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Diabetes commonly is associated with CAD risk factors, in addition sub-optimal metabolic control of diabetes is associated with increased incidence of thyroid function disorders. In this study patients with diabetes type II who were referred to 5th Azar Hospital in Gorgan were assessed to find out the relationship between thyroid dysfunction and NIDDM in such patients in Gorgan. We studied 210 diabetic patients in hospital outpatient department. The blood pressure, height, weight, serum total Cholesterol, Triglycerides, fasting blood sugar, and glycosylated hemoglobin (HbA1c) were determined. The obesity (BMI>30) were seen in 35% of the subjects. Hypertension and hyperlipidemia were seen in 38 and 65 of our patients respectively. The observed disorders included goiter (30%), sub-clinical hypothyroidism (13%), clinical hypothyroidism (4%), and clinical hyperthyroidism (0.5%). The patients were divided into two groups according to HbA1c: Group 1 with HbA1c<8 and group II with HbA1c?8. A significant difference was observed in TSH serum concentration between group I and II (1.5±1.2 vs. 3.7±11.3 mu/l, P<0.05), whereas the concentration of T4 (10±11 vs. 11±8) and T3 (2.4±3.7 vs. 1.9±3.2) were not significantly different between the two groups. The mean concentration of HbA1c in patients with hypothyroidism was significantly higher than those that of non-hypothyroid subjects (11±2.5 vs. 9±2.5, P<0.005). A significant positive correlation was observed between HbA1c concentration and TSH levels (R=0.2, P<0.01). Our results confirm the association between thyroid dysfunction and uncontrolled diabetes mellitus. It has been recommended that the final diagnosis of thyroid function disorder in diabetic patients should be made after optimal metabolic status has been archived.

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Background and Objective: According to world health organization statistics, at least 5.2% of world population is carrier for a main hemoglobin disorder. Previous reports showed that more than 10% of people are carrier for beta-thalassemia Northern Iran. This study was done to determine the prevalance of hemoglobinopathies in premarriage individuals referred to Babolsar, Iran.

Materials and Methods: This descriptive study was carried out on 8500 individuals  (4200 women and 4300 men) whome were attended the thalassemia counseling program in Babolsar, North of Iran during 2006-09. After performing the CBC test, for those MCV and MCH were less than 80 and 27 respectively, Hemoglobin A2 was evaluated. Subjects whome were volunteers for more comprehensive tests, basic and acidic electrophoresis and genetic tests were applied, subsequently.

Results: 1200 (14.11%) subjects had low hematological indexes. 474 (5.57%) subjects had high HbA2 and were classified as beta-thalassemia carriers and 726 (8.54%) had normal HbA2 level and were classified as alpha-thalassemia carriers. 6 (1.2%) subjects were identified with HbF level more than 10 and were identified as carriers for beta-gene cluster deletion carrier. Also, 16 (3.2%) individuals had HbE, 16 (3.2%) had HbS, 4 had HbD and 4 had HbH (0.33% in 1200 and 0.047% in 8500 subjects). Genetic study of 317 individuals for beta carriers and 145 subjects for alpha-carriers showed IVSII-1G>A (74.5%) in beta-globin and single gene deletion of 3.7 (47.5%) in alpha-globin genes were the most frequent mutations.

Conclusion: This study showed that carriers for alpha - thalassemia (8.5%) are more frequent compared with beta- thalassemia (5.57%). Also other hemoglobin variants included HbS, HbE, HbD or different beta-gene cluster deletions in the region are considerable and should be screened.

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Background and Objective: Hemoglobinopathies are among the most prevalent genetic disorders worldwide, and occur as a result of mutations in the gene involved in synthesizing hemoglobin chains. By now more than 1000 defects in hemoglobin chains are discovered. Hemoglobin D (Hb D) is one of these disorders, identified by a single nucleotide mutation on codon 121 of beta globin chain. This study was carried out to evaluate Hb D mutations through molecular methods in Mazandaran province of Iran. Materials and Methods: This descriptive laboratory study was done on 70 patients with an electrophoresis band in hemoglobin-S zone in Mazandaran province of Iran during 2010-11. Capillary zone electrophoresis was done to find out Hb D in 51 patients. Subsequently, PCR-RFLP was performed to evaluate the samples at molecular level. Results: Molecular investigation revealed all cases are carriers of hemoglobin D-Punjab. Two patients were shown to be homozygote carriers of the abnormal gene. Conclusion: This study showed all Hb D affected patients were carriers of Hb D Punjab.

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Background and Objective: Gestational diabetes is affected 3-12% of women and occurs at the final stage of second trimester. This study was done to determine the fructosamine and glycated hemoglobin level in pregnant women with abnormal glucose challenge test. Methods: This case – control study was carried out on 96 pregnant women with glucose challenge test (GCT)>140 mg/dl as cases and 96 pregnant women with GCT<140 mg/dl as controls. The serum fructosamine and glycated hemoglobin determined using ELISA and chemical methods, respectively. Results: In pregnant woman with abnormal GCT, there was a significant correlation with glycated hemoglobin and fructosamine. The glycated hemoglobin correlation was more significant compared to fructosamine (0.63 to 0.24). There was not significant correlation between GCT with fructosamine and glycated hemoglobin in individuals with normal GCT. Conclusion: The measurement of glycated hemoglobin is more accurate than fructosamine in pregnant women with abnormal glucose challenge test.

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Background and Objective: Hemoglobin D-Punjab is one of the variant of hemoglobin caused by a mutation on position 121 of beta globin gene which is frequent in India, Pakistan and Iran. Heterozygote form of this variant is mainly asymptomatic while in combination with hemoglobin S, severe form of anemia occure. This study was carried out to determine the beta globin gene haplotypes associated with hemoglobin D-Punjab in Northern Iran. Methods: This descriptive study was carried out on families of 18 individuals whom were carriers of hemoglobin D-Punjab in Sari in Northern Iran. Genomic DNA was extracted from peripheral blood samples using Phenol-chloroform standard protocol. In order to identify different haplotypes associated with hemoglobin D-Punjab, PCR-RFLP method and family linkage analysis were used. Results: In 17 subjects hemoglobin D-Punjab was linked to [+ - - - - + +] haplotype and in one case association with [- + + - + + +] haplotype was observed. Conclusion: The hemoglobin D-Punjab alleles have mainly unicentric origin and [- + + - + + +] rare haplotype may have different genetic origin or is created as a result of gene recombination.

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Background and Objective: Diabetes mellitus is the most common type of metabolic diseases which is characterized with hyperglycemia due to implicit or relative insulin deficiency. Diabetes mellitus is acutely related to obesity. Agouti-related protein (AGRP) has 132 amino acids and increases appetite in humans. This study was done to determine the effect of eight weeks aerobic exercise on plasma level of agouti-related protein, glycated hemoglobin and glucose in non-active type II diabetic women. Methods: In this quasi-experimental study, 30 female diabetic patients were divided into exercise and control groups. The training program was performed 3 sessions a week in course of 8 weeks, each session was last for 60 minutes, and the controls did not have any exercise. The plasma level of agouti-related protein, glycated hemoglobin and glucose were measured. Results: There was no significant alteration in the level of AGRP, HbA1c and glucose in either exercise or control groups. There was no significant relation between AGRP with glucose, AGRP with HbA1c and HbA1c with glucose in the exercise and control groups. Conclusion: Eight weeks of aerobic exercise is not enough for making any changes on plasma level of AGRP, HbA1c and glucose in non-active type II diabetic women.

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Background and Objective: Irrational consumption of blood products leads to unwanted side effects in patients and imposes additional financial burdens on society and patients. This study was done to determine the pattern of consumption of packed red blood cells (PRBC) in hospitalized newborns and children.
Methods: This prospective descriptive-analytic study was conducted on 80 newborn (less than 4 months age) 36 children (more than 4 months to 16 years old) who used PRBC in Sari Bu-Ali Sina hospital, north of Iran. Demographic characteristics of patients and parameters of blood product were recorded and compared with standard guideline.
Results: During the study period, administration of 116 units of PRBC (28.5%) was studied. Totally, in 24 % of cases PRBC consumption did not follow the guideline. PRBC consumption was inappropriately prescribed for patients with hemoglobin higher than 12 g/dL (12%) and for patients with hemoglobin higher than 10 g/dL (12%). Both of the consumption volume to weight ratio (P<0.05) and rate of infusion (P<0.05) were significantly higher in children less than or equal to 4 months, than in children older than 4 months. The most commonly indications were respiratory distress syndrome in neonates (62.1%) and bone marrow suppression (14.7%).
Conclusion: A significant percentage of patients were received PRBC out of guideline recommendations.  It seems, for rational use of PRBC in children and neonates the existing guidelines should be more considered to reduce the cost and side effects.
 

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Background and Objective: Ventilator-associated pneumonia (VAP) is an important complication in intensive care unit (ICU) patients with endotracheal intubation. Finding potential early indicators of this condition can aid in reducing the disease burden. We aimed to investigate the relationship between VAP occurrence and serum levels of C-reactive protein (CRP), procalcitonin (PCT), and hemoglobin (Hgb) during ICU hospitalization of brain trauma patients.
Method: This descriptive-analytical study was carried out on brain trauma patients (99 male, 39 female), referring to the 5th Azar hospital in Gorgan, Iran, in the course of 2017. The patients were hospitalized in ICU with endotracheal intubation and mechanical ventilation. The diagnosis of VAP was confirmed by a 12-score rating based on chest radiographs, body temperature, white blood cell count, and sputum culture. After admission, serum CRP, PCT, and Hgb were documented daily for 6 days.
Results: According to the diagnostic criteria, VAP was confirmed in 41 patients (30%). Serum CRP and PCT levels on the 6th-day post-admission were significantly associated with VAP diagnosis, while Hgb levels did not differ significantly between VAP and non-VAP patients. Serum levels of CRP, PCT, and Hgb on the 6th day were not associated with age or sex.
Conclusion: Our results indicate that serum CRP and PCT levels are associated with the occurrence of VAP in ICU patients receiving mechanical ventilation. Therefore, these biomarkers could be utilized to warn physicians about the possibility of VAP, thereby reducing mortality rate and hospitalization length.