The link between intergenic distances and controls exerted on the transcriptional regulation; an inferential approach

The position of genes along the genome is an important evolutionary factor for organizing gene regulation. Hence, transcriptional regulatory network have been studied much more extensively from gene distributions rather than other viewpoints. The systematics of intergenic distances, therefore, should be taken into account as an important source of information on the controls exerted on gene expression by various biological mechanisms. Here we study a collection of features including, intergenic and interoperonic distances, distances between isolated genes, distances between regulatory genes and distances between isolated and regulatory genes/operons in order to provide a more informative picture of gene distributions via firstly discovering the statistical model of these features. We find that all these features significantly follow the lognormal distribution. Then we test a few important biological hypotheses particularly in relation to controls exerted in the transcriptional regulatory network in a completely inferential approach using generalized p-value based on the discovered model. We find that mean distances of isolated genes significantly is less than that of regulatory genes.  These findings are consistent with the previous evidences that many biological variables, especially in relation to systems biology, follow lognormal distribution. furthermore, our results inferentially support the crucial hypothesis on the two distinct logical types of control, namely digital control (i.e. control mediated by specific transcription factors) and analog control (i.e. control mediated by distribution of supercoiling energy and based on gene neighborhood) previously proposed by studying expression patterns.

Messaging standard requirements for electronic health records in Islamic Republic of Iran: a Delphi study

The present descriptive-comparative study was conducted to give an overview of the messaging standards that are necessary for interoperable electronic health records (EHRs). We designed a preliminary model after data collection and compared the messaging standards of Health Level Seven (HL7) and the International Organization for Standardization (ISO). The data were assessed with the Delphi technique. A comprehensive model for the messaging standards of EHRs in the Islamic Republic of Iran was presented in three pivots: structural characteristics (standard for all EHRs, XML-based and object-oriented messages, and dual model); model specifications (reference model, archetypes and classes of reference model), and general features (distinct ontology, mapping with other standards, and using reference archetypes for exchanging documents). In conclusion, we gave an overview of messaging standards for the interoperability of EHRs and experts selected ISO13606 as a suitable standard for the Islamic Republic of Iran.

Crocin improves spatial learning and memory deficits in the Morris water maze via attenuating cortical oxidative damage in diabetic rats

The purpose of the current study was to examine the influence of crocin on improving spatial memory deficits and cerebral oxidative damage in streptozotocin-induced diabetic rats. Crocin was administered intraperitoneally daily at doses of 15, 30 and 60mg/kg for 6 weeks. Spatial memory performance was measured in rats by the Morris water maze paradigm. Lipid peroxidation and total thiol levels as parameters of oxidative stress were assessed in the cerebral cortex at the end of week 6. Diabetic rats showed spatial learning and memory deficits in the Morris water maze which was accompanied by increased lipid peroxidation levels in the cerebral cortex. By contrast, chronic treatment with crocin (15, 30 and 60mg/kg, ip, 6 weeks) improved cognitive performance and lowered hyperglycaemia and oxidative stress in diabetic rats. In conclusion, the results suggest that beneficial effects of crocin on streptozotocin-induced memory dysfunction may be attributed to its antidiabetic and antioxidant activity, which could find clinical use in treating cognitive dysfunction in diabetics.

Failure of single-unit restorations on root filled posterior teeth: a systematic review

This systematic review investigated the failure rate of conventional single-unit restorations in root filled posterior permanent teeth. Two reviewers independently applied eligibility criteria, extracted data and assessed the quality of the evidence of each included study according to the Cochrane Collaboration's procedures for randomized control trials (RCTs) and the STROBE criteria for observational studies. The MEDLINE (via Ovid), EMBASE (via Ovid), Cochrane Oral Health Group Trials Register and CENTRAL (via Cochrane Library) databases were searched electronically (January 1993 to week 1, February 2015). This was complemented by an additional hand search of selected journals and the references of relevant studies. Clinical studies published on root filled single-unit restorative treatments with a mean follow-up period of at least 3 years were selected. The outcome measured was clinical or radiological failure. Overall, the four RCTs and the single observational study included were of low and high quality, respectively. Therefore, a meta-analysis was not possible. The pooled mean failure rates were reported according to the type of treatment and remaining coronal tooth structure. The current evidence suggested that the failure rates of the treatments may depend on the amount of remaining tooth structure and type of treatment. Post-retained crowns were associated with the most favourable outcome in teeth with one to two remaining coronal tooth wall(s), whereas post-free crowns were superior when greater tooth structure was available. Restorations in teeth without ferrules had such a high rate of failure that other treatment options should be considered.

[From facial pain to toxic epidermal necrolysis: a rare complication of carbamazepine usage]

BACKGROUND

Toxic epidermal necrolysis (TEN) is a rare disease that is characterised by epidermal loss, often as a result of medication use - particularly sulfonamides and anti-epileptics. People of South-East Asian descent are at increased risk of developing TEN since they may carry the HLA-B*1502 allele.

CASE DESCRIPTION

A 61-year-old female of Indonesian descent developed TEN due to carbamazepine use, resulting in admission to the intensive care department of a specialised burn centre in the Netherlands. She was successfully treated with high-dose prednisone and local therapy for the skin disorder.

CONCLUSION

The US Food and Drug Administration advises screening of patients of South-East Asian descent for HLA-B*1502 prior to initiation of treatment with TEN-related medication. In the Netherlands, screening for this allele is currently not mandatory.

Pulmonary hypertension in rheumatic mitral stenosis revisited

BACKGROUND

In patients with mitral stenosis (MS), pulmonary hypertension (PH) is a significant contributor to the associated morbidity. We aimed to study factors associated with the presence of significant PH (sPH) and whether incorporating body surface area (BSA) in the mitral valve area (MVA) would improve the predictive value of the latter.

METHODS

The medical records of 558 patients with severe MS undergoing percutaneous balloon mitral commissurotomy were evaluated over a period of 8 years. Factors associated with the presence of significant PH (sPH) defined as mPAP ≥ 40 mm Hg were examined.

RESULTS

A total of 558 patients (423 women) were enrolled. Overall, 153 (27%) patients had sPH. Patients with sPH were similar to the rest of the subjects in terms of demographics, body habitus, blood group, and incidence of atrial fibrillation. Among echocardiographic findings, absolute MVA, indexed MVA, and mean transmitral valve gradient were associated with the presence of sPH. Transmitral valve gradient during right heart catheterization had the highest area under the curve for an association with sPH.

CONCLUSION

Age, gender, heart rhythm, and blood group were not associated with the presence of sPH in severe MS. The predictive value of the indexed MVA for the presence of sPH was not higher than that of absolute MVA.

Paracetamol 325 mg/tramadol 37.5 mg effect on pain during needle electromyography: a double-blind crossover clinical trial

Needle insertion during electromyography (EMG) may cause varying levels of pain that could lead to inaccurate assessment and premature termination of the procedure. The aim of this study is to compare paracetamol 325 mg/tramadol 37.5 mg with placebo in relieving pain before EMG. This is a randomized, crossover, placebo-controlled, double-blind clinical trial; forty-four healthy individuals, including 27 males with a mean age of 35.3 years (range 18-59 years), entered this study. The needles were inserted unilaterally 2 h after administration of two analgesic tablets of paracetamol 325 mg/tramadol 37.5 mg or two placebo tablets. The pain was scored through a 100-mm visual analog scale (VAS) immediately and 2 h after the procedure. The side effects were also recorded. Within a week, the procedure was repeated on the other upper limb, changing the treatment and placebo. The immediate and 2-h VAS scores were notably lower after administration of treatment compared to placebo (immediate pain: 17.5 ± 12.8 vs. 32.1 ± 16.0, P < 0.001; and 2-h pain: 1.6 ± 5.6 vs. 5.8 ± 7.9, P = 0. 002). There was a higher prevalence of side effects when treatment was used (48 vs. 9 %, P < 0.001). Although most symptoms were mild, transient and resolved without medical interventions, on one occasion a volunteer experienced brief loss of consciousness and one subject had severe vertigo that required hospitalization and fluid therapy. Paracetamol 325 mg/tramadol 37.5 mg administration prior to EMG could effectively alleviate pain. Further application of this medication in patients with neuromuscular disorders would warrant additional clinical trials, particularly considering the adverse events.

SiRNA/DOX lodeded chitosan based nanoparticles: Development, Characterization and in vitro evaluation on A549 lung cancer cell line

High-mobility group AT-hook2 (HMGA2), involved in epithelial mesenchymal transition (EMT) process, has a pivotal role in lung cancer metastasis. Lung cancer therapy with HMGA2 suppressing small interfering RNA (siRNA) has been introduced recently while doxorubicin (DOX) has been used as a frequent cancer chemotherapy agent. Both reagents have been faced with obstacles in clinic which make them ineffective. NanoParticles (NPs) provided a platform for efficient co delivery of the anticancer drugs. The aim of this study was production and in vitro characterization of different pharmacological groups (siRNA, DOX or siRNA-DOX) of carboxymethyl dextran thrimethyl chitosan nanoparticles (CMDTMChiNPs) on cytotoxicity, gene expression, apoptosis and migration of metastatic lung cancer cell line (A-549). CMDTMChiNPs were synthesized and encapsulated with siRNA, DOX or siRNA-DOX. Then the effects of HMGA2 siRNA and DOX co delivery was assessed in A549 viability and target genes (HMGA2, Ecadherin, vimentin and MMP9) by MTT and real time PCR, respectively. In addition capability of apoptosis induction and anti-migratory features of formulated NPs were analyzed by flowcytometry and wound healing assays. SiRNA-DOX-CMDTM ChiNPs approximate size were 207±5 with poly dispersity index (PDI) and zeta potential of 0.4 and 16.3±0.3, respectively. NPs loaded with DOX and siRNA were the most efficient drug formulations in A549 cell cytotoxicity, altering of EMT markers, apoptosis induction and migration inhibition. Generally our results showed that co delivery of HMGA2 siRNA and DOX by novel designed CMDTMChiNPs is a new therapeutic approach with great potential efficiency for lung cancer treatment.

Tailoring the Catalytic Properties of Metal Nanoparticles via Support Interactions

The development of new catalysts for energy technology and environmental remediation requires a thorough knowledge of how the physical and chemical properties of a catalyst affect its reactivity. For supported metal nanoparticles (NPs), such properties can include the particle size, shape, composition, and chemical state, but a critical parameter which must not be overlooked is the role of the NP support. Here, we highlight the key mechanisms behind support-induced enhancement in the catalytic properties of metal NPs. These include support-induced changes in the NP morphology, stability, electronic structure, and chemical state, as well as changes in the support due to the NPs. Utilizing the support-dependent phenomena described in this Perspective may allow significant breakthroughs in the design and tailoring of the catalytic activity and selectivity of metal nanoparticles.

Factors contributes to spontaneous abortion caused by Listeria monocytogenes, in Tehran, Iran, 2015

Spontaneous abortion is the loss of a fetus before the 20th week of pregnancy, when occurring naturally without any surgical or pharmaceutical intervention. On the other hand, Listeria monocytogenes, as one of the foodborne pathogens, is a causative agent of listeriosis. The transfer of L. monocytogenes in pregnant women occurs as self-limited flu-like symptoms which may result in abortion, stillbirth or premature birth of infected infants. The purpose of this study was the identification of Listeria monocytogenes risk factors in women with spontaneous abortion admitted to Tehran Province health care centers in 2015. In this cross-sectional study, 317 women were examined for L. monocytogenes using Polymerase Chain Reaction (PCR) and the related risk factors. Two questionnaires on "L. monocytogenes Probable Risk Factors" and "Socio Economic Factors" were completed. Out of 317 samples of vaginal swabs, 54 (17%) isolates of L. monocytogenes were identified. In addition significant differences in terms of age of mother and her husband, mother and the husband&apos;s level of education , house prices, place of residence, gestational age of first abortion, gestational age of current abortion, gestational age of second abortion, consumption of unpasteurized dairy products, consumption of feta and soft cheese, consumption of smoked see food products, consumption of processed meat products and half-cooked meat products, consumption of ready-to-eat vegetables, history of contact with domestic animals three month before pregnancy and during pregnancy and consumption of smoked meat products during pregnancy were studied between two groups of patients positive and negative with L. monocytogens (P < 0.001). Based on the study, the detection of L. monocytogens risk factor during pregnancy as well as taking the issue into account while giving information and counseling in pregnancy can be vital to reduce the incidence of this bacterium and subsequently its side effects during pregnancy.

Size-dependent adhesion energy of shape-selected Pd and Pt nanoparticles

Thermodynamically stable shape-selected Pt and Pd nanoparticles (NPs) were synthesized via inverse micelle encapsulation and a subsequent thermal treatment in vacuum above 1000 °C. The majority of the Pd NPs imaged via scanning tunneling microscopy (STM) had a truncated octahedron shape with (111) top and interfacial facets, while the Pt NPs were found to adopt a variety of shapes. For NPs of identical shape for both material systems, the NP-support adhesion energy calculated based on STM data was found to be size-dependent, with large NPs (e.g. ∼6 nm) having lower adhesion energies than smaller NPs (e.g. ∼1 nm). This phenomenon was rationalized based on support-induced strain that for larger NPs favors the formation of lattice dislocations at the interface rather than a lattice distortion that may propagate through the smaller NPs. In addition, identically prepared Pt NPs of the same shape were found to display a lower adhesion energy compared to Pd NPs. While in both cases, a transition from a lattice distortion to interface dislocations is expected to occur with increasing NP size, the higher elastic energy in Pt leads to a lower transition size, which in turn lowers the adhesion energy of Pt NPs compared to Pd.

Tooth Loss Increases the Risk of Diminished Cognitive Function

Emerging evidence suggests that oral health is associated with cognitive function. This review aims to systematically assess this association in adult populations via prospective cohort study designs. Eligible study reports were identified by searching the MEDLINE (via Ovoid), EMBASE, PsycoINFO, and Cochrane Library databases. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated with a random effects model. From 1,251 identified articles, 10 were included in the systematic review and 8 in the meta-analysis. Random effects analysis showed, with statistically low heterogeneity, that individuals with suboptimal dentition (<20 teeth) were at a 20% higher risk for developing cognitive decline (HR = 1.26, 95% CI = 1.14 to 1.40) and dementia (HR = 1.22, 95% CI = 1.04 to 1.43) than those with optimal dentition (≥20 teeth). Studies on the association between periodontal disease and cognitive status showed conflicting results. Within the limits of the quality of published evidence, this meta-analysis lends further support to the hypothesis that tooth loss is associated with an increased risk of cognitive impairment and dementia.

Knowledge Transfer Statement: Based on the published literature, the results of this study show that the risk for cognitive impairment and dementia increases with loss of teeth. This information adds to the evidence showing links between oral and general health and suggests that oral health strategies aimed to preserve teeth may be important in reducing risk of systemic disease.

Multiple sclerosis influences on the augmentation of serum Klotho concentration

We have already shown that the concentration of secreted form of Klotho decreases in the cerebrospinal fluid of patients with relapsing-remitting multiple sclerosis (RRMS). The current study aimed at assessing possible changes in the serum Klotho concentration of MS patients. Participants involved 15 new cases of RRMS patients in the relapse phase, 15 RRMS patients who had been suffering from the disease for more than three years and were under regular treatments (interferon beta-1a) and, finally, 15 non-MS patients who constituted the control group. Beside thorough neurological examinations, demographic and clinical data (e.g. gender, age, duration of disease and expanded disability status scale) were obtained. Serum Klotho concentration was measured using ELISA method. The results showed no statistically meaningful difference between new cases of RRMS (585.56pg/ml±153.99) and control group (556.81pg/ml±120.36; P=0.859). The serum Klotho level, however, was significantly higher in patients with prolonged disease duration (696.94pg/ml±170.52; P=0.037) in comparison with the subjects in the control group. In conclusion, this study showed that serum Klotho concentration tends to be higher in MS patients when compared to control group. This finding might be attributed to treatment of MS patients with immunomodulatory drugs or a compensatory response to enhance CNS regeneration and/or vitamin D biosynthesis. Further studies are required to elucidate the role of Klotho in MS pathophysiology.

Health Related Quality of Life, Depression, Anxiety and Stress in Patients with Beta-Thalassemia Major

BACKGROUND

Awareness of factors associated with quality of life (QOL) in patients with beta-Thalassemia major (β-TM) is necessary to develop clinical programs in order to improve social support and QOL in β-TM patients. This study aimed to examine QoL, depression, anxiety, and stress in β-TM patients in Ahvaz, Iran.

MATERIALS AND METHODS

A cross-sectional study was conducted on173 β-TM patients aged ≥12 years (12-18=55, ≥19=118). Subjects were selected using a census method. Data collection instrument consisted of three parts including: demographic questions, SF-36 questionnaire and depression, anxiety, and stress scale (DAS-21).

RESULTS

The participants obtained a mean score of 64.38±18.20 for QOL, 6.4±5.1 for depression, 4.8±3.9 for anxiety, and 7.3±4.9 for stress. Significant relationship was found between QOL and employment (P=0.02) and education level (P<0.001). Patients in the age group of 12-18 years old had higher mean scores in the majority of QoL dimensions than those aged ≤19. The mean scores of depression, anxiety, and stress were higher in patients aged ≤19. No significant correlation was observed between QOL and depression, anxiety, stress scores, and other demographic variables. Moreover, a significant inverse correlation was found between QOL and depression (P<0.001,r= -0.62), anxiety (P<0.001,r= -0.55), and stress scores (P<0.001, r= -0.5) .

CONCLUSION

This study showed that β-TM patients experienced a considerable decrease both in their overall QoL and in its dimensions. A majority of the β-TM patients were also suffered from mild to severe depression, anxiety, and stress.

Indirect role of microRNAs and transcription factors in the regulation of important cancer genes: A network biology approach

Cancer is one of the leading causes of death worldwide. Although the mechanisms of gene regulation in cancer have been the subject of intense investigation during the last decades, the precise role of regulatory processes in cancer is largely unknown. More specifically, it is not completely understood how microRNAs and transcription factors regulate and influence the cancer-related processes. In the present study, using cancer-specific biological networks we examine the role of microRNAs and transcription factors (TFs) in regulation of important cancer genes. The importance measures which are used in this study consider both network structure information and biological data on miRNA- and TF-based gene regulation. By analyzing cancer-specific PPI, signaling and metabolic networks, it was shown that microRNAs and transcription factors tend to regulate those genes which are in the neighborhood of important components of cancer-specific PPI, signaling, and metabolic networks. The role of microRNAs was found to be particularly important, which confirms our previously-published results on the importance of microRNAs in detecting important network components. Moreover, we highlight that the miRNAs appear to apply their function via regulating the "neighbors" of important cancer genes, which implies their indirect role in cancer, and presumably, in fine-tuning the effect of other cancer-related genes.

Association of ABO blood types with the risk of in-stent restenosis

OBJECTIVES

To investigate the prevalence of in-stent restenosis (ISR) in patients with various ABO blood types.

METHODS

Clinical information from 150 patients with a confirmed diagnosis of ISR and 150 patients with a diagnosis of patent coronary stents in the secondary angiography was collected. Comprehensive demographic and laboratory data, including ABO and Rhesus blood groups, as well as comorbid conditions and vessel and stent characteristics, were recorded for each patient. The association of ABO blood groups with the risk of ISR before and after controlling for coronary risk factors was determined. Categorical data were analyzed with the Chi-square test and numerical values were analyzed with t-tests. Binary logistic regression models were constructed to compare type A and non-A for the frequency of risk factors.

RESULTS

A total of 392 stents were implanted in 300 patients. Two hundred and fourteen stents (54.6%) were patent and 178 stents (45.4%) were stenosed. Blood group A was significantly more common in the ISR group (43.3% vs. 28.7%, p=0.03). However, the frequencies of other blood types, as well as Rh antigen, were similar between the two groups. Triglyceride and low-density lipoproteins were the only significantly different variables (221 ± 198 mg/dL vs. 138 ± 76 mg/dL, p<0.001 and 108 ± 36 mg/dL vs. 96 ± 73 mg/dL, p=0.04, in type-A vs. non-A, respectively). After matching for coronary risk factors, there was no difference between A blood type patients and their controls.

CONCLUSION

ISR is significantly more prevalent in individuals with the type A blood group. However, this higher association is most likely due to higher atherogenic conditions in patients within this population.

Decarboxylation of oleic acid over Pt catalysts supported on small-pore zeolites and hydrotalcite

The catalytic decarboxylation and further conversions of oleic acid to paraffins, branched and aromatic hydrocarbons over Pt supported on small pore zeolites and hydrotalcite are demonstrated.

Information needs assessment of medical equipment offices based on Critical Success Factors (CSF) and Business System Planning (BSP) methods

Introduction: Given the ever-increasing importance and value of information, providing the management with a reliable information system, which can facilitate decision-making regarding planning, organization and control, is vitally important. This study aimed to analyze and evaluate the information needs of medical equipment offices. Methods: This descriptive applied cross-sectional study was carried out in 2010. The population of the study included the managers of statistic and medical records at the offices of vice-chancellor for treatment in 39 medical universities in Iran. Data were collected by using structured questioners. With regard to different kinds of designing information systems, sampling was done by two methods, BSP (based on processes of job description) and CSF method (based on critical success factors). The data were analyzed by SPSS-16. Results: Our study showed that 41% of information needs were found to be critical success factors of managers of office. The first priority of managers was "the number of bed and bed occupancy in hospitals". Of 29 identified information needs, 62% were initial information needs of managers (from the viewpoints of managers). Of all, 4% of the information needs were obtained through the form, 14% through both the form and database, 11% through the web site, and 71% had no sources (forms, databases, web site). Conclusion: Since 71% of the information needs of medical equipment offices managers had no information sources, the development of information system in these offices seems to be necessary. Despite the important role of users in designing the information systems (identifying 62% of information needs), other scientific methods is also needed to be utilized in designing the information systems.

The significance of chest ultrasound and chest X-ray in the diagnosis of children clinically suspected of pneumonia

Background. Community-acquired pneumonia (CAP) is the most prevalent diseases and a significant determinant of morbidity and death global. This study intended to compare and evaluate the benefits and importance of chest X-ray and chest ultrasound in the investigation of CAP in children. Methods. Study Population. One hundred children of one-month to five-years of age who suggested to the Children's Hospital in Bandar Abbas for pneumonia were evaluated by chest ultrasound and chest X-ray by different radiologists. Results. Evidence of involvement was recognized in 96% of the chest X-rays of those children, and also in 9% of the chest ultra-ultrasounds (6% opacity, 3% effusion). Pleural effusion was recognized in three of the children only by ultrasound. Conclusion. The utilization of ultrasound is a suitable method to estimate the complication of pneumonia.

The Effectiveness of self management program on quality of life in patients with sickle cell disease

BACKGROUND

Sickle cell patients suffer from many physical, psychological, and social problems that can affect their quality of life. To deal with this chronic condition and manage their disease and prevent complications associated with the disease, they must learn skills and behaviours. The aim of this study was to determine the effectiveness of self-management programs on quality of life in these patients.

MATERIAL AND METHODS

Samples of this quasi-experimental study, which included 69 patients with sickle cell disease referring to the Thalassemia Clinic of Shafa Hospital, were entered into the study by census method. Patients received a self-management program using the 5A model for 12 weeks, while their quality of life before the intervention were assessed at the twelfth week and thirty-sixth week using SF-36 questionnaire. Data were analyzed by descriptive statistics, paired t-test, Wilcoxon test, Hotelling's T2, and repeated measures test.

RESULTS

The eight dimensions and the total QoL score after intervention were significantly increased compared to those before the intervention (P<0.001). Repeated measures test showed that the mean score of eight QoL dimensions and the total QoL score decreased in the thirty-sixth week, compared to twelfth week. However, it was significantly enhanced in comparison with the intervention baseline (P<0.05).

CONCLUSIONS

Current study revealed the efficacy of self-management interventions on the quality of life in patients with sickle cell disease. Therefore, application of this supportive method could be useful to empower the patients and help them to manage the disease.

A survey of characteristics of self-immolation in the northern iran

Background:

Suicide is an action deliberately initiated and performed by a person with complete awareness of its fatal outcome, prevalence of which is very rare in developed countries, but it is reported with more frequency in Middle East including Iran.

Aim:

This study was carried out to analyze the characteristics, mortality, and related factors of burned patients who attempted to suicide by self-immolation in Northern Iran.

Materials and Methods:

In this retrospective study, the archived files of 101 cases that referred to the main burn care center located in northern Iran (Included: Mazadaran, Golestan cities) - cause of suicide attempting by self-immolation during 2 years 2010-2011, analyzed. A record sheet designed to extract data such as: Age, education, occupation, gender, residence, marital status, drug abuse, and extent of the burn injuries as a percent of burned total body surface area (TBSA).

Results:

The incidence rate of suicide attempted cases were 1.98/100,000 person-years. The mean ages for cases were 31.8 (13.6). The mean age for males and females were 36.1 (14.8) and 30.1 (12.9) years, respectively. In, about 84% (84/101) of the patient's burned TBSA was more than 40% (41/101). Burn injuries were more frequent, larger, and included higher mortality in females than males. Kerosene was the most common used material to self-burning. The mortality rate was about 74% (74/101), which showed a high mortality rate in this study. Other social factors such as marital status, employment, and education level have a role as individually protective or risk factors for self-burning.

Conclusion:

Finding of the current study manifested high rate of suicide by self-immolation among young, married, and low educated women in Northern Iran. It implies a social problem, and need to an arrangement of a cultural program aimed to improving health, psychological habits and educational level.

Targeted radionuclide therapy with RAFT-RGD radiolabelled with (90)Y or (177)Lu in a mouse model of αvβ3-expressing tumours

PURPOSE

The αvβ3 integrin plays an important role in tumour-induced angiogenesis, tumour proliferation, survival and metastasis. The tetrameric RGD-based peptide, regioselectively addressable functionalized template-(cyclo-[RGDfK])4 (RAFT-RGD), specifically targets the αvβ3 integrin in vitro and in vivo. The aim of this study was to evaluate the therapeutic potential of RAFT-RGD radiolabelled with β(-) emitters in a nude mouse model of αvβ3 integrin-expressing tumours.

METHODS

Biodistribution and SPECT/CT imaging studies were performed after injection of (90)Y-RAFT-RGD or (177)Lu-RAFT-RGD in nude mice subcutaneously xenografted with αvβ3 integrin-expressing U-87 MG cells. Experimental targeted radionuclide therapy with (90)Y-RAFT-RGD or (177)Lu-RAFT-RGD and (90)Y-RAFT-RAD or (177)Lu-RAFT-RAD (nonspecific controls) was evaluated by intravenous injection of the radionuclides into mice bearing αvβ3 integrin-expressing U-87 MG tumours of different sizes (small or large) or bearing TS/A-pc tumours that do not express αvβ3. Tumour volume doubling time was used to evaluate the efficacy of each treatment.

RESULTS

Injection of 37 MBq of (90)Y-RAFT-RGD into mice with large αvβ3-positive tumours or 37 MBq of (177)Lu-RAFT-RGD into mice with small αvβ3-positive tumours caused significant growth delays compared to mice treated with 37 MBq of (90)Y-RAFT-RAD or 37 MBq of (177)Lu-RAFT-RAD or untreated mice. In contrast, injection of 30 MBq of (90)Y-RAFT-RGD had no effect on the growth of αvβ3-negative tumours.

CONCLUSION

(90)Y-RAFT-RGD and (177)Lu-RAFT-RGD are potent agents targeting αvβ3-expressing tumours for internal targeted radiotherapy.

Hypoxia modulates the activity of a series of clinically approved tyrosine kinase inhibitors

BACKGROUND AND PURPOSE

Hypoxia in tumours is known to cause resistance to conventional chemotherapeutic drugs. In contrast, little is known about the effects of hypoxia on targeted anti-cancer drugs. This study evaluated the effect of hypoxia on a series of clinically approved tyrosine kinase inhibitors (TKIs).

EXPERIMENTAL APPROACH

The effect of hypoxia (0.1% oxygen) on the activity of conventional cytotoxic drugs (5-fluorouracil, doxorubicin and vinblastine), the hypoxia-activated prodrug tirapazamine and 9 TKIs was determined in a panel of cell lines. Where hypoxia had a marked effect on chemosensitivity, Western blot analysis was conducted to determine the effect of hypoxia on target expression and the effect of TKIs on cell signalling response under aerobic and hypoxic conditions.

KEY RESULTS

Three patterns of chemosensitivity were observed: resistance under hypoxia, equitoxic activity against hypoxic and aerobic cells, and preferential cytotoxicity to hypoxic cells. Significant hypoxia selectivity (independent of HIF1) was observed in the case of dasatinib and this correlated with the ability of dasatinib to inhibit phosphorylation of Src at tyrosine 530. Sorafenib was significantly less effective under hypoxic conditions but resistance did not correlate with hypoxia-induced changes in Raf/MEK/ERK signalling.

CONCLUSIONS AND IMPLICATIONS

Hypoxia influences the activity of TKIs but in contrast to conventional cytotoxic drugs, preferential activity against hypoxic cells can occur. The search for hypoxia-targeted therapies has been long and fruitless and this study suggests that some clinically approved TKIs could preferentially target the hypoxic fraction of some tumour types.

The predictive Value of Total Neutrophil Count and Neutrophil/Lymphocyte Ratio in Predicting In-hospital Mortality and Complications after STEMI

Introduction: Leukocytosis, predominantly neutrophilia, has previously been described following ST elevation myocardial infarction (STEMI). The exact contribution of this phenomenon to the clinical outcome of STEMI is yet to be shown. We examined cellular inflammatory response to STEMI in the blood and its association with in-hospital mortality and/or adverse clinical events.

Methods: In this cross-sectional study, 404 patients who were admitted with the diagnosis of acute STEMI at Madani Heart Hospital from March 2010 to March 2012 were studied. The complete blood cell count (CBC) was obtained from all patientswithin12-24 hours of the onset of symptoms. Total leukocytes were counted and differential count was obtained for neutrophils, lymphocytes and neutrophil/lymphocyte ratio (NLR) were evaluated. Association of cellular response with the incidence of post-MI mortality/complications was assessed by multiple logistic regression analyses.

Results: In-hospital mortality and post-STEMI complication rate were 3.7% and 43.6%, respectively. Higher age (P=0.04), female gender (0.002), lower ejection fraction (P<0.001) and absolute neutrophil count (P=0.04) were predictors of mortality. Pump failure in the form of acute pulmonary edema or cardiogenic shock occurred in 35 (8.9%) of patients. Higher leukocyte (P<0.03) and neutrophil counts (P<0.03) and higher NLR (P=0.01) were predictors of failure. The frequency of ventricular tachyarrhythmias (VT/VF) at the first day was associated with higher neutrophil count (P<0.001) and higher NLR level (P<0.001). In multivariate analysis neutrophil count was an independent predictor of mortality (OR=2.94; 1.1-8.4, P=0.04), and neutrophil count [OR=1.1, CI (1.01-1.20), P=0.02], female gender [OR=2.34, CI (1.02-4.88), P=0.04] and diabetes [OR=2.52, CI (1.21-5.2), P=0.003] were independent predictors of heart failure.

Conclusion: A single CBC analysis may help to identify STEMI patients at risk for mortality and heart failure, and total neutrophil count is the most valuable in predicting both.

Copper ion as a new leakage tracer

STATEMENT OF PROBLEM

Most failures of root canal treatments are caused by bacteria. Studies showed that the most common cause of endodontic failures were the incomplete obturation of the root canal and the lack of adequate apical seal. Some in-vitro methods are used to estimate sealing quality, generally by measuring microleakage that allows the tracer agent to penetrate the filled canal.

PURPOSE

Conventional methods of evaluating the seal of endodontically treated teeth are complicated and have some drawbacks. We used copper ion diffusion method to assess the leakage and the results were compared to dye penetration method.

MATERIALS AND METHOD

The crowns of 21 extracted teeth were cut off at the CEJ level. After preparing the canals, the teeth were placed in tubes containing saline. They were divided randomly into 15 experimental cases; 3 positive and 3 negative controls. Positive controls were filled by single cone without sealer while the experimental and the negative control groups were filled by lateral technique. The coronal portion of gutta was removed and 9mm was left. The external surface of each tooth was coated with nail polish. Two millimeters of apical portion was immersed into 9ml of distilled water and 0.3ml of CuSO4 solution was injected into the coronal portion. After 2 days, copper sulfate was measured by an atomic absorption spectrophotometer. The teeth were then immersed in 2% methylene blue for 24 hours, sectioned and the extent of dye penetration was measured by a stereomicroscope.

RESULTS

The maximum and minimum recorded copper ion concentrations for the experimental group were 18.37 and 2.87ppm respectively. The maximum and minimum recorded dye penetrations for the experimental group were 8.5 and 3.5mm respectively. The statistical analysis, adopting paired samples test, showed poor correlation between average recorded results of two methods.

CONCLUSION

Based on our results, there was no significant correlation between the dye penetration and the copper ion diffusion methods.

Information technology acceptance in health information management

OBJECTIVE

User acceptance of information technology has been a significant area of research for more than two decades in the field of information technology. This study assessed the acceptance of information technology in the context of Health Information Management (HIM) by utilizing Technology Acceptance Model (TAM) which was modified and applied to assess user acceptance of health information technology as well as viability of TAM as a research construct in the context of HIM.

METHODS

This was a descriptive- analytical study in which a sample of 187 personnel from a population of 363 personnel, working in medical records departments of hospitals affiliated to Tehran University of Medical Sciences, was selected. Users' perception of applying information technology was studied by a researcher-developed questionnaire. Collected data were analyzed by SPSS software (version16) using descriptive statistics and regression analysis.

RESULTS

The results suggest that TAM is a useful construct to assess user acceptance of information technology in the context of HIM. The findings also evidenced the perceived ease of use (PEOU) and perceived usefulness (PE) were positively associated with favorable users' attitudes towards HIM. PU was relatively more associated (r= 0.22, p = 0.05) than PEOU (r = 0.014, p = 0.05) with favorable user attitudes towards HIM.

CONCLUSIONS

Users' perception of usefulness and ease of use are important determinants providing the incentive for users to accept information technologies when the application of a successful HIM system is attempted. The findings of the present study suggest that user acceptance is a key element and should subsequently be the major concern of health organizations and health policy makers.

Early re-presentations and the potential role of catheter-directed thrombolysis in patients diagnosed with a lower limb deep vein thrombosis: a single-centre experience

Introduction

Catheter-directed thrombolysis (CDT) for iliofemoral deep vein thrombosis (DVT) restores venous patency, reduces the risk of the post-thrombotic syndrome and may reduce longer term treatment costs. This study assessed the potential role of CDT in patients with DVT with regard to representation following the index event.

Methods

A retrospective review of all patients with a positive lower limb DVT scan. Potential suitability of each patient to undergo CDT was based on well-recognized inclusion/exclusion criteria.

Results

In total, 1689 patients underwent a DVT-specific lower limb venous duplex. A total of 269 were found to have a DVT. Fifty-three of these patients met the inclusion criteria for CDT (only 2 underwent CDT). Fifty-nine of the 269 patients with an index DVT re-presented to our institution with a venous thromboembolism-related clinical event. These patients were significantly younger than those who did not reattend. A higher proportion of patients who represented were deemed suitable for CDT for the index DVT compared with those who did not represent (17/59 versus 36/210; P = 0.04).

Conclusion

This pragmatic study highlights the fact that significant number of patients return to secondary care with actual/perceived complications following initial diagnosis and treatment of a DVT which may have been amenable to CDT.

Mortality causes in children 1-59 months in iran

BACKGROUND

Mortality rate indicator for children under 5 years old is one of the important indicators in countries' development. Identifying the most common causes of mortality is one of the most important attempts to reduce mortality in children less than 5 years. The purpose of this study was to identify distribution of the mortality causes in Iranian children less than 5 years.

METHODS

This cross-sectional study has been carried out based on the results of data from the Child Mortality Surveillance System since 2007 to 2008. To determine the causes of death questionnaires have been designed which include personal data of the deceased child, medical history, and information on procedures at the time of hospitalization or death.

RESULTS

Of 5926 deaths on children under 5 years which the questionnaires were filled out, 63.2% were postneonatal deaths (1-11 month). Totally 60% of mortalities occurred in the rural areas and 52% of them had been among boys. The most common causes of mortality were the congenital and chromosomal abnormalities with 23.4%. The most incidences among diseases were respiratory system diseases.

CONCLUSIONS

Carrying out more epidemiologic studies, providing health programs to control and prevent diseases with high incidences and delivering more specialized health facilities and services could be the proper strategies to reduce under 5 mortality rates in Iran.

Epidemiological data, outcome, and costs of burn patients in Kermanshah

Burn injuries in both developed and developing countries cause long-term disability, mortality, and socio-economic costs that are imposed on patients, families, and societies. This study was carried out to investigate the epidemiology, outcome, and cost of hospitalization of 388 burn patients admitted to the Imam Khomeini Hospital Burn Center in Kermanshah, Iran, between 21 March 2011 and 20 March 2012. The data about demographics, cause of burns, degree of burns, outcome of burns, burned body surface (BBS), length of stay (LOS), and cost of hospitalization were collected by reviewing medical records and analysed by SPSS 16. The patients' mean age was 27 years. The male/female ratio in burn patients was 1.14/1. The mean BBS was 36.06%. The mean LOS was 9.04 days. Flame (67.0%) and hot liquids (21.9%) were the major causes of burn. Burn injuries were more common in the upper limbs (81.4%), lower limbs (70.9%), and head and neck (65.2%). 11.6% of patients had all the regions involved. The fatality rate was 18.8%. The mean cost per patient was 20,463,227 Iran Rials (IRR). The cost per one percentage of burn and one day of hospitalization was 562,632 IRR and 2,263,631 IRR, respectively. The main factors relevant to death were identified including the extent of burn, gender, age, causes, and degree of burn. In addition, LOS proved to have a higher impact on costs than burn percentage.

Developing data elements for research information system in health; a starting point for systems integration

BACKGROUND

This study defines necessary data elements required for the research information system in the domain of health, and its level of accountability to national health research indicators from the experts' perspective is being explored.

METHODS

This qualitative study was conducted based on comparative approach using the focus group method. Data were collected through 6 semi-structured group discussions held at the Undersecretary for Research and Technology, Ministry of Health and Medical Education, Tehran, Iran. For this study, 48 researchers were selected for the group discussions. All interviews and group discussions were recorded and transcribed. The Data analysis was performed simultaneously using Strauss and Corbin method.

RESULTS

BASED ON CONTENT ANALYSIS, THE NECESSARY DATA ELEMENTS IDENTIFIED FOR THE NATIONAL HEALTH RESEARCH INFORMATION SYSTEM DESIGNED FOR ALL DATABASES WERE THE FOLLOWING: organizations, researchers, journals, articles, research projects and dissertations. Also, extracted from the focus group discussion were three main themes regarding data elements of these databases for the National Health Research Information System: 1) essential elements for each database 2) the system's data elements accountability to the national indicators in the domain of health research and 3) recommendations in the direction of optimizing the data.

CONCLUSIONS

The results obtained from this study can serve as a valuable source in designing research information system in the domain of health within the country and in the region as well.

Prevalence and genetic variation of salivary gland hypertrophy virus in wild populations of the tsetse fly Glossina pallidipes from southern and eastern Africa

The Glossina pallidipes salivary gland hypertrophy virus (GpSGHV) is a rod-shaped, non-occluded double-stranded DNA virus that causes salivary gland hypertrophy (SGH) and reduced fecundity in the tsetse fly G. pallidipes. High GpSGHV prevalence (up to 80%) makes it impossible to mass-rear G. pallidipes colonies for the sterile insect technique (SIT). To evaluate the feasibility of molecular-based GpSGHV management strategies, we investigated the prevalence and genetic diversity of GpSGHV in wild populations of G. pallidipes collected from ten geographical locations in eastern and southern Africa. Virus diversity was examined using a total sequence of 1497 nucleotides (≈ 1% of the GpSGHV genome) from five putative conserved ORFs, p74, pif1, pif2, pif3 and dnapol. Overall, 34.08% of the analyzed flies (n=1972) tested positive by nested PCR. GpSGHV prevalence varied from 2% to 100% from one location to another but phylogenetic and gene genealogy analyses using concatenated sequences of the five putative ORFs revealed low virus diversity. Although no correlation of the virus diversity to geographical locations was detected, the GpSGHV haplotypes could be assigned to one of two distinct clades. The reference (Tororo) haplotype was the most widely distributed, and was shared by 47 individuals in seven of the 11 locations. The Ethiopian haplotypes were restricted to one clade, and showed the highest divergence (with 14-16 single nucleotide mutation steps) from the reference haplotype. The current study suggests that the proposed molecular-based virus management strategies have a good prospect of working throughout eastern and southern Africa due to the low diversity of the GpSGHV strains.

Cadmium and lead content in several brands of rice grains (Oryza sativa) in central Iran

The aim of this study was to investigate the cadmium (Cd) and lead (Pb) content of several commercially available brands of rice grains (Oryza sativa) in central Iran. A total of 67 samples of the most widely consumed brands of rice grains were purchased from local bazaar markets in Shahrekord, Iran. The first step, grains of raw rice were digested by acid digestion method and then were analyzed by atomic absorption spectrometer. The results showed that Cd concentration in rice grains ranged from 0.0378 to 0.1225 ppm dry weight and its average concentration was 0.062 ± 0.019 ppm and Pb content ranged from 0.0405 to 0.1281 ppm dry weight and its average concentration was 0.068 ± 0.0185 ppm. Cd and Pb concentrations in the sampled rice grains were lower in comparison with their upper limits (0.2 and 0.2 ppm for Cd and Pb, respectively) approved by food sanitary standard. Therefore, it can be concluded that there is no health problems due to the consumption of brands of rice grains, for these two elements. The results indicated that weekly intake of Cd and Pb from rice grains was below the provisional tolerable weekly intakes recommended by WHO/FAO.

A fatal case of Degos’ disease which presented with recurrent intestinal perforation

Degos’ disease, otherwise known as “malignant atrophic papulosis” is a rare vasculopathy with an unknown etiology characterized by typical cutaneous lesions. Involvement of the gastrointestinal (GI) tract is observed in approximately half of patients and small infarctions in the mucosa can cause perforation and resulting peritonitis, the leading cause of death. We present a fatal case of Degos’ disease with skin and GI involvement, manifesting as recurrent intestinal perforations and peritonitis, in a 15-year-old Iranian boy.

Oro-dental health status and salivary characteristics in children with chronic renal failure

Children suffering from decreased renal function may demand unique considerations regarding special oral and dental conditions they are encountered to. It is mentioned that renal function deterioration may affect the hard or soft tissues of the mouth. Having knowledge about the high prevalence of dental defects, calculus, gingival hyperplasia, modified salivary composition and tissue responses to the dental plaque may aid the physician and the dentist to help nurture the patient with chronic renal failure through the crisis, with an aesthetically satisfying and functioning dentition.