Effect of single‐dose injection of vitamin D on immune cytokines in ulcerative colitis patients: a randomized placebo‐controlled trial

Ulcerative colitis (UC) is a chronic recurrent inflammation of the colon. It has been proposed that the UC pathogenesis may be related to vitamin D deficiency and/or vitamin D administration in UC patients may have an ameliorating effect on the intestinal inflammation. The aim of this study was to assess the effect of vitamin D on the serum levels of immune cytokines in UC patients. In this double‐blind randomized controlled trial, 90 mild‐to‐moderate UC patients were assigned to get either a single muscular injection of 7.5 mg vitamin D3 or 1 mL normal saline as placebo. Three months later serum levels of IL‐4, IL‐10, IL‐12p70, IFN‐γ, and TNF‐α were measured. Two group variables were compared using independent t‐test and analysis of covariance (ANCOVA). There was a significant increase in vitamin D only in the vitamin D group. Compared to placebo, vitamin D had significant decreasing effects on serum TNF‐α, IFN‐γ, and IL12p70 levels, but it had no significant effect on serum levels of IL4 and IL10. Vitamin D seems to inhibit Th1 immune responses and have no effect on Th2 responses. The findings of this study support several in vitro studies, which suggest a therapeutic immunomodulatory potential of vitamin D.     

Follow-up standard agglutination and 2-mercaptoethanol tests in 175 clinically cured cases of human brucellosis

BackgroundThe standard agglutination (SAT) and 2-mercaptoethanol (2-ME) tests are usually used in the follow-up of treated cases of human brucellosis. The purpose of this study was to monitor the levels of these tests, two years after clinical cure in cases of brucellosis.MethodsFrom April 2003 to September 2008, 175 clinically cured cases of brucellosis (103 males, 72 females) were evaluated. Diagnosis of brucellosis was established with a SAT of ≥1:320 and a 2-ME of ≥1:80, with clinical symptoms and signs compatible with brucellosis. SAT and 2-ME were retested at the end of therapy and at 3-monthly intervals for two years. Serologic cure was considered in the event of a SAT titer decrease to ≤1:160 or a 2-ME decrease to < 1:80.ResultsThe mean age of study patients was 31 ± 13.5 years. At 6, 12, 18, and 24 months after treatment, SAT titers ≥1:320 were seen in 41 (23.4%), 22 (12.6%), 7 (4%), and 6 (3.4%) cases, respectively, whereas 2-ME titers ≥1:80 were seen in 51 (29.1%), 24 (13.7%), 12 (6.9%), and 8 (4.6%) cases, respectively. The probability of serologic cure for patients with SAT titers ≤1:640 was higher than for those >1:640 (95% confidence interval (CI) 2.5–3.47, p = 0.023). The probability of serologic cure for patients with 2-ME titers ≤1:320 was higher than for those >1:320 (95% CI 2.48–3.5, p = 0.04).ConclusionsSAT and 2-ME may be found in significant titers in less than 5% of clinically treated cases after two years. Serologic cure for both tests with lower titers were higher than with higher titers.     

The incidence of berry aneurysm in the Iranian population: an autopsy study

Intracranial berry aneurysms are the most common kind of aneurysms in the brain, and are caused by head trauma in 1% of cases. They may remain asymptomatic for a long time or may rupture and cause intracranial hemorrhage. These aneurysms are associated with a high mortality rate. A definitive diagnosis can be made by angiography or autopsy. We studied the cadavers of 425 people who passed away accidentally. The number and location of berry aneurysms were recorded. Twelve cases (2.82%) were found to have a single berry aneurysm and two (0.47%) had multiple aneurysms. The aneurysms had a tendency to occur in the frontal half of the Circle of Willis and in approximation of the bifurcation of arteries. The main characteristics of cases of berry aneurysm in the Iranian population were in agreement with that reported in previous Western studies.     

The effect of plasmapheresis on treating disseminated intravascular coagulation (DIC) caused by a Hemiscorpius lepturus (Gadim) sting

Introduction: The highest mortality from scorpion stings in Iran is due to the stings of a particular type of scorpion known as Hemiscorpius lepturus (H. lepturus, Gadim in local language). The present study aimed at investigating the use of plasmapheresis to treat severe cases of H. lepturus stings.

Method: This pilot study was a randomized clinical trial conducted from June 2015 to June 2016 in Razi hospital of Ahvaz, Iran. Twenty-nine patients who had been stung by H. lepturus and admitted to ICU because of disseminated intravascular coagulation (DIC) were randomly assigned into control (15 patients, supportive treatments) and plasmapheresis (14 patients, supportive treatments?+?plasmapheresis) groups, and the patient outcomes were compared between the two groups.

Findings: Eighteen patients were female (62%), and the mean of patient age was 24?±?7. Most of the sting cases had occurred in the torso (15 patients, 52%). Only 10 patients (34%) arrived in the hospital within 12?h of being stung. There was no significant difference between the two groups in terms of the demographic and sting features. In the plasmapheresis group, hemoglobin level was significantly lower, while the PT and INR were measurably higher. In total, the plasmapheresis group experienced 29 sessions of treatment (an average of two sessions for each patient). Overall, 19 patients (66%) expired, whereas 10 patients (34%) experienced recovery with or without complications. The rate of recovery was significantly higher in the plasmapheresis group compared with controls, with eight patients (57%) in the plasmapheresis group surviving compared with two (14%) in the control group (p=.045). The duration of hospitalization was higher in the plasmaphersis group (p?Conclusions: The findings of this small-scale pilot study show that using plasmapheresis in treating DIC in patients stung by H. lepturus can prevent death and encourage recovery. However, prior to using plasmapheresis as a routine treatment for severe cases of people stung by this scorpion or other similar ones, further controlled studies with a larger sample size are needed.     

The relation of Dietary diversity score and food insecurity to metabolic syndrome features and glucose level among pre-diabetes subjects

Introduction

Prediabetes is considered as an increased risk factor for cardiovascular disease and overt diabetes and is the precursor stage of diabetes. Dietary Diversity Score (DDS) is recognized as an essential factor of a high-quality diet. However, diets with more varieties of food items might increase calorie intake and body weight. Therefore, this study was carried out to determine the association of DDS with metabolic syndrome features in adults with prediabetes.

HLA-DRBeta1, circulating Th1/Th2 cytokines and immunological homunculus in coronary atherosclerosis

Coronary atherosclerotic disease is one of the most endangering health disorder worldwide. This study was designed to investigate the correlation between HLA-DR1 alleles and circulating Th1/Th2 type cytokines in coronary atherosclerosis. By Elisa, Th1/Th2 type cytokines were determined in serum samples of 31 subjects with unstable angina, 27 subjects with chronic stable angina and 24 individuals as normal control. By SSP-PCR, more than 100 alleles of HLA-DRBeta1 were typed in 24 subjects who had skewed serum levels of Th1/Th2 type cytokines. Lipid profiles were determined by the routine methods of clinical laboratory in all subjects. The mean serum concentration of IL-10 in normal control subjects was higher in comparison to the patient groups.0.33±0.59 pg/ml versus 0.064±0.3 pg/ml in unstable angina pectoris group (p<0.028) and 0.22±0.6 pg/ml in chronic stable subjects. There was no statistically significant difference among the groups in serum levels of other desired cytokines (IFN-Gamma, IL-4). 33.33% of normal control subjects were HLA-DR16 positive whereas none of the subjects with chronic stable angina or individuals with unstable angina pectoris was positive for this antigen. The mean concentration of serum LDL-cholesterol in normal control group was high 142.046±35.40 (pg/ml).This preliminary study shows that the atherogenic effect of the LDL- cholesterol may be dampened by HDL-cholesterol through anti inflammatory cytokine IL-10 and HLA-DR16, a phenomenon interpretable via immunological homunculus theory.     

Blood Levels of Methemoglobin in Patients with Aluminum Phosphide Poisoning and its Correlation with Patient’s Outcome

Although methemoglobinemia following aluminum phosphide (AlP) intoxication has been reported, probable effect of blood level of methemoglobin (Met-Hb) on outcome of AlP-poisoned patients has not yet been investigated. This study aimed to evaluate blood levels of methemoglobin in patients with AP intoxication and its correlation with patient’s outcome. This prospective study was carried out at the Loghman–Hakim poison hospital from April 2009 to August 2009. All patients aged >12 years who had ingested AlP and were admitted at the hospital were enrolled in the study. Using the co-oximetry, blood Met-Hb level was measured at the time of admission and 24 h later if the patient survived. Forty-eight patients with AlP intoxication including 24 males were evaluated. Mean age of the patients was 25.5 ± 9.5 years. There was significant association between blood level of Met-Hb at the time of admission and mortality (2.4% ± 7.1% in survivors versus 15.2% ± 13.5% in non-survivors, P < 0.001). The same association was found at the 2nd day of admission (2.9% ± 8.2% in survivors versus 26.5% ± 19.9% in non-survivors, P = 0.02). The present study found an association between blood level of Met-Hb and mortality in patients with AlP intoxication. Effect of administration of vitamin C and methylene blue on outcome of patients with AlP intoxication should be investigated in future studies.     

An Iranian herbal-marine medicine, MS14, ameliorates experimental allergic encephalomyelitis

Multiple sclerosis is an inflammatory and demyelinating disease of the central nervous system which mainly affects young adults. To overcome wide spectrum troublesome symptoms of multiple sclerosis which affects the quality of life both in patients and their families, new drugs and remedies have been examined and offered. The preclinical beneficial effects of different medicines have mostly been examined in an animal model of multiple sclerosis called experimental allergic encephalomyelitis (EAE). In this study we have tested a traditionally used natural (herbal-marine) product called MS(14) in EAE mice. EAE mice were fed with MS(14) containing diet (30%) on the immunization day and monitored for 20 days. The results show that while clinical scores and therefore severity of the disease was progressive in normal-fed EAE mice, the disease was slowed down in MS(14)-fed EAE mice. Moreover, while there were moderate to severe neuropathological changes in normal fed mice, milder changes were seen in MS(14) fed mice.