The Association between Nutrition Style through the First 2 Years of Life, Maternal and Childhood Indicators with Type 1 Diabetes Mellitus in Children: A Case-Control Study

Background: Nutrition and dietary habits is one of the determinant factor on glycemic control of diabetes mellitus. This study aims to investigate the association between type 1 diabetes mellitus (T1DM) and diet in the first two years of life as well as a select group of demographic variables. Methods: This case-control study was conducted on 76 children with T1DM and 209 non-diabetic children selected through convenience sampling from the population of people visiting the community health centers of the city of Jahrom, Iran. The required data were collected by a questionnaire of diet and demographic information completed by the mothers of the children. The data were analyzed using logistic regression and adjusted odds ratio. Results: Finally, the results of multiple backward logistic regression showed that the studied factors had a significant association with T1DM (P < 0.05), including body mass index (BMI) less than 18 kg/m2 for mothers before pregnancy (OR: 4.4, 95% CI: 1.61 to 11.97), mothers without a history of diabetes (OR: 0.02, 95% CI: 0.001 to 0.60), mother’s weight before pregnancy (OR: 0.88, 95% CI: 0.84 to 0.91), mother’s excess weight during pregnancy (OR: 0.83, 95% CI: 0.75 to 0.93), exclusive breastfeeding for more than six months (OR: 0.19, 95% CI: 0.03 to 0.96), low weight gain in the first two years of life (OR: 6.98, 95% CI: 2.16 to 22.5), and the breastfeeding less than 12 months  (OR: 10.52, 95% CI: 1.62 to 66.64). Conclusion: BMI less than 18 kg/m2 for mothers before pregnancy, low weight gain in the first two years of life, and breastfeeding less than 12 months increased the risk of developing T1DM in children.

The Evalutation of the Effect of 12 Weeks of Water Aerobic Exercise and Atrovastatin Drug on Apolipoproteins A1 Changes, ANP, BNP and CRP in Older Men with Cardiovascular Disesaes

Background

The aim of this study is to investigate the effect of of 12 weeks of water aerobic exercise and atrovastain drug on apolipoproteins changes A1, ANP, BNP and CRP in older men with cardiovascular disesaes.

Methods

In this study, we chose 40 patients with cardiovascular disease that were divideded in to four groups. Experimental groups selected exercise 3 times per weeks during 3 months with the method ofwalking on the water and carnal swimming.

Results

The results were expressed as the mean ± sd, and all statistical comparisons were made by means of a one-way ANOVA test, followed by Tukey'sPost-Hoc analysis.

Conclusion

The effect of exercise and intervention taking Atorvastatin increased Apolipoproteins A1changes, but reducedANP, BNP, and CRP, followed by the reduction of disease cardiovascular and improve cardiovascular function.

Effects of Interval Training Intensity and Curcumin on expression of Endothelial Progenitor Cells mRNA and C Reactive Protein in Elderly Rats Heart

INTRODUCTION

Endothelial progenitor cells (EPCs) play a role in preventing endothelial dysfunction and increasing the angiogenesis process. Regular training increases these cells. Turmeric Curcumin has anti-inflammatory and anti-atherosclerotic properties.

ANIMAL, MATERIALS AND METHODS

49 Wistar rats were randomly assigned to control (C), Saline (S), curcumin (cur), moderate interval training (MIT), high interval training (HIT), MIT+curAndHIT+cur. The training groups trained 8 weeks,3 sessions per week and 40 minutes each session at 28 and 34 m / min. 48 hours after the last training, The gene expression of the CD34 and KDR was measured by Real-time PCR and CRP usesthe ELISA method.

FINDINGS

CD34 and KDR mRNA in cur, MIT and HIT groups showed a significant increase compared to C and Sgroups.The highest levels of CD34 and KDR mRNA were observed in HIT+curgroup. While the increase of CD3 mRNA in HIT group was greater than the cur and MIT groups(P = 0.0001). KDR showed a significant increase in MIT and HIT groups compared to C, S, cur and MIT+cur groups. Serum CRP means significantly decreased in all experimental groups compared to C and S groups.

DISCUSSION AND CONCLUSION

The rate of increase in EPCs mRNA in response to aerobic training is dependent on training intensity. HIT training is likely to be more effective in the repair and development of coronary arteries. These findings can be useful for cell therapy and improve cardiovascular regeneration after injury and myocardial disor-der, especially in elderly conditions.

Routine Karyotyping Reveals Frequent Mosaic Reciprocal Chromosome Translocations in Swine: Prevalence, Pedigree, and Litter Size

In the routine commercial karyotype analysis on 5,481 boars, we identified 32 carriers of mosaic reciprocal translocations, half of which were carrying a specific recurrent translocation, mos t(7;9). An additional 7 mosaic translocations were identified through lymphocyte karyotype analysis from parents and relatives of mosaic carriers (n = 45), a control group of non-carrier boars (n = 73), and a mitogen assessment study (n = 20), bringing the total number of mosaic carriers to 39 cases. Mosaic translocations in all carriers were recognized to be confined to hematopoietic cells as no translocations were identified in fibroblasts cells of the carriers. In addition, negative impact on reproduction was not observed as the fertility of the carriers and their relatives were comparable to breed averages, and cryptic mosaicism was not detected in the family tree. This paper presents the first study of mosaic reciprocal translocations identified in swine through routine screening practices on reproductively unproven breeding boars while presenting evidence that these type of chromosome abnormalities are not associated with any affected phenotype on the carrier animals. In addition, the detection of recurrent mosaic translocations in this study may emphasize the non-random nature of mosaic rearrangements in swine and the potential role of genomic elements in their formation.

The effects of yoga in women with generalized anxiety disorder

Introduction

GAD is one of the most common disorders in psychiatry, usually observed twice in women than in men.

Aims

Considering the side effects of drugs and their financial burden, the purpose of this research was to study the effects of yoga as a complementary treatment on GAD in women.

Methods

In a single blind clinical trial the effects of yoga on GAD was studied in 40 women who were diagnosed with GAD by psychiatrist interview, SADS questionnaire and spilberger's anxiety scale in psychiatric clinics. The participants were randomly divided into two intervention and control. All the participants took the usual drugs (SSRIs). The intervention group was given Hata yoga instruction for six weeks, while the control group was only watching movies. At the end of the six week period the spilberger anxiety scale was refilled for both groups. Finally the comparison was done by statistical methods for both groups.

Results

The mean ages of intervention and control groups were 37.7 ± 9.87 and 37.65 ± 10.42 respectively. Improvement was observed in both groups after the six week period. The grades of state and trait anxiety were declined according to spilberger anxiety scale but no statistical difference was observed in two groups regarding improvement.

Conclusions

In the present study no statistical difference was observed between two groups however the participants of intervention group were inclined to continue their yoga sessions due to sense of well being. So it is concluded that yoga can have a positive effect on anxiety in long terms.

Potential application of lutetium-177-labeled prostate-specific membrane antigen-617 radioligand therapy for metastatic castration-resistant prostate cancer in a limited resource environment: Initial clinical experience after 2 years

In recent years, lutetium-177 (177Lu)-labeled prostate-specific membrane antigen (PSMA)-617 has become a promising new therapeutic agent in patients with metastatic castration-resistant prostate cancer (mCRPC). In this study, we report on an early experience of 177Lu-PSMA therapy with an evaluation of its efficacy and safety in mCRPC patients. Twenty-one mCRPC patients with a mean age of 70.3 ± 9.6 (54-88)-year-old were treated with one to four therapy cycles (median two cycles) and administered activity of 3.7-29.6 GBq (mean of 15.4 GBq). A prostate-specific antigen (PSA) decline ≥ 50% was considered to be a biochemical response (BCR). To evaluate the clinical response, the Eastern Cooperative Oncology Group (ECOG) status was used. Within 2 weeks before and 1 and 2 months after each therapy cycle, hematology, renal function, liver status, alkaline phosphatase, and PSA were checked. The Common Terminology Criteria for Adverse Events was used for grading adverse events induced by 177Lu-PSMA. Furthermore, overall survival (OS) was calculated and analyzed. During the treatment, a BCR was seen in 62% of patients; 19% of patients showed progression and 19% of patients showed stable disease. ECOG status was improved after treatment, and OS was 62.7 weeks. After the treatment, two patients showed Grade II toxicity of white blood cells, Grade I thrombocytopenia was observed in two patients, one patient showed Grade II toxicity in serum creatinine and transient Grade I toxicity in creatinine was seen in two patients. In total, our initial experience demonstrates that 177Lu-PSMA therapy has the potential to positively affect the development and maturation of radioligand practices in selected mCRPC patients, even in resource limited, developing country environments. However, some challenges, such as practitioner training, poor initial acceptance by colleagues and financial concerns, particularly in developing nations, still exist.

KINETIC PARAMETERS CALCULATION DURING FIRST CYCLE OF THE WWER-1000 REACTOR CORE

Determination of the effective delayed neutron fraction (βeff) and neutron generation time (Λ), on account of their important role in the reactivity transients analysis, safety, and control of nuclear reactors, is of the great importance in the reactor physics calculations. In this paper, evaluation of the kinetic parameters (effective delayed neutron fraction and prompt neutron lifetime) in PWRs is calculated. Software was developed to automate the procedure of kinetic parameters calculations. We used both a deterministic and a probabilistic method for calculation of the delayed neutron parameters. The results performed well in comparison to the reference.

First records of long-legged flies (Diptera, Dolichopodidae) from Fars Province of Iran

This paper provides data on distribution of 9 long-legged fly species (Diptera, Brachycera, Dolichopodidae) belonging to 6 genera from Fars province, southern Iran. Four species, Asyndetus albifrons Loew, 1869, Asyndetus chaetifemoratus Parent, 1925, Medetera media Parent, 1925 and Sciapus adumbratus (Becker, 1902) are newly added to the Iranian insect fauna. In addition, available information for each species and comments on geographical distribution and taxonomy are also included.

Meiotic Synapsis and Gene Expression Altered by a Balanced Y-Autosome Reciprocal Translocation in an Azoospermic Pig

Meiotic sex chromosome silencing (MSCS) has been argued as a prerequisite for normal meiotic cell division progression during the synaptic prophase I stage. Furthermore, irregular asynapsis of autosomal axes at meiosis may be encompassing the lack of transcriptional activity normally observed for the X and Y sex chromosomes. Therefore, any chromosomal rearrangement compromising the normal mechanism of MSCS and/or the contrary, the normal meiotic transcriptional activity of autosomal chromosomes, may be observed as a meiotic and concomitant spermatogenesis arrest. Previously, we have described a Y-autosome translocation t(Y;13)(p1.3;q3.3) in an azoospermic boar. Its chromosome synapsis behavior by synaptonemal complex immunostaining and FISH analyses is documented here. Histone γH2AX protein foci appeared to be located at unsynapsed chromosomal segments (e.g., X chromosome univalents or unpaired multivalent segments), although interestingly a high proportion of primary spermatocytes showed full paired synaptonemal complex-multivalent configurations which were devoid of a γH2AX focus signal, indicating meiotic chromosome silencing. RT-qPCR analysis of testicular expression showed downregulation of 3 SSC13 genes (MLH1, SOX2, UBE2B) and upregulation of SSCY genes (ZFY, SRY). The irregularity of the normal transcription pattern in case of these genes with proven roles in the testis is in agreement with the cytological observations and could contribute to the observed phenotype.

Prevalence of burnout among nurses in Iran: a systematic review and meta-analysis

AIM

This study aimed to summarize the available information in the literature to make an accurate estimate of the prevalence of burnout among Iranian nurses.

BACKGROUND AND INTRODUCTION

Burnout is a work-related stress syndrome that has negative impact on healthcare providers, patients and healthcare delivery systems.

METHOD

A comprehensive search of literature using international [PubMed, Scopus and the Institute for Scientific Information (ISI)] and Iranian scientific data bases [Scientific Information Database (SID), IranMedex and Magiran] was conducted to identify English and Persian language studies, published between 2000 and 2016, that examined the prevalence of burnout among nurses in Iran. The I-squared test and Chi-squared-based Q-test suggested heterogeneity of reported prevalence among the qualified studies; thus, a random-effects model was applied to estimate the overall prevalence of burnout among nurses in Iran.

RESULTS

Based on 21 selected articles with 4180 participants, the overall prevalence of burnout among Iranian nurses was estimated to be 36% [95% confidence interval (CI), 20-53%] in Iran. Meta-regression indicated that sample size and year of data collection, mean age of samples, female to male ratio and geographic regions were not statistically significantly associated with the prevalence of burnout. Also, based on Egger's test and funnel plot, there is no publication bias among studies included in the analysis.

CONCLUSION

Professional burnout affects more than one-third of nursing staff in Iran; thus, effective interventions and strategies are required to reduce and prevent burnout among nurses.

IMPLICATION FOR NURSING AND HEALTH POLICY

Due to the negative consequences of burnout on patients, nurses and organizations, nursing and healthcare managers should intervene to prevent and reduce burnout among nurses in Iran. Policy attention should focus on developing effective interventions to prevent and minimize the burden of burnout among nurses in Iran. Nurses' involvement in the policy-making process is crucial in the implementation of effective programs and initiatives tailored to address the higher prevalence of burnout among Iranian nurses.

Epidemiological status of dermatophytosis in Guilan, north of Iran

Background and Purpose:

The epidemiological features of dermatophytoses have been characterized in many geographical locations of Iran, but not in Guilan, North of Iran. This study was carried out to determine the distribution pattern of dermatophytoses and their relevant agents in Guilan, North of Iran, over a period of one year, from April 2010 to April 2011.

Materials and Methods:

The clinical samples of skin, hair, and nail from 889 outpatients (317 men vs. 572 women) were used for direct microscopy and culture. All the culture-positive samples were then subjected to amplification of the internal transcribed spacer (ITS) of the nuclear rDNA followed by a restriction fragment length polymorphism (RFLP) assay to verify the causative agents.

Results:

The infection was confirmed in 90 (44.3%) males and 113 (55.7%) females. The most common type of dermatophytoses was tinea cruris (42.9%), followed by tinea pedis (20.2%), tinea corporis (11.3%), tinea unguium (7.4%), tinea faciei (6.9%), tinea manuum (6.4%), and tinea capitis (4.9%). ITS-RFLP based of the identification of isolates, showed that the infections were significantly associated with anthropophilic species, of Trichophyton rubrum (41.9%), Epidermophyton floccosum (19.7%), T. tonsurans (5.4%), and T.violaceum (2%). Other causative agents were T. interdigitale (22.6%), Microsporum canis (4.9%), T. verrucosum (2.5%), and M. gypseum (1%).

Conclusion:

The higher prevalence of T. rubrum, as the agent of dermatophytoses, than other species has never been reported from Iran and is of public health concern because of the chronic nature of infections with anthropophilic species. To thoroughly investigate the epidemiological trend of dermatophytoses in Iran, further periodical and molecular-based studies are necessary.

Azoospermia and Testicular Hypoplasia in a Boar Carrier of a Novel Y-Autosome Translocation

Few sex-autosome chromosome abnormalities have been documented in domestic animal species. In humans, Y-autosome chromosome abnormalities may occur at a rate of 1/2,000 live births, whereas in the domestic pig only 2 Y-autosome reciprocal translocations have been previously described. During a routine cytogenetic screening of young boars, we identified a new Y-autosome translocation carrier, which after puberty showed semen devoid of sperm and testicular hypoplasia with spermatogenesis arrest. Whole chromosome painting by FISH analysis corroborated the reciprocal nature of the chromosomal exchanges between the Y chromosome and SSC13. The possible causes for the observed meiotic arrest of the carrier are reviewed.

Relative inequalities in geographic distribution of health care resources in Kermanshah province, Islamic Republic of Iran

This study aimed to evaluate inequalities in the geographical distribution of human and physical resources in the health sector of Kermanshah province, Islamic Republic of Iran. In a retrospective, cross-sectional study, data from the Statistical Centre of Iran were used to calculate inequality measures (Gini coefficient and index of dissimilarity) over the years 2005-11. The highest Gini coefficient for human resources was observed for pharmacists in 2005 (0.75) and the lowest for paramedics in 2010 and 2011 (0.10). The highest indices of dissimilarity were also for pharmacists in 2005 (29%) and paramedics in 2011 (3%). For physical resources, the highest and lowest Gini coefficients were for rehabilitation centres in 2010 (0.59) and health houses in 2011 (0.12) respectively. Generally, inequalities in the distribution of health care resources were lower at the end of the study period, although there was potential for more equitable distribution of pharmacists, specialists, health houses and beds.

Assessment of the efficacy of 8 weeks of primaquine for the prevention of relapse in vivax malaria patients using SSCP-PCR and sequencing in South and South-East Iran, 2008-2011

BACKGROUND

Treatment of vivax malaria with primaquine prevents the risk of relapse. This study was designed to assess the efficacy of 8 weeks of primaquine treatment in prevention of relapse in patients with vivax malaria in south and south-east Iran by SSCP-PCR and sequencing.

METHODS

A total of 163 symptomatic vivax malaria cases were followed up in Hormozgan and Sistan, Baluchestan provinces in south and south-east Iran between December 2008 and December 2011. DNA was extracted from primary and secondary positive samples. A variation region of PvMSP-1 gene was selected and amplified by PCR. The obtained fragments were processed in polyacrylamide gel for single-strand conformational polymorphism (SSCP) and then sequenced.

RESULTS

Among 145 patients treated with chloroquine plus primaquine who completed the study period, two patients (1.4%) experienced a secondary infection after the initial episode of Plasmodium vivax. The comparison between primary and secondary isolates by SSCP indicated different banding patterns and electrophoretic mobility. Alignment of nucleotide sequences between pair primary and secondary isolates revealed dissimilar homology. Secondary isolates of both patients were considered as reinfection. Five of the 18 cases (28%) treated with chloroquine only revealed secondary infection. Analysis of nucleotide sequences and SSCP patterns indicated the relapse in all of them.

CONCLUSION

This survey indicates that intake of primaquine, 0.75 mg/kg, weekly for 8 consecutive weeks, is effective for the prevention of relapse in vivax cases in Iran.

Epidemiological data, outcome, and costs of burn patients in Kermanshah

Burn injuries in both developed and developing countries cause long-term disability, mortality, and socio-economic costs that are imposed on patients, families, and societies. This study was carried out to investigate the epidemiology, outcome, and cost of hospitalization of 388 burn patients admitted to the Imam Khomeini Hospital Burn Center in Kermanshah, Iran, between 21 March 2011 and 20 March 2012. The data about demographics, cause of burns, degree of burns, outcome of burns, burned body surface (BBS), length of stay (LOS), and cost of hospitalization were collected by reviewing medical records and analysed by SPSS 16. The patients' mean age was 27 years. The male/female ratio in burn patients was 1.14/1. The mean BBS was 36.06%. The mean LOS was 9.04 days. Flame (67.0%) and hot liquids (21.9%) were the major causes of burn. Burn injuries were more common in the upper limbs (81.4%), lower limbs (70.9%), and head and neck (65.2%). 11.6% of patients had all the regions involved. The fatality rate was 18.8%. The mean cost per patient was 20,463,227 Iran Rials (IRR). The cost per one percentage of burn and one day of hospitalization was 562,632 IRR and 2,263,631 IRR, respectively. The main factors relevant to death were identified including the extent of burn, gender, age, causes, and degree of burn. In addition, LOS proved to have a higher impact on costs than burn percentage.

Correlation between the Pulmonary Artery Pressure Measured in Echocardiography and Pulmonary Artery Diameter in the CT-Scan of Patients Suffering from Interstitial Lung Disease

BACKGROUND

Pulmonary hypertension (PH) is a significant cause of morbidity and mortality in patients suffering from pulmonary parenchymal diseases. Diagnosis of PH has always been a major clinical dilemma due to its non-specific clinical manifestations. However, diagnosing PH and determining its severity are essential for the prognosis and treatment planning in PH patients. This study aimed at evaluating the correlation between the pulmonary artery diameter (PAD) in the CT-scan and pulmonary artery pressure (PAP) in echocardiography of patients.

MATERIALS AND METHODS

PAD was evaluated in the CT-scan of 117 patients suffering from interstitial lung disease (ILD) and the correlation between PAD and PAP was studied. A receiver operating characteristic curve (ROC curve) which is indicative of the precision of the diagnostic test was drawn to find the cut off point for the MPAD representing PH. The area under the curve was also calculated in order to define the discriminative power of the test.

RESULTS

PAP higher than 25 mmHg was considered as PH. PAD over 29 mm reported in the CT-scan for the diagnosis of PH in ILD patients had sensitivity of 63% and specificity of 41.5%. No significant linear correlation was found between PAD and PAP (P-value = 0.17, r = 0.15). The area under the ROC curve was calculated to be 0.49 in the cutoff point of 29 mm for determining PH (CI 95% = 0.38-0.60, P = 0.89).

CONCLUSION

ROC curve showed a weak discriminative power. PAD had low sensitivity and specificity in the CT-scan for the diagnosis of PH. Therefore, we conclude that CT-scan alone is not helpful in finding PH cases and further examinations are required.

Comparison of two techniques for evaluation of coronal leakage along of a glass fiber post

OBJECTIVE

Contradictory results have been reported over microleakage studies of restorative materials and methods. Despite the number of publications on leakage there are few evidences comparing the different microleakage evaluation methods. The purpose of the present study was to compare the clearing technique and longitudinal sectioning in the evaluation of dye penetration along a glass fiber post.

MATERIALS AND METHODS

Fifteen single-rooted human teeth were endontically prepared and obturated with gutta percha points and a resin based sealer (AH26). A glass fiber post (Glassix) was cemented into each post space with a dual polymerizing resin cement (Varilink II) and the composite core (Tetric Ceram) was fabricated. Specimens were immersed in Indian ink solution for 72 hours after completion of 1500 cycles of thermal cycling. Then demineralized, cleared and evaluated for the deepest length of dye penetration using a stereomicroscope. Specimens were then cut longitudinally and the length of penetration was measured again by the same instrument. The mean difference of the penetrated length was analyzed by two methods using the paired t test and an analysis of correlation (α = 0.05).

RESULTS

No significant difference was found in the mean microleakage measured by the two methods (P= 0.07). Significant correlation was found between them (P=0.0001, r= 0.9)

CONCLUSION

The clearing technique and longitudinal sectioning showed the same results in microleakage of Glassix post and composite core within the limitation of the present study.

Serological Evaluation of EgAgB16 kDa, a Recombinant Antigen from Echinococcus granulosus for Diagnosis of Human Hydatidosis

BACKGROUND

Regarding that accurate diagnosis of human hydatidosis still needs more investigations, the present study was conducted to clone, express, and evaluate the gene encoding AgB subunits (EgAgB16 kDa) from Echinococcus granulosus (Iranian G1 strain) and its evaluation by ELISA test.

METHODS

DNA was extracted from protoscoleces and was utilized by PCR for strain identification. Total RNA was prepared with RNeasy protect mini kit from E. granulosus (Iranian G1 strain) protoscoleces collected from naturally infected sheep with hydatid cyst. Recombinant AgB16 kDa was produced using pETDuet as vector and evaluated by ELISA method. A panel of sera including hydatid cyst-infected individuals (n=72), healthy individual (n=48), toxoplasmosis (n=4), strongyloidosis (n=4), kala-azar (n=5) and tuberculosis (n=5) were examined using this recombinant antigen.

RESULTS

Recombinant protein was purified by affinity chromatography using His-Tag column. After purification, recombinant protein was confirmed by western blot analysis using His Tag monoclonal antibody or hydatid positive human serum. The sensitivity, specificity; positive and negative predictive values were calculated as 93.5%, 95.6%, 96% and 92.9%, in that order. The cut-off point was detected 0.3 for rAgB16.

CONCLUSION

While the produced recombinant AgB16 kDa showed promising results in diagnosing human hydatidosis, but more investigations should be implemented to reach an accurate gold standard.

Molecular Monitoring of Plasmodium vivax Infection after Radical Treatment in Southeastern Iran

BACKGROUND

The aim was to evaluate the relapse risk of vivax malaria in patients who received radical treatment in Hormozgan Province, a malarious area located on southeast of Iran.

METHODS

A total of 95 symptomatic vivax malaria infected patients were enrolled in urban health centers of Bandar-Abbas, Minab, Bandar-Jask and Bashagard districts of Hormozgan Province, southeast of Iran from January 2008 to March 2009 for consideration as a case- series study. DNA was extracted from parasite infected whole blood samples. A polymorphic region of Plasmodium vivax merozoite surface protein 1 (pvMSP1) was selected and a PCR method was employed for all the samples to amplify the specific variable gene fragment. The obtained fragments in primary and secondary samples were sequenced. Both nucleotide and amino acid sequences of the samples were investigated for returned patients.

RESULTS

3.2% of the patients experienced a second attack between 83-199 days after the initial episode of infection. Alignment of nucleotide and their deduced amino acid sequences between pair sequences of primary and secondary isolates revealed 8 and 6 dissimilarities respectively for the first case, and 9 and 7 dissimilarities for the second case. Although microscopical examination of recurrent thick blood smear of the third patient confirmed new P. vivax infection, the venous blood sample was accidentally missed. Sequencing results of primary and returned isolates 1P, 1S, 2P, 2S and 3P in this study showed an identity with BP13, T117, BP13, TC28 and Chesson genotypes respectively.

CONCLUSION

The returned (secondary) isolates may account to be for the sake of reinfection.

Non-operative management of blunt trauma in abdominal solid organ injuries: a prospective study to evaluate the success rate and predictive factors of failure

AIM

Over the past several years, non-operative management (NOM) has increasingly been recommended for the care of selected blunt abdominal solid organ injuries. No prospective study has evaluated the rate of NOM of blunt abdominal trauma in the northwest of Iran. The objective of our study was to evaluate the success rate of this kind of management in patients who do not require emergency surgery.

METHODS

This prospective study was carried out in Imam Khomeini Hospital (as a referral center of trauma) at Tabriz University of Medical Sciences, Iran, between 20 March 2004 and 20 March 2007. All trauma patients who had suffered an injury to a solid abdominal organ (kidney, liver, or spleen) were selected for initial analysis, using the Student's t test or the c2 test.

RESULTS

During the three years of the study, 98 patients (83 males and 15 females) with blunt trauma were selected to NOM for renal, hepatic and splenic injuries. Mean age was 26.1+/-17.7 years (range, 2 to 89) and mean injury severity score (ISS) was 14.5+/-7.4. The success rate of NOM was 93.8%. Fifty-one patients (43 males, 8 females; mean ISS, 14.2+/-5.8) underwent NOM of splenic trauma; 38 patients (33 males, 5 females; mean ISS, 12.9+/-8.2) hepatic trauma, and nine patients (7 males, 2 females; mean ISS, 22.2+/-7.6) renal trauma. Six patients underwent laparotomy due to the failure of NOM. The success rates of this treatment were 94.1%, 94.7% and 88.8% for the spleen, liver and kidney injuries, respectively. Age, female gender and ISS were significant predictors of the failure of NOM (P<0.05).

CONCLUSION

According to the authors NOM can be successfully performed for the hemodynamically stable patients with solid organ blunt trauma. The study indicates that the rates of NOM vary in relation to the severity of the organ injury. This suggests trauma centers should use this approach.

Dermatofibrosarcoma protuberans, magnetic resonance imaging and pathological correlation

Dermatofibrosarcoma protuberans (DFSP) is a rare slow-growing soft tissue tumour which characteristically occurs on the chest, head and neck regions. Typical histologic features include monomorphous spindle-shaped cells arranged in a storiform pattern on a background of fibrous stroma. The tumour has a propensity for local invasion and high recurrence rate. While the imaging features are not pathognomonic of the tumour, the characteristic location and shape should prompt inclusion in the differential diagnostic list.

The first survey of Hendersonula toruloidea as a human pathogen in Iran

The possible presence of Hendersonula toruloidea in the environment and its role as a human pathogen in Iran was studied. Samples were collected both from trees likely to be infected and from patients who presented with suspected fungal infections of the hands and feet. The samples were mainly collected in areas of southern Iran where the climate is similar to that of areas where H. toruloidea has been found previously to infect humans. H. toruloidea type B was isolated from plant samples (eucalyptus trees) for the first time in Iran but it could not be isolated as a human pathogen.