Short-course treatment in neurobrucellosis: A study in Iran

Neurobrucellosis is a rare neurological complication of brucellosis. This report describes 19 patients of neurobrucellosis and they accounted for 8% of all cases of brucellosis admitted to Shiraz University Hospitals over a period of eight years. Headache, fever, fatigue, drowsiness and neck stiffness were the common clinical features. Cerebrospinal fluid (CSF) showed pleocytosis in 100%, elevated protein levels in 89% and low glucose level in 47% of the patients. All the patients improved with specific antibiotic treatment. Of the 19 patients, 10 (52.5%) patients received treatment for 8 to 28 weeks. Duration of antibiotic treatment was: 8-14 weeks in 8 (42%) patients; 24-28 weeks in 2 (10.5%) patients; 6 months in 7 (37%) patients; 12 months in 1 (5.3%) patient; and 18 months in 1 (5.3%) patient. Clinicians in endemic areas should consider the likelihood of neurobrucellosis in patients with unexplained neurological and psychiatric symptoms

Right coronary artery-to-pulmonary artery fistula, the role of echocardiography

Coronary artery fistula is an uncommon but hemodynamically significant anomaly of the coronary arteries, occurring as an incidental finding in 0.1% to 0.2% of coronary angiograms. Although half of the patients with a coronary artery fistula remain asymptomatic, the other half develops CHF, infective endocarditis, myocardial ischemia, or rupture of an aneurysm. This report is illustrative of the right coronary artery fistula to the right pulmonary artery in a 57-year-old male. The definitive diagnosis was made during transesophageal echocardiography and confirmed at operation

Effect of Metformin on Serum Ferritin Level in Women with Polycystic Ovary Syndrome

Background: Polycystic ovary syndrome (PCOS) is one of the most common diseases among women associated with various inflammatory reactants such as C-reactive protein (CRP) and ferritin. This study aimed to investigate the effect of metformin on probable reduction of serum ferritin in patients with PCOS.Methods: This study was conducted on 45 patients with PCOS who had not other systemic diseases and did not take any medications. Weight, waist and hip circumstances (WHR), body mass index (BMI), metabolic indexes,CRP, ferritin and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) double acute accent were measured before the study. Metformin (500 mg/tid) tablets were prescribed for three months and then same above parameters were re-measured.Results: Of 45 patients, 19 (42.2) were overweight and 14 (31.1) were obese. After drug therapy, there was a significant reduction in waist circumstance and serum ferritin. This reduction was significant only in the lean and overweight groups but not in the obese group. There was not significant association between serum ferritin and CRP, HOMA-IR, BMI and WHR. There was not significant correlation between CRP and HOMA-IR and also BMI.Conclusion: The effect of metformin on reduction of serum ferritin was not significant just in obese group and was not associated with metabolic and anthropometric indexes. © Iranian Red Crescent Medical Journal

Evaluation of dental solid waste in Hamedan

"nBackground and Aim: Today, one of the most important environmental issues is dental solid wastes which are of great importance because of the presence of hazardous, toxic and pathogen agents. In this survey, solid waste produced in Hamedan general dental offices is evaluated. "nMaterials and Methods: In this descriptive study, from 104 general dental offices in Hamedan , 10 offices were selected in simple random way. From each offices, 3 sample at the end of successive working day (Sunday, Monday and Tuesday) were analyzed. Samples were manually sorted into different 74 components and measured by means of laboratory scale. Then, measured components were classified in the basis of characteristic and hazardous potential as well as material type. "nResults: Total annual waste produced in general dental offices in Hamadan is 14662.67 Kg (9315.45>95.0% Confidence Interval>20009.88). Production percentages of infectious, domestic type, chemical and pharmaceutical and toxic wastes were 51.93, 38.16, 9.47, 0.44 respectively. Main components of produced dental waste were 14 components that consist of more than 80 percents of total dental solid waste. So, waste reduction, separation and recycling plans in the offices must be concentrated on these main components. "nConclusion: In order to dental waste proper management, it is suggested that in addition to educate dentists for waste reduction, separation and recycling in the offices, each section of dental waste(toxic,chemical and pharmaceutical, infectious and domestic type wastes) separately and according to related criteria should be managed

Iranian Osteoporosis Research Network: Background, Mission and Its Role in Osteoporosis Management

"nBecause of increase in elderly population, osteoporosis appears to become as a major public health issue in developing countries as in Iran. In order to obtain a clearer picture of osteoporosis in Iran, studies on different aspect of osteoporosis especially national projects about epidemiology and burden of disease, are required. Coordinating research programs is pos­sible only by establishing a research network, so the national osteoporosis research network was suggested by Endocrinol­ogy and Metabolism Research of Tehran University of Medical Sciences. Iranian Osteoporosis Research Network (IORN) was established in 2002 by approval of Deputy for Research and the National Advisory Committee on Non-communicable Diseases of Ministry of Health and Medical Education of Iran. At first, five centers of Medical Sciences Universities and Research Centers in addition to the EMRC, participated in this project. Gradually more centers joined to the network and the numbers of IORN members are now 41 persons from 21 universities and research centers. IORN has had several activi­ties: 1) Research projects, from among them are Iranian Multi-center Osteoporosis Study (IMOS) and Hip Fracture Registry Project (HFRP) in Iran 2) Educational activities with the aim of preventing osteoporosis and its related fractures 3) Estab­lishment of osteoporosis clinic.  In summery osteoporosis is an important public health issue especially in developing coun­tries be­cause of increasing in elderly population. Close relationship between academic and research centers through the IORN mem­bership provided possibility of designing and applying national research projects on epidemiology and burden of osteoporosis

Cytotoxic T-lymphocyte associated antigen 4 gene polymorphisms and autoimmune thyroid disease: a meta-analysis.

CONTEXT: Cytotoxic T-lymphocyte associated antigen 4 (CTLA-4) polymorphisms have been widely examined for their associations with autoimmune thyroid diseases [Graves' disease (GD) and Hashimoto thyroiditis (HT)], but their relative population effect remains unclear. OBJECTIVE: The aim was to generate large-scale evidence on whether the CTLA-4 polymorphisms (A49G and CT60) and haplotypes thereof increase the susceptibility to GD and/or HT. DESIGN, SETTING, AND PARTICIPANTS: Meta-analyses of group-level data were reviewed from 32 (11,019 subjects) and 12 (4,479) published and unpublished studies for the association of the A49G polymorphism with GD and HT, respectively (PubMed and HuGeNet search until July 2006). There were 15 (n = 7246) and six (n = 3086) studies available for the CT60 polymorphism, respectively. Meta-analyses of individual-level data from 10 (4906 subjects) and five (2386) collaborating teams for GD and HT, respectively, were also reviewed. MAIN OUTCOME MEASURES: Association of gene variants and haplotypes with GD and HT was measured. RESULTS: Group-level data suggested significant associations with GD and HT for both A49G [odds ratios 1.49 (P = 6 x 10(-14)) and 1.29 (P = 0.001) per G allele, respectively] and CT60 [1.45 (P = 2 x 10(-9)) and 1.64 (P = 0.003) per G allele, respectively]. Results were consistent between Asian and Caucasian descent subjects. Individual-level data showed that compared with the AA haplotype, the risk conferred by the GG haplotype was 1.49 (95% confidence interval 1.31,1.70) and 1.36 (95% confidence interval 1.16,1.59) for GD and HT, respectively. Data were consistent with a dose-response effect for the G allele of CT60. CONCLUSION: The CT60 polymorphism of CTLA-4 maps an important genetic determinant for the risk of both GD and HT across diverse populations