[Relationship between vitamin D plasma level and Foxp3 gene expression among rheumatoid arthritis patients]

Background and Aim: Rheumatoid arthritis [RA] is an autoimmune disease. It seems that the function of regulatory T cells [Tregs] is compromised in RA. Foxp3 is a critical transcription factor of these cells. The aim of this study was to determine the relationship of vitamin D plasma level with Foxp3 gene expression in the patients with RA

Material and Methods: 18 untreated RA patients and 41 healthy people participated in this study. Plasma levels of vitamin D were measured by competitive ELISA method. Foxp3 gene expression was also determined by using realtime PCR technique

Results: The expression of Foxp3 gene was significantly lower in RA patients compared to that in the healthy controls [p<0.001] .There was no significant relationship between vitamin D plasma levels with the rate of Foxp3 gene expression

Conclusion: We found low levels of vitamin D could not affect the expression of Foxp3 gene. It seems that vitamin D deficiency cannot be considered as an effective environmental factor in the pathogenesis of RA

[ effect of concomitant administration of furosemide and salbutamol on spirometry parameters in persistent asthma]

Considering the effectiveness of nebulized furosemide in asthma crisis that were non-responsive to the inhalational beta-agonists, this study aimed to examine the effect of concomitant administration of furosemide [10 mg] and nebulized salbutamol [2.5 mg] on spirometry parameters in persistent asthma. In this clinical trial, 53 patients [age, 18-75 years] with a 6-months history of persistent asthma were randomly allocated to two groups, the salbutamol [n=27] and salbutamol + furosemide [n=26] groups. Participants in each group were classified into the mild, moderate and severe persistent asthma on the basis of FEV1. Participants were administered salbutamol or salbutamol + furosemide, and then the spirometry parameters were recorded 15 minutes after the completion of nebulization treatment. Before and after the treatment, mean and standard deviation of the spirometry parameters and their changes were calculated. Results showed no significant difference regarding the mean percentage change for FEV1 in the salbutamol [27.5%] and salbutamol + furosemide groups [25.83%] after the treatment [P=0.72]. Moreover, no significant difference was seen between the two groups regarding the mean percentage changes in other parameters after the treatment [FVC, FEV1, PEF, MMEF, FEV1/FVC, P>0.25]. Concomitant administration of furosemide and salbutamol has no advantage over salbutamol in normalizing the spirometry parameters of persistent asthma

[Effect of a cardiac rehabilitation program on clinical and paraclinical findings of patients with ischemic heart disease]

Ischemic heart disease [IHD] is predicted to be the most common cause of death worldwide by 2020. Cardiac rehabilitation [CR] as a secondary preventive measure can reduce the cardiac risk factors, mortality and morbidity, and improve the quality of life in such patients. This study aimed to investigate the effect of an 8-week CR program on clinical and paraclinical findings of patients with IHD. This clinical trial was performed on IHD patients referred to Kashan Shahid Beheshti hospital. Patients were allocated the two groups [rehabilitation and control]. The rehabilitation group received an 8-week rehabilitation program; the clinical and paraclinical evaluations were performed before and after the program. This study showed that body weight, BMI, HDL, TG, FBS, resting heart rate and the systolic and diastolic blood pressure, quality of life, exercise capacity, maximal oxygen uptake during exercise and the numbers of recurrent hospitalization were significantly improved in the rehabilitation group [P<0.001]. The rehabilitation program had no effect on the platelet count, frequency and duration of chest pain, total cholesterol, and LDL. Using an 8-week cardiac rehabilitation program can be beneficial in the management of IHD patients and ultimately can reduce the risk factors of the heart diseases, improve the quality of life and reduce the risk of disease exacerbation

[Evaluation of the problems among the physical-mental disabled children under the coverage of Kashan rehabilitation centers]

In recent years, special emphasis has been placed on the problems of the parents with disabled children. Hence, this study aimed to evaluate the problems in the families of disabled children. This cross-sectional study was conducted on 352 disabled children residing in rehabilitation centers of Kashan during 2007-8. A census was conducted in families of the children through an interview and a questionnaire. Moreover, some demographic characteristics [e.g. family attitude, and problems related to disabilities] were evaluated and analyzed using the descriptive statistics. Among 352 cases, 234 [66.6%] were male and most of them [36.1%] aged 10-19 years. The mean age of children was 24.2 +/- 18.5 years. Ninety-seven percent of mothers were housewives; 52% mentally disabled; 15.6% physically disabled and the remaining both mentally and physically disabled. Almost one-third of the families had more than one disabled children. The most frequent disabilities were associated with behavioral disorders, facial paralyses, limb deformities, fecal and urinary incontinence, running off at the mouth and convulsion, respectively. Most children were dependent on their adults in feeding, dressing and playing. In addition, the most important problems of the children were fecal and urinary incontinence, impairment in social adaptation with healthy children, verbal communication, recognizing individuals and also financial problems. Moreover, a significant relationship was seen between the severity of physical disability and gender [P=0.001]. Considering that the disabled children face multiple social and physical problems, they require financial, social and familial support to have a near normal life

[Frequency of musculoskeletal complications among the diabetic patients referred to Kashan diabetes center during 2009-10]

Diabetes Mellitus is one of the most common metabolic disorders causing pathophysiologic changes in multiple organs. Considering the burden of diabetes and its complications, this study aimed to evaluate the frequency of musculoskeletal complications in diabetic patients. This cross-sectional study was performed on 327 diabetic patients referred to Kashan diabetes center during 2009-10. Age, the type of diabetes and clinical manifestations such as arthralgia, paresthesia, and limited joint movements were obtained from the hospital medical records of patients and then musculoskeletal complaints [e.g., adhesive capsulitis, carpal tunnel syndrome, dupuytren's contracture, trigger finger, and limited joint movements] were diagnosed and recorded by a rheumatologist. The mean ages of type II and I diabetic patients were 54.6 +/- 12.61 and 29.7 +/- 10.36 years, respectively. Carpal tunnel syndrome [49.8%], knee osteoarthritis [45%], sclerodactyly [27.2%], dupuytren's contracture [14.1%], trigger finger [11.9%], adhesive capsulitis [11.9%], limited joint movements' syndrome [8%] and Charcot joint [0.6%] were seen in patients. There was a significant relationship between the type of diabetes and knee osteoarthritis [P<0.003; OR=1.86; CI=1.05-3.30] and also carpal tunnel syndrome [P<0.045]. A significant relationship was also seen between duration of disease and trigger finger, dupuytren's contracture [OR=3.76; CI=1.9-7.41] and limited joint movements. The findings of this study indicated that type of diabetes and also its duration [over 15 years] may increase the risk of musculoskeletal complications. Hence, careful periodic examinations of all diabetic patients are recommended

[Efficacy of stool antigen test for the non-invasive diagnosis of helicobacter pylori infection in dyspeptic patients referred to GI clinic of Kashan Shahid Beheshti hospital during 2007-8]

Dyspepsia is one of the most common ailments today and Helicobacter pylori infection is known as one of the common causes of dyspepsia in adults and children. Histopathologic diagnosis of Helicobacter pylori is a standard method and biopsy samples can be obtained by invasive endoscopy method. The current study was designed to evaluate the diagnostic value of stool antigen test of Helicobacter pylori as a non-invasive method. In this study all dyspeptic patients referred to GI clinic of Kashan Shahid Beheshti Hospital from 2007 to 2008 were involved in this study. In upper gastrointestinal endoscopy, mucosal biopsy was taken from antrum and corpus; simultaneous examination of the stool antigen sample for diagnosing of Helicobacter pylori was evaluated using ELISA method [positive titer>1/1]. Data were collected and analyzed for sensitivity, specificity, positive predictive value and negative predictive value. Among the 100 dyspeptic patients 50 were men and the remaining 50 women with a mean age of 43.3 +/- 17.13. The sensitivity, specificity, positive predictive value and negative predictive value in stool antigen test were%83.3,%79.4, 88.7% and 71.7%, respectively. There was a direct correlation between the severity of Helicobacter pylori infection and stool antigen titer in biopsy samples. The stool antigen test as a noninvasive method of diagnosing Helicobacter pylori can be regarded as an affordable alternative to the invasive biopsy procedure

[Prevalence of metabolic syndrome among students of Kashan University of Medical Sciences in 2008]

Background: Metabolic syndrome or X syndrome is a combination of disorders such as: central obesity, hypertension, increased blood glucose and impaired blood lipids. Metabolic syndrome increases risk of cardiovascular disease, diabetes, dislipidemia and some cancers. This study was carried out to determine the prevalence of metabolic syndrome in students of Kashan University of Medical Sciences in 2008

Materials and Methods: This study is a cross-sectional survey carried out on 221 students in an age range of 19-27 years. Metabolic syndrome was defined having at least three of the Third Report of the Adult Treatment Panel [ATP III] criteria as the following: triglycerides >/=150 mg/dL; high blood pressure [systolic blood pressure>/=130 mmHg or diastolic blood pressure >/= 85 mmHg]; fasting glucose>/=110 mg/dL; waist circumference>/=102 cm in men and >/= 88 cm in women and HDL<40 mg/dL in men and<50 in female

Results: Approximatry 30.8% of subjects had one component of metabolic syndrome. The most prevalent metabolic syndrome components had high blood pressure [16.7%] and low HDL [26.2%]

Conclusion: The results show that the important metabolic syndrome risk factors among students are high diastolic blood pressure and low HDL

[Relevance of serum vitamin D level and the disease activity in rheumatoid arthritis]

Rheumatoid arthritis [RA] is one of the most prevalent autoimmune diseases in the world. Some of the researches have suggested that the serum vitamin D level may relate to disease activity. The current study was designed to identify the correlation between serum vitamin D level and the disease activity index [DAI]. In this sectional study, 108 patients [diagnosed based on the American Committee of Rheumatology criteria] were enrolled. In all cases after determining the serum vitamin D level and ESR, complete joint examination were done. The normal range of vitamin D was 47.7-144 nm/lit. Then, the specified disease activity form [DAS-28] and visual analog scales [VAS] were filled out. The correlation between disease activity index, [based on VAS, tendered or swelled joints and ESR] and serum vitamin D was analyzed using Chi square, Mann Whitney and t-tests. Seventy nine [73.14%] out of 108 patients had normal serum vitamin D and 29 [26.86%] had low serum vitamin D level. The mean age of patients with normal and low serum vitamin D level were 52.22 +/- 11.6 and 48.48 +/- 12.51, respectively [P=0.075]. The mean DAI in normal and low vitamin D patients were 3.75 +/- 1.37 and 5.19 +/- 1.56, respectively [P=0.00]. The mean number of swollen joints in normal and low vitamin D patients was 1.24 +/- 1.39 and 3.65 +/- 3.3, respectively [P=0.001]. The mean number of tender joints in normal and low vitamin D patients were 6.84 +/- 4.41 and 9.44 +/- 3.62, respectively [P=0.042]. The mean ESR in normal and low vitamin D patients were 19.40 +/- 12.40 and 37.91 +/- 21.72, respectively [P=0.002]. Moreover, the mean VAS in normal and low vitamin D patients was 23.29 +/- 19.42 and 50.68 +/- 30.78, respectively [P=0.003]. The more active the RA, the less serum vitamin D level

[Assesing the result of exercise test on the patients with typical and atypical chest pain referring to the Mazandaran Cardiac Center in 2007]

The main signs of cardiac disease [particularly the coronary disease] was chest pain and the shortness of breath. ETT is a prognostic and diagnostic tool for assessing the ischemic heart patients. The aim of present study was to determine the results of applicating ETT for patients with typical and atypical chest pain complaints referring to the Mazandaran Cardiac Center 2007. This descriptive study was conducted on 500 patients with typical and non Typical pain referring to the heart centers of Mazandaran province. After the interview, examination and laboratory tests, attended by the researcher and cardiologist, the patients under went ETT [Exercise Tolerance Test] with Tread mill according to Bruce protocol [Bruce Protocol] in four steps. The present study showed the positive effect of exercise test in 80[16%] of cases. The positive test results of exercise test in the cases with typical heart pain was 25 times more than the cases with atypical heart pain. 43[53.75%] of the cases with positive test were male the majority of whom were [41caseses,51.25%] in age range of 51-65 years. 12.5% of cases with positive test and also 78.6% with negative test had atypical pain. getting serious signs and symptoms of various disease serious [especially of the typical and atypical chest pain] is among the main educational priorities for the prevention of cardiac infarction

[ survey on the effect of lovastatin and exercise on serum lipid profiles in hyperlipidemic patients]

Background: high lipid serum level was a risk factor for cardiovascular disease. This study was performed to evaluate the effects of Lovastatin and exercise on hyperlipidemic patients at Kashan Shahid Beheshti Hospital during 2005-6

Materials and Methods: this randomized clinical trial study was carried out on hyperlipidemic patients [age>30 years]. After registering the personal data of the patients the participants were selected based on the inclusion criteria [HDL<35 mg/dl, LDL >/= 160 mg/dl, TG >/= 200 mg/dl, Chol >/= 200 mg/dl]. The Lovastatin group [40 mg/daily] and the exercise group [waking 35 minutes/day, 3 times a week]. The clinical tests were repeated for six consecutive weeks. Data were analyzed using t-Test, Wilcoxon Signed Rample Test, Kolomogorou-Smirnov Test, Mann-Whitney Test, levens Test

Results: from Ninety-six out of 150 cases were hyperlipidemic signifying that only 80 [59 male, mean age 55.12 +/- 8.4 case and control 55.35 +/- 9.2 years] out of 150 hyperlipidemic patients were qualified for the study. The mean decrease in TG level between the Lovastatin and exercise groups were 21.4 [P=0.2] and 20.5 mg/dl [P=0.2], respectively. The mean decrease in cholesterol level between Lovastatin and exercise groups were 41.3 and 1.5 mg/dL [P=0.001]. The mean decrease in LDL level between Lovastatin and exercise groups were 35.8 and 8.5 mg/dl [P<0.001], respectively. Finally, the mean increase in HDL level between Lovastatin and exercise groups were 5.4 and 0.4 mg/dl

Conclusion: exercise may be effective for decreasing the LDL. While Lovastatin could decrease the total cholesterol TG and increase HDL levels, using a combination is recommended for hyperlipidemic patients