Serum magnesium in association with parathyroid hormone levels in routine hemodialysis patients

Abstract Introduction: The homeostasis of magnesium (Mg) is perturbed in chronic kidney disease. It has been supposed that plasma Mg has a principal role to regulate the secretion of parathyroid hormone (PTH). Plasma Mg is capable of modulating secretion of PTH. Recent investigations showed that low serum Mg levels in patients with kidney disease have been linked to increased mortality. Objectives: The aim of this study was to determine the relationship between serum Mg and PTH levels in hemodialysis patients. Patients and Methods: This cross-sectional study was conducted on 56 hemodialysis patients in hemodialysis center of Hajar hospital of Shahrekord in 2015. Regular hemodialysis patients who had at least three months history of dialysis were enrolled to the study. The serum levels of Mg, calcium, phosphorus, intact PTH (iPTH), alkaline phosphatase, albumin and bicarbonate were measured. Results: In this study, 61.5% of the 52 patients were male. Mean ± standard deviation (SD) of patients’ age was 60.5 ± 17.7 years with median of 63 years old. The average duration of dialysis was 44±39.5 months (median 36 months). Additionally the dialysis dose was 517 ± 479 weeks (median; 414 weeks). Mean ± SD of serum iPTH and Mg were 360.1 ± 238.2 pg/mL and 2.2 ± 0.2 mg/mL respectively. In this study we found a significantly positive correlation of iPTH with serum Mg levels (r=0.28, P=0.04). Conclusion: This study shows impact of Mg on parathormone secretion. Our findings require further investigations with larger and multicentric studies. Please cite this paper as: Fooladgar M, Malekpour A, Asgari-Savadjani S, Mardani S. Serum magnesium in association with parathyroid hormone levels in routine hemodialysis patients. J Parathyr Dis. 2018;6(1):13-15. DOI: 10.15171/jpd.2018.05. Copyright © 2018 The Author(s); Published by Nickan Research Institute. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work i

Association of serum magnesium level with resistant hyperlipidemia in diabetic and hypertensive patients

Introduction: Both diabetes mellitus and hypertension are aspects of metabolic syndrome. Objectives: The aim of this study was to determine the relationship between serum magnesium level with resistant hyperlipidemia in a group of diabetic and hypertensive patients. Patients and Methods: The present cross-sectional study was carried out on 90 hypertensive and diabetic patients who referred to outpatient university clinic in Shahrekord (45 hypertensive and 45 diabetic patients). Included patients had high triglyceride levels despite 8 weeks of treatment with lipid-lowering agents. Results: There was an inverse significant relationship between serum magnesium and triglyceride levels in diabetic patients (P = 0.002, r =-0.458), however, this correlation was not significant in hypertensive patients (P = 0.754, r = 0.048). Conclusion: This study showed, serum magnesium may affect triglycerides levels in diabetic patients, however, our finding requires further investigation with larger population

The effect of chronic obstructive pulmonary disease’s severity on complications after coronary artery bypass graft surgery

Background and aims: Smoking is an important etiologic factor for cardiac and pulmonary diseases. Chronic Obstructive Pulmonary Disease (COPD) is common in candidates for Coronary Artery Bypass Graft (CABG) surgery. Severity of COPD is determined with spirometry. The aim of this study was comparison of complications after CABG in COPD patients with different severity and without COPD. Methods: This study is a cross sectional research. We divided 125 CABG patients more than 40 years old based on preoperative spirometry to four groups: without COPD (60), mild (29), moderate (24) and severe (12). Spirometry was done using spirometer MIR, made in Italia. Mortality and postoperative complications including cardiovascular and respiratory were recorded until 30 days after the surgery. Data were analyzed by SPSS, fisher exact test and 2χ, and P˂0.05) was considered significant. Results: Complications with significant difference between groups were atrial fibrillation (AF) and delirium. Frequency of AF was: Without COPD 6 (10%), mild COPD 6 (20.70 %), moderate COPD 7 (29.20%), and severe COPD 5 (41.70%) (P=0.02), and delirium was: Without COPD 3 (5%), mild COPD 1 (3.40%), moderate COPD 3 (12.5%), and severe COPD 5 (41.70%) (P=0.003). Conclusion: Based on our results, COPD even moderate and severe is not contraindication of CABG. These patients should be carefully evaluated before surgery and must be treated preoperative completely by the specialist. Under this condition, patients can tolerate and benefit from surgery with acceptable risk

Low-level laser for treatment of tinnitus: a self-controlled clinical trial

BACKGROUND: Despite the high prevalence and morbidity, tinnitus still remains an obscure symptom. We assessed the efficacy of low-level laser for treatment of tinnitus. METHODS: It was a self controlled clinical trial study on 61 outpatients with subjective tinnitus. The patients were irradiated with a 650-nm, 5-mW soft laser for twenty days and twenty minutes per day. The sensation of tinnitus was measured on a Visual Analog Scale (VAS) before and two weeks after treatment and they were compared by means of Wilcoxon signed rank-test. RESULTS: Thirty-eight (62.3%) patients were men and twenty-three (37.7%) were women. Fourteen patients (31.8%) worked in noisy environment. The VAS mean difference before and after the treatment was statistically significant (p < 0.0001). The best treatment effect was in the youngest group and there were significant differences between this group and the middle age and older groups (p = 0.018 and 0.001, respectively). The mean VAS score reduction was not statistically significant between male and female patients (p = 0.23). Also, the treatment outcome according to the noise level in patient’s workplaces was not significantly different in women (p = 0.693), but it was significant in men (p = 0.029). CONCLUSIONS: Transmeatal low-level laser irradiation is effective for the treatment of tinnitus and some variables like age and job can affect the treatment outcom

The research and development on the antioxidants in prevention of diabetic complications

Diabetes mellitus can damage the eyes, kidneys, nerves and heart. Microvascular and macrovascular disorders are the leading causes of morbidity and mortality in diabetic patients. Hyperglycemia can increase the indicators of lipid peroxidation and oxidative stress in which free radicals have the main role in the pathogenesis of these complications. Therefore, antioxidants which combat oxidative stress should be able to prevent and repair free radicals induced damages. Although free radicals contribute to kidney damage, atherosclerosis, diabetes, heart disease, nephrotoxicity and hepatotoxicity; however, clinical trials do not uniquely confirm a substantial impact on diabetic damage. It seems that antioxidants in vegetables, fruits and grains help preventing diabetes complications; however, there is little evidence that taking single antioxidants such as vitamin E or vitamin C protect these complications. The findings about combination antioxidants are also complicated and not entirely clear. In this review paper we tried to present the role of oxidative stress on micro-vascular complications of type 2 diabetes mellitus. Other objective of this paper is to review the new findings about the role of various antioxidants on prevention and treatment of diabetes mellitus as well as its complications including retinopathy, nephropathy and neuropathy

The viewpoints of members of medical teams about patients’ privacy

زمینه و هدف: حریم خصوصی در محیط های درمانی ارتباط بسیار نزدیکی با ارزش های هنجاری دارد و موضوعی است که افراد به طور معمول میل دارند آن را محفوظ داشته، از آن حفاظت کرده و بر آن کنترل داشته باشند. این مطالعه با هدف بررسی دیدگاه اعضای تیم درمان نسبت به حریم خصوصی بیماران طراحی و اجرا شده است تا بدینوسیله راهکارهایی در راستای حل مشکلات موجود و افزایش رضایتمندی بیماران اندیشیده شود. روش بررسی: این مطالعه یک بررسی توصیفی مقطعی با روش نمونه گیری آسان است که در آن دیدگاه ها و نظرات 150 نفر از اعضای تیم درمان در مراکز آموزشی درمانی دانشگاه علوم پزشکی شهرکرد اعم از پزشکان، پرستاران، ماماها، کارکنان آزمایشگاه و کارکنان بخش رادیولوژی در نیمۀ اول سال1391، در خصوص رعایت حریم خصوصی بیماران در مراکز درمانی با استفاده از پرسشنامه پژوهشگر ساخته مورد نظرسنجی قرار گرفت. یافته ها: از نظر اکثر شرکت کنندگان در مطالعه (92) حفظ حریم افراد مفهومی مهم و نیازی اساسی در انسان است. همچنین 3/93 اعتقاد داشتند برای جلوگیری از تجاوز به حریم خصوصی بیماران ارائه راهکارهای جدید ضروری است و طبق نظر 7/66 افراد در رابطه با حفظ حریم بیماران در بعد آموزش توجه زیادی صورت نمی گیرد. 7/72 افراد لزوم تغییر در برنامه آموزش دانشجویان علوم پزشکی در خصوص حریم خصوصی بیمار را ضروری دانستند. نتیجه گیری: با توجه به نتایج این مطالعه تغییر در برنامه آموزشی دانشجویان گروه علوم پزشکی در خصوص حریم بیماران به نحوی که باعث افت کیفیت آموزشی نشود، یک راهکار مناسب جهت اصلاح دیدگاه و عملکرد دانشجویان و فارغ التحصیلان در این زمینه و بر بالین بیماران است

Frequency determination association of parent's smoking with tonsillectomy in children referring to Kashani hospital in Shahrekord in 2017-2018

Background and Objectve: Throat infections such as tonsilitis and pharyngitis in children can lead to absence from school, deferment from class, imposing treatment cost, and increasing the use of antibiotics. In addition to decreased mucosal salivary and mucosal immunity, smoking has harmful effects on oral microflora and may lead to tonsilitis. The aim of this study was to determine the effect of parents’ cigarette smoking on incidence of tonsillectomy in children referred to Kashani Hospital in Shahrekord during the period of 2017-2018. Subjects and Methods: This cross-sectional study was performed on children with tonsillitis who referred to ENT department of Rasool and Imam Ali Clinic Shahrekord Medical University. Eighty children aged 3 to 12 years old with tonsillitis and tonsillectomy indications were included in the study. Children age, gender and surgery type as well as information about their mother and father cigarette smoking habits were recorded. The data were analyzed by SPSS software using chisquare and logistic regression. Results: from 80 children, 42.5% were male and 57.5% were female. The mean age of children was 7.30±2.26 y. The cases of adenoidectomy, tonsillectomy and adenotonsillectomy were 66.3, 32.5 and 1.3%, respectively. 2.5% of mothers of children and 45% of fathers of these children had cigarette smoking. From smokers’father, 52.8% had cigarette smoking in outdoors and 47.2% had cigarette smoking indoor. There was no significant relationship between the type of surgery and status and place of cigarette smoking by mothers and fathers. Conclusion: Although there was no significant relationship between incidence of parents' cigarette smoking and tonsillectomy, the prevalence of cigarette smoking was relatively high among fathers of these children. Key words: Tonsillectomy, Children, Passive smokin

The clinical presentation of Post-Transplant Lymphoproliferative Disorder (PTLD) following pediatric liver transplantation

Post-transplant lymphoproliferative disorder is a life-threatening complication of solid organ transplantation. In pediatric recipients, PTLD has been reported in 6.4-19.5 of lung, heart and heart-lung transplants, 4-15 of liver transplants and 1.2-10.1 of kidney transplants. Although most lymphomas typically occur in lymph nodes, extranodal involvement is also common. The aim of our study was to determine the site and symptoms of PTLD in children who underwent liver transplantation during 2009-2012 in Liver Transplantation Center of Nemazee Hospital. Material and methods: This study is a cohort study on existing data of children who received liver transplant between Juanury 2009 and December 2012 at Liver Transplant Center of Nemazee Hospital in Shiraz. During the study period, the PTLD occurrence was assessed in follow up visits, if the diagnosis of PTLD was confirmed the affected patient was entered the study and additional information was obtained. The diagnosis of PTLD was considered in patients with fever of undetermined origin, lymphadenopathy, allograft dysfunction, and pulmonary infiltrates. The data was analyzed using SPSS software ver.18. Statistical descriptive methods, Chi square test, and independent t-test, were used for analyzing the data. P value smaller than 0.05 were considered significant. Results: Totally, 203 children undergoing liver transplant surgery were evaluated. The age range of patients was 8 months to 18 years with mean of 8.8±5.6 years old. In our study 17 (8.4) patients developed PTLD. The mean interval between transplantation and PTLD diagnosis was 8.4 ±5.61 months ranging from 4 to 24 months. A total of five patients (2.5) died during the follow-up period and all of them were PTLD affected children (29.4 of PTLD patients). Lymph nodes were the most predominant site involved (64.7), while liver and GI involved in 35.2. Conclusion: The results of this study emphasize the relatively high incidence of PTLD after liver transplantation in children. Because of its impact on patient's outcome and reducing recipient's survival, it is important to minimize this problem by early diagnosis and providing effective treatment

Study of changes in rs2283265 polymorphisms in dopamine receptor D2 and rs27072 in dopamine transporter gene (SLC6A3) in patients with attention-deficit hyperactivity disorder

ObjectivesAttention-deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in children that lead to numerous complications. This study examined the changes in rs2283265 polymorphisms in the dopamine receptor D2 (DRD2) and rs27072 in the dopamine transporter gene (SLC6A3) in ADHD patients.Materials &amp; MethodsThis descriptive-analytical study was performed on children aged 4-12 years with ADHD. In this study, 100 patients in the ADHD group (according to DSM-IV-TR criteria and diagnosed by interview by a child and adolescent psychiatrist) and 100 children in the control group (including patients referring to the pediatrician without hyperactivity) were enrolled.Two polymorphisms rs2283265 and rs27072 in two groups were comparatively investigated using PCR-RFLP method and restriction enzymes. Data were analyzed using SPSS 17. ResultsThere was a significant correlation between gender and ADHD, and the disease was more common in boys (P=0.021). In this study, there was no significant relationship between ADHD types and frequency distribution of rs2283265 (DRD2) and rs27072 (SLC6A3) polymorphism genotypes (P&lt;0.05). However, there was a significant correlation between distribution of rs2283265 (DRD2) and rs27072 (SLC6A3) polymorphisms and ADHD (P&lt;0.05). ConclusionIt seems that the changes in DRD2 and SLC6A3 genes are associated with ADHD, and study of these genes can be helpful in diagnosis and genetic screening

Evaluation and Comparison of Clinical Rounds from the Perspective of Professors and Students of Shahrekord University of Medical Sciences

Introduction: Evaluating different fields of clinical education is necessary to improve the medical course. Among these, clinical rounds are an important part of clinical education. Therefore, achieving maximum realization in any clinical field is the goal of every medical training center. Methods: Present descriptive cross-sectional study was conducted at Shahrekord University of Medical Sciences by census method on more than 67% of clinical medical professors and 79% of medical students who are on internship. The research instrument included a questionnaire of demographic information and a clinical round, which was prepared based on clinical standards approved by the Ministry of Health. 30 out of 44 clinical professors and 30 out of 38 interns succeeded in completing the questionnaires. The obtained data were analyzed by SPSS-16 software and tests (T-test and ANOVA). Result: The mean scores of clinical rounds of professors were 65± 13.16 and interns were 52.47± 35.19 and in general, the situation in this field was described as higher than the average (42) for both groups. Comparison of the two groups also showed a significant difference (P = 0.00). Thus, the mean scores of clinical round scores in the professors’ group were higher than the average scores of the interns’ group. Conclusion: The current clinical rounds situation in Shahrkord University of Medical Sciences was described as more favorable than average. Therefore, in order to further promote medical education, it is recommended that universities continuously evaluate and monitor the status of various areas of clinical education in order to reach the ideal level as soon as possible. Keywords: Teaching Rounds, Education, Medical, Student