[Effect of oral vitamin c on anemia, uremia and blood pressure in patients with chronic renal failure receiving hemodialysis]

Vitamin C deficiency is a common in hemodialysis patients. Evidences indicated that oxidative stress is associated with Vitamin C deficiency. Oxidative stress plays an important role in the progression of anemia, uremia and hypertension in the patients with chronic renal failure that receiving hemodialysis. The purpose of this study was to determine the vitamin C effects on systolic blood pressure, hemoglobin, hematocrit, blood urea and creatinine. In a randomized clinical trials with registry number IRCT:2387 in Emam Reza and Besat University Hospitals in 2009, fifty six hemodialysis patients who met the inclusion criteria were selected by simple randomization method. These subjects were divided in two groups randomly: The experimental group who received oral vitamin C 250 mg, three times per week until two months. The amounts of blood pressure, hemoglobin, hematocrit, blood urea and creatinine tests were compared before and after the intervention. Finally the results were analyzed statically with T test by considered P-value less than 0.05. The level of hemoglobin and blood pressure was higher in experimental compared to control not significantly. While the blood urea and creatinine was insignificantly lower after intervention. These results show a statistical significance difference due to increasing of hematocrit level by using of oral vitamin C [P<0.05]. There is association between supplementation with oral vitamin C in hemodialysis patient and systolic blood pressure, hemoglobin, hematocrit, blood urea and creatinine. Therefore further studies are needed to determine the clinical benefits of antioxidants interventions in hemodialysis patients

Ups and downs of hypertension

Hypertension is a growing pandemic in the world and causes 7 million deaths annually. In Iran, about 10 million people have hypertension. Hypertension is an important risk factor for other diseases. Therefore monitoring and evaluation of blood pressure [BP] has clinical and epidemiologic importance. Although there has been lot of breakthroughs in diagnosis and treatment of HTN, only few patients merit an adequate blood pressure control. On the other hand, white coat syndrome has caused an inadvertent administration of anti-hypertensive drugs, inflicting unnecessary drug complications on the patients. Therefore, constant self blood pressure measurements in home seems indispensable to achieve a true presentation of BP and subsequently a depiction of BP rises and falls though graphs. This article employed data from original articles of renowned journals and the corresponding author. Daily fluctuations of BP, nocturnal falls, heart rate fluctuations and BP rises herald crucial information regarding renal and cardiovascular accidents. BP monitoring during physical activities such as exercise stress test, reveal diseases that may be still in subclinical stages. These information are of utmost importance in prognosis and risk assessment of high risk patients with diabetes, heart failure and chronic renal disease. In addition, they could be established for recording subclinical events in occupational hazards in army personnel's, flight personnel's, military commanders, security service personnel's and other stressful professions. in this article, we established a review on the subject and a practical approach in BP monoitoring from the clinical epidemiologic prospective

[ effect of oral vitamin C on fatigue in hemodialysis patients at selected hospitals of army university medical science in 2009]

Fatigue is a debilitating symptom or side effect experienced by many patients on dialysis therapy. Fatigue has a considerable effect on quality of life in these patients. The purpose of this study was determination of the vitamin C effect on fatigue measure. We investigated 56 hemodialysis patients who complained of fatigue and admitted at Emam Reza and Besat University Hospitals in 2009. The inclusion criteria: 1]Subjects diagnosed with chronic renal failure and received regular hemodialysis treatment for at least six month, 2] Aged 18 years or older, 3] conscious alerts and oriented, 4] Without other systemic diseases causing or increasing levels of fatigue such as chronic heart, liver and pulmonary diseases, cancer, mental retardation and chronic psychological disease, 5] Ability to communicate verbally and give informed consent and participate in this study. The exclusion criteria: the patients were excluded when supplementation with vitamin c in oral or injection form and adverse reaction occurred. The patients who met the inclusion criteria were randomly and equally in number assigned to Case and Control Groups. Case group members received oral vitamin C for two month, 250 mg, three times per week. The patients conducted fatigue severity questionnaires before and after of intervention. The results were statistically analyzed with T-test and P-value under 0.05. The fatigue score of the patients in the case group before intervention was 5.29 and after it were 3.94 while in the control group, the fatigue score of the patients were 5.007 and 4.93 before and after of intervention respectively. These results shows a statistical significance in decrease of fatigue score with [P<0.05] by using of oral vitamin C. We thing that the oral vitamin C in hemodialysis patient who complaint of fatigue is helpful

[ effect of oral vitamin C on fatigue in hemodialysis patients at selected hospitals of army university medical science in 2009]

Background: fatigue is a debilitating symptom or side effect experienced by many patients on dialysis therapy. Fatigue has a considerable effect on quality of life in these patients. The purpose of this study was determination of the vitamin C effect on fatigue measure

Materials and Methods: we investigated 56 hemodialysis patients who complained of fatigue and admitted at Emam Reza and Besat University Hospitals in 2009. The inclusion criteria: 1] Subjects diagnosed with chronic renal failure and received regular hemodialysis treatment for at least six month, 2] Aged 18 years or older, 3] Conscious alerts and oriented, 4] Without other systemic diseases causing or increasing levels of fatigue such as chronic heart, liver and pulmonary diseases, cancer, mental retardation and chronic psychological disease, 5] Ability to communicate verbally and give informed consent and participate in this study. The exclusion criteria: The patients were excluded when supplementation with vitamin c in oral or injection form and adverse reaction occurred. The patients who met the inclusion criteria were randomly and equally in number assigned to Case and Control Groups. Case group members received oral vitamin C for two month, 250 mg, three times per week. The patients conducted fatigue severity questionnaires before and after of intervention. The results were statistically analyzed with T-test and P-value under 0.05

Results: the fatigue score of the patients in the case group before intervention was 5.29 and after it were 3.94 while in the control group, the fatigue score of the patients were 5.007 and 4.93 before and after of intervention respectively. These results show a statistical significance in decrease of fatigue score with [P<0.05] by using of oral vitamin C

Conclusions: we think that the oral vitamin C in hemodialysis patient who compliant of fatigue is helpful

[Evaluation of nosocomial urinary tract infection in the intensive care unit patients at Tehran 501 hospital during 2007]

Background: nosocomial urinary tract infection is one of the most common nosocomial infection causing an increase in mortality and high expenses for the patients. In this study we have tried to investigate the effects of various Factors including age, sex, marritial status, usage of urine catheter and the duration of it, any pervious urinary infection, smoking, urinary tract obstruction and any surgery on the urinary tract

Materials and Methods: in order to make this research more comprehensive and perspective, all the 88 ICU patients hospitalized at Tehran 501 hospital went under observatoin for a period of 4 months. A questionnaire was given to each patient, their urine samples were taken on first, third and seventh day of their acceptance. the data was then analysed using SPSS software

Results: the results shows that in our 88 patients [of which 46.6% were male and 53.4% Female with an average age of 64 years], 89.8% were married and 10.2% single, 30.7% had diabet mellitus, 79.5% used urine catheter with an average of 12 days of catheterization and 26.1% had previous urinary tract infection [p <0.05]. There was no significant relationship between urinary tract infection and the smoking [10%], obstruction of urinary system [9.1%], surgical history [4%] and the marritial status [P>0.05]. The main reason of the urinary tract infection was candida [66.7%] and the rest was E.coli [33.3%]

Conclusion: on the basis of this study we can say that urinary tract infection has a direct relationship with the usage of urine catheter and the period of its use, age, sex, diabetic, hospital staying and previous urinary tract infections

[Acute Renal Failure due to injectable Methamphetamine abuse]

Background: "Prerenal" azotemia is the most common cause of acute renal failure that almost caused by hypovolemia and or sepsis.Good management of these, results in good prognosis and prevents of chronic renal failure

Case report: we report a 20 years old man in coma,incontinence and fever that restricted in military concentration camp and was on water and food strike from 4 days. He had prolonged time abuse of methamphetamine and other narcotics as injectable forms. We detected uremic encephalopathy due to prerenal azotemia that controlled by hemodialysis.Azotemia was acured base on infective endocarditis,that treated by ceftazidim and vancomycin in 4 weeks

Conclusions: water and electrolytes resourcement,supportive treatment of kidney by dialysis and specific treatment of infections are the "Goal" of management in this patient

[Study on the etiology of urinary tract infection and benign prostate hypertrophy in the patients referred to 501 hospital from 2005 to 2006]

Background: the urinary tract infection is common the etiologic of U.T.I is gram negative bacillary [especially E.coli] in general. Multiple risk factors as B.P.H, nephrolithiasis, diabete, previous U.T.I, folley catheter, genetic, cigarette and alcoholism is predispose to U.T.I

Material and methods: in this study urine culture of 100 male patients with U.T.I and B.P.H evaluated

Results: the most common etiologic causes U.T.I in B.P.H is E.coli [80%], other causes is proteus [10%] and klebsiella [5%]

Conclusions: thus, our data show causes of U.T.I in male with B.P.H like to other general population