Microsatellite Instability and Colorectal Cancer, Immunohistochemical and Molecular Evaluation by Using DNA Sequencing: A Single Center Experience.

BACKGROUND & OBJECTIVE: Microsatellite instability is common in familial colorectal cancers. It can be tested by the molecular and immunohistochemical methods. There are very few studies which address comparing the clinicopathological characteristics of microsatellite stable (MSS) and microsatellite unstable (MSI) colorectal cancers from Iran. In this study, we aimed to evaluate the clinicopathological and immuno-histochemical findings of MSS and MSI colorectal cancers in our Center as the largest Center of gastrointestinal surgery and oncology in the South of Iran. We also compared the immunohistochemical method vs. molecular study using DNA sequencing. METHODS: For 5 years (2015-2019), 34 patients who underwent operation in the affiliated Hospitals of Shiraz University of Medical Sciences were clinically suspected to microsatellite instability (MSI). The molecular diagnostic tests with DNA sequencing were performed. Clinicopathological and immunohistochemical findings of MSI colorectal cancers were compared with those who were stable. RESULTS: In the South of Iran, MSI colorectal cancers were more common in males. These tumors were more common in the right side with more tendencies to produce mucin with lymphocytic infiltration. CONCLUSION: Immunohistochemistry would be a specific method for diagnosis of MSI colorectal cancers but may be associated with high rate of false negative results and of low sensitivity. Therefore, we recommend performing molecular studies by DNA sequencing in those colon cancers with clinical suspicion for MSI and negative immunohistochemical findings.

The data on the relationship between polymorphism of HTR1B and DBH genes and attention-deficit hyperactivity disorder in adults with or without substance use disorders.

There is a positive relationship between attention-deficit hyperactivity disorder and tendency toward drug use in numerous studies. The present study was aimed to investigate the relationship between polymorphism of serotonin receptor 1B gene (HTR1B) and Dopamine beta-hydroxylase gene (DBH) with attention-deficit hyperactivity disorder in adults with or without substance use disorders. In the present case-control study, as many as 355 individuals entered the present study and was categorized in different groups: control healthy group, substance use disorders group, and attention-deficit hyperactivity disorder group. For confirming attention-deficit hyperactivity disorder in adults, demographic and Conners forms were used. Moreover, SCID-I questionnaire was used to confirm or reject the individual׳s suffering from substance use disorders and other psychiatric diseases. The polymorphism of abovementioned genes was conducted by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). In case of DBH gene-Rs2519152, the findings indicated that TT, TC, and CC genotypes and T and C alleles are not different in the attention-deficit hyperactivity disorder group, substance use disorder group, the group with patients suffering from both disorders, and control group. Moreover, the frequency of TT, TA, and AA genotypes as well as T and A alleles was same in the attention-deficit hyperactivity disorder group, substance use disorder group, the group with patients suffering from both disorders, and control group.

Evaluation of anxiety and depression among female spouses of Iranian male drug dependents.

BACKGROUND: Existing evidences suggest the more vulnerability of spouses of drug dependents, in exposure to mental disorders. OBJECTIVES: This study aimed to evaluate the associated parameters of anxiety and depression among female spouses of male drug dependents. PATIENTS AND METHODS: With a cross-sectional design in 2010, a total of 237 Iranian women were selected and divided into three groups: 1. non-drug-dependent wives who had non-drug-dependent husbands (Group I), 2. non-drug-dependent wives who had drug-dependent husbands (Group II), and 3. drug-dependent wives who had drug-dependent husbands (Group III). Socio-demographic characteristics were collected by a checklist, and the levels of anxiety and depression were measured through the Hospital Anxiety and Depression Scale (HADS). Linear regression was applied for determination of anxiety and depression predictors. RESULTS: Mean age of the participants was about 35 years, and mean duration of marriage was 14 years. Drug dependence of the husband (P = 0.010) and lower monthly income of the family (P = 0.007) predicted the higher level of anxiety among the participants, while older age (P = 0.031), shorter marital duration (P = 0.016), and lower educational level (P = 0.045) in addition to spousal drug dependence (P = 0.023), and lower family income (P = 0.014) were significantly associated with higher levels of depression. CONCLUSIONS: Findings of the present study demonstrate that spousal drug dependence and lower monthly income were common predictors of anxiety and depression among spouses of drug dependents in Iran, while older age, shorter marital duration and lower educational level were predictors of depression. However, more research is needed to find casual relationships between spousal drug dependence and mental health in Iran.

Drug Use among Iranian Drivers Involved in Fatal Car Accidents.

BACKGROUND: Although the problem of substance use among drivers is not limited to certain parts of the world, most epidemiological reports on this topic have been published from industrial world. AIM: To investigate pattern of drug use among Iranian drivers who were involved in fatal road accidents. METHODS: This study enrolled 51 Iranian adults who were involved in fatal vehicle accidents and were imprisoned thereafter. Data came from a national survey of drug abuse that was done among Iranian prisoners. The survey collected data at the entry to seven prisons in different regions of the country during a 4-month period in 2008. Self-reported lifetime, last year, and last month drug use was measured. Commercial substance screening tests were applied to detect recent substance use (opioids, cannabinoids, methamphetamines, and benzodiazepines). RESULTS: The commercial substance screening test showed three distinct patterns of recent illicit drug use: opioids (37.3%), cannabinoids (2.0%), opioids and cannabinoids (13.7%). 29.4% were also positive for benzodiazepines. The substance use screening test detected 23.5% of participants who had used drugs but did not disclose any substance use. CONCLUSION: Opioids are the most common illicit drugs being used by Iranian drivers who are involved in fatal car accidents. The high rate of substance use prior to fatal car accidents in Iran advocates for the need for drug use control policies and programs as major strategies for injury prevention in Iran. There is also a need for substance screening among all drivers involved in fatal car accidents in Iran, as more than 20% of users may not disclose substance use.

Drug Injection to Sites other than Arm: A Study of Iranian Heroin Injectors.

For almost all injecting drug users (IDUs), the first site of injection is the arm. Years after injection, IDUs may shift to using other sites for intravenous (IV) access. Although injection to sites other than the arm is associated with higher risks, literature is limited regarding this behavior. We aimed to determine the prevalence and associated factors of using IV access points other than the arm among a national sample of IDUs in Iran. Data came from the National Drug Dependence Survey, 2007, which had enrolled 863 IDUs with at least one daily injection. Data on socio-demographics, pattern of drug use, and injection-related behaviors were entered into a logistic regression to determine predictors of injection to sites other than the arm. From all participants, 54.8% reported current injection sites in areas other than the arm. The other injection sites were the femoral venous sinus (17.0%), followed by the groin (14.5%) and neck (11.5%). Logistic regression revealed that living alone [odds ratio (OR) = 1.789, 95% confidence interval (CI) = 1.218-2.629], being Sunni (OR = 3.475, 95% CI = 1.775-6.801), having higher family income (OR = 1.002, 95% CI = 1.001-1.003), higher age at first drug use (OR = 1.039, 95% CI = 1.009-1.069), longer injection duration (OR = 1.071, 95% CI = 1.041-1.102), and more injection frequency (OR = 1.255, 95% CI = 1.072-1.471) were associated with higher likelihood of using injection sites other than the arm. Using sites other than the arm for IV injection is linked to socio-demographics, drug use data, and injection-related characteristics that can be used by policy makers. This information can be used for harm reduction planning.

Compulsory maintenance treatment program amongst Iranian injection drug users and its side effects.

BACKGROUND: Psychoactive substance use can cause a broad variety of mental health disorders and social health problems for the drug users, their family and society. OBJECTIVES: The Ministry of Health, Treatment, and Medical Education of Iran has recently proclaimed an estimated number of 2 million drug abusers and 200,000 injecting drug users (IDUs). PATIENTS AND METHODS: For data collection, the directory of mental, social health, and Addiction designed a questionnaire in cooperation with Drug Control Headquarters of Iran. RESULTS: Among 402 IDUs patients, a large amount of them were male, single, and younger than 39 years. Regarding psychotic and somatic symptoms caused by methadone therapy, most of the participants had no problem with methadone maintenance treatment (MMT). CONCLUSIONS: There is a need to train health staff, and the community, concerning preventive measures, treatment, and reducing harm for substance drug users.

Descriptive Aspects of Injection Drug Users in Iran's National Harm Reduction Program by Methadone Maintenance Treatment.

BACKGROUND: The Ministry of Health, Treatment and Medical Education of Iran has recently announced an estimated figure of 200,000 injecting drug users (IDUs). The aim of this study was to pilot a national program using demographics, types of drug abuse and prevalence of blood-borne infections among IDUs. METHODS: In order to elicit data on demographics, types of drug abuse and prevalence of blood-borne infections among IDUs, a questionnaire was designed in the Bureau of Mental-Social Health and Addiction in collaboration with Iran's Drug Control Headquarters of the Police Department. Therapeutical alliance of addiction in Shafagh Center was based on Methadone Maintenance Therapy (MMT). RESULTS: Among 402 reported IDUs most of them were male, single and in age range of 20 to 39 years old with 72.7% history of imprisonment. Most of them had elementary and high school education and a history of addiction treatment. The majority were current users of opioid, heroin and crack. The prevalence of blood-borne infections was 65.9% and 18.8% for HCV and HIV/AIDS infections, respectively. CONCLUSION: Prevention programs about harm reduction, treatment and counseling should include young IDUs as a core focus of their intervention structure.

Inconsistent Condom Use among Iranian Male Drug Injectors.

OBJECTIVES: The aim of this study was to determine the prevalence and associated factors of inconsistent condom use among Iranian male injecting drug users (IDUs). MATERIALS AND METHODS: Data came from the national Iranian behavioral survey of drug dependence, which sampled 7743 individuals with drug dependence, from medical centers, prisons, and streets in 29 provinces in Iran, in 2007. This study included all individuals who were male, IDUs, and were sexually active (n = 1131). The main outcome was inconsistent condom use which was assessed using a single item. A logistic regression was used to determine the association between socio-economic data, drug use data, and high risk injection behaviors with inconsistent condom use. RESULT: 83.3% of sexually active IDUs (n = 965) reported inconsistent condom use. Based on the logistic regression, likelihood of inconsistent condom use was higher among those with a history of syringe sharing [Odds Ratio (OR); 1.63, 95% Confidence Interval (CI); 1.13-2.34], but lower among those with higher education levels (OR; 0.34, 95% CI; 0.14-0.82), those who mostly inject at home (OR; 0.09, 95% CI; 0.02-0.47), and those with a history of treatment (OR; 0.54, 95% CI; 0.31-0.94). CONCLUSION: Because of the link between unsafe sex and risky injecting behaviors among Iranian IDUs, combined programs targeting both sexual and injection behavior may be more appropriate than programs that target sexual or injection behavior. The efficacy of combined programs should be, however, compared with traditional programs that only target sexual or injection behavior of IDUs.