TyG index and insulin resistance in beta-thalassemia

Insulin resistance (IR) underlies some glucose metabolism abnormalities in thalassemia major. Recently, triglyceride glucose index (TyG) has been proposed for evaluating insulin resistance as a simple, low cost, and accessible tool. In this study, the TyG index were studied for IR monitoring in beta-thalassemia major (βTM) patients. The participants were 90 βTM patients on chronic regular transfusion therapy. The TyG index was computed based on fasting plasma glucose (FPG) and triglyceride (TG). The time gap between the first and the second TyG index survey (TyG.1 and TyG.2) was 2 years. The agreement between TyG and HOMA-IR were studied with the extension of limit of agreement (LOA). We included 90 patients 53.3 % men (n = 48). Among them, 14.4 % (14.6 % male, 14.3 % female) had impaired fasting glucose level (e.g., 100–125 mg/dl) at first test. It rose to 37.8 % (27.1 % male, 50 % female) during 2 years. Based on TyG.1, the 34.4 % of patients was detected as IR cases. After 2 years, the percent of IR based on TyG.2 was 82.2 %. The mean differences between TyG.1 and TyG.2 and their differences from the considered cutoff values were significant (P < 0.001). The prediction limits between TyG and HOMA-IR had good agreement. These data may suggest the use of TyG index for detection/monitoring of IR in βTM patients. © 2015, Research Society for Study of Diabetes in India

The effect of gag reflex on cardiac sympatovagal tone

Objectives: Heart velocity may be influenced by gagging. The medulla oblongata receives the afferents of gag reflex. Neuronal pools of vomiting, salivation and cardiac parasympathetic fibers are very close in this area. So, their activities may be changed by spillover from each other. Using the heart rate variability (HRV) analysis, the effect of gagging on cardiac sympatovagal balance was studied. Methods: ECG was recorded from 9 healthy nonsmoker volunteer students for 10 minutes in the sitting position between 10 and 11 AM. Gagging was elicited by tactile stimulation of the posterior pharyngeal wall. At 1 kHz sampling rate, HRV was calculated. The mean of heart rate at low and high frequencies (LF: 0.04-0.15; HF: 0.15-0.4 Hz) were compared before and after the stimulus. Results: The mean of average heart rate, LF and HF in normalized units (nu) and the ratio of them (LF/HF) before and after the gagging were 89.9 ± 3 and 95.2 ± 3 bpm; 44.2 ± 5.8 and 21.2 ± 4; 31.1 ± 5.3 and 39.4 ± 3.8; and 1.7 ± 0.3 and 0.6 ± 0.2 respectively. Conclusion: Gagging increased heart velocity and had differential effect on two branches of cardiac autonomic nerves. The paradoxical relation between average heart rate and HRV indexes of sympatovagal tone may be due to unequal rate of change in autonomic fiber activities which is masked by 5 minutes interval averaging. © OMSB, 2012

Change in bone mineral density in post menopausal women with rheumatoid arthritis

Introduction: Low bone mass is a serious complication of post menopausal women with rheumatoid arthritis. We determined the Change in Bone Mineral Density in postmenopausal women with rheumatoid arthritis. Methods: This retrospective cohort study was carried out on consecutive postmenopausal women with rheumatoid arthritis who were referred to the Azar 5th teaching hospital affiliated to Golestan University of Medical Sciences, North of Iran in 2009. The required data were gathered from the patients' medical records. The data were analyzed using SPSS software and statistical tests. Results: We studied 98 postmenopausal women with rheumatoid arthritis. Mean number of years since menopause and mean duration of disease were 9.39 and 5.13 respectively. T Score mean in femoral neck and lumbar spines was -1.45±1.26 and -2.45±1.44 respectively. The overall prevalence of osteoporosis at both the lumbar spine and femoral neck was 13.3. We have found a significant correlation between age, duration of disease, duration of menopause and bone mineral density (P-Value<0.01). Conlusion: Our results indicate a negative effect of age, number of years since menopause and duration of disease on bone mineral density. So, BMD should be measured in high risk women prior to the implementation of any treatment or prevention program

Use of leisure time in cardiovascular patients in Gorgan (South East of Caspian Sea)

The aim of this study was to compare activity patterns and leisure time between matched groups of patients with cardiovascular disease and individuals without a heart disease. The study included 100 patients recruited from those referred to cardiology department of 5th Azar General Hospital of Golestan University of Medical Sciences in Gorgan (South East of Caspian Sea) and 100 matched control subjects during the period 2007-2008. Odds ratios (OR), together with 95% confidence intervals (95% CI), were calculated using logistic regression, as estimates of relative risks. Listening to music OR = 8.800 (95% CI: 2.717-28.499, p<0.05), meditation OR = 6.111 (95% CI; 2.616-14.274, p<0.05) were independent risk factors. Subjects who performed 2 h per week and 2-4 h per week physical activity, the odds ratios were 0.038 ( 95% CI: 0.012-0.124, p<0.05) and 0.079, (95% CI: 0.024-0.260, p<0.05), respectively. Low physical activity and use of long time relaxation are associated with cardiovascular disease in these patients. Regular participation in physical activity such as walking 2 h per week and 2-4 h per week, are associated with reduced risk of cardiovascular disease. This study suggests the importance of both leisure-time physical activity and sedentary behaviors in the prevention of CVD. © 2009 Asian Network for Scientific Information

Antimicrobial resistance patterns of urinary tract pathogens in young children from Gorgan, Northern Iran

The antibiotic resistance or susceptibility patterns of common bacterial pathogens vary between geographical regions. We investigated the antibiotic resistance pattern of common uropathogens in a population of young children. In this cross- sectional retrospective study, children suspected of having urinary tract infection (UTI) that were referred to Taleghani Pediatric Hospital from March 2009 until March 2010 were included. Urine cultures were performed before initiation of antibiotics. Demographic information and results of cultures and antibiograms were obtained from the laboratory archive. Cultures with colony count ≥ 105 cfu/ml in midstream urine samples or any colony count in the suprapubic samples were considered to be positive. Antimicrobial susceptibility testing was performed using the Kirby Bauer disc diffusion method. We evaluated 7844 urine cultures of which 153 (2%) were obtained from supra-pubic aspiration route. 3839 (48.9%) were male. In total, 533 (6.8%) of cultures were positive (64.2% were female). E. coli was the most common organism in positive samples in both sexes, but it was significantly more common in the females than males (83.3% vs. 75.4%, P < 0.05). E. coli showed the highest percentage of resistance to ampicillin (84.1%) and the lowest resistance to amikacin (11%). We found that E. coli was the predominant bacterial pathogen and that the antimicrobial resistance patterns of the different uropathogens were highly variable, emphasizing the importance of continuous surveillance of trends in resistance patterns of uropathogens. © 2013 - IOS Press and the authors. All rights reserved

Prevalence and risk factors of osteoporosis in postmenopausal women with rheumatoid arthritis: a brief report

Background: Low bone mass is a serious health problem mostly seen in postmeno-pausal women with rheumatoid arthritis. The purpose of this study was to determine the prevalence of osteoporosis and some related risk factors in postmenopausal women with rheumatoid arthritis.Methods: The data for this descriptive analytical study was extracted from the medical records of 98 postmenopausal women with rheumatoid arthritis who had attended the 5th of Azar Teaching Hospital affiliated to Gorgan University of Medical Sciences, in Iran, in 2009.Results: The mean durations of menopause and rheumatoid arthritis were 9.39 and 5.13 years, respectively. The overall prevalence of osteoporosis was 13.3%. We found a significant correlation between age, disease duration, and duration of menopause with bone mineral density (P<0.05).Conclusion: Our results indicate a high prevalence of osteoporosis at the lumbar spine of postmenopausal women with rheumatoid arthritis