Iranian Red Crescent Medical Journal
Year:2011 | Volume:13 | Issue:10|Papers Count:12

Background: Due to worldwide spread of influenza A (H1N1) virus, the World Health Organization declared the first pandemic of influenza in four decades. This study aims to report the mortality from pandemic influenza A (H1N1) in Iran population and its epidemiologic and clinical characteristics up to December 21, 2009.Methods: The data were obtained from all provinces and reported to center for disease control of Ministry of Health and Medical Education (MOHME) of Iran through nationwide surveillance system for influenza A (H1N1) was implemented by MOHME since April 2009.Results: Of 3672 confirmed cases of influenza A (H1N1) in Iran between 22 May and 21 December 2009, 140 (3.8%) deaths were reported, mostly in 15-65 year old (yo) age group (67%). The highest admission mortality rate was in>65 yo group (107 deaths/1000 hospitalized cases). Of decedent patients, 54% had no long term condition or risk factor, 34% had one, 11% had two, and 1% had three. Diabetes mellitus, pregnancy, chronic respiratory diseases and hypertension were the most common underlying conditions. The most common clinical pictures of death were acute respiratory distress syndrome and viral pneumonia. Although 66% of decedent patients received oseltamivir, enough information was not available about time of onset of antiviral therapy.Conclusion: As death due to influenza A (H1N1) occurs in all age groups and in those with and without any predisposing factors, we recommend health policy makers to provide influenza vaccination for people with underlying conditions and respiratory hygiene for all people.

Background: Tetralogy of fallot (TOF) is the most common cyanotic congenital heart disease. Anesthesia induction is a challenging issue in these patients due to the risk of worsening hypoxemia following decrease in pulmonary blood flow. We evaluated the effect of three anesthetic induction regimens on the arterial oxygen saturation (SaO2%) in children with TOF.Methods: Seventy six children aged 50 days to 15 years old with TOF, scheduled in Nemazee and Faghihi hospitals to undergo elective cardiac surgery during 1385-1388 were randomly divided into 3 groups to receive three anesthetic induction agents including ketamine (2 mg/kg, IV), ketamine (5 mg/kg, IM) and halothane for gas induction. SaO2% and heart rate were recorded before induction and thereafter every 1 minute during induction of anesthesia till 10 min post-induction.Results: There were not significant differences between three groups regarding pattern of changes in SaO2% during 10 min post-induction. All three groups showed an increase in SaO2% committed over 6th minute but this pattern was not seen after that time. In addition, there were not significant differences among groups according to heart rate in the study period.Conclusion: It seems that anesthesia induction in TOF patients with ketamine IV and IM and halothane did not have significant adverse effects on SaO2%. Indeed, oxygenation during induction may offset other possible adverse effects of induction drugs on SaO2%.

Background: Scientists have shown that consumption of antioxidants can reduce hypercholesterolemia including fruit and vegetables. This study aims to compare the effect of tomato and tomato paste supplementation on the level of serum lipids and lipoproteins in rats fed with high cholesterol diet.Methods: Four groups of rats (10 male rats per group) were enrolled. Control group received basal diet, second group received basal diet and 2% cholesterol (Chol group), third and forth groups received basal diet, 2% cholesterol, tomato and tomato paste respectively (20% of the diet) for a month. Then, serum total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL) and triglyceride (TG) were measured.Results: In Chol group, all lipids except HDL significantly increased compared with the control group. Tomato and tomato paste supplementation decreased TC, LDL and TG levels significantly compared to the Chol group. Tomato paste could decrease lipid levels more in comparison to tomato.Conclusion: Decreases of TC, LDL and TG may be related to tomato antioxidant effects. This finding in human still requires more investigations.

Background: Chronic obstructive pulmonary disease (COPD) is currently the fourth leading cause of death in the United States. As there is systemic as well as local inflammation in COPD patients and evaluating the stage of the disease is not possible by spirometery alone, we evaluated High-Sensitivity C-reactive Protein (HS-CRP) in a group of COPD patients as an available and cost effective auxiliary marker in determining COPD stages.Methods: In a cross-sectional study in 160 COPD patients who were admitted for exacerbations in Razi Hospital in Rasht, Data on patients' demographic characteristics, pulmonary function test (PFT) and laboratory results consist of arterial blood gases and HSCRP levels were analyzed.Results: A significant positive correlation was seen between serum HSCRP level and stages of the disease (as GOLD criteria). There was a significant relationship between HSCRP level and patients' sex, BMI, and smoking history in a way that men and smokers showed higher and patients with normal BMI showed lower HSCRP levels. The patients with higher PCO2 also showed a higher level of serum HSCRP.Conclusions: This survey supports the role of HSCRP as a simple auxiliary marker in staging and determining the prognosis of COPD for early management.

Background: Lysozyme is an antimicrobial protein widely distributed among eukaryotes and prokaryotes and take part in protecting microbial infection. Here, we amplified cDNA of MesoLys-C, a c-type lysozyme from the most common scorpion in Khuzestan Province, Southern Iran.Methods: Scorpions of Mesobuthus eupeus were collected from the Khuzestan Province. Using RNXTM solution, the total RNA was extracted from the twenty separated venom glands. cDNA was synthesized with extracted total RNA as template and modified oligo (dT) as primer. In order to amplify cDNA encoding a lysozyme C, semi-nested RT-PCR was done with the specific primers. Follow amplification, the fragment was sequenced.Results: Sequence determination of amplified fragment revealed that MesoLys-C cDNA had 438 bp, encoding for 144 aa residues peptide with molecular weight of 16.702 kDa and theoretical pI of 7.54. A putative 22-aminoacids signal peptide was identified. MesoLys-C protein was composed of one domain belonged to c-type lysosyme/ alphalactalbumin.Conclusion: Multiple alignment of MesoLys-C protein with the related cDNA sequences from various organisms by ClustalW program revealed that some of the conserved residues of other c-type lysosymes were also seen in MesoLys-C. However, the comparison suggested thatMesobuthus eupeus of Khuzestan and east Mediterranean Mesobuthus eupeusbelonged to different subspecies.

Background: MicroRNAs are endogenous non-coding RNAs with important regulatory and cell fate functions. Many studies have shown that several microRNAs are obviously up-regulated during stem cell differentiation. The question rises here is weather inhibiting differentiation will affect the stemness and self renewal status of stem cells.Methods: miRCURY ™LNA microRNA inhibitor (anti-miR-145 and anti-let7g) are a sequence-specific and chemically modified oligonucleotide that specifically target and knockdown miR-145 and let7g miRNA molecules. Unrestricted somatic stem cells (USSCs) were isolated from umbilical cord blood and treated with LNAs. The effect of anti-miRNA transfection was assessed by quantitative real-time PCR.Results: Real-time PCR showed that LNA was efficiently introduced into the cells and reduced miR145 and Let7g expression levels to 40% and 10% in relation to corresponding scramble control, respectively. Gene expression analysis as to self renewal and expansion showed more than 3.5 fold up regulation in Oct4 in cells treated with mir145 inhibition. Similarly a significant up to 2.5 fold up-regulation in Oct4 and cMyc expression was observed in samples treated with anti-let7g.Conclusion: Suppression in differentiation inducing microRNAs (miR-145 and let7g) can enhance the self renewal and stemness status of USSCs at transcriptional level.

Background: Pre-hospital emergency medical services, a subsystem of Emergency Medical Services (EMS), provides early care to critically ill and injured patients in the field. Time is an important factor in pre-hospital care and the length of time it takes to reach care, has a significant impact on patient outcome. This study aims to calculate the response time in EMS stations of Yazd, Iran.Methods: During 2008-2009, 11961 run report forms from all 7 EMS stations in Yazd that had been submitted to central station were surveyed. By using Excell statistical software and descriptive statistics (percent, cumulative distribution and standard deviation), we calculated fractile response times for Yazd EMS.Results: 81.15 percent of response times were within 8 minutes as a referenced standard for EMS.Conclusion: The majority of call services in Yazd EMS have been responded in a suitable time interval comparing with reference standards and country's approved EMS response time goal, but there are still rooms for improvement.

Background: Burn injury is a major cause of death and disability worldwide. A domestic medication in wound healing, preventing infection and reduction of scar tissue as well as availability is still an important challenge. This study aims to evaluate the efficacy of yolk egg oil in treatment of burn wounds in rats.Methods: A standard 3rd degree burn wound was produced and the animals were divided into three groups according to topical treatment including yolk oil, 1% silver sulfadiazine (SSD) and control. In days 7, 14 and 30, animal’s weight, wound size, as well as histopathological findings of skin were evaluated in different groups.Results: Average size of wound after 7 days was 3.4, 5.3, and 6.7 cm in yolk oil, SSD and control groups. There were significant differences between yolk oil and the other groups in this aspect. The wound size of yolk egg group was also significantly smaller than other groups in 14th and 30th days. Results of the histological studies indicated significant differences between yolk oil, SSD and control groups on day 30, with mean score of 3.75, 3.5 and 2.8 respectively. The difference between yolk oil and the other groups was significant.Conclusion: Yolk oil-treated burned animals showed abundant re-epithelialization without tissue scar in comparison with SSD group. Although the egg yolk has many vital nutrients, but its exact mechanism in healing process is unknown. Therefore, further studies evaluating the influence of individual components on burn-healing process is advised.

Dear Editor: Renal transplantation is the treatment of choice for vast majority of patients with end-stage renal disease. Marked improvements in early graft survival and graft function have resulted in kidney transplantation being a cost-effective alternative to dialysis. Among the most age groups and etiologies of end-stage renal disease, renal transplantation prolongs patient lifespan. Accordingly in this study, short and long-term follow ups of patients undergoing kidney transplant were evaluated in a thirteen-year cohort study.

Dear Editor: Fasting during Ramadan month is an Islamic obligation which may have side effects on vision of fasting Muslims. Previous studies showed that there was no relationship between Islamic fasting and myopia and changes in intraocular pressure due to fasting in healthy person were not considerable.

Dear Editor: Rheumatoid arthritis (RA) is a chronic systemic inflammatory disorder affecting about 1% of the world population. In recent years, biologic agents were introduced for many aspects of medicine including RA, but their cost and potential side effects prohibited its widespread use.

Dear Editor: The frequency of diabetes mellitus is increasing and it is expected that this disorder will affect 300 million people in 2025. It has been suggested that diabetes is an immune dependent disease in which the pattern of cytokine expression is changed. As an example, in type 2 diabetes, the monocytes of peripheral blood produce more inflammatory cytokines than those from normal patients.