Correlation of cardiac MRI T2* with echocardiography in thalassemia major.

BACKGROUND AND OBJECTIVE: Myocardial iron deposition and cardiac failure in thalassemia major (TM) is the most serious reason of morbidity and mortality. Cardiac magnetic resonance imaging (MRI T2*) can indirectly quantified myocardial iron content. Moreover echocardiographic left ventricular diastolic evaluation in comparison to systolic evaluation is more sensitive to detect early myocardial dysfunction secondary to iron overload. The aim was to determine some diastolic and tissue Doppler echo indices correlated with cardiac MRI T2* to predict iron load. PATIENTS AND METHODS: Thirty three TM patients (17F/16M) with history of 15 years transfusion or more were selected. They did cardiac MRI (CMR) with measurement of relaxation time of T2* and also echocardiographic examination with systolic and diastolic evaluation and tissue Doppler imaging. RESULTS: The mean value of cardiac T2* was 20.41 +/- 12.1 ms. Patients with abnormal T2* (< 20 ms) had abnormal ejection fraction (EF) in 10 (53.6%), and abnormal diastolic indices including deceleration time (DT), early (E) and late (A) transmitral peak flow velocity ratio (E/A), E/Em and Tei- index in 13 (72.2%), 12 (66.7%), 18 (100%) and 14 (77.8%) patients respectively. There was a good correlation between DT, Tei index and E/Em index with cardiac T2* values (p < 0.05, r = 0.70-0.81), poor correlation between E/A with T2* (p < 0.05, r = -0.44) and no significant correlation of liver T2* with cardiac T2* (p = 0.819). CONCLUSIONS: In unequipped centres which CMR is not available because of good correlation between diastolic echocardiographic parameters and CMR T2*, the use of echocardiographic diastolic parameters for evaluation of cardiac state could be a replacing tool. In equipped centres we suggest doing CMR T2* as a first step examination in high risk patients, and then doing regular F/U with echocardiographic evaluation of diastolic and tissue Doppler echocardiographic parameters especially DT, E/Em and Tei index.

Seroprevalence of hepatitis E in Nahavand, Islamic Republic of Iran: a population-based study.

A 2-month community-based survey in February/March of 2003 was carried out to study the seroprevalence of hepatitis E virus (HEV) infection in Nahavand, Islamic Republic of Iran. From each of 6 urban regions of Nahavand, 304 inhabitants > or = 6 years were recruited through systematic random sampling (total 1824). Participants were tested for anti-HEV IgG using ELISA. The overall seroprevalence of HEV was 9.3% (95% CI: 8.2%-10.9%). Based on multivariate adjustment, only sex (OR = 1.61, 95% CI: 1.13-2.28) and age (OR = 1.03, 95% CI: 1.01-1.04) emerged as significant risk factors. This intermediate prevalence urges further investigations on HEV infection in the Islamic Republic of Iran.

Seroprevalence of hepatitis E in Nahavand, Islamic Republic of Iran: a population-based study

A 2-month community-based survey in February/March of 2003 was carried out to study the seroprevalence of hepatitis E virus [HEV] infection in Nahavand, Islamic Republic of Iran. From each of 6 urban regions of Nahavand, 304 inhabitants >/= 6 years were recruited through systematic random sampling [total 1824]. Participants were tested for anti-HEV IgG using ELISA. The overall seroprevalence of HEV was 9.3% [95% CI: 8.2%-10.9%]. Based on multivariate adjustment, only sex [OR = 1.61, 95% CI: 1.13-2.28] and age [OR = 1.03, 95% CI: 1.01-1.04] emerged as significant risk factors. This intermediate prevalence urges further investigations on HEV infection in the Islamic Republic of Iran

Prevalence of antibodies to hepatitis E virus among male blood donors in Tabriz, Islamic Republic of Iran.

Serum samples from 399 voluntary male blood donors were tested for anti-hepatitis E virus (HEV) IgG during July and August 2004 at a blood transfusion centre in Tabriz city. The prevalence of anti-HEV IgG was 7.8% (95% CI: 5.2-10.4). Risk factors for infection included age and a low educational level. Seroprevalence increased significantly with age, from 3.3% in subjects under 30 years of age to 37.5% in individuals 50 years and over. Illiterate individuals were at significantly higher risk for infection than educated persons. The high seropositive rate among our male blood donors is compatible with endemicity of HEV in the Islamic Republic of Iran.

Rotavirus VP7, VP4 and VP6 genotypes co-circulating in Tehran, Iran, between 2003 and 2004.

Rotaviruses were detected by enzyme-linked immunosorbent assay (ELISA) in 92 out of 374 faecal samples collected between November 2003 and October 2004 at the Markaz Tebbi Koudakan Hospital, Tehran, Iran, from children aged 6 months to 5 years. Analysis of clinical and disease severity data showed a significant association between rotavirus infection and diarrhoea, vomiting and severe dehydration. Ninety-two samples (64 rotavirus ELISA-positive and 28 ELISA-negative samples) were sent to the Enteric Virus Unit, Virus Reference Department, Centre for Infection, Health Protection Agency, UK for rotavirus characterization by G-typing, P-typing and subgrouping (SG) using reverse transcriptase (RT)-PCR, semi-nested PCR and sequencing methods. In this study, both common and uncommon rotavirus genotypes were detected. The most prevalent types were G1P[8], SGII (59.2%) followed by G9P[8] SGII (15.5%) which has not been previously reported from Iran. Unusual genotypes G1P[10] SGI (2.8%) and G12P[8] SGII (1.4%) and strains derived from reassortment between common co-circulating genotypes such as G1P[4] SGII represented 5.6% of strains. Mixed infections with combinations of G1+G4P[8] SGII and G1+G9P[8] SGII were also found. This contrasts with previous reports from Iran in which a small number of common rotavirus strains (G1 and G4) were found. This study highlights the need for continued surveillance and characterization of rotaviruses to take account of the rapid evolution and introduction of novel rotaviruses into the human population.

Prevalence of antibodies to hepatitis E virus among male blood donors in Tabriz, Islamic Republic of Iran

Serum samples from 399 voluntary male blood donors were tested for anti-hepatitis E virus [HEV] IgG during July and August 2004 at a blood transfusion centre in Tabriz city. The prevalence of anti-HEV IgG was 7.8% [95% CI: 5.2-10.4]. Risk factors for infection included age and a low educational level. Seroprevalence increased significantly with age, from 3.3% in subjects under 30 years of age to 37.5% in individuals 50 years and over. Illiterate individuals were at significantly higher risk for infection than educated persons. The high seropositive rate among our male blood donors is compatible with endemicity of HEV in the Islamic Republic of Iran