Survey of the effect of biotin on glycemic control and plasma lipid concentrations in type 1 diabetic patients in Kermanshah in Iran [2008-2009]

Diabetes mellitus is the most common chronic endocrine disease worldwide. Intensive glycemic control plays an important role in decreasing morbidity and mortality rate of the disease. Preclinical studies have shown that biotin has an essential role in regulating blood glucose and serum lipid metabolism. This study aims to evaluate the effect of biotin on glycemic control and plasma lipids concentrations in type 1diabetic patients. This randomized double-blind placebo-controlled clinical trial study was conducted 70 type 1 diabetic patients with an age range 5-25 years old with poorly controlled [glycosylated hemoglobin >/=8%]. Subjects were randomly allocated into two groups. In the intervention group biotin [40 microgram/kg] was administered plus daily insulin, while the control group received placebo plus daily insulin regimen for three months. Laboratory tests including glycosylated hemoglobin [HbA1c], fasting blood sugar and plasma lipids were measured at the base and after 3 months. In this study, seventy patients were evaluated, 35 were allocated to each group. There were no statistically significant differences between age, gender, duration of diabetes, BMI and BP between the two groups [p>0.05]. HbA1c in the intervention [biotin] group was 9.84 +/- 1.80 at base and after 3 months treatment, it declined to 8.88 +/- 1.73 [p<0.001]. In the control group HbA1c at base was 9.39 +/- 1.58, after 3 months it increased to10.11 +/- 1.68. There were statistically significant differences in the mean of HbA1c in both the biotin and the control groups [p<0.001]. FBS in the biotin group at base was 275 +/- 65.76 mg/dl and after 3 months it had reduced to 226 +/- 41.31 [p<0.001]. There were statistically significant differences in the mean of total cholesterol, low density lipoprotein cholesterol and triglyceride between the two groups at the end of 3 months [p<0.05]. Results of this study showed that biotin administration as an adjuvant in addition to insulin regimen can improve glycemic management and decrease plasma lipids concentrations in poorly controlled type 1 diabetic patients

Effect of white plastic cover around the phototherapy unit on hyperbilirubinemia in full term neonates

Jaundice is a common problem in neonatal period. Phototherapy is the most common treatment for neonatal jaundice. The purpose of this study was to determine the effect of adding white plastic cover around the phototherapy unit on hyperbilirubinemia in full term neonates with jaundice. In this randomized controlled trial, over 12 months [October 2009 - September 2010], 182 term neonates with uncomplicated jaundice, admitted to neonatal unit of Imam Reza Hospital [AS] in Kermanshah province of Iran, were selected. They were randomized in two groups. Control group received conventional phototherapy without cover around the apparatus and covered group received conventional phototherapy with plastic cover around the unit. After enrolment, total serum bilirubin was measured every 12 hours. Phototherapy was continued until the total serum bilirubin decreased to or less than 12.5 mg/dl. There were no significant differences between the two groups for gestational age, birth weight, postnatal age, weight [at admission], serum level of hemoglobin, hematocrit and reticulocyte count. Total serum bilirubin in covered group, during the first 48 hours of treatment, declined significantly than in control group [P. value=0.003]. The cover around the phototherapy unit not only did not increase the side effects of phototherapy, but also had a positive impact in reducing duration of jaundice [P. value <0.0001] and duration of hospitalization [P. value <0.0001]. The study results showed that using white plastic cover around the phototherapy unit can increase the therapeutic effect of phototherapy

[Comparison of intermittent versus continuous phototherapy and position change effect on treatment of term newborns with jaundice]

Hyperbilirubinemia is a common problem of neonatal period and phototherapy serves as the effective method in treatment. Despite its worldwide application, there are many unanswered questions regarding enhancement of its efficacy. The aim of present study was the comparison of intermittent versus continuous phototherapy and position change effect on treatment of term newborns with jaundice A clinical randomized controlled trial was performed during a 17 months at NICU of Imam Reza's hospital in Kermanshah. Eighteen jaundiced neonates were selected according to inclusion and exclusion criteria. The neonates were randomized into three groups receiving different regimens of phototherapy. Group I was treated with continuous single phototherapy in supine position during phototherapy. Group II received intermittent single phototherapy without change position, and group ?II received continuous single phototherapy with changing position. Total and direct serum bilirubin levels were measured every 12 hours after starting phototherapy. Phototherapy was continued until the serum bilirubin level declined to less than 13mg/dl. The data was analyzed using t-test and ANOVA tests. There was no statiscally significant difference between sex, birth weight and other variables within three groups. The mean duration of phototherapy was 47.5h in group I, 51.6h in group II and 39.3h in group III. There was no significant difference for the duration of phototherapy between the three groups [p=0.18]. We can conclude that an intermittent single phototherapy was as effective as continuous single phototherapy in treatment of neonatal hyperbilirubinemia in the term newborns

[ effect of calcium and phosphorus supplements on bone mass and serum alkaline phosphatase in premature infants]

Osteopenia is common problem in premature infants. Low-birth weight babies do not receive adequate amounts of calcium and phosphorus through breast feeding. This study examines the effect of calcium and phosphorus supplements on osteopenia in premature infants. This clinical trial included 42 premature infants hospitalized at Razi hospital in Kermanshah. All the babies had a birth weight of less than 1800 grams. They were assigned into two groups of control and case. While babies in the control group received only breast milk, calcium [80mg/kg/day] and phosphorus [40mg/kg/day] were added to the breast milk for the infants in the other group. All the infants received a daily supplement of 400 iu vitamin D. Anthropometric measurements, serum calcium, phosphorus, and alkaline phosphatase concentration were examined once at the beginning of the study and then every two weeks until week 6. At the end of the period, wrist x- ray was administered for all the infants. Data were then analyzed using t-student and chi square. Radiographic criteria did not indicate any signs of osteopenia. Yet a significantly higher serum alkaline phosphatase concentration was revealed through biochemical analysis in control group [p=0.001]. Anthropometric measurements showed improvements in height, weight and head circumference for the two groups. Treatment with calcium and phosphorus supplements was associated with a decrease in serum alkaline phosphatase concentration which is an indication of osteopenia. However the treatment did not reduce incidence of osteopenia in premature infants