Photokeratitis induced by ultraviolet radiation in travelers: A major health problem.

Ultraviolet (UV) irradiation is one of the several environmental hazards that may cause inflammatory reactions in ocular tissues, especially the cornea. One of the important factors that affect how much ultraviolet radiation (UVR) humans are exposed to is travel. Hence, traveling is considered to include a more acute UVR effect, and ophthalmologists frequently evaluate and manage the ocular manifestations of UV irradiation, including UV-induced keratitis. The purpose of this paper is to provide an evidence-based analysis of the clinical effect of UVR in ocular tissues. An extensive review of English literature was performed to gather all available articles from the National Library of Medicine PubMed database of the National Institute of Health, the Ovid MEDLINE database, Scopus, and ScienceDirect that had studied the effect of UVR on the eye and its complications, between January 1970 and June 2014. The results show that UVR at 300 nm causes apoptosis in all three layers of the cornea and induces keratitis. Apoptosis in all layers of the cornea occurs 5 h after exposure. The effect of UVR intensity on the eye can be linked to numerous factors, including solar elevation, time of day, season, hemisphere, clouds and haze, atmospheric scattering, atmospheric ozone, latitude, altitude, longitudinal changes, climate, ground reflection, and geographic directions. The most important factor affecting UVR reaching the earth's surface is solar elevation. Currently, people do not have great concern over eye protection. The methods of protection against UVR include avoiding direct sunlight exposure, using UVR-blocking eyewear (sunglasses or contact lenses), and wearing hats. Hence, by identifying UVR intensity factors, eye protection factors, and public education, especially in travelers, methods for safe traveling can be identified.

Comparative trial of Aloe vera/olive oil combination cream versus phenytoin cream in the treatment of chronic wounds.

OBJECTIVE: Aloe vera is a medicinal plant that has been traditionally used to accelerate wound healing. Olive oil is also a natural product that may contribute to wound healing owing to its antimicrobial and anti-inflammatory effects. The present study aimed to evaluate the effect of an Aloe vera-olive oil (AVO) combination cream on the healing process of chronic wounds. METHOD: In this randomised, double-blind, comparator-controlled, parallel-group trial, patients with chronic wounds were treated with either AVO cream or phenytoin cream as the standard treatment for a period of 30 days. Wound healing was evaluated using Bates-Jensen assessment tool and the severity of pain was assessed using a visual analogue scale (VAS). RESULTS: After initial assessment, 60 patients with chronic wounds (41 with pressure ulcer, 13 with diabetic wounds and 6 with venous ulcers), were recruited and randomised into 2 groups of 30. After 30 days of treatment, significant improvements in the wound size, depth, and edges; necrotic tissue type and amount; exudate type and amount; colour of wound surroundings; and peripheral tissue oedema score were observed in the AVO cream group (p<0.001). The total score of wound healing showed significant improvement with both AVO (p<0.001) and phenytoin (p<0.01) creams, although AVO was more efficacious (p<0.001). Likewise, although both treatments reduced the initial VAS score, the efficacy of AVO was significantly greater (p<0.001). CONCLUSION: AVO cream significantly accelerates biological healing of chronic wounds and helps to reduce pain severity with a higher efficacy compared with phenytoin cream.

Specific PCR Assay for Rapid and Direct Detection of Neisseria meningitidis in Cerebrospinal Fluid Specimens.

BACKGROUND: Neisseria meninigitidis is one of the most frequently encountered microorganisms associated with central nervous system infections. The aim of this study was to evaluate a PCR-based assay for specific and rapid detection of N. meninigitidis in CSF specimens. METHODS: Since April 2002 to July 2006, 130 CSF specimens were collected from patients suspected of having bacterial meningitis. Bacterial isolation and identification was carried out according to the standard bacteriological methods. The PCR was used to amplify a 101bp fragment of capsular transport gene A (ctrA) of N. meningitidis. RESULTS: PCR yielded an amplified product with the expected size of 101 base pair fragment. Sensitivity test proved 500 ng of N. meningitidis DNA as the final detection limit and specificity test revealed no cross-reaction for a wide range of respiratory pathogenic organisms. CONCLUSION: The PCR assay was more sensitive than the bacterial culturing. It might be possible to apply this procedure for rapid diagnosis of meningococci in clinical samples.

The study of prevalence and antimicrobial susceptibility of tracheal bacterial strains isolated from pediatric patients.

The aim of this study was to investigate the prevalence and antimicrobial susceptibility of bacterial strains isolated from tracheal specimens obtained from pediatric patients admitted to a major children hospital in Tehran, in 2007. Tracheal specimens were cultured on the appropriate bacteriological media. Bacterial isolates were identified by standard biochemical and serological tests. Antimicrobial susceptibility testing was performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Pseudomonas spp. was identified as the most prevalent bacterial isolate (32%) followed by Staphylococcus aureus (27.6%). Thirty strains (16%) were identified as Klebsiella spp., 18 (9.6%) as Enterobacter spp. and the rest belonged to coagolase negative Staphylococci, Streptococcus viridans, Acinetobacter spp., Escherichia coli and Neisseria spp. All Pseudomonas spp. were resistant to ampicllin, kanamycin and ceftizoxime. Staphylococcus and Klebsiella spp. showed high degree of resistance to 40% of examined antibiotics.

Rapid detection of Borrelia burgdorferi strains by nested polymerase chain reaction.

This study was carried out to evaluate the nested PCR for specific detection of different strains of B. burgdorferi. Five strains of B. burgdorferi including ACA-1, B-31, 2B45, 3B45, 7B49 obtained from different countries were used in this study. The strains of B. hermsii, Escherichia. coli and T. pallidum were also included as control strains. Two pairs of nested PCR primers were used to amplify the gene encoding the Osp-A protein of B. burgdorfer under standard PCR condition. In a two stage procedure, nested PCR yielded a positive reaction for five tested strains of B. burgdorferi. None the strains including B. hermsii, E. coli and T. pallidum showed positive reaction when used as control strains in PCR. In conclusion, nested PCR showed acceptable specificity for rapid detection ofB. burgdorferi.

Latex gloves allergy in dental workers, Iran.

Dermal-respiratory reactions to latex glove is a common problem and sometimes life threatening. Some of the health related past histories such as hand dermatitis, atopy and food allergy increase the probability of these reaction. The purpose of this study was to evaluate reactions to latex gloves amongst dental workers in military dental health centers. In this cross-sectional descriptive survey, dental workers with minimum three months length of employment and most often use of latex gloves were asked to fill standard questionnaire regarding latex related clinical manifestation and personal medical history and predisposing factors. Those with clinical problems did Skin Prick Test (SPT). In this study 330 personnel were assessed. The mean age and length of employment was 31.6 and 8 years, respectively. The most occupation was dentistry. A total of 232 subjects (70.3%) reported latex gloves-allergic symptoms. 72 (21.8%) of persons have history of atopy and food allergy was seen in 114 (34.5%). 63 (19.1%) of subjects reported history of hand dermatitis. All of these had positive regression with allergic responses. Among 73 (34%) symptom positives, 28 (38%) had positive result of SPT. In this survey, the prevalence of allergic reactions is higher than similar studies, which may be due to type of gloves, lack of preemployment assessments and other factors. Because of relationship between allergic reactions to latex gloves and some medical histories, it seems to be necessary for preemployment evaluation and periodic health surveillance of dental workers.

Spinal tuberculosis: a major public health hazard in Isfahan.

The purpose of this study is to review of spinal tuberculosis in three hospitals in Isfahan of Iran. We carried out a cross sectional study of 630 patients with tuberculosis and identified 100 patients with spinal involvement in the three hospitals. Tuberculosis was diagnosed based on one of a compatible clinical picture. A radiographic study of the spine with suspicious signs and skin tested were performed for each patient. Demographic data, sign, symptoms and site of spinal involvement were recorded. In all patients, a chest X ray and sputum smear and culture was performed for rouling out of pulmonary tuberculosis. Out of the 100 patients with spinal tuberculosis, 58% were male and 42% were female. Main symptoms were spinal deformity, local tenderness and neurologic deficits. Fever and constitutional symptoms were in 80% of cases. Only 68% had a positive tuberculin skin test. Three percent involvement were the upper thoracic spine, 23% the lower thoracic spine, 69% also the lower thoracic, T12 and upper lumbar spines, (thoracolumbar) and 5% the cervical spine. 40 cases underwent bone biopsy that 25% had a positive smear, whereas 62.5% had a positive culture. Histologic findings suggestive of tuberculosis involvement of the bone were found in 37 of the 40 biopsies. The most common age for spinal involvement were 20-40 years (p < 0.05). Spinal tuberculosis may be missed in patients with no evidence of pulmonary. No pathognomonic imaging signs allow tuberculosis to be readily distinguished from other conditions. In this here, we discuss about clinical and histopathological findings in patients with spinal tuberculosis.