in KCNJ11 gene has no association with the high susceptibility to CHD.

Sarcoidosis is a multisystem chronic disorder of unknown etiology that affects all of the organs, but the most commonly involved organs are the lungs. Pulmonary involvement is reported in 90% of patients and splenomegaly is reported in 20% of cases. In this study, we report one patient with sarcoidosis and splenomegaly without pulmonary involvement. Patient was a 52 years old, married housewife who referred to the hematology clinic with complaints of anemia, weight loss and high sedimentation. Results revealed minor normochromic normocytic anemia and splenomegaly. Because of low reticulocyte count and high ESR, biopsy and bone marrow aspiration was done to exclude malignancies and results showed erythroid hyperplasia and minor eosinophilia. Diagnostic splenectomy was also done and pathology reports of liver& spleen biopsy showed granulomatous inflammation and the presence of noncaseating granulomas in the involved organs. Final diagnosis was “Granulomatous inflammation” and the presence of noncaseating granulomas due to sarcoidosis. Patient was treated with prednisone. After splenectomy and onset of treatment, clinical presentation improved and patient gained weight. After one year of treatment and follow up, patient had no apparent clinical problem and treatment was stopped. Sarcoidosis is a rare disorder in Iran and difficult to differentiate from other liver & spleen disorders. It is necessary that proper diagnostic tests should be done for all patients so as to diagnose and treat sarcoidosis patients on time and prevent complications.