Iranian Journal of

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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: All contemporary methods of insulin administration are non-physiological. Insulin is not absorbed from the gastrointestinal tract because of its peptide nature. The aim of the present study was to examine the absorption of oral insulin from gastrointestinal tract, using novel oral formulation- adding a delivery agent superporouse hydrogel (SPH) and SPH composite (SPHC) in combination with insulin.
Methods: Capsules containing insulin and SPH &SPHC were administered orally, to 15 non-diabetic subjects in order to assess its biological effects and safety. Plasma glucose, insulin and c – peptide serum levels were determined, at timed intervals up to 4 h.
Results: In the present study, we showed that AUC of exogenous insulin in polymer -insulin group was higher than sub-cutaneous regular insulin group. It means that addition of SPHC polymer caused increase in insulin absorbtion.In addition, Insulin Tmax in polymer group was longer than sub-cotaneaus insulin group. Blood glucose AUC in sub-cotaneaus group was higher than polymer group.AUC C-peptide serum level in polymer group was higher than sub-cutaneous group.
Conclusions: Insulin in combination with a novel delivery agent, SPH and SPHC, given orally is absorbed through the GI tract in a biologically active form. This was demonstrated by suppression of endogenous insulin secretion.

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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: All contemporary methods of insulin administration are non-physiological. The euglycemia that is achieved in at the expense of the adverse effects of systemic hyper-insulinemia, emphasize the importance of devising methods to deliver insulin physiologically and directly into the portal circulation. The aim of the present study was to evaluate the oral absorption of insulin from gastrointestinal tract, using novel oral drug delivery system delivery based on superporouse hydrogel (SPH) and SPH composite (SPHC) in combination with insulin.
Methods: This study has been done based on interventional clinical trial in healthy volunteers. Capsules containing insulin and SPH &SPHC in various combination were administered orally, to 15 non-diabetics subjects in order to assess this biological effects and safety. Serum glucose, insulin and C - peptide levels were determined, at predetermined timed intervals up to 4 h.
Results: An increase in serum insulin level was demonstrated in all subjects that used polymer plus insulin. The nadir of serum glucose level appeared after 60 - 120 min following the ingestion of polymer plus insulin. Serum C - peptide levels were suppressed while exogenous insulin was absorbed at the same time. No adverse effects were detected during the trial and several weeks following the trial using SPH based drug delivery system.
Conclusions: Insulin in combination with novel delivery agents, SPH & SPHC, given orally was partially absorbed through the GI tract in a biologically active form. This was demonstrated by serum glucose lowering effect of the delivery system as well as a suppression of plasma C-peptide which also represented a decrease in endogenous insulin secretion.

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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.