Archives of Iranian Medicine
Volume:4 Issue: 3, Jul 2001

Bakground-Aflatoxins (AF) and ochratoxin A (OA) are two toxic substances produced by specific types of fungi. Many reports consider them as carcinogens and nephropathogens, respectively. Objective-The aim of this study was to present the natural occurrence of AF and OA in some important foodstuffs in the southern Caspian littoral. Methods-Fourteen barley and nine corn samples, intended for animal feed, were collected from Golestan and Mazandaran provinces, northern Iran, and were analyzed for AF and OA by high performance liquid chromatography (HPLC).Results-In corn samples, aflatoxin B1 (AFB1) and aflatoxin B2 (AFB2) were detected in 8 (88.8%) and 6 (66.6%) samples at a mean level of 15.83 and 2.99 ppb (median 1.72 and 1 ppb) respectively. Only one of the AF-contaminated corn samples was co-contaminated with OA at a concentration of 0.35 ppb. Neither AF nor OA were found in any of the barley samples. Conclusion-This study was the first report on natural occurrence of OA and its co-occurrence with AF in the corn samples of northern Iran. Although our findings showed a low level of AF and OA, we recommend a periodical survey to be conducted on the natural occurrence of mycotoxins in cereals from the Caspian littoral.

Background-Hepatitis C virus (HCV) is transmitted mainly via sexual contacts and blood (or its products’) transfusion. Transmission of this virus by contaminated needles used by IV drug users has raised great concern.Objective-In the present survey, the rate of HCV infection among a group of IV drug users was investigated and some important risk factors of the virus transmission were determined.Methods-A total of 402 male IV drug users from Ghasr Prison in Tehran, Iran, entered the study (1995). At the stage of blood sampling, a questionnaire including demographic data; history of blood transfusion, tattooing and cupping (or Hejamat, the traditional way of phlebotomy in Iran) was also filled for every enrolled prisoner. HCV 3.0 ELISA and RIBA II were used to detect the HCV antibody and antigen in blood sera, respectively. Data were analyzed using Chi-square and Fisher’s exact tests.Results-HCV antibody was found in the sera of 182 of 402 cases (45.3%). Seventy-three of 182 (40.1%) HCV antibody-positive persons had a history of tattooing. All cases with a history of cupping were antibody positive. There was a statistically significant relationship between antibody positivity and having a history of tattooing/cupping (p< 0.005). Other risk factors did not seem to have a significant relationship with HCV antibody positivity. Conclusion-Similar to the findings of many developed and developing countries, a high rate of hepatitis C infection is present among Iranian IV drug users. We believe that tattooing and cupping are two important risk factors associated with HCV infection in IV drug users in Iran.

Background-Hematocrit and red blood cell count can be easily measured with an acceptable accuracy in most rural health care centers. Methods-A linear regression analysis was performed on the hemoglobin (dependent variable) and hematocrit (independent variable) levels of 22 patients with isolated iron-deficiency anemia, 26 known cases of isolated b -thalassemia trait, and 25 normal individuals. Results-It was found that the mean corpuscular hemoglobin concentration (MCHC) has an almost constant value of 33 g/dL in the three conditions studied. The relative error was below 3% in determining the Hb concentration from hematocrit among normal people and patients with either iron deficiency or minor b -thalassemia.Conclusion-Using this finding, we tried to explain how to derive other important hematological indices, i.e. blood hemoglobin level, mean corpuscular volume, and mean corpuscular hemoglobin from hematocrit and red blood cell count, with an acceptable accuracy in the situations studied. This could be considered as a useful method to determine blood hemoglobin concentration in rural health care centers without recouse to Coulter analyzers

Background-The pathogenesis of cataract has been found to be influenced by a number of factors including oxidative stress. Human body contains natural antioxidants, including the enzymes glutathione peroxidase and superoxide dismutase which help it withstand stress. Some environmental and nutritional factors can affect antioxidant systems. Objective-This study was undertaken to assess the status of total antioxidants, glutathione peroxidase (GPx) and superoxide dismutase (SOD) in the Iranian population whose lifestyle is both nutritionally and environmentally different from other populations on which such studies have been conducted. Methods-Forty-five patients with senile cataract and 35 controls were selected and matched. The levels of the above-mentioned enzymes and chemicals were measured in erythrocytes and plasma and compared by Student’s t-test (p<0.05 for significance).Results-The level of GPx erythrocyte activity in patients and controls was found to be 51.24±13.46 μ/gHb and 40.87±7.04 μ/gHb respectively (p<0.0001). SOD levels were 1239.83±275.96 μ/gHb in patients and 1126±201.72 μ/gHb in controls (p=0.045). Total antioxidant status of the patients and controls were 1.39±0.27 mMol/L and 1.64±0.36 mMol/L respectively (p<0.001). Conclusion-Even though the relationships of these factors to cataractogenesis is still unknown, we believe that a better knowledge about their role could strengthen our understanding of the pathogenesis, diagnosis and perhaps the treatment of cataract. Still, it is safe to assume that educating people on consumption of a diet richer in antioxidants (like vegetables) is beneficial in preventing diseases like cataract.

Background-Palmar hyperhidrosis is a fairly common disease with an unknown etiology. Some treatment modalities have shown benefits, the most recent of which is the injection of botulinum toxin A (BTX-A). We tried to test the beneficial effects of BTX (Dysport) in Iranian patients.Methods-Fifteen volunteers with severe palmar hyperhidrosis, diagnosed by iodine starch test, were enrolled in the study. Employing a standardized scheme, Dysport was injected intradermally into the palmar aspect of patients’ dominant hands. The distal parts of the non-dominant hands were injected by normal saline as control. Follow-up was performed using iodine starch test. Wilcoxon signed rank test was used for comparison between the cases and controls.Results-Satisfactory response to treatment was achieved in 13 out of 15 patients. Comparing the cases with the controls, Dysport showed a significant beneficial effect (p<0.001). Weakness of handgrip was seen in 13 patients.Conclusion-We suggest using Dysport in the treatment of selected cases of severe palmar hyperhidrosis.

Background-Measurement of adrenocortical steroids at birth is of paramount importance especially for early diagnosis and treatment of some grave diseases including congenital adrenal hyperplasia and adrenocortical insufficiency. Objective- To determine the serum levels of 17α–hydroxyprogesterone (17α-OHP), 4Δ-androstenedione and cortisol in normal full-term neonates.Methods-The level of the above-mentioned corticosteroids were measured at the time of delivery, and 12 and 24 hours after birth in 15 healthy neonates by use of specific radioimmunoassays (RIA). Results-The present study indicated that there are no significant differences between the adrenocortical steroid levels of the two sexes. The level of each corticosteroid declined in the first 24 hours of life.Conclusion-The mean and standard deviation of the above-mentioned corticosteroids are higher (but not statistically significant) in comparison to studies conducted in different geographical areas, perhaps due to difference in race, consanguinity and high frequency of congenital adrenal hyperplasia in Iran.

Background-Nimodipine has been shown to have a neuroprotective effect. Garlic also displays features that are potentially effective in inhibiting ischemic damage. In this study the efficacy of both garlic and nimodipine in preventing ischemic brain injury were assessed.Methods-Twenty-four rabbits were divided into four groups: nimodipine-treated group (NP), garlic-treated group (GR), normal saline group (NS), and polyethylene glycol-treated as the vehicle group (VH). All animals were subjected to 15 minutes of bilateral common carotid artery (CCA) occlusion. NP and GR groups received garlic and nimodipine 60 minutes before occlusion of the CCA respectively. Cerebral blood flow (CBF) was measured by Laser Doppler flowmetry, during and after the occlusion. Histopathology of the brain was blindly evaluated. The percentage of degenerated cells in the hippocampus was estimated and vascular congestion was graded on a 3-point scale (0, I, II).Results-After reperfusion, nimodipine and garlic increased the cerebral blood flow (CBF) by 41% and 24% respectively. Comparing these values to the extent of CBF increase in the VH and NS (2% in both) groups, the differences were statistically significant (p<0.05). The percentage of degenerated neuronal cells in zone CA1 was 23%, 31%, 43% and 44% in NP, GR, VH and NS groups, respectively. NP and GR showed a higher grade of congestion compared to control groups (VH and NS)(p<0.05).Conclusion-This study demonstrates that neuronal damage to the rabbit hippocampus is reduced by garlic administration, although nimodipine can increase CBF more effectively.

The leishmaniases are parasitic infections with various clinical manifestations and great geographical distribution. Mucosal leishmaniasis (ML) is an important problem in Latin America but is rarely encountered in Iran. There has been a report of the involvement of mucosal tissues with L. major and/ or L. tropica in the Southwest of Iran. In this report, we describe 3 rare clinical presentations of mucosal leishmaniasis, which were treated with meglumine antimoniate (Glucantime). No evidence of recurrence was noted after several years of follow-up.

A 30 year-old male patient was referred with RUQ abdominal pain of 10 months duration. With the impression of acute abdomen, the patient underwent surgery. The pathologist proposed hydatid cyst as the probable diagnosis. Because of persisting abdominal pain the patient was reevaluated. CT scan showed a mass lesion, 22cm in diameter, in the right hepatic lobe and thus right hepatic lobectomy and cholecystectomy were performed. Histologic findings were consistent with angiosarcoma. Increased familiarity with this cancer will facilitate correct diagnosis and will help to differentiate it from the more prevalent hepatic mass lesions found in Iran

Recent advances in biomedical technology have facilitated global analysis of cellular proteins and are termed as “proteomics”. Proteomics has become the key area of research in biomedicine and microbiology which uses meticulous and sophisticated techniques including two-dimensional acrylamid gel electrophoresis, mass spectrometry and bio-informatic databases. Proteomics is rapidly growing into post-genomic era in biomedical investigations. Its base lies on structural, physical, functional and other bio-characteristics of proteins and its application provides great opportunity to clarify the action of various pathogenetic agents. It will identify new diagnostic methods, new diagnostic markers of disease, new therapeutic agents, as well as protein candidates for vaccines. Application of this phenomenon expands from basic research, to clinical applications such as drug development, control of infectious diseases, cancer, neuropathology and cardiovascular diseases.