The impact of illicit drug use on Spontaneous Hepatitis C Clearance: Experience from a large cohort population study

Background and Aims: Acute hepatitis C infection usually ends in chronic infection, while in a minority of patients it is spontaneously cleared. The current population-based study is performed on a large cohort in Golestan province of Iran to examine the demographic correlates of Spontaneous Hepatitis C Clearance. Methods: Serum samples used in this study had been stored in biorepository of Golestan Cohort Study. These samples were evaluated for anti hepatitis C Virus by third generation Enzyme-linked immunosorbent assay (ELISA). Subjects who tested positive were then invited and tested by Recombinant Immunoblot Assay (RIBA) and Ribonucleic Acid Polymerase Chain Reaction test (PCR). If tested positive for RIBA, subjects were recalled and the two tests were re-done after 6 months. Those subjects who again tested positive for RIBA but negative for PCR were marked as cases of spontaneous clearance. Results: 49,338 serum samples were evaluated. The prevalence of Chronic Hepatitis C Virus (CHCV) infection based on PCR results was 0.31. Among those who had acquired hepatitis C, the rate of SC was 38. In multivariate analysis, illicit drug use both Injecting Use (OR = 3.271, 95 CI: 1.784-6.000, p-value<0.001) and Non-Injecting Use (OR = 1.901, 95 CI: 1.068-3.386, p-value = 0.029) were significant correlates of CHCV infection versus SC. Conclusions: Illicit drug use whether intravenous or non-intravenous is the only significant correlate of CHCV, for which several underlying mechanisms can be postulated including repeated contacts with hepatitis C antigen. © 2011 Poustchi et al

Candidate gene association study of esophageal squamous cell carcinoma in a high-risk region in Iran

There is a region with a high risk for esophageal squamous cell carcinoma (ESCC) in the northeast of Iran. Previous studies suggest that hereditary factors play a role in the high incidence of cancer in the region. We selected 22 functional variants (and 130 related tagSNPs) from 15 genes that have been associated previously with the risk of ESCC. We genotyped a primary set of samples from 451 Turkmens (197 cases and 254 controls). Seven of 152 variants were associated with ESCC at the P = 0.05 level; these single nucleotide polymorphisms were then studied in a validation set of 549 cases and 1,119 controls, which included both Turkmens and non-Turkmens. The association observed for a functional variant in ADH1B was confirmed in the validation set, and that of a tagSNP in MGMT, the association was borderline significant in the validation set, after correcting for multiple testing. The other 5 variants that were associated in the primary set were not significantly associated in the validation set. The histidine allele at codon 48 of ADH1B gene was associated with a significantly decreased risk of ESCC in the joint data set (primary and validation set) under a recessive model (odds ratio, 0.41; 95 confidence interval, 0.29-0.76; P = 4 × 10⁻⁴). The A allele of the rs7087131 variant of MGMT gene was associated with a decreased risk of ESCC under a dominant model (odds ratio, 0.79; 95 confidence interval, 0.64-0.96; P = 0.02). These results support the hypothesis that genetic predisposition plays a role in the high incidence of ESSC in Iran. ©2009 American Association for Cancer Research

Etnicidad, nacionalismo y el Estado en Afganistán

The paper begins by surveying the cultural, linguistic, occupational and sectarian diversity of Afghanistan's population, going on to discuss the origins of the modern Afghan state in the reign of Amir Abdur Rahman Khan in the late 19th century. It explains that it has almost always been dominated by Pashtuns, particularly Durranis, and that this has often been resented by non-Pashtuns. It looks at the way that starting in the 1920s efforts were made to link Afghan national identity with Pashtun culture and values. Opposition to King Amanullah's modernisation programme led to his departure in 1928. For a brief period in 1929 a Tajik ruler, Habibullah II, held power, but Amanullah's third cousin, Nadir Khan, soon restored the Durrani monarchy. A renewed emphasis on the Pashtun character of the Afghan state followed, with for instance Pashtu being proclaimed the official language in 1937. After drawing attention to the significance of the Prime Minister Daud Khan's support for an independent Pashtun state, Pashtunistan, in the 1950s, the paper looks at the emergence of a somewhat more inclusive ethos and a stronger sense of a shared national identity in the 1960s. Finally it examines the impact of the Saor Revolution in April 1978, the anti-Soviet jihad of the 1980s and the rise of Taliban in the mid-1990s on identity, concluding that ethnic divisions and tensions became more marked in the last quarter of the 20th century

Prognostic factors for esophageal squamous cell Carcinoma-A Population-Based study in Golestan province, Iran, a high incidence area

Golestan Province in northern Iran is an area with a high incidence of esophageal squamous cell carcinoma (ESCC). We aimed to investigate prognostic factors for ESCC and survival of cases in Golestan, on which little data were available. We followed-up 426 ESCC cases participating in a population-based case-control study. Data were analyzed using the Kaplan-Meier method and the Cox proportional hazard models. Median survival was 7 months. Age at diagnosis was inversely associated with survival, but the association was disappeared with adjustment for treatment. Residing in urban areas (hazard ratio, HR = 0.70; 95 CI 0.54-0.90) and being of non-Turkmen ethnic groups (HR = 0.76; 95 CI 0.61-0.96) were associated with better prognosis. In contrast to other types of tobacco use, nass (a smokeless tobacco product) chewing was associated with a slightly poorer prognosis even in models adjusted for other factors including stage of disease and treatment (HR = 1.38; 95 CI 0.99-1.92). Opium use was associated with poorer prognosis in crude analyses but not in adjusted models. Almost all of potentially curative treatments were associated with longer survival. Prognosis of ESCC in Golestan is very poor. Easier access to treatment facilities may improve the prognosis of ESCC in Golestan. The observed association between nass chewing and poorer prognosis needs further investigations; this association may suggest a possible role for ingestion of nass constituents in prognosis of ESCC. © 2011 Aghcheli et al

Trend of stunting, overweight and obesity among children under five years in a rural area in Northern Iran, 1998–2013: Results of three cross-sectional studies

Background: Obesity is a common health problem in the world and the purpose of this study was to identify the trend of overweight, obesity and stunting among children under five from 1998 to 2013 that was carried out in three stages in the villages of Golestan province in the northern Iran (south east of the Caspian Sea). Methods: Three cross-sectional studies with sample sizes of 7575, including 2339, 2749 and 2487 cases were carried out in 1998, 2004 and 2013, respectively. Among 118 villages, 20 were chosen by random sampling and all of the under-five-children in these villages were assessed. For all subjects, a questionnaire was completed and anthropometric indices were measured. Z-score was used for body index classification with following categories: Z ≤ 2SD=Normal or under-nutrition; >2SD Z ≤3SD = Overweight and Z>3SD = Obesity. P-value under 0.05 indicated significance. Results: In 1998, 2004 and 2013, the prevalence of overweight was 8.5% (95% Cl; 7.3–9.6), 3.3% (95% Cl; 2.7–4.0) and 5.2% (95% Cl; 4.2–6.1), that of obesity was 4.6%(95% Cl; 3.8–3.5), 1.2% (95% Cl; 0.8–1.6) and 3.5% (95% Cl; 2.8–4.3), and that of stunting was 32.8% (95% Cl; 31.0–34.6), 13.4% (95% Cl; 12.2–14.6) and 15.7% (95% Cl;14.3–17.2), respectively. In boys, the mean of height was significantly different in all age groups while the mean of weight was significant only at ages 13–24, 37–48 and 49–60 months (P< 0.005 for all). In girls, the mean of height significantly different from 36 months age (P < 0.01) whereas weight difference was significant only at age of 37–48 months (P = 0.002). Conclusion: A heterogenic trend was seen in stunting, overweight and obesity. Although short stature was the main cause of obesity in 1998, extra weight was its major cause in 2013. Renewed increase of obesity among children under-five is considerable in the northern Iran. © 2016, Academy of Medical Sciences of the I.R. Iran

Endoscopic screening for precancerous lesions of the esophagus in a high risk area in northern Iran

Background: Esophageal squamous cell carcinoma (ESCC) is a major health problem in many developing countries, including Iran. ESCC has a very poor prognosis, largely due to late diagnosis. As a first step in developing an early detection and treatment program, we conducted a population-based endoscopic screening for ESCC and its precursor lesion, esophageal squamous dysplasia (ESD), in asymptomatic adults from Golestan Province, northern Iran (a high-risk area for ESCC) to evaluate the feasibility of such a program and to document the prevalence and risk factor correlates of ESD. Methods: This cross-sectional study was conducted among participants of the Golestan Cohort Study (GCS), a population-based cohort of 50,000 adults in eastern Golestan Province. Randomly selected GCS participants were invited by telephone. Those who accepted were referred to a central endoscopy clinic. Eligible subjects who consented were asked to complete a brief questionnaire. Detailed information about selected risk factors was obtained from the GCS main database. Endoscopic examination with was performed with Lugol's iodine staining; biopsies were taken from unstained lesions as well as the normally stained mucosa of the esophagus, and the biopsies were diagnosed by expert pathologists according to previously described criteria. Results: In total, 1906 GCS subjects were invited, of whom only 302 (15.8%) were successfully enrolled. Esophagitis (29.5%) and ESD (6.0%) were the most common pathological diagnoses. Turkmen ethnicity (adjusted OR = 8.61; 95%CI: 2.48-29.83), being older than the median age (OR = 7.7; 95% CI: 1.99-29.87), and using deep frying cooking methods (OR = 4.65; 95%CI: 1.19-18.22) were the strongest predictors for ESD. There were significant relationships between esophagitis and smoking (p-value<0.001), drinking hot tea (P value = 0.02) and lack of education (P value = 0.004). Conclusion: We observed a low rate of participation in endoscopic screening. The overall prevalence of ESD was 6.0%. Developing non-endoscopic primary screening methods and screening individuals with one or more risk factors may improve these rates

Images of Trebizond and the Pontos in Contemporary Literature in English with a Gothic Conclusion

A Byzantinist specializing in the history of the Empire of Trebizond (1204–1461), the author presents four books of different genres written in English and devoted to the medieval state on the south coast of the Black Sea. The most spectacular of them is a novel by Rose Macaulay, Towers of Trebizond. Dąbrowska wonders whether it is adequate to the Trebizondian past or whether it is a projection of the writer. She compares Macaulay’s novel with William Butler Yeats’s poems on Byzantium which excited the imagination of readers but were not meant to draw their attention to the Byzantine past. This is, obviously, the privilege of literature. As a historian, Dąbrowska juxtaposes Macaulay’s narration with the historical novel by Nicolas J. Holmes, the travelogue written by Michael Pereira and the reports of the last British Consul in Trabzon, Vorley Harris. The author of the article draws the reader’s attention to the history of a rather unknown and exotic region. The Empire of Trebizond ceased to exist in 1461, conquered by Mehmed II. At the same time the Sultan’s army attacked Wallachia and got a bitter lesson from its ruler Vlad Dracula. But this Romanian hero is remembered not because of his prowess on the battlefield but due to his cruelty which dominated literary fiction and separated historical facts from narrative reality. The contemporary reader is impressed by the image of a dreadful vampire, Dracula. The same goes for Byzantium perceived through the magic stanzas by Yeats, who never visited Istanbul. Rose Macaulay went to Trabzon but her vision of Trebizond is very close to Yeats’s images of Byzantium. In her story imagination is stronger than historical reality and it is imagination that seduces the reader

Afghan Refugees in Buffalo

Afghanistan is a diverse country with many different ethnicities, often differentiated by language or religious beliefs. Many of the groups can also be found in the nations that border Afghanistan: Pakistan, Iran, Turkmenistan, Uzbekistan, Tajikistan, and China. Since 2003, New York State has resettled 395 Afghan refugees, including 63 in 2013. Many of these have settled in Erie County. Many recently resettled individuals from Afghanistan have come with “SIV” status. Similar to refugee status, SIV indicates “Special Immigrant Visa”, made available to individuals who worked with the US Armed Forces in Afghanistan (often as a translator or interpreter)