Molar pregnancy and co-existent foetus: A report of two cases

Molar pregnancy with a co-existent foetus will lead to preterm labour, severe preeclampsia or bleeding in most of the cases and may need urgent intervention. However, if it does not become complicated with preeclampsia or preterm Labour, the outcome is usually good, with minimal post partum complications and so such pregnancies can be managed with watchful waiting and close observation. The first case was a 29 year-old at 19 weeks of gestation, with hypertension, oedema and severe epigastric pain. Karyotypic assessment of the contents of the uterus revealed a 46-XX foetus with no chromosomal abnormality, as well as the molar placenta also suggesting a complete mole with 46-XX. The second case was a 19 year old woman in labour. A pathological study of the delivered contents of the uterus revealed a complete hydatidiform mole and a normal placenta

Effect of lead intoxication and D-penicillamine treatment on hematological indices in rats

Lead is one of the most important environmental pollution which is toxic to many organ systems. D-penicillamine (D-P) is a chelator drug which is used for treatment of lead toxicity for several years. This study was conducted in order to evaluate the efficacy of D-P in reducing the effects of lead on hematological indices. This study was done on 36 male adult, 6-8 weeks albino Wistar rats in Gorgan University of Medical Sciences. At first male adult rats were exposed to lead acetate in their drinking water. After 8 weeks, 6 rats were selected and blood samples were prepared to assess the effects of lead toxicity. The remained lead exposed rats were divided into recovery and treatment groups where distilled water and D-P was administered for them, respectively. After lead exposure, red blood cell count increased slightly, but hemoglobin and hematocrite were decreased. Also MCV and MCH were significantly decreased (P<0.05). RDW, PDW and MPV were significantly higher in lead exposed rats (P<0.05). After recovery period, most of parameters were close to normal while there were no significant differences between recovery and treatment groups. This study showed that hematologic effects of lead are reversible and D-P administration do not play an important role in subchronic lead intoxication

Morphometric changes of rat testis after subchronic oral lead intoxication and D-penicillamine treatment

Lead poisoning is a worldwide health problem and its treatment is under investigation. The aim of this study was to assess the efficacy of D-Penicillamine in reducing lead induced morphometric changes in rat testis. Male adult rats were exposed to 0.4% lead acetate in drinking water for 8 weeks. After this period 6 rats were sacrificed and testes were removed to evaluate the effects of lead intoxication. The remained lead exposed rats were divided into two groups, one group received distilled water and the other group received oral D-P treatment for six weeks, after one week of recovery. Testis morphometric changes were studied in H and E stained sections. After 8 weeks, width of germinal epithelium and number of sertoli cells in test group were decreased compared with negative and positive control rats (p<0.05), while no changes were observed in the number of spermatogonia or primary spermatocytes. After recovery or treatment, germinal epithelium and sertoli cells were still significantly lower than control group (p<0.05). Primary spermatocytes and spermatogonia were decreased after both recovery and treatment periods which was not significant. This study showed that subchronic oral lead intoxication induces some changes in adult testis which are not reversible even after D-P administration. © 2006 Asian Network for Scientific Information

Temporal variations of dietary habits in a high-risk area for upper gastrointestinal cancers: A population-based study from Northern Iran

Background: Nutrition transition is a global health problem, especially in developing countries. It is known as an important factor for development of different types of health conditions including cancers. Objectives: We aimed to assess the pattern of nutrition transition in a high-risk area for upper gastrointestinal cancers in Northern Iran during the last decade. Materials and Methods: This cross-sectional study was conducted on households of Golestan province, Iran. Data on household food consumption between 2001 and 2010 were obtained from the Statistical Center of Iran. The proportions of households with medium/high consumption of main foods were calculated for each year. Joint point software was used for assessing trends. Annual percent changes (APCs) and 95CIs were calculated. Results: In total, 12,060 households were recruited. The APCs (95CI) of the proportion of households medium/high consumption of cereals, vegetables, legumes, fish, dairy products and meats were -3.1 (-4.1 to -2.2), -2.9 (-3.8 to -2.1), -2.3 (-3.2 to -1.4), -2.8 (-3.3 to -2.4), -1.9 (-3.0 to -0.9) and 2.7 (1.2 to 4.3), respectively. Conclusions: We found significant increase in meat consumption among our population between 2001 and 2010. Our results also suggested significant decreasing trend in consumption of so-called healthy foods including, plant foods, fish, and dairy products. Regarding its correlation with health conditions including cancers, nutrition transition should be considered as a priority in health policy making in our region as well as other high-risk populations. It is recommended to conduct community level interventions to increase consumption of plant foods, fish, and dairy products

Polycyclic aromatic hydrocarbons and esophageal squamous cell carcinoma

Esophageal cancer (EC) is the 8th most common cancer and the 6th most frequent cause of cancer mortality worldwide. Esophageal squamous cell carcinoma (ESCC) is the most common type of EC. Exposure to polycyclic aromatic hydrocarbons (PAHs) has been suggested as a risk factor for developing ESCC. In this paper we will review different aspects of the relationship between PAH exposure and ESCC. PAHs are a group of compounds that are formed by incomplete combustion of organic matter. Studies in humans have shown an association between PAH exposure and development of ESCC in many populations. The results of a recent case-control study in a high risk population in northeastern Iran showed a dramatic dose-response relationship between PAH content in non-tumor esophageal tissue (the target tissue for esophageal carcinogenesis) and ESCC case status, consistent with a causal role for PAH exposure in the pathogenesis of ESCC. Identifying the main sources of exposure to PAHs may be the first and most important step in designing appropriate PAH-reduction interventions for controlling ESCC, especially in high risk areas. Coal smoke and drinking mate have been suggested as important modifiable sources of PAH exposure in China and Brazil, respectively. But the primary source of exposure to PAHs in other high risk areas for ESCC, such as northeastern Iran, has not yet been identified. Thus, environmental studies to determining important sources of PAH exposure should be considered as a high priority in future research projects in these areas

Different features in Wegener's granulomatosis: Report of five cases

Wegener's granulomatosis (WG) is an autoimmune inflammatory condition. It is often a rapidly progressive and potentially fatal disease. The clinical presentation of WG can be so diverse that the list of its differential diagnosis is vast, ranging from infectious diseases to other vasculitis (e.g. Behcet's disease), as well as malignancies. The exact aetiology of WG remains unclear. The upper airway diseases including sinusitis, oral lesions and otitis media are the most common presenting features of WG. In this paper, we have described 5 WG cases. They had different presentations and chief complaints. Some of them presented with upper airways diseases, while the others mainly suffered from the manifestations of pulmonary involvement. Although all of them were finally diagnosed as WG cases, the processes of the work up for the diagnosis as well as the outcome of the disease were not the same. So, the diversities in the presentation should be mentioned in the management of the WG suspected patients

The role of IL-6 for predicting neonatal sepsis: A systematic review and meta-analysis

Objective: Neonatal sepsis (NS) is a common and life-threatening disorder in infants. Previous studies showed that interleukin-6 (IL-6) may be a valid non-invasive and rapid method for diagnosis of NS. We conducted this review to assess the validity of IL-6 for predicting NS. Methods: This was a systematic review with meta-analysis. Embase, Medline and Web of Science databases were searched between January 1990 and December 2009. The search terms used were "cytokine", "neonate", "sepsis" and "interleukin-6". We used standard methods recommended for meta analyses of diagnostic test evaluations. The analysis was based on a summary ROC (SROC) curve. Meta-regression analysis was used to assess the effects of some confounding factors on the results of meta-analysis. Potential presence of publication bias was tested using funnel plots and the Egger test. Findings: Meta-analysis was performed on 13 publications including 353 infants with sepsis and 691 control infants. The pooled sensitivity and specificity of IL-6 was 0.79 and 0.84, respectively. The maximum joint sensitivity and specificity (i.e., the Q value) in SROC curve was 0.82 and the area under curve (AUC) was 0.89 (95% CI: 0.84-0.94). Meta-regression analysis showed that the diagnostic accuracy of IL-6 was not affected by confounding variables. The evaluation of publication bias showed that the Egger test was not significant (P=0.07). Conclusion: IL-6 seems to be a valid marker for predicting NS. It may be considered for early diagnosis of sepsis in neonatal care units. © 2011 by Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, All rights reserved

Anthropometric indices in individuals infected with ascaris lumbericoids in Iran

Context: Ascaris Lumbericoids infection is more common in children and teenagers and in areas with poor sanitation or crowded living conditions. Largest of all the parasites inhabiting the human intestine it is also the most common of parasitic infections in developing countries. It has been reported to infect about one-fourth of the world population. Chronic ascariasis has been reported to adversely effect the growth rate and anthropometric indices in infected individuals of growing age. Aims: The goal of this research was to evaluate the anthropometric indices in individuals infected with Ascaris in Hamedan province of Iran. Settings and Design: This was a descriptive cross sectional study. Methods and Material: Six hundred fourteen randomly selected individuals who were inhabitants of Hamedan province of Iran were chosen for this study. Stool samples of these individuals were collected and then experimented with Formel-Ether method to determine Ascaris Lumbericoids infection. Height and weight of these individuals were measured and compared with the indices related to NCHS. Demographic information of these individuals was entered into questionnaires and ultimately was analyzed with SPSS software. Results: Out of the total study population, 16.5% of individuals were found to be infected with Ascaris. Out of the individuals infected with Ascaris, 1% were underweight. In the age groups of 6-10, 11-15, 16-20 years, 3.5%, 5.1% and 3.5% were found to be suffering from malnutrition, respectively. Conclusion: Malabsorption in children might result in malnutrition. In this study, few individuals infected with Ascaris had malnutrition, thus Ascaris infection may not be an important cause of malnutrition among children in our area

Healthcare utilization in patients with esophageal cancer in a high risk area in northeast of Iran

Introduction: Golestan, a province located north of Persian Gulf in northeastern part of Iran is a well known area for high risk of esophageal cancer (EC) in the world. There is no information about healthcare utilization in populations residing in the area. This study was conducted to assess utilization of healthcare and its associated factors among esophageal cancer patients in this region as well as to address ethical implication of this utilization. Methods: All new cases of EC in Golestan province during year of 2007 were recruited. Seven diagnostic and five therapeutic services were used to assess diagnostic utilization index (DUI), and therapeutic utilization index (TUI), respectively. Multivariate regression analysis was used to assess the relationship between variables and DUI or TUI. P-value of less than 0.05 was considered as statistically significant. Results: Tow hundred twenty three, patients were enrolled with mean (Standard Deviation) age of 64.3 (12.5) years with 57.8% male. We observed that occupation (P<0.01), ethnicity (P<0.01) and sex (P=0.03) were strongly associated with DUI. Insurance coverage (P<0.01), place of residency (P<0.01), and occupation (P=0.01) were associated with TUI. Conclusion: We concluded that several factors contribute to disparity in healthcare utilization in the studied population

Pulmonary tuberculosis and some underlying conditions in Golestan Province of Iran, during 2001-2005

Context: Pulmonary tuberculosis has been a major health problem in Golestan province of Iran. Aims: This descriptive cross-sectional study was performed to evaluate the frequency of coexisting medical conditions and their effects on some epidemiologic factors in patients with pulmonary tuberculosis. Setting and Design: This was a descriptive cross-sectional study. Methods and Material: Demographic information, time of admission in the hospital and coexisting medical conditions (diabetes, chronic renal failure/hemodyalysis, corticosteroids consumption and malignancies) were extracted from the patient's file. Statistical analysis used: Chi-square test was used to assess the relationship between variables. Results: Two hundred forty three patients with pulmonary tuberculosis during 5 years were studied. Out of all, 162 cases (66.7%) did not have any co-morbidities. Diabetes mellitus was found to be the most prevalent condition (23.05%) followed by chronic renal failure, corticosteroid consumption and malignancy ranking second, third and forth in the list (5.8%, 2.5% and 2 respectively). The mean age of the patients was 50.15±19 years old. In the group without co morbidities, male/ female ratio was 1.41/1, but co morbidity with diabetes was significantly more prevalent in females (p<0.05). Conclusions: We suggest screening of tuberculosis in patients with chronic renal failure and diabetes mellitus in our area. Also for patients with pulmonary tuberculosis, diabetes screening should be considered essential