Zahedan Journal of Research in Medical Sciences
Volume:14 Issue: 8, 2012 Oct

The usual method for laboratory diagnosis of cutaneous leishmaniasis was the direct observation of parasites under a light microscope. Although this method has high specificity, it has low sensitivity. The purpose of this study is to compare three methods of direct observation, culture and Mini-exon-PCR to diagnose cutaneous leishmaniasis in Khuzestan province. This study intends to compare sensitivity of PCR approach with sensitivity of the existing traditional methods to diagnose cutaneous leishmaniasis using Mini-exon gene. A total 216 skin biopsies prepared from patients with cutaneous leishmaniasis were studied though direct method, culture in NNN, culture in RPMI 1640 and Mini-exon-PCR and the sensitivity of these methods were compared with each other. In this study Mini-exon-PCR was considered as the gold standard method. Results showed that 46.7% with direct method, 35.1% with culture method in RPMI 1640, 57.8% with culture method in NNN and 70.3% with PCR were positive. Sensitivity was obtained 66.4% for microscopic observation, 50% for culture in RPMI1640, and 82.2% for culture in NNN and 100% for PCR. This study showed that PCR on samples stored in normal saline has higher sensitivity and specificity than other traditional methods (p>0.05). Thus, Mini-exon-PCR on samples in normal saline is a reliable method to diagnose cutaneous leishmaniasis, especially in cases where the diagnosis is negative with the other methods.

Cutaneous leishmaniasis or oriental sore has continuously expanded during the recent years in the country. Jask County in the easternmost point of Hormozgan province with 245 cases in 2007 has been the main focus of the disease. The present study was conducted to investigate the role of Gerbillus nanus as the reservoir of cutaneous leishmaniasis in this center. In a cross-sectional study during 2007-2008, rodents were caught from infected villages and after anesthesia, two slides were prepared from each ear of rodents using abrasive grinding and after recording morphometric specifications, their liver and spleen were kept in the 70% ethanol and the rest of the body was kept in 10% formalin for identification. Studies to determine leishmania infection were conducted through microscopic and molecular techniques. DNA was extracted through phenol/chloroform/lsoamyl alcohol method and it was proliferated through Nested-PCR method with primers LINR4, LIN17 and LIN19. A total of 106 rodents were caught. Species Gerbillus nanus (Muridae: Gerbillinae), with 17 heads, included 16.03% of haunting. Leishmania infection was found in a male sample of this species of rodent through microscopic method and two male and female samples (11.76%) through molecular method and specific PCR specified the parasite Leishmania major. Cutaneous leishmaniasis in this center is of zoonotic or damp type with leishmania major agent and the rodent Gerbillus nanus will be introduced in Hormozgan province for the first time as a possible reservoir host of the disease in this center. Infection of this species with Leishmania major is reported for the first time in the world.

Study on ecology and larval habitats of anopheline mosquitoes are important in terms of some aspects such as, vector control through manipulation and modification of these habitats that can reduce the burdens of mosquito-borne diseases. Given the likelihood of malaria epidemy, this work has been conducted to study anopheline mosquito fauna, larval habitat features and seasonal activity of the genus Anopheles in the Mahroo and Sepid – Dasht rural districts, Luristan province. This descriptive cross-sectional investigation was done from April to November 2001-2002. Larvae were collected by means of dipper and dropper from breeding places using the standard dipping technique, every two weeks. The third and fourth instar anopheline larvae were preserved in Lactophenol and identified into species using morphological characters. Larval habitat characteristics were recorded. A total of 4376 Anopheles larvae were collected. Five species and two morphological forms were found which include Anopheles superpictus Grassi form A (76.3%), A. dthali Patton (9.7%), A.turkhudi Liston (8.5%), A. marteri Senevet and Prunelle (4%), A. superpictus Grassi form B (1.1%) and A. apoci Marsh (0.4%). In these districts, anopheline larval activity began in early May and ended in early November. In this paper, the characteristics of larval habitats of any species have been discussed separately. The main larval habitats of important vector of the region, A. superpictus, were determined river sides, stream margins and rice fields. The findings of this research can be used to manage control of vectors.

Cutaneous and visceral leishmaniasis is important endemic diseases in many parts of the world, including Iran, which are transmitted by bites of sandflies. This study is conducted to identify Phlebotomine sand flies fauna in Hamadan, Iran. This is a descriptive cross-sectional study which caught sand flies in the months of May, June, July, August, September and October. The catch was performed by sticky traps. In this study, a total of 4871 sand flies were collected and identified. The number of sand flies caught from indoor and outdoor places was respectively 1302 (26.73%) and 3569 (73.27%). As a result of this study, nine species of sand flies were identified in the city of Hamadan, seven of which are of genre Phlebotomus (P. papatasi, P. kandelakii, P. sergenti, P. major, P. caucasicus, P. ansarii, P. halpensis) and two species are of the genre Sergentomyia (S. sintoni, S. dentata). In order to avoid the possible transmission of diseases and reduction of harassments of this insect during warm months of the year, personal protection such as use of mosquito nets, application of window and door mesh and use of repellents are recommended.

Leishmaniasis is one of the main health problems in Iran. The purpose of this study was to determine species composition, sex ratio and relative abundance of sandfliesas vectors of cutaneous leishmaniasis. This cross-sectional study was conducted in Chabahar, Iran. Sandflies were caught using sticky traps. Traps were installed in 21 rural and urban areas. A total of 17859 sandflieswere caught. Species caught including Phlebotomus papatasi Scopoli, P. salehi Mesghali, P. sergenti Parrot, P. alexandri Sinton, P. kazeruni Theodor and Mesghali, P. bergeroti Parrot, P. mesghali Seyedi-Rashti and Nadim, P. elaenorae Sinton, Sergentomyia clydei Sinton, S. sintoni Pringle, S. tiberiadis Adler, Theodor and Lourie, S. baghdadis Adler and Theodor, S. hodgsoni Sinton, S. dentate Sinton, S. africana Newstead, S. dreyfussi Theodor and Mesghali, S. mervynae Pringle, S. iranica Lewis and Mesghali and S. christophersi Sinton. Seven species, including P. elaenorae, P. kazeruni, S. hodgsoni, S. dreyfussi, S. mervynae, S. iranica and S. christophersi are reported for the first time in Chabahar. P. papatasi and P. salehi respectively play the role of primary and secondary vectors of cutaneous leishmaniasis in Chabahar city, due to their high abundance, presence in all the monthly activities, presence in all areas affected with oriental sore and finding leptomonad infection in them.

tuberculosis is a chronic contagious infectious disease which is fatal within 5 years in more than half of cases if not diagnosed. Since the fight against tuberculosis is based on early diagnosis and complete treatment of all TB patients, useful biochemical methods are emphasized to find a more rapid diagnostic method. This study aims to evaluate the impact of diagnostic value of T-SPOT® serology in patients suspected or diagnosed with tuberculosis admitted in Bou-Ali Hospital of Zahedan, Iran. The descriptive-analytic study conducted on 60 patients, 30 of whom had AFB sputum smear positive pulmonary tuberculosis, and 30 patients had AFB sputum smear negative pulmonary tuberculosis. The results were stated as sensitivity, specificity, positive and negative predictive value and likelihood ratio using conventional epidemiological table. In 23 out of 30 patients with AFB sputum smear positive pulmonary tuberculosis, T-SPOT® serology became positive and in 12 out of 30 patients with AFB sputum smear negative pulmonary, T-SPOT® serology became positive. According to the epidemiological table in this study, sensitivity, specificity, positive and negative predictive value and likelihood ratio of this test were determined respectively 76%, 40%, 56%, 63% and 1.25%. According to the results, this test is not able to distinguish active pulmonary tuberculosis from latent infection. Moreover, considering high contact of regional people with TB patients and pulmonary involvement of people due to factors other than TB, the test value with this likelihood ratio is low.

Tuberculosis is now the major cause of mortality in the world. This study has tried to identify the factors affecting the diagnosis of this disease by determining the relationship between delay in diagnosis and factors associated with patient and health system. This research was a cross-sectional study conducted on smear positive pulmonary tuberculosis patients referred to the tuberculosis center in the first half of 2008. Required information was completed through patient records and patient interviews. A total 98 patients were studied including 42 males and 56 females. Average age of patients was 51.6±19.57. Average delay in diagnosis was 2.8±1.78 months. The average delay of patients and health system was respectively 2.6±1.76 months and 6±4.27days. Data analysis showed that there is no relationship between the delay in diagnosis and individual variables such as age, gender, occupation, etc., and examination of sputum smears at the first visit. However, there is a significant relationship between patient delay with different factors such as education (p=0.03), marital status (p=0.03), existence of hospital or medical centers in the residence (p=0.02), distance to the medical center (p=0.02) and between health system delay and residence in the city (p=0.01), distance to this medical center (p=0.03) and obtaining chest X-ray (CXR) in the first visit (p=0.003). The results showed that with the increase of literacy, the establishment of new hospitals and health centers in remote areas and suburbs as well as chest X-ray in the first visit, the amount of delay in diagnosis can be reduced.

Extended-spectrum beta-lactamase (ESBLs) producing bacteria are issued as a serious problem considering their ability to hydrolyze most of beta-lactam antibiotics. The outbreak of infections derived by ESBL-producing enterobacteriaceae is increasing throughout the world. Therefore, this study aims to determine a pattern of antibiotic resistance and investigate the extended-spectrum beta-lactamases production of enterobacteriaceae isolates separated from clinical specimens. In this study, 170 various strains of enterobacteriaceae isolated from clinical specimens in teaching hospitals of Arak cultured and identified applying standard methods during one year (2010-2011). The antibiotic resistance of isolates was investigated through disk Agar diffusion according to CLSI criteria. The resistant isolates against ceftazidime and cefotaxime antibiotics were studied through the combined disk test for the final confirmation of ESBL-production. The minimum inhibitory concentration was determined through micro broth dilution. In this study, the resistance rate of various strains of enterobacteriaceae against amoxiclav, cefotaxime, ceftriaxone, ceftazidime, cefoxitin, cefotetan, meropenem and imipenem were respectively, 91.1%, 70%, 68.8%, 62.9%, 28.2%, 11.1%, 11.1% and 1.7%. Among 125 resistant enterobacteriaceae isolates against ceftazidime or cefotaxime, 108 isolates (86.4%) had ESBL-positive phenotype and 17 isolates (13.6%) had ESBL-negative phenotype. The MICs of the resistant isolates were indicated within a range of 16 to 512 µg/ml for ceftazidime and 64 to 512 µg/ml for cefotaxime. According to the results of this study, imipenem is the most effective antimicrobial antibiotic. On the other hand, the present study indicates that the bacteria within the family of ESBL producing enterobacteriaceae are highly prevalent among the patients. The increase in rate of such cases is often resulted by irrational antibiotic prescription. Application of new antimicrobials, limitation of the use of antimicrobial factors and increasing the utilization of infection control tools are all required in order to solve this problem.

This study examined the prevalence of Tinea gladiatorum as a superficial dermatophytosis in wrestlers of Hamedan and reviews this infection in the wrestling mats in terms of dermatophytic factors. This study was conducted (Oct. 2009 to the end of Sep. 2010) on 1,800 people in 10 wrestling halls. Samples of skin were collected from suspected wrestlers and evaluated via potassium hydroxide. Sterile carpet method (5×5) was also used for sampling from mats surfaces. Common mediums and methods in mycology were used to culture samples and detect grown fungi. 44 individuals (2.4%) of the wrestlers were diagnosed with ringworm. A mat (10%) was infected with dermatophytes. Dermatophytic factor isolated from wrestlers and wrestling mats was Trichophyton tonsurans in all cases. Highest rate of infection in terms of weight was weight group above 90 kg, with infection rate of 5.4% and in terms of age, it was age group of 16-21 with infection rate of 2.6%. Most lesions were observed in the upper body areas in neck 21.3% and the least lesions were seen in the leg 8.2%. In this study, proportion z-test) showed a significant difference between the infected and non-infected wrestlers with ringworm in terms of frequent contact of the lesion with the mat surface and recurrence (p>0.05). On the other hand, statistical z-test showed that there is no significant difference between the infected and non- infected wrestlers with Tinea gladiatorum in terms of domestic and foreign travel and for training or competition with rivals, the number of domestic and foreign travels, weight, age, type of bathing, wrestling type, the geographic location of wrestling hall and anatomic location of lesion (p>0.05). Rapid diagnosis and appropriate treatment of dermatophytic infection and observance of health issues of athletes to prevent reduction and interruption of the exercises and competitions are essential.

Rotaviruses are one of the most important causes of acute gastroenteritis and death in children worldwide. WHO suggested hospital based surveillance all over the world in order to evaluate the prevalence of rotavirus diarrhea. This study was conducted to determine the prevalence of rotavirus gastroenteritis in hospitalized children in Shiraz. In this study 138 stool samples from children aged <5 years old with severe diarrhea (>3 loose watery stools per 24 hours), hospitalized at Shaheed Dastgheib and Nemazee hospitals in Shiraz, were collected during 2006-2007. All the stool specimens were evaluated for Group A of rotaviruses with enzyme immunoassays (EIA). Then demographic and clinical data were analyzed by SPSS software. Out of total collected samples rotavirus infection was detected in 48(34.78%). The highest infection rate was among children less than two years old (70.83%). Diarrhea (97.92%), vomiting (77.08%) and fever (52.08%) were the most frequent reported clinical symptoms in children with rotavirus infection. The highest of isolation of virus was observed in autumn (45.83%) and the lowest in spring (8.33%) (p=0.012). Also, there was no significant difference between the frequency of the rotavirus diarrhea and the pattern of nutrition (p= 0.236). Regarding to high frequency of rotavirus infection, concurrently surveillance of rotavirus gastroenteritis in other hospitals of Iran is recommended.

Tuberculosis is now the major cause of mortality in the world. This study has tried to identify the factors affecting the diagnosis of this disease by determining the relationship between delay in diagnosis and factors associated with patient and health system. This research was a cross-sectional study conducted on smear positive pulmonary tuberculosis patients referred to the tuberculosis center in the first half of 2008. Required information was completed through patient records and patient interviews. A total 98 patients were studied including 42 males and 56 females. Average age of patients was 51.6±19.57. Average delay in diagnosis was 2.8±1.78 months. The average delay of patients and health system was respectively 2.6±1.76 months and 6±4.27days. Data analysis showed that there is no relationship between the delay in diagnosis and individual variables such as age, gender, occupation, etc., and examination of sputum smears at the first visit. However, there is a significant relationship between patient delay with different factors such as education (p=0.03), marital status (p=0.03), existence of hospital or medical centers in the residence (p=0.02), distance to the medical center (p=0.02) and between health system delay and residence in the city (p=0.01), distance to this medical center (p=0.03) and obtaining chest X-ray (CXR) in the first visit (p=0.003). The results showed that with the increase of literacy, the establishment of new hospitals and health centers in remote areas and suburbs as well as chest X-ray in the first visit, the amount of delay in diagnosis can be reduced.

Nowadays the scientific research outputs indexed in international databases are used in the bibliometric rankings of researchers, departments and universities. Measuring the impact and value of scientific publications is used by policy makers to distribute the research funds in way that support high quality research projects. In this scientometric study, SCOPUS citation database was used to evaluate the scientific research productivity of Zahedan University of Medical Sciences (ZAUMS) over the period of 1976-2011. We retrieved the number of publications and citations of researchers, academic groups, and university and calculated their h-index scores. The affiliation varieties were used by researchers to address the university and different spellings of authors names were determind. The results showed that scientific productivity of ZAUMS has been improved so that it’s h-index increased from 1 in 2000 to 19 over the period of the study. Total number of 504 publications were indexed in SCOPUS in the forms of original article, review article, conference paper, letter, editorial, and note. Most of the publications were in the form of research article (91.2%). There was a significant coorelation between the number of publications, citation rates and h-index scores. Departments of biochemistry and infectious disease ranked first on the basis of producing the most scientific output of the university.

One third of world population is infected with TB germs. If untreated, each TB patient infects 15-20 people. Therefore, the rapid diagnosis of infectious TB patients is the basis to prevent from tuberculosis. Therefore, proper utilization of the methods of TB disease is very important. This study was conducted to evaluate the efficacy of active intervention in high risk areas of Shirabad of Zahedan city. In this study, two methods of house to house visit and face to face training were used to. All residents of above 6 of Shirabad, who were 55845 people, were examined for tuberculosis from mid-July to December 2008 (with emphasis on the detection of pulmonary TB). The evaluation was performed based on clinical symptoms (more than 2 weeks coughing), sputum smear and chest radiography. Data collected analyzed by the software SPSS-13. Infectious TB disease had a significant increase within 2 years (320% in 2007 and 500% in 2008 (p=0.001). The incidence was significant in different nations. It had significant increase in Iranian population (p=0.001) and significant decrease in non-Iranian population (p=0.001). Reduced delay in diagnosis of non-Iranian women made smear significantly positive (p=0.014). The results showed that active intervention is effective in the discovery of infectious TB cases with 100% efficiency of passive TB screening. To treat patients effectively, efficient and effective DOTS strategy is the main underlying prerequisite for active intervention.

Cholera is a diarrheal disease in tropical regions that exclusively affects humans. This study conducted to compare changes in antibiotic resistance patterns in 2011with that of the period of 2008-2010 on cholera patients in the area covered by Zahedan University of Medical Sciences. In this descriptive study, rectal swab samples within Blair working environment of all suspected patients of each region were sent to the laboratory of each region and diagnostic procedures were performed, and Antimicrobial Susceptibility Testing (AST) was performed trough distribution methods on agar disk. Disks were prepared from Iranian Padtan Teb Company and the results were evaluated and reported using NCCLS table and the other experimental antimicrobial susceptibility determination tables. In this study, antimicrobial susceptibility testing was performed on 81 positive samples including Agave or Inaba during 4 years. The samples in 2008, 2009 and 2010 followed a similar susceptibility pattern and all these samples were resistant to co-trimoxazole, nalidixic acid and ampicillin, had intermediate sensitivity to furazolidone, were sensitive to tetracycline, ciprofloxacin, doxycycline, erythromycin and susceptibility pattern of cases in 2011 included sensitivity to erythromycin and ciprofloxacin and have shown no sensitivity to doxycycline and tetracycline and halo of their lack of growth were placed in the intermediate range. Vast border between the province and Afghanistan and Pakistan and inevitability of the occurrence of regional cholera epidemics may cause a serious problem in control of the possible epidemics and recalls the need to perform drug sensitivity tests during epidemics before any remedial action more than ever.

Objective of this study was to determine the seroprevalence of herpes simplex virus type 1 and 2 in Anzali city for the first time. 200 persons selected randomely and demographic data gathered. HSV-1, 2 and HSV-2 ELISA kits used to determine IgG type specific antibodies. HSV-1 and HSV-2 IgG antibodies were positive in 131 (65.5%) and 7(3.5%) subjects. HSV-1 Was more prevalent than HSV-2 and seropositivity increased with age

Malaria is still one of the most serious health problems all across the world. This study aimed at investigating the epidemiological features of malaria in Qom province form 2001 to 2011. It was a descriptive-analytic cross-sectional study conducted on the malaria cases in Qom province from 2001 to 2011. The data analyzed by SPSS software and t-test and chi-square test. During those 10 years, 553 cases of malaria were reported. Most of those cases were Iranian men of 15 years old and over. In most of the cases, Plasmodium vivax was the main cause of the disease. Considering the huge number of pilgrims entering Qom city and also the existence of Mosquito vectors, programs to combat malaria should continue.

Treatment for urinary tract infection should be based on common uropathogenes and their resistance to antibiotics. The aim of this study was to evaluate antibiotic resistance patterns in urinary tract infection. In this cross-sectional study, 11 common antibiotics were evaluated with antibiogram on urine samples of 2876 cases with urinary tract infection during 2010-2011. The most common uropathogen was E. coli (62.41%) and highest resistance of pathogen was against cefixime (84.5%) in this study. As the least resistance of uropathogens was against ciprofloxacin, we propose this antibiotic as the first line treatment for urinary tract infection.

Cutaneous leishmaniases is the problem in our country. The aim of this study was determine of cutaneous leishmaniases in Kermanshah. This descriptive–analytic study was and the statical society includes individual information with diagnosis during the 2006-2008 in the county health department in combating communicable disease were registered. Most cases were in age group 20-29 year. Most patients had a wound on his body (52.36%) and most of them were on hands (52%). The disease is not endemic in Kermanshah.

Scorpion stings cause a serious problem all over the globe. This study aimed to trace the epidemiological profile of scorpion stings and some common clinical symptoms in Dezful County. Our work is an analytical cross-sectional study of scorpion stings based on medical files of stung patients referred during 2007- 2008. During 2007-2008, 820 cases were registered. 59.9% of the cases were from rural areas. The stings had the most frequency in spring months, particularly in June, when yearly temperature was favorable. Based on the results of this study, scorpion sting envenomation is of clinical importance in this area.

Given the importance of healthy vegetables, the present study was conducted to determine parasitic infection of vegetable consumed in Shahroud. This cross-sectional study has been conducted on 92 samples of various vegetables collected from 16 vegetable growing farms and 1 vegetable process workshop. Sixty two percent of tested vegetables lacked parasites and the highest amount of parasites observed (34.78%) was related to Giardia lamblia. A significant relationship was observed between parasite and having toilets in the farms as well as the extent of farms. safety of fertilizers consumed by farms and healthy fruits can have an effective role in reducing the parasitic infections.

Klebsiella pneumoniae is considered of the bacteria causing urinary tract infection and one of the opportunistic pathogens and cause of nosocomial infections. Outbreak of ESBL (broad-spectrum β-Lactamase) in the bacteria leads to the improvement of antibiotic resistance and mortality in patients. This descriptive study in 2010 took 22 months. Bacteria were identified according to the microbiological methods and production of broad-spectrum β-Lactamase through screening and confirmatory tests. Based on the results, the frequency of Klebsiella pneumoniae in samples of inpatients and outpatients has been respectively 15% and 14%, and the frequency of broad-spectrum β-Lactamase in Klebsiella pneumoniae bacteria in samples of inpatients and outpatients has been respectively 64% and 22%. The results indicated the prevalence of broad-spectrum β-Lactamase in isolated strains from comparison between inpatients and outpatients.

Scabies is one of the most common causes of itching dermatosis in the world. This disease is caused by Sarcopetes scabiei. The purpose of this study was to determine the prevalence of scabies and demographic factors affecting it, such as age, gender, residence, education and occupation in patients of health centers in the county during 1998-2006. This study was conducted as a descriptive cross-sectional study. The necessary information included positive cases of disease and effective demographic factors such as age, gender, occupation, education and residence using the contents recorded in health centers of the county. Fifty one out of total 203 suspected cases were positive. The most positive cases were observed in males in age group of 16-25, soldiers, low educated people (guidance school) and in urban areas. This study indicates the relationship between the prevalence of scabies in soldiers in the region according to the population density in the garrisons. It also revealed that the disease is significantly related to educational level, gender and occupation.

Tuberculosis is more prevalent among renal transplant recipient than general population. Immunosuppressive drugs and corticosteroids are the most important causes of the disease. Although extra pulmonary tuberculosis constitute about 40% of the cases pulmonary tuberculosis is the most common clinical presentation. Isolated gastrointestinal tuberculosis is rare in these patients. This study presents a case of intestinal tuberculosis in a renal transplant recipient who died of intestinal perforation. Another interesting point of the case is development of tuberculosis after 18 years of transplantation. Previous studies showed the median interval of 18 months. The patient had received long-term immunosuppressive drugs as well as corticosteroid.