Nelaton catheter assisted versus standard nasogastric tube insertion: a randomized, clinical trial

It is sometimes difficult to insert a nasogastric tube in an anaesthetized patient. We evaluated the benefit of reinforcing the distal portion of the nasogastric tube with a Nelaton catheter: 8 and 10 French Nelaton catheters were inserted into 16 and 18 French nasogastric tubes respectively through the first proximal holes of tubes up to their tips. The patients anaesthetized were randomly allocated into either the control or the Nelaton groups, and nasogastric tube was inserted as deeply as the catheter length, then the catheter was withdrawn and the tube was inserted farther to reach the stomach. Eighty patients [40 in each group] were included in this study. The success rate of nasogastric tube insertion was 90% in the Nelaton group and 57% in the control group [P = 0.001]. The mean insertion time was 80 [SD 43] and 92 [SD 35] seconds in the Nelaton and the control groups respectively

Effect of communication skills training on health belief model constructs about AIDS in Zanjan health volunteers [2010-11]

The prevalence of AIDS/HIV is dramatically increasing worldwide. Iran and other Middle East countries are no exception in this regard. The main aim of this study was to assess the effects of communication skills program and AIDS education on Health Belief Model [HBM] constructs among the health volunteers in Zanjan. The study was conducted as a quasi-experimental trial. Eighty health volunteers were divided into two equal groups. The interventional group participated in two educational programs on communication skills and AIDS, compared to the control group that participated in AIDS education program only. Data collection was done both prior to and 20 weeks after the intervention using a self-report type questionnaire. The results of this study show that combining AIDS education program and communication skills training had a significant effect on susceptibility, [P<0.01] severity [P<0.003] and perceived barrier [P<0.0001] constructs of AIDS in the test group. By contrast, only the perceived barrier construct [P<0.0001] showed a significant change in the control group. Self-efficacy was the strongest predictor within the HBM. Findings of this study indicate that a combination of communication skills training and AIDS education program could have a better effect on Health Belief Model constructs on AIDS in health volunteers than the AIDS education program by itself

Association of cord blood resistin with leptin, insulin, growth indices and fat levels in neonates of Mousavi hospital of Zanjan in 2009

Resistin is a novel adipokine which may play a role in insulin resistance. In this study we aimed to determine the cord blood resistin, leptin, insulin and maternal serum resistin levels during pregnancy; and to investigate correlation between these metabolic hormones; and also to evaluate their association with newborn growth indices. This study was conducted on 80 newborns and their mothers in Mousavi Hospital Zanjan, Iran in 2009. Newborn growth indices including birth weight, height, body mass index [BMI], Ponderal index, Homeostatic Model assessment [HOMA-IR] and their mothers' BMI were determined. Resistin, leptin and insulin levels were measured by ELISA. In this study, cord blood resistin levels were higher than serum resistin levels of pregnant mothers [10.77 +/- 1.53 vs. 7.91 +/- 5.71 ng/ml]. Moreover, serum resistin levels of mothers' did not exhibit any correlation with cord blood resistin, leptin and insulin levels, as well as neonatal anthropometric indices. Meanwhile, there was no significant correlation between cord resistin levels, insulin resistance, fat percentage and newborn growth factors. Cord resistin levels were positively correlated with cord blood leptin levels [r=0.222; p=0.048]. Also, there was a significant positive correlation between cord blood leptin and neonatal BMI [r=0.223; p=0.047], Ponderal index [r=0.212; p=0.058], HOMA-IR [r=0.426; p=0.052] and fat percentage [r=0.247; p=0.014]. On the basis of the findings, increased cord blood resistin levels may indirectly influence fetal growth through leptin or other cytokine levels. Though, further researches are needed to confirm this matter

[ relation between serum zinc level and febrile seizures in children admitted to Zanjan Valie-Asr Hospital]

Febrile seizures [FS] are the most common seizures seen in childhood with a prevalence of 2-14% in different societies. This study was carried out regarding the possibility of the relationship between serum zinc levels and occurrence of FS. 117 children ranging from 6 months to 5 years were divided into four groups: FS [n=39], febrile patients with no seizures [FNS] [n=40], control group of afebrile patients with no seizures [AFNS] [n=32], and patients with seizures without fever [n=6]. After completion of a questionnaire and obtaining blood, serum zinc levels were measured. Data was analyzed using SPSS software. The mean serum zinc levels in 39 FS patients was 75.67 mcg/dl, 40 febrile patients with no seizure had a mean serum zinc level of 87.58 mcg/dl. 32 afebrile patients with no seizure had a mean serum zinc level of 89.06 mcg/dl and in 6 afebrile patients with seizure; the mean serum zinc level was 96/67 mcg/dl. The serum zinc level in FS patients was significantly lower than the other groups [p=0.002 and p=0.001], whereas the 3 other groups had no significant difference [P= 0.971]. Regarding the high incidence of hypozincaemia in FS, low serum zinc levels may be associated with the occurrence of FS

[Association of cord blood resistin with leptin, insulin, growth indices and fat levels in neonates of Mousavi hospital of Zanjan in 2009]

Resistin is a novel adipokine which may play a role in insulin resistance. In this study we aimed to determine the cord blood resistin, leptin, insulin and maternal serum resistin levels during pregnancy; and to investigate correlation between these metabolic hormones; and also to evaluate their association with newborn growth indices. This study was conducted on 80 newborns and their mothers in Mousavi Hospital Zanjan, Iran in 2009. Newborn growth indices including birth weight, height, body mass index [BMI], Ponderal index, Homeostatic Model assessment [HOMA-IR] and their mothers. BMI were determined. Resistin, leptin and insulin levels were measured by ELISA. In this study, cord blood resistin levels were higher than serum resistin levels of pregnant mothers [10.77 +/- 1.53 vs. 7.91 +/- 5.71 ng/ml]. Moreover, serum resistin levels of mothers. did not exhibit any correlation with cord blood resistin, leptin and insulin levels, as well as neonatal anthropometric indices. Meanwhile, there was no significant correlation between cord resistin levels, insulin resistance, fat percentage and newborn growth factors. Cord resistin levels were positively correlated with cord blood leptin levels [r=0.222; p=0.048]. Also, there was a significant positive correlation between cord blood leptin and neonatal BMI [r=0.223; p=0.047], Ponderal index [r=0.212; p=0.058], HOMA-IR [r=0.426; p=0.052] and fat percentage [r=0.247; p=0.014]. On the basis of the findings, increased cord blood resistin levels may indirectly influence fetal growth through leptin or other cytokine levels. Though, further researches are needed to confirm this matter

[ comparison of serum homocysteine, folate and vitamin B12 in postmenopausal women with low and normal bone mineral density]

Osteoporotic fractures are major health problems in contemporary societies which are associated with increased morbidity and mortality and substantial economic costs. Recently, increased plasma homocysteine [Hcy] level has been suggested as an independent risk factor for osteoporotic fractures. This study aimed to compare the level of plasma homocysteine, folate and vitamin B12 in Iranian postmenopausal women with low and normal bone mineral density [BMD]. In this case-control study which was performed from August 2006 to May 2007, BMD of 130 Iranian postmenopausal women were measured by dual energy X-ray absorbtiometry [DXA]. The subjects were assigned to one of the two groups of case [BMD<-1; n=67] and control [BMD>/=-1; n=63]. Fasting plasma Homocysteine, folate and vitamin B12 were also determined. BMD at the neck of femur and lumbar spine, together with other collected data were analyzed with SPSS and T-test. The mean age of the subjects was 58.1 +/- 6 years. The mean of Hcy level in the case group was 16.98 +/- 9.4 and in the control group was 12.39 M mol/L. The mean of vit-B12 in the case group was 598 +/- 801 and in the control group was 551.2 +/- 410 Pg/L. Mann-Whitney test exibited a significant difference. The mean of serum folate level in the case group was 5.2 +/- 2.9 and in the control group was 6.5 +/- 2.9 Ng/L. Hcy, folate and B12 were significantly related to low BMD. LS .T score was negatively related to Hcy level and FN T-score had a positive relation with folate and B12 [p=0.002, p=0.017 and p=0.007, respectively]. There was a relationship between folate and B12 and with increasing serum folate level, B12 level increased, too. The results suggest an association of vitamin B12 and folate with BMD. Whether this relationship is causal, remains unclear and demands further study

[Prevalence of cough variant asthma in patients with chronic cough attending Vali-e Asr hospital of Zanjan, Iran, 2009]

Asthma is one of the most common chronic diseases that in some cases it is manifested as chronic coughs without any other symptoms. Cough variant asthma [CVA] is an occult form of asthma of which, the only sign or symptom is chronic cough and therefore should always be considered in the differential diagnosis of chronic coughs. The aim of the present study was to detect the prevalence of cough variant asthma [CVA] among patients with chronic and persistent coughs. This study was performed in the respiratory outpatient clinic at Vali-e Asr Hospital of Zanjan, Iran, during 2009. Methacholine challenge test was carried out in 92 patients suffering from chronic coughs. CVA was diagnosed as chronic coughs without wheezing or any apparent cause which had persisted for more than 8 weeks, with a normal CXR and spirometry but with bronchial hyperresponsiveness to methacholine, based on% 20 drop in FEV1 before and after methacholine challenge test. Of the 92 patients suffering from chronic cough, 24 patients [%26.1] satisfied the criteria for CVA and had positive methacholine challenge test. There was a significant association between patients ' job [P=0.003] and education [P=0.001] and positive test. These findings suggest that CVA is a common etiology for chronic cough and its early diagnosis and treatment is significantly important to prevent progression of the disease to classic asthma

[Evaluation of the influence of intravenous carnitine on hemoglobin and hematocrit levels in end stage chronic renal failure patients under hemodialysis]

Anemia is present in 60-80% of hemodialysis patients. Recombinant erythropoietin is the treatment of choice for anemia in these patients, but it is expensive. Many researchers have shown the effect of carnitine on anemia. Therefore, this work was designed to evaluate the influence of intravenous carnitine on hemoglobin and hematocrit levels in chronic renal disease patients who were under hemodialysis. This study was accomplished on 29 patients who were under hemodilysis for at least one year and did not have other reasons for their anemia. Using balance block randomization method the patients divided in to two groups: placebo group [n=15] and case group [n=14]. After each dialysis session [3 times a week for 3 months] the case group was injected 1 gr intravenous carnitine while the placebo group received 1 gr distilled water. There was no significant difference between the two groups regarding sex and age. The average amount of hemoglobin and hematocrit was equal in two groups before the intervention. But, finally after the intervention the amount of hemoglobin and hematocrit significantly increased in the case group [P=0.001 and P=0.003 respectively]. Findings of this study revealed that carnitine increases the amount of hemoglobin and hematocrit in hemodialysis patients and improves their anemia. However, further studies with more patients are recommended

[Evaluation of psychological problems in teenagers suffering from polycystic ovary syndrome]

Polycystic ovary syndrome [PCOS] is the most common disorder of endocrine among the women capable of reproduction. This disorder involves 6-7 percent of women. With regard to mental health, disorders such as depression and eating disorder can be seen and a change in their quality of life is expected. One thousand and eight hundred and twenty four female students were evaluated psychologically in order to assess the prevalence and development of polycystic ovary syndrome. The students suffering from polycystic ovary were assessed mentally. Eighty students between 15-18 years old were suffering from PCOS. Previous family problems were significantly higher in control group [P=0.03]. There were no significant differences in terms of drug misuse, committing suicide, physical problems and daily sleepiness. Depression symptoms were observed in 38.3 percent of control group and 32.6 percent of sufferers of PCOS. Anxiety assessment indicated that 22.5 percent of PCOS group and 22.3 percent of control group were suffering from anxiety. Despite universal reports regarding psychological effects of PCOS in the quality of life of adult sufferers such as depression, sleeping and eating disorders, such differences were not observed in our PCOS study group. This may indicate the role of age in developing psychological disorders among the sufferers. Moreover, parameters such as cultural factors, the importance of considering own physical state and the impact of social view on interpersonal relationships can play an important role

[Incidence of bone fracture among osteoporotic women during a six-year period of follow-up and its relation to type of therapy]

Background and Objective: due to a high prevalence of osteoporosis and its costs and regarding different ways of treatment for this disease and lack of knowledge about their efficacy in fracture rate in Iran, this study was designed in Zanjan to determine fracture rate in hypogonadal osteoporotic women who were on different types of anti-osteoporotic treatments

Materials and Methods: in this historical cohort study, 160 osteoporotic women were investigated. They were under treatment for their osteoporosis during 2001-2007. The cases were divided into 4 groups based on their type of treatment: 1] Calcium 1000 mg/daily + Vit D 200 IU/daily 2] Calcium 500 mg/daily + Vit D 200 IU/daily + Alendronate 10 mg/daily 3] HRT with Calcium D 4] Combination therapy. One group that didn't receive any type of treatment, were considered as control group. At least two densitometries were carried out in each case that the first one being done at the beginning of the study. Bone density was measured in three sites including: hip, spine and forearm with DEXA method. The rate of osteoporotic fractures was investigated in any site of the body during the follow-up period based on patient's invitation and their documents. Data were analyzed using Chi square, t-test, Logistic regression and Kaplan-Meier survival curve

Results: the rate of fracture was 11% [18 cases]. Most of the fractures were non-vertebral [17 cases] and occurred in ages less than 50 years [17.9%]. The most effective treatment to reduce fracture rate was Alendronate [with 69.9% reduction rate]. HRT was as effective as Calcium and Vit D in reducing the fracture rates. Bone density in forearm region was known as the most vigorous predictive factor of fracture rate in our study. Most of the fractures were reported in forearm and leg regions [63.3%]

Conclusion: based on this study it can be concluded that Alendronate is the most effective treatment to reduce fracture rate in osteoporotic women. Densitometry is also recommended for women under 50 years old with hypogonadysm for early diagnosis and treatment

[ prevalence of polycystic ovarian syndrome in 14-18 year old girls of Zanjan high schools, 2008]

Polycystic ovarian syndrome [PCOS] is the most common endocrine disorder among reproductive-age women. There is very little information about the prevalence of PCOS in Iran. With regard to the symptoms of PCOS which begin after menarche and regarding to its side effects on women's health, we aimed to determine the prevalence of PCOS in adolescents in Zanjan, Iran. In this descriptive community based study, 1882, 14-18 year old adolescents were randomly selected from Zanjan schools. The presence of PCOS was determined by the presence of olygomenorea, hirsutism, acne and androgenic alopecia. For correlation between PCOS and obesity, BMI and central obesity was evaluated. Statistical analysis was performed using K[2] test. PCOS was present in 54[2.9%], hirsutism was present in 161 [8.6%], acne was present in 220 [11.7%], androgenic alopsia was present in 130[6.9%] and menstrual irregularity was present in 281 [16.9%] of the cases. The prevalence of central obesity and over weight did not differ among the studied groups. The prevalence of PCOS in our study was similar to the results reported from other societies. With regard to PCOS side effects, we suggest that the diagnosis and treatment of PCOS is better to be started from adolescence

[Evaluation of early oral feeding and traditional oral feeding in upper gastrointestinal surgeries]

Due to fears of postoperative complications following upper gastrointestinal surgeries [UGI], fasting before bowl function recovery is a traditional practice, but fasting following elective surgery is controversial. The aim of this study was to compare early oral feeding versus traditional oral feeding in patients who underwent UGI surgeries. Fifty two patients who underwent UGI anastomosis or surgery for various reasons were randomly divided into early oral feeding [EOF] group and traditional oral feeding [TOF] group. The nasogastric tube [NGT] removal time, tolerance of oral feeding, ileuses, nausea and vomiting, vital sign before and after surgery, postoperative stay, patients. satisfaction and complications were recorded. The mean time of NGT removal was 1.62 +/- 0.49 and 4.61 +/- 1.99 days in EOF group and TOF group respectively [p=0.0005]. The mean start time of oral feeding was 2.04 +/- 0.19 and 5.87 +/- 1.32 days in the EOF group and TOF group respectively [p=0.0005]. Tolerance of oral feeding was seen in 24 [92.3%] patients and 21 [91.3%] patients in the EOF and TOF groups respectively. Duration of hospital stay following surgery was 5.62 days in the EOF group and 8.04 days in the TOF group. 24[92.3%] out of 26 patients in the EOF group were satisfied with oral feeding that started in the second postoperative day. 13 patients [56.5%] complained of delay feeding in the TOF group. The results of the present study suggest that early oral feeding following upper gastrointestinal anastomosis or surgery is safe and can result in a shorter hospital stay and less cost

[Comparison of the impacts of family-based and individual-based interventions on body mass index and life style]

Obesity has been known as a risk factor in cardiovascular disease. Educational intervention aimed at modifying dietary habits and physical activity patterns are essential in management of obesity. The purpose of this study was to compare the effects of family-based intervention and individualbased intervention on body mass index and life style. This quasi-experimental study was conducted on subjects suffering from obesity or overweight in Islam-Abad, Zanjan [2005-2006]. The subjects were assigned nonrandomly to either the family-based group [n=42] or individual-based group [n=49]. Data were collected using a questionnaire. Intervention included counseling to make change, in eating habit and exercise behavior. Subjects in the individual-based group received intervention individually in the clinics, and those in the family-based intervention received intervention by home visit. The data were analyzed using Chi-square test, T-test, Paired T-test, Mann-Whitney test and, Wilcoxon test. The mean of body mass index decreased from 30.74 +/- 3.99 to 30.1 +/- 3.90 and from 31.98 +/- 6.64 to 31.57 +/- 6.63 in family-based group and in individual-based group, respectively. After intervention, the mean of body mass index significantly decreased in both groups [p < 0.05]. There was no significant difference in body mass index between two groups after intervention [P=0.52]. The mean scores of dairy product consumption and fruit consumption as well as physical activity were increased in both groups [p < 0.0001]. It was concluded that both family-based and individual -based intervention, focusing on physical activity and diet counseling through regular follow-up meetings, could be effective ways of controlling CVD risk factors

Serum level of anti-hepatitis B surface antigen 6-8 years after hepatitis B vaccination at birth

The duration of protection after hepatitis B vaccination in children is unknown. We determined the serum level of antibody to hepatitis B surface antigen [anti-HBsAg] in 273 randomly selected 7-9-year-old schoolchildren from Zanjan City, Islamic Republic of Iran, who had been fully vaccinated against hepatitis B starting at birth. Titres

[Effects of alendronate and hormone replacement therapy [HRT] on bone mineral density of postmenopausal women]

Although there are several methods of treatment of osteoporosis, prospective studies to compare their effect on bone density in Iranian population are rare. This study was designed to compare the effect of alendronate and hormone replacement therapy on bone mineral density of postmenopausal Iranian women living in Zanjan. We treated 115 women [mean age 54/8 +/- 9 years]. Twenty four women were treated with conjugated equine estrogen [0.625 mg], 5 mg medroxyprogesterone, and 1000 mg elemental calcium with 400 IU vitamin D daily. Forty four subjects received 10 mg/d alendronate plus calcium and vitamin D in the same dose and 37 women were taken placebo with 1000 mg/d calcium and 400 IU/d vitamin D. Their bone mineral densities [BMD] were measured at the lumbar spine, hip and mid radius every 12 months for three years. All cases with secondary osteoporosis were excluded from the study. Significantly a higher percentage increases in BMD at the lumbar spine [P< .008, 2-way analysis of variance] were found in the alendronate group than in the HRT and calcium + vitamin D groups throughout the 36-month study period. However, there was no difference in BMD at the femoral neck and mid-radius between alendronate and HRT groups. Treatment with alendronate resulted in a 11% increase at the L-spine BMD [P: 0/00]. A non significant reduction of about 4% at the femoral neck BMD was detected in alendronate group at the end of the 3-year study period. Although there was no significant change in the femoral neck, lumbar spine or mid-radius BMD with HRT, a significant decline [about 9%] in the BMD of the femoral neck was observed in the placebo group [P: 0.004]. There was no difference in upper gastrointestinal or drug-related side effects between the groups. Our data suggest that the use of alendronate was well tolerated for 3 years and significantly increased BMD at the L-spine. It also can reduce the rate of BMD reduction at the femoral neck as was seen in the placebo group in postmenopausal Iranian women. Although HRT can inhibit BMD reduction at the femoral neck and lumbar spine, this regimen cannot increase BMD in postmenopausal Iranian women

[Predictive value of nucleated red blood cells count in cord blood of newborn]

The screening of infants who need to be admitted immediately following birth but without application of invasive procedures is of prime importance. The aim of this study was to evaluate the value of nucleated red blood cells [nRBCs] count of cord blood in predicting the need for admission to NICU or neonatal ward. This was a case-control study performed on 100 live, newly born full-term infants [70 healthy infants and 30 infants admitted to NICU or neonatal ward] at Vali-e-Asr Hospital of Zanjan [Iran] in 2005. Umbilical cord blood was collected at delivery time to measure the nRBCs count. Data were collected through questionnaires and further analyzed by SPSS using chi square and Mann-Whitney Tests. The mean nRBCs counts in admitted neonates [case group] and healthy infants [control group] failed to show a statistically significant difference however, by omitting the cases for whom negative nRBCs counts were reported, a significant difference between two groups was observed. The number of abnormal nRBCs, the mean number of abnormal nRBCs, and the number of absolute abnormal nRBCs [nRBCs>1000] in cord blood of the case group were significantly higher than those in control group. The sensitivity and specificity of nRBCs count were 33.3% and 100%, respectively. Although the nRBCs count alone could not be considered as an ideal screening tool for those group of neonates with clinical complications however, it seems that the nRBCs count could be a helpful diagnostic parameter in predicting a need for admission

[ effect of male participation in quality and quantity improvement of family planning in Islamabad- Zanjan]

Efficacy of family planning is an important factor in reducing fetomaternal mortality and morbidity. Since men could influence their spouses' attitudes toward reproduction, we conducted this study to investigate the role of male education and participation in increasing the use of safe contraceptive methods. This quasi-experimental study was carried out on all fertile couples of Islamabad [Zanjan] who used withdrawal method for contraception. 90 families were entered into the study and following completing the questionnaire randomly divided into two groups of treatment and control. Intervention was performed through face-to-face education by NGO'S of the related regions for two months. After 6 months the second questionnaire was filled out to investigate the contraceptive methods. The data was analyzed using chi-square statistical test. Rate of application of safe contraceptive methods [TL, OCP, condom, IUD, DMPA] was higher in treatment group than in control group compared with withdrawal method which showed a significant difference [p=0.04]. Knowledge of using OCP and condom in both groups were high. There were 4 and 1 cases of unwanted pregnancy in control and treatment groups respectively [non-significant difference]. Despite the difficulties in performing the research, the study results showed that participation of men positively affects family planning. More investigafion regarding the inolvement of men in family planning is recommended

[Rate of knowledge and use of contact lenses by high school female students in Zanjan in 2003]

The aim of this study was to investigate the knowledge and use of contact lenses by high school female students in Zanjan in 2003. The designed questionnaire was randomly distributed among the high school female students. Then the questionnaire's questions were standardized based on the study. The main sample size was 700. The samples were selected out of seven high schools in Zanjan regarding the geographic distribution. Then the questionnaires were investigated and following the omission of imperfect cases statistical data was analyzed using SPSS software. Out of 700 studied students, 37.7% had the history of using contact lenses, out of whom 4% had used medical lenses, 2.1% chromato- medical lenses and 32.2% chromatic lenses. Only 11% of the students had appropriate knowledge about contact lenses and merely 14% of the students had obtained the lenses through ophthalmologist. 45% of the users suffered from one of ophthalmic complications. Regarding the high prevalence of using contact lenses and their relatively common complications, informing the users through the media seems necessary and the lenses should be prescribed by ophthalomologists

[Delay in diagnosis and treatment of gastric cancer from the begining of symptoms to surgery]

In developed countries diagnosis of gastric cancer is performed in early stages through screening and the 5 year survival rate has risen to 86%. Although the patients in developing countries have digestive symptoms for quite a while, they do not undergo early endoscopy. The patients refer to the physicians in developed stages. This research was conducted to determine the median time of delay from the beginning of symptoms to surgery. In this research 63 patients suffering from gastric cancer were investigated during 2004-2005. Research questionnaire was completed from patient's admission to endoscopy until surgery through interview with the patients. Mann- Whitney statistical test and SPSS software were used for data analysis. Out of 63 patients 48 [76.2%] were male and 43 [68.3%] rural esidents. The most common cancer area was cardia [31 patients] and the most common symptom was abdominal pain [28 patients]. The results showed of median total delay from the beginning of symptoms until surgery was 96 days, which the patient delays 8 days, from the first referring to endoscopy [General practitioner delay] 57 days, from endoscopy to pathology affirmation 12 days, and from pathology affirmation to surgery performance 7 days. Factors like place of residence, education, income and gender had no significant effect on the time of delay. Delay from referring to endoscopy performance and from performance of endoscopy to pathologic confirmation was higher than expected. Screening plan for timely referring of patients and performance of endoscopy seems essential. To reduce the time of delay cooperation of different units like medical education, hospital units, pathology and supply of necessary hospital equipment is highly recommended

[ effect of high dose vitamin d3 on the level of serum alkaline phosphatase, calcium, phosphor and vitamin d3 in children older than 3 years old who were receiving phenobarbital]

Background and Objective: chronic use of antiepileptic drugs may influence the bones and their mineral metabolism due to deficiency of vitamin D3. In this study we investigated the effect of high dose vitamin D3 on bones and their mineral metabolism

Materials and Methods: fifty six children older than 3 years old who were affected by epilepsy and had taken the antiepileptic drugs at least for 6 months were included in the study. Levels of alkaline phosphatase [ALP], calcium, phosphorus and vitamin D3 were measured. The patients were divided into three groups; one group was provided with 1peril of 50000 units of vitamin D and the other two groups took 2 and 3 perils of vitamin D. Two months after prescription, serum level of the above parameters were measured and compared with the results before vitamin D prescription

Results: after prescription of vitamin D3, decrease of ALP [p<0/001], increase of calcium [p=0/01] and increase level of vitamin D3 in serum [p<0/001] was observed. The highest increase in the serum level of vitamin D3 was observed in the group which had received 3 perils of vitamin D [p<0/0001]

Conclusion: decrease in the serum level of vitamin D3 following long term use of antiepileptic drugs and its increase as a result of vitamin D supplementation suggests that this method of therapy can prevent the skeletal abnormalities due to side effects of these drugs