Progress of Education, Research and Services in Medical Genetics, in Some Institutions of Iran

The present paper is a review of progress and major activities in education, research, services and ethics in the field of medical genetics in some centers in Iran. National projects of population genetics, genetic epidemiology, like national human genome projects, Connexin 26 and Pejvakin, distribution of thalassemia, hemophilia, etc in different ethnic groups, and religious minorities of Iran, are mentioned

Quality of life in patients with advanced gastric cancer: a randomized trial comparing docetaxel, cisplatin, 5-FU (TCF) with epirubicin, cisplatin, 5-FU (ECF)

BACKGROUND: Health related quality of life (HRQOL) is an important outcome after treatment for upper gastrointestinal carcinoma. This study aimed to compare HRQOL in patients with advanced gastric cancer (GC) receiving either a standard or an experimental treatment. METHODS: Seventy-one patients have been treated in Cancer Institute (Tehran, Iran) with docetaxel, cisplatin, 5 FU (TCF) or epirubicin, cisplatin, 5-FU (ECF) and were followed from Jan 2002 to Jan 2005. End points were response rate, HRQOL and survival. HRQOL was assessed using the EORCT QLQ-C30 at baseline and after the third cycle of chemotherapy. RESULTS: The baseline HRQOL scores were comparable between two groups. After treatment improvement was seen in a number of items and domains except for cognitive functioning, and diarrhoea. Pain decreased and physical functioning improved in both groups. However, only the TCF group showed statistically and clinically meaningful improvement in global QOL (P = 0.001). Surgical and pathologic response was better with TCF but there was no difference in survival rate between two groups. CONCLUSION: Docetaxel based treatment (TCF) showed better palliation and improvement of global QOL as compared with epirubicin based treatment (ECF). However, it seems that regardless of treatment offered, effective chemotherapy was the most important factor affecting QOL in these patients

Efficacy of flour fortification with folic acid in women of childbearing age in Iran

Background: Flour fortification with folic acid is one of the main strategies for improving folate status in women of childbearing age. No interventional trial on the efficacy of folic acid fortification has been conducted so far in Iran. Objectives: To study the effects of flour fortification with folic acid on any reduction in neural tube defects (NTDs) and folate status of women of childbearing age. Methods: In a longitudinal hospital-based study, 13,361 postpartum women were studied after admission for childbirth before and after fortification. In addition, two cross-sectional surveys were conducted before (2006) and after flour fortification (2008). The cluster sampling method was used and 580 women, 15-49 years old, were studied as a representative sample of Golestan province in the north of Iran. Fasting blood samples were collected to measure serum vitamin B 12, folate and plasma homocysteine. Sociodemographic data, health characteristics and dietary intake were determined. Results: The mean daily intakes of folate from natural food before and after flour fortification were 198.3 and 200.8 μg/day, respectively. The total folate intake increased significantly from 198.3 to 413.7 μg/day after fortification (p < 0.001). Folate intake increased by an average of 226 μg/day from fortified bread. The mean serum folate level increased from 13.6 to 18.1 nmol/l; folate deficiency decreased from 14.3 to 2.3% (p < 0.001). The incidence rate of NTDs declined by 31% (p < 0.01) in the post-fortification period (2.19 per 1,000 births; December 2007 to December 2008) compared to the pre-fortification period (3.16 per 1,000 births; September 2006 to July 2007). Conclusions: Implementation of mandatory flour fortification with folic acid can lead to a significant increase in serum folate and a significant decrease in NTDs. Copyright © 2011 S. Karger AG, Basel

A predictive analytics model for differentiating between transient ischemic attacks (TIA) and its mimics

Transient ischemic attack (TIA) is a brief episode of neurological dysfunction resulting from cerebral ischemia not associated with permanent cerebral infarction. TIA is associated with high diagnostic errors because of the subjective nature of findings and the lack of clinical and imaging biomarkers. The goal of this study was to design and evaluate a novel multinomial classification model, based on a combination of feature selection mechanisms coupled with logistic regression, to predict the likelihood of TIA, TIA mimics, and minor stroke

Quality of life in patients with gastric cancer: translation and psychometric evaluation of the Iranian version of EORTC QLQ-STO22

<p>Abstract</p> <p>Background</p> <p>Disease and treatment related events, can adversely affect the quality of life of patients with cancer. The purpose of this study was to translate and validate a gastric cancer specific health related quality of life questionnaire (EORTC QLQ-STO22) for Iranian patients suffering from gastric cancer.</p> <p>Methods</p> <p>Forward-backward procedure was applied to translate the English language version of the EORTC QLQ-STO22 into Persian (Iranian language). Then, the questionnaire and the EORTC core quality of life instrument (QLQ-C30) were administered to a sample of patients with confirmed diagnosis of gastric cancer. All patients filled in questionnaires before and after one month of treatment. Patients were divided into two groups based on intension of treatment (curative vs. palliative). Reliability and validity of the module was tested by internal consistency and known group comparisons, respectively.</p> <p>Results</p> <p>In all, 105 patients were entered into the study. Cronbach's alpha for multi-item scales (to test reliability) ranged from 0.54 to 0.87. The questionnaire discriminated well between clinically distinct subgroups of patients both before and after treatment lending support to its convergent and clinical validity.</p> <p>Conclusion</p> <p>Overall, the Iranian version of the EORTC QLQ-STO22 demonstrated a good reliability and clinical validity to support its use in combination with core questionnaire in outcome studies of gastric cancer in Iran. However, using the QLQ-STO22 in a wide range of Iranian patients with gastric cancer should allow further confirmation for its psychometric properties.</p

Systematic review of available guidelines on fertility preservation of young patients with breast cancer

Background: Since the survival rate of breast cancer patients has improved, harmful effects of new treatment modalities on fertility of the young breast cancer patients has become a focus of attention. This study aimed to systematically review and critically appraise all available guidelines for fertility preservation in young breast cancer patients. Materials and Methods: Major citation databases were searched for treatment guidelines. Experts from relevant disciplines appraised the available guidelines. The AGREE II Instrument that includes 23 criteria in seven domains (scope and purpose of the guidelines, stakeholder involvement, rigor of development, clarity, applicability, editorial independence, and overall quality) was used to apprise and score the guidelines. Results: The search strategy retrieved 2,606 citations; 72 were considered for full-text screening and seven guidelines were included in the study. There was variability in the scores assigned to different domains among the guidelines. ASCO (2013), with an overall score of 68.0, had the highest score, and St Gallen, with an overall score of 24.7, had the lowest scores among the guidelines. Conclusions: With the promising survival rate among breast cancer patients, more attention should be given to include specific fertility preservation recommendations for young breast cancer patients

Role of L- and T-Type Calcium Channels in Regulation of Absence Seizures in WAG/Rij Rats

In chronic experiments on five groups of WAG/Rij rats (a genetic model of absence epilepsy; six animals in each group), we recorded EEG activity from the S1po cortical area through implanted electrodes and subjected the cortex to the action of four agents affecting L- and T-type calcium channels (injections through an implanted cannula). A blocker of L-type channels, verapamil hydrochloride, an agonist of these channels, Bay K8644, an antagonist of T-type calcium channels, L-ascorbate, and an agonist of the latter channels, PMA, were used. The parameters of 7- to 10-Hz spike-wave discharges, SWDs, spontaneously generated in the cortex of this rat strain (frequency of SWDs, mean duration of the latter, and their number) were measured within the baseline interval (before injections) and within three subsequent 20-min-long post-injection intervals. Normal saline was injected in the control group. There were no significant differences in the mean peak frequency in SWDs between all examined groups (P > 0.05 in all cases). Verapamil significantly (by more than 40%; P < 0.05) decreased the mean SWD duration throughout the entire period of post-injection observation. The dynamics of the Bay K8644 effects were rather similar, but the intensity of SWD duration changes was somewhat smaller. Both the above agents in the doses used dramatically decreased the number (frequency of appearance) of SWDs within the observation period. L-ascorbate also suppressed SWD generation. The duration of these phenomena decreased mildly, while their number dropped dramatically. In the PMA group, the number of SWDs increased significantly (by 50%, P < 0.05) within the first 20-min-long interval, but this was not observed within subsequent intervals. These findings confirm that blocking or activating of L- and T-type Ca2+ channels in the S1po area (cortical focus area) can significantly control generation of SWDs during absence seizures. Possible mechanisms underlying actions of the tested agents are discussed.У хронічних експериментах на п’яти групах щурів лінії WAG/Rij (генетична модель абсанс-епілепсії; шість тварин у кожній групі) ми відводили ЕЕГ-активність від кортикальної зони S1po через імплантовані електроди і піддавали кору дії чотирьох агентів, що впливають на кальцієві канали L- та T-типів (ін’єкції через імплантовану канюлю). Використовували блокатор кальцієвих каналів L-типу верапамілу гідрохлорид, агоніст цих каналів Bay K8644, антагоніст кальцієвих каналів T-типу L-аскорбат та агоніст останніх каналів PMA. Вимірювали параметри розрядів пік-хвиля (РПХ, частота 7–10 Гц), котрі спонтанно генеруються у корі головного мозку щурів указаної лінії (частоту в межах РПХ, середню тривалість останніх та їх кількість) протягом інтервалу порівняння (перед ін’єкціями) та трьох послідовних 20-хвилинних інтервалів після ін’єкцій. Щурам контрольної групи ін’єкували фізіологічний розчин. Істотних різниць між величинами частоти в межах РПХ у всіх досліджених групах не спостерігалося (P > 0.05 у всіх випадках). Верапаміл істотно (більш ніж на 40 %; P < 0.05) зменшував середню тривалість РПХ протягом усього періоду спостереження після ін’єкцій. Динаміка ефектів Bay K8644 була вельми подібною, але інтенсивність скорочення тривалості РПХ – дещо меншою. Обидва вказані агенти у використаних дозах зумовлювали драматичне зменшення кількості (тобто частоти виникнення) РПХ протягом усього періоду спостереження. L-аскорбат також істотно пригнічував генерацію РПХ. Тривалість цих феноменів зменшувалася помірно, а їх кількість скорочувалася дуже сильно. У групі РМА кількість РПХ протягом першого 20-хвилинного інтервалу спостереження істотно зростала (на 50 % , P < 0.05), але цього не спостерігалося в межах наступних інтервалів. Наші результати підтверджують, що блокування або активація кальцієвих каналів L- та T-типів у фокальній кортикальній зоні S1po здатні істотно контролювати генерацію РПХ під час прояву абсансних судом. Обговорюються можливі механізми дії тестованих агентів

Enhancement of CD8 T-cell function through modifying surface glycoproteins in young and old mice

Previous work from our laboratory has shown that modifying cell surface glycosylation with either a Clostridium perfringens -derived sialidase (CP-Siase), or an O-linked glycoprotein endopeptidase (OSGE) can enhance the function of CD4 T cells from both young and old mice at multiple levels. Here we have re-assessed the effect of age on CD8 T-cell function, and examined the outcome of enzymatic treatment with CP-Siase and OSGE on its different aspects. Pre-treatment of CD8 T cells with either CP-Siase or OSGE led to a significant increase in anti-CD3-mediated Ca 2+ response in both young and old mice. Pre-treated CD8 T cells from both age groups also displayed a significant increase in activation-induced CD69 and CD25 expression, and produced significantly higher amounts of interleukin-2 and interferon-γ in comparison to their untreated counterparts. Furthermore, pretreatment with either enzyme enhanced granzyme B expression in CD8 T cells, and increased their cytolytic activity in vitro . These data support the notion that glycosylated surface proteins hinder CD8 T-cell activation and function in both young and old mice, and raise the possibility of significantly improving CD8 T cell function in older individuals through enzymatic alteration of surface glycoproteins.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75199/1/j.1365-2567.2006.02420.x.pd

Interleukin‐22 and CD160 play additive roles in the host mucosal response to Clostridium difficile infection in mice

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/110834/1/imm12414.pd

Management of spine trauma in COVID-19 pandemic: A preliminary report

Background: COVID-19 was first identified in Iran in February 2020 and since then it spread rapidly through all over the country and soon after that it was reported as a pandemic. The current study presents a preliminary report of spine trauma management during COVID-19 pandemic. Methods: A cross sectional study was designed to evaluate patients admitted for vertebral fractures with diagnosis of COVID-19 infection on February and March 2020. Analysis was made based on clinical and laboratory data along with the imaging findings from chest HRCT. Results: Seven patients with spine trauma including five males and two females ranging from 14 to 59 years were diagnosed for COVID-19 infection through CT-scan findings. Except one, all other patients were asymptomatic for COVID-19 at the time of admission. In three cases the COVID diagnosis was made the day after arrival and in others after 10, 14 and 35 days. Five patients were treated surgically among whom four were admitted to ICU soon after the surgery. The mean ICU stay for operated patients were eight days and the mean hospital stay was 22.6 days. Conclusion: Proper diagnosis of COVID-19 is the keystone to protect both patients and health care providers. During the pandemic all admitted patients should be screened for COVID-19 infection. Unnecessary procedures for spine trauma patients should be avoided in order to reduce complications related to surgery and to preserve ICU beds. © 2020 BY THE ARCHIVES OF BONE AND JOINT SURGERY