مجله دانشگاه علوم پزشکی ایلام
سال بیستم شماره 1 (پیاپی 74، بهار 1391)

Salmonella typhi is an important enteric pathogen that can be transmited via food and water. So, careful and rapid identification of this organism is very important. Today, new techniques in rapid diagnosis of pathogenic bacteria in food are important. The purpose of this study was molecular detection of S. typhi in food samples by PCR using invA gene.

After extraction of genomic DNA by two standard methods, molecular method of PCR by specific primer of invA gene on any of the standard strains of bacteria was set. Then, using the PCR method, S. typhi was detected in samples of contaminated food.

The results showed that invA gene is the suitable sequence for detection of S. typhi in contaminated foods. Also, designed PCR method in this study is a method with high sensitive (detectable copy number is 1. 89×108) and specificity for rapid detection of S. typhi in contaminated food. Discussion &

The results of this study shows that PCR method is safe, fast and sensitive for rapid detection and identification of bacteria in contaminated foods and can be an appropriate substitute method for the current and conventional methods.

The oral insulin delivery is the most familiar, easy and patient friendly of all the routes of insulin applications. The aim of this study was to generate a new chitosan coated insulin nanoliposomes and evaluate their potential for the delivery of insulin.

Nanoliposomes encapsulated insulin with negative surface charge was prepared by reverse phase evaporation method. For such a preparation, nanoliposomes lecithin, cholesterol, cetyl-diphosphate and β-cyclodexterin were used. Then, nanoliposomes were coated by means of incubation with the chitosan solution. The encapsulation efficiency of the prepared nanoliposomes was measured by spectrophotometry technique after dissolution of the nanoparticles. The hypoglycemic efficacies of chitosan-coated insulin nanoliposomes were investigated by monitoring the blood glucose level after oral administration to diabetic rabbits.

Insulin entrapment efficacy for the prepared nanoliposomes by application of the new formulation was significantly (p<0.05) higher (79±0.16) than those of other formulations, respectively. The in vivo result clearly indicated that the insulin-loaded nanoliposomes could effectively reduce the blood glucose level in diabetic rabbits. Discussion &

The results clearly suggested that the prepared nanoliposomes could be considered a good candidate for oral insulin delivery.

The incidence rate of Primary Biliary Cirrhosis (PBC) is 100 to 200 cases per 1,000,000 individuals and the majority of cases are reported among women with the mean age of about 50 years. Cholestatic properties are predominant in PBC and this disease is usually detected by progressive hepatic failure. The current case was about a 57-years-old woman presented with a sudden decrease in consciousness level, who had experienced a cholecystectomy operation 1 week prior to admission due to severe abdominal symptoms. Brain CT-Scan and LP were normal and the neuro-logic examinations were also symm-etrical. The patient was treated primarily for basilar infarction disease. As the levels of serum ALK. P, AST and ALT increased, hepatic encephalopathy was considered the possible cause of decrease in the consciousness level. Following compl-ementary examinations and the dia-gnosis confirmation, the patient's consciousness level was restored to normal after the treatment of hepatic enceph-alopathy. Ultrasonography showed a small liver with rough parenchymal appearance (considered hepatic cirrhosis). PBC was reported as the main cause of hepatic cirrhosis in path-ologic examinations. Further assessments showed that the patient was also suffering from celiac sprue.

Diabetes is a chronic disease capable of causing serious complications affecting the circulatory and nervous systems, kidneys, eyes, and feet, and is associated with high rates of morbidity and mortality. One reason for the failure in achieveing optimal therapeutic results in diabetic patients is their non-participation in the treatment of their disease; thus, diabetes self-management education is a key element in the prevention and treatment of diabetes. The purpose of this study was to determine the effects of self management education program among type II diabetic patients referred to health centers in rural Gachsaran, Iran.

This interventional quasi-experimental study was performed by choosing 120 diabetic patients randomly divided into two experimental and control groups. Educational programs designed for patients in the intervention group included six sessions and two sessions for their families. The major training method was lecture and group discussion. Two months after the educational intervention, the results were evaluated. Participants resp-onded to the standard writing question-naires. Information was collected through interviews and data were analyzed by SPSS-13.

The results indicated a positive impact on knowledge (t=-8.476& p< 0.000) and self management (t=-8.975 & p<0.000) among patients of the intervention group. Discussion &

The results showed the positive role of education program to increase self management among diabetic patients, while implement-ting such programs seem to be effective in the treatment and prevention of diabetes complications.

Pandemic influenza has always been a common problem of human societies. Preparedness for dealing with massive economic and social crisis that simultaneously causes a worldwide involve-ment requires a readiness and on-time response. This study was conducted to evaluate the level of preparedness of schools and universities against pandemic influenza in Ilam (western Iran).

This cross sectional study was designed and developed by the researchers to determine the level of prep-aredness of schools and universities against pandemic influenza H1N1.In this study, plan documents for dealing with H1N1 flu were surveyed by using a modified version of CDC and WHO check lists.

The mean preparedness score of schools was based on the CDC and WHO checklists respectively, 78/9 (±11/9) and 73/4 (±9/6), and for the universities 67/42 (±13/9) and 49/44 (±16/1). In general, we found that the schools preparedness was “high“but preparedness of the universities was”low”. There was a significant statistical difference among the preparedness levels of the elementary, guidance, and high schools, (p=0 /04).

Despite the good level of schools, the universities prepared-ness level was "low" and the major problem was accounted for education and planning to deal with pandemic flu.

Specific effects of chemo-therapy regimens and their side-effects considerably influence on patients lives and their desires of accepting or rejecting therapies. It is obvious that the patient`s idea about the effectiveness of therapy process and accepting the treatment by the patient can facilitate the recovery process greatly. In this study, the side effects and toxicity of Docetaxel-Adriamicine-Cycl-ophosphamide (TAC) and Adriamicine-Cyclophosphamide- 5 FU (FAC) as two chemotherapy regimens were investigated.

This investigation was done on a cohort of 100 patients suffering from breast cancer with node- positive being treated with TAC or FAC as a double blind study. Data was gathered by completing special check-lists as interviews at the last session of chemotherapy and surveying the patients` medical records. Data was analyzed by relevant statistical tests such as Independent T-test.

The results showed that in most the aspects such as amenorrhea, anemia, febrile neutropenia, hyper pigmentation and nail disorder, neurologic toxicity, convul-sion, nomeness and edema, the average mean was higher in TAC arm statistically significant.

Applying treat-ment managing approaches tend more to emphasize on patient’s education and im-proving their knowledge before starting chemotherapy cycle, convening of compul-sory consult meetings with expert psychiat-rists and psychologists and establishing su-pportive groups by patients who have recovered from cancer can lead to better and more conscious encountering for such patients and help them accept the therapy more conveniently.

In recent years, chronic and persistent bacterial infections are introduced as predisposing factors of acute myocardial infarction (MI) that is a main cause of health problems, worldwide. In this study, the relationship between previous my-coplasma pneumonia infection and further myocardial infarction was investigated through seropositivity rate of mycoplasma pneumonia in patients with (MI) and control group.

In this retrospective descriptive study, 374 sera of patients and 185 sera of control group were examined by a commercial quantitative specific myco-plasma pneumonia IgG-ELISA kit (EUR-OIMMUNE, Germany) simultanously. The results were analyzed by Qui square test in SPSS, Ver. 16 software.

We found no significant rela-tionships between seropositivity to myco-plasma pneumonia (IgG) and sex (P=0.080), age (P=0.700), occupation (P=0.080), and living place (P=0.150), but the relationship between history of previous acute febrile diseases, infective chest disea-ses, hypertension and MI with mycoplasma pneumonia was significant (P=0.003, P=0.004, P=0.003, P=0.003 consequently). Discussion &

Regarding the results of this study, it can be said that history of previous mycoplasma pneumonia infections can be considered one of the etiological agents in MI.

Pseudomonas aeruginosa is an opportunistic pathogen and one of the most frequent pathogens in nosocomial infections. It causes different types of infections including urinary tract infections and Bacteremiae. This bacterium has many pathogenic factors including; exotoxin A, lipopolysacharide, phospholipase C, pili, elastase and alkaline protease. In this study, frequency of exotoxin A and alginate genes in clinical pseudomonas aeroginosa strains isolated from nosocomial infections were analysed.

50 Pseudomonas aeroginosa strains were isolated in clinical samples of Ilam hospitals and Milad hospital in Tehran. The isolates were identified by biochemical methods, after- wards DNAs were extracted. Next, using special primers for exotoxin A and alginate genes PCR was applied to detect the presence or non-presence of the related geres.

According to PCR results, 37 isolates (74%) and 46 ones (92%) had exotoxin A and alginate respectively. Among Pseudomonas aeroginosa strains isolated from urinary tract infections including 30 isolates, exotoxin A and alginate genes were observed in 21 (70%), and 26 (86/6%) isolates, respectively. Also, in other strains isolated from burn wound infections including 20 isolates, exotoxin A and alginate genes were detected in 16 (80%) and 20 (100%) isolates.

The results of our study confirm that exotoxin A and alginate genes presence is considered an important virulence factor of pseudomonas aeruginosa. The results of our study showed that alginate gene is so important in pseudomonas aeroginosa strains isolated from urinary tract infections and burn wound infections.