[Effects of niasine on serum phosphorus, PTH and lipid profile in the hemodialysis patients in Shahroud city]

Control of the phosphorus, parathyroid hormone, and serum lipids in dialysis' patients is very important and can be done in many ways. The purpose of the study was to determine the effect of niacin on the serum phosphorus, parathyroid hormone and lipid profile among hemodialysis patients. This double blind controlled randomized study was done on 120 dialysis patients whom were divided into two groups: 60 patients [taking niacin] and 60 patients as control groups [taking placebo]. Niacin was prescribed as increasing dose from 200 mg to 600 mg monthly in three steps. Phosphorus, PTH and lipid profile were measured in the both groups. P-value<0.05 was considered as significant. 40 patients of case group [66.7%] and 37 patients [61.7%] of control group were male. Niacin significantly decreased serum levels of phosphorus [p<0.001] and parathyroid hormone [PTH] [p<0.001], also it significantly increased serum levels of HDL [p<0.01]. Nicotinic acid can decrease serum phosphorous and PTH level, and increase HDL cholesterol level. However, it needs a well design and larger trial study for determining the most effective doses of the nicotinic acid

prevalence and related factors of diabetic nephropathy in Shahroud

Diabetic nephropathy is a dangerous complication of diabetes which has a high prevalence among diabetic patients and is a cause of end stage renal failure in these patients. The aim of the present study was to investigate and determine the prevalence of diabetic nephropathy and related factors of diabetic nephropathy in Shahroud. This descriptive study was carried out on 858 diabetic patients referred to diabetic center of shahroud city in 2011. General examination and nephrologic study with collection of urin protein in 24 hours and sonography was done. 858 patients with mean age of 47.9 +/- 11.7 years were studied. Mean duration of diabetes, BMI and fasting blood glucose was 53.8+/-48.5 months, 27.9 +/- 4.9 kg/m[2] and 287.5 +/- 158.4 mg/dl, respectively. 24hr urine protein exam showed 607 [70.7%] normal condition and 251 [29.3%] diabetic nephropathy, in which 23.4% had mild type and 5.9% had severe type. Significant relationship were observed between diabetic nephropathy and age of patients [p<0.005], type II diabetes [p<0.003], duration of diabetes [p<0.003], fasting blood sugar [p<0.008] and kind of anti-diabetic drugs [p<0.003], but there was not a relationship between gender and diabetic nephropathy [p=0.345]. By timely diagnosis of diabetes mellitus, controlling the accelerating factors of diabetic nephropathy and informing the patients, we can decrease prevalence of this important complication of diabetes mellitus

Tuberculosis of knee joint: a case report

Ostheoarticular tuberculosis is a chronic disease that destroys bones and joints. A woman presented to Imam Hossein hospital because of pain, joint swelling and limitation of joint motion in her right knee. Her chief complaints were pain, swelling and limitation of right knee motion from 2 week ago. There was a large mass around the knee with spontaneously drainage after one week of swelling. At admission, she had mild fever, swelling in the posterior of right knee joint, tenderness and limitation of join motion. ESR was reported 55 mm/ 1 hour. Imaging showed narrowing of the joint cleft. Acid-fast staining organism of joint fluid was positive. After confirming tuberculosis of knee joint, standard anti-tuberculosis regimen was started. After two months of treatment, symptoms and signs were improved