Pitfalls in estimation of celiac disease prevalence using serology: a cross-sectional study

Celiac disease [CD] is an auto-immune disorder. The prevalence of CD has been estimated mainly based on serological tests. The aim of this study was to evaluate the seroprevalence of celiac disease in the adult general population of Mashhad, northeast of Iran and pitfall of serology in epidemiological studies considering the importance of serology titer

Materials and Methods: 1558 subjects aged 35 to 65 years and 1025 individuals aged between 15 to 35 years were selected randomly from multistage cluster sampling papulation for this cross sectional study. Anti-tissue transglutaminase [tTG]-IgA assay was performed by ELISA[Enzyme-Linked Immunosorbent Assay]. The manufacture's cut-off point of anti tTG was 20 IU/mL and the prevalence of positive serology was estimated based on being just above the upper limit of normal [20 IU/mL], twice or three times above the normal value at 40 and 60 IU/mL, respectively

Results: In both age group 35-65 year-old and 15 to 35 years adults, the prevalence of positive serology was 1.2% for anti-tTG level more than 60 IU/mL, which was three times of the kit references [95% CI: 0.7- 1.9] and [95% CI: 0.7-2.1], and based on our previous study in Mashhad if we consider the cut-off point as 76 IU/mL anti-tTG for mucosal atrophy, the prevalence of CD would be 0.69

Conclusion: Epidemiological data of CD is mainly based on serology and as these tests are to some extent non-specific at lower levels, the accuracy of the previous reported prevalence of CD in some studies are questionable and level of anti-tTG is important

Accuracy of color Doppler ultrasonography and magnetic resonance imaging in diagnosis of placenta accreta: a survey of 82 cases

Background: placenta adhesive disorder [PAD] is one of the most common causes of postpartum hemorrhage and peripartum hysterectomy. The main risk factors are placenta previa and prior uterine surgery such as cesarean section. Diagnosis of placenta adhesive disorders can lead to a decrease of maternal mortality and morbidities

Objective: the purpose of this study was to compare the accuracy of color Doppler ultrasonography and magnetic resonance imaging [MRI] in the diagnosis of PADs

Materials and Methods: in this is cross-sectional study, Eighty-two pregnant women who were high risk for PAD underwent color Doppler ultrasound and MRI after 18 weeks of gestation. The sonographic and MRI findings were compared with the final pathologic or clinical findings. P<0.05 was considered statistically significant

Results: mean maternal age was 31.42+/-4.2 years. The average gravidity was third pregnancy. 46% of patients had placenta previa. The history of the previous cesarean section was seen in 79 cases [96%]. The diagnosis of placenta adhesive disorder was found in 17 cases [21%]. Doppler sonography sensitivity was 87% and MRI sensitivity was 76% [p=0.37]. Doppler sonography specificity was 63% and MRI specificity was 83% [p=0.01]

Conclusion: women with high-risk factors for PAD should undergo Doppler ultrasonography at first. When results on Doppler sonography are equivocal for PAD, MRI can be performed due to its high specificity

Effect of birth ball exercises during pregnancy on mode of delivery in primiparous women

Considering the fact that cesarean section [c-section] poses greater risks of maternal and neonatal complications, compared to vaginal delivery, scholars seek different strategies to decrease the prevalence of this surgical procedure. Birth ball exercises during pregnancy are among the proposed strategies. Thus, this study aimed to determine the effect of using birth ball during pregnancy on mode of delivery in primiparous women. This clinical trial was conducted on 54 women, referring to the maternity ward of Omolbanin Hospital. Subjects were randomly assigned to intervention and control groups. The intervention group performed birth ball exercises for 4-6 weeks; on the other hand, the control group only received routine care. Data were collected using questionnaires, forms of examination and observation, and checklists for recording exercise movements on a weekly basis. Chi-square, Fisher's exact test, and Mann-Whitney U test were performed, using SPSS version 16. Rates of vaginal delivery and c-section in the intervention group were 92.6% and 7.4%, respectively, while the corresponding values in the control group were 66.7% and 33.3%, respectively. Chi-square showed a significant difference between the two groups in terms of mode of delivery [P=0.018]. Considering the significance of promoting vaginal delivery among women, performing birth ball exercises is recommended as a useful, non-pharmacological, and inexpensive strategy for reducing c-section rate

Relationship between demographic factors and gender role attitudes in women referring to Mashhad health care centers in 2014

Gender roles are affected by biosocial and cultural factors. These roles have significant impacts on one's professional, social, and family life. Therefore, given the recent changes in gender roles in Iran, we aimed to determine the relationship between demographic factors and gender role attitudes among women.This cross-sectional study was conducted on 712 females, selected via stratified sampling. Data were collected using a demographic checklist and a gender role questionnaire including 2 sections: gender role stereotypes and gender egalitarianism. The validity of this questionnaire was confirmed by content validity and its reliability was verified by internal consistency [alpha=0.77]. For data analysis, ANOVA and correlation coefficient tests were performed, using SPSS version16.The mean scores of gender role stereotypes and egalitarianism were 29.55 +/- 4.33 and 112.55 +/- 14.64, respectively. Stereotypic and egalitarian attitudes were significantly correlated with age, family size, duration of marriage, women's age at first childbirth, educational level, intentions to pursue education in future, and occupational status. As to the finding, gender role attitudes were influenced by social, economic, and demographic factors in Iran. By paying attention to these factors, we can implement proper interventions in order to promote personal and social health among women

Study of factors associated with postoperative pain following episiotomy in primiparous women at Mashhad Omalbanin Hospital in 2012

Episiotomy is a common medical procedure for widening the perineum. In fact, perineal pain is the most common complaint after episiotomy. Therefore, it is important to determine factors associated with postoperative pain following episiotomy in order to provide comfort for women after delivery. This study aimed to investigate factors associated with postoperative pain following episiotomy in primiparous women. This analytical, descriptive study was conducted on 119 eligible mothers, selected via convenience sampling, referring to Mashhad Omolbanin Hospital. Childbirth-related information was collected using a questionnaire. Neonates and mothers were also evaluated using Redness, Edema, Ecchymosis, Discharge, and Approximation [REEDA] scale and McGill Pain Questionnaire for perineal pain on days 1, 7, 10, and 14 after delivery. Kolmogorov-Smirnov, one-way ANOVA, Spearman's test, and Pearson's correlation were performed, using SPSS version 16. P-value

Effects of telephone support on stress and perceived social support in primiparous women experiencing nausea and vomiting in the first half of pregnancy

Gestational nausea and vomiting are positively correlated with stress and stress is negatively associated with social support. Due to advances in technology, telephone has become the most accessible device for home-based support. This study aimed to determine the effects of telephone support on stress and perceived social support in primiparous women experiencing nausea and vomiting during the first half of pregnancy. This clinical trial was conducted on 60 healthy pregnant women suffering from mild nausea and vomiting in the first half of pregnancy. They were randomly assigned to intervention [n=30] and control [n=30] groups. The intervention group received social support twice a week for a period of four weeks. Each phone conversation lasted around 15-20 minutes. During these conversations, dietary and lifestyle changes during pregnancy, as well as ways to reduce fatigue and improve psycho-emotional status, were discussed. The control group received routine care. Data were collected using a demographic questionnaire, Multidimensional Scale of Perceived Social Support, and Visual Analogue Scale for stress. Independent t-test and paired test were performed, using SPSS version 16. No significant difference was found in the mean scores of stress in two groups at the beginning and end of the study [P=0.052]. However, social support score at the beginning of the study was significantly different from that at the end of the study in both groups [P=0.036]. It is recommended that telephone support be integrated into the routine care of women with nausea and vomiting in order to improve their perceived social support and decrease their stress

Comparing the effects of progressive muscle relaxation and guided imagery on sleep quality in primigravida women referring to Mashhad health care centers -1393

Decreased sleep quality is a common complaint during pregnancy. Relaxation is one of the non-pharmaceutical treatments for sleep disorders. Different techniques could have different impacts on various biological and mental stressors. Therefore, this study aimed to compare the effects of progressive muscle relaxation and guided imagery on the sleep quality of primigravida women. This three-group clinical trial was conducted on 100 primigravida women, referring to Mashhad health care centers in 2014. All women, who met the inclusion criteria, were randomly assigned to three groups: progressive muscle relaxation, guided imagery, and control groups. The intervention groups performed the exercises twice a day for a period of four weeks at home after two sessions of relaxation training [held during two weeks]. Then, the quality of sleep was measured using Pittsburgh Sleep Quality Index. For data analysis, ANOVA, Kruskal-Wallis, paired t-test, and post-hoc test were performed, using SPSS version 11.5.The total score of sleep quality and its components [except use of sleep medication] was significantly lower after the intervention, compared to the pre-intervention period in progressive muscle relaxation and guided imagery groups [P<0.001]. Both relaxation techniques were effective in improving sleep quality and its components [P<0.001]. However, the effect of guided imagery was more significant than progressive muscle relaxation [P=0.015]. Both guided imagery and progressive muscle relaxation positively affected the sleep quality of primigravida women, although the effect of guided imagery was more significant. It is recommended to integrate guided imagery into pregnancy care for primigravida women with sleep disorders

Preventing and therapeutic effect of propolis in radiotherapy induced mucositis of head and neck cancers: a triple-blind, randomized, placebo-controlled trial

Background: Mucositis is one of the acute complications of radiotherapy which can ulcerate oral mucosa and cause severe pain and discomfort which can affect oral normal function. Propolis is a natural source of flavenoid which has antiulcer, antibacterial, antifungal, healing and anti-inflammatory effects. Using such an affordable compound without any bad smell or taste that has reasonable price can help the radiotherapy undergoing patients

Objectives: Our goal is assessing the preventing and therapeutic effect of propolis in radiotherapy induced mucositis in patients with head and neck cancer

Patients and Methods: In a randomized triple blind clinical trial, 20 patient were selected randomly to swish and swallow 15 ml of water based extract of propolis mouth wash 3 times a day in the case group [n = 10] and 15 ml placebo mouth wash in control group [n = 10]. We use NIC-CTC scale for determining mucositis grading

Results: We use T-test, Man-Whitney, Chi-square, and Friedman as analyzing tests. Case group had significantly [P < 0.05] lower grade of mucositis in all of the follow-ups, but xerostomia is not significantly different in two groups [P > 0.05]

Conclusions: This is a pilot study which shows water based extract of propolis efficiently prevents and heals radiotherapy induced mucositis

Factors related to marital satisfaction in primiparous women during postpartum period

Postpartum period is often associated with decreased marital satisfaction in couples. The present study aimed to investigate factors contributing to marital satisfaction in primiparous women during postpartum period. This correlational study was performed on 104 primiparous women who referred to health care centers, Mashhad, Iran in 2013, 8 weeks after delivery, to receive health care services. Convenient sampling was the method of choice, and data collection tools included Nathan H. Azarin marital satisfaction questionnaire, stress, anxiety and depression scales [DASS-21], and demographic and fertility-related questionnaire. Data were analyzed using SPSS version 16, and statistical tests of Kruskal-Wallis and Pearson correlation coefficient. The mean score of women's marital satisfaction was 65.37 +/- 17.4. There was a significant inverse correlation between duration of marriage [r=-0.246, P=0.01], women's age [r=-0.203, P=0.03] and husband's age [r=-0.219, P=0.02] with marital satisfaction. Also a significant relationship was seen between the onset of sexual intercourse after childbirth [r=0.268, P=0.006] and frequency of intercourse per week [P=0.001] with marital satisfaction. Additionally, there was a significant inverse correlation between depression [r=-0.414, P=0.001], anxiety [r=-0.27, P=0.004], and stress [r=-0.203, P=0.03] with marital satisfaction. The age of women and their spouses, the duration of marriage, the onset and frequency of sexual intercourse after delivery, stress, depression, and anxiety are factors contributing to females' marital satisfaction in postpartum period. As marital satisfaction affects the health of couples and families, it is therefore recommended to increase females' marital satisfaction during the postpartum period through recognizing the related factors and planning appropriate interventions

Effect of late-pregnancy consumption of date fruit on cervical ripening in nulliparous women

Cervical ripening before the onset of labor is an important factor for the prediction of delivery mode, and is directly associated with vaginal delivery. The search for a safe, inexpensive, and easy method of cervical ripening is of great significance. Few studies have focused on the effect of date fruit on uterine contractions and cervical ripening. Therefore, the purpose of this study was to determine the effect of late pregnancy consumption of date fruit on cervical ripening in nulliparous women. This randomized clinical trial was performed on 210 women with a singleton pregnancy, cephalic presentation, and gestational age of 37-38 weeks. The study was conducted at Omolbanin Hospital, Mashhad, Iran in 2013. The subjects were randomly assigned into two groups of 105 women [experimental and control groups]. Since the 37th week of gestation, the experimental group consumed date fruit [70 to 75 gr per day] until the onset of labor pain, and the control group received routine care.Data were collected using demographic questionnaires, fetal movement record form, and the checklist related to daily consumption of date fruit. Data analysis was performed using SPSS version 14, and Chi-square, t student, and Mann-Whitney test. P-value less than 0.05 was considered statistically significant. The mean Bishop score at admission was higher in the experimental group [7.67 +/- 2.28], compared to the control group [5.12 +/- 2.77] [P<0.001]. Mean cervical dilatation at admission was 4.05 +/- 1.63 cm in the experimental group and 2.97 +/- 4.63 cm in the control group [P<0/05]. Also the success rate of labor induction was higher in the experimental group compared to the control group [P=0.006]. Mean cervical dilatation was higher in women consuming date fruit, compared to the non-consuming group. Since date fruit is full of energy and nutrients, it is recommended for pregnant women to help with cervical ripening, particularly in the last weeks of gestation

relationship between job satisfaction and job performance among midwives working in healthcare centers of Mashhad, Iran

Job satisfaction represents individuals' positive or negative attitude towards their occupation. Job satisfaction is of high significance in health care field and could affects the quality of patients' health care and satisfaction. Every organization should pay considerable attention to job satisfaction and performance and continually monitor these indices. Therefore, we aimed to determine the relationship between job satisfaction and job performance of midwives, employed in health care centers of Mashhad, Iran. This descriptive correlational study was performed on 90 midwives, working in healthcare centers of Mashhad, Iran, in 2014 who were selected through multistage sampling from five healthcare centers. Data collection tools included a questionnaire to record demographic, personal and occupational data, Minnesota Job Satisfaction Questionnaire [MSQ] as well as a self-structured observational checklist to measure the quality of educational, care, and communicative job performance of midwives. SPSS version 19 was used to analyze data through descriptive statistics, and also Spearman and Kruskal-Wallis tests. The mean age of the participants was 39.63 +/- 6.92 years. Spearman correlation test showed a direct correlation between job satisfaction and the total score of job performance [P<0.001, r=0.490]. A direct relationship was also found between job satisfaction and the quality of educational performance [P<0.001, r=0.415], care performance [P<0.001, r=0.335], and communicative performance [P<0.001, r=0.510]. There was a positive correlation between job satisfaction and job performance of midwives. Therefore, it is recommended that health care administrators provide organizational supports for midwives to improve their professional performance

Comparing two treatment methods of Vitamin E suppository and conjugated estrogen vaginal cream on the quality of life in menopausal women with vaginal atrophy

Menopause is one of the most critical stages in a woman's life. Special attention needs to be paid to the quality of life of menopausal women. Symptoms of genitourinary atrophy can affect women's comfort and quality of life. The aim of this study was to compare two treatment methods of vitamin E suppository and conjugated estrogens vaginal cream on the quality of life of menopausal women with vaginal atrophy. This clinical trial was performed on 52 menopausal women [40-65 years old], referring to the gynecology clinic of Ghaem Hospital, Mashhad, Iran in 2013. Women were randomly assigned to two groups to use either conjugated estrogens vaginal cream or vitamin E suppository for 12 weeks. Women's quality of life was measured in both groups before the study and 4, 8 and 12 weeks after the interventions. Data collection tools included a demographic questionnaire and Menopause-Specific Quality of Life [MENQOL] questionnaire. Fisher's exact test, repeated measures ANOVA, Mann-Whitney and t-test were performed to analyze data, using SPSS version 11.5. The mean scores of quality of life before intervention and after 4, 8 and 12 weeks of therapy were 70.03 +/- 26.34, 53.96 +/- 23.75, 43.03 +/- 20.62 and 33 +/- 18.26 in vitamin E suppository group, respectively. These values in the estrogen cream group were 64 +/- 27.83, 50.76 +/- 21.51, 37.23 +/- 20.96 and 29.53 +/- 18.65, respectively. Comparison of quality of life scores between the two groups did not show a statistically significant difference [P>0.05]. The two groups were not significantly different in terms of the effectiveness of two methods of therapy. Therefore, it seems that vitamin E suppository could be used as an effective method for the improvement of quality of life in patients with vaginal atrophy

Clinical, toxicological, biochemical, and hematologic parameters in lead exposed workers of a car battery industry

Background: Lead is a toxic element which causes acute, subacute or chronic poisoning through environmental and occupational exposure. The aim of this study was to investigate clinical and laboratory abnormalities of chronic lead poisoning among workers of a car battery industry

Methods: Questionnaires and forms were designed and used to record demographic data, past medical histories and clinical manifestations of lead poisoning. Blood samples were taken to determine biochemical [using Auto Analyzer; Model BT3000] and hematologic [using Cell Counter Sysmex; Model KX21N] parameters. An atomic absorption spectrometer [Perkin-Elmer, Model 3030, USA] was used to determine lead concentration in blood and urine by heated graphite atomization technique

Results: A total of 112 men mean age 28.78 +/- 5.17 years, who worked in a car battery industry were recruited in the present study. The most common signs/symptoms of lead poisoning included increased excitability 41.9%, arthralgia 41.0%, fatigue 40.1%, dental grey discoloration 44.6%, lead line 24.1%, increased deep tendon reflexes [DTR] 22.3%, and decreased DTR [18.7%]. Blood lead concentration [BLC] was 398.95 micro g/ L +/- 177.40, which was significantly correlated with duration of work [P=0.044] but not with the clinical manifestations of lead poisoning. However, BLC was significantly correlated with urine lead concentration [83.67 micro g/L +/- 49.78; r[2]=0.711; P<0.001], mean corpuscular hemoglobin [r=-0.280; P=0.011], mean corpuscular hemoglobin concentration [r=-0.304; P=0.006] and fasting blood sugar or FBS [r=-0.258; P=0.010]

Conclusion: Neuropsychiatric and skeletal findings were common manifestations of chronic occupational lead poisoning. BLC was significantly correlated with duration of work, urine lead concentration, two hemoglobin indices and FBS

Seroepidemiology of HTLV infection in Sabzevar blood donors from 2007 to 2008

Background: Human T-lymphotropic virus [HTLV], a retrovirus, is the causative agent of adult T-lymphocytic leukemia [ATL] and tropical spastic paraparesia [TSP]. HTLV-1 is transmitted mainly through blood transfusion. Sabzevar is an endemic region for HTLV infection; hence it is essential to detect the prevalence of HTLV1/2 infection in the blood donors of this city

Materials and Methods: In this cross-sectional study, blood samples of all donors referring to Sabzevar Blood Transfusion Center from 2007 to 2008 were screened for HTLV infection using ELISA, and positive samples were confirmed by western blotting. Data were analyzed in SPSS software version 17.0 using Chi squared and Student's t-test

Results: The results showed that 56 of donors [44 male: 78.6% and 12 female: 21.4%] were infected to HTLV, with average age 40.27 +/- 10.02. The prevalence of HTLV infection among all donors was 0.26%. There was a significant correlation between age, marital status, times of blood donation and educational levels and HTLV infection

Conclusions: Regarding lower rate of infection among younger and regular blood donors and donors with higher educational levels, it should be considered to select donors from this population

[Rhegmatogenous retinal detachment Eye research Center-Mashhad University of Medical Sciences]

Evaluation of epidemiology and seasonal variation of Rhegmatogenous Retinal Detachment [RRD], in patients undergoing retinal detachment surgery. Medical records of 416 patients admitted in KHATAM eye hospital [Mashhad, IRAN] were reviewed between years 2000 to 2008. Information about sex, age, season and month of incidence and operation and concomitant risk factors of patients, were gathered and analyzed. Average age of patients was 41 years old. Most of the cases of the disease were observed in the age group of above 6- y/o [35%]. The frequency of the RRD was higher in male patients than in females. [Ratio: 1.7 to 1]. Distribution of our cases in different seasons showed no significant difference between them [P value = 0.142]. The highest and lowest rate of RRD was observed in October and September respectively with October having 51 patients [12.3%] and September having 23 patients [5.5%]. Myoia and pseudophakia were most common risk factors. There was no statistically significant relationship between age and month [and season] of incidence [or diagnosis and surgical procedure] of the RRD, likewise for gender. This study showed more RRD in male patients. Patients above than 60 years old have greater risks of incidence of RRD. No seasonal incidence pattern for RRD was founded; however, most of cases occurred in October, and at least in September

General dental paractitioners awareness of the guidelines about post-exposure procedures relating to Hepatitis and HIV

To evaluate awareness of general dental practitioners [GDP] in Iran about the post-exposure management of hepatitis and HIV. A randomly selected sample of 136 registered GDPs who were practicing dentistry in Khorasan [Iran] completed the questionnaire. Statistical analysis was performed by use of SPSS 11.5 Software and One way test and Student t-test for parametric data and Chi-square tests for non-parametric data. The average score was 11.8% showing the low level of awareness among GDP in Iran. The awareness level was higher in relatively more experienced GDPs. The age group between 25 and 34 years had the highest knowledge. Awareness of the participating GDPs about HBV was of higher level than that related to AIDS and HCV. The results of this study showed a significant lack of awareness among GDPs in Khorasan about post exposure management of hepatitis and HIV. An educational program focusing attention on post exposure management of hepatitis and HIV for GDPs is needed

[Relation between depression, anxiety, self-esteem, marital satisfaction, demographical factor and maternal complications with fear of childbirth in nulliparous women]

In the present study, the relation of depression, anxiety, self-esteem, marital satisfaction, demographical factor and early maternal complications with Fear of childbirth in primiparous women have been analyzed. This study which was done on 100 term primiparous women who referred for caring in last month of pregnancy to prenatal clinic of Omolbanin hospital. Women who had inclusion criteria and consented for participation in this study, filled the questionnaires include personal, demographic, and social characteristics. Fear of childbirth was assessed by a research designed questionnaire, satisfaction from matrimonial life, self-esteem, anxiety, and depression in participants were determined by using Enrich marital satisfaction questionnaire, Rosenberg scale, Spiel-berger test, Beck depression inventory. After delivery outcomes of their childbirth were recorded and data were analyzed by using SPSS software [version 13] and statistical tests [Pearson correlation, Spearman rating, Man-Whitney, Kolmogorov-Smirnov]. The average age was 22.54 +/- 3.7 within the range of 16-36 years. There was a positive and significant correlation between the level of individual's covert and overt anxiety and fear of childbirth [P<0.05]. There also was a negative and significant correlation between the level of knowledge about the process of natural childbirth, the rate of cooperation in childbirth, and Apgar score of the neonate with fear of childbirth [P<0.05]. There was no significant relationship between the rate of self-esteem, depression, satisfaction from matrimonial life, age, education, income, and early maternal complications with fear of childbirth [P>0.5]. Fear of childbirth in primiparous had a positive and significant correlation with covert and overt anxiety but a negative and significant relationship with level of knowledge about the process of natural childbirth, rate of cooperation in childbirth and Apgar score

Body fat distribution and its association with cardiovascular risk factors in adolescent Iranian girls

The relationships between body fat distribution, lipid profile and blood pressure, have not been studied extensively in young population. This study was designed to evaluate the association between measures of adiposity and established cardiovascular risk factors in adolescent girls. A total of 477 adolescent girls aged 15 to 18 years were recruited from Mashhad high schools. Socio-demographic characteristics were assessed using a self-administered questionnaire. Anthropometric assessments, blood pressure measurement and biochemical assessment were performed. Total and regional fat mass were determined by bio-impedance analysis. Cardiovascular disease risk factors were assessed in relation to body fat measures with adjustment for confounder factors including age and family socioeconomic status. The prevalence of overweight and obesity was 14.6% and 3.4% respectively; 16% of study population had greater fat mass compared to its ideal distribution. The majority of cardiovascular risk factors, especially systolic and diastolic blood pressure, triglyceride concentration, CRP and fasting blood sugar were significantly higher in group with a high body fat when compared to those with normal and low values. All anthropometric indices showed significant correlation with fat mass, fat free mass, total and regional body fat percent [P<0.001]. After adjustment for age and family socioeconomic status, a high fat mass especially, truncal fat, was positively associated with triglyceride and blood pressure. Adiposity, especially truncal adiposity, which can be assessed by simple measures such as Body Mass Index [BMI] and Waist Circumference [WC] may predispose adolescent girls for demonstration of metabolic abnormalities and consequently cardiovascular diseases

Alternaria in patients with allergic rhinitis

Inhalation of fungal spores is shown to participate in the development of allergic rhinitis symptoms. In this study, relation between presence of Alternaria in the human nasal cavity and allergic rhinitis is assessed. In a case-control study, 58 allergic rhinitis patients were compared with a well-matched control group of fifty healthy volunteers for sensitization to Alternaria [by skin prick test] and detection of Alternaria in their nasal mucous by conventional methods [microscopy with Methylene Blue stain and culture in Sabourad dextrose agar]. Severity of the disease was determined according to the ARIA classification. Pearson chi-square test was applied to compare the proportional difference between the study groups for detection of Alternaria in the nasal cavity, and sensitization to Alternaria. Relation between detection of Alternaria and allergic rhinitis was significant [OR = 18.18 [4.02-82.50]] In addition, sensitization to Alternaria showed a significant relation with the disease [OR = 2.8 [2.1-3.8]]. There was a significant relation between the presence of Alternaria in the nasal cavity and sensitization to Alternaria [OR = 10.4 [3.8-28.3]]. Both sensitization to Alternaria and presence of Alternaria in the nasal cavity did not have a significant relation with the severity of allergic rhinitis. This study suggests Alternaria as a major allergen that its presence in the nasal cavity and subsequent development of sensitization have significant role in the induction of allergic rhinitis

Hyperuricemia and albuminuria in patients with type 2 diabetes mellitus

Hyperuricemia is an independent risk factor for kidney dysfunction in diabetic patients. On the other hand, albuminuria is considered as the proxy of early stages of diabetic nephropathy. We investigated the correlation between hyperuricemia and albuminuria in patients with diabetes mellitus. In a cross-sectional study of 1275 patients [555 men and 720 women] with type 2 diabetes mellitus, serum uric acid and urinary albumin-creatinine ratio were determined. Other metabolic parameters including lipid profile, hemoglobin A1c, glomerular filtration rate, body mass index, blood pressure, blood glucose were assessed, as well. The mean age of the patients was 52.45 +/- 10.11 years old. Serum uric acid levels for normoalbuminuric, microalbuminuric, and macroalbuminuric patients were 4.49 +/- 1.22 mg/dL, 4.84 +/- 1.52 mg/dL, and 6.15 +/- 1.68 mg/dL, respectively. Among patients with clinical metabolic syndrome, 233 [27.5%] were in the forth upper quartile of uric acid level [> 5.3 mg/dL], but in diabetic patients without this syndrome, only 80 [18.7%] were in this group. There was a significant relationship between hyperuricemia and serum triglyceride, fasting blood glucose, hemoglobin A1c, glomerular filtration rate, and serum creatinine levels [P < .001]. No significant correlation was found between hyperuricemia and cholesterol levels, age, duration of diabetes mellitus, and body mass index. Serum uric acid level correlated positively with urinary albumin-creatinine ratio [P = .04]. We showed that higher serum uric acid concentrations were associated with a greater probability of albuminuria in patients with type 2 diabetes mellitus