[Effect of oral Rifampin in prophylaxis of Staphylococcus Aurous nasocarriers of hemodialysis patients]

Background: patients on hemodialysis exhibit higher susceptibility of infection because of decreased immunity. Several microbial pathogens are responsible for the variety of infections. Staphylococcus aurous is one of the most important bacterial agents that specially colonized the skin, nasal mucosa and pharynx. The nasal carriage rate is estimated to be about 42% to 60% in similar studies that is greater than then general population [20% - 40%]. Staphylococcus aurous is one of the most important causes of shunt infection, exit site infection, bacteremia, septicemia, bone and joint infection in hemodialysis patients

Material and methods: we conducted a clinical trial before and after treatment in which culture specimens were collected from anterior nasal nares of hemodialysis patients and were cultured

Results: in a total of 74 patients, 35 cases were culture positive [47/3%]. Rifampin 300mg twice daily was prescribed for patient with positive culture for 5 days. In five month follow up, 21 cases had negative culture after 1 month and 19, 18, 16 and 14 specimens had negative culture for the further evaluation, respectively [90/4%, 85/7%, 76/1%, 66/6%]

Conclusions: there was not a significance difference between the duration of hemodialysis and the colonization rate of staphylococcus aurous [p >0.05]

[Determining the diagnostic value of alkaline phosphatase in comparison with parathyroid hormone [PTH] of renal osteodystrophy for treatment with calcitriol in hemodialysis patients]

Serum parathyroid hormone [PTH] is one of the most important tests for treatment of hemodialysis patients with calcitriol. This drug should be started when the PTH >/= 200 pg/ml. However, the appropriate level of serum alkaline phosphates [ALP] for starting calcitriol is unclear. The aim of this study was to determine serum ALP as cutoff point for treatment of secondary hyperparathyroidism with calcitriol. This study was a cross sectional. The serum level of PTH and ALP were measured in 75 chronic hemodialysis patients. The correlation between PTH and ALP in diagnosis for treatment with calcitriol was significant [Kappa test P-Value=0.000]. In determination of diagnostic value of ALP [at level 300IU/L] for treatment with calcitriol, sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 88.9%, 93.9%, 66.7%, 98.4% and 93.3%, respectively. The cutoff point of ALP for treatment with calcitriol was 300IU/L [normal 100-290IU/L]. These findings suggest that serum ALP is a good test for treatment of secondary hyperparathyroidism. The results also indicate that calcitriol administration should not be started with ALP<300 IU/L

[Comparison of effect of chlroquine and placebo on blood sugar of patient with uncontrolled type ii diabetes mellitus]

Diabetes mellitus as a most common metabolic disorder of human has a progressive prevalence that in this disease hyperglycemia from different causes produces several chronic complications in multiple organs by different mechanism. Normoglycemia is the way of prevention of complication that can induce by treatment with oral hypoglycemic agent [O.H.A] or insulin. In type II diabetes the patient treated with O.H.A the failure of treatment is important problem that maybe primary or secondary. Resolving of this problem is changing the treatment to insulin therapy. Before this changing we can add some accessory drug to O.H.A regimen for better controlling of blood sugar. One of these drugs is Chlroquine. In this study we decided to evaluate the effect of Chlroquine on level of blood sugar of DM II. During one year 55 patient in 2 groups as case [25 patients] and control [29 patients] treated with Chlroquine and placebo for 3 months. At first point and end of first, second and third month of study we measured the fasting blood sugar [FBS] and two hours post prandial blood sugar [2hppBS] and evaluate the change of FBS and 2hppBS in each group and between of two groups. The mean age of the case and control group are 53/53 +/- 6/44 and 53/58 +/- 7/83 and mean BMI of two groups are 26/25 +/- 3/6 and 24/95 +/- 3/25. Mean duration of disease of two groups are 7 +/- 4/68 and 6/44 +/- 5/3. Those two groups of patients for these parameters and also for basic FBS and 2hppBS are statistically equal. At the end of three months of study FBS and 2hppBS in each group significantly decreased [P < 0/001]. But this different between two groups are not significant [P-0/661 for FBS and P=0/782 for 2hppBS]. But in the end of the first and second months FBS in case group is significantly lower from control group [P=0/006 for first month and P=0/05 for second one]. Although in other studies that done Chlroquine has reported effective in decreasing of blood sugar of patient with DM type II, but in this study has not approved Reasons of this difference maybe because of different of duration of study or use of hydroxychlroquine instead of Chlroquine or don't being of control group in pervious study

[Evaluation of serum aluminum level before and after [DFO] test in patients of hemodialysis unit of Zahedan]

Background: aluminum accumulation in plasma and tissues is a well-described complication among persons undergoing peritoneal dialysis or hemodialysis. Excess bone aluminum is associated with low bone formation rates and increased risk for fractures. Current recommendations for care of patients with end-stage renal disease include screening for aluminum toxicity with plasma aluminum levels; patients with levels below20 micro g/L are considered to be at low risk for aluminum related bone disease [ARBD]. By attention to some clinical symptoms that maybe related to AL toxicity, we measured serum AL level before and after DFO test

Methods and materials: in this descriptive study the incidence of AL toxicity in patients on hemodialysis in Khatam-Al-Anbia hospital of Zahedan-Iran was measured. In 35 patients on hemodialysis, serum level of AL before and after DFO test was measured. We also measured serum level of Ca, P, ALP, PTH and Ferritin in these groups of patients. To evaluate AL level in water used for hemodialysis it was measured at the same time

Results: in our study serum AL levels in most of patients were high [32 out of 35]. It may be due to high level of AL in dialysate. Dialysate AL level before and after RO [Reverse Osmosis] were 16 microgram/Lit and 19.8 microgram/Lit respectively. In only 3 out of 35 patient's serum AL levels of baseline were less than 20 microgram/Lit and DFO test in one of them was positive. Serums AL level of 16 patients were between 20 to 40 microgram I Lit and in 16 patients were more than 40 microgram/Lit

Conclusions: in conclusion treatment with improperly processed water was the major causes of aluminum toxicity in uremic patients

[Prevalence of hypovitaminosis D in blood donors who referred to blood transfusion organization of Zahedan]

Background: because of increase in number of side effect that caused by hypovitaminosis D, this study has been done to find out prevalence of hypovitaminosis D in blood donors

Methods and Materials: in this Cross - sectional and descriptive study, we evaluated 183 persons, 163 male [89.07%] and 20 female [10.92%]. The average range of women and men was 17-52y and 17-53y respectively

Results: the results revealed that 8 persons [4.4%] had sever hypo vitaminosis D [vit<25 nmol/l]. 124 persons [67.8%]: mild hypovitaminosis D [vit D=25-62.4nmol/l], 45 persons [24.6%]: normal serum level of vit D [62.5-125 nmol/l] and 6 persons [3.3%] had hyper vitaminosis D [> 125 nmol/l]. Prevalence of hypocalcemia and hypophosphatemia in blood donors was 95 persons [51.9%] and 10 persons [5.5%] respectively. Also average serum level of PTH was 32.1 +/-33. 4 pg / ml

Conclusions: the above finding suggests a solid and effective programming for education of people about prevalence and complications of hypovitaminosis D, more effective screaming studies for improving knowledge of individual about prevalence of hypovitaminosis D and related disease in society and necessity of medical health personnel's knowledge about hypovitaminosis D