Salt and miscarriage: Is there a link?

Salt is a major mineral element that plays fundamental roles in health and disease. Excessive salt intake is a major cause of hypertension, cardiovascular disease and stroke. Miscarriage and preeclampsia are the most common pregnancy complications with multiple etiological factors, including inflammatory and autoimmune conditions. More recently, different studies indicated that excessive salt intake is involved in the development of inflammatory processes through induction of T helper-17 pathway and their inflammatory cytokines. On the other hand, several studies indicated the pivotal role of inflammation in the etiology of miscarriage, preeclampsia and adverse pregnancy outcome. Here, it is hypothesized that excessive salt intake around the time of conception or during pregnancy can trigger inflammatory processes, which consequently associated with increased risk of miscarriage, preeclampsia or adverse pregnancy outcome. Thus, this hypothesis suggests that low salt intake around the time of conception or during pregnancy can decrease the risk of miscarriage or adverse pregnancy outcome. This hypothesis also offers new insights about the role of salt in the etiology of miscarriage and preeclampsia.

ToRCH "co-infections" are associated with increased risk of abortion in pregnant women

ToRCH infections (toxoplasmosis, rubella, cytomegalovirus and Herpes simplex virus) have long been known to be associated with bad obstetric outcomes. However, little information is available about the impact of ToRCH co-infections on the outcome of pregnancy. Hence, we tested the IgG and IgM antibodies to Toxoplasma gondii, Rubella, Cytomegalovirus and Herpes Simplex Virus among 81 pregnant women with abortion (case group) and 98 pregnant women with normal delivery (control group). In the single-infection model, only CMV-IgM seropositivity was significantly increased in case than control group (25.9% in case and 12.2 % in control, OR = 2.5, P = 0.019). In the co-infection model, 14 patterns were recognized, but two patterns were significantly increased in the case than the control group. Co-infection of T. gondii IgG + CMV IgM was 9.1-fold increased in the case than the control group (8.6% in the case and 1% in control, OR = 9.1; P = 0.024). Also, co-infection of T. gondii IgG + HSV IgG + CMV IgM was 7.7-fold increased in case than the control group (7.4% in case and 1 % in control, OR = 7.7; P = 0.04). Although the OR of other co-infections was higher in the case than the control group, the difference was not statistically significant. These findings indicate that ToRCH co-infections are associated with increased risk of abortion than single infection. Hence, the rates of co-infections should be considered in prenatal screening of ToRCH infections.

Molecular detection of Toxoplasma gondii in house sparrow (Passer domesticus) by LAMP and PCR methods in Tehran, Iran

Toxoplasma gondii is one of the most common zoonotic parasitic diseases in human and warm-blooded animals worldwide. Birds are one of important intermediate hosts of T. gondii. The aim of this study is molecular detection of T. gondii in the house sparrow by LAMP and PCR methods in Tehran, Iran. A total 200 sparrows were captured in different regions of Tehran. DNA was extracted from tissue samples of each sparrow. LAMP and conventional PCR assays were carried out with a set of primers to detect the 529 bp fragment of T. gondii. LAMP and PCR were detected T. gondii from 17 (8.5 %) and 15 (7.5 %) of 200 sparrows respectively. These results indicated that sensitivity of LAMP was higher than conventional PCR. In our knowledge, this study is the first report of detection of T. gondii by LAMP method in bird hosts. Also, these findings provided an insight into epidemiological pattern of T. gondii infection in sparrow in Iran.

Toxoplasmosis-associated abortion and stillbirth in Tehran, Iran

OBJECTIVES

This study was aimed to evaluate the role of toxoplasmosis in etiology of abortion and stillbirth based on molecular and serological techniques.

MATERIAL AND METHODS

A total of 110 pregnant women with abortion and stillbirth were enrolled as the case group, and 110 pregnant women with normal delivery were enrolled as the control group. Serological and molecular detections of Toxoplasma gondii were assessed by ELISA and PCR methods.

RESULTS

The seroprevalence of IgG was 25.5% in the case group (26.8% in abortion and 21.4% in stillbirth) and 26.4% in the control group. IgM seropositivity was detected in 2.7% of the case group (3.6% in abortion and 0% in stillbirth) and 0.9% of the control group (p = 0.37). Toxoplasma gondii DNA was detected in 6.4% of the case group (7.3% in abortion and 3.6% in stillbirth) and 1.8% of the control group by PCR (p = 0.17). The major risk factor of congenital toxoplasmosis was the history of eating undercooked meat (p = 0.06).

CONCLUSION

Results of this study revealed that the rate of PCR positive in women with abortion and stillbirth was 3.7 times higher than that in normal delivery, but the difference was not statistically significant. These findings suggest that toxoplasmosis can be involved in etiology of abortion and stillbirth.

Prevalence of Trichomonas vaginalis infection in Kashan city, Iran (2012-2013)

BACKGROUND

Trichomonas vaginalis infection is one of the most common sexually transmitted diseases in humans. T.vaginalis is a parasitic protozoan with a predilection for human urogenital tract and causative agent for vaginitis, cervicitis and urethritis in females. T.vaginalis infection is associated with risk of Human Immunodeficiency Virus infectivity and pregnancy complication.

OBJECTIVE

In this study, the prevalence of T.vaginalis in individuals who referred to public health units in Kashan city, Iran was investigated.

MATERIALS AND METHODS

This study was conducted on 970 women and 235 men who referred to 5 government health centers in Kashan, Iran during October 2012 to August 2013. Demographic information was collected as per the study protocol. Vaginal discharges and urine samples were obtained and examined by Trypticase-Yeast Extract Maltose (TYM) culture medium and wet-mount methods. The prevalence of T. vaginalis was determined using culture based method and wet-mount examinations.

RESULTS

The overall prevalence of trichomonal infection was 2% (95% CI, 2±0.08). The age of infected individual was 33.7±9.4 years. All of those infected, were married housewives and 58.3% of them had primary school education. No statistical correlation was observed between clinical manifestations and parasitological results (p=0.8).

CONCLUSION

This study showed a relatively low prevalence of T.vaginalis infection in the study population. Since the clinical signs of trichomoniasis are the same of other Sexually Transmitted Diseases (STDs), confirmatory laboratory tests are necessary. Due to adverse outcomes of disease, there is a great need for public education regarding implementation of personal hygienic measures and prevention of inappropriate sexual contacts.

Neuropsychiatric manifestations of latent toxoplasmosis on mothers and their offspring

Toxoplasmosis is one of the most common parasitic diseases worldwide. It is estimated that approximately one-third of the world's population is latently infected. Infection generally occurs via oral the route and maternal transmission. Damage of the central nervous system is one of the most serious consequences of congenital toxoplasmosis. Moreover, recent investigations proposed that acute and sub-acute congenital toxoplasmosis as well as latent toxoplasmosis during pregnancy; play various roles in the etiology of different neuropsychiatric disorders in mothers and their offspring. This paper reviews new findings about the role of latent toxoplasmosis in the etiology of various neuropsychiatric disorders in mothers and their offspring.

Genetic differentiation between two sympatric morphs of the blind Iran cave barb Iranocypris typhlops

The phylogenetic relationship between two sympatric morphotypes of the Iran cave barb Iranocypris typhlops, and Garra rufa, was investigated by sequencing the cytochrome c oxidase I (coI) region (788 bp) providing the first molecular evidence of their phylogeny. Consistent with their morphological differences, the mean genetic distance between the two forms of I. typhlops was significantly higher than generally reported for intraspecific divergence in freshwater fishes. They were phylogenetically closer to G. rufa than to any other species.

Phylogenetic status of brown trout Salmo trutta populations in five rivers from the southern Caspian Sea and two inland lake basins, Iran: a morphogenetic approach

Interrelationships, origin and phylogenetic affinities of brown trout Salmo trutta populations from the southern Caspian Sea basin, Orumieh and Namak Lake basins in Iran were analysed from complete mtDNA control region sequences, 12 microsatellite loci and morphological characters. Among 129 specimens from six populations, seven haplotypes were observed. Based on mtDNA haplotype data, the Orumieh and southern Caspian populations did not differ significantly, but the Namak basin-Karaj population presented a unique haplotype closely related to the haplotypes of the other populations (0·1% Kimura two-parameter, K2P divergence). All Iranian haplotypes clustered as a distinct group within the Danube phylogenetic grouping, with an average K2P distance of 0·41% relative to other Danubian haplotypes. The Karaj haplotype in the Namak basin was related to a haplotype (Da26) formerly identified in the Tigris basin in Turkey, to a Salmo trutta oxianus haplotype from the Aral Sea basin, and to haplotype Da1a with two mutational steps, as well as to other Iranian haplotypes with one to two mutational steps, which may indicate a centre of origin in the Caspian basin. In contrast to results of the mtDNA analysis, more pronounced differentiation was observed among the populations studied in the morphological and microsatellite DNA data, except for the two populations from the Orumieh basin, which were similar, possibly due to anthropogenic causes.

Developing an educational scheme for undergraduate medical Curriculum: the unit of "infertility" as a sample

OBJECTIVES

To present our first experience in scheme development based on CPC philosophy in Iran.

HYPOTHESIS

One of the most important reasons of an obvious gap between medical education and professional expectations (outcomes) encountered by recent medical graduates is due to applying conventional curricula, which rely on hypothetical-deductive reasoning model. The University of Calgary has implemented a new curriculum which is organized according to 125 ways in which patients may present to a physician. In this study we will present our first experience in scheme development based on CPC philosophy in Iran.

METHODS

In 2007, research and clinical center for infertility (Yazd University of medical sciences, IRAN), began developing a full module for infertility (lesson plan) with fourteen components based on the new curricular philosophy. We recruited a scheme of infertility according to a specific way.

RESULTS

Thus, at the first step of the module creation, a scheme was made as the most important mainstay of presentation module, i.e. a structured scheme that includes all causative diseases of infertility.

CONCLUSIONS

Any effort in the organization of knowledge around schemes including in the domain of infertility would be valuable to meet some of the standards of WFME. Also, development of modules, by the teams composed of experts and students, can improve the quality of medical education.

Latent toxoplasmosis and human

Toxoplasmosis is one of the most common parasitic diseases worldwide. Although estimated that one third of the world's population are infected with Toxoplasma gondii, but the most common form of the disease is latent (asymptomatic). On the other hand, recent findings indicated that latent toxoplasmosis is not only unsafe for human, but also may play various roles in the etiology of different mental disorders. This paper reviews new findings about importance of latent toxoplasmosis (except in immunocompromised patients) in alterations of behavioral parameters and also its role in the etiology of schizophrenia and depressive disorders, obsessive-compulsive disorder, Alzheimer's diseases and Parkinson's disease, epilepsy, headache and or migraine, mental retardation and intelligence quotients, suicide attempt, risk of traffic accidents, sex ratio and some possible mechanisms of T. gondii that could contribute in the etiology of these alterations.

A new classification for female infertility

Infertility is defined as the inability of a couple to conceive after 12 months of regular, unprotected intercourse. However infertility is a clinical presentation and not a disease. Thus to be able to offer a new classification, it is necessary to apply a clinical presentation (philosophy) suggested by the University of Calgary in 1991. In recent years several classification algorithms have been proposed which apply key predictors of clinical, imaging, or morphological types to determine the diseases that can cause infertility. On the other hand, an algorithm is a product of an expert's mind after many years of practice and experience, which is too difficult to understand by a medical student. However there has not been any simple schematic classification based on a logical justification applying integration of etiologies with basic science to break down etiologies into categories, subcategories and disease classes of this clinical presentation. Because etiology has also become an important criterion for the characterization of causes of infertility, a classification proposal is presented here that attempts to include all relevant (basic science) features of the causative diseases of this clinical presentation.

The role of nitric oxide in bradycardia of rats with obstructive cholestasis

Nitric oxide (NO) has an important role in controlling heart rate and contributes to the cholinergic antagonism of the positive chronotropic response to adrenergic stimulation. Based on evidence of NO overproduction in cholestasis and also on the existence of bradycardia in cholestatic subjects, this study aimed to evaluate the chronotropic effect of epinephrine in isolated atria of cholestatic rats and determine whether alterations in epinephrine-induced chronotropic responses of cholestatic rats are corrected after systemic inhibition of NO synthase (NOS) with N(G)-nitro-L-arginine (L-NNA). Male Sprague-Dawley rats were used. Cholestasis was induced by surgical ligation of the bile duct under general anesthesia and sham-operated animals were considered as control. The animals were divided into three groups, which received either L-arginine (200 mg/kg/day), L-NNA (10 mg/kg/day) or saline. One week after the operation, a lead II ECG was recorded from the animals, then spontaneously beating atria were isolated and chronotropic responses to epinephrine were evaluated in a standard oxygenated organ bath. The results showed that plasma gamma-glutamyl transpeptidase and alanine aminotransferase activity was increased by bile-duct ligation, and that L-aginine treatment partially, but significantly, prevented the elevation of these markers of liver damage. The results showed that heart rate of cholestatic animals was significantly less than that of sham-operated control rats in vivo and this bradycardia was corrected with daily administration of L-NNA. The basal spontaneous beating rate of atria in cholestatic animals was not significantly different from that of sham-operated rats in vitro. Meanwhile, cholestasis induced a significant decrease in chronotropic effect of epinephrine. These effects were corrected by daily administration of L-NNA. Surprisingly L-arginine was as effective as L-NNA and increased the chronotropic effect of epinephrine in cholestatic rats but not in sham-operated animals. Systemic NOS inhibition corrected the decreased chronotropic response to adrenergic stimulation in cholestatic rats, and suggests an important role for NO in the pathophysiology of heart rate complications in cholestatic subjects. The opposite effect of chronic L-arginine administration in cholestasis and in control rats could be explained theoretically by an amelioration of cholestasis-induced liver damage by chronic L-arginine administration in bile duct-ligated rats.

N(G)-nitro-L-arginine methylester is protective against ethanol-induced gastric damage in cholestatic rats

In this study the effect of nitric oxide (NO) synthesis inhibition on ethanol-induced gastric damage was evaluated in bile duct-ligated, sham-operated and unoperated rats. The animals were injected intraperitoneally with saline, L-arginine (200 mg/kg) or N(G)-nitro-L-arginine methylester (L-NAME) in doses of 5, 15 and 30 mg/kg, 30 min before ethanol administration. The animals were killed 1 h after ethanol administration and their stomachs were removed for measurement of gastric mucosal damage. The results showed that L-NAME significantly enhanced the development of gastric mucosal lesions in sham-operated and unoperated rats, while in bile duct-ligated animals, L-NAME decreased and L-arginine enhanced the potentiation of ethanol-induced gastric mucosal damage. The plasma level of nitrite and nitrate was also measured and was significantly higher in bile duct-ligated rats than in control groups. The results suggest that inhibition of NO synthase with L-NAME has different effects on ethanol-induced gastric damage in cholestatic groups and in normal rats and that these effects can be explained by overproduction of NO in bile duct-ligated animals.