A clinical and molecular genetic study of 112 Iranian families with primary microcephaly.

BACKGROUND: Primary microcephaly (MCPH) is a genetically heterogeneous disorder showing an autosomal recessive mode of inheritance. Affected individuals present with head circumferences more than three SDs below the age- and sex-matched population mean, associated with mild to severe mental retardation. Five genes (MCPH1, CDK5RAP2, ASPM, CENPJ, STIL) and two genomic loci, MCPH2 and MCPH4, have been identified so far. METHODS AND RESULTS: In this study, we investigated all seven MCPH loci in patients with primary microcephaly from 112 Consanguineous Iranian families. In addition to a thorough clinical characterisation, karyotype analyses were performed for all patients. For Homozygosity mapping, microsatellite markers were selected for each locus and used for genotyping. Our investigation enabled us to detect homozygosity at MCPH1 (Microcephalin) in eight families, at MCPH5 (ASPM) in thirtheen families. Three families showed homozygosity at MCPH2 and five at MCPH6 (CENPJ), and two families were linked to MCPH7 (STIL). The remaining 81 families were not linked to any of the seven known loci. Subsequent sequencing revealed eight, 10 and one novel mutations in Microcephalin, ASPM and CENPJ, respectively. In some families, additional features such as short stature, seizures or congenital hearing loss were observed in the microcephalic patient, which widens the spectrum of clinical manifestations of mutations in known microcephaly genes. CONCLUSION: Our results show that the molecular basis of microcephaly is heterogeneous; thus, the Iranian population may provide a unique source for the identification of further genes underlying this disorder.

Prevalence of underweight, overweight and obesity among high-school girls in Sistan va Baluchistan.

This descriptive study determined the prevalence of underweight, overweight and obesity among 752 high-school girls aged 14-18 years in Sistan va Baluchistan province, Islamic Republic of Iran. Using the Centers for Disease Control and Prevention body mass index percentiles, the prevalences of underweight, overweight and obesity were 16.2%, 8.6% and 1.5% respectively. These rates were similar to the ones obtained using World Health Organization, First National Health and Nutrition Examination Survey, and International Obesity Task Force criteria. The frequency of underweight in high-school girls in this province is higher than most countries and other parts of the Islamic Republic of Iran.

Couple communication in family planning decision-making in Zahedan, Islamic Republic of Iran.

A qualitative study in Zahedan, Islamic Republic of Iran, used focus group discussions with 120 people in 8 main groups to understand more about couple's decision-making and the role of men in family planning. The study included men and women from Sunni and Shia sects as well as theologians from both sects. Shiites, lay people and theologians, believed that both husband and wife play a major role in decision-making about family planning, while Sunnis believed that men are the main decision-makers. All participants believed that men have an important role in family planning, but also that men do not like attending family planning clinics. Religious tenets were important in couple's decision-making about using contraceptives but there were confusions over different teachings.

Contraception continuation rates and reasons for discontinuation in Zahedan, Islamic Republic of Iran.

We evaluated contraception continuation rates and discontinuation reasons in Zahedan among 1741 women from 1998-2000. By Kaplan-Meier technique continuation rates were 92% for low dose combined hormonal oral contraceptives (OC), 86% for a levonorgestrel-releasing implant, 82% for intrauterine devices (IUD) and 53% for medroxyprogesterone acetate at the first year. After 3 years, continuation was 78% for levonorgestrel implant, 70% for OC, 60% for IUD and 44% for medroxyprogesterone acetate. The commonest reason for discontinuing OC and medroxyprogesterone acetate was changing method; for IUD and levonorgestrel-releasing implant, the commonest reason was side-effects. By Cox regression model, continuation rate and contraceptive type were significantly related to health centre.

Knowledge, perceptions and prevention of malaria among women in Sistan va Baluchestan, Islamic Republic of Iran.

A questionnaire about malaria knowledge, beliefs and practices was given to a random sample of 2168 married women from rural and urban areas of Sistan va Baluchestan, Islamic Republic of Iran. The mean knowledge score of subjects was low at 5.5 (maximum 15.0). Few respondents (37.6%) knew that malaria was an important disease in the area and only 58.4% knew that malaria was transmitted by mosquitoes. Most subjects (69.4%) never used a mosquito net. Only 49.9% of rural and 73.8% of urban residents would seek care for fever and chills from the local health centre. Community health workers (behvarz) were the main source of information (29.5%) for rural women; the role of physicians in education was minimal. Subsequent health education must be tailored to the educational needs of the target population in this area.

Opioid use in patients presenting with pain in Zahedan, Islamic Republic of Iran.

To study the prevalence and factors associated with opioid use in pain, 480 consecutive patients with a chief complaint of pain were interviewed at 10 clinics in Zahedan. The data were analysed in relation to 18 possible associated factors. The prevalence of opioid use was 28.5% in patients presenting with pain. There was no significant relation between opioid use and chronic pain (> or = 6 months), but there was a relationship with the following 5 factors: previous opioid use by friends (72.9% versus 20.4% without friends using), occupation (58.5% private sector employees/self-employed versus 17.4% housewives), cigarette smoking (60.8% versus 21.8% not smoking), consultation for a psychological problem (38.3% versus 23.3% without), and death of a spouse (60.0% versus 26.1% without).

Co-infection of Malaria and Crimean-Congo Hemorrhagic Fever.

Southeast of Iran is an endemic area for Malaria and Crimean-Congo hemorrhagic fever (CCHF). In 1999, we faced with an outbreak of CCHF in Sistan and Baluchistan Province, in the border of Pakistan and Afghanistan. The most cases of Malaria in Iran are also reported from this area. This article presents a 17-year- old woman who admitted to our hospital because of acute fever, headache, epistaxis, hemorrhagic lesions on the skin and vaginal bleeding. Finally, she was recognized as a case that was co -infected with CCHF and malaria.

Continuation of breastfeeding: is this a problem in Southeast Iran?

BACKGROUND: Despite widespread knowledge about breastfeeding benefits for mothers and neonates, duration of breastfeeding is decreasing in most countries. Many factors have an effect on continuation of breastfeeding. This study was designed to evaluate duration of breastfeeding and its associated factors in rural and urban children. METHODS: In a historical cohort study, health files of 1,264 Iranian children under 3 years old were selected by the multistage sampling method in the Zabol district, located in southeast Iran. Two lists of rural and urban health centers based on their distance were prepared, and by systematic sampling technique three centers were selected in each list. Tables, Kaplan-Meier analysis, and median and mean O SD values were used for data description; log-rank test and the Cox proportional hazard model were applied for data analysis. RESULTS: The mean duration of exclusive breastfeeding was 5.6 +/- 1.3 months, and the mean duration of any breastfeeding was 20.8 +/- 4.69 months. All children had started breastfeeding at birth. Breastfeeding continuation at 6, 12, 18, and 24 months was 98%, 92%, 76%, and 0.97%, respectively. Maternal age, mother's job, education level, living area, child's birth weight, child's birth rank, birth intervals, and age of onset of supplementary food had a significant relationship with breastfeeding continuation. CONCLUSIONS: Some risk factors for breastfeeding continuation were found, and it is suggested that more attention be paid to them in education programs by the health system.