Showing papers by "Shahid Beheshti University of Medical Sciences and Health Services published in 2004"

Mental health survey of the adult population in Iran

Abstract: Background No national data on the prevalence of mental disorders are available in Iran. Such information may be a prerequisite for efficient national mental health intervention. Aims To determine the mental health status of a population sample aged 15 years and over. Method Through random cluster sampling, 35 014 individuals were selected and evaluated using the 28-item version of the General Health Questionnaire. A complementary semi-structured clinical interview was also undertaken to detect learning disability (‘mental retardation’), epilepsy and psychosis. Results About a fifth of the people in the study (25.9% of the women and 14.9% of the men) were detected as likely cases. The prevalence of mental disorders was 21.3% in rural areas and 20.9% in urban areas. Depression and anxiety symptoms were more prevalent than somatisation and social dysfunction. The interview of families by general practitioners revealed that the rates of learning disability, epilepsy and psychosis were 1.4%, 1.2% and 0.6%, respectively. Prevalence increased with age and was higher in the married, widowed, divorced, unemployed and retired people. Conclusions Prevalence rates are comparable with international studies. There is a wide regional difference in the country, and women are at greater risk.

Age-Related Macular Degeneration: A High-Resolution Genome Scan for Susceptibility Loci in a Population Enriched for Late-Stage Disease

Abstract: Age-related macular degeneration (AMD) is a complex multifactorial disease that affects the central region of the retina. AMD is clinically heterogeneous, leading to geographic atrophy (GA) and/or choroidal neovascularization (CNV) at advanced stages. Considerable data exists in support of a genetic predisposition for AMD. Recent linkage studies have provided evidence in favor of several AMD susceptibility loci. We have performed a high-resolution (5-cM) genome scan of 412 affected relative pairs that were enriched for late-stage disease (GA and/or CNV). Nonparametric linkage analysis was performed using two different diagnostic criteria and also by dividing the affected individuals according to GA or CNV phenotype. Our results demonstrate evidence of linkage in regions that were suggested in at least one previous study at chromosomes 1q (236–240 cM in the Marshfield genetic map), 5p (40–50 cM), and 9q (111 cM). Multipoint analysis of affected relatives with CNV provided evidence of additional susceptibility loci on chromosomes 2p (10 cM) and 22q (25 cM). A recently identified Gln5345Arg change in HEMICENTIN-1 on chromosome 1q25 was not detected in 274 affected members in the restricted group with AMD, 346 additional patients with AMD, and 237 unaffected controls. Our results consolidate the chromosomal locations of several AMD susceptibility loci and, together with previous reports, should facilitate the search for disease-associated sequence variants.

Patterns of uveitis in a tertiary eye care center in Iran

Abstract: Purpose: To identify the distribution and characteristics of new uveitis referrals to a tertiary eye care center in Tehran. Methods: A three-year prospective study was carried out to obtain information on 544 new patients referred with uveitis. A complete ophthalmologic examination was performed in all cases; a routine set of tests and an additional battery of directed workup were conducted when indicated. Results: Mean age was 32.3 years. There was no significant sex predominance. The most common forms of uveitis were anterior (38.4%) vs. other anatomical forms, chronic (62.1%) vs. acute (28.3%), nongranulomatous (85.5%) vs. granulomatous (14.5%), and noninfectious (83.5%) vs. infectious (16.5%). With regard to etiology, 45.5% were idiopathic, 19.9% were due to specific ocular disease, and 37.3% were associated with systemic disorders. Behcet's disease was the most common noninfectious disease and toxoplasmosis the most common infectious entity. The most prevalent causes were idiopathic, Fuchs' heterochr...

Prevalence of overweight and obesity in adolescent Tehrani students, 2000-2001: an epidemic health problem.

Abstract: Department of Community Nutrition,Faculty of Nutrition Sciences and Food Technology, Shaheed Beheshti University of Medical Sciences and HealthServices, Tehran, IranSubmitted 28 April 2003: Accepted 1 December 2003AbstractObjective: Overweight has become a public health problem in most developingcountries. Evidence suggests that adolescence is a critical period in determiningadulthood obesity and its complications. The present study was carried out to assessthe prevalence of overweight and obesity among secondary school students.Design and setting: This descriptive study was conducted in Tehran city, 2000–2001.Body weight and height were measured and body mass index (BMI) valueswere calculated. Underweight, overweight and obesity were defined as ,5th, $85thand $95th percentile, respectively, of age- and sex-specific BMI values fromthe National Center for Health Statistics/Centers for Disease Control andPrevention (2000).Subjects: Using a multistage sampling method, 2321 students (1068 males and 1253females) aged 11–16 years were assessed in Tehran, the capital city of Iran.Results: The overall prevalences of overweight and obesity were 21.1 and 7.8%,respectively. The prevalence of overweight among girl students (i.e. 23.1%;95% confidence interval (CI) 20.8–25.4) was significantly higher than that amongboys (i.e. 18.8%; 95% CI 16.5–21.1, P ¼ 0.01) even after adjustment for age(odds ratio 1.26, 95% CI 1.03–1.55, P ¼ 0.02). No significant risk of obesityassociated with age was found in girls or boys. In both sexes, median values ofage-specific BMI in this study were statistically higher than corresponding valuescollected in Tehrani adolescents 10 years ago (P ¼ 0.03). Similarly, a significantdifference was seen between girl students in this study and the referencepopulation (P ¼ 0.03).Conclusion: According to this study, overweight, especially in girls, should beconsidered an epidemic health problem among adolescent students in Tehran.KeywordsAdolescenceOverweightObesityTehranOverweight, as a main feature of epidemiologicaltransition, has increased in most developing countriesover the last two decades

Paradoxical reaction following intravenous midazolam premedication in pediatric patients – a randomized placebo controlled trial of ketamine for rapid tranquilization

Abstract: Summary Background : Paradoxical reactions to benzodiazepines include restlessness, violent behavior, physical assault, act of self-injury and need for restraints. These may occur at variable times after administration. This study was designed to determine the incidence of paradoxical reactions following intravenous midazolam premedication in pediatric patients and to compare the efficacy of extra doses of midazolam with low-dose intravenous ketamine to rapidly tranquillize them. Methods : A total of 706 ASA I, II children scheduled for elective surgery were given intravenous midazolam premedication. Children who developed a paradoxical reaction were randomly divided into three equal groups to receive: (i) extra midazolam, (ii) ketamine, or (iii) placebo as the test drug for treatment of paradoxical reaction. Ease of rapid tranquillization and need for a rescue tranquillizer (i.e. ketamine; irrespective of patient group) were compared among the three groups. Results : Twenty-four (3.4%) children developed paradoxical reaction after midazolam premedication. Those who received ketamine as the test drug responded rapidly to ketamine. But the responses of the other two groups to their test drug were poor and the majority of them required ketamine as rescue tranquillizer (six in midazolam, seven in placebo, but no patient in the ketamine group; P < 0.05). Conclusions : The results of this study demonstrate that ketamine is an effective drug for the treatment of paradoxical reaction following intravenous midazolam premedication. The exact mechanisms of these reactions and how it is aborted by ketamine are not clear.

Use of amnion as a graft material in vestibuloplasty: a preliminary report.

Abstract: Objective The aim of this study was to evaluate the clinical use of amnion as a biodegradable graft material for vestibuloplasty. Study design Seven subjects who had been referred for preprosthetic surgery underwent mandibular vestibuloplasty using Clark's technique and amnion as graft material. Fresh amniotic membrane was placed in the area and an acrylic splint was used with soft liner and 0.4-mm wires to cover the surgical site. The area was reexamined after 1 week, 2 weeks, 4 weeks, 3 months, and 6 months. Results A white necrotic soft tissue layer could be seen with underlying hyperemic tissue and an average reduction of 1 to 3 mm in the depth of the labial vestibule after a week. By the end of the second week, the necrotic layer had disappeared, leaving slightly hyperemic mucosal tissue under. By the third week, the graft area could be noticed but the amnion had completely degenerated and disappeared. After 4 weeks, the subjects could be referred for their prosthodontic treatment. The reduction in the depth of the buccal vestibule ranged from 17% to 40% after 6 months' follow-up. Conclusion Amnion might be used as a potential graft material for vestibuloplasty.

Hydroxyurea in the treatment of major beta-thalassemia and importance of genetic screening.

Abstract: Efforts have been undertaken to find an alternative approach to packed red cell transfusion (PRCT) in major beta-thalassemia. Augmentation of fetal hemoglobin (HbF) by hydroxyurea (HU) has been reported to be less effective in this condition as compared to sickle cell anemia due to molecular heterogeneity of the former disease. HU efficacy and its relation to Xmn1 polymorphism and IVSII-1 mutation was evaluated in major beta-thalassemics. Forty-five patients, M/F ratio 0.8, aged 6-33 years, received oral HU, 20 mg/kg per day, 4 days per week and daily1 mg folic acid. Thirty-six patients were PRCT dependent (group A) and nine independent (group B). The aim was to stabilize or increase pre-PRCT Hb over 10.0+/-0.5 g/dl and to reduce the need or cease the PRCT in group A and to increase Hb level and curb the ineffective erythropoesis, e.g., splenomegaly, facial bone deformity, in group B. HU was administered for at least 6 months (mean: 9 months) and discontinued in case of response failure. Screening for Xmn1 polymorphism and IVSII-1 mutation was carried out in most patients. In group A, 25 patients have become PRCT independent for a period of 2.5-7.3 years (mean: 4 years). The mean Hb, pre-HU 10.0 and post-HU 10.7 g/dl (range: 8.8-13.7 g/dl), mean serum ferritin pre- and post-HU was1877 and 525 ng/ml. The PRCT requirement was reduced in one patient, and ten patients did not respond. In group B HU has been given over 3.3 years (range: 2.8-4.8 years), Hb increased from 9.3 to 10.4/dl, and there was no tangible progression of ineffective erythropoesis. Responders in both groups expressed more comfort with this regimen. Xmn1 and IVSII-1 (homo- and/or heterozygosis) are relevant markers in most responding patients. Molecular determination of genetic markers in early childhood will help to identify candidates for pharmacological HbF switching by HU.

A Comparative Study Of White Mineral Trioxide Aggregate And White Portland Cements Using X-ray Microanalysis

Abstract: The purpose of this study was to determine and compare the composition of white mineral trioxide aggregate (WMTA) and two different white Portland cements (WPCs). Samples of WMTA and WPCs were prepared and then imaged in a JEOL JSM6400 scanning electron microscope, equipped with an Oxford Instruments light element energy dispersive spectrometer detector for determining the elemental composition. Electron probe microanalysis (EPMA) results indicated that lime (CaO) and silica (SiO2) were the dominant compounds in each case. The results showed that the trace elements are similar in all of the samples but there was no detectable trace of bismuth oxide (Bi2O3) in WPCs. The range of crystal sizes observed in WMTA was found to be distinctly smaller than those observed in the WPCs. It was concluded that there is no significant difference between the dominant compounds in both WMTA and WPCs except the presence of bismuth oxide in WMTA.

Serum zinc and its relation to bone mineral density in β-thalassemic adolescents

Abstract: Trace elements have been considered to play critical roles in bone metabolism. This study aims at determining the serum zinc profile and its association with bone mineral density (BMD) abnormalities in thalassemic patients. In 131 transfusion-dependent beta-thalassemic patients, aged 10-20 yr, serum levels of zinc were measured by flame atomic absorption spectrophotometry (F-AAS). BMD values at the lumbar (L1-L4) and femoral neck were determined by dual X-ray absorptiometry (DXA). Dietary zinc intake and daily consumption of calcium were evaluated by a food-frequency questionnaire. Low serum zinc was found in 84.8% (in 44.7% severely low). Below -2 BMD Z-scores were observed in 68.7% and 17.6% of the patients at the lumbar and femoral regions, respectively. Female patients with severe zinc deficiency had lower lumbar BMD Z-scores in comparison to the other females (-3.26 vs -2.54). Serum zinc in females with femoral BMD Z-scores < - 2 was significantly lower by 16.4 microg/dL than other females. Our study suggests that serum levels of zinc can be lowered in the thalassemic patients and partly affect the BMD.

Cyproheptadine in the treatment of autistic disorder: a double-blind placebo-controlled trial

Abstract: SUMMARY Objective: Autism is a childhood-onset disorder of unknown, possibly of multiple aetiologies. The core symptoms of autism are abnormalities in social interaction, communication and behaviour. The involvement of neurotransmitters such as 5-HT has been suggested in neuropsychiatric disorders and particularly in autistic disorder. Increased platelet 5-HT levels were found in 40% of the autistic population, suggesting that hyperserotonaemia may be a pathologic factor in infantile autism. Therefore, it is of interest to assess the efficacy of cyproheptadine, a 5-HT2 antagonist in the treatment of autistic disorder. In this 8-week double-blind, placebo-controlled trial, we assessed the effects of cyproheptadine plus haloperidol in the treatment of autistic disorder. Methods: Children between the ages 3 and 11 years (inclusive) with a DSM IV clinical diagnosis of autism and who were outpatients from a specialty clinic for children at Roozbeh Psychiatric Teaching Hospital were recruited. The children presented with a chief complaint of severely disruptive symptoms related to autistic disorder. Patients were randomly allocated to cyproheptadine + haloperidol (Group A) or haloperidol + placebo (Group B) for an 8-week, double-blind, placebo-controlled study. The dose of haloperidol and cyproheptadine was titrated up to 0AE05 and 0AE 2m g/kg//day respectively. Patients were assessed by a third-year resident of psychiatry at baseline and after 2, 4, 6 and 8 weeks of starting medication. The primary measure of the outcome was the Aberrant Behaviour Checklist-Community (ABC-C) and the secondary measure of the outcome was the Childhood Autism Rating Scale (relating to people and verbal communication). Side effects and extrapyramidal symptoms were systematically recorded throughout the study and were assessed using a checklist and the Extrapyramidal Symptoms Rating Scale, administered by a resident of psychiatry during weeks 1, 2, 4, 6 and 8. Results: The ABC-C and the Childhood Autism Rating Scale scores improved with cyproheptadine. The behaviour of the two treatments was not homogeneous across time (groups-by-time interaction, Greenhouse‐Geisser correction; F = 7AE30, d.f. = 1AE68, P = 0AE002; F = 8AE21, d.f. = 1AE19, P = 0AE004 respectively). The difference between the two treatments was significant as indicated by the effect of group, and the between-subjects factor (F = 4AE17, d.f. = 1, P = 0AE048; F = 4AE29, d.f. = 1, P = 0AE045 respectively). No significant difference was observed between the two groups in terms of extrapyramidal symptoms (P = 0AE23). The difference between the two groups in the frequency of side effects was not significant. Conclusion: The results suggest that the combination of cyproheptadine with a conventional antipsychotic may be superior to conventional antipsychotic alone for children with autistic disorder. However the results need confirmation by a larger randomized controlled trial.

Seasonal variation of serum 25 hydroxy D3 in residents of Tehran

Abstract: Background and aim: vitamin D is essential for bone health. It has been shown that in many communities serum levels of vitamin D can be subject to seasonal variations but so far no study has been conducted on this variable in natives of Tehran. Subjects and Methods: 1172 natives of Tehran, 682 women and 490 men, aged 3–69 yr entered the study. Sampling was performed monthly except during Ramadhan, the holy month of Islamic fasting. Serum 25-hydroxyvitamin D (25-OHD) was measured using protein binding assay and levels below 20 ng/ml were determined as vitamin D deficient. Results: serum 25-OHD concentrations showed monthly variations in both sexes but the magnitude of variations was more pronounced in men. The nadir of serum levels in both sexes were seen in December and February, 12±13 and 14±14 ng/ml in women, and 28±16 and 24±18 mg/ml in men, respectively with the highest values being seen in October; 29±29 ng/ml in women and 55±27 ng/ml in men. During the whole period of study the maximum values for women were either equal or less than the minimum values for men. The values for men during summer and winter (31±17 and 28±22 ng/ml, respectively) were significantly lower than the values for spring and fall (38±27 and 43±29 ng/ml respectively). In women there was no significant difference in the values of the first three seasons and only the values pertaining to winter were significantly different from the values of fall.

The distribution of Entamoeba histolytica and Entamoeba dispar in northern, central, and southern Iran

Abstract: The present study was carried out from August 1999 through February 2002 in order to determine the prevalence of Entamoeba histolytica and Entamoeba dispar in three different climatic regions of Iran by using a PCR-RFLP method. A total of 16,592 stool samples were randomly collected from different age-groups in central, northern, and southern Iran in both urban and rural areas. The samples were examined by direct and formalin-ether concentration methods. A total of 226 samples were positive for E. histolytica/E. dispar cysts. Of these, 101 isolates were cultured and maintained successfully in Robinson’s medium and were identified by the PCR-RFLP method. The study showed that 92.1% of isolates were E. dispar and 7.9% were E. histolytica or mixed infections. The ratio of E. histolytica to E. dispar was higher in southern regions (tropical and subtropical) than in the other two regions. This study demonstrated that E. dispar is the predominant species found among “cyst passers” in Iran.

Female paraurethral cysts: experience of 25 cases

Abstract: OBJECTIVE To report and describe the diagnosis and treatment of female paraurethral cysts. PATIENTS AND METHODS Twenty-five cases of cysts of the external female genitalia were diagnosed over a 7-year period, using a physical examination, routine blood tests, urine analysis, abdominal ultrasonography and cysto-urethroscopy in all. The cysts were incised, drained and marsupialized; no attempt was made to excise or remove the internal wall of the cyst and it remained in situ. RESULTS All patients responded to simple marsupialization, with no recurrence of the cyst. CONCLUSION Cysto-urethroscopy and a limited laboratory and imaging evaluation were enough for the diagnosis.

Randomized trial of a single, double and triple dose of 10 mg/kg of a human formulation of triclabendazole in patients with fascioliasis.

Abstract: 1. A study performed > 10 years ago and case reports published recently suggest that triclabendazole is effective for the treatment of patients with fascioliasis. 2. To confirm the efficacy of a human formulation of triclabendazole, we enrolled 165 patients into the present study and divided the subjects into two groups: (i) those who had fascioliasis, as evidenced by the presence of ova in their stools; and (ii) patients with clinical and laboratory data suggesting fascioliasis. 3. Patients were randomly allocated to receive 10 mg/kg, p.o., triclabendazole for 1, 2 or 3 days (single-, double- and triple-dose groups, respectively). Medical history and physical and laboratory examinations were performed at baseline and at 7, 14, 30 and 60 days after treatment. Results were based on 152 patients who completed the study. 4. A sharp decrease in the proportion of clinical signs and symptoms was observed in all groups immediately after treatment. Ova disappeared from the stools of all patients in the single- and double-dose groups. Thirty days after treatment, ova were identified in the stools of two patients in the triple-dose group who received a second course of triclabendazole. 5. All cases were cured on day 60. However, the cure rate was lower when the patients with suggestive fascioliasis were included in the analysis. The cure rate was not significantly different (P > 0.05) among the three dose groups. No cases of toxic hepatitis were observed. 6. In conclusion, oral administration of 10 mg/kg of the human pharmaceutical preparation of triclabendazole for 1-3 days is safe and effective in the treatment of human fascioliasis.

Anthocyanins from Vaccinium arctostaphylos berries

Abstract: The systematic investigation of the berries of Vaccinium arctostaphylos L. (Ericaceae), a native medicinal plant growing in Iran, permitted the identification of three major anthocyanins. The compounds were isolated from the acidified extract of the berries using the repeated paper chromatography with different mobile phases and were characterized using chromatographic, chemical, and spectroscopic methods as delphinidin 3-O-β-glucoside, petunidin 3-O-β-glucoside, and malvidin 3-O-β-glucoside.

Arylamine N-acetyltransferase 2 slow acetylator polymorphisms in unrelated Iranian individuals

Abstract: To determine the frequency of mutations at the polymorphic gene coding for arylamine N-acetyltransferase 2 (NAT2, EC 2.3.1.5) and NAT2 genotypes associated with slow acetylation in healthy Iranian individuals. The polymorphisms in the NAT2 gene from 88 unrelated healthy subjects (48 men/40 women) from the general Tehran population were discriminated using polymerase chain reaction (PCR) with allele-specific primers (341 C>T) and PCR-restriction fragment length polymorphism analysis (481 C>T, 590 G>A, and 857 G>A). Frequencies of the studied polymorphisms showed the most common alleles to be NAT2*4 (0.43) and NAT2*5, 481 C>T (0.32), followed by NAT2*6 (0.19) and NAT2*7 (0.06), previously referred to as WT, M1, M2, and M3, respectively. The most prevalent genotypes were NAT2*4/*5 [(31.8%; 95% confidence interval (CI): 29–34%] and *4/*4 (18.2%; 95% CI: 16–21%). When grouped according to the expected phenotypical effects, the resulting genotypes revealed the significant prevalence of the subjects with slow (32.9%) and intermediate (48.9%) acetylation status compared with wild-type rapid (18.2%) acetylators (P<0.01). The overall allele pattern and acetylator status distribution in Iranians displayed the considerable prevalence of “slow acetylators” over “rapid acetylators,” similar to those of Caucasians except for a minor difference observed in the frequency of the NAT2*7 allele. Nucleic acid testing for common NAT2 mutations might be a potentially useful tool for an accurate phenotype interpretation and identification of Iranian individuals at risk.

Microleakage assessment of pit and fissure sealant with and without the use of pumice prophylaxis.

Abstract: Summary. Objectives. This study evaluated the effect of pumice prophylaxis on the level of microleakage around and between the sealant and enamel. Materials and methods. A total of 32 freshly extracted sound upper first premolars, assigned as suitable for sealant application, were chosen and divided randomly into two groups: (1) a test group, without prophylaxis; and (2) a control group, with prophylaxis. Sealant was applied to all teeth using the same conventional technique, with prophylaxis being omitted in the test group. The sealed teeth were thermocycled (120 × 30 s, 5 and 55 °C cycles) and then immersed in 2% Basic Fuchsin solution for 72 h. Each tooth was sectioned and examined for dye penetration under a stereomicroscope (× 60 magnification). Results. No dye penetration was seen in 19 (29·6%) of the teeth in the test group and 36 (56·2%) of the teeth in the control group. Dye had penetrated to the base of the fissure in 31 (48·4%) of the teeth in the test group and 23 (35·9%) of the teeth in the control group. Using a chi-square test for trend, the frequency of microleakage was significantly higher in the test group compared to the controls (P < 0·016). Conclusion. Prophylaxis has a role in improving sealant retention. Removing this step may cause an increase in microleakage.

Is bladder cancer more common among opium addicts

Abstract: Purpose: Many environmental and occupational risk factors have been proposed for bladder cancer, among which opium consumption has been considered in few studies. We designed a study to determine the relationship between opium consumption and bladder cancer. Materials and Methods: In a retrospective, case-control study, male patients with bladder cancer, who had been referred to our hospital in a three-year period, were selected. Data regarding age, gender, smoking, and opium consumption were collected from patients' records and compared with data of a control group, consisting of patients with benign prostatic hyperplasia (BPH). Results: Fifty-two male patients with bladder tumor (group 1) were compared with 108 patients with BPH (group 2). Of the patients with bladder cancer, 36 (68%) were smokers, of whom 12 were also opium addicts. In general, 13 (25.5%) patients were opium consumers (one opium consumer was not smoker). From 108 patients with BPH, 25 (23%) were smokers, of whom, 5 were also opium addicts. Mean duration of cigarette smoking was 31 ± 13.6 and 20.2 ± 14.7 years in patients with bladder cancer and BPH, respectively. The duration of opium consumption was 11.9 ± 1.4 and 6.2 ± 1.3 years in groups 1 and 2, respectively. The duration of cigarette smoking and opium consumption in group 1 was greater than that in group 2. In addition, smoking increases the risk of bladder cancer 3.8-fold (OR = 8.3, 95% CI = 1.8-7.8). Simultaneous cigarette smoking and opium consumption increases the risk of bladder cancer 6.2-fold (OR = 6.2, 95% CI = 2.04-18.7). Conclusion: There are few studies regarding the carcinogenic effect of opium on bladder. We demonstrated that, the incidence of bladder cancer in smokers, who are simultaneously opium consumers, was higher than in patients who were only smokers. Simultaneous opium addiction and cigarette smoking may have some roles in the pathogenesis of bladder tumor. However, further studies with large sample sizes are warranted.

Synthesis and cytotoxic evaluation of two novel anthraquinone derivatives.

Abstract: The antitumor activity of dihydroxyanthracenediones such as mitoxantrone on a panel of cancer cell lines during the last 30 years, led investigators to synthesize thousands of anthracycline analogs and test their cytotoxicity to identify compounds superior to the parent drugs in terms of increased therapeutic effectiveness, reduced toxicity or both. To achieve this, new synthesized congeners either have different side arms or have extra rings on their skeletons. Following these studies, we proposed total synthesis of 2-amino- N -[4-(2-amino-3-hydroxy-propionylamino)-9,10-dioxo-9,10-dihydroanthracene-1-yl]-3-hydroxy-propionamide (V) and 6-amino-hexanoic acid [4-(5-amino-pentanoylamino)-9,10-dioxo-9,10-dihydro-anthracen-1-yl]-amide (VI). Acetylation of 1,4-diaminobenzene using acetyl chloride and reaction with phthalic anhydride under a Friedel–Crafts reaction and then cyclization gave 1, 4-diamino-anthraquinone. This compound was reacted with two amino acids ( l -serine and 6-amino hexanoic acid) in their ester forms, using ethyl chloroformate as a coupling agent. Hydrolyzing esterified compounds gave their amino substituted derivatives. These compounds with diamine side arms are supposed to provide better intercalation with DNA. Synthesized novel ametantrone derivatives were tested against a panel of cancer cells (KB, Hela, MDA-MB-468 and K562), using MTT assay. The results showed that tested compounds inhibited the growth of cancer cells at micromolar concentrations. However, compound (VI) was more cytotoxic than compound (V) probably because of its longer side chains and better intercalation with DNA.

Analysis of smoking behaviour among Iranian population: a cohort and period analysis.

Abstract: BACKGROUND The patterns of smoking in ageing cohorts are important to public health authorities. The aim of this study is to describe the patterns of smoking among Iranian population. METHODS Data from cross-sectional surveys of Health and Disease Survey (HDS) in Iran were utilized. Smoking was categorized as no smoker, light smoker (less than 10 cigarettes a day), moderate smokers (10 to 20 cigarettes a day), and heavy smoker (more than 20 cigarettes a day). Age group cohorts were constructed by following each age group to the next age group in two consecutive surveys. The change in smoking behavior was express as the difference of smoking prevalence and 95% confidence interval around the difference were constructed. Three birth cohorts of 1930, 1960, and 1975 were constructed among smoker and their age at initiation of smoking were assessed for the three cohorts. RESULTS Smoking was more prevalent among age group 25-39 in males and age group 40-60 in females. Smoking prevalence increased in all categories of smoking behavior among male cohort of 15-25 year age-group and stayed stable afterward up to their 40's. After age 40, the prevalence of smoking decreased in heavy smokers and stayed stable in light and moderate smokers. A different pattern was seen among female smokers. Age at initiation of smoking decreased in the last decades. Among the male birth cohort of 1930, just 32.6% of smokers started smoking before age 20 compared with 48.7% in birth cohort of 1975, P value < 0.0001. Similar pattern was seen among the female smokers. CONCLUSIONS The pattern of smoking in Iranian population high lights the fact that smoking behavior is highly age dependent.

A Comparison between Laparoscopic and Open Pyeloplasty in Patients with Ureteropelvic Junction Obstruction

Abstract: Purpose: To compare clinical and radiological outcomes, complications, and hospital stay in laparoscopic and open pyeloplasty. Materials and Methods: From February 2002 to February 2003, 69 patients with ureteropelvic junction obstruction (UPJO) were assigned into two groups. Thirty-seven patients underwent transperitoneal laparoscopic pyeloplasty and 32 underwent open surgical pyeloplasty. Clinical symptoms were assessed before and after surgery, subjectively. Radiological assessment was also done three months postoperatively. Results: Mean operative time was 3.2 hours and 2.2 hours in laparoscopic and open pyeloplasty groups, respectively. Intraoperative bleeding was trivial in both groups and no complication or conversion to open surgery occurred. Postoperative complication rates were 24% and 6% in laparoscopic and open pyeloplasty groups, respectively. Mean hospital stay was similar (6.2 days) in the two groups. Mean follow-up was 16.5 months versus 11.4 months. Clinical and radiological success rates were 89% and 83.8% for laparoscopy group versus 96.5% and 87% for open pyeloplasty group. Due to recurrence of stricture, repeated surgery was performed in 4 patients of laparoscopy and 1 of open pyeloplasty groups. Conclusion: Laparoscopic pyeloplasty is a less invasive method with less pain, cosmetic advantages, no long incision, and outcome comparable with open surgery. Hospital stay is also not longer than that in open surgeries. Hence, laparoscopic pyeloplasty can be a substitute for skilled surgeons.

Management of magnetic intravitreal foreign bodies in 71 eyes.

Abstract: Background and objective To evaluate the management of a series of eyes with magnetic intravitreal foreign bodies. Patients and methods This retrospective review examined consecutive cases of ocular injury associated with intraocular foreign bodies; 71 eyes included had a single metallic intraocular foreign body ( Results Factors predictive of good visual outcome (visual acuity > 20/200) were: shortest interval between trauma and foreign body extraction, preoperative visual acuity of 20/200 or better, and absence of afferent pupillary defect. Conclusions In this nonrandomized study, good visual results could be obtained in eyes undergoing prompt foreign body removal, especially those with good preoperative visual acuity and no afferent pupillary defect.

N,N-Diethyl N-Methyl Chitosan as an Enhancing Agent for Colon Drug Delivery

Abstract: Chitosan exhibits poor solubility above pH 6 which prevents absorption at treatment sites in the colon. pH titrations and infrared methods were used to determine the degree of deacetylation of the starting chitosan. In the present work, N,N-diethyl N-methyl chitosan (DEMC) was synthesized based on a modified two-step process via a 2 2 factorial design to optimize the preparative conditions. DEMC chloride was characterized using FTIR and 1 H NMR spectroscopy. For pharmacological and pharmaceutical applications, DEMC needs to have specific degrees of quaternization. Based on the 1 H NMR data, a high degree of quaternization was achieved by the two-step process. The N-diethyl methyl chitosan chlorides were completely soluble in water at room temperature. Sodium fluorescein and brilliant blue were used as model reagents for in vitro colonic absorption studies. These studies show a significant increase in the absorption of sodium fluorescein and brilliant blue in the presence of DEMC in comparison with normal chitosan. DEMC with positive charge is able to interact with tight junctions of colon epithelial cells and hence increased the permeability of sodium fluorescein and brilliant blue across the tight junctions. These investigations demonstrated that the DEMC derivative of chitosan could have a significant effect on colonic drug absorption.

Lacunar stroke associated with methylphenidate abuse.

Abstract: Introduction: Le methylphenidate est un stimulant du systeme nerveux central utilise dans le traitement du syndrome d'hyperactivite/deficit d'attention et de la narcolepsie et, comme d'autres psychostimulants, peut entrainer des abus. Presentation de cas: Il s'agit d'un jeune homme qui a subi un infarctus cerebral lacunaire suite a l'abus oral chronique de methylphenidate. Conclusions: L'experience de notre patient et une revue de la litterature suggerent que l'infarctus cerebral puisse etre un effet secondaire de la consommation chronique de methylphenidate.