Hepatitis B vaccination coverage among Iranian children aged 15-26 months in 2006

This study in 2006 estimated the hepatitis B virus [BHV] vaccination coverage in the Islamic Republic of Iran at the national and district levels in urban, rural and remote populations of 41 university health service areas. Of 21 905 children recruited to the study, vaccination coverage based on vaccination card records was 100% in 14,15 and 10 of the 41 university areas for the 1st, 2nd and 3rd doses of HBV respectively. National levels of HBV1, HBV2 and HBV3 coverage were 98.9%, 98.8% and 98.4% respectively. The lowest HBV vaccination coverage rate was 90.7% [in a remote district]. HBV vaccination coverage was at an acceptable level in Iranian children

[Correlation between insulin-like growth factor-I [Igf-1] levels and severity of liver involvement in patients afflicted with liver cirrhosis]

Insulin-like growth factor [IGF-1] is a polypeptide that 90% of it is secreted by liver. Cirrhosis of liver is a condition accompanied with decreased level of IGF-1, and with progression of the disease the level of IGF-1 may be further decreased. In this study the relation between the degree of IGF-1 and severity of liver disease on the basis of Child-Pugh and Model for end stage liver disease[MELD] score is investigated. In this cross sectional study, 100 cirrhotic patients who were diagnosed on the basis of liver biopsy or clinical criteria, referring to the gastroenterology clinic of Imam Khomeini Hospital in Tehran, Iran during the years 2007-2008 were recruited. Laboratory investigations including IGF-1, CBC, liver Enzymes, Alkaline phosphates, serum Albumin, Creatinine, direct and total Bilirubin were carried out for all the patients. Similarly ultrasound for evaluation of ascites and endoscopy for varices were performed. 100 cirrhotic patients with male to female ratio of 63 to 37 and median age of 44.4 +/- 15 years were enrolled in the study. This study showed a mean IGF-1 level [ +/- standard deviation] equal to 92.95 +/- 91.51 ng/dl. Fourteen patients [14%] had IGF-1 within normal limits while 86 patients [86%] had abnormal IGF-1 level. In all patients the correlation coefficient between IGF-1 and MELD was -0.317 [p=0.001] and correlation coefficient between IGF-1 and Child-Pugh was equal to -0.478 [p<0.001]. The findings of this study showed that IGF-1 could be an index of severity of cirrhosis and can be used to determine the severity of the disease in patients, in particular, when liver biopsy is not possible

Molecular epidemiology of measles virus before and after the 2003 mass vaccination campaign for measles/rubella in Iran

Molecular epidemiology of measles virus [MV] is important, not only to measure the success of measles vaccination programs but also to monitor the circulation and elimination of the virus worldwide. In this study, we compared MV obtained from patients before the 2003 mass vaccination MR campaign and viruses detected after 2003 until 2008 in Iran. The nucleoprotein [N] gene of 29 MV strains circulating in Iran between 2002 and 2008 were amplified by RT-PCR and subjected to sequence and phylogenetic analysis. Molecular characterization of MV studied here revealed that although the outbreaks in Iran were associated with MV genotype D4, the isolated viruses clearly belonged to several different lineages. Maximum and minimum homology within the 29 Iranian strains in our study was100% and 94.9% within the carboxyl terminus of the N gene, respectively. Using Clustal X program, the alignment of Iranian MV sequences showed nine lineages. This study provides the usefulness of MV sequence analysis for the demonstration of local interruption of indigenous strain transmission as well as providing a valuable means for monitoring the elimination processes of MV control

Distinguishing between primary infection and reinfection with rubella vaccine virus by IgG avidity assay in pregnant women

During the mass measles/rubella vaccination campaign in 2003 in Iran, many pregnant women were vaccinated mistakenly or became pregnant within 1 month of vaccination. To distinguish pregnant women who were affected by rubella vaccine as primary infection from those who had rubella reinfection from the vaccine, serum samples were collected 1-3 months after the campaign from 812 pregnant women. IgG avidity assay showed that 0.3% of the women had no rubella-specific IgG response; 14.4% had low-avidity anti-rubella IgG and were therefore not immune to rubella before vaccination; 85.3% had high-avidity antirubella IgG and were regarded as cases of reinfection

Prevalence of oropharyngeal colonization by Haemophilus influenzae type b in Iranian children

Healthy carriers of Haemophilus influenzae type b [Hib] play an important role in the spread of invasive disease. The aim of this study was to assess the need for Hib vaccination in Iranian children by estimating the prevalence of Hib oropharyngeal colonization among children in Tehran. Cultures were prepared from oropharyngeal swabs of 1000 children in 25 day-care centres in Tehran from October 2005 to March 2006. The prevalence of Hib carriers was 7.6%, similar to other developing countries prior to inoculation with the conjugate Hib vaccine. We recommend Hib vaccination be included in the Iranian national programme of immunization

[Prevalence and molecular characterization of rotaviruses from children with acute diarrhea in Tabriz]

Rotavirus is the common cause of acute diarrhea in infants and young children. Hence it is required to investigate rotavirus infection in diarrheal samples in order to determine the prevalence and predominant genotypes for controlling the misusage of antibiotics and vaccination. To determine the prevalence and predominant genotypes of rotavirus in children under five years of age with acute diarrhea in Tabriz. Rotaviruses were detected by ELISA in stool samples collected during one year [2005-2006] from children under five years old, admitted to Pediatric Center, in Tabriz. Positive samples in standard condition transferred in our laboratory [RCGLD] and RT-PCR were used for genotyping. In total of 213 samples, 113 samples were positive for group A rotavirus. Prevalence of rotavirus infection was 54%. Samples were typed as follows: G1 [21.4%], G2[3.1%], G4[42.9%], G2+G4[5.1%], G1+G4[17.3%] and G1+G2+G4[3.1%]. Genotype G9+G4 was detected in one sample [1%]. P [8] was found in 68.4% of samples, P [4+8] 12.2%, P [4] 12.2%, P [6] 2%. The major finding of our study was that the main cause of infectious gastroenteritis in Tabriz occurs by rotavirus. The most prevalent genotyping were G4 P[8], vaccination may be the best way to control rotavirus

[Emerging and pandemic of influenza A[H1N1]]

Influenza is one of the known viral infectious diseases, which has killed millions of peoples during pandemics, epidemics and sporadic forms. One of the most remarkable features of influenza virus is the frequency of changes in antigenicity. Alteration of the antigen structure of the virus leads to infection with variants to which little or no resistance is present in the population at risk. Pandemics of influenza type A, result from the emergence of a new virus which the population contains no or limited immunity to it. The interval between pandemics is 10-30 years. But Influenza virus has been causing epidemics of febrile respiratory disease every 1 to 3 years. Pandemic [H1N1] 2009 is a new virus that has not circulated among human population before. This virus is different from previous or current human seasonal influenza viruses. Influenza type A[H1N1] virus is transmitted by inhaling infected droplets expelled by coughing or sneezing or by touching contaminated hands or surfaces as the same as the normal seasonal flu. The symptoms and signs of A[H1N1] influenza are as similar as seasonal influenza and include fever, coughing, runny nose and sore throat. Some people have also reported, nausea, vomiting and diarrhea. People with existing cardiovascular disease, respiratory disease, diabetes and cancer are at higher risk of serious complications. Asthma and other respiratory disease are other underlying conditions associated with severe disease. Pregnant women are at higher risk for more severe disease and obesity may be another risk factor for severe disease. To prevent spread, people should cover their mouth and nose when coughing or sneezing, stay at home when they are unwell, clean their hands regularly, and avoid crowded areas if possible. The pandemic virus is currently susceptible to neuraminidase inhibitors; Oseltamivir and Zanamivir but resistant to Amantadine and Rimantadine. Ministry of health and medical education, Center for Infectious Diseases Management in Islamic Republic of Iran is ready for control and management of novel influenza A[H1N1]

Lecithin cholesterol acyltransferase activity is decreased in type 2 diabetes mellitus

Lecithin cholesterol acyltransferase [LCAT] plays a major role in the removal of free cholesterol from tissues via assisting HDL-C maturation, and its activity has been proposed as the main indicator of HDL-C function. The aim of the study was to measure LCAT activity in type 2 diabetic patients and to elucidate whether LCAT is associated with metabolic control, and insulin resistance. A case-control study was conducted, recruiting 45 type 2 diabetes mellitus patients and 45 healthy subjects. Cases and controls were matched regarding gender, age and body mass index [BMI]. FBS, lipid profile, LCAT activity, HbA[IC], insulin were measured and insulin resistance [HOMA-IR] was calculated for both patients and controls. The studied variables were then compared between the two groups, and the association of LCAT activity with any of the variables was examined. Twenty-five subjects were female and 20 male both among patients and controls. Mean age of diabetics was 49.9 yrs and of controls 51.1 yrs. FBS, HbA[IC], HOMA-IR and TG in patients were significantly higher than controls, and HDL-C in controls was significantly higher than patients. LCAT activity of patients [73 +/- 9.1 nmol/L/h] was significantly lower than that in controls [88 +/- 4.5 |imol/L/h] [P < 0.001]. LCAT activity had significant inverse correlations with HbA[IC] and duration of diabetes. After multilinear regression analysis in patients, LCAT activity was only correlated with HbA[IC] level [B= -0.9, P < 0.001]. LCAT activity had no significant association with HDL-C and HOMA-IR in any of the groups. LCAT activity is significantly decreased in patients with type 2 diabetes compared with healthy controls, and has an inverse correlation with the magnitude of hyperglycemia