A. R. Dehpour, PharmD, PhD
A. Javadian, MD
Vol 56, No 5 (2018)
Cadmium (Cd) induces carcinogenicity and cytotoxicity through a variety of mechanisms. Metallothioneins (MTs) play critical roles in metal detoxification and radical scavenging. Here we evaluated the possible involvement of NO and MT in Cd-induced toxicity and resistance development. By utilizing Cd-resistant Caco-2 cells as a model of chronic exposure to Cadmium, we observed that Cd decreased Caco-2 cell proliferation, whereas Cd-resistant cells showed a lower sensitivity to Cd cytotoxicity. L-NAME as an iNOS inhibitor and cPTIO as an NO scavenger induced a significant reduction in Cd-mediated toxicity of parent Caco-2 in spite of resistant cells. In resistant cells, iNOS mRNA expression was declined; however, MT protein synthesis was increased following acute and chronic Cd exposure. It seems that NO synthesis involves in Cd-induced cytotoxicity, while elevated MT expression is associated with Cd detoxification and resistance.
Chronic heart failure (CHF) is a complex clinical syndrome that represents the end stage of various cardiac diseases and is characterized by the inability of the heart to meet metabolic demands of the body. Many physiological systems are involved in this disease. In particular, the activation of the immune system has received considerable interest in the last decade. Evidence from both experimental and clinical trials indicates that inflammatory mediators are of importance in the pathogenesis and progression of chronic heart failure. Excessive pro-inflammatory cytokines induce contractile dysfunction, hypertrophy, and fibrosis and cell death in Cardiac myocyte. We examined the expression of IL-23 in PBMCs between CHF patients and healthy controls. In this report, we used real-time PCR assay to compare the relative expression of IL-23 in peripheral blood mononuclear cells (PBMC) from CHF patients with various heart diseases (n=42, EF<45%, range of New York Heart Association (NYHA) 1 to 4) and matched healthy control subjects (n=42).We also determined the IL-23 concentrations of cell culture supernatant of PBMCs with ELISA. A total of 42 patients with CHF, with 42 age and sex-matched control group subjects were enrolled in the present study. The culture supernatant levels of IL-23 in PBMC of CHF patients were significantly higher (133.95±108.99 pg/mL) than in the control group (83.43±76.2 pg/mL) (P<0.05). The gene expression of IL-23 was also markedly upregulated in PBMC from CHF patients in comparison with the control group, but it was not statically significant 80. These results demonstrate that in patients with CHF and especially those with severe CHF, expression of pro-inflammatory cytokines and levels of IL-23 cytokine is markedly increased in PBMC. These finding suggested that IL-23 may play an important role in the progression of CHF among these patients.
Thiopurine s-methyltransferase (TPMT) plays a key role in the metabolism of the drug; 6-MP in children with acute lymphoblastic leukemia (ALL). The wild-type TPMT*1 allele and mutant alleles are associated with normal and intermediate enzyme activity, respectively. In patients with intermediate or deficient TPMT activity, normal dose of the drug may cause serious side effects such as bone marrow toxicity. The aim of this study was to assay the enzyme activity by HPLC for right ordering of chemotherapy drug doses in the patients. TPMT activity was measured in RBC of healthy adults (n=73) and children (n=10). Also, TPMT (*2, *3A, *3B and *3C) genotype of the samples were assessed by ARMS-PCR and RFLP-PCR. No indication of gender and age differences in the TPMT activity was found. This study showed that the HPLC method was sensitive, accurate and precise and can be used in routine clinical laboratory tests.
The purpose of the current study was to investigate the impact of a 2-months implementation of GnRH-agonist (prolonged) versus the OCP+long protocol before in-vitro fertilization-embryo transfer (IVF-ET) on IVF outcomes in infertile patients with Grade III-IV endometriosis. A total of 70 infertile patients with endometriosis participated in this randomized clinical trial and randomly received either the prolonged GnRH-agonist protocol (38 patients) as control or the OCP+long protocol (32 patients) as the case group. This was followed by standard controlled ovarian hyperstimulation (COH) in all subjects. The fertilization rate, the implantation rate, and the clinical pregnancy rate were measured and compared between the two groups. A statistically significant trend toward better embryo quality was observed in the control group (P=0.01). In addition, clinical pregnancy rate, implantation rate and fertilization rate did not differ significantly between two groups (P=0.43, P=0.54, P=0.1 respectively). GnRH agonist treatment for 2 months before ART in women with high-grade endometriosis was associated with better embryo quality compared to three weeks of treatment with OCP. OCP before assisted reproductive technology (ART) was as effective as GnRH agonist treatment regarding clinical pregnancy and implantation rates in infertile patients with severe endometriosis.
Suicide by self-burning remains a common method of suicide amongst women in Iraq and some neighboring countries. This study aimed to describe the problem of self-burning in Basra province and investigate the associated factors. A prospective study was undertaken between October 2016 and May 2017 in Al-Fayhaa Burn Center. Data were collected from all patients admitted to the center for a self-inflicted burn. Sociodemographic information and cause of suicide were obtained using an interviewer-administered questionnaire, and clinical data were transcribed from hospital records. There were 62 cases (females 74%, males 26%) of self-burning during the 6 months data collection accounting for 22% of all burn admission. The age ranged from 9-56 years (mean 25.3, SD 10.8 year). The vast majority had no or only basic education (92%), 55% were married, 60% were from outside Basra city and 53% considered themselves from a poor socioeconomic background. The incident mostly occurred at home (84%) while the person was alone (91%) using kerosene as the burning material (82%). The total burn surface area ranged from 20-100% with a median of 80% (IQR 60-95). The median hospital stay was 5 days (IQR 1-12 days). In-hospital mortality rate was 72.6%. Suicide by self-burning seems not to be uncommon in Basra and require more attention from public health and social services. More research is required to provide a better estimation of the problem and in-depth understanding of the factors that contribute to the problem.
To determine the distribution of corneal thickness and its associated factors in the over 5-year-old population in the north and south rural areas in Iran. In this study, samples were selected using multi-stage cluster sampling. After vision and refraction tests and the slit lamp exam, the central corneal thickness (CCT), apical corneal thickness (ACT), and the thickness at four peripheral areas of the cornea were measured using Pentacam. Of the 3851 selected samples, after applying the exclusion criteria, the analysis was done on data from 2681 people. The mean age of the participants was 36.03±18.51 years, ranging from 6 to 90 years, and 58.1% of them were female. Mean CCT and ACT were 533.87 μm (95%CI: 532.05 -535.69) and 536.72 μm (95%CI: 534.9 -538.54), respectively. Mean peripheral corneal thickness was 637.46 μm (95%CI: 635.09 -639.83) in the superior quadrant, and 594.34 μm (95%CI: 592.2 -596.47), 620.81 μm (95%CI: 618.66 -622.97), and 584.55 μm (95%CI: 582.18 -586.93) in the inferior, nasal, and temporal quadrants, respectively. Linear regression analysis showed significant associations between CCT and gender (P=0.001), age (P<0.001), geographical location of residence (P<0.001), the radius of corneal curvature (P<0.001), anterior chamber depth (P<0.001), and corneal volume (P<0.001). This study is one of the few studies describing the distribution of the corneal thickness in a population of over 5-year-olds using Pentacam. Gender, anterior chamber depth, and corneal radius of curvature are some of the factors associated with CCT.
There are controversies on the association of childhood allergic diseases with inflammatory bowel diseases (IBD). The aim of this study was to examine the association between food allergy, cow’s milk allergy (CMA), and asthma with pediatric IBD in Iranian population. This case-control study was conducted on 200 individuals less than 18-year-old (100 with IBD and 100 as control group). Medical records, clinical presentation, and laboratory and para-clinical findings related to food allergy, CMA, and asthma were reviewed for all participants in both groups and were recorded. Among 100 children with IBD, 40 had Crohn's disease, and 60 had ulcerative colitis. The frequency of food allergy, cow's milk allergy, and asthma in children with IBD was significantly higher than the control group (P<0.001). Asthma in children with Crohn's disease was significantly more prevalent than children with ulcerative colitis (P=0.008). Food allergy (OR: 22.1, 95% CI: 5.1-95.05, P<0.001), CMA (OR: 15, 95% CI: 3-67, P<0.001), and asthma (OR: 10, 95% CI: 3-37.05, P<0.001) were significantly associated with increased risk of IBD in children. Food allergy, CMA in infancy and asthma are more prevalent in children with different subtypes of IBD. The diagnosis of these risk factors is associated with increased risk of Crohn's disease and ulcerative colitis.
Laparoscopic sleeve gastrectomy (LSG) is the most common bariatric surgery technique. In this technique, bleeding and staple line the leakage is considered as the most important complications. The current study aimed at evaluating the effect of reinforced the taple line on the level of bleeding and leakage after the surgery. Overall, 199 patients meeting the eligible criteria with morbid obesity (BMI>40 kg/m2) were enrolled in the study after signing the written informed consent. Patients were randomly allocated to intervention group (with reinforced staple line) and control group (Standard treatment) using simple randomization technique. Out of 199 cases, 120 (60%) were female, and 80 (40%) male; their mean BMI was 44.79± kg/m2, ranging from 40 to 58 kg/m2. Staple site bleeding was observed; therefore, no significant relationship was observed between the groups regarding bleeding decrease. Staple line leakage was observed in 2 cases of the control (without reinforcement) group and none of the cases in the intervention (with reinforcement) group. According to the results of the current study, no statistically significant relationship was observed between the groups regarding the level of leakage (P=0.249). Also, there was no significant relationship between age, gender, and BMI of cases, and the level of bleeding and leakage from the staple site. The average duration of surgery was 52.03 and 69.64 minutes for the control and intervention groups, respectively, which indicated prolonged surgery in the intervention group (P<0.001). The current study results indicated no significant relationship between the groups regarding the level of bleeding and leakage from the staple site.
Although rare, Cerebrospinal Fluid (CSF) Leakage can result in deadly complications such as meningitis and brain abscess. Previously, primary spontaneous CSF leakage was referred to leakages without any detectable causes. However, it has been found recently that it may be related to abnormal increased intracranial pressure (ICP). Here, we reported demographic, clinical, and therapeutic features in addition to the outcomes of five patients with Idiopathic Intracranial Hypertension (IIH) presented with spontaneous CSF leakage as the initial symptom. Four of our patients were female. The mean age was 38 years old. Rhinorrhea was the first manifestation of the CSF leakage in our patients. Ethmoidal cells were the most common site of leakage. The mean opening pressures (OP) was 31.3 cmH2O. The computed tomography (CT) scan and magnetic resonance imaging (MRI) of the brain was normal in all patients except one patient showing fullness in left ethmoidal cells. In all of the patients, cerebral CT cisternography was diagnostic to detect the site of leakage. CSF leak in two patients resolved with medical therapy but CSF diversion procedure was mandatory in other three patients. CSF leakage resolved in all of them. CSF leakage can be the first and only presenting symptom of abnormal increased ICP. The key point in patient treatment is controlling the elevated ICP, even though some patients may need to CSF diversion procedure eventually.
Fat necrosis is a benign condition that can occur anywhere in the breast and can affect women of any age. Although it is frequently seen in female breast, it is a very rare condition that occurs in a male breast, and a very few cases have been reported so far. We report a case of fat necrosis of the breast in a 22-year-old male. The case was referred for surgical excision. The excised tissue showed typical multiple areas of saponification and calcification. A diagnosis of fat necrosis was confirmed by histopathologic examination.
MYO7A is an unconventional myosin that is essential for ordinary hearing and vision; mutations in the MYO7A gene result in Usher syndrome type 1B and other disorders. In this manuscript, we reported a mutation (c.4705delA) in exon 35, causing the alteration of a Ser amino acid to Ala at codon 1569 (p.H2027del) located within the first FERMdomain of the human protein myosin VIIA. This mutation involved in the pathogenesis of hearing loss, congenital night blindness, muscular weakness, skin problem, and difficulty in keeping balance in the 13-year-old female. After checkup the patient’s DNA was extracted from peripheral blood and amplification was performed by PCR. Sequencing method was performed for identification of the mutation. The c.4705delA mutation in exon 35 was found in the patient in heterozygosis form; this means that her mother and father were carriers. This mutation is located on the tail of the myosinVIIA protein and is associated with several disorders.
Kawasaki disease (KD) is a self-limited syndrome with serious heart complications, mostly seen in children of age 5-month to 4-year-old. KD needs to be diagnosed soon to start IVIG within 10 days of starting symptoms to lower heart complications to 5 folds. Our case, a 2-year-old boy presented with prolonged fever and pharyngeal erythema. In early evaluation, erythrocyte sedimentation rate (ESR) was elevated, and after that, Color Doppler echocardiography with suspicion for KD was performed and showed aneurysm and thrombosis formation in the left coronary artery (LCA). Hence, intravenous immunoglobulin (IVIG) was started for the patient concurrent with daily check of troponin I level. In this case report, we present remarkable echocardiographic findings of a patient with the delay in diagnosis of KD demonstrating an aneurysm and acute thrombus formation in LCA.
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