Kowsar Corp Research Articles

Serum Mannan-Binding Lectin in Egyptian Patients With Chronic Hepatitis C: Its Relation to Disease Progression and Response to Treatment

: Background: Chronic hepatitis C virus (HCV) infection is a major worldwide public health problem. Egypt has the highest prevalence of adult HCV infection in the world, averaging 15%–25% in rural communities. Mannan-binding lectin (MBL) is a liver-derived pluripotent serum lectin that plays a role in the innate immune system of the host. It is an acute-phase protein that is involved in the activation of the classical complement pathway. MBL may play a defensive role in HCV infection.Objectives: To investigate the relationship between MBL concentration and HCV infection in Egyptian patients suffering chronic hepatitis C.Patients and Methods: Serum samples obtained from 35 Egyptian hepatitis C patients and 30 normal controls were assayed for MBL. MBL concentrations were correlated to disease characteristics and treatment response.Results: Serum MBL was significantly higher in HCV patients than in controls, but no relationship was found between MBL concentration and disease progression in terms of hepatic fibrosis and inflammation. Responders to interferon (INF)-based therapy had significantly higher serum MBL than non-responders.Conclusions: We found no association between serum MBL concentration and progression of HCV related liver disease. Responders to INF-based therapy had significantly higher serum MBL than non-responders. Implication for health policy/practice/research/medical education:MBL may be considered as a predictor of response to antiviral therapy in HCV patients and MBL replacement therapy may improve the response to antiviral therapy in these patients. Please cite this paper as:Esmat S, Omran D, Sleem GA, Rashed L. Serum Mannan-Binding Lectin in Egyptian Patients With Chronic Hepatitis C: Its Relation to Disease Progression and Response to Treatment. Hepat Mon. 2012;12(4):259-64. DOI: 10.5812/hepatmon.704 Copyright © 2012 Kowsar Corp. All rights reserved.

Molecular Characterization of Leishmania Infection in Sand flies From Sistan Va Baluchistan Province, Southeastern Iran

: Background: Cutaneous leishmaniasis (CL) is a zoonotic disease that is caused by various species of the genus Leishmania. The disease is considered a major health problem in different areas of Iran and is an endemic disease in rural areas of Mirjaveh, Chabahar, and Konarak Counties, Sistan Va Baluchistan Province.Objectives: The aim of this study was to identify Leishmania species that was isolated from potential sand fly vectors by molecular analysis in Chabahar County.Materials and Methods: To collect Sand flies, sticky traps were placed at the entrance of rodents burrows in Dashtiyari division of Chabahar County, where CL is endemic. Freshly collected Sand flies were identified with regard to species, dissected in normal saline using binocular, and examined for leptomonads under a microscope. Leptomonads from the Sand flies were used to inoculate the base of Balb/c mice tails subcutaneously; after an incubation period and the development of lesions, the parasites were transferred to NNN + LIT medium culture. The harvested Leishmania parasites were subjected to DNA extraction and analyzed by random amplified polymorphic DNA polymerase chain reaction (RAPD-PCR).Results: DNA from Leishmania species from Phlebotomus papatasi and P. salehi Sand flies produced distinctive patterns of bands of L. major with all primers. However, the products at approximately 2100 bp and 800 bp that were amplified with primer 329 were stable and reproducible in all assays. This is the first report on the isolation and identification of L. major in P. salehi from Iran and P. papatasi from Sistan va Baluchistan.Conclusions: The study shows that P. papatasi and P. salehi Sand flies play a major role in the maintenance and transmission of disease to humans in this area. Implication for health policy/practice/research/medical education:Identification of P. papatasi and P. salehi Sand flies as the insect vectors as well as the Leishmania species they harbor would be the key elements in understanding the epidemiology of leishmaniasis and its control in Chabahar County. Please cite this paper as:Kassiri H, Naddaf SR, Mohebali M, Javadian EA. Molecular Characterization of Leishmania Infection in Sand flies From Sistan Va Baluchistan Province, Southeastern Iran. Jundishapur J Microbiol.2012;5(2):430-1. DOI: 10.5812/jjm.3523 Copyright © 2012 Kowsar Corp. All rights reserved.

Prevalence of Occult Hepatitis B Virus Infection in Hemodialysis Patients From Egypt With or Without Hepatitis C Virus Infection

: Background: While prevalence of Hepatitis B virus (HBV) in patients with end-stage renal failure (ESRF) who are undergoing dialysis has decreased significantly during the past few decades, it still remains a distinct clinical problem. The immunosuppressive nature of renal disease often leads to chronicity of the HBV infection and an opportunity for nosocomial spread of the infection among dialysis patients. Egypt is among the countries with intermediate endemicity of HBsAg (range, 2%–7%). Large-scale geographic heterogeneity in HBV prevalence has been reported worldwide and HBV prevalence is especially heterogeneous in Egypt.Objectives: To assess the prevalence of occult HBV infection (OBI) in hemodialysis patients with or without chronic hepatitis C (HCV) from Minia and Assuit, Upper Egypt, using HBV DNA assays.Patient and Methods: Sera from 145 hemodialysis patients with negative HbsAg were investigated for HBV DNA using real-time polymerase chain reaction (RT-PCR). Only serum samples with repeatedly detectable HBV DNA were considered positive. Patients were divided into 2 groups: HCV RNA positive and HCV RNA negative, based on the results of a third generation enzyme linked immunosorbent assay (ELISA) anti-HCV test and HCV RNA PCR.Results: HBV DNA was detected in 6 of the 145 patients (4.1%) and HBcAb was detected in 29/145 patients (20%). There were no statistically significant differences in the age, duration of hemodialysis, biochemical parameters, serological markers of HBV, or HBV DNA between patients with and without HCV infection.Conclusions: Four percent of the hemodialysis patients had OBI. There was no significant difference in the prevalence of OBI between hemodialysis patients with or without HCV co-infection. Implication for health policy/practice/research/medical education:Exploring the prevalence of occult HBV infection in hemodialysis patients with or without chronic hepatitis C in Egypt has significant clinical implication. Reading this article is recommended to all internists, gastroenterologists and hepatologists. Please cite this paper as:Abu El Makarem MA, Abdel Hamid M, Abdel Aleem A, Ali A, Shatat M, Sayed D, et al. Prevalence of Occult Hepatitis B Virus Infection in Hemodialysis Patients From Egypt With or Without Hepatitis C Virus Infection. Hepat Mon. 2012;12(4):253-8. DOI: 10.5812/hepatmon.665 Copyright © 2012 Kowsar Corp. All rights reserved.

Comparison the Radiologic Findings of Pulmonary Tuberculosis Among HIV-Seropositive With HIV-Seronegative Patients

: Background: Approximately 1.8 million of the world’s population is infected with both M.tuberculosis (TB) and HIV. HIV-seropositive patients with TB may have radiographically atypical presentations.Objectives: This study aimed to determine whether there was any difference in radiological presentation of pulmonary TB between HIV-seropositive and HIV-seronegative patients.Patients and Methods: Information on 204 patients who were admitted with a diagnosis of pulmonary TB to the infectious ward of Razi Hospital, Ahvaz, between 2004 and 2008 was obtained from their records. They were divided into HIV-seropositive and HIV-seronegative groups. All clinical signs and symptoms and radiological findings were extracted from each patient file and recorded in a questionnaire.Results: Normal thoracic radiography, pleural effusion, milliary pattern, and hilar and mediastinal lymphadenopathy were more common in the HIV-seropositive group. Pulmonary infiltration and cavitary lesions in Chest X-ray (CXR) were more frequent in the HIV-seronegative group. The prevalence of fibrosis in HIV-seronegative patients was higher than in HIV-seropositive subjects. Upper lobe pulmonary involvement in HIV-seropositive patients was less frequent than HIV-seronegative persons due to their immunodeficiency.Conclusions: Radiological presentation of pulmonary TB differs between HIV-seropositive and HIV-seronegative patients due to progressive immunodeficiency from HIV infection. Implication for health policy/practice/research/medical education:As pulmonary tuberculosis is an important opportunistic infection in patients with advanced HIV infection, delay in diagnosis and treatment may lead to severe morbidity and death. So clinicians should be aware about different and sometimes atypical radiographic manifestations of pulmonary tuberculosis in HIV infected patients. The importance of this study is to define such atypical. Please cite this paper as:Ahmadi F, Salmanzadeh S, Kimyai M, Comparison the Radiologic Findings of Pulmonary Tuberculosis Among HIV-Seropositive With HIV-Seronegative Patients. Jundishapur J Microbiol.2012;5(2):421-3. DOI: 10.5812/jjm.3536 Copyright © 2012 Kowsar Corp. All rights reserved.

Prevalence of Occult Hepatitis B Virus Infection in Hemodialysis Patients From Egypt With or Without Hepatitis C Virus Infection

While prevalence of Hepatitis B virus (HBV) in patients with end-stage renal failure (ESRF) who are undergoing dialysis has decreased significantly during the past few decades, it still remains a distinct clinical problem. The immunosuppressive nature of renal disease often leads to chronicity of the HBV infection and an opportunity for nosocomial spread of the infection among dialysis patients. Egypt is among the countries with intermediate endemicity of HBsAg (range, 2%-7%). Large-scale geographic heterogeneity in HBV prevalence has been reported worldwide and HBV prevalence is especially heterogeneous in Egypt. To assess the prevalence of occult HBV infection (OBI) in hemodialysis patients with or without chronic hepatitis C (HCV) from Minia and Assuit, Upper Egypt, using HBV DNA assays. Sera from 145 hemodialysis patients with negative HbsAg were investigated for HBV DNA using real-time polymerase chain reaction (RT-PCR). Only serum samples with repeatedly detectable HBV DNA were considered positive. Patients were divided into 2 groups: HCV RNA positive and HCV RNA negative, based on the results of a third generation enzyme linked immunosorbent assay (ELISA) anti-HCV test and HCV RNA PCR. HBV DNA was detected in 6 of the 145 patients (4.1%) and HBcAb was detected in 29/145 patients (20%). There were no statistically significant differences in the age, duration of hemodialysis, biochemical parameters, serological markers of HBV, or HBV DNA between patients with and without HCV infection. Four percent of the hemodialysis patients had OBI. There was no significant difference in the prevalence of OBI between hemodialysis patients with or without HCV co-infection.

Oxidative Stress and Benefits of Antioxidant Agents in Acute and Chronic Hepatitis

Oxidative damage due to oxidative stress is the failure of the cell's defense against the deleterious effects of harmful agents by means of its numerous autoprotective mechanisms. oxidative stress is a key impairment induced by various conditions, including atherosclerosis, hypertension, ischemia-reperfusion, hepatitis, pancreatitis, cancer, and neurodegenerative diseases. Oxidative stress is a common pathogenetic mechanism contributing to the initiation and progression of hepatic damage in cases of inflammatory liver disorders, including acute and chronic hepatitis. Antioxidant administration is a good therapeutic strategy for the treatment of hepatitis. Our comprehensive review of the literature revealed that contradictory results have been obtained with many antioxidants and antioxidant agents. Since clinical studies to date have generally involved testing of the effects of antioxidant mixtures containing more than 2 antioxidants and also have been limited because of toxic effects of high doses of some antioxidants, antioxidant therapy for acute and chronic hepatitis needs further study.

Development and Validation of a Simple, Rapid and Inexpensive PCRRFLP Method for Genotyping of Common IL28B Polymorphisms: A Useful Pharmacogenetic Tool for Prediction of Hepatitis C Treatment Response

In 2009, 3 genome-wide association studies implicated IL28B single-nucleotide polymorphisms (SNPs) as the strongest genetic pretreatment predictor of sustained virological response (SVR) in hepatitis C infection. Recently, the American Association for the Study of Liver Diseases (AASLD) and the European Association for the Study of the Liver (EASL) included IL28B testing in their guidelines. The main aim of this study was to develop and validate a simple, rapid, and inexpensive polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method for genotyping of common IL28B polymorphisms (rs12979860 and rs8099917). Two methods were developed to genotype common IL28B polymorphisms: 1) PCR-sequencing as a reference method and 2) PCR-RFLP as a rapid and inexpensive method. Both polymorphisms were genotyped in 104 Iranian hepatitis C patients by both methods simultaneously. To validate the PCR-RFLP method, the PCR-RFLP genotyping results should be 100% concordant with the PCR-sequencing results. Genotyping of rs12979860 and rs8099917 by PCR-RFLP was concordant with PCR-sequencing in 104 (100%) individuals. The analytical sensitivity and specificity of the PCR-RFLP method for genotyping of both SNPs are 100%. Among these 104 patients with chronic hepatitis C, the frequency of the rs12979860 CC, CT and TT genotypes were 40.4%, 47.1% and 12.5% and the frequency of the rs8099917 TT, GT and GG genotypes were 59.6%, 35.6% and 4.8%, respectively. Also, three IL28B haplotypes (rs12979860-rs8099917) were found among our patients including C-T, T-G and T-T with 63.9%, 22.6% and 13.5% frequency, respectively. C-G haplotype was absent in all of our patients. We have developed a validated, fast, and simple PCR-RFLP method for genotyping of common IL28B SNPs that is more cost-effective than sequencing.

Hepatitis B Immune Globulin in Liver Transplantation Prophylaxis: An Update

: Context: Liver transplantation is the best treatment option for end-stage liver disease following hepatitis B (HBV) infection. However, the high rate of recurrence of HBV infection following transplantation is a disadvantage of this option.Evidence Acquisition: Over the past 2 decades, the gold standard of prophylactic treatment for the prevention of HBV re-infection following liver transplantation has been the administration of low- to high-dose hepatitis B immune globulin (HBIg) along with an antiviral agent to induce passive immunity.Results: The effectiveness of HBIg in preventing the recurrence of HBV depends on the dosage, route of administration, and duration of HBIg treatment, and the viremic status at the time of transplantation. There is currently no consensus on a standardized recommendation for therapeutic options that include HBIg administration.Conclusion: This review attempts to summarize the available data on the feasibility of such options. Most recent studies support the use of long-term combination therapy of HBIg and antiviral NAs (especially new agents). Implication for health policy/practice/research/medical education:The article is suitable for hepatologist, internists, infectious specialists and liver transplantation departments. Please cite this paper as:Dindoost P, Jazayeri SM, Alavian SM. Hepatitis B Immune Globulin and Liver Transplantation Prophylaxis: An UpDate. Hepat Mon.2012;12(3):168-76. DOI: 10.5812/hepatmon.832 Copyright © 2012 Kowsar Corp. All rights reserved.

Oxidative Stress and Benefits of Antioxidant Agents in Acute and Chronic Hepatitis

: Context: Oxidative damage due to oxidative stress is the failure of the cell's defense against the deleterious effects of harmful agents by means of its numerous autoprotective mechanisms. oxidative stress is a key impairment induced by various conditions, including atherosclerosis, hypertension, ischemia-reperfusion, hepatitis, pancreatitis, cancer, and neurodegenerative diseases.Evidence Acquisition: Oxidative stress is a common pathogenetic mechanism contributing to the initiation and progression of hepatic damage in cases of inflammatory liver disorders, including acute and chronic hepatitis. Antioxidant administration is a good therapeutic strategy for the treatment of hepatitis.Results: Our comprehensive review of the literature revealed that contradictory results have been obtained with many antioxidants and antioxidant agents.Conclusion: Since clinical studies to date have generally involved testing of the effects of antioxidant mixtures containing more than 2 antioxidants and also have been limited because of toxic effects of high doses of some antioxidants, antioxidant therapy for acute and chronic hepatitis needs further study. Implication for health policy/practice/research/medical education:Acute and chronic hepatitis are common viral diseases. Since oxidative stress is a common pathogenetic mechanism contributing to initiation and progression of hepatic damage in acute and chronic hepatitis, antioxidants represent a good therapeutic strategy for the treatment of acute and chronic hepatitis. Therefore, study of this article is recommended to the epidemiologists, hepatologists,virologists and other researchers who are interested in the field of public health. Please cite this paper as: Esrefoglu M. Oxidative Stress and Benefits of Antioxidant Agents in Acute and Chronic Hepatitis. Hepat Mon. 2012;12(3):160-7. DOI: 10.5812/hepatmon.837 Copyright © 2012 Kowsar Corp. All rights reserved.

Changing Pattern of Clinical Epidemiology on Hepatitis C Virus Infection in Southwest China

: Background: The changing pattern of hepatitis C virus (HCV) infection could have a significant impact on future medical prevention practices and therapies.Objectives: The purpose of this study was to describe the changing pattern of HCV infection in southwest China using clinical epidemiology, and to assess the association between the genotypes distribution and certain potential risk factors.Patients and Methods: A retrospective analysis which included 1 208 subjects with chronic HCV registered at the Southwest Hospital (Chongqing, Southwest China) was performed. The information was reviewed and the data collected from clinical records and short telephone interviews when necessary. HCV genotypes were determined by nucleotide sequencing of the CE1 regions followed by phylogenic analysis with the published HCV genotype. HCV genotype distribution was analyzed according to the patients' age, gender, risk exposure, and the initial risk exposure.Results: Among the 1 208 patients, the HCV subtype 1b was the most prevalent (32.9%), followed by subtype 3b (18.9%), 6a (18.0%), 3a (12.8%) and 2a (10.4%), while subtypes 1a and 6k accounted for cases of HCV infection in only 9 and 3 cases respectively. Individuals older than 40 years were mainly infected with subtypes 1b and 2a, whereas younger patients were predominantly infected with genotypes 3 and 6. Subtypes 1b and 2a were observed more frequently among 44.4% and 16.0% patients respectively, with a history of invasive operations. Subtypes 3b and 6a constituted the majority of HCV infections among intravenous drug users (IDUs) (28.7% and 34.9%, respectively). A significant difference (P < 0.001) was observed between the HCV genotype distributions, according to the potential route of infection.Conclusion: In southwest China, the most common remaining subtype is the 1b genotype, but this has declined significantly among young patients. This is followed by subtype 3b and 6a which has increased significantly, especially among young patients. The distribution of such genotypes was also variable according to gender and age. The changing pattern of HCV infection was associated with changes in the modes of HCV acquisition, which raises an alarm signal concerning the major steps that need to be taken in order to reduce such infections in southwest China. Implication for health policy/practice/research/medical education:This article investigates the changing pattern of clinical Epidemiology on hepatitis C virus infection in Southwest China. This has an important implication for those who are involved in medical prevention and therapy to chronic hepatitis C. Please cite this paper as:Yan Z, Fan K, Wang W, Fan Y, Tan Z, Deng G. Changing Pattern of Clinical Epidemiology on Hepatitis C Virus Infection in Southwest China. Hepat Mon. 2012;12(3):196-204. DOI: 10.5812/hepatmon. 857 Copyright © 2012 Kowsar Corp. All rights reserved.

Development and Validation of a Simple, Rapid and Inexpensive PCR-RFLP Method for Genotyping of Common IL28B Polymorphisms: A Useful Pharmacogenetic Tool for Prediction of Hepatitis C Treatment Response

: Background: In 2009, 3 genome-wide association studies implicated IL28B single-nucleotide polymorphisms (SNPs) as the strongest genetic pretreatment predictor of sustained virological response (SVR) in hepatitis C infection. Recently, the American Association for the Study of Liver Diseases (AASLD) and the European Association for the Study of the Liver (EASL) included IL28B testing in their guidelines.Objectives: The main aim of this study was to develop and validate a simple, rapid, and inexpensive polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method for genotyping of common IL28B polymorphisms (rs12979860 and rs8099917).Patients and Methods: Two methods were developed to genotype common IL28B polymorphisms: 1) PCR-sequencing as a reference method and 2) PCR-RFLP as a rapid and inexpensive method. Both polymorphisms were genotyped in 104 Iranian hepatitis C patients by both methods simultaneously. To validate the PCR-RFLP method, the PCR-RFLP genotyping results should be 100% concordant with the PCR-sequencing results.Results: Genotyping of rs12979860 and rs8099917 by PCR-RFLP was concordant with PCR-sequencing in 104 (100%) individuals. The analytical sensitivity and specificity of the PCR-RFLP method for genotyping of both SNPs are 100%. Among these 104 patients with chronic hepatitis C, the frequency of the rs12979860 CC, CT and TT genotypes were 40.4%, 47.1% and 12.5% and the frequency of the rs8099917 TT, GT and GG genotypes were 59.6%, 35.6% and 4.8%, respectively. Also, three IL28B haplotypes (rs12979860-rs8099917) were found among our patients including C-T, T-G and T-T with 63.9%, 22.6% and 13.5% frequency, respectively. C-G haplotype was absent in all of our patients.Conclusions: We have developed a validated, fast, and simple PCR-RFLP method for genotyping of common IL28B SNPs that is more cost-effective than sequencing. Implication for health policy/practice/research/medical education:This article focuses on development of a simple method for genotyping of IL28B polymorphisms. This study is recommended to researchers in the field of viral hepatitis. Please cite this paper as:Sharafi H, Pouryasin A, Alavian SM, Behnava B, Keshvari M, Mehrnoush L, et al. Development and Validation of a Simple, Rapid and Inexpensive PCR-RFLP Method for Genotyping of Common IL28B Polymorphisms: A Useful Pharmacogenetic Tool for Prediction of Hepatitis C Treatment Response. Hepat Mon. 2012;12(3):190-5. DOI: 10.5812/hepatmon.849 Copyright © 2012 Kowsar Corp. All rights reserved.

Anemia in the Elderly After Renal Transplantation

The recent publication on anemia in the elderly after renal transplantation is very interesting (1). Rostami et al. concluded that “Anemia is very common in elderly patients undergoing kidney transplantation, particularly in patients with deteriorated allograft function (1).” The information from this report is very interesting. However, there are some concerns. First, the data is from a cross sectional descriptive study. The risk implication might be limited. There is also no data on the prevalence of anemia among these patients prior to renal transplantation. For sure, the pre-transplantation occulted anemia diseases, both genetic and non genetic ones, cannot be excluded. The good examples of underlying anemia are thalassemia and sickle cell anemia (2, 3). To conclude that anemia is adverse effect might not be suitable. Published by Kowsar Corp, 2012. cc 3.0.

Resuscitation in the Holy Quran

c 2012, The Ministry of Health’s Quran and Etrat Center. Published by Kowsar Corp. Translated version of: http://dx.doi.org/10.5812.quranmed.7141 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. One of the most important and primary steps in the process of understanding cardiopulmonary resuscitation (CPR) is the historical steps evolving to the present situation (1-3).