Low rates of symptomatic venous thromboembolism in patients with gastrointestinal cancer: an Iranian study.

: Venous thromboembolism (VTE), which mostly includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is associated with considerable morbidity and mortality in patients with cancer. As little is known about VTE associated with gastrointestinal cancers among the populations in the Middle East. This study aimed to determine the relative frequency of symptomatic VTE in patients with gastrointestinal malignancies in Iran. The charts of patients with gastrointestinal cancers in our institute from April 2010 to March 2015 were investigated for symptomatic VTE in a retrospective study. In this study, all of the patients received chemotherapy. The data included the site of cancer, time of therapies initiation, patient's characteristics, type of VTE, the time of developing symptomatic VTE of patients with gastrointestinal cancer and the stage which VTE occurred. All of DVTs and pulmonary embolism were confirmed by Doppler ultrasonography and computed tomography angiography. A total of 614 consecutive patients with gastrointestinal cancer were included in study. In total, 22 patients (3.6%) were found to have experienced symptomatic VTE (confidence interval 95%: 2.1-5.1%) which included: 19 patients who suffered from DVT and three of them detected pulmonary embolism, and other types of VTE were not reported. Out of 22 patients with VTE, 17 of them have been occurred after chemotherapy (77%) within 6.17 ±â€Š5.17 (range, 1-19) month after starting chemotherapy. The distribution of frequency of stage in which the VTE occurred, was more in stage III and IV. The rate of symptomatic VTE in patients with gastrointestinal cancer in Iran is relatively lower than other studies done in the west. Therefore, it seems the rate of VTE differs in different ethnic groups.

Association between Glutathione S-Transferase GSTM1-T1 and P1 Polymorphisms with Metabolic Syndrome in Zoroastrians in Yazd, Iran.

BACKGROUND: The aim of this study was to assess the possible association between genetic polymorphisms of the glutathione S-transferase (GST) gene family and the risk of the development of metabolic syndrome (MS) in Zoroastrian females in Yazd, Iran. METHODS: In this case-control study, GSTM1, T1, and P1 polymorphisms were genotyped in 51 randomly selected MS patients and 50 randomly selected healthy controls on February 2014 among Zoroastrian females whose ages ranged from 40 to 70 yr. DNA was extracted from peripheral blood. Data were analyzed with SPSS version 17. RESULTS: We observed a significant association of GSTP1-I/V (Isoleucine/Valine) allele and GSTP1-V/V (Valine / Valine) allele with MS (P = 0.047 and P = 0.044, respectively). The combined analysis of the two genotypes, the present genotype of GSTT1, I/V and V/V alleles of GSTP1 genotype demonstrated a decrease in the risk of acquiring MS (OR = 0.246, P = 0.031). The null genotype of GSTM1, I/V, and V/V alleles of the GSTP1 genotype showed a lower risk in double combinations (OR = 0.15, P = 0.028 and OR = 0.13, P = 0.013, respectively). The combinations of the GSTM1 null genotypes and GSTT1 present genotypes and the GSTP1 I/V and V/V alleles together were associated with decreased risk of having MS in triple combinations (OR = 0.071, P = 0.039 and OR = 0.065, P = 0.022, respectively). CONCLUSION: GSTP1-I/V and V/V alleles, alone or in association with GSTM1 null and GSTT1 present genotypes, are related with decreased susceptibility to the development of MS in Zoroastrian females.

Evaluation of glutathione S-transferase T1 deletion polymorphism on type 2 diabetes mellitus risk in Zoroastrian females in Yazd, Iran.

BACKGROUND: There has been much interest in the role of free radicals and oxidative stress in the pathogenesis of diabetes mellitus (DM). The aim of this study was to assess the possible association between genetic polymorphisms of the glutathione S-transferase-Theta (GSTT1) and the risk of the development of DM in Zoroastrian females in Yazd, Iran. MATERIALS AND METHODS: This was a case-control study in which GSTT1 polymorphism was genotyped in 51 randomly selected DM patients and 50 randomly selected healthy controls among Zoroastrian females whose ages ranged from 40 to 70. RESULTS: The frequencies of GSTT1 null genotype and GSTT1 present were 72% and 28%, respectively, in control samples, while in patients with type 2 diabetes (T2DM), the frequencies of GSTT1 null genotype and GSTT1 present were 27.5% and 72.5%, respectively. There were higher levels of triglyceride (TG), fasting blood sugar (FBS), total cholesterol (TC), low-density lipoprotein (LDL), Urea, and high-density lipoprotein (HDL) in cases of GSTT1 null genotype compared to the GSTT1 present genotype in controls. CONCLUSIONS: Our results indicated that healthy subjects had a higher frequency of the GSTT1 null genotype than patients with T2DM. However, we observed no significant association between the GSTT1 null genotype and T2DM in the current study.

Study of the association between blood types and breast cancer among Isfahanian women with breast cancer.

BACKGROUND: Previous studies suggest a possible association between ABO blood group and the risk of breast cancer. The aim of this study is to investigate the presence of a possible association between breast cancer and blood groups ABO and Rh. MATERIALS AND METHODS: 549 women including 173 cases and 376 controls were selected. The case group included patients with breast cancer and the cancer diagnosis was confirmed for all of them. The control group included women with no reports of breast cancer. Blood group sampling of all cases was performed. The obtained information regarding presence or absence of cancer, blood type, age group and type of cancer were analyzed. RESULTS: There is no significant association between blood types ABO (Rh) and the breast cancer. (P > 0.05) It has been found that the prevalence of invasive intraductal carcinoma was 85% among the cases. About 5% of the total diagnosed cancers in the case group were allocated to modularly carcinoma, invasive lobular carcinoma and Paget's disease. There was no relative frequency in specific blood group for these three types of cancer. The blood types ABO (Rh) and breast cancer type showed no significant relation (P = 0.2). CONCLUSION: According to the obtained results from this study, there was no relative frequency in specific blood group for these three types of cancer and the blood type could not be influenced as a risk factor in breast cancer.

Frequency of subclinical hypothyroidism in 5- to 15-year-old children with migraine headache.

BACKGROUND: Migraine is the most frequent acute recurrent primary headache in childhood. Hypothyroidism may be an exacerbating factor for some primary headaches. The purpose of this study was to determine the frequency of subclinical hypothyroidism in children with migraine headache. METHODS: In a cross-sectional analytic study, the thyroid function tests of 5- to 15-year-old migraineurs who were referred to the Pediatric Neurology Clinic of Shahid Sadoughi University of Medical Sciences from January 2010 to February 2011 in Yazd, Iran, were measured based on the second edition of the International Classification of Headache Disorders. RESULTS: Forty-eight girls (46.2%) and 56 boys (53.8%) with mean age of 10.46±2.72 years were evaluated. Twenty-five (24%) children had hypothyroidism. The monthly frequency of headache (mean±SD, 14.75±8.9 vs. 20.12±9.49, p=0.04) and the duration of headache (mean±SD, 1.96±1.08 vs. 3.75±2.71 h, p=0.03) were more statistically significant in migraineur children with hypothyroidism, but the mean age, mean of onset age of migraine, sex distribution, and severity of headache were not statistically different in both groups. CONCLUSION: Based on the results of this study, subclinical hypothyroidism was as an exacerbating factor for migraine headache. Therefore, it is logical to check the thyroid function tests in migraineur children.

Efficacy of levothyroxine in migraine headaches in children with subclinical hypothyroidism.

OBJECTIVE: Hypothyroidism may be an exacerbating factor for primary headaches and migraine is one of the most common primary headaches in childhood. The purpose of this study was to evaluate the effect of treatment of subclinical hypothyroidism on children with migraine headache. MATERIALS & METHODS: In a quasi-experimental study, the severity and monthly frequency of headache of 25 migraineur children with subclinical hypothyroidism who were referred to the pediatric neurology clinic of Shahid Sadoughi University of Medical Sciences,Yazd, Iran between January 2010 and February 2011 and were treated with levothyroxine for two months were evaluated. RESULTS: Thirteen girls (52%) and 12 boys (48%) with the mean age of 10.2 ± 2.76 years were evaluated. In children with hypothyroidism, the monthly frequency of headache (mean ± SD: 17.64 ± 9.49 times vs. 1.2 ± 1.1 times) and the severity of headache (mean± SD: 6.24±1.8 scores vs. 1.33 ± 0.87 scores) were significantly decreased by treatment. CONCLUSION: Based on the results of this study, treatment of subclinical hypothyroidism was effective in reducing migraine headaches. Therefore, it is logical to check thyroid function tests in migraineur children.

Assessment of intranasal midazolam administration with a dose of 0.5 mg/kg in behavior management of uncooperative children.

AIM: Intranasal midazolam has been used to induce conscious sedation in children with negative and aggressive behavior The main goal of this study was to determine the effectiveness of intranasal administration of midazolam (with a dose of 0.5 mg/kg) in behavior management of uncooperative children. MATERIALS AND METHODS: Thirty healthy, difficult children of 3-5 years were evaluated. At the beginning of each session, ordinary techniques of behavior management to treat patients were applied. In cases of unsatisfactory responses, intranasal midazolam was immediately employed. To determine the efficacy of the drug, child behavior was evaluated before and after administration of midazolam using Houpt rating scale of general behavior. RESULTS: A statistically significant difference was demonstrated in the patients 'behavior before and after administration of intranasal midazolam. CONCLUSIONS: this drug is effective in sedation and reduction of the anxiety of children under treatment.

HESA-A: new treatment for breast cancer and choroidal metastasis.

BACKGROUND: Breast cancer is one of the main causes of mortality among women worldwide. This type of cancer metastasizes to different body tissues, giving rise to many problems. The effect of HESA-A, a drug of herbal-marine origin, on vision, quality of life, and survival of end-stage breast cancer patients was investigated in this study. MATERIAL/METHODS: In a double-blind study, 24 breast cancer patients with choroidal metastasis, aged between 41 and 49 years, were divided into case and control groups, treated with 50 mg/kg/day of HESA-A and placebo, respectively. The patients were evaluated in respect to the intensity of experienced pain, by assessing their rate of narcotic analgesic use. The patients' vision scale was also evaluated. RESULTS: Notable improvement was seen in the vision of patients treated with HESA-A. Patients receiving HESA-A used narcotics at lower doses, owing to reduced experience of pain. No changes were observed in the vision of control group patients, or their pain experience. CONCLUSIONS: The effects of natural compounds with antioxidant and anticancer properties have been emphasized by different studies. HESA-A is a compound of natural origin, consisting of rare elements and organic materials, which in several animal and cellular studies has shown powerful anticancer effects and less toxicity on normal cells. The results of this study showed considerable improvement in the vision of breast cancer patients treated with HESA-A.

Blood pressure in children of hypertensive and normotensive parents.

This study was conducted to compare the blood pressure (BP) of children (aged between 6 to 18 years) of hypertensive (n =746) and normotensive parents (n = 2238) in Iran. Blood pressure (BP), weight and height were measured. The mean systolic (SBP), diastolic (DBP) and mean arterial blood pressure (MABP) was significantly higher in children of hypertensive parents than controls in preadolescents (107.4 +/-1: 15.1, 68.7 +/- 1:10.5, 81.1 +/- 1:12.4 vs.100.2 +/- 1:12.3, 61.1 +/- 1:10.1, 74.4 +/- 1:11.8 mmHg, respectively; p <0.05) and adolescents (111.7 +/- 1:14.5,79.2 +/- 1:11.3,90.7 +/- 1:12.1 vs 109.4 +/- 1:14.1,70.4 +/- 1:11.1, 83.5 +/- 1:12.2 mmHg respectively, p<0.05). The mean SBP and DBP in children of hypertensive mothers was significantly higher than controls (SBP: 108.8 +/- 14.2 vs. 104.3 +/- 15.2, 95% CI = 98.2-107.4, P<0.05 and DBP: 72.4 +/- 11.4 vs. 67.6 +/- 11.2, 95% CI = 64.2- 70.1 respectively, p<0.05). Regarding fathers, this difference was significant only for SBP (107.1 +/- l5.4 vs. 104.4 +/- l5.1, 95% CI=99.1-105.7,p<0.05). The mean SBP and DBP of children were higher when both parent being hypertensive than one of them (115.56 +/-1:15.45, 72.15 +/- 1:11.27 vs 106.4 +/- 1:15.31, 67.82 +/- 1:12.47 mmHg respectively, p <0.05). Using logistic regression analysis, SBP and DBP more than 95th percentile in children were significantly associated with mean parental BMI (p <0.05).

Isfahan Healthy Heart Programme: a comprehensive integrated community-based programme for cardiovascular disease prevention and control. Design, methods and initial experience.

The Isfahan Healthy Heart Programme (IHHP) is a five to six year comprehensive integrated community-based programme for cardiovascular diseases (CVD) prevention and control via reducing CVD risk factors and improvement of cardiovascular healthy behaviour in a target population. IHHP started late in 1999 and will be finished in 2005-2006. A primary survey was done to collect baseline data from interventional (Isfahan and Najaf-Abad) and reference (Arak) communities. In a two-stage sampling method, we randomly selected 5 to 10 percent of households from randomly selected clusters. Then individuals aged > or = 19 years were selected for the survey. This way, data from 12,600 individuals (6300 in interventional counties and 6300 in the reference county) was collected and stratified according to living area (urban vs. rural) and different age and sex groups. The samples underwent a 30-minute interview to complete validated questionnaires containing questions on demography, socioeconomic status, smoking behaviour, physical activity, nutritional habits and other behaviour regarding CVD. Blood pressure and body mass index (BMI) measurements were done and fasting blood samples were taken for two hours post load plasma glucose (2 hpp), serum (total, HDL and LDL) cholesterol and triglyceride levels. A twelve-lead electrocardiogram was recorded in all persons above 35 years of age. Community-wide surveillance of deaths, hospital discharges, myocardial infarction and stroke registry was carried out in the intervention and control areas. Four to five years of interventions based on different categories such as mass media, community partnerships, health system involvement and policy and legislation have started in the intervention area while Arak will be followed without intervention. Considering the results of the baseline surveys, (assessments needed, the objectives, existing resources and the possibility of national implementation) the interventions were planned. They were set based on specific target groups like school children, women, work-site, health personnel, high-risk persons, and community leaders were actively engaged as decision makers. A series of teams was arranged for planning and implementation of the intervention strategies. Monitoring will be done on small samples to assess the effect of different interventions in the intervention area. While four periodic surveys will be conducted on independent samples to assess health behaviours related to CVD risk factors in the intervention and reference areas, the original pre-intervention subjects aged more than 35 years will be followed in both areas to assess the individual effect of interventions and outcomes like sudden death, fatal and nonfatal MI and stroke. The whole baseline survey will be repeated on the original and an independent sample in both communities at the end of the study.