[To compare dialysis adequacy in patient's that referred to Golestan province hemodialysis centers]

Hemodialysis has been used as a replacement therapy in patients with end-stage renal failure for several decades. Insufficient and low efficient hemodialysis increases the mortality rate in the patients. The aim of this study to compare the dialysis adequacy in patient's that referred to Golestan province hemodialysis centers. In this descriptive-comparative study 389 patients that have been underling permanent hemodialysis in eight hemodialysis centers of Golestan province were selected as census sampling method. Demographic date form [7 questions] patient registered dates in dossier according to study purpose [12 questions] were used as date gathering tools. Blood samples obtained before and after hemodialysis. Before starting hemodialysis and five minutes after pump stopping, arterial Blood urea nitrogen [BUN] was measured and then KT/V was calculated according to Daugirdas II formula. Statistical tests such chi-square, one way ANOVA and post hoc Analysis with Scheffe' test were used for data analyses in SPSS 13 environment. Mean of KT/V and URR in the eight hemodialysis centers of Golestan province were 1.33 and 63.22% respectively. Kalaleh hemodialysis center had highest level of KT/V [Mean=1.59] and Aghala hemodialysis center had lowest level of KT/V [Mean=1.03] and this difference was statistically significant [P<0.05]. There was statistically significant correlation between KT/V and hemodialysis time, venous and arterial needle distance, venoarterial needle direction and blood flow rate [P<0.05]. The study showed that, hemodialysis efficacy in this province is near to standard and it could be improved with some considerations such as increasing in hemodialysis time, venous and arterial needle distance and needle distance

[Comparison of the effects of oral charcoal capsule with aluminum hydroxide syrup on pruritus in hemodialysis patients]

Uremic pruritus is one of the most common and interruptive symptoms in patient with hemodialysis. Approximately, 60% of these patients suffering from this condition. There are several causes for pruritus, thus, various treatments are applied in order to control it. Comparison the effects of Oral charcoal capsule with Aluminum Hydroxide Syrup on pruritus in hemodialysis patients in 5 Azar hospital, Gorgan. Using a cross-over clinical study, we examined 30 patients with moderate and severe pruritus [two groups; n= 15 per group]. Subjects received oral charcoal capsule [6g daily in three doses] for two weeks as well as hydroxide aluminum syrup [30 cc; three times per day before each meal] for the same time. Wash out period was considered 48 hours. Pruritus severity was determined by visual analog scale [VAS] and measurement of pruritus scale [MPS]. Data were analyzed by SPSS using Wilcoxon, Mann-Whitney, unpaired and paired t-test. P=0.05 was considered as statistic significant level. Based on VAS and MPS, patients in the first group showed 40% moderate pruritus and 60% severe pruritus. However, patients in the second group showed 46.7% moderate pruritus and 53.3% severe pruritus at the beginning of the clinical trials. The results also showed that oral charcoal significantly decreased the severity of pruritus in both groups [alpha<0.05]. However, this effect was not the case for hydroxide aluminum syrup. This study showed that oral charcoal capsule was an effective drug to decrease pruritus in hemodialysis patients to compare with hydroxide aluminum syrup

[ comparative study of kojic acid cream and hydroquinone in treatment of melasma]

Melasma is an acquired hyper pigmentation on the face which generally happens in women between the ages of 30 to 35. If there is no timely treatment, it can cause a lot of cosmetic problems. The aim of this study was to compare the effect of kojic acid cream and hydroquinone 2% in treatment of melasma. This clinical trial was done on 100 women who had epidermis melasma and were referred to the dermatology department of the 22 Bahman Hospital in mashhad, Iran. Each patient had at least two melasma scars with similar severity and size on both sides of the face. For each of the patient, kojic acid cream on one side of the face and hydroquinone 2% cream on the other side of the face was prescribed. The researchers assessed the rate of improvement during a three month period. Data were analyzed using Wilcoxon test. One month after the start of treatment there was a positive response of both applications, 7% from Koji acid treatment and 10% from hydroquinone treatment. Two months after the treatment there was a positive response of 24% from kojic acid and 22% from hydroquinone. In both treatments, there was no statistical significance but there was a statistical significance after 3 months of treatment which was 58% in kojic acid and 30% in hydroquinone, group. Based on the length of the treatment during the trial, kojic acid was found to be more suitable in the treatment of melasma. Therefore, it should be considered in the protocol of treatment for this pigmentation disorder

[ effect of intravenous Iron therapy on haemoglobin level and optimization of erythropoietin therapy in haemodialysis patients]

Decrease in production of erythropoietin has been noted as one of the main factors causing anemia in ESRD patients, and administration of recombinant human erythropoietin [rhEPO] has been used to correct the anemia. Iron deficiency, including functional iron deficiency, limits the efficacy of rhEPO therapy in ESRD patients. This study examined the effects of maintenance intravenous iron sucrose [Venofer] on haemoglobin level and, optimization of erythropoietin therapy. Forty eight haemodialysis patients with haemoglobin level<9 gr/dl who were dialyzed three times weekly went under the study. Two thousands units of rhEPO were given subcutaneously at the end of each dialysis for seven weeks. At the end of the seventh week, those with haemoglobin level<9 gr/dl and with ferritin level <200 ng/dl [29 patients] were chosen for intravenous administration of 100 mg Venfor during the next five consecutive haemodialysis while maintaining the rhEPO dose at 2000 units with each dialysis. A week after the last dose of Venofer, haemoglobin and serum ferritin were determined. Average haemoglobin level among the patients before administration of rhEPO was 7.5 gr/dl. After seven weeks of subcutaneous rhEPO at 2000 units with each haemodialysis, the average haemoglobin level raised to 8.5 gr/dl. The effect of maintenance IV Venofer was an increase in average haemoglobin level to 10.4 gr/dl. The same effect was seen on the ferritin level. The ferritin level of 131 ng/dl increased to 237 ng/dl a week after last dose of IV venofer. Intravenous [IV] iron improves haemoglobin response and, thus, optimizes rhEPO therapy