Effect of vitamin D3 supplement in glycemic control of pediatrics with type 1 diabetes mellitus and vitamin D deficiency

Background: Glycemic control prevents microvascular complications in patients with type I diabetes mellitus such as retinopathy, nephropathy and neuropathy that influences quality of life. Some studies show the immunomodulatory effect of vitamin D in synthesis and secretion of insulin. Aims: In this study we evaluate glycemic changes after vitamin D3 supplement in children with type I diabetes mellitus and vitamin D deficiency. Materials and Methods: In children with type I diabetes mellitus, level of vitamin D and HbA1C was measured. Patients with type I diabetes mellitus who had vitamin D deficiency (25OHD 9.9. This supplement transfer patients toward better glycemic control for the entire group (p-value < 0.0001). Conclusion: Vitamin D3 supplement improves HbA1C in pediatrics with type I diabetes mellitus and vitamin D deficiency. © 2015, Journal of Clinical and Diagnostic Research. All Rights Reserved

Changes in Bone Turnover, Inflammatory, Oxidative Stress, and Metabolic Markers in Women Consuming Iron plus Vitamin D Supplements: a Randomized Clinical Trial

We aimed to investigate whether combination of vitamin D and iron supplementation, comparing vitamin D alone, could modify bone turnover, inflammatory, oxidative stress, and metabolic markers. Eighty-seven women with hemoglobin (Hb) � 12.7 g/dL and 25OHD � 29 ng/mL vitamin D deficiency/insufficiency aged 18�45 years were randomly assigned into two groups: (1) receiving either 1000 IU/day vitamin D3 plus 27 mg/day iron (D-Fe); (2) vitamin D3 plus placebo supplements (D-P), for 12 weeks. In D-Fe group, significant decrease in red blood cells (RBC) (P = 0.001) and hematocrit (Hct) (P = 0.004) and increases in mean corpuscular hemoglobin concentration (MCHC) (P = 0.001), 25OHD (P < 0.001), osteocalcin (P < 0.001), high-density cholesterol (HDL) (P = 0.041), and fasting blood sugar (FBS) (P < 0.001) were observed. D-P group showed significant decrease in RBC (P < 0.001), Hb (P < 0.001), Hct (P < 0.001), mean corpuscular volume (MCV) (P = 0.004), mean corpuscular hemoglobin (MCH) (P < 0.001), MCHC (P = 0.005), serum ferritin (P < 0.001), and low-density cholesterol (LDL) (P = 0.016) and increases of 25OHD (P < 0.001), osteocalcin (P < 0.001), C-terminal telopeptide (CTX) (P = 0.025), triglyceride (TG) (P = 0.004), FBS (P < 0.001), and interleukin-6 (IL-6) (P = 0.001) at week 12. After the intervention, the D-P group had between-group increases in mean change in the osteocalcin (P = 0.007) and IL-6 (P = 0.033), and decreases in the RBC (P < 0.001), Hb (P < 0.001), Hct (P < 0.001), and MCV (P = 0.001), compared with the D-Fe group. There were significant between-group changes in MCH (P < 0.001), MCHC (P < 0.001), ferritin (P < 0.001), and serum iron (P = 0.018). Iron�vitamin D co-supplementation does not yield added benefits for improvement of bone turnover, inflammatory, oxidative stress, and metabolic markers, whereas, vitamin D alone may have some detrimental effects on inflammatory and metabolic markers. IRCT registration number: IRCT201409082365N9 © 2020, Springer Science+Business Media, LLC, part of Springer Nature

Relationship between 25-hydroxy vitamin-D and obesity in 2-7 years old children referred to a paediatric hospital in Iran

Background: Obesity is increasing in children and it can cause many complications in adulthood, such as Diabetes mellitus (DM) and metabolic syndrome. In observational studies, vitamin-D was one of the factors which were found to be associated with obesity

Usefulness of Doppler ultrasound for the early diagnosis of diabetic nephropathy in type 1 diabetes mellitus

Purpose: Early diagnosis and management of diabetic nephropathy (DN) might prevent or delay its progression to end-stage renal disease. The purpose of this study was to investigate whether changes in the duplex Doppler resistivity index (RI) are useful for the early identification of renal involvement in children and adolescents with insulin-dependent diabetes mellitus and associated conditions. Materials and methods: A total of 49 diabetic patients (two groups: 21 with DN and 28 without DN) were included in this study. DN was defined as 30�300 mg/l of albumin excretion in a random urine sample. The RI of the main renal arteries and their intrarenal branches (arcuate, interlobar) were evaluated with duplex Doppler ultrasound and correlated with age, renal length, duration of diabetes, and laboratory examinations. Results: The mean age did not significantly differ between the two groups. The patients with DN had a significantly longer duration of type 1 diabetes (p = 0.02). The majority of patients (90.5) had mild renal involvement with microalbuminuria and normal renal function. The mean RI was normal in both groups of patients, with no significant difference between the two groups. Conclusion: The RI did not increase in the early clinical stage of DN and was not a reliable marker for the screening of DN in patients with type 1 diabetes mellitus. © 2021, Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB)

Correlation between Grade in Transitional Cell Carcinoma (TCC) and Expression of Epidermal Growth Factor Receptor (EGFR)

Background: The present study was undertaken to investigate the correlation of Epidermal Growth Factor Receptor (EGFR) expression with grade of Transitional Cell Carcinoma (TCC). Methods: Tumor samples of 75 patients from Mostafa Khomaini Hospital with Transitional Cell Carcinoma of the bladder were analyzed by immunohistochemistry for expression of EGFR. In this context, we assigned the bladder tumors a grade accord¬ing WHO classification. Results analyzed for possible correlation with the expression status of the Epidermal Growth Factor Receptor (EGFR). Results: This cross-sectional study showed that all grades of Transitional Cell Carcinoma expressed EGFR, and 14 cases were LMP (18.9%) which 10 cases among them had negative cells according EGFR point of view(71.4%) and 4 cases had re¬ported positive (28.6%). Thirty five cases were low grade (46.7%) which 18 cases among them had reported negative cells (51.4%) and 17 cases had positive cells (48.6%). Twenty six cases were high grade (34.7%) that 9 cases among them had reported negative cells (34.6%). Seventeen cases had positive cells (65.4%). Mann-Witney test showed relation between grade and expression of EGFR (P&lt;0.05). Conclusions: This study showed that expression of EGFR is correlated with grade of tumor

High Dose Oral Calcium Treatment in Patients with Vitamin D-dependent Rickets Type II

BACKGROUND AND OBJECTIVE: Vitamin D-dependent rickets type II (VDDR2) is a rare genetic disorder caused by mutations in vitamin D receptor (VDR) and leads to resistance to biological effects of calcitriol. Based on the type of mutation, this disease is resistant to calcitriol even at high doses of calcitriol and successful treatment of these patients requires hypocalcemic modification through administration of high doses of calcium and bypassing the intestinal defect in VDR signaling. In addition to the need for frequent hospitalization and high costs, intravenous administration of calcium is associated with complications and problems such as arrhythmia and sepsis, venous catheter infection and hypercalciuria. This study aims to report the positive treatment effects of high doses of oral calcium in 4 patients with vitamin D-dependent rickets type II. CASE REPORT: In this study, 4 patients with vitamin D-dependent rickets type II, diagnosed based on clinical and biochemical symptoms of rickets with alopecia, underwent therapy using high doses of oral calcium (300 mg/kg/day) in pediatric endocrinology and metabolism center of Imam Reza hospital. After a short period, increased growth rate in height, strength and elasticity of muscles was observed in addition to biochemical improvements without serious side effects and even one patient started walking independently within the first week of therapy for the first time. Patients were regularly followed up in terms of height and weight, growth rate and biochemical factors including calcium, phosphorus and alkaline phosphatase every 3 months for one year. CONCLUSION: Regardless of the type of mutation in vitamin D receptor, it is suggested that a 3-6 months trial of high dose oral calcium be started in each patient with vitamin D-dependent rickets type II, particularly for patients whose disease was diagnosed at lower ages

Effect of letrozole on the predicted adult height in boys with constitutional delay of growth and puberty: A clinical trial

Objectives: The aim of this was to investigate the effect of letrozole (an aromatase inhibitor) on the Predicted Adult Height (PAH) in boys with constitutional delay of growth and puberty. Methods: In this clinical trial, the boys with constitutional delay of growth and puberty referred to Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences. Tehran was studied. Patients were treated with letrozole (letrofome, Iran Hormone Manufacturing Co., Tehran, Iran) at a dose of 2.5 mg for one year and then discontinued for 6 months and patients were followed up. Results: During one year taking letrozole, bone age was progressed from 12.49 ± 0.9 y to 13.18 ± 0.7 y and 13.64 ± 0.7 at 6 months after discontinuation. PAH at baseline was 172.5 ± 5.4 cm and after 12 and 18 months was 175.2 ± 4.3 and 174.9 ± 5.4 cm, respectively. PAH mean difference at baseline and 12th month was 2.8 cm (P=0.02), and at 12th and 18th months was-0.3 cm (P=0.70). In bone densitometry, Z-score of spine during treatment with letrozole and after discontinuation increased to 0.084 ± 0.3 and 0.083 ± 0.1, respectively, and the difference was not significant. Mineral density of the femoral neck in the treatment period, 0.04 decreased, but after discontinuation the treatment, 0.4 increased that change was not significant. Conclusions: The study provides an indication for the treatment with letrozole (aromatase inhibitors) increase PAH with slowing the progression of bone age and letrozole has no adverse effects on bone metabolism and serum lipids. © 2017, Scientific Publishers of India. All rights reserved

Utility of Urine N-acetyl-β-D-glucosaminidase for Prediction of Renal Damage in Obese Children

The incidence of obesity has increased globally in children and adults. In addition, renal dysfunction is an important complication of childhood obesity. This study was performed to identify the diagnostic value of N-acetyl-β-D-glucosaminidase (NAG), a renal injury marker, for the early determination of renal damage in childhood obesity. Totally, 115 obese children and 115 healthy normal weight controls were enrolled in a cross-sectional case�control study. Urine NAG was measured in sample urine and normalized by urine creatinine (CR). In addition, correlation of urine NAG with other variables such as blood pressure (BP), blood glucose, and urine albumin was evaluated. Mean systolic BP (P <0.001), serum glucose (P = 0.047), urine albumin/Cr (P = 0.049), and urine NAG/Cr (P = 0.037) were significantly higher in obese children, compared with normal healthy controls. There was no correlation between urine NAG and urine albumin excretion. Urinary NAG/Cr was a simple and safe screening test for early determination of renal damage in children with obesity. © 2021 Saudi Center for Organ Transplantation

Evaluation of libido in post hysterectomy patients

Background: Hysterectomy is a common surgery as treatment for chronic and benign gynecologic problems. Eeach year more than half million women in USA undergo hysterectomy. Methods: This analytical cross-sectional study, was done on 100 women who had underwent hysterectomy at least two years before the study; and met inclusion criteria of study. During interview, the questionnaire were completed, then examination was done by gynecologist. Most of the information were collected from the patient’s files. Results: In this study the most indication of hysterectomy was fibroma and the most common type surgery was total abdominal hysterectomy, and mostly were done without oophorectomy. 20% of cases were without or weak prior to operation and 80% with medium (or high) libido, after hysterectomy the figures changed to 41% and 59% respectively. After hysterectomy libido with P=0.001, frequency of coitus with P=0.001, and sexual satisfaction with P=0.013, significantly declined. Libido after hysterectomy declined with aging (P=0.01). There was no significant correlation between oophorectomy and libido. Conclusion: Sexual function declines significantly after hysterectomy, with no association with oophorectomy and type of surgery

Diltiazem-loaded electrospun nanofibers as a new wound dressing: fabrication, characterization, and experimental wound healing

Calcium channel blockers such as diltiazem have recently been investigated for their wound-healing potential. The aims of this study were to fabricate diltiazem-loaded nanofibers for a new wound dressing and investigate their beneficial properties for wound healing. Nanofibers were electrospun using polyvinyl alcohol solution containing 0, 2 or 4% diltiazem. Fibers were characterized in terms of physicochemical properties, drug release and fibroblast viability, and in animal wound healing assays. Compared to other formulations, nanofibers containing 4% diltiazem showed thin fiber size (152.7 nm), high porosity (88.4%), high swelling (110.4%), low water contact angle (29.1°) and little weight loss (17.3%). Drug release from 4%-diltiazem nanofibers showed good fit to a Korsmeyer–Peppas model, suggesting a non-Fickian release mechanism (R 2 = 96%, n = 0.52). In vitro, 4%-diltiazem mats were not cytotoxic and enhanced fibroblast proliferation by 263% after 5 days of treatment compared to control. In vivo, wounds treated with this mat for 14 days showed the smallest size (14.7%) and better histopathologic characteristics compared to other wounds. The 4%-diltiazem mat also demonstrated significant antioxidant activity by reducing tissue MDA and nitrite levels by 63 and 59% compared to normal saline. The findings support the eligibility of this novel wound dressing for additional clinical research