Therapeutic effect of sodium alginate on bleomycin, etoposide and cisplatin (BEP)-induced reproductive toxicity by inhibiting nitro-oxidative stress, inflammation and apoptosis.

Impaired spermatogenesis and male infertility are common consequences of chemotherapy drugs used in patients with testicular cancer. The present study investigated the effects of sodium alginate (NaAL) on testicular toxicity caused by bleomycin, etoposide, and cisplatin (BEP). Rats in group 1 received normal saline, while groups 2 and 3 were treated with 25 and 50 mg/kg of NaAL, respectively. Group 4 was treated with a 21-day cycle of BEP (0.5 mg/kg bleomycin, 5 mg/kg etoposide, and 1 mg/kg cisplatin), and groups 5 and 6 received BEP regimen plus 25 and 50 mg/kg of NaAL, respectively. Then, sperm parameters, testosterone levels, testicular histopathology and stereological parameters, testicular levels of malondialdehyde (MDA), nitric oxide (NO), and total antioxidant capacity (TAC), and the expression of apoptosis-associated genes including Bcl2, Bax, Caspase3, p53, and TNF-α were evaluated. Our findings revealed that NaAL improved sperm parameters, testosterone levels, histopathology, and stereology parameters in BEP-administrated rats. NaAL also improved testis antioxidant status by enhancing TAC and ameliorating MDA and NO. Further, modifications to the expression of Bcl2, Bax, Caspase3, p53, and TNF-α suggested that NaAL alleviated BEP-induced apoptosis and inflammation. Collectively, NaAL protects rats' testes against BEP-evoked toxicity damage through the modulation of nitro-oxidative stress, apoptosis, and inflammation.

Utility of vitamin C in ameliorating citalopram-induced testicular toxicity via modulating nitro-oxidative stress and apoptosis in mice.

There is a growing concern that antidepressant drugs impair sexual function and adversely impact spermatogenesis and male fertility. Vitamin C is a natural antioxidant that plays a vital role in the male reproductive system. The present study investigated the ameliorating potential of vitamin C against citalopram (CTL)-evoked testicular toxicity and spermatogenesis impairment in mice. Mice were randomly divided into six groups: control, CTL, vitamin C 100, vitamin C 200, CTL plus vitamin C 100, and CTL plus vitamin C 200. Adult male mice were intraperitoneally (ip) injected with 10 mg/kg of CTL for 35 days with or without vitamin C. At the end of the study, body and testes weight, sperm parameters, histopathology of testes, testosterone level, testicular levels of malondialdehyde (MDA), nitric oxide (NO), total antioxidant capacity (TAC), and apoptosis (TUNEL assay) were evaluated. Our findings revealed that vitamin C restored spermatogenesis by improving sperm count, motility, viability, morphology, and chromatin integrity. Testosterone levels and testes histopathology were significantly improved in the vitamin C-administrated groups. Furthermore, vitamin C administration markedly alleviated CTL-induced nitro-oxidative damage, enhancing TAC levels, and reducing NO and MDA levels. Whilst CTL therapy induced a significant increase in the number of TUNEL-positive cells compared to the control, the administration of vitamin C significantly prevented the apoptotic effects of CTL. Together, vitamin C therapy protects against CTL-induced testicular damage via mitigating nitro-oxidative stress and apoptosis, which provides evidence for vitamin C as a beneficial therapy against antidepressant drug-associated reproductive toxicity and male sub/infertility.

Validation of a temperature-humidity index (Humidex) in evaluating heat stress at a tile factory in Iran.

BACKGROUND: Several heat indices have been developed in industrial health, but each has its limitations. OBJECTIVE: The objective of this article is to determine the validity and applicability of a temperature-humidity index, named Humidex compared with the Standard Wet-Bulb Globe Temperature (WBGT) index (ISO 7243). METHOD: This cross-sectional study was conducted in the summer of 2019, in a tile factory in the west of Iran. 59 measurements were performed in 8 different workstations. Environmental parameters including natural wet bulb temperature (Tnw), dry bulb temperature (Ta), globe bulb temperature (Tg), and heat stress (WBGT) were measured. Humidex was calculated according to an equation. SPSS software (version 16) was used for data analysis. RESULTS: There was a high correlation between Humidex and WBGT in the estimation of heat stress (R=0.912, P<0.001). The Kappa Coefficient between Humidex and WBGT was 0.298, P=0.001. CONCLUSION: Humidex is highly correlated with WBGT. Humidex can be used instead of the WBGT index, especially in hot and humid environments.

The efficacy of theory driven treatment adherence promotion program among type 2 diabetic patients: application of intervention mapping and mHealth.

Background: Mobile health interventions (mHealth) may improve health-related lifestyle behaviors and disease management. Successful management of diabetes is patient-centered responsibility. The aim of this research was to determine the efficacy of the theory driven program of promoting treatment adherence in type 2 diabetes (T2DM) patients based on mHealth. Methods: This quasi-experimental research was conducted on 70 T2DM patients in Tehran, Iran. Participants were randomly divided into intervention (n = 35) or control (n = 35) groups. The data collection tool was a questionnaire based on some of constructs Social Cognitive Theory (SCT) which elicit from formative evaluation. The SCT theory-based intervention program was developed, implemented, and evaluated based on Intervention Mapping (IM) as a framework in 8 sessions using online WhatsApp application. The data was collected through by online interviews before and one month after the implementation of the program and analyzed in SPSS version 16. Results: After the implementation of the program, a significant increase in self-efficacy (P = 0.009), outcome expectations (P < 0.001), and also diabetes treatment adherence behaviors (P = 0.024) were indicated in the intervention group. The estimated effect sizes for self-efficacy, outcome expectations, social support, and diabetes treatment adherence behaviors were 0.78, 0.06, 0.07, and 0.62, respectively. Conclusion: Estimated effect size of the implemented intervention was evaluated as "large" effect for diabetes treatment adherence behaviors. Findings indicated the usefulness and efficacy of the mHealth educational program based on SCT constructs and the IM approach in treatment adherence behaviors promotion among T2DM patients in Iran. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-023-01291-5.

Fertility-enhancing effects of inositol & vitamin C on cisplatin induced ovarian and uterine toxicity in rats via suppressing oxidative stress and apoptosis.

Cisplatin can lead to infertility due to its negative impact on the uterus and ovaries. This study aimed to explore the effects of Inositol and vitamin C on cisplatin-induced infertility. Forty-eight adult female Wistar rats were divided into eight groups (N = 6) and orally treated for 21 days. The treatments were as follows: negative control (saline), positive control (saline and cisplatin injected into the abdomen on day 15), T1-T3: rats given vitamin C (150 mg/kg), Inositol (420 mg/kg), and vitamin C + Inositol, respectively, along with cisplatin injected into the abdomen on day 15, T4-T6: rats given only vitamin C, Inositol, and vitamin C + Inositol, respectively. Vitamin C and Inositol enhanced cisplatin-induced histopathological improvements in the uterus and ovaries, raising progesterone and estradiol serum levels. Furthermore, the supplements enhanced ESR1 gene expression in the uterus and ovary, reducing uterine and ovarian apoptosis caused by cisplatin through modulation of caspase 3, 8, and Bcl-2 gene levels. These substances decreased ovarian and uterine malondialdehyde levels, boosted total antioxidant capacity and superoxide dismutase, and alleviated oxidative stress. The findings reveal that vitamin C and Inositol shield against cisplatin-related infertility by reducing oxidative stress and apoptosis in the uterus and ovaries.

The global prevalence of ADHD in children and adolescents: a systematic review and meta-analysis.

BACKGROUND: Attention-Deficit / Hyperactivity Disorder is a developmental neurological disorder that has three basic characteristics: Attention Deficit, Hyperactivity, and impulsivity. This study aimed to investigate the prevalence of ADHD in children and adolescents. METHODS: This investigation was carried out using the meta-analysis method under PRISMA guidelines. Until October 2020, the articles were gathered by scanning PubMed, Scopus, WOS, and Science Direct databases. The second version of Comprehensive Meta-Analysis software was used to run analyses after extracting data from chosen papers. At a significance level of 0.05, the I2 test was used to analyze study heterogeneity, and the Egger test was used to assess publication bias. RESULTS: This analysis includes 61 cross-sectional research, with 53 research used to determine the prevalence of ADHD in children, 7.6% of 96,907 children aged 3 to 12 years had ADHD (95% confidence interval: 6.1-9.4%), and 5.6% of teenagers aged 12 to 18 years have ADHD (95% confidence interval: 4.8-7%). The prevalence of ADHD in children and adolescents according to the DSM-V criterion is also higher than previous diagnostic criteria, according to studies. CONCLUSION: The findings of this study based on meta-analysis show the high prevalence of attention deficit hyperactivity disorder (ADHD). The findings of this study demonstrate the importance of management and policy in the treatment and control of ADHD in children and adolescents.

The protective role of melatonin in citalopram-induced reproductive toxicity via modulating nitro-oxidative stress and apoptosis in male mice.

Citalopram is the most potent selective serotonin reuptake inhibitor, commonly prescribed as an antidepressant, which can cause sexual dysfunction. Melatonin is a natural, highly effective antioxidant playing a pivotal role in the male reproductive system. The present study aimed to explore the ameliorating potential of melatonin on citalopram-evoked testicular toxicity and injury in mice. In this regard, mice were randomly divided into six groups: control, citalopram, melatonin 10 mg/kg, melatonin 20 mg/kg, melatonin 10 mg/kg plus citalopram, and melatonin 20 mg/kg plus citalopram. Adult male mice were intraperitoneally (i.p.) injected with 10 mg/kg of citalopram for 35 days with or without melatonin. At the end of the study, sperm parameters, testosterone level, testicular levels of malondialdehyde (MDA), nitric oxide (NO), total antioxidant capacity (TAC), and apoptosis (Tunel essay) were evaluated. Our findings revealed that melatonin restored spermatogenesis by improving sperm count, motility, viability, morphology, and chromatin integrity. Testosterone levels and the histopathology of the testes were markedly improved in the melatonin-administrated groups. Furthermore, citalopram administration significantly increased oxidative stress; however, melatonin restored antioxidant status by enhancing TAC levels and decreasing NO and MAD levels. More notably, citalopram therapy induced a significant increase in the number of Tunel-positive cells, while melatonin administration significantly mitigated the apoptotic impacts of citalopram. Together, melatonin therapy provides protection against citalopram-induced testicular damage via modulating nitro-oxidative stress and apoptosis, which provides evidence for melatonin as a promising treatment against antidepressant drug-associated reproductive toxicity and male sub/infertility.

Beneficial effect of L-Proline supplementation on the quality of human spermatozoa.

L-Proline is a natural anti-oxidative and osmoprotectant agent, playing a versatile role in cell metabolism and physiology. The present study aimed to explore the antioxidant effects of L-Proline on human sperm function during incubation. Thirty healthy, normozoospermic men (27-40 years) were enrolled. Sperm samples were incubated in an unsupplemented sperm medium (control group), or supplemented with L-Proline (1, 2 and 4 mmol/L) to evaluate its effect during 0, 1, 4 and 24 h of incubation. Sperm were assessed in terms of motility, viability, morphology, chromatin and DNA integrity. Moreover, the levels of reactive oxygen species (ROS), malondialdehyde (MDA), and total antioxidant capacity (TAC) were determined in the sperm medium. The results indicated that 2 mmol/L of L-Proline significantly improved the maintenance of sperm motility, viability, normal morphology, chromatin and DNA integrity, and TAC levels compared to the control group during 24 h of incubation (p < 0.05). However, 1 and 4 mmol/L of L-Proline could not significantly preserve sperm parameters, chromatin quality, and antioxidant status during different incubation times compared to the control group (p > 0.05). Collectively, the inclusion of L-Proline (2 mmol/L) in the human sperm medium maintains sperm parameters and chromatin quality probably by modulating the oxidative status.

L-proline as a novel additive to cryopreservation media improved post-thaw quality of human spermatozoon via reducing oxidative stress.

Sperm cryopreservation as a routine technique in assisted reproductive technique (ART) laboratories has detrimental effects on spermatozoa. Various methods have been introduced to improve it. The aim of this research was to evaluate the effects of L-proline supplementation in cryopreservation medium on normozoospermic semen samples. A total of 30 semen samples were collected from normozoospermic men. Cryopreservation media were supplemented with different concentrations of L-proline (0, 1, 2 and 4 mmol/L). The semen samples were cryopreserved. After thawing, sperm parameters and chromatin integrity (aniline blue (AB), toluidine blue (TB), sperm chromatin dispersion test (SCD) and chromomycin A3 (CMA3)), reactive oxygen species (ROS), and total antioxidant capacity (TAC) and malondialdehyde (MDA) levels were evaluated. A total of 4 mmol/L L-proline significantly improved progressive motility and viability (p < 0.05). MDA and ROS levels significantly diminished in samples were cryopreserved by 4 mmol/L L-proline supplemented cryopreservation media (p < 0.001). Also, it significantly increased TAC level. Also, chromatin damages (AB, TB and CMA3) significantly improved in samples were cryopreserved by 4 mmol/L L-proline supplemented cryopreservation media (p < 0.05). The results support that the usage of L-proline supplemented cryopreservation media to improve sperm quality after cryopreservation.

An assessment of noise exposure and hearing health status among auto body workers in Kermanshah, Iran.

BACKGROUND: Unwanted sound is recognized as the most extensive source of contaminant in the workplace. Exposure to intense, continuous, and higher than 85 dB level noise can lead to noise-induced hearing loss. The aim of the present study was to determine the level of noise exposure and its impact on hearing health among auto body workers. MATERIALS AND METHODS: This descriptive-analytic study was conducted in 2020 to investigate the hearing health status of workers in auto body workshops. Sixty-one participants were randomly selected for audiometric testing. The equivalent sound level (Leq) of the workers was measured using a Casella CEL-320 noise dosimeter. Audiometric testing was performed using an AC40 audiometer. The mean hearing threshold levels (HTLs) of both ears were calculated for different frequencies. The results obtained were analyzed using SPSS v21.0 at a significance level of 95%. RESULTS: The participants had an average age of 35.5 ± 11.8 years and an average work experience of 16.5 ± 9.8 years. The mean Leq was 92.3 ± 4.7 dB. The mean HTLs for the right ear and left ear were 20, 15, 17.6, 19.2 dB, respectively with the right ear suffering more loss. A significant relationship was found between hearing loss in both ears (P < 0.001). The highest prevalence of hearing loss in both ears was observed at a frequency of 4 kHz. About 73.8% of the subjects had a normal HTL, 23.3% had mild hearing loss, and 3.3% had severe hearing loss. With increasing work experience, HTLs also increased significantly, particularly at 2-8 kHz. CONCLUSIONS: Chronic exposure to noise pollution threatens hearing health. Therefore, it is necessary to raise the level of awareness among workers in order to enable better hearing health protection and also to promote the use of hearing protection devices.

Melatonin protects rats testes against bleomycin, etoposide, and cisplatin-induced toxicity via mitigating nitro-oxidative stress and apoptosis.

There is growing concern that some cytotoxic regimens for cancer adversely affect spermatogenesis and male fertility. Increasing evidence demonstrated that melatonin has beneficial impacts on reproductive processes; however, whether melatonin can protect against bleomycin, etoposide, and cisplatin (BEP) chemotherapy regimen-induced testicular toxicity, remains obscure. The present study aimed to explore the effect of melatonin on BEP-evoked testicular injury in rats. Adult male Wistar rats (n = 10/group) were intraperitoneally (i.p.) injected with one cycle of 21 days of 0.33 therapeutically relevant dose levels of BEP (.5 mg/kg bleomycin, 5 mg/kg etoposide, and 1 mg/kg cisplatin) with or without melatonin. At the end of the study, sperm parameters, testosterone level, stereology of testes, testicular levels of malondialdehyde (MDA), nitric oxide (NO), and total antioxidant capacity (TAC), the expression of apoptosis-associated genes such as Bcl2, Bax, Caspase-3, p53, and TNF-α (Real-time PCR and Immunohistochemistry) were evaluated. Our findings showed that melatonin restored spermatogenesis by improving sperm count, motility, viability, and morphology. Testosterone level, histopathology, and stereology of testes were significantly improved in melatonin-administrated groups. Furthermore, melatonin recovered the oxidative status of the testes through elevating TAC and ameliorating MDA and NO levels. More importantly, melatonin therapy suppressed BEP-evoked apoptosis by modulating Bcl-2, Bax, Caspase-3, p53, and TNF-α expression in testes. In conclusion, melatonin protects the testes against BEP-induced testicular damage by attenuating nitro-oxidative stress, apoptosis, and inflammation, which provides evidence for melatonin as a possible clinical therapy against BEP-associated gonadotoxicity and male sub/infertility.

Occupational Exposure to Respirable Dust, Crystalline Silica and Its Pulmonary Effects among Workers of a Cement Factory in Kermanshah, Iran.

BACKGROUND: Although the main hazard in cement processing is dust, and its effects on pulmonary function constitute the most important group of occupational diseases in this industry, evidence for association between exposure to cement dust and pulmonary function has not been conclusive. This study was performed with the aim to evaluate the impact of cement dust in the workplace on decreasing pulmonary function parameters among the workers. MATERIALS AND METHODS: In this cross-sectional study 283 workers were studied, of which 140 workers were considered as exposed group and 143 workers as non-exposed group. Fifty samples of respirable dust were collected from breathing zone of workers in different sections of cement factory. Visible absorption spectrophotometry was used according to the NIOSH Method 7601 to measure crystalline silica content of reparable dust samples. Spirometry test was also applied to assess workers' pulmonary function parameters. RESULTS: Respirable dust concentration was in the range of 1.77 to 6.12 mg/m3. The concentration of crystalline silica in all units was higher than the Threshold Limit Value (TLV) (0.025 mg / m3). There were a significant difference in the Peak Expiratory Flow (PEF) parameter among workers in the two exposed and non-exposed groups to respirable dust (P= 0.017). In other parameters of pulmonary function (FVC, FEV1, FEF 25-75, FEV1/FVC %), there were no significant differences between the two groups under study (P= 0.45, P= 0.14, P= 0.29 and P= 0.23, respectively). CONCLUSION: The findings of this study have provided an evidence to confirm the hypothesis that exposure to cement dust can cause complication in PEF parameter of cement industry workers.

Data for the prevalence of nurses׳ burnout in Iran (a meta-analysis dataset).

The present dataset was carried out using meta-analysis method towards investigation of the prevalence of nurses׳ burnout in Iran. To this end, the keywords were searched in the Iranian databases such as Medlib, SID, Iranmedex, Magiran or even some international databases such as Cochrane, Science-Direct, Scopus, PubMed, and Google Scholar. The data were analysed using the STATA Software Version 12. In ten articles with a sample size of 1758 subjects, an average age of 30.73 (54%) and the confidence interval of 43-64, the prevalence of burnout was reported. The obtained data indicated that Fars and Zanjan Provinces had the highest and lowest rates of burnout (72% and 26%, respectively). According to the acquired data, the total prevalence of burnout among men and women measured 46% and 65%, respectively. Given the high prevalence of burnout among the Iranian nurses in this dataset and the importance of nursing in public health which requires highly motivated and committed nurses with high job satisfaction, it is recommended that the intensity of burnout be reduced through supervising the nurses׳ professional performance, supporting, paying attention to their problems, following up and providing the necessary strategies to improve their environmental, economic, and personal conditions.

The relationship between lifetime suicide attempts, serum lipid levels, and metabolic syndrome in patients with bipolar disorders.

OBJECTIVES: To assess the relationship between lifetime suicide attempts (SAs), serum lipid values, and metabolic syndrome (MetS) in patients with bipolar disorders (BPD). METHODS: Eighty patients with BPD took part in the study (M = 40.60 years). After psychiatric diagnosis, demographic data, SAs, and serum lipids were measured and MetS was calculated. RESULTS: 70% reported at least one suicide attempt. 52.5% suffered from MetS. Suicide attempters had higher cholesterol values. SAs were associated with a family history of suicide, current mood state, and lower educational level. SAs were unrelated to MetS. CONCLUSIONS: In patients with BPD, against expectations, the occurrence of SAs was associated with higher cholesterol values. Serum lipid values are not suitable as a biological trait marker to predict SAs.

Attribution of lifestyle risk factors in subjects with and without impaired fasting glucose.

OBJECTIVE: To investigate the association between lifestyle risk factors and impaired fasting glucose level. METHODS: The large-scale, community-based, cross-sectional study was conducted in 2012 in Ilam province, Iran, and comprised 150 impaired fasting glucose cases and 450 controls. Face-to-face interviews were conducted using a standard lifestyle questionnaire, and subjects were checked for fasting plasma glucose. Chi-square test and multivariate logistic regression were used for statistical analysis. RESULTS: Of the 600 participants, 172 (28.7%) were males and 428 (71.3%) were females. Their ages ranged from 20 to 83 years with a mean of 48.9 +/- 14.2 years for the cases and 45.5 +/- 13.4 years for the controls (p < 0.008). There was no statistically significant difference in terms of age, gender, marital status, location, family history of diabetes and body mass index in the two groups (p > 0.05). Using multivariate logistic regression, ghee consumption increased the risk of impaired fasting glucose up to 2.2 folds (Odds Ratio = 1.28, 95% Confidence Interval: 0.75-2.2); inactivity up to 2.33 folds (Odds Ratio = 1.33, 95% Confidence Interval: 0.75-2.33) and smoking up to 3.13 folds (Odds Ratio = 1.46, 95% Confidence Interval: 0.68-3.13). The differences were not statistically significant. CONCLUSION: Risk of impaired fasting glucose increases with lifestyle risk factors that need to be considered seriously by policy makers.

The prevalence of anemia and hemoglobinopathies in the hematologic clinics of the kermanshah province, Western iran.

Hemoglobinopathies are the most common single gene disorders worldwide with a considerable frequency in certain area particularly Mediterranean and Middle Eastern countries. Hemoglobinopathies include structural variants of hemoglobin (Hb S, Hb C, HbE,…) and thalassaemias which are inherited defects in the globin chains synthesis. The present study was conducted to determine the prevalence of hemoglobinopathies in western Iranian patients. A total of 344 patients (151 males and 193 females) with abnormal CBC and/or hemoglobin electrophoresis were enrolled in the present study. Cellulose acetate gel electrophoresis was performed for all patients and abnormal bands were identified by citrate agar gel electrophoresis and PCR based methods. Iron deficiency anemia (IDA) was present in 156 (45.3%) individuals. Thirty four (9.8%) patients had both iron deficiency anemia and α-thalassemia trait trait, 41(11.9%) patients were with both iron deficiency anemia and minor ß-thalassemia. There were 31(9%) patients with α-thalassemia trait and 5 (2.2%) patients with Hb H disease. Fifty six (16.2%) patients had minor ß-thalassemia. Also, there were 10 (2.9%) individuals homozygous for hemoglobin D-Punjab and one patient with hemoglobin G (0.3%). There was one sample with hemoglobin C. Further, we found 3 patients (0.9%) with sickle cell trait and more 3 patients (0.8%) with S/ ß +-thalassemia. Our results indicated that the most frequent cause of hypochromic and/or microcytic anemia in our population was IDA and the minor ß-thalassemia was the second cause that needs to more attention in screening programs.

Clinical features and types of von Willebrand disease in women with menorrhagia referred to hematology clinic of kermanshah.

Menorrhagia is the most common symptom that is experienced by women with bleeding disorders. Von Willebrand disease (VWD) is the most common congenital human bleeding disorder that is manifested as a quantitative deficiency in Von Willebrand factor (VWF) or dysfunction of this factor. The frequency of VWD is similar in both men and women. However, VWD is more readily detected in women due to the presence of severe bleeding associated with menstrual cycles and childbirth. The present study was carried out to find the frequency of VWD, its types, and clinical features of the disease among women with menorrhagia who referred to the Hematology Clinic of the Kermanshah University of Medical Sciences. The study comprised 482 women with menorrhagia. After excluding patients with confounding factors, 56 (11.6%) patients were evaluated for inherited bleeding disorders. We detected 31 (55.3%) patients with VWD. Type 3 of VWD was the most frequent subtype (45.2%) followed in frequency by type 2 (32.3%), and type 1 (22.5%). In conclusion, our study indicated that menorrhagia can be the first symptom of VWD. Therefore, rare coagulation disorders should be considered in women with idiopathic menorrhagia, particularly in regions with high rates of consanguinity.

Poor platelet Count Response to Helicobacter Pylori Eradication in Patients with Severe Idiopathic Thrombocytopenic Purpura.

INTRODUCTION: ITP is an autoimmune blood disorder in which platelet destruction is mediated by anti-platelet antibodies. The mechanisms of anti-platelet antibodies development are still a little known. The rate of some bacterial or viral agents in cause of ITP is well known. Recently, some study proposed that H pylori infection may be associated with ITP and H pylori eradication can improves platelet counts in infected ITP patients. MATERIALS AND METHOD: A baseline platelet count <50×10(3) µL for 4 weeks prior to study entry were required. These patients were tested for H. pylori infection by urea breath. All positive H pylori patients received triple therapy for 7 or 14 days to eradicate H pylori infection. These patients followed for six months. RESULTS: Of 92 patients with ITP, H pylori infection was found in 59.7% (55/92). After excluding patients with confounding factors, 41 patients were remained. After H pylori eradication, CR wasn't obtained in any patients. Partial response were obtained only in 3 (7.3%) of the 41 patients and no response in 38 (92.6%) patients. There is a significant difference between the platelet counts of PR and NR groups (P < 0.001). CONCLUSION: The results of this study and our previously study showed H pylori eradication therapy has beneficial effect for patients with mild thrombocytopenia but the chance of obtaining a response by H pylori treatment is lower in patients with severe thrombocytopenia.

Kaposi's Sarcoma after Kidney Transplantation: a 21-Years Experience.

INTRODUCTION: The long-term use of immunosuppressive agents for prevention of allograft rejection increases the risk of malignancy approximately 100 times as high as that in the general population and Kaposi's sarcoma (KS) is a relatively common malignancy after kidney transplantation. The aim of present study was to investigate the frequency of KS in patients with kidney transplantation in 20 years period. MATERIAL AND METHODS: In this study Charts and pathology reports of 1487 recipients for kidney allografts treated at Imam Reza hospital between 1991 and 2012 were reviewed. The SPSS software package version 16 (SPSS Inc., Chicago, Illinois, USA) was used for the statistical analysis. RESULTS: There were 17 of 1487 incident cases of KS kidney transplant population at our hospital in period of study. There is no significant difference between age and gender of patients. The mean time between transplantation and non-KS malignant tumors was 34.4 ± 21.8 months (range 12-140 months), while in KS patients it was 18.7 ± 25.2 months, which was statistically significantly different (P < 0.05). After detection of KS in 12 patients, we perform serum antibody detection against HHV. Among them, 8 (66.6%) were seropositive. CONCLUSION: KS is a common long-term complication in renal transplant recipients, with an increased incidence compared with the general population. Given that candidates for organ transplantation who are seropositive for HHV-8 -and thus at risk for KS- can now be identified, chemoprevention should be available in this high-risk population.

Platelet Count Response to Helicobacter pylori Eradication in Iranian Patients with Idiopathic Thrombocytopenic Purpura.

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune hematological disorder characterized by auto antibody-mediated platelet destruction. Although the main cause of ITP remains unclear, but its relationship with some infection was demonstrated. In recent years, many studies have demonstrated improvement of platelet counts in ITP patients after treating Helicobacter pylori infection. The aim of this study was to investigate the effects of H. pylori eradication on platelet count response in Iranian ITP patients.A total of 26 patients diagnosed with both ITP and H. pylori infection. ITP were diagnosed whose platelet counts were less than 100×10(3)/µL. These patients were tested for H. pylori infection by Urea Breath Test and serum H. pylori antibody. All patients received triple therapy for 7 or 14 days to eradicate H. pylori infection. These patients followed for six months.Prevalence of H. pylori was 67.3%. H. pylori eradication achieved in 89.5% (26/29). Of the 26 patients, 15 (57.7%) exhibited a complete response (CR) and 11 (42.3%) were unresponsive. We did not find partial responders. There was a significant difference in the baseline platelet count of responders and non-responders patients (p<0.001). All responders had platelet count ≥50×10(3)/µL and all non-responders had platelet count <50×10(3)/µL.Results of this study revealed that eradication therapy of H. pylori infection can improve platelet counts in ITP patients especially with mild thrombocytopenia and support routine detection and treatment of H. pylori infection in ITP patients in populations with a high prevalence of this infection.