مجله دانشکده پزشکی اصفهان
پیاپی 206 (هفته چهارم آبان 1391)

Diabetes is the most prevalent disease in the world. It is in many cases associated with complications such as nephropathy. Like other chronic diseases، diabetes can be accompanied by mood disorders including depression. However، studies about the frequency of major depressive disorder and bipolar disorder among diabetic patients are limited. In this research، we surveyed the frequency of major depressive disorder and bipolar disorder in patients with diabetic nephropathy. This cross-sectional research was performed on 250 patients with diabetic nephropathy in Isfahan، Iran during 2011. Beck Depression Inventory and Mood Disorder Questionnaire were used to assess depression and bipolar disorder، respectively. Data was analyzed with SPSS18. Males and females constituted 47. 2% (n = 118) and 52. 8% (n = 132) of the studied population، respectively. The frequency of depression was 84. 8%. Moreover، 24% of the patients had bipolar disorder. The mean of hemoglobin A1C (HbA1C) level of depressed patients was significantly higher than non-depressed patients (P = 0. 01). The prevalence of major depression is significantly higher in patients with diabetic nephropathy compared to the general population. This factor can have undesirable effects on follow-up and treatment of patients with diabetic nephropathy.

The goal of this study was to determine the ratio of vascular endothelial growth factor (VEGF) to soluble VEGF receptor 1 (SVEGFR1) in aqueous humor of patients with non-proliferative diabetic retinopathy (NPDR). We also investigated the association between this ratio and macular edema.

In this randomized، cross-sectional study، aqueous humor was collected during Avastin injection in ocular fluid of patients with NPDR. Concentrations of VEGF and SVEGFR1 were then determined. Macular thickness was measured with ocular coherence tomography (OCT).

VEGF/SVEGFR1 had a significant correlation with macular thickness (r = 0. 46; P = 0. 05). Therefore، imbalance between VEGF and its soluble receptor in ocular fluid is related with macular edema.

Decreased level of SVEGFR1 increases the activity of VEGF. As a result، vessels in retina become permeable. This pro-angiogenic factor will in turn increase macular edema.

Insufficient sleep، poor sleep quality، and sleepiness are common problems in children and adolescents. Such problems can affect learning، memory، and academic performance. No previous studies have assessed the relationship between sleep problems/habits and academic performance in Iranian secondary school students. Therefore، we surveyed a sample of secondary school students and their parents in Isfahan (Iran) to assess the relation between sleep problems/habits and academic performance. In this cross-sectional study، data was collected by a reliable (Cronbach’s alpha = 0. 87) and valid self-reporting questionnaire. Multi-stage cluster random sampling was used to select 110 secondary school students in Isfahan، Iran. Academic performance was assessed using the latest term evaluation report provided by the school. Students’ performance was stratified as excellent [grade point average (GPA) ≥ 17]، average (GPA = 15-17)، and poor (GPA < 15). The collected data was analyzed with SPSS20. Descriptive statistics (mean ± standard deviation)، independent t-test، chi-square test، and analysis of variance (ANOVA) were used to analyze the data. There were 535 boys (48. 6%) and 565 girls (51. 4%) in this study. The mean age of students was 13. 26 ± 1. 09 years (range: 11-16 years). While 42. 3% of the students had excellent performance، 30. 1% and 27. 6% of them had average and poor performance، respectively. Academic performance of the students was significantly associated with their age، gender، and fathers and mothers’ education levels and jobs. It was evident that the presence of sleep problems، poor sleep habits، or shortened total sleep time affected the students’ academic performance. In other words، sleep problems and habits may negatively affect academic performance.

Parkinson’s disease (PD) is a progressive neurodegenerative disorder causing motor and non-motor symptoms. The latters are common and include autonomic dysfunction، cognitive impairment، and sleep difficulties. Many of the non-motor aspects of PD such as sleep disturbance are more common and significantly affect everyday activities and quality of life of patients. The most important aim of this study was to evaluate sleep quality in patients with PD. In this case-control study، 34 patients with PD and 34 healthy controls were included. The patients had referred to the Neurology Clinic of our teaching hospital (Isfahan، Iran) in 2011. Sleep quality of all subjects was evaluated by Parkinson’s Disease Sleep Scale (PDSS) which is a reliable and valid tool to measure sleep disorders in PD. The mean total PDSS score in patients was 55. 29 ± 26. 92 which indicated moderate to severe sleep disturbances. The mean total score in the control group was 20. 34 ± 10. 65. The difference between mean scores of the two groups was statistically significant (P < 0. 05). Our study demonstrated that patients with PD experienced poorer nocturnal sleep quality than the control group.

Sepsis is a rapidly progressive and life-threatening syndrome. It is defined as a systemic inflammatory response syndrome (SIRS). In order to achieve acceptable clinical outcomes and reduce mortality and morbidity associated with sepsis، accurate and timely diagnosis of this syndrome is very important. The aim of this study was to evaluate the validity of one of the most common tests used in the diagnosis of sepsis (blood culture) with SIRS in teaching hospitals in Arak، Iran. In this analytical study، 289 patients who had been admitted to teaching hospitals in Arak and consented to participate were evaluated. Patients were only included if they had received intravenous antibiotics for less than 24 hours and their blood culture was performed during the past 24 hours. The results of blood cultures were evaluated in two groups of SIRS+ and SIRS-. The sensitivity and specificity of the test were then determined. Of 289 studied samples، 215 (74. 6%) patients were SIRS+ and 74 (25. 6%) were SIRS-. In cultured samples، 29 (10. 03%) were positive but only 6. 9% were true positive. However، 3. 1% of the samples were contaminated. The sensitivity and specificity of blood culture were 9. 3% and 87. 84%، respectively. According to the importance of accurate and timely diagnosis of sepsis and low sensitivity of blood culture، it seems that decision making based on clinical symptoms and testing indications and standards is essential.