نازنین نوری

Mohammad Shafie Ebn Mohammad Esmaeil Shirazi known as Mirza Kochek with pseudonym of Vesal born on 1197 AH and passed away on 1262 AH in Shiraz is among prominent poets and return movement musician who had a capable hand in composing ghzal and while imitating great Ghazal composers, he has maintained main traits of the best traditional poem specimens and his ghazals enjoy a tonic and appealing tune. The aim of this study is to examine internal music of the poet ghazals using analytical research method and to show that internal music how much influences the poem tone verse and that how Vesal has inducted the poems meaning to the reader using repetition which is the main pillar of internal music. One of the features of poem language is voluntary utilization of this language from poetical devices and techniques which bring it out of routine and colloquial state and give it an artistic aspect. Here, the most tangible factor which gives the language eminence is the poem music. The poem's music has been divided to four types of external, internal, lateral and virtual. That in this paper, only the poem internal music has been examined.
The series of coordination which appear in the words of a poem due to unity or similarity or contrast of consonants and vowels is the flourish of this type of music. Techniques which have played role in the domain of this music are figures of speech like various puns, epanalepsis and so on all of which are subsets of repetition, therefore, repetition in examining the poem internal music has a considerable role. Vesal Shirazi has utilized repetition for increasing the word music and developing and better inspiring the meaning and repetition could be seen in his various poems level. Techniques which have formed in his poem based on repetition mostly include repetition of words and letters and what mostly shows off is word repetition.
Repetition is Vesal’s Divan appears in two forms, sometimes these repetitions are subject to a special order which is displayed as Aenat, equilibration and epanalepsis and sometime is in free form that its prominent sample could be seen in various types of pun. So that it could be said that various puns and word repetition scattered across couplet is among free repetitions of Vesal poems. In Vesal’s poem, pun as a type of word arrangement has a special role in creating his poems internal music and various types of pun are considered the most frequently used types of repetition in his poem. Especially surplus pun and difference in type of letter that due to undulation of movements they have, their musical impact is more than homogenous pun and these two types of pun totally have designated 413 cases of the poet ghazals puns to themselves.
Repetition of one or some words in a poem constitutes 520 cases of repetitions of Vesal ghazals sparsely. Sometimes, Vesal emphasizes on his considered notion with this poetic trick and nurtures a notion and concept in the mind of reader.
Reduplication is also another type of word repetition which is called repetitive and is considered among natural repetitions. Vesal Shirazi has used this figure of speech for emphasis, inspiring the concept and making his word more musical since such repetitions indicate multiplicity, emphasis and intensity.
Another kind of this technique is regular repetitions that in Vesal Ghazals include Eanat, coupled, epanalepsis, expizeuxis, simile, converse, leonine verse and equilibration among which epanalepsis with 595 cases is in the first rank. Vesal has utilized such repetitions for emphasis and embossing his considered concepts.
One of most frequently used types of repetition is phoneme repetition. This imagery which is called alliteration has a very high aesthetic value. Depending on his art and taste, Vesal Shirazi has used this imagery very much for illustration and elegance and enrichment of his poems music and the music arising from consonant alliteration is more patent is his poems.
Consonants also have a prominent role in good tune of his poems and among them, decorating the speech with long consonants is more and more salient than short consonants.
Though with repetition of vowel e , that the ancients considered repetition of this vowel as obstacle of speech clarity and reach, and also repetition of vowel o, Vesal increases the couplet music and increases the word influence, and sometimes even by bringing additional and descriptive compounds successively, gives a special music to word which influences the reader's mind. So, many verbal and phoneme repetitions are observed in his poem which causes his word phonemic prominence and this, by itself, is a style characteristic of his ghazals.

Systemic and vascular inflammation are two risk factors for the development of diabetic nephropathy. In diabetic patients, serum systemic and vascular inflammatory factors have positive correlations with albuminuria. The present study was designed to investigate the effects of combined administration of lipoic acid and pyridoxine on the serum concentrations of these factors in patients with diabetic nephropathy. The study was a double-blind randomized clinical trial in which 38 patients with diabetic nephropathy (23 females and 15 males) were randomly assigned to either the supplement-taking or the placebo group. The patients in the supplement group received 800 mg lipoic acid and 80 mg pyridoxine daily for 12 weeks, while the placebo group received corresponding placebos. At baseline and the end of week 12, a urine sample and 10 ml blood was collected from each patient after a 12 to 14-hour fast and serum high sensitive C-reactive protein (hs-CRP), soluble intercellular adhesion molecule type 1 (sICAM-1), soluble vascular cell adhesion molecule type 1 (sVCAM-1), sE-selectin, Interleukine-6 (IL-6), glucose, percent of blood hemoglobin A1c and urinary albumin were measured. In the present study, no significant differences were observed between the two groups in mean changes of hs-CRP, IL-6, sICAM-1, sVCAM-1, sE-selectin, glucose, percent of blood hemoglobin A1c. Mean urinary albumin concentration decreased significantly in the supplement-taking group at the end of week 12, compared to the baseline (P<0.05) and the reduction was significant in comparison with the placebo group (P<0.05). The results of the present study indicate that combined administration of lipoic acid and pyridoxine has no effect on serum systemic and vascular inflammatory factors, but it reduces urinary albumin concentration significantly. Therefore, combined administration of lipoic acid and pyridoxine may have an effective role in retarding the progression of diabetic nephropathy with a mechanism different from the effects of these supplements on inflammation.

Diabetic nephropathy is the most common cause of kidney failure. High serum concentrations of advanced glycated end products, oxidative stress, and hypertension are three important risk factors for diabetic nephropathy. As individual administration of lipoic acid or pyridoxine is not effective in improving diabetic nephropathy, the present study was designed to investigate the effects of combined administration of lipoic acid and pyridoxine on albuminuria, oxidative stress, blood pressure, serum advanced glycated end products, nitric oxide and endothelin-1 in patients with diabetic nephropathy. The study was a double-blind randomized clinical trial, in which 38 patients with diabetic nephropathy (23 females and 15 males) were randomly assigned to either a supplement-taking group or a placebo group. The patients in the supplement group received 800 mg lipoic acid and 80 mg pyridoxine daily for 12 weeks, while the placebo group received placebos. At baseline and at the end of week 12, a urine sample and 8 ml blood were collected from each patient after a 12- to 14-hour fast and serum pentosidine, carboxymethyl lysine, malondialdehyde, endothelin-1, nitric oxide, glucose, urinary albumin, systolic and diastolic blood pressures were measured. The serum concentrations of pentosidine and carboxymethyl lysine decreased significantly in the supplement-taking group at the end of week 12 as compared to the baseline values (P<0.05). The combined supplement also brought about significant reductions in the serum malondialdehyde (25%), systolic blood pressure (2 mmHg) and urinary albumin concentration (74 mg/g creatinine); the reductions were significantly different from the placebo group values (P<0.05). On the other hand, the serum nitric oxide concentration increased significantly in the supplement-taking group as compared to the placebo group (P<0.05). No significant differences were observed between the two groups in the mean changes of serum endothelin-1, glucose or diastolic blood pressure. The results indicate that combined administration of lipoic acid and pyridoxine reduces significantly serum pentosidine, carboxymethyl lysine, malondialdehyde, systolic blood pressure and urinary albumin concentration, and increases serum nitric oxide. This treatment may, thus, have an effective role in retarding the progression of diabetic nephropathy.

Carbohydrate contents of different foods may have different effects on postprandial blood glucose. This study was done to measure and compare glycemic indices and some nutrients in three types of rices. This study was conducted to compare the glycemic effects of 50g carbohydrate in the Basmati, Kazemi and Sorna Perl types of rice in normal subjects. Thirty healthy subjects (13 male and 17 female), aged between 20-40 years, were selected, and were evaluated 4 times at 1 week intervals. On the first day, all subjects consumed 50 gram glucose they were then divided into 3 groups. Each group consumed one of the 3 rice types, with 50g carbohydrate content each week. Blood samples were collected before and at 15,30,60 and 120 minutes, after taking glucose and rice. At the end of the experiment, all subjects received all three kinds of rice and the GI was calculated for each rice as the ratio of the incremental area under the 3- hour glycemic response curve to rice, to the incremental area under the 3- hour glycemic response curve to sugar. The glycemic indices of Sorna Pearl, Kasemin and Basmati were 52/2±5/1, 67/6±13 and 61/2±6/1 respectively, the GI of Sorna perl being lower than the others (p<0/05). Maximum changes of blood sugar for Sorna Perl, Kasemi and Basmati were 21/8±12, 27/4±6 and 31/7±5/9 mg/dl respectively. The results of this study indicate that in healthy of the 3 types of rice cnsumed subjects Sorna Perl had the lowest GI and GL.

Recent studies have shown that dairy consumption is inversely associated with the metabolic syndrome. Calcium and vitamin D, two major components of dairy products, have been postulated as being primarily responsible for the beneficial effect of dairy consumption. The objective was to examine whether and to what extent intakes of calcium and vitamin D are related to the metabolic syndrome in adults. In this population-based cross sectional study, a representative sample of 808 subjects (male and female) aged 18-74 y were randomly selected. Subjects were categorized based on quartile cut-points of dietary intakes of calcium and vitamin D. Multivariate logistic regression was used in 4 models to compare different dietary intake levels of calcium and vitamin D adjusted for lifestyle and nutritional confounders. Each model was additionally adjusted for more variables than the previous one. After adjusting for age, calories, smoking status, exercise, BMI and parental history of myocardial infarction before age 60 years, dietary calcium levels were significantly and inversely associated with the prevalence of metabolic syndrome, and the ORs of having the metabolic syndrome for increasing quartiles of dietary calcium intake were 1.00 (reference), 0.90 (95% CI 0.61–1.04), 0.85 (0.78–0.99) and 0.74 (0.62–0.95) P for trend <0.02, and was not appreciably altered by additional adjustment for dietary vitamin D intake. Dietary vitamin D was inversely associated with the prevalence of metabolic syndrome but was not independent of total calcium intake. Similar strong relations between intakes of dairy products and metabolic syndrome were also observed and the multivariable OR comparing highest with lowest intake quartiles was 0.81(0.64-0.98), P for trend <0.03. It is concluded that intakes of calcium and dairy products may be associated with a lower prevalence of the metabolic syndrome in adults.

Only limited data are available on the benefits of fruits and vegetable consumption on CVD risk factors. The aim of this study was to examine whether and to what extent intake of fruits and vegetables are inversely associated with cardiovascular (CVD) risk factors in adults. In this population-based cross-sectional study a representative sample of 840 Tehranian adults (361 men and 479 women) aged 18-74 years were randomly selected in 1998. Usual dietary intake was assessed with the use of food frequency questionnaire. Portion sizes of consumed foods were converted from household measures to grams and analyzed by using Nutritionist III software designed for Iranian foods. Subjects were categorized based on category cut-points.: 0-1.9, 2-2.9, 3.0-3.9, and>=4 servings/d. In multivariate logistic regression after adjusting for confounders, dietary fruits and vegetable were found to be significantly and inversely associated with CVD risk factors. Adjusted odds ratio for high LDL concentrations were 1.00, 0.88, 0.81, 0.75(P for trend < 0.01) in first model which was adjusted for age, body mass index (BMI), energy intake, smoking status, dietary cholesterol, and prevalence of diabetes mellitus and coronary artery disease, a trend which was not appreciably altered by additional adjustment for education, physical activity, and saturated, polyunsaturated, total fat, Potassium and vitamin C intakes. This association was observed across categories of smoking status, physical activity, and tertiles of the Keys score. Consumption of fruits and vegetables more than 4 servings a day is associated with lower concentrations of total cholesterol and LDL-C and with decrease in the risk of cardiovascular diseases.

While many studies have reported cross-sectional associations between metabolic syndrome components, few have prospectively examined the development of the metabolic syndrome and comprehensive set of risk factors in a cohort. The objective was to evaluate the role of nutritional and anthropometrical factors in the incidence of metabolic syndrome in adults. In this population-based cohort study a representative sample of 410 subjects (male and female), aged 18-74 years who were free of the metabolic syndrome at baseline, were categorized based on quartile cut-points of metabolic syndrome components and food consumption. Baseline blood pressure, waist circumference, serum glucose and lipids, physical activity and dietary intake were measured and tested for predictors of the metabolic syndrome. Metabolic syndrome developed in 71 subjects during the subsequent 3.5 years. The best predictors of incident metabolic syndrome were hypertension [odds ratio (OR) by quartile:1, 1.2, 1.6, 4.2, p for trend<0.05], waist circumference(1, 1.1, 2, 5.3, p for trend<0.05), triacylglycerol(1, 1, 2, 3, p for trend<0.05) and HDL cholesterol(1, 0.4, 0.4, 0.3 p for trend<0.05). In multivariate analysis increased waist circumference was the optimum predictor [OR 8(4-12.2)]. A prominent dose–response relationship across the carbohydrate and fat intake categories and the odds of metabolic syndrome was observed. This report confirms the role of blood pressure, waist circumference and lipid measurements in risk stratification of metabolic syndrome in adulthood. Interventions that address obesity and reduce waist circumference and an appropriate diet may reduce the incidence of the metabolic syndrome in adults.

Waist and hip circumference play important roles in epidemiologic and clinical studies. The purpose of the present study was to determine the effect of weight loss on the waist and hip circumference of overweight and obese women.

This is a before-after experimental study carried out on 289 women between the ages of 18 and 73 years old. Demographic data were gathered. Weight and height was measured using standard protocols and Body Mass Index (BMI) was also calculated. Waist circumference (WC) –the minimum between the costal margin and iliac crest- and hip circumference (HC) -at the greater trochanters- were measured. Waist to hip ratio (WHR) was also calculated. Obesity was defined with a BMI >30 kg/m², overweight with a 25 ≤ BMI ≤ 30 kg/m² and abdominal obesity with a WHR ≥ 0.8.

The mean age of our subjects was 34.9±11.5 years. At the beginning of the study, mean W and BMI was 81.8±14.6 Kg and 31.8±5.4 kg/m², mean WC was 95.3 ±10.3 cm, mean HC was 114.6±10.8 cm and mean WHR was 0.83±0.06. Two months after the diet recommended for weight reduction, W, BMI, WC, HC and WHR were 77.8±14.5 Kg, 30.4 ±5.4 kg/m², 91.1±10.5 cm, 111.8±11 cm and 0.81±0.06 respectively (P value <0.05 for all).

Our findings suggest that in obese and overweight women a low calorie diet results in a significant weight loss with significant reduction in BMI, WC, HC, WHR. We also demonstrated that these changes in WC and HC have a direct connection with their primary BMI.

The importance of feed controlling has been proved in metabolic control of diabetic patients. An appropriate metabolic control prevents later complications. Patients with diabetes mellitus are deprived from eating sweat foods. Considering the effect of different carbohydrates on blood sugar, physicians and patients confront a lot of questions about eating these foods. The aim of this study was to compare the effect of sugar cube and Date consumption on blood sugar in patients with type 1 diabetes. As a clinical-trial, we selected 20 patients with type I diabetes mellitus sequentially. They were divided into two groups with 10 subjects in each group. The patient’s blood sugar was measured in 2 days with one week interval, before and after eating a Date (10gr) and a sugar cube (5gr). We measured blood sugar at 30, 60, 90 and 120 minutes after consumption. Data analysis was performed by SPSS software version 11, and the results were compared by paired t test. There was no significant difference between the blood sugar after eating Date and sugar cube. We also compared the surface under the curve of blood sugar after eating date and sugar cube in 2 hours, which was 1619.4 ± 614 mg.min/dL and 1572 ± 967 mg.min/dL for sugar cube and Date respectively, which the difference was not significant. Rising in blood sugar after Date consumption has not significant difference in comparison with sugar cube consumption in patients with type I diabetes. So, eating Date in diabetic patients is not preferable to eating sugar cube.

Infection is a common complication of diabetic foot that needs hospital admission and surgical intervention.Diabetic foot occurs in one of each ten diabetic patients. Diabetic foot complications are osteomyelitis, arthritis and abscess formation. Radiography, isotope scans, MRI and CT-scan are the procedures that help diagnosis of these complications but these are not always cost effective or available. If ESR and CRP level could help us to determine depth and width of diabetic foot ulcer and the possibility of presence of osteomyelitis, we can cost saving and begin appropriate therapy very soon. A retrospective chart review of 35 diabetic patients admitted to the Rassol Akram Hospital with diagnosis of osteomyelitis or cellulites of the foot during a 2-year periods (1999-2000) was performed. Depth and width of ulcer, presence or absence of osteomyelitis, ESR and CRP level are compared in this group. A retrospective review of 35 diabetic patients that admitted to this hospital only for control of blood glucose also was performed as control group. In this survey ESR and CRP level in diabetic foot group was higher than control group(P.value=0.00), and in diabetic foot with osteomyelitis was higher than diabetic foot without osteomyelitis(P.value=0.001 for ESR and P.value=0.00 for CRP). CRP level in large ulcers were higher than small ulcers(P.value=0.001). ESR and CRP level in patients with long duration of admission were higher than patients with short duration (P.value=0.00 for ESR and P.value=0.001 for CRP). We concluded that higher ESR and CRP level is seen in diabetic foot with osteomyelitis and higher CRP level is indicated of the presence of large ulcer and if patient with diabetic foot has a high ESR and CRP level, need a long period of treatment. We concluded that in diabetic foot only when ESR and CRP level is high investigation for presence of osteomyelitis could be necessary.