مجله دانشکده پزشکی اصفهان
پیاپی 368 (هفته چهارم اسفند 1394)

In recent years, limited information has been provided regarding the occurrence of aflatoxins in flour samples and in traditional flat breads in comparison to the leavened breads in Iran. In this study, aflatoxin contamination in some bakery products and assessment of risk of aflatoxin intake were investigated.
In this experimental cross-sectional study, 66 samples including 29 different flour samples, 14 traditional flat bread samples, 10 leavened bread samples, and 13 samples of sesame and seeds used for dressing breads were randomly collected from different factories and bakeries in Isfahan, Iran, and examined for aflatoxin residue using the enzyme-linked immunosorbent assay (ELISA) specific kit. The risk of aflatoxin intake for consumers was assessed using hazard quotient and mean and data analysis was conducted using one-way ANOVA and Fisher’s least significant difference (LSD).
Findings: Aflatoxin residue was found in all of the studied samples in the range of 0.5 to 6.54 pbb and did not exceed the national standard level (15 pbb). Traditional flat breads contained two times more aflatoxin than leavened breads. Hazard quotient ranged from 5.4 to 101 and the relative carcinogenic risk was higher than 10-4.
Despite the low aflatoxin contamination levels in bread in this study, the hazard index of higher than the tolerable limit for humans showed that reduction of daily bread consumption in Iran is critical.

Constipation is a common disorder of the gastrointestinal tract which affects the quality of life (QOL) of patients. However, findings of studies on the relationship between obesity and constipation are conflicting. The aim of the present study was to assess the relationship of general and central obesity with constipation and functional constipation in a large group of Iranian adults.
This cross-sectional study was conducted on 4457 adults, through obtaining anthropometric measures using a validated self-report questionnaire. The subjects were classified into three categories of normal weight, overweight, and obese based on their body mass index (BMI) and normal, central overweight, and central obesity based on their waist circumference. The prevalence of constipation, functional constipation, and its components was investigated according to Rome III criteria.
Findings: The prevalence of constipation and functional constipation among the study population was 33.6% and 15.3%, respectively. After adjustment for potentially confounding factors, obese individuals were at a 32% greater risk of constipation compared to those with normal BMI (OR: 1.32; 95% CI: 1.03-1.71). There was no significant association between general obesity and functional constipation. Gender-stratified analysis revealed a significant association between overweight and obesity, and constipation among women in the crude model; overweight women (OR: 1.21; 95% CI: 1.02-1.45) and obese women compared to women with normal BMI (OR: 1.65; 95% CI: 1.26-2.15) were 21% and 65% more likely to have constipation. Although significant associations were found between abdominal obesity, and constipation and functional constipation in the crude model, these associations disappeared with adjustment for confounding factors. Gender-stratified analysis revealed no significant associations between abdominal obesity, and risk of constipation or functional constipation in men or women.
General obesity was associated with a significant increase in the risk of constipation, while abdominal obesity was not associated with constipation and functional constipation. General obesity was related to increased risk of constipation in women. However, no significant association was found between constipation and functional constipation, and obesity or abdominal obesity in men.

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in Western industrialized countries. The pathogenesis of NAFLD has not been clearly determined, but the most widely supported theory is the mechanism of insulin resistance. Therefore, the aim of this study was to evaluate the frequency of diabetes and pre-diabetes in patients with NAFLD.
The present study was performed on 80 patients and 26 healthy controls matched for age and sex. Patients were diagnosed with NAFLD through ultrasound and were selected. From each participant, a 5 cc sample of blood was obtained and sent to a pathology laboratory for analysis. Quantitative data and qualitative data were analyzed using t-test and chi-square test, respectively. Moreover, multivariate tests, such as regression tests, were used where necessary.
Findings: Among the participants, 64 (60.3%) were women and 42 (39.7%) were men. The average age of the subjects in the case group was 48.8 ± 10.8 years and in the control group was 42.3 ± 13.4 years. Of the 106 participants, 44 patients (41.5%) had pre-diabetes and 11 (10.4%) had diabetes; all were in the case group. In the control group, no subjects had pre-diabetes (P This study showed that the prevalence of diabetes in patients with NAFLD was high. Even with the removal of confounding factors, factors associated with diabetes, such as hemoglobin A1c, fasting plasma glucose, and insulin, had significant association with this disease, indicating a strong relationship between the two diseases.

Functional constipation in childhood is a common and frustrating problem and probiotics are increasingly used in the treatment of functional gastrointestinal disorders. This study investigated the effect of probiotics on the treatment of functional constipation in children of 4 to 12 years of age.
This clinical trial was conducted on 4 to 12-year-old children with functional constipation, according to Rome III, who referred to the clinic of Besat Hospital in Sanandaj, Iran, in 2013. The exclusion criteria included receiving any kind of laxative during the previous 4 weeks, mental retardation, hypothyroidism, cystic fibrosis, and intestinal surgery. The sample consisted of 90 children who were randomly assigned to either the intervention or the control group. The control group received routine treatment of constipation (0.7-1.5 gr/kg Pidrolax powder daily) for 4 weeks and the intervention group received routine treatment of constipation in addition to probiotics. Patients were examined 2 and 4 weeks after the intervention. Initial assessment included the frequency of bowel movements per week, stool consistency, number of fecal incontinence per week, and abdominal pain and painful defecation. The secondary assessment consisted of successful treatment, and side effects such as diarrhea and vomiting.
Findings: The results showed no statistically significant difference between the two groups before and 2 and 4 weeks after the intervention in terms of the frequency of painful and difficult defecation in (P > 0.05). Nevertheless, there was a statistically significant difference between the two groups in terms of abdominal pain in 2 and 4 weeks after the intervention (P The results show that probiotics have no side effects; thus, their addition to standard therapy can be useful in children with functional constipation.

Various tumor suppressor genes play a role in colorectal cancer; the role of breast cancer 1 (BRCA1) tumor suppressor gene is of the most importance among them. The biological performance of breast cancer 1 (BRCA1) in cancer has been recognized and its prognostic significance has been verified in colorectal cancer; decrease in the expression of this protein in cancer indicates a poor prognosis for patients. The aim of the current study was to evaluate BRCA1 protein expression in cancerous colorectal specimens compared to healthy tissue surrounding the tumor using immunohistochemistry method.
A total of 50 cancerous colorectal and 50 healthy specimens were collected. The expression of BRCA1 protein was evaluated upon paraffin sections through immunohistochemistry method.
Findings: The findings of the current study showed that the level of BRCA1 protein expression significantly decreased in cancerous specimens compared to healthy tissue surrounding the tumor (P = 0.026).
The expression of BRCA1 could be used as an appropriate biological marker in the diagnosis and prognosis of colorectal cancer.

Apoptosis defect plays an important role in the formation of tumors and its disruption causes resistance to treatment. The effects of pomegranate on the inhibition of apoptosis and cell proliferation of some cancer types have been demonstrated. The aim of this study was to investigate the effect of black pomegranate peel extract on cell survival, morphology, and apoptosis of melanoma cells and human umbilical vein endothelial cells (HUVECs).
The hydroalcoholic extract of black pomegranate pericarp was prepared. Toxicity of melanoma and HUVEC was evaluated through MTT assay (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) in the experimental group at different concentrations of the extract (10, 100, 200, 300 μg/ml) and dimethyl sulfoxide (DMSO) 0.1% in the control group. In addition, apoptosis was studied using Annexin-V test and flow cytometry. The morphology of the cells was examined under a microscope.
Findings: After 48 hours, melanoma cell survival significantly decreased in a concentration-dependent manner (P Pomegranate peel extract induces apoptosis, death, and morphological changes in melanoma cells. However, it has no effect on HUVECs. It seems that this extract can be a good candidate for apoptosis induction in melanoma cells as complementary therapy.

DNA sequencing is an approach exploited to determine the sequence of a DNA molecule. It includes any method or technology used to identify and determine the order of the four bases of adenine, guanine, cytosine, and thymine in a strand of DNA. DNA sequencing might be used to determine the sequence of individual genes, larger genetic regions, full chromosomes, or entire genomes. Traditional sequencing methods are mainly based on the original Sanger sequencing technique which makes them very expensive and low-throughput; thus, they do not meet the needs of researchers. Consequently, with the considerable advances in molecular biology and the high demand for low-cost sequencing has encouraged the development of high-throughput sequencing (or next-generation sequencing) technologies that parallelize the sequencing process, producing thousands or millions of sequences concurrently. Next-generation sequencing enable us to rapidly sequence a large piece of DNA which could span the whole genome with the latest instruments capable of producing gigabases of data in one isolated sequencing run. Next-generation sequencing platforms have a wide variety of applications, such as whole-genome sequencing, de novo sequencing, RNA sequencing (for applications such as transcriptomics and small RNA analysis), methylation analysis, and protein-nucleic acid interaction analysis.