Journal of Advances in Medical and Biomedical Research
Year:2011 | Volume:19 | Issue:76|Papers Count:17

Background and Objective: In patients with diabetes, elevated homocysteine levels have been reported to be associated with endothelial dysfunction, insulin resistance, dyslipidemia, poor control of disease, nephropathy, macroangiopathy and oxidative stress. Thus, this observational study was performed to determine the plasma homocysteine level and its correlation with clinical, biochemical and nutritional variables.Materials and Methods: This study was performed on 70 men with type 2 diabetes under metformin (at least 1500 mg daily) treatment. Regarding plasma homocysteine, patients were divided into two groups: 31patients with normal homocysteine (group 1: Hcy<15 µmol/L) and 39 patients with hyperhomocysteinemia (group 2: Hcy>15 µmol/L) Results: 55.1% patients had hyperhomocysteinemia but none of them had folate and B12 deficiency. Significant differences between the two groups were found for serum folate, total antioxidant capacity and creatinine. No differences were found for insulin resistance and glycemic control. Multiple stepwise linear regression analysis using plasma homocysteine as a dependent variable and all other clinical and laboratory parameters as independent variables indicated that age (b=0.344), creatinine (b=0.351), vitamin B12 (b=0.235), total antioxidant capacity (b=0.285) and malondialdehyde (b=0.245) were independently associated with homocysteine concentration. No correlation was found between the homocysteine and glycemic control, HOMA-IR and intake of B vitamins and caffeine.Conclusion: Further studies with a large sample size are required to assess the association of plasma homocysteine with total antioxidant capacity and other biomarkers of oxidative stress in type2 diabetes.

Background and Objective: Osteoporotic fractures are major health problems in contemporary societies which are associated with increased morbidity and mortality and substantial economic costs. Recently, increased plasma homocysteine (Hcy) level has been suggested as an independent risk factor for osteoporotic fractures. This study aimed to compare the level of plasma homocysteine, folate and vitamin B12 in Iranian postmenopausal women with low and normal bone mineral density (BMD).Materials and Methods: In this case-control study which was performed from August 2006 to May 2007, BMD of 130 Iranian postmenopausal women were measured by dual energy X- ray absorbtiometry (DXA). The subjects were assigned to one of the two groups of case (BMD < -1; n= 67) and control (BMD ≥ -1; n=63). Fasting plasma Homocysteine, folate and vitamin B12 were also determined. BMD at the neck of femur and lumbar spine, together with other collected data were analyzed with SPSS and T- test.Results: The mean age of the subjects was 58.1 ± 6 years. The mean of Hcy level in the case group was 16.98±9.4 and in the control group was 12.39 M mol/L. The mean of vit-B12 in the case group was 598±801 and in the control group was 551.2±410 Pg/L. Mann-Whitney test exibited a significant difference. The mean of serum folate level in the case group was 5.2±2.9 and in the control group was 6.5±2.9 Ng/L. Hcy, folate and B12 were significantly related to low BMD. LS –T score was negatively related to Hcy level and FN T-score had a positive relation with folate and B12 (p=0.002, p=0.017 and p=0.007, respectively). There was a relationship between folate and B12 and with increasing serum folate level, B12 level increased, too.Conclusion: The results suggest an association of vitamin B12 and folate with BMD. Whether this relationship is causal, remains unclear and demands further study.

Background and Objective: Asthma is one of the most common chronic diseases that in some cases it is manifested as chronic coughs without any other symptoms. Cough variant asthma (CVA) is an occult form of asthma of which, the only sign or symptom is chronic cough and therefore should always be considered in the differential diagnosis of chronic coughs. The aim of the present study was to detect the prevalence of cough variant asthma (CVA) among patients with chronic and persistent coughs.Materials and Methods: This study was performed in the respiratory outpatient clinic at Vali-e Asr Hospital of Zanjan, Iran, during 2009. Methacholine challenge test was carried out in 92 patients suffering from chronic coughs. CVA was diagnosed as chronic coughs without wheezing or any apparent cause which had persisted for more than 8 weeks, with a normal CXR and spirometry but with bronchial hyper-responsiveness to methacholine, based on % 20 drop in FEV1 before and after methacholine challenge test.Results: Of the 92 patients suffering from chronic cough, 24 patients (%26.1) satisfied the criteria for CVA and had positive methacholine challenge test. There was a significant association between patients' job (P=0.003) and education (P=0.001) and positive test.Conclusions: These findings suggest that CVA is a common etiology for chronic cough and its early diagnosis and treatment is significantly important to prevent progression of the disease to classic asthma .

Background and Objectives: Rheumatoid arthritis (RA) disease is a common inflammatory arthritis associated with joint destruction, motor disorder, and decreased life span. Hepcidin is an acute phase reactant protein which increases in inflammatory conditions mediated by IL-6 and its concentration elevates within the cell through regulating iron metabolism. The aim of this study was to evaluate the serum hepcidin and its association with acute-phase proteins and disease activity in patients with rheumatoid arthritis. Materials and Methods: In this case control study, 45 women with rheumatoid arthritis without prior therapy and 45 healthy individuals were investigated. After the physical examination and assessment of the disease activity based on DAS28-3(CRP) questionnaire, serum levels of hepcidin, TNF-α, hsCRP, ferritin, hemoglobin, and MDA (Malondialdehyde) were determined.Results: Serum levels of hepcidin, MDA, TNF-α and high-sensitivity C-reactive protein (hsCRP) were higher in RA patients than the control group (P=0.028, P=0.001, P=0.001, P=0.014). Hepcidin and MDA levels did not correlate with the disease activity scores and TNF-a, hcCRP, and hemoglobin levels in the RA group. Hepcidin was significantly correlated with the serum levels of ferritin higher than 60 ng/ml (r=0.57, P=0.031).Conclusion: From the results of this study it can be concluded that serum hepcidin and ferritin concentrations could be a useful laboratory marker in confirmatory diagnosis of anemia and atherosclerosis in patients with rheumatoid arthritis.

Background and Objective: Mutations in GJB2 gene is the most common cause of autosomal recessive non-syndromic hearing loss in many populations. The aim of this study was to determine the frequency of 35delG, 167delT, M34T, 235delC mutations in West Azarbaijan population.Materials and Methods: 129 patients from 96 families were studied. Mutations were detected using ASO-PCR and PCR-RFLP methods.Results: Totally, 65.89% of cases were sporadic and the remaining (34.11%) were familial. Six out of 8 cases with 35delG mutation and one case with 235delC mutation were offspring of consanguineous union. Mutations of 35delG were detected in 8 families. 167delT and M34T mutations were not found but 235delC was detected only in one family. On the other hand, 13 out of 258 chromosomes had 35delG mutations. Five patients were homozygous and 3 were heterozygous for 35delG mutation. It means that, in 5.04% of the patients the major reason for hearing loss was 35delG mutation. One out of 258 (0.39%) chromosomes had heterozygous 235delC mutation.Conclusion: It can be concluded that the other genes or mutations could result in autosomal recessive non-syndromic hearing loss in West Azerbaijani population.

Background and objective: One of the causes of male infertility is the lack of proper mobility. One way to deal with this problem is to add adenosine to human sperms in the laboratory. Therefore, this study aimed to determine the effect of different doses of adenosine on sperm motility in the ejaculates of fertile and infertile individuals. Materials and Methods: In this experimental laboratory study, 60 samples of seminal fluid of infertile and fertile men who referred to Yazd Infertility Center were analyzed according to WHO guidelines. Sperm counts, morphology and motility (fast, slow and immotile) were studied. After using Swim-up technique, the washed samples were divided into 4 groups, containing doses of 0, 2, 5 and 10 mg adenosine. The sperm parameters were evaluated after the addition of adenosine. Data were analyzed statistically using paired T-test and independent T-test. Results: The initial assessment indicated significant differences in sperm parameters, except for slow motility between the two groups. In fertile group, dose of 5mg adenosine increased sperm count, and rapid motility, but lowered the rates of sperm immotility at doses of 5 and 10 mg. In the infertile group, sperm count improved at dose of 5 mg adenosine, but it showed no effect on slow sperm motility. 5mg adenosine also improved rapid sperm motility, but dose of 10 mg had no effect. Both 5 and 10 mg adenosine significantly lowered rates of immotile sperms.Conclusion: Based on the results of this study, it can be concluded that addition of 5 mg adenosine to washed sperms can improve sperm motility of infertile men in vitro.

Background and Objective: Gastroenteritis is a major cause of mortality and morbidity among infants and children around the world. Zinc with increasing the absorbent capacity of enteric villous cells and decreasing the enteric gram negative bacteria and blocking chloride excretion leads to cell healing and helps diarrhea to resolve faster. The present study evaluates the effect of oral zinc sulfate syrup on infants of the city of Zanjan- Iran.Materials and Methods: In this randomized double blind trial, 400 hospitalized infants (age range of 6 to 24 months) with acute gastroenteritis were divided into two equal groups. The case group received 22 mg of daily oral zinc sulfate; whereas control group took the placebo. Data was gathered with questionnaires and recorded precisely over 10 days and then analyzed with independent statistical t-test and Mann-Whitney U-test.Results: Findings indicated that the frequency of diarrhea in the case group was less than the control group and weight gain after 10 days in the case group was more than the control group (P<0.0001). Meanwhile, there was no significant difference in hospitalization period and duration of diarrhea.Conclusion: The results of this study pointed out that there is a meaningful relation between times of diarrhea and weight gain in infants with acute gastroenteritis receiving oral zinc sulfate. Thus, prescrip-tion of zinc sulfate for infants with acute diarrhea for a period of 10 to 14 days is suggested.

Background and Objective: Urinary Tract Infection (UTI) is one of the most common diseases of childhood which may cause serious morbidity. We evaluated recurrence rate of UTI in children without congenital abnormalities who were at the age of 1 month to 12 years old. Materials and Methods: This cross- sectional study was carried out for three months after the termination of the treatment in order to determine the rate of recurrence and re-infection in children (sex segregationation) at the age of 1 month to 6 years and 6 to 12 years who did not have any anatomical or functional urinary abnormalities at Arak Amir kabir Hospital.Results: In total, 250 patients (224 girls and 26 boys) were evaluated. 17 girls had recurrences, of whom, 2 cases (11.7%) were under 1 year old, 14 cases (82.2%) had 1 to 6 years old and 1 case (5.8%) was in the 6 to 12 years old group. In the first month there was no relapse and most recurrences occurred through the third month (65%). All recurrences were symptomatic.Conclusion: Due to low rate of recurrence of urinary infection in our study group, repeated cultures and prophylactic treatments is not recommended in children and infants without underlying congenital renal abnormalities. In such cases, UTI can be prevented by effective trainings.

Background and Objective: Minor aphta has a high incidence in the populations ranging from 2-50%. In spite of its frequency and severity of discomfort, there is not an absolute treatment for it. So, the main objective of this study was to evaluate the efficacy of a herbal medicine in the control of Minor aphta.Materials and Methods: In this double-blind, randomized study 137 patients with Minor aphta (with not more than four days from the onset) were selected and then placed into one of the groups of A (solution containing 5 percent Myrtus communis and Melissa officinalis in ethanol 80) and B (solution containing 10 percent Myrtus communis and Melissa officinalis in ethanol 80) or C (placebo containing ethanol 80). Results: Mean duration for complete recovery in minor aphta was 3.5 days in group A, 7.5 days in group B and 7.3 days in group C. There were significant statistical differences among the three groups (p<0.0005).Conclusion: The results of this study revealed that using a combination of Myrtus Communis and Melissa Officinalis plants was effective in the treatment of recurrent aphtous stomatits (RAS). In order to obtain the accurate concentrations of the ingredients of this compound, further studies are necessary.

Background and Objective: Available information suggests that pregnant women infected with Trichomonas vaginalis may be at increased risk of preterm delivery and low birth weight (LBW). This study evaluated the association between T. vaginalis infection and the risk of LBW.Materials and Methods: In this cohort study, we evaluated 1000 pregnant women (gestational age ≥ 28 weeks) for trichomoniasis by using direct and culture methods at the time of delivery at two hospitals of Zanjan, Iran. All the infected women (33 cases) and non-infected women (107) who had been selected with purposive quota sampling were compared with each other. Questionnaires were used to collect demographic and obstetric parameters. Consequently, infants' weights were recorded using mothers’ files.Results: The prevalence of T. vaginalis infection was 3.3% (33 cases). Mean gestational age of the infected women at the time of delivery was significantly less than the non-infected (36.5±4.5 weeks vs. 39±1.9 weeks; P= 0.009). Higher parity, and living in city were significantly associated with the increased risk of vaginal trichomoniasis (P< 0.05). No significant association was found between the T. vaginalis infection and degree of education, type of delivery, family income, and frequency of LBW.Conclusion: The results of this study suggest that, T. vaginalis infection may be associated with low gestational age and higher parity at the time of delivery. However, no significant association was found between the T. vaginalis infection and LBW in the third trimester of pregnancy.

Background and Objective: Recent studies suggest that sub-lethal ischemia protect the brain from subsequent ischemic injuries. This study was an effort to identify and shed light on the nature of changes in the blood brain barrier permeability and brain edema. Materials and Methods: Rats were divided into four main experimental groups, each of 21 animals. The first group acted as a model of ischemic preconditioning which was subjected to 10 minutes of temporary middle cerebral artery occlusion in the first day (tMCAO) and in the second day, was subjected to 60 min middle cerebral artery occlusion (MCAO). The second group acted as a control group and did not receive any surgery except 60 min middle cerebral artery occlusion in the second day. The third group served as a sham group, and was subjected to surgery with 10 min of temporary middle cerebral artery occlusion (tMCAO) in the first day. The fourth group remained intact and was not subjected to any surgery. Each main group subdivided into three subgroups (n=7) for infarct volume (n=21), blood brain barrier permeability, and brain edema. After 24 hours, each main group was subjected to 60min of right MCAO occlusion. Then, neurologic deficit score (NDS), infarct volume, blood brain barrier permeability, and brain edema were assessed in the subgroups. Results: Preconditioning with tMCAO decreased NDS and infarct volume, brain barrier permeability, and brain edema. Conclusion: Temporary middle cerebral artery occlusion (tMCAO) is associated with neurologic deficit scores, infarct, blood brain barrier permeability, and brain edema consistent with an active role in the genesis of ischemic protection.

Background and Objective: Nursing research plays an outstanding role in the quality of care. One strategy to put the research into practice and change current practice is to identify barriers and then implement tailored interventions to reduce them. Therefore, the purpose of this study was to describe Registered Nurses perceptions of barriers to utilization of research results at University affiliated and educational hospitals of Zanjan, Iran.Materials and Methods: In this cross-sectional study data were collected using the Funk’s Evidence Based Practice Barriers Scale. Sample of the study consisted of 170 graduate nurses employed in Zanjan Educational Hospitals. Descriptive and inferential statistics were applied to analyze the data.Results: According to the research results, the first three important barriers were insufficient facilities (65.3%), lack of time to read research results (64.7%), and insufficient time on the job to implement new ideas (62.4%). However, perceptions of barriers to research utilization did not show a significant difference based on demographic variables of the nursing staff.Conclusion: It is highly recommended that the Zanjan hospitals education styles should be modified in order to provide the nurses with sufficient facilities and time to read and implement recent research findings.