ناصر آقا محمدزاده

Limited energy intake with physical activity is effective to reduce health problems associated with obesity. It has been shown that PYY3-36 level increased after intense exercise. This study investigated effect of exercise therapy on appetite suppression and weight loss among obese and/or overweight women.

There was a quasi-experimental with a pretest-posttest design, two groups (control-exercise) study. Study population was overweight or obese women with 20-34 years old and body mass index 27-34 kg/m2. 13 women were randomly assigned in 2 groups (exercise group with 8 weeks of aerobic exercise training (n=7) and control group (n=6)). Weight, waist circumference, hip circumference, lipid profile, cortisol and PYY3-36 were measured at baseline and end of the study.

In baseline of study, there was no significant difference across the groups in factors mean (P>0.05).In control group, after 8 weeks, there was no significant difference in variables.(P>0.05) However, In exercise group significant decrease was observed in BMI, WHR, PYY3-36, TG, CHOLESTROL(TC) and LDL, compared to control group (P<0.05).

Aerobic exercise within the 80% of heart rate reserve is beneficial in lipid profile, appetite management and modified anthropometric factors. These studies demonstrate that a cortisol change is not along with PYY3-36 changes. We suggest the longer exercise training for this purpose.

Papillary thyroid carcinoma (PTC), unlike other cancers, is completely curable if the treatment begins at early stages of the disease, before any metastasis occurs. One of the common places that the cancer may invade is the cervical lymph node. On this basis, many surgeons suggest prophylactic central cervical lymph nodes dissection in such patients, but others do not agree because of the risks that may exceed the benefits of this approach. Despite the presence of several studies in this regard, the debate is still ongoing. This study aims to examine the effect of prophylactic central cervical lymph node dissection in preventing recurrence in patients with PTC.
Methods & Materials: A total of 122 patients with PTC who were operated at Sina Hospital, Tabriz, were enrolled in this study. They were categorized in two equal 61-patient groups, with (case) and without (control) prophylactic central cervical lymph node dissection. Short-term (up to 10 days post-operation) and long-term (6 months post-operation) consequences were compared between the two groups. None of the patients had evidences of central cervical lymph node involvement before operation.
Both groups were comparable in terms of age (mean, 46.1 years in the case group, 45.8 years in the control group, p=0.91) and sex (10 males in the case group, 11 males in the control group, p=0.81). In the case group there were 16 patients (26.2%) with pathology-proven central cervical lymph node involvement. Serum calcium level dropped more significantly in the case group immediately after the surgery, but returned to a comparable level with that in the controls at the 6-month time-point. Comparing cases and controls showed no significant difference in terms of vocal cord involvement (4.9% vs. 3.3%, respectively; p=0.50), recurrent mass (0% vs. 3%, respectively; p=0.49) or new regional lymphadenopathy (1.6% vs. 7%, respectively; p=0.37). There were neither any deceased patient nor any patient with recurrent nerve injury in this study.
Prophylactic central cervical lymph node dissection has no significant effect on the occurrence rate of short-term/long-term complications of surgery in patients with PTC.

Considering the increased illness caused by obesity, therapeutic methods for controlling or preventing obesity and overweight are interest to researchers. Meanwhile, the manipulation of appetite hormones by exercise has been studied as a low-risk factor in the health process.
Material and A total of 13 healthy women with overweight or obesity of grade one with an average age of 25 years and an average body mass of 31.23 kg / m2 participated in the study. The test session included 3 stages of blood collection (before the activity 30 minutes and two hours after the activity) to measure the acylated ghrelin (AG) and peptide YY3-36 (PYY 3-36), as well as seven stages of completion of the VAS questionnaire to measure appetite. Data were analyzed by SPSS software version 20 and using repeated analysis of variance and LSD post hoc test.
There was no significant difference between the AG and PYY 3-36 post-activity levels compared to baseline (P Changes in appetite hormones are not always associated with changes in appetite. Other factors contribute to the response of these hormones

Capecitabine (Xeloda) is an orally administered pro-drug of 5-fluorouracil، which is used as chemotherapeutic agent. Some studies have raised concerns about the lipid profile changes following Xeloda. In this study we examined such probable changes in patients before and after receiving Xeloda. Lipid profile changes were measured before and after administration of Xeloda in 100 patients with gastrointestinal cancers. Serum levels of triglyceride، total cholesterol، low-density lipoprotein (LDL)، and high-density lipoprotein (HDL) were measure at baseline and 3 months after starting Xeloda. Hypertriglyceridemia was defined as serum triglyceride>200 mg/dl and hypercholesterolemia was defined as serum total cholesterol>200 mg/dl. A total of 64 male and 36 female patients with a mean age of 61. 11±12. 51 years (range: 31-68) were recruited. The mean serum level of triglyceride increased significantly from 148. 51±39. 28 mg/dl at baseline to 194. 17±78. 88 mg/dl 3 months after taking Xeloda (p<0. 001). Similar trends were observed for serum levels of total cholesterol (from 190. 29±51. 56 mg/dl to 197. 86±56. 44 mg/dl; p<0. 001) and HDL (from 44. 35±9. 94 mg/dl to 45. 94±9. 13 mg/dl; p=0. 001). Change of serum LDL was not significant (p=0. 10). We found that forty-two percent and 15% of patients developed hypertriglyceridemia and hypercholesterolemia 3 months after treatment، respectively. Xeloda increases serum levels of triglyceride، total cholesterol and HDL.

Patients with hypothyroidism require thyroid hormone replacement. Many studies have shown that bone density reduction is caused by suppressive doses of levothyroxine, but there are contradictory results regarding the effect of levothyroxine replacement dose (non suppressive). The purpose of this study was to investigate the effect of replacement doses of levothyroxine on bone mineral density in premenopausal females with primary hypothyroidism. In this analytic case - control study, 55 females aged 30 to 50 years with primary hypothyroidism who received levothyroxine for at least two years, with TSH of 0.1 to 4.5 over their follow ups underwent densitometry using DXA method in spine and hip and then were compared with 55 subjects in the control group. The mean differences in bone mineral density and Z-score of total femur zone, neck of femur and lumbar spine zone were significant in control and case groups. There were no significant correlations between the duration and dose and bone density in femur zone (neck and total) and lumbar spine. Likewise, there was no significant correlation between TSH and bone density in total femur zone and lumbar spine; however, the difference was significant in femur neck zone, but not at the level of osteoporosis and osteopenia. This study indicates that taking levothyroxine even with replacement dose (TSH within the normal range) can result in prominent changes in bone density, although it is not clinically significant.

Vitamin D (Vit D) deficiency is an important health problem that is prevalent the among elderly and probably is more prevalent in nursing home residents. So we conducted a study to evaluate the prevalence of Vit D deficiency in elderly nursing home residents and compared it with the other elderly population. In a cross-sectional study 140 aged nursing home residents (G1) & 140 elderly in the community (G2) were enrolled. Serum 25(OH) D, parathyroid hormone (PTH), Alkaline phosphatase (alp), Calcium, Phosphor, Albumin were measured in all subjects. We used t test, chi square test, ANOVA and correlation for statistical analysis of hypothesis. mean serum 25(OH) Vit D was 16.1±16.64 ng/ml in G1 and 39.62 ± 24.78 in G2 (p= 0.000) Vit D level less than 20 IU/ml was found in 75% of G1 and 24% of G2. There was a significant correlation between serum 25(OH)D and PTH in both groups, and between 25(OH)D and Alp in cases.(P=.001) In this study we showed that Vit D deficiency among the elderly in nursing home residents was higher than the adjusted population out of nursing homes. So we recommend to use replenishment methods or Vit D for the elderly who were more at risk.

Diabetic is one of the important inner disorder that mankind face with it beside arrange (Adjustment) of glucose(Blood Sugar) relation with self-care behavior in diabetic patient some characteristic personality. this research with assigning relation between characteristic and self-care behavior and it`s out come in diabetic to perform. This research is descriptive correlation from prognosis sort statistical society of this research include type I and II diabetic that they went to clinic private in Tabriz city (2011) from age range from 30-80 that they don`t have any other discos women and men that suffer (type I or II) Diabetes, 70person chose with available sampling useful tools in this brief Questionnaire about self-care in diabetic – short form of Questionnaire – characteristic of personality (NEO-Five Factor Inventory) Questionnaire that made by scholar and outcome of care that is performed for people who participate research paint with statistical analysis regression with several variable discovered. This study showed that among personality characteristics with self protective behaviors’ and remedy result, only the openness parameter could forecated the behaviors’ such as butrition diet and practicing and sport outcome and the anxiety parameter could forecast the changes of foot control and its result, the conscientious parameter also could fore cast the nutrition diet out come. P<0.05 since the global incidence of diabetes has increased dramatically, based on findings recommended training and intervention programs in self-care behavior and some personality factors, especially the openness and conscientiousness may cause upgrade to patient s sense of control and acceptance of responsibility is to increasing the empowerment of patients.

There are still needs for new therapy for treatment of Type 2 Diabetes Mellitus (T2DM). Bromocriptine has several advantages including plasma glucose and lipid reduction. This study was designed to examine the effectiveness of Bromocriptine on glycemic control in poorly controlled T2DM patients. In the present clinical trial study, 43 T2DM patients were investigated. Bromocriptine was administrated with a dose of 1.25 mg/day orally at bedtime. The mentioned dose was gradually increased up to 2.5 mg twice aday. The demographic characteristics, height, weight, fasting blood glucose, 2-hour postprandial blood sugar, glycosylated hemoglobin (HbA1C), lipid profile and creatinine were measured. Patients were followed-up during 1.5, 3, and 6 months later. The mean age of study was 55.0±7.2 years. Mean of baseline fasting blood glucose of patients were decreased from 184.3 mg/dL to 155.5, 148.9 and 159.5 mg/dL in 1.5, 3 and 6 months after treatment, respectively (p<0.0001). Two-hour postprandial blood sugarreached to 217.0, 205.1 and 201.0 mg/dL in baseline times from 276.6 mg/dL (p<0.0001). After three months observation, there was 0.8% reduction in HbA1C whereas, it was 0.9% in month six (p<0.0001). The concomitant treatment with bromocriptine and other antiglycemic drugs was effective in glycemic control of T2DM cases.

Interleukin-18 (IL-18) plays a key role in autoimmunity، inflammation and infection diseases and its higher levels are reported during the subclinical stage of type 1 diabetes mellitus. The aim of this study was to evaluate the recently described single-nucleotide-polymorphisms of promoter of IL-18 gene at position-137، in type 1 diabetic patients، which has been suggested to cause differences in transcription factor binding and IL-18 gene activity. In this study، 104 type 1 diabetic patients (33female and 71 male) with mean age of 19. 6 10. 4 years، and 92 ages and sex matched، healthy individuals without family history of diabetes and autoimmune diseases were selected as controls. The single- nucleotide-polymorphism (SNP) at position-137 (G/C) in the promoter region of IL-18 gene was analyzed by sequence-specific PCR. The genotype distribution differed significantly between patient and controls (p=0. 038). The difference reflected as an increase in The GG genotypes at position-137 in promoter of IL-18 gene. The results of these studies suggest an association between type 1 diabetes and polymorphisms in the promoter region of IL-1

Vitamin D deficiency is one of the most important health problems of any society. It is more common in elderly even in those dwelling in rest homes. By now, several studies have been conducted on vitamin D deficiency using current statistical models. In this study, corresponding proportional odds and stereotype regression methods were used to identify threatening factors related to vitamin D deficiency in elderly living in rest homes and comparing them with those who live out of the mentioned places.

In this case-control study, there were 140 older persons living in rest homes and 140 ones not dwelling in these centers. In the present study, 25(OH)D serum level variable and age, sex, body mass index, duration of exposure to sunlight variables were regarded as response and predictive variables to vitamin D deficiency, respectively. The analyses were carried out using corresponding proportional odds and stereotype regression methods and estimating parameters of these two models. Deviation statistics (AIC) was used to evaluate and compare the mentioned methods. Stata.9.1 software was elected to conduct the analyses.

Average serum level of 25(OH)D was 16.10±16.65 ng/ml and 39.62±24.78 ng/ml in individuals living in rest homes and those not living there, respectively (P=0.001). Prevalence of vitamin D deficiency (less than 20 ng/ml) was observed in 75% of members of the group consisting of those living in rest homes and 23.78% of members of another group. Using corresponding proportional odds and stereotype regression methods, age, sex, body mass index, duration of exposure to sunlight variables and whether they are member of rest home were fitted. In both models, variables of group and duration of exposure to sunlight were regarded as meaningful (P<0.001). Stereotype regression model included group variable (odd ratio for a group suffering from severe vitamin D deficiency was 42.85, 95%CI:9.93-185.67) and duration of exposure to sunlight variable (odd ratio for a group suffering from severe vitamin D deficiency was 0.717, 95%CI: 0.642-0.792).

This study demonstrated high prevalence of vitamin D deficiency in older people living in rest homes comparing with those who do not live in such centers. It seems that stereotype regression as a modern method among multicategory logistic models is well capable in sieving kinds of diseases especially vitamin D deficiency.

There is a lack of national/regional data on the relationship between breast cancer and thyroid diseases and the limited data available are controversial. This study was designed and conducted to investigate thyroid autoimmunity in women with newly diagnosed breast cancer. Methods and Materials: In a case-control study, 40 women with confirmed diagnoses of breast cancer and 40 age-matched healthy counterparts were recruited during a 12-month period from outpatient clinics of the Tabriz University of Medical Sciences. The case group were enrolled for the study before receiving treatment. Thyroid and physical examination was carried out in all participants and serum levels of TSH, FT4, ATPO and ATG were determined. The results were compared between two groups, and different histopathological subgroups of breast cancer. The mean age was 49.48±7.75 and 46.80±7.00 years in the case and control groups respectively. Thyroid and physical examination were normal in all participants. TSH, ATPO and ATG serum levels were comparable between the two groups; however, the median level of serum FT4 was significantly higher in the case group (1.20 μg/dl vs. 1.03 μg/dl; p<0.001). Increased levels of serum TSH and FT4 were found in 7.5% of the cases, while there were decreased levels in 2.5% of the cases, with no significant differences between the two groups. Thyroid tests were comparable between the different histopathological subtypes of breast cancer. No relationship was found between thyroid autoimmunity and breast cancer, a finding in concordance with some reports and in contrast with others. It seems that further studies with larger sample sizes are needed for conclusive findings.

There are some suggestions that an epidemiological association exist between HCV infection and type 2 diabetes mellitus. This study aimed to evaluate the prevalence of HCV infection in patients with type 2 diabetes mellitus (DM). In a descriptive study, 400 patients with definite diagnosis of type 2 DM were recruited. After gathering the demographic and clinical data they underwent physical examinations, and fasting venous blood samples were taken and examined for blood sugar and serum levels of triglyceride (TG) and cholesterol. Serum titer of antibodies against hepatitis C virus was also measured in all of them, using the third-generation ELISA method. Four hundred diabetic patients (M/F 268/132, mean age 54.87±8.36 years) were studied. The mean duration of Diabetes diagnosis was 9.26±7.04 years. History of smoking was positive in 154 (38.5%) patients. The mean body mass index was 26.59±4.53 kg/m2. The mean systolic and diastolic blood pressures of the patients were 141.50±25.46 mmHg and 77.93±18.47 mmHg, respectively. Blood levels of FBS and serum TG and cholesterol were 133.30±20.61 mg/dL, 229.02±112.14 mg/dL and 197.53±75.66 mg/dL respectively. Based on the results of ELISA test, 10 (2.5%) patients were infected with HCV (95%CI: 0.9-4.1 percent). Prevalence of HCV infection has been estimated to be less than 1% among Iranian general population. We found a higher rate of infection (almost 2.5 times) in our type 2 diabetic studied population.

The hypoglycemic effects of the Uritca Dioica (UD) extract, used for treatment of diabetes mellitus for many centuries, have been documented in several studies. The present study was designed to determine the possible mechanisms of hypoglycemic effects of UD on human muscle cells and RIN5F rat pancreatic b cells.

In the cell culture laboratory of the Drug Applied Research Center, pancreatic b cells and human muscle cells were prepared in multiple flasks containing culture media. Alcoholic extract of UD at concentrations of 50, 100 and 200 mg/mL were added to muscle cell flasks. The same concentrations of extract plus insulin were added to other muscle cell flasks. Glucose levels were measured in the flasks before and after 60, 120 and 180 minutes after adding of extract. Also the same concentrations of UD were added to flask containing RIN5F rat pancreatic b cells, and insulin and C-peptide level were measured at 0, 60, 120 and 180 minutes.

Mean glucose level in the muscle cell media with UD alone and UD plus insulin, at the concentrations and time intervals mentioned, did not change significantly. Insulin levels in pancreatic cells media, before and after applying of UD at different concentrations, and at different times was ≤0. 2 µg/ml. C-peptide (µg/ml) levels in these medias with a dose of 50 µg/ml of UD and at above mentioned times were 0. 31, 0. 33, 0. 86 and 0. 8 at concentration of 100 µg/mL they were 0. 7, 0. 2, 0. 4 and 0. 39, and at concentration of 200 µg/mL were 0. 32, 0. 33, 0. 93, 0. 77 respectively (Nonsignificant changes).

The results of the present study showed that alcoholic extract of UD was unable to increase insulin sensitivity in muscle cells and/or increase insulin and C-peptide secretion from RIN5F pancreatic b cells. It seems that hypoglycemic effects of UD were not mediated through the proposed mechanisms of this study.

Osteoporosis is the most common metabolic bone disease that characterized by reduced bone strength. The aim of this study was to evaluate the prevalence of effective factors in decreased bone density and secondary causes of osteoporosis. This descriptive cross sectional study was done on 105 patients (76 female and 29 male) suffering from osteoporosis, evaluated in the endocrinology Department of Sina hospital, Tabriz- Iran from March 2003 to March 2006. Past medical history clinical symptoms and biochemical results were of patients. Data analyzed using SPSS-14 and chi square test. Osteoporosis and osteopenia were seen in 55% and 45% of patients with reduced bone density, respectively. Daily calcium intake in patients with less than 400 mg, between 400-1000 mg and more than 1000 mg were 63.8%, 31.9% and 3.4%, respectively. The mean±SD of sera calcium and vitamin D level were 9.5±0.6 mg/dl, 45±37.1 nmol/l respectively. 61.2% of patients had vitamin D deficiency. 33% of patients had secondry osteoprosis. Among the patient with primary osteoprosis 11.3% afflicted to hyper claciuria. This study showed that decresing bone density was more prominate in women. The rate of daily calcium intake among patients were low. It is sugested these patients osteoprosis could be prevented by consumption food nutrient rich in calcium and vitamin D suplementation.

Diabetes mellitus is the most frequent cause of chronic renal failure. Microalbuminuria is the first clinically important sign of renal impairment in diabetes mellitus. The main pathophysiology of diabetic nephropathy is not understood. This study was done on 100 patients with type 2 diabetes for determination of the prevalence of diabetic nephropathy with urine albumin assay in Sina Hospital in Tabriz, North-West of Iran. In this discriptive study, 100 patients with type 2 diabetes whome consecutively referred to Endocrine and Diabetes Clinic of Sina Medical Center in Tabriz were enrolled. At the first visit clinical and biochemical parameters such as systolic and diastolic blood pressure, age, sex, body weight, length, body mass index, FBS, HbA1C, plasma creatinine, urine microalbumin and urinary creatinine were measured. FBS, HbA1C, plasma creatinine, urine microalbumin and urinary creatinine measurements repeated every 2 months up to three times during the study. Patients with confounding factors such as uncontrolled hypertension, urinary tract infection, congestive heart failure and hyperlipidemia were excluded. The prevalence of diabetic nephropathy was 36% in our patients. There were not statistically significant differences in age and sex and diastolic – systolic blood pressure and creatinine between nephropathy and, non-nephropathy groups. There was significant differences in body mass index between two sex groups, females were more obese than males. Mean duration of diabetes in diabetic nephropathy group and in diabetic patients without nephropathy were 12.4±8.1 and 9.1±5.5 respectively (P<0.05). Comparison of HbA1c, FBS and drugs used for diabetes treatment were not significant differences between these groups. This study showed that prevalence of diabetic nephropathy was higher than other studies, although there were not significant differences between FBS, HbA1c and hypertension in patients with and without diabetic nephropathy.

Thalassemia major is a genetic disorder, in which blood transfusion is critical for the survival of patients. Over the course of the past two and three decades, hypertransfusion therapy in these patients has significantly increased life expectancy and quality of life. Unfortunately however this type of therapy has also increased the frequency of complications due to iron overload. Today endocrine abnormalities are far more common than before in beta-thalassemia patients. The aim of this study was to evaluate the prevalence of endocrine disturbances in patients with thalassemia major, aged over 10 years. Fifty-six patients, aged over 10 years, with thalassemia major were enrolled. Physicians collected demographic data and history of therapies as well as menstrual history in females. Patients were examined to determine their pubertal status and SDS of height for evaluation of short stature. For evaluation of glucose tolerance, fasting blood glucose and oral glucose tolerance tests were performed. Serum levels of calcium, phosphorous, thyroid stimulating hormone, free thyroxin, luteinizing hormone, and follicular stimulating hormone, estradiol in girls and testosterone in boys were measured. Fifty-six patients 10 to 27 years with thalassemia major old were evaluated. In this study, the prevalences of diabetes mellitus, impaired fasting glucose and impaired glucose tolerance test were 8.9%, 28.6% and 7.1% respectively. Short stature (SDS ≤ -2) was seen in 70% of boys and 73% of girls hypocalcaemia and primary overt hypothyroidism were present in 41% and 16% respectively 14.3% did not have any endocrine abnormalities. Despite recent therapy with Desferal in the management of beta-thalassemia major, the risk of secondary endocrine dysfunction remains high, with hypogonadism being one of the most frequent endocrine complications. Endocrine evaluation in patients with thalassemia major must be carried out regularly especially in those patients over the age of 10 years in Tabriz.