Prenatal screening and counseling in Iran and ethical dilemmas.

OBJECTIVE: Prenatal screening has become an increasingly common procedure all over the world. It offers couples useful information relating to the health of their fetus, although it faces us with serious ethical dilemmas as well. This study was conducted to find out the attitudes of Iranian scholars towards prenatal screening and counseling with respect to ethical issues. METHODS: Two hundred and one physicians, genetic and religious scholars were interviewed with regard to demographics and attitudes towards the ethical dilemmas in prenatal screening and counseling. Interviews were analyzed using the four-principle approach. RESULTS: Findings showed scholars' attitudes towards: (1) the right of couples to choose prenatal screening, (2) the role of prenatal screening and counseling concerning termination of an affected fetus, (3) screening results and emotional distress in couples, and (4) the impact of prenatal screening and counseling on disability rate. CONCLUSION: Iranian scholars were willing to consider prenatal screening to help prevent transmission of diseases to the next generation. This goal is attained through the autonomous choice of the couple to participate in prenatal screening and counseling.

Hemochromatosis mutations in Iranians with hepatitis B virus infection.

In this study, the frequencies of the common hemochromatosis gene mutations were assessed in 75 Iranian subjects with chronic hepatitis B infection. We found that the major C282Y mutation was significantly more frequent in subjects infected with hepatitis B virus (4%) than in 194 control subjects (0%, P=.02; Fisher's exact test).

An economic analysis of premarriage prevention of hepatitis B transmission in Iran.

BACKGROUND: To assess the economic aspects of HBV (hepatitis B virus) transmission prevention for premarriage individuals in a country with cultural backgrounds like Iran and intermediate endemicity of HBV infection. METHODS: A cost-effectiveness analysis model was used from the health care system and society perspectives. The effectiveness was defined as the number of chronic HBV infections averted owing to one of the following strategies:1) HBsAg screening to find those would-be couples one of whom is HBsAg positive and putting seronegative subjects on a protection protocol comprising HBV vaccination, single dose HBIG and condom protection.2) HBsAg screening as above, in addition to performing HBcAb screening in the HBsAg negative spouses of the HBsAg positive persons and giving the protocol only to HBcAb negative ones.Sensitivity and threshold analyses were conducted. RESULTS: The cost of each chronic infection averted was 202$ and 197$ for the strategies 1 and 2, respectively. Sensitivity analysis showed that strategy 2 was always slightly cheaper than strategy 1. The discounted threshold value for the lifetime costs of chronic liver disease, above which the model was cost saving was 2818$ in strategy 1 and 2747$ in strategy 2. CONCLUSIONS: Though premarriage prevention of HBV transmission in the countries with cultural backgrounds similar to Iran seems cost saving, further studies determining precise costs of HBV infection in Iran can lead to a better analysis.

Liver, spleen, pancreas and kidney involvement by human fascioliasis: imaging findings.

BACKGROUND: Fasciola hepatica primarily involves the liver, however in some exceptional situations other organs have been reported to be involved. The ectopic involvement is either a result of Parasite migration or perhaps eosinophilic reaction. CASE PRESENTATION: Here we report a known case of multiple myeloma who was under treatment with prednisolone and melphalan. He was infected by Fasciola hepatica, which involved many organs and the lesions were mistaken with metastatic ones. DISCUSSION: Presented here is a very unusual case of the disease, likely the first case involving the pancreas, spleen, and kidney, as well as the liver.

Age-specific seroprevalence of hepatitis A infection among children visited in pediatric hospitals of Tehran, Iran.

BACKGROUND: Hepatitis A is an enterically transmitted disease that still remains endemic in many developing countries. In some countries improvements in living conditions have recently led to changing in epidemiology of hepatitis A virus (HAV) infection. In our country there are very few reports on prevalence of HAV infection. OBJECTIVE: To determine the seroprevalence of anti-HAV IgG among children visited in pediatric hospitals of Tehran, Iran. METHODS: The study group included 1018 children who were 6 months-14.9 years of age. These children were visited in four major pediatric hospitals of Tehran. The children were separated to three age groups: Group 1 (6 months-4.9 years; n = 469), Group 2 (5.0-9.9 years; n = 290), and Group 3 (10.0-14.9 years; n = 259). Serum anti-HAV IgG was tested with commercial ELISA kits. The data were tested for statistical significance with chi2 test. RESULTS: In all subjects, seroprevalence of hepatitis A was 22.3% (95% CI: 19.7, 24.9). There was no significant difference between genders (22.2% vs. 22.5% in males and females, respectively) and among age groups (Group I was 22.1% and Group 3 was 25.9; p > 0.05). CONCLUSIONS: In summary, it seems that HAV infection is not highly endemic at least in some urban areas of Iran. On the basis of this epidemiologic data, post exposure prophylaxis would be necessary for children and young adults, and hepatitis A vaccination strategy should be revised.