Prevalence of Hearing Disorders among Type 2 Diabetes Mellitus Patients with and without Vitamin D Deficiency.

Most of the previous studies have marked hearing loss as another complication of diabetes mellitus, while some other authors had different ideas. The relation between diabetes mellitus and sensorineural hearing loss has been under investigation for a century. However, it has remained controversial. Changing in the metabolism of glucose alters inner ear function and leads to hearing and vestibular disorders. We performed a study on type 2 diabetes mellitus patients with vitamin D deficiency, vitamin D insufficiency and with normal levels of vitamin D in an attempt to find out the prevalence of hearing loss among them. Prevalence of hearing loss was significantly higher in the group with vitamin D insufficiency/deficiency based on X2 test. Results showed that diabetic patients with abnormal levels of vitamin D had a higher risk to develop hearing loss compared to those with normal levels. There was a significant difference between subjects with normal and abnormal levels of vitamin D in terms of hearing loss degree based on the X2 test. In general, hearing loss was more prevalent in patients with abnormal levels of vitamin D, the severity of the loss mostly including slight and mild degrees. The results of the present study suggest that abnormal levels of vitamin D may be associated with a higher risk of hearing loss.

Detection of significant left renal artery stenosis caused by fibromuscular dysplasia with selective angiography.

A 22-year-old female, was referred with a history of a headache and elevated blood pressure without family history of hypertension or familial dyslipidemia. Initially, a spiral computed tomographic angiography of the renal arteries was conducted, demonstrating completely abnormal left renal artery at the medial portion of the vessel with suspicious stenosis, which was supposed to be due to fibromuscular dysplasia (FMD). Subsequently, the patient underwent selective renal angiography and balloon angioplasty. Severe stenosis was observed on the left side and moderate stenosis on the right side in the medial and proximal part of the vessels, respectively. After the diagnosis of FMD, the left side was treated by balloon and finally, the patient was discharged with good control of blood pressure by losartan/amlodipine treatment.

Approach to a target value for 2-hours post dose cyclosporine (C2) during the first week post renal transplantation.

BACKGROUND: There is not a wide consensus on whether recommended target ranges for 2-hours post dose cyclosporine (CsA) blood level (C2) are generalizeable to all kidney recipient populations worldwide. In this study we aimed to assess in which C2 level we can obtain the least acute rejection (AR) episodes in our kidney transplanted patients. MATERIAL/METHOD: In a retrospective cross-sectional study, we investigated all our renal recipients with at least a valid C2 blood level at the days between 5-9 post transplantation. All patients were under immunosuppressive therapy with CsA (Neoral), prednisolone and MMF. RESULTS: Hundred forty-four patients were eligible for inclusion in the study. Mean age of the study subjects at the time of transplantation was 36.8+/-16.6 years. 99 (69%) of the patients were male. Overall, 16 (11%) patients experienced AR during the first two weeks post-transplantation. Mean C2 blood levels for patients experiencing AR was 793+/-335 compared with 1028+/-391 for patients without AR (p=0.023). We found that none of the patients with a C2 level of higher than 1300 ng/mL experienced an episode of AR. CONCLUSIONS: According to our findings, we recommend that for minimization purpose of the incident AR episodes among LURD kidney, a C2 blood level of higher than 1300 ng/mL to be obtained during the first week post-transplantation. Alongside, approaching specific C2 targets for patients with different drug regimen or genetic polymorphisms seem necessary.

Association Between Thyroid Function and Development of Different Obesity Phenotypes in Euthyroid Adults: A Nine-Year Follow-Up.

BACKGROUND: Considering inconsistent and conflicting data on associations of thyroid function, within the reference range, with anthropometric measures and metabolic syndrome, this study aimed to investigate the relationship between thyroid function and different obesity phenotypes over nine years of follow-up. METHODS: This study was conducted on 1938 individuals from an ongoing population-based cohort study, the Tehran Thyroid Study. Participants were categorized into four obesity phenotypes based on body mass index and metabolic status. To investigate the associations of thyrotropin and free thyroxine (fT4) with incidence of different obesity phenotypes across the study period, a multivariate approach based on a generalized estimating equation method was used. RESULTS: At baseline, individuals with the metabolically healthy normal weight (MHNW) phenotype had higher serum fT4 levels (1.2 ± 0.16 ng/dL vs. 1.14 ± 0.14 ng/dL, 1.16 ± 0.14 ng/dL, and 1.17 ± 0.15 ng/dL in metabolically healthy obese [MHO], metabolically unhealthy normal weight, and metabolically unhealthy obese individuals, respectively). The results of the generalized estimating equation analysis after multivariate adjustment for age, sex, smoking, physical activity, education level, thyroid peroxidase antibody status, and homeostasis model assessment-insulin resistance showed that each 1 ng/dL increment in fT4 levels within the reference range was accompanied with a 1.65-fold [confidence interval (CI) 1.09-2.5] increase of developing the MHNW phenotype during 9.2 years of follow-up. Moreover, each 1.0 ng/dL increment in fT4 within the reference range was associated with a 50% decreased risk of developing the MHO phenotype (odds ratio = 0.50 [CI 0.32-0.76]). Meanwhile, a significant positive association was found between serum thyrotropin levels and development of the metabolically unhealthy normal weight phenotype (odds ratio = 1.22 [CI 1.01-1.48]). CONCLUSIONS: Serum fT4 concentrations within the reference range are associated with the development of some obesity phenotypes, including the MHNW and MHO phenotypes, after consideration of potential confounders.

Early hyperglycemia after allogenic kidney transplantation: does it induce infections.

BACKGROUND: Although impact of diabetes mellitus after solid organ transplantation is a broadly investigated issue, a potential impact of early hyperglycemia after renal transplantation has not received enough consideration. In this study, we aimed to evaluate the potential impact of early hyperglycemia on the hazards of infections development leading to re-hospitalization. MATERIAL/METHODS: We evaluated 1931 non diabetic renal allograft recipients, undergone renal transplantation at the Baqiyatallah Hospital, Tehran from 1984 to 2006. Level of hyperglycemia was defined at 126 mg/dL. Patients who had at least two glucose concentration results over the mentioned level in two different days during their early post transplantation period were determined as hyperglycemic. RESULTS: Overall, 7.6% of patients were determined as having early post transplant hyperglycemia. Multivariable hazard analysis using Cox regression model showed that early post transplantation hyperglycemia has an independent impact on rehospitalization of non-diabetic kidney allograft recipients for developing infectious diseases. CONCLUSIONS: Regarding findings of our study and previous studies we conclude that renal transplant recipients who develop hyperglycemia during their early post transplantation period should receive higher amount of attention over their follow up periods.

Healthy eating index in women with polycystic ovary syndrome: A case-control study.

BACKGROUND: Despite many effort to identify and control the factors involved in polycystic ovary syndrome (PCOS), there are no available reports indicating the association of healthy eating index (HEI) and PCOS. OBJECTIVE: The present study has been conducted to examine the relationship between HEI and PCOS. MATERIALS AND METHODS: In this case-control study, the study population comprised 297 women aged 20-40 yr referred to Baqiyatallah Hospital Clinics, Tehran, Iran in two groups: case group (n=99) and control group (n=198). The usual dietary data were collected using a validated 168-item semi-quantitative food frequency questionnaire. Standard anthropometric measurements (height, weight, and waist circumference) were also taken. Unconditional logistic regression was used to analyze the relationship between the PCOS and the HEI. RESULTS: The mean age and body mass index of case and control groups were 29±5.5 vs. 29.5±6 yr and 26.6±4.8 vs. 26±4.2 kg/m², respectively (p=0.752, p=0.822). Mean HEI scores for the case and control groups were found to be 61 and 65, respectively. In final model and after adjustment for confounders, the prevalence of PCOS in subjects in the highest tertile HEI score was significantly (50%) less than those in the lowest tertile HEI score (OR=0.50; 95% CI: 0.25-0.74, p=0.001). CONCLUSION: Our results suggest that HEI score is inversely associated with the risk of PCOS in adult women.

Epidemiologic Investigation of Dysentery in North of Iran: Use of Geographic Information System (GIS).

INTRODUCTION: Dysentery is an intestinal inflammation which is created by the microorganisms attacking intestine mucus. Knowing the prevalence of this disease in different societies paves the way for programming and providing treatment and preventive measures. The main purpose of this study is to investigate the epidemiologic pattern and geographical distribution of dysentery based on GIS. METHOD: This was a cross-sectional and analytical study. The dysentery cases were gathered from the section of contagious diseases in health chancellery of Mazandaran University of medical sciences through a checklist during the years 2008 to 2013. In order to analyze the data, we made use of chi-square test. Then, the GIS software was used to recognize the geographical distribution of the disease. FINDINGS: There was reported about 653 cases affected by dysentery and the disease proportion was equal for both men and women. Most of the persons with dysentery was city dwellers. The highest rate of incidents was reported to be in Fereidunkenar in 2011, and the disease was mostly found among farmers, students, and college students. CONCLUSION: Since dysentery is a disease transmitted from water and food, and in this study, it was found out that the disease sources included using polluted water, vegetables, and lack of appropriate personal hygiene. Therefore, it is essential to take into consideration the health issues. Moreover, the suitable conditions of the geographical area which has the highest rate of incident have paved the way for dysentery occurrence. In addition, using geographic information system (GIS) as a visual instrument can help the stakeholders and officials to elaborate on the death trend and recognize the areas for optimal use of the available resources.

Langerhans' cell histiocytosis.

Adult onset Langerhans cell histiocytosis is uncommon. A 29 year old man is presented who developed classic cutaneous disease with severe systemic involvement. He responded completely to a two month course of thalidomide.

The comparison between the efficacy of high dose acyclovir and erythromycin on the period and signs of pitiriasis rosea.

BACKGROUND: Pityriasis Rosea (PR) is an acute inflammatory and self-limiting skin disorder, sometimes with troublesome symptoms. To date, there are few treatments available for this disorder. AIM: Compare the traditional treatment with erythromycin to a newly introduced antiviral treatment acyclovir for PR. MATERIALS AND METHODS: Patients with clinically confirmed diagnosis of PR, matching our exclusion criteria, were enrolled. They were randomized in two groups that received high-dose oral acyclovir or erythromycin. The participants were evaluated two, four, and eight weeks after commencement of the study and followed for one year. RESULTS: A total of 30 patients including 15 males and 15 females completed the study. After eight weeks, 13 patients in the acyclovir group experienced complete response, while in the erythromycin group only six patients had complete response (P < 0.05). Also, patients in the acyclovir group experienced faster resolution of pruritus in comparison with the erythromycin group (not significant). No adverse drug reaction was detected in both groups. CONCLUSION: It seemed that a high-dose of oral acyclovir was a safe and effective therapy for PR, although this remained to be confirmed in larger studies.