مجله دانشکده پزشکی اصفهان
پیاپی 343 (هفته سوم شهریور 1394)

In the mid-1940s، the diphtheria toxoid (inactivated toxin) vaccine was developed via combination with tetanus and pertussis vaccines (DTP vaccine) and successfully conducted to eradication of diphtheria disease throughout the world. Optimization of diphtheria toxoid absorption on aluminum phosphates to improve the rate of absorption and increase the efficacy of vaccine was our aim. In this study، the effect of different parameters، such as initial pH، temperature and final pH، on the adsorption rate of diphtheria toxoid on aluminum phosphate gel waz studied in vitro and vivo. Purified diphtheria toxoid was used for vaccine preparation. It was adsorbed to aluminum hydroxide with different pH values (5. 0، 5. 2، 5. 4، 5. 6، 5. 8 and 6. 0) and exposed to various temperatures (4، 24 and 37°C) and adjusted to the final pH values of 6. 4، 6. 6 and 6. 8. The effective formulation was the pH of 5. 8 at the temperature of 4°C with the final pH of 6. 6. The level of antibody in the immunized animals significantly was high. It is suggested that with new formulated vaccine with the optimized conditions، can significantly make the rate of toxoid and level of antibody high in the immunized animals.

Pseudomonas aeruginosa is one of the important factors for nosocomial infections، particularly in patients with impaired immune systems and children. Carbapenems resistance، due to the presence of metallo-beta-lactamase (MBL) genes encoding enzymes، is considered as a serious threat. This study aimed to detect metallo-beta-lactamase genes encoding enzymes in Pseudomonas aeruginosa strains isolated from non-hospitalized patients and to assess its antibiotic resistance. Fifty strains of Pseudomonas aeruginosa were isolated and antibiogram test was investigated with 7 different antibiotics. For 8 imipenem-resistant strains، phenotypic testing was performed via double disk synergy test (DDST) and combine disk methods. Finally، to confirm phenotypic methods، multiplex polymerase chain reaction (PCR) test was performed for detection of target genes. According to the results of the antibiogram test، 16% of the samples were resistant to imipenem and 8% to meropenem or ceftizoxime. DDST and Combine disk methods did not found any beta-lactamase positive strain. Results of phenotypic methods were confirmed via multiplex PCR and no metallo-beta-lactamase specimen was identified. According to the study، meropenem and ceftizoxime are good alternative medicines for imipenem. As appropriate phenotypic and molecular methods showed، the metallo-beta-lactamase genes were not prevalent in non-hospitalized patients.

Acute disseminated encephalomyelitis (ADEM) is an uncommon monophasic disease often with good prognosis. It is a differential diagnosis of multiple sclerosis (MS). Accurate distinction between acute disseminated encephalomyelitis and multiple sclerosis is important for prognosis and treatment; as many patients with multiple sclerosis may benefit from early disease-modifying therapy to suppress ongoing and future relapses. In a retrograde study، all the patients presented to Alzahra hospital (Isfahan، Iran) with definite diagnosis of acute disseminated encephalomyelitis during a 10-year period were included. Demographic data، clinical signs and symptoms، and laboratory and imaging findings were collected and analyzed using t and chi-square tests via SPSS software. Forty-two patients with mean age of 20. 05 ± 10. 04 years and a female-predominance of 64. 3% participated in the study. Thirty-three patients (78. 6%) had a recent history of infectious disease. A seasonal pattern of distribution in spring (31%) and autumn (31%) was seen. The cerebrospinal fluid (CSF) analysis findings showed pleocytosis and increased protein in 26 (61. 9%) and 25 (59. 6%) cases، respectively. First magnetic resonance imaging (MRI) findings revealed that most of the lesions were in the periventricular (83%) and re-imaging in 25 cases showed completely or partially resolution of previous lesions with no new lesion in 18 (72%) and 7 (28%) patients، respectively. We found some controversies to previous studies in epidemiological and imaging studies which could be of a significant role in detecting and accurate diagnosis of acute disseminated encephalomyelitis which can significantly impact on physicians’ view of the disease.

Considering high prevalence of treatment failure in migraine and resistance to common drugs and their side effects، trying to find new treatments in chronic and relapsing migraine is important. The aim of this study was comparing the effect on memantine and sodium valpruate in treatment of chronic and episodic migraine headaches. In a cross-over clinical trial study، 70 patients with chronic or relapsing migraine were selected and randomly divided in two equal groups. The groups were treated using memantine or sodim valruate for 3 months and after 4 weeks of wash-out، the method of treatment was replaced and continued for 3 months. The number of headache attacks، pain intensity، analgesia consumption and duration of headache were compared between the two groups. Time، intensity and duration of headaches were decreased in both groups significantly; but the number of attacks and duration of headache was not significantly different. The decrease of headache intensity in the memantine groups was significantly higher than the sodium valpruate groups (P = 0. 021). Both memantine and sodium valpruate had positive effects for prevention of relapsing migraine attack، headache intensity and duration of headache; but the side effects of memantine in lower and it is a better selection for prevention of migraine headache.

A safe and effective rejuvenation method with few side effects is one of the main purposes of most of the aesthetic procedures. As wound healing process is similar to rejuvenation mechanisms، diverse methods such as ablative and non-ablative laser have been applied to meet this target. A recent method that has remarkably taken experts'' and technicians’ attention is platelet-rich plasma (PRP) injection. This article reviews molecular mechanisms of aging and rejuvenation. It also evaluates clinical documents regarding the effects of platelet-rich plasma in rejuvenation beside its possible side effects. Because of high concentration of growth factors in platelet-rich plasma، it potentially can accelerate wound healing. However، there is a concern about the relation between the high level of growth factors and induction of signaling cascades of tumors. Long-term platelet-rich plasma outcomes need to be more investigated in cohort studies.