Evaluation of the frequency and diagnostic delay of primary immunodeficiency disorders among suspected patients based on the 10 warning sign criteria: A cross-sectional study in Iran

INTRODUCTION

The prevalence of undiagnosed primary immunodeficiency diseases is remarkably high and contributes to increasing the rate of morbidity and mortality among this group of patients.

OBJECTIVE

To examine the 10 warning sign scoring system in patients suspected of primary immune deficiency and also estimate the diagnostic delay in patients with proven disease.

METHODS

This descriptive cross-sectional study was carried out during the years 2015-2016 in Ali Asghar (AS) Clinic and Hospital. Two hundred patients with suspected primary immune deficiency disease were eligible for inclusion in the study. Multivariable logistic regression analysis was used to determine the relation between findings.

RESULTS

In this study, the majority of suspected cases of immunodeficiency were males (57%) with a mean age of 3.33±2.89 years. Twenty-one (10.5%) patients were diagnosed with immunodeficiency disease. The mean diagnostic delay among primary immune deficient patients was 2.05±1.7 years. There was a significant relationship between having parental consanguinity (OR=2.68, 95% CI: 1.07-6.70), allergies (OR=5.03, 95% CI: 1.13-22.31), vaccine adverse effects (OR=9.31, 95% CI: 1.24-69.96) and primary immune deficiency diagnosis. No association was observed between age (OR=0.98, 95% CI: 0.84-1.14), gender (OR=0.99, 95% CI: 0.39-2.47), immune deficiency scoring (OR=0.68, 95% CI: 0.31-1.45) and primary immune deficiency diagnosis.

CONCLUSION

Ten warning sign scoring system is of less value to consider a patient suspected of having primary immune deficiency. There is a meaningful delay in diagnosis of primary immune deficiencies especially in antibody deficiency defects which seeks further upgrading of knowledge in physicians.

The Fauna and Active Season of Mosquitoes in West of Fars Province, Southwest of Iran

Culicidae are highly important for public health as they can be vectors of diseases and are responsible for a wide spectrum of infections. Five collection sites were selected randomly with regards to existing facilities in Firouzabad County. For collecting larvae and total catch for adult mosquitoes, sampling was carried out by dipping technique for collecting larvae and total catch for adult mosquitoes. A total of 689 adults and 1313 larvae of Culicidae were collected, of which 3 genera and 6 species of Culicidae were recognized, namely, Anopheles superpictus, Anopheles d’thali, Culex sinaiticus, Culex theileri, Culex mimeticus, and Culiseta longiareolata. Cx. theileri was the most frequent Culicidae collected at Firouzabad, with a total of 613 and 247 larval and adult specimens, respectively. The highest number of mosquitoes was collected in June (31.1%) and the lowest in May (3.4%). The mean temperatures in June and May were 31.3˚C and 28.2˚C, respectively. We found some vectors that are of medical and veterinary importance; our results could be applied in vector control programs that aim at eradication or control of mosquitoes in this area.

BACKGROUND TRACK DENSITY REDUCTION OF 50-HZ-HV ECE-PROCESSED THICK POLYCARBONATE DETECTORS TO IMPROVE LOWER DETECTION LIMIT

A recent novel development of 50-Hz-HV ECE of 1-mm-thick and 250-µm-thick polycarbonate track detectors (PCTDs) has proved some promising results for some health physics, dosimetry and ion-beam-related applications. The method while proved having some good characteristics for some applications provided a relatively higher background track density (BGTD) in particular when very high voltages are applied to the PCTDs. In order to decrease the minimum detection limit (MDL) of the PCTDs and to further promote its applications for low dose, the BGTD was reduced by applying a layer removal methodology applying ethylendiamine (EDA). The effects of EDA concentrations (50, 60, 65, 70, 75, 80, 85 and 90 %) in water at room temperature (26°C) and soaking durations up to 100 min at different EDA concentration on BGTD reduction were studied. The thickness of the layer removed from the surface of a PCTD highly depends on the soaking time and EDA concentration; it increases as the EDA concentration increases up to for example 700 µm after 2 h of soaking in the EDA solution. After ∼10 min of soaking duration at any of the above-stated concentrations, the BGTD reaches its minimum value, a value which differs from concentration to concentration. An EDA concentration of 85 % in water provided the lowest BGTD of 64.06 ± 3.12 tracks cm^{- 2}; ∼6 times lower than that of its original value. It is shown that the layer removal process does not change the registration characteristics of the PCTD and its appearance significantly. The MDL of the PCTDs depends strongly on the BGTD. The MDL values for a desired confidence level were also studied by three calculation methods. The results of the BGTD and the MDL studies under different conditions applied are presented and discussed.

Does consumption of polyunsaturated fatty acids influence on neurorehabilitation in traumatic spinal cord-injured individuals? A double-blinded clinical trial

STUDY DESIGN

A double-blinded randomized clinical trial.

OBJECTIVES

The anti-inflammatory and neuroprotective effect of omega-3 fatty acids have been shown so far, but still its influence on clinical measures in spinal cord-injured human models were not known. We tried to investigate changes in disability and dependency scores in chronic traumatic spinal cord-injured patients after 14 months of ω-3 fatty-acid consumption.

METHODS

Main inclusion criteria were: traumatic spinal cord injury (SCI) and post injury duration longer than 1 year. Disability and dependency was assessed using U.K Functional Independence Measure and Functional Assessment Measure (FIM+FAM) scale. MorDHA capsules (435 mg of docosahexaenoic acid and 65 mg of eicosapentaenoic acid) were administered in treatment group, whereas control group received placebo capsules for 14 months. U.K. FIM+FAM scale were estimated before intervention and at the end of the trial.

RESULTS

Fifty-four patients in treatment group and 50 patients in placebo group completed the trial. Highest scores were detected in cognitive domain in both groups before and after intervention. Most dependency was observed in locomotion subscale and secondly in sphincter control. Scores of none of these components were changed by ω-3 fatty-acid consumption.

CONCLUSION

Although omega-3 fatty acids have been shown to have neuroprotective effect in acute phase of SCI, it seems that they have no significant influence in chronic inflammatory state of SCI. The positive effect of ω-3 fatty acid in chronic neurorecovery process, if exists, is weaker to exert any significant improvement in UK FIM+FAM scores in spinal cord-injured individuals.

Management of anticancer treatment in patients under chronic dialysis: results of the multicentric CANDY (CANcer and DialYsis) study

BACKGROUND

One million people worldwide benefit from chronic dialysis, with an increased rate in Western countries of 5% yearly. Owing to increased incidence of cancer in dialyzed patients, the management of these patients is challenging for oncologists/nephrologists.

PATIENTS AND METHODS

The CANcer and DialYsis (CANDY) retrospective multicenter study included patients under chronic dialysis who subsequently had a cancer (T0). Patients were followed up for 2 years after T0. Prescriptions of anticancer drugs were studied with regard to their renal dosage adjustment/dialysability.

RESULTS

A total of 178 patients from 12 institutions were included. The mean time between initiation of dialysis and T0 was 30.8 months. Fifty patients had received anticancer drug treatment. Among them, 72% and 82% received at least one drug needing dosage and one drug to be administered after dialysis sessions, respectively. Chemotherapy was omitted or prematurely stopped in many cases where systemic treatment was indicated or was often not adequately prescribed.

CONCLUSIONS

Survival in dialysis patients with incident cancer was poor. It is crucial to consider anticancer drug treatment in these patients as for non-dialysis patients and to use current available specific drug management recommendations in order to (i) adjust the dose and (ii) avoid premature elimination of the drug during dialysis sessions.

Molecular analysis of human influenza virus in Tehran, Iran

BACKGROUND

To date there are no reports of molecular and phylogenetic analyses of human influenza virus in Tehran, Iran.

OBJECTIVES

We isolated and characterized circulating influenza viruses in a sample of patients in Tehran.

METHODS

Nasal and pharyngeal swabs were collected from 57 individuals who were suspected of having influenza between October 2005 and January 2007. These samples were cultured and subsequently genotyped by RT-PCR and sequencing analyses.

RESULTS

Twelve of 57 samples (21%) were positive for human influenza virus. Out of the 12 positive samples, 7 were A/H3N2 (58%), 3 were A/H1N1 (25%) and 2 were B subtypes (17%). The phylogenetic analysis of the hemagglutinin gene showed that the H1N1 isolates were close to the A/New Caledonia/20/99 and the H3N2 isolates were close to the A/Panama/2007/99 and A/Moscow/10/99 vaccine strains.

CONCLUSION

In a sample of clinical patients in Tehran, Iran, the predominant subtype of human influenza virus was determined to be A/H3N2, followed by A/H1N1 and B. In addition, phylogenetic analysis on H1 showed some genetic drifts from vaccine strains, but the phylogeny of H3 demonstrated that these isolates were from the previous vaccine strains.

Hemodialysis reduces plasma apolipoprotein C-I concentration making VLDL a better substrate for lipoprotein lipase

Apolipoprotein Cs (apoC-1, apoC-II, and apoC-III) are lipoprotein components that have regulatory effects on enzymes involved in lipoprotein metabolism. Owing to their low molecular weights, apoCs can adsorb onto and/or pass through dialysis membranes. Our study determines the consequence of hemodialysis (HD) on plasma concentrations of apoCs and on the activities of enzymes modulated by apoCs. Plasma samples were collected from 28 patients with chronic renal failure before and after HD. Plasma apoC-II levels were unchanged, whereas apoC-III levels were slightly decreased in post-dialysis plasmas. The apoC-I content was markedly reduced during HD. This was due to a significant decrease in the apoC-I content of very low-density lipoprotein (VLDL), whereas the apoC-I content of high-density lipoprotein (HDL) was unchanged. Although HDL bound apoC-I is thought to inhibit cholesterol ester transfer protein, no change in the ability of pre- and post-dialysis VLDL to interact with the transfer protein were observed. Complementary experiments confirmed that VLDL-bound apoC-I has no transfer protein inhibitory potential. In contrast, an increase in the ability of post-dialysis apoC-I-poor VLDL to act as substrate for lipoprotein lipase (LPL) was found compared to pre-dialysis VLDL. Our study shows that apoC-I losses during HD might be beneficial by improving the ability of VLDL to be a substrate for LPL thus improving plasma triglyceride metabolism.