Clonal relatedness and antimicrobial susceptibility of Salmonella serovars isolated from humans and domestic animals in Iran: a one health perspective.

Background: Salmonellosis is one of the most important zoonotic diseases in humans and animals worldwide. Aims: The main objective of this study was to report serovars, clonal relatedness, and antimicrobial resistance of Salmonella strains isolated from human, different animal hosts including pigeons, broilers, cattle, camel, parrots, and hamsters in different regions of Iran. Methods: Twenty-four Salmonella isolates were confirmed at the genus level by biochemical tests and polymerase chain reaction (PCR) by showing the presence of invA gene. Serovars were determined and their clonal relatedness was assessed by RAPD-PCR and antibiotic resistance profiles. Results: Overall, Salmonella Typhimurium was the most prevalent serovar (45.8%, 11/24), which was recovered from humans, pigeons, and camels. Salmonella Enteritidis (29.2%, 7/24) was the second common serovar that was recovered from cattle, broilers, humans, and hamsters. Salmonella Infantis (12.5%, 3/24) belonged only to broiler sources, and Salmonella Seftenberg (12.5%, 3/24) was isolated from eggs and a parrot. The major RAPD pattern was VI (33.3%) in which the two S. Typhimurium isolates (belonged to humans and pigeons) exhibited similarity in both RAPD pattern and resistance profile. Antimicrobial susceptibility test showed full resistance to tylosin and erythromycin (100%, 24/24). All isolates (100%, 24/24) were susceptible to ceftriaxone, cefixime, and gentamicin. In total, 75% of the isolates were multi-drug resistant (MDR) and revealed 15 different antimicrobial resistance profiles (R-type). Conclusion: This study supports the potential transmission of Salmonella serovars via animal contacts. Thus, it is necessary to establish a national systematic monitoring program with one health approach for controlling Salmonella infections.

Allergic angiitis of Churg and Strauss syndrome. Response to pulse methylprednisolone.

Our patient presented with widespread airspace consolidation. He was a steroid-dependent asthmatic receiving moderate doses of corticosteroid therapy. Open lung biopsy showed allergic angiitis of Churg and Strauss syndrome. The patient continued to deteriorate on high doses of prednisone. He was subsequently given four pulses of intravenous methylprednisolone with dramatic clearing noted on x-ray film and resolution of his shunt.

Albendazole versus placebo in treatment of echinococcosis.

Echinococcus granulosus infection can have multiorgan involvement, and is common in Third-World countries. Uncontrolled studies show that albendazole can be effective in its treatment, but there are also reports of spontaneous resolutions. We therefore undertook a placebo-controlled double-blind parallel-group randomized study in Iran to evaluate the effect of albendazole on hydatid cysts. Twenty-nine patients with 240 cysts entered the study in 1994-95 and received either albendazole (400 mg twice a day, in 3 cycles of 6 weeks with 2 weeks between cycles) or placebo. At study completion, 172 and 31 cysts in the albendazole and placebo groups, respectively, were evaluable. In the treatment arm, 134 cysts showed improvement or cure compared to 4 in the placebo group (P < 0.001). Eighteen (82%) of 22 patients in the treatment arm showed either cure (8 patients) or improvement (10 patients); in the placebo group only 1 (14%) of 7 showed spontaneous improvement but no cure. Some patients with liver cysts after treatment showed increasing heterogeneity and density suggestive of inactive cysts. Patients with larger cysts and those with pulmonary involvement were better responders. Age and gender had no effect on outcome. The observed results are encouraging, showing albendazole has good effect on hydatid cysts and should be offered to patients before surgical treatment is considered.

Lung function values in healthy non-smoking urban adults in iran.

BACKGROUND: The values of lung function tests (LFTs) are dependent on height, age, and sex. In addition, there is evidence of LFT variation in different ethnic groups. OBJECTIVE: We have therefore derived prediction equations for LFTs from a healthy, non-smoking, urban adult population in the city of Mashhad (northeast Iran). METHODS: Predicted equations for normal lung function have been derived from 572 healthy, non-smoking subjects including 326 men (height 154-195 cm) and 246 women (height 144-174 cm) aged 18-65 years. The subjects underwent measurement of spirometric flow and volume. The following variables were measured: forced vital capacity (FVC), forced expiratory volume in 1 s (FEV(1)), maximal mid-expiratory flow (MMEF), peak expiratory flow (PEF) and maximal expiratory flow at 75, 50 and 25% of the FVC (MEF(75), MEF(50), and MEF(25), respectively). Regression analysis using height and age as independent variables was applied to provide predicted values for both sexes. RESULTS: There was a negative correlation between each lung function and age. The largest negative correlations were found for FEV(1) and FVC in men and women, respectively. All parameters correlated positively with height; the largest positive correlation was observed for FVC in both sexes. Comparison of LFTs derived from the equations of the present study showed significant differences with those of several previous studies. CONCLUSION: In this study, a set of LFT reference values and prediction equations for both sexes have been derived using a relatively large, healthy, non-smoking Iranian, adult population which was different from several other prediction equations.

Allergen-induced increase in airway responsiveness is not inhibited by acute treatment with ketotifen or clemastine.

Allergen-induced increase in airway responsiveness to histamine or methacholine provides a useful model for investigation of prophylactic or "antiinflammatory" asthma treatments. This can be inhibited by corticosteroids or by sodium cromoglycate but not by beta agonists or by theophylline. A single-blind, crossover, random-order trial was conducted to compare ketotifen, clemastine, and placebo in six atopic subjects undergoing allergen inhalation tests. Ketotifen, 2 mg; clemastine, 1 mg; and placebo one tablet were administered twice daily for four days (eight doses) up to and including one hour before allergen inhalation. None of the three produced a significant reduction in the allergen-induced early or late asthmatic responses, or in the allergen-induced fall in methacholine PC20. There was a subtle nonsignificant suggestion of a reduction in the early portion of the early asthmatic response induced by both ketotifen and clemastine. Both ketotifen and clemastine produced a similar 8-fold inhibition of histamine skin test endpoint indicating equal systemic H1 blocking effect at the time of allergen inhalation. Sodium cromoglycate, 10 mg, single dose, by metered dose inhaler ten minutes before allergen challenge, added as an unblinded "positive control", inhibitory effects on the allergen-induced late and presumed inflammatory sequelae. It is possible that longer treatment periods (several weeks or months) might prove effective.

A 3-month evaluation of the efficacy of nedocromil sodium in asthma: a randomized, double-blind, placebo-controlled trial of nedocromil sodium conducted by a Canadian multicenter study group.

Nedocromil sodium is a pyranoquinoline dicarboxylic acid derivative, formulated in a metered-dose inhaler. Because nedocromil sodium has in vitro and in vivo anti-inflammatory properties, it was evaluated in a group of steroid-dependent patients with asthma to observe how well it might be tolerated and for evidence of any beneficial effects. In a double-blind, group-comparative study, 127 patients received nedocromil sodium and 61 received placebo, administered as two puffs of 2 mg, four times per day, for 12 weeks. Ten patients developed adverse reactions, seven receiving active drug and three patients receiving placebo. Two patients of each group withdrew because of worsening asthma. Despite selecting patients whose asthma was stable, when they were receiving established therapeutic regimens that included steroids and bronchodilators, it was found that diary-card symptom scores, morning and evening peak expiratory flow rate values, and inhaled beta-agonist usage all demonstrated slight but significant benefit with addition of nedocromil sodium. It is concluded that the inhaled, anti-inflammatory agent, nedocromil sodium, may be added to asthma-treatment regimens with the reasonable expectation of further modest symptomatic benefit.

A placebo controlled study of albendazole in the treatment of pulmonary echinococcosis.

Infection with Echinococcus granulosus is endemic in Middle Eastern countries. Some patients are noted to undergo spontaneous resolution, but many require surgical removal with its associated risks. Although, there are studies showing favourable responses to medical treatment, there is no controlled study on the effect of albendazole. In this study, 20 patients with 179 E. granulosus cysts affecting the lungs were entered into a triple blind parallel randomized clinical trial comparing the effects of albendazole versus placebo. Fifteen patients (150 cysts) completed 6 months of treatment; four patients (26 cysts) were in the placebo group and 11 patients (124 cysts) in the treatment group receiving 800 mg albendazole daily in three cycles of 6 weeks with 2 weeks between cycles. Ten of 11 patients (91%) in the treatment group showed either cure (five patients) or improvement (five patients); in the placebo group, only one of four (25%) showed spontaneous improvement but no cure. In the treatment group, 88 of 124 cysts (71%) showed improvement compared to four of 26 (15.4%) in the placebo group (p=0.000). Complication from therapy was insignificant; one case had recurrent disease, which responded to further therapy. It is suggested that patients suffering from uncomplicated hydatid disease should be given a trial of albendazole before surgery is considered.