Iranian Red Crescent Medical Journal
Year:2014 | Volume:16 | Issue:1|Papers Count:20

Background: Liver injury or dysfunction is considered as a serious health problem. The available synthetic drugs to treat liver disorders are expensive and cause further damage. Hence, hepatoprotective effects of some herbal drugs have been investigated, and one of the methods to choose herbs in order to study their biological effects is to search in ancient medical texts. Avicenna who is known as the prince of physicians had collected and classified Greek, Persian and Islamic medicine in the best possible way in the book of Canon in Arabic.Objectives: Avicenna’s book of The Canon of Medicine was reviewed to find the hepatoprotective herbs.Patients and Methods: Three different versions of the Canon were prepared and utilized. To find scientific names of plants we took advantage of three botany references. All of the herbs were investigated on the basis of scientific data from hepatoprotective effects point of view. The searched term was "hepatoprotective" without narrowing and limiting. The searched databases included Cochrane library, Web of science, SID, Irandoc and Iran Medex.Results: 18 plants were found.85% of the presented species, genus or families of plants were reported to have hepatoprotective properties and in the remaining 15% there were no reports of hepatoprotective effect. Flowers and fruits were the most used part of the plants. Most of the plants had simultaneous protective effects on multiple organs but the protective effect on the liver was mostly accompanied by protective effect on the stomach (83%). The average temperament of these herbs is "hot" in the 2nd phase of the 2nd grade, and "dry" in the 3rd phase of the 2nd grade. Hepatoprotective herbs mostly prescribed as a part of hepatoprotective compound drugs formula or other formula for liver diseases are Crocus sativus, Pistacia lentiscus, and Cinnamomum spp.Conclusions: Maybe there is common mechanism for protecting both liver and stomach. Aquilaria agallocha, Aquilaria malaccensis, and Ruscus aculeatus whose hepatoprotective effects have not yet been reported are considered as good candidates for future investigations. Given that Crocus sativus, and Cinnamomum spp are used as flavors in most countries, they will be introduced for more investigation in order to produce hepatoprotective drugs.

Background: University of Pennsylvania Smell Identification Test (UPSIT) is one of the most common smell identification tests to assess olfactory function.Objectives: The study was conducted to assess the accuracy of University of Pennsylvania Smell Identification Test (UPSIT) in Iranian population.Materials and Methods: University of Pennsylvania Smell Identification Test was performed on 30 (50%) female and 30 (50%) male, who were healthy adult volunteers. The total mean score as well as mean scores according to the gender were assessed and compared to the UPSIT classification. Odors considered valid and accurate if its correct identification ability rate was more than 70% among study population.Results: The test score was 25.04±4.92 in female and 23.29±4.23 in male volunteers that all were considered as microsmia according to UPSIT. Sixteen odorants were correctly identified by about 70% of the volunteers and the remains 24 odorants were identified by less than 70%, 7, 5 and 12 odors was identified by60%-70%, 50%-60% and less than 50% of the volunteers, respectively.Conclusions: According to the results of the study, documented that even less than half of the odors (16 out of 40) were identified correctly by the volunteers, which indicating that the UPSIT is not a suitable test to evaluate olfactory function in Iranian population due to the high amount of unfamiliar smells that should be replaced with more familiar ones.

Background: Patient participation means involvement of the patient in decision making or expressing opinions about different treatment methods, which includes sharing information, feelings and signs and accepting health team instructions.Objectives: Given the importance of patient participation in healthcare decision making which empowers patients and improves services and health outcomes, this study was performed to review previous studies on patient participation in healthcare decision making.Materials and Methods: To prepare this narrative review article, researchers used general and specific search engines, as well as textbooks addressing this subject for an in-depth study of patient involvement in healthcare decision-making. As a result, 35 (out of 100 relevant) articles and also two books were selected for writing this review article.Results: Based on the review of articles and books, topics were divided into six general categories: definition of participation, importance of patient participation, factors influencing participation of patients in healthcare decisions, method of patient participation, tools for evaluating participation, and benefits and consequences of patient participation in health care decision-making.Conclusions: In most studies, factors influencing patient participation consisted of: factors associated with health care professionals such as doctor-patient relationship, recognition of patient's knowledge, allocation of sufficient time for participation, and also factors related to patients such as having knowledge, physical and cognitive ability, and emotional connections, beliefs, values and their experiences in relation to health services.

Background: Although vitamin D deficiency has been linked to potential complications in reproductive women, the recommended intake dosage of this vitamin in populations with high incidence of deficiency in preconception period has not been defined.Objectives: The study investigated the effect of consuming a dosage of 2000 IU/day oral vitamin D for 105 days, on serum levels of this vitamin in reproductive women.Materials and Methods: 229 women with 18-35 years old, who were confirmed to be vitamin D deficient (vitamin D<75 nmol/L), were randomized into the intervention and control groups and after 15 weeks consumption of the supplement and placebo, their serum samples were obtained.Results: At baseline the mean serum levels of vitamin D in the control group was 23.34±15.87 nmol/L and in intervention group was 25.13±18.46 nmol/L, that these values didn’t have any significant difference (P=0.43), while after intervention, significant differences between the two groups was noticed (P<0.001). The affecting factors to achieve normal range of vitamin D in the intervention group included basal amounts of vitamin D and two underlying factors based on questionnaire data: use of oral supplements (except vitamin D and calcium) in daily life and perfect sun exposure.Conclusion: This study showed positive effect of the 2000 IU/day oral vitamin D on the serum level elevation of this vitamin in reproductive women.

Background: Non-alcoholic fatty liver disease (NAFLD) is a common liver disease in the western population and expanding disease in the world. Pathological changes in fatty liver are like alcohol liver damage, which can lead to end-stage liver disease. The prevalence of NAFLD in obese or overweight people is higher than general population, and it seems that people with high Body Mass Index (BMI) or abnormality in some laboratory tests are more susceptible for severe fatty liver and high grade of NAFLD in ultrasonography (U.S).Objectives: This study aimed to evaluate the correlation of BMI and laboratory tests with NAFLD in ultrasonography.Materials and Methods: During a multi-step process, we selected two-hundred and thirteen cases from four hundred and eighteen patients with NAFLD. Laboratory tests performed included: ALT, AST, FBS, Triglyceride and cholesterol levels, hepatitis B surface antigen, hepatitis C antibody, ceruloplasmin, serum iron, TIBC, transferrin saturation, ferritin, AMA, ANA, ANTI LKM1, serum protein electrophoresis, TSH, anti TTG (IgA). BMI and ultrasonography for 213 patients were performed, and then data was analyzed. These parameters and grades of ultrasonography were compared with the values obtained using one way ANOVA. An ordinal logistic regression model was used to estimate the probability of ultrasonography grade. The Statistical Package for the Social Science program (SPSS, version 16.0) was used for data analysis.Results: Two-hundred and thirteen cases including 140 male and 73 female, were studied. In general, 72.3% of patients were overweight and obese. Post-hoc tests showed that only BMI (P<0.001) and TG (P<0.011) among variables had statistically significant associations with ultrasonography grade (USG), and ordinal logistic regression model showed that BMI and AST were the best predictors.Discussion: Our results suggest that in patients with NAFLD, BMI and TG are most effective factors in severity of fatty liver disease and ultrasonography grade (USG). On the other hand, BMI as a predictor can be helpful. But, AST has not been a reliable finding, because it changes in many conditions.

Background: Severe birth asphyxia (apgar<7 at the 5th minute of birth) is recognized as a hearing loss risk factor by the joint committee on infant hearing (JCIH). About half of the newborns with hearing loss do not indicate any sign and risk factor at birth. Accordingly, the joint committee recommended performance of hearing screening test in 2000, especially for babies born with risk factors.Objectives: The aim of this study was to evaluate hearing loss in asphyxiated neonates. Early diagnosis would result in early treatment of these newborns.Patients and Methods: We assessed the relationship between asphyxia and hearing impairment in newborns admitted to a referral hospital, Tehran, Iran within 3 years (2003-2006). Hearing problems were diagnosed and followed by otoacoustic emission (OAE) in the third and fifth days of birth. Asphyxiated neonates with abnormal OAE were referred to an ENT specialist, second OAE and tympanometry were carried out after 2 weeks. Based on the results, newborns underwent treatment or were discharged.Results: Of 149 asphyxiated neonates, 80 had mean first minute apgar score of 4.01, and mean 5th minute score was 7.24. Two percent (3.149) of asphyxiated neonates had abnormal OAEs. No statistical correlation was found between the 5th minute apgar score and abnormal OAE (P value=0.391). However, a significant relationship between the mean birth weight and abnormal OAE (P value=0.0406) was found.Conclusions: It seems that birth asphyxia is not correlated with hearing loss.

Background: Dysmenorrhea is one of the most common types of cyclic pain that affects 50% of women and girls in their menstrual ages. Because of the side-effects and contraindications of chemical medicines, using herbs has been investigated in treating dysmenorrhea.Objectives: The aim of this study was to determine the effect of Rosa damascena extract on primary dysmenorrhea among the students of Kowsar dormitory in Tabriz University of Medical Sciences.Materials and Methods: This study was performed in Iran on 92 single 18-24 year old students with BMI: 19-25 and obtaining pain intensity score of 5-8 in Visual Analogue Scale that were randomly classified and included in two groups of 46 persons. The participants received two capsules of Mefenamic Acid and Rosa damascena with the similar physical properties in two consecutive cycles per 6 hours for 3 days in a cross-over form. The data were collected through the questionnaire of demographic characteristics and check-list of visual analogue scale. Descriptive statistics and repeated measurement test and independent samples t test by using SPSS (13/win) were used in order to determine and compare the effects of two drugs on dysmenorrheal pain intensity of the groups.Results: There was a significant difference between the average of pain intensity at different hours of measurement in each group after the end of first cycle and second cycle (P<0.001). There was no significant difference between the average of pain intensity in two groups in the first cycle (P=0.35) and second cycle (P=0.22).Conclusions: In this study, Rosa damascena and Mefenamic acid had similar effects on pain intensity of primary dysmenorrhea. With further studies, Rosa damascena which has no chemical side effects, can be suggested for treating primary dysmenorrhea.

Background: Dietary habits are established in childhood and will persist until adulthood, being one of the human health pillars. Many diseases of humans have roots in the individuals’ diet, of which dental caries are one of the common infectious diseases. Diabetes Mellitus is also considered as the most common metabolic disorder in children.Objectives: The purpose of this study was to compare the dietary patterns of children with type I Diabetes Mellitus with that of non-diabetic children, in relation to dental caries.Materials/Patients and Methods: In this study, 31 patients (13 boys and 18 girls, mean age of 11±5.4 years) with type I Diabetes Mellitus referred to the Diabetes Mellitus Center and university hospitals were selected. Controls were 31 healthy students matched for age and sex. The study was based on the data obtained from the questionnaire containing information about dietary patterns and oral hygiene habits, social class and decayed/missing/filled teeth (DMFT) index. Dietary patterns were assessed using a food frequency questionnaire developed on the basis of caries preventing or inducing foods and then scored. Data were analyzed by using the t-test and McNamara's test.Results: Diabetic children had less frequent cariogenic snacks than their controls. The mean diet scores for diabetic and healthy subjects were 7.65±3.27 and 11.9±2.03 (P<0.05), respectively. There was no significant difference in DMFT between the diabetics and controls (3.71±2.48 vs.4.35±2.74, respectively). There were also no differences in frequency of tooth brushing and use of mouth washes. However, more diabetics reported that they have never used dental floss compared to controls (42.2% vs.71%, P<0.05). Having cheese with bread as snack was more prevalent in diabetics (P<0.05).There was a positive correlation between DMFT and dietary scores (r=0.3, P<0.05).Conclusions: Controls scored higher in their dietary habits and dental flossing but lower in tooth brushing and mouth washing. More diabetics tend to have snacks like cheese and bread, which is a caries-preventing habit.

Background: Domestic violence appears to be a major social problem. Researches in the last 10 years have uncovered multiple effects of witnessing domestic violence on children, ranging in severity from little or no effect to sever psychological harm.Objectives: This study aimed to measure the prevalence of exposure to domestic violence among high school students in Tehran.Materials and Methods: A cross-sectional survey was conducted on high school students of Tehran in the school year 2011–2012. The "Childrens Exposure to Domestic Violence Scale" was administered to a total cohort of 1, 212 students (615 males and 597 females) selected by the stratified sampling method.Results: Approximately one-half of the participants (44.3%) had been exposed to their fathers's violence against their mothers at least sometimes in their lives, the most common form of which was preventing the mother from doing something (28.5%) and the least common, hurting the mother with sharp or deadly tools (9.6%). A substantial proportion of the students (90.6%) had been exposed to violence in the community or at school, the most common kind would be being heard from someone calling another person names or making fun of them (81.7%) and the least common, being injured a child in the community or at school (31.8%).Conclusions: Exposure to violence is a widespread problem among children in Tehran. It encompasses a wide range and children were exposed to violence in different ways and forms.

Background: The increase in high-risk injections and unsafe sexual behaviors has led to increased HIV infection prevalence among Intravenous Drug Users (IDUs). The high costs of HIV/AIDS care and low financial resources necessitate an economic evaluation to make the best decision for the control of HIV/AIDS.Objectives: This study was conducted to determine the cost-effectiveness of Methadone Maintenance Treatment (MMT) centers in HIV infection prevention among drug users.Materials and Methods: In this interventional study, we included all the seven MMT centers and the drug users registered there (n=694). We calculated all the costs imposed on the government, i.e. Provider of case. Mathematical models were used to estimate the number of HIV cases averted from high-risk behaviors. Sensitivity analyses were performed to show the effects of uncertainty in parameters on the number of HIV cases averted and also Incremental Cost-Effectiveness Ratio (ICER).Results: Based on the averted models, the selected MMT centers could prevent 128 HIV cases during 1 year. The total cost was $ 547423 and that of HIV/AIDS care in the no intervention scenario was estimated $ 14171816. ICER was $ 106382 per HIV case averted. The results of the sensitivity analysis indicated that MMT intervention was cost-effective even in the worst scenario and ICER varied from $ 39149 to $ 290004 per HIV case averted.Conclusions: With regard to the high prevalence of drug injection among drug users and considering the high effectiveness and cost-effectiveness of MMT centers in preventing HIV infection, establishment of MMT centers in regional and national levels seems reasonable.

Background: Noise most frequently affects hearing system, as it may typically cause a bilateral, progressive sensorineural hearing loss at high frequencies.Objectives: This study was designed to compare three different methods to evaluate noise-induced hearing loss (conventional audiometry, high-frequency audiometry, and distortion product otoacoustic emission).Material and Methods: This was a cross-sectional study. Data was analyzed by SPSS (ver.19) using chi square, T test and repeated measures analysis. Study samples were workers from tile and ceramic industry.Results: We found that conventional audiometry, extended high-frequency audiometry, low-tone distortion product otoacoustic emission and high-tone distortion product otoacoustic emission had abnormal findings in 29%, 69%, 22%, and 52% of participants. Most frequently affected frequencies were 4000 and 6000Hz in conventional audiometry, and 14000 and 16000 in extended high-frequency audiometry.Conclusions: Extended high-frequency audiometry was the most sensitive test for detection of hearing loss in workers exposed to hazardous noise compared with conventional audiometry and distortion product otoacoustic.

Background: Scorpion venom is important and rich source of peptides, most of which have been widely used as pharmacological tools for unraveling structure-function relationship of various ion channels. Naturally occurring toxins can be also considered as lead compounds in the development of novel drugs.Objectives: In this context, the scorpion-derived peptide neurotoxins specific to sodium channels have shown promise as potential therapeutic targets for the treatment of various human diseases.Materials and Methods: A cDNA library from the extracted RNA was constructed using RT-PCR and semi-nested RT-PCR. DNA sequencing followed by phylogenetic analysis was applied to screen the cDNA library clones. For molecular characterization of the BMK gene we used cloning and recombinant protein expression techniques based on E.coli systems. Then we performed mice immunization and Western blot and Immunodot analyses.Results: A novel BMK neurotoxin has been cloned, expressed and characterized from the Iranian scorpion M. eupeus venom. We analyzed the recombinant BMK by immunoblotting with treated antiserum. The result showed that mice antiserum can react also with scorpion crude venom, so is able to recognize native BMK toxin.Conclusion: The newly produced recombinant protein BMK revealed to be immunogenic. Moreover, anti-BMK antibodies produced in mice were able to recognize both the recombinant BMK neurotoxin and the one in M. eupeus crude venome. Taken together, the molecular characterization and recombinant production of the Iranian scorpion M. eupeus venom component can serve as a new probe for further studies of sodium channels function and physiology. This provides a promising perspective for the future design of selective drugs, as well as for research of antivenom production.

Background: Adiponectin, an adipocyte-derived hormone, is implicated in diabetes mellitus type 2 and atherosclerosis. The study was designed to investigate whether serum adiponectin levels in patients with both coronary artery disease (CAD) and diabetes mellitus type 2 (T2DM) are lower than in patients with CAD alone and control subjects.Objectives: In this present study, we measured serum adiponectin levels in consecutive CAD patients with and without T2DM and investigated whether decreased adiponectin is associated with risk factors of CAD.Materials and Methods: The study included 198 subjects, 138 patients with CAD (72 of whom had both CAD and T2DM), and 60 control subjects. We measured serum adiponectin, interleukin-6 (IL-6) and insulin by ELISA. In addition, Lipid profile, glucose and anthropometrical measurements were performed in all subjects.Results: The results revealed significant difference in serum adiponectin levels between patients with CAD+T2DM and patients with CAD alone (3.80±1.52 vs.5.25±2.35, P=0.007), between patients with CAD and control (5.25±2.35 vs.7.04±3.32, P=0.001), and between patients with CAD+T2DM and control (3.80±1.52 vs.7.04±3.32, P<0.001). Serum adiponectin level was significantly higher in women in contrast to men (5.97 ± 3.15 vs.4.62±2.81 mg/ml, P=0.002). Serum adiponectin levels were correlated significantly with insulin (r=-0.178, P=0.013), total cholesterol (r=-0.313, P<0.001), low density lipoprotein (r=-0.154, P=0.016), body mass index (r=-0.171, P=0.016), glucose (r=-0.202, P=0.006), HOMA-IR (r=-0.251, P=0.001), and IL-6 levels (r=-0.321, P=0.001). Adiponectin was correlated positively only with high density lipoprotein (r=0.389, P<0.001).Conclusions: It is speculated that increased insulin resistance and increase in other adipokines such as IL-6 may contribute to the decreased serum levels of adiponectin in patients with both CAD and T2DM.

Esophageal melanocytosis is a rare and benign condition, characterized by melanocytic proliferation of the esophageal squamous epithelium with heavy melanin deposition. The etiology and pathogenesis has not been exactly known but it seems to be a chronic stimulus such as gastroesophageal reflux. This condition is very rare and about 35 cases have been reported so far, most of which have been from India and Japan. Herein, we present a case of esophageal melanocytosis in a patient with long history of oral opium consumption. To the best of our knowledge, such a history has not been reported.

Background: Recent studies show that the prevalence of tobacco use among teens and students is increasing, and the initiation age of tobacco use has decreased.Objectives: The current research aimed to signify the role of schools in the process in which student teenage boys became smokers in 2012 in Mashhad.Materials and Methods: The current study was part of a qualitative research conducted by content analysis method and purposive sampling, performing 35 in-depth interviews, and 2 focused group discussions. The participants in this research included teenagers, teachers, students` parents, psychologists, and experts in the field of fighting against tobacco use, those who either had the experience of exposure to cigarettes at school, or were well-informed persons about tobacco use.After performing each interview, the interview was transcribed, and analyzed before the next interview. The data were under continuous consideration and comparative analysis in order to achieve data saturation.Results: After analysis and codification of data, four concept categories were achieved to clarify the role of schools in student smoking: 1) School purity or impurity to high-risk behaviors, 2) Directive or nondirective schools for controlling tobacco, 3) Preventive or predisposing schools for smoking behavior, and 4) Perceived positive outcomes from smoking at school. Each main category was divided into three subordinate themes.Conclusions: With regard to decrease of cigarette use initiation age and the great influence of schools on teenagers’ behavior, it is recommended to perform special screening programs based on the achieved themes in this research to reduce tobacco use. It is also suggested that school staff pay more attention to students’ communication networks and pressures that are imposed on a student for smoking cigarettes during the school time.

Background: Pain is one of the major concerns of patients underwent Total Knee Arthroplasty (TKA), appropriate pain management is a key factor in patient's early physical fitness to move, physiotherapy, and most importantly, patient satisfaction.Objectives: In this study the analgesic effect of single injection femoral nerve block (SFNB) was compared with local infiltration analgesia (LIA).Patients and Methods: Forty patients who underwent TKA under spinal anesthesia were randomized to receive single femoral nerve block (group F) or intra-periarticular infiltration (group I). Group F received single injection 20cc ropivacaine (10mg/cc) and in group I, a combination of 300mg ropivacaine, 30mg ketorolac and 0.5mg epinephrine diluted to a volume of 150cc and locally injected in and around the knee joint in 3 stages. Postoperative pain intensity measured by Visual Analog Scale (VAS). Morphine consumption, mobilization time and patients’ satisfaction evaluated as well.Results: Group I had significantly lower morphine consumption in the first postoperative day (10 vs.12.5mg, P-value<0.05). Within 6 hours postoperatively, VAS score was statistically lower in group I compared to group F (3 vs.4, P-value<0.05). However, within 12 hours it was statistically higher in group I than group F (6 vs.5, P-value<0.05). Other parameters were not statistically different in two groups.Conclusions: Both methods LIA and SFNB provided excellent pain relief and lower morphine consumption following TKA. LIA is a surgeon-controlled analgesic technique, which can be used to enhance patients’ satisfaction and reduce the pain in the very early postoperative period by surgeon independently.

Background: Patients with breast cancer are predisposed to some psychiatric symptoms and mental disorders due to their life styles or disease conditions. These problems cause patients to deal with daily stress, feeling guilty, anxiety, dysphoric mood, and impaired social relations. Such problems would lead to serious mental disorders.Objectives: Therefore, life skills training may help patients to cope better with their condition, and improve their mental health.Materials and Method: In an experimental study, 50 patients with breast cancer were selected randomly and assigned to 2 experimental and control groups. The experimental group attended life skills training classes for 10 weeks continuously (each class lasting 2 hours). Participants in both the experimental and control groups completed a GHQ-28 questionnaire form before the commencement of classes, and again after 2 weeks to 2 months of the course completion. T-test was used as the statistical method.Results: In life skills training group, depressive and anxiety symptoms, somatization disorders, sleep disorders and disorders of social functioning were significantly decreased (p<0.0001). These changes were not observed in the control group.Conclusions: The results showed that life skills training is an effective method in reducing symptoms of depression, anxiety, sleep and somatic disorders. Also, it would be useful in reducing problems of social dysfunction.

Background: Before primary percutaneous coronary intervention (PCI) in patients with ST elevation myocardial infarction (STEMI), it is not clear whether a routine early administration of glycoprotein IIb/IIIa inhibitors in the emergency ward is beneficial or their administration in selected cases in the catheterization laboratory.Objectives: The present randomized clinical trial sought to investigate whether an earlier administration of Tirofiban could exert any impact on TIMI grade 3 flows and ST resolution in the electrocardiography of patients with STEMI before primary PCI.Materials and Methods: Patients with STEMI within twelve hours of symptom commencement were included if primary PCI was planned to be performed within ninety minutes of admission and excluded if they had contraindications for Tirofiban. Seventy patients were randomized to receive 25 mg/kg of bolus Tirofiban early in the emergency ward (the early Tirofiban group) in three minutes and 70 did not receive Tirofiban (the control group). The primary endpoint of the study was a Thrombolysis in Myocardial Infarction (TIMI) grade 3 flows on the initial angiogram. The study is registered as IRCT201105126463N1 in: www.irct.ir.Results: The study population had a mean age of 57.17±10.09 years and included 79.3% males. TIMI grade 3 flow was seen in 15 (21.4%) patients of the Tirofiban group and 7 (10%) of the control group (P=0.06, odds ratio=0.407, and 95 % confidence interval=0.155-1.072). Complete ST resolution was seen in 30 (42.9%) patients of the Tirofiban group and 34 (48.6%) of the control group (P=0.5).Conclusion: Although TIMI grade 3 flows trended to be higher in the patients who received early Tirofiban in the emergency ward, the difference did not constitute statistical significance and possible benefits, therefore, require further clarification.

Background: Preeclampsia is the most common serious disorder during pregnancy and studies show several immune-related processes in its pathophysiology. The role of cytokines and their expression remains controversial in this field. One of the cytokines of interest in recent studies has been TNF-a, which has been shown to have a higher level in maternal plasma of preeclamptic women.Objectives: This study was designed to evaluate the role of TNF-a polymorphism at position -238 in the risk of developing preeclampsia during pregnancy.Patients and Methods: One hundred fifty three preeclamptic cases and 140 healthy pregnant women were retrieved from two major hospitals of Mashhad, Iran. Methods a case-control study were designed. Anyone with a history of inflammatory disease, hypertension, or chronic kidney disease was excluded. DNA was extracted from peripheral blood leukocytes. Both groups were genotyped for the polymorphism of the TNF-a gene at position -238 by the RFLP method with Ava II enzyme. Allele and genotype frequencies were compared using one-way ANOVA and the Fisher's exact test.Results: There were significant differences between the two groups in TNF-a genotype at position -238 (P<0.001). In the preeclamptic group, the frequency of the AA genotype was higher (P<0.001) and the frequency of the GG genotype was lower (P<0.001). The overall prevalence of the A allele at position -238 was higher in preeclamptic cases (P<0.001).Conclusion: In this study group, TNF-a -238 polymorphism was shown to be different in preeclamptic and non-preeclamptic pregnant women. The AA genotype and the A allele may carry an increased risk for developing of preeclampsia.

Background: Background: Today, occupational accidents are one of the most important problems in industrial world. Due to lack of appropriate system for registration and reporting, there is no accurate statistics of occupational accidents all over the world especially in developing countries.Objectives: The aim of this study is epidemiological assessment of occupational accidents in Iran.Materials and Methods: Information of available occupational accidents in Social Security Organization was extracted from accident reporting and registration forms. In this cross-sectional study, gender, age, economic activity, type of accident and injured body part in 22158 registered accidents during 2008 were described.Results: The occupational accidents rate was 253 in 100, 000 workers in 2008.98.2% of injured workers were men. The mean age of injured workers was 32.07±9.12 years. The highest percentage belonged to age group of 25-34 years old. In our study, most of the accidents occurred in basic metals industry, electrical and non-electrical machines and construction industry. Falling down from height and crush injury were the most prevalent accidents. Upper and lower extremities were the most common injured body parts.Conclusion: Due to the high rate of accidents in metal and construction industries, engineering controls, the use of appropriate protective equipment and safety worker training seems necessary.