study of relationships between beta-globin gene mutations in beta-thalassaemia patients, in response to hydroxyurea treatment

Beta-thalassaemia is the most frequent inherited disorder in the world, especially in Iran and Mazandaran Province. It is caused by mulation in beta-globin gene on chromosome 11 with more than 150 different mulations causing beta-thalassaemia, has been identified in the beta-globin gene to date. Hydroxyurea, is one of the drugs used in Thalassemia patient's treatment, however, it is not effective in all patients. The mechanisms of the hydroxyuea effect in not clear yet. This study compared different beta-globin gene mutations in beta-thalassaemia patients who were referred to the Thalassemia Research Center in Sari in two groups, good responder and non-responder, to the hydroxyurea. This was a case-control study, comparing two groups of 30 thalassaemic patients who received hydroxyurea. Two groups were included, 30 good responders to hydroxyurea treatment [control] and 30 who did not respond to the treatment [case]. First, DNA was extracted from peripheral blood. Then, two different methods for mutation detection were used. In the Thalassaemia Research Center in Sari, mutations in 60 patients were identified using ARMS-PCR. Also the results were confirmed in Genetic laboratory of Amirkola, using two mutation detection methods, reverse-dot blot hybridization and ARMS-PCR. In the group of good responder [control], the average patient's age were 28/1 +/- 7/78 years, and the average age at the onset of blood transfusion was reported to be 8/5 +/- 8/56 year. In this group, the mean comparison of the hemoglobin level and red blood size [MCV] prior and after drug consumption were statistically significant. In the group of non-responder [case], the mean age was 21.3 +/- 6.43, the mean age starting blood transfusions was 3.3 +/- 3.75, and the mean of drug consumption was 2.3 +/- 0.8 months. From the mutations identified, IVSII-1G>A was the most common type in both case and control group, while of 30 of control group, 22 individuals were homozygous, and 7 individuals were heterozygous for this mutation [frequency% 42.5]. For the 30 case patients, 11 individuals were homozygous, while 11 were heterozygous [frequency% 27.5]. Comparison between two groups, case and control group, were statistically significance [P < 0.008]. The correlations of IVSII-1G>A mutation in good responder patients to hydroxyurea as compared to the non responder group, is significant and similar to the previous findings

[Study of awareness towards and the pattern of milk consumption in 7-12 year old elementary school students in the city of Sari and their mothers [2005-2006]]

Today, most societies face significant decrease in consuming milk products in children and this process would cause problems in providing the calcium needed by children, particularly since the osteoporosis is definitely connected to a lack of receiving sufficient calcium in children and adolescence age. Therefore, the goal of this study is to study the knowledge and pattern of milk consumption in 7-12 year old children of Sari and their mothers. The research samples consisted 638 male and female student at 7-12 in elementary schools [urban and rural], chosen at random from 16 schools. Necessary data were obtained through separate and different questionnaires on the output of milk consumption and its products through direct interviews. The data of the study were analyzed using t-Test, ANOVA, Duncan follow up, Chi-square and correlation coefficient. In this study, 44% of children and 37.7% of mothers consumed milk and 50.1% of children and 19.4% mothers sometimes consumed milk. 5.5% of children and 19.4% of mothers did not consume milk. Mostly, the reason for non-consuming milk among children and mothers was: not having access to milk [27.9% and 17.7%]. The awareness towards the advantages of milk was desirable in 67% children and 48.7% of mothers. It was almost desirable in 21.1% children and 4.5% of mothers and undesirable in 1.4% of children and 1.1% of mothers. The amount of milk consumption for 62% of urban children and 49% of rural children was only one unit, and, in sum, the amount of milk consumption for 59% of boys and 55% of girls was less than the recommended figures. The mean average of criteria deviation in the amount of milk consumption for children showed a significant difference from their educational levels [p=0.001] and insignificant difference from their sex. In addition, the pattern of milk consumption of children had significant relationship with the sex, education level and education of father; however, it had significant relationship with the education level of mothers and the jobs of mother and father. Children's knowledge about the advantages of milk had a significant relationship with the education level of mothers, fathers and jobs of mothers [P<0.004]; however, it had a insignificant relationship with their sex. In this study, the amount of milk consumption in half of the population subjects of the study was less than the standard recommended amount; therefore, to improve children's health status and prevent the destructive effects of osteoporosis in adulthood, there should be necessary actions to increase milk consumption among children

[Relation between chronic urticaria and thyroid autoimmunity]

Chronic urticaria is a tormenter and does not have a known etiology. Association between chronic urticaria and thyroid auto-immunity has shown different results. The aim of this study is to evaluate the effect of Levo-thyroxine on the chronic urticaria and association between chronic urticaria with thyroid auto-immunity. In a prospective case-control study, we compared the frequency of thyroid auto antibodies in 60 patients [all females, with exception of six males, ages 15 to 60 years] with chronic urticaria and compared with 60 mached age healthy volunteers. All cases with chronic urticaria and control group were normal CBC, antinuclear antibodies, rheumatoid factors, complement, stool exam, liver function test [LFT], kidney function and skin prick test, prior to being referred to us. We performed thyroid auto antibodies, thyroid hormones and IgE antibodies before treating all subjects. Half of them with positive anti-thyroid antibody [n=11], received Levo-thyroxine [100 micro g] daily for 1 month and the remaining half [n=11] were control group. The frequency of thyroid auto antibodies was significantly higher in patients with chronic urticaria than in healthy control [36.6% vs. 9%; p<0.01]. All patients were euthyroid, however, one was found to have increased anti-thyroid antibody levels with sub clinical hypothyroidism [TSH increased, low T4]. Total serum IgE increased in ten cases of patients group [16.6%] compared with six control groups [10%]. Nine patients [40%] had complete response, five patients [30%] had partial response and five patients [30%] did not show any response to treatment compared with control group, in which complete and partial resolution was 30% and others with no resolution. Chronic urticaria may be associated with thyroid disorders [positive anti- thyroid antibodies] despite normal thyroid function test. For chronic urticaria despite increase serum IgE level with unknown origin, must be evaluated by a thyroid function test, along with anti -thyroid antibodies and treatment if necessary

Rapid reinfection by Giardia lamblia after treatment in a hyperendemic area: the case against treatment

We selected 405 children aged 1-10 years with Giardia lamblia infection but without abdominal or gastrointestinal complaints for the previous month. For 5 days, 204 received metronidazole 15 mg/kg/day and 201 received B-complex syrup. Stool samples were examined 2-3 weeks and 3 months after treatment and results were tested with chi-squared. Weight and height 6 months after treatment were compared with primary weight and height by Z-score and Student t-test. Metronidazole efficacy at 2-3 weeks was 85.3%. Three months after treatment, 60 were reinfected [34.5%] and 71 had spontaneously cleared [35.3%]. Because of high reinfection, spontaneous clearing and treatment failure rates, and the lack of effect on nutritional status or growth, we do not recommend treatment for children with asymptomatic giardia infection

Left ventricular diastolic abnormalities in beta-thalassemia major with normal systolic function

In order to identify left ventricular diastolic function in patients with beta- thalassemia major and normal systolic function by noninvasive M-mode and Doppler echocardiography, an analytic study was designed in a university hospital in Sari. We have studied 44 patients [23 men and 21 women], mean age 15.48 +/- 2.16 [range 12 to 20] and 43 age and sex matched control subjects. Peak flow velocity in early diastole increased in patients compared with controls [98 +/- 14vs. 86 +/- 13 cm/sec; p<0.0001], rate of deceleration of flow velocity was also increased [778 +/- 142 vs. 592 +/- 193 cm/sec [2] and 2.24 +/- 51 vs. 1.73 +/- 36, respectively; p<0.0001]. Peak flow velocity during atrial contraction was not significantly different in patients and normal control subjects. Doppler diastolic indices had no correlation with age, serum ferritin levels and cumulative blood transfused in thalassemic patients. We concluded that left ventricular diastolic flow indices identified noninvasively by Doppler echocardiography in patients with thalassemia major are altered in an early phase, when systolic function is normal