Optimization of registry records [registration of patients] of hemodialysis patients it in the country

Background and Aim: Establishment of registry system is an important criterion for health care management system. In this study we extended registry system which included only a few items of personal information

Data concerning epidemiologic issues and important criteria influencing the status of these patients were collected

Materials and methods: In a cross-sectional study, in cooperation with the specific diseases and organ transplantation management of Ministry of Health and Medical Education, we collected and studied data of the hemodialysis patients in our country

This study included 18,160 patients from 428 dialysis departments

We collected demographic, clinical and laboratory data including demographic characteristics, disease duration, cause of renal disease and recorded serum levels of hemoglobin, calcium, PTH, ferritin and, during a period of 2 months

Using SPSSv.18 software data were analyzed by t-test

Results: The mean age of the patients was 67.86 +/- 16.7 years. The most common causes of ESRD were diabetes [37.35%] and hypertension [23.9%] respectively. 2.2 percent and 3.06 percent of the patients were positive for HBSAg and HCVAb respectively

Most patients [75.7%] had been on dialysis 3 times a week. Hemoglobin levels were less than 10 mg / dl in 42.3 % of the patients . 20.3 % of the patients had calcium levels of less than 8 mg/dL PTH level was more than 300mg/dl in 22.6% of the patients

Conclusion: Poor control of hemoglobin, albumin, ferritin, etc., as predictors of survival in hemodialysis patients can lead to higher mortality and development of cardiovascular disease in these patients

Control of diabetes and high blood pressure can be effective in reducing the incidence of ESRD

[Effects of omega-3 fat supplementation and feeding frequency on glucose metabolism and insulin in on Mahabad kid]

Background: previous studies have shown that high intake and level of omega-3 have a positive impact on insulin sensitivity in the tissues

Objectives: this study investigated the effect of omega-3 fat supplementation on glucose metabolism and insulin in Mahabadi kid

Methods: twenty-eight Mahabad goat kids [3 to 4 months, with an average initial weight of 17 +/- 5 kg] were randomly assigned to four dietary treatments with a 2 × 2 factorial arrangement, with 2 types of feeding frequency [twice or 4 times in a day] combined with 2 types of fat [saturated fat and fish oil in 2% of DM] to investigate the effect of omega-3 fat supplementation and feeding time frequency on glucose and insulin metabolism. Goats were fed individually for 90 days. On day 70 an intravenous glucose tolerance test was performed after 20 hours of food deprivation. Blood samples were collected at -15, -10, -5, 5, 10, 15, 20, 30, 45, 60, 120 and 180 min after glucose injection. Data were analyzed using the SAS GLM procedure

Results: the IVGTT indicated that Omega-3 supplementation had a significant effect [p<0.05] on glucose clearance rate [CR]. On the other hand, with increasing feeding frequency, kids had higher glucose clearance rate [K] and lower glucose half-life

Conclusions: the results suggested that dietary supplementation with omega-3 fat and increased feeding frequency of diet improved glucose and insulin metabolism

Effectiveness of residents as teachers, researchers and role models: a unique program at SUMS

Background and purpose: Residents across the world spend several hours every week teaching medical students and junior residents. Workshops developed with the aim of improving resident teaching skills are becoming increasingly common in the various fields of medicine. The objectives of this study were to evaluate the effect of a resident-as-teacher educational intervention on the resident's knowledge of medical education

Methods: The study was performed in SUMS, Iran, in 2010-2011 on all the junior residents from the different fields, including 104 men and 66 women. For data collection, a questionnaire [pre-test, post-test] was used with 40 questions on medical education. The data were analyzed using descriptive statistics, tables and t test employing the SPSS software

Results: In total, 120 participants completed the questionnaires. According to the pre-test and post-test results, residents received extremely low scores in different subjects before the course implementation, whereas after it was implemented their scores had significantly increased fairly well. The comparison between the participants, average scores before and after the program indicates that the "resident-as-a-teacher, researcher and role model" course has been meaningful and significantly effective in improving their knowledge in this area

Conclusions: A few residency programs had instituted the resident teacher training curricula. A resident teacher training workshop was perceived as beneficial by the residents, and they reported improvement in their teaching skills

[ comparison of the effect of food sources of saturated and unsaturated fatty acids on ovarian activity of holstein dairy cows in close up period]

Background: Application of different sources of fatty acids and their effect on ovarian performance is a current issue in animal science and research centers

Objectives: The purpose of this study was to determine the effect of different fatty acids in close-up period on population and size of follicles and measuring blood parameters related to the energy state of the body after calving of lactating dairy cows

Methods: In this study 15 Holstein cows were selected by expected date of parturition [around 30 days before calving] and assigned them randomly within treatments diets. The diets were formulated to be isonitrogenous. Cows were fed 1] control [carbohydrate source], 2] Rumen-protected fat [RF] [saturated fatty acids] and 3] Roasted Soybean [RS] [unsaturated fatty acids]. Blood sample was collected at 7 day intervals in -21, -14, -7, 1, 7, 14, 21 periods of calving. Also dry matter intake and body condition score cows were recorded. Ovarian activity was monitored by daily transrectal ultrasound scanning from 30 to 40 and 61 to 70 DIM

Results: Average plasma glucose and cholesterol concentration were significantly different among treatment groups. Numerically, follicular classes were higher in cows, fed with fat diet compared with control group

Conclusions: According to the results of this experiment, it seems that application of polyunsaturated fatty acids, to improve the energy and ultimately the function of the ovaries, has more advantage than saturated fatty acids

[Effect of diagnostic and treatment factors on growth development of children with congenital hypothyroidism: a prospective longitudinal study]

Introduction: no study has yet been conducted evaluate the factors influencing the growth of patients with congenital hypothyroidism [CH], in Iran. The high prevalence of this disease in Iran, particularly in Isfahan, made it necessary to investigate biomedical diagnostic and early treatment factors potentially affecting growth status among patients with CH

Materials and Methods: in this prospective cohort study, 760 CH neonates [born 2002-2010], diagnosed and followed up [minimum 1, maximum 5 years] during the CH screening program in Isfahan were enrolled. Height, weight and head circumferences of the patients, during follow up and in subsequent periods, were measured. Diagnostic and therapeutic factors included serum T4 and TSH concentration at diagnosis and after treatment initiation, age at onset of therapy, initial dosage of levothyroxine and age at first normalization of T4 and TSH. Quantile regression for longitudinal data was used for investigating the effects of main factors determining growth development. R free software was used for analyzing data

Results: longitudinal growth in height and weight was significantly correlated with age at onset of therapy and initial dosage of treatment [p<0.01], while head circumference was associated only with initial dosage [P<0.05]. Increase in weight and head circumference were affected by serum TSH concentration at diagnosis [p<0.05], and age of T4 normalization also had significant impact, on some of the proposed quantiles, i.e. weight [p<0.05], height [p<0.01] and head circumference [p<0.001]

Conclusion: among the factors studied, initial dosage of treatment and age at onset of therapy seem to be more important factors for growth development, suggesting that more optimal outcomes are possible through earlier treatment and appropriate levothyroxine dosage

[Effect of chromium-methionine supplementation on hematologic characteristics and meat quality parameters in goat kids]

Previous research has shown that Cr is needed for growth and protein synthesis. This study was carried out to determine the effects of supplementing chromium-methionine [Cr-Met] on performance, hematologic characteristics and meat quality parameters in kids. Thirty-two male kids [average initial BW of 22 +/- 2 kg, 4mo] were used in a completely randomized design with four treatments: 1. control [without Cr], 2. 500, 3. 1000 and 4. 1500 ug Cr/kg of Cr-Met diet. The animals were kept in separate pens for 100 days. Kids were weighed at 21 day intervals and blood samples drawn on 75 day of the experiment were analyzed for hematologic characteristics. Kids were slaughtered at the end of the trial, and meat quality parameters [Warner-Bratzlershear force, color, chemical composition, water retention and pH] of longissimus dorsi muscle [LDM] were studied. The average of dry matter intake and daily gain weight were not affected by chromium supplementation [p>0.05] but, feed conversion ratio [FCR] improved in 1500 ug Cr/kg group. Chromium supplementation increased total white blood cell count [p<0.05] although, the other hematologic parameters were not affected by Cr-Met [p>0.05]. Addition of different levels of [Cr-Met] failed to significantly effect on lightness [L[asterisk]], pH, moisture [%], intramuscular fat [%], cooking loss and drip loss percentage [p>0.05]. Chromium supplementation increased redness [a[asterisk]], yellowness [b[asterisk]], chroma, hue angle and crude protein content[%] of LDM [p<0.05]. Supplemental Cr decreases Warner-Bratzlershear force of LDM [p<0.1]. These results indicate that Cr-Met diet improved performance, meat quality and increased white blood cells in Mahabadi goat kids

Reform in medical and health sciences educational system: a Delphi study of faculty members' views at Shiraz University of Medical Sciences

Despite the strengths in the Iranian medical and health sciences educational system, areas in need of improvement have been noted. The purpose of this study was to understand the views of faculty members at Shiraz University of Medical Sciences about current and future needs for medical and health sciences education, with the goal of improving the quality of the educational system. The data were collected using a Delphi consensus method. Analysis of the findings identified the following key themes among the factors likely to contribute to medical and health sciences education and training: adding and/or increasing student numbers in higher degrees in preference to associate degrees; providing more interactive, student-centred teaching methods; improving the educational content with more practical and research-based courses tailored to society's needs; and an emphasis on outcome-based student evaluation techniques. These changes aim to respond to health trends in society and enhance the close relationship between medical education and the needs of the Iranian society

[Physiologic changes in serum T4, TSH during the neonatal period in suspected babies at hypothyroidism screening in Isfahan, Iran in 2009-2010]

Significant changes in thyroid hormones occur during the first weeks after birth. We assessed the degree of changes in thyroid-stimulating hormone [TSH] and total thyroxin [T4] concentrations in neonates screened seven days after the first high serum TSH levels, just before starting treatment. This prospective study was carried out on newborns referred for their high TSH concentrations on heel blood spot in hypothyroidism screening tests [5- 20 miu/ml], between December 2009 and December 2010. First, serum TSH and T4 were assessed by radioimmunoassay. One week later, in neonates with the first serum TSH >/= 10, serum TSH and T4 were rechecked before starting treatment. Any definite decision to continue treatment was based on the second test results. The results showed a significant decrease in serum TSH level after one week [p<0.01]. Serum T4 level increased significantly in neonates with the first serum TSH >/= 40 [p<0.05], while no significant difference was observed in other infants with the first serum TSH<40. Incidence rate of Congenital Hypothyroidism [CH] reduced from 1/329 to 1/851, during the study. It may be appropriate to repeat serum T4 and TSH concentrations after 2 and 4 weeks in neonates with normal serum T4 but elevated TSH. In the case of persistent TSH elevation, the infant should be treated as this can prevent unnecessary treatments, family stress and iatrogenic hyperthyroidism in these patients

[Providing national draft on bridging education service gap in Iran]

Theory-practice gap or education-service gap is one of the most important challenges and important issues in today's nursing care which is an important issue in Iran health care system. In this study we aimed at providing national draft on bridging the theory-practice gap of nursing care in Iran. We designed the study in three phases. In the first phase, a systematic review was done. In the second phase, a qualitative content analysis was conducted and in the last phase, we conducted a study using Delphi method. After analyzing the data, we prepared a draft with 12 documents in three structural, educational and clinical sections. After examining structural, educational and clinical components; this draft tried to provide an internalization strategy on nursing needs in Iran. Evidently, the draft belongs to specific period; hence, continuous updating of the draft is a significant key to its dynamics

[Prevalence and risk factors of diabetes, pre-diabetes and metabolic syndrome in first-degree relatives of patients with type II diabetes]

The aim of this study was to estimate the prevalence and risk factors for diabetes, pre-diabetes and metabolic syndrome in first-degree relatives [FDRs] of patients with type 2 diabetes. In a cross-sectional study between 2003 and 2005, 3228 of first-degree relatives of patients with type 2 diabetes [841 men and 2387 women] from Isfahan Endocrine and Metabolism Research Center outpatient clinics, Iran, were examined. All subjects underwent a standard 75 g 2-h oral glucose tolerance test [OGTT]. Impaired glucose tolerance [IGT], impaired fasting glucose [IFG] and type 2 diabetes were diagnosed according to the criteria of the American Diabetes Association and metabolic syndrome, according to the Third Report of the National Cholesterol Education Program adult treatment panel [NCEP-ATP III]. The Prevalence of metabolic syndrome, type 2 diabetes, IGT and IFG were 35.8, 10.3, 19.5, and 17.3 percent, respectively. IGT [OR: 0.66; 95% CI: 0.51-0.87] and metabolic syndrome [OR: 0.72; 95% CI: 0.61-0.85] were more common among women, whereas IFG [OR: 1.41; 95% CI: 1.10-1.80] was higher in men. Multivariate analysis revealed that age and obesity or abdominal obesity were significantly associated with diabetes, IGT and IFG. IGT, IFG and lower HDL were associated with metabolic syndrome. First-degree relatives of patients with type 2 diabetes are at higher risk of IGT, type 2 diabetes and metabolic syndrome. This risk increases with age and obesity. These findings may provide evidence for necessity of screening program in identifying a special subset of the population at particular risk of developing type 2 diabetes

Rational evaluation of antimicrobial properties of lactobacilli isolates against some pathogenic microorganisms: a new method comparing the susceptibility of indicator microorganisms

Lactobacilli are known as a valuable source of antimicrobial compounds and have a high potential of use in food biopreservation against food related microorganisms. Antimicrobial potency of 63 dairy lactobacilli isolates against four highly important food-related microorganisms were evaluated. In addition, a new way in data organization was introduced, which led to a more informative and rational comparison of indicator microorganisms' susceptibilities to a set of compounds. Correlation of pH and antimicrobial properties was investigated. Microbroth dilution assay was used to evaluate indicator microorganisms' susceptibility to lactobacilli CFCS [cell free culture supernatant]. Results were organized by both the conventional way - demonstrating the minimum inhibitory and lethal concentrations of CFCS - and a new suggested method, representing comparative effectiveness of each CFCS specimen against indicator microorganisms of comparison interest. Susceptibilities of tested strains were in the following order: Escherichia coliO157:H7 > Listeria monocytogenes > Aspergillus parasiticus> Candida parapsilosis. Despite the high susceptibility of L. monocytogenes, it showed the highest resistance to death among the tested microorganisms. Efficiency of Lactobacilli CFCS in killing the tested strains showed the following susceptibility order: E. coli O157:H7 > A. parasiticus> C. parapsilosis> L. monocytogenes. Antimicrobial property was in correlation with the pH value of CFCS. PH had a pronounced impact on susceptibilities of C. parapsilosis and E. coli in pH values of concentrated CFCS lower than 4 and 4.5, respectively. Potency of lactobacilli isolates in growth inhibition of the indicator microorganisms was found promising, and the suggested data organization method provided additional information, leading to more precise comparison of indicator microorganisms

Effects of Nigella sativa L. seed oil in type II diabetic patients: a randomized, double-blind, placebo - controlled clinical trial

Nigella sativa [N. sativa] seeds are used to treat diabetes mellitus in traditional medicine. Moreover, N. sativa oil has reduced the fasting blood glucose level in non-diabetic volunteers. The present study was undertaken to explore the possible anti-hyperglycemic effect of N. sativa oil in type 2 diabetic patients. A randomized clinical trial was conducted in 70 type 2 diabetic patients referring to Baqiyatallah Hospital. The subjects were enrolled into two groups of 35 each. One group received 2.5 ml N. sativa oil and the other group received similarly 2.5 ml mineral oil two times a day for three months. The fasting and 2 hour postprandial blood glucose, glycosylated hemoglobin [HbA1c], lipid profile, BMI [body mass index], liver and renal function test were determined at the baseline and after three months. The blood levels of fasting and 2 hours postprandial glucose and HbA1c were significantly decreased in the N. sativa group compared with the placebo group at the end of the study. The BMI of the N. sativa group was decreased significantly from baseline. No side effects were reported. N. sativa oil improves glycernic control in type 2 diabetic patients without any side effects

Candida parapsilosis as a potent biocontrol agent against growth and aflatoxin production by aspergillus species

Aflatoxin contamination of food and feed stuff is a serious health problem and significant economic concerns. In the present study, the inhibitory effect of Candida parapsilosis IP1698 on mycelial growth and aflatoxin production in aflatoxigenic strains of Aspergillus species was investigated. Mycelial growth inhibitions of nine strains of aflatoxigenic and non-aflatoxigenic Aspergillus species in the presence of C. parapsilosis investigated by pour plate technique at different pH, temperature and time of incubation. Reduction of aflatoxin was evaluated in co-cultured fungi in yeast extract sucrose broth after seven days of incubation using HPLC method. The data were analyzed by SPSS 11.5. The presence of the C. parapsilosis at different pH did not affect significantly the growth rate of Aspergillm isolates. On the other hand, temperature and time of incubation showed to be significantly effective when compared to controls without C. parapsilosis [P<0.05]. In aflatoxigenic strains, minimum percentage of reductions in total aflatoxin and BI, 62, Gi, G2 fractions were 92.98, 92.54, 77.48, 54.54 and 72.22 and maximum percentage of reductions were 99.59, not detectable, 94.42, and not detectable in both GI and G2, respectively. C parapsilosis might employ as a good biocontrol agent against growth and aflatoxin production by aflatoxigenic Aspergillus species

Research priorities in medical education in the Eastern Mediterranean Region

Ways are needed to effect quality improvement in medical education research in the Eastern Mediterranean Region [EMR]. This study aimed to determine the principle themes and to draw up a list of priorities in medical education research in EMR. Using the nominal group technique with a group of 30 experts, a list of major themes in medical education research was prepared. In a 2-round Delphi survey the list was sent to another 47 experts in the Region with a questionnaire that included open questions about change and reform in medical education. In the final list of 20, the 5 highest priorities identified were: training physicians to be effective teachers; community-driven models for curriculum development; clinical teaching models; education about professionalism and ethics; and education for evidence-based medicine. Themes determined by this survey can help researchers in EMR to focus on priority areas in research

[Barriers to blood glucose level management in the health care system: view points of patients, families and medical personnel]

Health care system barriers are major barriers to management and control of blood glucose level control. Documenting the viewpoints of patients, their families and the medical team, on these barriers is an important step towards correct planning and effective control of blood glucose. This study aimed to document and compare viewpoints of patients, their families and medical team about health care system barriers to control of glucose levels in diabetes centers of Isfahan city. This was a descriptive- comparative, cross-sectional, one stage, study of three groups, in which a total of 938 subjects, including 420 type2 diabetic patients, 420 members of their families and 98 medical staff participated. Data were collected using a researcher-designed questionnaire that was completed by subjects. Data were analyzed using descriptive and inferential statistical methods and SPSS software. Results showed significant differences between viewpoints of the 3 groups, i.e. patients, their families and the medical team regarding barriers of the health care system to blood glucose control [Pvalue< 0.001]. The medical team gave the highest importance to these barriers, while patients gave the lowest. Regarding the significant differences between the viewpoints of these three groups, it can be concluded these differences account for lack of success in controlling patient glucose levels, because medical teams focus on barriers that are not so important to patients and their families, while barriers which are important to patients and their families are less considered by members of the medical team

[Prediction of infant motor performance through performance evaluation of behavior]

Nowadays, comprehensive developmental assessment of infants is highly considered. But, some assessments, especially those which use more manipulations on high risk infants, can cause more stress on them. So sometimes it is necessary to use one group of developmental assessments to predict another developmental aspect. The aim of this study was to investigate the relationship between scores of behavioral scale and motor performance. In this cross-sectional study that was conducted in neonatal intensive care unit and pediatric clinic of Shahid Akbarabadi hospital, Tehran, 50 under 2 months low birth weight infants after met inclusion criteria were selected via convinence sampling method. The Test of Infant Motor Performance [TIMP] and the Neonatal Behavioral Assessment Scale [NBAS] was used for assessing motor performance and behavioral performance respectively. The TIMP consist of elicited and observational parts. NBAS was consisted of habituation, social interaction, motor system, state organization, state regulation, autonomic system, smile, supplementary items, and reflex items. There was not any significant relationship between habituation part of NBAS and TIMP and also between autonomus system part of NBAS and observational part of TIMP [P<0.05]. Association between other variables was statistically significant [P>0.05]. Some items of behavioral assessment can be used to predict the motor performance in low birth weight infants

[Socio-economic and cultural factors affecting child feeding practices: an exploratory qualitative study in Damavand]

Early child nutrition plays a vital role in the growth and development not only in infancy but also later in life. This study was carried out to determine the views, beliefs and experience of mothers, caregivers and health professionals about the role of socio-economic and cultural factors in child feeding practices in Damavand, a district located in the north of Tehran, in 2008. In a qualitative study 23 focus group discussions [FGDs] were held with the presence of a facilitator, 2 rapporteurs, and a supervisor. Mothers of under-2-year-old children attended 11 FGDs, and 8 FGDs were arranged for home caregivers [grandmothers], out-of-home care-givers [community child health nurses], and rural and urban health workers. At the end of the field work all the notes taken in the FGDs were coded based on objectives of the study. Then the subgroups for each objective and emerging themes were derived and reported. The data were analyzed using content analysis. Most participants were aware of breast feeding and complementary feeding benefits. However, exclusive breast feeding was not followed precisely and the quality and diversity of the diet of children were ignored. The participants thought that social and economic factors, such as literacy, income, erroneous beliefs, family restrictions, and interference of elderly females, had a role in failure of breast and complementary feeding. Cultural factors appeared to have an important influence on mothers' infant feeding practices and feeding patterns of their children. To overcome the problems related to breast feeding and complementary feeding practices, revision of the current nutritional protocols and educational programs is essential. In addition, involvement of mothers, caregivers, elderly women, and all those involved in child care, in nutrition education activities is recommended

Talents for future: report of the second national medical science Olympiad in Islamic Republic of Iran

This report describes a unique experience of Second National Medical Science Olympiad that was held in August 2010 in Shiraz, Islamic Republic of Iran. The history of medical science Olympiad in Iran and the development, process and domains in the Olympiad and the way for future will be discussed

Population pharmacokinetics of oral high-dose busulfan in adult patients undergoing hematopoietic stem cell transplantation

Many factors have been reported that contribute to the wide intra- and inter-patient variability of Busulfan [Bu] disposition. The purpose of this study was to develop a population pharmacokinetic model and to determine the covariates affecting the pharmacokinetics [PK] of Bu in Iranian adult patients who received oral high-dose as a conditioning regimen before Hematopoietic Stem Cell Transplantation [HSCT]. A population PK analysis was performed in 30 patients who received an oral Bu and cyclophosphamide regimen before HSCT. Bu was given orally according to the protocol of the institution. In order to prevent seizures caused by Bu, phenytoin was administered orally one hour before each dose of Bu. A total of 180 blood samples were analyzed by HPLC and PK parameters were estimated by the non-linear mixed effect model by MONOLIX 3.1 program. A one-compartment model with an additive error model was used to describe the concentration-time profile of Bu. CL=13.4[1+ [0.141xDisease]], Vd=42.6[1+0.010x [Weight - 63.9]] Patients' disease and weight was found to be the determinant factors for clearance [CL] and the volume of distribution [Vd] according to Monolix analysis. The covariate entered in final model followed by these equations: In this limited study, the age [15-43 years] had no significant effect. For a patient weighting 60 kg, the typical CL and Vd were estimated to be 13.4 l/hr and 42.6 L, respectively. The interindividual variability of CL and Vd were 13.6 and 6.3%, respectively. There was no significant metabolic induction in these four days as is evident by comparing the trough levels of Bu. However it should be mentioned that, one tailed t-test p-values of the days of two and three, two and four and three and four were 0.083, 0.069 and 0.388, respectively. Results of this study showed that the type of disease was a determinant of CL and the weight of patient was a determinant of Vd for Bu population PK parameters. A reliable PK parameters and Css, estimated from only one plasma concentrations [5 hrs after the first dose], were validated. Since these methods require few sampling and are easy to be used, the limited sampling methods might be advantageous in the routine clinical practice

[Comparison of urinary N-acetyl-beta-D-glucosaminidase in non-diabetic subjects and type2 diabetic patients]

For renal impairment, in clinical diagnostic practice currently the assessment of urinary enzymes is used. One of these enzymes is N-acetyl-beta-D-glucosaminidase [NAG], a widely distributed lysosomal enzyme with a molecular weight of 140000 Da, located predominantly in the renal proximal tubules. NAG activity in the urine increases in patients with various glomerulonephritides, diabetic nephropathy, tubulointerstitial diseases, renal allograft rejection and toxic renal injury. The study population included 30 type 2 diabetes and 30 non-diabetic subjects, and the latter group had normal glucose tolerance test. Urinary NAG, albumin, creatinine, serum glucose and HbA1c% were measured. The urinary NAG and albumin index in non-diabetic subjects were compared with those of the diabetic patients. The differences between the two groups [HbA1c<%7 and HbA1c>%7] were calculated. Significant differences were determined in NAG activity between the diabetic and non-diabetic subjects [p< 0.001]. Excreted urinary NAG increased in diabetes patients with poor glycemic control [HbA1c>7%] compared to those with good glycemic control [HbA1c<7%], an increase that was significant [p<0.05]. There was an increase in urinary NAG excretion in diabetic patients with abnormal albumin excretion compared to those with normal albumin excretion [p= 0.001]. NAG excretion had a positive correlation with blood glucose and HbA1c%. Our results showed that determination of urinary NAG activity could be useful marker of early renal damage in diabetic nephropathy and confirmed the use of NAG enzyme as a routine screening test