فهرست مطالب همایون شیخ الاسلامی

Osteoporosis is the commonest systemic disease leading to increased bone fragility and fracture. Vitamin D receptor Polymorphism is thought to have the most genetic influence on BMD.

The aim of this study was to investigate the association between vitamin D receptor Apa1 and Taq1 genes polymorphism and osteoporosis in postmenopausal women.

This was a case/control study in which 80 patients with osteoporosis (case group)، referred to rheumatology ward at Boalisina Hospital during 2010 were investigated. The control group included an equal number of patients who visited other wards of the hospital for a variety of reasons. We obtained the bone mass densitometry (grams per centimeter square) results of case and control groups at the lumbar spine، wrist and hip by dual-energy X-ray absorptiometry. The distribution of Apa1 and Taq1 polymorphism in the VDR gene was determined by PCR-RFLP. Data were statistically analyzed by SPSS software using chi-square and ANOVA tests.

There was no relationship between the Apa1، Taq1 VDR polymorphism and BMD results. We found that patients with Taq1 genotype (tt) had lower bone mass in the femur and wrist compared with Tt.

Based on our findings، a relationship between the VDR polymorphism and osteoporosis remains unclear requiring further in-depth studies. Our results showed that other secondary factors may influence the bone mass density.

Polycystic ovary syndrome (PCOS) is among the most common endocrine disorders in women of reproductive age and affects 7% of this population. PCOS is identified as a reproductive disorder characterized by an ovulation, hyperandrogenism and insulin resistance. PCOS increases the risk for type 2 diabetes mellitus and metabolic syndrome, a constellation of cardiovascular risk factors associated with insulin resistance. The aim of our study was to investigate and compare insulin resistance reduction and chemical changes during the application of insulin sensitizers from two different groups (metformin and pioglitazone). This randomized clinical trial lasted for 3 months and was conducted in Avicenna Hospital, Qazvin, Iran. Overall, 56 women with PCOS were randomly divided into two groups. Group 1 received 500 mg metformin three times daily and group 2 was treated with pioglitazone 30 mg per day. Serum levels of insulin, fasting blood sugar (FBS), and lipid metabolism parameters including triglyceride (TG), cholesterol (Chol), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were measured before the treatment and in the 3rd month. Homeostasis model assessment of insulin resistance (HOMA-IR) was used. Body mass index (BMI) was also calculated at baseline and at the end of therapy. Before the treatment, the two groups matched for age, weight, and BMI (P > 0.05). Before the treatment, there were no statistically significant differences in FBS, HDL, LDL, TG, Chol and serum levels of insulin between the two groups. Three months after treatment, mean serum levels of FBS, TG, Chol, LDL and insulin decreased significantly in both groups. Moreover, the treatment significantly increased HDL levels in both groups (P < 0.01). In metformin group, mean values of BMI before and after treatment were 26.1 and 25.5 (P < 0.05). The corresponding values in pioglitazone group were 25.9 and 25.2 (P > 0.05). Our findings showed that in women with PCOS, treatment with metformin and pioglitazone for 3 months resulted in similar beneficial effects on laboratory parameters of insulin sensitization. However, there is no evidence that pioglitazone improves BMI when compared to metformin. Further research is needed to investigate whether treatment with insulin sensitizers in women with PCOS can also reduce cardiovascular risk factors.

Irritable bowel syndrome (IBS) is a common disease; it seems that psychological factors play a role in development and maintenance of IBS. The main purpose of the current study is to compare patients with IBS and healthy individuals regarding anxiety, sensitivity, and neuroticism.Participants included 76 IBS patients (41 female and 35 male) who referred to the Qazvin Bou Ali Sina especial Center and 76 individuals not diagnosed with IBS. All participants filled out the Anxiety Sensitively Scale and Neuroticism subscale of the Eysenk Personality Questionnaire-Revised (short scale).Results showed no significant difference between the two groups in terms of psychological factors. Sampling method and the complex nature of IBS among other factors has been discussed to account for such results.It can be concluded that anxiety, sensitivity, and neuroticism cannot predict the development of IBS.

Introduction & Metabolic control in adolescents with type 1 DM who are in pubertal period will be impaired, thus finding a therapeutic strategy such as adding metformin to insulin to reduce insulin resistance will be useful in blood glucose control and metabolic state improvement. This was a randomized double blind placebo controlled 3-month trial metformin therapy in 32 adolescents with type 1 DM. These patients were divided in two groups of metformin and placebo and treated with metformin and placebo for 3-months. Their HbA1C, FBS, Insulin dosage, TG, Cholesterol, and LDL were measured at the initiation and end of the treatment. After the study there was a significant improvement of FBS and TG in metformin group versus placebo group (P=0.02 and P=0.028 in order). But, there was not significant difference in other variables such as BMI, insulin dosage, HbA1C, Cholesterol and LDL between the two groups. Metformin treatment in teenagers with type1 DM who are in pubertal period will improve the control of FBS and lowers TG but has not any significant effect on HbA1C, BMI, insulin dosage, Cholesterol and LDL.

ِDiabetic ketoacidosis is one of the major complications of diabetes whose due treatment can reduce its mortality. The aim of this study was to evaluate the clinical manifestation, laboratory data and precipitating factors in admitted patients to Booali hospital in Ghazvin. In this descriptive retrospective study, all medical files of DKA patients between 1999 and 2004 in Ghazvin Booali hospital were surveyed. Totally, 60 episodes were evaluated with respect to clinical features, lab. findings and hospital mortality. Finally, the obtained data was statistically analyzed by means of SPSS software. Mean±SD age of patients was 26. 63±11. 74. Females and males were 60% and 40%, respectively. Mean±SD hospitalization time was 7. 2±3. 9 days. DKA as the first symptom of diabetes occurred in 18. 3% of clients. Feebleness and weakness were the most common complaint in 50% of patients, 75% were alert to their problem when hospitalized. Fever was detected in 50 %. The mean PH was 7. 1±0. 1. Hyponatremia occurred in 25%, urinary tract infection (UTI) in 54%, and hypoglycemia in 23% of the patients. During management, recurrent DKA was found in 3. 3% and mortality rate was 5%. Regarding the results of the study, which confirms lack of knowledge of the clinical staff as to how to confront and manage DKA-as a medical emergency due education in this field can reduce prevalence and mortality of DKA.

Pareneteral vitamin D3 administration, a common practice in Iran, is usually used based mainly on clinical symptoms or serum mineral disturbances. Since studies about the effects and side effects of parenteral vit D3 preparations are limited, this study was designed to evaluate the effect of different intramuscular vitamin D3 dosage on serum 25(OH)D levels. In this study, 54 health voluneers were selected, and randomly assigned to 4 groups, based on their serum vitamin D3. Mean body mass index, age and sex frequency were not significantly different between groups. Mean serum 25(OH)D levels before injections were 27.24±21.30, 25.21±17.09, 24.70±16.8 and 25.10±14.48 ng/mL in groups I to IV respectively. Vitamin D3 was injected in dosages of 300/000, 600/000, 900/000 units and placebo in groups I-IV respectively. 25(OH)D levels were determined before, and at 2 weeks, 2 months and 4 months after injection. Serum 25(OH)D levels before injection were significatly higher compared to levels assessed 2 and 4 months after injection. At the end of study, in groups I to III, mean serum 25(OH)D levels in group I to IV were 48.20±28.32 ng/mL, 65.46±33.52 ng/mL, 72.90±37.68 ng/mL, and 14.38±11.14 ng/mL respectively. Frequency of vitamin D hypervitaminosis in groups I, II and III was 9%, 38% and 40% respectively. Usage of parenteral vit D3, especially dosages higher than 300/000 IU, is associated with a high risk of vitamin D hypervitaminosis.

Several studies and research have shown a higher prevalence of celiac disease (CD) and elevation of serum antibody (AGA-IgA & IgA-tTG & EMA-IgA) in patient with diabetes mellitus type I (T1DM) in versus general and non-diabetic population. Thus screening of CD is recommended in T1DM). This study was conducted to compare frequency of celiac disease in patients with T1DM and healthy persons. As a case-control study,60 patient with T1DM that reffered to endocrine clinic of Qazvin’s Boo-Ali hospital, in nearly one year period were enrolled as case group. 60 non-diabetic healthy subjects with age and sex matched, were selected as control group. Blood levels of Total IgA, AGA-IgA and IgA-tTG were measured in all of them, subjects who had elevated of both AGA-IgA and IgA-tTG underwent an upper GI endoscopy and biopsy was done from distal part of duodenum. Any one in case group hadnt IgA deficiency. 14 subjects in control and 12 subjects in case group had positive AGA-IgA that there was no significant difference between them. 2 subject of case group had positive IgA-tTG. Duodenal biopsy in 1 of 14 cases who had elevated AGA-IgA)1 of 2 cases who had elevated IgA-tTG), revealed total villous atrophy indicating CD (Type IIIC with revised Marsh criteria 2001) and in other cases pathologic findings were normal or with nonspecific changes. Frequency of CD in T1DM in our study is 1.67%. There is not any significant difference between case and control groups in prevalence of Celiac disease. But we conclused that screening with AGA-IgA is not a reliable screening test for CD, because there is not significant difference between T1DM and general population.