Journal of Research in Medical Sciences
Volume:13 Issue: 6, Nov & Dec 2008

Nowadays, driving is an unseparated part of our new modern lifestyle; and we are exposed to this environment all the days for several hours whether as drivers or as riders. Many reports indicated that Iran is on the top rank of automobile-related morbidity and mortality among developed and even many developing countries that can be due to dangerous driving habits in Iran. We designed this study to find out if environment of driving have clinically important effects on blood pressure (BP) and how strong is the effect. We also examined if there were any predictors for the BP rises in driving time. In a cross-sectional study, 31 healthy male taxi drivers were included through a multistage proportional sampling method in winter and spring 2007. They were referred to the clinic of hypertension in Shafa Hospital, Kerman. A trained nurse measured the BPs. She also did set up the Ambulatory Blood Pressure Monitor (ABPM) on the drivers’ left arms for BP recording every 30 minutes during the day. Based on the diurnal recorded BPs, the subjects were allocated into normotensive and hypertensive (systolic BP > 135 or diastolic BP > 85mmHg) groups. The difference among the clinic BPs and the driving BPs was examined by t-test in Stata version 8, followed by a multivariate analysis for exploring the main predictors for BP rises in driving time. Both mean systolic and mean diastolic BPs were significantly increased from 116.85 (SE 2.28) and 74.44 (SE 2.22) mmHg in clinic to 138.64 (SE 2.77) and 95.70 (SE 2.55) mmHg during driving, respectively (P = 0.0001). Pulse pressure remained constant (P = 0.87). The difference between clinic''s and driving time measurements was higher in hypertensive group. Those with higher systolic blood pressures in clinic had more frequent and higher BP rises in driving time (P = 0.02). Driving increased BP averagely 20 mmHg especially in those with higher BP measurements. Drivers with higher baseline systolic BPs were more prone to higher BP rises in driving time.

Hepatitis C (HCV) is increasing worldwide including Iran. HCV is more prevalent among intravenous drug abusers (IDU), especially if imprisoned, mostly due to needle sharing. We determined the rate of HCV seropositivity among IDU prisoners and compared it with those of non-prisoners. A cross-sectional study was conducted on consenting IDUs inhabiting two prisons and attending three rehabilitation centers in Tehran, Iran. A questionnaire was completed for each subject and 5 ml blood was drawn. The samples were kept at 2-8°C until the sera were separated and stored at -70°C. HCVAb (ELISA) was checked by a single technician. Chi-square, Fisher''s exact test and multivariate analysis were used where appropriate. Five-hundred and eighteen subjects were enrolled. About 74.5% were prisoners and 89.6% were male. Overall, 59.5% were positive for HCVAb (93.2% males and 6.8% females, P < 0.02). HCV seropositivity was higher among prisoners compared to non-prisoners (78.3% vs. 30.6%, respectively, P < 0.001). Also, it was higher in IUD older than 45 year-old compared to those younger than 30 year-old (77.8% vs.54.2%, respectively, P = 0.002). Multivariate analysis showed significant association of HCV seropositivity with imprisonment (OR: 9.32, 95% CI: 5.60-15.51), sharing syringes (OR: 2.00, 95% CI: 1.26-3.17) and duration of intravenous drug use (OR: 0.86, 95% CI: 0.80-0.92). HCV is rather common among IDU prisoners. Imprisonment is an independent risk factor for HCV and the infected IDUs going back to the society could be an important source of HCV. Taking effective strategies (education of high risk groups, provision of sterile syringes, identification and treatment of infected IDUs) to reduce the risk of this public health problem is needed urgently.

This study was undertaken to detect the prevalence of ocular symptoms and signs in professional video display users (VDUs) and non-users in Isfahan. This is a cross-sectional descriptive case-control study. The VDUs group was selected from among employees working with computer and the control group was selected from among employees not working with computer. Fifty seven VDUs (34 male & 23 female with mean age of 30.7 ± 6.8) and 56 employees in the control group (25 male & 31 female, mean age of 27.6 ± 7.2) were evaluated. Complete ocular examination was done for both groups. Among VDUs, 45 cases (79%) had burning eyes and tearing, 38 cases (66%) had dry eye, 37 cases (65%) had asthenopia, and 47 cases (82.5%) had musculoskeletal pain but these values for the control group were 24 (42.8%), 18 (32.2%), 22(39.3%) and 15 (26.8%) respectively and the difference was statistically significant (p = 0.037, p = 0.023, p = 0.044, p = 0.013). Schirmer''s test was positive in 22 VDUs (38.5%) vs. 6 (10.7%) of control group (p = 0.012). There was heterophoria in 19 VDUs (33.3%) vs. 3 controls (5.4%) (p = 0.032). Eye burning and tearing, dry eye, asthenopia and musculoskeletal problems were obviously more common in VDUs. Considering the extensive use of computers at home and work, a plan is required to detect dangers and provide appropriate solutions.

CD44 is an extracellular matrix molecule that has hyaluronan as one of its principal ligands. The interaction between CD44 and its ligand initiates activation and migration of endothelial cells. Migration of endothelial cells holds importance in neovascularization during cancer metastasis where new blood vessels are formed in order to nurture metastasized cancerous tissue. Studies on bovine endothelial cells showed that greater degree of migrations occurred with addition of lower molecular weight hyaluronic acid fragments (HAF) than the whole molecule of hyaluronan (HA). Our study included addition of heparin to the seedings of HA and HAF at concentrations of 105g/ml, 1005g/ml, 2505g/ml and 5005g/ml to endothelial cells and measuring the degrees of migrations obtained on migration assay. HUVECs were isolated from umbilical cords obtained from Kasturba Medical College, Manipal, India. The cells were standardized to 2000 cells/ml and cultured in co-star well plates and were seeded with HA and HAF at concentrations of 105g/ml, 1005g/ml, 2505g/ml and 5005g/ml. Basal level of control were resting cells and PMA treated cells were positive control. Migration assay was done on which the endothelial cells were embedded. After treatments, the migrations were measured and compared. Expression of CD44 was done using SDS-PAGE and Western Blot analysis. Heparin seems to play a role in the activation and migration of endothelial cells and their sustenance and viability in the medium. In Heparin M199 medium, the endothelial cells showed greater migrations when seeded with HAF than with HA. At 1005g/ml heparinised endothelial cells showed greater degree of migration with HAF than HA added at the same 1005g/ml. In heparin-free medium, the primary HUVECs migrated more at 105g/ml for cells seeded with HA while they migrated more with HAF at a concentration of 2505g/ml. SDS–PAGE and western blot analysis showed CD44 molecules on the primary HUVECs. The assays were set up and studied in duplicate. Further analysis should be done in order to substantiate the role of heparin in the migration of primary human umbilical vein endothelial cells following signaling with CD44 and HA. This might hold promise for therapeutic research into cancer metastasis and neovascularisation.

A common polymorphism at codon 72 of TP53 gene has been associated with increased risk for many human cancers. We studied this TP53 polymorphism in colorectal adenocarcinomas in small population selected from Isfahan city. Samples: We undertook a case-control study on 180 controls and 180 paraffin block specimens of sporadic colorectal adenocarcinomas. PCR amplification of TP53 codon 72 polymorphism: TP53 codon 72 genotypes were detected by PCR using specific primer pairs for amplifying the Proline or the Arginine alleles. STATISTICAL ANALYSES: The 42-test was used to assess the significance of any difference in the prevalence of TP53 codon 72 polymorphism between colorectal cancer patients and controls. In control samples, the genotype distribution for TP53 polymorphism showed 28.3%, 48.9% and 22.8% for the Arginine/Arginine, Arginine/Proline and Proline/Proline genotypes, respectively. In the cancer group 40% of the cases were Arginine/Arginine, 42.2% were Arginine/Proline and 17.8% were Proline/Proline. A significant difference between cases and controls was found for the Arginine/Arginine genotype compared with (grouped) Arginine/Proline and Proline/Proline genotypes (Odds Ratio = 1.686 (1.085-2.620), P = 0.02). TP53 codon 72 polymorphism may be a genetic predisposing factor for colorectal adenocarcinomas in Isfahan city.

The present paper was to reduce biased estimation using new approach (Penalized Maximum Likelihood Estimation Method) in Logistic Regression. It was assumed in the present paper that four various data sets on coronary heart disease (CHD) and smoking (including separation case) were obtained. Maximum Likelihood Estimation and Penalized Maximum Likelihood Estimation Methods were applied and compared for separation case including biased estimation in Logistic Regression when one of the cells in 2 x 2 contingency tables becomes equal to zero (separation problem).The values of parameters and their standard error obtained by using Maximum Likelihood estimation for four data sets were found approximately: 12.56±257.8, 13.46±264.3, 13.42±210.3, and 13.41±180.4, respectively, meaning that Maximum likelihood Estimations are biased estimates. However, corresponding values for Penalized Maximum Likelihood Estimation Method were found 2.28 ± 1.81, 3.05 ± 1.59, 3.45± 1.53, and 3.45 ± 1.53, respectively, meaning that Penalized Maximum likelihood Estimations was unbiased estimates. For example, it is clear that standard error value for data set 1 reduced from 257.8 to 1.81 when using Penalized Maximum Likelihood Estimation Method for separation problem. According to the original approach, the odds of being coronary heart disease (CHD) risk for smoking were increased 21.08 times than that for no smoking in data set 2, which is statistically significant at 1% level. The odds of being coronary heart disease (CHD) risk for smoking were increased 31.63 times than that for no smoking in data set 3 (P < 0.001). The odds of being coronary heart disease (CHD) risk for smoking were increased 41.93 times than that for no smoking in data set 4. When one of the cells in 2 x 2 contingency tables becomes equal to zero (separation problem), Penalized Maximum Likelihood Estimation Method was more superior to Maximum Likelihood Estimation Method because Penalized Maximum Likelihood Estimation Method may be performed unbiased (reliable) estimation

Mucositis is one of the most common complications of radiotherapy in head and neck cancers. The aim of this study was to evaluate sucralfate mouthwash in prevention of radiation induced mucositis. A clinical randomized trial performed on 52 patients with head and neck cancers in Sayyed-Al-Shohada Hospital of Isfahan University of Medical Sciences. These patients randomly assigned in 2 groups of 26 patients. Placebo and sucralfate was used for control and experimental patients respectiv ly, from the beginning of radiotherapy. Patients were visited weekly until the end of treatment. Grade of the mucositis was evaluated according to WHO grading scale. Sucralfate significantly reduced the mean grade of mucositis in weeks one to four (with P-values of 0.02, 0.02, 0.001 and 0.004, respectively). Development of grade3 mucositis was also lower in sucralfate group (P-value = 0.0001). But, time interval between radiotherapy and appearance of mucositis was not statistically different in the two groups (P-value = 0.9) This study indicated that using oral suspension of sucralfate reduced the grade of radiation-induced mucositis, but did not prevent or delay it.

Recently, diet-disease relations have been recommended to be looked for through dietary pattern approach rather than traditional approach (nutrient or food-oriented approach). Dietary pattern analysis allows consideration of the entire diet, rather than individual foods or ingredients. This approach can be particularly useful when traditional analyses in nutritional epidemiology cannot move beyond weak associations. The dietary pattern approach is more realistic than the food-based or nutrient approach, in that inter-correlations and biological interactions between foods and nutrients confound the associations of a single food or nutrient with a certain chronic disease. Several studies provide evidence supporting use of the dietary pattern approach in nutritional epidemiology. Most of these studies indicate that empirically derived food intake patterns by statistical methods are related to chronic diseases. This review aims to provide more detailed information about the methods of measurement, advantages and disadvantages of the dietary pattern approach and to assess whether major dietary patterns are related to the prevalence of metabolic syndrome and insulin resistance.

Uterine malignant mixed müllerian tumor (MMMT) is an uncommon carcinosarcomatous neoplasm with a highly malignant, biphasic pattern consisting of both epithelial and mesenchymal components. This paper reports the clinical, pathological and immunohistochemical features of heterologous MMMT of a diabetic and hypertensive patient. A 73-year-old white woman presented with post- menopausal bleeding for six months. The patient underwent TAH&BSO with pelvic lymph nodes dissection. In pathologic evaluations, a polypoid solid and white mass measuring 4.5cm×3cm×1.5cm was identified. Light microscopy showed biphasic pattern of epithelial component with clear cell change and sarcomatous elements of spindle cells with cartilage and bone differentiation. Immunohistochemistry was performed on formalin fixed and paraffin embedded tissue with a panel of immunohistochemical markers comprising cytokeratin (CK), vimentin and S100. The epithelial component was reactive for CK and vimentin. S100 positivity was seen in stromal and chondroid elements; so the diagnosis of MMMTS was confirmed. There may be an association between diabetes mellitus and the development of malignant mixed mesodermal tumor. Special attention should be paid when attempting to sample the endometrium of these patients. But further studies are needed to verify this hypothesis.