Diabetic Hemodialysis: Vitamin D Supplementation and its Related Signaling Pathways Involved in Insulin and Lipid Metabolism.

BACKGROUND: This study was conducted to determine the effects of vitamin D supplementation on some of the gene expressions related to insulin and lipid metabolism in diabetic hemodialysis (HD) patients. METHODS: A double-blind, randomized, placebo-controlled clinical trial was carried out in 55 patients with diabetic HD. The current project used two groups in which each subject received vitamin D supplements (50,000 IU, n=28) or placebo (50,000 IU, n=27) every 2 weeks for 12 weeks. Gene expression analyses (RT-PCR) were included to obtain the rate of gene expression of the related insulin and lipid metabolism genes in peripheral blood mononuclear cells (PBMCs) of patients with diabetic HD. RESULTS: Our data revealed that consumption of vitamin D supplementation enables to overexpress the peroxisome proliferation-activated receptor gamma (PPAR-γ) (P=0.001), AKT (P=0.04), PI3K (P=0.02), insulin receptor substrate-1 (IRS1) (P0.008) and glucose transporter type 4 (GLUT-4) (P=0.01) and downregulate the expression of protein kinase C (PKC) (P=0.001) in patients with diabetic HD than control group following the 12-week intervention. In addition, vitamin D supplementation downregulated low-density lipoprotein receptor (LDLR) (P=0.03) expression in the subjects with diabetic HD than the control group. Vitamin D supplementation did not show any effects on the expression of pyruvate dehydrogenase kinase 1 (PDK1) (P=0.37), IRS2 (P=0.90) and lipoprotein (a) [Lp(a)] (P=0.05). CONCLUSION: Our findings confirmed that diabetic HD subjects who received the vitamin D supplementation (for 12 weeks), showed a significant overexpression in the PPAR-γ, AKT, PI3K, IRS1 and GLUT4 genes, and also showed a significant downregulation in the PKC and LDLR genes. Moreover, no effects on PDK1, IRS2 and Lp(a) expression were observed.

Factors Influencing Animal Bites in Iran: A Descriptive Study.

OBJECTIVES: Animal bite is a significant health economic challenge worldwide. In Iran, there has been an increase in the number of animal bites in recent years. This study was performed to investigate the epidemiology of animal bites and their influencing factors in Semirom, Iran, from 2008 to 2012. METHODS: This was a descriptive study conducted for 5 years. The data were based on the information sheets presented in health-care centers concerning how to combat against rabies caused by animal bites. The data obtained were classified and analyzed statistically. RESULTS: During the 5-year study period, 1,246 animal bite cases were reported; 60% of the victims belonged to rural areas and the remaining 40% to urban areas. Among various aggressive animals, dogs had the highest rate of attacks (63.4%). The highest rate of animal bite (23.19%) was reported in the age group of 10-19 years and the lowest one (2.32%) was reported in the age group of 0-4 years. The animal bite rates among men and women were 76% and 24%; respectively. The highest and lowest rates were found among students (23.5%) and employees (5.5%), respectively. Regarding the commonly injured organ, the highest (67%) and lowest rates (23%) were for lower extremities and head and face, respectively. Regarding the nationality of the victims, 98% were Iranians and the rest were Afghan. CONCLUSION: Given the increasing number of animal bites reported, there is a need to implement strategies to prevent bite-related complications, which may have health and financial burden on the country. It is also necessary to increase awareness among target groups and to formulate preventive strategies with the help of various authorities to control animal bites.