Prevalence of West Nile virus in Mashhad, Iran: A population-based study.

OBJECTIVE: To evaluate the prevalence of West Nile virus seropositivity in the general population of Mashhad, Northeast of Iran. METHODS: One hundred and eighty two individuals living in the city of Mashhad were studied using cluster sampling method. Both IgM and IgG antibodies against WNV were detected by ELISA method. RESULTS: In this study, the overall IgG seroprevalence of positive West Nile virus was 11%; however, IgM antibody was not found in the participants. CONCLUSIONS: Our study suggested that the prevalence rate of West virus is considerable in Mashhad city. It seems necessary for clinicians and health care workers to be aware of WNV infection in the Northeast Iran.

The association between neutrophilic hypersegmentation and iron deficiency with regard to folate status in 16-30 year-old women.

INTRODUCTION: Neutrophilic hypersegmentation (NH) is a hematological anomaly that is mainly related to the deficiency of folic acid and/or cobalamin. There are also controversial studies showing that NH relates to iron deficiency anemia (IDA). The aim of this study was to investigate this relationship by comparing two groups: iron deficient (ID) and IDA. The effect of low normal folate level on this relationship was also investigated. METHODS: In this prospective cohort study, performed in Mashhad, Iran in 2011, ninety 16 - 30 year-old women were selected and divided into three groups, ID, IDA, and control. NH was examined in peripheral blood smears by two experts. CBC was done on a Sysmex K-21 hematologic analyzer. Colorimetric methods were utilized to measure the serum iron and total iron binding capacity. Serum ferritin as well as folate and cobalamin were measured by radioimmunoassay methods. Data was analyzed with SPSS 11.5 software. A p-value < 0.05 was considered to be significant. RESULTS: Twenty nine ID, thirty IDA, and thirty one control participants were studied. Chi square tests showed statically significant differences in NH values among these three groups (p-value = 0.001), and a correlation between NH and decreased serum iron/ferritin levels (p-value = 0.001). With logistic regression analysis, it was observed that the relation between NH and ID/IDA is due to concomitant low normal folate levels (p-value = 0.044). CONCLUSIONS: The detection of NH in a peripheral blood smear of patients with ID/IDA is a possible reason for a coexistence of mild folate deficiency. It is suggested that in addition to ID/IDA, latent folate deficiency should be investigated in these patients.

Homocysteine, Cobalamin and Folate Status and their Relations to Neurocognitive and Psychological Markers in Elderly in Northeasten of Iran.

OBJECTIVE(S): Incidence of neurocognitive and psychological disorders may be related to serum homocystein (Hcy), cobalamin (vitamin B12) and folate levels in old people. The aim of this study was to assess the relation between Hcy, cobalamin, folate and neurocognitive and/or psychological disorders in the elderly. MATERIALS AND METHODS: In this cross-sectional study, 280 subjects with ≥ 65 years old ,were evaluated. The subjects were selected from 12 regions of Mashhad, Iran, over March to October 2009. After blood sampling, data were collected by questionnaire, face to face interview and performing neurocognitive and psychological tests. The sera of 250 persons were analyzed for cobalamin and folate by RIA method. Amongst the aforementioned samples, 78 cases with cobalamin <300 pg/ml and folate <6.5 ng/ml were analyzed for Hcy by ELISA method. RESULTS: Amongst the people, 126 (45%) were male and 154 (55%) were female. The prevalence of hyperhomocysteinemia (HHcy) was 59.5% and 37.1% in male and female respectively (P -value =0.049). Hcy inversely correlated to cobalamin (r=-0.282, P=0.014) and to folate (r=-0.203, P=0.014). Hcy, cobalamin and folate correlations to neurocognitive and psychological impairments were not statically significant. CONCLUSION: Hyper Hcy or low cobalamin and folate in the elderly, are prevalent but their relationships with neurocognitive and psychological impairments is controversial. If these relationships had been confirmed, performing a single serum Hcy or cobalamin test would have been enough enough to diagnose and prevent neurocognitive impairments and inversely, neurocognitive-psychological sign and symptoms could have meant probable tissue vitamin deficiencies. However methods of assessing neurocognitive and psychological markers with validity and reliability of clinical and laboratory tests for finding aforementioned relationships should be revised.

Circumcision in males with bleeding disorders.

INTRODUCTION: Male circumcision practice is an invasive procedure that is using worldwide. It makes challenges to haemostatic system and its possible haemorrhagic side effects are more serious in bleeding individuals than normal subjects. In most cases, it can be complete controlled using infusion of appropriate amount of coagulation factors before and post circumcision. AIM: We aim to documentation type of coagulation therapy and post circumcision practice haemorrhagic presentation among 463 bleeder males of both common and rare bleeding disorders in north eastern part of country. METHODS: We retrospectively gathered information using evaluation medical records in 3 major hospitals during last 15 years and list of patients with bleeding disorders that obtained from haemophilia center. Also a call phone established for each bleeder person to complete data and updating of them. The survey took time from Sep 2009 - Mar 2011. The designed question form included data on doing circumcision or not, types of treatment before and post the procedure and occurrence of bleeding episodes after the surgery. RESULTS: Overall among 424 cases with various common and rare bleeding disorders who had circumcised, 239 cases (56.3%) had passed the procedure with bleeding experience (indication of undiagnosed cases who underwent circumcision or inadequacy of coagulation therapy), while 185 cases (43.7%) had passed it successfully and without noticeable bleeding experience. The types of coagulation therapy in each group have been cited. CONCLUSION: The circumcision practice in unequipped medical center for bleeder ones may make challenges for them and medical services. Also it needed supervision of expert haematologist for.

An investigation of the spectrum of common and rare inherited coagulation disorders in north-eastern Iran.

BACKGROUND: Health care officials and legislators need accurate data on prevalence and numbers of individuals with bleeding disorders in order to plan and allot their budgets; the manufacturers of coagulation factors also need these data to estimate the amount of factors required to prevent scarcity of these products. MATERIALS AND METHODS: We surveyed the prevalence of haemophilia A, haemophilia B, von Willebrand's disease and rare bleeding disorders in North-Eastern Iran. The survey was done in the period from September 2009 to March 2011. Information was collected from the medical records in three major hospitals and a haemophilia centre; the patients' updated data were obtained by telephone. RESULTS: Overall in the current survey 552 patients with inherited coagulation disorders were identified and their medical records obtained. Of these, 429 (77.5%) had common bleeding disorders (haemophilia A, haemophilia B, von Willebrand's disease), 85 (15.6%) had rare bleeding disorders (deficiency of coagulation factors V, VII, X, XIII, I, XI, combined factor V and VIII deficiency) and 38 (6.9%) had platelet disorders.The commonest bleeding disorders were haemophilia A (n=287, 51.9%), haemophilia B (n=92, 16.6%), von Willebrand's disease (n=50, 9%), factor V deficiency (n=21, 3.8%), factor VII deficiency (n=19, 3.4%), factor X deficiency (n=2, 0.36%), combined factor V and VIII deficiency (n=28, 5.8%), factor XIII deficiency (n=11, 1.99%), factor XI deficiency (n=2, 0.4%), afibrinogenaemia (n=2, 0.36%) and platelet disorders (n=38, 6.9%). DISCUSSION: There is notable population of individuals with bleeding disorders in North-Eastern Iran.

Correlation between blood lead concentration and iron deficiency in Iranian children.

BACKGROUND: Iron deficiency anaemia is the most common nutritional anaemia among children. Lead toxicity is a serious health threat, especially in developing countries due to environmental pollution. It was thus aimed to investigate correlation between blood lead concentration and iron deficiency in children of Mashhad, Iran. MATERIALS AND METHODS: This cross sectional study was performed on children between 1 year and 10 years, in Imam Reza teaching hospital of Mashhad, Iran, in 2010. Indeed during complete blood count (CBC), we measured iron and total iron binding capacity (TIBC) by colorimetric methods, ferritin by radioimmune assay and blood lead concentration by atomic absorption method. Results were analysed by Statistical Package for Social Sciences (SPSS) (version 11.5), using statistical tests including independent sample t-test, Mann-Whitney U test, Spearman's test and analysis of variance (ANOVA) and Pearson's or Spearman's correlation coefficient. P value ≤ 0.05 was considered as a significant level. RESULTS: We studied 223 cases including 98 control children and 125 patients. All children had lead intoxication. Mean (±SD) blood lead concentration in the control group was 57.1 ± 25.3 (ranged 20-212) µg/dl and in the patient group was 57 ± 20.4 (ranged 10.9-159) µg/dl with no significant difference (P value = 0.713). We also did not find any correlation between blood lead concentration and haemoglobin, ferritin, iron, TIBC, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), white blood cells (WBC) and platelets. CONCLUSION: Based on these results, no correlation was found between blood lead concentration and iron deficiency in the children. Because all children had lead intoxication, further studies in highly polluted and a comparison with a low polluted area are necessary to make a general conclusion.

Serum immunoglobulins in patients with iron deficiency anemia.

Iron deficiency is a common cause of anemia worldwide. Documentation shows that these patients have impaired immunity and are prone to infections. The aim of this study was to confirm whether serum immunoglobulins change in adult nonpregnant females with iron deficiency anemia. Based on patients' clinical history, CBC results, and serum ferritin, iron and total iron binding capacity, 45 healthy patients and 45 iron deficiency anemia (hypochrom microcytic) patients were entered into this case-control study. Serum IgG, IgA and IgM were measured in patient and control groups using the nephelometry method. Both of the groups were compared using suitable statistical test. Mean serum values of IgG, IgA and IgM in the patient group were 12.47 ± 7.67, 1.93 ± 0.92 and 1.35 ± 0.90 g/l respectively. Mean serum values for the control group were 12.51 ± 6.85, 2.14 ± 0.88 and 1.49 ± 0.73 g/l respectively. Although serum immunoglobulins were slightly lower in the patient group compared to the control group these differences were not significant with the t test. Our study showed serum immunoglobulin levels did not change in iron deficiency anemia.