Publications by authors named "Mojgan Sanjari"

23 Publications

  • Page 1 of 1

Henoch-Schönlein Purpura (IgA Vasculitis) in Association with Thyrotoxicosis.

Case Rep Endocrinol 2021 22;2021:6669653. Epub 2021 May 22.

Pathology Department, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.

Graves' disease is the most common cause of hyperthyroidism, which is characterized by thyroid antibodies and the following clinical manifestations: goiter, ophthalmopathy, and pretibial myxedema. On the other hand, Henoch-Schönlein purpura is an IgA-mediated small-vessel vasculitis. Review of the literature showed a relationship between propylthiouracil overdose and the following Henoch-Schönlein purpura (IgA vasculitis) as a side effect. The patient was a 31-year-old woman with a chief complaint of tremor and significant weight loss who contracted pruritic palpable purpura during her disease course. Then, she underwent the treatment of hyperthyroidism by methimazole which intensified her cutaneous lesions. The diagnosis of Henoch-Schönlein purpura (IgA vasculitis) was confirmed after skin biopsy. Finally, she was treated with colchicine, prednisolone, and radioiodine ablation, which caused her lesions to disappear. The temporal priority of pruritic palpable skin lesions to hyperthyroidism treatment with methimazole suggested that Henoch-Schönlein purpura (IgA vasculitis) was related to hyperthyroidism and was intensified by antithyroid agents in this patient.
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http://dx.doi.org/10.1155/2021/6669653DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8166464PMC
May 2021

Distribution of Myeloid and Plasmacytoid Dendritic Cell Subpopulations in Peripheral Blood of Hyperprolactinemic Women.

Iran J Allergy Asthma Immunol 2021 Apr 17;20(2):198-204. Epub 2021 Apr 17.

Pathology and Stem Cell Research Center, Kerman University of Medical Sciences, Kerman, Iran.

Dendritic cells (DCs) play key roles in regulating the immune response using the specialized function of processing and presenting antigens. Prolactin (PRL), a hormone produced by the pituitary gland, participates in DC maturation and function. The present study was aimed to determine the frequencies of peripheral blood DC subpopulations of myeloid DC (MDC) and plasmacytoid DC (PDC) in hyperprolactinemic (HPRL) women compared to normal healthy volunteers. This study was conducted on 70 women, including 35 HPRL patients and 35 matched healthy controls, whose PRL serum levels were in the normal range (lower than 25 ng/mL). Serum thyroid-stimulating hormone (TSH) levels were measured in both groups as an indicator of normal thyroid function. The electrochemiluminescence immunoassay method was applied to measure the serum levels of TSH and PRL. The frequencies of MDC and PDC in the peripheral blood samples of both groups were determined by flow cytometry. The mean serum PRL levels in the HPRL patients and healthy individuals were 46.41±21.96 and 13.75±11.19, respectively (p<0.0001); however TSH levels in both groups were similar and within the normal range (0.4-4.5 mIU/mL) (p=0.2). The frequencies of both MDC and PDC subpopulations in the peripheral blood of HPRL patients were significantly lower than they were in the healthy controls. However, the ratio of MDCs/PDCs in HPRL patients was not significantly different between the two groups (p=0.8). Our study revealed that an increased level of serum PRL may lead to a reduction in the number of MDC and PDC subpopulations. These results could help clarify the complex relationship between the immune system and the neuroendocrine axis and may be of potential use in understanding the pathogenesis of endocrine and immune disorders.
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April 2021

Safety and efficacy of Berberis integerrima root extract in patients with type 2 diabetes. A parallel intervention based triple blind clinical trial.

J Diabetes Metab Disord 2020 Jun 4;19(1):71-80. Epub 2020 Mar 4.

Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Purpose: To evaluate the safety and efficacy of methanol extract of root on type 2 diabetes compared to metformin.

Methods: In a parallel triple blind clinical trial, 80 type 2 diabetic patients,, were randomized into two groups (treated with Berberis integerrima root, 480 mg (oral), compared to control group treated with metformin 1000 mg daily). Efficacy was evaluated by fasting and prandial glucose and HbA1c and side effects confirmed by physical examination, biology and hematology tests and urinalysis on days 15, 45 and 90. They were followed for 3 months.

Results: Two hundred and eighteen patients were recruited and 80 (55female and 25 male) patients randomized in two groups and 60 patient were analysed. The mean age of patients was 51.8 ± 9.3 and 46.5 ± 10 in the experimental ( and control (metformin) groups respectively ( = 0.02). The mean HbA1c at baseline was 8.1 ± 1.6% and 7.9 ± 1.6% for and metformin group respectively (P = 0.53), and there was no significant difference between the two groups (7.5 vs. 7.2) after 3 months (P = 0.34).Weight loss was observed in both groups compared to baseline.No adverse event led to preventing the study was reported.

Conclusion: root not only was effective as much as metformin in reducing blood glucose and controlling type 2 diabetes but also, no specific side effect was reported (in short term).So, it might be an effective and safe complementary therapy in diabetic patients.Iranian Research and Clinical Trial (IRCT) registeration number; 201,207,191,774 N5.Funding: Vice chancellor for research, Physiology Research Center of Kerman University of Medical Sciences and the Exir pharmaceutical company.
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http://dx.doi.org/10.1007/s40200-019-00478-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7270296PMC
June 2020

The effect of IFN-β 1a on expression of MDA5 and RIG-1 in multiple sclerosis patients.

Biotechnol Appl Biochem 2021 Apr 25;68(2):267-271. Epub 2020 May 25.

Immunology of Infectious Diseases Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.

The aims of this study were to compare mRNA levels of melanoma differentiation-associated protein 5 (MDA5) and retinoic acid-inducible gene 1 (RIG-1) in multiple sclerosis (MS) patients in comparison to the healthy controls as well as investigating the effects of IFN-β 1a on the expression of these molecules. In this study, mRNA levels of MDA5 and RIG-1 in peripheral leukocytes of 30 new cases of MS patients and 35 healthy controls were evaluated using the real-time-PCR method. mRNA levels of MDA5 and RIG-1 were determined in the MS patients 6 months after treatment with standard doses of IFN-β 1a. mRNA levels of MDA5 and RIG-1 were significantly decreased in the MS patients in comparison to the healthy controls. The analysis also revealed that IFN-β 1a therapy leads to the upregulation of RIG-1, but not MDA5, in the total MS patients and the female group. MS patients suffer from insufficient expression of MDA5 and RIG-1, and IFN-β 1a therapy results in the upregulation of RIG-1 in the patients, especially in the female patients. Thus, it seems that IFN-β 1a not only decreased pathogenic inflammatory responses but also modulated the expression of RIG-1 to protect the patients from infectious diseases and upregulation of IFN-I in a positive feedback.
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http://dx.doi.org/10.1002/bab.1920DOI Listing
April 2021

Enhanced expression of Cyclin D1 and C-myc, a prognostic factor and possible mechanism for recurrence of papillary thyroid carcinoma.

Sci Rep 2020 03 20;10(1):5100. Epub 2020 Mar 20.

University of British Columbia Vancouver, Vancouver, BC, Canada.

A direct association has been shown between Cyclin D1 and C-myc gene expressions and the proliferation of human thyroid tumor cells. Our previous study showed that increased β catenin led to a reduction in disease-free probability in patients with papillary thyroid cancer. This study was designed to investigate Cyclin D1 and C-myc genes as targets for β catenin function in PTC and to determine the association between genes expression and staging, recurrence, metastasis, and disease-free survival of PTC. This study was conducted via a thorough investigation of available data from medical records as well as paraffin blocks of 77 out of 400 patients over a 10-year period. Cyclin D1 and C-myc gene expression levels were measured using real-time polymerase chain reaction (RT-PCR) and the Kaplan-Meier method was used to evaluate disease-free survival. Higher levels of Cyclin D1 and C-myc gene expressions were observed in patients with recurrence by 8.5 (P = 0.004) and 19.5 (p = 0.0001) folds, respectively. A significant positive correlation was found between Cyclin D1 expression and the cumulative dose of radioactive iodine received by patients (r = -0.2, p value = 0.03). The ten-year survival rate in the patients included in this study was 98.25% while disease-free survival was 48.1%. Higher Cyclin D1 and C-myc gene expression levels were observed in patients with recurrence/distant metastasis. Inversely, lower expression of Cyclin D1 and C-myc genes were associated with better survival of patients (SD, 0.142-0.052) (Mantel-Cox test, P = 0.002). The enhancement of Cyclin D1 and C-myc gene expression may be a potential mechanism for recurrence and aggressiveness of PTC.
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http://dx.doi.org/10.1038/s41598-020-61985-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083882PMC
March 2020

Comparison of Pulp Sensibility Tests Responses in Type 2 Diabetes Patients and Healthy Individuals.

J Endod 2020 Mar 17;46(3):364-369. Epub 2020 Jan 17.

School of Dentistry, University of Western Australia, Perth, Australia.

Introduction: Diabetes is a common disease that may have some influence on sensory nerves. The aim of this study was to evaluate dental pulp responses to 2 pulp sensibility tests (ie, cold and electric) in patients with type 2 diabetes compared with healthy individuals.

Methods: Three hundred twenty-two premolar teeth in 51 patients who had type 2 diabetes and 347 premolar teeth in 53 individuals with no medical conditions were investigated. The patients with type 2 diabetes were unified and had fasting plasma glucose <300, hemoglobin A1C <10, less than a 10-year history of diabetes mellitus, and no history of hypertension. Electric and cold pulp sensibility tests were performed for all teeth. The cold test results were recorded by the Heft-Parker visual analog scale, and the electric pulp test results were recorded based on the pulp tester's grade that evoked a response.

Results: There was no statistically significant difference between upper and lower premolar teeth in healthy individuals compared with the patients with diabetes in response to the cold and electric pulp tests (P > .05). In the patients with diabetes, the response of their upper premolars to the cold test was significantly reduced in diabetic patients >45 years of age (β = -1.15, P = .013). However, there was no significant correlation between the cold test and age in the lower premolars of both diabetic and nondiabetic participants (P > .05). There was also no significant correlation between the need for a higher number of the electric pulp test current to evoke a response in maxillary and mandibular premolars of the patients with diabetes and nondiabetic participants with age (P > .05).

Conclusions: There was a significant correlation between the reduction of maxillary premolar teeth responses to the cold test in diabetes patients >45 years of age.
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http://dx.doi.org/10.1016/j.joen.2019.11.016DOI Listing
March 2020

The correlation between blood oxidative stress and sialic acid content in diabetic patients with nephropathy, hypertension, and hyperlipidemia.

Diabetol Int 2020 Jan 9;11(1):19-26. Epub 2019 May 9.

2Pharmaceutics Research Center, Institute of Neuropharmacology, Faculty of Pharmacy, Kerman University of Medical Sciences, Haft Bagh-e-Alavi Highway, 7616911319 Kerman, Iran.

This clinical study was designed to find out the correlation between oxidative stress and sialic acid (SA) content of plasma and RBCs in patients with type 2 diabetes. We evaluated SA concentration and oxidative stress biomarkers in healthy subjects and diabetic patients with and without complications in a cross-sectional survey. Significant changes in oxidative stress biomarkers and RBC-SA were revealed in the diabetic patients compared to those in the healthy group. Plasma SA significantly increased with an increase in lipid peroxidation of RBCs (LPO-RBC) ( < 0.001) in the diabetic patients without complication. RBC-SA significantly decreased with an elevation in LPO-RBC ( < 0.001) in all the diabetic patients and those with nephropathy. There was no significant correlation between plasma and RBC-SA and other oxidative stress biomarkers in the diabetic subjects. In multiple logistic regression analysis, RBC-SA was independently related to LPO-RBC in all the diabetic patients and those with nephropathy. We conclude that the induction of LPO-RBC in diabetic patients and those with nephropathy may influence the SA decomposition of RBC membrane, thereby altering its functions and transporter activities. Therefore, LPO-RBC and SA levels in RBCs can be used for prediction of diabetic nephropathy, and further studies to evaluate other factors contributing to desialylation of RBC membrane are justified.
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http://dx.doi.org/10.1007/s13340-019-00395-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6942093PMC
January 2020

Combination of different clinical reasoning tests in a national exam.

J Adv Med Educ Prof 2019 Oct;7(4):230-234

Medical School, University of Montreal, Montreal, Canada.

Introduction: Clinical reasoning as a critical and high level of clinical competency should be acquired during medical education, and medical educators should attempt to assess this ability in medical students. Nowadays, there are several ways to evaluate medical students' clinical reasoning ability in different countries worldwide. There are some well-known clinical reasoning tests such as Key Feature (KF), Clinical Reasoning Problem (CRP), Script Concordance Test (SCT), and Comprehensive Integrative Puzzle (CIP). Each of these tests has its advantages and disadvantages. In this study, we evaluated the reliability of combination of clinical reasoning tests SCT, KF, CIP, and CRP in one national exam and the correlation between the subtest scores of these tests together with the total score of the exam.

Methods: In this cross sectional study, a total number of 339 high ranked medical students from 60 medical schools in Iran participated in a national exam named "Medical Olympiad". The ninth Medical Olympiad was held in Shahid Beheshti University of Medical Sciences, Tehran, Iran, under the direct supervision of the Ministry of Health and Medical Education in summer 2017. The expert group designed a combination of four types of clinical reasoning tests to assess both analytical and non-analytical clinical reasoning. Mean scores of SCT, CRP, KF, and CIP were measured using descriptive statistics. Reliability was calculated for each test and the combination of tests using Cronbach's alpha. Spearman's correlation coefficient was used to evaluate the correlation between the score of each subtest and the total score. SPSS version 21 was used for data analysis and the level of significance was considered <0.05.

Results: The reliability of the combination of tests was 0.815. The reliability of KF was 0.81 and 0.76, 0.80, and 0.92 for SCT, CRP, and CIP, respectively. The mean total score was 169.921±41.54 from 240. All correlations between each clinical reasoning test and total score were significant (P<0.001). The highest correlation (0.887) was seen between CIP score and total score.

Conclusion: The study showed that combining different clinical reasoning tests can be a reliable way of measuring this ability.
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http://dx.doi.org/10.30476/jamp.2019.83101.1083DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6820014PMC
October 2019

Gestational diabetes mellitus in association with macrosomia in Iran: a meta-analysis.

J Diabetes Metab Disord 2019 Jun 21;18(1):41-50. Epub 2019 Feb 21.

9Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran.

Purpose: This meta-analysis aimed to estimate the association between gestational diabetes mellitus (GDM) and occurrence of macrosomia for the first time among Iranian population.

Methods: A systematic review was done of national and international databases. Lists of relevant articles were checked to increase sensitivity of the search reference. Also, access to unpublished articles and documents were accessed by negotiation with related individuals and research centers. These published epidemiological studies (cross-sectional, case-control and cohort studies) were used for comparisons to determine whether GDM was associated with macrosomia. Finally, the Mantel-Haenszel method and the fixed and random-effect models based on heterogeneity of the primary studies were used according to pool results and estimate the odds ratio of macrosomia in women with GDM.

Results: Of 1870 articles, thirty relevant articles were eligible for the current meta-analysis. Our findings showed that 335 of 2524 women with GDM had macrosomia while only 775 of 26,592 women without GDM had macrosomia. Using random-effect model, the pooled odds ratio (OR) relation between GDM and occurrence of macrosomia was estimated as of 5.49 (95% CI: 4.27-7.04). Subgroup analysis showed no difference regarding different study designs and definitions of macrosomia. There was no evidence of publication bias based on the result of Egger's test (β = 0.1,  = 0.70).

Conclusions: This meta-analysis shows that GDM is directly associated with the risk of macrosomia in the Iranian population. This confirms the findings of previous studies in the wider scientific literature.
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http://dx.doi.org/10.1007/s40200-019-00388-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6582006PMC
June 2019

Immunohistochemical Evaluation of β-Catenin Marker in Papillary Thyroid Cancer: Clinicopathologic Significance.

Iran J Pathol 2018 17;13(2):151-156. Epub 2018 Jul 17.

Dept. of Pathology, AJA University of Medical Sciences, Tehran, Iran.

Background & Objective: papillary thyroid cancer is the most common cancer of thyroid accounting for 75%-85% of all thyroid malignancies. Recently, β-catenin has been determined to play a role in clinical course of human epithelial cancers. This study was designed to reveal the association of β-catenin marker and papillary thyroid carcinoma behavior.

Methods: 63 paraffin blocks of papillary thyroid carcinoma were stained with ready to use monoclonal β-catenin antibody according to manufacturer's instructions. Memberanous, cytoplasmic and nuclear staining was scored according to intensityof immunoreactivity. β-catenin immunostaining association with clinical parameters like number of recurrences and cumulative dose of radioiodine therapy were analyzed using SPSS version 15. Histopathologic parameters like tumor stage, grade, capsular invasion, lymphovascular invasion, lymph node involvement, distant metastasis andother variables were also evaluated for association with β-catenin immunoreactivity.

Results: 77.8% of papillay thyroid carcinoma were well differentiated and the remaining were poorly differentiated. Loss of β-catenin membrane immunostaining depicted correlation with number of recurrences (=0.023% , Pearson correlation=-0.285). Its loss of memberanous staining correlated similarly with cumulative dose of radioiodine (= 0.046, Pearson correlation = -0.253). Loss of membranous β-catenin was significantly associated with some histopathologic findings like nodal involvement (<0.001), distant metastasis (=0.003) and tumor dedifferentiation (< 0.001).

Conclusion: Loss of β -catenin membranous staining and its cytoplasmic accumulation were associated with aggressive clinicopathologic behavior. The exact effect of radioiodine exposure on β-catenin pathway remained to be determined in future.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6339484PMC
July 2018

Downregulation of IL-22 can be considered as a risk factor for onset of type 2 diabetes.

J Cell Biochem 2018 11 28;119(11):9254-9260. Epub 2018 Jun 28.

Immunology of Infectious Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.

There is some controversy as for the roles played by tumor growth factor-β (TGF-β), interleukin-1β (IL-1β), and IL-22 in the onset process of type 2 diabetes (T2D). The main aim of this project was to examine serum levels of TGF-β, IL-1β, and IL-22 in the new cases and long period T2D patients as well as healthy controls. In this study, 115 new T2D patient cases (group 1), 434 T2D patients who have suffered from the disease more than 2 years (group 2), and 104 healthy controls have been selected from 6240 (3619 females) patients who were under study population from Kerman Coronary Artery Disease Risk Factor Study. Serum levels of TGF-β, IL-1β, and IL-22 have been evaluated using commercial kits. Serum levels of TGF-β and IL-1β significantly increased, while IL-22 decreased in 2 groups in comparison to healthy controls. Serum levels of IL-22, but not TGF-β and IL-1β, were significantly decreased in group 1 in comparison to healthy controls. There were no significant differences between groups 1 and 2 as for the cytokine levels. Serum levels of IL-22 increased in the females in group 2 when compared to females in group 1. It appears that TGF-β and IL-1β participate in the induction of inflammation after establishment of T2D, while decrease in IL-22 may be considered as a key factor for onset of the disease. Gender can also be considered as the main risk factor for variation in cytokine levels.
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http://dx.doi.org/10.1002/jcb.27194DOI Listing
November 2018

ENHANCED BETA-CATENIN EXPRESSION IS ASSOCIATED WITH RECURRENCE OF PAPILLARY THYROID CARCINOMA.

Endocr Pract 2018 May 2;24(5):411-418. Epub 2018 Mar 2.

Objective: A direct role of β-catenin 1 (β-cat) in the proliferation of human thyroid tumor cells has been identified. This study aimed to determine if there is an association between β-cat gene expression and the staging, recurrence, metastasis, and disease-free survival of papillary thyroid cancer.

Methods: A retrospective cohort study was conducted using data from available information in the medical records and paraffin blocks of 81 of 400 patients referred to the endocrine clinic over a 10-year period. Real-time polymerase chain reaction was used to evaluate β-cat gene expression. Disease-free survival was assessed using the Kaplan-Meier method.

Results: The 10-year survival rate in these patients was 98.25%, and disease-free survival was 48.1%. Cumulative dose of radioactive iodine that patients received was significantly and positively correlated with β-cat gene expression ( r = -0.2; P = .03). Also, in patients with recurrence, β-cat gene expression was higher and statistically significant (5-fold increase; P = .002). Patients in more advanced stage and those with recurrence/distant metastasis had higher β-cat gene expression. We found that the patients had a better survival (lower recurrence) if they had a lower β-cat gene expression (SD, 0.142 to 0.052) (Mantel-Cox test, P = .002).

Conclusion: We conclude that β-cat gene expression is positively correlated with recurrence, distant metastasis, and tumor-node-metastasis stage.

Abbreviations: β-cat = β-catenin 1; CI = confidence interval; PTC = papillary thyroid carcinoma; ROC = receiver operating characteristic.
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http://dx.doi.org/10.4158/EP171983.ORDOI Listing
May 2018

Interferon-β 1a Modulates Expression of RAGE but Not S100A12 and Nuclear Factor-κB in Multiple Sclerosis Patients.

Neuroimmunomodulation 2016 22;23(5-6):345-351. Epub 2017 Apr 22.

Neurology Research Center, Kerman University of Medical Sciences, Kerman University of Medical Sciences, Kerman, Iran.

Objectives: Interferon-β 1a (IFN-β 1a) is a common strategy therapy for multiple sclerosis (MS) with unknown mechanisms. S100A12 (S100 calcium-binding protein A12) is a damage-associated molecular pattern molecule which binds to its receptor, RAGE (receptor for advanced glycation end products), and activates nuclear factor-κB (NF-κB). NF-κB is transcribed from proinflammatory molecules, which may participate in the pathogenesis of MS. Therefore, the aims of this study were to compare mRNA levels of S100A12, RAGE, and NF-κB in newly diagnosed MS patients with healthy controls and determine whether IFN-β 1a therapy affects the expression of the molecules.

Methods: S100A12, RAGE, and NF-κB mRNA levels in 30 new cases of untreated MS patients and 35 healthy controls were evaluated using the real-time PCR technique. The mRNA levels were also evaluated in the MS patients after 6 months of IFN-β 1a therapy.

Results: S100A12, RAGE, and NF-κB mRNA levels were significantly decreased in the new cases of untreated MS patients in comparison to healthy controls. IFN-β 1a therapy results in upregulation of RAGE in MS patients, but not S100A12 and NF-κB.

Conclusions: It appears that S100A12 participates in the pathogenesis of MS, and it seems that IFN-β 1a modulates immune responses in an S100A12-independent manner. Based on the reported anti-inflammatory effects of RAGE, it seems that RAGE may be considered as a mechanism by IFN-β 1a to modulate immune responses. NF-κB is produced permanently in the human cells and is inactive in the cytoplasm; therefore, the effects of IFN-β 1a may be related to its functions rather than expressions.
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http://dx.doi.org/10.1159/000464136DOI Listing
February 2018

HYPERTHYROIDISM AND HYPERPROLACTINEMIA: IS THERE ANY ASSOCIATION?

Endocr Pract 2016 Dec 19;22(12):1377-1382. Epub 2016 Aug 19.

Objective: To compare the serum prolactin level in hyperthyroid and normal control females. Hyperthyroidism is a common disease. Although a direct association has been demonstrated between hypothyroidism and increased prolactin levels, this association has not been established for hyperthyroidism.

Methods: Cross-sectional study in cases and control groups. Control subjects were chosen from those participating in the Kerman Coronary Artery Disease Risk Factors study. To select the cases, all women referred to the laboratories of Kerman with a thyroid-stimulating hormone (TSH) level ≤0.5 mIU/L who met the inclusion criteria were entered in the study. A total of 231 women aged 15 to 50 years were enrolled. The case group included 71 hyperthyroid women, and the control group included 160 women with normal thyroid function matched by age.

Results: The mean (SD) serum level of prolactin was 16.56 (0.97) ng/mL (95% confidence interval [CI], 15.41 ng/mL to 15.71 ng/mL) in the controls and 23.07 (1.49) ng/mL (95% CI, 22.7 ng/mL to 23.4 ng/mL) in the case subjects. Hyperprolactinemia was more common in the hyperthyroid group (16.5 [0.97] ng/mL versus 23.07 [1.49] ng/mL; P<.001). The prolactin level decreased with age. Hyperthyroidism and estradiol increased the prolactin level. After adjusting for age and estradiol, hyperthyroidism increased the serum prolactin level (P<.001).

Conclusion: The results of this study revealed that hyperprolactinemia is more frequent in hyperthyroid females. Serum prolactin level can be increased in hyperthyroidism.

Abbreviations: PRL = prolactin T4 = thyroxine TRH = thyrotropin-releasing hormone TSH = thyroid-stimulating hormone.
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http://dx.doi.org/10.4158/EP161293.ORDOI Listing
December 2016

Evaluation of Salivary Secretory Immunoglobulin A Levels in Diabetic Patients and Association with Oral and Dental Manifestations.

Sultan Qaboos Univ Med J 2015 Nov 23;15(4):e507-11. Epub 2015 Nov 23.

Oral & Dental Diseases Research, Institute of Basic & Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.

Objectives: Oral and dental manifestations in diabetic patients can arise due to numerous factors, including elevated salivary secretory immunoglobulin A (s-IgA) levels. This study aimed to evaluate s-IgA concentrations in patients with type 2 diabetes mellitus (T2DM) and to investigate the association between s-IgA levels and oral and dental manifestations of T2DM.

Methods: This cross-sectional descriptive study was carried out between October 2011 and September 2012 in Kerman, Iran, and included 260 subjects (128 patients with T2DM and 132 healthy controls). Unstimulated salivary samples were collected from all subjects and s-IgA levels were determined using the immunoturbidimetric method. The oral cavities and teeth of T2DM patients were evaluated for oral and dental manifestations.

Results: Both diabetic and control subjects with higher concentrations of s-IgA had significantly higher numbers of decayed, missing or filled teeth (DMFT) and periodontal index (PDI) scores (P <0.050). s-IgA levels were significantly higher in subjects with oral candidiasis (P <0.050). Among diabetic patients, significantly higher s-IgA levels were concomitant with xerostomia and denture stomatitis (P ≤0.050). There were no significant differences between s-IgA concentrations and other oral or dental manifestations in either group.

Conclusion: Individuals with a greater number of DMFT, a higher PDI score and oral candidiasis had significantly higher s-IgA levels. s-IgA levels were not significantly higher among diabetic patients in comparison to the control group. However, significantly higher s-IgA levels occurred with xerostomia and denture stomatitis in diabetic patients. In addition, s-IgA was significantly higher in patients with uncontrolled diabetes compared to those with controlled diabetes.
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http://dx.doi.org/10.18295/squmj.2015.15.04.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4664096PMC
November 2015

The effect of vitamin D on COPD exacerbation: a double blind randomized placebo-controlled parallel clinical trial.

J Diabetes Metab Disord 2015 26;15(1):33. Epub 2016 Aug 26.

Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.

Background: To investigate the effect of supplementation of standard treatment (inhaled long-acting β2 agonists, anticholinergics and corticosteroids) with vitamin D on C reactive protein and pulmonary function tests in patients with COPD exacerbation.

Methods:

Design: Randomized, single-center, double-blind, placebo-controlled parallel trial. One teaching hospital Participants: 135 patients in pulmonary ward with moderate to severe COPD and exacerbations.120 patients fulfilled the study protocol.

Interventions: Patients were randomly divided into three groups receiving 7 day treatment with 0.25 μg calcitriol daily (n = 45), 50000 IU daily of vitamin D (n = 45) or placebo (n = 45). An independent nurse was responsible for allocation, preparation, and accounting of trial medications.

Main Outcome Measures: Maximal expiratory flow volume (FEV1) and forced volume capacity curves (FVC) and Modified Medical Research Council (MMRC) scale.

Results: Out of 135 patients who were recruited consecutively, 45 patients randomly were randomly assigned in three groups (balance blocked randomization.15 patients were dropped out due to non-compliance for second PFT. Intention to treat analysis was carried out for 120 participants. The difference between before and after treatment FEV1 and FEV1/FVC ratio had no significant difference between treatment groups and placebo. (P = 0.43, P = 0.51, respectively)but clinical improvement was significant in patients who received calcitriol. No side effects were reported.

Conclusions: Short term treatment with either calcitriol or 25(OH) 2Vit D didn't changed FEV1 or FVC in vitamin D sufficient patients with COPD exacerbation; nevertheless it can provide clinical benefit.

Trial Registration:

Trial Registration: Iranian Registry of Clinical Trials no. IRCT138712271774N1. Registered 10 April 2011.
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http://dx.doi.org/10.1186/s40200-016-0257-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5002185PMC
August 2016

The association between urinary lgM excretion and diabetic retinopathy in diabetic patients.

J Diabetes Metab Disord 2015 29;15:18. Epub 2016 Jun 29.

University of British Columbia (UBC), 2329 West Mall, Vancouver, BC V6T 1Z4 Canada.

Background: Diabetic Retinopathy is one of the most common causes of blindness among adults. Microvascular complications may have common origins. The objective of the present study is to analyze the correlation between urinary IgM excretion and diabetic retinopathy based on the type of diabetes.

Methods: The present study is cross-sectional analytic and was carried out on 140 type2 diabetic patients (of which 70 patients diagnosed with retinopathy) and 76 type1 diabetic patients (of which 37 patients diagnosed with retinopathy). For every patient in each of the test groups, fasting plasma glucose, triglyceride, cholesterol, creatinin and HbA1c tests were done. The value of IgM, the albumin- to- creatinine ratio and the urine analysis test were also used to rule out the significant proteinuria of the patients. Then, IgM Index was measured using the following equation: Igm Index = Urine IgM/Urine Cr.

Results: The level of IgM index in the diabetic patients (type1 and type2) had no significant correlation with retinopathy. Cut point = 1.49, sensitivity = 0.703 and specificity = 0.308 in type1 diabetes were used for screen retinopathy. In type1 diabetic patients, the duration of diabetes had a significant correlation with urinary protein while in type 2 diabetic patients, the diabetes duration and HbA1c were significantly correlated with retinopathy.

Conclusion: The results of this study demonstrate that the level of urinary IgM in diabetic patients has no difference in those who have or lack retinopathy, but the urinary IgM level of more than 1.49 mg/dl can be considered as a cut point in type1 diabetic patients to screen retinopathy.
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http://dx.doi.org/10.1186/s40200-016-0242-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928287PMC
July 2016

The Association between Cobalt Deficiency and Endemic Goiter in School-Aged Children.

Endocrinol Metab (Seoul) 2014 Sep 25;29(3):307-11. Epub 2014 Sep 25.

Kerman High Technology and Environmental Sciences, Kerman, Iran.

Background: In Iran, an iodine deficiency control program was initiated in 1989 by iodizing salt. Despite this program, goiters have remained an endemic condition in most parts of Iran. Thus, it is possible that other factors aside from iodine deficiency may contribute to endemic goiter. The aim of this study was to investigate the association between cobalt deficiency and endemic goiter in a region of Iran with a high prevalence of goiter.

Methods: A cross-sectional study was conducted among school children aged 9 to 11 years in the city of Kerman, Iran. In the first phase of the study, a multistage, proportional-to-size, cluster sampling method was used to screen 5,380 out of 29,787 students. After the screening phase, 170 students (130 goitrous and 40 nongoitrous) were randomly selected, and serum and urine specimens were obtained. We measured thyroid function, serum cobalt level, and urinary iodine excretion. Univariate and multiple logistic regression analyses were performed.

Results: The prevalence of grade 2 goiters was 34.8% (95% confidence interval [CI], 31.5 to 42.5), with both sexes being equally affected. The weight and body mass index of goitrous subjects was significantly lower (P<0.001) than those of nongoitrous subjects. The serum cobalt levels were lower in goitrous subjects than in nongoitrous subjects (4.4±2.9 µg/L vs. 6.4±2.7 µg/L). The urinary iodine levels were also lower in goitrous subjects than in nongoitrous subjects (198.3±108.3 µg/L vs. 270.2±91.1 µg/L). Multiple regression analysis showed that only cobalt deficiency, not iodine deficiency, significantly contributed to the presence of goiter (odds ratio, 0.78; 95% CI, 0.61 to 0.99; P=0.042).

Conclusion: Cobalt deficiency may be an important independent predicator for goiter in endemic regions, especially areas in which goiters persist despite salt iodization programs.
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http://dx.doi.org/10.3803/EnM.2014.29.3.307DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4192825PMC
September 2014

Epidemiology of diabetes mellitus, pre-diabetes, undiagnosed and uncontrolled diabetes and its predictors in general population aged 15 to 75 years: A community-based study (KERCADRS) in southeastern Iran.

J Diabetes 2015 Sep 10;7(5):613-21. Epub 2014 Sep 10.

Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.

Background: The goal of this research was to measure the age-sex standardized prevalence of pre-diabetes (pre-DM) and diabetes (DM), and the effectiveness of diabetes management (using HbA1C as the indicator) in an urban area in Iran.

Methods: Using a randomized cluster household survey, we recruited 5900 individuals whose age ranged from 15 to 75 from Kerman for assessing coronary artery disease risk factors (KERCADRS) including diabetes. In 2010 and 2011, all of the participants were interviewed by trained staff for medical history and physical activities, and were then examined for blood pressure and anthropometric measures. Venus blood sample was also collected for fasting plasma glucose and HbA1c.

Results: The age-sex standardized prevalence of pre-diabetes, diagnosed and undiagnosed was 18.7%, 6.3% and 2.7%, respectively. Diabetes increased by age (from 14.7% in the 15-24 years old group to 28.4% in the 65-75 years old group), particularly after 40 years. Occasional opium users had the highest prevalence of Pre-DM (34.6%). Seventy-nine percent of the depressed and 75.5% of the anxious participants with diagnosed-DM were identified as uncontrolled-DM. More than 60% of diagnosed diabetic cases had impaired HbA1c. Overweight and obesity (adjusted odds ratio (AOR) 1.6) and low physical activity (AOR 1.5) were the most preventable risk factors associated with diabetes.

Conclusion: Considerable prevalence of diabetes, susceptibility in progressing to diabetes and uncontrolled diabetes among individuals living in Kerman, suggested ineffective prevention and treatment of diabetes in urban areas in Iran. Successful experience regarding primary health-care in rural areas should be expanded to urban settings.
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http://dx.doi.org/10.1111/1753-0407.12195DOI Listing
September 2015

Evaluation of effect of acarbose consumption on weight losing in non-diabetic overweight or obese patients in Kerman.

J Res Med Sci 2013 May;18(5):391-4

Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran.

Background: High prevalence of obesity and the importance of this issue as a risk factor for chronic diseases such as severe cardiovascular diseases, diabetes, and cancer necessitate the need for treatment. The aim of this study was the evaluation of acarbose effect on the weight loss in non diabetic overweight or obese patients in Kerman.

Materials And Methods: A double blind randomized controlled clinical trial was performed on 66 patients with the body mass index (BMI) between 25 and 35 kg/m(2). Patients were divided in treatment and control groups using the randomization. The treatment group took 100 mg acarbose 3 times a day for 20 weeks in combination with the low calorie diet and exercise. Control group was given placebo, low calorie diet, and exercise. BMI was measured after 20 weeks. The analyses were carried out using t-test and repeated measured ANOVA.

Results: Patients in acarbose and placebo group had a non significant difference in BMI at baseline. Reducing in weight was considered in every month in both groups, but this reduction was higher in the treatment group. At the 5(th) month, the difference of BMI in the treatment group was significantly lower than the placebo group (2.31 ± 0.6 vs. 0.76 ± 0.6 kg/m(2), P < 0.001).

Conclusion: Acarbose, especially in combination with the low calorie diet and exercise, seems to lose weight effectively in obese and overweight patients in communities that have a high carbohydrate intake (like Persian diet).
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810572PMC
May 2013

Association of adiponectin and metabolic syndrome in women.

J Res Med Sci 2011 Dec;16(12):1532-40

Assistant Professor, Kerman Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran.

Background: An inverse association between serum adiponectin level and metabolic syndrome was seen in few studies. The aim of this study was to assess the association between serum adiponectin levels and metabolic syndrome in a sample of Iranian women from Kerman.

Methods: In a cross-sectional study 946 subjects were studied to determine the prevalence of metabolic syndrome and in a case control study (170 subjects for each group) the association between serum adiponectin levels and metabolic syndrome were investigated. Metabolic syndrome was defined using International Diabetes Federation (IDF) criteria. Socio-demographics factors and measures of waist circumference, blood pressure and lipid profiles were collected. Serum adiponectin level was measured by ELISA method.

Results: The prevalence of the metabolic syndrome was 36.7%. Mean of serum adiponectin level in individuals with metabolic syndrome was lower than individuals without it (10.5 ± 4.1 and 13.45 ± 5.6 μg/ml, respectively, p < 0.001). Low level of adiponectin was a good predictor for metabolic syndrome (a range of β coefficients out of -2.03 to -2.85 according to five models). Systolic blood pressure, body mass index (BMI) and diastolic blood pressure were independent predictors of serum adiponectin (p values were 0.001, 0.009 and 0.034, respectively).

Conclusions: We found that adiponectin is negatively associated with metabolic syndrome. Systolic and diastolic blood pressure and BMI were identified as independent predictors.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3434893PMC
December 2011

Serum zinc levels and goiter in Iranian school children.

J Trace Elem Med Biol 2012 Jan 23;26(1):42-5. Epub 2012 Feb 23.

Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran.

Iodine deficiency has been shown to have high prevalence in Iran despite sufficient iodine supplementation. Zinc deficiency may also contribute to the pathogenesis of endemic goiter. The aim of this study was to compare serum zinc level in Iranian school children with and without goiter. A cross-sectional study was performed among urban children aged 8-12 years in city of Kerman, Iran. A multistage proportional to size cluster sampling method was used to screen 5500 subjects out of 29,787 students. After the screening phase, serum and urine specimens of randomly selected 165 students were evaluated for serum zinc levels and urinary iodine excretion and compared in goiterous and non-goiterous children. Serum zinc level was 149.5±29.4 μg/l in goiterous children and 141.2±52 μg/l in non-goiterous children but no significant difference was found between the groups (p=0.37). But urinary iodine excretion was significantly (p<0.001) lower in goiterous children (207.5 μg/l in goiterous children and 262.5 μg/l in non-goiterous children). This study showed that serum zinc level in goiterous and non-goiterus children is not different and zinc deficiency is not a risk factor for endemic goiter in this population.
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http://dx.doi.org/10.1016/j.jtemb.2011.11.005DOI Listing
January 2012

A cross-sectional study in Kerman, Iran, on the effect of diabetic foot ulcer on health-related quality of life.

Int J Low Extrem Wounds 2011 Dec;10(4):200-6

Physiology Research center, Kerman University of Medical Sciences, Kerman, Iran.

This study describes the impact of diabetic foot ulcers (DFUs) on health-related quality of life (HRQoL) using a generic instrument including 8 domains. Data were obtained from 54 patients with DFU who were compared with 78 patients who had diabetes without foot ulcer. HRQoL was measured using the Iranian version of Medical Outcome Study-Short Form (SF-36). The fasting plasma glucose, creatinine, glycosylated hemoglobin (HbA1c), and urine microalbumin as well as ankle-brachial pressure index (ABI) were measured for all participants in the 2 groups. In all, 51.9% of patients with DFU had ABI scores of <0.9 compared with only 11.8% of the control group (P < .001). No differences were found in any of the treatment characteristics (oral/insulin therapy) between the 2 groups (case/control). HRQoL evaluated by the SF-36 questionnaire, in particular in the areas of physical function, is lower in patients with diabetes with foot ulcers compared with patients with diabetes without foot ulcers (41.04 ± 22.69 vs 56.67 ± 25.57; P < .01). After adjusting by sex, 2 domains of physical functioning and bodily pain as well as the total HRQoL score in patients with DFU were lower than in patients with diabetes (P < .001). This study showed that physical functioning and bodily pain along with total score of HRQoL were important aspects that were lower in patients with DFU than in patients with diabetes. Gender was considered as a confounding factor, which was omitted in multivariate analysis.
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http://dx.doi.org/10.1177/1534734611428728DOI Listing
December 2011
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