[Predictors of hypoglycemia fear in patients with type 2 diabetes under treatment of oral anti hyperglycemic agents]

Introduction: Hypoglycemia is a medical emergency that disrupt routine life. Hypoglycemia experience likely causes fear of its recurrence. Even mild or moderate episodes may worry patients for frequent events. Limited studies have assessed predictors offear of hypoglycemia in patients with diabetes. The aim of the present study was to determine the predicting factors of hypoglycemia in type 2 diabetic patients treated with oral anti-hyperglycemic agents. Materials and Methods: This cross-sectional study was conducted on 357 patients with type 2 diabetes treated with oral anti-diabetic drugs. Data was collected through interviews by using a three-part questionnaire [socio-demographic and clinical characteristics, HFS-II]. The data was analyzed with descriptive and deductive statistic methods [Generalized Linear Models] at 5<0.05 using SPSSv.16 software. Results: Mean age of patients was 54.11 +/- 11.54 years and the majority were female [56.6%]. The mean HFS score was 16.8 +/- 16.33. In regression analysis, frequency of hospitalization [p<0.001], employment [p<0.048], number of medications [p<0.029], hyperlipidemia [p<0.026], hypoglycemia [p<0.001] and hypoglycemia intensity [p<0.001] were related to fear of hypoglycemia. Conclusion: According to the results of the present study, hypoglycemia and its intensity are considered as the strongest predictors of fear of hypoglycemia. Therefore, prevention of hypoglycemia occurrence and reduction of its related fear can be performed by modifying the other predictors identified in this study

[Effects of apple consumption on lipid profile among hyperlipidemic and over weight men]

This study was conducted to evaluate the effects of apple consumption on lipid profiles among hyperlipidemic and overweight men. We performed an experimental study on 46 hyperlipidemic men, aged between 30-50 years[TC=200-240 mg/dl, TG=150-350 mg/dl], randomly divided into two [apple and control] groups. The apple group [23 subjects] received 300 gr of whole apples per day [Golden Delicious] for 8 weeks, while controls [23 subjects] had the regular dietary pattern for the same period of time. Blood samples were collected at baseline and after intervention and analyzed for serum TG, TC, LDL-C, HDL-C, VLDL, Apo[B], Lp[a] and LDL/HDL levels. Before study, education level and family size were compared. Before and after intervention, physical activity and dietary intake were compared between the two groups. Both total polyphenol and the total fiber consumed in apples were measured. Total polyphenol and total fiber intakes were 485 mg/kg fresh apple and 4.03 gr/100 gr of fresh apple, respectively. After 8 weeks, mean differences in TG and VLDL concentrations increased statistically in the apple group compared to the control group, but, no significant differences were observed in the TC, LDL-C, HDL-C, Apo[B], Lp[a] and LDL/HDL levels, between two groups. Consumption of Golden Delicious apples seemed to increase serum TG and VLDL concentrations in hyperlipidemic men. More studies are needed to investigate the effect of Golden delicious apple on serum TC, LDL-C, HDL-C, Apo[B], Lp[a] and LDL/HDL concentrations

Correlation of obesity and cardiovascular diseases risk factors in girls: Tehran lipid and glucose study [TLGS]

This study aimed at investigating the correlation of obesity with cardiovascular disease risk factors among children and adolescent girls. In this cross sectional study, representative samples of 2061 girls, aged 3-18 years, were selected from among participants of the Tehran Lipid and Glucose Study. Systolic and diastolic blood pressure [BP], weight and height were measured and BMI was calculated. Serum concentrations of triglycerides [TG] and HDL-C were measured and LDL-C was calculated. Obesity affected 4.7% of the girls. Mean values of BMI, systolic and diastolic BP and TG increased with advancing age. Serum HDL-C, LDL-C and cholesterol levels increased with age up to the age of 12 years and decreased thereafter with advancing age. Compared with non-obese girls, obese girls had greater risks of high TG [OR=1.76, CI=0.48-5.08], high LDL-C [OR=1.3, CI=0.86-0.95], high cholesterol [OR=2.0, CI=0.06-3.72], low HDL-C [OR=1.46, CI=0.21-5.20], high systolic BP [OR=2.3, CI=0.08-5.22], and high diastolic BP [OR=2.4, CI=1.71-14.48]. Prevalence of cardiovascular risk factors increase in children and adolescent obese girls in Tehran

[Survey of precipitating factors of suicide attempts in persons who referred to emergency department]

Abstract Introduction: Survey of suicide attempts and its precipitating factors is important because 30% to 60% of suicides were preceded by an attempt, and 10% to 40% of suicide attempters eventually kill themselves

Objective: to assess the precipitating factors of suicide attempts and to evaluate relation between general psychiatric symptoms and repetition of suicidal attempts

Materials and Methods: This is a cross sectioned study which included 575 suicide attempts patients who referred to Boali sina hospital in Qzvin between 2004 and 2005 years. All patients completed a self- report questionnaire and questionnaire about socio-demographic and family variables and other general and specific characteristics

Results: The mean age of patients who attempted suicide ware 23.2 +/- 8.2 years [the ratio of female to male was 1:2.4 and range of 13 to 74 years old]. The most suicide attempt was between 15 to 24 years-old in both sexes. The most common method of suicide attempts was drug-poisoning for both sexes in all areas, Self-poisoning with agricultural pesticides in rural areas. The most common precipitating problems that were reported by the patients were conflict between married couples and parents, break up of a love relationship and mental illnesses. Mean total and subscales scores on GHQ was significantly higher in patients with history of previous attempt

Conclusion: According to Economic - cultural and social difference there are pivotal differences in suicidal behaviors and suicide precipitating factors in different countries. And prevention of suicidal behaviors and control of its precipitating factors need a comprehensive multi-sectoral approach rather than an intervention inside the health sector

[Investigation of insulin resistant in patients with liver cirrhosis and its relationship with severity of disease]

Insulin resistance and glucose intolerance are commonly associated with liver cirrhosis. Resistance to insulin is an important prognostic factor in liver cirrhosis. To determine the relationship between insulin resistance and severity of liver cirrhosis. This was a descriptive-analytic study carried out on 76 patients with stablished liver cirrhosis in Booali hospital [Qazvin] in 2006 and 2007. Their fasting blood sugar, serum insulin level and oral glucose tolerance test [OGTT] were measured. Patients divided into three groups of A, B and C according to the child-pugh classification. Insulin resistance was determined by the homeostasis model assessment [HOMA-IR] in all patients. Data analysis was performed using t test, variance analysis, chi-square and Fishers exact test. Cirrhosis was found to be strongly associated with insulin resistance [60.5%] and the values obtained for prevalence of insulin resistance for groups A, B, and C of Child-Pugh Classification were%31.6,%66.7 and%74.1, respectively. The relationship between IR and severity of liver cirrhosis was significant, statistically [p=0.01]. Diabetes mellitus was diagnosed in 26 subjects [34.2%], impaired glucose tolerance in 24 [31.6%] and normal glucose tolerance in 26 [34.2%] using OGTT. Insulin resistance increased with stage of liver cirrhosis as defined by Child-Pugh score

[Association of uric acid and albuminuria in patients with type 2 diabetes]

High serum uric acid is associated with kidney damage manifested by glomerular sclerosis, hypertrophy and albuminuria in animal models. To evaluate the relationship between elevated serum uric acid and urinary albumin/creatinine ratio in type2 diabetes. In this cross-sectional study, 290 patients [130 males and 160 females] with type 2 diabetes were recruited for measuring, cholesterol, triglycerides, uric acid and albumin/creatinine ratio [ACR]. The data obtained for albumin/creatinine ratio were expressed as mean +/- SD or percentage and a P value 0.05 was considered as significant. One-way analysis of variance and Pearson correlation coefficient were used for statistical studies. The mean ages of patients were 58.2 +/- 8.6 years. Uric acid levels for normalbuminuria, microalbuminuria and marcoalbuminuria were [5.1 +/- 0.7, 6.3 +/- 1.1, and 8.1 +/- 1.3 mg/dl, respectively]. While the uric acid level in men was shown to have a positive correlation with natural logarithmic ACR [Ln [ACR]], [Segma=0.53, p<0.05], a positive correlation with both triglycerides and Ln [ACR] was found among women [Segma=0.263, P<0.01]. Based on our data, serum uric acid was found to be independently correlated with urinary ACR in patients with type 2 diabetes

[Comparison of insulin secretion and resistance in patients with acute coronary syndrome]

Bulk of increasing evidences indicates that the postprandial hyperglycemia is considered as a risk factor for atherosclerosis and coronary artery disease. Several different pathophysiologic mechanisms contribute to disturbances in glucose homeostasis. To evaluate the frequency of post-challenge hyperglycemia in acute coronary syndrome [ACS] patients with previously undiagnosed diabetes and fasting glucose concentrations of less than 126 mg/dl in Qazvin and also to determine the main cause of glucose intolerance. This analytic study was accomplished at Qazvin Metabolic Diseases Research Center in 2007. A total of 120 patients with acute coronary syndrome who met the recommended inclusion criteria were studied. An oral glucose tolerance test with sampling at minutes 0, 30 and 120 was performed for each patient. The data were statistically investigated by analysis of variance, Pearson correlation and chi-square test. Normal glucose tolerance [NGT], impaired glucose tolerance [IGT], and diabetes mellitus [DM] were found in 40, 48, and 32 cases of patients, respectively. The homeostasis model assessment for insulin resistance [HOMA-IR] showed no substantial difference among three groups however, the insulinogenic index in IGT and DM patients was lower than those of NGT group with two-hour plasma insulin level higher in the former groups compared to the latter. Post-challenge hyperglycemia, caused primarily by impaired insulin initial secretion and muscle insulin resistance, is common among the ACS patients with previously undiagnosed diabetes in Qazvin. Hyperinsulinemia is a good indicator of insulin resistance in postprandial hyperglycemia. Assessing the oral glucose tolerance test of post-challenge hyperglycemia is essential in ACS patients with previously undiagnosed diabetes

[Hypothyroidism and type 1 diabetes mellitus]

Type 1 diabetes mellitus is frequently associated with autoimmune thyroid disease. Genetic susceptibility to autoantibody formation in association with autoimmune thyroid disease and type 1 diabetes mellitus has been described with varying frequencies. To investigate the prevalence of anti-thyroid peroxidase [anti-TPO] and also the overt and subclinical hypothyroidism in type 1 diabetic patients. In this case-control study, 65 subjects with type 1 diabetes mellitus and 65 unrelated normal controls were recruited for detection of anti-TPO and thyroid-stimulating hormone [TSH]. Radioimmunoassay [RIA] was used for anti-TPO and TSH detection. Out of 65 type 1 diabetic patients, 18 [27.7%] were positive for anti-TPO and 18 [27.7%] with abnormal serum TSH level. Among the patient group, 11 [16%] were found to have overt hypothyroidism and 7 [10.8%] with subclinical hypothyroidism. The mean anti-TPO levels were higher in patients with overt hypothyroidism [238.18 +/- 223.69 U/ml] than in patients with subclinical hypothyroidism [36.38 +/- 22.46 U/ml]. Of a total of 11 patients with overt hypothyroidism, 9 [81.1%] showed abnormal anti-TPO levels, whereas positive anti-TPO was detected in 57% [4 out of 7] of patients with subclinical hypothyroidism. The presence of anti-TPO in 27.7% of type 1 diabetic patients confirmed a strong association between autoimmune thyroid disease and type 1 diabetes mellitus, Thus, for early detection of autoimmune thyroid disease in patients with type 1 diabetes mellitus, the measurement of anti-TPO and TSH, preferably at the onset of disease, is recommended

effect of exogenous expression of TP53 gene carried by dendrosme, an lranian vector, on human T-lymphomd and leukemia cells

The tumor suppressor p53 protein can induce apoptosis in some cellular contexts. Among the apoptosis-inducing genes, p53 has received the most attention for cancer gene therapy. In this study, the role of Dendrosome and Lipofectin mediated normal cDNA of TP53 into MOLT-4, CCRF-CEM[T-lymphoma] and K562 cell lines was assessed. At first, CCRF-CEM, MOLT-4 and K562 [erythroleukemic] cell lines were transfected by Dendrosome and Lipofectin separately. Then, viability study was carried out by Trypan blue exclusion. The rate of apoptosis and necrosis in transfected cell lines was evaluated by Flow Cytometry. Trypan blue exclusion assay in K562 and CCRF-CEM revealed 55.8% and 17.97% viability reduction in the Dend+p53 in comparison to Dend+pcDNA3 [control], respectively. Flow Cytometry studies confirmed a significant enhancement of apoptosis and necrosis in TP53 transrected K562 and CCRF-CEM cells. Flow Cytometry and viability studies on transfected MOLT-4 cells showed no significant changes. The results showed that expression of normal cDNA of TP53 in K562 and CCRF-CEM cell lines could induce apoptosis in these cell lines with different levels. Transfection of MOLT-4 cell Line by Dend+p53 and Lipo+53 could not result in apoptosis

Expression of hepatitis B surface antigen in saccharomyces cerevisiae

The genome of HBV virus of serotype ayw cloned in pBR322 and expression shuttle vector pYES2 were used for construction of the HBsAg chimeric genes and their expression in Saccharomyces cerevisiae. Two recombinant plasmids were constructed. One of them contained the coding sequences for the major polypeptide of surface antigen. Another construct carried the major polypeptide with the pre-S2 antigenic determinant. These vectors were transferred into the yeast. Only pDF1 which contained the HBsAg gene was expressed. Some peculiar features of recombinant plasmid construction and expression of the HBsAg gene are discussed

Drinking water and esophageal cancer in northern Iran

Fifty-one out of one-thousand stations were selected in Northern Iran for evaluating the genotoxicity of daily consumed drinking water. This part of Iran has one of the highest prevalences of esophageal cancer in the world. Water sampling was carried out from river, stored rain water, spring, canal, deep and shallow wells. Extracts prepared from river and stored-rain waters induced high mutagenicity in Salmonella typhimurium TA98 strain, while the TA100 strain did not show any response. Spring and canal water extracts caused a significant increase in the TA98 his+ revertants which was not observed in TA100. Among the 40 sampled deep and shallow well water concentrates, only 1/3 of the latter induced significant mutagenicity in the TA98 strain, 2/3 of extracts of both sources showed no sign of mutagenicity in TA100, while the remaining 1/3 caused various levels of lethalities in this strain. No lethalities were detected in this strain when river and stored rain water extracts were tested. Among all of the prepared extracts, only those belonging to river and stored rain water caused remarkable induction of DNA breaks in V79 fibroblasts