Researcher Bulletin of Medical Sciences
Year:2005 | Volume:10 | Issue:4 (46)|Papers Count:13

Background: Although dietary guidelines recommend increased intake of grain products to prevent chronic diseases, no epidemiologic data exist regarding whole-grain intake association with hypertriglyceridemic waist phenotype. This study was conducted to evaluate the relationship between whole-grain intakes and the prevalence of hypertriglyceridemic waist phenotype in Tehrani adults.Materials and Methods: This population-based cross-sectional study was conducted on 827 subjects (357 men and 470 women) aged 18-74 years randomly selected from among participants of the Tehran Lipid and Glucose Study. Usual dietary intake was assessed using a food frequency questionnaire for one year. The procedure developed by Jacobs et al was used to classify grain products into whole- and refined grains. Weight and height were measured according to standard protocols and body mass index was calculated. Fasting blood samples were taken for biochemical measurements. Blood pressure was measured according to standard protocol. Cut off points of serum triglyceride concentration and waist girth used to define hypertriglyceridemic waist phenotype were 150 mg/dl for both genders and 80 cm for men and 79 cm for women, respectively. Subjects were categorized into four groups based on the mentioned cut-points: TgHWH, TgLWH, TgHWL, TgLWL. Subjects were categorized based on quartile cut-points of whole- and refined-grain intake.Results: Mean (±SD) consumptions of whole- and refined grains were 93±29 and 201±57 gld, respectively. Both men and women reported higher intakes of refined grain than of whole-grains. Compared with subjects in the lower quartile category, those in the upper category of whole-grain Intake had lower prevalence of TgHWH phenotype (29% vs 44%, P<0.05). Conversely, those in the upper category of refined grain intake had higher prevalence of this phenotype (45% vs 27%, P<0.05). After controlling for confounders, a significantly decreasing trend was observed for the risk of having hypertriglyceridemic waist phenotype among quartile categories of whole-grain intake (odds ratios among quartiles: 1.00, 0.95, 0.90, 0.78, respectively). Higher consumption of refined grains was associated with higher odds of having hypertriglyceridemic waist phenotype (1.00, 1.38, 1.65, 2.1).Conclusion: Whole grain intake is inversely and refined grain intake is positively associated with the risk of having hypertriglyceridemic waist phenotype. Further studies are required to assess the responsible mechanisms of actions of whole- and refined-grain intakes on metabolic risks.

Background: Regarding to the prevalence and complications of preterm labor and two previous studies about the role of subclinical chorioamnionitis in inducing preterm labor, this study was carried out at Mahdieh hospital during 2003-2004 to determine the relationship between subclinical chorioamnionitis and preterm labor.Materials and Methods: This case-control study was performed on 94 women with preterm labor and 100 ones with term labor, without symptoms and signs of clinical chorioamnionitis. Factors affecting preterm labor (ego pregnancy complications like as pre-eclampcia, maternal systemic disease, surgical complications, history of abortion, maternal systemic infections, anatomical abnormality of placenta, multiple pregnancies, PROM with more than 24 hour duration, clinical chorioamnionitis, and etc.) were similar in both groups. Histopathologic evaluation of chorioamnionitis was made on placentas of both groups in which no specific one was informed (a blind study). The frequency of chorioamnionitis, OR and CI with 95% probability were determined.Results: Chorioamnionitis was observed in 24.0 percent out of control group and in 46.8 percent out of case group (P<0.05, OR =2.8). Severity of chorioamnionitis had inverse relationship with gestational age in preterm labor group.Conclusion: Subclinical chorioamnionitis may lead to preterm labor. Since ascending vaginal infection is one of the most important causes of chorioamnionitis, it is recommended to evaluate the effect of vaginitis treatment on chorioamnionitis of preterm labor.

Background: To determine frequency of C282Y and H63D mutations in patients with autoimmune hepatitis and to evaluate the effect of these mutations on ferritin level.Materials and Methods: We investigated the frequency of these mutations in 66 patients and 120 age- and sex-matched healthy controls. DNA extraction through salting-out method was performed on blood samples and then mutation detection based on PCR-RFLP method was done. C282Y and H63D mutations were sought in all subjects by digestion of PCR products with Rsal and Bell restriction endonueleases, respectively.Results: There was no C282Y mutation in either patients or controls. Forteen (21.2%) patients and 26 (21.7%) controls were heterozygote for H63D mutation, and two (3%) patients and two (1.7%) controls were homozygote. The H63 D allele frequency was 13.6 and 12.5 in patients and controls respectively (p=0.828). We did not detect any significant difference in ferritin level among patients with H63D mutation and the ones without it.Conclusion: There is no marked difference in the frequency of H63D mutation between patients with autoimmune hepatitis and healthy controls. Meanwhile we did not detect any C282Y mutation in our patients. These results also suggest that there is not any association between HFE gene mutations and ferritin level in autoimmune hepatitis.

Background: Diarrheal diseases represent the second most common cause of death worldwide.The aim of the present study was to investigate the presence and the frequency of potential enteropathogen and diarrheagenic E. coli, shigella and salmonella were isolated from stool speciments by using both tradititional and molecular diagnostic methods in patients with acute diarrhea in Hamedan, Iran.Materials and Methods: We selected all the health centers of Hamedan Health Network in summer 2003 and investigated all the patients with acute diarrhea visited above mentioned treatment centers. For every patient a fresh stool sample was taken and was transported to central laboratory by using the transport media in less than 6 hours.Results: We totally collected 144 samples in which the isoloated pathogenic bacteria were Shigella strains in 17(11.8%) cases consisting 10 S.flexneri, 3 S.sonnei, 2 S.boydii and 2 untyped Shigella strains. No Salmonella strains were isolated. In molecular diagnostic section, the diarrheagenic E.coli was detected in 37(25.7%) cases, ETEC 22(15.2%), STEC 15(10.4%), EAEC 10(7%) and EPEC 2 (1.3%) In 14 (9.7%) of patients there were co-infections, in which 9(6.25%) had two or more diarragenic E.coli, 4(3%) had co-infection with diarrheagenic E.coli and Shigella strain and 1 case had two diarrheagenic E.coli strain and Shigella strain.Conclusion: Diarrheagenic E.coli is among the most prevalent agents in acute diarrhea in Iran, specially in children, so we should consider the significant role of E.coli in further studies about outcome and complications of acutes diarrhea in Iran.

Background: In regard to the prevalence of rectal cancer and morbidity and the significance of the effect of biologic marker on the response to therapy and also the reports on the association of Thymidylate Synthase (T.S.) overexpression and the response to therapy in Locally Advanced Rectal cancer this study was done in Imam Hossein Hospital Tehran in 2003-2005.Material and Methods: The research is done by a cohort study design on 9 patients with overexpressed Thymidylate Synthase Enzyme (cases) and 11 patients with normal enzyme levels (controls). The diagnosis of rectal cancer was pathologic and all patients were matched in the same staging and type of therapy. The patients underwent neoadjuvant chemoradiation in 5-6 weeks, then after 6-8 weeks of completion of therapy they were operated by radical surgery. The pathologic results and the status of anal sphincter was determined and evaluated by statistical analysis using Fisher Exact Test and also the R.R, A.R. of the association between overexpression of Thymidylate Synthase Enzyme and therapeutic response rate was determined.Results: Research on 9 cases and 11 controls showed us that patients with normal T.S. enzyme had %44.4 and those with overexpressed T.S. had %9.1 responses to therapy (P < .09). The sphincter preservation rate in control were %81.8 and in cases were %44.4 (P< .09).Conclusion: It appears that overexpression of Thymidylate Synthase enzyme has an inverse association with the positive therapeutic response to neoadjuvant chemoradiation in Locally Advanced Rectal cancer. It is much better to study on the etiology of overexpression of T.S. enzyme and also doing this study in more patients and more precise study design.

Background: According to this experimental theory that rising O2 in the breathing air may prevent myocardium from Ischemia it is routine to use oxygen for all patients with Acute Coronary Syndrome (ACS) for at least 24-48h. Using O2for patients who are not hypoxemic not only causes extra costs but also is harmful via decreasing cardiac output. The aim of this study was to measure the blood oxygen saturation in patients with ACS admitted in coronary care units (CCUs).Materials and Methods: This was a descriptive study on 100 patients with Acute Myocardial Infarction (AMI) or Unstable Angina (UA) who were admitted in coronary care unit of the Loghman Hospital. Cases were selected via convenience sampling. Our standard for hypoxemia was oxygen saturation<90 % (O2Sat <90 %). Data were analyzed through chi-square and t-tests.Results: The frequency of hypoxemia in this study was 22% that was apparently higher in older patients. Hypoxemia was significantly higher among women, but there was no significant relationship between smoking cigarette or hookah and O2 Sat.Conclusion: According to the results, 78 percent out of the patients had an appropriate O2 Sat and considering the adverse effects of O2 therapy and the economic burden it causes, it seems that using a pulse oxymeter in CCU and ordering O2 for patients according to their O2 Sat is a suitable solution.

Background: The incidence of urolithiasis is gradually increasing and it is about 109/100000/year in females and 36/100000/year in males. Prevalence of urolithiasis is 1.7 - 4.1% in females and about 4 - 9% in males. Nowadays one of the most important etiologic factors for production of stones is drug. Ceftriaxone is a widely used third-generation cephalosporin. It is generally very safe, but complications of biliary pseudolithiasis, cholecyctitis and, rarely, nephrolithiasis have been reported in children. The aim of this study was to evaluate the prevalence of nephrolithiasis due to ceftriaxone therapy in children.Materials and Methods: This is a Quasi Experimental and a before and after study conducted between act. 2003 Oct. 2004 on all children admitted due to pyelonephritis at Mofid Childrens Hospital. All patients treated with Ceftriaxone 75 mg/kg (max= 2 g/day) intravenousjy method. Diagnosis of pyelonephritis was based on standard criteria. First kidney ultrasonography has done at 1st and 2nd days of admission and second time at the last days of admission. We also evaluated target patients with third kidney ultrasonography three months after treatment. After detection of stone in ultrasonography blood and timed urine samples were obtained for hematological and biochemical tests to rule out other causes of nephrolithiasis.Results: We evaluated 184 pediatric patients 135 (73%) female and 49 (27%) male. The first US was normal in all of our patients. On the second evaluation the presence of one was reported in two children (1.1%). A 8-year - old girl and a 4 -month - old boy, biochemical laboratory tests and random urine for stone evaluation were in normal ranges in both children. Patients remained symptom free up to three months. Last kidney ultrasonography performed 3 months after discontinuation of treatment and the results of both ultrasonogram were normal.Conclusion: Ceftriaxone can cause nephrolithiasis. Dehydration and immobilization are important predisposing factors for formation of stone. This complication can be self limited as far as hydration and mobilization are maintained. So clinicians and radiologists should be aware of this complication as an etiology of nephrolithiasis. The antibacterial and pharmacokinetic benefits of ceftriaxone outweigh the problem of reversible nephrolithiasis with this antibibiotic.

Background: Renal cells are not fully differentiated at birth. We do not have, therefore, enough information about renal electrolyte excretion for following renal function in full term and low birth weight infants. Renal insufficiency and renal immaturity could be evaluated using enzymuria and low- and high-molecular-weight proteinuria and renal electrolyte excretion as noninvasive methods.Materials and Methods: This was a descriptive study conducted between Dec. 2004 Feb. 2005 on all healthy neonates attended in nursery of Mahdieh Hospital. The first fresh Urine sample was collected and analyzed for Na-K-Ca-P- Creatinine and uric acid. In our study sampling was census and plan for data collection was observation and we used Hest, Chi square, Regression analysis and Mann Withney test for statistic analysis.Results: We studied 100 neonates. We found different levels of urinary electrolyte in comparing with reference ranges in our neonates. There was a significant correlation between urine sodium and neonatal birth weight (R=0.361 and P<0.0005) and urinary uric acid and gestational age (R= 0.199 and P<0.047).Conclusion: We conclude that urinary levels of electrolytes are different with reference range in our neonates and they may correlate with neonatal gestational age, birth weight and kind of delivery.

Background: Central venous catheter (CVP)-related infection is one of the most frequent complications, seen with central venous catheterization. This complication occurs with 3% to 7% of catheters. It can be localized or systemic. This complication may increase morbidity and mortality rates, and may prolong hospitalization. Moreover, it can increase medical service costs.Strategies for preventing of this complication should be determined by the incidence of infection and the type of the colonized microorganism.Materials and Methods: In this cross sectional descriptive-analytical study, adult patients who required for more than 3 days catheterization were evaluated from 2002 till 2003 at Loghman medical center. Residents of general surgery inserted all of the catheters with the same manner and removed them in a sterile condition. Then the distal 5cm of the tip and 5cm subcontinents segment sent to hospital lab. for performing semi quantitative culture. Fifteen or more colony forming units (CFU) of any segment of catheter without clinical evidence of infection defined as colonization but isolation of the same organism (with the same species and arteriogram) of 15 or more CFU from blood and one or both catheter segment at the same time with no other identified source defined as catheter-related blood stream infection (CR-BSI).Results: Of 202 patients with CVPs, 4 patients (1.98%) had CR-BSI and 47 patients (23.22%) had colonization. The most common organism that colonized was coagulas negative staphylococcus. Although there was meaningful correlation between duration of catheterization and indication for catheterization and prevalence of colonization but there was not any statistical relation between these factors and CR-BSI.Conclusion: Over all incidences of colonization and CR-BSI in our study was similar to those observed in other studies. It can be concluded that the causative organisms of CR-BSI and catheter colonization are originated from skin around catheter insertion site.

Background: There is a great area to study the consequence of malnutrition and weight on children because of their impacts on the whole society.Materials and Methods: The descriptive study was conducted on 1521 children under the age of 6 referring to rural and urban delivery points supervised by Shaheed Beheshti University of Medical Sciences. These samples were selected systematically and their characteristics such as age, weight and height were registered in the research forms.Results: The study showed that the prevalence of underweight is 23 percent (22.74% among girls and 23.26% in boys). In all age groups, the prevalence of underweight by age in girls is more than boys, except for less than one year age group. The prevalence of mild underweight in boys is higher than girls while moderate and severe underweight in boys is lower than girls in this age group.Conclusion: It is emphasized that the difference of malnutrition between boys and girls is not significant if each sex group compared with own sex group growth curve.