Age related metabolic syndrome among hemodialysis patients in Gorgan, Iran

People with metabolic syndrome are at high risk for developing cardiovascular disease. The present study aimed to determine the age related metabolic syndrome of hemodialysis patients. The biochemical parameters and demographic information were registered. The prevalence of metabolic syndrome was significantly high in ages 50-59 and 60-69 years in hemodialysis patients when compared with other age groups (P< 0.05). There was elevated frequency of metabolic syndrome from age 50-59 and 40-49 years in male and female hemodialysis patients, respectively. The frequency of metabolic syndrome in female subjects (65.27%) was higher than male (47.14%, P<0.05). The prevalence of metabolic syndrome was high in ages 50-59 years in males and females. There was a significant difference in hemodialysis patients with metabolic syndrome in ages 50-59 years in males and from ages 40-49, 50-59 and 60-69 years in females (P< 0.05). Our results show that 25.71%, 18.57% and 2.86% males and 36.11%, 20.83% and 8.33% females had three, four and five criteria for metabolic syndrome, respectively. The results of this study showed that females patients were more affected than males. This may depended on the specific lifestyle alterations among females and males patients in this area. Marjani et al

A rare presentation of the Klinefelter's syndrome

A 16 years old boy with Chronic Renal Failure (CRF) was not suspected of having Klinefelter's syndrome until he complained of painful gynecomastia. He was under haemodialysis for 2 years. At first, he was in an approximately full pubertal development (P5, G5), but he had a small and a firm testis (length 2.2cm) and some degree of facial male pattern hair. He also had a decreased upper to lower body segment ratio and despite having chronic renal failure, he was taller than his parents and siblings. His laboratory tests showed high levels of FSH and normal levels of LH and testosterone. With regards to all these findings, we suspected that there might be an occult Klinefelter's syndrome. So, we made his karyotype that showed a 47XXY pattern. Because there are only a few number of cases that have occult Klinefelter's syndrome in the basis of chronic renal failure, we decided to report this case

Comparison of glycemic excursion in patients with new onset type 2 diabetes mellitus before and after treatment with repaglinide

Due to industrialization and sedentary life, incidence of type 2 diabetes (DM2) is increasing seriously. Repaglinide is a glucose reducing agent that predominantly reduces post-prandial glucose. Continuous glucose monitoring system (CGMS) monitors blood glucose excursions over a 3-day period. CGMS can be used as a therapeutic and diagnostic instrument in diabetics. There are not enough studies about using CGMS in DM2. The aim of this study was to determine the blood glucose excursions in patients with new onset of DM2. 10 patients with new onset of DM2 were entered to this study. As the first therapeutic management, patients received diabetic diet and moderate exercise for 3-weeks, if they did not achieve blood glucose goal (Fasting blood glucoser (FBG) <120mg/dl, 2-hour postprandial blood glucose (2hpp) <180mg/dl), were considered to undergo 3-days CGMS at baseline and after 4-weeks on Repaglinide (0.5mg three times before meals). Mean excursions of blood glucose were not different at the onset and at the end of treatment (6±4.05 VS 7.6±5.2 episodes, P=0.49). There were also no significant differences between mean duration of hypoglycemic episodes (zero VS 5.1±14.1 hours, P =0.28) and hyperglycemic episodes before and after therapy (7.6±5.2 VS 5.7±4.1, P=0.42), but mean hyperglycemia duration was significantly reduced at the end of therapy (21±26.17 VS 57.7±35.3, P=0.001). Patients experienced a mean of 0.3±0.67 episodes of hypoglycemia after therapy showed no significant difference before it (P =0.19). Mean FBG (with CGMS) was significantly lower after therapy than before it (142.9±54.31 VS 222.9±82.6, P <0.001). This study showed the usefulness of CGMS not only as a diagnostic but also as an educational and therapeutic tool that in combination with Repaglinide (with the lowest effective dose and duration) can significantly reduce FBG and glycemic excursions in DM2 patients and hypoglycemic events are low. © Hezarkhani et al

Prevalence of metabolic syndrome among Fars ethnic women in North East of Iran

The metabolic syndrome is described by the clustering of several risk factors for cardiovascular disease. This study aimed to assess the metabolic syndrome among Fars ethnic women in Gorgan, Capital City of Golestan province, North East of Iran. The study conducted on the hundred and sixty Fars women (20- 40years) who were referred to the Health Centers in Gorgan. Metabolic syndrome was diagnosed using Adult Treatment Panel-III (ATP-III) guidelines. The mean triglyceride, total cholesterol, waist circumferences and fasting blood glucose levels were significantly higher in the subjects with metabolic syndrome, but the mean HDL-cholesterol was lower (p< 0.05). The prevalence of metabolic syndrome was 20.62%. High abdominal obesity and low HDL-cholesterol level are the most frequent characteristics in comparison to other metabolic components. According to our results, 13.75%, 5.62%and 1.25% had three, four and five criteria for metabolic syndrome, respectively. Low HDL-cholesterol and high waist circumference were the most usual factors of metabolic abnormality among women. Prevalence of cardiovascular diseases might be increased. We have shown some related factors of metabolic syndrome in these women to predict metabolic syndrome in these ethnic groups and help to prevent cardiovascular disease. © IDOSI Publications, 2012

Global agricultural supply chains under tariff-rate quotas

Supporting information is available online at https://onlinelibrary.wiley.com/doi/10.1111/poms.14054#support-information-section .Copyright © 2023 The Authors. The tariff rate quota (TRQ) is a widely utilized market access instrument in global agricultural trade that allows a predetermined quantity of a product to be imported at a lower tariff rate than the usual rate. This study examines the design and administration of TRQ systems from an operations management perspective and analyzes their impact on market access, fill rates, and revenue for policymakers. We investigate the two most common TRQ administration methods, namely, licensing and first-come, first-served (FCFS) systems. We characterize the Nash equilibria (NE) of importers' strategies and observe how information delays and lead times can result in under-utilization (i.e., imports being less than the quota limit) in licensing and over-utilization (i.e., imports exceeding the quota limit) in FCFS TRQ systems. We introduce a dual TRQ system and demonstrate its superiority over licensing and FCFS systems. We study the effects of stock-keeping options through customs-bonded warehouses and the choice of logistics channels on arrival patterns and fill rates. We conduct a case study of the United Kingdom and the European Union imported beef market using customs data. Our numerical study provides an explanation for the suboptimality of the current TRQ systems and proposes modifications to transform the existing systems. Our findings offer practical directions for agricultural traders to reassess their supply chain strategies by considering the logistical implications of TRQ systems and understanding their competition. This study also urges policymakers to adopt an integrative approach in (re)designing TRQ systems, recognizing the pivotal role of supply chains in global agricultural trade.British Academy of Management; Australian and New Zealand Academy of Managemen

The effects of 8 weeks of levothyroxine replacement treatment on metabolic and anthropometric indices of insulin resistance in hypothyroid patients

Background: Insulin resistance (IR) is an independent cardiovascular risk factor. IR predisposes to metabolic syndrome and diabetes. Meanwhile, little evidence exists about the effect of levothyroxine replacement treatment (LRT) on IR in hypothyroid patients. Objective: To investigate metabolic and anthropometric indices of IR in hypothyroid patients before and after 8 weeks of LRT. Methods: This pre-post study evaluated the 8 weeks outcomes of LRT on 66 patients with recently diagnosed hypothyroidism. Outcome measures included body mass index (BMI), waist circumferences (WC), waist to hip ratio (WHR), waist to height ratio (WHtR), body fat percent (BF), free thyroxin (FT4), triglyceride (TG), low density lipoprotein (LDL), fasting plasma levels of glucose (FPG) and insulin. Sex- specific cut offs of two metabolic indices i.e. the triglyceride-glucose (TyG) and the homeostasis model assessment (HOMA) were used for IR diagnosis. The changes in TyG and HOMA were also compared after LRT. Results: Participants were overt and subclinical hypothyroidism 71 and 29, respectively. After LRT the mean values of the following anthropometric indices significantly decreased: weight (79.61 vs. 78.64), BMI (29.53 vs. 29.2), WC (98.25 vs. 97.39) and BF (35.34 vs. 34.95). After LRT the HOMA and TyG had no significant changes relative to their initial values. Also, IR that was determined on the basis of these metabolic indices more commonly observed in participants. Conclusion: Despite decreasing some anthropometric indices, the diagnosis of IR based on metabolic indices increased following 8 weeks LRT in hypothyroid cases. © 2020 Bentham Science Publishers

Lead and zinc geochemical behavior based on geological characteristics in Parkam Porphyry Copper System, Kerman, Iran

Parkam (Sarah) porphyry system is located on the metallogenic belt of Kerman, Iran. Due to existence of some copper-rich resources in this region, finding out the exact statistical characteristics such as distribution of data population, mean, variance and data population behavior of elements like Cu, Mo, Pb and Zn is necessary for interpreting their geological behavior. For this reason, precise calculation of statistical characteristics of Pb and Zn grade datasets was performed and results were interpreted geologically. The natures of Pb and Zn distributions were initially identified and their distributions were normalized through statistical treatment. Subsequently, the variograms were calculated for each exploration borehole and show that both Pb and Zn geochemical variates are spatially correlated. According to the similarity of the behavior of Pb and Zn in these calculations, it is decided to measure their exact behavior applying K-means clustering method. K-means clustering results show that the Zn grade varies linearly relative to that of Pb values and their behavior is similar. Based on the geochemical behavior similarity of Pb and Zn, throughout the pervasive secondary hydrothermal activity, they are remobilized in the similar manner, from the deep to the shallow levels of the mineralization zones. However, statistical analysis suggests that hydrothermal activity associated with secondary waters in Parkam is effective in remobilizing and enriching both Pb and Zn since they have similar geochemical characteristics. However, the process does not result in generation of economic concentrations

Some statistical analyses of Cu and Mo variates and geological interpretations for Parkam porphyry copper system, Kerman, Iran

Precise calculation of statistical characteristics of Cu- and Mo-grade datasets was performed and results were interpreted geologically. The nature of Cu and Mo distributions were initially identified and the distributions were normalized through statistical treatment. Subsequently, the variograms were calculated for each exploration borehole and showed that both Cu and Mo geochemical variates have a spatial correlation, the result upon which the k-means clustering analysis for the whole Cu- and Mo-grade values in the area (see the text) became feasible. Based on the different geochemical behaviors of Mo and Cu, pervasive secondary hydrothermal activity which may exist for long periods, can remobilize Cu from deep parts of mineralization to the shallower levels while Mo is not remobilized significantly. However, in this paper, statistical analysis suggested that hydrothermal activity associated with secondary waters in Parkam was not effective enough to remobilize and enrich Cu. Yet the lower variation (variance) of Cu may indicate some sort of remobilization and enrichment of this element in the system (compared to Mo with higher variance); however, the process did not make the system evolve economically