The Effect of Different Zinc Sources on Biochemical Parameters, Intestinal Morphology, Carcass Characteristics and Performance in Finishing Lambs

To investigate the effect of different sources of zinc supplements on blood serum parameters, nutrient digestibility, growth performance, carcass characteristics, and intestinal morphology, 18 male Zandi lambs (with initial body weight of 31 ± 1.2 kg and 120 ± 8 days old) were divided into three groups, six animals each in a completely random design. Experimental treatments include (1) control treatment of basal diet without zinc supplementation, (2) basal diet with 40 mg/kg of zinc supplementation from zinc sulfate source, and (3) basal diet with 40 mg/kg of zinc supplementation with origin it was organic (Zn-peptide). All lambs were kept in individual pens with cemented floor and provision of individual feeding and watering. Mean daily weight gain increased with zinc supplementation (P < 0.05), but feed intake and feed conversion ratio were not affected by zinc supplementation in the diet. Zinc supplementation increased the apparent digestibility of the dry matter (P < 0.05), but the digestibility of dietary fat, neutral detergent fiber (NDF), and acid detergent fiber (ADF) were not affected by zinc supplementation. In this experiment, the addition of organic and inorganic supplements to the diet of fattening lambs had no significant effect on serum triglyceride, cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL) and glucose concentrations, and carcass traits. The concentration of aspartate aminotransferase (AST) enzyme in the zinc sulfate group was significantly higher than the control and organic zinc groups (P < 0.05). Concentrations of blood urea nitrogen were lower in zinc fed lambs, compared to control (P ≤ 0.05). The villi width in the duodenum was higher in the zinc supplementation treatments (P < 0.05). Also, in the ileum section, the height of the villi in the treatment of zinc sulfate supplement was higher, compared to the complement and control (P < 0.05). The results of this study showed that Zn supplementation, regardless of its source, improved growth performance in fattening lambs. However, no effect was observed on feed intake and efficiency, carcass traits, and blood parameters.

Infectious keratitis: an update on the prevalence, risk factors, culture results, clinical features, visual outcomes, and therapeutic strategies of infectious keratitis

OBJECTIVE

This study aimed to assess the prevalence, risk factors, culture results, clinical features, visual outcomes, and therapeutic strategies of infectious keratitis after surface ablation (PRK).

PATIENTS AND METHODS

This single-center prospective case-series review comprised 6500 eyes of 3400 patients undergoing PRK operation successively at the Ardabil Noor Surgical Center between January 1, 2003, and February 1, 2020. The incidence, risk factors, and clinical course were recorded for these samples.

RESULTS

Three clinical and culture-proven cases of infectious keratitis in three eyes of three patients were diagnosed during the study period. Post-operative keratitis was observed in cases 1 and 2 after 3 days and in case 3 after 112 days. The results of cultures were positive in all three cases. The isolated microorganisms were Staphylococcus species in cases 1 and 2 and Candida Albicans in case 3. The final corrected distance visual acuity was 20/25 and 20/20 in cases 1 and 2, respectively, and hand motion in case 3. All three patients had some risk factors such as well-controlled familial Mediterranean fever, mild Meibomian gland dysfunction, and the healthcare environment of the patient's wife in case 1, contact lens manipulation in case 2, and dry eye in case 3.

CONCLUSIONS

The prevalence of infectious keratitis after PRK was 0.046%. Infectious keratitis is one of the complications of PRK that can threaten patients' vision. Accordingly, proper preoperative clinical history taking, adequate eye exam and aggressive management can help maintain good eyesight in patients who undergo PRK surgery.

The effect of digital nerve block on the accuracy of hemoglobin monitoring during surgery: A randomized clinical trial

Background: The decision to transfuse blood products to patients during surgery is critical, due to the potential complications and costs of transfusion. Measuring hemoglobin level by spectrophotometry (SpHb) plays an important role in making this decision. The accuracy of SpHb depends on the finger perfusion. Since digital nerve blocks (DNB) can enhance blood circulation, we aimed at investigating DNB effects on the accuracy of SpHb. Methods: Patients undergoing spine surgery were randomly assigned to two groups. Group A received DNB in the left hand, and group B received DNB in the right hand. In each group, the other hand was considered as the control. Rainbow adult ReSposable sensors were attached to the patients’ both hands. Before surgical incision and every 1.5 hours, the SpHb values of both hands and the perfusion index were recorded. Concomitantly, arterial blood samples were drawn and sent to the lab for hemoglobin concentration measurement. This served as the gold standard for assessing hemoglobin levels (labHb). We used a mixed-effects generalized linear model to test the effect of independent variables on the difference between SpHb and labHb at each time point. Results: The SpHb displayed higher hemoglobin levels than those assessed by the lab. For lower labHb values, the SpHb-labHb differences were larger. A one-unit decrease in labHb increased the difference between SpHb and labHb by 0.56 g dL -1 , which was statistically significant. DNB significantly increased the difference between SpHb and labHb by 0.42 g dL -1 . The effect of DNB on the difference between SpHb and labHb was significant up to three hours after the beginning of surgery (0.58 g dL -1 difference between blocked and non-blocked hands). Conclusion: This study shows that, when hemoglobin levels are low, the accuracy of spectrophotometry decreases. Although DNB increases finger perfusion, it leads to an overestimation of hemoglobin levels by SpHb.

Thin Split Thickness Skin Grafting on Human Acellular Dermal Matrix Scaffold for the Treatment of Deep Burn Wounds

BACKGROUND

Use of AlloDerm™ is highly suggested for the treatment of deep burns and burn sequela reconstruction. Scar formation and contracture are recognized as long-term consequences of split-thickness skin autografting, which is applied for full-thickness burn injuries. Mature fibroblasts, in the absence of dermis, seem to secrete collagen in the reformed scar pattern.

OBJECTIVE

To process AlloDerm™ from fresh allograft and use it as a dermal substitute for covering deep wounds in burn patients and evaluate its effectiveness.

METHODS

In this case-series, 7 patients with deep burn wounds involving different locations on the body surface were exposed to combined AlloDerm™ (processed from fresh human allograft) with thin split thickness skin autograft on it. On the 5^th post-operative day, wound dressings were changed to evaluate the graft survival with the human acellular dermal matrix scaffold. To determine the skin profiles, follow-ups continued for at least 6 months.

RESULTS

The results showed excellent graft take, good elasticity, acceptable thickness, and little contracture and scarring according to fix surgeon assessment in 6 patients. Graft rejection happened only in one patient with chronic electrical injury.

CONCLUSION

AlloDerm™ derived from cadaver skin and combination of it with thin split thickness skin auto grafting constitute a cost-effective and favorable option for the treatment of deep burn wounds in our center, considering the increased tendency of the population towards organ donation in the event of brain death.

Molecular dynamics simulation and experimental study of the surface-display of SPA protein via Lpp-OmpA system for screening of IgG

Staphylococcal protein A (SpA) is a major virulence factor of Staphylococcus aureus. S. aureus is able to escape detection by the immune system by the surface display of protein A. The SpA protein is broadly used to purify immunoglobulin G (IgG) antibodies. This study investigates the fusion ability of Lpp'-OmpA (46-159) to anchor and display five replicate domains of protein A with 295 residues length (SpA295) of S. aureus on the surface of Escherichia coli to develop a novel bioadsorbent. First, the binding between Lpp'-OmpA-SPA295 and IgGFc and the three-dimensional structure was investigated using molecular dynamics simulation. Then high IgG recovery from human serum by the surface-displayed system of Lpp'-OmpA-SPA295 performed experimentally. In silico analysis was demonstrated the binding potential of SPA295 to IgG after expression on LPP-OmpA surface. Surface-engineered E. coli displaying SpA protein and IgG-binding assay with SDS-PAGE analysis exhibited high potential of the expressed complex on the E. coli surface for IgG capture from human serum which is applicable to conventional immune precipitation.

Evaluation of Metabolic Syndrome among Locomotive Drivers

Introduction: Screening of risk factors for metabolic syndrome among commercial and train drivers that are considered safety sensitive jobs, is an important issue in safety of transportation system. Metabolic syndrome is consisted of disturbed lipid profile, high blood pressure, and high waist circumference. It can lead to decrease the quality of life and higher health associated costs for these patients. This study aimed to assess risk factors for metabolic syndrome among train drivers. Methods: This cross-sectional study was conducted on 281 train drivers referred to their annual health examinations to Occupational Medicine Clinic of Baharloo Hospital, Tehran University of Medical Sciences. Demographic characteristics of participants were recorded. Blood pressure, body mass index and waist circumference of drivers were measured. Participants’ blood sample for fasting blood sugar, triglyceride, high and low density lipoproteins were collected. Metabolic syndrome was defined according to the NCEP ATP III criteria. Results: All of the participants were males.  Their mean age and BMI was 43±10 year and 26.60±3.67 Kg/m2, respectively. Fifty three (21%) of the participants were diagnosed with metabolic syndrome. The more frequent risk factor for metabolic syndrome was triglyceride more than 150mg/dl. Conclusion: Findings of the present study revealed high prevalence of metabolic syndrome among train drivers. Further studies are needed for screening the metabolic syndrome in this occupational group as it is a sensitive occupation.

Detection of Acanthamoeba spp. from dust phenomenon in Ilam Province, West Iran

In recent years, increasing dust phenomenon in the west of Iran has led to social, economic, and health concerns. This study aimed to represent the existence and genotyping of Acanthamoeba spp. in dust phenomenon in Ilam Province, Iran. In this study, 55 dust samples were collected and by targeting the diagnostic fragment 3 region of the 18S rRNA gene, the genotypes were determined. Utilizing the tolerance ability test, the pathogenic potential of all positive isolates was also recognized. Eighteen samples of Acanthamoeba (32.7%) were detected in the sampling areas. According to sequencing analysis, the isolates related to T4 (77.7%) and T2 (22.3%) genotypes were reported. It was revealed by thermo- and osmotolerance tests in which six strains are extremely pathogenic. To our knowledge, the pathogenic Acanthamoeba was potentially isolated initially from dust phenomenon in Ilam Province. Thus, these strains are probably highly virulent, and dusts are possible sources of Acanthamoeba infection in humans.

A national survey of natural radionuclides in soils and terrestrial radiation exposure in Iran

In the past, some efforts have been made for measuring natural radioactivity and evaluating public exposure to natural radiation in certain areas of Iran especially in well-known High Level Natural Radiation Areas (HLNRA) in Ramsar and Mahallat. However, the information on radionuclide concentrations, and, consequently, terrestrial radiation exposure for many other areas are not available. There was therefore a need for a systematic and nation-wide survey. For this purpose, 979 soil samples from 31 provinces were collected. The activity concentrations of ⁴⁰K, ²²⁶Ra and ²³²Th were measured by HPGe detector. The average activity concentrations for Iran were found to be 457.7 Bq/kg for ⁴⁰K, 24.3 Bq/kg for ²²⁶Ra and 25.8 Bq/kg for ²³²Th. Results were compared with previous regional or provincial surveys. The population-weighted average outdoor and indoor annual effective dose due to external exposure to terrestrial sources of radiation are 0.06 mSv and 0.33 mSv, respectively. It was shown that there is a significant correlation between the activity concentrations of ²³²Th and ⁴⁰K in soil. In addition, the results of chi square tests show normal and lognormal distributions cannot be considered for the frequency distributions of activity concentration of ²³²Th and ²²⁶ Ra while ⁴⁰K has a normal distribution.

Evaluation of outcomes of suction drainage in patients with haemophilic arthropathy undergoing total knee arthroplasty

INTRODUCTION

Closed suction drainage has been extensively applied for orthopaedic procedures for the sake of avoiding fluid collections around the wound at the operated limb.

AIM

We believed that without application of suction drainage after total knee arthroplasty (TKA), the risk of infection and haematoma formation will not increase while the need for blood transfusion because of decreased blood loss will be lesser.

METHODS

In a prospective randomized clinical trial from April 2010 to April 2014, 176 patients with haemophilia who underwent TKA were included. The study group consisted of 88 patients (108 knees), in which we did not insert suction drain and the control group included 88 patients (106 knees), in which drain was inserted at the end of the surgery. All patients underwent TKA via anterior knee incision and medial parapatellar approach.

RESULTS

The mean follow-up period of study group and control group was 21 ± 11 months vs. 20 ± 9 months consecutively (P = 0.54). The mean hospital stay was 13 ± 8 days vs. 14 ± 8 days in study and control group consecutively (P = 0.40). In both groups, the major part of improvement in clinical knee society score was due to increase in pain subset (mean increase of 42 vs. 39 points consecutively) and to a lesser extent to alleviation of flexion contracture (mean increase of 13 vs. 15 points consecutively). We observed no differences in the mean visual analogue scale (VAS) value between both groups. Average functional outcome in both groups improved during follow-up visits.

CONCLUSION

We can conclude that there is no rationale for the use of drain after primary TKA.

Postconditioning is protective in renal reperfusion injury only in male rats. A gender difference study

PURPOSE

We investigated the impact of sex on the protective effect of postconditioning (POC), a series of brief ischemia-reperfusion (IR) cycles at the reperfusion onset, as a recently described novel approach to attenuate renal IR injury. In this study, the left renal pedicles of uni-nephrectomized male and female rats were clamped for 45 minutes followed by 24 hours of reperfusion as IR groups. Uni-nephrectomized, sham-operated male and female rats served as control groups. Ischemic postconditioning was performed using 4 cycles of 10 seconds of IR of renal pedicle at the end of the ischemia. Twenty-four hours later, BUN (blood urea nitrogen), plasma creatinine (Cr), and renal histological changes, as well as kidney levels of MDA (malondialdehyde) and SOD (superoxide dismutase) as oxidative stress markers were evaluated to detect the protective effect of POC against IR injury in rats.

RESULTS

Induction of IR resulted in significant reduction in renal function, demonstrated by increase in plasma Cr and BUN, histological changes and oxidative stress in both genders. Application of POC afforded significant protection against these injuries in male rats, namely decreased levels of BUN and Cr, histological improvements and less oxidative damages. However, there were no significant differences in the above-mentioned parameters in female rats.

CONCLUSION

While POC is shown to be beneficial against renal IR injury in male rats, it did not show any protective effect in female rats.

Reconstruction of canine diffuse large B-cell lymphoma gene regulatory network: detection of functional modules and hub genes

Lymphoma is one of the most common malignancies in dogs. Canine lymphoma is similar to human non-Hodgkin's lymphoma (NHL) with shared clinical presentation and histopathological features. This study reports the construction of a comprehensive gene regulatory network (GRN) for canine diffuse large B-cell lymphoma (DLBCL), the most common type of canine lymphoma, and performs analysis for detection of major functional modules and hub genes (the most important genes in a GRN). The canine DLBCL GRN was reconstructed from gene expression data (NCBI GEO dataset: GSE30881) using the STRING and MiMI interaction databases. Reconstructed GRNs were then assessed, using various bioinformatics programmes, in order to analyze network topology and identify major pathways and hub genes. The resultant network from both interaction databases had a logically scale-free pattern. Gene ontology (GO) analysis revealed cell activation, cell cycle phase, immune effector process, immune system development, immune system process, integrin-mediated signalling pathway, intracellular protein kinase cascade, intracellular signal transduction, leucocyte activation and differentiation, lymphocyte activation and differentiation as major GO terms in the biological processes of the networks. Moreover, bioinformatics analysis showed E2F1, E2F4, PTEN, CDKN1A, PCNA, DKC1, MNAT1, NDUFB4, ATP5J, PRKDC, BRCA1, MYCN, RFC4 and POLA1 as the most important hub genes. The phosphatidyl inositol signalling system, P53 signalling pathway, Rac CycD pathway, G1/S checkpoint, chemokine signalling pathway and telomere maintenance were the main signalling pathways in which the protein products of the hub genes are involved.

Preventive effect of methanolic extract of Zataria Multiflora Boiss on liver toxicity of paracetamol in rats

Background: The analgesic paracetamol causes a potentially fatal, centrilobular hepatic necrosis when taken in misuse and overdose. This research aimed to evaluate the protective effects of methanolic extract of Zataria Multiflora Boiss (Z. Multiflora) against hepatic damage induced by paracetamol-induced hepatotoxicity in male Wistar rats. Methods: for this purpose, paracetamol was administrated orally at a dose of 2 g/ kg body weight (b.w.)/ day on the seventh day after the oral administration of a methanolic extract of Z. Multiflora at doses of 100 mg/ kg, 200 mg/ kg and 400 mg/ kg b.w. The lipid peroxidation level and activities of liver aminotransferases and enzymes contributing to the oxidative damage were measured in serum, and a histopathological examination of liver sections was also performed. Results and Discussion: The results showed that Z. Multiflora reduced the activity of aminotransferases in rats treated with paracetamol. This extract also inhibited lipid peroxidation and protein carbonylation by an increase in the activity of the antioxidant enzyme and the elevation of glutathione content of the liver. Conclusion: These effects are related to the antioxidant compounds of Z. Multiflora. The methanolic extract of this herb exhibits protective effects against paracetamol-induced hepatotoxicity.

Serological Study on Cytomegalovirus and Toxoplasma Gondii in Thalassemia Major Patients of Yazd, Iran

BACKGROUND

Beta-thalassemia patients receive blood products from blood transfusion centers repeatedly. Blood transfusion can transmit Cytomegalovirus (CMV) and Toxoplasma gondii. The aim of this study was serological evaluation of these two infectious agents in thalassemia patients.

MATERIALS AND METHODS

In a cross-sectional study, the enzyme-linked immunosorbent assay (ELISA) testing was performed to detect IgM and IgG antibodies against CMV and Toxoplasma gondii in 96 thalassemia patients (under 18 years) and 144 healthy people. Data were analyzed by SPSS software and Chi-square test.

RESULTS

A significant difference was observed in CMVIgM antibody levels between test groups in women (p<0.05). The prevalence of CMV IgM, CMV IgG, Toxo-IgG, and Toxo IgM antibodies in thalassemia patients were 5.2%, 95.9%, 16%, and 0%, respectively.

CONCLUSION

In all thalassemia patients, Cytomegalovirus IgG is higher than healthy people. In addition, CMV IgM antibodies are higher in female patients. Antibody screening (IgM) on blood products for detecting Cytomegalovirus is necessary, but for Toxoplasma gondii is not necessary in the Yazd transfusion center.

Cryopreservation of ram semen in extenders containing soybean lecithin as cryoprotectant and hyaluronic acid as antioxidant

A soybean lecithin-based extender supplemented with hyaluronic acid (HA) was assayed for effectiveness to improve the quality of frozen-thawed ram semen. HA has not been tested yet in an extender containing soybean lecithin for freezing ram semen. Thus, the aim of this study was to analyse the effects of soybean lecithin at 1% or 1.5% along with HA at 0, 0.5 and 1 mg ml(-1) in a Tris-based extender on the motion characteristics, membrane integrity (HOST), viability, GSH peroxidase (GSH-PX) activity, lipid peroxidation and acrosomal status after freezing-thawing. Semen was collected from four Mehraban rams during the breeding season and frozen in the six lecithin×HA extenders. The extender containing 1.5% lecithin supplemented with no HA yielded higher total motility (52.5%±1.6), viability (55.8%±1.6) and membrane integrity (44.5%±1.7), but the effects of the lecithin concentration did not reach signification. Linearity-related parameters, ALH, BCF, lipid peroxidation, GSH-PX activity, morphology and acrosomal status were not affected by the extender composition. In general, adding HA significantly decreased sperm velocity (1 mg ml(-1) HA), total motility (only with 1.5% lecithin), viability (1 mg ml(-1) HA for 1% lecithin; both concentrations for 1.5% lecithin) and membrane integrity. In conclusion, adding HA to the freezing extender supplemented with soybean lecithin failed to improve quality-related variables in ram semen. Increasing the lecithin content could have a positive effect, but further studies are needed.

Pulmonary computed tomography scan findings in chronic granulomatous disease

BACKGROUND

Chronic granulomatous disease is a phagocyte defect, characterised by recurrent infections in different organs due to a defect in NADPH oxidase complex. This study was performed to investigate pulmonary problems of CGD in a group of patients who underwent computed tomography (CT) scan.

METHODS

Computed tomography scan was performed in 24 patients with CGD. The findings of the CT scan were documented in all of these patients.

RESULTS

Areas of consolidation and scan formation were the most common findings, which were detected in 79% of the patients. Other abnormalities in order of frequencies were as follows: small pulmonary nodules (58%); mediastinal lymphadenopathy (38%); pleural thickening (25%); unilateral hilar lymphadenopathy (25%); axillary lymphadenopathy (21%); bronchiectasis (17%); abscess formation (17%); pulmonary large nodules or masses (8%); and free pleural effusion (8%).

CONCLUSION

The pulmonary CT scans of the patients with CGD demonstrated a variety of respiratory abnormalities in the majority of the patients. While recurrent respiratory infections and abscesses are considered as prominent features of CGD, early diagnosis and precise check-up of the respiratory systems are needed to prevent further pulmonary complications.

Predominance of rotavirus G8 genotype in hospitalized children with acute gastroenteritis in Yasuj, Iran

BACKGROUND

Rotavirus infection is the most common cause of gastroenteritis among children worldwide. In this study, we were evaluated the occurrence of rotavirus infection and genotypes causing gastroenteritis among children under 5 years in Yasuj, Iran.

MATERIALS AND METHODS

This cross sectional-descriptive study was done on 184 fecal samples collected from children aged < 5 years old with acute gastroenteritis. All the stool specimens were tested for group A rotavirus with enzyme immunoassays (EIA). Rotavirus-positive specimens were genotyped by the Nested reverse transcription polymerase chain reaction (RT-PCR) with using different type of specific primers.

RESULTS

The prevalence of rotavirus was 28.26% and predominant genotypes were G1 (1.92%), G2 (7.69%), G4 (1.92%), G8 (46.16%), N.T.A (40.39%), mixed infections (1.92%). Predominance of rotavirus G8 genotype in the current survey was reported for the first time in Iran. The highest prevalence of rotavirus infection was observed in autumn (48.08%), and the lowest in spring (5.77%).

CONCLUSIONS

The result of study showed that prevalence of rotavirus genotypes in this region of the country is different from that of other regions. The continuous stability of rotavirus in Iran, regarding to the regional differentiates and prevalence of circulating strains, can be useful indication in order to supply and effective vaccine against the rotavirus infections.

Prevalence of food contamination with Listeria spp. in Kermanshah, Islamic Republic of Iran

Listeria monocytogenes is a human pathogen causing serious diseases. We aimed to determine food contamination with Listeria spp. in Kermanshah, Islamic Republic of Iran. Samples (185 dairy, 187 meat products and 158 ready-to-eat foods such as salads) were randomly collected from markets. After processing, samples were cultured in half-Fraser and Fraser broth followed by cultivation on PALCAM and Oxford media. Confirmatory tests including carbohydrate utilization were performed on isolates to determine species. Bacteria were isolated from 66/530 samples (12.5%). Meat products showed the highest (27.2%) and dairy products the lowest (3.8%) contamination rates. L. innocua was found in 56 (10.6%) samples, but L. monocytogenes was only found in 3 samples (0.6%). The results indicate that the rate of contamination with L. monocytogenes, even for ready-to-eat foods, was low but for other Listeria spp., in particular strains of L. innocua, the rate of contamination was higher, suggesting that more control on food sanitation is required.

Correlation of biochemical markers of primary hyperparathyroidism with single adenoma weight and volume

Preoperative laboratory markers of primary hyperparathyroidism including serum parathormone (PTH), calcium and phosphate level may have some predictive value about the size and volume of the abnormal parathyroid gland tissue which needs to be resected in primary hyperparathyroidism. In a Prospective study from 2003 to 2010, 69 patients with parathyroid adenoma were enrolled. The correlation between preoperative serum PTH, calcium and phosphate level with adenoma's weight and volume was analyzed separately. Adenoma volume was calculated via an equation for the volume of a spheroid object. The data were analyzed via a multiple analysis of variance, and a correlation coefficient was calculated. The level of significance was set at p _ .05. There was a significant correlation between adenoma weight and serum calcium and parathormone levels (p = .0001 and p = .0001, respectively). There was no significant correlation between adenoma weight and serum phosphate. With respect to adenoma weight, there was a significant relationship with parathormone levels and serum calcium (p = .0001 and p = .0001, respectively). There was no significant relationship between serum phosphate and aden2oma weight. Preoperative serum PTH and calcium levels may be valuable in predicting parathyroid adenoma volume and weight in primary hyperparathyroidism for a single adenoma.

NeutroPhase(®) in chronic non-healing wounds

Chronic non-healing wounds, such as venous stasis ulcers, diabetic ulcers, and pressure ulcers are serious unmet medical needs that affect a patient's morbidity and mortality. Common pathogens observed in chronic non-healing wounds are Staphylococcus including MRSA, Pseudomonas, Enterobacter, Stenotrophomonas, and Serratia spp. Topical and systemically administered antibiotics do not adequately decrease the level of bacteria or the associated biofilm in chronic granulating wounds and the use of sub-lethal concentrations of antibiotics can lead to resistant phenotypes. Furthermore, topical antiseptics may not be fully effective and can actually impede wound healing. We show 5 representative examples from our more than 30 clinical case studies using NeutroPhase(®) as an irrigation solution with chronic non-healing wounds with and without the technique of negative pressure wound therapy (NPWT). NeutroPhase(®) is pure 0.01% hypochlorous acid (i.e. >97% relative molar distribution of active chlorine species as HOCl) in a 0.9% saline solution at pH 4-5 and is stored in glass containers. NovaBay has three FDA cleared 510(k)s. Patients showed a profound improvement and marked accelerated rates of wound healing using NeutroPhase(®) with and without NPWT. NeutroPhase(®) was non-toxic to living tissues.

Burden and typing of rotavirus group a in children with acute gastroenteritis in shiraz, southern iran

BACKGROUND

Human 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.

METHODS

During 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.

RESULTS

Out 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.

CONCLUSION

The 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.

The dilemma of hyperoxia following positive pressure mechanical ventilation: role of iron and the benefit of iron chelation with deferasirox

BACKGROUND AND OBJECTIVE

Increased oxidative stress in patients under treatment with high concentrations of oxygen (hyperoxia) is considered to be one of the major mechanisms of lung injury, which is thought among different mediators, transition metal ion, iron, by generation of very reactive free radicals which play an important role. Disruption of normal iron homeostasis has been reported in hyperoxic conditions. We hypothesized that chelation of iron can reduce hyperoxia-induced lung injury.

METHODS

Mechanically ventilated patients, who received oxygen with FiO2 >0.5 for at least 3 days, underwent bronchoscopy before and 72 hours after receiving "Deferasirox". Oxidative injury index and iron homeostasis markers were measured in lavage fluid and plasma.

RESULTS

In 12 patients, the concentrations of 8-isoprostane (p=0.005), 8-oxoguanine (p=0.04), carbonyl proteins (p=0.04)--as markers of oxidative stress--decreased significantly in lavage fluid after intervention. Levels of iron-related proteins, ferritin (p=0.04) and transferrin (p=0.005) also decreased significantly in lavage fluid.

CONCLUSION

Deferasirox--as an iron chelator--decrease oxidative injury index in hyperoxic condition and it could be consider safe and beneficial agent, along with other supportive measures in hyperoxia-induced lung injury for better toleration of oxygen therapy.

NVC-422 topical gel for the treatment of impetigo

Impetigo is a highly contagious bacterial skin infection affecting children worldwide that is caused by the Gram-positive bacteria Staphylococcus aureus, Streptococcus pyogenes, or both. Staphylococcus species can quickly develop drug resistance rendering mupirocin, fusidic acid, and erythromycin ineffective. Preclinical and clinical studies demonstrated that NVC-422 (N, N-dichloro-2, 2-dimethyltaurine) rapidly kills pathogens without the development of drug resistance. 129 patients with clinically diagnosed impetigo were randomized to three dose groups (0.1, 0.5, or 1.5% NVC-422 topical gel) in a study conducted at 2 centers; 125 patients (97%) had microbiologically confirmed infection. Treatment was administered three times a day (TID) for 7 days to all randomized subjects. Response was measured at the completion of treatment (Day 8) and 1 week post treatment (Day 15) by the Skin Infection Rating Scale (SIRS) and by microbiological response. A total of 120 subjects (96%) completed all 7 days of treatment and were assessed at end of treatment (EOT). Clinical response rate at EOT in the PPC population was excellent in each of the dose groups (84.6%, 87.2%, and 92.3% in the 0.1%, 0.5% and 1.5% dose groups respectively). The majority of the infections were caused by S. aureus, alone (106/125, 85%) of which approximately 10% were MRSA. There were no clinical recurrences in any treatment groups. Treatment-emergent adverse events were seen in 5.4% of the subjects (7/129) and were mild to moderate and resolved. NVC-422 topical gel administered TID was well tolerated, with high rates of clinical and microbiological responses for treating impetigo.