Self-care behaviors and related factors in women with type 2 diabetes

To prevent diabetes complications and improve the quality of life of these patients, adherence to self-care is essential. The purpose of present study was to examine self-care behaviors and related factors in women with type 2 diabetes. This descriptive analytic cross sectional study was performed on 140 female patients with type 2 diabetes who referred to the diabetes clinic in Ahvaz between December-March 2014. Research data were collected through interviews using demographic and disease characteristics questionnaires and the summary of diabetes self-care activities measure. Validity and reliability of the questionnaire was assessed and approved. The range of self-care scale was 0-77. Data were analyzed using descriptive statistics, Pearson's correlation coefficients tests, t-test, one-way ANOVA, Kruskal-Wallis and multiple linear regression models. The mean score of self-care behaviors in patients was 11.55 +/- 30.93, indicating moderate self-care. The highest mean scores were those of diet, 16.28 +/- 5.38 and proper medication compliance 5.74 +/- 2.57, while blood sugar monitoring 1.89 +/- 3.38 and physical activity 2.24 +/- 3.09 showed the lowest scores. The score of self-care behaviors showed a statistically significant difference among levels of education, duration of disease, life network, level of fasting blood glucose and mode of physician referral [P<0.05]. These significant variables, except fasting blood glucose explained 23% of self-care variance. The findings of this study could be useful for designing and implementation of educational programs to promote self-care behaviors and more effective control of type 2 diabetes in women

[Investigation of temporal pattern of scorpion sting and snakebite incidence in patients referred to Masjedsoleiman's main hospital, during 24 months from 21 March 2008 to 20 March 2009]

Scorpion sting and snakebite are the important problems in some area such as Iran that must be addressed. This study was to investigate temporal pattern of scorpion sting and snakebite incidence in patients referred to Masjedsoleiman's main hospital, during 24 months from 21 March 2008 to 20 March 2009. It was an analytical study to scrutiny of monthly and seasonal procedure of scorpion sting and snakebite. Data were analyzed by SPSS and Minitab. To identify the goodness of fit model for monthly and seasonal incidence of scorpion sting and snakebite, autoregressive integrated moving average [ARIMA] models were used to explore time series analysis. Of all 9457 scorpion sting and snake-bite cases in patients referring to hospital, 45% [n = 4253] were men. Mean age of them was 28.26 +/- 0.36 years. Significant numbers [27%] of these patients had 21-30 years old, and were bitted in urban [93%], at their home [99.7%]. The auto regression suggested that monthly average incidents model have a moving average. The analyses through Anderson- Darling test provide evidence that the distribution of residuals was normal [P = 0.125]. Weather variables can be as the predictors of scorpion sting and snake-bite incidence for Masjedsoleiman.

Protective effect of Adenosine A1 receptor and ascorbic acid on hippocampal neuronal density and memory disorder in ischemia reperfusion induced Rats

Brain ischemia is one of the most important factor of morbidity and mortality and leaving many people with mental and physical disabilities. Until now there are no appropriate medications to prevent and cure ischemic injury. This study was done to evaluate the protective effect of Adenosine A1 receptor and ascorbic acid on hippocampal neuronal density and memory disorder in ischemia reperfusion induced Rats. This experimental study was performed on the hippocampus pyramidal neurons on 56 male BALB/c mice. Animals randmly allocated into 8 groups [N=7] including: 1] intact, 2] ischemic control group, 3] ischemic, plus agonist and adenosine of A1 receptor, 4] ascorbic acid [100 mg/daily], 5] ischemic plus agonist adenosine receptor [1 mg/1 kg] one week after ischemia, 6] ischemia, ascorbic acid befor and after ischemia and A1 receptor [1 mg/1 kg] agonist after ischemia, 7] A1 receptor, antagonist [2.25 / 1 kg], one weed after ischemia, 8] Ascorbic acid [100 mg/1kg] before and after ischemia plus A1 receptor antagonist [2.25 / 1 kg] after ischemia. Ischemia induced by clamping of common carotid artery and the drugs was injected subsequently into peritoneum after reduction of inflammation of ischemic zone. The Y-maze memory test performed after completing the treatment period, afterward brains fixed and prepared for microscopic nissl staining method. The counting of pyramidal cells were performed at 53500 square micrometer of CA1. Data were analyzed using SPSS-15 and ANOVA test. The Y-maze test showed extensive de?cit in short-term memory in ischemic group [PA=200] but in treatment groups this deficit significantly reduced [PA=243, 248 and 265]. The normal neuronal cell in ischemic group was significantly lowered [n=87] than treatment groups [n=111, 105 and 125] including ascorbic acid group [125], adenosine receptor agonist [105] and ascorbic acid plus agonist adenosine receptor [111]. The number of normal neuronal cell in ischemic groups significantly is reduced compared to treatment group [P<0.05]. This study showed that concurrent treatment of ascorbic acid and Adenosine A1 receptor agonist can significantly reduce the complications caused by brain ischemia in CA1 area of hippocampus

[Effects of olive oil consumption on stroke complications, particularly in the hippocampal region, in mice]

Preliminary studies have shown reductions in apoptosis in brain ischemia following treatment with antioxidants. In this study, the relationships between consumption of olive oil and apoptosis in hippocampal neurons and changes in memory following brain ischemia in mice were determined. Three groups of 7 mice each were included in the study: healthy, ischemic control, and treatment groups. The mice were treated with olive oil as a pre-treatment for a week [tube-feeding]. Ischemia was then induced by common carotid artery occlusion. This was followed, after the inflammation in the ischemic area was reduced, by furher treatment for a week with olive oil. Histological examinations were made using Nissl staining for counting necrotic cells, TUNEL kit was used to quantify apoptotic cell death, and short-term memory scale was determined by the shuttle box test In the ischemic group high rates of necrosis and apoptotosis were seen, which were associated with short-term and spatial memory loss. Apoptosis rate in the treatment group was much less than in the ischemic group, confirming results of the memory tests. Ischemia-reperfusion for 15 minutes induces vast and permanent cell death in the hippocampus in mice, particularly in the CA1 region. Olive oil consumption significantly reduces cell death and decreases memory loss

Adult-onset familial Mediterranean fever in northwestern Iran; clinical feature and treatment outcome

Familial Mediterranean fever [FMF] is an autosomal recessive disorder characterized by sporadic, paroxysmal attacks of fever and serosal inflammation. Although the disease usually begins before the age of 20 years, we aimed to evaluate the demography, clinical features and treatment outcome of familial Mediterranean fever in Iranian adult patients above 20 years old. In this cross-sectional study, adult patients [first attack at the age of > 20 years] with a diagnosis of FMF who referred to the gastroenterology and rheumatology clinics of Ardebil University of Medical Science [situated in north west of Iran] over the period of 2004-2009 were enrolled. FMF diagnosis was based on clinical criteria. Forty four FMF patients [30 male and 14 female] with the mean [ +/- Standard Deviation [SD]] age of first attack of 29 +/- 7.8 years were enrolled. Abdominal pain [95.5%] and fever [91%] were the most common clinical findings. All of the patients had satisfactorily responded to therapy. Response was complete in 76.7% and partial in 23.3% of the patients. There was no clinical or laboratory evidence of amloidosis at the time of diagnosis or during follow-up. Our findings demonstrated that adult-onset FMF in Iran has different characteristics [more common in males, lesser prevalence of arthritis and erysipelas-like erythema, less delay in diagnosis] and treatment outcome [favorable response even to low-dose colchicines] in comparison with the previous data on early onset patients

[ correlation between serum C-reactive protein and staging of gastric and colon cancers in the patients reffered to firoozgar hospital from march 2010 to august 2011]

C - reactive protein [CRP] is an acute-phase plasma protein that can be used as a marker of activation of the immune system. In response to several inflammatory reactions, the concentration of CRP increases and recently have been applicated as a cancer detector in some studies. We aimed to evaluate the relation between CRP level and the staging and grading of gastric and colon malignancies that are the most common gastrointestinal cancers. In this analytic cross sectional study, 100 patients with gastric and colon cancer referred to Firoozgar hospital from march 2010 to august 2011, were recruited. The diagnosis of cancer was confirmed with multiple biopsies and pathologic study. The exclusion criteria were as follow being febrile or having any clinical evidence of infection, diabetes mellitus, cardiovascular disease, inflammatory bowel disease and autoimmune disease via history and record of the patients. The stage and grade of cancers were determined by two expert pathologists. A 5 cc blood sample was taken from anticobital vein of each patient before any intervention such as surgery, chemotherapy and/or radiotherapy was done and CRP quantitative levels were assessed by ELISA technique. CRP level more than 5 mg/dl was assumed as abnormal. Correlation between CRP and Staging, grading and the location of tumor [gastric and colon malignancies] and the type of tumor [adenocarcinoma and large cell lymphoma] was evaluated. There was no significant correlation between CRP level and the type of tumor [p=0.32] or location of the tumor [p=0.83].A significantly positive correlation was seen between CRP level and the stage of gastric and colon cancers [p=0.02] as well as CRP level and the grade of these tumors [p=0.03]. CRP blood level correlates with the staging and grading of the GI cancer and the level of CRP rises as the stage and grade of the tumor developes

Lipoid proteinosis: a case report urbach and wiethe disease

Lipoid proteinosis [LP] is a rare autosomal recessive disease characterized by the deposition of an amorphous hyaline material in the skin, mucosa and viscera. The classic manifestation is onset in infancy with a hoarse cry due to laryngeal infiltration. Skin and mucous changes develope, and the disease follows a slowly progressive course. In this case report, a 49 year-old man presented with a longstanding hoarseness since childhood, dysphagia and asymptomatic skin lesions. Esophageal biopsy showed the deposition of homogenous eosinophilic hyaline-like material compatible with LP

Histopathological study of chronic hepatitis B: a comparative study of Ishak and METAVIR scoring systems

Ishak and METAVIR scoring systems are among the most commonly used histopathological systems to evaluate chronic hepatitis. To assess the level of agreement between these two scoring systems in patients with chronic hepatitis B. Liver biopsy samples taken from 92 patients with chronic hepatitis B were considered as the training set; 57 more biopsy specimens were used as the validation set. In the training set, grade of necroinflammation and stage of fibrosis for each liver biopsy specimen were determined by two expert liver pathologists using both Ishak and METAVIR systems. Inter-observer variability between the two pathologists was evaluated. Biopsy specimens of the validation set were seen and scored by a third expert pathologist. In the training set, criteria were developed to categorize Ishak grading and staging systems separately to best fit with the METAVIR scoring system. The criteria found in the training set, was then tested in the validation set. The level of agreement between the two scoring systems was assessed by weighted kappa statistics. For the training set, agreement between the two pathologists was excellent. Using our proposed criteria in the training set, there was excellent level of agreement in grading [Kappa = 0.89] and staging [Kappa = 0.99] between Ishak and METAVIR systems. In the validation set, the criteria led to substantial correlation [Kappa = 0.61] in grading, and excellent correlation [Kappa = 0.94] in staging between the two systems. Using our proposed criteria, excellent or at least substantial concordance between Ishak and METAVIR scoring systems can be achieved for the degree of both necro-inflammatory changes and fibrosis

Therapeutic effect of sodium selenite and zinc sulphate as sup-plementary with meglumine antimoniate[glucantime] against cutaneous leishmaniasis in BALB/C Mice

Successful therapy of leishmaniasis depends on effective cellular immune response. We evaluated the effectiveness of sodium selenite and zinc sulphate as known immunomodulator materials, in combination with Glucantime in treatment of cutaneous leishmaniasis lesions resulting from Leishmania major in susceptible animal model. Thirty three female mice weighing 18-20 g at the age of 7-8 week infected with L. major were randomly divided into 3 groups: group1: treated by sodium selenite [0.35 mg/kg for 30 days], group2: treated by zinc sulphate [2 mg/kg for 30 days] and group3: treated by distilled water [0.01 ml/gr body weight for 30 days] as control. All groups received Glucantime as a standard anti- leishmanial agent [60 mg/kg, ip] for 14 days. To assess the results of treatment measurement of lesions size and parasitological tests were done weekly. The lesion sizes increased continuously in sodium selenite group .Although, in zinc group did not increase compared to baseline but with considering the time- group interaction there was no significant difference between zinc and control group during this study. There was no difference between lesion sizes and Leishmanial loads in the interventional and control groups, respectively. Sodium selenite and zinc sulphate at mentioned doses and duration of treatment did not show any treatment effect on cutaneous leishmaniasis caused by L. major in BALB/c mice. Increasing the dose of supplements and considering the follow up period after treatment can help more certain conclusion

[ epidemic of cutaneous leishmaniasis in baft district in Kerman province and its probable causative risk factors]

In Iran, cutaneous leishmaniasis [CL] as a health problem is increasing and presenting two epidemiological forms; Zoonotic CL [ZCL] and anthroponotic CL [ACL]. The objective of the present study was to introduce the CL epidemic in Baft district, Kerman province. This study was conducted in 3 villages; Soltanabad, Vakilabad and Shahmaran as a census between spring and autumn of 1998 in Orzoeihe region, Baft district. Various epidemiological aspects of this epidemic including prevalence and related demographic factors, diagnosis by direct smears, identification of the causative species by immunological and biological methods were determined. Population of the 3 villages was 13721; mean 21.8 +/- 13.9 years, 50.7% males and 49.3% females. The prevalence rate of 12.3% with mean age of 16.3 +/- 12.1 years was infected. Most of the cases were in 10-20 years of age and in Soltanabad [30.6%]. The mean number of lesions was 2.58, majority with >/= 2 lesions, frequently located on the legs and hands. No previous history of CL scar was observed. All 100 IFAT, 30 ELISA tests and 18 inoculated mice showed L.major as the overall causative agent. This is the first epidemic of CL occurred in the southern villages of Baft district with high severity in all age and sex groups in a new agricultural region. Probably the source of infection was the new comers who arrived the region from endemic areas for agricultural purposes and infecting the gerbils. Thus, this new agricultural development has created an extraordinary suitable condition for propagation of rodents and sand fly populations, then the occurrence of the new epidemic in rural residence, consequently

Survey of culture and antibiogram in patients with impetigo

Impetigo is a common infectious skin disease and most commonly occurs in children. Etiologic agents are Staphylococcus aureus or Beta-heamolytic Streptococcus group A or combination of these organisms. Adequacy of treatment is related on sensitivity of bacteria to common prescribed antibiotics. Study of the frequency of bacterial culture results from lesions and antibiograms for four systemic antibiotics cephalexin, erythromycin, cloxacillin and penicillin were assayed. Impetigo cases admitted to the dermatology clinic of Ghaem hospital in Mashhad for one year beginning from June 2001, were studied. These patients had no history of systemic or topical antimicrobial agents application. Results of antibiograms obtained from culture of skin lesions were analyzed with Chi-Square test. Twenty two [88%] patients were younger than 20 years. Twenty one cases [84%] had non bullous impetigo. In 17 [68%] cases lesions were localized on the face. Because of secondary contamination in 3 cases, statistical analysis was performed on 22 cases. The most common bacteria [95.5%] was Staphylococcus aureus. Antibiograms of S.aureus showed complete sensitivity to cephalxin in 85.3%, erythromycin in 63.6%, cloxacillin in 40.9%, and penicillin in 13.6% of cases. Staphylococcus aureus was the most common organism in 95.5% of cases and cephalexin was the first choice oral antibiotic followed by erythromycin

Assessment of inter-and intra-observer variability of the la classification for gerd

Los Angeles classification is widely adopted as a means of unifying endoscopic observation for GERD. We assessed the inter- and intra-observer variability of LA classification. Two-hundred fifty-four still images of the lower esophagus taken by an expert endoscopist [RM] were randomly selected and presented to 9 gastroenterologists [2 females, 6 experts, 3 trainees]. They were asked to report the images according to LA classification. After 2 weeks the images were re-ordered and the same people were asked to report them again. Kappa-statistics was calculated for intra- and inter-observer variability. Mean kappa for intra-observer agreement was 0.54 for experts and 0.55 for trainees [p = NS]. Mean intra-observer kappa was greater among females than males [0.70 vs 0.50 respectively, p=0.05]. Mean inter-observer kappa was 0.20 and 0.31 for experts and trainees respectively [p = NS]. Mean inter-observer weighted kappas were 0.25 and 0.07 [p = 0.007] for males and females respectively. Analyzing data for source of the discrepancy showed that the least reproducible reading was GERD-A both for intra- and inter-observer agreement calculations. According to our data, the LA classification, although a major advance in reporting GERD, has a poor to fair reproducibility. There was no difference between experts and trainees in using the LA classification. Females seem to be more consistent in their readings, but have less agreement with others. Despite the inherent short-comings of kappa statistics and the limitation caused by the possible quality of the still images, revision of the LA system seems to be advisable

[Herpes simplex virus encephalitis during immunosuppressive treatment of ulcerative colitis]

Today, with the advent of new medications, treatment of Ulcerative colitis [UC] has been markedly improved. Immunosuppressive drugs used in therapy predispose patients to opportunistic infections. A 22-year-old woman was admitted to emergency department due to acute exacerbation of UC and decreased level of consciousness. She was under treatment with 5-aminosalicylate, prednisolone and azathioprine. In neurological evaluation, patient had cerebral herniation. Non-contrast CT scan revealed multiple hemorrhagic areas in both frontal lobes. Right frontal craniotomy was performed emergently. Histopathologic evaluation of brain tissue was reported as "Herpes simplex encephalitis". Polymerase chain reaction [PCR] assay was also positive for HSV DNA. Immunosuppressive drugs such as azathioprine have a pivotal role in the treatment of resistant and/or severe cases of UC. Prevalence of infectious complications was reported to be 7.4%, 1.8% of which were severe [including herpes zoster encephalitis] .Our review of literature indicates that no case of herpes simplex encephalitis following immunosuppressive therapy for UC has been reported