Polymorphisms of plasminogen activator inhibitor-1, angiotensin converting enzyme and coagulation factor XIII genes in patients with recurrent spontaneous abortion

We investigated polymorphisms of plasminogen activator inhibitor-1 (PAI-1), angiotensin converting enzyme (ACE ) and coagulation factor XIII (FXIII) genes and their association with recurrent spontaneous abortion (RSA) in Iranian patients and normal healthy controls. Ten (18.5%) patients were homozygote (4G/4G) for PAI-1 polymorphism, in contrast with two (2%) controls (p = 0.001). Patients with homozygote 4G mutation were significantly more prone to RSA in contrast to others (odds ratio: 11.0, 95% CI: 2.3-52.4). Nineteen (30.2%) patients and 25 (26.6%) controls were homozygote (DD) for ACE polymorphism. We observed only two patients and one control with homozygosity (34leu) for FXIII polymorphism. 4G/4G polymorphism for PAI-1 gene could be a thrombophilic mutation leading to abortion in Iranian population

The effect of intravenous vitamin C on the phosphorus level reduction in hemodialysis patients: A double blind randomized clinical trial

Aim The majority of hemodialysis patients are hyperphosphate-mic. Hyperphosphatemia in these patients can lead to renal oste-odystrophy, vascular calcifcation, cardiovascular events, and is independently associated with mortality risk. The aim of this study was to evaluate the effect of intravenous vitamin C on phosphorus level in hemodialysis patients. Methods Using a double blind randomized clinical trial, a total of 60 qualified hemodialysis patients were randomly allocated in two intervention and control groups and serum phosphorus, CRP, calcium, albumin and PTH levels were measured. At the end of each hemodialysis session, intervention group received vitamin C vial (500mg/5cc) intravenously three times a week for 8 weeks and control group received normal saline in the same way. Data were collected before and after two months of treatment. Data were analyzed using independent t-test, paired t-test and chi-square test. Results Vitamin C treated group had a significant decrease in phosphorus (p=0.01), CRP level (p=0.01) and Ca�P product (p=0.03). In contrast, there was no significant difference in phosphorous (p= 0.5) and CRP levels (p= 0.6) and Ca�P product (p=0.7) in the control group. In addition, there was no statistically significant change in calcium (p=0.1), PTH (p=0.4) and albumin (p=0.4) levels in both groups. Conclusion Intravenous vitamin C can significantly decrease phosphorus level in hemodialysis patients

Maternal haemoglobin concentrations before and during pregnancy and stillbirth risk: A population-based case-control study

Background: Results of previous studies on the association between maternal haemoglobin concentration during pregnancy and stillbirth risk are inconclusive. It is not clear if haemoglobin concentration before pregnancy has a role. Using prospectively collected information from pre-pregnancy and antenatal visits, we investigated associations of maternal haemoglobin concentrations before and during pregnancy and haemoglobin dilution with stillbirth risk. Methods: In a population-based case-control study from rural Golestan, a province in northern Iran, we identified 495 stillbirths (cases) and randomly selected 2,888 control live births among antenatal health-care visits between 2007 and 2009. Using logistic regression, we estimated associations of maternal haemoglobin concentrations, haemoglobin dilution at different stages of pregnancy, with stillbirth risk. Results: Compared with normal maternal haemoglobin concentration (110-120g/l) at the end of the second trimester, high maternal haemoglobin concentration (≥140g/l) was associated with a more than two-fold increased stillbirth risk (OR = 2.31, 95% CI [1.30-4.10]), while low maternal haemoglobin concentration (<110g/l) was associated with a 37% reduction in stillbirth risk. Haemoglobin concentration before pregnancy was not associated with stillbirth risk. Decreased haemoglobin concentration, as measured during pregnancy (OR = 0.61, 95% CI [0.46, 0.80]), or only during the second trimester (OR = 0.75, 95% CI [0.62, 0.90]), were associated with reduced stillbirth risk. The associations were essentially similar for preterm and term stillbirths. Conclusions: Haemoglobin concentration before pregnancy is not associated with stillbirth risk. High haemoglobin level and absence of haemoglobin dilution during pregnancy could be considered as indicators of a high-risk pregnancy. © 2016 The Author(s)

Cancer incidence in Golestan province: Report of an ongoing population-based cancer registry in Iran between 2004 and 2008

Background: Golestan Province, at the western end of the Asian esophageal cancer (EC) belt in northeastern Iran, was reported to have one of the highest worldwide rates of EC in the 1970s. We have previously shown a declining incidence of EC in Golestan during the last decades. This study reports additional new results from the Golestan Population-based Cancer Registry (GPCR). Methods: The GPCR collected data from newly diagnosed (incident) cancer cases from all 68 public and private diagnostic and therapeutic centers in Golestan Province. CanReg-4 software was used for data entry and analysis based on the guidelines of the International Agency for Research on Cancer (IARC). Age-standardized incidence rates (ASR) of cancers were calculated using the 2000 world standard population. Results: From 2004 through 2008, 9007 new cancer cases were reported to the GPCR. The mean (SD) age was 55.5 (18.6) years, and 54 were diagnosed in men. The ASRs of all cancers were 175.3 and 141.1 per 100,000 person-years for males and females, respectively. Cancers of the stomach (ASR:30.7), esophagus (24.3), and lung (15.4) were the most common cancers in males. In females, breast cancer (ASR:26.9) was followed by malignancies of the esophagus (19.1) and stomach (12.4). The diagnosis of cancer was based on histopatho- logical reports in 71 and on death certificate only in 9 ofcases. Conclusions: The EC incidence rate continues to decline in Golestan, while the incidence rates of stomach, colorectal, and breast cancers continue to increase

Lymphomas in Golestan province of Iran: Results of a population-based cancer registry

Introduction: Malignancies of lymphoid cells can be divided into Hodgkin and non-Hodgkin lymphomas (NHL) on the basis of pathologic features, clinical manifestations and treatment. In this paper we present data on lymphomas in Golestan province, in the northeast of Iran, during 2004-2006, using three years results of the Golestan population-based cancer registry (GPCR), a voting member of the International Association of Cancer Registries (IACR). Methods: GPCR started collecting data on all cancers from all public and private diagnostic and therapeutic centers (hospitals, specialist physicians' offices, pathology, laboratory, and imaging centers) of Golestan province in 2004. Here, we used the Iranian national census data to identify the population characteristics of this geographical area. The last census was done in 2006 and the next one will be done in 2011. The population data for years between the national census intervals are retrieved from provincial census done annually by health deputy of Golestan University of Medical Sciences (GOUMS). Results: A total of 5,076 cancer cases were diagnosed in the GPCR between 2004 and 2006. Of these, 237 (4.67 %) were lymphomas, among the ten top cancers of this area, the patients having a mean (±SD) age of 45.2 (±20.9) years. The number of cases, frequency, age specific rates, crude rates and age standardized incidence rates (ASR) (per 100,000 personyears) for lymphomas in males and females are presented. Conclusion: It could be concluded that according to available therapies for HL and NHL, the outcome of the patients could be improved in this area, due to the better diagnostic and therapeutic methods now available

Consanguineous marriage, prepregnancy maternal characteristics and stillbirth risk: A population-based case-control study

Introduction. Consanguineous marriage is associated with increased risks for congenital anomalies, low birthweight, and other adverse perinatal outcomes. In this population-based, case-control study we investigated the association between consanguineous marriage (first-cousin marriage) and stillbirth risk, using prospectively collected information from prepregnancy visits. Material and methods. From 2007 to 2009, we identified 283 stillbirths (cases) and 2088 randomly selected live control births through prepregnancy visits in rural Golestan, Iran. The associations between consanguinity and prepregnancy maternal characteristics and stillbirth risk were examined using multivariate logistic regression. Results. The rate of consanguineous marriage was 19.4% among cases and 13.6% among controls. Consanguinity was associated with increased stillbirth risk [odds ratio (OR) 1.53; 95% CI 1.10-2.14]. The association was significantly increased for preterm stillbirth (< 37 gestational weeks) (OR 2.43; 95% CI 1.46-4.04) but not for term stillbirth (≥ 37 weeks) (OR 1.14; 95% CI 0.75-1.74). Low and high maternal age, underweight, obesity, nulliparity, a history of infertility or miscarriage, previous obstetric complications (preeclampsia, preterm delivery, and stillbirth in previous pregnancies) were also associated with increased stillbirth risks. Conclusions. Consanguineous marriage is associated with increased risk of stillbirth, particularly preterm stillbirth. Findings for other maternal risk factors for stillbirth in rural Iran are consistent with previously reported findings from high-income countries. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology

Modeling and predicting drug pharmacokinetics in patients with renal impairment

Current guidance issued by the US FDA to assess the impact of renal impairment on the pharmacokinetics of a drug under development has recently been updated to include evaluation of drugs with nonrenal elimination routes. Renal impairment not only affects elimination of the drug in the kidney, but also the nonrenal route of drugs that are extensively metabolized in the liver. Renal failure may influence hepatic drug metabolism either by inducing or suppressing hepatic enzymes, or by its effects on other variables such as protein binding, hepatic blood flow and accumulation of metabolites. Prior simulation of the potential exposure of individuals with renal impairment may help in the selection of a safe and effective dosage regimen. In this article, we discuss the application of a systems biology approach to simulate drug disposition in subjects with renal impairment. © 2011 Expert Reviews Ltd

Efficacy and safety of using amplatzer ductal occluder for transcatheter closure of perimembranous ventricular septal defect in pediatrics

Background: Perimembranous Ventricular Septal Defect (PMVSD) is the most common subtype of ventricular septal defects. Transcatheter closure of PMVSD is a challenging procedure in management of moderate or large defects. Objectives: The purpose of this study was to show that transcatheter closure of perimembranous ventricular septal defect with Amplatzer Ductal Occluder (ADO) is an effective and safe method. Patients and Methods: Between April 2012 and April 2013, 28 patients underwent percutaneous closure of PMVSD using ADO. After obtaining the size of VSD from the ventriculogram a device at least 2 mm larger than the narrowest diameter of VSD at right ventricular side was chosen. The device deployed after confirmation of its good position by echocardiography and left ventriculography. Follow up evaluations were done 1 month, 6 months, 12 months and yearly after discharge with transthoracic echocardiography and 12 lead electrocardiography. Results: The mean age of patients at procedure was 4.7 ± 6.3 (range 2 to 14) years, mean weight 14.7 ± 10.5 (range 10 to 40) kg. The mean defect size of the right ventricular side was 4.5 ± 1.6 mm. The average device size used was 7.3 ± 3.2mm (range 4 to 12 mm). The ADOs were successfully implanted in all patients. The VSD occlusion rate was 65.7 at completion of the procedure, rising up to 79.5 at discharge and 96.4 during follow-up. Small residual shunts were seen at completion of the procedure, but they disappeared during follow-up in all but one patient. The mean follow-up period was 8.3 ± 3.6 months (range 1 to 18 months). Complete atrioventricular block (CAVB), major complication or death was not observed in our study. Conclusions: Transcatheter closure of PMVSD with ADO in children is a safe and effective treatment associated with excellent success and closure rates, but long-term follow-up in a large number of patients would be warranted. © 2015, Growth & Development Research Center

Verification and Validation in GERAM Framework for Modeling of Information Systems

The main aim of this article is to propose a methodology for using verification and validation tools in a framework for modeling of an Industrial Enterprise Information Systems. The first part of this paper introduces the Generalized Enterprise Reference Architecture and Methodology (GERAM) framework and its parts that are used for modeling of industrial enterprise information systems. The second part introduces the verification and validation concepts and tools. The third part of this article proposes the use of the verification and validation tools in GERAM framework to improve the coherency, correctness, error-free, qualitative aspects and efficiency of an enterprise information system

Aflatoxin contamination of wheat flour and the risk of esophageal cancer in a high risk area in Iran

Background: Golestan province in northeastern Iran has been known as a high-risk area for esophageal cancer (EC). This study was conducted to assess aflatoxin (AF) contamination of wheat flour (WF) samples in high and low EC-risk areas of Golestan province. Methods: Four WF samples were collected randomly from each of 25 active silos throughout the province in 2009. The levels of AFs were measured using the High-performance liquid chromatography method. Using the data of EC rates obtained from Golestan population-based cancer registry, the province was divided into high and low risk areas for EC. Student t-test and multivariate regression analysis were used to compare the levels of aflatoxins as well as the condition of silos between the two areas. Results: One hundred WF samples were collected. The mean levels of total aflatoxin and aflatoxin B1 was 1.99 and 0.53ngg-1, respectively. The levels of total AF (p=0.03), AFG2 (p=0.02) and AFB1 (p=0.003) were significantly higher in samples obtained from high risk area. Multivariate regression analysis showed that humidity of silo was the most important source of difference between silos of the two areas (p=0.04). Conclusion: We found a positive relationship between AF level of WF samples and the risk of EC. So, AF contamination may be a possible risk factor for EC in our region. We also found that humidity of silos was the most important determinant of AF contamination of WF. Intensive control of silos conditions including humidity and temperature are needed especially in high EC-risk areas. © 2013 Elsevier Ltd