There is clinical and biological evidence suggesting that patients with anger attacks, sudden spells of anger accompanied by intense autonomic activation, may represent a distinct psychopathological subgroup of patients with depressive disorders. We compared the prevalence of anger attacks in 168 outpatients with atypical depression or primary dysthymia with 38 normal subjects and tested the effect of treatment on anger attacks in a double-blind, placebo-controlled trial of sertraline versus imipramine. Patients were randomly assigned to sertraline (n = 56), imipramine (n = 52), or placebo (n = 60) and were administered the Anger Attacks Questionnaire before and after treatment. Depressed outpatients were significantly more likely to report anger attacks than controls. Anger attacks ceased in 53 percent of the patients receiving sertraline, 57 percent of those receiving imipramine, and 37 percent of those in the placebo group. Our findings support previous studies indicating that anger attacks are more prevalent among depressed outpatients than normals. Our results also suggest that sertraline and imipramine may be more effective than placebo in reducing the number of anger attacks following treatment although the differences were not statistically significant. Larger studies are needed to confirm our findings.

The efficacy of the 2 antimicrobial compounds, erythromycin and trimethoprim-sulphamethoxazole, were compared in the treatment of the clinical symptoms of cholera and the eradication of Vibrio cholerae O1 organisms from the stools of patients infected with tetracycline-resistant strains. 47 patients with a clinical diagnosis of cholera, without prior antibiotic therapy, were included in the trial and received either erythromycin, trimethoprim-sulphamethoxazole, or a placebo twice daily. The mean number of vibrios per gram of stool decreased from 5.2 x 10(8) +/- 0.3 per ml to 0 within 36 h of admission following either erythromycin or trimethoprim-sulphamethoxazole therapy, while organisms persisted in placebo-treated controls for more than 7 d. Clinically there was a significant reduction in the number of diarrhoeal stools per day and duration of diarrhoea in the erythromycin-treated group compared with the placebo-treated controls. During the study an isolate resistant to trimethoprim-sulphamethoxazole but sensitive to erythromycin was obtained. As an adjunct to oral rehydration therapy, erythromycin may serve as an effective alternative treatment for cholera, especially in areas where trimethoprim-sulphamethoxazole resistance may be emerging.

OBJECTIVES:

As Afghans make up the largest group of foreign nationals in Iran, the aim of this study was to assess the proportion of Afghan immigrants among those afflicted by the most prevalent infectious diseases in Iran.

METHODS:

National and international online scientific databases were searched through November 2013. The reference lists of included studies were also searched. All descriptive studies concerning the most common infectious diseases in Iran, including tuberculosis, multiple-drug-resistant tuberculosis, malaria, cholera, Crimean-Congo hemorrhagic fever, leishmaniasis, and hepatitis B were retrieved. The nationality of patients was not considered. The selection of studies and data extraction was performed separately by two authors. Results were reported using a random effect model with a 95% confidence interval (CI).

RESULTS:

The overall proportion of Afghan immigrants with the aforementioned infectious diseases was 29% (95% CI, 21 to 37). According to a stratified analysis, the proportion of Afghan immigrants afflicted with tuberculosis was (29%), multiple-drug-resistant tuberculosis (56%), malaria (40%), cholera (8%), Crimean-Congo hemorrhagic fever (25%), leishmaniasis (7%), and hepatitis B (14%).

CONCLUSIONS:

It is highly recommended to monitor the health status of the Afghan immigrants when entering Iran, to reduce the spread of communicable diseases, which are viewed as serious in international health regulations.

To evaluate the antisecretory activity of berberine sulfate (BS), we studied 165 adult patients with acute diarrhea due to enterotoxigenic Escherichia coli (ETEC) and Vibrio cholerae in randomized controlled trials. In patients with ETEC diarrhea who received 400 mg of BS in a single oral dose, the mean stool volumes were significantly less than those of the controls during three consecutive 8-hr periods after treatment (P less than .05). At 24 hr after treatment, significantly more patients who were treated with BS and had ETEC diarrhea stopped having diarrhea as compared with the controls (42% vs 20%, P less than .05). In patients with cholera who received 400 mg of BS, the mean 8-hr stool volume during the second 8-hr period after treatment declined to 2.22 liters, which was significantly less than the 2.79 liters found in the controls (P less than .05). However, patients with cholera who received 1200 mg of BS plus tetracycline did not have significant reduction in stool output compared with patients who received tetracycline alone. No side effects of BS were noted. These results indicated that BS is an effective and safe antisecretory drug for ETEC diarrhea, whereas the activity against cholera is slight and not additive with tetracycline.

To evaluate the impact of food on the efficacy of oral rehydration solution (ORS), a randomised, controlled clinical trial was conducted in 182 adults with cholera. After initial rehydration with an intravenous polyelectrolyte solution for four hours, the patients were randomised to receive one of four rehydration therapies: glucose based ORS and no food for the first 24 hours (group A), glucose based ORS plus food from the beginning of treatment (group B), rice based ORS with no food for the first 24 hours (group C), and rice based ORS plus food from start of therapy (group D). Tetracycline was given after 72 hours to all patients. No significant differences in ORS intake, stool output, and duration of diarrhoea were noted between groups A and B and between groups C and D. A substantial and significant reduction in stool output was, however, shown in the groups who received rice based ORS irrespective of feeding. These results show that food does not potentiate the efficacy of either glucose based or rice based ORS in adults with cholera. Rice based ORS compared with glucose ORS substantially reduces purging in cholera patients.

BACKGROUND AND GOAL:

Surveillance systems for communicable diseases are primarily passive in most countries, including Iran. Laboratory-based surveillance and use of cell phone surveillance may be a useful method.

MATERIAL AND METHOD:

We established a new model for gathering data directly from district laboratories to regional laboratories and from them to national manager of public health laboratories by using cell phone. We assessed the coverage of Mobile and Cell phone in the laboratory Technicians, and Directors of Public Health in 27 universities in Iran by a simple data collection form to evaluate the feasibility of this method. And then this method was piloted for the last Cholera outbreak in Iran in 2005.

RESULT:

From data of 27 universities with 184 cities, we gathered 769 data health directors' mobile, total mobile penetrating rate, SMS users, and SMS penetrating rate was 57.9%, 77.1%, and 44.6% between Directors in Medical Universities of Iran and 54.5%, 54.9% and 29.9% in Directors of Laboratory. In the Cholera epidemic in Iran in summer 2005, CDC of MOH registered near 900 cases of cholera from 70000 rectal soap's exam in whole of country. The median reporting interval was under one day.

CONCLUSION:

Although the advent of the cell phone will probably change the way in which surveillance is delivered by health system, further studies are warranted to evaluate this method for laboratory based surveillance of lethal infections.

El hielo fue el vehículo de transmisión del cólera en uno de los peores brotes ocurridos en Latinoamerica en la última década, El presente estudio tuvo como objeto evaluar la supervivencia del Vibrio cholerae O1 en 20 muestras de hielo comercial almacenadas a -5ºC y -20ºC. La calidad microbiológica del hielo se determinó mediante el recuento de microorganismos aerobios mesófilos, coliformes totales, coliformes fecales y detección de V.cholerae O1. Para estudiar la supervivencia de V.cholerae O1 en hielo, poblaciones de 10 elevado a 9 ufc/ml de este microorganismo fueron inoculadas en muestras de hielo previamente descongeladas y sometidas a un proceso de congelación rápida y almacenamiento a -5ºC y -20ºC. La enumeración de las células sobrevivientes de V.cholerae O1 se realizó mediante la técnica del número más probable (NMP) usando agua peptonada alcalina como caldo de enriquecimiento, estriado en agar tiosulfato-citrato-sales biliares-sacarosa (TCBS) y confirmación de las colonias típicas mediante pruebas bioquímicas y serológicas. La población inoculada se redujo entre 6 y 7 ciclos logarítmicos después de 21 , días de almacenamiento en congelación y la eliminación total de células viables se produjo a los 30 días, siendo el proceso de congelación a -5ºC la causa de muerte del mayor número de células de Vibrio cholerae O1 (p<0,05). Por razón el consumo de hielo elaborado sin las medidas sanitarias adecuadas representa un riesgo para la transmisión del cólera, sobre todo cuando se utilizan temperaturas de -20ºC durante el proceso de congelación

El POMS es un cuestionario para la medida del estadode ánimo, con aplicaciones en diferentes ámbitos, particularmente en el entorno deportivo. En un trabajo preliminar (Arce, Andrade y Seoane, 2000), el POMS fue traducido al castellano y administrado a una muestra formada por 374 estudiantes. Teniendo en cuenta criterios tanto psicométricos de la versión resultante, con 63 items, en una muestra de 216 deportistas. Mediante análisis de items y análisis factorial, el cuestionario fue reducido a 48 items, que abordan 6 estados de ánimo: Cólera, Depresión (estado deprimido), Tensión, Fatiga, Vigor y Amistad. Los coeficientes de consistencia interna de los factores oscilaron entre 0,76 (Amistad) y 0,91 (Cólera). Además, se han comparado las puntuaciones de deportistas con las obtenidas por una muestra de 268 estudiantes universitarios que no practicaban deporte. Se encontraron diferencias significativas entre deportistas y no deportistas en Cólera, Tensión, Vigor y Amistad. Las diferencias observadas entre ambos grupos en Depresión no resultaron significativas. Ambos mostraron también puntuaciones similares en Fatiga (AU)

This study compared the effectiveness of the enuresis alarm alone with a brief version of Dry Bed Training in treating 74 enuretic children. Both procedures were equally effective, and in the total sample a better response to treatment was predicted by the child's report of being teased by siblings. Maternal anger was associated with a greater drop-out rate.

Diarrhea caused by enterotoxigenic E.coli (ETEC) is an important health problem in developing countries and in travelers to these areas. In previous trials formulations of ETEC vaccines containing the B-subunit of cholera toxin, which is antigenically similar to the heat labile enterotoxin of ETEC, and the most prevalent colonization factor antigens of ETEC, were shown to stimulate relevant mucosal immune responses in volunteers from Sweden and Egypt.