The concentration-dependent effects of indocyanine green on retinal function in the electrophysiological ex vivo model of isolated perfused vertebrate retina

BACKGROUND

Dye solutions such as indocyanine green (ICG) are used for the staining of intraocular structures. The aim of the presented study was to investigate the effects of ICG on bovine retinal function using different concentrations of ICG.

METHODS

Bovine retina preparations were perfused with a standard solution and the electroretinogram was recorded. The nutrient solution was substituted by an ICG solution at varying concentrations for 45 min. Afterwards the preparations were reperfused with standard solution for at least 85 min.

RESULTS

Significant reductions in b-wave amplitude were found for concentrations of 0.0025% (p = 0.0099) and 0.025% (p = 0.0378). For the concentration of 0.025%, the b-wave amplitude remained significantly decreased (p = 0.0082) after the observation period, but a full recovery of the b-wave was observed for the concentration of 0.0025% (p = 0.1917).

CONCLUSION

Intraocular application of sufficient ICG concentrations for internal limiting membrane staining seems not possible without interfering with retinal function.

Monitoring of the therapeutic efficacy of chloroquine for the treatment of uncomplicated,Plasmodium falciparummalaria in Iran

Between 2002 and 2004, the standardized 28-day protocol recently developed by the World Health Organization was used to explore the efficacy of chloroquine, in the treatment of uncomplicated, Plasmodium falciparum malaria, in five sentinel sites in southern Iran. All but 14 of the 158 patients enrolled (128, 28 and two from the provinces of Sistan-Baluchestan, Hormozgan and Kerman, respectively) were successfully followed-up. The overall frequency of treatment failure by day 28 was 78.5%, with 17.4% of the patients being classed as early treatment failures, 34.7% as late clinical failures, and 26.4% as late parasitological failures. There appeared to be no significant change in the frequency of treatment failure between the 2002-2003 and 2003-2004 transmission seasons, nor any significant between-site variation in the efficacy of chloroquine. Given these observations, the replacement of chloroquine, as the first-line drug for the treatment of uncomplicated, P. falciparum malaria in Iran, was inevitable. Artesunate-sulfadoxine-pyrimethamine is now the recommended first-line treatment, with artemether-lumefantrine used for second-line treatment. The efficacies of these combination therapies are currently being evaluated and monitored.

Choroidal neovascularization reduced by targeted drug delivery with cationic liposome-encapsulated paclitaxel or targeted photodynamic therapy with verteporfin encapsulated in cationic liposomes

PURPOSE

Intravitreal antivascular endothelial growth factor (anti-VEGF) application has revolutionized the treatment of choroidal neovascularization (CNV), a hallmark of wet age-related macular degeneration. However, additional treatment options are desirable as not all CNV lesions respond to anti-VEGF injections. Here, we assessed the feasibility of targeted delivery of cationic liposome-encapsulated paclitaxel (EndoTAG-1) in treating CNV. Furthermore, we investigated whether a new formulation of verteporfin encapsulated in cationic liposomes (CL-VTP) enhances the effect of photodynamic therapy (PDT).

METHODS

EndoTAG-1, LipoSPA, and CL-VTP were produced by encapsulating paclitaxel, succinyl-paclitaxel, or verteporfin in cationic liposomes (CL). Mice underwent argon laser coagulations at day 0 (D0) to induce CNV. EndoTAG-1 and LipoSPA were injected into the tail vein at D1, D3, D5, D7, and D9. Taxol, CL, or trehalose buffer alone was injected in control animals. At D10, all animals were perfused with fluorescein isothiocyanate (FITC)-dextran. Flatmounts comprising the retinal pigment epithelium, choroid, and sclera were prepared for quantifying the CNV by measuring the area of lesions perfused with FITC-dextran. For PDT, mice received an injection with CL-VTP or Visudyne at D10. One eye was treated with PDT while the other served as a control. Evaluation of RPE-choroid-scleral and retinal flatmounts was performed at D12, D14, or D17. Perfusion with FITC-dextran and tetramethylrhodamine-5-(and 6)-isothiocyanate-lectin staining was used to distinguish between perfused and non-perfused choroidal vessels.

RESULTS

EndoTAG-1 or LipoSPA significantly reduced CNV size to 15% compared to trehalose controls. The mean CNV area of mice treated with CL was reduced (though not significantly) to about one-half of the value of the trehalose control group. The same was observed for paclitaxel. Thus, the reduction in the CNV size between treatment with CL and treatment with EndoTAG-1 or LipoSPA was 40%, which was not significant. PDT using either CL-VTP or Visudyne reduced CNV size to 65% (D17) of trehalose control size. CNV size was further diminished to 56% with Visudyne and 53% with CL-VTP when PDT was repeated twice. Most importantly, PDT-associated retinal damage was less pronounced using CL-VTP compared to Visudyne.

CONCLUSIONS

Systemic intravenous injection of paclitaxel (EndoTAG-1)- or succinyl-paclitaxel (LipoSPA)-loaded CL had a significant antiangiogenic effect in a CNV mouse model. PDT with CL-VTP was as effective as Visudyne in neovascular obliteration but induced less tissue damage. Our data suggest that systemic application of cationic liposome formulations may serve to treat ocular neovascular diseases. This approach may reduce the need for intraocular injections and may benefit patients with neovascular lesions irresponsive to anti-VEGF treatment.

Lessons learnt from malaria epidemics in the Islamic Republic of Iran

The Islamic Republic of Iran is in the pre-elimination phase of malaria control, but malaria epidemics are still a concern in the south of the country. This retrospective study presents the epidemiological characteristics and predisposing factors of 60 of the malaria epidemics reported in Sistan va Baluchestan province during 2005-09. A zero-truncated negative binomial model was used to investigate the relation between predictor variables and the total number of malaria cases. Malaria epidemics occurred mainly in the southern part of the province, mostly between July and October, peaking in August. Most malaria epidemics were small-scale (68.3% were < 100 cases) and short (51.7% lasted < 1 month). Plasmodium falciparum was present in 46.7% of the epidemics. An increase in the rainfall rate as well as population movements were the most significant predisposing factors. The results may help inform an epidemic investigation and reporting system as the country approaches the malaria elimination phase.

Antimicrobial evaluation of some novel derivatives of 3,4-dihydropyrimidine-2(1H)-one

The antimicrobial activity of thirty six novel dihydropyrimidine derivatives was evaluated against common pathogenic bacteria. Significant antimicrobial activity (MIC=32, 64 μg/ml) was observed. Escherichia coli and Pseudomonas aeruginosa as Gram-negative bacteria and Staphylococcus aureus as Gram-positive bacteria were determined to be the most susceptible pathogens in this study. The highest inhibitory activity was observed against Gram-negative microorganisms. The widest spectrum of antibacterial activity was exerted by C6 and C22. Most of the compounds had remarkable antifungal activity (MIC=32 μg/ml).

Effects of nitrogen treatments and harvesting stages on the aconitic acid, invert sugar and fiber in sweet sorghum cultivars

Sweet sorghum is adapted to the hot and dry climatic conditions and its tolerance to slat is moderately. It can be used for different products such as food, feed, fiber and fuel. This study was carried out to evaluate the effects, three nitrogen treatments, and three harvesting stages on the aconitic acid, fiber and invert sugar of three sweet sorghum cultivars in the experimental station and the results showed that the effects were significant. Among nitrogen treatments, application of 100 kg ha(-1) urea at planting and 200 kg ha(-1) urea at 4 leaf stage had the highest aconitic acid (0.26%) and invert sugar (3.44%). Among sweet sorghum cultivars, IS2325 and Vespa had the highest aconitic acid (0.26%) and invert sugar (3.86%), respectively Plant harvested at 4 leaf stage had the highest aconitic acid (0.26%) and the highest invert sugar (3.85%). Rio had higher fiber content than Vespa and IS2325 and all cultivars had the highest fiber content before chilling harvesting stage. In general, since high invert sugar and high aconitic acid interfere crystallization of sugar so, it is suggested that to plant Vespa, apply urea 100 kg ha(-1) urea at planting, 100 kg ha' urea at 4 leaf stage and 100 kg ha(-1) urea at booting and harvested before chilling that had lowest aconitic acid and invert sugar. Thereby, it is recommended to plant Vespa, apply urea 100 kg ha(-1) urea at planting, 100 kg ha(-1) urea at 4 leaf stage and 100 kg ha(-1) urea at booting and harvested at 4 leaf stage that had the highest aconitic acid.

The interleukin-1 family gene polymorphisms and Graves' disease

Genetic factors, including cytokine gene polymorphisms, are potential contributors to the pathogenesis of the Graves' disease (GD). We attempted in this study to determine the association between GD and the following polymorphisms in the interleukin-1 (IL-1) family genes: IL-1alpha (-889C/T), IL-1ss (-511C/T), IL-1ss (+3962C/T), IL-1R (Pst-1 1970C/T) and IL-1RA (Mspa-I 11100C/T). We studied 107 patients with an established diagnosis of GD and 140 healthy controls. Cytokine typing was performed by the polymerase chain reaction with sequence-specific primers assay. Genotype distributions among patients were in Hardy-Weinberg equilibrium for all polymorphisms. The frequency of the IL-1alpha -889T allele was significantly higher in patients than in controls (51.9% vs. 31.6%, OR=2.33, 95% CI=1.61-3.38; p<0.0001). The IL-1RA Msp-I 11100C allele was significantly more frequent in patients than in controls (50.0% vs. 22.9%, OR=3.38, 95% CI=2.29-4.97, p<0.0001). No significant associations were found for other polymorphisms. Although the IL-1 family has well-known roles in GD pathogenesis, the contributions of their genetic variations to the disease are unclear. In this study, we documented a highly significant association between GD and polymorphism in IL-1alpha and IL-1RA genes. Further studies in other populations are necessary to confirm our results.

Seroprevalence of Helicobacter pylori in Nahavand: a population-based study

In this cross-sectional study, we evaluated H. pylori seroprevalence and the relevant factors in 1518 people aged > or = 6 years from the general population of Nahavand, western Islamic Republic of Iran. Questionnaires covering sociodemographic variables were completed by interview. Blood samples were taken from each individual. Sera were tested for anti-H. pylori IgG using commercial enzyme immunoassay. Overall, seroprevalence of H. pylori was high, 71.0% (95% CI: 69.0%-73.0%). There was a gradual increase with age. Based on multivariate adjustment, only female sex and age could be considered risk factors.

Neurobrucellosis: report of a rare disease in 20 Iranian patients referred to a tertiary hospital

We reviewed the clinical manifestations and outcome of 20 cases of neurobrocellosis out of 1375 patients with brucellosis admitted to the infectious diseases ward of a tertiary hospital in Hamedan, Islamic Republic of Iran. Of the 20 cases, 12 had meningitis (acute and subacute), 4 had meningoencephalitis, 2 had myelopathy, 1 had polyradiculopathy and 1 had meningovascular complications manifested by stroke. The most prevalent symptoms were headache (75%), vomiting and fever (50%) and unconsciousness (35%). Among 20 neurobrucellosis patients, 1 died and the other 19 recovered; 14 fully recovered and 5 patients had residual neurological deficits. In endemic areas, the disease should be ruled out in all patients who develop unexplained neurological symptoms.

Patient concerns regarding chronic hepatitis B and C infection

Counselling of patients with viral hepatitis is often limited to discussions about how the virus is transmitted. The aim of the present study was to document the principal concerns of patients suffering from chronic hepatitis B and C infection. The most common volunteered concerns were infecting family members (80.6%), infecting others (66.7%), side-effects of treatment (50.0%), disease progression to cirrhosis (44.4%), loss of employment (41.7%), liver transplantation (36.1%), social stigma (36.1%), change in lifestyle (33.3%), development of liver cancer (25%), costs and money (22.2%), fear of disease (5.6%) and psychological disease (5.6%). Health care providers who focus counselling efforts exclusively on viral transmission are unlikely to address other important concerns.

Survey of antibiogram tests in cholera patients in the 2005 epidemic in Hamadan, Islamic Republic of Iran

An analytical cross-sectional study determined the serogroups and serotypes of Vibrio cholerae, and their antibiotic resistance rates, in the 2005 cholera epidemic in Hamadan. All 190 patients with positive stool cultures had V. cholerae serogroup O1, biotype El Tor and serotype Inaba positive. Of 60 cases selected randomly for antibiogram testing, sensitivity to norfloxacin, ciprofloxacin, kanamycin, amikacin, tetracycline and doxycycline was 97%, 92%, 88%, 85%, 77% and 67% respectively. Resistance to furazolidone, trimethoprim-sulfamethoxazole and erythromycin was 100%, 98% and 62% respectively. Comparison with the results of the 1998 epidemic suggests a worrying increase in the resistance of V. cholerae to erythromycin, doxycycline and ciprofloxacin.

Multivariate analysis of morphological variation in accessions of Aegilops crassa from Iran

Principal component and cluster analyses were used to evaluate the pattern of morphological variation in 122 accessions of Aegilops crassa for 14 quantitative characters. With the principal component analysis, the first five principal components with eigenvalues more than 1 contributed 69.5% of the variability amongst accessions, whereas PC6 to PC14 were less than unity. Plant height, stem diameter, spike length and number of spikelets per spike were the most important characters in the first principal component. The germplasm was grouped into five clusters using cluster analysis. Although each cluster had some specific characteristics of its own, but clusters were not clearly separated when plotted by the first two principal components. Mahalanobis distances (D2) determined that plant height, stem diameter, spike length, number of spikelets per spike, node width, seed length, seed width and flowering date characters as the most important characters in differentiating the accessions. The morphological variation of Aegilops crassa accessions obtained in this study provides useful information for the future collection and makes these genetic resources more accessible to breeders.

Escherichia coli, Shigella and Salmonella species in acute diarrhoea in Hamedan, Islamic Republic of Iran

This study investigated the frequency of Escherichia col, Shigella and Salmonella species in stool specimens from patients with diarrhoea presenting to health centres in Hamedan province, Islamic Republic of Iran. From 144 samples, Shigella strains were isolated in 17 cases (11.8%): 10 Sh. flexneri, 3 Sh. sonnei, 2 Sh. boydii and 2 untyped strains. No Salmonella strains were isolated. Using molecular diagnostic methods, diarrheogenic E. coli were detected in 37 cases (25.7%), the majority were enterotoxigenic (ETEC) (22 cases) and Shiga toxin-producing (STEC) strains (15 cases). In 14 cases (9.7%) there was co-infection.

Seroprevalence of hepatitis B in Nahavand, Islamic Republic of Iran

We determined the seroprevalence of hepatitis B in Nahavand in a sample of 1824 subjects > 5 years in 2002. Face-to-face interviews were conducted and blood samples taken. The association between risk factor and hepatitis B was assessed using logistic regression. The prevalence of HBsAg positive cases was 2.3%, and HBcAb and HBsAb were isolated in 7.8% and 11.6% of the participants respectively; 11.9% were positive for both HBcAb and HBsAb. History of surgery and imprisonment were the major risk factors for infection with odds ratios of 2.14 (95% CI: 1.22-3.05) and 3.57 (95% CI: 1.68-5.4) respectively.

Albendazole versus metronidazole in the treatment of patients with giardiasis in the Islamic Republic of Iran

We examined the therapeutic effects of albendazole compared to metronidazole in 120 patients with giardiasis in Hamdan. Patients were randomized to receive albendazole (400 mg, once daily for 5 days) or metronidazole (250 mg, 3 times a day for 5 days). Demographic data of the patients, results of stool examination for Giardia trophozoites before and after treatment, and drug side-effects were recorded. After treatment 6 (10.0%) of the albendazole group had trophozoites compared with 14 (23.3%) of metronidazole group (P < 0.05). Patients in the albendazole group had fewer side-effects while 43.3% of the metronidazole group experienced a metallic taste and 35.0% experienced loss of appetite. Albendazole is an easy, safe and effective treatment for giardiasis.

TLR4 polymorphism in Iranian patients with brucellosis

OBJECTIVE

Brucellosis is a zoonosis of both public health and economic significance in most developing countries. Polymorphisms in Toll-like receptor-4 (TLR4) have been reported to be associated with a blunted immune response to microbial pathogens. Information regarding any association between genetic variation of TLR4 and susceptibility to brucellosis is not available in the literatures. The main purpose of this research is to evaluate the role of polymorphic alleles of TLR4 gene in susceptibility to brucellosis.

MATERIALS AND METHODS

In this case-control study, 198 patients with brucellosis and 111 healthy volunteers matched for sex, age and geographic area were evaluated by genotyping for polymorphism in TLR4 gene (Asp299Gly) using amplification refractory mutation system (ARMS)-PCR method.

RESULTS

Allele 896G was more prevalent in patients with brucellosis compared to healthy controls (33.6% vs. 20.7%, P=0.000003). Also the frequency of G allele of TLR4 gene was significantly higher in male patients with brucellosis compared to the same sex in control group (36% vs. 21.7%, P=0.00005). Multiple logistic regression analysis demonstrated that male patients heterozygous at allele G gene had a significantly higher risk for brucellosis with an odds ratio of OR 2.89, 95% CI: 1.79-4.69, P<0.0001).

CONCLUSION

This study is the first to show an association between genetic polymorphism in TLR4 gene and susceptibility to brucellosis.

Is unintended pregnancy a risk factor for depression in Iranian women?

A study was carried out to determine the association between unintended pregnancy and pre- and postpartum depression in 163 women in Kermanshah city, Islamic Republic of Iran. Using the self-administered Beck Depression Inventory for educated women and a special interview for illiterate women, 105 intended and 58 unintended pregnancies were studied. Of the 58 women with unintended pregnancy, 43% reported attempting to abort the fetus. Depression at 37 weeks' gestation was slightly higher in the unintended than the intended pregnancy group (53.4% versus 41.0%; relative risk = 1.3) and depression 10 days postpartum was much higher in the unintended group (48.7% versus 25.6%; relative risk = 1.9). Screening for depression is recommended for pregnant women with unintended pregnancy.