مجله دانشگاه علوم پزشکی اراک
سال چهاردهم شماره 4 (پیاپی 57، مهر و آبان 1390)

Preeclampsia is one of major reasons of mortality in mother and child and its early diagnosis is one of the most important parts of health care during pregnancy. The current study was done to find the relationship between hemoglobin and hematocrit in the first trimester of pregnancy and the incidence of preeclampsia in women referring to Milad Hospital in Tehran in 2009-2010.

This prospective cohort study was conducted on 700 pregnant women in the first trimester of pregnancy, selected by convenience sampling. Prenatal tests were run in Milad Hospital and the results were recorded. Then samples were monitored for preeclampsia until delivery. Data were analyzed by SPSS version 18 (P < 0.05).

The highest percentage of research groups suffering from preeclampsia was in hemoglobin ≥12/5% g/dl and hematocrit of ≥38% group. There was a significant relationship between hemoglobin and hematocrit levels during the first trimester of pregnancy and preeclampsia (P<0.001, P=0.002). Hemoglobin of ≥ 12.45 g/dl presented a sensitivity of 85%, the specificity of 43.04%, positive predictive value of 9.63%, and negative predictive value of 97.57%. Hematocrit of ≥ 38% presented the sensitivity of 77.5%, the specificity of 50.71, the positive predictive value of 10.1%, and the negative predictive value of 96.93%.

The presence of high hemoglobin and hematocrit in the first trimester of pregnancy can be a predictive factor for diagnosing preeclampsia

Different studies have proposed the cognitive deficits as one of the main aspects of schizophrenia; furthermore, the presence of psychosis in these patients can influence the degree of deficiency in executive functions. The purpose of this study is to compare the executive function in patients with schizophrenia, non-psychotic major depression and normal individuals. In this cross-sectional study, 28 patients with schizophrenia, 28 patients with non-psychotic major depression and 28 normal subjects were selected from hospitals in Tehran through available sampling method which were matched according to age, sex, and level of education. The executive functions of subjects were evaluated using Wisconsin Card Sorting Test, and data were analyzed using one-way ANOVA and Turkey post-hoc test. Schizophrenic patients had poorer performance in comparison with non-psychotic depressives and normal individuals in all variables of Wisconsin test (P<0.001). Also, depressive patients showed more preservative error than normal subjects (P<0.001), but no significant difference was found between the two groups in the number of categories and specific error variables. Greater impairment in the executive functions in the Wisconsin card sorting test is mainly associated with psychosis which might be introduced as a special profile of schizophrenia. Noticing the amount of deficiency in executive functions in each group of patients, the positive or negative prognosis can be diagnosed initially.

Leishmania major and leishmania tropica are the main causes of cutaneous leishmaniasis in Iran, especially in Isfahan and Bam regions. In this study, noticing the effect of diversity of this parasite strains on designing disease control strategies, human isolates were examined through PCR-RFLP to determine the type of strains. In this experimental study, 340 samples obtained from CL patients due to Leishmania were cultured and prepared for microscopic study and examined through PCR-RFLP. The products of some of these samples were sequenced and analyzed. ITS1 region of genomic DNA was extracted and amplified with LITSr and L5.8s primers. Data on sequencing the samples were related to ITS1 region that in extracted DNAs with LITSr and L5.8s primers appeared with four kinds of genotype patterns, two for L.major and two for L.tropica in Isfahan and Bam regions. Genotypic groups, LmA and LmB, were detected from L.major isolates while LtA and LtB genotypic groups were indicated for L.tropica in these two regions. The most prevalent genotypes related to isolates of Isfahan were LmA geneotype, whereas LtA geneotype was mostly reported in isolates of Bam. Leishmania major and leishmania tropica, the causative agents of zoonotic cutaneous leishmaniasis (ZCL) in Isfahan and anthroponotic cutaneous leishmaniasis (ACL) in Bam, respectively, are genetically polymorphic species. There exists a relationship between genetic heterogeneousness and clinical manifestation and geographical regions of this disease in human.

Today, there is growing interest in using traditional medicine for healing cutaneous wounds. Probiotics are defined as different microorganisms that may have positive effects on prevention or treatment of special pathologic conditions. The present study was designed to investigate the effect of Lactobacillus brevis on cutaneous wound healing. In this experimental study, through phenol-sulfuric acid method, 22 strains of lactobacillus isolated from dairy-traditional products were investigated in terms of exopolysaccharide production. Lactobacillus brevis, which had high exopolysaccharide (EPS) production, was selected. A wound was created on the back of male Wistar rats in control, negative control, and experimental groups. Control and experimental groups underwent regional treatment by eucerin and eucerin contained Lactobacillus brevis, respectively, but the negative-control group did not receive any treatment. On days 1, 7 and 21, the rats were killed and their cutaneous wound samples were studied. Data analysis was done through SPSS version 11.5. The percentage of wound healing (99.53%) and inflammation in the experimental group on day 21 compared to control (90.55%) and negative groups (91.14%) was significantly higher (P<0.001). The number of neutrophils in the experimental group decreased in later phases of wound healing compared to the control and negative control groups. The present study showed that Lactobacillus brevis significantly decreases inflammation and accelerates wound healing in treated rats. The findings of this study can be applied clinically in near future.

Stress gradually makes immune system weak and suppresses it, therefore makes body susceptible to various types of diseases, and may delay the healing of the wound. The aim of this study was to show the effects of cold and immobilization stresses on wound healing in Balb/c mice.

In an interventional study 30 female Balb/c mice were divided into 3 groups randomly. First and second groups were exposed to cold and immobilization stresses respectively and third group (control group) left with no stress. Wound healing was checked every other day and compared with each other.

Results showed that the mean of wound sizes of stressed groups was bigger than control group (p<0.05).The wounds healing duration was 11 days in control group and 15 days in test groups.

Stress has negative effect on wound healing, therefore a peaceful and calm environment is recommended for patients with serious injuries.

Recent studies have shown that nicotinic-amide and niacin induce significant reductions in serum phosphorous in patients undergoing hemo-dialysis. The aim of the present study was to determine the effect of nicotinic acid on serum phosphorous level in patients undergoing long-term hemodialysis. In an 8-week cross-over randomized double-blind clinical trial, 37 patients were assigned to nicotinic acid or placebo groups with titration from 400 to 1000 mg/ daily. A 2-week washout preceded the switch from nicotinic acid to placebo or vice versa. Statistical analysis was performed using paired- sample t test. The mean dose of nicotinic acid at the end of the period was 740±204 mg/daily. Nicotinic acid showed a significant decrease in serum phosphorus after the 8-weeks treatment; however; no significant changes occurred in the placebo group (P =0.01). Also, nicotinic acid resulted in an increase of HDL cholesterol levels after 8 weeks. Nicotinic acid can lead to a decrease and an increase in serum phosphorous and HDL cholesterol levels, respectively. However, there is need for longer trials with larger sample sizes for determining the most effective doses of this drug.

In traditional medicine, Olive oil (Olea europaea L.) from Oleaceae family is known as a remedy for alleviating pain. This study investigates the antinociceptive effects of olive oil on male adult NMRI mice. In this experimental study, using the acetic acid-induced writhing and formalin tests, the anticipative effects of olive oil were evaluated. Olive oil (1, 5, and 10 ml/kg bodyweight), morphine (10 mg/kg bodyweight), and indomethacin (10 mg/kg bodyweight), as standard drugs, were injected intraperitoneally. The control group did not receive any treatment. Data were analyzed using one-way ANOVA and Tukey test. Olive oil significantly decreased acetic acid-induced abdominal writhes (P<0.001). Olive oil could only decrease the induced pain in the second phase of the formalin test (P<0.001). Olive oil decreases inflammatory pain (the second phase of the formalin test and acetic acid-induced writhing tests), but it has no significant effects on neurogenic pain (the first phase of the formalin test). Further studies are required to elucidate the antinociceptive effects of olive oil.

Polymerase chain reaction is the most common technique in the field of molecular biology that use for amplification of a specific nucleic acid sequence. Degenerate primers have ability to amplify related but distinct sequences. The aim of current study was to use, two sets of degenerate primers in combination with Hemi Nested PCR for detection V3-Loop sequence of envelope gene from wide spectrum of Human Immunodeficiency Virus (HIV) subtypes.

In this experimental study we designed and optimized, a degenerate primer pair in combination with Hemi Nested PCR, to detect HIV-1 V3 loop from Envelop gene that has wide variations among genotypes. The developed assay was used to check, 40 HIV infected, 10 negative controls as well as 5 samples from each HCV, HBV, HGV, and TTV were analyzed using developed method.

after optimization, 35 out of 40 positive controls were positive using our test. None of the negative human and viral control samples showed specific band. Also, in positive samples, non-specific bands were not detected.

In this study moreover than standard PCR, we used two degenerate primers that could detect specific region of genome. In fact, first round of PCR product act as a template for second round inner primers and can produce smaller sequence with high sensitivity due to degeneracy. Based on the current investigation, the developed assay had advantages including product confirmation and hence more sensitivity.

Type III Interferon (IFN) is a novel member of the interferon family, which contains three ligands: IFN-λ1 (IL-29), IFN-λ2 (IL-28A) and IFN-λ3 (IL-28B).These three ligands use the same unique heterodimeric receptor composed of CRF2-12 (IFN-λ-R1/IL-28Ra) and CRF2-4 (IL10-R-b) chains which are completely different from type I & type II IFN receptors. IFNsλ exhibit several features such as antiviral activity, antiproliferative activity, immunomodulatory activity and in vivo antitumour activity. In this work we aimed to clone the ogene of IFN-λ1 obtained from dendritic cells and assess protein production in eukaryotic expression vector. in thid experimental study, total RNA was extracted from monocyte derived dendritic cells stimulated with 100 ng/ml of LPS. cDNA was synthesized from total RNA. Then cDNA of IFN-λ1 was amplified by PCR with specific primers and cloned into the PTZ57R/Tvector in the E.coli (DH5α). This was subsequently subcloned into plasmid pcDNA3.1+, using KpnI and BamHI restriction endonucleases. After tranfection into HEK293 T, expression of protein was tested by sandwich-ELISA method. The DNA sequence of the insert was identical to the published sequences encoding IFN-λ1 in GeneBank. It was demonstrated that IFN-λ1 gene was markedly transcribed in transfected cells. Expression of IFN-λ1 in HEK293 T cells was confirmed by sandwich ELISA. Successful cloning and expression IFN-λ1 can be the first step for more production and further investigation about other activities of this cytokine and provides grounds for research on obtaining new therapeutic approaches for cancer, viral, autoimmune and allergic disease and designing more effective vaccines.

APACHE IV scoring system is one of the most useful scoring systems for evaluating the quality of health care services in ICU. The aim of this study was to evaluate the quality of health care services in ICU wards of Valiasr and Amiralmomenin Hospitals of Arak. This cross-sectional study was conducted on 100 patients admitted to ICU wards in Valiasr and Amiralmomenin Hospitals of Arak. First, the predicted mortality and length of stay (LOS) in ICU were calculated by APACHE IV scoring system. Then the real mortality and the real length of stay in ICU were recorded. Data were analyzed by SPSS software version 11.5 and t-test. Real mortality in men and women were 57.2% and 61.9%, respectively. The real length of stay in men and women were 11.58 and 11.62 days, respectively. Predicted mortality calculated by APACHE IV in men was 23.72% while it was 24.1% in women. Predicted LOS by APACHE IV in men was 15.02 days while it was 16.64 days in women. There was a significant difference between real mortality and predicted mortality (P = 0.001). The findings of this study indicate that the quality of health care services in ICU wards of Valiasr and Amiralmomenin Hospitals of Arak are far from international standards.

Leukemia is a malignant and progressive disease. Over-expression of inhibitors of apoptosis proteins (IAPs), such as survivin and its anti-apoptotic variants, including sur-ΔEx3, is the main cause of resistance to apoptotic effects of chemotherapy drugs. In the present study, the effects of CBX on apoptosis and expression level of survivin and sur-ΔEx3 and K562 cells (experimental model of chronic myeloid leukemia) were investigated. In this experimental study, human K562 cells were cultured and exposed to CBX. Trypan blue exclusion test was used to evaluate growth inhibitory and viability effects of the drug. Fluorescent microscopy (acridine orange/ ethidium bromide double staining) and DNA electrophoresis were applied to the study of apoptosis. The expression level of survivin and sur-ΔEx3 was studied by semiquantative RT- PCR. The results showed that after the 48 h treatment of K562 cells with 150 µM CBX, significant growth inhibitory and apoptotic effects (up to 50%) were induced. In addition, after 2-4 h of treatment with CBX (150 µM), down-regulation of survivin and sur-∆Ex3 were observed. However, the expression level of survivin and sur-ΔEx3 increased to the level of control cells with longer treatment times (6-12 h). Noticing the apoptotic and down-regulatory effects of CBX on survivin and sur-∆Ex3 expression, this drug can be used as a potential candidate for further studies on CML treatment, especially for inhibition of drug resistance in leukemia cells.

Streptokinase is one of the antigenic proteins secreted by streptococcus pyogenes. This protein has an important role in bacterial pathogenesis. The aim of this study was to produce recombinant forms of this enzyme so that the product would change in accordance with changes in the media.

In this experimental study, we amplified the streptokinase gene by polymerase chain reaction (PCR) method. After extraction, it was sub-cloned to prokaryotic expression vector pET32a. pET32a-Ska was transferred to E.coli BL21-DE3-plySs strain. Protein production was induced by IPTG and optimization of culture media and OD of bacteria. The recombinant protein was extracted by Ni-NTA and its concentration was measured by Bradford assay. Western- Blot analysis was used to verify the recombinant protein.

The nucleotide sequence of the amplified gene was the same as streptokinase gene of the streptococcus pyogenes. The production of recombinant streptokinase by induction of plasmid pET32a-Ska was done by IPTG. The recombinant streptokinase had the same antigenic properties as natural streptokinase. The largest amount of recombinant protein was produced in bacteria concentrations with OD = 0.8. Also, the production of the recombinant protein was higher in media with no glucose.

Changes in culture media can increase the production of recombinant proteins in host bacteria. The presence of nutrients, such as glucose, alone not only can not increase the amount of production but it might even decrease it.

Pseudomonas aeruginosa is one of the most important causes of nosocomial infection which due to extended spectrum-beta lactamases (ESBLs) and metallo-beta lactamase (MBL) producing strains is resistant to a wide range of antibiotics. The aim of this study was to detect ESBL and MBL producing P.aeruginosa isolated from patients and investigate the effects of methanol extracts of Zataria multiflora, Myrtus communis, and Peganum harmala on them. In this experimental study, samples were obtained from 245 patients, referring to Shafa Hospital, Kerman, Iran. ESBLs producing strains were detected by double disk synergy test and phenotypic confirmatory test. In addition, E-test strips were used for MBL detection. P.aeruginosa MIC was determined for cefotaxime, ceftazidime, azteronam, imipenem, and meropenem. Methanol extracts of Zataria multiflora, Peganum harmala, and Myrtus communis plants were prepared by Agar perculation method. Out of 245 patients referring to the burn unit, 120 P.aeruginosa isolates were detected from which 41 contained ESBL but they lacked MBL. 60% of isolates were resistant to cefotaxime, 66% to ceftazidime, 42% to azteronam, 3% to imipenem, and 5% to meropenem. Among the extracts, Zataria multiflora had the highest antibacterial effect on standard strains of P.aeruginosa in comparison with Peganum harmala and Myrtus communis. The prevalence of ESBL producing P.aeruginosa strains is high. In addition, noticing their high antibiotic resistance, utilization of herbs, such as Zataria multiflora may be considered an appropriate alternative for treatment; however, more investigations are needed.

Mycobacterium marinum is an atypical mycobacterium that causes a type of skin infection known as fish tank granuloma affecting people who are exposed to aquatic environments and manifests with erythematous, papulonodular or plaque-like lesions of the extremities. Case: A 15 year-old woman working in a tropical aquarium in Khomein referred with a non-tender nodule on the dorsum of fourth finger of left hand for 4 months. There were no specific findings in physical examination. Routine laboratory tests were normal. Skin biopsy was obtained which revealed suppurative granulomas, but staining of PAS and Ziel-Nelson were negative. The patient was treated with doxycycline 100 mg P.O. BID for 2 months with complete improvement of the lesions. In patients with a history of work in aquatic environments who manifest erythematous, papulonodular, or plaque-like lesions of the extremities should be checked in terms of fish tank granuloma and infection with mycobacterium marinum and skin biopsy and culture should be done for lesions.