Examining the relationship between land use and childhood leukemia and lymphoma in Tehran.

We conducted a hospital-based case-control study to explore the association between proximity to various land use types and childhood leukemia and lymphoma. This research involved 428 cases of childhood leukemia and lymphoma (2016-2021), along with a control group of 428 children aged 1-15 in Tehran. We analyzed the risk of childhood cancer associated with land use by employing logistic regression adjusted for confounding factors such as parental smoking and family history. The odds ratio (OR) for children with leukemia and lymphoma residing within 100 m of the nearest highway was 1.87 (95% CI = 1.00-3.49) and 1.71 (95% CI = 1.00-2.93), respectively, in comparison to those living at a distance of 1000 m or more from a highway. The OR for leukemia with exposure to petrol stations within 100 m was 2.15 (95% CI = 1.00-4.63), and for lymphoma it was 1.09 (95% CI = 0.47-2.50). A significant association was observed near power lines (OR = 3.05; 95% CI = 0.97-9.55) within < 100 m for leukemia. However, no significant association was observed between power lines and the incidence of childhood lymphoma. There was no association between bus stations, major road class 2, and the incidence of childhood leukemia and lymphoma. In conclusion, our results suggest a possible association between the incidence of childhood leukemia and proximity to different urban land uses (i.e., highways and petrol stations). This study is the first step in understanding how urban land use affects childhood leukemia and lymphoma in Tehran. However, comprehensive studies considering individual-level data and specific pollutants are essential for a more nuanced understanding of these associations.

The c.1243T>C mutation in the PROC gene is linked with inherited protein C deficiency and severe purpura fulminans.

Purpura fulminans is a severe coagulation disorder that often leads to death in neonates. Mutations in the protein C (PROC) gene can cause protein C deficiency, leading to this disorder. This study aimed to investigate a family with a history of coagulopathies, particularly those related to protein C deficiency. The primary objective was to identify any genetic mutations in the PROC gene responsible for the coagulopathies. The study focused on a male neonate with purpura fulminans who ultimately died at 2 months of age. The patient had low protein C activity levels (6%). The entire PROC gene of the patient and his family was analyzed using next-generation sequencing to identify any genetic mutations. Segregation analysis was conducted to determine if the mutation followed an autosomal dominant inheritance pattern. In silico analysis was also conducted to evaluate the pathogenicity of the identified mutation. Analysis revealed a novel homozygous c.1243T>G variant PROC gene. The mutation resulted in a Phe415Val substitution. The mutation was found in at least three generations of the family. Carrier family members had lower protein C activity levels than wild-type homozygotes. Additionally, the mutation may account for the observed reduction in protein C enzyme activity.

Bilateral hip septic arthritis caused by nontyphoidal Salmonella group D in a 16-year-old girl with COVID-19: A case report.

INTRODUCTION AND IMPORTANCE: Nontyphoidal Salmonella infection can lead to gastroenteritis, enteric fever, and bacteremia. However, joint infections due to this bacterium are rare, and usually associated with immunosuppressive disorders. CASE PRESENTATION: A 16-year-old girl, with a recent history of acute lymphocytic leukemia (ALL) presented with bacteremia, and bilateral hip pain after COVID-19 symptoms. Clinical presentation, laboratory features and imaging showed bilateral nontyphoidal Salmonella septic arthritis. We administered antibiotics, based on antibiotics susceptibility pattern of the isolated Salmonella. CLINICAL DISCUSSION: The case is presented because reports of bilateral hip joint infection due to nontyphoidal Salmonella are rare especially after COVID-19. When the patient presents with joint discomfort, the clinician should think infection especially in immunocompromised hosts. CONCLUSION: It illustrates successful management of septic arthritis requires prompt clinical diagnosis, microorganism identification, administration of appropriate systemic antibiotics and hip joint surgery.

Identification of Antibodies against Neutrophil Surface Antigens in Two Iranian Patients with Autoimmune Neutropenia.

Autoimmune neutropenia is a type of immune-mediated neutropenia, caused by antibody-induced neutrophil destruction. Here we report two cases (3-year-old boy and 9-year-old girl) with suspected autoimmune neutropenia. The presence of neutrophil antibodies in sera of these patients was investigated using standard neutrophil antibody screening tests such as granulocyte immunofluorescence test (GIFT), granulocyte agglutination test (GAT), and lymphocyte immunofluorescence test (LIFT). A positive reactivity with two panel cells was found in GIFT. No reactivities with panel cells were observed in GAT and LIFT. To the best of our knowledge, this is the first report for detecting the neutrophil reactive antibodies using genotyped neutrophils in patients with autoimmune neutropenia in Iran. The final diagnosis of our patients was primary autoimmune neutropenia for the boy and autoimmune neutropenia associated with familial Mediterranean fever for the girl.

Effect of Phenobarbital on Nitric Oxide Level in Term Newborn Infants with Perinatal Asphyxia.

OBJECTIVES: Perinatal asphyxia (PA) is very significant in perinatal medicine due to the involvement of the central nervous system. This study was conducted to investigate the biochemical, clinical, and paraclinical changes associated with phenobarbital administration in neonates with PA. METHODS: In this prospective, case-control study, 30 neonates with PA in two groups of 15 each (case and control) were investigated. The case group received 20 mg/kg intravenous phenobarbital within six hours of birth, and the control group did not receive phenobarbital. Serum concentrations of nitric oxide (NO) were measured at enrollment and one week after birth in the two groups. Clinical, electroencephalography, and magnetic resonance imaging findings of the two groups were compared. RESULTS: At enrollment, the two groups did not differ in clinical severity, seizure incidence, or NO concentration. After one week, NO concentration was significantly lower in the case group (p < 0.050), but there was no significant difference in other variables between the two groups. CONCLUSIONS: Early administration of phenobarbital in term neonates with PA could protect them against encephalopathy.

Relationship between Serum Visfatin and Vascular Inflammation Markers Level in Beta Thalassemia Major Patients.

BACKGROUND: Understanding the possible role of visfatin in the pathogenesis of beta-thalassemia major (BTM) and its relationship with markers of endothelial function could help us to provide more effective therapeutic approaches for treatment of patients with BTM and its related complications. The aim of current study was to compare serum level of visfatin between patients with BTM and control group and determine its correlation with markers of endothelial function, intracellular adhesion molecule (ICAM) and vascular adhesion molecule (VCAM). METHODS: In this case-control study, patients with BTM receiving regular blood transfusion aged 10-20 years and a group of healthy subjects were enrolled. Selected subjects examined clinically and venous blood samples obtained for visfatin, ICAM, VCAM, cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol and ferritin measurements. Mean (standard deviation) of studied laboratory measurements compared in two studied groups and the relation between visfatin and ICAM, VCAM, ferrittin, body mass index determined. RESULTS: In this study 31 patients with BTM and 30 healthy controls studied. Mean of visfatin was significantly higher in patients with BTM than control group (133.9 ± 60.1 vs. 43.3 ± 27.9, P < 0.001). CONCLUSIONS: The higher level of visfatin among patients with BTM indicated the possible inflammatory role of this adipocytokine in BTM. It seems that for understanding the underlying mechanisms and its relation with vascular inflammatory markers and endothelial function further studies with larger sample size is needed.