Anaemia and its risk factors and association with treatments in patients with diabetes: A cross-sectional study.

BACKGROUND: Anaemia is frequently seen in patients with diabetes and the main cause is renal failure. At all stages of renal failure, however, the prevalence of anaemia is higher in diabetes patients than expected for their glomerular filtration rate, suggesting that causes of anaemia other than renal failure are at work. The present cross-sectional study was conducted to investigate the possible iatrogenic causes of anaemia in patients with diabetes. SUBJECTS AND METHODS: This was a hospital-based cross-sectional study of all patients who had biological and clinical data covering a 2-year period. All had been in contact with the diabetes department either as outpatients or as inpatients mostly for educational purposes. Clinical factors, including type of diabetes, known diabetes complications, treatments received and biological data, were reviewed for their possible involvement in anaemia. RESULTS: A total of 4145 consecutive patients were included. Anaemia was observed in 1065 (25.7%) of them. Patients with anaemia were more frequently women and those with longer durations of diabetes. Haemoglobin concentrations were decreased, and prevalence of anaemia was increased at all stages of renal failure, already at stage 2, KDIGO classification. Anaemia patients were more frequently taking insulin, antiplatelet agents and renin-angiotensin system blockers (RASBs). After exclusion of patients with specific causes of anaemia, logistic regression analysis of all parameters correlated with anaemia on univariate analysis revealed that anaemia was associated with gender, antiplatelet agents and RASBs. CONCLUSION: This study has confirmed that anaemia is frequently seen in diabetes patients and strongly associated with renal failure (already at stage 2). Our observations highlight the adjuvant role of drugs, particularly RASBs, in the risk of anaemia in patients with diabetes.

High rate of contamination with Staphylococcus aureus in traditional Koozeh cheeses. A molecular typing approach.

BACKGROUND: Koozeh cheese is an Iranian dairy product in rural areas, it is necessary to consider the microbial contamination in this supply. OBJECTIVE: This study evaluates microbial contamination in Koozeh cheese by molecular tools. MAATERIAL AND METHODS: S. aureus and its enterotoxins including type A and type B were identified by biochemical and polymerase chain reaction (PCR) and molecular typing was done by RAPD (Random Amplification of Polymorphic DNA) method. A total of 42 sheeps and cows Koozeh cheese samples were collected from random market in the cities and the surrounding villages. RESULTS: 71.42% of samples were contaminated with Staphylococcus spp. and in 50% of isolates, S. aureus specific coagulase gene "coa" was detected. High-level contamination was observed in 7.14% of samples. The SEA or SEB enterotoxins were produced in 42.84% of isolates. No clonal relationship was observed by molecular approach. CONCLUSION: The obtained results indicate a high level of microbial contamination in Koozeh cheese. Half of isolates were enterotoxin producer and had high diversity and no clonal relationship. Long processing and manipulation are involved in contamination. Improvement in hygiene, training local manufactures of Koozeh cheese, control of products for possible contamination and developing new protocols is needed to decrement of S. aureus contamination in Koozeh Cheese products.