Research in Medicine
Year:2006 | Volume:30 | Issue:1|Papers Count:19

Background: Non-alcoholic fatty liver disease (NAFLD) is a relatively prevalent disorder with many suspected risk factors. The aim of this study was to assess the association between the suspected risk factors with the presence of NAFLD according to the ultrasonographic criteria in type II diabetic patients.Materials and methods: The study was performed on 76 type 2 diabetic patients attending consecutively to endocrine clinic. Negative history of alcohol use and hepatitis Band C were our basic inclusion criteria. All candidates underwent thorough clinical and biochemical assays consist of height, weight, waist circumference, fasting blood sugar, HbA1c, triglyceride, total cholesterol, HDL and LDL, liver trans-aminases, alkaline phosphatase, thyroid function tests, serum iron and total iron binding capacity and liver sonography to detect the presence (stage I to III) or absence of steatosis. The score of metabolic syndrome was determined according to the latest ATP III criteria. Pearson and Spearman correlation coefficients and logistic regression were used to assess the relationship between suspected risk factors and the presence of NAFLD.Results: Forty-ninepatients (64.4%) were female. The mean age (±standard deviation) was 59.7±8.8 years. The mean BMI in patients with and without NAFLD were 29.4±4.5 and 24.8±3.8kg/m2, respectively (p<0.001). Prevalence of NAFLD was significantly higher among patients with metabolic syndrome (89% vs. 43%, p<0.05). Age (r=-0.24, p<0.05), waist circumference (r=0.27, p<0.05) and triglyceride (r=0.28, p<0.05) had significant correlation with steatosis. However, in logistic regression analysis, only BMI (for each 5 unit increment) was independently associated with the presence of NAFLD (OR=4.25, 95% CI: 1.7-10.9, p<0.05).Conclusion: In type 2 diabetic patients, only BMI had a significant role in predicting NAFLD. It seems that other metabolic factors will not give any additional information for predicting NAFLD.

Background: The present study was designed to assess the effect of Mg, Zn, vitamin C and E supplements on microalbuminuria and urinary albumin excretion and N-acetyl-b-D-glucosaminidase activity (bNAG) in type 2 diabetic patients.Materials and methods: In a randomized, double-blind, placebo controlled clinical trial, 69 type 2 diabetic patients were randomly divided into four groups and received one of the following daily supplement for 3 months; group M: 200 mg Mg and 30 mg Zn (n=16), group V: 200 mg vitamin C and 100 IV vitamin E (n=18), group MV: minerals plus vitamins (n=17), group P: placebo (n=18). Serum malondialdehyde concentration as well as urine microalbumin concentration and bNAG activity and blood pressure were measured at the baseline and following the intervention.Results: Results have revealed that following the intervention urinary albumin decreased in V and MY groups. Vrinary bNAG activity and protein concentration did not change significantly; however, malondialdehyde concentration was significantly decreased in M and MV groups. Finally, systolic, diastolic and mean blood pressure decreased significantly in the MV group.Conclusion: Our findings indicate that a combination of vitamin and mineral could decrease urinary concentration of microalbumin in type 2 diabetic patients. Thus, these supplements could be prescribed to improve renal function in type 2 diabetic patients.

Background: It is frequently thought that lumbar puncture (LP), is a mandatory procedure in all children presenting with febrile convulsion since convulsion may be the sole clinical manifestation of bacterial meningitis. The present study was conducted to assess whether meningitis could be recognized using readily available clinical information.Materials and methods: During the study period, 254 previously healthy children aged 6 months to 5 years were brought consecutively to the pediatric department of a teaching university hospital after their first febrile convulsion. Lumbar puncture (LP) was performed in all cases. Children with febrile convulsion and meningitis served as cases and those with febrile convulsion in the absence of meningitis, served as controls. The following factors were compared between groups: age, lethargy, irritability, vomiting, nuchal rigidity, bulging fontanel, headache, drowsiness, toxicity, coma, complex seizure, and prior antibiotic use.Results: of 245 infants, 12(4.7%) had meningitis. The following risk factors were significantly associated with meningitis: lethargy (p<0.0006), irritability (p<0.0008), vomiting (p<0.0001), nuchal rigidity (p<0.0001), bulging fontanel (p<0.05), headache (p<0.006), drowsiness (p<0.0001), toxicity (p<0.0012), coma (p<0.005), complex seizure (p<0.04), and prior antibiotic use (p<0.0002). All children with meningitis had at least one of the following risk factors: prior antibiotic use, positive clinical manifestations.Conclusion: Our results indicate that clinical manifestations and type of convulsion (simple or complex) could be used to diagnose meningitis, thus, there is no need for routine "LP" in all children who present with fever and seizure. However a lumbar puncture is mandatory in infants younger than 12 months or those who have received prior antibiotics.

Background: The present study was conducted to examine the relationship between variety scores of food groups and specific nutrient adequacy in Tehranian adult men.Materials and methods: In this cross-sectional study, 295 men aged 18 years and over were included. We assessed food intake by two 24-hour recalls questionnaires. Two different dietary diversity indices; dietary diversity score (DDS) and food variety (FV) score were used. Mean adequacy ratio (MAR), i.e. the mean ratio of intake to recommended amount of 12 nutrient and energy, was calculated as an indicator of nutrient adequacy. Meanwhile, nutrient adequacy ratio (NAR) was calculated.Results: The mean of age and body mass index was 40±13 years and 25±4 kg/m2. The mean of DDS was 6.05±1.02. DDS was correlated with MAR (r=0.4, p<0.05) as well as the NAR of thiamine (r=0.2, p<0.05), vitamin A (r=0.4, p<0.05), calcium (r=0.4, p<0.05), phosphorus (r=0.4, p<0.05) and total fat (r=0.4, p<0.05). Variety of whole grain was correlated mostly with the NAR of vitamin B2 and protein (r=0.3, p<0.05). Variety of vegetable and fruit had the highest correlation with the NAR of vitamin C (r=0.3, p<0.05). In the forth quartile of variety score of food groups the intake of most macro-and micronutrients were in the highest amount. Variety of meat and milk were the most important predictors of MAR.Conclusion: Variety of different food groups is a useful indicator of specific nutrient adequacy. Thus to determine the adequacy of a specific nutrient, the variety score of specific food groups can be considered.

Background: Depression is prevalent health concern in patients with unstable angina. Mild depressive symptoms could increase the risk of cardiac mortality after unstable angina. The purpose of the present study was to evaluate the symptoms of depression in patients with unstable angina.Materials and methods: For this descriptive study, 100 patients with unstable angina (49 females and SI males) who have been hospitalized in teaching hospitals affiliated to Shaheed Beheshti University of Medical Sciences were included. Depression was evaluated by means of Beck test. Chi square was used for data analysis.Results: Depression was found in 71% of the subjects; 21% severe depression, 3S% moderate and IS% mild depression. Times of admission were significantly more in depressed patients. Meanwhile, female subjects showed further susceptibility to depression.Conclusion: Appropriate diagnosis and treatment of depressed subjects who had suffered from an acute coronary heart disease may substantially reduce cardiovascular mortality and morbidity.

Background: The present study was designed to evaluate blood pressure changes in Tehranian 8-13 y old fasting girls during Ramadan and determine effective factors in order to observe blood pressure alteration independently.Materials and methods: Totally, 337 female students aged 8-13 years (mean 10±1 w), ere selected by stratified randomized method among volunteer girls intending to fast the whole month of Ramadan. Study was conducted in three stages; before and during the 2nd and 4th weeks of Ramadan. At each visit, systolic and diastolic blood pressure, pulse rate and pulse pressure, and anthropometric indices were recorded. Girls were also evaluated for pubic hair, breast development and menarche.Results: Totally, 283 girls completed all the three stages. Girls had been fasting for 9±3 and 25±4 days in the 2nd and 3rd visits, respectively. As compared to baseline, there were slight reductions in anthropometric indices during fasting. Mean systolic blood pressure decreased from 102±11 mmHg before fasting to 99±11 mmHg in the 2nd week of fasting and returned to basal level at the end of Ramadan (p<0.001). Mean diastolic blood pressure were 70±9 and 71±8 mmHg before and in the 2nd week of fasting and increased to 74±9 mmHg at the end of Ramadan (p<0.001). Systolic and diastolic pressures were significantly correlated with most anthropometric and pubertal indices. Weight showed the strongest correlation with systolic (r=0.48) and diastolic (r=0.40) blood pressure (p<0.001). Linear regression analysis demonstrated weight as the best predictor for systolic and diastolic blood pressure. Adjusting systolic and diastolic blood pressure according to the weight of the girls did not cause considerable change in their values and patterns during fasting.Conclusion: Blood pressure changes in Tehranian 8-13 year old girls during Ramadan fasting in autumn season were slight, within normal range and independent from weight changes.

Background: Hydrocarbon injection is a strange method of suicidal attempt; however, it can be also seen in domestic and industrial accidents. Management of chemical cellulites and other complications are matters of controversy among surgeons. T present study aimed at determining the surgical approach in soft tissue injection of hydrocarbons.Materials and methods: For this descriptive study, 21 patients referred to Loghman hospital in Tehran with hydrocarbon injection in a 4-year period (2001-2005) were included.Results: Most of the patients were male, single and aged between 20-29 years. Approximately, half of the cases were opium addicted. Only 6 patients had a documented psychological problem and 5 patients had a previous suicidal attempt. Choline-estrase inhibitors with hydrocarbon carrier and base were the most common injected substances (in 10 patients). Anterior of forearm was the most frequent site of injection (in 15 patients). Pain and swelling in injection site (21 patients) were the most prevalent symptoms while localized tenderness (21 patients) and erythema (17 patients) were the most common signs. Most of patients had leukocytosis (18 patients) and normal chest x-ray. All of the patients have been operated during the first 24-hour following the admission. The most common early-operations were fasciotomy and debridement (13 patients) and the most common late-operation was skin graft (10 patients). The most frequent complication was skin irritation and then compartment syndrome.Conclusion: Close monitoring of injection site for local complications and monitoring for systemic complications seem to be necessary in these patients. The majority of patients will need at least one operation despite conservative management.

Background: Human behavior is influenced by what we know or believe. In research projects, when the researcher expected a particular finding then explaining the results would be biased. Thus, blinding is a fundamental aspect of all research projects. Materials and methods: A retrospective descriptive study was performed. During a 4-year period (2001- 2004) all approved research projects in deputy of research affaires of Kerman University of Medical Sciences that had been referred to pathology laboratories were evaluated. The mechanism used for blinding is questioned by interview with researchers or reviewing the proposals.Results: Only 31% of research proposals had observed blinding policies correctly. Mistakes occurred most often in blinding process were as follow: single pathologist who was aware of research design, inappropriate group labeling by alphabetic abbreviations rather than case labeling by randomized numbers, remaining of interventions such as orthopedic devices in the test group, step by step remittance of specimens to pathology laboratory in multiphase studies, etc.Conclusion: Our results revealed that the pathologist should be blinded to group assignment. The blinding process and evaluating techniques should be supervised by statisticians and the monitoring committee (research center).

Background: P-glycoprotein, the product of MDR1 (multi drug resistance) gene, is a trans membrane efflux pump, transferring drugs and toxins from intracellular to extracellular domains. It acts as a protective barrier to keep toxins out of the body by excretingthem into the bile, urine and intestinal lumen. In the human gastrointestinal tract, P-glycoprotein is found in high concentrations on the epithelial cells of colon and small intestine. MDR1 gene polymorphism such as C3435T is associated with lower Pglycoprotein expression, thus it is suggested to have an association with ulcerative colitis. We tried to determine the frequency of C3435T polymorphism of MDR1 gene in Iranian patients with ulcerative colitis and compare it with healthy control population.Materials and methods: In this case-control designed study, we assessed the C3435T polymorphism of MDR1 gene, in 150 ulcerative colitis patients and 150 sex- and ethnicity-matched healthy controls, who were visited at a teaching hospital during a one year period.(2002-2003). The extracted leukocyte DNA was amplified by polymerase chain reaction (PCR) with specific primers, and C3435T polymorphism was detected by RFLP method.Result: The mean age of patients was 40.1±13.9 years (14-74) and of controls was 40.7±14.0 years (16-79). The frequency of C3435T allele was significantly higher in ulcerative colitis patients compared with controls (OR=1.58, 95% CI= 1.13 - 2.22, p<0.008). The frequency of C/T genotype was also significantly higher in patients with ulcerative colitis (OR=1.67, 95% CI=1.06-2.64, p<0.028).Conclusion: This study suggests that the higher frequency of 3435T allele has an association with ulcerative colitis in Iranian population as previously reported in western countries.

Quantum medicine is an emerging technology in medical sciences also called alternative and complementary medicine, takes advantage from low dose electromagnetic fields interaction with body organs. The main base of this specialty is originated from this fact that human body itself consists of electromagnetic fields flow inside and outside of the body that play an important role in physical, chemical and mental changes. These are the fundamentals of new medical technologies employed in medicine to diagnose and cure disorders and diseases. This article reviews the principles of quantum medicine and devices recently invented in this field.

Nocardia could be transmitted to lungs through dust particles; then transmitted to other organs via vascular system. We describe a 11-year old boy presenting with headache and vomiting. CT studies revealed hemorrhage in his right hemisphere as well as cerebral edema. He was hospitalized with primary diagnosis of hydrocephaly and pseudotumor cerebri. Further studies showed nocardia astroides in acid fast and blood agar culture.