Association between the severity of angiographic coronary artery disease and paraoxonase-1 promoter gene polymorphism T[-107] C in Iranian population

The oxidation of low-density lipoproteins and cell membrane lipids is believed to play an integral role in the development of fatty streak lesions, an initial step in coronary artery disease [CAD]. Paraoxonase-1 [PON1] is an enzyme associated with the high-density lipoprotein [HDL] particle. PON1 protects LDL from oxidative modification by hydrolyzing lipid peroxides, suggestive of a role for PON1 in the development of CAD. The present study tested the hypothesis that Paraoxonase-1 promoter polymorphism T[-107]C could be a risk factor for severity of CAD in Iranian population. Paraoxonase-1 promoter genotypes were determined in 300 consecutive subjects [> 40 years old] who underwent coronary angiography [150 subjects with >50% stenosis served as cases [CAD+] and 150 subjects with < 20% stenosis served as controls [CAD-]]. PON1 promoter genotypes were determined by PCR and BSTU1 restriction enzyme digestion. CAD+ Subjects did not show any significant differences in the distribution of PON1 promoter genotypes as compared to CAD- Subjects [P = 0.075]. However the analysis of PON1 promoter genotypes distribution showed a higher percentage of [-107] TT among CAD+ compared with CAD- [P = 0.027]. After controlling for other risk factors, the T[- 107]C polymorphism had interaction with age [P = 0.012], but did not show any interaction with other risk factors such as BMI, gender, smoking, diabetes, level of HDL-C, LDL-C, triglyceride and Total cholesterol. These data suggest that the TT genotype may represent a genetic risk factor for Coronary artery disease in Iranian population

Blood transfusion in pediatric critical care setting: report of a survey

With the increased awareness regarding transfusion- related complications, blood transfusion therapy has become an issue of increasing concern. In this survey, the rate of blood transfusion was evaluated among children between the ages of 1 month to 14 years who were admitted to the pediatric intensive care unit [PICU] of the Children's Medical Center. Children with chronic diseases and malignancy were excluded. Among 262 patients who were eligible to participate in this study, 116 [44.3%] had history of blood transfusion during PICU admission. Most of them were infants under the age of one year [56.1%]. The rate of blood transfusion, volume of blood sampling, oxygenation, need for mechanical ventilation, and the mortality rate were compared between the children who had received blood transfusion with the group without blood transfusion. The differences between these two groups [with and without blood transfusion] with regard to oxygen saturation or assisted ventilation did not show significant differences, but the mean volume of blood sampling and length of PICU stay were significantly different [p<0.0001]. Blood transfusion did not cause any changes in the mortality rate [9 patients with blood transfusion died in comparison to 5 patients in the other group]. Although anemia is very common in the critical care setting, it seems that blood transfusion has no significant effect in improving oxygenation, or mortality rate

correlation between serum lactate at the time of admission and the final outcome of neonates admitted in the intensive care unit, an initial assessment

An assessment of neonates in order to pinpoint early recognition of circulatory failure, institution of appropriate treatment, and in assessing response in sick neonates in intensive care units and their outcome is one of the major concerns of the neonatologists. None of the routine assessments such as ABG, and scoring systems [SNAP II PE, CRIB] are highly sensitive in this regard. Tissue hypoperfusion, resulting from any threatening illnesses, leads the neonate to anaerobic metabolism and lactate generation. Blood lactate concentration has been used widely as reliable indicator of tissue hypoxia in this regard. We evaluated the possible relationship between arterial blood lactate level at time of admission and the outcome of 50 neonates who were admitted in neonatal intensive care unit [NICU] of Children's Medical Center in 2004. Other parameters such as clinical findings, SNAP II PE and CRIB scores, ABG indices, a possible need for mechanical ventilation and the duration of assisted ventilation were also considered along with the predictive value of blood lactate concentration. In alive neonates, lactate levels [21.3 +/- 10.6 mg/dl] were significant, comparing to those who died [42.0 +/- 26.5 mg/dl] [p=0.037]. The significant correlation between blood lactate concentrations and 02 saturation in ABG [p=0.02], and lactate levels and respiratory system involvement were relatively correlated [p=0.049] Blood lactate concentrations could be a useful tool in the prognosis of outcome in sick neonates in the intensive care units

Dental care provision in private clinics: an introductory explanation for dental manpower estimation and dentistry educational needs assessment

Having an estimate of needed workforce is necessary for workforce planning. Time and work study is a means to provide basic data in this regard. To determine delivery time for common type of dental care, dentists' working time in Tehran. A cross-sectional study was conducted among the general dentists who work in private clinics in Tehran. 100 dentists were chosen randomly. They filled out a self-administered questionnaire. In order to determine the time spent on each service by the dentists, the median was calculated as the central index. The list of dental treatments was determined by median time to deliver each of them. The useful working time was 90000 minutes for each dentist during a year. The results of this study can be used in estimating dental workforce and reforming dental educational programs