Association analysis of DISC1 gene polymorphisms with Attention-Deficit Hyperactivity Disorder in Iranian population

Attention deficit hyperactivity disorder [ADHD] is a common heritable psychiatric disorder with a worldwide prevalence of 5%. The etiology of ADHD is still incompletely understood, but several studies, consistently indicate the strong role of genetic factors on this disorder. The aim of this study was to determine the effect of three SNPs rs11122319, rs11122330 and rs6675281 in the etiology of ADHD in an Iranian children. In this research work, for the first time, we investigated the association of three SNPs [rs11122330, rs6675281 and rs11122319] in theD/5C7 gene with ADHD in Iranian population. Two hundred fourthy subjects composed of 120 patients and 120 healthy controls were included and tetra-primer ARMS PCR technique was used for genotyping all selected SNPs. We found differences in genotype and allele distributions of rs 6675281 polymorphism between our patients and controls. The A, T and A alleles were the more frequent alleles in rs11122319, rs6675281 and rs11122330 polymorphisms in both case and control groups respectively. The TT genotype was more frequent in control group compared to patients. [P value = 0.008, OR= 1.5837, 95% Cl= 1.1012 to 2.2776], Our findings strengthens the role of DISC1 gene as a susceptibility locus for ADHD and indicate that rs6675281 polymorphism is a susceptibility factor for ADHD for the first time in children reported in an Iranian population in this part of the world

[Hypertension and aeromedical considerations]

Hypertension is the most prevalent risk factor for arterial disease in the industrialized world and is a frequently encountered clinical problem in the aircrew population. Arterial systolic and diastolic blood pressures are continuously varying quantities, influenced by a host of extraneous factors. Aviators with hypertension responsive to life-style modifications should have serial BP rechecks quarterly to semi-annually during the first year to assure success of the lifestyle modifications. Failure to achieve blood pressure control with lifestyle modifications, or an initial blood pressure average exceeding 160 mmHg systolic or 100 mmHg diastolic, requires initiation of pharmacotherapy. In this study we evaluate books, magazines, articles, guidelines and reliable websites related to aeromedical concerns and waiver considerations in aircrew with hypertension. Two major "types" of essential hypertension are generally recognized. One is characterized by suppressed renin activity and sensitivity to dietary sodium, the other by high renin activity and a lack of response to sodium intake. Thiazide diuretics are certainly the initial therapy of choice, particularly for older subjects. Aircrew with blood pressure that is controlled adequately with thiazides, with no other uncontrolled cardiovascular risk factors, and with no evidence of end-organ damage, are usually fit to return to unrestricted flying in military and civilian spheres. ACE inhibitors are an alternative initial choice in younger aviators, are positively indicated in patients with type 2 diabetes, and have no adverse effects on serum lipids. Hydrochlorothiazide [hctz], with or without triamterene or potassium replacement, can be used as a first line agent for treatment of hypertension in designated personnel. ACE inhibitors might have an adverse effect on G-tolerance have not been borne out by experience in either the US Air Force or the Royal Air Force [RAF], and the US Navy accepts these agents for unrestricted flying without G-tolerance testing

[Ankylosing spondylitis in a military aviator]

Ankylosing spondylitis or Marie Strumpell disease, the most common form of the spondyloarthritides, is a chronic inflammatory disease principally involves the hips and axial skeleton and peripheral joints. In addition, in severe forms of disease, systemic involvements such as uveitis, pulmonary fibrosis and aortic insufficiency can be seen. Its onset is insidious, can have extra-articular manifestations, and is diagnosed by clinical suspicion supported by imaging techniques and associated human leukocyte antigen HLA-B27. The disease may present with nonspecific symptoms such as low fever, fatigue and weight loss. The illness commonly affects young adults with a peak of the third decade of life. The male to female ratio is approximately 2 to 3:1. In the aviators, medical problems may induce a large impact on the ability of aircrew,s safety and their duties. Musculoskeletal diseases that affect the joints and range of motion are important when conside aviators as waiver for aircrew members. Non-specific symptoms such as fatigue may decrease tolerance to acceleration forces in military aviators. So flight surgeons must consider severity of disease and adverse reaction of drugs on the flight safety and its impact on health's aviator. In this paper we report a jet pilot with ankylosing spondylitis disease with a good response to treatment with etanercept

[Central venous catheter related infection among patients on hemodialysis]

End Stage Renal Disease [ESRD] patients need vascular access for hemodialysis and infection is the most common late complication of central venous catheters. A descriptive prospective study was done on hemodialysis patients to evaluate the prevalence of the catheter-related infections. Patients with possible central venous catheter infection were enrolled from July 2009 to April 2011 at Imam Reza Hospital, Mashhad. We checked the apparent exit site infection as well as the systemic signs and symptoms of catheter-related infection. Specimens were obtained from the catheter blood, the catheter tip and the peripheral blood for culture and antibiogram. Then data was collected by using SPSS. Frequency tables, graphs and mean were prepared for describing data. From total 65 hemodialysis patients [34 females, 31 males with a mean age of 54.9], 41 ones [63/1%] had a past history of catheter-related infection. As for the local signs of infection, 52 patients [80%] had tenderness, 41 [63.1%] had induration, 35 [53.8%] had redness and 32 ones [49.2%] had pus discharge from the catheter insertion site. Staphylococcus aureus was the prevalent organism among 76.7% of patients with positive culture out of which 79.6% were vancomycin sensitive. Catheter had to be removed in 21[33.3%] of the dialysis patients. Staphylococcus aureus was the most common organism involving in catheter-related infection among hemodialysis patients and the most common clinical sign of infection, was tenderness at the catheter insertion site. We suggest that these findings could be used for early diagnosis and starting the empiric antibiotic regimen in patients with central venous catheters