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pISSN: 2251-6085
eISSN: 2251-6093
Chairman & Editor-in-Chief:
Dariush D. Farhud, MD, Ph.D., MG.
This journal is a member of, and subscribes to the principles of, the Committee on Publication Ethics (COPE). 
Vol 36 No 1 (2007)
Articles
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Background: Mutations in the GJB2 gene encoding connexin 26 protein, are the main cause for autosomal recessive and sporadic non syndromic hearing loss in many populations. Here, we have taken together and reviewed results from our six previous publications, our unpublished data from ten Iranian provinces, as well as data from two previous mutation reports to provide a comprehensive collection of data for GJB2 mutations and deafness in Iran. Methods: In all, 1095 hearing impaired students and their deaf siblings from 890 families in 10 provinces of Iran were studied. The prevalence and type of the GJB2 gene mutations were investigated using nested PCR pre screening strategy and direct sequencing of the coding exon of the gene. Results: Altogether 31 different genetic variants were detected from which 17 GJB2 mutations were identified. GJB2 mutations were found in 14.6% of deaf families (18.29% of familial and 12.7% of sporadic cases). We found GJB2 mutations in both alleles in 78% of GJB2 mutations chromosomes. However, 35delG mutation was the most common GJB2 mutation accounting for 74.5% of the mutations in populations studied. Conclusion: Our data indicated that a specific combination of GJB2 mutations types and frequencies was presented in different populations of Iran. These results also highlight the importance of GJB2 mutations in development of hearing loss in familial and sporadic deaf families in different parts of the country and can be used as a basis of genetic counseling and clinical guideline in Iran.
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Background: To investigate the effect of CaNa2-EDTA and experimental diabetes (IDDM) on zinc and carbohydrate metabolism and the activities of GOT, GPT and alkaline phosphatase. Methods: Forty male normal albino (Wistar) rats of 8 weeks of age were fed with a basal diet. Twenty rats were then intraperitoneally injected with alloxan to induce diabetes. Then after one week ten rats from each group (n= 20) were administrated intraperitoneally with CaNa2-EDTA for further three weeks. Body weight gain and food intake were recorded regularly. On day 21 animals were killed and blood glucose, serum and tissues zinc concentrations, liver glycogen contents, serum transaminase enzymes (GOT, GPT), and serum alkaline phosphatase activities were determined. Results: The administration of CaNa2-EDTA significantly altered body weight gain, food intake and serum zinc concentration of either diabetic or non-diabetic animals. Both diabetic and non-diabetic rats given CaNa2-EDTA had higher blood glucose than their controls. Liver glycogen was also found to be higher in CaNa2-EDTA non-diabetic rats than their controls. CaNa2-EDTA also led to increasing of GOT and GPT, and decreasing serum alkaline phosphatase. Conclusion: To conclude, the present study demonstrates that CaNa2-EDTA had an effect on the previous parameters. Therefore it was appeared that CaNa2-EDTA resulted in the development of severe diabetes.
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Background: Anaphylactic reactions, such as urticaria, edema, respiratory symptoms, and anaphylactic shock often complicate the course of Cystic Echinococcosis (CE). Methods: To investigate the role of the IgE immunoreactive antigen 5 (Ag 5) in the sero-positive patients with CE, we determined N-terminal of 57 kDa subunit of Ag5 responsible for IgE and C-terminal of this active antigen related to induction of IgG specifically. Results: Immunoblotting analysis showed that specific IgE to 57-kDa subunit related to inter-chain disulphide band of two 22 kDa and 38-kDa component of Ag5 and conformational epitope on this subunits. In addition, since the 57 kDa component arise from the removal of the C-terminal portion of 22 kDa subunit of Ag5, thus IgE specifically recognized N-terminal of 22 kDa subunit which remain bounds to the other component, whereas IgG reacted with C-terminal of 38 kDa component of Ag5. Conclusion: Recognition of the specific binding site on the 57 kDa subunit of Ag5 could leads to understanding the mechanism regulating IgE/IgG production in some immune circumstances that IgE tends to some dominate, whereas in other IgG predominates.
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Background: To check the feasibility of using geographical information system (GIS) methods, we linked the brucellosis data of human and animals. Methods: In a village-based ecological study in Bardsir- a district in Kerman Province located nearly to the central part of Iran- data of human brucellosis, socio-economic level, and livestock characteristics (2001-4) were linked by using GIS methods. Results: Annual incidence of human brucellosis was 141.6 cases per 100,000 inhabitants. Most of the high risk villages were seen in the north and south of Bardsir (3.6% of villages). A positive association was observed between the frequency of brucellosis and density of cattle (OR=1.81, P= 0.007). In addition, the size of human population was an independent determinant factor (OR= 1.94, P< 0.001). No association was found between frequency of the disease and socio-economic indicators and also the density of sheep. Conclusion: Our study showed that we could generate informative risk maps of brucellosis using health and veterinary data which might improve the quality of control programme in Iran.
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Background: Although numerous studies have found deleterious effects of inbreeding on childhood and pre-reproductive mortality, one question remains inadequately addressed: Dose inbreeding lead to increased childhood mortality rates in countries with high level of consanguinity? Methods: To evaluate the public health impact of inbreeding on offspring mortality, the association between mean of inbreeding coefficient (α) and sex specific child and adult mortality rates in 24 countries from Asia and Africa was analyzed. Results: Statistical analysis showed that countries with relatively higher rates of consanguineous marriages have higher mortality rates than the countries with lower consanguinity rates. Also, countries with relatively higher GDP per capita have lower mortality rates. After controlling the GDP per capita, significant positive correlations between α and child (Female: r=0.4355, df=21, P=0.038; Male: r=0.3991, df=21, P=0.059) mortality rates were observed. There was no significant correlation between α and adult (Female: r=0.2977, df=21, P=0.168; Male: r=0.2207, df=21, P=0.312) mortality rates, after controlling for GDP per capita. Conclusion: It is concluded that consanguinity influences child deaths rate independent of the GDP per capita and that a large proportion of deaths could be attributed to inbreeding in several countries due to high frequencies of consanguinity.
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Background: Yeast infections are increasing cause of morbidity and mortality in immunocompromised patients. In order to perform a DNA-based diagnostic test, availability of a rapid and easy-to-perform DNA extraction protocol is essential. In the present study we evaluated colony-PCR as the easiest way to amplification of target DNA. Methods: Instead of using templates of purified genomic DNA, we performed the PCR directly from yeast colonies or cultures. Serial cell dilution of three reference yeast strains including Candida albicans, Cryptococcus neoformans and Saccharomyces cerevisiae were used for determining the sensitivity of the colony-PCR. A total of one hundred yeast isolates were also tested. All reactions were performed using the universal fungal primers ITS1 and ITS4 complementary to the rDNA region. Results: The colony-PCR resulted in a single band (with different sizes) for 106 cells or more for all reference species. Furthermore 98 out of 100 (98%) of samples showed a relevant single band after PCR. Conclusion: Directly application of the yeast cells obtained from culture colony for PCR reaction is a fast, reliable, cost-effective and simple method for performing any PCR-based protocol including diagnostic tests.
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Background: Echinocuccus granulosus, the causative agent of cystic echinococcosis has long been recognized as having a high degree of genetic divergence. The strains characterization seems to be essential for the establishment of a preventive and control strategy in every endemic area. Using DNA based methods for strain /genotype characterizations of E. granulosus have some difficulties, especially access to an efficient and pure concentration of DNA and proper primers. Methods: Using grinder method, a pure and high concentration DNA was extracted from 10 human hydatid cysts collected from Isfahan (central Iran) hospitals, and processed for PCR reaction. Results: Using DNASIS, the primers were designed in internal transcribed spacer 1 (ITS1) region, following analysis of 30 E. granulosus nucleotide sequences, extracted from gene bank. Conclusion: This new and specific E. granulosus primer which amplified DNA thoroughly can be applied for molecular studies on echinococcosis.
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Background: Flow cytometry is a rapid, sensitive, and reliable method for determination of bacterial viability. Here we assayed the capability of flow cytometry to detect Helicobacter pylori viable cells in both forms of spiral and coccoid. Methods: Viable bacteria stained with Rhodamin 123 and fluoresced with laser beam of 488nm. The rate of Rh123 absorption was determined in both forms of bacteria. Results: In positive control that consisted of live bacteria, the rate of rh123 absorption was at highest, but negative control that consisted of dead bacteria, the rate of Rh 123 absorption was at lowest absorption. This method showed that non-culturable coccoid forms of H. pylori, which could resist environmental stresses, were alive and might be responsible for bacterial transmission and failure in disease treatment. Conclusion: Due to simplicity, reliability, and sensitivity of flow cytometry, this method is preferred to other expensive and no reliable methods such as autoradiography, PCR and Electron microscopy used for assessment viability.
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Background: Various responses and different prognosis to specific treatment in different patients from one hand, and importance of IFN-γ producer cells on the other hand impressed us to study Tc1. Methods: The study was conducted in Ghaem Medical Center and Bu-Ali Research Institute, Mashhad University of Medical Sciences, Iran from 2001 to 2002. Lymphocytes of 36 patients were counted and cultured. Percentage of different responsible immunity cells in 29 patients, were determined by Flow Cytometry System before and after medication with glucantime (IM). Patients who showed improvement after the treatment were put into group 1 and those who did not recover were labeled group 2. In this self-control clinical trial, sampling method was consecutive non-probability and the results were analyzed by t-test consequently. Results: The percentage of Tc1 cells showed a significant increase despite of being stimulated with Phorpol-Mristate-Acetate (PMA) among the whole studied patients and group 1 (P= 0.069 and P= 0.040, respectively). While no significant change was observed among patients in group 2. Conclusion: This verifies the influence of Tc1 cells for the treatment of patients with CL and perhaps the role of glucantime in improving the cell immunity response through increasing such cells.
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Background: Except in emergency cases, all patients should be seen first by a primary healthcare physician who decides whether a referral to secondary care is necessary. The present study examined the reasons for patient self-referral to specialists. Methods: A random sample of 1036 individuals was selected from people attending public outpatient clinics and specialists’ offices in the private health sector. Of the sample, 40% were insured by the closed loop referral; 14% by the semi-closed-loop referral; and 46% were open referral. The data were analysed using χ 2 statistical test. Results: Of the closed-loop referral system patients, 6.8% were self-referred, as were 29.7% of semi-closed referral system patients and 75.5% of open referral system patients. There was a significant association between insurance type and patient self-referral to specialty care (χ 2 = 504; P< 0.0001). The main reasons patients gave for by-passing GPs and self-referring to specialists were: the specialist’s high degree of skill in the specific area of the health problem (54%); waste of time to see the GP for a referral (14.9%). Conclusion: The findings of this study demonstrate the high degree of difference in the rates of referral by GP and self-referral according to the healthcare delivery system.
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Background: Leptospirosis is the most widespread zoonosis in the world and is more prevalent in tropical and temperate regions. Guilan Province in north of Iran, is an endemic region of human leptospirosis. Since diagnosis of leptospirosis according to clinical symptoms is very difficult due to lack of characteristic pathogonomic sign(s), laboratory support is necessary. Methods: In 2003, we obtained blood samples from patients hospitalized in main general hospitals of Guilan Province and were suspected as having leptospirosis according to their clinical presentations. We examined 995 sera by a commercial IgM and IgG ELISA kit to find positive cases. Results: 62.7% of positive cases were male and about 86% of them were farmer. High distribution rate of leptospirosis was seen in middle-aged people (65% in 20-50 years old). Conclusion: It seems that leptospirosis has a high occurrence in major cities and is mostly distributed in warm months of the year. Demographic analysis of the results indicates that leptospirosis is typically a rural and an occupational disease in the area.
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Background: The association between helminthic parasitic infection and cognitive function has long been recognized, however there are few reports about Giardia lamblia infection. This paper describes a study about the effect of G. lamblia infection on the cognitive function. Methods: One hundred thirty two children infected with G. lamblia from Robat Karim south of western Tehran, Iran were compared with 150 children without any parasitic infection. These two groups were identical in socioeconomic and nutritional status. Cognitive function was assessed using, three tests from Wechsler Intelligence Scale for children and one subset of the Clinical Evolution of Language Function. Results: Comparison of two groups revealed that uninfected children improved significantly more than children who had G. lamblia infection in the tests of Fluency (P< 0.02) and Digit-span Forwards/ Backwards (P< 0.004). Conclusion: Regular stool examination is suggested in areas with low hygienic conditions, since G. lamblia infection might be present without any clinical manifestation.
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With an estimated 170 million infected individuals, hepatitis C virus (HCV) has a major impact on public health. Frequency of HCV infection was studied in 785 referred patients to a private Laboratory, Tehran, Iran from April 2003 until March 2006 by PCR method. Analyzed results revealed infection rate was 40.27%, 35.51% and 33.09% in the first, second and third year, respectively. Frequency rate of the infection shows a fluctuated shape during months of three years. Maximum rate of the HCV infection was in May of the first and in June of the second and third year, respectively. It shows decrease and increase within rest months in each year. HCV infection rate was higher in 31 to 40 years old group of patients. Analysis of the data revealed higher HCV infection in men than women had. It was concluded that HCV frequency pattern underlines specific attention to suspected patients during high rate time.
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Background: Dogs have been previously reported to be reservoirs of Leishmania infantum as the etiological agent of human visceral leishmaniasis in Iran. We report a case of canine visceral leishmaniasis (VL) caused by L. tropica from the north- west of Iran where human visceral leishmaniasis is endemic. Methods: The canine VL was initially screened by dipstick rK39 and direct agglutination test, then the dog was dissected and obtained samples were examined by parasitological (direct exam, cultivation) and molecular techniques (RAPD-PCR and RFLP-PCR). Results: Leishmania parasites were found in spleen and liver of the dog. The serological tests for the detection of specific anti-leishmania antibodies showed positive results. Conclusion: L. tropica as another agent of canine VL was determined.
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Background: Urinary Tract Infections (UTIs) are one of the most common infectious diseases diagnosed all over the world. Meanwhile most episode of UTIs are caused by Escherichia coli (up to 85%) and frequently fluoroquinolones are preferred as initial agents for empiric therapy of UTIs. Widespread use of fluoroquinolones has resulted in an increasing incidence of resistance these agents all over the world. The aim of this study was to assess, susceptibility of Escherichia coli strains from UTI patients against common fluoroquinolones. Methods: Antimicrobial susceptibility testing was determined by disk agar diffusion (DAD) and Minimal Inhibitory Concentration methods as described by the National Committee for Clinical Laboratory Standards (NCCLS). Results: One hundred sixty four clinical isolates of E. coli were collected by urine cultures from patients with UTI. The extent of resistant to nalidixic acid, ofloxacin, norfloxacin and ciprofloxacin, by disk diffusion method was 49.3%, 44.5%, 41.4% and 40.2%, respectively. Resistance to ciprofloxacin by MIC method was 4.9%. Conclusion: This study represents high level resistant of E. coli isolates from UTI patients. It is because of inappropriate and incorrect administration of antimicrobial agents in blind cases. This problem remarks significance of performing antimicrobial susceptibility testing before empiric antibiotic therapy. To overcome this problem use of unnecessary antibiotics therapy should be limited.
