[Effects of niasine on serum phosphorus, PTH and lipid profile in the hemodialysis patients in Shahroud city]

Control of the phosphorus, parathyroid hormone, and serum lipids in dialysis' patients is very important and can be done in many ways. The purpose of the study was to determine the effect of niacin on the serum phosphorus, parathyroid hormone and lipid profile among hemodialysis patients. This double blind controlled randomized study was done on 120 dialysis patients whom were divided into two groups: 60 patients [taking niacin] and 60 patients as control groups [taking placebo]. Niacin was prescribed as increasing dose from 200 mg to 600 mg monthly in three steps. Phosphorus, PTH and lipid profile were measured in the both groups. P-value<0.05 was considered as significant. 40 patients of case group [66.7%] and 37 patients [61.7%] of control group were male. Niacin significantly decreased serum levels of phosphorus [p<0.001] and parathyroid hormone [PTH] [p<0.001], also it significantly increased serum levels of HDL [p<0.01]. Nicotinic acid can decrease serum phosphorous and PTH level, and increase HDL cholesterol level. However, it needs a well design and larger trial study for determining the most effective doses of the nicotinic acid

prevalence and related factors of diabetic nephropathy in Shahroud

Diabetic nephropathy is a dangerous complication of diabetes which has a high prevalence among diabetic patients and is a cause of end stage renal failure in these patients. The aim of the present study was to investigate and determine the prevalence of diabetic nephropathy and related factors of diabetic nephropathy in Shahroud. This descriptive study was carried out on 858 diabetic patients referred to diabetic center of shahroud city in 2011. General examination and nephrologic study with collection of urin protein in 24 hours and sonography was done. 858 patients with mean age of 47.9 +/- 11.7 years were studied. Mean duration of diabetes, BMI and fasting blood glucose was 53.8+/-48.5 months, 27.9 +/- 4.9 kg/m[2] and 287.5 +/- 158.4 mg/dl, respectively. 24hr urine protein exam showed 607 [70.7%] normal condition and 251 [29.3%] diabetic nephropathy, in which 23.4% had mild type and 5.9% had severe type. Significant relationship were observed between diabetic nephropathy and age of patients [p<0.005], type II diabetes [p<0.003], duration of diabetes [p<0.003], fasting blood sugar [p<0.008] and kind of anti-diabetic drugs [p<0.003], but there was not a relationship between gender and diabetic nephropathy [p=0.345]. By timely diagnosis of diabetes mellitus, controlling the accelerating factors of diabetic nephropathy and informing the patients, we can decrease prevalence of this important complication of diabetes mellitus

[ rare case report: SCARF syndrome]

SCARF syndrome is a rare syndrome that so far only two cases have been reported in the papers. In this paper, a 3 months female SCARF syndrome was presented with multiple congenital abnormalities and problems to Imam Hossein hospital of Shahroud

[Comparison of serum level of CRP and platelet in acute perforated and non-perforated appendicitis in Imam Hossein hospital of Shahroud in 2011]

Appendicitis is one of the most common and important surgical problem and its early diagnosis is very important. Diagnosis of appendicitis is based on clinical examination and laboratory tests. Therefore, we decided to take a small step in recognition of problems by evaluation of CRP and Platelet level in diagnosing of non-perforated and perforated appendicitis patients. This cross- sectional study was done on 160 patients with diagnosis of appendicitis on 2011. Patients were examined and then were operated in operation room by standard method. The patients were divided in two groups in terms of perforated and non-perforated appendicitis. Data were analyzed by SPSS software and related statistical tests. Of 160 patients, 124 patients [77.5%] were male and others were female. Forty nine patients [30/6%] had perforated appendicitis and 111 patients [69/4%] non-perforated appendicitis. Mean age of participants in the perforated and non-perforated groups were 28.35 +/- 20.15 and 27.75 +/- 21.65 years, respectively. There was no significant difference between two groups regarding sex distribution, but risk of perforation increased by aging [odds ratio: 1.1] CRP levels were significantly higher in the perforated group than non-perforated appendicitis group [p<0.003], but platelet levels were similar between two groups. This study showed that it is possible to use CRP for diagnosing of acute and perforated appendicitis, but it may never be replaced exact clinical examination and sonography

Impact of maternal fasting during Ramadan on growth parameters of exclusively breastfed infants in Shahroud, 2012

There are many advantages in breastfeeding of infants. The impact of fasting of breastfeeding mothers during Ramadan, on their exclusively breastfed infants' growth, is still unclear. The objective of this study is to determine the impact of maternal Ramadan fasting on growth parameters of exclusively breastfed infants. This cohort study was conducted on 55 healthy, exclusively breastfed infants, aged 1 to 6 months, during Ramadan and three months after it. 20 infants, whose mothers fasted throughout Ramadan [case group] and 35 infants, whose mothers did not fast [control group], were enrolled in the study. All infants underwent periodic physical examinations, twice in Ramadan and 3 times in the first, second and the third months after Ramadan. The data analyses were done using a repeated measure analysis of variance. Statistical significance was defined as P<0.05. Analyses were performed using SPSS statistical package and repeated measures ANOVA. The average age was 3.43 +/- 1.38 months in the case group and 2.31 +/- 1.45 months in the control group that presence no significant difference between. From the total number of infants, 23 cases [41.8%] were males and the rest were females. All growth parameters increased during the study period [P<0.05], with the same rate of increase for both groups [P=0.125]. Ramadan fasting by breastfeeding mothers did not adversely affect the growth parameters of exclusively breastfed infants in short-term

[Comparison the analgesic effect of naproxen suppositories with intra wound injection of markain after inguinal hernia surgery]

Anti-inflammatory drugs are used for reducing the pain after surgery especially in minor surgery and local anesthesia drugs, especially Markain, is also employed. Regarding performing little studies about the comparison of these two kinds of drugs, this study was done for comparison two methods. This double-blind randomized clinical trial study was done on 198 patients with inguinal hernia. Patients were divided into case group [intra wound Markain] and control group [the suppository of naproxen]. Surgery was done with standard method [Liechtenstein] and the severity of pain was assessed by the visual analogue scale [VAS] in one, six and 24 hours after surgery. Data were analyzed by SPSS- ver16 software. Mean age in case group were 52.6 +/- 5.7 years and in control group were 53.7 +/- 4.9 years. Mean pain intensity in the first and 6[th] hours in case group were 6.3 and 4.6 and in control group were 3.9 and 2.9, respectively [P<0.001]. The pain immediately and 24 hours after surgery were similar in both groups and there was no significant difference between the two groups. Need to opioid analgesics was further reduced in the naproxen group one and six hours after surgery. Although both methods were effective in reducing postoperative pain and less expensive, but naproxen suppositories was more effective pain reliever for optimal pain control, especially in the first and six hours after surgery and is more effective in reducing pain intensity than Markain. Naproxen also reduces the need to deal with housing has been opioid analgesics

case report of brucellosis with concurrent hepatic and renal disorders

Brucellosis is one of the most common joint diseases of humans and livestock, which has a high prevalence levels. Diversity of clinical symptoms and sometimes unusual symptoms of the disease confuses physicians regarding the diagnosis and treatment. This increases duration of disease, treatment costs and also mortality and morbidity. A47-year-old man with rural agricultural job admitted to emergency room of Imam Hossein hospital of Shahroud, complaining prolonged fever, weakness, paralysis, nausea, anorexia and abdominal pain, and jaundice. Initial laboratory exams, including Wright, coomb's Wright and 2MB, were normal except increased value of BUN and creatinine. Ultrasound and CT scan of abdomen were normal. After 3 days, repetition of tests showed positive Wright and 2MB. Standard treatment with anti- brucellosis drugs was prescribed. After ten days, he discharged from the hospital and treatment continued at home. Awareness of different manifestations of brucellosis leads to early diagnosis and treatment and also prevention of complications

Breast feeding transmission of brucellosis

Brucellosis is a common zoonosis disease which affects both humans and animals. Common symptoms of brucellosis are: fever, sweating, weakness, lethargy, loss of appetite and arthritis. The patient was a 3.5 month infant with irritability, loss of appetite and immobility of left hip joint since 10 days ago. There was no medical problem during fetal and neonatal period of his life. The infant nutrition was provided by breast feeding. About one month ago his mother has been treated as a brucellosis patient but because of disappearance of her symptoms [pain, knee edema] she stopped her treatment ahead of schedule. In physical exam of the infant his growth and developing indices were normal but there was hypersensitivity in his left hip joint. The important laboratory results were as follows: leukocytosis, Wright=1/640, Coomb's Wright=1/1280 and 2ME=1/160. His disease diagnosed as brucellosis transmitted by lactation and he was treated with co-trimoxazole and rifampin. Breast feeding was discontinued and he was fed with formula thereafter. After a few days all symptoms disappeared and he discharged in a good condition. Applying serologic tests for infant whose mother is suspected of brucellosis seems logical