Seasonal variation of HBA1C children and adolescents with type 1 diabetes

If HbA1c levels vary by season, evaluation of quality of care using HbA1c levels may be biased without adequately considering the seasonal effect on HbA1c. The aim of this study is to measure whether there is a seasonal variation in glycosylated hemoglobin concentrations and insulin dose used in children and adolescents with type 1 diabetes. A total of 118 children and adolescents with type 1 diabetes mellitus [45 boys and 73 girls], <18 years of age [10.03 +/- 3.9], attending the Iraqi Diabetic Center in Al-Mustansiriya Medical College, Baghdad, were included in this cross-sectional study, with diabetes onset before 2005, they were studied over one year in a cohort 2005-2006. HbA1c, insulin dose and recurrent severe hypoglycemia, were registered at visits scheduled quarterly, but not standardized in time. Seasonal mean values were calculated for HbA1c [defined by age, sex] and insulin dose for each season over one year. Lower mean HbA1c was seen in summer [7.85 +/- 2.28%], and higher in winter [9.04 +/- 2.38%], with a highly significant seasonal variation [p=0.0001, but there was no significant seasonal variation in insulin dose. Seasonal mean values for HbA1c in both sexes were higher in winter and lower in summer, with a significant seasonal variation in males [p=0.023], and females [p=0.035], and a highly significant seasonal variation [p=0.001] in patients <13 years only. Highest percent [62.1%] of measurements which indicated poor control [HbA1c>8.0%] was in winter, but the lowest [34.6%] was in summer. A seasonal variation in the concentration of the HbA1c was observed with the lowest level in summer consistent with an improved metabolic control in the diabetic children during the summer period. These effects are likely attributable to cold climate, with higher HbA1c levels in winter and lower levels in summer. A seasonal pattern of HbA1c appeared in both sexes and in patients <13 years old. Such variation wasn't related to recurrent severe hypoglycemia

Impaire effects of MLD and IPC on cure of breast cancer lymphoma

Lymphedema is a common complication after surgical treatment of breast cancer. MLD is standard care of it, but this treatment has some limitation such as time consumption and dependence of therapist. An alternative treatment modality is IPC. In this study we compared therapeutic effects of these two modalities on lymphedema in surgically-treated breast cancer patients who referred to physical medicine and rehabilitation service of shohada medical center in 2008-2009. This study was final studental research. In this randomized clinical trials we studied patients with unilateral lymphedema of upper limb as a complication of mastectomy for breast cancer treatment who referred to our service. 11 patients were treated by IPC method [cases group] and 12 patients were treated by MLD method [control group]. Each patient was treated for 10 session. Before trial, 5th and 10th session after treatment the Lymphedema was assessed in five part of limb [hand, wrist, 5 cm below elbow, 5 and 10 cm above elbow]. Results were compared between groups and also in each group before and after treatment with t-paired test [independent and paired] and repeated measure ANOVA and SPSS 16th edition. The mean [ +/- SD] of age was 46.6 +/- 9.4 years in cases and 45.8 +/- 9.3 years in control group. The mean [ +/- SD] of lymphedema was 133 +/- 9 [cm] in cases and 135 +/- 9 [cm] in control groups after 10 session treatment. There was no significant difference between two groups. Our results suggest that improvement of lymphedema have not significant different in these methods, but further studies are necessary for final judgment

Leukemia below two years: a teaching hospital study

A significant increase happened in infant acute leukemias incidence of around 2.5% per year for 15 years, suggesting the presence of an environmental factor. To find out the percentage of leukemia below two years. A retrospective study of [497] children with cancer [/= 50 x 10 g /L. We found that increase in numbers of previous maternal abortions was related to leukemia, one abortion represented [9.8%] and repeated abortions represented [18.2%] of the cases. Three patients were Down's syndrome constituting [4.9%] of cases. Eight patients[14.1%] were still alive on chemotherapy, while 27 patients [43.3%] were dead, and 26 patients [42.6%] lost their follow up. The percentage of leukemia below 2 years represented 17.1% of childhood leukemia < 15 years, with ALL has accounted for the highest percentage. Males were predominant in ALL, AML and CML. History of maternal abortion and Down's syndrome were both related to occurrence of leukemia below 2 years