ARCHIVES OF IRANIAN MEDICINE
Year:2016 | Volume:19 | Issue:5|Papers Count:12

BACKGROUND: Perinatal asphyxia is an important cause of death, as well as permanent neurological and developmental complications. Diagnosing in time would lead to better prognosis and applying the most proper treatment. We sought to define the predictive values of serum concentrations of interleukin-1 b (IL-1b) and interleukin-6 (IL-6) in newborns with perinatal asphyxia to see if there is a relation between the short-term neurological deficit and serum IL-1 b and IL-6 concentrations.METHODS: This was a prospective (case-control) study conducted between March 2006 and April 2013, at the Neonatal Intensive Care Unit, Mashhad, Iran. Serum IL-1 b and IL-6 levels were measured at birth in 38 consecutive uninfected neonates with perinatal asphyxia (blood pH < 7.2, low Apgar score, signs of fetal distress) and 47 randomly selected healthy newborns. The results were compared between the groups, using Chi-Square, t-tests, and Mann-Whitney tests, as well as receiver operator characteristics (ROC) curves and regression models.RESULTS: Serum IL-1 b and IL-6 concentrations in the infants who developed perinatal asphyxia were significantly higher compared to values in the normal infants [16.88 vs 3.34 pg/mL for IL-1 b, (P = 0.006), and 88.15 vs 6.74 pg/ mL for IL-6, (P < 0.001) respectively]. The sensitivity and specificity for the diagnosis of perinatal asphyxia using serum IL-6 were 80.5% and 81.6% respectively. The sensitivity and specificity using serum IL-1 b  were 71% and 89.1%, respectively.CONCLUSION: Evaluating serum IL-6 and 1 b simultaneously, could improve the sensitivity and specificity of early diagnosis of the perinatal asphyxia. The most appropriate indicator of perinatal asphyxia is combined measurement of interleukin 1 b and interleukin 6.

INTRODUCTION: To evaluate the perioperative complications and long-term restenosis rates following percutaneous transluminal angioplasty and stenting (PTAS) in patients with intracranial atherosclerotic stenosis (ICAS).METHODS: A retrospective analysis was performed on the clinical data of 102 ICAS patients (103 cases of stenosis) who underwent PTAS. The perioperative complications and long-term restenosis rates were analyzed.RESULTS: The success rate of PTAS was 100%. Six patients (5.83%, 6/103) had perioperative complications. Six cases (6.52%, 6.92) of restenosis occurred and one patient (1.09%) died. Five of the 6 restenosis cases (5.43%) occurred in the blood-supplying region and were associated with ischemic symptoms and one patient (1.09%) had no ischemic symptom. The postoperative restenosis rates at 6, 6 – 12, and 12 – 74 months were 3.26%, 2.56%, and 2.38%, respectively. The postoperative restenosis rates had a significant difference between the residual stenosis rate ≥ 20% and < 20% (P < 0.05), and between postoperative regular medication and non-regular medication (P < 0.05). The postoperative restenosis risk in patients with age ≥ 60 years was 13.481 times to that in patients with age < 60 years. The postoperative restenosis risk in patients with residual stenosis rate < 20% was 31.25 times to that in patients with residual stenosis rate ≥ 20%. The postoperative restenosis risk in patients with regular medication was 12.65 times to that in patients without regular medication.CONCLUSIONS: The vasospasm, arterial dissection, arterial occlusion and acute thrombosis are common perioperative complications following PTAS in patients with ICAS. The medium- and long-term postoperative restenosis rate is low. Age is the risk factor for postoperative restenosis.

INTRODUCTION: To evaluate the accuracy of transcutaneous bilirubin measurement in a large population of newborn infants, before and during the phototherapy.PATIENTS AND METHODS: A single Bilicheck instrument was used for transcutaneous measurements. A photo-opaque patch was positioned over the measurement site prior to starting phototherapy. Transcutaneous bilirubinometry was conducted on an unpatched area of the forehead skin and on the nearby site covered by the photo-opaque patch. Readings were obtained from patched and unpatched areas and simultaneous total serum bilirubin concentrations were compared.RESULTS: We studied 134 term and 36 preterm newborns. Pre-phototherapy measurements showed a strong correlation (r: 0.929, P < 0.001, Limit of agreement: -1.8 to 3.1) between Bilicheck and serum bilirubin readings. Post-phototherapy correlation between Bilicheck and serum bilirubin readings was (r: 0.921, P < 0.001, LOA: -1.8 to 2.8) among term and (r: 0.887, P = 0.001, LOA: -1.4 to 2.7) among preterm neonates in patched areas. These correlations were (r: 0.666, P < 0.001, LOA: -1.7 to 7.3) among term and (r: 0.756, P < 0.001, LOA: -0.5 to 5.3) preterm neonates post-phototherapy in unpatched areas.CONCLUSION: BiliCheck can be safely used for the evaluation of bilirubin levels in preterm and term newborn infants under phototherapy. BiliCheck is slightly less reliable among preterm newborns.

OBJECTIVES: To evaluate the HIV/AIDS burden in Iran from 1980 to 2010 using the Global Burden of Disease Study 2010 (GBD 2010).METHODS: The burden of HIV/AIDS in Iran was obtained from a systematic study from 1990 to 2010 by the GBD team. The GBD 2010 disability weights were used to calculate the HIV/AIDS Disability Adjusted Life Years (DALY) based on the HIV prevalence reported by the Joint United Nations Program on HIV/AIDS (UNAIDS) estimation. Mortality data were obtained from the vital registration and statistics system of Iran. In the current study, the results are discussed, and the potential solutions are provided for observed deficiencies.RESULTS: HIV/AIDS-related DALYs (3.6 per 100,000 in 1990, and 154 per 100,000 in 2010) and death (0.07 per 100,000 in 1990, and 3 per 100,000 in 2010) had increased in Iran from 1990 to 2010. The majority of individuals who died of HIV were between 15 to 49 years old. The estimated rank of HIV/AIDS burden compared with the burden of other leading disease was 152nd in 1990 and considerably increased to 37th in 2010 in Iran.CONCLUSION: Since the majority of HIV/AIDS DALYs and deaths occur among young people, the burden of HIV/AIDS still remains high in Iran. Due to the limitations of the GBD study, National and Sub-National Burden of Diseases (NASBOD) study is being conducted in Iran to calculate the burden of diseases, including HIV/AIDS.

INTRODUCTION: Rabies is an acute viral disease that causes encephalomyelitis in mammals and human. The only way to prevent this disease is through vaccination before or after exposure. The aim of this study is to evaluate the efficiency of the Pasteur virus (PV) minigenome, using PV strain.MATERIALS AND METHODS: Enhanced Green Fluorescent Protein (EGFP) sequence was placed between the designed necessary elements (Hammerhead, HDV ribozyme, 3’ Leader, and 5’ Trailer sequences), which resemble the rabies virus PV strain (PV2061) genome and anti-genome. These constructs were placed between T7 polymerase promoter and T7 polymerase terminator sequences. The accuracy of the minigenome was confirmed by the expression of EGFP using the helper virus in T7-BHK cell line.RESULTS: The viral necessary elements of positive and negative sense strands were evaluated for the ability of EGFP expression in the presence of the helper virus. While the positive strand showed background results, no EGFP background was observed in the negative strand application.CONCLUSION: Establishment of minigenome system does not require advanced biosafety levels. Furthermore, using minigenome system eliminates many potential confounding factors that may be present in coding regions of the genome. Use of the minigenome system is easier and more feasible than the full genome rescue of the virus. This study successfully shows the efficiency of the constructed rabies virus minigenome in expression of inserted gene.

BACKGROUND: Despite the fact that the recommendations of counteracting obesity advocate for changing lifestyle and physical activity habits, the prevalence of obesity continues to rise. The aim of the study was to investigate the effect of omega-3 PUFAs supplementation with lifestyle modification on anthropometric indices and Vo2max in overweight women.METHODS: Fifty overweight women aged between 20 to 45 years were recruited in this interventional study. Women randomly were divided into two experimental groups (n = 25). Group 1 received omega-3 supplement, aerobic exercise program, and a healthy diet education. Group 2 was similar to group 1, except in that patients received placebo instead of omega-3 capsules. Experimental and placebo group subjects were asked to take one supplementary capsule every day, for 8 weeks. Anthropometric indices were measured in the fourth and eighth weeks of the trial. The maximum aerobic capacity (Vo2max) was determined using a gas analysis device. The level of significance for comparing the results before and after the trial was considered at P < 0.05.RESULTS: According to the data, body weight, body fat percentage, waist circumference, and abdominal skinfold thickness significantly reduced in the omega-3 treated group compared to the control group during 8 weeks after the initiation of the study (P < 0.05). In addition, supplementation of omega-3, significantly improved the VO2max outcome compared to that of the control group (P=0.03).CONCLUSION: According to the results, it seems that omega-3 PUFAS supplementation with lifestyle modification has positive effects on anthropometric indices and Vo2max in overweight women.

BACKGROUND: A combination of radio-frequency (RF) and ultrasound cavitation (UC) has been reported to reduce indices of obesity. In this study, we aimed to investigate the effect of a combination of these techniques on anthropometric indices, pro-oxidant–antioxidant balance (PAB), and serum high-sensitivity C-reactive protein (hs-CRP).MATERIALS AND METHODS: This randomized clinical trial was performed on 50 healthy women between January 2014 and June 2014 in Ghaem Hospital, Mashhad, Iran. Participants were randomized to one of two groups, both of which received a low-calorie diet containing 500-kcal energy deficit per day. The trial group included twenty-five subjects who were assigned to the combined treatment of RF and ultrasound cavitation program of abdomen and flank areas. There were twenty-five control subjects who received the low calorie diet alone. Biochemical markers, including serum hs-CRP and PAB values, and anthropometric indices were measured in the intervention group and healthy controls.RESULTS: For both the intervention and control groups, waist circumference was reduced significantly by 3.76 ± 1.69 and 2.40 ± 1.04, respectively (P < 0.05). In addition, abdominal circumference was reduced by 9.5 ± 2.66 and 3.12 ± 1.88, in these groups, respectively (P < 0.001). Decrement of PAB level in the intervention group, and its increment in the control group, were not significant (P > 0.05). In addition, reductions of hs-CRP and PAB between the two studied groups during five weeks of study were not significant (P > 0.05).CONCLUSION: Although there were significant reductions in anthropometric indices following treatment with RF and UC, the effects on serum PAB or hs-CRP were no significantly different, compared to the control group. Further studies are needed to confirm the beneficial effect for the use of these techniques.

INTRODUCTION: Pseudomonas aeruginosa is a gram-negative and opportunistic bacterium that causes opportunistic infections in immunosuppressed patients. The main purpose of this study was to investigate the association between exotoxin A and exoenzyme S production with antibiotic resistance patterns.METHODS: The toxA and exoS genes were detected in 102 clinical isolates by PCR. Antibiotic susceptibility tests were performed by disk diffusion method (Kirby Bauer). The chi-square and Fisher's test were used for evaluation of the association between “toxins and infections source” and “toxins and antibiotic resistance” respectively.RESULTS: Frequency of toxA+ and exoS+ strains was 81% and 61%, respectively. The association between drug resistance and toxA+ genotype was significant for all antibiotics tested (P < 0.05) except aztreonam; however, no significant association was observed between drug resistance and exoS gene (P > 0.05).CONCLUSIONS: High frequency of toxA+ resistant strains isolated from inpatients and significant association between the toxin and drug resistance in more antibiotics, reinforces possible role of exotoxin A as an extracellular protein in the regulation of drug resistance genes. The results may be further verified by Southern blot analysis of toxA and exoS gene expression and elucidation of the mechanism of antibiotic resistance.

BACKGROUND: According to many studies, vitamin D deficiency has been linked to cardiovascular diseases (CV). Other than maintaining skeletal health, vitamin D has been shown to decrease the risk of developing CV disease such as hypertension, coronary artery disease (CAD) and thromboembolism.MATERIALS AND METHODS: To perform a comprehensive review of the current literature on vitamin D and CV disease, we searched the online database, including PUBMED, Scopus, and Google Scholar until data inception January 2016. The search term included "vitamin D", "blood pressure", "hypertension", "coronary artery disease "and "thrombosis". We only included human studies that were published in English.RESULTS: A majority of data indicate that there is no relationship between vitamin D and hypertension, but the association of vitamin D with thrombosis is yet to be determined. Vitamin D is a fair predictor of adverse outcomes in coronary artery disease (CAD), which highlights it for future studies.CONCLUSION: According to research, there is a high prevalence of vitamin D deficiency among patients with CV diseases, which needs to be diagnosed and treated.

Intellectual Disability (ID, also known as mental retardation) is a debilitating neurodevelopmental disorder affecting nearly 1% of the general population worldwide. Occurrence of behavioral disorders in individuals with ID is four times higher than that in the general population. An increasing number of studies seek to find a common pathway to elucidate brain structure/function and its contribution to behavior. This article deals with different behavioral disorders reported in individuals with syndromic and non-syndromic ID and possible candidate genes, most of which are involved in synaptic formation and function. Many ID cases with behavior impairments were referred to genetic centers to identify genetic causes; therefore, the authors gathered data from their own studies along with similar published reports, to provide a review on genes involved in brain development and cognition. In this study, we argued how defects in genes with diverse functional role may contribute to behavior impairments and a brain malfunction. Evidences from individual with cognitive impairment as well as murine and drosophila animal models have been used to show behavioral consequences of functional deficits in genes speculated to play a role in cognition and learning.

The scrotal bladder hernia is a rare condition that may present as scrotal swelling and urinary system obstruction or infection symptoms. Diagnosis of this condition before the operation decreases the severe complications like bladder injury during operation.In this article, a 75-year-old man presented to our clinic with right inguinal swelling and lower urinary system infection. Inguinal bladder hernia was diagnosed after performing a computed tomography. The hernia was repaired without any complications.

In brief, we present a case of acute myeloid leukemia (AML) with 5, 17 and 18 monosomies as stemline clonal abnormality in his cytogenetic analysis. To the best of our knowledge, this is the first report of such a chromosomal abnormality as a clonal aberration in AML with M0 French-American-British (FAB) type. It seems that this monosomal karyotype imposed adverse prognosis on this patient and could be related to the rapid and malignant course of the disease as seen.