Effi cacy of tricyclic antidepressants in irritable bowel syndrome:A meta-analysis

We aimed to evaluate the efficacy of tricyclic antidepressants(TCAs) as a therapeutic option for irritable bowel syndrome(IBS) through meta-analysis of randomized controlled trials.For the years 1966 until September 2008,PubMed,Scopus,Web of Science,and Cochrane Central Register of Controlled Trials were searched for double-blind,placebo-controlled trials investigating the effi cacy of TCAs in the management of IBS.Seven randomized,placebo-controlled clinical trials met our criteria and were included in the metaanalysis.TCAs used in the treatment arm of these trials included amitriptyline,imipramine,desipramine,doxepin and trimipramine.The pooled relative risk for clinical improvement with TCA therapy was 1.93(95% CI:1.44 to 2.6,P<0.0001).Effect size of TCAs versus placebo for mean change in abdominal pain score among the two studies was -44.15(95% CI:-53.27 to -35.04,P<0.0001).It is concluded that low dose TCAs exhibit clinically and statistically signifi cant control of IBS symptoms.

A systematic review of effi cacy and tolerability of mebeverine in irritable bowel syndrome

We evaluated the eff icacy and tolerability of mebeverine, a musculotropic antispasmodic agent, in irritable bowel syndrome (IBS) and compared its usual dosages by meta-analysis. Medical databases and all relevant literature were searched from 1965 to June 2009 for any placebo-controlled clinical trials of mebeverine, using search terms such as mebeverine, clinical trials, and IBS. Eight randomized trials met our criteria, including six trials that compared mebeverine with placebo and two that compared mebeverine tablets with capsules. These eight trials included 555 patients randomized to receive either mebeverine or placebo with 352 (63%)women and 203 (37%) men in all subtypes of IBS. The pooled relative risk (RR) for clinical improvement of mebeverine was 1.13 (95% CI: 0.59-2.16, P = 0.7056) and 1.33 (95% CI: 0.92-1.93, P = 0.129) for relief of abdominal pain. The efficacy of mebeverine 200 mg compared to mebeverine 135 mg indicated RRs of 1.12 (95% CI: 0.96-1.3, P = 0.168) for clinical or global improvement and 1.08 (95% CI: 0.87-1.34, P = 0.463) for relief of abdominal pain. Thus, mebeverine is mostly well tolerated with no signif icant adverse effects; however, its eff icacy in global improvement of IBS is not statistically signif icant.

Evaluation of bioefficacy ofα-cypermethrin in long lasting impregnated net(Interceptor~) using analytical method

Objective:To evaluate relationship betweenα-cypermethrin residues in Interceptor~? nets by using HPTLC methods and mortality percentage in standard WHO’s method 'cone test' after repeated washings.Methods:Interceptor~? containingα-cypermethrin was provided by BASF Company.The washing procedure and bioassay tests were carried out according to the WHO-recommended methods.Malaria vector,An.stephensi was exposed to impregnated bed net for three minutes and then mortality measured after 24 hour recovery period.Chemical analysis was carried out in chemical laboratory by using high performance thin layer chromatography method.Results:Result of cone bioassay method showed that washing reduced the efficacy of Interceptor~? bed net from 100%in unwashed nets to 15%at 20 washes.After 20 washes,nets contain(61.2±2.8) mg/m^2 resulting 15%mortality in cone test.Killing activity was reduced when nets were washed.Conclusions:Results will provide an essential clue for monitoring and evaluation of bioefficacy of any long lasting impregnated bed net for quality control.Findings of this study will be useful for WHO.local investigators and people who wish to use pyrethroid-impregnated bed nets for malaria vector control.

Demonstration of malaria situation analysis,stratification and planning in Minab District,southern Iran

Objective:To demonstrate malaria situation analysis,stratification and planning for an endemic area in southern Iran.Methods:Data on health system,population,meteorological parameters, malaria cases,anopheline vectors,and control activities during 2005-2007 was obtained from Minab Health Center,Minab Meteorological Station and published documents about malaria elements in the study area.A datasheet was created in excel 2003 for analysis.Results:There were 644 health staff working in Minab District including 99 health staff in malaria control program.The health facilities are distributed as follow:1 hospital with 96 beds,23 health centers including private centers(10 in Minab city and 13 in rural area of Minab District) and 119 health houses in rural areas of Minab District.Anopheles stephensi was the dominant species in Minab District,however,Anopheles dthali,Anopheles superpictus,Anopheles fluviatilis,Anopheles multicolor,Anopheles pulcherrimus and Anopheles turkhudi can also be found in the area. Anopheles stephensi was reported susceptible to malathion,propoxur,primphos-methyl,lambdacyhalothrin permethrin and deltamethrin,and resistant to DDT and dieldrin in the area.During the study period a total of 10 665 positive cases were reported,mainly due to local transmission (99.6%).Plasmodium vivax was the main causative agent followed by Plasmodium falciparum. There were reports about drug resistance of Plasmodium falciparum in the area.Conclusions: Using different parameters,Minab was classified into 3 strata.A plan was designed based on described goal,objectives and targets.The approaches of this plan were categorized into:health education,early detection and correct treatment,and vector control.Main constraints of these approaches are population movement between Iran,Pakistan and Afghanistan;vector control challenges at district,inadequate skilled medical staff in malaria case management and weak inter-sectorial coordination for malaria control,especially in urban areas.

Phenology and population dynamics of sand flies in a new focus of visceral leishmaniasis in Eastern Azarbaijan Province,North western of Iran

Objective:To investigate species composition,density,accumulated degree-day and diversity of sand flies during April to October 2010 in Azarshahr district,a new focus of visceral leishmaniasis in north western Iran.Methods:Sand flies were collected using sticky traps biweekly and were stored in 96%ethanol.All specimens were mounted in Puri’s medium for species identification using valid keys of sandflies.The density was calculated by the formula: number of specimens/m of sticky traps and number of specimens/ number of traps.Degree-day was calculated as follows:(Maximum temperature + Minimum temperature)/2—Minimum threshold.Diversity indices of the collected sand flies within different villages were estimated by the Shannon- weaver formula(H’=sum form(i=1) to s Pi log_e Pi ).Results:Totally 5 557 specimens comprising 16 Species(14 Phlebotomus,and 2 Sergentomyia) were indentified.The activity of the species extended from April to October.Common sand-flies in resting places were Phlebotomus papatasi, Phlebotomus sergenti and Phlebotomus mongolensis.The monthly average density was 37.6.41.1, 40.23,30.38 and 30.67 for Almalodash,Jaragil,Segaiesh,Amirdizaj and Germezgol villages, respectively.Accumulated degree-day from early January to late May was approximately 289 degree days.The minimum threshold temperature for calculating of accumulated degree-day was 17.32℃.According on the Shannon-weaver(H’),diversity of sand flies within area study were estimated as 0.917,1.867,1.339,1.673,and 1.562 in Almalodash,Jaragil,Segaiesh,Amirdizaj and Germezgol villages,respectively.Conclusions:This study is the first detailed research in terms of species composition,density,accumulated degree-day and diversity of sand flies in an endemic focus of visceral leishamaniasis in Azarshahr district.The population dynamics of sand flies in Azarshahr district were greatly affected by climatic factors.According to this study the highest activity of the collected sand fly species occurs at the teritary week of August.It could help health authorities to predicate period of maximum risk of visceral leishamaniasis transmission and implement control program.

First report on natural Leishmania infection of Phlebotomus sergenti due Leishmania tropica by high resolution melting curve method in Southeastern Iran

Objective:To identify the Leishmania species in infected sand flies by Real-time PCR coupled with HRM analysis.Methods:Real-time PCR coupled with HRM analysis targeting the first internal transcribed spacer(ITS1)of nuclear ribosomal DNA as the genetic marker was used to identify and distinguish Lelthmania species in sand flies specimens.Results:Three out of 115females of Phlebotomus sergenti(P.sergenti)(2.6%)were positive to Leishmania tropica(L.tropica).Conclusions:This is the first report on P.sergenti as the main and proven vector of anthroponitic cutaneous leishmaniasis in Dehbakri County using Real-time PCR coupled with HUM analysis.This method is rapid,sensitive and specific for diagnosing of parasites in infected Sand flies and ideal for large scale genotyping projects.

First detection of Leishmania infantum DNA in wild caught Phlebotomus papatasi in endemic focus of cutaneous leishmaniasis,south of Iran

Objective:To identify the vectors and reservoirs of cutaneous leishmaniasis in the endemic focus of Farashband,Fars Province,South of Iran.Methods:Sticky papers and Sherman trap were used for collection of sand flies and rodents,respectively.Polymerase chain reaction(PCR)of kDNA,ITS1-rDNA were used for identification of Leishmania parasite in sand flies as well as rodents.Results:Totally 2010 sand flies were collected and the species of Phlebotomus papatasi Scopoli was the common specimen in outdoors and indoors places.PCR technique was employed on 130females of Phlebotomus papatasi.One of them(0.76%)was positive to parasite Leishmania major(L.major)and one specimen(0.76%)was positive to Leishmania infantum.Microscopic investigation on blood smear of the animal reservoirs for amastigote parasites revealed 16(44%)infected Tatera indica.Infection of them to L.major was confirmed by PCR against kDNA loci of the parasite.Conclusions:The results indicated that Phlebotomus papatasi was the dominant species circulating two species of parasites including L.major and Leishmania infantum among human and reservoirs.Furthermore,Tatera indica is the only main host reservoir for maintenance of the parasite source in the area.

Bioassay evaluation on the efficacy of a-cypermethrin impregnated into long lasting insecticide treated nets using Anopheles stephensi

Objective:To evaluate the bioefficacy ofα-cypermethrin impregnated into long lasting insecticide treated nets(LLITNs- INTERCEPTOR?) against main malaria vector,Anopheles stephensi（An.stephensi）.Methods:The effectiveness of bed net impregnated withα-cypermethrin(INTERCEPTOR?) with washing was evaluated.The washing procedure and bioassay tests were carried out according to the WHO-recommended methods.Malaria vector, An.stephensi was exposed to impregnated bed net for three minutes and then mortality measured after 24 h recovery period.Knockdown was also measured according to the logarithmic times. Results:Result of cone bioassay method showed that bioefficacy ofα-cypermethrin decreased from 100%in unwashed to 15%in 20 washes.KT50 was measure as one minute in one wash and increased to 40 min in 20 washes.Discussion:Findings of this study provide guideline for malaria vector control authorities and people using pyrethroid-impregnated bed nets.