[Effects of calcitriol [1,25[OH]2D3 treatment on control of glucose intolerance in hemodialysis patients]

Impaired carbohydrate metabolism is a common finding in patients with chronic renal failure. Although intermittent hemodialysis results in a significant improvement of impaired glucose metabolism of uremia, complete normalization did not occur. Vitamin D[3] deficiency, it seems is linked with disturbance of glucose metabolism. A role of vit D in endocrine pancreatic function has been suggested. The aim of this study was to determine the effects of 1,25 [OH]2D3 treatment on glucose tolerance, insulin resistance and beta cell function in hemodialysis patients. Of sixty-five patients with uremia on hemodialysis, twenty -seven who had never been treated with vitamin D or related drugs and without history of diabetes were selected for this study. These patients were randomly divided to two groups, group I were treated with oral calcitriol [0.5 mcg/day] for 8 weeks and group it received placebo for the 8 weeks. In all cases, before and 8 weeks after treatment fasting glucose, insulin, total cholesterol, triglycerides, HDL, LDL, calcium, phosphorous, PTH, HbA1C and blood sugar after 75 gr load of glucose were measured. Insulin resistance [homostatic model assessment-insulin resistance = HOMA-IR] and beta cell function [homostatic model assessment- insulin secretion =HOMA-SECR] were calculated and results of these measurements, before and after 8 weeks, in both groups were compared. In group I, after calcitriol treatment, blood sugar after 75 gr load of glucose [p= 0.045], HOMA -IR [p= 0.035], HbA1C [p=0.00], total cholesterol [p=0.037], and triglycerides [p=0.036] decreased, whereas calcium levels increased, significantly [0.014]; changes in other parameters were not significant. In group II [without treatment] after 8 weeks of observation, fasting blood sugar [p=0.002], HbA1C [p=0.004], HOMA -IR [p=0.036] significantly increased and beta cell function decreased significantly [p= 0.032]; again alterations in other parameters were not significant. These results seem to confirm that the active form of vitamin D influences glucose and lipid metabolism, by the improvement of insulin resistance

Prevalence of hydrocephalus in infants under 1 year with myelomeningocele

Myelomeningocele is a congenital defect in posterior arch of vertebra with herniation of cord and meanings in which presence of hydrocephalus with high prevalence complicates its treatment. This study tries to determine the frequency of hydrocephalus associated with myelomeningocele [MMC] in different levels of spinal column. In a descriptive study over the course of five years 1371 -75, children under one years with myelomeningocele admitted to Tabriz Medical Center of Imam Khomeini were followed for hydrocephalus. Of ninety-five patients of MMC, 56.8% developed hydrocephalus [68.4% male ,31-5% female]. Prevalence of MMC in each level of spinal column was: Lumbar 60%, Lumbosacral 31.5%, Thorasic and cervical 4.2% equally, prevalence of hydrocephalus with mmc in lumbar Lumbosacral, cervical and thoracic region were 68%, 48%, 25% and 0% in order. More percentage of females with lumbosacral MMC developed hydrocephalus, whereas in other levels male gender were more prominent in developing hydrocephalus. studies or study showed that lumbar and then lumbosacral MMC had more susceptibility to develop hydrocephalus