Is Stress Hyperglycemia a Predicting Factor of Developing Diabetes in Future?

OBJECTIVE: Stress hyperglycemia is a transient increase in blood glucose during an acute physiological stress in the absence of diabetes. Stress hyperglycemia can be occurred in certain clinical conditions such as trauma, burns, sepsis and strokes in adults. In this study we aimed to evaluate the incidence of stress hyperglycemia among patients admitted to the Firouzgar hospital. METHOD: In this analytical cross sectional study, all patients who referred to emergency department of Firouzgar hospital due to one of the causes of trauma, myocardial infarction (MI), subarachnoid hemorrhage (SAH), head trauma, sepsis, CVA, and abdominal surgery and had stress hyperglycemia during 2012-2014 were evaluated. Blood glucose test including random blood sugar (BS) and glycosylated hemoglobin (HbA1C) was performed for patients at admission. Patients with BS>180 mgmg/dl and no previous history of diabetes were enrolled in this study. Patients were referred to endocrinology clinic after 3 months of the first test and were re-evaluated for diabetes mellitus. Fasting Blood Sugar (FBS), HbA1C and 2 h post glucose load test blood sugar were measured. Diabetes was confirmed if FBS was above 126 mg/dl or 2 h post glucose load BS was over 200 mg/dl. RESULT: A total of 98 (67 males & 31 women) patients enrolled in the study. No significant statistical relation found between mean of HBA1C at 3 months after admission and the background event (P=0.138). No statistical relation found between BMI and developing diabetes (P=0.352). 26 and 8 percent of the participants developed diabetes, and 25.8% were in pre-diabetic state. There was a statistical relation between gender and developing diabetes (P=0.027) and men developed diabetes more than women. Based on logistic regression the Odds Ratio (OR) was 1.017. CONCLUSION: Our study demonstrates a significant relationship between stress hyperglycemia and development of diabetes. Stress hyperglycemia could be a predicting factor of development of diabetes.

Candida infection in the intensive care unit: A study of antifungal susceptibility pattern of Candida species in Milad hospital, Tehran, Iran.

OBJECTIVE: The occurrence of Candida infections has improved during the past two decades as a result of increase in the number of immunocompromised patients. In this study the antifungal susceptibility patterns of Candida species isolated from sterile body sites of patients admitted in Milad Intensive Care Unit (ICU) during 6 months were determined. METHODS: Candidal isolates were obtained from 50 patients admitted in Milad ICUs from April to September 2013. Identification of the isolates was performed by using morphological and polymerase chain reaction assay. Resistance to the antifungal agents containing caspofungin, posoconazole, voriconazole and amphotericin B was determined using E-test method. RESULTS: Out of 67 Candida isolates 47.8% were Candida glabrata, 28.3% were C. albicans, 7.5% were C. tropicalis, 7% were C. guilliermondii, 3% were C. krusei and 2% were C. dubliniensis. C. glabrata was the least susceptible species, with 9.4% of the isolates resistant to amphotericin B and 6.3% resistant to posoconazole and voriconazole. No resistance to caspofungin was observed among C. glabrata isolates. One of the C. krusei isolates was resistant to amphotericin B while no resistance to voriconazole, caspofungin and posoconazole was detected among C. krusei strains. Increase in the prevalence of antifungal-resistant non-C. albicans species in recent years has become a problematic event amongst clinicians caring for ICU patients. C. glabrata as the most common species isolated from ICU patients in this study indicated higher levels of antifungal resistance in comparison with other species. This observation accentuates the importance of managing preventive treatments to avoid development of resistance to the current antifungal drugs.

Reliability and validity of Persian version of World Health Organization health and work performance questionnaire in Iranian health care workers.

BACKGROUND: The effect of health status on productivity has widely been studied and discussed in literature. Valid and reliable tools are needed to evaluate the levels of health and productivity and provide detailed information, before any intervention is implemented. World Health Organization Health and Work Performance Questionnaire (HPQ) is a widely used instrument in estimating the workplace costs of health problems in terms of reduced job performance, sickness absence, and work-related accidents and injuries. OBJECTIVE: To assess the reliability and validity of Persian version of HPQ in Iranian health care workers. METHODS: The questionnaire was translated to Persian and back translated. 102 health care workers completed the questionnaire. Absence and sick-leave data was extracted from administrative records. RESULTS: Factor analysis revealed acceptable validity for the questionnaire in part A (health). Cronbach's alpha was >0.73 for all scales of Parts B (work) and C (demographic). Questions targeting days of absence and sick-leave had acceptable correlation with administrative records (Pearson's r >0.75), while questions on total hours worked showed lower correlation. CONCLUSION: Persian version of HPQ can be considered a reliable and valid tool in Iranian health workers.

Contact lens disinfecting solutions antibacterial efficacy: comparison between clinical isolates and the standard ISO ATCC strains of Pseudomonas aeruginosa and Staphylococcus aureus.

PURPOSE: To evaluate the disinfectant properties of the three multipurpose contact lens disinfecting solutions available in Iran, against clinical isolates and the standard ISO ATCC strains of Pseudomonas aeruginosa and Staphylococcus aureus, based on the international organization for standardization (ISO) 14729 guidelines. METHODS: Three multipurpose solutions that were tested were ReNu Multiplus, Solo Care Aqua and All-Clean Soft. The test solutions were challenged with clinical isolates and the standard strains of P. aeruginosa(ATCC 9027) and S. aureus(ATCC 6538), based on the ISO Stand-alone procedure for disinfecting products. Solutions were sampled for surviving microorganisms at manufacturer's minimum recommended disinfection time. The number of viable organisms was determined and log reductions calculated. RESULTS: All of the three test solutions in this study provided a reduction greater than the required mean 3.0 logarithmic reduction against the recommended standard ATCC strains of P. aeruginosa and S. aureus. Antibacterial effectiveness of Solo Care Aqua and All-Clean Soft against clinical isolates of P. aeruginosa and S. aureus were acceptable based on ISO 14729 Stand-alone test. ReNu MultiPlus showed a minimum acceptable efficacy against the clinical isolate of S. aureus, but did not reduce the clinical isolate by the same amount. CONCLUSIONS: Although the contact lens disinfecting solutions meet/exceed the ISO 14729 Stand-alone primary acceptance criteria for standard strains of P. aeruginosa and S. aureus, their efficacy may be insufficient against clinical isolates of these organisms.

Comparison of dentine removal using V-taper and K-Flexofile instruments.

AIM: To compare the dentine removal ability of V-Taper and K-Flexofile instruments in mesiobuccal canals of extracted mandibular first molar teeth. METHODOLOGY: Preoperative images of 40 mesiobuccal canals of mandibular first molars (with a curvature between 20° and 35°) were obtained at 2, 4.5, and 7 mm from the root apices by CT-scan and divided into two groups. Group F was prepared with K-Flexofiles and Gates Glidden drills and Group V with V-Taper Ni-Ti rotary and stainless steel hand instruments. Post-instrumentation images were then obtained and compared with the preoperative images. The ratio of dentine removal based on pre- and postoperative images was calculated, and data was analysed by anova and Tukey post hoc test. RESULTS: In group F in the coronal sections, the least ratio of the dentine removal to the initial root thickness was on the buccal aspect (15.14% ± 6.72), and the greatest ratio was found on the distolingual (29.38% ± 8.19). In group V in the coronal, the least ratio of the dentine removal to the initial root thickness was on the buccal aspect (9.81% ± 3.26); the greatest ratio was found on the distolingual surface in the coronal sections (34.38% ± 10.51). In the middle sections, the least ratio was on the buccal (10.51% ± 3.39) and the greatest on the distolingual aspects (27.46% ± 12.34) of the roots. In the apical sections, the amount of the dentine removed from the mesial and distal surfaces in group V was significantly more than group F (P < 0.01). CONCLUSION: The distolingual aspect of the root canal is a danger zone for the mesiobuccal canal of the mesial root in mandibular molar teeth, and preparation of that area should be performed with caution. Except the apical part of the canal, no significant difference was found between the two preparation files or techniques used. Apart from the apical part of the canal, neither instrument maintained the original shape of the coronal and middle parts of the canal.

Iron status in female athletes participating in team ball-sports.

Iron deficiency anemia is the most prevalent micronutrient deficiency in the world, affecting 20-50% of the world's population. It is estimated that 10 and 20% of male and female athletes are iron deficient, respectively. Iron deficiency has deleterious effects on the physical performance of athletes. It decreases aerobic capacity, increases heart rate and elongates the recovery time after exercise. In this cross-sectional study, 42 semi-professional female athletes who had been playing in basketball, volleyball and handball super league teams served as subjects. Data on socioeconomic and fertility status as well as the type of sport were obtained through a questionnaire. Nutritional data were gathered with a 3 day dietary recall. Total intake of calorie, iron, zinc, folate, vitamin C and B12 were also analyzed. In addition, ferritin and TIBC were measured and a CBC test was done for each subject. The results showed that the mean total calorie intake of women was 2049.79 +/- 735.12 kcal, where their iron intake was 22.33 +/- 9.24 mg day(-1). There was a significant difference between the iron intake of basketball and volleyball players (p = 0.036). Of our subjects, 33.33% had low ferritin levels (< 30 ng mL(-1)) and it was lowest in handball players. Higher than normal ferritin levels were seen in 12.5% of the subjects. We saw a significant difference in ferritin levels of basketball and handball players (p = 0.047). We conclude that the intake of calorie and iron is low in female athletes and therefore, their hematological indices such as ferritin level are below standard values.

Prevalence of helminth ova in soil samples from public places in Shiraz.

To determine the prevalence of helminth eggs in public places and children's playgrounds, 112 soil samples were collected in 26 sites in Shiraz, southern Islamic Republic of Iran, during September 2002-September 2003. Toxocara cati ova were found in 7 (6.3%) samples, 2 had Ascaris lumbricoides ova, 3 had larvae morphologically similar to Strongyloides stercoralis. Coccidia oocysts were also observed in 4 samples. No contamination was observed during the dry season.