High frequency of metabolic syndrome in adult Zoroastrians in Yazd, Iran: a cross-sectional study.

BACKGROUND: Metabolic syndrome (MS) is a cluster of metabolic disturbances, and its prevalence is increasing worldwide. MS exhibits variations among ethnic groups. Zoroastrianism is an ethnic minority which has maintained its isolation and endogamy up to now. So, we evaluated the frequency of MS in Zoroastrians of Yazd, Iran. METHODS: In this cross-sectional study, participants aged ≥30 years were selected using a systematic random sampling. Weight, height, body mass index (BMI), waist circumference (WC), hip circumference (HC), waistto- hip ratio (WHR) and blood pressure (BP) were measured using standard methods. Also, blood levels of glucose, triglycerides (TG), total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), urea, creatinine and uric acid (UA) were measured. Both revised National Cholesterol Education Program Adult Treatment Panel III (ATPIII) and Joint Interim Statement (JIS) criteria were used to diagnose the MS. RESULTS: The mean±SD age of the participants (n=403) was 56.9±12.8 years. The frequency of MS was 69.7% and 74.9% based on JIS and ATPIII criteria, respectively; this was significantly different by age, marital status, job, educational level, and menopausal status (p<0.05). The most prevalent abnormal parameters of MS according to ATPIII and JIS criteria were high WC (95%) and low HDL (87.9%), respectively. Mean LDL, systolic BP, WHR, UA, urea, and creatinine were different between men and women. The difference between the age groups was statistically significant for BMI, systolic BP, diastolic BP, TG, WHR and urea (p<0.05). CONCLUSION: This study showed a high frequency of MS in Zoroastrians of Yazd, Iran.

Risk of Wheezing Attacks in Infants With Transient Tachypnea Newborns.

BACKGROUND: The most common reason of respiratory distress in the newborn is transient tachypnea of the newborn (TTN). There are some reports saying that TTN is associated with increased frequencies of wheezing attacks. OBJECTIVES: The aims of this study were to determine the risk factors associated with TTN and to determine the association between TTN and the development of wheezing syndromes in early life. MATERIALS AND METHODS: In a historical cohort study, we recorded the characteristics of 70 infants born at the Shohadaye Kargar Hospital in Yazd between March 2005 and March 2009 and who were hospitalized because of TTN in the neonatal intensive-care unit. We called their parents at least four years after the infants were discharged from the hospital and asked about any wheezing attacks. Seventy other infants with no health problems during the newborn period were included in the study as the control group. RESULTS: The rate of wheezing attacks in newborns with TTN was more than patients with no TTN diagnosis (P = 0.014). TTN was found to be an independent risk factor for later wheezing attacks (relative risk [RR] = 2.8). CONCLUSIONS: The most obvious finding of this study was that TTN was an independent risk factor for wheezing attacks. So long-term medical care is suggested for these patients who may be at risk, because TTN may not be as transient as has been previously thought.

Association between Glutathione S-Transferase GSTM1-T1 and P1 Polymorphisms with Metabolic Syndrome in Zoroastrians in Yazd, Iran.

BACKGROUND: The aim of this study was to assess the possible association between genetic polymorphisms of the glutathione S-transferase (GST) gene family and the risk of the development of metabolic syndrome (MS) in Zoroastrian females in Yazd, Iran. METHODS: In this case-control study, GSTM1, T1, and P1 polymorphisms were genotyped in 51 randomly selected MS patients and 50 randomly selected healthy controls on February 2014 among Zoroastrian females whose ages ranged from 40 to 70 yr. DNA was extracted from peripheral blood. Data were analyzed with SPSS version 17. RESULTS: We observed a significant association of GSTP1-I/V (Isoleucine/Valine) allele and GSTP1-V/V (Valine / Valine) allele with MS (P = 0.047 and P = 0.044, respectively). The combined analysis of the two genotypes, the present genotype of GSTT1, I/V and V/V alleles of GSTP1 genotype demonstrated a decrease in the risk of acquiring MS (OR = 0.246, P = 0.031). The null genotype of GSTM1, I/V, and V/V alleles of the GSTP1 genotype showed a lower risk in double combinations (OR = 0.15, P = 0.028 and OR = 0.13, P = 0.013, respectively). The combinations of the GSTM1 null genotypes and GSTT1 present genotypes and the GSTP1 I/V and V/V alleles together were associated with decreased risk of having MS in triple combinations (OR = 0.071, P = 0.039 and OR = 0.065, P = 0.022, respectively). CONCLUSION: GSTP1-I/V and V/V alleles, alone or in association with GSTM1 null and GSTT1 present genotypes, are related with decreased susceptibility to the development of MS in Zoroastrian females.

High prevalence of type 2 diabetes and pre-diabetes in adult Zoroastrians in Yazd, Iran: a cross-sectional study.

BACKGROUND: The prevalence of type 2 diabetes mellitus (T2DM) varies among ethnic groups. We aimed to estimate the prevalence of diagnosed and undiagnosed diabetes mellitus, impaired fasting glucose (IFG), and impaired glucose tolerance (IGT) for the first time in an ethnic population, specifically Zoroastrian citizens in Yazd, Iran whose ages were 30 or older. METHODS: In a cross-sectional study, participants aged≥30 years were selected using systematic random sampling. An inventory, including socio-demographic data, was completed. Weight, height, body mass index (BMI), and blood pressure (BP) were measured using standard methods. Also, blood levels of glucose, triglycerides (TG), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), urea, creatinine (Cr), and uric acid were measured. The latest criteria established by the American Diabetes Association (ADA) were used to diagnose DM. RESULTS: The mean age of the participants (n=403) was 56.9±12.8 years. The total prevalence of diabetes, including previously diagnosed and undiagnosed diabetes, IFG, and IGT was 26.1%, 18.6%, 7.5%, 34.7% and 25.8%, respectively. Participants with diabetes had higher fasting blood sugar (FBS) (P<0.001), oral glucose tolerance test (OGTT) (P<0.001), urea (P=0.019), BMI (P=0.001), systolic blood pressures (P<0.001), TG (P=0.007) and lower HDL (P=0.034) than patients with IFG, IGT, and normoglycemic subjects. CONCLUSIONS: The current study showed a high prevalence of T2DM in the Zoroastrian population of Yazd, Iran. One-third of the total cases with diabetes were undiagnosed.

Evaluation of glutathione S-transferase T1 deletion polymorphism on type 2 diabetes mellitus risk in Zoroastrian females in Yazd, Iran.

BACKGROUND: There has been much interest in the role of free radicals and oxidative stress in the pathogenesis of diabetes mellitus (DM). The aim of this study was to assess the possible association between genetic polymorphisms of the glutathione S-transferase-Theta (GSTT1) and the risk of the development of DM in Zoroastrian females in Yazd, Iran. MATERIALS AND METHODS: This was a case-control study in which GSTT1 polymorphism was genotyped in 51 randomly selected DM patients and 50 randomly selected healthy controls among Zoroastrian females whose ages ranged from 40 to 70. RESULTS: The frequencies of GSTT1 null genotype and GSTT1 present were 72% and 28%, respectively, in control samples, while in patients with type 2 diabetes (T2DM), the frequencies of GSTT1 null genotype and GSTT1 present were 27.5% and 72.5%, respectively. There were higher levels of triglyceride (TG), fasting blood sugar (FBS), total cholesterol (TC), low-density lipoprotein (LDL), Urea, and high-density lipoprotein (HDL) in cases of GSTT1 null genotype compared to the GSTT1 present genotype in controls. CONCLUSIONS: Our results indicated that healthy subjects had a higher frequency of the GSTT1 null genotype than patients with T2DM. However, we observed no significant association between the GSTT1 null genotype and T2DM in the current study.

Bony manifestation of rickets in a sunny city - a case report from Yazd, Iran.

Rickets is disease that occurs in growing bones in which defective mineralization occurs in both the bone and the cartilage of the epiphyseal growth plate, resulting in the retardation of growth and skeletal deformities. Rickets is more common in areas with less sunlight. However, this case report presents a case of the bony manifestation of rickets with the intake of vitamin D supplements in Yazd, a city in central Iran that has sunshine almost every day. A patient was referred to an out-patient general pediatric clinic for deformities of the legs and growth disturbance, with his height far below the normal range. The changes that were most evident in his X-rays were the bowing of the long bones of the legs and forearms and the cupping of the wrist metaphyseal region. In summary, we present a patient with bony manifestation of rickets despite living in a sunny area and taking vitamin D supplements. Thus, it is important to remember that rickets is still a common disease among children in Iran. More studies of this issue should be conducted, including the identification of abnormal cases and rescheduling vitamin D supplementation programs.

Unusual presentation of a perforated appendicitis in a four-year-old girl - a case report from Yazd, Iran.

Difficulties in the early diagnosis of appendicitis, particularly in children, often lead to complications, such as perforation of the appendix, within 36 hours of the onset of symptoms. A four-year-old girl presented to the Emergency Department at Shohadaye Kargar Hospital in Yazd (a city in central Iran) in February 2013 with a history of chronic abdominal pain that began 20 days before admission. Her physical examination revealed a low-grade fever, conjunctivitis, dysuria with malodorous urine, and a mass in right, lower quadrant without localized tenderness in that area. Intestinal intussusception was suggested as the most likely diagnosis, and a laparotomy was performed. The appendix was perforated and an appendicular abscess had caused intestinal obstruction. The rarity of this case, with its unusual presentation and findings, which included unexplained chronic pain, necessitated an immediate operation that revealed the acute presentation of a mechanical obstruction of the intestine. Appendicitis must be kept in the differential diagnosis of any child who presents with chronic abdominal pain. In conclusion, chronic abdominal pain in children is not always of functional origin, and discerning the correct diagnosis can be very challenging. Therefore, clinicians should think broadly since multi-disciplinary input may be inevitable.

Evaluation of Glutathione S-transferase T1 (GSTT1) deletion polymorphism on type 2 diabetes mellitus risk in a sample of Yazdian females in Yazd, Iran.

BACKGROUND: There has been much interest in the role of free radicals and oxidative stress in the pathogenesis of diabetes mellitus (DM). The aim of this study was to assess the possible association between genetic polymorphisms of the glutathione S-transferase-mu (GSTT1) and the risk of the development of DM in a sample of Yazdian females in Yazd, Iran. METHODS: This was a case-control study in which GSTT1 polymorphism was genotyped in 51 randomly selected DM patients and 50 randomly selected healthy controls among Yazdian females whose ages ranged from 40 to 70. RESULTS: The frequencies of GSTT1 null genotype and GSTT1 present were 8 and 92%, respectively, in the control samples. In patients with type 2 diabetes (T2DM), the frequencies of GSTT1 null genotype and GSTT1 present were 14 and 86%, respectively. There were higher levels of triglycerides (TG), fasting blood sugar (FBS), total cholesterol (TC), low density lipoprotein (LDL), body mass index (BMI), and high density lipoprotein (HDL) in patients with GSTT1 null genotype than in patients with the GSTT1 present genotype. CONCLUSIONS: Our results indicated that the GSTT1 deletion polymorphism is a risk factor for T2DM. We did not determine any significant association between the GSTT1 null genotype and T2DM.

Effect of Off-Pump Coronary Artery Bypass Surgery on Patients' Quality of Life.

BACKGROUND: Off-pump coronary artery bypass (OPCAB) surgery is a common technique used to control the incidence of myocardial ischemia and to increase the lifespan of patients with coronary artery disease (CAD). There is still considerable controversy about effect of OPCAB on patients' quality of life. The purpose of this study was to determine the effect of OPCAB on different aspects of the patients' quality of life. METHODS: A total of 190 patients who underwent elective OPCAB surgery at Afshar Hospital in Yazd, Iran, from October 2012 through April 2013 participated in the study. Nottingham Health Profile (NHP) questionnaire was used in structured interviews before and 3 months after the OPCAB surgery. Independent samples t-test, Mann-Whitney test and analysis of variance were used for statistical analysis. RESULTS: Quality of life from the aspect of pain (P = 0.014), energy (P = 0.001), emotional reaction (P < 0.001), social isolation (P = 0.002) and physical activity (P = 0.005) were significantly different, but there was no significant difference in sleep between men and women (P = 0.06). Women achieved a better quality of life 3 months after OPCAB surgery (P < 0.001). There was no significant difference in patients' quality of life in terms of their ejection fraction (P = 0.06). There was no significant difference in patients' quality of life in terms of their New York Heart Association (NYHA) functional class score (P = 0.57). Patients' quality of life scores before OPCAB surgery and 3 months after the surgery showed no significant difference after adjusting for history of myocardial infarction (P = 0.82), hyperlipoproteinemia (P = 0.38), cigarette addiction (P = 0.2), hypertension (P = 0.7) and diabetes mellitus (P = 0.15). CONCLUSION: Most aspects of patients' quality of life were better after OPCAB surgery. The most obvious finding to emerge from this study was that women's quality of life was better than men's after OPCAB surgery. Since CAD is prevalent and OPCAB is one way to treat and manage this disease, patients' quality of life can be improved if they are managed appropriately after OPCAB surgery (especially for men).