Short-term neonatal outcome in singleton, late preterm deliveries: a three-year experience at a single Lebanese center

There has been a decrease in the mean gestational age at delivery worldwide mostly due to an increase in deliveries occurring at late preterm period [LPP] with a concomitant rise in the rate of morbidities among newborns delivered at this period. To report the frequency of common short-term neonatal morbidities in infants born at LPP [between 340/7 and 36 6/7 weeks' gestation] and to compare these frequencies with those of full-term infants born at our institution. A descriptive cohort study [2008-2010] at Makassed General Hospital. All deliveries occurring at LPP constituted the study group [n = 361], while births at or beyond 37 weeks' gestation were considered as controls [n = 2814]. The average rate of deliveries in LPP was 11.4% for the entire study period. The rate of Neonatal Intensive Care Unit admissions, respiratory morbidities, sepsis, jaundice, hypothermia, hypoglycemia and overall neonatal morbidity were all significantly higher in LPP infants when compared to those at term [p-value < 0.013]. In our cohort of Lebanese newborns delivered at LPP, significantly higher morbidities were encountered when compared to full-term newborns. Every possible effort should be exerted to avoid elective deliveries during LPP in order to curb the incidence of neo- natal morbidities

[ effects of cashew consumption on serum glucose, insulin and lipoprotein in type 2 diabetic patients]

Diabetic dyslipidemia is a complication of diabetes and several studies have demonstrated that nut consumption exerts beneficial effects on serum lipid profile. We designed an intervention study to evaluate the effects of cashew on fasting serum glucose, insulin and lipoprotein in type 2 diabetic patients. In an 8 week randomized parallel clinical trial, 50 diabetic patients [34 women and 16 men] were randomly assigned to two groups] the intervention [cashew] and the control [regular diet] groups. Cashews replaced 10% of total daily calorie intake in the intervention group. Blood samples were collected from fasting subjects at entry to the study and at the end of the study. All dietary data were obtained using 24-hours recalls at baseline, in the middle and at the end of the study. Mean HDL-C and insulin concentrations were statistically different between the intervention and control groups [P=0.01, P=0.023, P=0.043 and P=0.023 respectively], while other biochemical indices such as serum glucose and other lipoproteins, were not. The results indicated that replacing 10% of daily calorie intake with cashew in patients with type 2 diabetes may prevent HDL-C reduction and also decrease serum insulin, and hence possibly play an important role in decreasing cardiovascular risk factors in diabetic patients

[ effect of self care program education by group discussion method on self concept in diabetic adolescent girls reffered to Iranian diabetes society]

Diabetes is a chronic illness which needs the self care behaviors up to the end of life. If this illness attends with adolescence because of the nature and properties of the adolescence creates problems of adapting to the illness and doing self care behaviors for adolescent and his/her family. On the other hand studies have shown that in chronic illnesses such as diabetes, self care interacts with self concept. How ever diabetes adolescents affiliating has problem for self concept and since adolescence the effect of self care on self concept has important value. So this study has been done to assess the effect of self care program with group discussion on self concept of diabetic young girls. This research is a semi experimental study has been done in 2008- 2009 with 80 diabetic adolescent girls between 15-19 [40 as test group and 40 as evidence group] in Iranian Diabetes Society. After data collection result in pre intervention stage with knowledge, practice and self concept questionnaire and need measuring in each group, self care program was designed and then self care program was discussed in 6 sessions for test group. Then immediately and after one month of intervention again the same questionnaire completed for test and evidence group of diabetic adolescent girls. Results after data analysis showed that test and evidence group were same for independent sample t test and chi-square test for demographic information [age, height, weight, fathers job...]. In test group in comparison among before, immediately after and after one month of intervention there was significant difference in increasing score of knowledge, practice and self concept [P<0.0001]. But this difference was not significant in evidence group [P>0.05] and independent t-test [P>0.05] showed no significant difference in knowledge, practice and self concept between test group, and evidence group before intervention. Immediately and after one month of intervention between two groups with independent t-test, was seen significant difference in mean score of knowledge, practice and self concept [P<0.05]. Generally results of the research showed that performing the self care program by group discussion was effective in increasing self concept of diabetic adolescent girls and it is suggested that teaching self care behavior by group discussion is used as a effective method to improve self concept in other adolescents with chronic disease

Relationship between serum zinc and insulin concentration, insulin resistance and oxidative stress in postmenopausal diabetic women

The metabolism of Zine [Zn], an essential nutrient, changes in diabetes. It has been shown that there is a relationship between Zn and both, type 1 or insulin-dependent diabetes mellitus [IDDM] and type 2 or non-insulin-dependent diabetes mellitus [NIDDM]. Increased lipid peroxidation in diabetic patients leads to MDA production. This study aimed to investigate relationships between serum Zn concentration and insulin, insulin resistance and oxidative stress in postmenopausal diabetic women. We studied 45 diabetic women and 45 healthy ones [controls] with BMI 25-30 kg/m2 and age 45-60 y. Fasting blood sugar [FBS], serum zinc, insulin, insulin resistance and MDA were determined in both groups. There were non significant correlations between Zn, insulin [r= -0.06] and insulin resistance [r = -0.027] and MDA [r = -0.09] as well in diabetic group. There were no significant relationships between serum zinc and insulin, insulin resistance and MDA in postmenopausal diabetic women

effects of omega-3 fatty acids plus vitamin E and vitamin C plus zinc supplementations on glycemic control in postmenopausal women with type 2 diabetes

Outcomes of diabetes mellitus play an essential role in the pathogenesis of atherosclerosis and its complications. Persons with type 2 diabetes mellitus have lower plasma vitamins E and C levels. Lower levels of these vitamins may increase the risk of oxidative stress. In this study we assessed the effects of omega-3 fatty acids plus vitamin E and vitamin C plus zinc supplementations on glycemic control in postmenopausal women with type 2 diabetes, compared with a control group. In this 12-week double-blind placebo-controlled clinical trial, 75 postmenopausal women with type 2 diabetes from among those consulting the Iranian Diabetes Association, Tehran, participated. The subjects were randomly assigned to one of three groups, to take, daily for 12 weeks, 1.8 g omega-3 fatty acids plus 400 mg vitamin E [group 1], 5 mg zinc plus 300 mg vitamin C [group 2], or a placebo [group 3]. Analysis of variance and repeated measure analysis of variance were used for inter-group comparisons and the changes in the three groups and adjustment of the other variables, respectively. At baseline, there were no significant differences in glycemic parameters among the three groups. Changes in HOMA-IR in group 1 were significantly higher than those in group 2 and the placebo group [-0.9 +/- 0.6 vs. 0.9 +/- 0.5 and 0.4 +/- 0.4, respectively] [p=0.012]. After intervention, changes in fasting plasma insulin [-1.6 +/- 1.3 vs. 0.6 +/- 0.8 and 1.6 +/- 0.7 mU/l, respectively] [p=0.038] were higher in group 1, while they were lower in the other 2 groups. The supplementation caused a significant decrease in the mean changes in fasting plasma glucose in group 1 and a significant increase in group 2 [-11.1 +/- 14.1 vs. 27.9 +/- 10.9 mg/dl, respectively][p= 0.039]. Simultaneous reductions in HOMA-IR and plasma insulin as the most important cardiovascular risk factors in group 1 taking daily 1.8 g omega-3 fatty acids plus 400 mg vitamin E is encouraging, because it can have practical clinical implications. Duration of diabetes may have influenced effectiveness of the treatments

[ moderating role of coping strategies in relationship between illness perception, quality of life and HBA1c in patients with type I diabetes]

The aim of this study was to investigate the moderating role of coping strategies in the relationship between illness perception, quality of life and HbA1c in patients with type I diabetes. Three hundred patients [172 females and 128 males, 18-30 years] aged with type I diabetes from the Iranian Diabetes Society completed the Illness Perception Questionnaire [IPQ], Coping Inventory for Stressful Situations [CISS], and Quality of Life scale for Diabetics [D-39]. HbA1c level was obtained from patient's laboratory examination. Results of stepwise regression analysis revealed that the influence of illness perception on HbA1c was moderated by task-oriented coping strategy. The relationship between illness perception and quality of life was influenced by three coping strategies, task oriented, emotion-oriented, and avoidant. Coping strategies affect the relationship between illness perception, quality of life and HbA1c in patients with type I diabetes. Results can be helpful in devising preventive policies, determining high risk patients and designing of psychological interventions

[Effects of the administration of anticoccidial vaccines and drugs on intestinal lesions and biochemical variables of broiler chicks challenged with experimental coccidiosis]

Coccidiosis is one of the most important disease in poultry. Since using of anti-coccidial drugs or vaccination are considered as the most common preventive measures of this disease, an experiment was conducted to compare effectiveness of these methods. Nine hundred and sixty day-old male Ross broiler chicks were randomly assigned to eight treatments and fed with a corn-soybean meal basal diet during experimental period. Treatments 3 and 4 received salinomycin and diclazuril as coccidiostate, respectively, but did not immunize. Chicks in treatments 5 to 8 immunized with anti-coccidial vaccines [including Livacox Q, Paracox 5, Livacox T, and Iracox, respectively] by drinking water on 5 days of age. Chicks in all treatments except treatment 1 were inoculated with a suspension of four Eimeria species on 26 days of age. From 28 days of age, blood samples were taken on a weekly and serum concentrations of beta-carotene, albumin, globulin, albumin to globulin ratio, vitamin A, and total protein were measured. One week post-challenged, 6 birds in each treatment were slaughtered and intestinal lesions were scored. The results indicated that the birds fed diets supplemented with salinomycine or diclazuril had the highest concentrations of vitamin A. Serum concentration of alpha-carotene was higher in negative control [non-infected] treatment. No significant differences were observed in relation to other serum biochemical values among treatments. It was concluded that serum concentrations of vitamin A and alpha-carotene could be considered as most important serum biochemical values in coccidian-infected broilers

Relationship between serum leptin concentration and inflammatory factors and oxidative stress in postmenopausal type II diabetic women

Leptin, a hormone secreted by the adipocytes, has a role in the pathogenesis of obesity and non-insulin-dependent diabetes mellitus [NIDDM]. There are relationships between Tumor Necrosis Factor-alpha [TNF-alpha] and lnterleukin-6 [IL-6] with Body Mass Index [BMI] and insulin resistance. Increased lipid peroxidation leads to produce MDA in diabetic people. It have been shown that, there are relationships between leptin and TNF-alpha, IL-6, and MDA, showing that increased lipid peroxidation leads to MDA production in diabetics. This study investigates relationships between serum leptin concentration and inflammatory intermediate and oxidative stress in postmenopausal diabetic women. We studied 45 postmenopausal diabetic women and 45 postmenopausal healthy women [controls], aged between 45-60 y and with BMI 25-30 kg/m2. Fasting blood sugar, serum leptin, TNF-alpha, IL-6, and MDA were determined in postmenopausal diabetics and healthy women, and comparisons were performed using the t test in the diabetic and healthy groups. Pearson correlation was used to evaluate the relations among different variables in two groups. There were non significant correlations between leptin and TNF-alpha [r=0.2] and IL-6 [r= -0.06] in postmenopausal diabetic women, and also between leptin and MDA [r= 0.04] in postmenopausal diabetic women. There were no significant relationships between serum leptin and TNF-alpha, IL-6, and MDA in postmenopausal diabetic womer It seems these relationships need to be further clarified in future studies with larger sample sizes

[Effects of omega 3 on serum level of malondialdehyde and homocysteine in type 2 diabetic patients]

Diabetes is regarded as a serious condition for both the individual and the society. One of the most important mortality reasons in diabetic patients is atherosclerosis. Many epidemiological studies have shown that the total homocysteine concentration is a risk indicator for cardiovascular disease. Malondialdehyde [MDA] also is a highly toxic by-product formed in part by lipid oxidation derived free radicals. Many studies have shown that its concentration increases considerably in diabetes mellitus. Epidemiological data indicate that the consumption of omega-3 unsaturated fatty acids [O3FA] leads to a reduction in cardiovascular disorders may protect against metabolic diseases. In recent years, numerous researches on omega-3 fatty acids have been done but it cannot be used as a confident additive. So in order to evaluate and compare the effects of omega 3 on malondialdehyde [as fat peroxidation indicator] and homocysteine on diabetic type 2 patients, this research was carried out in Tehran University. A randomized double blind placebo controlled clinical trial was conducted on 81 type 2 diabetic patients, 45-85 years old with diabetes for at least 2 years. Diabetic patients were randomly assigned to one of the case or control groups, each subject received 3 capsules per day of omega-3 or placebo for a period of 2 months. 10 ml blood was collected from each subject at the beginning and at the end of a 2-month trial. Serum MDA was determined with Tiobarbituric acid for more sensitivity and homosystein was measured by Hitachi autoanalyzer with Enzymatic Cycling method. Nutrients intakes were estimated using 24 h dietary recall questionnaire at the beginning and at the end of the 2-month trial for 2 days and analyzed by FPn. T-test also was used to compare groups. Comparing the meant +/- S.D of BMI and food intake in both groups showed no significant differences. MDA level degreased 0.72 nmol/ml in case group but the difference with the control group was not significant but the differences of homosystein level in case [3.10 micro mol/lit] and control [0.126 micro mol/lit] groups were significant. Consumption of omega-3 fatty acids supplementation [3 gr/per day] in capsul form can decrease the serum level of homocysteine in diabetic patients without inducing any changes in MDA level and lipid peroxidation

Assessment of effect of applying the transtheoretical model to physical activity on health indexes of diabetic type 2 patients

About 3 million [3-5 percent] of Iranian population have diabetes mellitus. This study was conducted to investigate the impact of physical activity training on the participants' health indexes [fast blood sugar, HBA1c, body mass index, lipids of blood, pulse rate and blood pressure] based on the transtheoretical model [ a kind of behavior change model] among type 2 diabetic patients in 2007. In this quasi-experimental study with a before and after design, 32 patients with type 2 diabetes who were the member of the Iranian Diabetes Society were selected according to the inclusion criteria by non-probable [simple] sampling. Data regarding to the participants' health methods before and after 1.5 and 3 months physical activity training sessions. Some health indexes of the participants, including FBS, HBA1c, TG, LDL, were improved significantly after 3 months of the study [P<0.05] which demonstrates the positive effect of doing exercises on patients. Moreover, the quality of doing each exercise was also significantly improved [P<0.05] Based on the transtheoretical model the stages of patients' physical activity were improved and most of them were categorized in the maintenance stage after 3 months. This study confirms the positive impact of physical activity training on the participants' health indexes based on the transtheoretical model among type 2 diabetic patients and recommends doing exercise regularly

[IL- 12 gene polymorphism in type I diabetes mellitus]

Type 1 diabetes is an autoimmune disease characterized by T-cell mediated destruction of pancreatic ?-cells. A variety of environmental and genetic factors are involved in the development of the disease. IL-12 is a cytokine secreted by different cells and plays and important role in cell-mediated immune responses and maintenance of cytokine network balance. Genetic polymorphisms in the IL-12 gene were shown to interfere with the transcriptional activity of the IL-12 gene, and this influences the production, secretion or activity of IL-12 growth factor. In this study the polymorphism in the 3'-untranslated region of the IL12Bgene encoding IL-12 p40 was investigated. In this case control study 75 type 1 diabetic patients who had definitely been diagnosed at least 2 years before sampling and were under Insulin therapy, recruited. A total of 88 healthy controls selected from voluntarily blood donors who had referred to IRAN Blood Transfusion Organization. DNA extracted from whole blood and polymorphism at +1188 nucleotide was assessed by SSP-PCR. Data were analyzed by SPSS, using chi- square test with 95% confidence interval. A statistical significance of AA presence [57%] at the +1188 3'-UTR position of IL-12 B gene in patients was found, after genotyping, compared to the control group[p<0.05]. Interleukin-12 [IL-12] is a key cytokine for the induction of Th1 immune responses. Polymorphism in the 3'-UTR of the IL-12 p40 gene and association with susceptibility to Diabetes type I evaluated. AA genotype was more frequent than AC and the AC more common than CC in diabetic patients. In another word, the A allele of the [A/C] polymorphism at position +1188 in the 3'-UTR found to be preferentially transmitted to people with type I diabetes.These polymorphisms may affect gene transcription of IL-12 p40, causing individual variations in cytokine production. A better understanding of the molecular mechanisms, will give us the opportunities to develop new and effective therapeutic approaches

Lifestyle education and diabetes mellitus type 2: a non-randomized control trial

Diabetes mellitus [type 2] is an important health problem throughout the world. This study aimed at evaluating the effect of a designed educational program on the lifestyle of the patients suffering from type 2 diabetes mellitus. Ninety eligible diabetic patients aged 30-60 years old were recruited and then willingly assigned to two groups of clinic group [n= 45] who received only routine medication/ education underwent their leading physician in diabetes society and intervention group [n= 45] who received routine medication/education plus 2 two- hour educational sessions regarding healthy lifestyle to control and prevent diabetes. A five- part questionnaire was used for data collection at baseline and 1- month follow up. Collected data were analyzed by SPSS software. The educational program caused a significant increase in the knowledge [P< 0.001], attitude [P< 0.01] and practice [P< 0.01] of intervention group towards healthy behaviors regarding nutrition, physical activity and self care. It was concluded that our designed educational program could improve the lifestyle of the patients suffering from type 2 diabetes mellitus

Blood transfusion acute reactions in patients of Shahid Ghazi Hospital

Cancer patients due to bone marrow suppression, sepsis, and other relevant complications require appropriate blood components for transfusion. However, there are risks of transfusion reactions. These reactions are influenced by many factors varying across different geographic regions and medical centers. This study was performed to determine incidence of early transfusion reactions and their clinical symptoms and signs in cancer patients, and to calculate the correlation of these adverse reactions with some demographic data and some specifications of blood components. In this descriptive study, 39 reactions from 4023 blood transfusion attempts were assessed. Patients were monitored for symptoms and changes in vital signs within 24 hours following transfusion. Data analysis was performed by descriptive and inferential statistics [X 2 and ANOVA].The majority of reactions belonged to platelets [56.43%] and packed cells [43.58%]. The most common symptoms were shown to be rigors [2.72%], and fever [2.33%]. The incidence rate was estimated to be 2.7% for FNHTR, and 2.1% for allergic reactions. Haptoglobin deficiency was found in 0.8% of FNHTR cases. A correlation was observed between sex and history of previous reactions [p=0.048, p=0.04, respectively] with blood transfusion reactions. These findings indicated that incidence of blood transfusion reactions and clinical symptoms correlated with other studies. The incidence of reactions in women and individuals with previous history of repeated blood transfusions was shown to be greater. Transfusion of packed cell was associated with allergic reactions [p=0.04], and high platelet lifetime associated with pulmonary reactions [p=0.044]

study of soluble adhesion molecules [SICAM-1, SVCAM-1, SELAM-1] in serum and membrane form of adhesion molecules [VCAM-1, ICAM-1] on the monocytes in diabetic subjects type 1

The adhesion molecules are involved in adhesion of leukocytes to endothelial cells and other immune cells. Not only adhesion molecules have membrane form, but they also have soluble form. In this paper, we attempted to investigate the concentration of soluble adhesion molecules in the type 1 diabetic patients [n = 40] and healthy subjects [n = 10]. The results indicated that there was an increase in the concentration of soluble adhesion molecules: sICAM-1, sVCAM-1 and sELAM-1, in the sera of diabetic patients rather than the healthy ones [p = 0/00]. Increased concentration of sVCAM-1 with the insulin injection dose [p = 0.01] and sICAM-1 with duration of disease [p = 0.05] indicated significant reversel linear correlation in the patients groups. Also, sELAM-1 with sVCAM-1 and sICAM-1 showed significant direct linear correlation in the same group [p = 0.01]. Adhesion molecules were determined by the sandwich ELISA principle. One of the most important factors in the development of atherosclerosis is the adhesion of monocytes to endothelial cells. Therefore, in this study, the percentage of expression of membrane form of VCAM-1, not ICAM-1, was increased on 10000 monocytes of diabetic patients type-1 [n=20] in comparison with normal subjects [n = 20, p = 0.05]. The expression tensive of membrane form of cams on the surface of monocytes was performed by flowcytometry technique. We concluded that the increase in sICAM-1, sVCAM-1 specially sELAM-1 and also mVCAM-1 indicated endothelial activation, stimulatability of leukocyte cells and increased interaction to endothelial cells. Although, scientists are not aware about the role of elevated CAMs concentration, it can be suggested that the increasing level of sICAM-1, sVCAM-1, sELAM-1 and mVCAM may reflect cellular expression, function of CAMs in autoimmune disease and also provide a potential therapeutic target for human IDDM