Cross-reactivity between Mycobacterium avium subspecies paratuberculosis 4027 peptide and Human IRF5 may contribute to Multiple Sclerosis in Iranian patients.

Background: The etiology of Multiple sclerosis (MS) is complicated and can be affected by several environmental factors, such as Mycobacterium avium subspecies paratuberculosis (MAP) infection in genetically predisposed individuals. The link between MAP and MS depends on host genetic and epigenetic aspects and population-based features that require further investigation. We aimed to study the possible role of MAP in triggering MS using molecular and serological methods. Materials and methods: This case-control study examined 200 blood samples (100 MS patients and 100 HCs) to search for the MAP-specific IS900 gene. In addition, ELISA was conducted to determine the humoral response against MAP_402718-32 and its human IRF5424-434 peptide homolog. Results: The frequency of MAP detection based on the molecular method in MS patients and HCs was 48 % and 13 %, respectively (p < 0.0001). The presence of antibodies against MAP_402718-32 and IRF5424-434 was 55 % and 65 % in MS patients versus 9 % and 7 % in HCs, respectively (p < 0.0001). A good correlation was observed between MAP_4027 and IRF5 antibodies (r = 0.5782, p < 0.0001), indicating that the same antibodies recognized common peptide epitopes. Conclusion: Our research revealed a significant association between MAP and MS, highlighting the possible role of MAP as an important infection trigger factor of MS. It is hypothesized that cross-reactivity between MAP4027 and IRF5 may dysregulate immune homeostasis.

Cannabinoid CB2 Receptor Functional Variation (Q63R) Is Associated with Multiple Sclerosis in Iranian Subjects.

The cannabinoid system has been identified as a critical endogenous regulator of immune homeostasis through immunomodulatory actions. This system is one of the main regulatory systems of the central nervous system (CNS). Variations in the cannabinoid CB2 receptor gene (CNR2) could affect intracellular signaling and reduce system function, which has been associated with an unbalanced immune response and increased risk of a variety of autoimmune inflammatory disorders. The present study investigated the relationship between CNR2 rs35761398 (Q63R) functional variation and multiple sclerosis (MS). A total of 100 Iranian MS patients and 100 healthy controls were enrolled in the study and genotyped through TaqMan assay. The co-dominant, dominant, recessive, over-dominant, and additive inheritance models were analyzed using SNPStats software. A significant genetic association was observed between Q63R polymorphism and MS. The dominant model was accepted as the best inheritance model to fit the data (OR 2.70, 95% CI 1.47-4.97, p = 0.001). The data implied the involvement of the CNR2 gene in susceptibility to MS in Iranian patients.

Differential diagnosis of cervical malignant lymphadenopathy among Iranian patients.

OBJECTIVE: To investigate the differential diagnosis in cases referred with neck lumps suspicious to malignant nodal masses and its relation to demographic variants. METHODS: Individuals who entered in this cross-sectional study conducted at the Department of Otolaryngology, Ghaem Medical Center, Mashdad, Iran from May 1995 to April 2005 were re-evaluated by history taking, physical examination and imaging studies. Fine needle aspiration was applied to obtain tissue sampling. Among the patients, 232 cases had malignant disease confirmed by pathology reports. Cases with unknown primary tumor underwent investigations including pan-endoscopy, and further imaging studies were carried out to determine the primary tumor site. Demographic data as gender, age, location, size, and pathology of tumor were considered. RESULTS: The results of this study showed that 50% of patients which were referred with neck masses had malignant neoplasm. The most common pathology in patients younger than 40 years were lymphoma (55%) and thyroid cancer (26%), whereas, in patients older than 40 years squamous cell carcinoma (67%) was more common. The most involved lymph nodes were jugulodigastric chain. Larynx and hypopharynx are the most common sources of aerodigestive tract metastatic. CONCLUSION: According to high incidence malignancy (50%) among neck lesions, an asymmetrical neck mass in adults should be considered malignant until proven otherwise. It seems that age is an important predictor of tumor pathology, and determination of further diagnostic investigations would be helpful.

Heart Disease Is Associated With Anthropometric Indices and Change in Body Size Perception Over the Life Course: The Golestan Cohort Study.

BACKGROUND: Cardiovascular disease and obesity are now becoming leading causes of morbidity and mortality in low- and middle-income countries. OBJECTIVES: We investigated the relationship between prevalent heart disease (HD) and current anthropometric indices and body size perception over time from adolescence to adulthood in Iran. METHODS: We present a cross-sectional analysis of baseline data from a prospective study of adults in Golestan Province, Iran. Demographics, cardiac history, and current anthropometric indices-body mass index, waist circumference, and waist to hip ratio-were recorded. Body size perception for ages 15 years, 30 years, and at the time of interview was assessed via pictograms. Associations of these factors and temporal change in perceived body size with HD were evaluated using multivariable logistic regression models. RESULTS: Complete data were available for 50,044 participants; 6.1% of which reported having HD. Higher body mass index, waist circumference, and waist to hip ratio were associated with HD (p < 0.001). Men had a U-shaped relationship between HD and body size perception at younger ages. For change in body size perception, men and women demonstrated a U-shaped relationship with prevalent HD from adolescence to early adulthood, but a J-shaped pattern from early to late adulthood. CONCLUSIONS: HD was associated with anthropometric indices and change in body size perception over time for men and women in Iran. Due to the increasing prevalence of overweight and obesity in low- and middle-income countries, interventions focused on decreasing the cumulative burden of risk factors throughout the life course may be an important component of cardiovascular risk reduction.

Comparison of sinonasal symptoms in patients with nasal septal deviation and patients with chronic rhinosinusitis.

INTRODUCTION: Disorders of the nose and paranasal sinuses are among the most common chronic illnesses. Although considerable progress has been made in the medical and surgical control of these diseases, a large number of questions relating to the diagnosis, evaluation, and treatment of these conditions remain unanswered. The aim of the present study was to evaluate differences in the frequency of symptoms and disease severity in patients with nasal septal deviation (NSD) compared with chronic rhinosinusitis (CRS). MATERIALS AND METHODS: A total of 156 patients, divided into NSD and CRS groups, were studied in relation to symptoms and disease severity. Patients were selected from those referred to the Ear, Nose, and Throat (ENT) Wards of the Imam Reza and Ghaem Hospitals, who had not responded to a variety of treatments. Depending on the type of disease, patients were candidates for either septoplasty or endoscopic sinus surgery. The Rhinosinusitis Symptom Inventory was administered to measure the severity of symptoms, with scores assigned based on the answers given by patients (Likert scale). Scores were compared between the CRS and NSD groups. RESULTS: A total of 156 patients (78 with NDS and 78 with CRS) entered the study in overall sinonasal symptoms were more prevalent in CRS group. Nasal congestion, runny nose, earache, toothache, and smelling disorder were significantly more common in the CRS group (P<0.001); while there were no significant differences in symptoms such as facial pressure, fever, or headache between the two groups (P>0.05). CONCLUSION: Patients with CRS manifested statistically significantly greater sinonasal symptom scores than patients with NSD.

Histopathologic Relationship Between Ethmoid Sinus and Ipsilateral Middle Turbinate in Non-Polypose Chronic Sinusitis by FESS.

Chronic rhinosinusitis (CRS) is a common disease with significant effects on the quality of life. Infection was previously a common cause of rhino sinusitis, while nowadays its main cause is inflammation. Non-polyposis CRS patients who were resistant to medical treatment and underwent endoscopic sinus surgery in Ghaem and Imam Reza hospitals were studied from December 2008 to November 2009. There were 11 males and four females ranging in age from 14 to 57 years with the average age of 32.2. First, samples were taken from the ethmoid sinus and the ipsilateral middle turbinate. Then, histopathologic research on grade of inflammation, mucosal thickness, inflammatory cell count, metaplasia type, and hypersecretion was performed. Fifteen patients were studied. There were positive statistical correlations between inflammation grade, eosinophil counts and plasma cell counts in ethmoid and turbinate; but such a correlation was not found in lymphocyte and neutrophil in two sites. The prominent inflammatory cell in both areas was the same for 11 patients; whereas in other four cases, it was insignificantly different. Positive statistical correlation between the inflammation grades in two sites shows the coexistence of rhinitis and sinusitis; therefore, this proves the correct combination usage of rhinosinusitis. Prominent cells of the samples which were obtained from two places were similar for most patients, so this similarity is a sign of inflammatory process presence in both places. The prominent cells were mostly lymphocytes.There were more lymphocytes than eosinophils in non-allergic patients.

Assessment of aminoglycoside-induced hearing impairment in hospitalized neonates by TEOAE.

CONTEXT: Aminoglycosides, as potent bactericidal antibiotics against aerobic gram-negative infections, is still widely used, especially in NICU patients, despite their known potential ototoxic effects. AIMS: To evaluate the potential of transient evoked otoacoustic emissions (TEOAEs) in early identification of decreased hearing sensitivity in hospitalized neonates receiving aminoglycosides for severe gram-negative infections. MATERIALS AND METHODS: Fifty (50) neonates treated with intravenous gentamicin (5 mg/kg/day) or amikacin (15 mg/kg/day) were tested with TEOAE in the beginning and the end of aminoglycoside therapeutic course. There were 23 males and 27 females, ranging from 29 to 40 weeks (mean: 36 weeks). The treatment duration was 3-30 days (in 26 neonates up to 7 days - group A, and in 24 neonates higher than 7 days - group B). RESULTS: In group A, no statistically significant difference in the mean response level was found between the onset and the end of treatment course (p > 0.001). In group B, a statistically significant difference in the mean response level was found between the onset and the end of treatment course, especially at high frequency region (p < 0.001). CONCLUSIONS: TEOAE is sensitive enough to detect early aminoglycoside ototoxicity. As this test is simple to perform, non-invasive and reliable, so we suggest that TEOAE test should be performed in NICU as routine for monitoring cochlear function to prevent permanent hearing loss especially in those who are receiving aminoglycoside for more than 7 days.