Serological Evaluation of Toxoplasmosis and Related Risk Factors Among HIV+/AIDS Patients in Northern Iran.

PURPOSE: Toxoplasma gondii is an important opportunistic intracellular protozoan parasite that can cause severe sequelae and even death in immunodeficient patients. This study aimed to evaluate the seroprevalence and risk factors of toxoplasmosis among HIV+/AIDS patients of the study area. METHODS: A cross-sectional study was carried out on 121 registered HIV+/AIDS patients of behavioral diseases consultation center (BDCC) in Guilan province, north of Iran. Anti-Toxoplasma IgG and IgM antibodies were measured by ELISA technique in the serum samples. IgG avidity was measured for IgG- plus IgM-positive cases. Also, the relationship between T. gondii infection and related demographic and clinical characteristics were investigated. RESULTS: Anti-T. gondii IgG and IgM antibodies were detected in 60.3 and 4.9% of patients, respectively. One case of acute toxoplasmosis (0.83%) was detected using an IgG avidity test. A significant correlation was observed between toxoplasmosis with age and marital status in these patients. The mean CD4+count of HIV+/AIDS patients was 549 ± 27 cells/µl. Viral load in 69.7% of the HIV patients was less than1000 copies/ml. CONCLUSION: None of the T. gondii IgM-positive HIV patients received anti-Toxoplasma prophylaxis. This finding highlights the importance of T. gondii infection surveillance in HIV patients. Regarding the high prevalence of toxoplasmosis in the study population, educational efforts are recommended to prevent reactivation or acquiring primary infection and developing severe cases of toxoplasmosis in immunocompromised HIV+/AIDS patients.

Trends in the incidence of Oral and Pharyngeal Cancer (ICD00-14) in Guilan, North of Iran.

AIM: This study sought to assess the incidence of oral and pharyngeal cancer based on ICD-10 in Guilan, Iran, from 2004 to 2009. METHOD: This retrospective study assessed data collected from the Iranian cancer registries and publications. The rate, age-standardized incidence, type, and location of lesions according to ICD-10 were evaluated. Annual percent changes (APC) were estimated. RESULTS: A total of 1533 head and neck cancers were recorded. Of them, 290 cases (185 males and 105 females) were identified with oral and pharyngeal carcinoma (ICD00-14) with a mean age of 58.92 ± 17.94 years. The most common type of cancer was oral squamous cell carcinoma (n = 156). Cancer of the oropharynx (ICD 06) and lips (ICD00) had high incidence. APC was 1.36%. ASR was 3.5 and 2.04 per 100 000 among males and females, respectively. The mean crude rate was 3.69 per 1 000 000. CONCLUSION: In contrast to the global cancer statistics (ICD 00-14), Guilan showed lower incidence of oral and pharyngeal cancer during the understudy years. Oral squamous cell carcinoma was the most common type of cancer in this region.

Congenital hypothyroidism: etiology and growth-development outcome.

One of the most preventable causes of mental and growth retardation is congenital hypothyroidism (CH). This study tries to investigate growth and mental outcome of patients with CH. Since November 2006 and November 2007 in Guilan province, north of Iran, all neonates who were diagnosed with CH, evaluated for etiology of CH by laboratory follow up, thyroid sonography or scan. Growth and development of patients with CH were compared with healthy children in same age, geographical area, social and economical classes in four years old. Demographic characteristics including height, weight, and head circumference at birth, follow up time (four years old) and IQ (Good enough test) were recorded in questionnaires. Among 28904 screened neonates, 37 patients with CH were diagnosed. Incidence of CH was 1:781 in live births, 20 (54%) in female neonates and 17 (46%) in male neonates. The incidences of permanent and transient hypothyroidism were 43.2% (16 cases) and 56. 8% (21 cases) respectively. The incidence of permanent and transient hypothyroidism were 16 (43.2%) and 21 (56, 8%), respectively. In permanent CH, 11 cases (%.68.2) had dyshormonogenesis and 5 cases (%.31.2) had thyroid dysgenesis. Significant statistical difference was only in family history of thyroid disease (34, 3% Positive family history in CH vs. 13.2% in control group, P-value 0.03). All other demographic characteristics and IQ had no statistical difference. Patients with CH diagnosed through neonatal screening and treated had normal growth as general population that indicates effective screening program and treatment in this area (3.2%).

Cardio-metabolic risk factors in Iranian children: where we are and the others?

Rising obesity incidence and its complications have lead to change of our view about cardio-metabolic risk factors and need of reassessment of these complications in childhood age. The aim of current study was to evaluate prevalence of obesity and related cardio-metabolic risk factors of children. This was a cross-sectional study in a representative sample of 12 years old children in Rasht, the biggest city in north of Iran. Participants were interviewed and examined by a trained research team and demographic characteristics, detailed examination (height - weight - blood pressure) were recorded. Blood samples were drawn for biochemical testing including Fasting blood sugar, Triglyceride, Cholesterol, HDL & LDL. Data analysis was done using SPSS software. Total participants were 858 children and 550(64%) were male. Prevalence of underweight, normal weight, overweight, obese were 22.5%, 54.4%, 11.3%, 11.8%, respectively. The prevalence of cardio-metabolic risk factors included hypercholesterolemia (6.7%), hypertriglyceridemia (33.6%), high LDL (5.9%), low HDL (28 %), high systolic (7.6%) & diastolic blood pressure (10.6%) (> percentile) and abnormal carbohydrate metabolism (12%) revealed hypertriglyceridemia as the most common dyslipidemia. Correlation analysis didn't show significant correlation between BMI & FBS but LDL, Cholesterol and TG had week positive correlation with BMI (Pearson correlation: 0.161, 0.285, 0.222 respectively, p value <0.001). Obesity and dyslipidemia are common problems in this area and we should note to screen cardiometabolic risk factors in addition of obesity, especially in children with rapid weight gain. This study highly recommended more investigation to evaluate final effect of these factors in adulthood.

The prevalence of iodine deficiency disorder in two different populations in northern province of Iran: a comparison using different indicators recommended by WHO.

Comparison of the prevalence of iodine deficiency disorder (IDD) in neonates and school children using two different WHO indicators. From 2006 to 2010, 119701 newborns were screened by measurement of serum TSH level by heel prick. Neonates who had blood TSH ≥ 5 mIU/l were recalled for more evaluation. In the same period of time, urine iodine was measured in 1200 school-aged children. The severity of IDD was classified using WHO, UNICEF, ICCIDD criteria. Between 2006 and 2010 a total of 138832 neonates were screened in Guilan province and the total recall rate (neonates with TSH level ≥ 5 mIU/l) was 1.8 %. The incidence rate of Congenital Hypothyroidism (CH) was 1/625. The median urine iodine level in school-aged children was 200-299 µg/l. Considering the WHO, UNICEF, ICCIDD criteria, Guilan province would be classified as a none-IDD endemic area. However, health care systems should pay attention to the iodine excess and the risk of iodine induced hyperthyroidism in this population.