فهرست مطالب
Iranian Red Crescent Medical Journal
Volume:14 Issue: 9, Sep 2012
- تاریخ انتشار: 1391/07/17
- تعداد عناوین: 14
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Pages 508-514BackgroundAt present the mumps virus strain used for production of mumps vaccine for our local use is Hoshino strain. However, according to our National public health policies, this strain should be replaced with a safer strain. Based on our previous data, the Iranian mumps strain; RS-12 has been proved to be the most suitable alternative to Hoshino strain with little or no adverse events following vaccination..MethodsThe aim of the present study was to optimize propagation of RS-12 strain and prepare standard seeds for vaccine mass production. The virus was inoculated to cells using different methods and different multiplicity of infection (MOI). The viral suspensions were harvested using different methods. Quality control tests were run at different stages..ResultsMaximum viral yield was achieved when cell suspensions were inoculated at MOI of 1:10 and incubated at 36-37ºC for 48 hours, followed by replacement of the media and incubation at 33-34 ºC for 5-7 days. Filtration did not affect the viral titre. A standard seed lot system was successfully established and experimental batches of MMR vaccines were produced..ConclusionThe established seed lot system has met all requirements of WHO regulations and could be used in mass production of safe and efficacious mumps and MMR vaccines. Clinical trials are in progress for this newly produced vaccine..Keywords: RS, 12, MMR, mumps, vaccine
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Pages 515-522BackgroundUremic pruritus is a common and bothersome complaint among end-stage renal disease which affect between 25% and 60% of this population. But there is no decisive cure for treatment of it. In this study, the effects of omega-3 for treatment of pruritus were investigated in hemodialysis patients..MethodsA double-blind randomized study was carried out in the form of placebo-controlled crossover study in four dialysis centers in Tehran, Iran during 2008. At first, 22 hemodialysis patients suffering from pruritus with previous drug resistance were selected. Next, these patients were randomly allocated into two groups of omega-3-placebo (group A) and placebo-omega-3 (group B). Patients in group A were treated with a 1-gram Fish oil capsule for 20 days, and subsequently, they were treated with placebo for 20 days after a 14-day wash-out period. But the reverse act was done in group B.The pruritus assessment was made quantitatively through Detailed Pruritus Score..ResultsPruritus was decreased up to 65% from score mean of 20.3 (95% CI: 16.7-23.8) to 6.4 (95% CI: 2.9-9.8) in omega-3 group and the decrease in the placebo group was 15% from score mean of 17.0 (95% CI: 12.4-21.6) to 14.4 (95% CI: 10.5-18.2).So the level of statistical difference was significant (P=0.0001).Pruritus was decreased up to 65% from score mean of 20.3 (95% CI: 16.7-23.8) to 6.4 (95% CI: 2.9-9.8) in omega-3 group and the decrease in the placebo group was 15% from score mean of 17.0 (95% CI: 12.4-21.6) to 14.4 (95% CI: 10.5-18.2).So the level of statistical difference was significant (P=0.0001)..DiscussionOmega-3 fatty acids found to be more effective than placebo in decreasing of uremic pruritus. So it seems that Omega-3 fatty acids could be used as an efficient drug for treatment of pruritus in uremic patients..Keywords: Fatty Acids, Omega, 3, Fish Oils, pruritus, Renal Dialysis, Uremia
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Pages 523-530BackgroundMetastatic spinal tumors are common and major causes of pathological spinal fractures that result in severe pain, weakness, and progressive neurological deficits. This study aims to evaluate the efficacy of percutaneous vertebroplasty (PVP) in pain-relief in patients with spinal fractures due to metastatic spinal tumors..MethodsWe evaluated 25 documented cases of metastatic spinal tumors with pathologic vertebral fractures who were suffering from severe pain and underwent vertebroplasty. Degree of pain was measured by visual analog scale (VAS). The symptoms were evaluated 24 hours and 2 months after vertebroplasty regarding the degree of pain relief.Complications such as leakage, embolism and infection were assessed..ResultsMeanVAS score was 8.23 before therapy in the patients that was reduced to 2.12 and 1 in the patients 24 hours and 2 months after vertebroplasty, respectively. The most common complication was cement leakage (44%) and there was no embolism or infection. Data was analyzed by SPSS version 18 software through ANOVA test with Greenhouse-Geisser correction and P-value of 0.00 was obtained in the patients 24 hours and 1 month after surgery..ConclusionConsidering significant decrease in the mean pain severity degree after the treatment, veretebroplasty seems to be significantly effective in pain relief in metastatic spinal tumors..Keywords: Polymethylmethacrylate (PMMA), Vertebroplasty, Spinal metastasis, Tumors, Spine, Pain
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Pages 531-540BackgroundHuman Rotavirus is a significant cause of severe gastroenteritis in infants and young children worldwide. In recent years, Rotavirus genotyping by RT-PCR has provided valuable information about the diversity of Rotaviruses circulating worldwide. The purpose of the present study is to monitor the prevalence of the different G types of Rotaviruses circulating in Shiraz, Southern Iran and detect any uncommon or novel types.MethodsDuring the period from December 2007 to November 2008, a total of 138 stool samples were collected from children less than 5 years old who were hospitalized for acute gastroenteritis. Rotavirus-associated diarrhea was investigated in fecal specimens with enzyme immunoassays (EIA). Rotavirus-positive specimens were typed by the Nested RT-PCR and by using different types of specific primers..ResultsOut of the 138 collected samples, 34.78% (48 cases) tested positive for Rotavirus. The frequency of G1, G2 and G4 types was 6.25%, 2.08% and 27.08%, respectively. Mixed and non-typeable infections were detected in 33.34% and 31.25% of hospitalized children with acute diarrhea, respectively. This is the first time mixed Rotavirus infections with G1/G3 have been reported in Iran..ConclusionThe high frequency of Rotavirus detection indicates the severity and the burden of Rotavirus disease may be able to reduce through the implementation of an effective vaccine and continual surveillance for the detection of Rotavirus genotypes circulating in other regions of Iran. Regarding to the noticeable frequency of non-typeable and mixed infections, it is suggested to use the other specific primers and further studies to detection of other novel and unusual types..Keywords: Human Rotavirus, Diarrhea, Hospitalized children, G types
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Pages 541-548BackgroundPremature rupture of membranes (PROM) is one of the most common complications of pregnancy that has a major impact on pregnancy outcomes. A diagnostic tool that is non-invasive, specific and quick is needed to predict PROM. The purpose of this study was to evaluate the diagnostic power of the vaginal washing fluid prolactin for the diagnosis of premature rupture of membranes and to determine cut-off values.MethodsA total of 114 pregnant women were recruited in this diagnostic trial. The PROM group consisted of 54 pregnant women between 20 and 41 weeks of gestation with diagnosis of confirmed PROM [amniotic fluid pooling (+) and Nitrazine paper test (+) and fernt test (+)]. The control group consisted of 60 pregnant women between 20 and 41 weeks of gestation without any complaint or complication. All patients underwent speculum examination for amniotic fluid pooling, nitrazine paper test, fern test, vaginal washing fluid prolactin sampling.ResultsVaginal fluid concentrations of prolactin was significantly different between the two groups (P < 0.001). The sensitivity, specificity, positive and negative predictive values and accuracy were 87.03%, 75.0%, 75.80%, 86.53% and 83.33% in detecting PROM by evaluation of vaginal fluid prolactin concentration with a cut-off value of 9.50 µIU/ml, respectively.ConclusionsThe prolactin levels in the washing fluid of the posterior vaginal fornix in our experience is reliable and non-invasive diagnostic tests of PROM.Keywords: Premature rupture of membranes, Prolactin, Vaginal washing fluid
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Pages 549-557BackgroundAlthough dolomite is classified as a relatively non-toxic, nuisance dust, little information exists as to its potential to produce respiratory disorders following occupational exposure. The purpose of this study was, therefore, to evaluate the possible effects, if any, of heavy inhalation exposure to this chemical on the prevalence of respiratory symptoms, functional impairments and radiographic abnormalities of the lungs..MethodsThe study population consisted of a group of 39 exposed subjects engaged in digging and excavating activities that were in operation for building a local dam, as well as 40 healthy non-exposed employees that served as the referent group. Subjects were interviewed and respiratory symptoms questionnaires, as suggested by the American Thoracic Society (ATS), were completed for them. Thereafter, they underwent chest X-ray and lung function tests. Additionally, using routine gravimetric techniques, personal dust monitoring for airborne inhalable and respirable dust was carried out at different dusty work sites. Finally to determine the chemical composition of the dust, it was analyzed by X-ray fluorescence (XRF) technique..ResultsXRF revealed that the major component (50.52%) of the dust was calcium magnesium carbonate, dolomite. Additionally, levels of exposure to inhalable and respirable dust were estimated to be 51.7±24.31 and 23.0±18.11mg/m3, respectively. Statistical analysis of the data showed that symptoms such as regular cough, phlegm, wheezing, productive cough and shortness of breath were significantly (p<0.05) more prevalent among exposed workers. Similarly, the ratio of FEV1/FVC in exposed subjects was significantly different from that of non-exposed individuals. In contrast, no significant abnormalities were observed in the chest radiographs of both groups..ConclusionsIn conclusion, while these data cast doubt on the notion that dolomite is a harmless chemical, they provide evidence in favour of the proposition that exposure to high atmospheric concentrations of this compound is likely to be associated with respiratory symptoms..Keywords: Dolomite dust, Occupational exposure, Respiratory symptoms, Functional impairments of the lungs
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Pages 558-568BackgroundCopper (Cu) is an essential trace element involved in normal reproduction but its over-exposure may produce some detrimental effects. The aim of this study was to investigate the effects of copper sulfate poisoning on morphometery of mice ovarian structures and probable intracellular changes..MethodsThirty mature female mice were randomly allocated to control and two treatment groups. In treatment groups, two different doses of copper sulphate including 100 mg/kg and 200 mg/kg in 0.2 cc were applied once a day for 35 consecutive days by gavage. Control animals received normal saline using the same volume and similar method. Animals from each experimental group were sacrificed 14 and 35 days after the beginning of drug administration and the left ovaries were removed for stereological evaluations by light microscopy and right ovaries were obtained for preparing electron microscopic sections..ResultsThe morphometrical results showed that only the number of antral follicles was decreased by 100 mg/kg copper sulfate on day 14 compared to the control group (P=0.043). Hence, higher copper dose or longer consumption period significantly reduced different classes of follicles and corpora lutea. With 100 mg/kg copper sulfate some mild ultrastructural cell damages such as decrease of zona pellucida thickness, limited vacuolated areas and nuclear envelop dilation were seen on day 14. Higher or longer Cu administration produced more detrimental effects including more vacuolated areas, presence of secondary lysosomes, irregularity in cell shape and segmented nuclei with condensed and marginated chromatin and more enlarged and damaged mitochondria..ConclusionNew evidences of early as well as late intracellular damages of copper has been presented by accurate stereological and ultrastructural methods. Antral follicles was the most suscep%3.Keywords: Copper poisoning, Electron microscopy, Morphometry, Ovary, Mice
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Pages 569-573BackgroundTopical anesthesia is a safe and cost-effective method considered as the first-choice in many procedures. Due to the physiological characteristics of eye, most of the local anesthetics cannot efficiently penetrate through the conjunctiva deep to tenon. The aim of this pilot study was to find a new form of lidocaine to give a sufficient level of anesthesia..MethodsLidocaine Cyclodextrin complex ophthalmic drop was produced and its pharmacological properties were studied [tested] in standard temperature and pressure. 30 patients (18 males, 12 females) with the mean age of 30.68±8.02 years enrolled in this clinical trial. All the patients were fully informed and signed the ethics committee consent forms. The patients were given tetracaine drop as the anesthetic: 3 drops separated 2 minute apart 10 min before the intervention. If we achieved a sufficient level of anesthesia, the procedure was done after. If the patient could not tolerate the procedure, the method was changed to lidocaine drop (administered after wash-out period like the first drop).The last option was conventional injection method if the patient could not tolerate the procedure with the second method either.We used this type of anesthesia for conventional procedures such as forced duction test, symblepharon, pterygium, and disport injection into extra-ocular muscles. All the procedures were done by one surgeon in a university hospital. We used a 0 to 10 visual analogue scale for pain and two 0 to 4 patient and physician satisfaction scales designed for this study..ResultsThe mean pain score was 7.53±0.90 in group 1 and 3.03±1.83 in group 2 (P=0.00). Patient and surgeon satisfaction in group 1 were 1.33±0.48 and 1.40±0.56 respectively; while 3.23±1.00 and 3.56±0.77 for group 2 (P=0.00). Tetracaine drop could not induce sufficient anesthesia for none of the patients. Cyclodextrin based lidocaine drop was successful except For two patients for whom we changed the anesthesia to Sub-conjunctival injection method..ConclusionOur newly manufactured cyclodextrin based lidocaine eye drop could successfully induce sufficient anesthesia for 28 of 30 patients. Further studies with larger sample sizes are now being designed to find more clinical evidence about this method..Keywords: Drug Delivery, Lidocaine, Cyclodextrin, Ophthalmicdrop, Symblepharon, Pterygium, Dysport
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Pages 574-577BackgroundSymptomatic spontaneous spinal epidural hematoma(SSEH) is an uncommon cause of cord compression that commonly is considered an indication for emergent surgical decompression. We aimed to investigate a patient with a SSEH that completely resolved clinically and radiographically, without surgical treatment. The patient presented three days after the sudden onset of back pain, numbness, and weakness. Magnetic Resonance Imaging(MRI) revealed a posterior thoracolumbar epidural hematoma extending from the level of T10 to L2 with significant cord compression. Decompression was recommended but he refused surgery and was managed conservatively. One month later weakness totally recovered and hematoma was absent on MRI..Keywords: Spinal epidural hematoma, Cord compression, Conservative therapy
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Pages 578-583BackgroundCutis marmorata telangiectatica congenita (CMTC) is a sporadic congenital skin vascular abnormality. Significant number of patients has other congenital anomalies.. Case Report: We report a case of a preterm male newborn with cutis marmorata pattern presented on the skin of the face, right side of front of the trunk, whole back, glutei and both legs. Besides, microretrognatia and asymmetric, bad-formed, low-set ears were notable. Ophthalmologic findings showed visual impairment and pale optic nerve papilla. Monitoring of child showed mental underdevelopment and motor retardation..ConclusionCMTC is a rare finding with good prognosis of skin malformations, with an obligation of dermatologist and paediatrician to investigate other associated congenital anomalies..Keywords: Cutis marmorata telangictatica congenital, Van Lohuizen syndrome
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Pages 584-586BackgroundGunshot trauma to the pancreatic duct mainly have been published from wartime experiences, but bullet injury in these cases has lead to pancreatic duct disruption, not obstruction. We report a case of chronic pancreatitis which is presented 27 years following pancreatic duct obstruction due to bullet injury during wartime, which successfully treated. He was a 45-year-old man came with chronic epigastric abdominal pain. Physical examination was suggestive of pancreatitis and laboratory data confirmed the diagnosis. Imaging studies revealed a metallic object in main pancreatic duct. He carefully treated with pancreatic head resection and pancreaticojejunal anastomosis..Keywords: Late, Pancreatitis, Gunshot, Trauma
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Pages 587-593BackgroundThere is some evidence suggesting that leptin and its negative regulator, soluble-leptinreceptor (SLR) may be able to influence inflammatory and autoimmune processes.MethodsIn this study, several variables including socio-demographics, health-related habits, depression score, serum molecules and blood parameters besides the SLR level were evaluated in patients with SLE (SLE-patients) and healthy controls.ResultsThe patients had significantly lower SLR level and higher depression score than the controls and both of these variables have a significant association with the occurrence of disease in logistic regression model. Moreover, the results of Pearson correlation analysis showed that patients’ SLR level was negatively correlated with their weights and BDI scores.ConclusionFor the first time, this study indicated a lower level of SLR in SLE-patients and suggested that lower concentrations of SLR in these patients may be implicated in the pathogenesis of SLE.Keywords: Soluble, leptin, receptor, Autoantibody, Systemic lupus erythematosus, Depression
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Pages 594-598BackgroundEscherichia coli O157:H7 is an enteric pathogen which can be frequently found asymptomatically in ruminant mammals, but can cause diseases from mild diarrhea to hemolytic uremic syndrome in humans..MethodsWe developed fluorescent amplification-based specific hybridization (FLASH–PCR) assay to detect the Stx-encoding gene Stx-1 of E. coli O157:H7..ResultPCR product of 336 bp was successfully amplified in a FLASH–PCR..ConclusionAs rapid detection and confirmation of the presence of E. coli O157:H7 are of importance for the medical, food, and water industries, FLASH-PCR is one of selective methods for detection of E. coli O157:H7..Keywords: E.coli O157:H7, Stx, 1 gene, Detection, FLASH, PCR