[Effect of N-acetylcysteine with letrozole to induction of ovulation in infertile women with polycystic ovarian syndrome]

Background and Objective: Polycystic ovary syndrome [PCOS] is the most endocrine disorder in women. This study was done to determine the effect of N-acetylcysteine with letrozole to induction of ovulation in infertile women with polycystic ovarian syndrome

Methods: This clinical trail study was carried out on forty PCOS women with normal TSH, prolactin, hysterosalpingographies and normal spermograms. The patients in control group were received letrozole 5 mg/d for 5 days starting at day 3 of the cycle. The patients in interventional group were received letrozole 5 mg/d with NAC 1.2 g/d [group II] for 5 days starting at day 3 of the cycle. On 14[th] day of cycle, transvaginal ultrasonography was performed to evaluate endometrial thickness and follicles properties. If mature follicle detected, hCG was injected and timed coitus at 12, 36 and 60 hours later advised. beta-hCG level was checked on day 16 after hCG injection

Results: The mean of endometrial thickness and follicles ovulation in hCG injection day was similar in the two groups. The pregnancy rate was 15% and 20% in control and interventional groups, respectively. This difference was not significant. The mean of follicles number was 1.13% and 1.47% in control and interventional groups, respectively. This difference was not significant

Conclusion: NAC as an adjuvant to letrozole was not effective for ovulation induction in patients with PCOS

Barriers to delivery of tissue plasminogen activator for patients with acuteischemic stroke

Stroke is the third leading cause of death and the first leading cause of disability worldwide. The tissue plasminogen activator [TPA] is one of the few treatments for this condition, which is currently used at a limited number of medical centers in Iran. Since the TPA is not used in Qazvin City, Iran, this study aimed to determine the frequency of qualified recipients to receive the TPA and the preventive factors associated with the use of the drug at the Boo Ali Center [Qazvin, Iran]. In this case study, 100 patients with the acute cerebral ischemic attack admitted to Boo-Ali hospital were selected during a six-month period [March to September 2014]. The patients were evaluated for receiving the TPA using a questionnaire and then the data were analyzed. Only 8% of the patients were qualified to receive the TPA. the main preventing factors in drug delivery with the highest rates were delay in visiting by a neurologist [75%], delay in referring the patients to the medical centers [67%], delay in preparing the clinical tests [46%], delay in visiting by an emergency department physician [39%], delay in preparing the CT scan result [36%], using the anti-platelets [35%], and anticoagulants [26%], respectively. Due to several preventive factors in the delivery of the drug, only a limited percentage of the patients were qualified to receive the TPA. More studies are needed to identify the causes and obviate them

[Insomnia in patients with obstructive sleep apnea syndrome]

Obstructive sleep apnea syndrome [OSAS] is a common sleep disorder. Insomnia complaint is the most common sleep disorders in the general population. The association between OSAS and insomnia symptom has received little attention from sleep investigators in the past few decades. This study investigates the prevalence of insomnia symptoms and related factors in patients with OSAS. This is a retrospective study of 151 consecutive patients with OSA who underwent sleep polysomnography. Patients were interviewed about their detailed sleep history. Insomnia and subjective daytime sleepiness was assessed using the Insomnia Severity Index and Epworth Sleepiness Scale. Polysomnographic recordings were compared in patients with and without insomnia symptom. Insomnia was a common complaint in patients being evaluated for obstructive sleep apnea. Among 151 patients with OSAS diagnosis, 81.7% of patients complained from one of the four insomnia symptom, 33.4% reported difficulty in falling sleep, 38.8% difficulty in sleep maintenance and 31.4% early morning awakening. Only 29.3% of patients were satisfied with their sleep quality. No significant association found between the insomnia symptom and mean nocturnal saturation of oxygen [P>0.05]. Insomnia is a common complaint in the patients suffering from OSAS. There was no relationship between insomnia symptom and severity of apnea or oxygen desaturation. Thus, nocturnal hypoxia is less likely to explain the high prevalence of insomnia among patients with OSAS

[Prevalence of metabolic syndrome among truck drivers and its relation to shift work]

Recent studies suggest that shift work is associated with metabolic syndrome in the shift workers. The population of truck drivers is of particular interest, because they frequently work irregular shifts. In addition, truck drivers have a high prevalence of sedentary habits, poor diet, and obesity. The aim of the present study was to investigate prevalence of metabolic syndrome and the relationship between metabolic syndrome and shift work schedule. We conducted a cross sectional study. A total of 192 truck drivers were assessed and the variables studied were: body mass index, waist circumference, blood pressure, triglycerides, total and fraction cholesterol, and fasting blood sugar. Metabolic syndrome was defined according to the criterion set by the National Cholesterol Education Panel III. The average age was of 39.4 +/- 1.3. According to the anthropometric data, it was observed that there were waist circumference >102 cm in 54%, HDL cholesterol <40/dl in 27%, triglyceride >150mg/dl in 29%, and glycemia >110mg/dl in 19.5%. Hypertension prevalence was 10.4%. Regression analyses to show the relationships between shift work and metabolic syndrome were performed using simple and multivariate models and adjusted for age, personal habit such as smoking, and physical activity. We found a significant association between shift work and metabolic syndrome. In truck drivers, shift work may be responsible for increased waist circumference, total cholesterol, and some features of metabolic syndrome

[Association between vitamin D receptor Apa1 and Taq1 genes polymorphism and osteoporosis in postmenopausal women]

Background: Osteoporosis is the commonest systemic disease leading to increased bone fragility and fracture. Vitamin D receptor Polymorphism is thought to have the most genetic influence on BMD

Objective: The aim of this study was to investigate the association between vitamin D receptor Apa1 and Taq1 genes polymorphism and osteoporosis in postmenopausal women

Methods: This was a case/control study in which 80 patients with osteoporosis [case group], referred to rheumatology ward at Boalisina Hospital during 2010 were investigated. The control group included an equal number of patients who visited other wards of the hospital for a variety of reasons. We obtained the bone mass densitometry [grams per centimeter square] results of case and control groups at the lumbar spine, wrist and hip by dual-energy X-ray absorptiometry. The distribution of Apa1 and Taq1 polymorphism in the VDR gene was determined by PCR-RFLP. Data were statistically analyzed by SPSS software using chi-square and ANOVA tests

Findings: There was no relationship between the Apa1, Taq1 VDR polymorphism and BMD results. We found that patients with Taq1 genotype [tt] had lower bone mass in the femur and wrist compared with Tt

Conclusion: Based on our findings, a relationship between the VDR polymorphism and osteoporosis remains unclear requiring further in-depth studies. Our results showed that other secondary factors may influence the bone mass density

[Relationship between obstructive sleep apnea and morning headache]

Obstructive sleep apnea syndrome [OSAS] is a common disorder in the general population. Several studies have suggested that headaches, particularly morning headaches, are more common in patients with OSAS than in normal subjects. This study investigates whether exist correlation between morning headache and polysomnographic sleep parameters. This is a cross sectional study of 150 consecutive patients with OSA who underwent sleep polysomnography. Patients were interviewed about their headache history. Insomnia and subjective sleepiness was assessed using the Insomnia Severity Index and Epworth Sleepiness Scale. Polysomnographic recordings were compared in patients with and without morning headache. Headache and non-headache patients did not differ in the Respiratory Disturbance Index, either in Mean nocturnal SaO2 or sleep efficiency [P>0.05]. The headache patients were more likely to be female and spend a lower time in sleep. Insomnia was a common complaint in patients being evaluated for obstructive sleep apnea. No significant association emerged between the Excessive Daytime Sleepiness with headache [P>0.05]. Thus, nocturnal hypoxia is less likely to explain the high headache prevalence among patients admitted for polysomnography