Toxocara sero-prevalence and its relationship with allergic asthma in asthmatic patients in north-eastern Iran.

Toxocariasis is an important neglected tropical disease that has been suggested as a possible etiologic agent of asthma. The objective of the present study was to investigate possible significant association between Toxocara seroprevalence and asthma in a clinic-based case-control study. Blood samples were collected from human subjects aged 5-70 years, 50 of whom had signs of asthma and 50 of whom had no signs of asthma. Risk factors for asthma and Toxocara spp. infection were assessed by a questionnaire given to each patient. Blood samples were analysed to measure levels of anti-Toxocara spp. immunoglobulin G (IgG). Patients with bronchial asthma were observed to have higher Toxocara spp. seropositivity than that of the non-asthmatic controls (6 vs 2%, P = 0.47). The mean anti-Toxocara spp. antibody titre was not significantly higher in patients with bronchial asthma than in individuals without asthma (P = 0.395, 95% CI = 0.579-1.45). There was no significant difference in the mean age, sex, social class, exposure to smoking and presence of domestic dog or cat at home between the two groups (P ≥ 0.05). The presence of anti-Toxocara spp. IgG was statistically associated with higher blood eosinophils, but it was not associated with asthma (P ≥ 0.05). The observed relationship between exposure to Toxocara spp. infection and bronchial asthma in Iranian patients warrants further evaluation. An understanding of any potential influence on the pathogenesis of human asthma provides a potential avenue for prevention.

Tuberculosis in patients with anthracosis of lung underlying mechanism or superimposed disease.

BACKGROUND: Anthracosis is the black pigment discoloration of bronchi with an unknown cause which can cause bronchial destruction and deformity (anthracofibrosis). The objective of this study was to determine the frequency of tuberculosis in anthracosis and evaluate their association. METHODS: One hundred and twenty subjects with bronchoscopy diagnosis of simple anthracosis, anthracofibrosis and non-anthracotic control groups entered this study. Demographic data and important clinical and radiological findings were recorded. Bronchial biopsy and bronchoalveolar lavage were performed for further cytopathological, acid-fast bacilli staining and culture in all cases. RESULTS: Cough and dyspnea were significantly higher in anthracosis subjects. Radiological characteristic of tuberculosis such as upper lobe localization and cavity were not significantly higher in anthracosis subjects that suffer from tuberculosis. Laboratory test for tuberculosis showed positive acid fast bacilli in 17.5 and 25% and caseating granuloma in 20 and 17.5% of anthracosis and anthracofibrosis subjects. Adding the result of culture, the frequency of tuberculosis in both groups of anthracosis was 27.5% that was significantly more than nonanthracotic control group (Odd ratio= 6.15, CL=1.29

Typhoid myopathy or typhoid hepatitis: a matter of debate.

PURPOSE: The aim of the present study was to evaluate the major source of increased serum enzyme level in typhoid fever and to determine the most relevant clinical entity, hepatitis or myopathy, during typhoid fever. METHODS: A total of 118 subjects proved to have typhoid fever were evaluated for serum enzymes such as transaminases, alkaline phosphatase, lactate dehydrogenase (LDH) and creatinine kinase (CK); and their relation with each other, clinical symptoms and serum bilirubin were evaluated by regression methods. RESULTS: Hepatomegaly was revealed in 14% of the cases and was correlated with elevated serum biliribin (5.05 +/- 13.03 mg/dL in hepatomegalic subjects). Alanine aminotransferase (ALT) and CK were elevated in 22 and 60% of the cases, respectively. Correlation coefficient of CK with aspartate aminotransferase (AST) and LDH was R2 = 0.68 and 0.75, respectively, which were higher than that of ALT with that two enzymes. CONCLUSIONS: In conclusion, elevation of serum enzymes in typhoid is mostly of muscular origin.

Association of HTLV1 infection and esophageal squamous cell carcinoma.

BACKGROUND: Both esophageal carcinoma and HTLV-1 (Human T cell lymphotropic virus 1) have high prevalence in northeastern of Iran. OBJECTIVE: To assess the presence of HTLV-1 genome in esophageal cancerous tissue and in tissues from non cancerous individuals. METHODS: Eighty five patients with esophageal squamous cell carcinoma and 48 non-cancerous control patients that underwent esophagogasteroscopy for other reasons were included in this study. All selected subjects are residing in northeastern part of Iran. All specimens were studied histopathologically by H&E staining and were evaluated for HTLV-1 by PCR method. In PCR, the presence of tax, pol, env and LTR segments of HTLV-1 genome were detected. RESULTS: Male to female ratio in the case group was 3 to 5. Average age and standard deviation in case and control group were 56 +/- 17 and 54 +/- 21 years, respectively; which did not have any significant differences. All the patients came from the same area in the northeastern part of Iran. HTLV-1 genome was found in two subjects with esophageal cancer and in one subject in the control group. Statistical analysis showed no significant differences between the two groups (chi square = 0.26, Fisher exact test P value = 0.7, Odd ratio = 1.13 [0.08

Prevalence of work-related respiratory symptoms in Iranian farmers.

BACKGROUND: Animal exposure may be an important trigger for work-related symptoms among farmers. OBJECTIVE: To estimate the prevalence of work-related respiratory symptoms (WRS) in sheep breeders and agricultural farmers and to determine work-related risk factors. METHODS: A family doctor used a questionnaire to interview a cohort of 173 farmers comprised of 127 sheep breeders and 46 agricultural farmers in the rural area of Rokh (northeast Iran). The questionnaire pertained to recurrent wheezing, cough, breathlessness or chronic phlegm while at work (these symptoms define WRS), flu-like illness and physician-diagnosed asthma. RESULTS: There were 71 subjects (41%) with WRS: 10 of 46 agricultural farmers (21.7%) and 61 of 127 sheep breeders (48.0%). The proportions of sheep breeders with wheezing (16.5%), asthma (14%), cough (29%), breathlessness (31.5%) and flu-like illness (38%) were higher than in agricultural farmers. A significant dose-response relationship among the daily hours worked with animals, the number of animals and the prevalence of symptoms was established for sheep farmers. Sheep shearing and the use of pesticide were associated with an increased risk of wheezing and phlegm. CONCLUSIONS: The results suggest that sheep farmers in general have higher rates of work-related symptoms than agricultural farmers. The severity of work-related symptoms will increase with an increase in frequency of animal contact; therefore, these results may underestimate the impact of this exposure.

Airway hyperresponsiveness to methacholine in chemical warfare victims.

BACKGROUND: The lung is one of the most exposable organs to chemical warfare agents such as sulfur mustard gas. Pulmonary complications as a result of this gas range from severe bronchial stenosis to mild or no symptoms. Airway hyperresponsiveness (AHR) which is usually assessed as response to inhaled methacholine is the most characteristic feature of asthma. AHR is reported in chronic obstructive pulmonary disease patients and smokers, and may also show in chemical warfare victims. However, there are little reports regarding AHR in chemical warfare victims. OBJECTIVE: Therefore, in this study, airway responsiveness to methacholine in victims of chemical warfare was examined. METHODS: The threshold concentrations of inhaled methacholine required for a 20% change in forced expiratory flow in 1 s (FEV1; PC20) or a 35% change in specific airway conductance (PC35) were measured in 15 chemical war victims and 15 normal control subjects. RESULTS: In 10 out of 15 chemical warfare victims (two thirds), PC20 and PC35 methacholine could be measured and subjects were called responders. AHR to methacholine in responder chemical war victims (PC20 = 0.41 and PC35 = 0.82 g/l) was significantly lower than in normal subjects (PC20 = 5.69 and PC35 = 4.60 g/l, p < 0.001 for both cases). There was a significant correlation between FEV1 and PC20 methacholine (r = 0.688, p < 0.001). The correlations between PC20 and PC35 were statistically significant as well (r = 0.856, p < 0.001). CONCLUSION: Results showed increased airway responsiveness of most chemical warfare victims to methacholine which correlated with the FEV1 value and which may be related to chronic airway inflammation or irreversible airway changes.