[ effects of Cinnamomum zeylanicum J. presl on blood glucose level in patients with type 2 diabetes, a double-blind clinical trial]

Cinnamomum zeylanicum J. Presl [cinnamon] have been used as food and herbal drug in Asia and Europe. Although some studies have been shown that cinnamon has blood glucose lowering effect but some reports denied it. This study was designed to investigate the efficacy of cinnamon on blood glucose level in patients with type 2 diabetes. This study was a double blind randomized controlled trial study. 61 type 2 diabetic patients with fasting blood glucose of 140 to 250 mg/dl were randomly divided in to two groups. The patients in cinnamon groups received two 500mg cinnamon capsules and patients in placebo group received two 500mg placebo capsules daily. The patients fasting blood glucose, HbA1c, cholesterol, triglyceride, LDL and HDL were determined at starting and after 8 weeks at the end of the study. There was no significant difference in patients fasting blood glucose, HbA1c, cholesterol, triglyceride, LDL and HDL between intervention groups compared with placebo on starting of the trial. Further results indicated that there were no significant difference between two groups regarding lowering of blood glucose, HbA1c, and blood lipids after 8 week of cinnamon and placebo treatment. According to the study results, consumption of one gram of cinnamon per day, do not have blood glucose lowering effects

Biodegradation of reactive orange 16 by Phanerochaete chrysosporium fungus; application in a fluidized bed bioreactor

Application of a fluidized bed bioreactor working for treatment of colored wastewaters has been studied using Phanerochaete chrysosporium fungus immobilized in calcium alginate biogel beads. The working volume of the bioreactor was 1 L; experiments were performed at room temperature and pH of culture medium was initially adjusted to 4. Manganese Peroxidase activity, glucose and ammonium concentrations have been assayed daily along the 7 operating days. Azo dye Reactive Orange 16 was added to the bioreactor after 7 days of incubation and decolorization was assayed by spectrophotometer for 1 h intervals. Maximum Manganese peroxidase activity of 96 +/- 8 U/L was obtained on day 7, and 70 +/- 3% decolorization was achieved after 6 h of dye addition. The results were compared to free cell cultures from previous studies and the role of agitation and immobilization of cells in increasing of the efficiency of decolorization was discussed. The mechanism and morphology of the immobilization of cells in ca-alginate beads were studied and the relationship between glucose and ammonium consumption and ligninolytic activity of fungi were discussed

Comparative study of pulmonary function tests before and after successful percutaneous transvenous mitral commissurotomy

Mitral stenosis [MS] causes elevation of left atrial and pulmonary venous pressures. Persistent elevation of pulmonary venous pressure causes anatomical and physiological changes in lung vasculature and tissue, and change in lung volumes thereafter. Studies showed improvement of lung function with improvement of mitral stenosis and decrease in left atrial pressure and pulmonary congestion. This study was performed to evaluate lung volumes before and after percutaneous transvenous mitral commissurotomy [PTMC], including FEV1, PVC, SVC, and their percent and FEF of 25, 50, 75, 25-27 percent and PEFR before and within 48 h after PTMC, and to evaluate correlation of each with valve area. 26 from 51 patients with inclusion criteria stayed in the study with non-random consequential selection and the others were excluded. All of the patients had moderate to severe MS, good mitral valve morphology, echo score below 11, and absence of clot in the left atrium. Spirometery was done in all of the patients before and after PTMC and FEV1, FCV, SVC, FEF25%, FEF59%, FEF75%, FEF25-75% FEF1/FVC, and PEFR were measured. There were 26 patients [12 female, 14 male] with a mean age of 38.38 years old, miral valve area was 0.88 cm2 before and 1.46 cm2 after PTMC [mean 0.58 cm2 increase [p<.000]. Mean value of lung volumes and flow changes were: SVC change= 100 ml [p<0.1], FVC= 230 ml [p<0.0005], FEV1= 250 ml [p<0.003], FEF50%= 0.85 [p<0.004], FEF25%= 0.98 [p<0.003], and FEF25-75%= 0.71 [p<0.01]. Values for SVC, PEFR, and FEF75% and PEFR had no significant improvement. This may suggest improvement of small airway function due to a decrease in lung congestion

[ study on prevalence of helicobacter pylori in acute coronary syndrome]

Coronary artery disease is the main cause of mortality in developing countries like Iran. Due to failure of classic risk factors to completely explain epidemiologic variability of the disease, other risk factors, for example infection diseases are under investigation. One of these infectious agents is Helicobacter pylor which have been investigated in numerous studies. This study was designed to assess the controversies about Helicobacter pylor prevalence in acute coronary syndrome. All the patients with ACS including unstable angina and myocardial infarction who referred to Fatemie Hospital between 20 Feb 2003 to 9 Feb 2004 and were admitted in CCU ward were included in this cross-sectional study. A total of 411 patients with ACS were evaluated for prevalence of Helicobacter pylor antibody. Mean age of patients was 59.97and 56% of them were male. The serological test for Helicobacter pylor infection was positive in 45.6%of cases, negative in 43.8% and borderline in 10.6% of patients. 191 patients had unstable angina and 220 patients had myocardial infarction. This study showed that prevalence of Helicobacter pylorinfection in patients with acute coronary syndrome was not high. Thus acute or chronic infection with Helicobacter pylor could not be a risk factor for ACS

[Evaluation of change in etiology and epidemiology of upper GI bleeding in a population study]

Acute upper GI bleeding [UGIB] is a common medical emergency situation. In the past years, important changes have taken place that might have influenced the incidence, etiology, and outcome for patients with acute UGIB. The aim of this study was to determine current time trends in the incidence, management, and prognosis of patients with UGIB in 14 years period in a region in center of Iran. All of the patients with UGIB who hospitalized in all hospitals from 1991 to 2004 in Semnan city were evaluated in a retrospective study. The patients with permanent residency in this area and age more than 15 years enrolled in the study. The patients were divided in two subgroups based on endoscpic diagnosis; peptic ulcer [PU] and non-peptic ulcer [Non-PU]. Again, analysis was performed by dividing the patients to acid-pepsin disorders [APDs] and non-acid pepsin disorders [Non-APDs]. 873 patients [617 male [70.7%], Mean +/- SD [46.9+/-21.2]] enrolled in the study. The incidence rate of UGIB has decreased from 98.4 to 40.1 in 100.000 person in year in this period [p<0.001]. The incidence rates of bleeding due to PU and Non-PU have decreased. However, in the second analysis the rate of APDs has decreased, but the rate of non-APDs has remained unchanged, during the study period. In regard to prognosis, the rates of endoscopic therapy, surgery and mortality were not changed significantly in this period. The overall incidence of UGIB, and bleeding due to APDs was declined in recent years that may be due to better approach to peptic ulcers and eradication of helicobacter pylori and wide spread use of PPIs and H2 blockers in APDs

[ value of clinical presentation in diagnosis of reflux in noncardiac chest pain patients]

Non-cardiac chest pain [NCCP] presents as a frequent diagnostic challenge, with patients tending to use a disproportionate level of health care resources. Gastroesophageal reflux disease [GERD] is the most frequent cause of NCCP. Thus the typical symptoms of reflux like Heartburn and regurgitation, when present as predominant symptoms are quite specific for diagnosing GERD patients but in patients with NCCP the clinical diagnos of reflux is difficult and need to utilize invasive methods or omeprazol [PPI] test for its detection. The aim of the study was to evaluate the role of clinical presentation in diagnosing GERD in NCCP patients. NCCP patients underwent upper endoscoy, Bernstein test and short course of omeprazol test. the patients were divided in two groups based on the GER or non-GER related chest pain. In the end, clinical presentation of the patients was compared in two groups. GERD was considered positive as evidences of mucosal injury on upper endoscopy and or Bernstein and PPI tests had been positive together. From 78 NCCP patients [41 male; mean age 50.4 +/- 2.3], the chest pain in 35 patients [44.8%] were related to GERD. Two groups were the same based on sex and age. The chest pain; severity, site, radiation and relation to food, exercise, and sleep were the same in two groups, except two symptoms; the pain that was relived by anti-acid [p<0.031] and presence of classical reflux symptoms [p<0.009] were seen in GERD patients. It was interest that in the history of the patients, heart burn [p<0.036] and regurgitation [p<0.002] were seen in patients with GERD-related chest pain. Clinical examination is important in diagnosing GERD in NCCP. Although the chest pain is the same in reflux and non reflux related NCCP, but the symptoms of heartburn or regurgitation in present or recent past history of patients are diagnostic for GERD-related chest pain

[ value of clinical presentation in diagnosis of reflux in noncardiac chest pain patients]

Non-cardiac chest pain [NCCP] presents as a frequent diagnostic challenge, with patients tending to use a disproportionate level of health care resources. Gastroesophageal reflux disease [GERD] is the most frequent cause of NCCP. Thus the typical symptoms of reflux like Heartburn and regurgitation, when present as predominant symptoms are quite specific for diagnosing GERD patients but in patients with NCCP the clinical diagnos of reflux is difficult and need to utilize invasive methods or omeprazol [PPI] test for its detection. The aim of the study was to evaluate the role of clinical presentation in diagnosing GERD in NCCP patients. NCCP patients underwent upper endoscoy, Bernstein test and short course of omeprazol test. the patients were divided in two groups based on the GER or non-GER related chest pain. In the end, clinical presentation of the patients was compared in two groups. GERD was considered positive as evidences of mucosal injury on upper endoscopy and or Bernstein and PPI tests had been positive together. From 78 NCCP patients [41 male; mean age 50.4 +/- 2.3], the chest pain in 35 patients [44.8%] were related to GERD. Two groups were the same based on sex and age. The chest pain; severity, site, radiation and relation to food, exercise, and sleep were the same in two groups, except two symptoms; the pain that was relived by anti-acid [p<0.031] and presence of classical reflux symptoms [p<0.009] were seen in GERD patients. It was interest that in the history of the patients, heart burn [p<0.036] and regurgitation [p<0.002] were seen in patients with GERD-related chest pain. Clinical examination is important in diagnosing GERD in NCCP. Although the chest pain is the same in reflux and non refluxrelated NCCP, but the symptoms of heartburn or regurgitation in present or recent past history of patients are diagnostic for GERD-related chest pain

[Azithromycin in one week quadruple therapy for H, pylori eradication]

In developing countries primary antibiotic-resistance and poor compliance are the main causes of helicobacter pylori [HP] eradication failure of standard regimens. AIM: To investigate eradication rate, patient's compliance and tolerability of a 1-wk Azithromycin based quaruple therapy versus the 2-wk conventional therapy. A total of 129 HP-positive patients were randomized to either omeprazole 20mg, bismuth subcitrate 240 mg, azithromycin 250 mg, metronidazole 500 mg, all twice daily for 1- wk [BOAzM] or omeprazole 20mg, bismuth subcitrate 240 mg, amoxicillin 1g, metronidazole 500 mg all twice daily for 2-wk [B-OAM]. HP infection was defined at entry by histology and rapid urease test and cure of infection was determined by negative urea breath test. HP eradication rates of B-OAzM and B-OAM were74.1% and 70.4% respectively at intention to treat and per-protocol analysis 78.1%versus 75.7% respectively. incidence of poor compliance was lower, although not significant, in patients randomized to B-OAzM than for B-OAM [3.5% versus 4.3%] but intolerability was similar in two groups [35% versus 33.3%]. 1-wk azithromycin based quadruple regimen achieves an HP eradication rate comparable to that of standard 2-wk quadruple Therapy and is associated with same patient's compliance and complications

Survey of cancer incidence during a 5-year [1998-2002] period in Semnan province

Suitable information of different cancers in special geographic area can define medical programs for treatment and screening of high-risk groups. The provincial health authority reported a high mortality rate from upper GI cancer in the center of Iran. A comprehensive search was undertaken to survey and register all cases of cancer during a 5-year [1998-2002] period among the indigenous population of Semnan province. Diagnosis of cancer was based on histopathology, clinical or radiological findings of patients, and death certificate. A total of 1732 patients with cancers [mean age 59.41 +/- 19.08 years] were found during the study. Of these, 936 [54.86%] were in males. Crude rate were 124.8/100'000 and 112.1/100,000 in males and females, respectively. Age-standardized rate [ASRs] for all cancers in males and females G were 156/100'000 and 136/100,000 person-year, respectively. Gastric cancer was the most common tumor with incidence rate of 19.7 per 100,000 people, ASRs=27.5. In UGIC, gastric cancer was the most common [47.17%], colon malignancies [8.1%, 9.5 per 100,000 populations], esophagus [6.8%, 7.9 per 100,000 populations], liver [2.4%, and 2.8 per 100,000 populations]. In women breast, uterine and ovary, stomach and skin were the most common cancers respectively. In young ages population the most common tumors were brain, ALL and bone, respectively. Gastric cancer alone constitutes one-fifth of all cancers in Semnan, with the highest incidence rate. The ASR of which is the highest reported from Iran up to now and one of the highest in the world

study of the hospital managers awareness of fire accident management in the hospitals affliated to Isfahan University of Medical Sciences

Since health care centres do not have developed plans to control fire accidents, the manager's knowledge, skills and attitude can play an important role to increase the hospital efficiency to fight fires. This is a desciptive, cross-sectional study which was carried out in educational and non-educational hospitals affiliated to Isfahan University of Medical Sciences. The study lasted six months and the data were collected by a researcher-made questionnaire. To analyze data, K2 Pearson and Spearman tests were used. The findings revealed a mean of 27.63 +/- 7.36 out of sixty. According to the results, the hospital manager's knowledge of crisis management was weak