Shiraz Emedical Journal
Volume:15 Issue: 1, Jan 2014

The prevalence of hypogonadism and associated related factors among a group of human immunodeficiency virus positive (HIV+) patients in Shiraz, Iran, were examined based on free testosterone (FT) and total testosterone (TT) levels.. In this study we planned to determine the prevalence of hypogonadism among a group of men with an HIV infection in Shiraz, Iran. Measurements of free and total testosterone levels and their association with some related factors were determined, in order to suggest new approaches in harm reduction strategies.. A total of 237 male, HIV-positive patients were recruited based on convenience sampling, from May to October 2010. All patients provided their informed consent, and blood samples were collected after an overnight fast in order to measure free testosterone concentrations, HGB, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactine (PRL) levels.. A total of 180 (75%) subjects were hepatitis C virus (HCV) positive, and 23 (9.7%) subjects were HBS-positive. Based on free testosterone (FT) levels 62.8% subjects had hypogonadism, and with total testosterone (TT) levels 59.6% subjects had hypogonadism. The results showed that FT levels were associated with; age, methadone use (OR = 1.74, CI: 0.97–3.1), LH (OR = 0.91, CI: 0.87-0.95), HGB (OR = 0.788, CI: 0.69-0.89), body mass index (BMI) (OR = 0.88, CI: 0.79-0.98) and PRL (OR = 1.18(CI: 1.09-1.28), but it had no significant association with highly active antiretroviral therapy (HAART), smoking, hepatitis or reaching the AIDS stage. On the other hand, TT had a significant association with BMI, LH, PRL, and HGB.. The prevalence of hypogonadism in the participants was high. It is recommended that a hypogonadism examination should be included in surveillance programs for HIV-positive men..

Patients with end stage renal disease (ESRD) who have advanced congestive heart failure (CHF) are not usually referred for kidney transplantation because of the high risk of surgical or cardiac complications.. We reported three patients on different renal replacement therapies who had severe CHF with ejection fraction (EF) of 15% to 20% and valvular heart involvement. Two patients were on maintenance hemodialysis and one patient was on ambulatory peritoneal dialysis. After successful kidney transplantation, the significant improvement in left ventricular function (increased EF) and valvular involvement was seen.. Kidney transplantation could be considered as the best choice for CHF and valvular involvement in patients with ESRD on renal replacement therapies..

Context: Ramadan is the month of fasting in Islam. Fasting is a religious duty for all healthy adult Muslims. During this month, strong persons abstain from different kinds of food and beverage, from sunrise until sunset. They usually eat a larger (300-700 kcal) meal after sunset and a lighter meal (200-500 kcal) before sunrise. Fasting lowers body weight, body fat percentage and body mass index (BMI). It can elevate high-density lipoprotein cholesterol (HDL-c). Al-Hourani HM studies showed that body weight and BMI decreased significantly during fasting. Body weight reduction has been reported quite frequently, whereas, the relationship between weight reduction and loss of body fat has not been studied. The aim of this review is to describe the effects of fasting on several anthropometric parameters on human body, supported by the evidence-based scientific manuscripts..Evidence Acquisition: Conducting any survey in any scientific field has its own limitations. Carrying out a study in holy Ramadan, with its special circumstances, like altering daily nutritional patterns, fasting hours, less number of daily meals and declining physical activities imposes limitations on any research in this field.. The basic information regarding changes in dietary intake and body composition are as follows: the majority of Muslims typically consume two meals per day during this month, including one just before dawn and another one after sunset. However, most studies demonstrated that fasting, in people without health problems, causes dramatic changes in body composition.. It can be concluded that fasting has various impacts on different individuals. These variations are highly dependent on daily nutritional habits and the season that Ramadan occurs in..

Context: Hypertension is defined as systolic blood pressure above 140 mmHg or diastolic blood pressure greater than 90 mmHg or both. Hypertension can be controlled by diet containing an adequate amount of phytochemicals..Evidence Acquisition: The article is based on non-systematic literature searches in PubMed, Ovid and ScienceDirect.. Hypertension is one of the major chronic diseases, which can affect people around the world. Today''s DASH diet (dietary approach to stop hypertension) is used to reduce and control blood pressure. The diet containing plenty of fruits, vegetables, nuts and whole grains including nutrients such as vitamins and minerals and non-nutrient elements is called phytochemical. Phytochemicals are materials at very low concentrations, which affect the expression of many genes, including transcription factors AP-1, NF-KappaB, SREBPs, PPARs and their cellular metabolism and gene regulation; also have antioxidant properties and antihypertensive effects. Moreover, increased intake of phytochemicals is associated with decreased mortality rate from cardiovascular diseases, stroke and injuries secondary to hypertension. Possible mechanisms of action of phytochemicals to reduce blood pressure include inhibition of angiotensin-converting enzyme and inactivation bradikinin and regulation of bioavailability of nitrous oxide. In conclusion, based on the results, increased intake of phytochemicals in daily diet is associated with decreased risk of mortality from coronary heart disease, stroke and injuries secondary to hypertension..

Inflammatory bowel disease (IBD) prevalence is increasing in Asia. Clinicians are faced with misdiagnosis for IBD even with classic symptoms. This case report shows that how a delayed diagnosis of IBD can produce significant problems for patient.. A 45 year-old man and known case of IPSID (Immunoproliferative small intestine disorder) was referred for follow-up to our GI (Gastrointestinal) clinic. He presented with a history of intractable watery diarrhea along with slight weight loss for the last 22 years. He was admitted with an episode of severe abdominal pain and acute peritonitis 10 years ago. At the time, laparotomy was performed due to a suspicious appendicular mass; however, the surgeon discovered a cecum mass and extended adhesion during laparotomy. According to IPSID diagnosis, he was then referred to an oncologist who treated him with chemotherapy and patient was advised to attend an annual colonoscopy checkup as follow-up. He was gradually complicated by renal stones, arthritis, hypoalbuminemia and bone disease during the follow-up. We as gastroenterologists reviewed his history again and requested a revision for all histopathology results by GI pathologist. Pathologist confirmed IBD (Crohn’s disease) from the first pathology and his treatment was started immediately.. Several diseases can mimic IBD symptoms but with careful consideration of patient’s symptoms, endoscopic findings and pathology results one should be able to diagnose IBD. Correct diagnosis of IBD can affect the quality of life of patient..

α-globin is encoded by two adjacent genes, αl and α2. Evidence suggests that these genes are not expressed equally and that the α2-globin gene encodes the majority of α-globin. This finding predicts that a thalassemic mutation of the α2-globin gene would result in a more severe loss of α-chain synthesis than a similar mutation in the αl-globin gene.. In the present study we described a novel non-deletion α-thalassemia defect in the 5''UTR region of the α2-globin gene.. For molecular analysis, genomic DNA was isolated from peripheral blood cells by a salting out procedure. The common alpha deletion mutations were ruled out using the published primers and conditions. The amplification of the entire β and α1 globin genes was also carried out and their DNA was sequenced. No mutation was detected.. The mutation under study was located on an AP-1 transcription factor binding site and inherited in two unrelated Iranian families with hypochromic microcytic anemia.. The patients in this study had moderate microcytosis and hypochromia without hemolysis, jaundice and splenomegaly. Molecular analysis in these patients revealed a non-deletion type of mutation in the promoter region, which is highly consistent with findings of other studies..

The two most common causes of neonatal cholestasis are biliary atresia (BA) and neonatal hepatitis (NH). Differentiating between them needs meticulous investigations.. We aimed to evaluate the different stereological findings of liver biopsies in BA and NH to find features that might be helpful in differentiating them from each other..Patients and Five patients with BA and four patients with NH were recruited. The study was restricted to infants with confirmed diagnosis through lab data, histopathological findings in liver biopsies, and by intraoperative cholangiography. The liver biopsies were evaluated with stereological study for the followings: volume density of connective tissue, fibrosis, hepatocytes, bile duct, and sinusoid; the diameter of duct, epithelium, and lumen; the length density of duct; numerical density cell; and the mean volume of hepatocyte and nucleus.. The stereological study findings revealed that the mean volume density of the connective tissue and fibrosis in NH was about 17.5% less than BA group. However, the other parameters did not show any significant difference between them.. Our results showed that portal fibrosis was a significant stereological study finding in BA that could differentiate it from NH. This study is the first stereological analysis of the patients with neonatal cholestasis. Further studies in this field are required to confirm our findings..

Aggression is a complex behavior affected by different psychological, genetic, and biological factors. Nutrition is an important factor affecting aggressive behavior.. The aim of the present research was to study the effect of cold and hot nature food on students’ mental health and aggressive behavior.. In a quasi-experimental study, we recruited 61 normal students in Gonabad University of Medical Sciences during summer semester. The students were randomly allocated into three groups for three weeks, of which one group was served with food of normal nature, the second with hot food and the third group with food of cold nature. Students'' mental health and aggressive behavior were measured by General Health Questionnaire (GHQ-28) and Buss and Perry Aggression Questionnaire before and after intervention.. There were no significant differences in demographic characteristics and physical examination among students of three groups (P > 0.05). There was no significant difference regarding mental health and its components after serving the students with normal, hot, or cold nature food (P > 0.05). No significant differences in aggressive behavior and associated factors were found among three groups of students before and after intervention (P > 0.05).. The findings of this study showed that cold and hot nature of food had no effect on students’ mental health and aggressive behavior..