Health-Related Quality of Life in Osteoporosis Patients with and without Fractures in Tehran, Iran

Background@#This study aimed to measure the health-related quality of life (HRQOL) of patients with osteoporosis with and without fractures in Tehran, the capital city of Iran. @*Methods@#We surveyed a sample of 478 patients with osteoporosis aged over 50 years. Participants with fractures included patients referred to hospitals due to osteoporotic fractures which were alive 6 months after the fracture. Participants without fractures were randomly selected from patients with a definite diagnosis of osteoporosis admitted to 3 outpatient clinics in Tehran. Data were collected using the EuroQol 5-dimensional 5-level questionnaire. Statistical differences between patients with and without fracture were tested with Pearson’s χ2 test, Student’s t-test, and the Mann–Whitney U-test. The association between HRQOL and other variables was evaluated using a multiple linear regression model. @*Results@#The patients’ mean age±standard deviation was 67.3±11.9 years, and 74.1% were women. One hundred and seventeen (23%) patients had hip fractures, 56 (11%) had vertebral fractures, 127 (25%) had forearm fractures, and 178 (40%) had no fractures. The median (interquartile range) values of HRQOL scores of those with hip, vertebral, and forearm fractures and those with no history of fracture were 0.53 (0.22), 0.60 (0.28), 0.64 (0.26), and 0.64 (0.27), respectively. The multiple regression model revealed a significant relationship between the HRQOL scores and sex, marital status, employment status, presence of any chronic illness in addition to osteoporosis, and type of fracture. @*Conclusions@#Osteoporosis and its related fractures can reduce the HRQOL.

The necessity for integrating traditional, complementary, and alternative medicine into medical education curricula in Iran / 中西医结合学报

BACKGROUND@#The use of traditional and complementary medicine (T&CM) is increasing in both developed and developing countries. The school of Persian medicine (PM) in Iran is a comprehensive medical school that is rich in history and has its own special principles, elements, philosophy, and diagnostic and treatment options. Many complementary therapy modalities are also popular and in demand among patients and physicians. The aim of this paper is to provide logic for the policymakers in Iranian medical education to make changes in medical education curricula, particularly on integrating T&CM.@*METHODS@#We reviewed the global experience in teaching T&CM to medical students, and highlighting the strengths of PM, described why it is necessary to integrate T&CM into general medicine curricula in Iran.@*RESULTS@#PM is a traditional system of medicine that dates back about 7000 years. Although there are few studies about the safety and effectiveness of PM, research into it has recently been accelerated. There is a suitable opportunity for integrating T&CM with conventional medicine. Physicians should be familiar with T&CM to avoid any contraindications, interactions, and unwanted effects.@*CONCLUSION@#Traditional medicine is part of Iran's heritage and, thus, needs special attention. Familiarization of physicians with T&CM can help them choose the best treatment options for their patients. To integrate T&CM into the medical education curricula of Iran, a two-credit course has been proposed for implementation across the country.

Internationalization of medical education in Iran: a way towards implementation of the plans of development and innovation in medical education

Introduction: academic institutions are the most important organizations for implementation of internationalization policies and practices for integrating an international, intercultural and global dimension in higher education system. Also, a globally increasing demand for higher education has been seen in the past two decades so that the number of students enrolled in higher education institutions in the worldwide nation-states has increased dramatically. The National Plan of International Development of Medical Education was designed with the aim of identifying available potentials in all the universities of medical sciences, encouraging the development of international standards of medical education, and planning for the utilization of the existing capacity in Islamic republic of Iran

Methods: authors have tried to review the several aspects of international activities in higher education in the world and describe national experiences and main policies in globalization of medical education in Iran within implementation of the National Plan for Development and Innovation in Medical Education

Results: the findings of some global experiences provide the policy makers with clear directions in order to develop internationalization of higher education

Conclusion: the Program for International Development of Medical Education was designed by the Deputy of Education in the Ministry of Health and the effective implementation of this Program was so important for promotion of Iranian medical education. But there were some challenges in this regard; addressing them through inter-sectoral collaboration is one of the most important strategies for the development of internationalization of education in the field of medical sciences

relationship between dietary intakes of amino acids and bone mineral density among individuals with spinal cord injury

Objectives: The effect of dietary protein intake on bone mineral density [BMD] has not been explained in patients with spinal cord injury [SCI]. In this study, we looked at the relationship between BMD and higher protein intake in patients with SCI while controlling for possible confounders

Methods: Patients with SCI, who were referred to the Brain and Spinal Cord Injury Research Center between November 2010 and April 2012, were included in the study. In total, the dietary intakes of 103 patients were assessed by 24-hour dietary recall interviews. We used dual-energy X-ray absorptiometry to measure BMD in the femoral neck, trochanter, intertrochanteric zone, hip, and lumbar vertebras

Results: Eighty-six men and 17 women participated in this study. Protein intake was negatively associated with the BMD of lumbar vertebrae [p = 0.001, r = -0.37 for T-score and p = 0.030, r = -0.24 for Z-score]. The BMD of lumbar vertebrae were negatively associated with intake of tryptophan, isoleucine, lysine, cysteine, and tyrosine [p = 0.007, 0.005, 0.009, 0.008, and 0.008 for T-score, respectively]. Higher intakes of threonine, leucine, methionine, phenylalanine, valine, and histidine were related to a lower BMD of lumbar vertebrae [p = 0.006, 0.010, 0.009, 0.010, 0.009, and 0.008 respectively for T-scores]

Conclusions: We found that high protein intake led to a lower BMD of lumbar vertebrae in patients with SCI after controlling for confounders including demographic and injury-related characteristics and calcium intake. No relationship between higher amino acids intake and BMD of the femur and hip was detected. Intake of alanine, arginine, and aspartic acid were not related to BMD

Ramadan major nutrient patterns are associated with anthropometric measurements and physical activity in Tehran, Iran

During Ramadan fasting quantity and quality of dietary intake may change. There was no data on nutrient patterns in Ramadan fasting. The purpose of this study was to identify Ramadan major nutrient patterns among those who fast in Tehran, Iran. 510 fasting people aged 18-65 years and BMI 18.5-40 Kg/m2 were recruited in our study by 2-stage cluster sampling method in June-July 2014. Data on the socio-demographic and physical activity level were collected by questionnaire. Usual diet during Ramadan was estimated by valid and reliable food frequency questionnaire. BMI was calculated based on measured height and weight. Three nutrient patterns derived by conducting principal component factor analysis on 30 major nutrients. Micronutrient and fiber pattern which characterized by high intake of vitamin K, total fiber, iron, manganese, magnesium, beta-carotene, folate, vitamin B12, potassium and calcium was adversely associated with weight [b=-0.16, P= 0.004]. High protein pattern had great loadings on protein, riboflavin, phosphorous and zinc which physical activity level was decreased by tertiles of this pattern [b=0.13, P=0.02]. High carbohydrate pattern which presented high positive loadings on carbohydrate and thiamin and negative loading on total fat, poly unsaturated fatty acids and monounsaturated fatty acids was positively associated with BMI [b= 0.12, P=0.03]. Adherence to different Ramadan nutrient patterns is associated with weight, BMI and physical activity level. People on high carbohydrate pattern may have a higher BMI and low micronutrient density diet that should be considered in Ramadan fasting nutrition educational programs

Altered suppressor function of regulatoryT cells in type 1 diabetes

Background: Type 1 diabetes [T1D] is a T cell mediated autoimmune disease targetingthe insulin-producing beta cells within pancreatic islets. Autoimmune diseases maydevelop as a consequence of altered balance between regulatory [Tregs] andautoreactive T cells

Objectives: To evaluate Treg cells frequency and suppressivefunction in the peripheral blood of newly diagnosed T1D patients in comparison withhealthy controls

Methods: Fifteen new cases of T1D patients and 15 age- and sexmatchedhealthy controls were recruited to this study. Their peripheral bloodmononuclear cells [PBMCs] were isolated and CD4[+]CD25[+]FoxP3[+]CD127[-/low] Treg cellswere studied by flowcytometry technique. Thereafter, Tregs were isolated by Magnetic-Activated Cell Separation [MACS] technology and by using CFSE [carboxyfluoresceinsuccinimidyl ester] dilution assay, their suppressive activity was evaluated in thecoculture of CD4[+]CD25[-] T responder cells with Treg cells

Results: The percentage ofCD4[+]CD25[+]FoxP3[+]CD127[-/low] Tregs did not differ between T1D patients and healthycontrols but the MFI [mean fluorescence intensity] of transcription factor FoxP3[forkhead box protein P3] was significantly decreased in T1D patients [20.03 +/- 1.4 vs.31.33 +/- 2.95, p=0.0017]. Moreover, the suppressive function of CD4[+]CD25[+]CD127[-/low]Treg cells was significantly diminished in T1D patients in comparison with controlgroup [35.16 +/- 4.93% vs. 60.45 +/- 5.26%, respectively, p=0.0015]

Conclusion: Presentstudy indicates an impaired immune regulation among T1D patients, characterized bydefects in suppressive function and expression of FoxP3 in Treg cells without anysignificant decrease in their frequency in peripheral blood

Misconceptions and negative attitudes towards the metabolic effects of Ramadan fasting, resulting in fasting avoidance

The aim of this study was to assess public knowledge about the effects of Ramadan fasting on various aspects of health and its association with fasting decision-making. This cross-sectional study was conducted on 600 subjects. The association between fasting and participants' knowledge and attitudes toward Ramadan fasting, anthropometric measurements, physical activity, depression, anxiety, stress, dietary intake, and prior history of diseases was evaluated. The results indicated an adverse correlation between negative attitudes towards the effects of Ramadan fasting and adherence to fasting [P<0.0001]. The prevalence of gastrointestinal disorders was higher in the non-fasting group [P=0.002]. No significant association was found between other investigated variables and fasting adherence. It seems that negative thinking about the effects of Ramadan fasting may be inversely associated with fasting decision-making. Therefore, evidence-based educational programs may improve public knowledge and encourage fasting among eligible people

relation between serum vitamin D levels and blood pressure: a population-based study

Vitamin D deficiency has been proposed as an associating factor with increased blood pressure. We studied the relationship between serum vitamin D and blood pressure in a large representative sample of Iranian population. In this cross-sectional study, based on the data of 2508 adults [aged between 20 and 70 years] from the Iran Multicenter Osteoporosis Study [IMOS], the association between serum vitamin D and blood pressure was investigated. There was a significant difference between mean [ +/- SD] vitamin D levels of the individuals with stage I hypertension and that of the three other groups [Normal: 32.9 [ +/- 27.5]; Prehypertension: 34.4 [ +/- 27.2]; Stage-I: 38.7 [ +/- 29.2]; Stage-II: 34.7 [ +/- 24.0] ng/ml; P<0.05. In multivariate regression models, the weak positive association of vitamin D and systolic blood pressure values disappeared after age and Body Mass Index [BMI] adjustment. We found a statistically positive but weak association between vitamin D serum concentration and systolic blood pressure. Considering the difference noted between our results and previous studies, further research is needed to assess the potential effect of ethnicity and genetic factors on these findings

effect of gamma irradiation on the osteoinductivity of demineralized human bone allograft

The gamma irradiation has been used for end sterilization of allograft bones and its effects with a 25 kGy dosage on the osteoinductive properties of demineralized bone allograft powder was studied. This work carried out using an experimental method in an animal model. In this study the demineralized bone allograft powder which had been sterilized and prepared with gamma irradiation in a 25 kGy dosage in 18 hours, was used as a study group and the demineralized bone allograft powder which had been prepared aseptically was used as the reference group. 30 mg of bone powder from each group were implanted into right and left paravertebral muscles of eighteen rats, separately. After four weeks, the implanted samples were harvested with a 0.5 cm border and then the osteoinductivity of implants in two groups were compared with histopathologic studies. In 94.4% of the reference samples a new bone formation was observed. In the study group, this difference was observed only in 27.7% of samples [P<0.002]. It appears that using gamma irradiation may lead to a reduction in osteoinduction properties of demineralized bone allograft powder

Prevalence of dyslipidemia in Iran: a systematic review and meta-analysis study

More than 80% cardiovascular disease [CVD] is preventable despite the fact that it is currently the ultimate cause of disability in the world. Assessment of the nationwide prevalence of dyslipidemia as a major CVD risk factor is essential to efficiently conduct prevention programs. We extracted data according to the cut-off points of dyslipidemia used in each study. All published papers on this topic in Iranian and international journals with affiliation of [Iran] were reviewed using standard keywords up to September 2011. We included all available population-based studies and national surveys conducted in individuals aged > 15 years. We excluded studies with < 300 individuals, non-population-based studies, or duplicated citations. We analyzed by random effect method due to between-study heterogeneity. The estimated prevalence and 95% confidence intervals in 29 eligible articles and one un-published data for hypercholesterolemia [>/= 200 mg/dl], hypertriglyceridemia [>/= 150 mg/dl], high levels of low density lipoprotein cholesterol [[LDL-C] [>/= 130 mg/dl]] and low levels of high density lipoprotein cholesterol [[HDL-C] <40 mg/dl in males, <50 mg/dl in females], in Iranian people were 41.6% [36.1-47.0], 46.0% [43.3-48.7], 35.5% [24.0-47.1] and 43.9% [33.4-54.4], respectively among both sexes and in both rural and urban areas. Hypercholesterolemia, high LDL-C and low HDL-C were more prevalent in women, whereas hypertriglyceridemia was more prevalent in men. All types of lipid component abnormalities were more prevalent in urban residents. Prevalence of dyslipidemia is considerable in Iran. It is necessary to enforce current measures of dyslipidemia control in the Iranian people to reduce CVD burden

Psychometric evaluation of the Persian version of the [aging male scales] questionnaire

Men, much like women, are faced with age-related menopause-like symptoms as they age. In recent years, increasing attention has been drawn to clinical research into elderly men and their health-related quality of life. The Aging Male Scales [AMS] questionnaire is an international tool for assessing the health-related quality of life in elderly men. Hence far this questionnaire has not been subjected to psychometric assessment in Iran. This study aims to evaluate the validity and reliability of the Persian version of the AMS questionnaire specific to the health of elderly men in Iran. To validate this instrument, a cross-sectional study was conducted on 521 healthy Iranian men aged 40-65 years old, who attended the blood transfusion center clinic between February 2011 and June 2012. The English version of the AMS questionnaire was translated to Persian and then back-translated. To determine the reliability of the AMS questionnaire, internal consistency was evaluated and test-retest was done. The questionnaire was validated using convergent and structural validity methods. To assess the factor structure of the questionnaire, a correlation matrix of questions and domains was used. Cronbach's alpha was higher than 0.7 [0.73-0.88] in all domains. A Pearson's correlation coefficient of 0.87 between pretest and posttest indicated a high correlation and an acceptable reliability. The convergent validity of the questionnaire was found acceptable by calculating the correlation between the domains and items-total correlation ranging 0.40-0.85, except for question 14 that had a 0.28 correlation with the whole test. The criterion-related validity of the questionnaire in the psychological domain was confirmed with the [two-item Patient Health Questionnaire] [r= 0.63, P < 0.001]. According to the results, the Persian version of the AMS questionnaire has high validity and reliability and may be used to assess the health-related quality of life of men between 40 and 65 years old

Developing a clinical diabetes guideline in diabetes research network in Iran

Development of evidence-based clinical guidelines to raising standards of medical care in diabetes is a core element of coping with the global diabetes epidemic. The purpose of this study was to develop a systematic clinical diabetes guideline from the latest scientific evidences and also to localize its recommendations according to regional and cultural needs of our society. Searches were conducted using NICE, SIGN, WDPCP, IDF, JDC, ADA, AACE, ICSI, CDA, AMDA, IDC, NyDoH guidelines which were examined and criticized and scored using Agree method. Guidelines which got higher score in some important areas of Agree scale including: rigor of development, clarity and comprehensiveness of the recommendations and applicability, especially in the climatic conditions of our country were selected. The existing recommendations were extracted by committee members and supporting evidences of each recommendation were determined based on the sources listed in the clinical guideline. Recommendations grading were classified from grade A to D based on the quality of their supporting evidences [BEL1-5]. This guideline covered all areas related to diabetes including screening and diagnosis, lifestyle modification and patient education, management, complications and hypoglycemia. Regarding capacities of this guideline and lack of comprehensive and updated guidelines in our country and region, it is suggested that designing a pilot study to implement this Learner-centered guideline and finding its weaknesses can lead to patient care improvement and also propel us towards our goal to design a comprehensive guideline in compliance with regional and national needs in Middle East

Patient's rights charter in Iran

Given the importance of patient's rights in healthcare, special attention has been given to the concept of patient's rights by the Ministry of Health and Medical Education in Iran. Iranian patient's rights charter has been compiled with a novel and comprehensive approach. This charter aims to elucidate rights of recipients of health services as well as observing ethical standards in medicine. This paper presents the Iranian patient's rights charter. Based on a study done from 2007 to 2009, the charter has been finalized through an extensive consultation involving all stakeholders, patients, physicians, nurses, lawyers, patient associations and health policy makers. The developed charter was adopted by the Ministry of Health in December 2009. Iranian patient's rights charter has been formulated in the framework of 5 chapters and 37 articles including vision and an explanatory note. The five chapters concern right to receiving appropriate services, right to access desired and enough information, right to choose and decide freely about receiving healthcare, right to privacy and confidentiality, and finally right to access an efficient system of dealing with complaints which have been explained in 14, 9, 7, 4 and 3 articles, respectively. The paper concludes that, adopting the patient's rights charter is a valuable measure to meet patient's rights; however, a serious challenge is how to implement and acculturate observing patient's rights in practice in our healthcare system in Iran

Ethical issues in the end of life care for cancer patients in Iran

In the recent years, advances in medical technologies for end stage cancer patients' care have affected the end-of-life decision-making in clinical practice and exposed oncologists to serious ethical dilemmas. But little is known about oncologists' viewpoints in our country regarding their ethical problems in this mention. We aimed to clarify the ethical dilemmas which Iranian oncologists may face in our health care setting and to determine factors influencing decision-making process. In this qualitative study, a phenomenological approach was used. We interviewed 8 cancer specialists in teaching hospitals in Iran and used content analysis to identify codes and categorize themes in the data. During the process of analysis, three main themes emerged about ethical dilemmas in end of life care for advanced cancer patients: illness factors, socio-cultural context and patient-physician relationship. Cancer specialists identified ethical problems on several main issues, the most important of which were telling the truth in Iranian cultural context, uncertainty in end stage definition, multidisciplinary team working and cost consideration in Iranian health care system. Health care and insurance system in Iran face to end of life care challenges; therefore, health care providers and policy makers need to allocate appropriate resources and programs to improve quality of care in terminal stages. Appropriate physicians' communication skills training, multidisciplinary team working and supplementary insurance services that provide essential health care can improve the quality of care of patients with end stages of cancer. the findings of this study can help us to provide ethical policies for decision-making in end-of-life care

Association of vitamin D receptor with longevity and healthy aging

Longevity is a multifaceted trait in which variety of genes and environmental factors are involved. Newly, the role of vitamin D has been revived regarding its potential advantage on delaying the aging process. Vitamin D exerts its effect through vitamin D receptor [VDR]. VDR-FokI is the only polymorphism which alters the VDR length. We examined the frequency of FokI genotypes in old age population as compared to young adults to determine the discerning genotype of FokI polymorphism leading to longer living. In addition, to highlight the position of FokI polymorphism in quality of life; a cognitive function assessment was performed. 728 participants participated in this study of which 166 individuals were elderly residents of Kahrizak Charity Foundation. The rest were participants of Iranian Multicenter Osteoporosis Study [IMOS]. Genomic DNA was extracted from peripheral blood and VDR genotype was detected by the polymerase chain reaction. The participants in the elderly group underwent a cognitive function assessment. Cognitive function was measured with the mini mental state examination [MMSE]. Data were analyzed by SPSS 16.5. The prevalence of ff genotype showed 48% decrease in elderly population as compared to young adults [P=0.06]. In addition, F allele was over-represented in the elderly group as compared to controls [P=0.05]. Also, "FF" participants of elderly group had higher MMSE as compared to "ff" genotype [18.16Vs17.12]. Our data suggest that single nucleotide polymorphisms [SNPs] in FokI may be possibly involved in longevity and cognitive function

Changes of bone density in pediatric patients with beta-thalassemia major after allogenic hematopoietic stem cell transplantation

Thalassemia major and its treatment by stem cell transplantation can have deleterious effects on bone integrity. This study assesses the adverse effects of transplantation on growing bones of pediatric thalassemic patients. Bone mineral density [BMD] of 20 patients from three thalassemia classes whose mean [SD] age was 7.4 [3.8] years were tested with a Norland XR-46 device at baseline [before transplantation], 6 and 12 months after transplantation. At 6 and 12 months after transplantation we observed no significant changes in mean BMD. There were no Z-scores less than -2 among patients. Class 3 thalassemia did not negatively impact BMD. Calcium [Ca], phosphorous [P] and ferritin levels were not significantly related to patients' BMD scores. Transfusion duration and chelation therapy showed positive significant relationships to BMD [g/ cm2], but no significant relation with the BMD Z-score. The deleterious relation between corticosteroid use and changes in BMD was not significant. In contrast, patients who developed acute graft versus host disease [aGVHD] after transplantation showed significant adverse effects on BMD of their femur [P = 0.020] and spine [P = 0.027]. Stem cell transplantation in pediatric thalassemic patients who do not develop aGVHD does not appear to have any significant positive or negative effects on BMD

Retrograde trans-femoral approach for successful percutaneous angioplasty in a diabetic patient with ischemic hand ulcer: a case report

Hand ischemia is a rare complication of diabetes and some other chronic vascular diseases. Critical hand ischemia causes painful limbs and disability and requires urgent revascularization. There have been a few reports of successful trans-brachial percutaneous angioplasty in the upper extremity in the radial or ulnar artery. Herein, we report the results of the endovascular treatment of a 68-year-old diabetic patient with an ischemic hand ulcer due to the severe stenotic lesions of the infra-brachial arteries. The patient underwent successful angioplasty via the retrograde trans-femoral technique to avoid the drawbacks. At the first week of post-procedural follow-up, the patient's finger was warm with a well-healing wound and reduced pain. In the next two months, he had no complaint of pain or active ulceration; the ulcer was well healed, and the hand was warm. The present case shows that history taking and physical examination should be followed by upper-extremity arteriography for the evaluation of hand ischemia. The trans-femoral approach enabled us to perform percutaneous catheterization for both diagnostic and interventional purposes. Not only is this strategy useful even for the severe stenotic disease of the distal parts of below-the-elbow arteries but also it avoids the unpleasant complications of antegrade brachial cannulation

[Ramadan fasting and diabetes]

Objective [s]: The effect of Ramadan fasting on diabetes control is not clear yet. Some lifestyle changes like changes in drug dose and time, sleep wake cycle, physical activity and diet occur in Ramadan and can lead to metabolic imbalances. As such some studies have shown increased risk of hyperglycemia and hypoglycemia. So, it is necessary to make decision based on scientific evidences about safety and allowing fasting in a wide variety of patients on different stages of metabolic control. Moreover, appropriate changes in drug prescription should be recognized and used. In this review the results of various studies regarding the effects of Ramadan fasting on metabolic control of type 1 and 2 diabetes mellitus have been summarized and provided

Method: Keywords including "Ramadan", "Ramadan Fasting", "Islamic Fasting", Fasting in Ramadan ", Calorie Restriction, Fasting and Starvation with words Diabetes Mellitus, Hyperglycemia, Hypoglycemia, Ketoacidosis, Glucose were searched via PubMed, SID [Scientific Information Database], and some regional journals and all articles [descriptive cross - sectional, cohort, clinical trial and review articles] from 1957 to 2010. The relevant articles were reviewed

Results: In all 86 papers were included in this review. In diabetic patients safety of Ramadan fasting is defined as blood glucose in normal range. In type 2 diabetics with no chronic complication and able to self care, with proper training, planning the time and dose of drug, controlling of diet and physical activity and regular monitoring of blood glucose, fasting is allowed. In type 1 diabetics or insulin users, fasting should be allowed with caution, because, they are more at risk of hypoglycemia

Conclusion: Diabetic patients who wish to fast in Ramadan need to care about time, type and dose of their medications

Does three months genistein and daidzein in the form of soy protein supplementation have any effects on bone formation markers after menopause?

Postmenopausal osteoporosis is caused by a sharp decrease in estrogen levels leading to an increased rate of bone remodeling. Dietary supplements are preferred as alternative therapeutic options for many women instead of estrogen therapy. These alternative therapies include the use of natural substances such as soy isoflavones due to their weak estrogenic activity and affinity for estrogen receptors.Present study was carried out as a "before and after clinical trial" on 25 postmenopausal women aged 45-64 years. Soy protein at 35g level containing 98.3mg isoflavones [containing 47.2 genistein and 37.8 daidzein] were given to subjects daily for 12 weeks. Blood and urine samplings were done in 3 stages, in the beginning and at the end of 6th and 12th week. Repeated measurement analysis was employed to analyze any possible changes in food intake and biochemical variables in 3 stages. The level of significance was set at below 5 percent [P<0.05]. Mean body mass index and physical activity level had no change and mean daily intake of macronutrients and important micronutrients were not different at 6 and 12 weeks compared to the start of the study The results showed a total serum alkaline phosphatase [TALP] significant increase while the other bone formation indicators namely osteocalcin and insulin growth factor binding protein [IGFBP3] did not change significantly. These data suggest that soy protein or its isoflavones may increase bone formation by supplementation

Goiter Frequency Is More Strongly Associated with Gastric Adenocarcinoma than Urine Iodine Level

PURPOSE: We designed our study to evaluate the hypothesis that gastric cancer is correlated with iodine deficiency or thyroid dysfunction. MATERIALS AND METHODS: We investigated the total body iodine reserve, thyroid function status and autoimmune disorder in 40 recently diagnosed gastric adenocarcinoma cases versus 80 healthy controls. The participants came from a region with high gastric cancer rate but sufficient iodine supply due to salt iodination. The investigation included urine iodine level, thyroid gland clinical and ultrasonographic examination, and thyroid function tests. RESULTS: Goiter was detected more frequently in the case group (P=0.001); such a finding, however, was not true for lower than normal urine iodine levels. The free T3 mean level was significantly lower in the case group compared to the control group (P=0.005). CONCLUSIONS: The higher prevalence of goiter rather than low levels of urinary iodine in gastric adenocarcinoma cases suggests that goiter, perhaps due to protracted but currently adjusted iodine deficiency, is more likely to be associated with gastric adenocarcinoma compared to the existing iodine deficiency itself.