Anti-irritable Bowel Syndrome Syrup Improves Constipation-Predominant Irritable Bowel Syndrome: A Randomized, Placebo-Controlled Trial / 中国结合医学杂志

OBJECTIVE@#To evaluate the efficacy and safety of administration of the formulated Persian herbal syrup on improving the symptoms of patients with constipation-predominant irritable bowel syndrome (IBS-C).@*METHODS@#This study was conducted in 70 patients with IBS-C, who were recruited from 3 medical centers in Mashhad, Iran, from November 2017 to August 2018. Seventy patients were randomly assigned to 2 groups including treatment and placebo groups by block randomization, 35 cases in each group. Patients in the treatment group received 15 mL of anti-IBS syrup, thrice daily for 6 weeks and followed up for 4 weeks. Placebo syrup was also prepared through similar instruction, BP syrup without plant extract was used. Primary outcome induding IBS Symptom Severity Scale (IBS-SSS) questionnaire and secondary outcomes in terms of Hospital Anxiety and Depression (HADS) questionnaires, the Bristol Stool Form Scale (BSFS) were completed and evaluated at weeks 6 and 10, respectively. Safety indices were collected at the end of the treatment and Common Terminology Criteria for Adverse Events v4.0 (CTCAE) was used to evaluate the adverse events.@*RESULTS@#The response to treatment was 84.4% (27/32) in the treatment group and 46.4% (13/28) in the placebo group, respectively (P= 0.002). Compared with pre-treatment, a significant decrease was found on the IBS-SSS and BSFS scores after 6-week intervention in both groups (P0.05). Side effects reported in the treatment group included 2 cases of headache during the first week of the onset of the treatment, 1 case of drowsiness, 1 case of increase in menstrual bleeding, which did not result in discontinuation of the treatment. In the placebo group, 1 case of exacerbation of the disease was reported.@*CONCLUSIONS@#Anti-IBS syrup significantly reduced the severity of IBS symptoms compared to placebo. However, there was a need for further investigation regarding the anxiety and depression scores. (Registration No. IRCT2017061034446N1).

Anti-irritable Bowel Syndrome Syrup Improves Constipation-Predominant Irritable Bowel Syndrome: A Randomized, Placebo-Controlled Trial / 中国结合医学杂志

OBJECTIVE@#To evaluate the efficacy and safety of administration of the formulated Persian herbal syrup on improving the symptoms of patients with constipation-predominant irritable bowel syndrome (IBS-C).@*METHODS@#This study was conducted in 70 patients with IBS-C, who were recruited from 3 medical centers in Mashhad, Iran, from November 2017 to August 2018. Seventy patients were randomly assigned to 2 groups including treatment and placebo groups by block randomization, 35 cases in each group. Patients in the treatment group received 15 mL of anti-IBS syrup, thrice daily for 6 weeks and followed up for 4 weeks. Placebo syrup was also prepared through similar instruction, BP syrup without plant extract was used. Primary outcome induding IBS Symptom Severity Scale (IBS-SSS) questionnaire and secondary outcomes in terms of Hospital Anxiety and Depression (HADS) questionnaires, the Bristol Stool Form Scale (BSFS) were completed and evaluated at weeks 6 and 10, respectively. Safety indices were collected at the end of the treatment and Common Terminology Criteria for Adverse Events v4.0 (CTCAE) was used to evaluate the adverse events.@*RESULTS@#The response to treatment was 84.4% (27/32) in the treatment group and 46.4% (13/28) in the placebo group, respectively (P= 0.002). Compared with pre-treatment, a significant decrease was found on the IBS-SSS and BSFS scores after 6-week intervention in both groups (P0.05). Side effects reported in the treatment group included 2 cases of headache during the first week of the onset of the treatment, 1 case of drowsiness, 1 case of increase in menstrual bleeding, which did not result in discontinuation of the treatment. In the placebo group, 1 case of exacerbation of the disease was reported.@*CONCLUSIONS@#Anti-IBS syrup significantly reduced the severity of IBS symptoms compared to placebo. However, there was a need for further investigation regarding the anxiety and depression scores. (Registration No. IRCT2017061034446N1).

effect of food service system modifications on staff body mass index in an industrial organization

Due to the adverse effects of obesity and overweight on health status of people, organizations that provide daily food aim for a healthy Body Mass Index among their staff. The purpose of this applied randomized controlled trial [RCT] was to study the effect of modifications in the food service section and nutritional intervention on the BMI of staff in an industrial center. In this applied randomized controlled trial which lasted for 40 days, 116 overweight people [BMI >/= 26] were randomly selected and divided into control and test groups. Individual daily food plan was prepared by a dietitian and nutritional education sessions were held for test group. At the management level, food menu was modified reduce the calorie intake by at least 1000 Kcal per day for the test group and also cost less for the center. The kitchen staffs were trained to promote healthy cooking and improving the food taste. The satisfaction level of food service was also evaluated before and after the intervention, using a questionnaire. To analyze the findings, SPSS 16 software, independent t-test and paired t-test, and Macnemar test were used. The results showed that BMI in test group decreased from 27.5 +/- 2.36 to 26.8 +/- 2.15 [p<0.05], while in control group increased by 0.5 Kg/m[2]. Similar result was observed in weight change. The level of satisfaction of food service following changes in the menu increased significantly in both groups. Also, cost of food and use of fat were reduced by 15% and 8%, respectively. Dietary interventions and improving the nutritional knowledge along with modification in food service system could result in better weight management in organization staff using canteen food

[Antifungal activity of total extract and chloroform, ethyl acetate, methanol and aqueous fractions of aerial parts of Ephedra pachyclada against fungal strains]

Increased consumption of synthetic antifungal compounds has created serious side effects and wide spread anti fungal resistance. This persuades researchers to look for effective herbal plants as an alternative option. We report the results of anti fungal properties of different crude extract and relevant fraction of aerial parts of Ephedra pachyclada. In this experimental study, extracts and fractions of Ephedra pachyclada were obtained by maceration standard methods. The crude extract and fractions were diluted in defferent values from 31.25 to 500mg/ml. Candida albicans, Aspergillus niger, Aspergillus flavus, Aspergillus fumigatus, and Fusarium oxysporium were used for anti fungal activity assessment using standard agar diffusion methods. Total extract and chloroform, ethyl acetate, methanol and aqueous fractions had antifungal effects against Candida albicans only. We concluded that this plant contains antifungal compounds on Candida albicans, so this experiments and evaluation are pre-requirement of any applicable recommendation

[Evaluation of antibiotic resistance in bacteria isolated from patients hospitalized in imam khomeini and burn hospitals in Ahvaz City, Iran]

In recent years the emergence of antibiotic resistance has a high prevalence, so that it has become one of the complexities in modern medicine. This study was performed with the aim of evaluating the bacteria isolated from clinical samples of the patients with various infections and estimating the prevalence of various bacteria and also antibiotic resistance pattern. At first, culture was prepared from wounds of the patients with nosocomial infection in Imam Khomeini and Burn hospitals in 2008-2009. Then, after isolation of bacteria, antibiotic susceptibility was determined using antibiotic discs. Data were analyzed using statistical tests [ratio] at the significance level of p

Helicobacter pylori eradication in renal recipient: triple or quadruple therapy?

Although triple [Omeprazole, Amoxicillin, and Metronidazole] and quadruple [Omeprazole, Tetracycline, Metronidazole, and Bismuth Subcitrate] therapeutic regimens for H. pylori eradication has been studied much in the general population, there is a lack of data in renal transplanted patients. So, this study aimed at comparing regimens in these patients who were considered being immunocompromised. The present clinical trial was carried out in Mashhad, Iran in 2010. Fifty-five patients who had received a kidney transplant in six months or earlier and referred for chronic dyspepsia were selected. They were resistant to H2-receptor antagonists or proton pump inhibitors therapy and had positive Rapid Urea Test. They randomly divided into two groups: triple and quadruple therapy. The treatment duration in both groups was similar [antibiotics for two weeks plus omeprazole for 4 weeks]. Urea Breath Test [UBT] was performed two weeks after treatment for assessment of its result. Total numbers of 39 patients [71%] were positive for H. Pylori which were divided into triple therapy group [21 patients] and quadruple therapy [18 patients]. Overall, the treatment was successful in 80% [71% in triple therapy and 89% in quadruple one] which was not different significantly between the groups [p=0.247]. The result of this study revealed that the prevalence of H. pylori infection in renal transplant patients is similar to the normal population. In these cases, triple and quadruple therapies were similar in eradication of H. pylori. So, triple therapy can be recommended in renal transplant recipients

Helicobacter Pylori infection and metabolic parameters: is there an association in elderly population?

The association between Helicobacter pylori [HP], as one of the most prevalent infections, and serum glucose level was inconsistent with previous studies. Moreover, there are contradictory reports about the relationship between HP infection and lipid profile. The purpose of this study was to determine the relationship between HP infection with glycemic and lipid profiles in elderly people. This cross-sectional study was conducted on 1,300 subjects over 60 years in Amirkola Health and Ageing Project. After using a standard questionnaire, the venous sampling was done to determine FBS, triglyceride [TG], cholesterol, low density lipoprotein [LDL], high-density lipoprotein [HDL] and IgG anti-HP after a 12-h overnight fast. The information about the individuals was analyzed using SPSS-17. The P < 0.05 was considered statistically significant. The prevalence of HP infection in diabetic and nondiabetic subjects was 77.5% and 75.7%, respectively, which had no statistically significant difference. Also, there was no significant difference between the serum lipid level including TG, LDL and HDL cholesterol with levels of anti-HP antibodies. The rate of HP infection in patients with hypertension was 75% and 78.3% in healthy patients, in which the difference was not statistically significant. In terms of body mass index [BMI], the prevalence of infection in the group with normal BMI was 77.3% and for the overweight and obese elderly population, it was 74.7%, and 77.5%, respectively [P = 0.445]. The findings revealed that in a large population of elderly in the northern part of Iran, HP infection is not associated with BMI, serum glucose and lipid profile as well as blood pressure

Cytotoxicity of ICD-85 NPs on human cervical carcinoma heLa cells through caspase-8 mediated pathway

The biological application of nanoparticles [NPs] is a rapidly developing area of nanotechnology that raises new possibilities in the treatment of human cancers. The cytotoxicity was evaluated by MTT and LDH assays. The apoptotic effect of free ICD-85 and ICD-85 NPs on HeLa cells was assessed using caspase-8 colorimetric assay. The MTT assay showed that ICD-85 NPs could enhance the in-vitro cytotoxicity against HeLa cells compared to the free ICD-85. The IC[50] value at 72 h was reduced from 25 +/- 2.9 Microg/mL for free ICD-85 to 15.5 +/- 2.4 Microg/mL for ICD-85 NPs. However, LDH assay demonstrated that ICD-85 has dose-dependent cytotoxicity on HeLa cells while ICD-85 NPs exhibited weaker cytotoxicity on same cells. The results also indicate that ICD-85-induced apoptosis on HeLa cells is associated with the activation of caspase-8. Moreover, caspase-8 assay analysis demonstrated that the ICD-85 NPs induced a higher apoptotic rate in HeLa cells compared to free ICD-85. Our results demonstrated that the encapsulation of ICD-85 enhances its anti-proliferative effects. Taken together, these results suggest that the delivery of ICD-85 in nanoparticles may be a promising approach for the treatment of the cancer

comparison of the effects of two aquatic exercise sessions with different duration on adiponectin and insulin resistance in women with type 2 diabetes

Background: Adiponectin is an adipocytokine that is hypothesized to be involved in insulin resistance and diabetes. The purpose of this study was to compare the effect of two different single-session aquatic exercises on serum adiponectin and insulin resistance in women with type 2 diabetes

Materials and methods: In an experimental study with crossover design, eight postmenopausal women with type 2 diabetes [mean age 56.6 +/- 4.9 years] were randomly assigned to three groups: control [Con], low duration [LD] exercise [45 - 50 min], and moderate duration [MD] exercise [65-70 min]. Blood samples were taken immediately and 24 hours after exercise. Data were analyzed using one-way repeated measures analysis of variance, in SPSS software version 16 [P<0.05]

Results: There were no significant differences in adiponectin level between groups immediately and 24 hours after exercise [P=0.70, P=0.97 respectively]. Increase in insulin level after exercise was lower in LD and MD groups compared to Con. group [P=0.013]. Insulin level was lower in LD group than MD group, 24 hour after exercise [P<0.042]. Immediately after exercise, more significant increase in glucose was observed in LD group than MD group [P<0.02]. There were no significant difference between groups in glucose concentration, 24 after exercise [P=0.88]. HOMA-IR significantly reduced in LD and MD groups immediately after exercise [P<0.01]. However, There were no significant differences between groups, 24 after exercise [P=0.06]

Conclusion: The results of this study indicated that acute aquatic exercise reduces insulin resistance without any changes in adiponectin levels

Regulatory aspects of clinical trials in Iran: third year report of clinical trial committee in food and drug organization

Clinical Trial Committee [CTC] has been established in Food and Drug Organization [FDO], in 2003 to assure efficacy and safety of all types of medicinal products which are meant to be registered in Iran Drug List and/or obtain market authorization. All clinical trial files, meeting minutes and databases in CTC secretariat in FDO were reviewed. Relevant information and data extracted, analyzed and reported. Total number of clinical trial [CT] files received by CTC, in 2011, was 76 cases: 21 CT protocols, 45 CT reports and 10 requests for importation of investigational new medicinal products [IMPs]. Number of CT files received for herbal and natural products was 8 cases while CT files reviewed for vaccines and biological products was 50; 66% of all CT files received. Local industries sponsored 28 CT studies while 47 studies were supported by multinational/foreign companies. Of all CT files reviewed, 54 cases accounted for phase III CTs and 20 cases for phase IV and periodic safety updated reports [PSUR]. With respect to the decisions made by CTC in 2011, 23 out of 45 CT reports were approved and the number of clinical trial authorizations [CTA] issued were 11; 52% of all CT protocols reviewed. Results presented in this report are indicative of a positive trend in compliance of pharmaceutical industries and clinical research groups to national regulations of CTs and IR-GCP. Effective communication with different parties involved in regulatory and industry sides of CTs will further enhance conducting quality CTs

impact of education on smoking refrain based on the theory of planned behavior on Shiraz High School students' attitudes

Background: Smoking is one of the preventable causes of diseases as well as early deaths all around the world. In addition, conducting educational interventions plays a major role in preventing adolescents from smoking. Therefore, the present study aimed to investigate the effect of educational intervention based on the theory of planned behavior on preventing Shirazi students from smoking

Methods: In the present quasi-experimental study, 154 male students of the 2[nd] grade of high school from Shiraz were selected through multi-stage cluster sampling and randomly assigned to a control and an experimental group. The study data were collected through a questionnaire including the demographic information, questions on knowledge, and questions based on the components of the theory of planned behavior. After the pre-test, the intervention group underwent the educational intervention and after 2 months, both groups took part in the post-test. Then, the data were entered into the SPSS statistical software [v.11.5] and analyzed through the non-parametric tests of Mann-Whitney, Fisher, and Chi- square as well as Linear Multiple Logistic Regression

Results: No significant difference was observed between the two groups' mean scores before the intervention. After the intervention, the intervention group's scores of knowledge, attitude, intention, subjective norms, and perceived behavioral control significantly increased

Conclusion: According to the findings of the present study, educational intervention based on the theory of planned behavior was highly effective in reducing Shirazi high school students' intention to smoke

Simultaneous detection and differentiates of Brucella abortus and Brucella melitensis by combinatorial PCR

OBJECTIVE@#To evaluate simultaneous detection and differentiates of Brucella abortus (B. abortus) and Brucella melitensis (B. melitensis) through the combinatorial PCR method.@*METHODS@#This study was designed using three primers that could simultaneously identify and differentiate two major species of pathogenic Brucella in humans and animals. Identification and differentiation of each species using the size of the PCR product were determined. To determine the specificity of the method, bacteria close to the genus Brucella were used. Finally, to confirm PCR products, In addition to the products sequence, RFLP was performed on PCR products using restriction enzymes.@*RESULTS@#The method of optimized combinatorial PCR in this study could simultaneously detect and differentiate B. abortus and B. melitensis with high specificity and sensitivity in clinical samples. Differentiation of species is based on the resulting bands; therefore, the band 494 bp for B. abortus and 733 bp for B. melitensis were obtained. RFLP and sequencing results confirmed PCR results.@*CONCLUSIONS@#The results of this study shows that without routine diagnostic methods such as culture and serology tests, using the molecular method of combinatorial PCR, important species of Brucella can be simultaneously identified and differentiated in clinical samples.

[Relation between helicobacter pylori infection with thyroid autoantibodies in dyspeptic patients]

Infections attributed to Helicobacter pylori [H. pylori] involve almost half of the world's population. One of the effects is auto-antibody induction and cross-reaction with numerous proteins in the body. As a result of its widespread prevalence and importance, this study evaluates the associations between H. pylori and thyroid auto-antibodies. This study enrolled 100 patients who were candidates for gastroesophageal endoscopy that referred to the Yazd Gastrointestinal Clinic. Patients underwent the following laboratory analyses: urease test, anti-H. pylori [IgG], TSH, T4, T3 and thyroid auto-antibodies [anti-thyroglobulin, anti-thyroid peroxides]. Patients were divided into two groups of H. pylori positive and negative according to the results of the anti-H. pylori IgG and urease tests. The level of thyroid auto-antibodies and thyroid function tests were compared between groups. Data were analyzed with chi-square and t-tests. SPSS software version 17 was used for data analysis. Overall, 61% of patients were H. pylori positive. The mean anti-Thyroid peroxidase level in the H. pylori positive group was significantly more than the negative group [p<0.01]. In addition, 19.7% of H. pylori positive patients and 5.1% of H. pylori negative patients had positive anti-TPO levels, which the difference between both groups was significant [p<0.04]. There was no significant difference in thyroid function between the two groups. Although no significant difference in thyroid function was seen in the two groups more patients tested positive for anti-TPO levels in the H. pylori positive group, which was suggestive of thyroid auto-antibody induction by H. pylori.

Role of frenular web preservation on ejaculation latency time

Premature ejaculation [PE] is one of prevalent male sexual dysfunctions worldwide. Despite many psychiatric backgrounds, yet there are speculations about organic etiologies considering both anatomic and physiologic points of view. This survey assesses effect of frenular web preservation on premature ejaculation. One thousand and forty otherwise healthy men being visited for urolithiasis [asymptomatic patients] were asked for PE according to the International Society of Sexual Medicine definition criteria as intravaginal ejaculation latency time [IELT] less than a minute according to stop watch checked by patients' partner and were examined for presence of frenular web. Frenular web defined as a residual of frenulum after a circumcision. Overall prevalence of PE was 18.2% [n=102]. We found the presence of frenulum at physical examination in 255 out of 560 [45.5%]. Prevalence of PE was 20.7% [n=53] and 16% [n=49] in patients with frenular web preserved and without it, respectively. PE was higher among the men with frenulum preserved; but no statistically significant differences were seen [P=0.70]. We did not find any relationship between frenular web and PE, and concerns about this, during circumcision, may not be justified. PE is a not only a problem of local anatomical condition but many psychological and neurological factors could interact with it

comparison between two health education methods on diet: lecture versus videotape

Diet is one of the most important components of life style and its improvement is very related to appropriate educational methods. The main objective of this research was a comparison between two health education lecture and video tape presentation among volunteer health workers. This was a quasi experimental study on 160 volunteer health workers who were under coverage of south Tehran health center. They randomly assigned into 2 groups with the same size. One group recieved a short time lecture about good diet and other group received education by video tape presentation. Data were collected by questionnaire as pretest and post test and was analyzed using chi 2, Mcnemar, t-test [paired-independent] statistical tests. Knowledge and attitude was found to be significantly improved by both methods [P<0.0001], however the lecture method had a greater effect [P<0.0001] on improvement of knowledge and attitude of participants. Most participants also reported mass media as prior information source about good diet. This research showed that both educational methods namely lecture and video tape presentation can be effective ways to increase knowledge and improve attitudes about good diet but lecture was a more proper method

[Study of celiac disease in patients with non alcoholic fatty liver disease in northeast of Iran]

Non alcoholic fatty liver disease probably is the most common liver disorder in the world. The causes of NAFLD may be divided into two board categories: drugs and metabolic abnormalities. Because previous studies reported relationship between celiac and NAFLD/ we have studied this association in this article. This study was performed between September 2007 and December 2008. We measured human anti-tissue transglutaminase IgA antibody titratage by ELISA technique in 95 NAFLD inflicted patients, with out any risk factors for NAFLD, then patients with positive ATTG underwent upper endoscopy with duodenal biopsy. Positive ATTG was found in 6 out of 80 patients [7.5% Endoscopy was performed in 6 patients. Duodenal biopsy was normal in 2 patients [33.3%] and 4 patients [66.7%] had abnormal duodenal biopsy. Two patients were in Marsh stage 1 and one in Marsh stage 2 and another one in Marsh stage 3. None of them had symptoms suggestive of celiac disease. This present study shows that positive ATTG is not rare in patients with NAFLD. We recommend serum ATTG should be check in patients with NAFLD without any obvious etiology, also upper endoscopy with duodenal biopsy should be taken for all patients with positive ATTG

[Incidence of van A, B, C, D, E in vancomycin resistant enterococcus isolated from fecal flora in Tehran]

Vancomycin-resistant enterococci [VRE] have emerged worldwide and have become an increasing problem in clinical settings. Acquired glycopeptide resistance in Enterococcus species is due to the acquisition of van A, van B, van D, van C and van E genes, resulting in the production of peptidoglycan precursors with reduced affinity for glycopeptide antibiotics. The origin of these van genes is still unknown, but recent studies have indicated that van B resistance in enterococci might arise from gene transfer from the human bowel flora. In this study, we investigated the presence of Enterococcus-associated van A, van B, van C, van D, van E genes in the feces of hospitalized patients. To determine the prevalence of vancomycin-resistant enterococci [VRE] fecal colonization of hospitalized patients, 422 Enterococcus spp. isolated from stool of patients in Amiralam hospital. Disk diffusion method was used to detect resistance to vancomycin. The MICs of vancomycin were determined by the agar dilution method. The presence of van A, B, C, D and E genes were assassed by PCR analysis. PCR was positive for van A for 6 out of 10 [60%] and van B for 4 out of 10 [40%] of VRE strains. Among the van positive enterococci, two [20%] specimens contained both van A and van B gene, whereas no van C, D and E positive enterococcal isolates were identified from these specimens. The MIC of VRE isolates were between 512- 1024 micro g/ml. Our results showed that most glycopeptide resistant Enterococcus isolated from stool of hospitalized patients carried van A and van B. It is also possible that frequency of infections caused by glycopeptide-resistant enterococci will increase in our geographical area

Detection of Brucella abortus by alkB and IS711 based primers

Brucellosis is a zoonotic disease, which involves both animals and human. Although the conventional methods have been widely used for its laboratory diagnosis, the PCR techniques have proved to be useful due to specificity, sensitivity and the rapidness. Various target sequences of brucella bacterium such as OMP2, 16s RNA and IS711 have been used for the primer designing. All primer sets have shown different sensitivities and specificities. In present investigation, PCR protocol and primer designated based on IS711 and a fragment of chromosomal DNA all were optimized with standard genome and clinical samples. Numerous tissue samples [liver, kidney, lymph node, and uterus] were prepared and were cultured by the bacteriological standard methods along with the serology positive human samples. PCR protocol was optimized and the primer's sensitivity and the specificity were checked using pure genome of B. abortus. All samples were tested by the standard bacteriological methods. The samples were then subject to PCR amplification and the PCR product was confirmed using the RFLP technique. The culture results indicated a poor sensitivity as it was previously reported. The PCR product 157 bp was observed on the agarose gel indicating that significant number of clinical samples [human brucellosis cases] were positive by PCR but not by the culture method. Although B. abortus DNA was detected in all the culture positive veterinary specimens, some cross-reactions with close related bacteria were observed that might influence the interpretation of the results. The sensitivity of the present PCR protocol was significantly higher when alk B and IS711 based primers were used in compare to each of the alkB and IS711 based primers alone. More research will be needed to improve the specificity and sensitivity of the PCR protocol before recommending for routine laboratory works

Collagenase activity in prevotella bivius Isolated from patients with premature rupture of membranes

Bacterial vaginosis [BV] has been considered to be the most prevalent infection found in sexually active women. BV is thought to paly an important role in the premature rupture of membranes [PROM] and preterm birth. Preterm delivery accounts for a substantial percentage of low birth weight infants and perinatal mortality and morbidity. Bacteroides and Prevotella species have been isolated from the amniochorion of women with preterm birth and PROM. Women with >10 [4]/mL Prevotella bivius [formerly Bacteroides bivius] have a 60-100% higher rate of preterm delivery. The purpose of this study was to determine wether some strains of Prevotella species isolated from PROM and BV patients produce proteases especially collagenase enzymess which faciliate the rupture of membranes leading to preterm birth. Vaginal specimens have been obtained from 120 women with BV and premature rupture of membrane in 30-44 weeksss gestational age. Twenty anaerobic coccobacilli consisiting of Bacteroides fragilis, black pigmented Bacteroides and Prevotella bivius were isolated and identiofied. The isolates were examined for protease activity, using porcine skin gelatin and casein as substrates by Martleys method. Elastase and collagenase activity were detected using elastin, guinea pig collagen, bovine Achilles tendon collagen, FALGPA and GP, VPR as substrates by leverson method. Collagenase and elatase activity was detected in 90 and 100% of isolates. Gelatinase and caseinase activity was detected in 40 and 50% of isolates. Collagenase produced by Prevotella bivia isolates was purrified by ammonium sulphate precipitation, gel filtration and ion exchange chromatography. The collagenase was cleaved from the synthetic collagen substrate FALGPA, and GP, VPK substrates. The activity of the enzyme was inhibited by EDTA, Antipain and PMSF. This study suggests that proteases produced by Prevotella bivia may be involved in pathogenesis of premature rupture of membrane. PROM before 37 weeks has been reported to be significantly higher among patients with Bacteroides and Prevotella colonisation of the genital tract. The amniochorion consists of collage and elastin which convey physical integrity to the placenta. Collagenase and elastase released into genital tract may promote connective tissue destruction in the cervix and chorioammion membranes