Serum copper concentration in newborns with neural tube defects in northern Iran; A case control study

Objective: This study was conducted to determine the eventual association between copper deficiency in newborns with neural tube defects (NTD) in Northern Iran. A high prevalence of neural tube defects has been reported from this region. Methods: This hospital based case control study was carried out on 13 newborns having neural tube defects and 35 healthy controls in Northern Iran during 2005-2006. Serum copper was measured by spectrophotometery. Findings: Serum copper level in newborns with NTD and healthy normal newborns was 16.5 (±7.2) μmol/l and 16.7 (±6.6) μmol/ l, respectively. In case group 38.5% of newborns and in control group 28.6% had copper deficiency. Logistic regression analysis showed no association between the presence of NTD and copper deficiency (OR:1.6, 95% CI=0.3-7.1, P=0.5). Conclusion: This study showed no association between NTD and copper deficiency in newborns. © 2009 by Center of Excellence for Pediatrics, Children's Medical Center, Tehran University of Medical Sciences, All rights reserved

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

Glycated hemoglobin measurements from dried blood spots: Reliability and relation to results obtained from whole blood samples

Background: Main objective was to measure glycated hemoglobin (HbA1c) in dried blood spots on paper filter and in whole blood samples in diabetic patients to evaluate relationship between two methods and their respective reliability. Methods: The 20�10 μl of venous blood samples of 33 diabetics were blotted onto the filter paper allowed to dry at room temperature and then stored at 25°C and 4°C. HbA1c was measured via the Turbidimetric Inhibition Immunoassay Technique. The relation was evaluated with correlation and linear regression tests using STATA software and SPSS. Agreement between the results obtained from the dried blood spots and others was evaluated using the Bland and Altman. The pitman's permutation test was also employed to compare the difference in variance. Results: A high positive correlation was detected between whole blood samples and dried blood spots stored at 4°C (r2 =0.90) and at 25°C (r2 = 0.95). The Bland and Altman graphs, as well as the Pitman tests, showed statistically significant differences in variability between the values obtained from whole blood samples and those derived from dried spots stored at 4°C (p=0.05) or 25°C (p=0.004). Conclusion: HbA1c measurements from dried blood spots on the filter paper yielded reliable results. That the Hitachi autoanalyzer is available in most countries renders this assay less costly than the High Performance Liquid Chromatography Method (HPLC). In addition, the filter paper method for Immuno-turbidimetric estimations of HbA1c at different temperatures is reliable and may be particularly useful in outpatient diabetes clinic

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

Serum zinc levels in newborns with neural tube defects

Neural tube defects (NTD) comprise of a group of congenital malformations that include spina bifida, anencephaly and encephalocele. Reports have implicated zinc deficiency as one of the causative factors of NTDs. We compared the serum zinc level of 23 newborns having neural tube defects with 35 healthy controls by spectrophotometery during 2003-2004. Zinc deficiency was documented in 43.5% of the cases and 8.6% of the controls (P = 0.002). Multivariate logistic regression analysis revealed a significant association between the presence of NTDs and zinc deficiency (OR = 8.2, 95% Cl: 1.9-34.7)

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

Estimating the avoidable burden of certain modifiable risk factors in osteoporotic hip fracture using Generalized Impact Fraction (GIF) model in Iran

Backgrounds: The number of hip fractures, the most common complication of osteoporosis, has increased rapidly over the past decades. The goal of this study is to estimate the avoidable burden of certain modifiable risk factor of the condition using the Generalized Impact Fraction (GIF) model, which has been suggested and used by epidemiologists to overcome the drawbacks associated with the use of Attributable Fraction index. In addition to preventing a risk factor or the avoidable fraction of burden, this index can also calculate the change in the burden, when a risk factor is altered.Methods: International databases were searched through PubMed, CINAHLD, Embase using OVID and Google scholar. National resources were searched through IranDoc, IranMedex, SID and Journal sites. Other resources include abstract books and articles sent to the IOF congress. The following search strategy was used: (" Osteoporotic fracture" OR " Fragility Hip fracture" OR " Calcium" OR " vitamin D" OR " BMI" OR " lean body weight" OR " Physical activity" OR " exercise" OR " Smoke" ) AND (" prevalence" OR " incidence" OR " relative risk" ) and limited to " humans." Results: With regards to different scenarios already explained in modifying the studied risk factors, the greatest impact in reducing the prevalence of risk factors on osteoporotic hip fractures, was seen in low serum vitamin D levels, low physical activity and low intake of calcium and vitamin D, respectively. According to the fact that interventions for low serum vitamin D and low intake of calcium and vitamin D, are related to each other, it can be concluded that implementing interventions to change these two risk factors, in the easy, moderate and difficult scenarios, would result in approximately a 5%, 11% and 17% decrease in the burden of osteoporotic hip fractures, respectively. The addition of interventions addressing low physical activity in the easy, moderate and difficult scenarios, an 8%, 21% and 35% reduction in the burden of osteoporotic hip fractures would be reported, respectively.Conclusion: Improving serum vitamin D levels, recommending the consumption of calcium and vitamin D supplementations and advocating physical activity are the most effective interventions to reduce the risk of osteoporotic hip fractures. © 2013 Shahnazari et al; licensee BioMed Central Ltd

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

A case-control study of the relationship between gastric cancer and meat consumption in Iran

Background: Despite the descending trends of gastric cancer in many parts of the world, its mortality rate has still remained high globally. Meat, red and processed meat in particular, may induce gastric carcinogenesis through potential mechanisms. However, the role of this dietary aspect in the risk of gastric cancer has not well been investigated so far. Therefore, we designed a study to assess the relation between meat consumption and the risk of gastric cancer in Golestan Province, a high- risk area for gastric malignancies in Iran. Methods: Subjects of this population-based case-control study included 190 histologically confirmed case so fgastric cancer and 647 controls. Meat consumption was evaluated using a 116-item semi-quantitative food frequency questionnaire. A lifestyle questionnaire also collected data concerning demographic features, anthropometric measures, and other known risk factors of gastric cancer. We estimated crude and adjust edoddsratios(ORs) and 95 confidence intervals (CIs) for the relation between meat intake and gastric cancer. Results: After being adjusted for potential confounders, red meat intake was positively associated with gastric cancer which reached statistical significance (OR=1.87, 95 CI: 1.01-3.47, Ptrend = 0.07). On the other hand, individuals in the highest quartile of white meat consumption had astatistically significant reduced risk of gastric cancer compared to those in the lowest quartile (OR = 0.36, 95 CI: 0.19-0.68, Ptrend = 0.005). Conclusions: We observed a positive association between red meat consumption and the risk of gastric cancer, and a reverse relationship regarding white meat intake and the risk of this malignancy

Effects of vitamin e and zinc supplementation on antioxidants in beta thalassemia major patients

Objective: In beta thalassemic patients, tissue damage occurs due to oxidative stress and it happens because of the accumulation of iron in the body. This study was conducted to determine the effect of zinc and vitamin E supplementation on antioxidant status in beta-thalassemic major patients. Methods: This double blind randomized clinical trial was carried out on 120 beta thalassemic patients older than 18 years. Patients were randomly categorized in four groups. Zinc (50mg/day) and vitamin E (400mg/day) supplements were administered for former and latter group, respectively. In the third group both supplements were administered in similar doses. The fourth (control) group received no supplement. The effect of supplementations on serum zinc and vitamin E, superoxide dismutase (SOD), glutathione peroxidase (GPX), total antioxidant capacity (TAC) and body mass index (BMI) were measured at the beginning and the end of the study. Findings: Serum zinc levels in group 1 and 3 were significantly increased (P<0.007 and P<0.005, respectively). Serum vitamin E levels in group 2 and 3 were also increased significantly (P<0.001). Mean GPX activity in group1, 2 and 3 decreased significantly (P<0.015, P<0.032 and P<0.029, respectively). Mean SOD activity and TAC did not show significant change after supplementation. BMI had significant increase in all treated groups (P<0.001). Conclusion: Our results suggest that beta thalassemic patients have enhanced oxidative stress and administration of selective antioxidants may preclude oxidative damage. © 2011 by Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, All rights reserved