A study on delta virus infection and its clinical impact in Iran

Summary During the period 1986–1988, the expression of anti-HDV in different high-risk groups and its clinical impact on patients with HBV-related chronic liver disease and hepatocellular carcinoma was investigated in Iran. Using the ELISA technique, we observed a 2.5% anti-HDV positivity in asymptomatic chronic HBsAg carriers (3 of 120); in hemophiliacs, two of six HBsAg carriers were positive for anti-HDV and zero of 50 anti-HBs positives. Anti-HBs positive dialysis patients were positive for anti-HDV in 2.0% of the cases (1 of 50), whereas the rate of anti-HDV positivity was 44.5% in hemodialysis patients positive for HBsAg (16 of 36). The figures were comparable in HBsAg positive patients with chronic active hepatitis and cirrhosis (49.2%; 31 of 63). Moreover, anti-HDV was detected in five of eight patients with hepatocellular carcinoma. These data indicate the endemicity of delta infection in Iran. The increased incidence among hepatocellular carcinoma patients is an interesting finding to be further investigated with larger groups of patients in this region.

---

Inzidenz und klinische Bedeutung der Delta-Virus-Infektion im Iran

Zusammenfassung Für den Zeitraum 1986–1988 wurden im Iran verschiedene Hochrisikogruppen auf Expression von anti-HDV untersucht und die klinische Bedeutung der HDV-Infektion für Patienten mit HBV-assoziierter chronischer Lebererkrankung und das hepatozelluläre Karzinom geprüft. Bei der Untersuchung von chronischen Trägern von HBsAg fand sich eine Rate positiver anti-HDV ELISA-Befunde von 2,5% (drei von 20). HBsAg-Carrier mit Hämophilie waren in zwei von sechs Fällen anti-HDV positiv, unter den 50 anti-HBs positiven Hämophilen hatte keiner Antikörper gegen Delta-Virus. Bei Dialysepatienten waren 2% der anti-HBs Positiven auch anti-HDV positiv (1 von 50), HBsAg-Carrier waren hingegen in 44,5% auch anti-HDV positiv (16 von 36). Vergleichbare Zahlen fanden sich bei HBsAg-positiven Patienten mit chronisch aktiver Hepatitis mit oder ohne Zirrhose (49,2%; 31 von 63). Bei Patienten mit hepatozellulärem Karzinom fand sich anti-HDV in fünf von acht Fällen. Diese Daten sprechen dafür, daß die Delta-Virus-Infektion im Iran endemisch ist. Besonders interessant ist das gehäufte Zusammentreffen von Delta-Virus-Infektion und hepatozellulärem Karzinom; weitere Studien an größeren Patientengruppen in dieser Region sind erforderlich.

     

A clinical evaluation of 3M no sting barrier film

The maintenance of healthy skin depends on factors such as moisture, the nutritional status of the patient, and mechanical forces. A barrier film can be a valuable adjunct in the prevention and treatment of injury to skin. One hospital evaluated barrier film, a new alcohol-free film-forming liquid skin protectant, in its geriatric and spinal cord rehabilitation units. A total of 33 patients were enrolled in the study. The purpose of the evaluation was to determine if barrier film reduced redness, assisted in the adhesion of dressing and condom catheters, prevented or reduced maceration, prevented or reduced skin stripping, and/or had any adverse effects on patients. Redness was reduced in 96% of patients who were at risk. Maceration was prevented in 94% of subjects, and skin stripping was prevented in 100% of patients. Dressing adhesion improved significantly in 90% of subjects. For all subjects, regardless of method of application, barrier film was easy to apply. No patient experienced any adverse effects during the study. On the basis of this clinical trial, we found barrier film to be an effective liquid skin sealant and protectant.     

Epidemiological and clinical aspects echinococcosis in East Iran.

Three hundred and fifty two cases of hydatid disease were diagnosed in a three year study in Eas Iran, where the disease is found frequently in rural areas. Camel meat is consumed in this region. The offal is given to domestic carnivorous animals, for example sheep dogs, and in these circumstances camels could contribute to the cyclozoonotic spread of the disease. Clinical symptoms are briefly mentioned.     

蜂螫伤中毒患者血清肿瘤坏死因子与血浆内皮素的变化及意义

目的探讨肿瘤坏死因子α(TNFα)与内皮素(ET)在蜂螫伤中毒患者中的变化及临床意义。方法将97例蜂螫伤中毒患者分成轻度、中度、重度中毒3组,并根据预后分成死亡组、存活组。另选取35例健康人作为正常对照组,各组均采用放射免疫法检测血清TNFα与血浆ET水平,同时进行对比分析。结果蜂螫伤中毒患者轻度中毒组血清TNFα(1．36±0．37)μg／L与血浆ET (55．20±12．60)ng／L的含量仅轻度升高,与正常对照组[(1．09±0．25)μg／L、(50．90±8．80)ng／L]比较差异无统计学意义(P>0．05);中度、重度组患者血清TNFα(2．82±0．79)μg／L、(4．02±0．93)μg／L与血浆ET水平(139．30±58．80)ng／L、(210．50±86．30)ng／L较正常对照组明显升高(P值均<0．01),中度组患者血清TNFα与血浆ET水平较轻度组为高(P<0．01),重度组患者又较中度组高(P<0．01)。死亡组血清TNFα(4．53±0．89)μg／L与血浆ET(267．50±98．70)ng／L水平高于存活组(2．40±0．82)μg／L、(107．60±57．90)ng／L(P值均<0．01)。蜂螫伤中毒患者血清TNFα与血浆ET水平呈正相关(r=0．62,P<0．01)。结论TNFα与ET可能协同参与了蜂螫伤中毒患者的发病过程。血清TNFα与血浆ET升高越明显,蜂螫伤中毒患者病情越重,病死率就越高。血清TNFα与血浆ET的检测可作为判断病情轻重和预后的一个重要临床指标。应用TNFα与ET拮抗剂或抑制剂对防治蜂螫伤中毒的发生发展、改善预后可能有重要的临床意义。     

Morphological study of fossa ovalis and its clinical relevance

AimsPatent foramen ovale (PFO) has been implicated in the etiology of a number of different pathologies, including cryptogenic stroke, decompression sickness in divers, etc. It can act as a channel for paradoxical embolism. PFO is not an uncommon condition, with a probe-patency in 15–35% population.The fossa ovalis (FOv) varies in size and shape from heart to heart; the prominence of annulus FOv also varies. The entire FOv may be redundant and aneurysmal. The anatomico-functional characterization of interatrial septum seems to be of paramount importance for both atrial septal defect (ASD) and PFO, not only for the device selection, but also for the evaluation of the outcome of this procedure.MethodThis study was conducted in 50 apparently normal hearts available in Department of Anatomy. After opening the right atrium, the shape of FOv was observed. The size was measured with the digital vernier caliper; the prominence and extent of limbus, and the redundancy or otherwise of FOv were noted; probe patency was confirmed.ResultsIn the majority, FOv was oval (82%); average transverse diameter was 14.53 mm and vertical 12.60 mm. In 90%, the rim of the annulus was raised; in 20%, a recess was found deep to the margin of the annulus; and 18% showed probe patency.ConclusionAs no study of this nature has been carried out in the Indian population, this provides pertinent information on the morphology of FOv, which may be useful for device selection in treating ASD and PFO.     

Screening for amyloid deposition by subcutaneous fat tissue aspiration technique in rheumatoid arthritic patients and investigating its clinical significance in Iran

Aim: This study examined the frequency of secondary amyloidosis in Iranian patients with rheumatoid arthritis (RA) in order to determine its clinical significance. Methods: A total of 220 RA patients (167 female, 53 male), with minimum disease duration of 5 years, were included in this prospective study over a period of about 2 years. Abdominal subcutaneous fat‐pad aspiration (ASFA) method was used in obtaining specimens from all subjects. All of the specimens were examined for apple‐green birefringence under polarized light microscope. Amyloid deposits were graded from 1+ to 3+. Clinical, radiological, and laboratory characteristics of the patients were assessed and recorded. Results: Amyloid deposition was detected in 11 (5%) of the fat smears stained with Congo red stain. All of the samples had minimal (1+) amyloid deposits. In this study, amyloid‐positive cases showed clinically significant symptoms; six of the patients (55%) presented with proteinuria, and seven other cases (64%) presented with severe constipation. Conclusion: Abdominal fat amyloid deposition was found to be uncommon in adult Iranian RA patients. In up to half of the patients the deposits were subclinical. A longer follow‐up and larger multicentric collaborative study is needed to determine the significance of subclinical amyloid deposits.     

Diabetes mellitus and its risk factors among a middle-aged population of Iran,a population-based study

Diabetes is a major health problem around the world. The risk of diabetes is increasing worldwide, and its misdiagnosis may have significant public health implications. This study aimed to determine the prevalence of diabetes and its risk factors among the middle-aged population in Shahroud, north of Iran. In the present study, the plasma glucose levels in 5190 subjects aged 40–64 years, participating in the first phase of the Shahroud Eye Cohort Study in 2009, were measured. Non-fasting glucose level greater than or equal to 200 mg/dl and/or the use of blood glucose-lowering drugs were considered as criteria for the diagnosis of diabetes. To determine the risk factors associated with diabetes, simple and multivariate logistic regressions were used. The prevalence of diabetes in men, women, and the total population were 10.4, 13.6, and 12.3 %, respectively. The mean blood glucose levels in men and women were 116.7 and 117.3 mg/dl, respectively. Age (odds ratio (OR)?=?1.04), hypertension (OR?=?2.5), being overweight (OR?=?1.5), and obesity (OR?=?1.5) were positively associated with diabetes. In addition, having an insurance (OR?=?0.48) and male gender (OR?=?0.81) was associated with a reduced risk of diabetes. Based on the results of the present study, the prevalence of diabetes in the studied population is high, and according to the epidemiological transition of diseases, a high percentage of the Iranian population are at risk for cardiovascular diseases. Considering the risk factors identified in the present study, developing effective interventions is essential.     

Diagnosis,clinical manifestations and management of rare bleeding disorders in Iran

Background: Rare bleeding disorders (RBDs) are heterogeneous disorders, mostly inherited in an autosomal recessive pattern. Iran is a Mideast country with a high rate of consanguinity that has a high rate of RBDs.

Objective: In this study, we present prevalence and clinical presentation as well as management and genetic defects of Iranian patients with RBDs.

Methods: For this study, all relevant publications were searched in Medlin until 2015.

Results and discussion: Iran has the highest global incidence of factor XIII deficiency. Factor VII deficiency also is common in Iran, while factor II deficiency, with a prevalence of 1 per ～3 million, is the rarest form of RBDs. Factor activity is available for all RBDs except for factor XIII deficiency, in which clot solubility remains as a diagnostic test. Molecular analysis of Iranian patients with RBDs revealed a few recurrent, common mutations only in patients with factor XIII deficiency, and considerable novel mutations in other RBDs. Clinical manifestations of these patients are variable and patients with factor XIII, factor X and factor VII more commonly presented severe life-threatening bleeding, while patients with combined factor V and factor VIII presented a milder phenotype. Plasma-derived products are the most common therapeutic choice in Iran, used prophylactically or on-demand for the management of these patients.

Conclusion: Since Iran has a high rate of RBDs with life-threatening bleeding, molecular studies can be used for carrier detection and, therefore, prevention of the further expansion of these disorders and their fatal consequence.     

非胰岛素依赖型糖尿病患者的红细胞变形性研究及其临床意义

利用北京医科大学基础医学院血液流变学研究中心与北京地质仪器厂共同研制的ＧＹＪ－Ⅱ型激光衍射仪对非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者的红细胞变形指数［（ＤＩ）ｍａｘ、ＩＤＩ］进行研究。其结果表明，ＮＩＤＤＭ患者的（ＤＩ）ｍａｘ、ＩＤＩ值随患者病程长短而有差异，与正常对照组相比，病程在３年以下者（ＤＩ）ｍａｘ无显著性差异，而ＩＤＩ值则有显著性差异；但如有合并症，则两个参数值均有显著性差异。３年以上者