Review of the role of cigarette smoking in diabetic foot.

Diabetic foot ulceration has been a serious issue over the past decades in Asia, causing economic and social problems. Therefore, it is important to identify and reduce the risk factors of diabetic foot. Cigarette smoking has been reported to be associated with diabetes and its macrovascular complications, but the relationship between smoking and diabetic foot ulcers is still unclear. In the present review, we summarize the effects of cigarette smoking on diabetic foot ulcers with respect to peripheral neuropathy, vascular alterations and wound healing. One underlying mechanism of these impacts might be the smoking-induced oxidative stress inside the cells. At the end of this review, the current mainstream therapies for smoking cessation are also outlined. We believe that it is urgent for all diabetic patients to quit smoking so as to reduce their chances of developing foot ulcers and to improve the prognosis of diabetic foot ulcers.

Growth Status and Its Relationship with Serum Lipids and Albumin in Children with Cystic Fibrosis.

Cystic fibrosis (CF) is an autosomal recessive disease, which affects many organs as it impairs chloride channel. This study was performed to evaluate growth status and its relationship with some laboratory indices such as Cholesterol (chol), Triglyceride (TG), albumin and total protein in children with CF referred to pediatrics center. This study was designed as a cross-sectional study in one year section. Demographic features were compared with standard percentiles curves. Chol, TG, albumin, total protein, prothrombin time, and hemoglobin were measured. Stool exams were also performed. A questionnaire was designed to obtain a history of the first presentation of disease, birth weight, type of labor and parent relativity. In 52% of patients, failure to thrive (FTT) was the first presentation. Steatorrhea and respiratory infections were the first presentations, which were seen in 13.7% and 33% of the cases, respectively. The weight of 88% of patients was below the 15th percentile while 82% had a height percentile below 15th. Head circumference in 53% of patients was below the 15th percentile. There was a significant association between weight percentile and serum albumin and total protein (P=0.03 and P=0.007, respectively). There was also a significant relationship between height percentile and serum albumin and total protein (P<0.001 and P<0.000, respectively). The relationships between head circumference and serum albumin and total protein were also significant (P=0.006 and P<0.000, respectively). There was also a significant association between height percentile and hemoglobin. The decrease in anthropometric percentiles leads to decreased serum albumin and total protein.

Changes in leukocyte subpopulations with decline in glomerular filtration rate in patients with type 2 diabetes.

Recent studies suggested the role of white blood cells (WBCs) in the pathogenesis and complications of type 2 diabetes. Increased WBC counts predict mortality in patients with chronic kidney disease (CKD). In this study alterations in WBC subpopulations in diabetic patients with non-dialysis dependent CKD are investigated. This was a cross-sectional study  on 376 participants, including   272 diabetic  patients  and  104  healthy  controls.  Total  and  differential  WBC  counts  were  compared  among diabetics with CKD, diabetics without CKD and controls. Among patients with type 2 diabetes, there was no significant difference in total WBC count between those with and without CKD. Diabetic patients with CKD had higher neutrophil, monocyte and eosinophil and lower lymphocyte count compared with both diabetic patients without CKD and healthy controls. Except for monocytes, a significant association was observed between GFR and differential WBC counts, which persisted after adjustment for conventional diabetes riskfactors (R2=0.272, P < 0.001 for regression model). Neutrophil/lymphocyte ratio was the best predictor ofGFR in total study population (beta= -1.995 ± 0.45, P<0.001). Changes in WBC subpopulations are present even before significant alterations in total WBC count. Immune system dysfunction needs special consideration in diabetic patients with CKD.

Evaluation of some psychological factors in psoriatic patients.

BACKGROUND: Psoriasis is a disease which may have a direct impact on the psychological and social aspects of the patient, particularly due to its visibility. To date, we are unaware of any study showing a relationship between psoriasis and psychological parameters such as psychological vulnerability and coping strategies. OBJECTIVE: The aim of this study was to evaluate the effects of psoriasis on some psychological parameters in an Iranian population. METHODS: Patients having histopathologically confirmed psoriasis for at least 6 months attending the Dermatology Clinic of Razi Hospital were included if they agreed to participate in the study. Patients with history of schizophrenia, major depression or other psychological disorders were excluded. All patients were at least 18 years old. The patients were then referred to the researchers for filling out the appropriate questionnaires under the guidance of an involved psychologist. To evaluate skin involvement, Psoriasis Area Severity Index (PASI) score was calculated and used for all patients. All data were stored in files for further analysis. RESULTS: There were 101 females and 99 males with the mean age of 43.2(±16.32). The mean PASI Score was 6.58 ± 6.04. Diffuse skin involvement was the commonest form of disease (133 patients, 66.5%). The highest score for Illness perception belonged to those with genitalia involvement (185.2, worst illness perception), and the lowest score for Illness perception belonged to those with nail involvement (168.2). Consistently, the lowest score of facing the problems (CISS: approach strategy to disease) belonged to those with hand involvement (50.5) whereas the highest score belonged to those with genitalia involvement (60.4). There was a significant correlation between psychological vulnerability vs. Illness perception score as well as psychological vulnerability vs. coping strategies score. Surprisingly, PASI score had an insignificant relationship with illness perception, coping strategies or psychological vulnerability score. CONCLUSION: PASI score as a representing factor of skin involvement has a limited role in predicting the effect of psoriasis on mental status and illness perception of psoriatic patients. Psychological vulnerability of the patients is the main predicting factor of illness perception and coping strategies (representing patients approach to their disease or their treatment beliefs).

Evaluating Necessity of Azygos Vein Ligation in Primary Repair of Esophageal Atresia.

Surgery has dramatically improved survival of infants with esophageal atresia. However, early and late complications of these surgeries affect the future life of this population. A probable step toward minimizing such complications is through modifying the technique of surgery. We evaluated two groups of esophageal atresia undergoing surgery with two different techniques including preservation and ligation of the Azygos vein and compared early complications, duration of surgery, and hospital and neonatal intensive care unit (NICU) stay between them. A total number of 24 patients with mean age of 24 to 48 h, who were diagnosed with esophageal atresia, were included in the study. All cases were randomly allocated in two groups: group A (case group) in which patients underwent surgery with preservation of the Azygos vein and group B (control group) in which patients underwent the former surgical method with ligation of the Azygos vein. Incidence of early complications, duration of surgery, and NICU and hospital stay were compared between the two groups. None of the complications occurred in either group. Duration of surgery, NICU stay, and hospital stay were not statistically significant between the groups. Preserving the Azygos vein during esophageal atresia surgery is probably a good modification of the classic technique.

Metabolic syndrome in premenopausal and postmenopausal women with type 2 diabetes: loss of protective effects of premenopausal status.

BACKGROUND: Diabetes is probably responsible for worsening of metabolic syndrome (MetS)components. The aim of the present study was to compare the components of MetS between premenopausal and postmenopausal women with type 2 diabetes (T2DM). METHOD: In this cross sectional study, we studied 639 women with T2DM that were divided in pre-menopausal (n = 221) and post-menopausal (n = 418) group. They were selected from participants of a diabetes clinic and assessed for MetS and its components. All MetS components were evaluated to follow age and duration of diabetes adjusted according to the ATP III criteria. RESULTS: The mean ages of pre-menopausal and post-menopausal were 43.33 ± 0.47 and 60.35 ± 0.38 years, respectively. MetS was defined for 88.3% of total subjects (87.5% and 87.7% in pre-menopausal and post-menopausal women with T2DM respectively). Systolic blood pressure (SBP) and waist circumference (WC) were significantly higher in post-menopausal women with T2DM in comparison with pre-menopausal ones. There were no significant differences in triglyceride (T.G) level, diastolic blood pressure (DBP) and high density lipoprotein cholesterol (HDL-C) between the two groups. Myocardial infarction (MI) occurred in 1% total subjects (1.3% and 1.8%) in pre-menopausal and post-menopausal women with T2DM, respectively (p = 0.21). CONCLUSION: Worsening of MetS and its components except for SBP and waist circumference has been shown in pre-menopausal women with T2DM similar to post-menopausal ones. The observed differences may be explained by increasing age. With respect to increasing of myocardial infarction in premenopausal subjects, we suggest that diabetes can abolish the protective effects of premenopausal status for MetS and MI.

Manual or automated sphygmomanometer? A historical cohort to quantify measurement bias in blood pressure recording.

The authors aimed to quantify end-digit and threshold biases in blood pressure (BP) measurement with manual and digital sphygmomanometers. In a 3-year follow-up, end-digit and threshold biases were investigated and a new index, called the deviation index, was used to quantify measurement bias. The distribution of systolic and diastolic BPs became close to normal after implementation of digital sphygmomanometers. The appearance of zero end digits decreased from 97% to 30% (P<.0001). The deviation index decreased from 97% to 20% (P<.0001). Mean systolic and diastolic BPs increased immediately after implementation of automated sphygmomanometers (124.22±0.83 vs 132.90±0.78 and 74.38±0.50 vs 80.43±0.51, respectively; P<.0001 for both) but showed a linear decreasing trend during follow-up (systolic -3.59 mm Hg per year; 95% confidence interval, -5.57 to -1.61 [P<.0001]; diastolic: -2.52 mm Hg per year; 95% confidence interval, -3.78 to -1.26 [P<.0001]). Threshold bias decreased from 12.94% to 6.68% (P<.0001). Replacing manual sphygmomanometers with digital devices decreased end-digit and threshold biases in BP measurement. The deviation index can be used to quantify the magnitude of measurement bias.

The degree of resistance of erythrocyte membrane cytoskeletal proteins to supra-physiologic concentrations of calcium: an in vitro study.

Calcium is a key regulator of cell dynamics. Dysregulation of its cytosolic concentration is implicated in the pathophysiology of several diseases. This study aimed to assess the effects of calcium on the network of membrane cytoskeletal proteins. Erythrocyte membranes were obtained from eight healthy donors and incubated with 250 µM and 1.25 mM calcium solutions. Membrane cytoskeletal proteins were quantified using SDS-PAGE at baseline and after 3 and 5 days of incubation. Supra-physiologic concentrations of calcium (1.25 mM) induced a significant proteolysis in membrane cytoskeletal proteins, compared with magnesium (p < 0.001). Actin exhibited the highest sensitivity to calcium-induced proteolysis (6.8 ± 0.3 vs. 5.3 ± 0.6, p < 0.001), while spectrin (39.9 ± 1.0 vs. 40.3 ± 2.0, p = 0.393) and band-6 (6.3 ± 0.3 vs. 6.8 ± 0.8, p = 0.191) were more resistant to proteolysis after incubation with calcium in the range of endoplasmic reticulum concentrations (250 µM). Aggregation of membrane cytoskeletal proteins was determined after centrifugation and was significantly higher after incubation with calcium ions compared with control, EDTA and magnesium solutions (p < 0.001). In a supra-physiologic range of 1.25-10 mM of calcium ions, there was a nearly perfect linear relationship between calcium concentration and aggregation of erythrocyte membrane cytoskeletal proteins (R(2) = 0.971, p < 0.001). Our observation suggests a strong interaction between calcium ions and membrane cytoskeletal network. Cumulative effects of disrupted calcium homeostasis on cytoskeletal proteins need to be further investigated at extended periods of time in disease states.

Study of cytomegalovirus infection in idiopathic infertility men referred to Shariati hospital, Tehran, Iran.

BACKGROUND: Cytomegalovirus (CMV) is a prevalent infection in humans. Recent studies have shown the role of CMV infection in male infertility disorder. AIM: Here we aimed to study the role of CMV infection in men with idiopathic infertility. MATERIALS AND METHODS: We performed a case-control study of CMV serology in 200 patients attending male infertility clinic of a university hospital. There were 154 men diagnosed with infertility and 46 men without infertility. The patients were asked to donate their sperm, blood, and urine. The presence of CMV infection was studied using quantitative polymerase chain reaction. RESULTS: CMV infection was present in 25 of all the studied participants. Controls had a higher sperm count and sperm motility and sperm morphology compared to patients. There were no significant differences in the studied variables between those with and without CMV infection, nor in patients, neither in controls. Sperm morphology was negatively correlated with cigarette smoking (r=-0.15; p<0.03). Even though the prevalence of CMV infection was higher in patients with infertility in control and patient (5/46 vs. 20/154) respectively, this was not statistically significant. CONCLUSION: We did not show a significant role for CMV infection in male infertility. Based on the previous studies, it could be assumed that CMV infection is an important part of the male infertility and its treatment would improve the sperm quality, however this was not confirmed by the present study.

Management of Intravenous Contrast Extravasations with Ultrasonography: A Case Report.

Extravasation of ionic and nonionic contrast materials is a well-recognized complication of contrast-enhanced imaging studies. Complications vary from minimal swelling to severe skin and subcutaneous ulceration, necrosis, and compartment syndrome. We report a case of Omnipaque (iohexol) extravasation in a 50-year-old man with erythema, blistering, and compartment syndrome who was treated medically but was not cured. Using gray scale ultrasonography, we determined the characteristics of the lesion, its distance from the skin, and its proximity to the vessels. We then determined the depth of the lesion, and then inserted the tip of the needle into the lesion. We also used ultrasonography in locations where extravasation was near an artery. After aspiration, the diameter of the lesion decreased significantly. The patient was cured by ultrasonography-guided aspiration from the extravasated site.

Does organophosphate poisoning cause cardiac injury?

Organophosphates are insecticides which are widely used as a suicidal agent in Iran. They are associated with different types of cardiac complications including cardiac arrest and arrhythmia, however their role in cardiac injury is not known yet. The aim of this study was to investigate the presence of myocardial damage in patients with cholinesterase poisoning.It was a prospective study conducted from January 2008 to March 2010. Cohorts of patients with cholinesterase poisoning due to suicidal attempt who have been referred to Loghman hospital were selected. Patients who have taken more than one poison or were used concomitant drugs were excluded. Physical examination was performed on admission to discover warning sign. Peripheral arterial blood gases, creatine kinase, creatine kinase-myocardial band, troponin-T measurements were performed in all cases. There were 24 patients, 7 of them women, with the mean age of 41.2±15.05 who were included in this study. Non-survivors had significantly higher levels of systolic blood pressure, partial pressure of oxygen in arterial blood, partial pressure of carbon dioxide, bicarbonate Glasgow Coma Scale scoring and longer duration of mechanical ventilation. Our findings showed that cardiac injury is an important cause of death in organophosphate poisoning. It could be hypothesized that cardiac injury is a strong predictor of death in patients with organophosphate poisoning.

Knowledge of medical students of Tehran University of Medical Sciences regarding plagiarism.

The core concept of plagiarism is defined as the use of other people's ideas or words without proper acknowledgement. Herein, we used a questionnaire to assess the knowledge of students of Tehran University of Medical Sciences (TUMS) regarding plagiarism and copyright infringement. The questionnaire comprised 8 questions. The first six questions of the questionnaire were translations of exercises of a book about academic writing and were concerning plagiarism in preparing articles. Questions number 7 and 8 (which were concerning plagiarism in preparing Microsoft PowerPoint slideshows and copyright infringement, respectively) were developed by the authors of the present study. The validity of the questionnaire was approved by five experts in the field of epidemiology and biostatistics. A pilot study consisting of a test and retest was carried to assess the reliability of the questionnaire. The sampling method was stratified random sampling, and the questionnaire was handed out to 74 interns of TUMS during July and August 2011. 14.9% of the students correctly answered the first six questions. 44.6% of the students were adequately familiar with proper referencing in Microsoft PowerPoint slideshows. 16.2% of the students understood what constitutes copyright infringement. The number of correctly answered questions by the students was directly proportionate to the number of their published articles. Knowledge of students of TUMS regarding plagiarism and copyright infringement is quite poor. Courses with specific focus on plagiarism and copyright infringement might help in this regard.

Heat shock protein 70 and albuminuria in patients with type 2 diabetes: a matched case control study.

Here, we aimed to study serum heat shock protein (HSP) 70 levels in diabetic patients with and without albuminuria. We performed a 1:1 matched case control study on 40 diabetic patients with albuminuria as cases and 40 age, sex, body mass index matched diabetic patients without albuminuria (normoalbuminuria) as controls. Normoalbuminuria was defined as urinary albumin excretion rate <15 mg/12 h, and albuminuria was defined as urinary albumin excretion rate between 100-400 mg/12 h. Patients with albuminuria had a higher HSP70 than controls (0.83 ± 0.50 vs. 0.63 ± 0.06; p = 0.02), while they did not differ in any other studied variables. In ten of the studied pairs, the controls had higher HSP70 levels than cases (reverse relationship). Patients in the "direct relationship group" had higher HbA1c values than the patients in the "reverse relationship group" (8.9 ± 0.3 vs. 7.3 ± 0.6, p = 0.04). Cases in the reverse pairs had a lower low density lipoprotein cholesterol levels than their controls. The odds ratio of HSP70 in the prediction of albuminuria was (28.69 (3.2-250.1), p = 0.002). In conclusion, we have shown an increased HSP70 levels in diabetic patients with albuminuria.

The lost correlation between leptin and CRP in type 2 diabetes.

C reactive protein (CRP) is an inflammatory marker believed to be of value in the early prediction of type 2 diabetes (T2DM). Recent studies have shown a positive correlation between leptin and CRP levels. Here, we aimed to study the correlation between leptin and CRP in patients with T2DM. We also studied the effect of metformin therapy on the CRP-leptin correlation in patients with newly diagnosed diabetes. We performed a follow-up study on three groups of participants defined as 1: patients with newly diagnosed T2DM, 2: patients with long-standing T2DM, and 3: healthy controls. Patients with newly diagnosed diabetes were followed for three months after the initiation of metformin therapy. The homeostatic model assessment of insulin resistance (HOMA-IR) decreased, while leptin levels (15.9 ± 1.6 versus 21.4 ± 2.5, p<0.01) increased after metformin therapy. Leptin levels correlated significantly with CRP in healthy controls (r = 0.48; p<0.01); patients with newly diagnosed diabetes before (r = 0.35; p<0.05), and after (r = 0.55, p<0.001) metformin therapy, while there was no significant correlation between leptin and CRP in patients with long-standing diabetes (r = 0.15; p = 0.55). After multiple adjustments for potential confounders, leptin was the best predictor of CRP in controls (ß coefficient = 0.433, p<0.01), and patients with newly diagnosed T2DM who received metformin (ß coefficient = 0.584, p<0.01). Statin treatment did not have any significant effect on the results. This is the first report demonstrating the restorative role of metformin on the leptin-CRP correlation in patients with newly diagnosed diabetes.

Inconsistency in albuminuria predictors in type 2 diabetes: a comparison between neural network and conditional logistic regression.

Albuminuria is a sensitive marker to predict future cardiovascular events in patients with type 2 diabetes mellitus. However, current studies only use conventional regression models to discover predictors of albuminuria. We have used 2 different statistical models to predict albuminuria in type 2 diabetes mellitus: a multilayer perception neural network and a conditional logistic regression. Neural network models were used to predict the level of albuminuria in patients with type 2 diabetes mellitus, which include a matched case-control study for the population. For each case, we randomly selected 1 control matched by age and body mass index (BMI). The input variables were sex, duration of diabetes, systolic and diastolic blood pressure, glomerular filtration rate, high-density lipoprotein, low-density lipoprotein, triglyceride, high-density lipoprotein/triglyceride ratio, cholesterol, fasting blood sugar, and glycated hemoglobin. Age and BMI were included only in the neural network model. This model included 4 hidden layers and 1 bias. Relative error of predictions was 0.38% in the training group, 0.52% in the testing group, and 1.20% in the holdout group. The most robust predictors of albuminuria were high-density lipoprotein (21%), cholesterol (14.4%), and systolic blood pressure (9.7%). Using the conditional logistic regression model, glomerular filtration rate, time of onset to diabetes, and sex were significant indicators in the onset of albuminuria. Using a neural network model, we show that high-density lipoprotein is the most important factor in predicting albuminuria in type 2 diabetes mellitus. Our neural network model complements the current risk factor models to improve the care of patients with diabetes.

The sensitivity, specificity and accuracy of anti-citrulline antibody test in diagnosis of rheumatoid arthritis.

Citrulline antibody, nowadays, is a new item which has been the center of attention due to its much more specificity to diagnose RA. The aim of the present study was to evaluate the efficacy and accuracy of anti-citrulline antibody test in RA diagnosis among hospitalized patients in Iran. Through a case-control study, we tried to calculate the accuracy of anti-cyclic citrullinated peptide antibody (anti-CCP) test used in the diagnosis of RA enrolling 200 participants divided into two groups of the patients with RA, on the one hand, and other diseases, on the other. Anti-CCP was measured by ELISA technique through which titers more than 15 were defined as high titer. Of all the studied population, 81 (81 %) were in active phase of RA, which had anti-CCP >15 U/ml, while only 25 controls (25 %) experienced these levels. The average anti-CCP was 144 U/ml in cases and 16.05 U/ml in controls with a P value <0.001, which confirmed significant difference between the two. Considering different comments on this matter besides our findings in the present research, we offer a combination of anti-citrulline antibody test rather than anti-CCP and RF to get the best results in RA diagnosis, discrimination and prognosis because of 97 % specificity.

Diabetes induces gender gap on LCAT levels and activity.

AIM: High density lipoprotein (HDL) decreases in diabetic women more rapidly than what is observed in diabetic men. Here we aimed to study serum LCAT levels and LCAT activity in men and women with type 2 diabetes (T2DM) as well as healthy controls. MAIN METHODS: We measured serum LCAT activity and levels in 40 patients with T2DM plus 40 age-sex and body mass index (BMI)-matched controls. The correlation between LCAT levels and activity was measured in the studied groups, stratified according to gender. KEY FINDINGS: Patients had a lower LCAT activity, diastolic blood pressure, fasting blood sugar, triglyceride, low density lipoprotein cholesterol and a higher LCAT levels than controls. The lower LCAT activity in patients with T2DM was significant after multiple adjustments for age, LCAT levels and BMI, using general linear model (67.9 ± 1.8 vs. 86.5 ± 1.8; P<0.001). Women with T2DM had a lower LCAT activity and a higher LCAT and HDL levels compared to men. The lower LCAT activity in women remained significant after multiple adjustments for age, BMI and LCAT levels; (61.9 ± 3.1 vs. 74.17 ± 3.61; P<0.05). Statin treatment did not have any significant value on the results. HDL was not correlated with LCAT levels or activity in any of the studied populations. SIGNIFICANCE: We showed that while LCAT activity is decreased in patients with T2DM, LCAT levels is increased. Patients with T2DM exhibit opposing effects on LCAT activity and LCAT production which is more severe in women. Future prospective studies may elucidate the underlying pathways for these observations.

Appearance of leptin-HSP70 correlation, in type 2 diabetes.

In vitro and in vivo studies have shown conflicting results regarding heat shock protein (HSP) and leptin correlation. More importantly both HSP70 and leptin are correlated with C reactive proteins. The purpose of the present study was to study the correlation between serum HSP70 and leptin levels in patients with type 2 diabetes stratified according to gender. We performed a cross sectional study on the established groups of patients with type 2 diabetes defined as 1: patients with long standing diabetes for more than 3 years; and 2: patients with newly diagnosed diabetes within recent 6 months who were not on any glucose lowering treatment other than by dietary means alone and 3: healthy controls. Patients with long standing diabetes had higher HSP70, HbA1c and triglyceride than controls. Serum leptin levels were significantly lower in patients with newly diagnosed diabetes. Women with type 2 diabetes had higher leptin levels compared to men, both before and after treatment. We showed a positive correlation between leptin and HSP70 levels in women with type 2 diabetes. The correlation was strongest in women with newly diagnosed diabetes (r = 0.59) and was attenuated in women who were on treatment (r = 0.3). The significance of this correlation was only observed in women with type 2 diabetes. There was no correlation between leptin and HSP70 in men. The positive correlation between leptin and HSP is observed in chronic inflammation such as type 2 diabetes. It could be hypothesized that the observed correlation between serum HSP70 and leptin implies a higher state of chronic inflammation.

The effect of Helicobacter pylori eradication on migraine: a randomized, double blind, controlled trial.

BACKGROUND: Recent studies have shown a positive correlation between Helicobacter pylori (H. pylori)infection and migraine headache. OBJECTIVE: To study the impact of H. pylori eradication on migraine headache. STUDY DESIGN: Double blind, randomized, controlled clinical trial. SETTING: Sixty-four patients diagnosed with migraine-type headache were included in the study. The patients were randomly allocated into 2 groups: a treatment group that received migraine treatment and H.pylori eradication treatment, and a control group that received migraine treatment and a placebo in place of H. pylori eradication treatment. METHODS: There were 25 women and 7 men in the treatment group and 22 women and 10 men in the control group. The MIDAS (Migraine Disability Assessment) questionnaire was used to assess the severity of symptoms, before and after treatment. RESULT: There was no significant difference between treatment group patients and control group patients with respect to age (44.6 ± 8.8 vs. 43.8 ± 13.8), clinical symptoms and signs. In the beginning of the study, patients in the treatment group had a higher MIDAS compared to patients in the control group (28.87 ± 6.18 vs. 25.43 ± 7.13, P < 0.05). There was no significant difference between the treatment and control groups, with respect to the MIDAS, after treatment (20.09 ± 1.14 vs. 20.00 ± 1.150, P = 0.5). General linear model, repeated measures demonstrated that the reduction in the MIDAS score was more prominent in the treatment group (Mean Square 164.25, F: 2.02, P = 0.05). LIMITATIONS: Short-term follow up. CONCLUSION: H. pylori eradication may have a beneficial role on migraine headache. This shows the significance of H. pylori treatment in the management of migraine headache among Iranian patients.

Appropriate BMI cut-off values for identification of metabolic risk factors: third national surveillance of risk factors of non-communicable diseases in Iran (SuRFNCD-2007).

AIM: To determine the appropriate threshold of body mass index (BMI) associated with increased risk of cardiovascular diseases in a large representative sample of an Iranian population. SUBJECTS AND METHODS: Data of third national surveillance of risk factors of non-communicable diseases (SuRFNCD-2007) were used in this study. Sensitivity, specificity, and shortest distance on the receiver-operating characteristic (ROC) curves were used to determine gender-specific optimal cut-offs of BMI for cardiometabolic risk factors including elevated blood pressure, low high-density lipoprotein cholesterol, high triglycerides, high fasting plasma glucose and for ≥ 2 of the aforementioned risk factors. RESULTS: There was a continuous increase in the prevalence of cardiometabolic risk factors with increasing BMI (p < 0.001). At the BMI of 25-29 kg/m(2) men were at higher risk of cardiovascular diseases compared to women (p < 0.001). The appropriate BMI cut-offs ranged from 24.6-26.1 kg/m(2) for men and from 26.9-28.8 kg/m(2) for women. The optimal BMI cut-offs for identifying any two or more of those risk factors were 25.2 and 27.3 kg/m(2) in men and women, respectively. CONCLUSION: In men the appropriate BMI cut-offs are ~25 kg/m(2), while in women higher BMI values are associated with risk of cardiovascular diseases.