REPORT OF A BOTULISM OUTBREAK TRACED TO THE TRADITIONALLY-MADE CHEESE CONSUMPTION
Botulism toxin is the most potent toxin known to the human. It is found in seven different forms (A-G), and has a mean molecular weight of 150 kd. There are many reports on botulism outbreak from different parts of the world: a massive outbreak associated with traditional salted fish in Egypt (1991) with 18% mortality, another report from China tracing the outbreak to home-made bean cans (1990) a report of garlic in oil associated botulism (1990), and an outbreak caused by consumption of yogurt from England.
Herein, we report on 27 cases of botulism from Looshan and Roodbaar, in North Iran, with clinical presentation of botulism. At the beginning of 1997, clinical specimens of these cases were examined at the Pasteur Institute. In 10 out of these 27 cases, type A toxin was isolated. All but one of the patients, were treated successfully with antitoxin sera. Further investigation, revealed that the source of infection was the cheese, made in traditional way in the region.
Authors: Poorshafi MR, Shafie E, Vahdani P, et al.
Source: Nabz 1997; 1; 7: 44-47.
SHIFT IN THE LOCATION OF GASTRIC CANCER FROM LOWER TWO-THIRD TO UPPER ONE-THIRD OF STOMACH DURING THE PAST THREE DECADES
The tumors of the upper third of stomach are usually diagnosed in higher stages, when curative therapy is not feasible, the diagnostic importance of the early detection is obvious, physicians should be more aware in suspicious cases.
The location of gastric cancer in patients admitted to the Firoozgar Medical Center, Tehran, was determined during two time intervals; 1969-1973 and 1989-1993. While between 1969 and 1973, 18% of tumors occurred in upper 1/3 of the stomach, during 1989 to 1993 period, the relative frequency rose significantly to 32% (p<0.05). This trend is in accord to what have been reported by other researchers at Michigan and Duke Medical Centers.
Authors: Azizi R, Shafie S.
Source: J Med Coun IRI 1996; 4: 144-147.
THE BIOLOGICAL CONTROL OF HOUSE FLIES BY SPALANGIA WASPS
The common house fly (Musca domestica) is an important vector in transmitting various bacterial, viral and protozoal infections. In the recent years, however, growing resistance to a large number of chemical insecticides has revived interest in biological control of the house flies. Some arthropods and insects kill the house fly by direct predation or parasitism (parasite induced mortality) and could be recruited for biological control of this insect. Among the lethal parasites are Spalangia endius walker wasps. These wasps infest the pupae of house flies and thus eradicate them.
In this study Spalangia endius wasps were collected from their natural habitats such as poultry houses and dairy farms and reared in the laboratory conditions.
Results showed that the female wasps stayed alive for a maximum of 17 days. During their lifetime each wasp destroyed an average of 7 pupae daily and produce about three progenies, meanwhile.
Therefore, considering the above mentioned features and the feasibity of rearing Spalangia wasps in laboratory contexts, it seems a suitable candidate for biological control of house flies in Iran.
Authors: Behbahani AA, Tirgari S, Ghassemi MJ.
Source: Urmia Medical Journal; 8;2; 1376: 84-90.
STUDY ON PRODUCTION OF INACTIVATED LEISHMANIA MAJOR FOR VACCINATION
During the last few years several studies have been performed regarding production of inactivated vaccine of L. major at the Razi Institute of Tehran. In the preliminary phase of these studies, through a series of trials on L. major, optimum growth conditions (pH, temperature, etc.) were determined. L. major seed (removed from liquid nitrogen) was grown in a suitable medium for vaccine production. In the production phase of the project, promastigotes of L. major were harvested and inactivated with different concentrations of merthiolate, centrifuged in several different conditions and then suspended in saline. After making sure that the promastigotes were totally inactivated, (by freeze-thawing or autoclaving methods), safety, sterility, unviability and potency tests were performed both in vitro and in vivo. After obtaining ethical permission, the trial vaccines were delivered to the Center for Skin Diseases and Leprosy, of the Ministry of Health and the Office of TDR in Iran to be evaluated on human volunteers in endemic areas (Iran, Pakistan and Sudan) for L. major, L. tropica and L. donovani. Field studies indicated that the vaccinated volunteers did not show any significant adverse effects. The immunogenicity of the vaccine was also satisfactory. The potency test is under evaluation in endemic areas. Should the tests render satisfactory results, the vaccine will be suitable for prevention of L. major, L. tropica and L. donovani.
Authors: Hashemi Fesharki H, Ale-Agha R, et al. AA.
Source: Iranian J of Infect. Trop. diseases; 6; 1998: 12-20.
SHIGELLOSIS: A 3 YEAR STUDY IN CHILDREN
Shigellosis is an acute intestinal infection caused by Shigella bacilli, a genus of gram-negative organisms. Species accounting for the disease are S. dysenteriae, S. flexneri, S. sonnei and S. boydii. Clinical manifestations are diverse and include both intestinal and extra-intestinal signs and symptoms. World wide fatalities due to shigellosis are reported annually.
In this study, we investigated the clinical and epidemiological aspects of shigellosis in the patients referred to the Qods Pediatric Center, and is an affiliate pediatric unit of the Qazvin Medical University in the city of Qazvin, west of Tehran.
From a total of 177 patients with definite diagnosis of shigellosis, 63.8% were male and 36.2% were female. The peak age of incidence was between 1 and 4 years, and the disease was most prevalent in the summer. Fever and bloody diarrhea were seen in 88% and 46.3% of the cases, respectively. Twenty-six percent of the patients had seizures and in 21% of the patients, seizure was the first manifestation of the disease.
Around 70% of the valid stool cultures were identified as S. flexneri and other species were involved in the remaining 30%. All of the mentioned shigella species (except for S. sonnei) were resistant to ampicillin while no instance of resistance was detected to nalidixic acid.
At least, 5% of the patients admitted for diarrhea to our clinic had shigellosis. The true rate is probably higher, because the stool culture may sometimes become negative in shigellosis. It is noteworthy that even higher rates are reported from countries like India. In comparison to the cases reported from the developed countries, our patients clearly suffered more frequently from seizures and fever. This is probably due to the higher prevalence of S. flexneri infection in the less developed countries. Our results are comparable to those reported from Chile.
It is concluded that higher prevalence and the more grave clinical picture of shigellosis in the third world countries mandate special attention from health care services.
Authors: Mahyar A
Source: Nabz; 7; 5: 1376: 36-40.
TUBERCULOUS ADENITIS: REPORT OF 31 PATIENTS WITH TB ADENITIS
Tuberculous lymphadenitis is the most common form of extrapulmonary tuberculosis. Mycobacterium tuberculosis and atypical mycobacteria (e.g. M. Scrofulacea, M. avium complex, M. avium intracellularis) are held responsible for the disease.
In this study, 31 patients with tuberculous lymphadenitis, referred to the Tuberculosis and Pulmonary Disease Research Center in Tehran from 1995-1996 underwent a retrospective analysis.
The age range was 15-84 years (mean 40 years). Prevalence was greatest among 15-40 year age group and the female to male ratio was 1.2:1.
We found that the cervical lymph nodes were the most frequently involved site and comprised 50% of the cases. Supraclavicular lymphadenopathy with 30% ranked second and axillary and parotid lymphadenopathy represented, 6% of the cases each. The remaining cases were subclavicular or general lymphadenopathy. Except for 3 patients, the chest x-ray did not reveal any radiographic abnormality. PPD was positive (induration of 14-30 mm) in 11 and negative in the remaining 20 patients. In one patient the smear and culture for AFB from the infected lymph nodes was 3+ positive; the diagnosis was made after excisional biopsy which showed caseation necrosis and granuloma. No patient was HIV positive. All patients were treated with six-months anti-tuberculous regimen and in five patients, the lymph nodes had to be extirpated on account of the lack of response to treatment.
After one year of follow up, 21 patients were completely cured and 6 were still suffering from lymphadenitis or its complications. Four patients were lost to follow-up.
The results are compared with those of other countries. The promising outcome of six-months antituberculosis regimen is underlined.
Authors: Velayati AA, Masjedi MR, Salehi M, Baghai N
Source: Iranian Journal of Infections and Tropical diseases; 5: 1998: 47-51.
ANTIHISTAMINIC AND ANTICHOLINERGIC EFFECTS OF BERBERIS VULGARIS
Beriberis vulgaris is a well known plant in Iran and its fruits are used in many indigenous Iranian dishes. The antihistaminic and anticholinergic effects of the fruit's aqueous extract on the isolated ileum of guinea pig are studied in this paper. The dose-response graphs of histamine and acetylcholine were produced in the presence and absence of the extract. The antagonistic power (pA2) of this extract as an antihistamine, versus dexchlorpheniramine, were calculated as follows;
PA2±SEM=4.5±0.01 (for extract)
pA2±SEM=9.36±0.14 (for dexchlorpheniramine)
These figures were compared with each other. The antagonistic power of the extract was also calculated and compared to atropine, as an anticholinergic agent:
pA2±SEM=4.37±0.03 (for extract)
pA2±SEM=8.99±0.13 (for atropine)
These results, which seem to be due to competitive antagonism, demonstrate the antihistaminic and anticholinergic effects of the extract.
Authors: Shamsa F, Ahmadiani A, Khosrokhavar R.
Source: Pazoohandeh; 6: 1376: 27-33.
IN VITRO & IN VIVO STUDY OF ANTIPARASITIC EFFECT OF FERULA ASA FOETIDA EXTRACT ON HYMENOLEPIS NANA WITH COMPARISON TO NICLOSAMIDE
In vitro effects of six different dilutions of hydroalcoholic extract of ferula asa foetida on hymenolepis nana were studied. The time needed to kill the worms with the extract (4.78 mg/ml) was close to the time, using 10 mg/ml of niclosamide. The concentrations of extract and niclosamide were given orally as a single dose (0.3 ml/mice) daily for seven days to the white mice infected with hymenolepis nana (30 mice for treatment with extract and 30 mice for niclosamide therapy). The control group were given normal saline. The extract and niclosamide were 66.6% and 80% effective in treating parasitized mice, respectively. In repeating the course of treatment the effectiveness rose to 73.3% and 93.3% for extract and niclosamide, respectively indicating that the extract was less effective in the treatment trial, as compared with the drug. With increasing the concentration of the extract to 7.17 mg/ml, the therapeutic effect increased almost to the level as high as that of niclosamide. It is concluded that, prescribing the ferula asa foetida extract with the concentration of 7.17% mg/ml as a single dose daily for two weeks was curative in mice infected with hymenolepis nana.
Authors: Maraghi S, Talebpour S.
Source: Scientific Medical Journal Ahwaz University; 23; 1376: 48-56.
THE LEISHMANIN TEST IN PATIENTS WITH LEISHMANIASIS: RELEVANCE TO CLINICAL TYPE AND DURATION OF ILLNESS
Leishmanin test is a good correlate of cellular immunity against cutaneous leishmaniasis and in fact the resistance against leishmaniasis is usually accompanied by a positive response. As far as we know, there is no reports on the precise relationship between the positive conversion of the leishmanin test and clinical appearance, or response to the treatment. In this study, we decided to investigate the potential correlation between positive conversion or the extent of induration with the length of the disease, type or number of lesions and also the age and sex of the patients. Of a total of 210 patients (102 males and 108 females) with estabilished leishmaniasis, one hundred and nighty-eight patients were followed up till the end of the study at the Dermatology Clinic of Khorshid Hospital in Isfahan. Leishmanin test was applied to all of the patients before institution of any kind of treatment: 179 (90.4%) responded positive and 7 (3.8%) converted to positive during treatment, twelve patients (6%) remained negative even after 2 years. The results showed no significant correlation between age, sex, duration of illness with positive conversion or extent of induration, but a significant correlation was noted between the clinical type and persisting negative tests. All the patients failing to incur conversion carried only a single lesion which was of papular type in most instances (7 of 12). The applicability of the leishmanin test as a diagnostic tool is discussed.
Authors: Moemeni A, Sadeghian G.
Source: Journal of Dermatology; 1; 1: 10-18.
CIGARETTE SMOKING IN IRAN: A NATIONAL HEALTH SURVAY
Cigarette smoking is strongly correlated with cardiovascular, pulmonary and neoplastic diseases. Smoking is hence considered a major health hazard. In this study, we investigated smoking habits in Iran to obtain estimates for age, sex, geographical distribution (urban vs. rural), age at starting the habit and amount of daily consumption of cigarettes among Iranian smokers. As a part of the National Health Survey Project, 1/1000 of the total inhabitants of the country were chosen through cluster sampling and the population aged 15-69 years were questioned regarding their smoking habits. Results showed that 14.6% of the participants were smokers and smoked an average of 13.6 cigarettes per day. This sums to a total of 68 million cigarettes per day with an estimated cost of 9300 million Rials (3 million dollars). Smoking was more prevalent in the urban than rural areas (16.3% vs. 13.5%) and more among men than women (27.2% vs. 3.4%). Sixty-six percent of smokers (70% of men and 34.9% of women) said that they started smoking between ages 15 to 24 (high school, college or military service). The impact of smoking on the public health and economy is discussed.
Authors: Mohammad K, Zali MR, Masjedi MR, Majdzadeh SR.
Source: J Med Coun I.R.I 1377; 16: 1: 33-37.
SURVEY OF AIR POLLUTANTS IN TEHRAN
The status of Air pollution and associated health hazards for the inhabitants, has made Tehran rank one of the most polluted cities in the world. In order to assess the situation and to provide suitable solutions to safeguard the public health, a comprehensive study project was launched. In this project, major air pollutants including carbon monoxide (CO), total suspended particulate (TSP), sulfur dioxide and lead were measured in different seasons of the year in 20 residential and selected commercial zones (CO was measured in both residential and selected commercial zones while other pollutants were measured only in the selected commercial zones). The selection was based on the population distribution in the city. Residential areas were selected randomly and systematically. Commercial areas were defined as the nearest crossroad or square to the related residential areas. Main results were: the mean carbon dioxide level in all seasons of the year were below the standard level in residential areas and above that level in commercial areas during autumn and winter. However, in all seasons there were only a few residential areas with a CO level above the standard. The mean concentration of sulfur dioxide and smoke was higher in autumn and mainly in the areas where there was no natural gas supply. Lead level was above standard level in autumn. It is concluded that in Tehran, air pollution is highest in autumn. Public information poll shows that in most days of this season, the "inversion phenomenon" was present and caused accumulation of pollutants.
Authors: Masjedi MR, Malek Afzali H, Saman Manesh H, Ahmadzadeh Z, Abdi A.
Source: J Med Coun I.R.I 1376(1998): 4:155-62.
LIP LEISHMANIASIS IN THE SOUTH WEST OF IRAN DURING THE LAST DECADE
Leishmaniasis is a zoonotic disease which exists in three, cutaneous, mucocutaneous and visceral (Kala azar) forms. Cutaneous leishmaniasis is seen both in the Old the New World while mucocutaneous form is restricted only to the New World. Both cutaneous and viseral leishmaniasis are prevalent in Iran. Some local authors believe that the reported cases of mucocutaneous leishmaniasis from Iran are probably cutaneous variants located in the porximity of mucosa; and what is known as espundia in Central America does not prevail in Iran. Cutaneous leishmaniasis is prevalent in many parts of the world. The parasite is usually transmited by Phlebotomus species. Lip leishmaniasis is a type of cutaneous leishmaniasis which is rarely encountered in Iran. In a retrospective study performed in Ahwaz, south-west of Iran, 2861 cases could have been documented during 1986-1996. Seventeen of these patients (0.59%) had lower or upper lip lishmaniasis. The patients' age ranged from 3 months to 40 years and duration of the infection was 2 to 4 months. While eleven patients had only lip lesions, 6 patients had one or more skin lesions elsewhere. The appearance of lesions ranged from nodules to crusted ulcers and were usually located on the vermilion border. Most of the cases had failed to respond favorably to topical or systemic antibiotic therapy. The diagnosis is based on the demonstration of Leishman bodies on the Giemsa stained smears. It is concluded that although lip leishmaniasis is a rare entity, it cannot be ignored in the differential diagnosis of lip lesions in the endemic areas.
Authors: Yaghuobi R, Hoghooghi Rad N.
Source: J. of Dermatology; 1; 1; 19-23.