Background: Preeclampsia is the most common serious disorder during pregnancy and studies show several immune-related processes in its pathophysiology. The role of cytokines and their expression remains controversial in this field. One of the cytokines of interest in recent studies has been TNF-a, which has been shown to have a higher level in maternal plasma of preeclamptic women.Objectives: This study was designed to evaluate the role of TNF-a polymorphism at position -238 in the risk of developing preeclampsia during pregnancy.Patients and Methods: One hundred fifty three preeclamptic cases and 140 healthy pregnant women were retrieved from two major hospitals of Mashhad, Iran. Methods a case-control study were designed. Anyone with a history of inflammatory disease, hypertension, or chronic kidney disease was excluded. DNA was extracted from peripheral blood leukocytes. Both groups were genotyped for the polymorphism of the TNF-a gene at position -238 by the RFLP method with Ava II enzyme. Allele and genotype frequencies were compared using one-way ANOVA and the Fisher's exact test.Results: There were significant differences between the two groups in TNF-a genotype at position -238 (P<0.001). In the preeclamptic group, the frequency of the AA genotype was higher (P<0.001) and the frequency of the GG genotype was lower (P<0.001). The overall prevalence of the A allele at position -238 was higher in preeclamptic cases (P<0.001).Conclusion: In this study group, TNF-a -238 polymorphism was shown to be different in preeclamptic and non-preeclamptic pregnant women. The AA genotype and the A allele may carry an increased risk for developing of preeclampsia.

Introduction: Little is known about the menstruating in patients with type one diabetes. Most studies have focused on adults, who have been asked to recall retrospectively their menstrual histories. A prospective study about menstruating with type one diabetic adolescence recommended.Materials and Methods: This study is a prospective longitudinal of correlation type. Subjects included 60 diabetic girls aged 11-19 referred to Iranian Diabetes Association.The amount of bleeding in terms of milliliter estimated by Higham pictorial chart. In this chart number and amount of wet pads used during menstruation completed by the patients. Also patients were asked to note starting and ending time of bleeding for 3 menstrual cycles.Twice HbA1c test at the distance 3 months were assessed. Those patients having Poly cystic ovarian syndrome (PCOs) or thyroid disturbance were excluded.2 test, t-test, Pearson correlation coefficients and odd ratio were used.Results: Mean HbA1c value was 8.31±1.63 percent. Thirty seven (61.67%) patients had normal menstrual, and twenty- three (38.33%) had menstrual disturbances, including: eight (13.79%) disturbance in menstrual duration, fourteen (24.1%) disturbance in bleeding intensive, six (10.3%) disturbance in the menstrual cycle length and two (3.33%) secondary amenorrhea. No one had primary amenorrhea. Mean age at menarche was 12.83±1.47 years and middle age at menarche was 13 years. There was a statistically significant difference (p<0.045) in mean HbA1c between those with normal menstrual and those with menstrual disturbances. As HbA1c increased, the percent of patients with menstrual disturbances increased. There was statistically significant correlation between mean HbA1c and menstrual duration (r=0.28, p=0.03) and bleeding intensive (r=0.48, p=0.000). There was no statistically significant correlation between mean HbA1c and menstrual interval (r=-0.10, p=0.45). There were no patients in either group with diabetic hypertension, retinopathy, nephropathy, neuropathy and heart disease.Conclusion: Tighter glycemic control, as measured by HbA1c concentrations, corresponded to improved menstrual disturbances in type one diabetes adolescents without PCOs and thyroid disturbance.

Introduction. Vitamin D toxicity is a known cause of hypercalcemia and renal failure. The daily requirement of vitamin D is about 200-600 Iu. We report here a case of self medication vitamin D intoxication in young male who presented with hypercalcemia, acute renal failure and gastrointestinal symptoms. Methods. Our patient was a 17 year-old male who had been talking 5 vitamin D3 pearls on a daily basis for body-building without a prescription. Results. After 2 months of regular consumption, he suffered from nausea, vomiting, anorexia, constipation and enuresis. Examinations revealed a pulse of 76/min, blood pressure of 110/80 and no systematic abnormalities except dry mucosa. Routine chemistry revealed: WBC 11500ml (N=65%,L=25%), Hb 13.3g/dl, plt 329000μl, FBS 94mg/dl, Urea 94mg/dl(17-43), Creatinine 4.6mg/dl (0.7-1.4), uric acid 6.3mg/dl, calcium 13.4mg/dl (8.5- 11), phosphorous 5.9mg/dl (2.5-5), Albumine 4.3g/dl, Na 140mEq/l, K 4.3mEq/l, AST 19Iu/l, ALT 19Iu/l, Alp 183u/l, total billirubine 0.5, Urine Analysis (WBC many, RBC negative, calcium oxalate many, protein negative, bacteria negative). The patient was managed by continuous saline infusion, diuretic (furosemide), cortone (dexamethasone), bisphosphonate (pamidronate) and calcitonin. Further paraclinic studies revealed: PTH 22pq/ml (10-65), 25(OH) vitaminD >100ng/ml (5-53), negative urine culture and normal chest X-Ray, Electrocardiography and kidney ultrasonography. The level of serum calcium on the 6th day of treatment was 10.5mg/dl that of phosphorus was 4.7mg/dl and the cratinine level stabilized at 1.8mg/dl. Urine analysis became normal at this stage. During hospitalization gastrointestinal symptoms disappeared and in further follow-up visit the cratinine level decreased to 0.8mg/dl. Conclusion. Although vitamin D has a wide therapeutic index, its toxicity is well known and various cases of accidental ingestion, self-medication and malpractice have been reported. This intoxication with mechanism of hypercalcemia due to increased intestinal absorption and in more serious cases increased bone resorbtion leads to several clinical manifestations including kidney disorders (65%), renal failure (51%), gastrointestinal tract disorders (23%) and hypertension (52%). Calcium serum levels of 12-15mg/dl which are gradually caused by ingestion of over than (40000-100000Iu/day) in a long period of time may decrease GFR reversibly by the mechanism of renal vasoconstriction and natriuresis– induced volume contraction. A positive drug history other than cratinine rise and high serum levels of vitamin D3 represents renal failure on the grounds of vitamin D3 intoxication. Although vitamin D is not regarded as a routine supplement for body-building, our patient took 250000 iu of vitamin D3 on a daily basis for 2 months. In spite of few reported cases of vitamin D intoxication, it should not be taken without indication as it may cause intoxication.

Background: Sound nutrition is very important in relationship with weight status especially in children. The aim of this study was to assess relationship between junk foods intake and weight in children aged 6-7.Methods: This cross-sectional study was carried out in Shahin Shahr and Meimeh in 2009. Anthropometric measures were taken and 24-hour food recall was used for dietary data and were analyzed with food processor 2 and then, compared with dietary reference intakes 2008) DRI).Results: 61.1% of subjects were residing in dormitories and 12.7% were married. Prevalence of overweight or obesity and abdominal obesity was 6.9% and 46.1%, respectively. Mean (±SD) systolic and diastolic blood pressure was 105.2±15.6 and 62.2±10.4 mmHg, respectively. Totally, 3.9% of subjects had hypertension. The analysis of food intake indicated that B12, folate, magnesium, potassium, calcium had levels below the recommended ones, and vitamins C, E, pantothenic acid, B1, B3, phosphate, zinc had higher levels than the recommended ones; Energy intake, macronutrients, vitamin A, pyridoxine, iron, selenium were generally in appropriate level.Conclusions: These results indicated appropriate levels of macronutrients intake; unbalance mainly existed in micronutrients. Increased intakes of important food groups such as dairy, vegetables, and fruits that are good sources of micronutrients are suggested.

Background: The prevalence of metabolic syndrome (MetS) in polycystic ovary syndrome (PCOS) has been studied in different populations, but their results were so controversial regarding Iranian women. These controversial data indicated the need for more investigation of MetS characteristics in PCOS patients in our population. So this study aimed to evaluate the clinical and laboratory characteristics and metabolic features of patients with PCOS in Rasht.Materials and Methods: This prospective cross sectional study was conducted on 215 PCOS women who lived in Rasht, north of Iran, from March 2010 to July 2012. The participants were then divided into two groups of women with MetS (n=62) and women without MetS (n=153). The diagnosis of PCOS and MetS were based on the Rotterdam 2003 criteria and the Adult Treatment Panel III (ATP III) criteria, respectively. Demographic characteristics, fertility characteristics, family history and laboratory findings were assessed.Results: The prevalence of MetS in women with PCOS was 28.8%. In PCOS women of both groups, the waist circumference (WC) exceeded 88cm in 72.6%, hypertension [systolic blood pressure (SBP) and/or diastolic blood pressure (DBP)³130/85mm Hg] was prevalent in 9.3%, fasting blood sugar (FBS) level was³110 mg/dl in 6%, triglycerides (Tg) level were³150 mg/dl in 47%, and high-density lipoprotein (HDL) level was<50 mg/dl in 86%. The values of WC, SBP, DBP, body mass index (BMI), ovarian size, Tg, cholesterol, FBS, 2-hour blood sugar, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were significantly greater in PCOS women with MetS than women without MetS. Also HDL and luteinizing hormone (LH) levels in women with MetS were significantly lower than women without MetS.Conclusion: Prevalence of MetS in PCOS women was 28.8%, indicating that this value is higher than other studies conducted on PCOS women in Iran and other studies conducted on general population in Iran. PCOS women are considered as a high-risk population for MetS. The special strategies are required to prevent MetS and its associated complications in PCOS women.