Caspian Journal of Internal Medicine
Volume:2 Issue: 2, Spring 2011

Osteoarthritis (OA) a common disease of aged population and one of the leading causes of disability. Incidence of knee OA is rising by increasing average age of general population. Age, weight, trauma to joint due to repetiting movements in particular squatting and kneeling are common risk factors of knee OA. Several factors including cytokines, leptin, and mechanical forces are pathogenic factors of knee OA. In patients with knee pain attribution of pain to knee OA should be considered with caution. Since a proportion of knee OA are asymptomatic and in a number of patients identification of knee OA is not possible due to low sensitivity of radiographic examination. In this review data presented in regard to prevalence, pathogenesis, risk factors.

CYP2D6 is polymorphically expressed enzyme that show marked interindividual and interethnic variation. Phenotyping of CYP2D6 provides valuable information about real-time activity of this important drug-metabolizing enzymes through the use of specific probe drugs. The aim of this study was to identify the CYP2D6 oxidation phenotype with dextromethorphan (DEX) as a probe drug in Mazandarani ethnic group among Iranian population. The study included 71 unrelated healthy volunteers. Dextromethorphan hydrobromide (30 mg) was given orally to healthy subjects and peripheral venous blood samples (10 ml) were taken at 3 hr post-dose. Dextromethorphan and the metabolite dextrorphan (DOR) were analyzed by the HPLC method. The log DEX/DOR metabolic ratio (MR) at 3 hr plasma sample was used as the index of CYP2D6 activity and a value of 0.3 was used as the antimode separating extensive metabolizers (EM) and poor metabolizers (PM) phenotypes. A 560-fold interindividual variation in dextromethorphan MRs was observed in this study. Considering the antimode 0.3 in log scale, 7.04% (5/71) volunteers were identified as PMs. The result showed that the frequency of CYP2D6 PM phenotypes accounted for 7.04% of subjects in our samples. Despite these findings, we propose a further study in larger samples to provide a wider image and to get more valuable information upon pharmacogenetic basis for individual therapy and personalized medicine.

Given to the abundant incidence of malnutrition in HIV+ patients and its effect on progress of AIDS disease, several studies have recommended supplementation therapy (such as Selenium, Levamisole, Zinc). This clinical trial was prefunded on patient''s with HIV + in Behavior Diseases Consulting Center, Kermanshah, Iran 2006-2007. One hundred-seventy eight out of all patients with CD4 1ess than 350 cell/mm3 who did not receive antiretroviral drugs were in this study. They were divided into four groups: the first group received 200 micg selenium per day, the second group received levamisole 50 mg every other day, and third group received both two drugs. The fourth group was the control group. All four groups were studied for six months. Patients'' baseline CD4 and other data were recorded in a form. CD4 was rechecked after six months and collected values were compared with basic values. CD4 changes were compared among all groups, either. One hundred-seventy eight patients initiated treatment and 108 cooperated in the 6-month follow up assessment. Niuety-two (85%) were males and 15% were female. CD4 decreased in control group and Levamisole group during the study which was significant, but 13 units increase was seen in Selenium-Levamisole group. CD4 count decreased 36 units in Selenium group. Comparing CD4 count change among 4 study groups showed that only CD4 change between Selenium-Levamisole group and control group was significant. Regarding to collected results, Selenium-Levamisole supplementation can be used as a supplementation therapy besides antiretroviral therapies.

Coronary Artery Disease is known as the main cause of death in industrialized countries. Relation between this disease and some infections such as Helicobacter pylori (H.pylori) has been shown in several studies. The purpose of this study was to dermine the relationship between Hypylori and mycardical infarctions. Seventy-three myocardial infarction patients and 78 individuals with no history of this disease were compared. Patients and control matched for age and sex person to person by the match method. Levels of serum IgA and IgG antibodies against H. pylori were measured by Elisa method. Also, cholesterol, triglyceride, LDL, HDL measured in both groups and data were compared between two groups in terms of relation with cardiac risk factors. From 151 participants, 73 were patients and 78 were control subjects. The percentage of IgG positive cases against H. pylori was 57.5% in the case group and 32.1% in the control group (p=0.002, OR: 2.87 CI: 95%; 1.5-5.6). Meanwhile, there was no significant difference in IgA positive cases between the two groups (42.5% and 48.7% in the case and control groups, respectively) (p=0.44; OR: 0.78 95% CI; 0.41-1.48). The study showed 74.2% of cases in the case group and 45.2% in the control group were positive for both IgG and IgA (p=0.01; OR: 3.5 95% CI; 1.3-9.5). No significant differences were found between two groups in terms of relation between H. pylori related antibodies level and heart disease classic risk factors (smoking, hypertension,…), sex, and age, but between dyslipidemia and H. pylori related antibodies was significant differences in case group (p=0.05). According to the results, it seems there is a relation between H. pylori infection and myocardial infarction. Also, between dislipidemia and H. Pylori antibodies in case group were significant difference. Therefore, H. pylori can be a new risk factor for atherosclerosis or can be exacerbate effect of other risk factors. Proper diagnosis and treatment of these infections can be useful in prone patients. More studies with larger sample groups are needed to review the possible role of this pathogen as a heart disease risk factor.

About 5–10% of patients with asthma suffer from poorly-controlled disease despite corticosteroid (CS) therapy. 21 severe and 30 mild asthma patients were recruited and underwent collection of blood sample. We determined whether there were any differences in inflammatory biomarkers between severe and mild asthma patients or not. Levels of Interleukin-8 (IL-8) and Interleukin-6 (IL-6) in blood supernatants were similar in both groups of asthma patients. Leukocytes were in range of normal in all patients. Increased eosinophil was in 29% of severe cases and 23% in mild cases. IgE level was increased in 43% of severe form and 50% in mild form. There is not any difference between severe and mild asthma in serum IL-8 and IL-6. Therefore, level of serum cytokines may not predict severity of asthma.

Hyperprolactinemia is the most common endocrine disorder in hypothalamic-pituitary axis and has been reported in variable levels in patients with overt primary hypothyroidism. We decided to determine the prevalence of hyperprolactinemia and clinical related symptoms in subclinical hypothyroidism patients. In this cross sectional study, prolactin levels of 481 subclinical hypothyroid patients were assessed. Prolactin measurement was performed using chemiluminescent immunoassay. Data were collected and analyzed. Sixty-two (13%) patients were males and 419 (87%) were females. The mean age of the patients was 32.53±10.13 years. Ninty-eight patients (91 females 7 males) had high prolactin. Prevalence of hyperprolactinemia in subclinical hypothyroidism was 20.4%. (11% in men and 22% in women, p=0.05). There was no correlation between the serum TSH and prolactin level. Clinical symptom prevalence was not different between patients with and without hyperprolactinemia. This study showed that prevalence of hyperprolactinemia in subclinical hypothyroidism is notable and this disorder is more common in female subclinical hypothyroidism than the men.

Recent researches have known long term infections such as periodontal disease to be related with the process of atherosclerosis. Periodontitis causes peripheral inflammation and immune cell stimulation which leads to an increase in C - reactive protein (CRP) and IgA Ab and there is a definite relation between cardiovascular disease, CRP increase and Periodontitis. The aim of this study was to evaluate the periodontal health status of patients with myocardial infarction who were hospitalized in Babol and Sari Hospitals. This descriptive study was done on 95 men and women age ranging from 40 to 70 years old hospitalized due to myocardial infarction diagnosis in Babol and Sari Hospitals. Periodontal health, of patients evaluated via Cowell Bleeding Index, Green and vermillion Debri Index, Tooth Mobility, Clinical attachment Level on Ramfjord teeth. Data were analyzed with SPSS and Kruskal-Wallis test and Mann-whitney test. Considered indexes were evaluated in 81men and 14 women studied which showed no significant difference among them in the average BI (p=0.52), average tooth mobility (p=0.117) and average CAL index (p=0.745). The only significant difference between men and women was found in average DI index (p=0.08). There was a significant difference between average CAL in Ramfjord teeth of upper and lower jaw (p=0.002). According to high prevalence of periodontitis in our study, periodontitis may be a risk factor of cardiovascular disease, it should be pointed out that here is the cardiologists'' emphasis on their patients referring to the dentists.

Burn injuries in many respects is the most tragic that a person may experience. The purpose of this study was to know the burn casualties prevalence in people over 15 years old to identify the risk and predisposing factors in the province of west Azarbaijan of Iran. This cross-sectional study was performed from March 2008 to March 2010. The demographic and epidemiologic information about burn and its complications were extracted from the data banks and records. Data were collected and analyzed. Four hundred twenty eight patients (44.9% female and 56.1% male) were studied. Most of the admissions were in 16 to 25 years age bracket. Burning with fire accounted (39.2%) of admission in males and (53.2%) in females which was the most common cause of burning. Percentage patients who had more than 40% body surface area (BSA) burned was 42.0% in males, and 30.1% in females. Patients with >40% BSA burn had a mortality of 73.8%. The mean body surface area burned was 33.8% in males and 25.2% in females. The mean duration of hospitalization was 6.19 days. The results of this study show that the prevalence of burn injuries is relatively high with high mortality rate in those with BSA> 40%. The commonest cause of burn was fire.

The Pelger-Huet anomaly dominantly is a rare and benign inherited defect of terminal neutrophil differentiation. Although neutrophil migration may be minimally impaired, granulocytes function is otherwise normal association abnormalities such as ocular, musculoskeletal are reported very rare. Case: An eight year-old boy with good consciousness but severe muscular atrophia and difficulty in respiration was admitted in Amirkola Hospital at Babol University of Medical Sciences Babol, Iran. The patient was febrile at presentation. The chest x-ray was normal and other causes of respiratory problem were ruled out. The patient and his mother have 30% to 40% band and Pelger-Huet cells in peripheral blood smear. He gradually has gotten hearing loss and decreased visual acuity for three years. He has optic nerve atrophia. The patient is an unusual type of Pelger-Huet anomaly with multiple organ dysfunctions probably due to simultaneous muscular degenerative disease.