effect of vitamin A supplementation on disease progression, cytokine levels and gene expression in multiple sclerotic patients: study protocol for a randomized controlled trial

Multiple Sclerosis [MS] is a chronic inflammatory disease that leads to degeneration of the brain and spinal tissue. Imbalances of CD4+ T cells including Thelper1 [Th1]/Thelper2 [Th2] and Thelper17 [Th17]/Tregulatory [Treg], their secreted cytokines and gene expressions, are important aspects of in immunopathogenesis of MS. Vitamin A and its metabolites can regulate the immune system and appears to be effective in preventing progression of the autoimmune disease such as MS. Disease progression was evaluated By Magnetic Resonance Imaging [MRI], Expanded Disability States Scale [EDSS] and Multiple Sclerosis Functional Composite [MSFC] tests. Cytokine levels were measured using ELISA kits and gene expression was quantified by Real time PCR [RT-PCR] system. According to the difference between the epidemiological and clinical data on the relationship between vitamin A and immune system regulation, this study of the first time assesses Immune function as well as gene expression and progression of the disease following administration of vitamin A supplement

Effects of eicosapentaenoic acid supplementation on lipid and lipoprotein profile in hypertriglyceridemic subjects with different proliferator-activated receptor alpha genotypes

We determined the blood lipid-lowering effects of eicosapentaenoic acid [EPA] on hypertriglyceridemic subjects with Leu162/Val in exon 5 and G/C in intron7 polymorphism of peroxisome proliferator-activated receptor alpha [PPAR alpha]genotypes that, to our knowledge, have not been previously studied. A total of 170 hypertriglyceridemic subjects were enrolled and genotyped for Ala54Thr, Leu162Val, and intron 7 polymorphism by the use of a polymerase chain reaction restriction fragment length polymorphism method. After determination of their genotypes, the first 23 eligible subjects who were found as Ala54 carriers and the first 23 eligible Thr54 carriers were enrolled in the study and stratified for PPAR alpha genotypes. Participants took 2 g of pure EPA daily for 8 weeks. Fasting blood lipid and lipoprotein profiles were determined and changes from baseline were measured. We observed significant difference between EPA supplementation and Leu162 and Val162, Interon 7 [GG and GC] carriers [P < 0.001]. We did not observe significant associations between the PPAR alpha L162V single nucleotide polymorphism and multiple lipid and lipoprotein measures. Although EPA consumption lowered lipid and lipoprotein concentrations in Leu162 and Val162 carriers and Interon 7 CC and GC carriers, these differences between the studied groups were not statistically significant. EPA consumption has a lipid-lowering effect in hypertriglyceridemic subjects in both Leu162 and Val162 carriers. But there was no significant interaction between EPA supplementation and PPAR alpha genotypes. Thus, genetic variation within the PPAR alpha Leu162/Val cannot modulate the association of EPA intakes with lipid and lipoprotein profile. However, we must note that the sample size in this study was small

Development and Validation of a Food Frequency Questionnaire for Assessing Dietary Calcium in Children

This study aimed to develop and validate a food frequency questionnaire [FFQ] for measuring calcium intake in 9-13 years old children in Tehran, Iran. A 56-item FFQ containing main contributors of calcium in Iranian diet was designed. Criterion validity of the calcium specific FFQ was evaluated through comparing its result with five 24-h recalls as the reference method. Reproducibility was measured by twice administration of FFQ, one month apart. The study was performed in the selected primary and middle schools of Tehran city. Subjects included 184 children aged 9-13 years [90 girls and 94 boys], who were recruited through two-stage systematic cluster sampling from 20 primary and middle schools. Mean calcium intake was 922.8 +/- 322.3 and 876.0 +/- 491.8 mg/d for the 24-h recalls and FFQ, respectively, indicating a mean difference of 46.7 +/- 458.7 mg/d [P<0.001]. Corrected Pearson's correlation was 0.57. Cross-classification analysis of the FFQ and 24-h recalls classified 80% of the subjects in the same or adjacent category, and 6% in the extreme quartiles. The FFQ correctly identified 85% of the children consuming less calcium than the age-specific Recommended Dietary Allowance [RDA] [1300 mg/d]. Pearson's correlation for repeated administrations was 0.65. Cross-classification analysis of the repeated administration of FFQ classified 81% of the subjects in the same or adjacent quartiles, and 3.3% in the extreme categories. The FFQ underestimates mean calcium intake of a group, and has limited use to estimate calcium intake for individuals. However, it has acceptable validity and reproducibility for epidemiologic studies to assess a group's mean calcium intake

Evaluation of vitamin D status in newly diagnosed pemphigus vulgaris patients

Pemphigus vulgaris [PV] is an autoimmune blistering disorder of the skin or mucosa. Since low vitamin D status has been linked to many immune disorders, we designed this study to compare the vitamin D status in PV patients with healthy controls. In this case-control study, vitamin D status of 32 newly diagnosed PV patients was compared with 36 healthy control subjects. All patients were selected from the specialized dermatology departments of Razi Hospital, Tehran University of Medical Sciences in a 2-year period [2009-2010]. The severity of the disease was estimated according to Harman's scores. Serum concentration of 25[OH]D was measured by Roche Elecsys System. Data were analyzed by independent t-test. Both groups were similar based on sex, age and body mass index. The mean duration of disease was 5.57 +/- 0.93 months. The mean oral and skin severities were 1.81 +/- 0.20 and 2.31 +/- 0.17 respectively, based on Harman's scores. Serum 25[OH]D was significantly lower in PV patients compared to controls [-8.90; 95% CI, 2.29-15.51 and P = 0.009]. There was a negative correlation between vitamin D level and the oral severity of disease [r = -0.39 and P = 0.02]. PV patients had significantly lower serum level of 25[OH]D compared to healthy subjects which might contribute to worsen the disease. These data indicate the importance of improving vitamin D level in pemphigus patients

Effect of family structure and behavioral and eyesight problems on caries severity in pupils by using an ordinal logistic model

Dental caries is one of the most preventable yet prevalent chronic diseases worldwide. Our objective was to evaluate the effect of family structure and behavioral and eyesight problems as they relate to caries severity in schoolchildren. This research was carried out on 845 primary schoolchildren aged 9 yr in Kerman, Iran, in 2012. Ten variables, including health records, family structure information and a dmft / DMFT index, were collected. Children were categorized into three groups based on the WHO caries severity classification. Low caries level was defined as dmft/DMFT<2.6, moderate as dmft/DMFT of 2.7-4.4 and high as dmft/DMFT>4.4. The Cochran-Armitage test and ordinal logistic regression were employed for data analysis. Almost half of pupils had moderate or high caries severity. The odds of being in a higher caries severity category in pupils with behavioral problems [OR=2.37, 95% CI: 1.29-4.38] and girls [OR=1.6, 95% CI: 1.22-2.06] were higher than in other categories. In addition, pupils with eyesight problems [OR=0.58, 95% CI: 0.37-0.90] and overweight pupils [OR=0.46, 95% CI: 0.31-0.71] had lower caries severity than others. The effects of parents' education, birth rank, living with parents and consanguineous relationship between parents were not significant on caries severity [P>0.05]. Female pupils with behavioral problems were at a higher risk of caries severity than other pupils. These pupils need to be educated and coached on proper dental care. In addition, overweight pupils and those with eyesight problems had less caries severity than others. Family structure in this study did not have an effect on the severity of dental caries

Eicosapentaenoic acid improves insulin sensitivity and blood sugar in overweight type 2 diabetes mellitus patients: a double-blind randomised clinical trial

<p><b>INTRODUCTION</b>Diabetes mellitus is the most common metabolic disorder in humans, and its incidence is increasing rapidly worldwide. Although polyunsaturated fatty acids have beneficial effects on diabetes mellitus, previous data regarding the possible positive effects of n-3 fatty acids on glycaemic indices were inconclusive. We conducted a double-blind randomised clinical trial to determine the effects of eicosapentaenoic acid (EPA), an n-3 polyunsaturated fatty acid, on overweight patients with type 2 diabetes mellitus (T2DM).</p><p><b>METHODS</b>This double-blind, placebo-controlled randomised clinical trial was conducted on a total of 67 overweight patients with T2DM for a duration of three months. Of these 67 patients, 32 received 2 g purified EPA daily, while 35 received a placebo of 2 g corn oil daily. The patients' fasting plasma glucose (FPG), serum insulin, glycated haemoglobin (HbA1c) and insulin sensitivity indices were assessed.</p><p><b>RESULTS</b>After three months of EPA supplementation, the group that received EPA showed significant decreases in FPG (p < 0.001), HbA1c (p = 0.01) and homeostasis model assessment of insulin resistance (HOMA-IR) (p = 0.032), when compared to the placebo group. EPA supplementation resulted in decreased serum insulin levels, with the levels between the EPA and placebo groups showing a significant difference (p = 0.004).</p><p><b>CONCLUSION</b>The results of our study indicate that EPA supplementation could improve insulin sensitivity. It was able to decrease serum insulin, FPG, HbA1c and HOMA-IR. EPA could have beneficial effects on glycaemic indices in patients with T2DM.</p>

Effects of educational intervention on long-lasting insecticidal nets use in a Malarious area, Southeast Iran

Long-lasting insecticidal nets [LLINs] have been advocated as an effective tool against malaria transmission. However, success of this community based intervention largely depends on the knowledge and practice regarding malaria and its prevention. According to the national strategy plan on evaluation of LLINs [Olyset nets], this study was conducted to determine the perceptions and practices about malaria and to improve use of LLINs in Bashagard district, one of the important foci of malaria in Southeast Iran. The study area comprised 14 villages that were randomized in two clusters and designated as LLINs and untreated nets. Each of households in both clusters received two bed nets by the free distribution and delivery. After one month quantitative data collection method was used to collect information regarding the objectives of the study. On the basis of this information, an educational program was carried out in both areas to increase motivation for use of bed nets. Community knowledge and practice regarding malaria and LLIN use assessed pre- and post-educational program. The data were analyzed using SPSS ver.16 software. At baseline, 77.5% of respondents in intervention and 69.4% in control area mentioned mosquito bite as the cause of malaria, this awareness increased significantly in intervention [90.3%] and control areas [87.9%], following the educational program. A significant increase also was seen in the proportion of households who used LLINs the previous night [92.5%] compared with untreated nets [87.1%]. Educational status was an important predictor of LLINs use. Regular use of LLIN was considerably higher than the targeted coverage [80%] which recommended by World Heaths Organization. About 81.1% and 85.3% of respondents from LLIN and control areas reported that mosquito nuisance and subsequent malaria transmission were the main determinants of bed net use. These findings highlight a need for educational intervention in implementation of long-lasting insecticidal nets; this should be considered in planning and decision-making in the national malaria control program during the next campaigns of LLINs in Iran

A Recombinant Plasmodium vivax Apical Membrane Antigen-1 to Detect Human Infection in Iran

In Iran, Plasmodium vivax is responsible for more than 80% of the infected cases of malaria per year. Control interventions for vivax malaria in humans rely mainly on developed diagnostic methods. Recombinant P. vivax apical membrane antigen-1 (rPvAMA-1) has been reported to achieve designing rapid, sensitive, and specific molecular diagnosis. This study aimed to perform isolation and expression of a rPvAMA-1, derived from Iranian patients residing in an endemic area. Then, the diagnostic efficiency of the characterized Iranian PvAMA-1 was assessed using an indirect ELISA method. For this purpose, a partial region of AMA-1 gene was amplified, cloned, and expressed in pET32a plasmid. The recombinant His-tagged protein was purified and used to coat the ELISA plate. Antibody detection was assessed by indirect ELISA using rPvAMA-1. The validity of the ELISA method for detection of anti-P. vivax antibodies in the field was compared to light microscopy on 84 confirmed P. vivax patients and compared to 84 non-P. vivax infected individuals. The ELISA cut-off value was calculated as the mean+2SD of OD values of the people living in malaria endemic areas from a south part of Iran. We found a cut-off point of OD=0.311 that showed the best correlation between the sera confirmed with P. vivax infection and healthy control sera. A sensitivity of 81.0% and specificity of 84.5% were found at this cut off titer. A good degree of statistical agreement was found between ELISA using rPvAMA-1 and light microscopy (0.827) by Kappa analysis.

Lymphocyte cytotoxicity of oxLDL in patients with atherosclerosis

Atherosclerosis, a chronic inflammatory disease of the vessel wall is characterized by local and systemic immune responses to a variety of antigens. Oxidized low-density lipoprotein [oxLDL] is considered as an important determining factor in the pathogenesis of atherosclerosis. The purpose of this study was to investigate the degree of peripheral blood mononuclear cells [PBMC] vulnerability to in vitro oxLDL-induced cytotoxicity from atherosclerotic patients in comparison to healthy individuals. Thirty patients with atherosclerotic lesions, confirmed by angiography, and 30 matched healthy individuals were investigated. PBMC was prepared from individuals' blood samples which were further stimulated with low dose [1 micro g/mL] and high dose [50 micro g/mL] of extensively oxidized LDL. MTT assay was utilized to measure cell viability and proliferation. Stimulation index [SI] was calculated as mean ratio of optical density [OD] of the stimulated cells divided by OD of untreated cells. Low dose oxLDL treatment caused no significant proliferative or cytotoxic effect in the control group; however, similar treatment caused significant cytotoxic effect in the patient group compared to the controls [p=0.026]. High dose oxLDL treatment induced more significant cytotoxicity in the patient compared to the control group [p=0.006]. Comparison of the SI between the two groups of patients and controls showed significantly lower index by either the low [p=0.03] or the high dose [p<0.001] oxLDL in the patients compared to the controls. PBMC from patients with atherosclerosis showed increased susceptibility to oxLDL-induced cytotoxicity. Our results imply that prolonged exposure to elevated levels of circulating oxLDL could weaken the cellular defense mechanisms by progressive depletion of the pool of antiapoptotic proteins, rendering the cells more vulnerable to oxLDL-induced cell death

Association between dietary factors and obesity in neishabour school children

The prevalence of childhood obesity in developed and developing countries is increasing. Different factors which are associated with childhood obesity should be assessed in each society. This study conducted to determine dietary risk factors of Neishabour school children in winter 2006. In a cross-sectional study 1471 students aged 6-12 years were selected using two stage cluster sampling. Pupils height and weight were measured and BMI was calculated. Obesity was defined as having a BMI= 95[th] percentile of Iranian reference; in this way, 114 students were selected as case group and control group were students having 15[th] =

Sonographic prediction of body fat volume [subcutaneous and visceral fat] in cardiovascular patients

Inappropriate body composition represents impaired energy and nutrient intake and can be a risk factor for many diseases, especially for cardiovascular disease. Different methods have been suggested for the estimation of body fat volume and its distribution. However, they may be either expensive or hazardous for some groups of patients. Sonography is a very accessible technique, which may be used for the evaluation of visceral and subcutaneous fat volume. The purpose of this study was to evaluate the sonographic prediction of body fat and its distribution in subcutaneous and visceral compartments. During a three-month period, we conducted sonographic evaluations for visceral and subcutaneous fat in 106 patients who were admitted to our hospital. The subcutaneous fat was measured at the para-umbilical region and visceral fat was measured in the right para-renal space. The results were compared with the data obtained from the body mass index [BMI] and bioelectric impedance analysis. The mean age of the patients was 58.8 years, and the mean BMI was 26.48 +/- 0.33. The mean values of fat percent and fat mass obtained by the electric-method were 31.07 +/- 0.81% and 22.12 +/- 0.68 kg, respectively. The respective mean values of subcutaneous and visceral fat obtained by sonography were 20.50 +/- 0.56 mm and 24.14 +/- 0.58 mm. The correlation between BMI and subcutaneous fat was 0.85 [p value<0.0001] and the correlation between BMI and visceral fat was0.46 [p value<0.0001]. Sonography is a reliable and available method for the estimation of body fat and its distribution in cardiovascular patients, in subcutaneous and visceral compartments

Familial risk factors of obesity in Neishabour school children

To determine obesity familial risk factors in school children in winter 2006. In a cross-sectional study 1471 students aged 6-12 years old selected by two stage cluster sampling. Height and weight of students and their mothers were measured and BMI was calculated. Obesity was defined as having a BMI >/= 95th percentile of Iranian reference. Thereafter, 114 pupils were selected as obese children and the control group was chosen from students having 15th /= 30 kg/m2= obese". Demographic questionnaire was completed by interviewing the mothers. Fifty five percent of obese pupils and 12.9% of control group had overweight mothers [P < 0.001]. There was a significant association between childhood obesity and mothers' age, parental occupation and education [P < 0.001]. Sixty eight percent of obese students had family history of obesity, while only 2.0% of control group had similar background [P < 0.001]. More than 21.1% of obese children were categorized as good economic status, but 2.0% of second group were in this rank. Family size was significantly different in two groups [P < 0.001]. In this study, mothers' obesity, family history of obesity, family size, economic status, mothers' age, parental education and occupation were the risk factors of obesity in Neishabour school children

[ assessment of risk factors for prostate cancer in Mazandaran province, Iran]

Prostate cancer is the most commonly diagnosed cancer in men and it is the second leading cause of cancer deaths among men after lung cancer. Therefore, this study was done to assess of risk factors for prostate cancer in Mazandaran province, Iran. A matched case-control study was conducted on 104 prostate cancer patients and 104 controls in Mazandaran province during 2005. The addresses of the patients were obtained using the cancer registry information existed in Babol research center in Iran. The data were collected using a questionnaire by in-person interview of cases and their controls and were analyzed using STATA [8.0]. Univariate condition logistic regression showed that age, prostatitis, drinking alcohol, using chopoghe, family history of prostate cancer, having other cancer, intensity of activity, time of job activity were found to be the risk factors although higher BMI and execreise were protective for prostate cancer [P<0.20]. In multivariate analysis, after adjusting for the effect of the confounders, prostatitis, age, alcohol consumption and family history of prostate cancer were found to the most important risk factors. This study identified prostatitis, age, alcohol consumption and family history of prostate as the independent risk factors for prostate cancer. We suggest that men after the age of 60 should be screened for prostate cancer annually