Journal of Kerman University of Medical Sciences
Volume:31 Issue: 1, Jan-Feb 2024

Methylation alterations of tumor suppressor gene promoters are essential aspects of epigenetic changes in gastric cancer (GC). Cadherin1 (CDH1) encodes a protein with essential roles in cell-cell adhesions. In this study association of organochlorine pesticides (OCPs) serum levels with the methylation profile of this gene was investigated in gastric cancer (GC), intestinal metaplasia (IM), and functional dyspepsia (FD) patients.

GC (n=34), IM (n=8), and FD (n=48) patient serums were analyzed for the determination of OCP levels by gas chromatography equipment. The methylation status of the CDH1 gene promoter was examined by methylation-specific PCR (MSP) method. In order to confirm reduced protein expression of this gene in methylated samples, immunohistochemistry (IHC) was used.

Our findings revealed significant hypermethylation of CDH1 gene promoter along with reduced expression in GC patients compared with IM and FD patients. Furthermore, there was significant association between CDH1 promoter hypermethylation and 2,4-DDT (odds ratio [OR]:1.183;95%CI:1.001-1.398, p=0.048) serum levels in GC patients.

Our results could suggest the association of 2,4-DDT OCP levels in the GC patient serums with CDH1 gene promoter hypermethylation. Additionally, this gene promoter methylation may play a role in the progression of pre-cancerous IM towards GC.

The purpose of this study was to development and validation of a simple equation to fat mass (FM) and percentage of body fat (PBF) in children and adolescents.

Participants were 404 (176 boys and 228 girls) children and adolescents (5 to18 years old) that were randomly divided into Derivation (n = 279) and Validation (n= 125) groups. FM and PBF were measured by Bioelectrical Impedance Analyzer. Based on demographic variables retrieved from the Derivation group, 10 FM and 10 PBF predictive equations were developed using multiple regression. Finally, the most accurate model (using the coefficient of determination (R2)) was chosen and then validated on the validation group.

The best equations of FM and PBF, which were derived from demographic characteristics, were:FM (kg) = Weight (Kg) x 0.15 + BMI x 1.53 + Sex x 3.40 – Age (years) x 0.37 – 26.20; where sex = 1 for male and 0 for female. R=0.97, R^2=0.94, standard error of the estimate = 3.74 Kg.PBF (kg) = 0.31 x Height (cm) - Weight (Kg) x 0.59 + BMI x 2.98 + Sex x 6.17 – Age (years) x 0.76 – 52.84; where sex = 1 for male and 0 for female. R=0.90, R^2=0.82, standard error of the estimate = 4.88 Kg.

Our predictive equations accurately predicted FM and PBF using simple parameters (Height, Weight, BMI, sex and age) in children and adolescents.

International Atomic Energy Agency (IAEA) and American Association of physicist in Medicine (AAPM) have introduced new protocols for dosimetry of electron and photon megavoltage beams and increased them to more than five protocols at the beginning of new decade. Selecting a protocol by medical physicists and acquiring skill for using reference conditions and recommended formulation by each protocol necessitate recognition of various dosimetry protocols. The aim of this study was to compare the protocols TRS-277, TRS-381, and TRS-398 of IAEA for megavoltage electron beams used in radiation therapy. Comparison of TRS-398 with other protocols was done as follows:1. Measurement and estimation of the absorbed dose of 6MeV Neptun 10 linear accelerator through ionization chamber with parallel NACP plates in water phantom and acrylic.2- Measurement of the absorbed dose in 17MeV Saturn 20 linear accelerator through ionization chamber with parallel NACP plates in water phantom The results indicated that the differences observed between the protocols compared to TRS-398 protocol was between -4.9 and 0.2%; the highest difference was related to 17 MeV electron beam using TRS-277 protocol. According to the results, the considerable difference observed in 17MeV electrons was related to TRS-277 and TRS-388 protocols. Given that calibration ratio of the absorbed dose in air is used in the TRS-277 protocol, the difference obtained was related to the application of secondary calibration used in this research.

HPV is a small, non-enveloped DNA virus that is related to human cervical cancer. The HPV genome encodes six characterized proteins. L1 is the major part of the current vaccines and any changes in this region can be followed by a decrease in vaccine efficiency. The aim of this research was comparison analysis among Iranian L1 protein sequences with reference sequences to determine the possible substation in this region; in addition, finding L1 physicochemical and structural properties by using bioinformatics tools to provide comprehensive comprehension of HPV L1 protein. 13 Iranian PV sequences L1 protein and reference sequences were selected and obtained from NCBI data bank. “CLC sequence viewer” was used to translate the alignment. To predict the signal peptide, “predisi”, and “phobius” were employed. Secondary and tertiary structure and structure validation of all sequences were analyzed.Findings showed that L1 is highly conserved and just two mutations were found in this region. No signal peptide was described and the main part of this region included the random coil. Tertiary structure by different software was mapped and 5 distinct loops were found. This study is the first report that investigated the change in the L1 protein of Iranian patients and provided practical comprehension of L1 properties that is vital for cloning and producing the new generation of virus-like particles (VLPs) vaccines. Furthermore, the structural analysis showed several loops that had an indispensable role in antibody binding and the prevention of HPV infections.

Heart disease is the main cause of mortality and morbidity in patients with beta thalassemia. Vitamin D and calcium deficiency also is common in these patients. We studied and compared vitamin D and calcium levels and other parameters with echocardiographic findings in patients with beta thalassemia. A cross-sectional study in patients with Transfusion-dependent thalassemia was conducted. 169 patients with Transfusion-dependent thalassemia were enrolled. Ejection fraction, valvular insufficiency and aortic diameter were determined. The aortic diameter of patients was measured using Mindray DC60 echo model. All of these patients were tested for levels of vitamin D, calcium (Ca), parathyroid hormone (PTH), alkaline phosphatase (ALP), platelet (PLT), and ferritin, Finally, the effect of these factors on aortic root (AR), aortic valve area (AVA) and ejection fraction (EF) was evaluated. One-way ANOVA was used to compare quantitative variables, and chi-square test with 95% confidence level was used to estimate relationships and compare ratios in groups. There was a statistically significant relationship between vitamin D deficiency and Serum Ca (P-value = 0.009). Our results showed that with the increase in the level of vitamin D, the EF also increased and the probability that the aortic root will have a normal size will be higher. Furthermore, disorder in PTH and PLT level causes a decrease in the EF. This study did show an association between Vitamin D deficiency and cardiac function in patients with Transfusion-dependent thalassemia. Vitamin D can be considered as a supplement in thalassemia patients.

Understanding the relationship between religiosity and health behaviors helps us to tailor messages based on cultural beliefs. We conducted an online survey to find any relationship between fatalistic beliefs, religiosity, and mask-wearing in an Islamic context. The participants consisted of 503 subjects from the adult population of Kerman Province located in the Southeast of Iran. The measurement tool consisted of four sections; (A) demographic characteristics, (B) three items related to mask-wearing, (C) The God Locus of Health Control (G LHC) scale consisting of six items measuring fatalistic beliefs, (D) The Duke University Religion Index (DUREL) consisting of five items measuring religiosity. The mean age of the participants was 36.5 ± 10.9 years, and females consisted 60% (n=302) of the sample. More than one-fifth (n=109) reported a history of COVID-19 infection. Approximately one-third of respondents (n=163) reported full mask adherence. Logistic regression model showed that there was no significant relationship between mask adherence and religiosity (odds ratio: 1.03; 95% confidence interval (CI): 0.99-1.08) and fatalistic beliefs (OR:1.01; 95% CI: 0.98-1.04 ).We found no association of fatalism and religiosity with the mask-wearing during COVID-19 in the Iranian Muslim population. So we can conclude that religious beliefs may have no place in cultural tailoring of health messages for promoting mask adherence.

Since in patients with type 2 diabetes (T2DM), there is an imbalance of inflammatory cells, the presence of inflammatory cytokines and defects in homeostasis are possible. The present study aimed to evaluate the percentage of Treg cells, lymphocytes, T cells, and T helper cells and gene expression of TGF-β cytokine in the T2DM patients.

Fifty patients with T2DM and 50 healthy controls were included in this study, according to the inclusion criteria. The percentage of Treg cells, T cells, and T helper cells was determined by flow cytometry. Also, the expression of CD4, CD25, and FOXP3 markers of Treg cells was examined. The gene expression of TGF-β cytokine was evaluated by real-time polymerase chain reaction (PCR).

The percentage of Treg cells was significantly lower in patients with T2DM than in healthy controls. The number of T helper cells and lymphocytes decreased in T2DM patients as compared to the healthy controls. Based on the results, the percentage of T cells was higher in T2DM patients than in healthy controls. The expression of CD25 and FOXP3 markers in Treg cells significantly reduced in T2DM patients compared to the healthy controls; however, this decrease was not significant for the CD4 marker. Conversely, the expression of TGF-β cytokine increased in patients with T2DM compared to the healthy controls.

Conclusion :

The expression of TGF-β and the percentage of CD4 + CD25 + regulatory T cells are impaired in patients with type 2 diabetes.

Cardiac iron overload causes severe cardiac complications and is a leading cause of death in beta-thalassemia major patient. T2*CMR can detect preclinical cardiac iron overload. We evaluated the ability of 12-lead electrocardiographic atrial and ventricular depolarization and repolarization parameters to predict cardiac iron loading in TM. This cross-sectional study was conducted on Patients with Beta thalassemia major; all participants underwent standard 12 lead electrocardiogram during a single study visit and the depolarization and repolarization parameters of ECG were measured and compared to the cardiac iron level detected by T2*CMR, with a detectable cardiac iron cutoff of T2*less than 20 ms. A total of 26 patients (mean 26.19 years old, 34.62% male) were included. Mean T2*CMR values were 21.53 ms (46.15% <20 ms, 53.85% ≥20 ms). Among ECG parameters, only Pwd, QTc and QTcd (p: 0.026, 0.030, and 0.006 respectively) were significantly prolonged in patients with T2* < 20 ms compared to patients with T2*≥ 20 ms. There was a statistically negative Correlation between T2 * CMR and Pwd and QTcd (p: 0.028, and 0.021 respectively). Moreover, no correlation was found between Tp-e, Tp-e d, JTc, JTcd, Tp-e/QT, Tp-e/JT, Tp-e/JTc and T2* values. PWD and QTcd can be used as an alternative to T2*CMR to predict cardiac iron load levels in patients with beta thalassemia major.

platelet count errors such as PU flag, could cause misdiagnosis.

Case report:

 a 36-year-old thalassemia minor male with fever and myalgia presented. Petechiae and purpura in the lower extremities of patients were observed in physical examination. The platelet count was assessed by Nihon Kohden’s Celltac G cell and Sysmex XP-300 cell counter and the platelet count was reported 10,000/μL and 129,000/μL respectively. But peripheral blood smear assessment confirms that the result of the Sysmex XP-300 cell counter was wrong and a platelet flag was seen. This situation can be corrected by the CBC histogram and peripheral blood smear evaluation.

Sysmex XP-300 cell counter inability to differentiate severely microcytic cells from platelets can cause the PU error, which means the severe microcytic RBCs were counted as platelets that cause the platelet count falsely higher than the actual number in this patient. The PU flag means the platelet histogram intersects the PU line and does not touch the zero baseline, that occur in conditions such as platelet clumps, giant platelet, microcytic and fragmented or dysplastic RBCs in hemolytic anemia. In Nihon Kohden’s Celltac G cell counter, due to the change in the PU line this error was prevented and the actual platelet count of the patient was reported. By the way, to avoid such errors, abnormal platelet counts should always be confirmed with the findings of PBS. ConclusionPoikilocytosis such as microcytic RBCs can cause the PU flag, so platelet and erythrocytes histograms and PBS evaluation should be assessed.