abdorrasoul malekpour

Considering the legalization of marijuana use in some countries and regions, its health effects and side effects have been investigated in scientific studies. In this review study, the health benefits and possible side effects of marijuana were investigated.

In a systematic review, all valid studies that investigated the side effects and therapeutic benefits of marijuana were analyzed. The search for articles and theses in Iranian sources was conducted in Medline, PubMed, Web of Science and Embase, Scopus, and Google Scholar by searching for keywords Marijuana, Therapy, Treatment, Therapeutics and side effects from 2010 to 2022. Also, the reference list of all the articles that were identified in the first steps was reviewed in order to obtain the cited articles that were not found by the electronic searches.

The findings of this study showed that marijuana increases energy and improves the quality of sleep, improves mood, improves appetite, calorie intake, sense of taste and perception of taste in cancer patients, increases the quality of sleep and relaxes the quality of life, improves pain control in It is effective for patients with chronic pain, relieving muscle spasm, treating chronic and neuropathic pain, treating symptoms in MS, and improving symptoms of inflammatory bowel disease (IBD). Also, anti-vomiting effects and improvement of quality in cancer patients, anti-cancer activity, treatment of anxiety and insomnia caused by PTSD in children, increase in general quality of life, mobility and mood, by reducing inflammation, intraocular pressure, spasm, convulsions, Treatment of pain, headache and migraine and in patients with MS plays a role in reducing the severity of the disease, stiffness of the hind limbs, motor function, neuroinflammation and demyelination. However, this substance may have side effects such as cognitive impairment, drowsiness, dizziness, dependence and addiction, as well as the possibility of fungal infection in patients with immune suppression.

Although marijuana has some known therapeutic contraindications and side effects, to ensure the therapeutic uses of marijuana, double-blind clinical tests are recommended in specific treatment target groups.

The 2019 novel coronavirus (2019-nCoV/SARS-CoV-2) initially appeared as part of an important prevalence of respiratory disease centered in Hubei province, China. Now, it is a pandemic globally and is a significant public health concern. Taxonomically, SARS-CoV-2 was revealed to be a Beta coronavirus (lineage B) related to SARS-CoV and SARS-related bat coronaviruses closely, and it has been stated to have a similar receptor with SARS-CoV (ACE-2). Here, we carried out the codon usage bias (CUB) by analyzing the codon bias index (CBI), codon adaptation index (CAI), and an effective number of codons (ENC) besides phylogenetic analysis of Coronaviridae and also structural modeling of the SARS-CoV-2 spike glycoprotein. We observed that 2019-nCoV has a rich composition of AT nucleotides that strongly affects its codon usage, which seems to be not optimized for the human hosts. Moreover, a close evolutionary phylogenetic relationship was detected between SARS-CoV-2/human/IRIN/ and SARS-CoV-2/human/CHN/WH-09/2020. By in silico modeling of spike glycoprotein, an I-TASSER server, the 3Dstructure of it was also evaluated. This type of analysis would be beneficial for exploring a virus adaptation to host, and evolution and is therefore of value to developing vaccine design and pharmaceutical agents.

The 2019 novel coronavirus (2019-nCoV/SARS-CoV-2) initially appeared as part of an important prevalence of respiratory disease centered in Hubei province, China. Now, it is a pandemic globally and is a significant public health concern. Taxonomically, SARS-CoV-2 was revealed to be a Beta coronavirus (lineage B) related to SARS-CoV and SARS-related bat coronaviruses closely, and it has been stated to have a similar receptor with SARS-CoV (ACE-2). Here, we carried out the codon usage bias (CUB) by analyzing the codon bias index (CBI), codon adaptation index (CAI), and an effective number of codons (ENC) besides phylogenetic analysis of Coronaviridae and also structural modeling of the SARS-CoV-2 spike glycoprotein. We observed that 2019-nCoV has a rich composition of AT nucleotides that strongly affects its codon usage, which seems to be not optimized for the human hosts. Moreover, a close evolutionary phylogenetic relationship was detected between SARS-CoV-2/human/IRIN/ and SARS-CoV-2/human/CHN/WH-09/2020. By in silico modeling of spike glycoprotein, an I-TASSER server, the 3Dstructure of it was also evaluated. This type of analysis would be beneficial for exploring a virus adaptation to host, and evolution and is therefore of value to developing vaccine design and pharmaceutical agents.

Protein is a major component of all biological evidence, often a matrix containing other biomolecules such as polynucleotides, lipids, carbohydrates, and small molecules. The proteins present in a sample reflect the transcriptional and translational program of the cell types of origin. For this reason, proteins can be used to identify body fluids and tissues, as well as to transmit genetic information in the form of single amino acid polymorphisms and the result of non-synonymous SNPs. This study examines the application and potential of proteomics in forensic medicine and examines the historical role that protein analysis has played in the development of forensic science. This review highlights how innovations in proteomic mass spectrometry have overcome many of the historical limitations of forensic protein science and how the application of forensic proteomics differs from proteomics in the life sciences. Two developing applications of forensic proteomics are reviewed in detail: body fluid and tissue identification and proteomics genotyping. This review then highlights emerging areas of proteomics that have the potential to impact forensic medicine in the near future, including fingerprint analysis, species identification, peptide toxicology, proteomic species estimation, and postmortem interval estimation. Finally, this review highlights some of the more recent innovations in proteomics that may guide further development of the field.

An autopsy is a post-mortem medical procedure performed on a deceased person with the primary purpose of collecting tissue to support basic research and knowledge translation. This method is increasingly used to investigate the pathophysiological mechanisms of cancer development, metastasis, and treatment resistance. In this review article, we discuss the reason for using research autopsy in cancer research and provide evidence-based discussion of the quality of postmortem tissues compared to other types of biological samples. It also discusses the advantages of using postmortem tissues over other types of biological samples, including the large amount of tissue available and the multi-area sampling that is available, which is not possible in living patients. An autopsy helps identify the clonal origin and ways in which metastases spread. Also, the study of the effect of treatments on the tumor and the creation of rare and tumor-derived tissue banks in the patient is an integral part of forensic strategies and research autopsy.

Small supernumerary marker chromosomes (sSMCs) are chromosomal fragments with abnormal structures found in patients with fertility problems and developmental delay. They may be detected in amniotic cell karyotypes. sSMCs are categorized as hereditary or de novo. Here, we describe a case of prenatal de novo 4q11q12 sSMC and its molecular cytogenetic features which had no apparent phenotypic abnormality.

The fetus of a 36-yr-old pregnant woman was detected positive for Down’s syndrome (trisomy 21) at the 16th wk of gestation. Quantitative Fluorescent polymerase chain reaction technique was applied for the rapid detection of numerical aneuploidy of chromosomes X, Y, 13, 18, and 21 microsatellites. Array comparative genomic hybridization (array CGH) technique was also conducted following the karyotype analysis of amniotic cells. The karyotype analysis was also done for the parents. Quantitative Fluorescent polymerase chain reaction result revealed a male fetus with a normal chromosomal pattern, while the amniocentesis karyotype analysis identified a male fetus with a marker chromosome (47, XY, +mar), and the sSMC were existing in 100% of amniocyte metaphase spreads. The parents’ normal karyotypes indicated that the sSMC was de novo. Array CGH analysis revealed a 6.48-Mb duplication at 4q11q12. Eventually, the parents decided to terminate the pregnancy by legal abortion.

Our study highlights the importance of the application of array CGH in combination with karyotype analysis for rapid and precise prenatal diagnosis of partial aneuploidy region.

Prebiotics are known as fermented ingredient with specific health benefits. The two main fermentative substrates of dietary origin are non-digestible carbohydrates and proteins which escape digestion in the small intestine. Beside traditional protocols for production of prebiotics, there are some commercial advanced methods for mass production of prebiotics with acceptable health effects. On the other hand, different types of nondigestible oligosaccharides (NDO) are used in the food and drug industries as functional foods and nutraceuticals due to their prebiotic effects and also immunomodulation effects (ex. SCFA modulate chemokine expression in intestinal epithelial cells). Prebiotics with novel and wide variety of health benefits deal with a bright future for improving society health.

Herbal compounds with antimicrobial effects are of major considerations because of increasing antimicrobial resistance of pathogenic bacteria. In this study, we investigated the antimicrobial effects of Melissa officinalis L, Plantago major L, Orobancha crenata Forsk, Phoenix dactylifera, Ziziphus mauritiana and Teucrium Polium seed extracts on some human pathogenic bacteria isolated from burn wounds. Disk-diffusion antibiotic sensitivity testing, Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) were applied to assess the antibacterial activity of the extracts in comparison to the tetracycline, as a control antibiotic. The extract of the Orobancha crenata showed stonger antibacterial effects than the other herbal extracts on Pseudomonas aeroginosa and Kelebsiela ponomoni. Staphylococcus aureus was the most sensitive one to the Ziziphus mauritiana nucleus extract compared to other herbs. According to the results of this study, it can be concluded that extracts of some native plants of Iran can be appropriate alternative to the existing antibiotics, applicable for prevention of burn infections.

Luciferase enzymes are involved in the bioluminescence reaction (light emission by living organisms). The bioluminescence process is a widespread phenomenon in the Nature. These enzymes are identified in some domains of life, but the luciferases from lampyrid genus are considered of for biological applications. The molecular cloning of a new type of firefly luciferase from Luciola lateralis was reported, previously. Here, we study its substrate binding site and rare codon with molecular docking and bioinformatics studies. By molecular modelling, some rare codons were identified that may have a critical role in structure and function of this luciferase. AutoDock Vina was used in the molecular docking that recognizes some residues that yield closely related with luciferin and AMP binding site. These types of studies help in the discovery of the light production reaction. Evaluation of these hidden information’s can improve the knowledge of luciferases folding and protein expression challenges and help in design of new drugs.

Strychnine is a toxic alkaloid which might be the source of poisoning with homicidal and suicidal purposes. Eleven fatal cases of strychnine ingestion were considered in this study. Strychnine was isolated from biological samples using the solid phase extraction (SPE) procedure and detected by analytical methods such as thin layer chromatography (TLC), gas chromatography/mass spectrometry (GC-MS) as well as high performance liquid chromatography (HPLC). Eleven cases of strychnine ingestion including 8 men and 3 women with minimum and maximum ages of 17 and 56 years old have been studied. Most of them had an education level of high school and had neither criminal history nor psychological disorders except for 3 cases that were using psychiatric drugs. Facial and ocular congestion, facial cyanosis, lung edema and hemorrhage were found in all of the cases. Hyperemic kidney, brain, liver and meninges and lung collapse were other pathologic findings encountered. Reactive gliosis, subarachnoid focal hemorrhage and 6 cm laceration on the left side of the face were separately found in three cases. Considering highly fatal effects of strychnine and its potential suicidal use, it should be strictly and severely prohibited and watched out for its misuse. On the other hand, the analytical methods used, indicated their reliable, simple, specific and sensible application in forensic and clinical investigations.

Hepatitis B virus (HBV) as an infectious disease that has nine genotypes (A - I) and a ‘putative’ genotype J..
The aim of this study was to identify the rare codon clusters (RCC) in the HBV genome and to evaluate these RCCs in the HBV proteins structure..
For detection of protein family accession numbers (Pfam) in HBV proteins, the UniProt database and Pfam search tool were used. Protein family accession numbers is a comprehensive and accurate collection of protein domains and families. It contains annotation of each family in the form of textual descriptions, links to other resources and literature references. Genome projects have used Pfam extensively for large-scale functional annotation of genomic data; Pfam database is a large collection of protein families, each represented by multiple sequence alignments and hidden Markov models (HMMs). The Pfam search tools are databases that identify Pfam of proteins. These Pfam IDs were analyzed in Sherlocc program and the location of RCCs in HBV genome and proteins were detected and reported as translated EMBL nucleotide sequence data library (TrEMBL) entries. The TrEMBL is a computer-annotated supplement of SWISS-PROT that contains all the translations of European molecular biology laboratory (EMBL) nucleotide sequence entries not yet integrated in SWISS-PROT. Furthermore, the structures of TrEMBL entries proteins were studied in the PDB database and 3D structures of the HBV proteins and locations of RCCs were visualized and studied using Swiss PDB Viewer software®..
The Pfam search tool found nine protein families in three frames. Results of Pfams studies in the Sherlocc program showed that this program has not identified RCCs in the external core antigen (PF08290) and truncated HBeAg gene (PF08290) of HBV. By contrast, the RCCs were identified in gene of hepatitis core antigen (PF00906 and the residues 224 - 234 and 251 - 255), large envelope protein S (PF00695 and the residues 53-56 and 70 - 84), X protein (PF00739 and the residues 10 - 24, 29 - 83, 95 - 99. 122 - 129, 139 - 143), DNA polymerase (viral) N-terminal domain (PF00242 and the residues 59 - 62, 214 - 217, 407 - 413) and protein P (Pf00336 and the residues 225 - 228). In HBV genome, seven RCCs were identified in the gene area of hepatitis core antigen, large envelope protein S and DNA polymerase, while protein structures of TrEMBL entries sequences found in Sherlocc program outputs were not complete..
Based on the location of detected RCCs in the structure of HBV proteins, it was found that these RCCs may have a critical role in correct folding of HBV proteins and can be considered as drug targets. The results of this study provide new and deep perspectives about structure of HBV proteins for further researches and designing new drugs for treatment of HBV..

The hepatitis C virus (HCV) has six major genotypes. The purpose of this study was to phylogenetically investigate the differences between the genotypes of HCV, and to determine the types of amino acid codon usage in the structure of the virus in order to discover new methods for treatment regimes..
The codon usage of the six genotypes of the HCV nucleotide sequence was investigated through the online application available on the website Gene Infinity. Also, phylogenetic analysis and the evolutionary relationship of HCV genotypes were analyzed with MEGA 7 software..
The six genotypes of HCV were divided into two groups based on their codon usage properties. In the first group, genotypes 1 and 5 (74.02%), and in the second group, genotypes 2 and 6 (72.43%) were shown to have the most similarity in terms of codon usage. Unlike the results with respect to determining the similarity of codon usage, the phylogenetic analysis showed the closest resemblance and correlation between genotypes 1 and 4. The results also showed that HCV has a GC (guanine-cytosine) abundant genome structure and prefers codons with GC for translation..
Genotypes 1 and 4 demonstrated remarkable similarity in terms of genome sequences and proteins, but surprisingly, in terms of the preferred codons for gene expression, they showed the greatest difference. More studies are therefore needed to confirm the results and select the best approach for treatment of these genotypes based on their codon usage properties..

Suicide is considered as the tenth cause of death worldwide. There are several suicide reports consist in the use of certain unusual drugs, such as chloroquine.
Case report: The cadaver of a 25-year-old single woman was found dead in her home and with suspect to using toxins or drugs was brought to Fars Province Forensic administration. She had history of psychiatric problems for which had referred to psychologist several times.
After the autopsy, there was no observation of pathologic lesions in her samples of liver, kidney, or heart. In bile samples, using Thin Layer Chromatography (TLC) and High Performance Liquid Chromatography (HPLC) methods, chloroquine was detected. In visceral and gut samples, chloroquine was found using TLC as reactions and it was confirmed by HPLC and Gas Chromatography Mass Spectrometry (GC-MS). After examining all the aspects, eventually chloroquine overdose and its complications was determined as the cause of the death.
Due to the high incidence of suicide in depressed patients and according to family and previous positive experience, preventive strategies based on the recognition and the treatment of depressed patients and also teaching the families to diagnose the illness in addition to the limitation of the free access to chloroquine and similar drugs is suggested to reduce overdose complications or suicide.

Acridine derivatives, especially 1,8-dioxo-9-aryl-decahydroacridine represent significant scaffolds in medicinal chemistry. Given the biological properties of such products which are used in drug development, they need to have appropriate carrier. Proteins are generally used as helpful tools in drug delivery. Consequently, molecular docking between these compounds and bovine serum albumin (BSA) has been taken into account. Furthermore, in order to achieve better results, the suggested compounds have been optimized using Gaussian 03 software.

Recent studies suggest that rare codon clusters are functionally important for protein activity.Here, for the first time we analyzed and reported rare codon clusters in Hepatitis C Virus (HCV) genome and then identified the location of these rare codon clusters in the structure of HCV protein. This analysis was performed using the Sherlocc program that detects statistically relevant conserved rare codon clusters.By this program, we identified the rare codon cluster in three regions of HCV genome; NS2, NS3, and NS5A coding sequence of HCV genome. For further understanding of the role of these rare codon clusters, we studied the location of these rare codon clusters and critical residues in the structure of NS2, NS3 and NS5A proteins. We identified some critical residues near or within rare codon clusters. It should be mentioned that characteristics of these critical residues such as location and situation of side chains are important in assurance of the HCV life cycle.The characteristics of these residues and their relative status showed that these rare codon clusters play an important role in proper folding of these proteins.Thus, it is likely that these rare codon clusters may have an important role in the function of HCV proteins. This information is helpful in development of new avenues for vaccine and treatment protocols.

Wilson disease (WD) is an autosomal recessive progressive degeneration of hepatolenticular tissue that causes the increase of copper deposition in the liver and other organs, with resultant hepatic, neurologic and psychological manifestations. WD is fatal if left untreated. The aim of the current study was to evaluate the clinical and Para-clinical findings in children with WD in Shiraz, Southern Iran.Patients and The Medical records of all children less than 18 years of age with definite diagnosis of WD, who were admitted in Nemazee Teaching Hospital from 2001 to 2009, or were under follow up at the Pediatric Hepatology Clinic affiliated to Shiraz University of Medical Sciences, were reviewed. Overall, 70 patients with WD (41 males, 29 females) were studied. The mean age at the onset of diagnosis was 10.3±3.2 years and the most common first presentation in our patients was hepatic (90%). The most common biochemical abnormalities were increased urinary copper content, increased liver enzymes (92.9%), and increased prothrombin time (71.4%). Wilson index was ≥11 in 44.3% of the patients. WD is a rare and fascinating disorder that often poses a diagnostic and therapeutic challenge for the physician. Maintaining a high index of suspicion is critical in diagnosing this readily treatable disease and early treatment can decrease its mortality rate.

Liver is prone to different diseases including metabolic, congenital, infections, drug injuries, and malignancies. Liver biopsy is an aggressive but definitive way to diagnose liver diseases.. The present study is designed to evaluate the results of liver biopsies in children referred to the Pediatric Gastroenterology Department of Nemazee Hospital.. The present retrospective study was conducted on 308 liver biopsy specimens from children suspected to liver diseases who had been referred to Pediatric Gastroenterology Department affiliated to Shiraz University of Medical Sciences between March 2003 and March 2008.. Totally 308 liver biopsies from the children aged less than 18 years was investigated. There were 128 girls and 180 boys with mean age of 6.04 ± 5.97 years and Male/Female ratio of 1.4/1. The most common pathologic findings were chronic hepatitis (n = 71; 23.1%), metabolic diseases (n = 37; 12.1%), cirrhosis (n = 27; 8.8%), secondary hemochromatosis (n = 22; 7.1%), neonatal hepatitis (n = 22; 7.1%), and hepatic malignancies (n = 21; 6.8%). Liver biopsy was non diagnostic in 16.2% (n = 50) of the patients.. Chronic hepatitis, metabolic liver diseases, cirrhosis, and neonatal hepatitis are the most common liver diseases in children in our center. In this study a high percentage of liver biopsies were non-diagnostic. Therefore, providing the necessary facilities and equipment for special assessment of liver tissue are essential in this center..

Chronic functional constipation is an epidemic problem in children that has effects on the growth status.. The aim of this study is to evaluate the growth parameters in children with chronic functional constipation and compare them with healthy individuals.. Patients and One hundred children with chronic functional constipation (defined as Rome III criteria) referred to Pediatric Gastroenterology Clinic enrolled in this study. Control group was consisted of 100 children who referred for well-child visits، without constipation. Weight، height، body mass index (BMI) and z-score weight، z-score height and z-score BMI was calculated for each patient and control group.. Both case and control groups were consisted of the same age (P = 0. 725) and gender (P = 0. 777) individuals. The BMI (P < 0. 0001) and BMI z-scores (P < 0. 0001) of constipated children was significantly higher than the control group. Also، weight (P = 0. 004) and weight z-scores (P < 0. 0001) were significantly higher in the study group. There was no significant difference in height between two groups (P = 0. 1)، but constipated children had higher height z-scores than control group (P = 0. 027). The rate of obesity (define as BMI z-score > 2) in children with chronic constipation was 40% that was significantly higher than normal control group (11%) (P < 0. 0001).. We found a higher obesity rate and also higher BMI and weight z-scores in functionally constipated children compared with healthy control group. The reasons for the association between obesity and constipation are not clear and multifactor including diet، activity level، or hormonal influences، are involved that required additional studies..

Autoimmune hepatitis (AIH) is a necroinflammatory liver disease of unknown etiology that occurs in the children of all ages. The present study aimed to evaluate the clinical and paraclinical presentations, including pattern of autoantibodies, response to treatment, mortality, and liver transplantation outcome in the Iranian children with AIH. The medical records of 87 children (56 girls and 31 boy) diagnosed with AIH between 2001 and 2010 were retrospectively analyzed for clinical and paraclinical profiles and also treatment outcome. The mean age of the patients was 10.1±4.5 years (64.4% females). The most common clinical findings were jaundice (70.1%), splenomegaly (67.8%), and hepatomegaly (51.7%). Antinuclear, anti-smooth muscle, and anti LKM antibodies were positive in 14/62, 22/53 and 6/40 patients, respectively (36 patients had type 1 AIH, 6 patients had type 2 AIH, 26 patients were seronegative, and autoantibodies were not available in 19 cases). The most common histological finding in the liver biopsies was chronic hepatitis with interface activity that was seen in 65 (74.7%) patients. The complete response was seen in 52 (59.8%) patients and 24 (27.6%) patients underwent liver transplantation. One-year and five-year survival rates were 87.5% and 80% in the transplanted patients. AIH should be kept in mind in the differential diagnosis of both acute and chronic liver diseases in the children and treatment with combination of corticosteroids and azathioprine is a good treatment option. In the patients with end stage liver cirrhosis that did not respond to medical therapy, liver transplantation is the treatment of choice.

Lower gastrointestinal bleeding (LGIB) in infants and children is a common problem in medical centers; however, its epidemiologic properties have not been studied well. Due to the fact that LGIB has various causes in different geographical places, considering the importance of etiology in decision making for diagnostic techniques and treatment and since the lack of comprehensive database related to this issue, the main purpose of the current study was to determine the main causes of LGIB in children in a single center from Southern Iran.Patients and The study was conducted on all the patients less than 18 years old with LGIB who referred to Pediatric Gastroenterology Ward affiliated with Shiraz University of Medical Sciences between 2005 and 2009. The data, including the patients’ sex, age, and endoscopic as well as pathological findings, were collected and analyzed. Overall, our series included a total of 309 patients with LGIB (185 males and 124 females) below 18 years old. The most common causes of LGIB included colorectal polyps (n = 90; 29.1%), lymphoid nodular hyperplasia (n = 62; 20%), solitary rectal ulcer (n = 31; 10%), and inflammatory bowel disease (n = 20; 6.5%). Nevertheless, no obvious causes were identified in 30.7% of the patients. The prevalence of lymphoid nodular hyperplasia in less than 2 years old patients and colorectal polyps in the 2-6 years old patients were significantly higher than the other causes (P = 0.001). The most cases with inflammatory bowel diseases and solitary rectal ulcer were more than 2 years old. On the other hand, no statistically significant differences were observed between males and females as well as different age groups regarding the means of the underlying causes of LGIB (P > 0.05). The results of present study could be used by the Iranian physicians in order to gain an overall picture of LGIB in Iran and guide the management of the patients with LGIB.

Despite the advances in the treatment of chronic hepatitis B virus (HBV) infection, liver transplantation (LT) remains the only hope for many patients with end-stage liver diseases resulting from HBV.. The aim of this study was to investigate the rate of HBV recurrence in cases that had undergone LT due to the HBV related liver cirrhosis..Patients and Forty-nine patients who underwent LT due to HBV related cirrhosis since 2001 to 2009 in Shiraz Organ Transplantation Center were enrolled in the present study. They were asked to complete the planned questionnaire and also to sign the informed consent in order to take part in this study. Post-transplant prophylaxis protocol against HBV recurrence was based on a hundred milligrams of lamivudine daily plus intramuscular injections of hepatitis B immune globulin (HBIG) with appropriate dosage to keep anti-HBs antibody titer above 300 IU/L and 100 IU/L in the first six months and afterwards, respectively. Blood samples were obtained and checked for HBsAg, HBeAg, and the titers of Anti -HBsAb as well as Anti- HBeAb with ELISA. A quantitative HBV DNA assay was also done on all samples (GENE-RAD® Real-time PCR).. There were 91.8% males and 8.2% females enrolled in the study. The duration of post-transplant prophylaxis ranged from 3 months to 8 years (mean 18.9 ± 19.3 months). HBsAg and HBeAg were positive in 24.5% and 2% of cases, respectively. Real-time PCR for HBV DNA were zero copies/mL in 91.8% of patients, none of which represented a positive value for HBV recurrence (Positive > 10,000 copies/mL). The mean Anti-HBs Ab titer was 231.7 ± 135.9 IU/L; it was above 100 IU/L in 71.4% of patients. Thirty-seven (75.5%) of the patients were taking tacrolimus plus mycophenolate mofetil, 6 (12.2%) were on cyclosporine plus mycophenolate mofetil, and 6 (12.2%) were taking sirolimus plus mycophenolate mofetil. HBsAg was detectable in seven patients taking tacrolimus plus mycophenolate mofetil (18.9%), in four patients taking cyclosporine plus mycophenolate mofetil (66.7%), and in one patient among the six who were taking sirolimus plus mycophenolate mofetil (16.7%). There was no significant statistical correlation between the presence of a positive value for HBsAg and the immunosuppression regimen or Anti HBsAb titer (P 0.05). Presence of a positive value for HBsAg was not predictive of a positive HBV DNA or its level in blood (P 0.05).. Post-transplant HBV prophylaxis with lamivudine and intramuscular HBIG with appropriate dosage to keep anti-HBs antibody titer above 300 IU/L in the first six months and above 100 IU/L afterwards is effective for prevention of HBV recurrence after LT.

Liver cirrhosis is one of the major causes of hospitalization and mortality in children. A wide spectrum of disorders including developmental abnormali­ties, infections, metabolic and genetic disorders can lead to liver cirrhosis in pediatric patients. Determination of its etiology is important for treatment mo­dality, prevention of progressive liver damage, family counseling and prioritiz­ing liver transplantation. The aim of this study is to evaluate the causes of liver cirrhosis in children in Southern Iran.We included all cirrhotic children aged less than 18 years who referred to an outpatient Pediatric Gastroenterology Clinic affiliated with Shiraz University of Medical Sciences between March 2009 and September 2010 in this cross-sectional study. The etiology of cirrhosis was determined according to clinical findings, laboratory tests, radiographic evaluation such as ultrasonography or computed tomography scan, hepatobiliary scintigraphy and histopathologic examination of the liver biopsy. Cirrhosis with unknown etiology was consid­ered as cryptogenic.A total of 106 cirrhotic children aged between 5 months to 18 years old with a mean age of 8.24 ± 6.12 years that included 60 boys (56.6%) and 46 girls (43.4%) were enrolled in the study. The most common causes of liver cirrhosis were Wilson disease (n=22; 20.7%), biliary atresia (n=19; 17.9%), and crypto­genic cirrhosis (n=14; 13.2%). Other causes were autoimmune hepatitis (n=12; 11.3%), idiopathic neonatal hepatitis (n=10; 9.4%), hepatorenal tyrosinemia (n=9; 8.5%), glycogen storage disease (n=6; 5.7%), and progressive familial intrahepatic cholestasis (n=4; 3.8%).Considering the most common etiology of liver cirrhosis in children in this part of Iran we suggest testing for Wilson disease in all cirrhotic children.

All conditions that interfere with blood flow at any level within the portal system can lead to portal hypertension. For better management of this disorder, it is important to determine the underlying cause. In previ­ous studies, extra-hepatic disorders have been reported as the main cause of portal hypertension in children. In this study, we investigate the under­lying causes of portal hypertension in children.This prospective, descriptive study investigated the etiology of 45 children with portal hypertension who referred to Nemazee Hospital Pe­diatric Gastroenterology Ward from 2005 to 2007. The underlying causes of portal hypertension were determined by liver biopsy, abdominal so­nography, abdominal computed tomography scan, and liver Doppler so­nography.In this study, 42 of 45 patients (93.3%) developed portal hypertension due to intrahepatic diseases. Extra-hepatic portal hypertension was de­tected in 3 (6.7%) patients with portal vein thrombosis.Intrahepatic diseases were the most common etiology of portal hyper­tension among children who referred to our center.