Iranian Journal of

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Background: There are disputed reports of the beneficial effects of magnetic fields on glucose homeostasis. Continuing from our previous work, we studied the effect of a constant magnetic field on blood glucose and weight gain in laboratory mice.
 Methods: 28 young, female bALB/c mice were randomly allocated into four groups A, B, C and D. Group A were placed in a constant magnetic field for 20 days, group B for 20 days in a placebo field, group C for 10 days in a constant magnetic field, after which the field was removed, and group D for 10 days in a placebo field, which was then removed the remaining 10 days of the study. The induction force of the magnetic field was 500 gauss, and was generated by two natural magnet bars. Placebo fields were created by two identical looking bars of granite. The mice were weighed daily and had their blood glucose measured at the end of the 20-day study.
Results: Weight gain was similar in the four groups. Blood glucose was significantly lower in group C mice than in groups B and D mice. No other significant difference in blood glucose between the groups was detected.
Conclusion: Even though blood glucose remained unchanged whilst mice are inside a magnetic field, the blood glucose of mice 10 days after field removal is lower than in mice that had never been inside a magnetic field.

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Background: Currently different criteria are used to diagnose Gestational Diabetes. ACOG (American college of obstetric and Gynecology) accepted NDDG's (criteria National Diabetes Data Group) Criteria and ADA (American Diabetes Association) accepted Carpenter Caustan’s. Although both of these criteria have been achieved by O Salivan and Mahan’s reaserches, the number of patients has been diagnosed are different .The aim of this study was to compare Gestational Diabetes prevalence according to Carpenter Caustan’s and NDDG’s Criteria.
Methods: 1200 pregnant women were screened in a prenatal care clinic. Patients with definite diabetes were excluded. According to universal GDM screening method, for all of the patients GCT and GTT (if GCT > 130) were preformed. The results evaluated according to Carpenter Caustan’s and NDDG’s criteria. Results: In this screening, 377 participants had positive GCT, according to Carpenter and Caustan’s criteria 83 women (6.9%), and according to NDDG criteria 50 women (3.6%) had Gestational Diabetes Mellitus. If the cut of point of GCT was 140 mg/dl instead of 130 mg/dl, according to Carpenter and Caustan’s criteria 16 women (18.1%), and according to NDDG 4 patients (9%) were missed.
Conclusion: Regarding the significant difference between two methods in diagnosis of gestational diabetes mellitus, assessment of each method value in improving prognosis and outcomes is necessary. According to the results the cut of point of 130mg/dl, as recommended in previous studies, has more accuracy for screening.

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Background: This study was performed to evaluate the prevalence and risk factors of asymptomatic bacteriuria (ASB) in women with type 2 diabetes mellitus in Iranian population.
Methods: Between March 2003 and December 2003, 202 nonpregnant women with diabetes type 2 who were between 31 to 78 years old and had no abnormalities of the urinary tract system were included. We defined ASB as the presence of at least 105 colony-forming units/ml of 1 or 2 bacterial species, in two separated cultures of clean-voided midstream urine. All the participants were free from any symptoms of urinary tract infection (UTI). Risk factors for developing bacteriuria was assessed and compared in participants with and without bacteriuria.
Results: In this study, the prevalence of ASB was 10.9% among diabetic women. E.coli was the most prevalent microorganism responsible for positive urine culture. Most of the isolated microorganisms were resistant to Co-trimoxazole, Nalidixic acid and Ciprofloxacin. Pyuria (P<0.001) and glucosuria (P<0.05) had meaningful relation with bacteriuria but no association was evident between age (P<0.45), duration of diabetes (P<0.09), macroalbuminuria (P<0.10) and HbA1c level (P<0.75), and the presence of ASB.
Conclusion: The prevalence of ASB is more prevalent in women with type 2 diabetes, which pyuria and glucosuria can be considered as risk factors in this regard. Routine urine culture can be recommended for diabetic women even when there is not any urinary symptom.

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Background: Oxidized low-density lipoprotein (Ox-LDL), a key factor in the development of atherosclerosis, can cause endothelial dysfunction and augment lipid accumulation within the arterial wall. Increased oxidative stress in diabetes contributes to this process. Ox-LDL is a highly immunogenic molecule and it is not clear whether anti oxidized LDL antibodies (OLAB) are pathogenic or protective in atherosclerosis? The aim of this study was to evaluate Ox-LDL and its antibody in type 2 diabetes and healthy subjects.
Methods: As a case-control study we evaluated 81 type 2 diabetic patients and 69 non-diabetic healthy persons aged 40 to 65 years. Controls were sex and BMI matched with diabetic patients. Patients with history of cigarette smoking, antioxidant or antihyperlipidemic drugs consumption, coronary heart disease, hypertension , and renal impairment were excluded. We measured serum level of Ox-LDL(two monoclonal antibody of Mercodia co.) and OLAB by ELISA. Lipid profile, serum electrolytes, and HbA1c (HPLC) were also determined. Ox-LDL and its antibody were compared between diabetic patients and controls and the correlation with lipid profile, HbA1c and BMI were assessed.
Results: Serum Ox-LDL concentration and Ox-LDL to LDL ratio were distinctively higher in controls (15.7+-6.9 vs. 11.8+-5.6, P < 0.005). Ox-LDL concentrations were correlated with LDL-C (rs=0.36, P<0.0005) and total cholesterol (rs=0.31, P<0.0005) in both groups but not with age and HbA1c. In diabetic patients, Ox-LDL and its antibody were positively correlated (rs=0.26, P<0.05). Obese diabetic patients (BMI > 30) had higher Ox-LDL concentrations in comparison with diabetic patients with BMI less than 30.
Conclusion: In diabetic patients Ox-LDL level is lower than non-diabetics and is correlated with its antibodies. Based on previous findings, we suppose that the pattern of LDL oxidation enhances Ox-LDL recognition by macrophage via specific legends. This results in low serum Ox-LDL concentrations in diabetes.

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Background: The aim of this study was to compare time action profile of regular human Insulin produced by Exir pharmaceutical Co. and Actrapid® HM produced by Novo Nordisk with euglycemic clamp technique for the first time in Iran.
Methods: Euglycemic glucose clamps were performed with two Insulin brands in a single-center, randomized, double-blind, and crossover study on 6 healthy male volunteers. Glucose disposal kinetics including metabolic clearance rate of glucose (MCRg) and metabolic clearance rate of insulin (MCRi) were determined during a 2-h predetermined intravenous Insulin infusion while blood glucose levels were maintained steady using variable continues intravenous glucose infusions based on method of De Fronzo.
Results: There were no differences in glucose kinetics or time action profile with respect to glucose infusion rates (688.4 vs. 664.6 mg/kg per 120min), MCRg (0.63±0.19 vs. 0.62±0.25 ml/kg), and MCRi(110 % vs110%) between Exir and Novo Nordisk regular human Insulin preparations. Serum insulin levels increased and serum C-peptide levels decreased with both exogenous Insulin infusions which were statistically the same for both preparations.
Conclusion: Time action profile and bioavailability of regular human insulin produced by Exir Pharmaceutical Corporation is comparable with commonly used Novo Nordisk preparation demonstrated by 2 hour euglycemic clamp study.

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Background: Obese patients are usually thought to have an increased risk for complications in coronary artery bypass grafting surgery (CABG). Several studies have been unclear about the relationship between obesity and the risk of adverse outcomes. The aim of this study was to assess the relationship between Body Mass Index (BMI) and in-hospital mortality following CABG.
Methods: Between December 2003 and February 2005, 1258 patients who underwent isolated CABG at Tehran Heart Center were included in this study. Patients were divided into three groups according to their BMI. Patients in group I had BMI<30 (non obese patients). In group II patients had (obese patients). Patients in group III had (very obese patients). Patients in each group were followed for in-hospital death and variables were compared to find any statistically meaningful relationship.
Results: No significant difference was found between non obese and obese patients (group I & II), but hypertension was more prominent in very obese patients (group III) and female sex was more prevalent in this group comparing two other groups. Mortality was more in the 3rd group as well. In non obese diabetic patients, the rate of mortality was higher than other patients. Logistic regression showed that BMI can not be considered as an independent factor to predict the risk of death in post CABG in-hospital mortality. Conclusion: It seems, in coronary artery bypass grafting, BMI is not an independent factor for predicting in-hospital mortality.

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Background: The liver plays a main role in the production and metabolism of lipoproteins, and then impaired lipid metabolism is often seen in patients with liver cirrhosis and chronic hepatitis (CH). As a result, plasma lipid levels could be as useful indicators of liver function and patient's prognosis especially in liver cirrhosis.
Methods: We measured the lipoprotein levels in 77 consecutive patients with liver cirrhosis and CH. 47 men (61%) and 30 women (39%) with mean age 43years (SD=16.4) and mean BMI 26(SD=4.2) have been recruited as patients group. Child score and MELD scale was determined in patients group. The control group was age and sex matched with patients group.
Results: In case group, the levels of HDL LDL, TG, and total cholesterol were significantly lower than control group (p <0.0001). In patients with cirrhosis, the levels of LDL, HDL and total cholesterol were progressively lower when comparing patients in Child class A with patients in class C (p<0.0001).This difference was more significant in LDL and total cholesterol and between upper Child scores ,similarly decreasing in LDL, HDL ,and total cholesterol level was observed when MELD score increased (P<0.0001).
Conclusion: There is a correlation between plasma lipid levels and liver function, so it may be mentioned as an accessible and reliable indicator of liver function in cirrhotic and CH patients.

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Background: In many studies, Serum lipoprotein(a) [Lp(a)] levels considered as an independent risk factor for atherosclerosis. The aim of this study was to assess the association between Lp(a) and cervical carotid artery stenosis in one sample the Iranian population.
Methods: As a cross sectional study, between June 2004 and January 2005, at Tehran Heart Center, 1189 candidates for any kind of open heart surgery, were recruited into this study. Carotid Dopplers ultrasonography was performed for all participants. Serum levels of Lp(a), total cholesterol, triglyceride and blood sugar and quantitative CRP were measured in fasting state and their correlations with carotid atherosclerosis were assessed.
Results: Among 1189 participants, 837 (70.5%) were male and 352 (29.4%) were female. Their mean age was 60±9.3 years (range between 35 to 88). There was not significant relation between Lp(a) serum levels and carotid artery stenosis (P=0.46). The relationship between Lp(a) levels and carotid artery stenosis in both ≤55 years and >55 years patients was not significant too (P=0.25). Also gender has no relationship in this regard (P=0.15). Significant relationship was found between Lp(a) level & hypoecho plaques (vulnerable lesions) (P=0.001).
Conclusion: In our study, we found no significant correlation between serum Lp(a) and carotid stenosis. Lp(a) was found to have positive relationship with hypoecho plaques (vulnerable lesions) which predispose patients for CVA. Further investigations suggest for better evaluations.

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  Background : PCOS (Polycystic Ovary Syndrome = PCOS) is a relatively common disease in women of childbearing age. Bisphenol s are chemical groups that are composed of two functional hydroxyl group and most of them are based on methane. In this study, the effects of phenolic compounds, (bisphenol A and AP) in polycystic ovary syndrome were investigated.

  Methods : mature Wister rats were classified in six groups . Healthy controls ( healthy rats that received Grape seed Oil as solvent ), PCOS Group ( disease induced by testosterone propionate ) experimental groups 1.2.3.4 , respectively. after induction of PCOS,they received bisphenol- A and AP in doses of25 mg / kg, 50mg/kg, by gavage . Blood samples were taken and the hormones LH, FSH was measured . Ovaries were also to be studied histologically .

  Results : The results showed that the amount of LH to FSH ratio increases after induction with bisphenol-A and bisphenols AP,. Furthermore the number of follicles and growing follicles were reduced significantly, and these concequences causing negative effects on polycystic ovary syndrome.

 

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Background: According to the importance of the family physicians program results in rural areas and government decision to apply this program in urban areas of Iran, This study aimed to determine the quality of care and blood sugar control, blood pressure and blood lipids in diabetic type &Iota&Iota patients in rural areas covered by family physicians. Methods: In this study, 380 patients 30-76 years old with medical records in the health centers of the malekan-Iran in rural areas in 2013, after informed consents were enrolled. Data were collected by interview and HbA1c examinations and using a standard questionnaire. Data analyzed by SPSS19 version. Multivariate logistic regression was used to estimate odds ratios adjusting for diabetes complications and related risk factors. Results: Results showed that 68% Study participants was women’s and average age of patients was 57.86±11.9 and sex ratio of females to males was almost 2.2 with 1. Final analysis showed that HbA1c levels more than 7% (PHbA1c=0.002), cholesterol over 240 mm/dl (Pcholesterol=0.04) and hypertensive over 140/90mm/Hg (PHTN=0.007) 1.52, 2.44 and 1.44 times increased risk of diabetes complications, respectively. Conclusions: The quality of care and blood sugar control in diabetic patients was lower than compared to the American Diabetes Association (ADA) standards, but our results are near to results of Country studies.

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Background: The process of wound healing is impaired in diabetes. Many efforts have been made to accelerate the wound healing process. Long time healing effect of a herbal complex containing Aloe vera, Myrrh, dragon’s blood and henna has been observed in wound healing, But sufficient scientific evidence of how the mechanism of action of this compound is absent in diabetic wounds Whereas the effect of each of them separately in several studies on ulcers observed. The purpose of this study was to evaluate the effect of topical herbal (briefly called Herbalin) on wound healing in diabetic rats.

Methods: The diabetic rats were divided into two groups: control (treated with Vaseline as a vehicle) and experimental (treatment with herbalin) were included. In each class, all wound round with a diameter of2cmwas made on the dorsal surface of diabetic rats. Wound measurement and histopathological parameters such as the formation of re-epithelization, granulation tissue formation and the average thickness of the epithelium at intervals of7, 14and21dayswere evaluated.  Strain epithelium on day 14andthe wound length atday21was evaluated in the terminal phase.

Results: In macroscopic study, the Herbalin treated wounds were found to healing much faster and the day 14 has considerable change compared with control group (P<0.05). In microscopic study, in all cases of the Herbalin treatment groups showed a significantly increased as compared with controls (P<0.05).

Conclusion: According to the results, the herbal complex, possibly by accelerating the formation of granulation tissue and epithelium and thickening of the epithelium has an important role in wound healing in diabetic and reduces the time required for healing.