[Investigation of insulin resistant in patients with liver cirrhosis and its relationship with severity of disease]

Insulin resistance and glucose intolerance are commonly associated with liver cirrhosis. Resistance to insulin is an important prognostic factor in liver cirrhosis. To determine the relationship between insulin resistance and severity of liver cirrhosis. This was a descriptive-analytic study carried out on 76 patients with stablished liver cirrhosis in Booali hospital [Qazvin] in 2006 and 2007. Their fasting blood sugar, serum insulin level and oral glucose tolerance test [OGTT] were measured. Patients divided into three groups of A, B and C according to the child-pugh classification. Insulin resistance was determined by the homeostasis model assessment [HOMA-IR] in all patients. Data analysis was performed using t test, variance analysis, chi-square and Fishers exact test. Cirrhosis was found to be strongly associated with insulin resistance [60.5%] and the values obtained for prevalence of insulin resistance for groups A, B, and C of Child-Pugh Classification were%31.6,%66.7 and%74.1, respectively. The relationship between IR and severity of liver cirrhosis was significant, statistically [p=0.01]. Diabetes mellitus was diagnosed in 26 subjects [34.2%], impaired glucose tolerance in 24 [31.6%] and normal glucose tolerance in 26 [34.2%] using OGTT. Insulin resistance increased with stage of liver cirrhosis as defined by Child-Pugh score

[Colonization rate of intravascular catheters and catheter related bacteremia in neonatal intensive care unit of Qods hospital, Qazvin [2005]

Peripheral intravenous catheters are increasingly used in neonatal intensive care unit [NICU] to administer intravenous fluids, blood products, drugs and nutrition. Catheter infection is associated with increased morbidity, mortality, and duration of hospital stay. To determine colonization rate of intravascular [IV] catheters and catheter related bactermia in NICU of Qods hospital. This was a descriptive study carried out on 100 infants who catheters were removed for any reason. A length of 3 cm from the catheter tip was cut aseptically and placed in thioglycolate media. In case of any growth within the next 7 days, subcultures on blood agar and MC agar media were performed followed by bacterial identification. Drug susceptibility profiles of isolated bacteria were detected according to standard methods. Before catheter removal, blood sample from each infant, was taken for culture, microbiological identification and susceptibility assay. Of 100 catheter tips, 35 [35%] samples produced positive cultures among those 19 cases [52%] identified as coagulase negative staphylococci [CNS]. Positive blood cultures were found in samples of 7 patients [7%], all from catheters colonized with bacteria, and identified as CNS [4 samples] and coagulase positive staphylococcus [3 samples]. Among the CNS isolated from catheters, the highest resistance [100%] was related to ampicillin and Oxicillin and the lowest [18%] resistance associated with vancomycin. Application of intravascular catheters in neonates should be accompanied with great attention in making a balance between the need for vascular access and the risk of bacteremia and thus, adequate control and rigorous preventive measures must be established when a vascular access is a necessity

[Evaluation of thyroid function tests in hemodialyzed patients]

Chronic renal failure and hemodialysis can cause some abnormalities in thyroid function tests [TFT]. To evaluate TFT abnormalities in hemodialyzed patients of Qazvin. In a descriptive study, blood samples were taken from all hemodialyzed patients at Bu-Ali hospital [Qazvin, Iran] in 2005. RIA and IRMA techniques were used to measure the serum levels of T3, T4, T3RU and TSH. Mean central statistical data were estimated. Forty two percent of cases were found to have no abnormalities in any parameters of TFTs, however, in 58% of cases, one or more parameters were shown to be abnormal. The most prevalent abnormality was related to T4 [all less than normal levels] and the least one associated with FTI. While the majority of abnormal T3 and FTI were diminished type, it was an elevated type for the majority of abnormal T3RU and TSH. Twenty two out of all abnormal TFT cases were detected to have hypothyroid criteria and 1 case with hyperthyroid criteria, nonetheless, a true hypo or hyper thyroid criteria was not established for the rest of abnormal TFT cases. The rate of true involvement of thyroid in hemodialyzed patients by laboratory criteria was higher than patients with no hemodialysis and most cases were affected by hypothyroidism. Regarding the high prevalence of non-specific abnormalities of the TFT results, they must be interpreted with cautions in hemodialyzed patients