مجله دانشگاه علوم پزشکی قم
سال دوم شماره 1 (پیاپی 5، فروردین 1387)

Type 2 diabetes mellitus is a chronic progressive illness that causes considerable morbidity and mortality. Despite recent technical advances in therapy more people are using alternative therapies. In this study evaluated the effect of sodium metavanadate on glucose levels and lipid profile in type 2 diabetes mellitus patients. Methods This is a randomized controlled trial study. Forty subjects admitted to Yazd Diabetes Research Center Yazd Iran were divided randomly into two groups and supplemented daily with 100 mg sodium metavanadate or placebo for six weeks. Body Mass Index (BMI) Blood Pressure and Fasting Blood Sugar (FBS) 2-h postprandial glucose(2hpp) Glycated hemoglobin (HbA1C) Triglyceride (TG) cholesterol (chol) low-density lipoproteins (LDL) high-density lipoproteins (HDL) Blood Urea Nitrogen(BUN) Creatinin (Cr) Alanine aminotransferases (ALT) Aspartate aminotransferases(AST) were assayed before and after 6 weeks sodium metavanadate supplementation. HbA1C BMI and blood pressure also were analyzed in 12th week to evaluate the long term effect of drugs. Results Thirty eight patients with mean age of 53.10±8.48 years old were included in the study. Although FBS HbA1C Cholesterol and LDL levels decreased after six weeks supplementation but it was not statistically significant. However a significant decrease occurred in TG levels (P=0.01) and BMI (p=0.03). After 12 weeks there was a significant decrease in BMI (P=0.01). Conclusion It is recommended to test another vanadium compound in type 2 diabetic patients to achieve better results.

Nowadays Laparoscopic Cholecystectomy is known as a gold standard method for Cholecystectomy. This study was done to evaluate outcomes of the surgery in the first admitted group of patients in Qom Golpaegani hospital. Methods All patients that had been treated by Laparoscopic Cholecystectomy during 2005-7 were included in this retrospective survey. Study population was consisting of 305 cases with age between 15 to 86 years old %64.9 women and 35/1% men and 80% with symptomatic gallstones. Data were collected using questionnaire and then analyzed using SPSS software. Results In 2007 multiplicity of Laparoscopic Cholecystectomy was the highest. The mean operation time was 45 min and duration of hospitalization was 12-48 hours. %80 of all cases (both men and women) had symptomatic gallstones which had been determined by sonography and others had acalculous Cholecystitis. The most common complication during operation was bradychardia as a result of gas flow into the abdomen. There was no case of death. Conclusion Our results showed that Laparoscopic Cholecystectomy is a standard method of Cholecystectomy and have a desirable outcome.

Metastatic calcification is usually found in patients with chronic renal failure and hemodialyzed patients. Heart calcification becomes worse in hemodialyzed patients due to several factors. The aim of this study was to investigate relationship between Calcium Phosphorous and Parathoromone(PTH) with calcification of heart valves in dialyzed patients. Methods This study is a Case- series study. 71 patients with calcification of heart valves who have referred for dialysis to Kamkar and Valiasr hospitals in Qom were selected as study population through echocardiography. Levels of Calcium Phosphorous and PTH in the patients were assayed by suitable methods. Results Our results showed that in %17/5 of study population the level of calcium was higher than 10.4mg/dl in %75.1 the level of PTH was higher than 70um/lit and finally the level of Phosphorous in %54.2 was higher than 4.5mg/dl. We concluded that there are a meaningful relationship between calcification of heart valves and levels of calcium Phosphorous and PTH. Conclusion Measurement of serum calcium Phosphorous and PTH and performing echocardiography for prevention of calcification of heart valves are necessary in individuals who are dialyzed.

Lactose intolerance is a discomfort state that occurs in some people after ingestion of milk and it is due to insufficient amount of beta galactosidase in the human gut to digest lactose. The aim of this study was to observe the presence of beta galactosidase enzyme produced by isolated lactobacilli from milk and cheese. Methods In this deh1ive study milk and cheese samples with different brand were bought from different shops. Lactobacilli were identified by plating samples on MRS medium Gram staining and standard biochemical methods. β-galactosidase production by bacteria was assessed by X-Gal and ONPG methods. β-galactosidase was also detected by SDS-PAGE. Results Fourteen genus of lactobacillus were isolated From 50 samples. All of the bacteria produced green color colonies on X-Gal plates (but in different times) that indicated the presence of enzyme in the bacteria. All isolated lactobacilli were shown β-galactosidase activity in ONPG test. The highest enzymatic activity was seen in one strain of Lactobacillus Delbrueckii (1966 Miller unit /ml). In some bacteria (37%) a strong β-galactosidase band(116-kDa) was seen by SDS-PAGE. Conclusion Addition of beta galactosidase containing lactobacilli as a probiotic agent to milk cheese and other dairy products could ameliorate lactose intolerance. Meanwhile X-gal and ONPG methods which are simple rapid and cheap can be used instead of SDS-PAGE.

Morbidity and mortality of urinary tract infection is common in spite of preh1ion of effective new antibiotics. Chronic pyelonphritis is one of the important reasons of end stage renal failure. Our study is carried out on 167 children admitted in Fatemi koodacan Hospital due to urinary tract infection. Major goal of this study was determination of epidemiology of urinary tract infection. Methods This study was cross sectional deh1ive and sampling method was census. Various Factors such as age gender causative pathogen used antibiotics and required time for getting negative urine culture test were studied. data were collected by means questionnaire. Results According to the study urinary tract infection was more common in females (74.2% of all cases) while in male neonates it is more common than females. Incidence peak of urinary tract infection is seen in children between 1-6 years old. The most common pathogens responsible to urinary tract infection was E coli and Klebsiella. The most common background disease was vesicoureteral reflux. The most common prescribed antibiotic was ceftriaxone (65%). After 2 days of taking antibiotic the majority of patients (87.7%) had negative urine culture. Conclusion In our study E. coli and Klebsiella are the most common pathogen responsible to urinary tract infection. In our study the frequency of urinary tract infection with Proteus was low (only 1.1%) in comparison with other studies. Other epidemiological indices in this study were comparable to previous studies.

Urinary incontinence is a common complain in women. There are some methods in modern and alternative medicine for treating this disorder. The aim of this study was to evaluate long term outcome of anterior colporrhaply with Kelly plication for treatment of stress urinary incontinence. Methods This deh1ive-analytic study was done on 20 patients who underwent Kelly plication for stress urinary incontinence between July to November 2005 in Beheshti Hospital of Isfahan University of Medical Science. Primary data were collected before operation and 2 times after operation (4&24 months). Questionnaires were filled out to assess the outcome of the procedure. Results The mean age of the patients was 42 years old. After 4 months of the surgery %80 of the patients had no complains of SUI. Recurrence of post operative urinary incontinence after two years was 50 %. Conclusion This study showed high recurrence rate of the disorder after two years. Therefore pre-operative counseling to aware patients about high chance of recurrence is necessary.

Balloon dilatation of stricture is one of the new treatment methods for patients with Gastric Outlet Obstruction (GOO). Prevalence and underlying etiologies of GOO in various populations are different. The goal of the present study was to determine the effectiveness of endoscopic balloon dilatation and factors that could affect method advantage among patients with benign etiology for GOO. Methods Forty-five patients with symptoms of benign GOO were randomly selected. The mean age of patients was 43.7±18.1 years and 86.7% of them were men. Gastric outlet was delineated using double channel videoendoscopy. The severity of gastric pain was measured by VAS test immediately before and one month after balloon dilatation. Patients were followed after procedure weekly (for the first month) and then monthly. Balloon dilatation was repeated for 27% patients during the follow up period. Results Patients were followed for 9.9±5.8 months. Furthermore 71.1% were H. pylori positive. Positive response percent to endoscopic balloon dilatation was 80% and eight patients were took under surgical resection. Weight loss was seen frequently in the non-respondent group. The pain severity was significantly reduced in respondent subjects. No meaningful correlations were found between the response to balloon dilatation and positive H. pylori and cigarette smoking. Conclusion Endoscopic balloon dilatation is a safe and effective method for treating most of patients with benign gastric outlet obstruction and has favorable long-term outcome.

Pollution of surface and ground water to arsenic (As) has been reported from many parts of the world and in some regions of Iran especially in Kurdistan province. Natural pollution of water to As is in fact dependent to geological characteristics of a region. To day various methods have been recommended for As removal that each of which has special advantages and drawbacks. Granular ferric hydroxide (GFH) is a relatively new adsorbent available in market which is principally introduced for As removal. Methods This study was an applied survey in which the effects of changing contact time As concentration adsorbent weight pH as well as the effect of sulfate and chloride ions in arsenic removal were determined. Moreover the model of absorption by GFH was studied and compared with Freundlich and Langmuir models. Raw data were analyzed by Excel and SPSS softwares. Results Results showed that As adsorption by GFH imitate both the Freundlich and Langmuir equations (with R2 >0.95). Optimum PH was 7.5 and duration of the process about 30 minutes was sufficient for optimum removal of As. It was also found that efficiency of As removal was high when small amounts of adsorbent were used. Furthermore sulfate and chloride ions in concentrations used in this study had no noticeable effect on As removal and Fe added during process remains in the water more than the standard value (0.3 mg/l). Conclusion According to this study GFH could be considered as a suitable adsorbent for As removal from polluted water resources because of its high performance without any needs to PH adjustment. However there are few drawbacks such as Fe addition and relatively high initial cost.

In the women with chronic renal insufficiency ovulation is suppressed therefore they rarely become pregnant. If pregnancy occurs they might encounter many conflictions. It may lead to death (fetus or mother). The aim of this study was reporting a successful pregnancy in a patient with advanced chronic renal insufficiency. Case report The patient was a 32 years old woman with long period of infertility (8 years). The first main clinical symptom was abdominal pain especially in hypogastric area as well as hyperuremia elevated levels of creatinine (2.9 mg/dl) mild proteinuria and hematuria. The urine specific gravity was 1010. Sonography data showed asymmetrical small kidneys. Other complaints were pruritus and flank pain during urination. The primary diagnosis was chronic renal failure due to probable chronic pyelonephritis. After an interval she returned with positive pregnancy test. She decided to continue the pregnancy in despite of obstetrician belief for aborting. During pregnancy proteinuria reached to two plus hemoglobin fell to 9.7 creatinine levels reached to 3.7 mg/dl and blood pressure was fluctuating between 110/80 and 130/85 mmHg. She admitted in the hospital in third trimester of pregnancy because of preterm labor. However the pain was suppressed after starting magnesium sulfate infusion.

Hemolytic uremic syndrome (HUS) is characterized by triad of microangiopathic hemolytic anemia thrombocytopenia and acute renal failure. It is more common in children younger than the age of 4 years and is the most common cause of acute renal failure in many parts of the world in this range of age. The classic form of the disease occurs after an episode of acute diarrhea which may lead to chronic renal failure in 9% of cases. Here in we report a case of HUS with recovery of renal function after 15 months of dialysis. Case report A 12 year old boy was admitted with major clinical symptoms including acute bloody diarrhea followed by acute renal failure thrombocytopenia and severe microangiopathic hemolytic anemia. Peripheral blood smear showed probability of HUS. Peritoneal dialysis was started and later followed by hemodialysis. Eventually after 15 months of dialysis he obtained normal renal function and now after 3 years he is in good health with normal renal function. Recovery of renal function in HUS is possible even after a prolonged period of renal failure.