Acta Medica Iranica
Volume:50 Issue: 10, Oct 2012

Methylenetetrahydrofolate reductase (MTHFR) enzyme is one of the most important enzymes with a pivotal role in the folate metabolism and DNA synthesis pathways. Single nucleotide polymorphism (SNPs) in the coding gene has been related to many medical diseases as well as diverse malignancies including the prostate cancer which is the leading cause of the cancer deaths in men and one of the major public health problems. The goal of this study is to determine the relationship between the MTHFR C677T SNP and the prostate adenocarcinoma in Iranian males attending to the Labbafi-nezhad hospital in Tehran. In this Case-control unmatched study, 67 and 75 paraffinized tissue samples were taken out of the specimens diagnosed previously as the prostatic adenocarcinoma and nodular prostatic hyperplasia for the case and control groups respectively. MTHFR C677T genotyping was done by the use of multiplex ARMS-PCR and frequencies of the alleles were compared between the case and control groups as well as calculating the deviation from Hardy-Weinberg equilibrium and Odds Ratio for the «T» allele regarding the prostatic carcinoma. The observed rates in the control group were not too different from that of expected from Hardy-Weinberg equilibrium (P=0. 407). Frequencies of the possible genotypes were as follows: CC, 43. 28% vs. 42. 67%; CT, 49. 25% vs. 52% and CT, 7. 46% vs. 5. 33% in the case and control groups respectively (P=0. 85). 1. 37 times increased risk was found for the homozygote carriers of C677T variant (OR: 1. 37, 95% CI: 0. 33-5. 6; P=0. 653) which is however statistically not significant. No association has been evident between the MTHFR 677C>T polymorphism and the risk of prostatic carcinoma in this study confirming the findings of some of the previous attempts; however, (OR: 1. 37, 95% CI: 0. 33-5. 6) implies a slight effect of the homozygote on the carcinogenesis. Thus larger studies especially with a greater number of the smaples are recommended.

We compared the extent of temporary threshold shift (TTS) and hair cell loss following high level 4 kHz noise exposure with those preconditioned with moderate level 1 and 4 kHz octave band noise. Fifteen Male albino guinea pigs (300- 350 g in weight) were randomly allocated into three groups: those exposed to 4 kHz octave band noise at 102 dB SPL (group 1, n=5); those conditioned with 1 kHz octave band noise at 85 dB SPL, 6 hours per day for 5 days, then exposed to noise (group 2, n=5); those conditioned with 4 kHz octave band noise at 85 dB SPL, then exposed to noise (group 3, n=5). An hour and one week after noise exposure, threshold shifts were evaluated by auditory-evoked brainstem response (ABR) and then animals were euthanized for histological evaluation. We found that TTS and cochlear damage caused by noise exposure were significantly reduced by 1 kHz and 4 kHz conditioning (P<0.001). We also showed that 4 kHz protocol attenuates noise- induced TTS but no significant TTS reduction occurred by 1 kHz conditioning. Both protocol protected noise-induced cochlear damage. We concluded that lower tone conditioning could not protect against higher tone temporary noise-induced hearing loss, thus conditioning is a local acting and frequency-dependent phenomenon.

The effect of opium addiction on the appearance of different types of arrhythmias after acute myocardial infarction (AMI) has been assessed in few studies. This study is aimed to determine the effect of opium on post-MI arrhythmia and also to address the differences in the appearance of different types of arrhythmias after AMI between opium addicted and non-addicted patients. In this comparative study, participants were classified into two groups with opium addiction (n=94) and without opium addiction (n=106). Post-MI arrhythmias were determined among each group. Study populations were included all patients with first AMI admitted within 6 hours of the onset of chest pain to coronary care units (CCU) of two teaching hospitals affiliated to Kerman University of Medical Sciences (KUMS) in the city of Kerman, Iran. Opium addicted subjects had significantly more frequency of arrhythmia than non-opium addicted subjects (80.9% vs. 22.6%, respectively; P<0.001). Opium addiction was a strong predictor for the occurrence of post-MI arrhythmias in two models of crude analysis (crude OR=14.4, P<0.001) and after adjusting for potential confounder factors (adjusted OR = 21.9, P<0.001). The prevalence of sinus tachycardia, sinus bradycardia and atrial fibrillation in opium addicts were significantly higher than non opium addicts (P<0.05). The results of our study showed that opium addiction is a potential and strong risk for occurring post-MI arrhythmias.

Premature ejaculation (PE) is one of prevalent male sexual dysfunctions worldwide. Despite many psychiatric backgrounds, yet there are speculations about organic etiologies considering both anatomic and physiologic points of view. This survey assesses effect of frenular web preservation on premature ejaculation. One thousand and forty otherwise healthy men being visited for urolithiasis (asymptomatic patients) were asked for PE according to the International Society of Sexual Medicine definition criteria as intravaginal ejaculation latency time (IELT) less than a minute according to stop watch checked by patients'' partner and were examined for presence of frenular web. Frenular web defined as a residual of frenulum after a circumcision. Overall prevalence of PE was 18.2% (n=102). We found the presence of frenulum at physical examination in 255 out of 560 (45.5%). Prevalence of PE was 20.7% (n=53) and 16% (n=49) in patients with frenular web preserved and without it, respectively. PE was higher among the men with frenulum preserved; but no statistically significant differences were seen (P=0.70). We did not find any relationship between frenular web and PE, and concerns about this, during circumcision, may not be justified. PE is a not only a problem of local anatomical condition but many psychological and neurological factors could interact with it.

Multiple Sclerosis (MS) is a demyelinating disorder of Central Nervous System. It involves 8th cranial nerve and its central nuclei and is an uncommon cause of the sensorineural hearing loss. For determining the prevalence of hearing loss (HL) especially retrocochlear type in MS, a cross-sectional study was designed using Pure-Tone Audiometry (PTA), Otoacustic Emissions (OAEs), Auditory Brainstem Responses (ABRs) compared with the control group. Data were analyzed by Qui2 & Fischer exact test in SPSS 17 software. Among 60 patients (44 women & 16 men) and 38 controls (27 women & 11 men) with a mean age of 29.9±9.8 and 31.4± 8.3 years, 12.5% of case ears and 3.9% of the control ears had abnormal PTA (P= 0.043). Frequency of abnormal high frequency-PTA and two modalities of OAEs were not significantly different between case and control ears. The means of overall correlation were 75.9±23.8 in cases and 70.0±27.2 in controls (P= 0.111). 20% of case ears, and 9.2% of the control ears had abnormal ABRs (P= 0.044). The absolute latencies of waves I, II & V had not significant difference, but 10% and 11.7% of case ears and 1.3% & none of the control ears had increased inter peak latencies of I-III, and III-V respectively (P<0.05). 6.7% of case ears and 2.6% of control ears had retrocochlear abnormality (P=0.181). In conclusion, HL is more common in MS patients, especially when determined by using PTA and ABR.

Anthropometry, a useful method for evaluating craniofacial soft tissues, makes the quantitative description of the face possible. It also assesses the degree of disharmony and imbalance in the growth and development of the face. The aim of this study was to examine the overall common age-related changes of nasomaxillary complex of adolescent boys in northeast Iran. Three- hundred- twelve 12 to 15 year-old boys voluntarily participated in this study. They were divided into three age groups (12-13, 13-14 and 14-15 year-old groups). Digital photographs of the subjects'' faces were taken in Natural Head Position (NHP) frontal and profile views. After determination of the landmarks, nine anthropometric parameters including nasal length, mouth width, alar width, columella width, philtrum height, nasal width, nasolabial angle, nasal root slope angle and nasal index were measured by the Smile Analyzer software considering the magnification ratio of each image. One way ANOVA and Tukey test were used for statistical analyses. Significant differences between the three groups were detected in the mean alar, mouth and philtrum widths, nose length, nasolabial angle and nasal index (P<0.05). We did not find any significant differences in the mean nasal-root-slope angle and the mean philtrum height between the groups (P=0.29 and P=0.13, respectively). Aging of the facial profile is not a gradual process; it occurs in spurts and at different periods of life. During the studied time span, significant growth in nose width and nose length was obvious.

While pterygium is considered a common eye disorder, the etiology and pathogenesis is still not known. The aim of this study was to describe the prevalence of pterygium and pinguecula in the over 40 population of Shahroud and assess associated factors. The present study is part of the phase one of the Shahroud Eye Cohort Study conducted in 2009, in which the target population was people between 40 and 64 years of age. Ophthalmic examinations were performed by two ophthalmologists who made the diagnosis of pterygium and pinguecula. We used Chi-square tests, analysis of variance, and multiple logistic regression tests to examine associations. Of the 6311 invitees, 5190 people participated in the study (response rate: 82.2%). The prevalence of pterygium in at least one eye was 9.4% (95% CI, 8.6-10.3), while 2.9% (95%CI, 2.4-3.3) had bilateral pterygium. The prevalence was significantly higher in men (11.4% vs. 8.0%), and remained relatively constant with age, while the prevalence in women significantly increased with age. The prevalence of pinguecula was 61.0% (95%CI, 59.1-62.9) in at least one eye, and 49.0% (95%CI, 47.1-50.9) in both eyes. The age difference between those with and without pinguecula was significant and the prevalence was significantly higher among men than women (70.6% vs. 53.8%). The prevalence of pterygium in our study was lower than reported rates in the world but higher than Tehran and was significantly associated with age, gender, working outdoors, and the level of education. The prevalence of unilateral and bilateral pinguecula falls in the mid range and was significantly associated with age, male gender, smoking, working outdoors, and level of education.

Coronary artery disease is one of the most common reasons of death around the world. Also, according to previous studies, the incidence of coronary artery disease is rapidly increasing in developing countries such as Iran. The aim of this study was to evaluate the knowledge and practice of pharmaceutical company workers towards the prevention of cardiovascular disease. In this cross sectional study that was conducted in Tehran, 1223 workers of a pharmaceutical company were enrolled. Data was collected using a questionnaire that assessed the level of knowledge and practice of the participants towards coronary artery disease. Regression analysis was used to evaluate the relationship between study variables and the workers knowledge level. The results of this study showed that 49% of the workers were in a good level of knowledge and according to the regression analysis, the female gender, age above 28, education level higher than high school diploma, body mass index above 25 kilograms per square meters, history of hyperlipidemia, history of diabetes, history of hypertension, history of myocardial infarction, daily activity and exercise, were significantly related to a good knowledge towards coronary artery disease. In addition, the mean score of the participants'' performance in preventing coronary artery disease was 4.66 out of 9. The results of this study showed that increasing level of knowledge of labors in order to prevent missing specialized work force, leads to imposition of health costs to the industry and the labor society.

Cleft lip and cleft palate are one of the most frequent congenital anomalies worldwide. This study was conducted in order to measure the frequency of cleft lip and palate among live births in Akbar Abadi Hospital. This is a descriptive study, dealing with 57526 cases of live birth out of 59477 medical files in Akbar Abadi Hospital from 2004 to 2008. All the collected data were recorded in specific data sheets. The frequency of cleft lip or palate or both was 103 cases in 57526 live births, which is 1.79 per 1000 live births. The frequency of cleft lip, cleft palate and concurrent cleft lip and palate were 0.53, 0.33 and 0.92 per 1000 live births respectively. Among the newborns with any type of this anomaly, 53 (51.5%) were males and 50 (48.5%) were females. Twenty nine neonates (28.2%) had limb anomalies, 13 (12.6%) had syndromic features, 4 (3.9%) had limb anomalies and syndromic features, and 3 (2.9%) had cardiovascular anomalies. Our study indicates a frequency of cleft lip and/or palate near to the average international figure, and close to the findings in European and East Asian countries. Furthermore, the frequency of cleft lip and palate in our study was different from American countries and India probably due to ethnic differences.

Cardiotoxicity is one of the most important adverse event related to anthracycline therapy and can lead in about 1-5% of cases to the occurrence of heart failure. In a higher percentage of patients treated with these drugs asymptomatic left ventricular dysfunction can occur, so that guidelines recommend a strict clinical and echocardiographic monitoring. However, the occurrence of left ventricular dysfunction can be multifactorial and the search of other concurrent etiologies, including ischemic heart disease, is pivotal in particular in patients at high cardiovascular risk. Here is reported the case of a young man with metabolic syndrome in whom the presence of ischemic heart disease was suspected six years after the diagnosis of cardiomyopathy following treatment with anthracyclines for an Hodgkin''s lymphoma; in fact, he was submitted to angiography only when symptoms of angina occurred in addition to left ventricular dysfunction. In this patient coronary angiography showed severe coronary artery disease which was treated with angioplasty and stenting. The present case suggest that also in young patients treated with anthracyclines developing left ventricular dysfunction, ischemic heart disease should be suspected in particular for those at high cardiovascular risk. To exclude this diagnosis a cardiac stress test or coronary angiography/computed tomography should be recommended.

Critical pulmonary valve stenosis (CPVS) and atrial septal defect (ASD) is an uncommon form of congenital heart disease. Concurrent transcatheter pulmonary valvuplasty and closure of secundum atrial septal defect appears to be an interesting alternative to surgical correction. We present the simultaneous balloon valvuloplasty of critical pulmonary stenosis (PS) with supra systemic right ventricular pressure and medium sized secundum ASD with right to left shunt.

The patent foramen ovale (PFO) usually is a very small potential opening in the atrial septum. Under the conditions of normal hemodynamics with higher left atrial than right atrial pressures, the septum primum is forced against the foramen by the higher left atrial pressure and there is no actual persistent opening through the foramen. However, with any, even transient, increase in right atrial pressure this flap or «valve» can be pushed away from the septum and forced open. This results in the shunting of blood and anything else in the right atrium from the right atrium to the left atrium. Often the «valve» of the foramen becomes redundant and develops an «aneurysm» of the atrial septum. A large, redundant septum primum can have several additional openings or «fenestrations» in it. The PFO is now can be treated by interventional percutaneous therapy. This case represents a 24-year-old male with an aneurysmal interatrial septum and patent foramen ovale associated with multiple fenestrations.

Tuberculous spondylitis is not an uncommon disease of the spine. Near one percent of all cases of spinal tuberculosis (TB) involves craniocervical junction. Hypoglossal nerve palsy is not an uncommon neurological finding, but isolated involvement of the hypoglossal nerve is rare and limited to case reports or small case series. Here, we report a case of craniocervical junction tuberculosis presenting with unilateral hypoglossal nerve palsy. Case is a 41-year-old woman with neck and suboccipital pain since one month and unilateral right hypoglossal nerve palsy since one week. All laboratory tests were unremarkable except raised ESR level. Involvement of C1-C2 and hypoglossal canal were demonstrated by CT scan of craniocervical junction. Tissue diagnosis of TB was established by open biopsy of the craniocervical junction.