Stroke Classification with Microwave Signals using Explainable Wavelet Convolutional Neural Network.

Stroke is one of the leading causes of death and disability. To address this challenge, microwave imaging has been proposed as a portable medical imaging modality. However, accurate stroke classification using microwave signals is still an open challenge. In addition, identified features of microwave signals used for stroke classification need to be linked back to the original data. This work attempts to address these issues by proposing a wavelet convolutional neural network (CNN), which combines multiresolution analysis and CNN to learn distinctive patterns in the scalogram for accurate classification. A game theoretic approach is used to explain the model and indicate distinctive features for discriminating stroke types. The proposed algorithm is tested in simulation and experiments. Different types of noise and manufacturing tolerances are modeled using data collected from healthy human trials and added to the simulation data to bridge the gap between the simulation and real-life data. The achieved classification accuracy using the proposed method ranges from 81.7% for 3D simulations to 95.7% for lab experiments using simple head phantoms. Obtained explanations using the method indicate the relevance of wavelet coefficients on frequencies 0.95-1.45 GHz and the time slot of 1.3 to 1.7 ns for distinguishing ischemic from hemorrhagic strokes.

Reduced susceptibility of Burkholderia pseudomallei following exposure to carbapenem.

Reduced susceptibility in Burkholderia pseudomallei during carbapenem therapy may lead to treatment failure. We isolated a clinical strain that had developed reduced susceptibility to carbapenems while on treatment. After reviewing the patient's clinical notes, the initial isolate (BUPS01/14) was exposed to carbapenem in vitro to mimic the clinical scenario. The stability of susceptibility of the carbapenem-exposed strain (BUPS01/14R) was examined by serial subculture in antibiotic-free broth. Biochemical and morphological comparison was performed by the VITEK® system and electron microscopy. MICs increased 32-fold following carbapenem exposure and became stable in the antibiotic-free environment. On electron microscopic examination, the BUPS01/14R cells were smoother and less wrinkled compared to BUPS01/14 cells. This report highlights a potential anti-melioidosis treatment failure due to the emergence of resistance while on carbapenem monotherapy. Further study of this strain is necessary to understand the mechanism of resistance at a molecular level.

Reduced susceptibility of Burkholderia pseudomallei following exposure to carbapenem

@#Reduced susceptibility in Burkholderia pseudomallei during carbapenem therapy may lead to treatment failure. We isolated a clinical strain that had developed reduced susceptibility to carbapenems while on treatment. After reviewing the patient’s clinical notes, the initial isolate (BUPS01/14) was exposed to carbapenem in vitro to mimic the clinical scenario. The stability of susceptibility of the carbapenem-exposed strain (BUPS01/14R) was examined by serial subculture in antibiotic-free broth. Biochemical and morphological comparison was performed by the VITEK® system and electron microscopy. MICs increased 32-fold following carbapenem exposure and became stable in the antibiotic-free environment. On electron microscopic examination, the BUPS01/14R cells were smoother and less wrinkled compared to BUPS01/14 cells. This report highlights a potential anti-melioidosis treatment failure due to the emergence of resistance while on carbapenem monotherapy. Further study of this strain is necessary to understand the mechanism of resistance at a molecular level.

EVALUATING SHORT-TERM EXPOSURE TO WI-FI SIGNALS ON STUDENTS' REACTION TIME, SHORT-TERM MEMORY AND REASONING ABILITY.

This study investigated the effect of short-term exposure to Wi-Fi signals on the cognitive functions of the mind. After obtaining permission from the local Ethics Committee of Shiraz University of Medical Sciences and approval by the Iranian Registry of Clinical Trials (IRCT2017041233398N1), 45 male and female students from Shiraz University of Medical Sciences volunteered to participate in this study. They were exposed to Wi-Fi signals in two sham and exposure sessions, each for 2 hours. After completion, they took part in reaction time, short-term memory, and reasoning ability tests. After scoring, the data were analysed by SPSS software. In addition, the electric field strength and power density were calculated. The results showed no statistically significant differences between the mean scores of reaction time, short-term memory, and reasoning ability in sham and exposure. Also, the obtained values from the electric field strength and power density (E = 4.1 Vm-1, P = 0.446 Wm-2) were lower than that of threshold values by the International Commission on Non-Ionizing Radiation Protection (ICNIRP). Our results can greatly reduce concerns regarding the effects of short-term exposure to Wi-Fi waves on cognitive functions.

Detection of Toxoplasma gondii B1 Gene and IgM in IgG Seropositive Pregnant Women.

BACKGROUND: The onset of acute toxoplasmosis in pregnant women may pose a risk to their growing fetuses. The timely diagnosis of infection in managing the disease and preventing its harmful consequences on the fetus is very important. Therefore, the study was conducted to identify acute toxoplasmosis in the pregnant women by detecting the specific IgM antibody and Toxoplasma gondii B1 gene. METHODS: A total of 653 serum samples of women who attended to Fatemieh Hospital of Hamadan University of Medical Sciences were tested for IgG antibodies against Toxoplasma gondii by enzyme-linked immunosorbent as-say (ELISA). The IgG positive specimens were further examined for IgM by ELISA and polymerase chain reaction (PCR) for B1 gene. In the second phase, change in IgG titers was evaluated on 47 IgG positive samples after two weeks. RESULTS: ELISA data showed that 167 out of 653 and 2 out of 167 samples were positive for IgG (25.6%) and IgM (1.2%), respectively. However, PCR detection showed that 36 cases (21.6%) were positive for the B1 gene. Seven out of 47 IgG positive samples showed an increase in the antibody titer and positive for the B1 gene. The most cases of IgG positives and the B1 gene samples were associated with the third trimester of pregnancy with 49.7% and 14%, respectively, and the most common abundance of the B1 gene was 14.4% in the age group of 26 - 35. The most commonly reported clinical symptoms in the B1 gene-positive women were nausea 15 (41.7%), cough 13 (36.1%), headache 12 (33.3%), and vomiting 11 (30.5%). CONCLUSIONS: Using PCR and the B1 gene in serum samples of pregnant women to detect acute toxoplasmosis is a more appropriate and accurate method than IgM antibody.

Multiple Sclerosis Lesions Segmentation in Magnetic Resonance Imaging using Ensemble Support Vector Machine (ESVM).

BACKGROUND: Multiple Sclerosis (MS) syndrome is a type of Immune-Mediated disorder in the central nervous system (CNS) which destroys myelin sheaths, and results in plaque (lesion) formation in the brain. From the clinical point of view, investigating and monitoring information such as position, volume, number, and changes of these plaques are integral parts of the controlling process this disease over a period. Visualizing MS lesions in vivo with Magnetic Resonance Imaging (MRI) has a key role in observing the course of the disease. MATERIAL AND METHODS: In this analytical study, two different processing methods were present in this study in order to make an effort to detect and localize lesions in the patients' FLAIR (Fluid-attenuated inversion recovery) images. Segmentation was performed using Ensemble Support Vector Machine (SVM) classification. The trained data was randomly divided into five equal sections, and each section was fed into the computer as an input to one of the SVM classifiers that led to five different SVM structures. RESULTS: To evaluate results of segmentation, some criteria have been investigated such as Dice, Jaccard, sensitivity, specificity, PPV and accuracy. Both modes of ESVM, including first and second ones have similar results. Dice criterion was satisfied much better with specialist's work and it is observed that Dice average has 0.57±.15 and 0.6±.12 values in the first and second approach, respectively. CONCLUSION: An acceptable overlap between those results reported by the neurologist and the ones obtained from the automatic segmentation algorithm was reached using an appropriate pre-processing in the proposed algorithm. Post-processing analysis further reduced false positives using morphological operations and also improved the evaluation criteria, including sensitivity and positive predictive value.

Effects of gelatin prepared from calf bones rich in phosphorus on broiler performance, bone characteristics and digestive enzymes activity.

1. Gelatin prepared from calf bones (GCB) is a novel source of high-quality protein and phosphorus. Its inclusion in broiler chicken diets may improve bone strength, plasma and digestive alkaline phosphatase activity (ALP), phosphorus digestibility and performance of broilers. Therefore, di-calcium phosphate in a corn-soy control diet was replaced with 12, 24, and 36 g/kg of GCB in a completely randomised design with four treatments of six replicates and 10 chicks in each pen. The trial lasted from 1 to 42 d of age. 2. Body weight and feed intake were measured weekly. Plasma calcium and phosphorus concentration along with plasma and digestive ALP were assayed throughout the trial. Trypsin, α-amylase, lipase and total protease activity were assayed at 14 and 28 d of age. Tibia ash, calcium and phosphorus content and breaking strength were measured at 14, 28 and 42 d of age. Phosphorus digestibility was measured at 36 d of age. 3. Body weight and feed intake showed no significant differences between controls and diets containing 12 and 36 g/kg GCB. Tibia ash and tibia length were increased by supplementation of GCB (P ≤ 0.001). Tibia calcium and phosphorus content were increased by GCB inclusion at 14 d of age (P ≤ 0.001). Digestive alkaline phosphatase activity was increased and trypsin activity was reduced by inclusion of GCB (P ≤ 0.001; P ≤ 0.004). α-amylase activity decreased by inclusion of 12 and 24 g/kg GCB, whereas an increase in α-amylase activity was observed by inclusion of 36 g/kg GCB (P ≤ 0.001). Supplementation of diets with GCB increased phosphorus digestibility (P ≤ 0.01) and suppressed ileum growth during the experimental period. 4. Results of the current study showed that phosphorus from gelatin can greatly improve broiler bone characteristics and phosphorus digestibility and complete elimination of inorganic phosphate sources from broiler diets is feasible with inclusion of 36 g/kg high phosphorus gelatin.

Does High Frequency Transcutaneous Electrical Nerve Stimulation (TENS) Affect EEG Gamma Band Activity?

BACKGROUND: Transcutaneous electrical nerve stimulation (TENS) is a noninvasive, inexpensive and safe analgesic technique used for relieving acute and chronic pain. However, despite all these advantages, there has been very little research into the therapeutic effects of TENS on brain activity. To the best of our knowledge, there is no evidence on the effect of high frequency TENS on the gamma band activity. OBJECTIVE: Investigation of the effect of high frequency TENS on the electroencephalographic (EEG) gamma band activity after inducing ischemic pain in healthy volunteers is considered. MATERIAL AND METHODS: The modified version of Submaximal effort tourniquet test was carried out to induce tonic pain in 15 right-handed healthy volunteers. The high frequency TENS (150µs in duration, frequency of 100 Hz) was applied for 20 minutes. Pain intensity was assessed at using Visual Analog Scale (VAS) in two conditions (after-pain, after-TENS). EEG gamma band activity was recorded by a 19-channel EEG in three conditions (baseline, after-pain and after- TENS). The repeated measure ANOVA and paired-sample T- tests were used for data analysis. RESULTS: EEG analysis showed an increase in gamma total power after inducing pain as compared to baseline and a decrease after the application of TENS (mean±SD: .043±.029 to .088±.042 to .038±.022 µV2 ).The analysis of VAS values demonstrated that the intensity of induced pain (mean±SD: 51.53±9.86) decreased after the application of TENS (mean±SD: 18.66±10.28). All these differences were statistically significant (p<.001). CONCLUSION: The results of this study revealed that the high frequency TENS can reduce the enhanced gamma band activity after the induction of tonic pain in healthy volunteers. This finding might help as a functional brain biomarker which could be useful for pain treatment, specifically for EEG-based neurofeedback approaches.

Novel Microwave Torso Scanner for Thoracic Fluid Accumulation Diagnosis and Monitoring.

Thoracic fluid accumulation is one of the significant and early-stage manifestations of fatal diseases, such as lung-cancer, liver-failure and congestive heart-failure. Currently, computational-tomography (CT)-Scan is the most widely used tool for the detection of thoracic fluid. Yet, it is unable to detect small amounts of fluid, has ionizing radiation and lacks mobility. On the other hand, microwave imaging systems have emerged as an accurate and portable complementary diagnostic tool. However, there is a lack of a complete clinical platform that can fulfill the requirements of accurate and reliable imaging. Therefore, a microwave torso scanner that is designed to meet those requirements is presented. In this system, two elliptical-arrays of microwave antennas (sensors) transmit signals towards the torso and collect the back-scattered signals. The captured signals are then processed by a frequency-based imaging algorithm to form microwave images that display a possible accumulated fluid. The system successfully detects and localized small volumes (3 mL) of fluid injected at different places inside a torso-phantom. As preparations for future clinical trials, the system is tested on healthy subjects to define the threshold range of healthy scenario images.

K-ras oncogene mutation in pterygium.

PurposePterygium is claimed to be a benign proliferation triggered by prolonged exposure to ultraviolet radiation. The frequency of K-ras oncogene mutation, which is among the initial mutations in tumorigenesis, is evaluated in this study.Patients and methodsIn this prospective randomized clinical, trial pterygium tissues and normal conjunctiva tissue specimens are obtained from the superotemporal quadrant of patients who underwent primary pterygium excision with autograft transplantation. DNA extraction from tissues was performed using the QIAamp DNA FFPE tissue kit. A PCR reaction was performed to amplify sequences containing codons 12, 13, and 61 of the K-ras gene in DNA. These PCR products then underwent the 'pyrosequencing' procedure for mutations at these codons.ResultsPterygium and normal conjunctival tissue samples of 25 patients (10 females, 15 males) were evaluated in the study. The mean age of the patients was 54.54±13.13 years. Genetic analysis revealed no K-ras mutations in normal conjunctival tissues, whereas pterygium tissues of the same cases demonstrated mutation at codon 12 in one case and mutations at codon 61 in seven cases, which was statistically significant (P<0.05). The point missense mutations at codon 61 were glutamine to arginine (Glu61Arg CAA>CGA) in four cases and glutamine to leucine (Glu61Leu CAA>CTA) in three cases.ConclusionThe significantly higher frequency of codon 61 mutation of the ras oncogene in primary and bilateral pterygium specimens compared with normal conjunctiva supports the tumoral origin of pterygium, and thus set the stage for research into a targeted therapy for pterygium with better outcomes than surgical excision.

Brain Volume Estimation Enhancement by Morphological Image Processing Tools.

BACKGROUND: Volume estimation of brain is important for many neurological applications. It is necessary in measuring brain growth and changes in brain in normal/abnormal patients. Thus, accurate brain volume measurement is very important. Magnetic resonance imaging (MRI) is the method of choice for volume quantification due to excellent levels of image resolution and between-tissue contrast. Stereology method is a good method for estimating volume but it requires to segment enough MRI slices and have a good resolution. In this study, it is desired to enhance stereology method for volume estimation of brain using less MRI slices with less resolution. METHODS: In this study, a program for calculating volume using stereology method has been introduced. After morphologic method, dilation was applied and the stereology method enhanced. For the evaluation of this method, we used T1-wighted MR images from digital phantom in BrainWeb which had ground truth. RESULTS: The volume of 20 normal brain extracted from BrainWeb, was calculated. The volumes of white matter, gray matter and cerebrospinal fluid with given dimension were estimated correctly. Volume calculation from Stereology method in different cases was made. In three cases, Root Mean Square Error (RMSE) was measured. Case I with T=5, d=5, Case II with T=10, D=10 and Case III with T=20, d=20 (T=slice thickness, d=resolution as stereology parameters). By comparing these results of two methods, it is obvious that RMSE values for our proposed method are smaller than Stereology method. CONCLUSION: Using morphological operation, dilation allows to enhance the estimation volume method, Stereology. In the case with less MRI slices and less test points, this method works much better compared to Stereology method.

Comparative Analysis of Wavelet-based Feature Extraction for Intramuscular EMG Signal Decomposition.

BACKGROUND: Electromyographic (EMG) signal decomposition is the process by which an EMG signal is decomposed into its constituent motor unit potential trains (MUPTs). A major step in EMG decomposition is feature extraction in which each detected motor unit potential (MUP) is represented by a feature vector. As with any other pattern recognition system, feature extraction has a significant impact on the performance of a decomposition system. EMG decomposition has been studied well and several systems were proposed, but feature extraction step has not been investigated in detail. OBJECTIVE: Several EMG signals were generated using a physiologically-based EMG signal simulation algorithm. For each signal, the firing patterns of motor units (MUs) provided by the simulator were used to extract MUPs of each MU. For feature extraction, different wavelet families including Daubechies (db), Symlets, Coiflets, bi-orthogonal, reverse bi-orthogonal and discrete Meyer were investigated. Moreover, the possibility of reducing the dimensionality of MUP feature vector is explored in this work. The MUPs represented using wavelet-domain features are transformed into a new coordinate system using Principal Component Analysis (PCA). The features were evaluated regarding their capability in discriminating MUPs of individual MUs. RESULTS: Extensive studies on different mother wavelet functions revealed that db2, coif1, sym5, bior2.2, bior4.4, and rbior2.2 are the best ones in differentiating MUPs of different MUs. The best results were achieved at the 4th detail coefficient. Overall, rbior2.2 outperformed all wavelet functions studied; nevertheless for EMG signals composed of more than 12 MUPTs, syms5 wavelet function is the best function. Applying PCA slightly enhanced the results.

The relationship between serum levels of vitamin D with asthma and its symptom severity: A case-control study

BACKGROUND: Asthma is a heterogeneous disease characterised by chronic inflammatory airways, and is affected by several immunological factors. One of the most discussed and researched hypotheses is the relationship between vitamin D serum levels with asthma. This study aimed to investigate the relationship between vitamin D serum levels with asthma and pulmonary functions in children in Kurdistan province, Iran. MATERIALS AND METHODS: In this case-control study, 120 children ranging from 6 to 18 years were referred in summer for investigation. Participants were divided into two groups: asthma group, N=60; and control group, N=60. After serum separation, samples were analysed using vitamin D ELISA kit. Additionally, pulmonary function test and serum IgE levels were measured in both groups. Data were analysed using Chi-square test and multiple regression analysis in SPSS15. RESULTS: No difference was shown between the groups in terms of gender composition (male: 57.5; female: 42.5) (P>0.05). Average Vitamin D serum level in the case group (17.98±8.68) was less than in control group (22.35±6.26) (P<0.01). In addition, the difference of vitamin D deficiency in level of suboptimal between the asthma (17.77±6.41) and the control group (24.9±3.18) was statistically significant (P<0.0001). Positive correlation existed between vitamin D levels with FEV1, FVC, and FEV1/FVC. Multiple regression analysis showed a reverse relationship between vitamin D levels with IgE serum levels; this remained after adjustment for potential confounders (e.g. age, sex, BMI, FEV1, and FVC). CONCLUSION: The results showed that serum levels of vitamin D in asthma patients were less than in healthy people, and also reduced lung function in these patients. So, the serum levels of vitamin D in asthma patients must be checked continuously

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An outbreak of yolk sac infection and dead-in-shell mortality in common canary (Serinus canaria) caused by Klebsiella pneumoniae.

Yolk sac infection (YSI) and dead-in-shell mortality caused by Enterobacteriaceae in birds are not a rare phenomenon, however there are only a few reports indicating the association between these conditions and Klebsiella spp. among canary chicks (Serinus canaria). There have been reports of high mortality among 1-3 day old canary chicks in an indoor flock of canaries. In order to study the causative agent, yolk sac samples from dead-in-shell and day-old canary chicks were cultured. Klebsiella pneumonia was isolated and identified based on biochemical tests and using genus and species-specific multiplex PCR and later tested for their susceptibility to 13 antimicrobial agents. The isolates showed susceptibility to Gentamycin, Chloramphenicol, Florfenicol and Streptomycin.

The relationship between serum levels of vitamin D with asthma and its symptom severity: A case-control study.

BACKGROUND: Asthma is a heterogeneous disease characterised by chronic inflammatory airways, and is affected by several immunological factors. One of the most discussed and researched hypotheses is the relationship between vitamin D serum levels with asthma. This study aimed to investigate the relationship between vitamin D serum levels with asthma and pulmonary functions in children in Kurdistan province, Iran. MATERIALS AND METHODS: In this case-control study, 120 children ranging from 6 to 18 years were referred in summer for investigation. Participants were divided into two groups: asthma group, N=60; and control group, N=60. After serum separation, samples were analysed using vitamin D ELISA kit. Additionally, pulmonary function test and serum IgE levels were measured in both groups. Data were analysed using Chi-square test and multiple regression analysis in SPSS15. RESULTS: No difference was shown between the groups in terms of gender composition (male: 57.5; female: 42.5) (P>0.05). Average Vitamin D serum level in the case group (17.98±8.68) was less than in control group (22.35±6.26) (P<0.01). In addition, the difference of vitamin D deficiency in level of suboptimal between the asthma (17.77±6.41) and the control group (24.9±3.18) was statistically significant (P<0.0001). Positive correlation existed between vitamin D levels with FEV1, FVC, and FEV1/FVC. Multiple regression analysis showed a reverse relationship between vitamin D levels with IgE serum levels; this remained after adjustment for potential confounders (e.g. age, sex, BMI, FEV1, and FVC). CONCLUSION: The results showed that serum levels of vitamin D in asthma patients were less than in healthy people, and also reduced lung function in these patients. So, the serum levels of vitamin D in asthma patients must be checked continuously.

Temperature-Dependent Development Modeling of the Phorid Fly Megaselia halterata (Wood) (Diptera: Phoridae).

The effect of temperature on the development of Megaselia halterata (Wood) (Diptera: Phoridae) on A15 variety of button mushroom in the stages of casing and spawn-running was investigated at eight constant temperatures (10, 12.5, 15, 18, 20, 22.5, 25, and 27°C) and developmental rates were modeled as a function of temperature. At 25 and 27°C, an average of 22.2 ± 0.14 and 20.0 ± 0.10 days was needed for M. halterata to complete its development from oviposition to adult eclosion in the stages of casing and spawn-running, respectively. The developmental times of males or females at various constant temperatures were significantly different. Among the linear models, the Ikemoto and Takai linear model in the absence of 12.5 and 25°C showed the best statistical goodness-of-fit and based on this model, the lower developmental threshold and the thermal constant were estimated as 10.4°C and 526.3 degree-days, respectively. Twelve nonlinear temperature-dependent models were examined to find the best model to describe the relationship between temperature and development rate of M. halterata. The Logan 10 nonlinear model provided the best estimation for T opt and T max and is strongly recommended for the description of temperature-dependent development of M. halterata.

Comparative trial of Aloe vera/olive oil combination cream versus phenytoin cream in the treatment of chronic wounds.

OBJECTIVE: Aloe vera is a medicinal plant that has been traditionally used to accelerate wound healing. Olive oil is also a natural product that may contribute to wound healing owing to its antimicrobial and anti-inflammatory effects. The present study aimed to evaluate the effect of an Aloe vera-olive oil (AVO) combination cream on the healing process of chronic wounds. METHOD: In this randomised, double-blind, comparator-controlled, parallel-group trial, patients with chronic wounds were treated with either AVO cream or phenytoin cream as the standard treatment for a period of 30 days. Wound healing was evaluated using Bates-Jensen assessment tool and the severity of pain was assessed using a visual analogue scale (VAS). RESULTS: After initial assessment, 60 patients with chronic wounds (41 with pressure ulcer, 13 with diabetic wounds and 6 with venous ulcers), were recruited and randomised into 2 groups of 30. After 30 days of treatment, significant improvements in the wound size, depth, and edges; necrotic tissue type and amount; exudate type and amount; colour of wound surroundings; and peripheral tissue oedema score were observed in the AVO cream group (p<0.001). The total score of wound healing showed significant improvement with both AVO (p<0.001) and phenytoin (p<0.01) creams, although AVO was more efficacious (p<0.001). Likewise, although both treatments reduced the initial VAS score, the efficacy of AVO was significantly greater (p<0.001). CONCLUSION: AVO cream significantly accelerates biological healing of chronic wounds and helps to reduce pain severity with a higher efficacy compared with phenytoin cream.

Feasibility of Using Wideband Microwave System for Non-Invasive Detection and Monitoring of Pulmonary Oedema.

Pulmonary oedema is a common manifestation of various fatal diseases that can be caused by cardiac or non-cardiac syndromes. The accumulated fluid has a considerably higher dielectric constant compared to lungs' tissues, and can thus be detected using microwave techniques. Therefore, a non-invasive microwave system for the early detection of pulmonary oedema is presented. It employs a platform in the form of foam-based bed that contains two linear arrays of wideband antennas covering the band 0.7-1 GHz. The platform is designed such that during the tests, the subject lays on the bed with the back of the torso facing the antenna arrays. The antennas are controlled using a switching network that is connected to a compact network analyzer. A novel frequency-based imaging algorithm is used to process the recorded signals and generate an image of the torso showing any accumulated fluids in the lungs. The system is verified on an artificial torso phantom, and animal organs. As a feasibility study, preclinical tests are conducted on healthy subjects to determinate the type of obtained images, the statistics and threshold levels of their intensity to differentiate between healthy and unhealthy subjects.

HLA class II susceptibility pattern for type 1 diabetes (T1D) in an Iranian population.

This study aimed to determine the HLA-DRB1/HLA-DQB1 susceptibility and protection pattern for type 1 diabetes (T1D) in a population from Hamadan, north-west of Iran. A total of 133 patients with T1D were tested for HLA-DRB1 and HLA-DQB1 alleles using PCR-SSP compared to 100 ethnic-matched healthy controls. Alleles and haplotypes frequencies were compared between both groups. The most susceptible alleles for disease were HLA-DRB1*03:01, DRB1*04:02, DQB1*02:01 and DQB1*03:02, and protective alleles were HLA-DRB1*07:01, *11:01, *13:01, *14:01 and DRB1*15 and HLA-DQB1*06:01, *06:02 and *06:03. Haplotype analysis revealed that patients with T1D had higher frequencies of DRB1*03:01-DQB1*02:01 (OR = 4.86, P < 10(-7) ) and DRB1*04:02-DQB1*03:02 (OR = 9.93, P < 10(-7) ) and lower frequencies of DRB1*07:01-DQB1*02:01 (P = 0.0005), DRB1*11:01-DQB1*03:01 (P = 0.001), DRB1*13:01-DQB1*06:03 (P = 0.002) and DRB1*15-DQB1*06:01 (P = 0.001) haplotypes compared to healthy controls. Heterozygote combination of both susceptible haplotypes (DR3/DR4) confers the highest risk for T1D (RR = 18.80, P = 4 × 10(-5) ). Additionally, patients with homozygote diplotype, DR3/DR3 and DR4/DR4, showed a similar risk with less extent to heterozygote combination (P = 0.0004 and P = 0.01, respectively). Our findings not only confirm earlier reports from Iranians but also are in line with Caucasians and partly with Asians and some African patients with T1D. Remarkable differences were the identification of DRB1*04:01-DQB1*03:02, DRB1*07:01-DQB1*03:03 and DRB1*16-DQB1*05:02 as neutral and DRB1*13:01-DQB1*06:03 as the most protective haplotypes in this study.