frequency of human leukocyte antigen-DRB1 alleles, using sequence-based genotyping in 68 parents-child trios study in Iranian subjects

Background: The human leukocyte antigen-DRB1 [HLA-DRB1] locus is one of the most polymorphic human loci and has a crucial role in the immune system. Assessing the allelic frequencies of HLA-DRB1 locus would be a fundamental factor in defining the origin of populations, relationships with other populations, disease association studies and the constitution of unrelated bone marrow donor registries. In the current study HLA-DRB1 alleles and their frequencies are determined in a family-based study by DNA sequencing-based typing high-resolution [2 field] level of typing

Materials and Methods: Genomic DNA from 3 members of 68 unrelated families [a total of 204 individuals] was extracted. Exon 2 of DRB1 gene was amplified and sequenced and allele assignment was performed using Assign SBT v4.7sequence analysis software

Results: We had DRB1*11:04 with frequency of 0.0931, DRB1*03:01 with 0.0882, DRB1*11:01 with 0.0735, DRB1*13:01 with 0.071 and also alleles DRB1*08:03, DRB1*13:42, DRB1*14:04 and DRB1*14:07 with frequency of 0.0024

Conclusion: A total of 34 different alleles were found in the study subjects with DRB1*11:04, DRB1*03:01, DRB1*11:01 being the most frequent alleles respectively

[Shariati and Sina hospital nurses' knowledge about osteoporosis]

Better understanding of etiology, risk factors and symptomatology of osteoporosis can have a great impact on self care and preventive bahvior. This is also true for nurses. This knowledge not only affects their lives but also have a positive impact on their job. In this study 389 randomly selected nurses completed a questionnaire with 37 questions about knowledge of osteoporosis, and nutritional aspects of the disease. Questionnaire also included basic personal information and questions about dairy intake, exercise and smoking. Completion of the questionnaire was in a semi supervised manner. SPSS 16, software was used for data analysis. Eighty seven percent were female and 46% were married. Median age was 33 years [SD:7.6] and median knowledge score was 21.7 through 37 maximum probable score. Misconception on symptomatology of osteoporosis was observed in 84% of the responders. The only significantly positive correlation for knowledge Score was higher degrees of education. Dairy intake was adequate in only 45.6% and it had also negative correlation with family crowding. Regular exercise was reported by only 38.7%. There was no correlation between adequate dairy intake and regular physical activity with knowledge score of responders. In comparison to other studies knowledge about osteoporosis is relatively good among nurses, but it is not enough. Dairy intake and regular physical activity were inadequate and these factors need more attention

Clinical characteristics of Buerger's disease in Iran

To determine the clinical course of Buerger's disease as observed in two vascular surgery centers located in the capital of Iran. Case series. Sina and Imam Hospitals, Tehran, Iran, during the years 1997 to 2002. The records of all the patients admitted with Buerger's disease diagnosed on the basis of Shionoya's clinical criteria were studied. Their clinical characteristics, treatment offered and short-term follow-up results are described as frequencies and percentages. A total of 116 patients, aged 41.1 +/- 11.3 years, were enrolled. All patients were males; 99% of them were smokers with an average of 22.9 pack-years of tobacco use. Lower-extremity was affected in 102 [87.9%] patients, upper-extremity in 3 [2.6%] patients and both in 11 [9.5%]. The most frequent reasons for being referred to hospital were ischemic ulcers [90.5%], claudication [87.9%], paresthesia [75.9%], rest pain [66.4%], gangrene [60.3%], Raynaud's phenomenon [23.3%] and thrombophlebitis [9.5%]. Diagnostic arteriography, vascular bypass surgery and sympathectomy were performed in 60%, 24% and 83% of the patients, respectively. Sixty-eight patients [58.6%] had one of the following amputations: toe 36 [52.9%], transmetatarsal 3 [4.4%], below knee 25 [36.8%], finger 3 [4.4%] and above knee one [1.5%] patient. Since the studied hospitals are the referral centers for vascular surgery in Iran admitting patients with severe symptoms; therefore, a higher number of complications and amputations was found in the present study. Upper extremity involvement as well as the occurrence of thrombophlebitis and Raynaud's phenomenon was rather infrequent among the studied cases

[Hereditary leiomyomatosis and renal cell carcinoma [HLRCC syndrome]: a case report]

Recently multiple cutaneous leiomyomas, uterine leiomyoimatosis and renal cancer have been described as a cancer syndrome with autosomal dominant pattern of inheritance. We report a 79-year-old man who presented with multiple hyperkertotic erythematous nodules on his right leg with histological diagnosis of pilar leiomyoma. In his past medical history several systemic complaints such as gross hematuria, weight loss and bone pain were noted and further investigation confirmed histological diagnosis of metastatic papillary renal cell carcinoma. History of uterine leiomyomas and hysterectomy was peresent in his sister. All these findings in this case can be attributed to hereditary leiomyomatosis and renal cell carcinoma syndrome [HLRCC Syndrome]

Outcome of upper gastrointestinal hemorrhage according to the bleed risk classification: a two-year prospective survey

Upper gastrointestinal bleeding [UGIB] is a common and serious medical emergency. The aim of this study was to predict UGIB patients' outcome according to a risk scoring system, independent of endoscopic findings, introduced by Kollef et al [BLEED: ongoing bleeding, elevated prothrombin time, erratic mental status, and unstable co-morbid disease]. Prospective study. Sina university hospital. We studied all patients who presented with UGIB during 2000 to 2002. Patients meeting the BLEED criteria at their initial assessment were classified as high-risk [71] and all others were categorized as low-risk [50]. In-hospital complications were defined as recurrent UGIB, surgery to control the source of hemorrhage and hospital mortality. There were 101 patients, aged 55.7 +/- 20.8 years. Re-bleeding, surgery and death occurred in 21 [20.8%], 28 [27.7%] and 14 [13.9%] of the patients, respectively. Therapeutic and diagnostic upper gastrointestinal endoscopy were performed in 7 [7%] and 83 [82.2%] of patients, respectively. Seventy percent were categorized as high-risk. There was significant difference in development of in-hospital complications, and death when considered individually, between the high and low-risk patients, but not in the rate of re-bleeding, length of hospital stay and transfused units of packed red blood cells. High-risk patients needed surgery more often than the low-risk cases but the difference was borderline significant [p=0.051]. Low systolic blood pressure and elevated prothrombin time were independent predictors of in-hospital complications among BLEED criteria. BLEED classification was capable of predicting in-hospital complications, especially mortality. It is, therefore, a helpful triage tool in centers where urgent endoscopy is hardly available