Original Article

Abdominal Pain in Opiate Addicted Patients and Other Industrial Opiates

Soroush Khorrami, Foroogh Forghani

Novelty in Biomedicine, Vol. 8 No. 2 (2020), , Page 59-62

Background: Recognition of abdominal pain help to give better diagnostic and therapeutic approaches and prevention of unnecessary surgeries. The purpose of this study was to determine the causes of abdominal pain in opiate addicted patients and other industrial opiates.

Materials and Methods: In the observational study, a cross-sectional survey was used. A total of 130 consecutive addicted patients and other industrial opiates were enrolled from Modarres Hospital, Tehran, Iran in 2017-2018. Causes of abdominal pain in them were determined and compared across the other variables.

Results: Results of this study demonstrated that the causes of abdominal pain were: defecation problems and constipation,dyspepsia,    peptic ulcer disease (PUD), acute abdomen, ileus, obstruction, and biliary problems and others (9.2%, 42.3%, 14.6%, 13.1%, 10%, 7.7%, and 3.1%, respectively).A significant relationship was found between high Lead level   and  constipation and dyspepsia  (P<0.05).

Conclusion: According to the obtained results, it may be concluded that dyspepsia and PUD are most common causes of abdominal pain in addict subjects that is similar to general population and accordingly therapeutic approaches in addict subjects should be similar to the general population.

Background: Pseudomonas aeruginosa is a common Gram-negative, rod-shaped bacterium that has a unique genome that allowed the bacteria to produce various enzymes and proteins. Azurin and arginine deiminase are low molecular weight proteins that produced by P. aeruginosa. These proteins can be used alone or in combination together in order to become effective in cancer therapy or inhibiting of metastasis. This study aimed to design, express and purify the Azurin and Arginine Deiminease recombinant fusion protein.

Materials and Methods: The sequences of Azurin and arginine deiminase from P. aeruginosa were studied for synthesis in a pET28a vector. The recombinant plasmid was transfected into the E.coli BL-21 strain and expression was induced by isopropyl-β-D-thio galactopyranoside (IPTG). The fusion protein expression was evaluated by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Purification of the recombinant product was performed by the Ni-NTA chromatography column, obtained product analysis with SDS-PAGE and Western blot technique.

Results: Cloning was confirmed by observing bands from the enzyme digestion. The protein band with a molecular weight of 65 kDa on the SDS-PAGE gel was an indication of the correct expression of the protein. The single-band of this recombinant protein was confirmed by the western blot technique.

Conclusion: In this study, due to the successful production of arginine deiminase-azurin fusion protein, and considering the separate anti-cancer properties of these compounds, which have been reported in previous studies, it is suggested that immunological assessments and effects of this fusion protein in different cancerous cell line be investigated.

Candiduria: Prevalence, Identification of Isolated Candida Species and Trends in Antifungal Susceptibility in Hospitalized Patients

Reza Ghasemi, Mohammad Mahdi Rabiei, Ensieh Lotfali, Sara Abolghasemi, Saham Ansari

Novelty in Biomedicine, Vol. 8 No. 2 (2020), , Page 71-76

Background: Urinary tract candidiasis is known as the most frequent nosocomial fungal infection worldwide. Some of the predisposing factors of candiduria are extensive use of broad-spectrum anti-fungal agents, diabetes mellitus, indwelling urinary catheter, corticosteroids and, immunosuppressive drugs. There are some antifungal agents available for the treatment of candiduria. In recent years, resistance to antifungal agents has been increased. The aim of this study was to evaluate different Candida species (sp.) that cause candiduria and their susceptibility pattern to antifungal agents in patients admitted to educational hospitals.

Materials and Methods: Urine samples (n=200) were obtained; they were spread onto Sabouraud Dextrose Agar plates. Plates were incubated at 37°C. Only specimens were considered as candiduria, which have a colony count of ≥104 CFU/mL colonies. Urine sediment was cultured in the CHROM agar Candida medium and incubated at 35°C for 48h. The cultures were evaluated based on color. PCR-RFLP was performed for a definite identification of Candida sp. In vitro antifungal susceptibility test of the Candida isolates against amphotericin B, fluconazole and itraconazole was performed using the microdilution method, according to the standard CLSI guidelines, document M27-S3.

Results: Molecular findings confirmed the result of the morphological method. Candiduria rate was 11.5% among our patients. According to CHROM agar Candida and PCR-RFLP, the most common species isolated was C. albicans (74%), followed by C. glabrata (26%). In vitro susceptibility tests of urinary Candida isolates to antifungals have been evaluated. All species were sensitive to amphotericin B. None of C. glabrata isolates were sensitive to fluconazole and itraconazole.

Conclusion: This study demonstrates the importance of Candida sp. in urine samples from hospitalized patients. It was concluded that Candida sp. obtained from candiduria in patients had excellent activity against Amphotericin B. Whereas, resistance against Itraconazole (21.7%) and especially Fluconazole (26%) was significant.

Background: Considering the diagnostic and therapeutic costs of patients with dyspepsia and the importance of diagnosis during gastrointestinal malignancies, in this study, we investigated the necessity of gastric mucosal biopsy in dyspeptic patients with normal upper endoscopy in Modarres hospital and their 6 months follow up. We studied their endoscopic biopsies changes and some of the involved risk factors this duration.

Materials and Methods: In this clinical trial study, 115 patients with dyspepsia, were referred from gastroenterology clinic of Modarres hospital during 2017-2018, were evaluated. Patients were enrolled in a study that did not have any ulcer and mass or deep mucosal lesion in the early endoscopy Surface erosions were no exception and could be included. Five biopsy samples were obtained from different stomach sites. After the pathology results, the patients who had malignancy reports, excluded from the study and other patients were treated with anti-acid drugs and, if necessary, eradicated Helicobacter pylori. After 6 months, they were again subjected to endoscopy and biopsies were taken. Data were analyzed by SPSS software version 22.

Results: The rate of Helicobacter pylori in patients with endoscopic dyspepsia without mucosal lesions after 6 months of treatment was reduced compared to pre-treatment p<0.05, 20.9% vs 12.2%. The severity of chronic gastritis mild to moderate in patients with endoscopic dyspepsia without mucosal lesions after 6 months of treatment was reduced compared to pre-treatment p<0.05, 89.6% vs 80%. There was a significant difference between metaplasia in patients with endoscopic dyspepsia without mucosal lesions before and 6 months after treatment p<0.05, 33%, vs 20%. Female gender, negative family history of GI cancer and not using alcohol were factors that significantly improved the results of biopsy chronic gastritis/ H. pylori /metaplasia after 6 months.

Conclusion: Regarding the reduction in the severity of chronic gastritis, Helicobacter pylori and metaplasia in this group of patients after 6 months of treatment, it is recommended that refraining from unnecessary follow-up and biopsy and imposing cost to the patient and the medical system and be limited to high-risk groups.

Background: Woman's decision-making for abortion entails understanding and assessing those options in the context of her unique situation, feelings, aspirations and beliefs. The objective of this study was to examine decision–making conflict and all relevant factors, among women seeking legal abortion authorization letter, referred to Legal Medical Centre in Tehran.

Materials and Methods: In this cross-sectional study, decision-making conflict assessed using the decisional conflict scale (DCS) among 282 pregnant women in their first trimester. Descriptive and logistic regression analyses were undertaken to describe and explore collected data.

Results: Eligible women requesting legal abortion were mostly in age group 25-34 years old (50.4% .142, M=31.55, SD=6.1, ranging from 17 - 46 years). They were mostly in gestational age<16 weeks, (212, 75.2%), with average 14.67 (SD=3.51), range 15.0 weeks (4-19 weeks). Some decision conflict (DCS score 25 or greater) was experienced by 182 (64.5%) participants.

Conclusion: Women seeking legal abortion may go against their own sense of right and wrong. They deserve pre-abortion consulting to deal with conflict and negative effects in decision-making.

Case Report

Mesenchymal Stem Cell Injection in Two Patients Suffer From Chronic Discogenic Low Back Pain

Masoud Hashemi, Siamak Moradi, Mehrdad Taheri, Siroos Momenzadeh, Alireza Shoae-Hassani, Ali Ghamari, Hasti Hassani, Mahshid Ghasemi, Ali Solhpour, Payman Dadkhah

Novelty in Biomedicine, Vol. 8 No. 2 (2020), , Page 95-97

Background: Discogenic low back pain is one of the leading causes of pain and disability across the world.  A growing interest in the area of regenerative medicine, led by an improved understanding of the role of mesenchymal stem cells in tissue homeostasis and repair.

Cases Report: We had two patients suffered from chronic discogenic low back pain. They were underwent injection of intra-discal 1.5 cc of Adipose Derived Mesenchymal Stem Cells (ADMSC) and followed up for 6 months. After this period of time, there was a significant reduction in both VAS and ODI scores in patients.

Conclusion: These data warrant further studies so that we can enhance our understanding of the other unknown mechanisms, which may exist behind stem cell injection. If the effectiveness of such injection to reduce pain and improve function is shown in the upcoming studies, it may provide a new insight for increasing this method of treatment as a proper option in the near future.

Imported Malaria in an Iraqi Immigrant to Iran: Relevance for the Maintenance of Elimination Status

Zahra Arab-Mazar, Sara Rahmati Roodsari, Zahra Mirabedyni, Leila Haghighi, Mohsen Rahimi

Novelty in Biomedicine, Vol. 8 No. 2 (2020), , Page 98-100

Background: Effective malaria control strategies require an accurate understanding of the epidemiology of locally transmitted Plasmodium species. Emerging evidence indicates that migrants from malaria endemic regions are at risk of delayed presentation of Plasmodium spp. and malaria infection.

Cases Report: We reported a case of P. vivax malaria occurring after arrival in Iran. Patient was originally from Iraq. A 48-year-old male patient who was hospitalized with fever attacks, chills, and headache after arriving from Iraq to Tehran.

Conclusion: In this patient, new prevention and screening strategies should be studied and blood safety policies adapted. Thus, ultimate elimination of malaria in Iran will require national malaria control program to adopt policy and practice aimed at all human species of malaria since neighbor country are still face to problem to control of malaria.

Letter to editor

Which Test to Perform for Cystic hydatic Diagnosis and When?

Zahra Arab-Mazar, Sara Rahmati Roodsari

Novelty in Biomedicine, Vol. 8 No. 2 (2020), , Page 101-102

Echinococcosis is one of the 17 neglected tropical diseases (NTDs) recognized by the World Health Organization. The two major species of medical importance are Echinococcus granulosus and Echinococcus multilocularis (1).

There are many studies about diagnostic method of hydatidosis, but there is still the question that which test to perform and when.