Association of geographical distribution of air quality index and type 2 diabetes mellitus in Isfahan, Iran

Air pollution is a hazardous environmental problem with several adverse health effects including its impact on the development of chronic diseases as diabetes mellitus. This study aimed to investigate the association of geographical distribution of air quality index [AQI] and type 2 diabetes mellitus in an air-polluted city by using geographic information system [GIS]. This cross-sectional study was conducted in Isfahan, Iran. The records that have been registered from 2009 to 2012 in major referral public diabetes clinics were gathered; they included data of 1467 diabetic patients. Their living area was represented with spots in the city map. AQI data were also interpolated from monitoring stations spreading around the city. The GIS maps of air pollutants and diabetes were developed and the associations were determined. The density of diabetic population was higher in highly polluted areas compared with areas with the lower levels of air pollution. No significant correlation was documented between the distribution of diabetic patients and air pollution level throughout the city. Although the density of diabetic patients was higher in areas with higher air pollution, but the lack of association between AQI and the prevalence of diabetes might be because the air of different parts of the city was highly polluted, and we could not compare the prevalence of diabetes in areas with clean and polluted air

effects of consumption of bread fortified with soy bean flour on metabolic profile in type 2 diabetic women: a cross-over randomized controlled clinical trial

Diabetes mellitus is one of the most common chronic diseases in the world and has become a major threat for global health. Recent studies reported that the soy has beneficial effects in diabetic mellitus patients. The aim of this study was to assess the effects of soybean flour fortified bread consumption on metabolic profile in type 2 diabetic women. This randomized, cross-over, controlled clinical trial was carried out in 30 type 2 diabetic women. At first, a 2-week run-in period was applied. Then, participants were randomly assigned to either intervention or control groups. Participants in the intervention group were asked to replace 120 g of soybean flour fortified bread with the same amount of their usual bread intake or other cereal products for 6 weeks. After a 4 weeks washout period, participants were crossed over for another 6 weeks. Mean [+/- standard deviation] age and body mass index of subjects was 45.7 +/- 3.8 years and 29.5 +/- 3.9 kg/m[2], respectively. The results of our study showed no significant effects of soybean flour fortified bread on metabolic profile. We found a reduction in serum triglycerides [change difference: -3.7, P = 0.82], serum low-density lipoprotein-cholesterol [change difference:-11.2, P = 0.50], insulin [change difference:-3.6, P = 0.7], and homeostatic model assessment of insulin resistance [change differences: -0.57, P = 0.45] after 6 weeks but these changes were not statistically significant. No significant effects of soybean flour fortified bread on serum concentrations of fasting blood sugar, glycated hemoglobin, high-density lipoproteins and total cholesterol levels were found. Six weeks consumption of soybean flour fortified bread among diabetic patients had no significant effects on metabolic profile

effect of quality of care on cardiovascular risk factors in newly diagnosed diabetic patients

In this study, we evaluated the quality of care and control of cardiovascular risk factors in newly diagnosed diabetic patients, identified during diabetes screening program, 1 year after diagnosis. In this prospective study, 83 newly diagnosed diabetic patients identified at screening in Isfahan, were studied. Height, weight, blood pressure, plasma glucose, lipids, and hemoglobin A1c [HbA1c] of these patients were measured 2 times, first at the time of diagnosis and then 1 year later, and the results were compared between two groups, with and without regular course of treatment. Nearly 46.99% and 53.1% of the studied patients have regular and irregular course of treatment. After 1 year, significant improvement in the mean of plasma glucose, cholesterol, triglyceride, low density lipoprotein [LDL], high density lipoprotein and HbA1c was seen in patients with regular course of treatment except for blood pressure [P < 0.05]. Frequency of controlled cardiovascular risk factors including fasting plasma glucose, HbA1c, cholesterol and LDL was significantly improved in patients with regular course of treatment [P < 0.05]. Mentioned changes were not seen in patients with irregular course of treatment. The findings of the current study demonstrated that though diabetes screening program result in earlier diagnosis of patients with type 2 diabetes, but it seems that regular follow-up and proper management of newly diagnosed patients is crucial for appropriate glycemic and metabolic control and preventing its related micro and macrovascular complication

Why 24-h urine albumin excretion rate method still is used for screening of diabetic nephropathy in Isfahan laboratories?

The first step in diagnosis of diabetic nephropathy is measurement of albumin in a spot urine sample. The aim of this study was assessment of the accuracy of urinary albumin to creatinine ratio [UACR] in random urine specimens [RUS] for microalbuminuria and macroalbuminuria screening in Iranian diabetic patients. A total of 200 diabetic patients participated to our study. 24 h timed urine specimens followed by RUS were collected. 24-h urine albumin excretion [24-h urinary albumin excretion [UAE]] and UACR in RUS were measured. Data were analyzed by Pearson's correlation, receiver operating characteristic [ROC] curve and McNemar test. A total of 165 patients finalized the study. Pearson's correlation of coefficient for 24-h UAE versus UACR was 0.64. The area under ROC curve for UACR was 0.83 in microalbuminuria and 0.91 in macroalbuminuria. The cutoff point of 30 mg/g in UACR method had 86% sensitivity and 60% specificity for microalbuminuria screening and cut-off point of 300 mg/g had 75% sensitivity and 99% specificity for macroalbuminuria screening respectively. UACR in RUS showed acceptable performance as a screening test for diagnosis of both micro and macroalbuminuria in Iranian diabetic patients

effects of probiotic supplementation on markers of blood lipids, and blood pressure in patients with prediabetes: a randomized clinical trial

Prediabetes is a high-risk condition for type 2 diabetes mellitus. The growing prevalence of diabetes emphasizes on the necessity of concentrating on various strategies to prediabetes prevention and management. Probiotics as a group of functional foods might exert antidiabetic effects. This study aimed to assess the effects of probiotic administration on blood lipid profile and blood pressure in patients with prediabetes. This randomized controlled trial consisted of 60 prediabetic patients, aged 25-65 years old, that were randomly assigned to the intervention [receiving 500 mg probiotic capsules, n = 30] or control group [receiving placebo, n = 30] for 8-week period. Demographic and anthropometric data were collected at baseline. Blood samples were collected at baseline and after 8 weeks for biochemical measurements. Blood pressure was measured at the baseline an after 8 weeks of intervention. Data regarding dietary intakes and physical activity were also collected during the study. We used SPSS software version 16 [SPSS Inc. Chicago, USA] for data analyzing. Probiotic supplementation did not contribute to significant changes in total cholesterol, low-density lipoprotein [LDL]-cholesterol, high-density lipoprotein [HDL]-cholesterol, Triglycerides [TG], TG/LDL and LDL/HDL ratios, after 8 weeks. After adjusting for potential confounders, HDL cholesterol reduced significantly in the placebo group compared with probiotic group. Percent change in systolic blood pressure was significantly different in the probiotic group in comparison with a placebo group [-3.10 +/- 2.22 vs. 3.24 +/- 1.96, P = 0.01], although this significance did not exist anymore after adjusting for confounders [P > 0.05]. Our study showed that probiotics did not have significant effects on lipid markers although they had positive effects on systolic blood pressure

B vitamins and antioxidants intake is negatively correlated with risk of stroke in Iran

Stroke is a leading cause of death in developed countries. However, current therapeutic strategies for stroke have been largely unsuccessful. Several studies have reported important benefits on reducing the risk of stroke and improving the post-stroke-associated functional declines in patients who ate foods rich in micronutrients, including B vitamins. Folic acid, vitamin B6, and vitamin B12 are all cofactors in homocysteine metabolism. Growing interest has been paid to hyperhomocyste inemia as a risk factor for stroke. Experimental studies suggest that oxidative stress plays an important role in the pathogenesis of ischemic cerebral injury, and higher intake of antioxidants has been associated with a lower risk of stroke in large population studies. The aim of this study was to examine whether the dietary intake of B vitamins and antioxidants in patients with stroke were comparatively worse than those in patients without stroke. In this case control study, 69 stroke patients [46 male, age = 56 +/- 18 years and 23 female, age = 52 +/- 7 years] admitted to Azzahra hospital between April 2009 and May 2010 were matched for age and sex with 60 patients [30 male and 30 female] from the same hospital who were not affected with acute cerebrovascular diseases and did not have a history of stroke. Dietary intake was assessed with a validated self-administered food frequency questionnaire [FFQ]. FFQ was collected conducting face-to-face interview with one of the patients' close relatives. Food intakes, translated into nutrient data, were compared between the two groups and with the recommended values. Intake of folic acid in men with stroke and vitamin B12 in women with stroke was significantly lower than that in the patients without stroke [P < 0.05], but there was no significant difference between the two groups in the level of antioxidant consumption in women and men [P > 0.05]. Our findings suggest that increased folic acid, vitamin B12, and vitamin E, C intake may be associated with decreased risk of stroke

Dietary intake of different carbohydrates among incident stroke patients during previous year

Stroke is a leading cause of preventable morbidity and mortality in the United States. Numerous studies have shown that dietary carbohydrates play an important role in stroke incident. Therefore, this study aimed to assess the association between dietary intake of carbohydrate and its types and stroke incidence among Iranian adults. A case-control study was performed among 46 men [5618] and 23 women [527] admitted to the Al Zahra hospital with stroke and 60 healthy people were chosen in control group. Dietary intake was measured by food frequency questionnaire [FFQ] including 168 items. Food processor software [version 2] was used to analyze data. Anthropometric indices of male and female patients were [BMI: 297.5], [Waist: 11215] and [BMI: 25.53.5], [Waist: 925] respectively. Energy intake and carbohydrate consumption of patients in both genders was higher than the healthy subjects which was statistically significant among men [P < 0.05]. Across different carbohydrate sources, refined carbohydrates consumption was higher among patients in both gender rather than the healthy subjects While, the healthy people had a higher whole grain consumption. High carbohydrate intake specially refined sources with high glycemic index [GI] and glycemic load [GL] is associated with increased risk of stroke. Hence, dietary intake requires improvement to provide protection from life threatening outcomes

Dairy consumption and stroke risk

Stroke is one of the most common causes of life-threatening disabilities and death around the world. Mortality rate is going to be doubled by 2030 in the Middle East countries. Prevention is a cost-effective approach to decrease risk of stroke. The present study assessed the relationship between dairy intake and stroke risk. This hospital-based case-control study was directed in a University hospital. The common food consumption of 129 men and women was assessed with food frequency questionnaire [FFQ]. The relationship between fermented and non fermented dairy intake and stroke were assessed between two patient groups. Total of dairy intake were lower in patients with stroke than control group [13.36 vs 19.61% in men and 11.14 vs 15.02% in women]. Similar relationships were observed between fermented and non fermented dairy intake and stroke in both genders. Lower dairy consumption can increase stroke risk in men and women

Intakes of vegetables and fruits are negatively correlated with risk of stroke in Iran

Stroke is a leading cause of death. Current therapeutic strategies have been unsuccessful. Several studies have reported benefits on reducing stroke risk and improving the post stroke associated functional declines in patients who ate foods rich in fruits and vegetables. Their potential protective effects may be due to their antioxidants, calcium, potassium, riboflavine, peridoxin, riboflavin contents. Folic acid, peridoxin, and riboflavin are all cofactors in hyperhomocysteinemia as a stroke risk factor. Studies suggest that oxidative stress plays important roles in pathogenesis of ischemic cerebral injury and higher intake of antioxidants has been associated with a lower stroke risk. The aim of this study was to examine if the dietary intake of vegetables and fruits in patients with stroke were comparatively worse than those in patients without stroke. In this case control study, 93 stroke patients admitted to Alzahra hospital were matched for age and sex with 60 patients who were not affected with acute cerebrovascular diseases and did not have a history of stroke. Dietary intake was assessed with a validated food frequency questionnaire. Food intakes were compared between two groups and with recommended value. Mean daily intake of vegetable and fruits was more in male with stroke than male without stroke as well as calorie intake from vegetables and fruit was higher in male with stroke. Mean daily intake of vegetable and fruits were lower in women with stroke than women without stroke as well as calorie intake from vegetables and fruit was lower in women with stroke. Our findings suggest that increased vegetable and fruits intake may be associated with decreased risk of stroke

association between serum vitamin D levels with general and abdominal obesity among patients with migraine

Obesity is a common health problem around the world. Studies have shown inverse relationship between serum vitamin D levels with obesity among patients and healthy population. The aim of this present study is to examine the relationship between serum vitamin D levels with general and abdominal obesity among migraine patients. The present study is a cross-sectional and 66 migraine patients aged 19-61 years were included for analysis. Partial correlation was performed to assess association between serum 25-OH-D with general and abdominal obesity. Adjustments were performed for age, sex, and education. No relationship was found between serum levels of vitamin D with general and abdominal obesity. However, a significant association was shown between waist circumferences [WC] with body mass index [BMI]. Serum levels of 25-OH-D were not associated with WC and BMI. Furthermore, after adjustment for confounder variables, no association was observed

Investigating the anxiety level in Iranian medical residents in 2010-2011

University entrance is accompanied by major changes in social relationship, rules, and expectations that lead to psychological disorders in susceptible students. The goal of this research is to study the anxiety rate in Iranian medical residents in 2010-2011. This study is a cross-sectional, descriptive study. It contains 370 medical residents from the 1[st] year to the 4[th] year of medical universities in Isfahan, Gilan, Zahedan, Sanandaj, and Kashan. The stratified sampling method proportionate to volume of participants is used in this study. The information is collected based on researchers' questioners and Zung self-rating anxiety scale and analyzed with the use of SPSS software version 16, addition to descriptive and analytic tests [Pearson, one way analysis of variance, t-test]. Meaningful level is regarded as P

Vitamin D deficiency, prevention and treatment

A 35 year female born and residing in Esfahan presents to the physician due to fatigue and sense of weakness. The patient refers that she has been having bilateral low back pain accompanied by throbbing bone pain in the lower extremities since 5 months ago. In past history menses is regular and 3 pregnancy followed by lactating the newborns. The patient denies use of any medication, except regular use of sunscreen. She also denies history of DM. In the physical examination: BP: 120/80 BMI: 30 Kg/M[2] Cranial nerves are intact Examination of nerves system is within normal limit There is no proximal myopathy. Laboratory examination revealed: o TSH and T4 within normal limits o Serum calcium 9.5 mg/dl [8.5-10.5] o Phosphate: 3.5 mg/d [2.5-4] o Albumin: 4 g/dl o 25[OH] D: 4 ng/ml o PTH: 84 Pg/ml [8-51]