Archives of Iranian Medicine
Volume:18 Issue: 5, May 2015

It is generally believed that the attributes of shared environment affect health of residents beyond the individual risk factors. This study investigates some individual and neighborhood characteristics that may affect self-rated health (SRH) in Iran. Questions were asked about the social capital, economic status and SRH of 1,982 citizens from 200 randomly selected locations in Tehran. The neighborhood characteristics were assessed by an observational checklist. A multilevel model was designed. SRH was significantly different between neighborhoods (P-Value < 0.001) and between economic groups (P-Value < 0.001). At the individual level, social capital (SC) and being married had a positive association with SRH, while age, being female and bad economic statuses were negatively associated with SRH. At the neighborhood level, neighborhoods with higher average education were positively association with SRH, and living in neighborhoods under construction had a negative association with SRH. These findings highlight the importance of shared social and physical environment, as well as individual characteristics on health, although the mechanisms may still be controversial.

As prevention of osteoporosis becomes more imperative with the global ageing of the population, establishing different measures to fight vitamin D deficiency will also become increasingly important. The aim of this study is to help assess the efficacy of vitamin D–fortified milk on circulating concentrations of 25(OH)D (as the primary outcome), a widely accepted indicator of vitamin D status, in Tehran students. Another objective of the protocol is to help assess the compliance with fortified dairy in students of different socioeconomic classes. The cluster-randomized trial (CITFOMIST) is conducted on 15- to19-year olds guidance and high school students of both genders from different districts of Tehran, in wintertime. The schools enrolled in this study are randomly assigned to receive one of the three groups of milk (whole milk, milk that contained 600 IU Vit D/1000cc, or milk that contained 1000 IU Vit D /1000cc) for a 30-day period. In order to study the effect of vitamin D–fortified milk on the circulating concentrations of 25(OH) D, a serum vitamin D levels are checked in a subgroup before and after the intervention. There are few data on the efficacy of incremental doses of vitamin D from fortified foods among adolescents. This is while developing an optimal model to fight vitamin D deficiency needs further research on bone health outcomes and the safety of vitamin D-fortified products. The modified version of this protocol could be applied in different parts of the country to assess the efficacy of a vitamin-D product.

To evaluate the potential association of anemia with micro- and macrovascular complications in Chinese patient with type 2 diabetes mellitus (T2DM). A total of 1997 patients with T2DM were included in this cross-sectional study. Patients were defined as anemic, if hemoglobin (Hb) levels were < 13 g/dL in males and < 12 g/dL in females. Data on demographics, anthropometric parameters, and co-morbidities were extracted for each patient. Twenty two percent of T2DM patients (439/1997) had anemia, and those patients with higher rates of micro- and macrovascular complications had higher rates of anemia. Univariate logistic regression analysis showed that anemia was a risk factor of microvascular complications (OR = 1.83, 95% CI: 1.45 – 2.31; P < 0.001) and macrovascular complications (OR = 2.10, 95% CI: 1.63 – 2.71; P < 0.001). After adjusting for conventional risk factors, anemia remained positively associated with microvascular complications (OR = 1.52, 95% CI: 1.17 – 1.99), but lost its association with macrovascular complications (OR = 1.01, 95% CI: 0.73 – 1.41). Anemia was also independently associated with diabetic retinopathy, nephropathy, and peripheral neuropathy. These findings suggest that anemia was related to both micro- and macrovascular complications in Chinese patients with T2DM, but was only an independent risk factor of microvascular complications. Assessment of Hb levels in T2DM patients may help to prevent subsequent diabetic micro- and macrovascular complications.

Functional foods are extensively studied for their cancer preventive effects. In the present study, we compared the anti-cancer activity of aqueous extracts of three species of mushrooms including: Pleurotus ostreatus (PAE), Auricularia polytricha (AAE) and Macrolepiota procera (MAE) on COLO-205 cells. Various in vitro approaches were performed to investigate the most potential mushroom variety that possesses maximum cytotoxic, anti-proliferative and apoptosis inducing properties. MTT assay was used to assess cytotoxicity. IC50 values were obtained and further used to perform clonogenic survival, wound scratch and apoptosis assays. Gene expression studies of apoptosis and cell cycle related studies were performed by reverse transcriptase PCR, followed by estimation of DNA content by flow cytometric analysis. Our study showed that PAE acts as the most prominent inducer of cancer cell death as compared to other species. Therefore, we performed expression studies for apoptosis and cell cycle to understand the genes which are responsible for their profound activities. Expression studies illustrated increased levels of caspase-9 (1 to 2.1, P < 0.01), caspase-3 (1 to 1.7, P < 0.01) and Bax (1 to 1.4, P < 0.05) genes followed by decreased levels of Bcl-2 (1 to 0.44, P< 0.05) gene with PAE treatment and this was attributed to the activation of intrinsic pathway. Along with apoptosis, an arrest at Go/G1 phase was observed through flow cytometric analysis followed by increased expression of inhibitors of cyclin dependent kinases (CKIs), p16 (1 to 1.5, P < 0.05) and p21 (1 to 2.4, P < 0.01). This study exemplifies the effectiveness of PAE and may serve as a potential therapeutic agent.

We have investigated the efficacy of QF-PCR for the prenatal recognition of common aneuploidy and compared our findings with cytogenetic results in our laboratories. A total of 4058 prenatal samples (4031 amniotic fluid and 27 chorionic villous samples) were analyzed by QF-PCR using several selected STR markers together with amelogenin. Results were compared to those obtained by conventional cytogenetic analysis. We detected 139 (3.42%) numerical abnormalities in our subjects by QF-PCR. Concordant QF-PCR and karyotype results were obtained in 4001 (98.59%) of the samples. An abnormal karyotype associated with adverse clinical outcome undetected by QF-PCR was found in 16.66% (n = 28) of samples. Using QF-PCR alone, we were able to detect abnormalities in 98.59% of all referred families; however the karyotyping results improved the detection rate to 99.85% of the referred cases. Individuals with neonatal screening result with 1:10 risk ratio showed 11.29% abnormal karyotype while this number was 2.16% in mothers with risk ratio of 1:250 or less. In countries where large scale conventional cytogenetic is hampered by its high cost and lack of technical expertise, QF-PCR may be used as the first line of screening for detection of chromosomal abnormalities. We also recommend QF-PCR for all the families that are seeking prenatal diagnosis of single gene disorders aneuploidies screening to be added to their work up.

The role of different viral proteins in the progression of the disease to cirrhosis is not completely understood. The ARFP/F protein is a newly described protein synthesized from the +1 or -2 reading frames of the core protein gene, which its function remains unknown. The purpose of this study is to detect specific antibodies to HCV-ARF/Core+1 protein in cirrhotic and non-cirrhotic patients with HCV and investigate any possible association. ARF/Core+1 recombinant proteins from HCV genotype 1a were expressed in Escherichia coli, and purified. Using an enzyme-linked immunosorbent assay, we assessed the prevalence of anti-ARF/Core+1 antibodies in 50 cirrhotic and 50 non-cirrhotic hepatitis C patients. All 50 cirrhotic patients were positive for anti-ARF/Core+1 antibody, while only 80% positive samples among non-cirrhotic patients were detected. The titer of anti-ARF/Core+1 antibody was also significantly higher in patients with cirrhosis than in non-cirrhotic patients. Compared to 80% positive samples among non-cirrhotic patients all 50 cirrhotic patients were positive for anti-ARF/Core+1 antibody and titer of anti-ARF/Core+1 antibody was significantly higher in patients with cirrhosis than in non-cirrhotic. These results suggest that ARF/Core+1 protein is associated with cirrhosis. A possible causative association between ARF/Core+1 and cirrhosis as well as the mechanism of this association needs to be further investigated.

Sepsis and septic shock persist as major healthcare challenge, with high morbidity and mortality. Fluid management is a large part of the treatment in patients with these disorders. Fluid therapy has been an important component of the care of patients for the past century. However, recently well-designed studies have been published focusing on the impact of the type and amount of fluids on important clinical outcomes. This review summarizes all the relevant recent studies and attempts to develop a rational approach to the initial fluid management of patients with suspected sepsis.

Oral squamous cell carcinoma (OSCC) represents 95% of all forms of head and neck cancers. The five-year survival rate of OSCC patients has been reported approximately 50%, which is not satisfactory despite new treatment modalities. The aim of the current review is to present factors (histologic, clinical, genetic and molecular biomarkers) correlated with survival rate in OSCC patients.A web-based search for all types of articles published was initiated using MEDLINE/PubMed. The search was restricted to articles focusing on relevant clinical, histologic, genetic and molecular factors of survival rate in OSCC and presenting new concepts in this field.Mode of invasion, presence of lymph node metastasis, extra-capsular spread, surgical margins and invasive tumor front grade are clinical and histologic parameters, which are strongly associated with survival rate. Focusing on selected proteins, wide range of molecular markers and gene alterations involving in cell cycle regulation, apoptosis, cell migration, cell adhesion and tumor microenvironment have been documented. Among well-known molecular markers, cyclin dependent kinase, survivin, CD44, BUBR1, and heat shock proteins (27,70) can be considered as independent prognostic factors of survival rate.The identified prognostic factors imply a relatively comprehensive understanding of factors related to survival rate in OSCC patients, and provide an additional tool for selecting patients who need more aggressive treatment design.

Oncocytoma is a rare benign salivary gland tumor, which mostly occurs in the parotid gland. In this article, we describe an early onset of oncocytoma of minor salivary gland in a 36-year, white male. On clinical examination, we encounter with a painless, granular, sessile mass. After Excisional biopsy, the histopathological features revealed sheets of cells with abundant granular eosinophilic cytoplasm, and large, round nuclei that are known as “Oncocyte”.

Atresia of the colon is a rare anomaly with an incidence of between 1:20,000 and 1:66,000 live births being reported. Hirschsprung''s disease association with Colonic atresia is usually diagnosed after several failures of intestinal anastomoses. We herein report one of the first patients in the literature diagnosed before a therapeutic challenge. A 2-day-old female was admitted with severe abdominal distention, bilious vomiting and failure to pass meconium. A distended abdomen accompanied by hypoactive bowel sounds was also observed. Abdominal X-ray revealed increased intestinal gas, mainly in the colon. Type IIIa atresia of the colon at the level of the splenic flexure was found at laparotomy. A temporary double-barrel colostomy was completed, and she was discharged from hospital on the tenth day after operation without any complications. At the age of 3 months, due to the aspect of the distal colon, a rectal biopsy was performed and aganglionosis was confirmed. The combination of intestinal aganglionosis and colonic atresia is extremely rare. The concomitance of colonic atresia and aganglionosis is calculated to be in 1 in 10 million live births. Wilson, et al. claims that 80 percent of infants with colonic atresia have associated gastrointestinal anomalies. These defects include rotation and fixation anomalies. However, aganglionosis and intestinal neuronal dysplasia should be taken into account as well. When both diseases are combined, the etiology is still uncertain and several etiologies have been suggested. The association should be suspected in all cases of colonic atresia and rectal biopsies are advocated at the primary operation in patients with atresia of the colon.