ABSTRACT
Glycine allele at codon 16 has previously been associated with the increase in asthma severity, bronchial hyperresponsiveness and also the increase in inhaled corticosteroid dependence. This study was designed to evaluate the genetic alleles in mild asthma
Thirty-four patients with diagnosis of mild asthma [FEV[1] >/= 80%, positive methacholine test] and body mass index [BMI
Among all, 20 [58.8%] Arg/Gly, 14 [41.2%] Arg/Arg and no Gly/Gly genotype were detected at codon 16. Genotyping at codon 27 revealed 2 [5.9%] Glu/Glu, 13 [38.2%] Glu/Gln and 18 Gln/Gln [52.9%].Based on the obtained results, Arg/Gly mutation had a higher rate among the studied subjects compared to Arg/Arg polymorphism. This is a pilot study which shows a probable usefulness of genotyping for predicting of asthma severity
ABSTRACT
Background: the incidence of idiopathic pulmonary fibrosis [IPF] appears to be increasing. In the western literature, the average age of presentation is in the seventh decade of life while it has been reported to be earlier in the Middle East and India. Given that a paucity of epidemiological data exists in Iran, we sought to describe the clinical pattern and course of the disease at a large Iranian referral center
Methods: a retrospective review was conducted of 132 patients diagnosed with IPF at the National Research Institute of Tuberculosis and Lung Diseases [NRITLD] in Tehran, Iran from 1988 through 2008. Data were collected from the medical records which consisted of demographics, clinical history, laboratory tests, pulmonary function tests [PFT], radiographic and pathology findings, treatment, and outcomes of the disease
Results: the mean age at diagnosis was 56.6 years [95% CI: 53.8 59.4] with no significant sex predilection. Common presenting symptoms included dyspnea and cough, which occurred for a mean period of 21 months prior to diagnosis. Common signs included end-inspiratory crackles and digital clubbing, which were found in 85.6% and 55.3% of the patients, respectively. Radiographically, reticular and reticulonodular opacities were seen in 47.3% and 20.9% of the patients, respectively on high resolution computed tomography [HRCT]. In patients who underwent lung biopsy, diffuse interstitial fibrosis was seen in 91.1% . The mean follow-up time for all patients was 32.8 months [95% CI: 23.2 42.4, range: 1 257 months]. There were 16 patients who died during the study period. The mean age of death was 56.8 years [95% CI: 46.2 67.4], which is significantly lower than the life expectancy in Iran [P-value: 0.017]. The mean survival time for patients who died was 1.1 years [95% CI: 0.5 1.7] after diagnosis. The one- and three- year overall survival rates for all patients were 88% and 79% , respectively
Conclusion: the clinical characteristics of IPF in Iran are similar to those in the western literature. However, Iranian patients appear to be developing the disease a decade earlier than western patients
ABSTRACT
Background: Nd-YAG laser is a relatively safe and effective procedure in the management of various types of endobronchial lesions including tracheobronchial tumors. It has been used in treatment of benign tumors and as a palliative therapy in obstructive airway lesions due to non-operable lung cancers
Materials and Methods: In this study, patients who underwent laser therapy because of their endobronchial lesions that admitted during 1994-99 in our hospital were investigated. A total number of 210 patients including 14 with benign tumors, 77 with malignant tumors, 11 with metastatic lesions, 14 with undefined prognosis tumor, and 94 with other lesions who seek laser therapy were investigated. The most common signs and symptoms among these patients were cough, dyspnea, hemoptysis, and obstructive pneumonitis. Improvement in airway obstruction following the application of laser therapy was assessed based on clinical signs and symptoms, arterial blood gas indices and spirometric results
Results: After performing laser therapy, cough in 95.1% of patients, dyspnea in 97.7%, hemoptysis in 89.4% and obstructive pneumonitis in all of these patients showed a significant improvement. Obstruction was relieved in more than 95% of the patients; however, this rate reached to 100% in lesions of trachea and main airways. 98% of 263 obstruction sites were relieved immediately after procedure, and 34.6 % of these cases were completely treated by laser therapy. Complications of laser therapy were observed only in 2 of these patients, that resulted in death in one case
Conclusion: The results of our study were consistent with the previous studies regarding the efficacy and safety of Nd-YAG laser therapy in endobronchial lesions
ABSTRACT
Background: HIV is the most common risk factor for reactivation of latent TB and is associated with increased rate of progression of infection to disease. Radiological presentation of TB is variable in both HIV [-] and HIV [+] patients but is more in the latter. In this study we describe and analyze radiological presentation of TB/HIV patients in Massih Daneshvari hospital in IRAN
Materials and Methods: We registered the demographic, clinical and laboratory information of TB/HIV patients in Massih Daneshvari hospital between 2002-2003. Inclusion criteria were standard serologic test for HIV [Two positive Elisa test and one positive westernblot test] and proof of TB with clinical and mycobacteriologic or pathologic criteria. Chest x-ray was reported by pulmonary imaging specialist and was divided to two category: Typical [fibrocavitary infiltration in posteroapical segment of upper lobes] and atypical [opacity in middle and lower lobe, hilar and mediastinal adenopathy, pleural effusion, diffuse nodular opacity and normal X-ray]. Findings were analyzed using SPSS version 10.5
Results: 15 patients, 13 men [86.7%] and 2 women were included. Mean [ +/- SD] of CD4 count was 229.15 +/- 199.45. 53.3% of patients had adenopathy, 26.7% had pleural effusion. Only one patient had cavitary disease. Radiographic pattern was typical in one [6.7%] and atypical in 93.3% of patients. In regard to severity of radiological presentation, mild; moderate and severe pattern was seen in 40%, 26.7% and 33.3% respectively. There was no correlation between severity of radiological presentation and death [p=0.8] and severity of radiological presentation and CD4 count [p=0.53]
Conclusion: In this study, it was shown that in spite of some other studies, radiological presentation had not direct correlation with CD4 count; thus, in HIV+ patient, we must consider TB in all atypical radiological presentation regardless of CD4 count
ABSTRACT
Background: Cigarette smoking is the first preventable death in the world. The number of cigarettes smoked per day and the years of smoking are considered as the main risk factors in causing the related disease, mortality, and morbidity. Since it seems that the age at which smoking is started has decreased in our society, it is important to recognize the cause and factors that affect the tendency towards cigarette smoking in this period of life
Materials and Methods: This research was conducted according to WHO questionnaire and Global Youth Tobacco Survey project [GYTS]. A total of 1119 high school students were chosen randomly from different educational districts of Tehran from the year 2002 to 2003 and questioned in this regard
Results: 28.2% of students [25.2% female and 30.8% male] smoked occasionally and 4.4% of them [1.5% female and 6.06% male] smoked daily. 67.7% of smoker students started smoking before the age of 15 and 88.7% of them before the age of 17. The most important reason for smoking among 55.3% of students was curiosity and leisurely smoking was observed in 19.3%. Also, presence of a smoker in the family is one of the effective factors that affects the initiation of smoking in students; this was statistically significant [p= 0.000]
Conclusion: According to the results of this research, students must be properly trained by appropriate methods in this regard in order to prevent the initiation of smoking in school-aged children
ABSTRACT
Background: Cigarette smoking is the first preventable death in the world. Presence of a positive attitude towards tobacco use in young adults is one of the effective factors in starting smoking. Since it seems that the age of starting smoking has decreased in our society, it is important to recognize the attitudes towards cigarette smoking in this period of life
Materials and Methods: Therefore, this research was conducted according to WHO questionnaire and Global Youth Tobacco Survey Project [GYTS] and 1119 high school students were chosen randomly from different educational districts of Tehran in the year 2003 and were questioned in this regard
Results: According to the results of this study 28.2% of students [25.2% female and 30.8% male] smoked occasionally and 4.4% of them [1.5% female and 6.06% male] smoked daily. 44.9% of the students believe that smoker students have less friends [than others] and 41.1% believe that smoker students are less comfortable in the parties. 77.7% of the students believe that there is no difference in attractiveness of smoker and non smoker students. 41.1% of the students consider the smoker boy as a "looser" and 38% of them consider the smoker girl as "stupid". 80.4% of students assume that quitting smoking is very easy
Conclusion: Although the results of this study show that the attitudes of students towards smoking are not positive but this attitude has not prevented them from smoking and more serious action must be taken. Also, there is no significant difference between the attitudes of smoker and non smoker students
ABSTRACT
Background: Tuberculosis [TB] is one of the commonest infectious diseases of our era; it is the second cause of death due to infectious diseases after AIDS. Studies have shown the significant effect of leukocyte integrins such as LFA-1and ICAM-1 on the function of macrophages against TB bacilli; increasing their activity during the process of TB infection. The objective of this research is to evaluate the changes observed in serum levels of SICAM-1 in pulmonary TB patients that had received treatment
Materials and Methods: All new pulmonary TB cases that had not received any treatment, did not suffer from any kind of co-existing or underlying disorders such as hepatitis, sarcoidosis, lung cancer, HBV, HCV and HIV infections, chronic renal failure, cirrhosis, malnutrition, collagen vascular disorders and had not consumed immunosuppressive agents, were enrolled in this study. The SICAM-1 levels of the cases were measured by ELISA method before and 2 months after treatment with standard anti-TB drugs [Isoniazid, Rifampin, Ethambutol and Pyrazinamide] at the same time. T - test was used to compare the two sets of values of SICAM-1 levels before and 2 months after therapy
Results: A total of 28 patients; 23 [82.1%] male and 5[17.9%] female cases were enlisted .Meanwhile, 50% of the patients were Iranian and the remaining had Afghan nationality. All of them were sputum smear and culture positive for Mycobacterium tuberculosis. Regarding the extent of pulmonary involvement as shown on lung CT-Scan, 68% demonstrated diffuse pulmonary involvement. The mean SICAM-1 level before the initiation of treatment was 554.17 +/- 202.85 ng/ml. Considering age, sex ratio, ESR level, PPD test and severity of lung involvement, the SICAM-1 levels did not show any significant differences in different groups of patients. Among the patients enrolled in the study we were able to follow the seventeen patients [61%] who completed 2 months of treatment. The mean level of SICAM-1 before and after treatment in these patients were 573.9 +/- 204.4 and 481.2 +/- 103.2 ng/ml, respectively [P <0.05]
Conclusion: SICAM-1 is considered as one of the inflammatory mediators that undergoes fluctuations during TB disease; its level is very much related to the extent of lung involvement. Since the level of this marker declines after therapy, it could be used as a "Serum marker "in evaluating the therapeutic response observed during the follow- up. Abbreviations: SICAM: Soluble Intercellular Adhesion Molecule, ICAM: Intercellular Adhesion Molecule, LFA: Leukocyte Function Antigen