White blood cell count and clustered components of metabolic syndrome: A study in western Iran.

BACKGROUND: White blood cell count (WBC) is one of the objective parameters of systemic inflammation. The aim of present study was to evaluate the relationship between WBC count and metabolic syndrome. METHODS: In this study on Lor population in Borujerd province (West of Iran), from 2011 to 2013, 800 persons were enrolled. MetS was defined based on ATP III criteria. Differences among the quartiles of WBC were examined by one-way analysis of variance. RESULTS: Only 14.7% did not have any of the five components and 43% of all subjects had metabolic syndrome. The means of WBC count in MetS group were significantly higher than the control group (p<0.0001). In subjects without any MetS components, the means of WBC was 5.321 /µL, and it was 5.664, 5.714, 5.961, 6.302, and 6.572 /µL in subjects with 1, 2, 3, 4, and 5 components, respectively. These differences show a significant increasing trend (p<0.0001). CONCLUSION: WBC count was associated with clustered components of metabolic syndrome. It seems that WBC counts could be considered as a predictive factor for metabolic syndrome in preventive medicine.

Fatal pulmonary Scedosporium aurantiacum infection in a patient after near-drowning: A case report.

Background and Purpose: Scedosporium spp. is a saprophytic fungus that may cause invasive pulmonary infection due to the aspiration of contaminated water in both immunosuppressed and immunocompetent hosts. Case report: Herein, we report a fatal case of pulmonary infection caused by Scedosporium species associated with a car crash and near-drowning in a sewage canal. Scedosporium aurantiacum isolated from bronchoalveolar lavage was identified by PCR-sequencing of ß-tubulin genes. The minimum inhibitory concentration values for amphotericin B, itraconazole, posaconazole, isavuconazole were >16 µg/ml, and >8 µg/ml for anidulafungin, micafungin, and caspofungin. Voriconazole was found to be the most active agent with a MIC of 1 µg/ml. Conclusion: This report, as the first case of pulmonary scedosporiosis after near-drowning in Iran, highlights the importance of high suspicion in near-drowning victims, prompt identification of Scedosporium spp., and early initiation of appropriate antifungal therapy.

The Relationship between Social Capital and Self-Efficacy in Women with Gestational Diabetes Mellitus: A Cross Sectional Study.

BACKGROUND: Self-efficacy is one of the most likely determinants of glucose self-management and self-monitoring by diabetic patients. Also, social capital is one of the effective social factors that may affect health behaviors. The aim of this study was to evaluate the relationship between social capital and self-efficacy in women with gestational diabetes mellitus (GDM). METHODS: This descriptive-analytical cross-sectional study was conducted on 212 women with GDM in two diabetes center in Mazandaran, north of Iran, from April to July 2019. Patients' social capital and self-efficacy levels were measured using the Social Capital Questionnaire (SCQ) and Confidence in Diabetes Self-Care Scale questionnaire, respectively. RESULTS: Among eight dimensions of social capital, the highest and the lowest mean scores were related to proactivity (21.3) and tolerance of diversity (5) dimensions. The mean (standard deviation=SD) of self-efficacy total score was 40.7(18.2), indicating moderate self-efficacy. Pearson correlation coefficient indicated that there was significant positive relationship between all dimensions of social capital and self-efficacy (p˂0.05). In addition, the results of multiple regression analysis indicated that community participation, neighborhood connections, family and friends' connections, tolerance of diversity and work connections, explained 55% of the variance in self-efficacy in women with GDM (p˂0.05). CONCLUSION: The results highlighted a significant positive relationship between social capital and self-efficacy in women with GDM. Improving women's social capital may enhance their self-efficacy in controlling GDM.

Metabolic syndrome and its components associated with chronic kidney disease.

BACKGROUND: There is limited information on the relationship between metabolic syndrome (MetS) and chronic kidney disease (CKD) in the Iranian population, a group that has a high prevalence of CKD and obesity. The aim of present study was to determine the relationship between MetS and CKD in West of Iran. MATERIALS AND METHODS: A total of 800 subjects aged more than 35 years admitted from 2011 to 2013 were enrolled in the study. MetS was defined based on the Adult Treatment Panel III criteria, and CKD was defined from the Kidney Disease Outcomes Quality Initiative practice guidelines. Waist circumference and body mass index were calculated, as well, blood samples were taken and lipid profile, plasma glucose levels, and serum creatinine were measured. Data were analyzed with SPSS version 17 (SPSS Inc., Chicago, IL, USA). RESULTS: CKD was seen in 14.8% patients with MetS and 8.3% individuals without MetS. MetS was associated with an increased odds ratio (OR) for a glomerular filtration rate <60 ml/min/1.73 m(2) (OR: 1.91; 95% confidence interval [CI]: 1.22-2.99; P = 0.004). Individuals with 2, 3, 4, and 5 components of the MetS had an increased OR for CKD: 2.19 (95% CI: 0.95-3.62), 2.65 (95% CI: 1.03-4.71), 2.86 (95% CI: 1.08-5.53), and 5.03 (95% CI: 1.80-8.57), respectively, compared with individuals with none of the components. CONCLUSION: We found a high prevalence of CKD in patients with MetS compared with the subject without MetS. Our observations raised major clinical and public health concerns in Iran, where both the MetS and kidney diseases are becoming common.

The rabies early death phenomenon: A report of ineffective administration of rabies vaccine during symptomatic disease.

It was reported that in some individuals who received postexposure rabies vaccine, clinical features of rabies developed at the shorter time compared to individuals who were exposed, but not received the vaccine, which called "early death" phenomenon. We reported an early death phenomenon in a 67-year-old woman who was bitten by a jackal, although receiving three dose of rabies vaccine. Results show that the immune response to rabies has a dual role, sometimes has a favorable effect on survival but sometimes amplification the disease.

The effect of 8 weeks aerobic exercise on insulin resistance in type 2 diabetes: a randomized clinical trial.

Diabetes complications are the main reasons behind morbidity and mortality preventable by healthy diet and physical activity. There are few studies about the effect of aerobic exercises on insulin resistance in human. Also various training protocols are associated with different results. Since approaches to decrease insulin resistance may be followed by more effectiveness treatment, this study assessed the effect of aerobic exercise on insulin resistance in type 2 diabetes mellitus. In this randomized clinical trial, 53 type 2 diabetic women were randomly divided into two groups as exercise (n=27) and control (n=26).The exercise protocol included warm-up by stretching and flexibility exercises for 10 m, followed by walking for 30 m with maximum intensity 60% increase in heart rate and then stretching in the seated position for 10 m, 3 times a week for 8 weeks. Resistance to insulin was assessed using Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Significant differences have been observed in insulin resistance, fasting glucose and plasma insulin between the groups after 8 weeks. There were significant differences in waist and hip circumference, BMI, plasma insulin and insulin resistance within the groups over time. In addition, the changes in waist and hip circumference, FBS, plasma insulin and insulin resistance had significant interaction with the time between the groups. The current exercise protocol has been effective in lowering plasma glucose (p = 0.05), insulin levels (p = 0.000) and insulin resistance (p = 0.02). It seems that aerobic exercises training promote the effectiveness of medical treatment in type 2 diabetes mellitus.