A Survey on Zinc Status among Chronic Allergic Asthma and in Atopic Phenotype

Background: Incidence of allergic asthma has increased in the worldwide. Zinc has significant effects on the pathogenesis of bronchial asthma. However, Zinc deficiency caused the enhanced allergy state. Investigations on the recent issue have been less often considered, and only a few studies were found in the literature review. Zinc status particularly has not been known in adult's allergic asthma. The aim of the study was to assess the sera level of zinc in chronic allergic asthma patient with atopic phenotype.Methods: A total 48 chronic allergic asthma phenotype enrolled among asthmatic population based on the protocol. Skin prick test was applied with six standard extract allergens. Total Immunoglobulin E antibodies and zinc level were measured in sera with the recommendation manufacturer.Results: The mean age was 32.75±9.86 SD years. Gender distribution was 52% females and 48% males. Mean of total IgE and zinc levels in sera was higher in males than females. 27% of participants had hypozincemia. Hypozincemia subset had a higher mean of total IgE level than a normal zinc level subset. Atopic phenotype was detected in 21% target population. Atopic asthmatic phenotype disclosed hypozincemia status with frequency 23%. Marked differences were observed between zinc and total IgE levels (p=0.04).Conclusion: The outcome disclosed there was a hypozincemia in the target population and atopic phenotype subset. Hypozincemic allergic asthmatic patients had a higher mean of total IgE level than normal Zinc level subjects. Allergic marker and hypozincemia were marked in the male and female focus population, respectively

Anguishing Reports of Ambient Air Pollution in Tehran Capital of Iran

Benzene is the aromatic hydrocarbon, organic and petrochemicals. It has high octane number and used as ethybenzene. It composed a few percent of gasoline mass less than 1%. Benzene was used before 1950 but after that year replaced with tetraethyl lead. The recent material was associated with environmental pollution so came back again benzene in the petrol cycle production.Human is exposed withbenzeneby several ruts; gasoline fumes, motor vehicle exhaust, and smoking. Inhalation is the main route of toxicity in urban area.Standard threshold of benzene concentration is 1.56 part per billion (PPB) in accepted air quality. The current study displayed that benzene concentrationin Tehran (capital of Iran) was between 2-20 times higher than the standard (1).  This is the first official report published aboutambient air pollution in 2013. However,IranMinistry of Health announced that Asbestos and benzene levels had 50-100, respectively. It means that there were 10 times more than standard levels in the Tehran urban area(2). These materials, specially benzeneBenzene has potential ability  as  cancer risk factor  to  inducing  acute and chronic bloods leukemia (3). In addition, there arerelations between benzene exposure and lung cancer (4).  Benzene can induce aryl hydrocarbon receptor which leads to tumorigenesis (5).The vision of information dictates assumption of planning in two aspects. The arrangement may be suggestedthat  the sources of pollutants will be  reduced in the environment thought activation of dependable organizations and investigation  of at-risk population based on the prioritizes

Assessment of Allergic Markers and Atopic Phenotype among Sulfur Mustard Induced Small Airway Diseases with Persistent Wheezes in Iranian Veterans; Post Wartime

Background: A wheezes is originated from small airway obstruction. Phenotypes of the wheeze have different in causal factors etiology.  Persistent wheeze detects in allergic and atopic disorders. Sulfur mustard (SM) is a potential chemical warfare agent. It can develop small airway diseases (SAD) with wheezes. The aim of the study was assessed prevalence of allergic markers and atopic phenotype among sulfur mustard induced small airway diseases with the persistent wheeze in Iranian veteran’s post wartime.Methods: The study designed in two stages; diagnosis of SM induced SAD and detection of atopic subjects. Skin prick test, Total immunoglobulin E antibody’s concentration in serum and peripheral blood eosinophil count applied on samples of study.Results: Sixty-three male chemical veterans associated with SAD meet criteria of the study. Chronic obstructive pulmonary disease (COPD) and asthma diseases had prevalently the frequency in focus population. Frequency of allergic status and atopic phenotype was observed in 56% and 22% of study population, respectively. Mean age recorded 45.98±9.99 SD years (ranged 35-67). The Mean±SD of total IgE (TIgE) concentrations and peripheral blood eosinophilia were 283.15±263.86 Iu/dl (range 5-900) and 266.60±240.94. A highly relevant difference in TIgE denoted between allergic and non-allergic subgroups (P<0.001). There were significant differences between allergic status with atopic phenotype (χ<0.001).Conclusion: The study demonstrated the noticeable prevalence of allergic marker and atopic phenotype among SM induced SAD with persistent wheezes. They markedly distributed in the subgroup of bronchial asthma and COPD asthma-phenotype of target population

Red-Alarm against Fibers Concentration of Asbestos in Atmospheric Urban Area of Tehran Capital of Iran

Asbestos is the natural silicate minerals with attractive physical properties such as; resistant to fire, electrical and chemical solvents. It composes of six types of materials include; Serpentine group; Chrysotile, Amphibole groups; amosite (Brown), Crocidolite (Blue) and other materials. It is popular for low cost favorable properties. All the six types have asbestiform fiber crystal, and can induce carcinogen in human. It was generally used during the boom of the industrial revolution since 1866, and the first publish of the unhealthy effect of asbestos reported nearly 30 years after industrial usage since 1899. The most common usage types of asbestos consist of chrysotile and the crocidolite. All the current types widely use in the building structures, brake pads (1) and clutch disc (2).Daily inhalation of asbestos occurs in the ambient air of cities which associated with poor air quality control. This event leads to generation of asbestosis disease (3), cancer development and mortality (4) and morbidity among at-risk population, such as asbestos –exposed workers (5), non-occupational subjects, people who living in  the asbestos fibers exposed environment (6).Corresponding author: Agin Kh, MD. Associated Professor of the Respiratory Medicine. Logman Hakeem General Teaching Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IranE-mail: [email protected]    &       [email protected] time exposure with asbestos leads to the development of chronic lung disease. It can be developed as occupational and non-occupational conditions (7, 8). Mesothelioma and lung cancer are the known causes of the asbestos exposure (9). In addition, it produces risk development of esophageal gastric, colorectal cancer (10) and head and neck squamous cell carcinoma (11). Children also are at risk of cancer by asbestos inhalation (12). The accepted threshold for asbestos is 100 fiber/liter that measured by phase-contrast optical microscopy (PCM) (13). There is a direct relationship between high level of asbestos in air and lung cancer (14). The first use of asbestos in Iran returns to World War II during the foundation of railroad and beginning product of cement manufacture in 1958 (15). Meanwhile, asbestos is producing up to 55000 tones cement in Iran annually, and near the 94% of produced cement that used in our country. The current output predominantly detected in the manufacture of building material (16), as pipe in the water delivery network (5000 Kilometer), brake pads (17) and pad shoes (15, 18).  The most common types of asbestos observed in the ambient urban area of Tehran, including; Chrysotil (60%), tremolite (10%), antophylline (10%) (19). The rate of asbestos in air of Tehran- Iran was 68 times higher in the USA in 2009 (19). Our ministry of health in 2013 reported that the asbestos levels in the Tehran was 50-100 times more than the standard definition of the world (20).It seems that the deadline of depreciating has been finalized to the issue of asbestos fibers in our atmospheric cities. It requires a national decision, though the creating practice planes in reducing the level of usage and replacement that with safe materials

Assessment Seroprevalence of Toxocara Canis Antibodies among Children's Outpatient with the Wheezing in Urban Public of Tehran

Background: Toxocariasis is a zoontic helminthes infection, occurring in human by the accidental ingestion of embryonated eggs of Toxocara canis (TC) and less frequently, Toxocara catis (TCC). Children are on the front line of encounter group. Clinical features may mimic respiratory symptoms as; asthma–like symptoms plus producing bronchial airway hyper-reactivity. The aim of this study was to determine seroprevalence of TC infection among children’s outpatient with the wheezing symptom among urban public of Tehran. Method: All of the children with current wheezing symptom that was coming in the chest clinic, sequentially enrolled as sample population. Diagnosis of known diseases associated with the wheezing was made possible. Anti TC Ig G antibodies in serum were measured based upon the recommendation commercial kit. Results: A total 89 children meet the study criteria. Mean age was 9.7±3.8 SD years, ranged 2-15 years. Boy/girl ratio was 1.2. Seropositive for TC antibody was 16%. TC infection was noticeable in boys subgroup 53%. Conclusion: Seroconvertion of TC infection was meaningful among children, 2-15 years in Tehran. School-aged group had been higher rated infection than other groups. Toxocariasis among children of target population was associated with eosinophilia and allergic reaction

Assessment of Allergic Biomarkers; Total Immunoglobulin E Antibodies Levels and Peripheral Blood Eosinophil among Public Transporter Drivers with Traffic–Related Respiratory Diseases in Tehran

Background: Traffic air pollution can be induced or developed the different respiratory diseases. Megacity has potential magnitude in the production of high density and large- volume traffic triggering factors in the outdoor environment. High concentrations of Formaldehyde and polycyclic aromatic hydrocarbons (PAHs) are found in traffic density of ambient air in urban area. It can be stimulated both allergic state and diseases. The PAHs originates from the motor engine are as pro-inflammatory compounds which can enhance Immunoglobulin E (IgE) responses. The purpose of the study was evaluation of allergic markers among public drivers in Tehran, to assess the respiratory diseases.Materials and Methods: A total of 151 subjects were sequentially enrolled among public drivers with traffic related respiratory diseases. The total IgE antibodies in serum were measured according to manufacture recommendation.Results: The mean age recorded 47.66±8.82 standard deviation (SD). The peripheral eosinophil proportion was 3.19±2.16 SD. The mean IgE antibody levels were 205.89±238.67SD. Allergic state was found in 47% of target population. Frequencies of traffic-related air pollution diseases (TRAPD) in chronic obstructive pulmonary disease (COPD) 34%, asthma 25%, rhinitis 21% and bronchitis 21%, respectively. Allergic state distributed high frequency in asthma, rhinitis, COPD and bronchitis diseases, respectively.Conclusion: Allergic biomarkers of IgE antibody and peripheral eosinophilia were widely distributed among TRAPD. They observed more frequency on the allergic base diseases than non-allergic small airway diseases. It may be reflected the actual role of traffic -related air pollution on the sensitization of all categories of TRAPD

Inflammatory Biomarker of Peripheral CRP and Analyzing Serum Trace Elements like Zinc, Copper, and Cu to Zn Ratios in Stable Chronic Obstructive Pulmonary Disease: Tehran-Iran

Background: Chronic Obstructive Pulmonary Disease (COPD) is characterized with incomplete airway reversibility by spirometric testing, chronic local airway and systemic inflammation. COPD is the most common lung disease related to smoking habit in general population. Oxidative stress (Os) is the key mechanism in inducing and progression of inflammatory productions in COPD pathogenesis. However, CRP is a peripheral biomarker to reflect systemic inflammation and tissue damage. Nutritional trace elements like Zinc (Zn) and Copper (Cu) are components of Os mechanism and as the anti-oxidant elements. Those changing serum levels influence on the reaction of recent process and production of inflammatory protein. Propose of the study was to evaluate status of CRP and Zn, Cu, Cu/Zn ratios among male patients with stable Chronic Obstructive Pulmonary Disease. Method: Stable COPD patients substantially were enrolled from pulmonary chest medicine. Applying criteria followed an instruction of thoracic society. Results: A total of 35 patients completed criteria of study. Mean age±SD was 52.8±5years (ranged 43-60). Hypozincemia and hypocupremia were found 11% and 14%, respectively. Conclusion: Increased CRP levels reflected presence systemic and pulmonary inflammation among stable COPD patients. In addition, Zinc and copper deficiency detected among target population.  The current trace elements are a part of oxidative stress, and their deficiencies may be effective in the induction of inflammation

A Survey on Thyroid Hormonal Status among Moderate to Severe Stable Chronic Obstructive Pulmonary Disease

Background:COPD is one of the common diseases in pulmonary medicine. Current knowledge indicated that there was a link between COPD with thyroid hormonal abnormalities. Thyroid function disturbances can be able to affect on the COPD through upper airway obstruction,respiratory muscle weakness, development of central and obstructive sleep apnea,alveolar hypoventilation, and pleural effusion. Thyroid abnormalities are often both detectable and treatable. The aim of the study is to assessserum levels of thyroid hormones among moderate to severe stable COPD patients.Methods: 34 men were enrolled consecutive among established and stable COPD patients with moderate to the severe stages. Their selection constructed on the ATS/GOLD guidelines.  Thyroid functions and hormonal concentrations measured according to manufacturer's instructions.Results:Mean age of sample was 51.7±5.76SD years. It ranged over 42–60 years (Mode=49). Significant thyroid hormonal abnormalities were detected among established moderate to the severe COPD patients. The mean±SD of TSH, TT4 and free T3 concentrations in the focus population was 2.36±1.53 microIU/ml, 12.15±2.15 Micro/dl and 2.20±0.45 pg/ml, respectively. Frequency distribution of thyroid disorders included euthyroid functions 76.5%; three subjects of those had euthyroid sick syndrome, subclinical hyperthyroidism 20.6% and over hypothyroidism 2.9%, respectively. Grades of goiter on WHO classifications observed 0=44% and 1=41%.Conclusion:Frequent exacerbations of thyroid disorders were detected among stable, moderate to severe COPD patients. Subclinical hyperthyroidism and euthyroid sick syndrome were significant. Despite that prevalence of hypothyroidism is considerable in age-rang of Iranian’s population

Frequency of Specific Immunoglobulin G Antibodies and Immediate Skin Test Reactivity to Aspergillus fumigatus Antigen among Adults with Allergic Asthma: Tehran

Background: The Aspergillus fumigatus (AF) has been found the most common etiologic agent in allergic aspergillosis. In addition, AF is responsible for 90% of human infections. Increasing the air pollution in urban area causes the increase in asthma rates. Significant cutaneous sensitization occurs in asthmatic population with AF. In these patients, susceptibility of diseases increases. The aims of this study were to identify frequency of specific IgG antibodies and sensitization to Aspergillus antigens through skin prick-test reactivity (SPT) among adults with allergic asthma and to diagnose atopic phenotype subset. Method: 201 chronic asthmatic patients were applied in order to instructions based on the increased level of immunoglobulin E antibodies concentrations in allergy, having criteria of the  study and specific immunoglobulin G antibodies against AF in serum and SPT reactivity with aspergillus antigen. Thereafter, atopic phenotype was diagnosed. Results: 42 (21%) subjects had positive skin reactivity to aspergillus antigens, also specific AF IgG antibodies was observed in 122 (61%).  36 (30%) of positive aspergillus skin prick test was found among those who were positive specific AF IgG antibodies of allergic asthma (P=0.001), 81 (40%) subjects of all allergic asthma patients were atopic. 19 (24%) of the atopic subsets had positive aspergillus skin prick test  and  specific AF IgG antibodies was seen in 41 (50%)  of atopic subjects. In addition, significant differences in aspergillus skin prick test was observed between atopic with nonatopic subgroups (P=0.01). Conclusion: Our finding indicated that significant frequency of specific IgG antibodies seroconvertion against AF in serum and immediate SPT sensitization to AF antigen were detected among chronic bronchial asthma with allergic and also, atopic phenotype subsets

Pre-operative Assessment of Unexpected Micronutrients Status among Elderly Patients with Elective General Surgery and no Apparent Clinical Indication; Zinc, Magnesium, Calcium, Inorganic Phosphorous

Background: Electrolytes and micronutrients abnormality level can influence the outcome of surgery. Measurement of Zinc (Zn), Magnesium (Mg), inorganic Phosphorous (P) and Calcium (Ca) routinely was not evaluated Pre-operatively. Determinations of serum level of micronutrients are exclusively attended on the emergency conditions or special procedures and rarely applied as pre-operative screening tests among elderly. In addition, older age encounters as an important risk factor due to reduced physiologic reserve, malnutrition and underlying disorders. The aim of the study assessed pre-operatively unexpected serum micronutrients among elderly patients for elective general surgery with no apparent clinical indication.Methods: Our target population is elderly patients from both genders (males and females). Patients that were coming in chest clinic for elective general surgery consultation were enrolled. Zn, Ca, P and Mg levels were measured in serum according to manufacturer's documentation kits.Results: A total of 171 elderly patients were female 55% male 45%.  Mean age was 69.12±6.66 SD years. The frequency of micro-nutrition elements deficiencies observed Zn 15.8%, Mg 11.1%, P 10.5% and Ca 6.4%, respectively.Conclusion: Considerable of unexpected deficiencies of the micronutrients was demonstrated in the focus population during the study. Global frequencies of deficiencies were hypozincemia, hypomagnesaemia, hypophosphatemia and hypocalcaemia, respectively. Sex distribution of electrolyte deficiencies noticed in Zn, Mg, P and Ca, individually. Moreover, the obvious some electrolyte disturbances in elderly should be considered as a health problem. Pre-operatively determination of unexpected electrolytes routinely may provide safety of surgery in our country