[Relationship of conicity index, waist circumference, body mass index and physical activity with lipid profile in patients with type 2 diabetes mellitus]

Cardiovascular diseases are the main causes of death in diabetic patients and lipid disorders are among the main risk factors for these diseases. The aim of this study was to determine the relationship of Conicity index [CI], body mass index [BMI], waist circumference [WC] and physical activity [PA] with lipid levels and to determine the best anthropometric measurement predictor of lipid profiles in patients with type 2 diabetes. A cross sectional study was conducted on 700 patients with type 2 diabetes. Measurements including weight, height, WC, BMI, CI and PA were obtained for each subject and fasting serum triglycerides [TG], total cholesterol [TC], HDL-cholesterol [HDL-C] and LDL-cholesterol [LDL-C] were documented. Overall, 97% of men and 95% women had abnormal CI. About 84.5% of participants had BMI over 25 [kg/m2]. In addition, 55.3% of men and 88.5% of women had abdominal obesity based on WC. There was significant increases in TG, TC and LDL-C and reduction of HDL-C with increasing CI quartiles. BMI showed significant and positive correlation to LDL-C. The correlation between WC and TG and LDL/HDL were also significant. PA showed a positive and significant correlation to HDL-C and negative correlation to BMI, WC, CI, and LDL / HDL in all subjects. CI, BMI, WC and PA have significant correlations to blood lipid disorders in type 2 diabetic patients and can be used in screening and predicting the risk of lipid disorders in type 2 diabetic patients. None of the measurements however showed a stronger relationship to these disorders in patients with type 2 diabetes

Quality assurance program for molecular medicine laboratories

Molecular diagnostic methods have played and continuing to have a critical role in clinical laboratories in recent years. Therefore, standardization is an evolutionary process that needs to be upgrade with increasing scientific knowledge, improvement of the instruments and techniques. The aim of this study was to design a quality assurance program in order to have similar conditions for all medical laboratories engaging with molecular tests. We had to design a plan for all four elements; required space conditions, equipments, training, and basic guidelines. Necessary guidelines was prepared and confirmed by the launched specific committee at the Health Reference Laboratory. Several workshops were also held for medical laboratories directors and staffs, quality control manager of molecular companies, directors and nominees from universities. Accreditation of equipments and molecular material was followed parallel with rest of program. Now we are going to accredit medical laboratories and to evaluate the success of the program. Accreditation of medical laboratory will be succeeding if its basic elements are provided in advance. Professional practice guidelines, holding training and performing accreditation the molecular materials and equipments ensured us that laboratories are aware of best practices, proper interpretation, limitations of techniques, and technical issues. Now, active external auditing can improve the applied laboratory conditions toward the defined standard level

[ relationship between Sidedness, communicative function and educational state in autistic students]

Difficulties in sidedness of autistic students and their defected language and communication function can be in relationship with their educational state. This research was designed to investigate the possible relationship among sidedness, communicative function and educational state in autistic students. This is a described-analytic research and a kind of cross sectional and comparative one. For these purpose 40 autistic students with age average 10 years old and 8 months [SD=2.5] were chosen. Communicative function questionnaire were completed by all subjects parents. We used observation check list to examine handedness, footedness, and dominant eye and ear. Using of T-test, covariance analysis data were analyzed. Data analysis indicated that there is not significant statistically difference between communicative function and educational state [p<0.05], but participants with weak educational state less tend to definite sidedness preference-in hand and foot not in eye and ear [p>0.05]. These findings reveal that stability of sidedness, which obtains with interventions rehabilitation in autistic students, can perform important role in high language skills and appropriate educational state for them

[Comparison between efficacy of ciprofioxacin-doxycycline and rifampin-doxycycline regimens in treatment of brucellosis]

Brucellosis is an endemic disease in Iran that has a worldwide spread and is associated with chronic disabilities in humans. Combination therapy of brucellosis leads to recovery of symptoms, shortening of the symptomatic intervals, and decrease in the rate of relapse and drug resistance. Considering the use of rifampin in the treatment of tuberculosis, and the necessity for an alternative treatment in regions endemic for both tuberculosis and brucellosis, in this study we compared the efficiency of the WHO's standard regimen of rifampin-doxycycline [RD] versus ciprofloxacin-doxycycline [CD] for the treatment of brucellosis. This randomized controlled trial was performed on 90 patients, affected with brucellosis, who were referred to the Infectious Disease Clinics at Arak University of medical sciences. The patients were randomly divided into two groups: the DR group, received 100 mg of Doxycycline twice a day and 300 mg of rifampin Bid daily for eight weeks; and the CD group, received 100 mg of doxycycline plus 500 mg of ciprofloxacin twice a day for eight weeks. The patients were analyzed for the relief of symptoms, drug side effects, and laboratory findings during the treatment. In this study, the rate of symptom relief and laboratory findings in both groups were similar. The relief of symptoms was seen in 93.2% and 83.9% of the patients for the DR and CD groups, respectively [P=0.182]. The side effects of the drug were not significant in either groups, with no significant difference, and did not lead to discontinuation of the therapy. Due to the similar efficacy of CD and DR regimens in the treatment of brucellosis and considering the usage of rifampin in regions with high prevalence of tuberclusis, the CD regimen is recommended as an appropriate treatment

Insulin-like growth factor-1 and zinc status of goitrous primary-school children in Arak, Islamic Republic of Iran

Despite a successful national salt iodinization programme, endemic goitre still persists in Iranian children. In a cross-sectional study in Arak the prevalence of goitre was 5.2% in a sample of 6520 primaryschool children. Subsamples of 193 children with goitre and 151 healthy children were assessed for urinary iodine excretion, thyroid hormone profile, insulin-like growth factor-1 [IGF-1] and serum zinc. The mean urinary iodine levels of goitrous children and healthy children were 17.4 micro g/dL and 15.3 micro g/dL respectively, suggesting that iodine consumption was adequate. No significant differences were found between goitrous and healthy schoolchildren in mean levels of urinary iodine, serum IGF-1 or serum zinc. Other factors need be evaluated to explain the residual prevalence of goiter

Precipitation of fluticasone propionate microparticles using supercritical antisolvent

The ability of supercritical fluids [SCFs], such as carbon dioxide, to dissolve and expand or extract organic solvents and as result lower their solvation power, makes it possible the use of SCFs for the precipitation of solids from organic solutions. The process could be the injection of a solution of the substrate in an organic solvent into a vessel which is swept by a supercritical fluid. The aim of this study was to ascertain the feasibility of supercritical processing to prepare different particulate forms of fluticasone propionate [FP], and to evaluate the influence of different liquid solvents and precipitation temperatures on the morphology, size and crystal habit of particles. The solution of FP in organic solvents, was precipitated by supercritical carbon dioxide [SCCO[2]] at two pressure and temperature levels. Effects of process parameters on the physicochemical characteristics of harvested microparticles were evaluated. Particle formation was observed only at the lower selected pressure, whilst at the higher pressure, no precipitation of particles was occurred due to dissolution of FP in supercritical antisolvent. The micrographs of the produced particles showed different morphologies for FP obtained from different conditions. The results of thermal analysis of the resulted particles showed that changes in the processing conditions didn't influence thermal behavior of the precipitated particles. Evaluation of the effect of temperature on the size distribution of particles showed that increase in the temperature from 40 °C to 50 °C, resulted in reduction of the mean particle size from about 30 micro m to about 12 micro m. From the results of this study it may be concluded that, processing of FP by supercritical antisolvent could be an approach for production of diverse forms of the drug and drastic changes in the physical characteristics of microparticles could be achieved by changing the type of solvent and temperature of operation

Risk of seizure recurrence following a first unprovoked seizure in childhood

There is still a question whether first seizure leads to epilepsy. Several risk factors have been reported in this relation. This study was undertaken to determine the risk of recurrence after a first unprovoked seizure in children In a prospective study between December 2003 and December 2005, 156 children who presented with a first unprovoked seizure were enrolled and followed for at least 18 months. Potential predictors of recurrence were compared, using the Cox Proportional Hazard model in a univariable and multivariate analysis. Survival analysis was performed, using the Kaplan-Meire curves. Seventy two children [46.2%] experienced subsequent seizures. The cumulative risk of seizure recurrence was 28.8%, 41.7% and 46.2% at 6, 12, and 24 months following the first seizure, respectively. The median time for repeated seizure was 4 months while 62.5% of the recurrence occurred within 6 months, 88.9% within 1 year and 100% till the end of the second year. On multiple analysis, risk factors for resumption of seizure consisted of abnormal electroencephalography [EEG], seizure during sleep, abnormal brain imaging and history of perinatal problems. On univariable analysis, abnormal EEG, abnormal imaging [remote etiology of seizure], history of neonatal problems, previous febrile seizure, and family history of afebrile seizure increased the risk of recurrence. The study revealed that the risk of seizure recurrence in our patients was relatively high. Those who had abnormal electroencephalography, past history of prenatal problems, remote etiology for seizure, abnormal brain imaging, and seizure during sleep were at greater risk for recurrence of seizure

[Ankle / brachial index in thrombotic cerebrovascular disease patients]

Previous studies showed that Ankle Brachial Index [ABI] score less than 0.9 increases probability of ischemic heart disease up to 2 times, risk of TIA/ stroke to quadruple, and asymptomatic carotid and popliteal artery stenosis to one and half fold. ABI <0.9 is related with diffuse atherosclerosis. The aim of this study was to review ABI findings in patients with cerebral artery disease. This cross-sectional descriptive study was done on 98 patients with thrombotic cerebrovascular accident in Yazd Shahid Sadughi Hospital, between February 2001 and February 2002. A questionnaire including demographic, clinical, and paraclinical data was completed and results were analyzed using descriptive statistics and frequency distribution tables. Forty four percent of the patients were men. Mean age was 73/1 +/- 1/5. ABI<0.9 was seen in 15% of the cases. In patients older than 65 years old ABI<0.9 frequency rate was 12.5% and in patients younger that 65 year old it was 3.1%. There was no significant difference between ABI<0.9 and history of diabetes mellitus, hypertension, smoking, and ischemic heart disease. ABI<0.9 was prominently seen in patients with hyperlipidemia [P<0.05]. ABI<0.9 was seen in older ages, hypertensive, smoker, and CAD patients more than the others [P>0.07]. Because of lack of samples in the present study, authors suggest a study with a larger sample group

Influence of Beta-cyclodextrin complexation on lovastatin release from osmotic pump tablets[OPT]

An extended-release osmotic dosage form was designed and the effect of beta-cyclodextrin [BCD] inclusion complexation on the solubility of lovastatin in aqueous media was investigated. The lovastatin BCD solid systems were prepared by kneading method. The elementary osmotic pumps [EOPs] were prepared with lovastatin BCD complex with cellulose acetate [CA] and polyethylene glycol as plasticizer. The effect of the BCD molar ratio on enhancement of lovastatin dissolution rate and the influences of various parameters [e.g. drug -BCD ratio, molecular weight and amount of PVP, coating weight gain] on drug release profiles were investigated. The solubility and dissolution rates of lovastatin were significantly increased by using inclusion complexation. It was found that PVP K90 was a suitable hydrophilic polymer with thickening effect and had profoundly positive effect on drug release. The present results confirmed that dissolution rate of lovastatin BCD were greatly enhanced and this system has suitable solubility behavior in EOP tablet formulations

[Role of obesity in premature MI occurrence and hospital and one year follow up mortality]

Nowadays, obesity is developing as an epidemy and it is one of major risk factors of coronary artery disease, therefore this study determinated the effect of obesity on age of occurrence of MI and It's mortality. In this prospective study we studied on 212 hospitalized patients because of MI in CCU[s] from May 2001 to October 2002 and they followed for one year, questionnaires for all patients were completed and data analyzed with SPSS ver.11.00.. 34.9% of patients were overweight and 16.5% were obese. Average BMI was 25.87 +/- 4.38. Obese patients were younger than overweight and normal weight patients significantly. [P=0.039] there was a linear relationship between BMI and age of occurrence of MI. [P=0.005]. Obesity and overweight status didn't affect on hospital and late [1 year] mortality. According to our results, obesity associated with premature occurrence of AMI because obesity accelerated coronary atherosclerosis but obesity didn't associate with increased incidence of inhopsital or one year mortality. Thus we suggest to long term follow up in later studies

CIDP and achalasia: two manifestations of a disease or coincidental association

Chronic inflammatory demyelinating polyneuroradiculopathy [CIDP] is an immune mediated disorder characterized by progressive developing or relapsing symmetrical motor or sensory symptoms in more than one limb over a period of two months. Achalasia, as a primary esophageal motility disorder, is also characterized by increasing the tone of lower esophageal sphincter, absence or incomplete sphincter relaxation in response to swallowing, loss of esophageal peristalsis and rising intra-esophageal pressure. Herein, a case of CIDP, dysmotility- like symptoms, and achalasia is presented

[ Study on Aegyptianella pullorum Infection in Native Chickens [Callus gallus domesticus]of Amol and Suburbs]

Study on prevalence rate of Aegyptianella pullorum infection in native chickens of Amol and suburbs. Cross- sectional study.50 Chickens.Blood sampling from 50 chickens [Gallus gallus domesticus], preparing Giemsa- stained blood smears, and measuring hematologic parameters. Three samples out of 50 [6%] were infected with A. pullorum. No significant difference was evident between hematologic parameters of infected and non-infected birds [P>0.05]. Hematological factors of infected birds were normal.The results confirmed A.pullorum infection in native chickens [Gallus gallus domesticus]of the area

[Measurement of total plasma homocysteine with reverse phase high performance liquid chromatography [RP-HPLC] method without internal standard]

Homocysteine is an amino acid with a free thiol [Sulphydryl] group and is an intermediate formed during the metabolism of methionine to cysteine. Measurement of total plasma Homocysteine may be of value in several clinical conditions including homocysteinuria, atherosclerosis, thrombophilia and folate/vitamin B12 deficiency. The purpose of this study was to measure total plasma Homocysteine using RP-HPLC with fluorescence detection method. Total plasma Homocysteine was measured with reverse-phase HPLC with fluorescence detection after reduction of Homocysteine with tris [2-carboxyetile] phosphine [TCEP] and derivatization of plasma thiols with ammonium 7-fluorobenzo-2-oxa 1,3-diazole-4-sulfonate [SBD-F]. Findings: The limit of detection for Homocysteine was 0.2 micromol/l. The within day coefficient of variation [CV] was 2.67% to 4.56% and the between day coefficient of variation was 5.43% to 8.17%. The mean recovery of Homocysteine was 93% to 103.4%. The results show that the HPLC method with fluorescence detection for measurement of total plasma Homocysteine, is sensitive [The limit of detection 0.2 micromol/l], accurate [CV between 2.67% and 8.17%] and it has acceptable recovery [93% to 103.4%]. Therefore, it is confident method especially for investigate application

[ comparison of ABI findings with ultrasound duplex scanning in PAD patients]

Atherosclerosis of peripheral arteries occurs in 12% of individuals with 65 years of age or older. Peripheral arterial disease [PAD] is one of the chronic diseases that is responsible for a significant number of mortality or morbidity in the developed countries. At least 28% of these patients have coronary heart diseases and 10% of them have cerebrovascular diseases. In addition, PAD is an independent predictor of both all causes and cardiovascular mortality. of this study is to calculate agreement between the two diagnostic tests of PAD, ankle brachial index [ABI] and ultrasound duplexes scanning [UDS] and to evaluate the results of these tests against symptoms of patients we designed this study on PAD patients. Forty symptomatic PAD patients that referred to the department of Sonography to complete their work up were enrolled in this validation study. Demographic characteristics, risk factors, symptoms, ABI and UDS measurements were recorded. Based on symptoms, ABI and UDS findings, patients were divided in to four groups and were compared with each other. Finally, agreement and association of these findings were analyzed. 32 patients [80%] were men with the mean age of 62 +/- 12.8 years [26-90]. Smoking [75%] and hypertension [100%] were the most common risk factors in men and women respectively and diabetes was ranked as the second common risk factor had the second degree in both genders. Agreement between ABI and UDS in men was significant, but was not significant in women. [P=0.02] Agreement between symptoms and ABI was significant [P=0.04] and between symptoms and UDS was not significant [P=0.037]. ABI is an appropriate tool for estimating the severity of arterial stenosis and lower extremity circulation

Early outcome of acute myocardial infarction

Introduction: Previos studies indicated that generally after acute myocardial infarction women have a poorer outcome thane men. Further studies with complete adjustements for coexisting condition are needed to determin whether the older age of the women who studied or the presence of other unfavorable prognostic factors or both explains this difference

Material and Method: We studied 817 consecutive patients [556 men and 261 women] hospitalized in all CCUs in city of Yazd due to acute myocardial infarction from May 2000 to October 2001

Results: In this survey, women were older than men [67.50 +/- 11 Vs 60 +/- 13] and had higher prevalence of hypertension, diabetes, dyslipidemia and in-hospital mortalities. The unadjusted odds ratio for death among women compared to men was 2.7[95 percent confidence interval, 1.79 to 4.28]. After adjustment for age the odd ratio reduced to 2.03 [95 percent confidence interval, 1.3 to 3.1]. Adjustmen for other differences in the base line characteristics reduced the odds ratio to 1.91 [95 percent confidece interval, 1.03 to 3.5]. These differences were significat, but after adjustment for treatment the odds ratio reduced to 1.51 [95 percent confidence interval, 0.6 to 3.7], and it wasn't Statistically significant

Conclusin: Women have worse prognosis after acute myocardial infarction and on the treatment may be contributing to this, and for correct judgement the difference of mortality after acute myocardial infarction, both sexes should under go the same approach for treatment