Objective: This study aimed to evaluate serum levels of pro-inflammatory cytokines and TGF-␤ in sickle cell disease (SCD) patients, and to compare the results during vaso-occlusive crisis (VOC) or steady state (StSt) conditions. Methods: 54 SCD patients (37HbSS and 17S␤ + Thal) were enrolled in the study and evaluated in two groups as follows; group A consisted of 39 VOC patients and group B comprised 15 StSt patients. Nineteen healthy volunteers were included as controls. Circulating levels of IL-1, IL-6, IL-8, IL-17,TNF-␣ and TGF-␤ were measured using ELISA. Results: Patients in VOC showed higher mean levels of all cytokines than those found in steady-state patients, but this was only marginally significant for IL-8 levels (P = 0.08). Increased levels of TGF-␤ and IL-17 were found in StSt patients versus normal controls (P = 0.004 and P<0.0001 respectively). A positive correlation was observed between IL-8 and IL-17 in both groups of patients (P = 0.002 and P = 0.005 respectively). Decreased levels of TNF-␣, IL-1␤ and IL-17 were found in hydroxyurea-treated patients. Additionally, significantly higher levels of IL-6 and IL-8 were observed in hydroxyurea-treated and untreated patients than in controls respectively (P = 0.04 and P = 0.01). Conclusions: Our findings indicate that pro-inflammatory cytokines, especially IL-8 and IL-17, could be used as related markers for assessing disease severity, and consequently therapeutic intervention.

These results taken together with recent studies in the area suggest that keratoconus may have a higher prevalence in the Middle East and Asia than in Western Countries.

Background:Urinary tract infection (UTI) is the most common disorder caused by bacterial agents in pregnancy, which can lead to important complications in newborn of such mothers in case of inappropriate diagnosis and treatment.Objectives:The purpose of this study was to study the prevalence of UTI among pregnant women and its complications in their newborns during the birth in the hospitals of Dezful City, Iran, during 2012 - 2013.Patients and Methods:In this cross-sectional retrospective study, 1132 women admitted to Dr. Ganjavian and Ayatollah Nabavi Hospitals in Dezful City, Iran, during 2012 - 2013 were randomly allocated into the case and control groups and were matched based on their age, numbers of pregnancy, sex and diseases of their children. UTI was the only difference between the two groups.Results:Twenty-two thousand six hundred deliveries occurred within the course of this study. Due to UTI, 5% of deliveries led to hospitalization of mothers (1132 patients).Weight and height of newborn infants of mothers afflicted with UTI (P < 0.001) were significantly lower compared to newborns of healthy women (P < 0.001). There was a significant association between the two groups of pregnant women with UTI in terms of type of delivery (normal and caesarean section) (P < 0.008).Conclusions:The lower incidence of UTI in pregnant women compared to other areas of Iran represents the role of climate and weather in the prevalence of UTI. In addition, the increased number of low-birth-weight infants had a remarkable correlation with UTI, which can influence the health of the next generation.

ABSTRACT.Purpose: To determine the distribution of ocular biometric components and their correlation with age and sex during the ages of ocular development in a 6-to 18-year-old population in Iran. Method: In this cross-sectional study, which was performed in October 2012, multi-stage stratified cluster sampling was used to sample the study population from Dezful schools, a city in the southwest of Iran. Biometric examinations were done by an experienced optometrist using the LENSTAR/BioGraph (WaveLight AG, Erlangen, Germany). Results: Among 864 selected students, 683 participated in the study (response rate: 79.1%); 377 participants (55.2%) were male, and the mean age of the participants was 12 AE 3.4 years (range: 6-18 years). The mean and 95% confidence interval of axial length (AL) were 23.13 mm (22.93-23.33), anterior chamber depth (ACD) was 3.01 mm (2.96-3.06), lens thickness (LT) was 3.58 mm (3.55-3.61), central corneal thickness (CCT) was 549.33 mic (546.59-552.07), corneal radius (CR) was 7.77 mm (7.74-7.81), corneal diameter (CD) was 12.34 mm (12.31-12.38) and pupil diameter (PD) was 4.97 (4.91-5.03). Mean AL, ACD, CD and CR were significantly higher in boys, and mean LT was significantly higher in girls. AL and ACD increased, while LT decreased significantly with age. Myopia was associated with an increase in AL and ACD, and hyperopia was associated with an increase in LT and a decrease in ACD. Conclusion: This study evaluated the distribution of the biometric components of the eye during the ages of ocular development in an Iranian population. In this age range, the majority of the changes were observed in the AL and LT.

The prevalence of obesity and diabetes is increasing worldwide. Obesity and diabetes are associated with oxidative stress, inflammation, endothelial dysfunction, insulin resistance, and glucose intolerance. Obesity, a chronic hypoxic state that is associated with decreased nitric oxide (NO) bioavailability, is one of the main causes of type 2 diabetes. The hypoxia-inducible factor-1α (HIF-1α) is involved in the regulation of several genes of the metabolic pathways including proinflammatory adipokines, endothelial NO synthase (eNOS), and insulin signaling components. It seems that adipose tissue hypoxia and NO-dependent vascular and cellular dysfunctions are responsible for other consequences linked to obesity-related disorders. Although hyperoxia could reverse hypoxic-related disorders, it increases the production of reactive oxygen species (ROS) and decreases the production of NO. Nitrate can restore NO depletion and has antioxidant properties, and recent data support the beneficial effects of nitrate therapy in obesity and diabetes. Although it seems reasonable to combine hyperoxia and nitrate treatments for managing obesity/diabetes, the combined effects have not been investigated yet. This review discusses some aspects of tissue oxygenation and the potential effects of hyperoxia and nitrate interventions on obesity/diabetes management. It can be proposed that concomitant use of hyperoxia and nitrate is justified for managing obesity and diabetes.

Background:The duration of protection following primary series vaccination against hepatitis B is unknown in children and adolescents. It has been shown that the level of anti-hepatitis B surface antigen antibodies (anti HBs Ab) declines over years after vaccination.Objectives:The aim of this study was to estimate the long-term immunity against hepatitis B virus infection among children and adolescents who had received a complete hepatitis B vaccination series during infancy.Patients and Methods:In a cross-sectional study, the - anti-HBsAb levels of 840 vaccinated children and adolescents were determined by enzyme-linked immunosorbent assay.Results:Hepatitis B seroprotection rates (anti HBsAb ≥ 10 IU/L) among vaccinated children and adolescents aged 1 and 18 years were 90% and 48.9%, respectively. The declining trend of geometric mean titer of anti-HBsAb levels was observed as changed from 272.3 IU/L to 94.1 IU/L in 1 and 18-year-old population, respectively. A significant negative correlation was found between age and anti-HBsAb levels (r = - 0.220, P = 0.0001).Conclusions:The results showed a declining trend in anti-HBsAb titers over the time after vaccination against hepatitis B virus in our region. Further studies are warranted to establish the need for a booster dose in cases that are at risk of hepatitis B virus infection.

PurposeTo determine the prevalence of refractive errors, among 6- to 15-year-old schoolchildren in the city of Dezful in western Iran.MethodsIn this cross-sectional study, 1375 Dezful schoolchildren were selected through multistage cluster sampling. After obtaining written consent, participants had uncorrected and corrected visual acuity tests and cycloplegic refraction at the school site. Refractive errors were defined as myopia [spherical equivalent (SE) −0.5 diopter (D)], hyperopia (SE ≥ 2.0D), and astigmatism (cylinder error > 0.5D).Results1151 (83.7%) schoolchildren participated in the study. Of these, 1130 completed their examinations. 21 individuals were excluded because of poor cooperation and contraindication for cycloplegic refraction. Prevalence of myopia, hyperopia, and astigmatism were 14.9% (95% confidence interval (CI): 10.1–19.6), 12.9% (95% CI: 7.2–18.6), and 45.3% (95% CI: 40.3–50.3), respectively. Multiple logistic regression analysis showed an age-related increase in myopia prevalence (p << 0.001) and a decrease in hyperopia prevalence (p << 0.001). There was a higher prevalence of myopia in boys (p<<0.001) and hyperopia in girls (p = 0.007).ConclusionThis study showed a considerably high prevalence of refractive errors among the Iranian population of schoolchildren in Dezful in the west of Iran. The prevalence of myopia is considerably high compared to previous studies in Iran and increases with age.

Background:Road traffic injuries are among the leading causes of death in the world and Iran.Objectives:The aim of this study was to assess the role of age, sex, education, and time of accident on human casualties and mortalities of road crashes in Iran.Materials and Methods:This study was based on data gathered by Iranian Police Department from the records of road crashes from April 4, 2008 through April 4, 2009. Road crashes are categorized into three types: with no human casualties, with injuries, and with human mortalities.Results:The largest rate of human causalities was observed in people aged between 25 to 34 years (P < 0.001). Illiterate people had 81% smaller odds of causality in road crashes (P < 0.001) in comparison with those with a kind of academic education. Overall, 73.4% of crashes had happened during the last ten days of a month were with human casualties (P < 0.001) and human casualties rate was slightly higher in crashes happened between 1 AM to 5 AM Fatality rate was slightly higher in the females (OR = 2.6, P = 0.068). The smallest odds of fatality were found in the people aged between 18 to 24 years and the highest odds were seen in people ≥ 55 years of age (P < 0.001). In people with a university education, 61.9% of crashes were with fatality (P = 0.026). In addition, 82.8% of crashes during winter, 60.2% of crashes during autumn, and 35.8% of crashes during summer were with mortalities. Overall, 78.3% of crashes with human casualties that had happened during 1 AM to 5 AM led to mortalities. There was also a significant association between injury and its intensity with fastening seatbelts.Conclusions:Older age, university degrees, female sex, wintertime, and the time of accident seem to be the most important risk factors in road crashes that lead to fatalities in Iran. Drivers in Iran should be informed and trained regarding these risk factors, which have direct effect on casualties and mortalities in road crashes.