Diagnosed tuberculous meningitis using cerebrospinal fluid polymerase chain reaction in patients hospitalized with the diagnosis of meningitis in referral hospitals in Isfahan.

BACKGROUND: Tuberculosis (TB) remains one of the leading infectious diseases throughout the world. Among various forms of extrapulmonary TB, tuberculous meningitis (TBM) is the most severe form and remains a major global health problem with a high mortality rate. Our study was designed to evaluate tuberculous polymerase chain reaction (PCR) positive rate in patients who present with fairly long symptoms of meningitis. MATERIALS AND METHODS: The 162 Patients with an indolent onset of symptoms compatible with central nervous system infection were admitted. Sample of cerebrospinal fluid (CSF) was evaluated for biochemistry and tuberculous real-time PCR. Data analyzed by Student's t-test and Fisher's test. RESULTS: Patients were mostly male (69.8%), with a median age of 43.69 ± 22.67 years. CSF real-time PCR results in 6 patients (3.7%) were positive for tuberculous DNA. Of these 6 patients, 4 of whom were men and two of whom were women. In other words, the frequency of positive tuberculous DNA was in male 5.3% and female 1.4%, respectively. CONCLUSION: Given that we live in Iran and in the vicinity of the tuberculous endemic countries, if we face a meningitis case with lasting symptoms and tendency to be chronic, TBM should be considered.

A local dissipation theorem.

The transient time correlation function is a standard method for measuring transport properties in simulations. It represents a special case of a more general theorem, the dissipation theorem, that indirectly calculates phase function averages though the use of the dissipation function. These indirect averages often have significantly less statistical error than direct averages. Recently, it has been demonstrated that a local version of the fluctuation theorem can be derived with a well defined deviation from the global result at sufficiently low fields. Here we show that a similar local expression can be obtained for the dissipation theorem, providing a way of determining values of phase functions by monitoring the fluctuations of phase functions in a small region of the system.

Recurrent Vulvovaginal Candidiasis: Could It Be Related to Cell-Mediated Immunity Defect in Response to Candida Antigen?

BACKGROUND: Recurrent vulvovaginal candidiasis (RVVC) is a common cause of morbidity affecting millions of women worldwide. Patients with RVVC are thought to have an underlying immunologic defect. This study has been established to evaluate cell-mediated immunity defect in response to candida antigen in RVVC cases. MATERIALS AND METHODS: Our cross-sectional study was performed in 3 groups of RVVC patients (cases), healthy individuals (control I) and known cases of chronic mucocutaneous candidiasis (CMC) (control II). Patients who met the inclusion criteria of RVVC were selected consecutively and were allocated in the case group. Peripheral blood mononuclear cells were isolated and labeled with CFSE and proliferation rate was measured in exposure to candida antigen via flow cytometry. RESULTS: T lymphocyte proliferation in response to candida was significantly lower in RVVC cases (n=24) and CMC patients (n=7) compared to healthy individuals (n=20, <0.001), but no statistically significant difference was seen between cases and control II group (P>0.05). Family history of primary immunodeficiency diseases (PID) differed significantly among groups (P=0.01), RVVC patients has family history of PID more than control I (29.2 vs. 0%, P=0.008) but not statistically different from CMC patients (29.2 vs. 42.9%, P>0.05). Prevalence of atopy was greater in RVVC cases compared to healthy individuals (41.3 vs. 15%, P=0.054). Lymphoproliferative activity and vaginal symptoms were significantly different among RVVC cases with and without allergy (P=0.01, P=0.02). CONCLUSION: Our findings revealed that T cells do not actively proliferate in response to Candida antigen in some RVVC cases. So it is concluded that patients with cell-mediated immunity defect are more susceptible to recurrent fungal infections of vulva and vagina. Nonetheless, some other cases of RVVC showed normal function of T cells. Further evaluations showed that these patients suffer from atopy. It is hypothesized that higher frequency of VVC in patients with history of atopy might be due to allergic response in mucocutaneous membranes rather than a functional impairment in immune system components.

Physical activity, sex, and socioeconomic status: A population based study.

BACKGROUND: The purpose of the present study was to investigate physical activity by socioeconomic status (SES) and sex in an Iranian adult population. METHODS: In a cross-sectional study, 6622 adults, who participated in the Isfahan Healthy Heart program (IHHP) surveys in 2004 and 2005 and were living in urban areas, were studied. Daily leisure time, household, occupational, and transportation physical activity, and total physical activity were calculated and compared in 3 socioeconomic status groups classified by the two-step cluster analysis procedure. RESULTS: Statistically significant variations were found in all physical activity levels, except transportation, by sex. Men were more active than women in all fields, except household physical activity. Leisure time physical activity of men and women were significantly higher in higher SES levels. There was an opposite correlation between SES and total physical activity in men. CONCLUSION: Considering the importance of physical activity as a component of a healthy lifestyle, differences among varying socioeconomic status and sex must be considered while planning for healthy lifestyle programs. Women with low SES, in particular, may need more attention.

Evaluating the effectiveness of adding magnesium chloride to conventional protocol of citrate alkali therapy in children with urolithiasis.

BACKGROUND: Potassium citrate (K-Cit) is one of the medications widely used in patients with urolithiasis. However, in some cases with calcium oxalate (CaOx) urolithiasis, the significant response to alkaline therapy with K-Cit alone does not occur. There is scarce published data on the effect of magnesium chloride (Mg-Cl(2)) on urolithiasis in pediatric patients. This study aimed to evaluate the effect of a combination of K-Cit - MgCl(2) as oral supplements on urinary parameters in children with CaOx urolithiasis. METHODS: This study was conducted on 24 children with CaOx urolithiasis supplements included potassium citrate (K-Cit) and magnesium chloride (Mg-Cl(2)). The serum and urinary electrolytes were measured before (phase 0) and after prescribing K-Cit alone (phase 1) and a combination of K-Cit and Mg-Cl(2) (phase 2). Each phase of therapy lasted for 4 weeks. RESULTS: The mean age of patients was 6.46 ± 2.7 years. Hyperoxaluria and hypercalciuria were seen in 66% and 41% of patients, respectively. Serum magnesium increased significantly during phase 2 comparing with phase 0. Urinary citrate level was significantly higher in phase 1 and 2 in comparison with phase 0, P < 0.05. In addition, urinary oxalate excretion was significantly diminished in phase 2 comparing with phase 0 and 1, P < 0.05. Soft stool was reported by 4 patients, but not severe enough to discontinue medications. CONCLUSIONS: These results suggested that a combination of K-Cit and Mg-Cl(2) chloride is more effective on decreasing urinary oxalate excretion than K-Cit alone. The Iranian Clinical Trial registration number IRCT138707091282N1.