Quality of Life Changes in Iranian Patients Undergoing Female-to-Male Transsexual Surgery: A Prospective Study

BACKGROUND

Gender identity disorder (GID) is associated with various adverse health outcomes as well as psychiatric problems. Quality of life (QOL) in patients after surgery is an important issue, as some cases report dissatisfaction and regret after surgery. The present study compared QOL in female-to-male (FTM) GID patients before and after gender reassignment surgery (GRS) in an Iranian population. In the present study, 42 natal female patients with Gender Disorder diagnosis, who were referred to the Fertility Research Center of Tehran University of Medical Sciences for GRS from December 2014 to December 2015, were prospectively recruited.

METHODS

The demographic characteristics, including age, body mass index (BMI), occupational and marital status, educational level, and family support were recorded. Then, participants were asked to complete the Persian version of the 36-Item Short Form Health Survey (SF-36) questionnaire under supervision of the researcher, once at baseline and once 6 months after surgery.

RESULTS

The changes in SF-36 scores and association with the demographic variables were then evaluated using SPSS 16 at significance level of 0.05. Mean age of patients was 34.17 ± 5.58 years with a mean BMI of 43.14 ± 6.91 kg/m2 . Most were single (54.8%), had primary school education (50.5%), and acceptable family support (59.5%). Total mean score of QOL significantly improved from 26.43±6.81 to 37.52 ± 8.67 (P < 0.001), 6 months after surgery and also in all domains (P < 0.001), although the increase in emotional problem was not statistically significant (P = 0.05).

CONCLUSION

In conclusion, as the results of the present study highlight, FTM GD patients have a low QOL before surgery that is significantly improved after surgery.

Innovation Network Development Model in Telemedicine: A Change in Participation

Objectives

This paper introduces a telemedicine innovation network and reports its implementation in Tehran University of Medical Sciences. The required conditions for the development of future projects in the field of telemedicine are also discussed; such projects should be based on the common needs and opportunities in the areas of healthcare, education, and technology.

Methods

The development of the telemedicine innovation network in Tehran University of Medical Sciences was carried out in two phases: identifying the beneficiaries of telemedicine, and codification of the innovation network memorandum; and brainstorming of three workgroup members, and completion and clustering ideas. The present study employed a qualitative survey by using brain storming method. Thus, the ideas of the innovation network members were gathered, and by using Freeplane software, all of them were clustered and innovation projects were defined.

Results

In the services workgroup, 87 and 25 ideas were confirmed in phase 1 and phase 2, respectively. In the education workgroup, 8 new programs in the areas of telemedicine, tele-education and teleconsultation were codified. In the technology workgroup, 101 and 11 ideas were registered in phase 1 and phase 2, respectively.

Conclusions

Today, innovation is considered a major infrastructural element of any change or progress. Thus, the successful implementation of a telemedicine project not only needs funding, human resources, and full equipment. It also requires the use of innovation models to cover several different aspects of change and progress. The results of the study can provide a basis for the implementation of future telemedicine projects using new participatory, creative, and innovative models.

Decreased serum level of soluble-leptin-receptor in patients with systemic lupus erythematosus

BACKGROUND

There is some evidence suggesting that leptin and its negative regulator, soluble-leptinreceptor (SLR) may be able to influence inflammatory and autoimmune processes.

METHODS

In this study, several variables including socio-demographics, health-related habits, depression score, serum molecules and blood parameters besides the SLR level were evaluated in patients with SLE (SLE-patients) and healthy controls.

RESULTS

The patients had significantly lower SLR level and higher depression score than the controls and both of these variables have a significant association with the occurrence of disease in logistic regression model. Moreover, the results of Pearson correlation analysis showed that patients' SLR level was negatively correlated with their weights and BDI scores.

CONCLUSION

For the first time, this study indicated a lower level of SLR in SLE-patients and suggested that lower concentrations of SLR in these patients may be implicated in the pathogenesis of SLE.

Strain-specific SCAR markers for the detection of Trichoderma harzianum AS12-2, a biological control agent against Rhizoctonia solani, the causal agent of rice sheath blight

In order to identify a specific marker for T. harzianum AS12-2, a strain capable of controlling rice sheath blight caused by Rhizoctonia solani, UP-PCR was performed using five universal primers (UP) both separately and in pairwise combinations. The application of two UP primers resulted in the amplification of unique fragments from the genomic DNA of T. harzianum AS12-2, clearly distinguishing it from other Trichoderma strains. The unique fragments had no significant sequence homology with any other known sequence available in databases. Based on the sequences of the unique fragments, 14 oligonucleotide primers were designed. Two primer sets amplified a fragment of expected size from the DNA of strain T. harzianum AS12-2 but not from any other examined strains belonging to T. harzianum, to other Trichoderma species assayed, or to other common fungi present in paddy fields of Mazandaran province, Iran. In conclusion, SCAR (sequence characterized amplified regions) markers were successfully identified and rapid, reliable tools were provided for the detection of an effective biocontrol Trichoderma strain, which can facilitate studies of its population dynamics and establishment after release into the natural environment.

Promoter polymorphism of transforming growth factor-β1 gene and ulcerative colitis

AIM: To elucidate the possible difference in two promoter polymorphisms of the transforming growth factor-β1 (TGF-β1) gene (-800G > A, -509C > T) between ulcerative colitis (UC) patients and normal subjects.

METHODS: A total of 155 patients with established ulcerative colitis and 139 normal subjects were selected as controls. Two single nucleotide polymorphisms within the promoter region of TGF-β1 gene (-509C > T and -800G > A) were genotyped using PCR-RFLP.

RESULTS: There was a statistically significant difference in genotype and allele frequency distributions between UC patients and controls for the -800G > A polymorphism of the TGF-β1 gene (P < 0.05). The frequency of the TGF-β1 gene polymorphism at position -800 showed that the AA genotype and the allele A frequencies significantly differed between the patients and healthy controls (P < 0.05). At position -509, there was no statically significant difference in genotype and allele frequency between the patients and control subjects.

CONCLUSION: The results of our study indicate that there is a significant difference in both allele and genotype frequency at position -800G > A of TGF-β1 gene promoter between Iranian patients with UC and normal subjects.

Association of IL-18 promoter polymorphisms with predisposition to Type 1 diabetes

AIMS

IL-18, a potent IFN-gamma-inducing cytokine, is capable of polarizing the immune response to a Th1 phenotype. Recent studies have demonstrated an association between single-nucleotide polymorphisms located at positions -607 (A/C) and -137 (C/G) in the promoter region of IL-18 gene and Type 1 diabetes. The aim of the present study was to determine whether the same polymorphisms of the gene were associated with Type 1 diabetes in Iranians.

METHODS

In 112 patients with Type 1 diabetes and 194 non-diabetic control subjects, these two single-nucleotide polymorphisms were analysed by sequence-specific PCR.

RESULTS

Allele and genotype frequencies of the IL-18 gene polymorphisms were similar in the whole group of Type 1 diabetic patients and controls. However, categorizing patients according to age at onset of diabetes revealed a significant difference in distribution of the genotypes at position -137 between patients with older age at onset (> 15 years) (GG 49%, GC 34%, CC 17%) and control subjects (GG 57.7%, GC 36.6%, CC 5.7%) (P = 0.027). Frequency of the C allele at position -137 was significantly higher in these patients than in controls (P = 0.038). Moreover, there was an association between -607AA/-137CC genotype combination and susceptibility to Type 1 diabetes in this subgroup of patients (pc = 0.027).

CONCLUSIONS

The results of this study show that polymorphisms of IL-18 promoter confer susceptibility to Type 1 diabetes in Iranian individuals with onset at older ages. Further investigations are necessary to clarify the effect of IL-18 variants on immune regulation.

Sheath rot of rice in Iran

Sheath rot of rice occurs in most rice-growing regions of the world. It usually causes yield losses from 20 to 85%. Sheath rot was reported from Iran in 1993. Year after year, the number of diseased plants increased in the Northern Iran. In summer of 2001, these symptoms were observed in most fields: lesions occur on the upper leaf sheaths, especially the flag leaf sheath. As the disease progresses, lesions enlarge and coalesce and may cover most of the leaf sheath. Panicle may fail to completely or at all. Brown or partially brown not filled or partially filled grain is also associated with infection of the panicle. A whitish powdery growth may be found inside affected sheaths. Infected plants were collected and trasferred to laboratory. Small pieces of diseased tissues were washed under tap water for one hour. Then tissues were placed on WA and incubated at 25 degrees C. These isolates were purified and identified as: Sarocladium oryzae, Fusarium udum, F. semitectum, F. avenaceum, F. flocciferum, F. graminearum, Bipolaris oryzae, Alternaria padwickii, Rhizoctonia solani, Paecilomyces sp., Nigrospora sp. and Trichoderma sp. This is the first report of F. udum in Iran. Also this is the first report that rice is the host for F. semitectum, F. avenaceum and F. flocciferum in Iran. Pathogenicity tests were conducted in glass house. Following species were found to be associated with sheath rot of rice: S. oryzae, F. graminearum, F. udum, F. avenaceum, B. oryzae, A. padwickii. This is the first report in the world that F. udum and A. padwickii are the causal agents of the sheath rot on rice plants.