Ameliorative effect of cotreatment with the methanolic leaf extract of Urtica dioica on acute kidney injury induced by gentamicin in rats.

OBJECTIVE: Effects of cotreatment with Urtica dioica (UD) methanolic leaf extract on gentamicin (GM)-induced acute kidney injury were evaluated in rats. MATERIALS AND METHODS: Male Wistar rats (n=32) were separated into four groups. Gentamicin (100 mg/kg/day, IP) was injected for eight days with or without UD methanolic extract (200 mg/kg/day, gavage).  The renal blood flow (RBF) and systolic blood pressure of rats were recorded. Concentration of creatinine, blood urea nitrogen (BUN), sodium, and potassium and osmolarity were measured in the urine and plasma samples. Oxidative stress level was determined by assessment of the levels of antioxidant power (FRAP) and lipid peroxidation (MDA) in the renal tissue. The renal injury and histopathological changes in the kidney were determined by microscopic evaluations. RESULTS: Administration of UD extract along with GM, compared to GM group, significantly decreased the amounts of plasma creatinine and BUN, urinary sodium excretion, fractional excretion of sodium and potassium, and MDA levels but significantly increased creatinine clearance, urine osmolarity, renal blood flow and FRAP levels. CONCLUSION: The cotreatment of UD extract can attenuate renal injury of GM by reduction of oxidative stress, lipid peroxidation, and oxygen free radicals. The potential nephroprotective effects of UD extract are probably mediated via its antioxidant and anti-inflammatory activity.

Determining the TSH reference range in national newborn screening program for congenital hypothyroidism.

Objective: Since the initiation of the thyroid screening program in Iran in 2005, 5 mIU/L has been selected as the threshold for thyroid stimulating hormone (TSH) for screening for congenital hypothyroidism. Given the specific disease pattern in the region and current controversies of the TSH cutoff point, a new cutoff point has been proposed in this study.Methods: This study was conducted on the existing database of the screening program consisting of 127,112 neonates in Markazi Province, center of Iran, during 2006-2012. Data on 614 referred neonates consisting of 414 neonates diagnosed of having hypothyroidism and 200 screened healthy neonates, were analyzed. The heel prick test had been done on the studied neonates to determine the TSH levels. The receiver-operator characteristic (ROC) curve and diagnostic values were used for data analysis.Results: The 5-mIU/L cutoff point in the study had a sensitivity and specificity and AUC of 86.5, 10 and 47%, respectively. Among the eleven selected cutoff points, 6.5 mIU/L had the appropriate sensitivity, specificity and AUC (58.9, 56.5 and 57%, respectively), negative and positive likelihood ratios (0.73 and 1.35, respectively).Conclusion: Given the very low specificity of the 5-mIU/L cutoff point for referral and with respect to the high rate of referrals and many false positive cases, we suggest to use the 6.5-mIU/L cutoff point which is more suitable.

5-Year Survival in Gastric Adenocarcinoma with Epithelial and Stromal Versican Expression.

BACKGROUND & OBJECTIVE: Gastric cancer is the second most frequent cause of cancer death worldwide, despite dif- ferences in incidence around the world. The majority of gastric cancer cases concern gastric adenocarcinoma, which has a fairly high 5-year survival rate when coupled with early-stage diagnosis. Versican, a member of the aggregating chondroitin sulfate proteoglycans family, is accumulated predominantly in the tumor stroma. The aim of our study was to investigate versican expression in gastric adenocarcinoma. METHODS: In this study we investigated 80 patients with gastric adenocarcinoma who underwent gastrectomy. Each sample was obtained from paraffin-embedded resected specimens of the stomach after histopathological diagnosis. Patient follow-up was performed every 3 months after the beginning of data collection. Survival analysis was calcu- lated using the Kaplan-Meier method for univariate analysis. RESULTS: Out of 80 patients with gastric adenocarcinoma, 76 cases (76.3%males and 23.7% females) completed the follow-up period. Positive versican expression in tumor epithelial and stromal cells was found in 39.5% and 22.4% of tumors, respectively. Shorter survival was observed among patients whose gastric adenocarcinoma expressed epithelial or stromal versican. CONCLUSION: In summary, the present study suggests that versican is likely a prognostic biomarker that predicts a poor outcome in patients with gastric adenocarcinoma. Comprehensive studies with larger sample sizes are needed.

Comparison of Survival Models for Analyzing Prognostic Factors in Gastric Cancer Patients

Objective: There are a number of models for determining risk factors for survival of patients with gastric cancer. This study was conducted to select the model showing the best fit with available data. Methods: Cox regression and parametric models (Exponential, Weibull, Gompertz, Log normal, Log logistic and Generalized Gamma) were utilized in unadjusted and adjusted forms to detect factors influencing mortality of patients. Comparisons were made with Akaike Information Criterion (AIC) by using STATA 13 and R 3.1.3 softwares. Results: The results of this study indicated that all parametric models outperform the Cox regression model. The Log normal, Log logistic and Generalized Gamma provided the best performance in terms of AIC values (179.2, 179.4 and 181.1, respectively). On unadjusted analysis, the results of the Cox regression and parametric models indicated stage, grade, largest diameter of metastatic nest, largest diameter of LM, number of involved lymph nodes and the largest ratio of metastatic nests to lymph nodes, to be variables influencing the survival of patients with gastric cancer. On adjusted analysis, according to the best model (log normal), grade was found as the significant variable. Conclusion: The results suggested that all parametric models outperform the Cox model. The log normal model provides the best fit and is a good substitute for Cox regression.

The Effect of l-Arginine on Dural Healing After Experimentally Induced Dural Defect in a Rat Model.

BACKGROUND: Incomplete repair of the dura mater may result in numerous complications such as cerebrospinal fluid leakage and meningitis. For this reason, accurate repair of the dura mater is essential. In this study, the effect of systemic and local supplementation of l-arginine on dural healing was evaluated. METHODS: Thirty male Wistar rats were used and divided into control, local, and systemic l-arginine groups, with 10 rats in each. In each group, a 5-mm experimental incision was made at the lumbar segment of the dura mater and cerebrospinal fluid leakage was induced. Each group was divided into 2 subgroups and at the end of the first and sixth weeks, the rats were killed and the damaged segments of the dura were separated, histologically evaluated and the dural healing indicators including cell types, granulation tissue formation, collagen deposit, and vascularization were compared between groups. RESULTS: The systematic supplementation of l-arginine showed a significant effect in dural healing compared with the control group. After the first week, granulation formation increased considerably (P < 0.031), and after 6 weeks, collagen deposition and neovascularization were significantly different compared with the control group (P < 0.030; P < 0.009). In comparison between different groups at the end of the first and sixth weeks, maximum changes in healing indicators were observed in the systemic group and the least variations were related to the control group. CONCLUSIONS: The systemic supplementation of l-arginine may accelerate dural healing by increasing the level of granulation tissue formation, collagen deposition, and vascularization.

Mid-gestational serum uric acid concentration effect on neonate birth weight and insulin resistance in pregnant women.

OBJECTIVE: To investigate the relationship between mid-gestational serum uric acid and birth weight in diabetic pregnant women with or without insulin resistance. METHODS: In a prospective cohort study, fasting uric acid, blood glucose, and serum insulin were measured in 247 pregnant women between 20-22 weeks of gestational period. Insulin resistance was estimated using the homeostasis model assessment-insulin resistance (HOMA-IR). Stratification analysis and independent t-test was used to assess the association between uric acid and birth weights regarding to insulin resistance. RESULTS: The means of the mid-gestational serum uric acid concentrations were not significantly different in women with and without insulin resistance. But stratification analysis showed that there was a significant difference between uric acid concentration and macrosomic birth in diabetic women without insulin resistance. CONCLUSIONS: Higher mid - gestation serum uric acid concentration, even if it does not exceed the normal range, is accompanied by lower birth weight only in non-insulin resistance women. Insulin resistance could have a negative confounding effect on hyperuriemia and birth weight.

The Correlation between Serum ApoA1 and B and Coronary Artery Disease as Well as Its Severity.

BACKGROUND: Some patients with Coronary Artery Disease (CAD) have no well-known risk factors of this disease, but are diagnosed with cardiovascular events. The present study aimed to assess the association between Apo A1 and ApoB and the severity of CAD and determine whether these parameters are better predictors of Ischemic Heart Disease (IHD). METHODS: In this case control study, 271 individuals who were suspicious of having CAD and had been referred to Arak Amir-al-Momenin hospital underwent coronary angiography. Based on the results of angiography, the participants with presence or absence of coronary artery stenosis were allocated into the case and the control group, respectively. The severity of CAD involvement was determined by Gensini score. The data were entered into the SPSS statistical software and analyzed through parametric and non-parametric tests, sensitivity analysis, and logistic regression. RESULTS: The results revealed no significant correlation between apoA-1 and severity of CAD involvement (GS) (r = 0.017, P = 0.797). However, a significant correlation was found between apoB and GS (r = 0.127, P = 0.047). Logistic regression model showed ApoB, sex, DM and, FH as the only proper predictors of IHD (P < 0.048, P < 0.002, P < 0.040, and P < 0.001, respectively). In comparison to angiography for diagnosis of CAD, ROC analysis represented ApoB as a more useful predictor (P = 0.023). CONCLUSIONS: In addition to measurement of conventional parameters for assessing CAD high risk groups, according to the results of this study using ApoB would be resonable as well. Further investigations are recommended to clear the problem.

Finding genes discriminating smokers from non-smokers by applying a growing self-organizing clustering method to large airway epithelium cell microarray data.

BACKGROUND: Cigarette smoking is the major risk factor for development of lung cancer. Identification of effects of tobacco on airway gene expression may provide insight into the causes. This research aimed to compare gene expression of large airway epithelium cells in normal smokers (n=13) and non-smokers (n=9) in order to find genes which discriminate the two groups and assess cigarette smoking effects on large airway epithelium cells. MATERIALS AND METHODS: Genes discriminating smokers from non-smokers were identified by applying a neural network clustering method, growing self-organizing maps (GSOM), to microarray data according to class discrimination scores. An index was computed based on differentiation between each mean of gene expression in the two groups. This clustering approach provided the possibility of comparing thousands of genes simultaneously. RESULTS: The applied approach compared the mean of 7,129 genes in smokers and non-smokers simultaneously and classified the genes of large airway epithelium cells which had differently expressed in smokers comparing with non-smokers. Seven genes were identified which had the highest different expression in smokers compared with the non-smokers group: NQO1, H19, ALDH3A1, AKR1C1, ABHD2, GPX2 and ADH7. Most (NQO1, ALDH3A1, AKR1C1, H19 and GPX2) are known to be clinically notable in lung cancer studies. Furthermore, statistical discriminate analysis showed that these genes could classify samples in smokers and non-smokers correctly with 100% accuracy. With the performed GSOM map, other nodes with high average discriminate scores included genes with alterations strongly related to the lung cancer such as AKR1C3, CYP1B1, UCHL1 and AKR1B10. CONCLUSIONS: This clustering by comparing expression of thousands of genes at the same time revealed alteration in normal smokers. Most of the identified genes were strongly relevant to lung cancer in the existing literature. The genes may be utilized to identify smokers with increased risk for lung cancer. A large sample study is now recommended to determine relations between the genes ABHD2 and ADH7 and smoking.

Comparison of five staging systems of lymph node metastasis in the gastric carcinoma.

BACKGROUND: The presence of metastatic lymph nodes is the most important prognostic factor for gastric carcinoma; however, the optimal system for the accurate staging of lymph node metastasis for patients with gastric cancer remains controversial. This study was designed to compare five systems in relation to the N classification of gastric carcinoma. MATERIALS AND METHODS: This multicentric historical cohort study was conducted on 148 patients with M0 gastric adenocarcinoma who underwent gastrectomy in, five referral hospitals in Iran. Lymph nodes were sectioned, stained with hematoxyl in and eosin. The lymph node status was classified according to the five systems which are: The number of involved lymph nodes (TNM staging), metastatic lymph node ratio (N ratio), and the largest involved lymph node size, largest metastatic nest size and largest metastatic nest to lymph node size ratio. RESULTS: Patients were classified into significant prognostic groups by the five N classification method including the TNM method, N ratio (0, ≤0.15, 0.15-0.4, >0.4), largest involved lymph node size (0, ≤5, 5-11, >11 mm), Largest metastatic nest size (≤1, 1-7.5, >7.5 mm) and largest metastatic nest to lymph node size ratio (≤0.3, 0.3-0.9, >0.9). All of the above systems remained as independently significant prognostic factors in terms of overall and disease free survival time. CONCLUSION: Among the N staging systems we recommend the metastatic lymph node ratio and largest metastatic nest to lymph node size systems, since they are reproducible, simple, have good survival applicability, have prognostic value and include less stage migration especially in patients whom fewer than 15 lymph nodes are dissected.

Evaluation of vaginal group B streptococcal culture results after digital vaginal examination and its pattern of antibiotic resistance in pregnant women.

BACKGROUND: Group B streptococcus (GBS) colonizes the gastrointestinal and genitourinary tract of 10-40% of pregnant women and it is a major cause of neonatal morbidity and mortality. OBJECTIVE: This study was to evaluate whether vaginal GBS culture results alter after digital vaginal examination or not. Antibiotic resistance pattern of this specie has been also assessed. MATERIALS AND METHODS: A total of 186 pregnant women with gestational age of 37 weeks were enrolled to the study. Two vaginal swaps were taken before and immediately after digital vaginal examination, then third swap was taken after 48 hours of examination. The cultures were evaluated for bacterial growth and the isolated bacteria were assessed for antimicrobial drugs sensitivity. RESULTS: Positive culture of GBS was seen in 16.1%. Initially negative GBS result was found not to change immediately after examination. But positive cultures were negative in 1.6% of women after digital vaginal examination. After 48 hours 2.7% of initially negative GBS was positive and no one with initially positive GBS had negative culture. Sensitivity to penicillin and vancomycin was 100%, erythromycin 74%, ampicillin 65%, cefazolin 62.8%, cefotaxime 54.2% and ceftizoxime was 40%. CONCLUSION: The present investigation showed that the vaginal GBS culture result is minimally affected by digital vaginal examination. Drug of choice for GBS eradication is penicillin; vancomycin could be the choice in the case of penicillin hypersensitivity. This article extracted from M.D. thesis. (Mahdokht Sadat Manavi).

Touch imprint and crash preparation intra operative cytology versus frozen section in thyroid nodule.

BACKGROUND: Intra operative cytology (IC), including touch imprint (TI) and crash preparations (CP), in general has been demonstrated to be a diagnostic tool for many organs but its validity and reliability for diagnosis of thyroid nodules remain controversial. We evaluate the diagnostic value of frozen section, touch imprint, crash preparation and the combination of touch imprint and crash preparation and the combination of frozen section, touch imprint and crash preparation. MATERIALS AND METHODS: [corrected] 55 intra operative specimens from patients with thyroid nodules who underwent thyroidectomy were evaluated at Alzahra and vali-Asr hospital laboratories. For all of the patients frozen section (FS), touch imprint (TI) and crash preparation (CP) was obtained and reviewed by two pathologists at the same time. Serial TI and CP, and FS, TI and CP were reviewed by the same pathologists. Sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and accuracy were calculated according to the permanent section as the gold standard test. RESULTS: In our study sensitivity, specificity and accuracy for FS was 100%, 97.6% and 98.1% respectively; for TI they were 78.6%, 95% and 92.4%; for CP they were 78.6%, 92.7% and 89.9%; for serial TI and CP they were 85.7%, 92.7% and 90.9%; and for the combination of FS and TI and CP they were 100%, 97.6% and 98.18% respectively. CONCLUSIONS: Intra operative cytology (including TI and CP) seems to be a useful, valuable and inexpensive method in clinics, which do not have equipment for frozen sections. Intra operative cytology combined with FS increased the overall accuracy of diagnosis. Further studies are needed to validate the obtained results of this study.

Determining the relationship between "microvessel density" and different grades of astrocytoma based on immunohistochemistry for "factor VIII-related antigen" (von Willebrand factor) expression in tumor microvessels.

BACKGROUND: Astrocytic brain tumors are the most common primary central nervous system tumors, which are classified into four grades. One of the most important pathologic criteria for the diagnosis of higher-grade astrocytomas (especially glioblastoma multiforme) is microvessel proliferation, particularly in the form of glomeruloid complex. Because tumor angiogenesis is a necessary factor for growth and invasiveness of malignancies, microvessel density (MVD) and intensity of angiogenesis may be used to determine the grade of astrocytomas and plan therapy accordingly. We have planned this study to evaluate the relationship between vwf expression in microvessels and different grades of astrocytoma. MATERIALS AND METHODS: Sixty-four formalin-fixed and paraffin-embedded blocks of surgical specimens with diagnosis of astrocytoma (grades I to IV, each of them 16 blocks) were selected in a simple-nonrandom sampling. Thin sections of tissue blocks underwent immunohistochemical staining for vwf. The stained slides were examined using a light microscope at low (100) and high (400) magnifications. MVD was estimated by calculating the mean number of stained microvessels in three areas of highest vascularization in the high-power field (400). The intensity of staining was determined based on a 3 scale model, in which scores 0, 1, 2, and 3 mean no detectable stain, trace staining, moderate amount of diffuse stain, and strong diffuse staining, respectively. RESULTS: Thirty-six (56%) patients were male and 28 (44%) were female. Scores 0 and 1 of microvessel staining intensity were not observed in any grades studied, but severe staining intensity (score 3) was observed in 18.8%, 37.5%, 56.3%, and 87.5% of grades I, II, III, and IV astrocytomas, respectively. "Vwf vessel index" (MVD staining intensity of microvessels) was 23.84, 25.62, 31.62, and 62.43 in grades I, II, III, and IV astrocytomas, respectively. CONCLUSION: We found a significant relationship between staining intensity of vwf in microvessels and different grades of astrocytomas. The intensity of microvessel stain increases in parallel with increasing tumor grade. Regarding "microvessel density" and "vwf vessel index," the difference is predominantly between grade IV and all other grades. However, there is no other statistically meaningful difference between grades I, II and III.

Prognostic value of insulin- like growth factor-I receptor expression in renal cell carcinoma.

The insulin-like growth factor-I receptor (IGF-IR), a tyrosine kinase receptor over expressed in many tumor cell lines and in some human tumors, plays a critical role in transformation, tumorigenicity and metastasis. The aim of the present study is to investigate the role of IGF-IR expression as a prognostic factor in RCC. This study was conducted in a historical cohort of 82 patients who had RCC treated with radical nephrectomy from 1994 to 2005. Specimens were reevaluated with regard to histological subtype, nuclear grade, stage and IGF-IR expression. The IGF-IR stain was semi-quantitatively evaluated using the Allred score system. Kaplan-Meier analysis demonstrated a significant positive correlation between Fuhrman nuclear grade and IGF-IR Allred score (P< 0.0001). Survival in patients with score IGF-I < or = 4 was 90.21 month and in patients with score IGF-1R> 4 was 33.39 month (P Value < 0.0001). Cox regression analysis indicated that expression of IGF-IR is a prognostic factor in patients with RCC (P Value < 0.0001, odds Ratio = 2.38). In conclusion, a statistically significant correlation was demonstrated between IGF-IR expression and Fuhrman nuclear grading and survival in patients with RCC. In stage-by-stage and grade-by-grade analysis; however, it seems that we cannot consider IGF-IR as an independent prognostic factor.

The predictive role of histopathological findings in renal insufficiency and complete remission in a sample of Iranian adults with primary focal segmental glomerulosclerosis.

BACKGROUND: Primary focal segmental glomerulosclerosis (FSGS) is defined by the presence of proteinuria, often in nephrotic range and pathologically by segmental scars (SS). The aim of this study is to identify the possible predictors of complete remission or progression to chronic kidney disease in Iranian adults with primary focal segmental glomerulosclerosis. METHODS: In this historical cohort study, pathological findings of 50 patients with primary FSGS were reviewed by single renal pathologist without knowing about patients' identities or outcomes. Patients were divided based on their histopathological findings and outcomes were compared among these groups. RESULTS: There were significant differences in the complete remission rate in subjects with and without mesangial hypercellularity (p < 0.05), and in patients with and without hyalinosis (p < 0.05). According to the cut off points based on ROC curve analysis for the quantitative data, there was significant difference in renal insufficiency between the patients with and without global scars more than 12% (p < 0.05). Also multiple logistic regression analysis strongly suggests the association of mesangial hypercellularity and global scar with no complete remission and progression to renal insufficiency, respectively. CONCLUSIONS: In the studied patients, presence of mesangial hypercellularity and hyalinosis has been suggested as prognostic factors for lower remission rate. According to multivariate analysis, only mesangial hypercellularity and global scar were found to act as independent prognostic predictors of lower complete remission rate and progression to renal insufficiency in patients with FSGS, respectively.

Correlation of kidney biopsy findings and clinical manifestations of primary focal and segmental glomerulosclerosis.

To evaluate the correlation of clinical, laboratory, and pathological features at pre-sentation of focal segmental sclerosis (FSGS), we reviewed in a cross sectional study the pathological findings of kidney biopsies in 64 cases of primary FSGS, and correlated them with the clinical and laboratory data obtained at the time of the biopsies. The data included blood pressure, glomerular filtration rate (GFR), serum albumin, and the level of proteinuria. The mean level of serum creatinine was significantly higher in the biopsies' findings of synechiae (adhesions) in the Bowman's capsule, interstitial fibrosis, and global scars (P< 0.05), and mean level of GFR was significantly lower with the presence of interstitial fibrosis (P< 0.05). Furthermore, there was a positive correlation between the level of serum creatinine and global sclerosis (r= 2.21, P= 0.04), and a negative correlation between the level of GFR and global sclerosis(r= 2.01, P= 0.02). All the patients with renal insufficiency had interstitial fibrosis in their biopsies in comparison of only the 24 patients (48%) of the group without renal insufficiency (P< 0.05). There was no significant difference between patients with and without hypertension and nephritic-ranged proteinuria. We conclude that we found a correlation of renal insufficiency in primary FSGS patients with interstitial fibrosis, global scars and the synechiae of Bowman's capsule in their biopsies.

Vitamin B12 may be more effective than nortriptyline in improving painful diabetic neuropathy.

INTRODUCTION: Despite many therapeutic options, painful diabetic neuropathy is still a common and challenging complication of diabetes mellitus and is often resistant to treatment with current modalities. METHODS: In this randomized, single-blind clinical trial we compared the efficacy of parenteral vitamin B(12) and nortriptyline, for symptomatic improvement of pain, paresthesia, burning, freezing, stabbing and electrical sensation. Changes in nerve conduction parameters of amplitude, duration and latency were also compared. RESULTS: One hundred patients (50 in each group) completed the study. After treatment, the pain score based on a visual analogue scale decreased 3.66 units in the vitamin B(12) group and 0.84 units in the nortriptyline group (P <0.001). Similarly, the paresthesia score decreased 2.98 units versus 1.06 units (P <0.001). The decrements of tingling sensation were 3.48 units versus 1.02 units (P <0.001). Changes in vibration, position, pinprick and nerve conduction parameters were not significant in two groups. CONCLUSION: In conclusion, vitamin B(12) is more effective than nortriptyline for the treatment of symptomatic painful diabetic neuropathy.

The relationship between involved lymph nodes, metastatic nest diameters and prognosis in colorectal cancer.

INTRODUCTION: Several studies evaluated the relation between colorectal cancer prognosis and various factors such as: depth of tumor invasion, involved lymph nodes size, counts and locations, metastatic nest expansion. We assessed the prognostic significance of the ratio between metastatic nest and involved lymph node diameter in colorectal cancer cases. METHODS: A historical cohort study was conducted on patients with known colorectal cancer and metastatic lymph nodes (Astler Coller's stage C), in whom diagnosis was confirmed at least one year before the study. Less than two months following surgery, patients were treated with the same chemotherapy protocol. Metastatic lymph node sizes were recorded in 63 pathologic samples. Metastatic nest borders were marked using a marker and a 40x magnifying microscope. The greatest metastatic nest to involved lymph node diameter ratio was obtained. The data were analyzed with SPSS analytic software. Actuarial and Kaplan-Meier methods were used to estimate survival. Survival functions were compared by Log rank and Cox regression tests. RESULTS: There was no significant relation between colorectal cancer prognosis and: the greatest involved lymph node diameter, the metastatic nest diameter and the ratio metastatic nest to involved lymph node diameter (p-values in sequence: 0.1, 0.07, 0.2). CONCLUSION: We found no significant relationship between the colorectal cancer prognosis and the greatest lymph node diameter, the greatest metastatic nest diameter and the greatest metastatic nest to involved lymph node diameter ratio. Further studies are required in order to reach a decisive conclusion.

Evaluation of the effect of Islamic fasting on lung volumes and capacities in the healthy persons.

OBJECTIVE: To evaluate the changes in pulmonary volumes during and after Islamic fasting. METHODS: It is a cohort study conducted on 117 healthy subjects selected on a random basis from employees, professors and students of Iran University of Medical Sciences, Tehran, Iran, between December 1999 and January 2000. All of them underwent spirometry 10 days prior to Ramadan, 2 times during Ramadan, and one time 10 days post-Ramadan. In first visit, in addition to spirometry they underwent medical examination to make sure they are healthy. All of their spirometries and background information were collected. Repeated measurements analysis of variance method was used to compare the measurements. RESULTS: Approximately 69% of subjects were male and the mean age was 23.9 years. Mean fasting time was 27.8 days. The mean difference in forced expiratory volume in 1 second (FEV1%) was significant between the 4 visits (p=0.01). The mean FEV1% increased both during fasting and after Ramadan (p=0.017). The mean vital capacity and peak expiratory flow rate values increased during Ramadan significantly (p=0.043, p<0.001). Although the mean maximum mid-expiratory flow decreased in the beginning of Ramadan and significantly increased subsequently (p=0.02), MEF50% (p=0.004) and MEF75% (p=0.047) increased in the beginning of Ramadan and decreased subsequently. CONCLUSION: As a whole, fasting increases lung volumes and might improve pulmonary function. This finding seems to be relevant to the changes in weight during Ramadan.

Correlation of dyslipidemia with waist to height ratio, waist circumference, and body mass index in Iranian adults.

Overweight and obesity are increasing problems in many countries and are related to multiple cardiovascular risk factors. Although imaging techniques can determine total body fat and its distribution reliably, anthropometric measurements remain important in clinical practice. The purpose of this study was to determine the association between some anthropometric measurements and dyslipidemia as an important cardiovascular risk factor in Iranian population. A total of 750 subjects (580 females and 170 males) were selected by multistage random sampling from residents of Arak (Iran) and related villages in 2005. None of them had any significant past medical history. Body mass index(BMI), waist circumference(WC), and waist to height ratio(W/Ht) of subjects were measured to identify their relationship with their lipid profile including total cholesterol(TC), triglyceride(TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), and the ratio of total cholesterol to high density lipoprotein cholesterol(TC/HDL-C). Fasting blood sugar (FBS) was also measured. WC and W/Ht showed greater correlation with TC, TG, LDL-C, TC/HDL-C level than did BMI. Among lipid profile, TG showed the closest correlation with W/Ht (r=0.309, p<0.001) and WC (r=0.308, p<0.001). HDL-C level did not show any statistical relationship with W/Ht, but it was weakly correlated with WC (r=-0.088, p<0.05). None of the indices showed any association with FBS level. It can be concluded that W/Ht and WC can best predict dyslipidemia in an Iranian adult population. We suggest using both W/Ht and WC as inexpensive and easy methods in clinical and epidemiological fields.