Investigation of melamine and cyanuric acid concentration in several brands of liquid milk and its non-carcinogenic risk assessment in adults and infants

In this study, the melamine and cyanuric acid concentration of widely used milk brands and the probability of non-carcinogenic risk of the brands for adults and infants were investigated. These values were 1.37 mg/L, 1.10 mg/L, and 1.09 mg/L, which corresponded to creamy sterilized sample, high-fat (creamy) pasteurized sample, and low-fat (less-creamy) pasteurized sample, respectively. Similarly, the highest amount of cyanuric acid occurred in brand A with the values of 0.79 mg/L, 0.65 mg/L, and 0.64 mg/L, which was reported in the same samples mentioned for melamine. The HQ (Hazard Quotient) of melamine in the brands of A, B, C and D for adults was 0.0025, 0.0011, 0.0006 and 0.0008 respectively. These values for infants were reported as 2.2280, 0.9444, 0.5714 and 0.6714 respectively. The risk probability of melamine for adults was less than 1. However, the HQ in brand A for infants was greater than 1 (2.380), which indicate the high probability of non-carcinogenic risk. Furthermore, the HI (Hazard Index) values of the brands of A, B, C and D for infants were 2.7913, 1.1737, 0.7067 and 0.838, respectively. The simultaneous melamine and cyanuric acid in the brands A and B in for infants increase the non-carcinogenic risk probability by approximately 2.8 and 1.2 times, respectively. The results revealed that the melamine and cyanuric acid concentrations in creamy milk samples (0.5%) were higher than in less-creamy milk samples (2.5%). Moreover, the amount of the compounds in sterilized milk samples was higher than pasteurized. In this study, a conversion factor (0.7) was proposed in order to find out the concentration of cyanuric acid in milk sample with the amount of melamine is known but the cyanuric acid concentration is unknown.

Determination of melamine contamination in chocolates containing powdered milk by high-performance liquid chromatography (HPLC)

Melamine is widely being reported as a food adulterant. Although its toxicity is currently recognized, melamine adulterations of dairy products are ongoing to apparently increase the amount of protein. The study was conducted to investigate the determination of melamine amounts in chocolates containing powdered milk. In this study, 60 samples of chocolates containing powdered milk, both imported and domestic brands, were collected. The samples were prepared by solid phase extraction (SPE) and analyzed using high-performance liquid chromatography (HPLC). According to the results, melamine was found in about 94% of imported samples and about 77% of Iranian samples. Melamine concentration in imported samples ranged from 0.032 to 2.692 mg/kg, while in Iranian ones it ranged from 0.013 to 2.600 mg/kg. The mean melamine concentrations of foreign and Iranian samples were 0.685 ± 0.68 and 0.456 ± 0.73 mg/kg, respectively. Moreover, the limit of detection (LOD) and limit of quantification (LOQ) values of melamine were 0.017 and 0.052 μg/ml, respectively. The recovery rate (R%) at fortified levels of 1-2 mg/kg was found to be 89.20-95.69% with an RSD (Relative Standard Deviation) of 1.8-2.7%. Based on the study results, melamine was present in 85% of all samples and the melamine level in one Iranian brand and one imported brand was higher than the Codex Organization standard. However, the consumption of chocolates containing these low levels of melamine does not constitute a health risk for consumers.

Evaluation of Th17 associated antigen in Old World Cutaneous Leishmaniasis: A comparative study in acute versus chronic human cutaneous Leishmaniasis using immunohistochemistry

There are little information about Th17 cells and cutaneous Leishmaniasis (CL), due to an important effect of Th17 cells on immune response, it is worth to explore the role of Th17 on CL. The purpose of this study was to assess Th17 population in patients with acute vs. chronic CL lesions in comparison with skin samples collected from healthy volunteers in an endemic region of Old World CL. A total of 49 patients with clinical manifestations of chronic (n=16) and acute (n=33) CL lesions were recruited. The clinical diagnosis of CL was confirmed by direct smear or PCR. Biopsy specimens from prelesional skin of non-infectious lesions of 30 healthy individuals were used as control. Tissue sections of 3µm thickness were prepared and used for immunohistochemistry (IHC) analysis with primary antibody specific for Th17 associated antigen (CD161). For IHC, Envision+ (DakoCytomation) system was used and developed by using diaminobenzidine (DakoCytomation). The mean age of 33 patients with acute CL and the mean age of 16 patients with chronic CL were accordingly 45.24±16.43 and 33.56±15.87. In acute and chronic CL the mean (±standard deviation) and median (±interquartile range) were accordingly 2.92±2.21, 2.56±2.9 and 2.1±1.99, 1.54±2.81. In healthy controls the mean (±standard deviation) and median (±interquartile range) were 0.72±0.41 and 0.61±0.58 respectively. With pairwise comparison of acute, chronic and control groups, there were significant difference between acute and control (P value < 0.001), chronic and control (P value = 0.043). The results showed that there was an increasing cellular response of Th17 in both acute and chronic CL patients. Th17 was significantly higher in patients with acute and chronic CL lesions in comparison with healthy control group. However, there was no significant difference between acute and chronic infection concerning to Th17 cells.

Bone mineral density is lower in male than female patients with plaque-type psoriasis in Iran

Background

There are many similarities with regard to contributing cytokines in patients with psoriasis and osteoporosis. A theory of probable relationship between these two entities has been proposed but there is no concordant consensus. The aim of this study was to evaluate bone mineral density (BMD) in patients with psoriasis.

Method and materials

This cross-sectional study of BMD was conducted with 64 eligible patients with psoriasis who were referred to the dermatology clinic of Razi hospital in Tehran, Iran in between 2011 and 2012.

Results

The mean T score of femoral neck was –1.17 and –0.49 in men and women, respectively, which was statistically significant (p = .047). The mean T score of the lumbar spine was –0.93 and –0.30 in men and women, respectively, but not statistically significant (p = .058). In total except with the exclusion of the study site (femur or lumbar), men and women did not have a statistically significant difference with regard to osteoporosis or osteopenia in BMD (p = .114). The Pearson correlation coefficient demonstrated a moderate inverse relationship between age and T score of the femoral neck and lumbar spine (r = –0.419 and –.406, respectively), which was statistically significant (p = .001). Although there was no statistically significant relationship between the Psoriasis Area and Severity Index (PASI) and T scores of the femoral neck (p = .596), a positive and weak correlation was observed between the PASI and T scores for the lumbar spine, which was statistically significant (r = 0.269; p = .03).

Conclusion

Patients with psoriasis had decreased bone density, which was more significant in men. Prevalence of osteoporosis showed no statistically significant difference when compared with the healthy population in Iran.

Patient manual handling risk assessment among hospital nurses

BACKGROUND

Manual patient handling is known to be the major source of musculoskeletal load among hospital nurses.

OBJECTIVES

The objectives of this study were to determine prevalence of musculoskeletal disorders (MSDs), assess patient manual handling risk and identify major factors associated with MSDs symptoms among hospital nursing staff.

METHODS

This cross-sectional study was conducted among 400 randomly selected nurses from 75 wards of 11 hospitals. Data were collected by demographic and Nordic musculoskeletal questionnaires together with MAPO checklist. Prevalence of MSDs was estimated with confidence interval of 95%. Chi-square test and independent sample t-test were used to investigate differences of MSDs prevalence for demographic variables between the subjects with and without MSDs. Multiple logistic regression analysis was performed (forward: Wald) to determine MSDs associated risk factors.

RESULTS

The means of age and job tenure in subjects were 30.76 ± 6.44 and 6.92 ± 5.75 years, respectively. Some form of musculoskeletal symptoms had been experienced during the last 12 months by 88.2% of the subjects. MAPO assessment revealed that 83.5% of the individuals were at risk. Statistical analysis showed that job tenure, nurse to bed ratio, gender, shift working and MAPO score were associated with MSDs (p< 0.05).

CONCLUSIONS

Prevalence of MSDs in hospital nursing personnel was high and the occurrence of MSDs was found to be associated with MAPO score. Based on the results, to improve working conditions, it is imperative to provide lifting equipment, implement training programs and increase nurse to bed ratio in hospitals.

Health consequences of shift-work: the case of iranian hospital security personnel

BACKGROUND

Shift-work, which is an ergonomics issue in workplaces, can negatively affect workers. The security personnel of medical centers in Iran have multiple responsibilities and consequently are exposed to such unwanted situations as observing patients, disputing with patient's attendants, unwanted shift schedules, and being away from family for long periods.

OBJECTIVE

This study assessed health problems of Iranian hospital security personnel (shift-worker personnel) using the Survey of Shift-workers (SOS) questionnaire (Persian version).

METHODS

This cross-sectional study was conducted in seven medical centers (4 hospitals and 3 clinics). A total of 416 workers were surveyed: shift-workers (exposed group) (n=209) and non-shift-workers (unexposed group) (n=207).

RESULTS

The prevalence of adverse health effects was higher in shift-workers than day-workers. The level of education and mean Body Mass Index (BMI) in shift-workers were significantly higher compared with day-workers. The prevalence of gastrointestinal disorders, cardiovascular and psychological problems were also significantly higher in shift-workers compared with day-workers.

CONCLUSIONS

Overall, the prevalence of health problems among the security personnel of medical centers was high. Hence, it is recommended that personnel be put under periodic monitoring and receive medical counseling and treatment if there is any disorder.

Isolated linear blaschkoid psoriasis

Linear psoriasis (LPs) is considered a rare clinical presentation of psoriasis, which is characterized by linear erythematous and scaly lesions along the lines of Blaschko. We report the case of a 20-year-old man who presented with asymptomatic linear and S-shaped erythematous, scaly plaques on right side of his trunk. The plaques were arranged along the lines of Blaschko with a sharp demarcation at the midline. Histological examination of a skin biopsy confirmed the diagnosis of psoriasis. Topical calcipotriol and betamethasone dipropionate ointments were prescribed for 2 months. A good clinical improvement was achieved, with reduction in lesion thickness and scaling. In patients with linear erythematous and scaly plaques along the lines of Blaschko, the diagnosis of LPs should be kept in mind, especially in patients with asymptomatic lesions of late onset.

Patients with psoriasis are at a higher risk of developing nonalcoholic fatty liver disease

BACKGROUND

Psoriasis is a chronic, immune-mediated inflammatory skin disease with many extracutaneous manifestations. Several recent studies have indicated an increased prevalence of nonalcoholic fatty liver disease (NAFLD) among patients with psoriasis. In the present study, we investigated the prevalence of NAFLD in a population of Iranian patients with psoriasis.

METHODS

NAFLD was assessed and graded using ultrasonography in 123 patients with psoriasis and 123 healthy controls (HCs) matched by age, sex and body mass index (BMI).

RESULTS

The prevalence of NAFLD was significantly higher in the psoriatic group compared with the HC group (65.6% vs. 35%, P < 0.01, OR = 3.53). Median NAFLD grade was significantly greater in patients with psoriasis compared with HCs (grade 2 vs. grade 1, P < 0.01). In patients with psoriasis, NAFLD was associated with a higher frequency of hypertension (16.5%), abnormal liver function test (LFT) results (16.4%) and metabolic syndrome (46.6%). Moreover, patients with psoriasis and NAFLD tended to have significantly higher values for BMI, waist circumference (WC), Psoriasis Activity and Severity Index (PASI), and levels of serum triglyceride, cholesterol, low-density lipoprotein and fasting blood sugar (FBS). Multivariate logistic regression revealed that WC, PASI, LFT abnormalities, hypertension and cigarette smoking were independent predictors of NAFLD grade.

CONCLUSIONS

Our findings warrant a detailed assessment of metabolic comorbidities including NAFLD in patients with a primary diagnosis of psoriasis. Lifestyle modifications, including weight loss and smoking cessation, may be necessary for patients with psoriasis to decrease the risk and severity of NAFLD.

C-reactive protein in psoriasis: a review of the literature

A great deal of research has addressed the elevation of C-reactive protein (CRP) among psoriatic patients and the role of this marker in assessment of disease severity and progression. However, there are some discrepancies in this area. We sought to figure out the relationship between CRP values and disease severity as well as the changes in marker levels after treatment through an extensive literature review. Comparison between CRP levels in psoriatic patients and those in healthy or non-psoriatic individuals was also another focus of this review. A thorough search in Pubmed and Embase was conducted for articles investigating different aspects of CRP measurement in patients with psoriasis. Overall, 32 articles were found to meet our inclusion criteria. Of 28 studies comparing the CRP values in psoriatic patients with those of controls, 24 found a statistically significant difference. In addition, 12 out of 16 papers examining the association between disease severity and CRP values noted significant results. With regard to CRP changes over the course of a treatment, all 15 studies addressing this issue revealed a significant decrease in marker levels. In conclusion, high CRP levels only for moderate and severe forms of disease might be inferred from the literature and there is no sufficient evidence suggesting a similar association for mild disease as well. Moreover, CRP may serve interchangeably with Psoriasis Area and Severity Index (PASI) as a measure of disease severity in the case of untreated psoriatic patients who do not have disease related arthritis. For other patients, however, a careful clinical examination and PASI calculation still remain the mainstay of severity assessment.

Respiratory disorders associated with heavy inhalation exposure to dolomite dust

BACKGROUND

Although dolomite is classified as a relatively non-toxic, nuisance dust, little information exists as to its potential to produce respiratory disorders following occupational exposure. The purpose of this study was, therefore, to evaluate the possible effects, if any, of heavy inhalation exposure to this chemical on the prevalence of respiratory symptoms, functional impairments and radiographic abnormalities of the lungs.

METHODS

The study population consisted of a group of 39 exposed subjects engaged in digging and excavating activities that were in operation for building a local dam, as well as 40 healthy non-exposed employees that served as the referent group. Subjects were interviewed and respiratory symptoms questionnaires, as suggested by the American Thoracic Society (ATS), were completed for them. Thereafter, they underwent chest X-ray and lung function tests. Additionally, using routine gravimetric techniques, personal dust monitoring for airborne inhalable and respirable dust was carried out at different dusty work sites. Finally to determine the chemical composition of the dust, it was analyzed by X-ray fluorescence (XRF) technique.

RESULTS

XRF revealed that the major component (50.52%) of the dust was calcium magnesium carbonate, dolomite. Additionally, levels of exposure to inhalable and respirable dust were estimated to be 51.7±24.31 and 23.0±18.11mg/m3, respectively. Statistical analysis of the data showed that symptoms such as regular cough, phlegm, wheezing, productive cough and shortness of breath were significantly (p<0.05) more prevalent among exposed workers. Similarly, the ratio of FEV1/FVC in exposed subjects was significantly different from that of non-exposed individuals. In contrast, no significant abnormalities were observed in the chest radiographs of both groups.

CONCLUSIONS

In conclusion, while these data cast doubt on the notion that dolomite is a harmless chemical, they provide evidence in favour of the proposition that exposure to high atmospheric concentrations of this compound is likely to be associated with respiratory symptoms.

One-Humped Camel (Camelus dromedarius) Infestation with Linguatula serrata in Tabriz, Iran

BACKGROUND

Linguatula serrata is one of well known members of Pentastomida which infects both human and animals. The aim of this study was to evaluate the prevalence of L. serrata in mesenteric lymph nodes, livers and lungs of camels slaughtered in Tabriz area, Iran.

METHODS

Mesenteric lymph nodes (MLNs), livers and lungs of 140 one-humped camels slaughtered in Tabriz, north-west of Iran were investigated for nymphs of L. serrata from July 2007 to June 2008. The organs were examined macroscopically and then a tissue digestion method was also done for investigation of liver and lung of the camels that had infected MLN. The liver and lung samples were mostly taken from condemned and rejected part of organs.

RESULTS

The infection rate of L. serrata nymphs in MLNs, livers and lungs was 13.5%, 1.4% and 1.4% respectively. The number of isolated nymph in infected lymph nodes varied from 2 to 18 with a mean of 4.78. Only one nymph was isolated from each infected livers and lungs. The infection rate increased with age (P< 0.05). No significant difference in different sex groups and seasons was observed (P> 0.05).

CONCLUSION

Considering this fact that consumption of undercooked camel liver was not common in the studied area, the zoonotic importance of this infection should be concluded.

Pemphigus and associated environmental factors: a case?control study

BACKGROUND

Recent reports have revealed the relatively high incidence of pemphigus in Iran. Occupational exposure and personal habits have been suggested to play a role in the aetiopathogenesis of this life-threatening disease.

AIM

In order to analyse the association of environmental factors with pemphigus, we conducted a case-control study to evaluate the possible role of smoking, pesticide exposure and hormonal factors in Iran.

METHODS

This study was conducted in Iran using a structured questionnaire. Questions included information on patients' smoking habits, occupational exposure to pesticides, use of oral contraception (OC) and number of pregnancies.

RESULTS

We enrolled 210 patients with pemphigus and 205 control subjects. Fewer of patients with pemphigus (17.1%) reported a current or past history of smoking, which was statistically different from the control group (27.3% smokers). The duration of smoking and the number of cigarettes smoked daily was also significantly lower in patients. Although OC use was significantly higher in women with pemphigus, the mean number of pregnancies was not different between the two groups. Occupational exposure to pesticides was significantly higher in patients with pemphigus (14.8%) than in controls (5.4%); patients with pemphigus were exposed to pesticides three times more often than were healthy subjects.

CONCLUSION

As a positive history of smoking was lower in patients with pemphigus compared with healthy subjects, it seems that smoking is a protective factor in pemphigus. This should encourage further investigations, searching for novel therapies. If pesticides and OC are confirmed as triggering factors, their cessation might reduce the need for pharmacological therapy.