Molecular epidemiology of human herpesvirus 8 variants in Kaposi's sarcoma from Iranian patients

Kaposi's sarcoma (KS) is a rare cancer in Iran and there is no epidemiological and molecular information about HHV-8 variants circulating among the Iranian population. In this study HHV-8 sequences have been analyzed in 43 cutaneous KS biopsies from Iranian patients mainly affected by classic KS. DNA samples were subjected to PCR amplification of HHV-8 ORF26, T0.7 and K1 followed by direct nucleotide sequencing and phylogenetic analysis. The analysis of ORF26 showed that 30 (69.8%) and 13 (30.2%) samples belonged to subtypes A/C and K, respectively. In general, the clustering of HHV-8 T0.7 variants paralleled that of ORF26. Genotyping of K1 sequences showed that the majority of samples (39 out of 41) fall into the large C clade with only 2 belonging to the A clade. In conclusion, HHV-8 variants identified among classic Iranian KS are largely related to Eurasian genotypes previously identified in KS from Mediterranean, Middle East, and East Asian regions.     

Poly thymidine polymorphism and cystic fibrosis in a non-Caucasian population

Background: Cystic fibrosis is a monogenic recessive disorder found predominantly in Caucasian population. This disease arises from mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. In this study we consider poly T polymorphism c.1210-12T[5], c.1210-12T[7], c.1210-12T[9] (T₅, T₇, T₉) in the intron 8 of CFTR gene in normal individuals and cystic fibrosis patients in the north of Iran. Material and methods: 40 CF patients and 40 normal individuals were screened for poly T polymorphism in intron 8 of CFTR gene using Reverse Dot Blot method which was also used to detect p.Phe508del among CF patients. Results: T₇ allele is the most prevalent in both normal and CF patients. Its abundance is approximately 75%. T₉ and T₅ represent approximately 20% and 5% of alleles respectively. T₇/ T₇ genotype is the most present in both normal and CF patients with 72.5% and 60% prevalence respectively. p.Phe508del was present in 13 CFTR alleles belonging to 7 patients with either homozygote T₉/ T₉, T₇/ T₇ or compound heterozygote T₇/ T₉ genotypes. Conclusion: Contrary to the Caucasians, T₇ allele is more frequent in Northern Iranian CF patients. The presence of p.Phe508del and T₇ allele in the same framework is reported for the first time in this part of the world. Further investigations of other populations will help to understand whether p.Phe508del arose by selection pressure in this part of the world or was imported from European countries. The abundance of T₅, T₇, T₉ alleles indicates that this polymorphism can be used as one of the informative markers for detection of normal and mutant alleles in prenatal diagnosis or carrier assessment in families with previous history of the disease in regions with high degree of CFTR mutation heterogeneity.     

Receiver operating characteristic (ROC) curve analysis in 5–10-year-old Bengalee girls from Calcutta,India

Summary.?Objective: The purpose of the present cross-sectional study was to evaluate the sensitivity (SN) and specificity (SP) of body mass index (BMI) and skinfolds thickness: BMI (subcutaneous to overall fat) in detecting excess adiposity in pre-menarcheal Bengalee girls.

Methods: Four hundred and fifty Bengalee girls aged 7.4 ± 1.16 years (mean ± SD; range: 5–10 years) from Calcutta were studied. Anthropometric measures – namely height, weight, circumference of mid upper arm, waist and hip, and skinfold thickness at biceps, triceps, subscapular and suprailiac – were taken from all participants using standard protocols. BMI and the log-transformed sum of four (biceps, triceps, subscapular, suprailiac) skinfolds (log₁₀ SF4) were computed subsequently. Values of log₁₀ SF4 were then converted into seven percentiles category (5th, 10th, 25th, 50th, 75th, 85th and 95th). Excess adiposity was defined as a level of log₁₀ SF4 greater than the internally derived 85th percentile (log₁₀ SF4>85th percentile). SN and SP of each internally derived percentile of BMI and log₁₀ SF4:BMI in detecting excess adiposity were then computed.

Results: SN and SP were 0.49 and 0.94 for the 95th percentile of BMI, and 0.76 and 0.82 for the 95th percentile of log₁₀ SF4:BMI. Moreover, there was a considerable decrease in overall misclassification with the use of log₁₀ SF4:BMI instead of BMI at the 95th percentile (11.2% vs 32%).

Conclusion: Percentiles of BMI in the study had higher SP but low SN in detecting excess adiposity. The use of log₁₀ SF4:BMI, on the other hand, had the merit of increasing SN in a screening programme to evaluate excess adiposity in Bengalee children aged 5–10 years.     

Organizational commitment, work environment conditions, and life satisfaction among Iranian nurses

Employee commitment to the organization is a crucial issue in today's health-care market. In Iran, few studies have sought to evaluate the factors that contribute to forms of commitment. The aim of this study was to investigate the relationship between nurses' organizational commitment, work environment conditions, and life satisfaction. A cross-sectional design was utilized. Questionnaires were distributed to all the staff nurses who had permanent employment (with at least 2 years of experience in nursing) in the five hospitals affiliated to Birjand Medical Sciences University. Two hundred and fifty participants returned completed questionnaires. Most were female and married. The correlation of the total scores of nurses' affective organizational commitment and work environment conditions indicated a significant and positive relationship. Also, a statistically significant relationship was found between affective organizational commitment and life satisfaction. The implementation of a comprehensive program to improve the work conditions and life satisfaction of nurses could enhance their organizational commitment.     

Economical impact of plasma fractionation project in Iran on affordability of plasma-derived medicines

In Iran all transfusion services are concentrated under authority of one public and centralized transfusion organization which has created the opportunity of using plasma produced in its blood centers for fractionation. In 2008 voluntary and non remunerated Iranian donors donated 1.8 million units of blood. This indicates a 25/1000 donation index. After responding to the needs for fresh plasma and cryoprecipitate each year about 150000 L of recovered plasma are reserved for fractionation. In an attempt to improve both blood safety profile and availability and affordability of plasma derived medicines, Iran's national transfusion service has entered into a contract fractionation agreement for surplus of plasma produced from donated blood by voluntary non remunerated donors. In order to ensure safety of product produced, Iran has chosen to collaborate with international fractionators based in highly regulated countries. The main objective of this study was to evaluate the impact of contract plasma fractionation on the affordability of the plasma derived medicines in Iran. During 2006–2008, Iran's contract fractionation project was able to produce 46%, 18% and 6% of IVIG, Albumin and FVIII consumed in Iran's market, respectively. In contrary to IVIG and Albumin, due to fairly high consumption of FVIII in Iran, the role of fractionation project in meeting the needs to FVIII was not substantial. However, Iran's experience has shown that contract plasma fractionation, through direct and indirect effects on price of plasma derived medicines, could substantially improve availability and affordability of such products in national health care system.     

The beginning doctor: a problem-based course for first year medical and dental students*

A problem-based course designated as ‘Beginning Doctor’ was given to 136 first year medical and dental students. The students were divided into small groups and under guidance of a tutor studied largely unfamiliar clinical problems presented to them as written résumés. They determined what further information they required, obtained the information on their own and described it to the others in plenary sessions. The tutors acted as facilitators of student learning rather than as sources of information. Contrary to the widely held assumption that students in these parts of the world are passive learners, incapable of taking direct responsibility for their own learning, the staff was pleasantly surprised to see the enthusiasm and the competence with which the students tackled the problems and easily adopted the self-learning mode.