Proinflammatory Cytokine Gene Polymorphisms in Bullous Pemphigoid

Bullous pemphigoid (BP) is a rare autoimmune skin blistering disease, characterized by the presence of autoantibodies against hemidesmosomal autoantigens. Cytokine expression is altered in BP patients, and several of these differently expressed cytokines, including IL-1α, IL-1β, IL-8, and TNF-α, contribute to disease pathogenesis. Since genetic polymorphisms in the genes of these cytokines might be implicated in susceptibility to BP disease, we aimed at testing this implication in susceptibility to BP in an Iranian cohort. Blood samples were collected from the subjects and genomic DNA was extracted. To detect the single nucleotide polymorphisms (SNPs), IL-1α (rs1800587), IL-1β (rs1143627, rs16944, rs1143634), IL-8 (rs4073), and TNF-α (rs1799964, rs1800630, rs1799724, and rs361525) genes were genotyped in BP patients and healthy controls as well as IL-8 (rs4073) in pemphigus vulgaris (PV) patients. Quantitative gene expression was evaluated by RT-PCR analysis. A significant difference was observed in the distribution of genotypes or alleles of IL-8 SNP between the BP patients and controls. The A-allele of IL-8 SNP is significantly more prevalent in the control individuals compared to the BP patient. To further validate this observation, we included PV patients as an additional control. Again, the A-allele of IL-8 SNP is significantly more prevalent in the PV compared to the BP patients. While we observed a trend toward significant differences regarding alleles of TNF-α rs1799724 as well as alleles of TNF-α rs1799964, this difference was, however, not evident after correction for multiple analysis. There was no significant difference in all other studied SNPs. In contrast to IL-1α, IL-1β, and TNF-α, IL-8 gene expression levels were significantly higher in the patients than that of controls. The minor allele in IL-8 SNP might play a protective role in susceptibility to BP in Iranian patients. Although higher expression levels of IL-8 gene was found in the patients compared with healthy controls, these levels, however, suggest no association with the examined polymorphism. Moreover, further investigation revealed an elevation in gene expression between wild and polymorphic genotypes of IL-1α rs1800587 and TNF-α rs361525 in the patient group and these SNPs are therefore associated with altering the levels of gene expression

Comparison of transcutaneous electrical nerve stimulation and lidocaine on episiotomy complication in primiparous women: A randomized clinical trial

Introduction: Transcutaneous electrical nerve stimulation (TENS) through the skin is a nonpharmacological method of pain relief. The present study aimed to compare TENS and lidocaine on episiotomy complication in primiparous women. Material and Methods: In a randomized, controlled clinical trial, 80 participants were included from March to July 2011 at the antenatal clinic and postdelivery ward in the Social Security Organization Hospital, Khorramabad, Lorestan, Iran. Data were collected using a demographic questionnaire, visual analog scale and redness, edema, ecchymosis, discharge, and approximation scales. The participants were randomized into two groups with equal number of participants. All participants received 5 cc of local infiltration of 1% lidocaine before episiotomy, and TENS electrodes were placed on He Gu and Shenmen points during the crowning of fetal head. The TENS group received TENS with 100; 250 μs, the output range of 15–20 mm amplifier from crowning of first stage of labor to the end of the episiotomy repairing. The lidocaine group received 10 cc of local infiltration of 1% lidocaine before episiotomy repair while did not receive TENS electrodes. The pain intensity during and after episiotomy repair was recorded. Results: TENS and lidocaine have similar effects on pain relief at the episiotomy cutting, the start of the episiotomy repair, and at end of the episiotomy repair; however, the pain relief of both the interventions was different during the episiotomy repair. The effect of TENS in reducing edema was statistically significant (P = 0.001). Conclusions: TENS and lidocaine are effective for the episiotomy complications during and after episiotomy repair

Falls and Postural Control in Older Adults With Eye Refractive Errors

Objectives: The eye refractive errors, including myopia, hyperopia, and astigmatism, are the most important visual impairments worldwide. Based on the existing evidence suggests, the visual impairment could contribute to falling in the elderly. Therefore, this study aimed to determine the influence of vision impairment of older adults with eye refractive errors on the occurrence of falls and postural control. Methods & Materials: The older people referred to the health center of the 9th district of Tehran municipality for ophthalmic examination were examined (using ophthalmoscope and Snellen chart) by skilled ophthalmologists. Then, certain information such as their age, sex, history of special eye disease or operation, history of fall during the last 12 months, etc. was gathered through questionnaires from the older people who accepted to participate in this study after giving their informed consents. Based on eye screening results, 77 older adults with refractive errors of hyperopia (n=19, mean [SD] age=67 [5.85] y); astigmatism (n=22, mean [SD] age=70.32 [5.60] y); and both hyperopia and astigmatism (n=36, mean [SD] age=69.78 [7.69] y), as well as 23 older healthy adults, mean (SD) age=70.29(5.29) y, without any obvious eye disorders were enrolled in this study. Their history of falls and postural control were evaluated. The postural control was determined using the Timed Up and Go (TUG) test. The statistical tests were analysis of variance (ANOVA) for comparing the groups with regard to postural control and the Chi-square test for comparing the prevalence of falls between groups with refractive errors and the healthy group. Results: The studied subjects comprised 23% (n=23) healthy ones, 19% (n=19) people with hyperopia, 22% (n=22) people with astigmatism, and 36% (n=36) people with both hyperopia and astigmatism. About 70% of them were women, and 30% were men. The results of our study showed that 15.8% of study participants with normal vision, 26.1% with hyperopia, 22.7% with astigmatism, and 38.9% with both hyperopia and astigmatism had experienced at least 2 falls in the past 12 months. The people with refractive errors showed a higher prevalence of falls; however, the result of the Chi-square test did not reveal any significant differences among these groups (P=0.25). Furthermore, the results of ANOVA for comparing TUG test (test of postural control) results showed no differences among these groups (P=0.64). Conclusion: Vision impairment of older adults due to refractive error is not associated with an increase in falls. Furthermore, TUG test results did not show balance disorders in these groups. Further research, such as assessment of postural control with advanced devices and considering other falling risk factors is also needed to identify the predictors of falls in older adults with eye refractive errors

Prevalence of Eye Disorders in Elderly Population of Tehran, Iran

Introduction: The decline of visual function with increasing age is a significant concern in elderly. Despite previous work on prevalence of specific ophthalmic pathologies, there has not been enough valid data about overall eye disorders in Tehran yet, and it is poorly defined and not underpinned by strong evidence. The purpose of this study was to investigate the common eye disorders in the elderly population of Tehran. Methods: A total of 392 elderly community residents aged 60 to 96 were enrolled. The 278 older adults referred to Tehran’s Polyclinic of 6th Region of municipality and 114 older adults referred to the health centers of 9th Region of municipality between 2013 and 2014 were examined. All participants underwent an extensive ophthalmologic screening examination including cataract, diabetic retinopathy of optic nerve, macular degeneration, and glaucoma. The prevalence of various eye disorders was calculated as percentages of the total study population and categorized by age and sex. Results: Of the 392 participants, 152 subjects (38.8%) had no eye disease. Common visual impairments in elderly were cataract (39.3%), macular degeneration (11.5%), diabetic retinopathy of optic nerve (5.6%) and glaucoma (4.8%). It has also showed cataract prevalence increased with age from (6.3%) in the 60-64 age group to (47.6%) for the patients 85years of age and older. Conclusion: Cataract is the most frequent eye disease in community dwelling older adults that should be considered at a younger age by health officials to provide preventive programs. Improving accessibility to surgery for the treatment of cataract among the old people will help diminish of untreated cataract that lead to visual impairment