Clozapine, Fluoxetine, and Benztropine- associated Ileus: Case Report

Gastrointestinal complications of anticholinergic medications are prevalent, potentially life-threatening, and could be more actively prevented. We present a case report of an ileus that required surgical intervention and developed in the context of clozapine, benztropine, and fluoxetine use. The case exemplifies the potential anticholinergic toxicities of clozapine and benztropine as well as possible pharmacokinetic interactions between fluoxetine, clozapine, and benztropine. We discuss ways to minimize the likelihood of anticholinergic complications with these medications

Potential risk factors for diabetic neuropathy: a case control study

BACKGROUND: Diabetes mellitus type II afflicts at least 2 million people in Iran. Neuropathy is one of the most common complications of diabetes and lowers the patient's quality of life. Since neuropathy often leads to ulceration and amputation, we have tried to elucidate the factors that can affect its progression. METHODS: In this case-control study, 110 diabetic patients were selected from the Shariati Hospital diabetes clinic. Michigan Neuropathic Diabetic Scoring (MNDS) was used to differentiate cases from controls. The diagnosis of neuropathy was confirmed by nerve conduction studies (nerve conduction velocity and electromyography). The multiple factors compared between the two groups included consumption of angiotensin converting enzyme inhibitors (ACEI), blood pressure, serum lipid level, sex, smoking, method of diabetes control and its quality. RESULTS: Statistically significant relationships were found between neuropathy and age, gender, quality of diabetes control and duration of disease (P values in the order: 0.04, 0.04, < 0.001 and 0.005). No correlation was found with any atherosclerosis risk factor (high BP, hyperlipidemia, cigarette smoking). CONCLUSION: In this study, hyperglycemia was the only modifiable risk factor for diabetic neuropathy. Glycemic control reduces the incidence of neuropathy, slows its progression and improves the diabetic patient's quality of life. More attention must be paid to elderly male diabetic patients with poor diabetes control with regard to regular foot examinations and more practical education

Treatment of hyperfunctioning thyroid nodules by percutaneous ethanol injection

BACKGROUND: Autonomous thyroid nodules can be treated by a variety of methods. We assessed the efficacy of percutaneous ethanol injection in treating autonomous thyroid nodules. METHODS: 35 patients diagnosed by technetium-99 scanning with hyperfunctioning nodules and suppressed sensitive TSH (sTSH) were given sterile ethanol injections under ultrasound guidance. 29 patients had clinical and biochemical hyperthyroidism. The other 6 had sub-clinical hyperthyroidism with suppressed sTSH levels (<0.24 μIU/ml) and normal thyroid hormone levels. Ethanol injections were performed once every 1–4 weeks. Ethanol injections were stopped when serum T(3), T(4 )and sTSH levels had returned to normal, or else injections could no longer be performed because significant side effects. Patients were followed up at 3, 6 and, in 15 patients, 24 months after the last injection. RESULTS: Average pre-treatment nodule volume [18.2 ± 12.7 ml] decreased to 5.7 ± 4.6 ml at 6 months follow-up [P < 0.001]. All patients had normal thyroid hormone levels at 3 and 6 months follow-up [P < 0.001 relative to baseline]. sTSH levels increased from 0.09 ± 0.02 μIU/ml to 0.65 ± 0.8 μIU/ml at the end of therapy [P < 0.05]. Only 3 patients had persistent sTSH suppression at 6 months post-therapy. T(4 )and sTSH did not change significantly between 6 months and 2 years [P > 0.05]. Ethanol injections were well tolerated by the patients, with only 2 cases of transient dysphonia. CONCLUSION: Our findings indicate that ethanol injection is an alternative to surgery or radioactive iodine in the treatment of autonomous thyroid nodules

Honey, a Gift from Nature to Health and Beauty: A Review

Benefits of honey are contributed by the composition of its elements such as glucose, fructose, glucose oxidase, vitamins and phenolic compounds. For health, honey can be used to treat wounds due to the antibacterial activity conferred by the hydrogen peroxide produced by glucose oxidase in honey. Anti-inflammatory, anti-oxidant, deodorizing and tissue regeneration activities in honey also help in the wound healing process. It can also be an alternative sweetener for diabetic patients to ensure compliance to a healthy diet. Moreover, honey exerts several effects such as lowering low density lipids and increasing high density lipids, thus reducing risk of atherosclerosis. In terms of beauty, honey can be used on skin and hair. It moisturizes skin through its natural humectant properties contributed by high contents of fructose and glucose. Honey treats acne on the skin due to its antibacterial activity, anti-inflammatory action and tissue repair. The hair can benefit from honey in such a way that the hair has abundance, and becomes easier to comb. However, there have not been as many studies regarding the use of honey in skin in comparison to its use for health. Therefore, future studies on honey could research its use, action and benefits in both cosmetics and dermatology

Osteoporosis, Global and Iranian Aspects

Osteoporosis, characterized by low bone mass and microarchitectural deterioration of bone tissue leading to enlarged bone fragility and a consequent increase in fracture risk is a leading cause of morbidity and mortality in elderly people. The mortality rate in elderly persons with hip fracture approaches 20%. Half of them will be disabled in the remained life. Iranian Multicenter Osteoporosis Study (IMOS) developed by Endocrinology and Metabolism Research Center of Tehran University of Medical Sciences (EMRC-TUMS) and Ministry of Health and Medical Education in 2000. The aim of this study with more than 6000 participitants, was to determine normal range of BMD in Iranian population and assessing the current calcium and vitamin D status in Iran. The results were used for determining the normrmogram of BMD in Iranians and prevalence of Vit-D deficinecy among them. This document outlines all aspects of osteoporosis including risk factors, diagnosis, treatment and prevention of osteoporosis

Iranian Osteoporosis Research Network: Background, Mission and Its Role in Osteoporosis Management

&quot;nBecause of increase in elderly population, osteoporosis appears to become as a major public health issue in developing countries as in Iran. In order to obtain a clearer picture of osteoporosis in Iran, studies on different aspect of osteoporosis especially national projects about epidemiology and burden of disease, are required. Coordinating research programs is pos&amp;shy;sible only by establishing a research network, so the national osteoporosis research network was suggested by Endocrinol&amp;shy;ogy and Metabolism Research of Tehran University of Medical Sciences. Iranian Osteoporosis Research Network (IORN) was established in 2002 by approval of Deputy for Research and the National Advisory Committee on Non-communicable Diseases of Ministry of Health and Medical Education of Iran. At first, five centers of Medical Sciences Universities and Research Centers in addition to the EMRC, participated in this project. Gradually more centers joined to the network and the numbers of IORN members are now 41 persons from 21 universities and research centers. IORN has had several activi&amp;shy;ties: 1) Research projects, from among them are Iranian Multi-center Osteoporosis Study (IMOS) and Hip Fracture Registry Project (HFRP) in Iran 2) Educational activities with the aim of preventing osteoporosis and its related fractures 3) Estab&amp;shy;lishment of osteoporosis clinic.&amp;nbsp; In summery osteoporosis is an important public health issue especially in developing coun&amp;shy;tries be&amp;shy;cause of increasing in elderly population. Close relationship between academic and research centers through the IORN mem&amp;shy;bership provided possibility of designing and applying national research projects on epidemiology and burden of osteoporosis

Iranian Osteoporosis Research Network: Background, Mission and Its Role in Osteoporosis Management

Because of increase in elderly population, osteoporosis appears to become as a major public health issue in developing countries as in Iran. In order to obtain a clearer picture of osteoporosis in Iran, studies on different aspect of osteoporosis especially national projects about epidemiology and burden of disease, are required. Coordinating research programs is possible only by establishing a research network, so the national osteoporosis research network was suggested by Endocrinology and Metabolism Research of Tehran University of Medical Sciences. Iranian Osteoporosis Research Network (IORN) was established in 2002 by approval of Deputy for Research and the National Advisory Committee on Non-communicable Diseases of Ministry of Health and Medical Education of Iran. At first, five centers of Medical Sciences Universities and Research Centers in addition to the EMRC, participated in this project. Gradually more centers joined to the network and the numbers of IORN members are now 41 persons from 21 universities and research centers. IORN has had several activities: 1) Research projects, from among them are Iranian Multi-center Osteoporosis Study (IMOS) and Hip Fracture Registry Project (HFRP) in Iran 2) Educational activities with the aim of preventing osteoporosis and its related fractures 3) Establishment of osteoporosis clinic. In summery osteoporosis is an important public health issue especially in developing countries because of increasing in elderly population. Close relationship between academic and research centers through the IORN membership provided possibility of designing and applying national research projects on epidemiology and burden of osteoporosis