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Background: The FAS and FAS-Ligand (FASL) system is an important apoptosis pathway in the liver. The FAS-mediated pathway functions by binding the FASL on the activated cytotoxic T lymphocytes and Natural Killer (NK) cells to the FAS receptor on infected hepatocytes. FAS and FASL polymorphisms, which are related to apoptosis, might influence the outcome of Hepatitis B Virus (HBV) infection. Objectives: Thus, the present study aimed to determine if FAS and FASL promoter polymorphisms are associated with the clinical outcome of HBV infection. Patients and Methods: DNA samples were obtained from the infected individuals including chronic carrier (n = 50), chronic hepatitis (n = 50), cirrhosis (n = 25), naturally recovered (n = 26) and compared with those of their matched healthy controls (n = 100). Genotyping for polymorphisms of FAS-670 A/G and -1377 G/A, and FASL -844 C/T was performed using polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) assays. Results: Multiple analyses for genetic association of FAS and FASL polymorphisms were not statistically different between HBV patients (n = 125) and healthy controls (n = 100). However, genotype and allele frequencies of FASL-844 C/T were significantly different between recovered individuals and patients with cirrhosis (P = 0.02 and P=0.01, respectively). Whereas, FAS-670A/G and -1377G/A polymorphisms were similarly distributed in these two groups (P = 0.8 and P = 0.47, respectively). Conclusions: The current study results showed that bearing -844T allele in FASL promoter region has a protective effect on cirrhosis and is involved in recovery from infection. In conclusion, it is proposed that HBV infection outcome might be influenced by FASL-844C/T polymorphism through alteration in apoptosis of hepatocytes.

ST2 is a member of IL-1 receptor family expressed on Th2 cells and regulates Th2 responces. The gene of ST2 encodes soluble ST2 (sST2) and the transmembrane ST2 (ST2L) isoforms through alternative mRNA splicing. The discovery of IL33/ ST2 signaling pathway, has drawn a great scientific attention to this system. sST2 has been shown to be an indacating factor in various infl ammatory conditions. This study aims to evaluate serum sST2 levels in HTLV-1 infected patients. This study included 49 HTLV-1 seropositive cases of which 14 were sympthomatic. Controls consisted of 30 healthy volunteers. sST2 level was measured using a quantitative ELISA assay and the results of the study groups were compared. Corroborating the previous reports, sST2 was lower in females (P = 0.003). The sST2 levels was slightly increased in HTLV-1 patients, though such increase was not statistically significant (P = 0.91), in addition sST2 level did not correlate significantly to the disease duration (P = 0.78). Despite some other chronic viral infection, HTLV-1 seems not to induce high serum sST2. However owing to relatively high normal variation of sST2 levels and rather small sample size, we stongly recommend further reseach with preferably larger sample size to evalute sST2 in HTLV-1 infected patients.

Many aspects of the pathogenesis of Human T-cell lymphotropic virus type 1 (HTLV-1) still need further elucidations. Previous studies have indicated that oxidative stress occurs during infection with the other retrovirus, human immunodeficiency virus 1 (HIV-1). Similar results have been observed in some other chronic viral infections including hepatitis B (HBV) and hepatitis C (HCV). In order to reveal possible oxidative stress in HTLV-1-infected patients, we evaluated serum total antioxidant capacity (TAC) as an indicator of oxidative stress in these patients. Forty-four HTLV-1-seropositive individuals were included in this study, consisting of 12 symptomatic and 32 asymptomatic (carrier) cases. Controls consisted of 36 apparently healthy, HTLV-1-, HIV- and hepatitis-seronegative individuals. All symptomatic patients had HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Serum TAC levels in patients and healthy individuals were measured using a quantitative TAC assay. The antioxidant capacity in HTLV-1-seropositive cases was significantly reduced compared to control group (P = 0.001). In addition, TAC was lower in patients with more than 5 years history of HAM/TSP compared to those with ≤5 years duration of the myelopathy (P = 0.03). Our results show a depletion of TAC during HTLV-1 infection, which intensifies along with the disease progress. This finding indicates a role of the oxidative stress in pathogenesis of HTLV-1. These results may prompt further research to evaluate any possible therapeutic effect of antioxidant dietary supplements for HTLV-1 infected individuals.

Background: Patients with cervical disc herniation (CDH) may present axial neck pain, radiculopathy, myelopathy separately or all these outcomes together. Objectives: This study aimed to evaluate the prevalence and severity of preoperative disabilities in Iranian patients with radiculopathy from CDH and compared these patients with those from other countries. Patients and Methods: In this retrospective study, medical records (including demographic characteristics, preoperative clinical presentations, and neck disability index score (NDI)) of the 93 patients (42 female, 51 male) with a mean age of 42.7 ± 9.5 (ranged; 23-71 years old) who had underwent surgery due to radiculopathy from cervical disc herniation between March 2009 and December 2013 in our orthopedic department were studied. Chi-square, Mann-Whitney, and Kruskal-Wallis tests were used to compare and correlate the variables. Results: The most common symptoms of our patients included pain (95.7%) and paresthesia (79.6%), while a positive Spurling test was the most common sign (68.8%). The mean NDI in our patients was 47.30% ± 12.81% (ranged; 28-66%) and the most common type of disability was severe disability. We could not find any significant correlation between NDI and sex, age, level or number of herniated discs but as the patient’s age increased, the probability of multilevel disc involvement also increased. Conclusions: Iranian patients with CDH usually consented to surgery while they had severe disability. In comparison with developed countries, it seems that Iranian patients with CDH present too late to be treated effectively.

Despite the strong evidence of child safety seats (CSSs) effectiveness in reducing injuries, it is still rarely used in some societies. The purpose of this study was to determine prevalence and predictors of CSS use in Mashad, Iran. Five hundred ninety kindergarten children whose parents owned a car were enrolled in the study. Parents were asked about using CSS for their children, reasons for CSS use/non-use, demographics, history of road traffic injuries and receiving any advice on CSS. Of families, 25.5% expressed that they used CSS for their child at present or any time in the past, but only 6.3% of children travelled restrained in CSS at the time of study. Age-appropriate CSS use was reported in 14.5% of infants and 2.3% of 1-5-year-old children. A significant relationship was observed between lower child age, higher maternal education and high family income with CSS use. The main reasons for CSS none-use were reported as not feeling the need (42%), followed by its high price (22%). Use of CSS was uncommon. The financial concerns and information gap about the essential need for CSS should be considered as priorities for action especially among lower socio-economic groups of society.

Biking has proven health, environmental and traffic benefits. To prevail biking at community infrastructures and "Bicycle Sharing Systems (BSS)" have been developed, but their effectiveness is dependent on people's attitudes and perceptions. We aim to investigate attitudes of people toward biking and related infrastructures with regard to demographic factors in Mashhad, Iran-a metropolis with unsuccessful BSS. The present work was conducted as a cross-sectional study at Mashhad, Iran, in 2015. In a multistage sampling, adult inhabitants were selected and data about their perceptions of benefits and barriers of biking were collected through a researcher-designed questionnaire. of 437 study participants with a mean ( ± SD) age of 29.9 ( ± 11.3) years, 250 (57.3%) were female. Only 3 (0.7%) of respondents used bikes. Positive attitudes were significantly associated with gender, marital status and occupation of participants. Car ownership was accompanied by higher perceptions of "tiredness of biking"(p = 0.02), its "low safety" (p = 0.02) and "time wasting" (p = 0.01). According to the results, cultural interventions are needed for biking promotion regardless of their socioeconomic status. Educational programs at academic settings are also valuable. Safety, convenience, and affordability of different groups of populations (like elderly and deprived people) should be regarded during designing and constructing biking infrastructures and setting participation rules.

Background Iran has one of the highest rates of road traffic crash death rates throughout the world and road traffic injuries are the leading cause of years of life lost in the country. Using child car safety seats is not mandatory by law in Iran. The purpose of this research was to determine the parental willingness to pay (WTP) for child restraints in Mashad, the second most populated city in Iran with one of the highest rates of road traffic-related deaths. Methods We surveyed 590 car-owner parents of kindergarten children who were willing to participate in the study in the year 2009. We asked them about the maximum amount of money they were willing to pay for car safety seats using contingent valuation method. Results The mean age of children was 33.5 months. The median parental WTP for CSS was about $15. Considering the real price of CSSs in Iran, only 12 percent of responders could be categorized as being willing to pay for it. Family income level was the main predictor of being willing to pay. Conclusions The median parental WTP was much lower than the actual price of the safety seats, and those who were of lower socio-economic class were less willing to pay. Interventions to increase low-income families' access to child safety seats such as providing free of charge or subsidized seats, renting or health insurance coverage should be considered.

Introduction Although some law reinforcements has recently decreased the high rate of death attributable to road traffic crashes in Iran, there are still no laws necessitating the use of child safety seats (CSS) in Iran. The purpose of the study was to determine the prevalence and pattern of CSS use in Mashad, Iran. Methods Mashad is the second highly populated city in the North-East of Iran with high injury death and morbidity. We performed a survey on 590 parents of kindergarten children who owned an automobile and were willing to participate in the study. The demographic characteristics, the history of road traffic crashes, history of receiving advice on CSS use and if they used CSS in the car were recorded in the questionnaires. Results About 25.4% of interviewed parents owned a CSS, among them 87 had bought, 19 had borrowed and 44 had received it as a gift. Of these 150 families with CSS, 113 (75.3%) did not use the CSS anymore as it was suitable for the infants. Thus, at the time of the study 37 families used CSS in their cars (6.3% of total). The main reason for nonuse was reported as not feeling the need(n=197), followed by high price (n=103). Discussion This study shows that the use of CSS in cars is rather scarce and should be promoted in Iran. There is also evidence of knowledge gap regarding effectiveness of CSS which needs to be addressed by health authorities.

Introduction Road traffic injuries are the leading cause of years of life lost in Iran with the highest rate of road traffic crashes fatalities is the Middle East. Child safety seats (CSS) are not still necessitated by law in Iran. The purpose of this research was to determine the parental willingness to pay (WTP) for child restraints in Mashhad, the second most populated city in Iran with one of the highest rates of road traffic-related death in the country. Methods We surveyed 590 parents of kindergarten children who owned an automobile and were willing to participate in the study in the year 2009. They were asked about the maximum amount of money they were willing to pay for CSS. Contingent valuation method (CVM) was used for assessing WTP among parents. Results The mean age of children was 33.5 months and 51% of them were female. The median parental WTP for CSS was estimated to be $15. Higher household economical status and higher parents educational grade were significantly associated with the amount of money they were willing to pay for CSS. Discussion Our study showed that the median parental WTP was much lower than the actual price of this equipment and those who were of lower socio-economic class were less willing to pay. Community-based interventions to give advice on and lend/or CSS to these families can be recommended.

Background: Being exposed to house dust mites intensifies atopic dermatitis. This study has investigated the con­tamination rate with Dermatophagoides mites in patient's residential home with atopic dermatitis. Methods: In this cross-sectional study, 40 patients took part with atopic dermatitis (positive or negative for mites by prick Dermal Test). Samples were collected from 3 locations (living room, bedroom and bed) by vacuum cleaner. Dust samples (transferred to freezer -20 ˚C) were examined by direct method and flotation. The data were analyzed using statistical SPSS vr.20 software. Results: Twenty patients of positive prick test included 8 (40%) male and 12 (60%) female. The results of direct observation of mites: 7 cases (35%) in bedding sheets, 6 cases (30%) bedrooms' carpet, 3 cases (15%) living room's carpet. Twenty patients of negative prick test included 8 (40%) male and 12 (60%) female. Only mites were found (5%) in living room's carpets of negative prick test patients. Dermatophagoides pteronyssinus was more frequent than Dermatophagoides farinae. (98% vs 83%). Conclusion: Fifty-five percent of residential homes of prick test positive patients and only 5% of residential homes of prick test negative patients were positive for mite. Sunshine provided home had fewer mites than home where sunshine is not provided. Prick test positive patients used handmade carpets more than machine made ones. In posi­tive prick test patients, mites were found in bed sheet and bedroom’s carpet more than negative prick test patient's sheets and carpets.

Postoperative pain is a common side effect following surgery that can significantly reduce surgical quality and patient's satisfaction. Treatment options are morphine and buprenorphine. We aimed to compare the efficacy of a single dose of intravenous morphine with sublingual buprenorphine in postoperative pain control following closed reduction surgery.This triple blind clinical trial was conducted on 90 patients referred for closed reduction orthopedic surgery. They were older than 18 years and in classes I and II of the American Society of Anesthesiologists (ASA) with an operation time of 30-90 minutes. Patients were divided into two groups of buprenorphine (4.5µg/kg sublingually) and morphine (0.2mg/kg intravenously). Baseline characteristics, vital signs, pain score, level of sedation and pharmacological side effects were recorded in the recovery room (at 0 and 30 minutes), and in the ward (at 3, 6 and 12 hours). SPSS version 19 software was used for data analysis and the significance level was set at P0.05.Ninety patients were studied, 60 males and 30 females with a mean age of 37.7±16.2 years. There was no significant difference between the two groups in terms of baseline characteristics. Pain score in the morphine group was significantly higher than the buprenorphine group with an average score of 2.5 (P0.001). Postoperative mean heart rate in the buprenorphine group was four beats lower than the morphine group (P0.001). Also, in the buprenorphine 48.6% and in the morphine group 86.7% of cases were conscious in recovery (P=0.001) with a higher rate of pruritus in the latter group (P=0.001).Sublingual buprenorphine administration before anesthesia induction in closed reduction surgery can lead to better postoperative pain control in comparison to intravenous morphine. Due to simple usage and longer postoperative sedation, sublingual buprenorphine is recommended as a suitable drug in closed reduction surgery.