Showing papers by "Shahid Beheshti University of Medical Sciences and Health Services published in 2009"

The burden of disease and injury in Iran 2003

Abstract: Background The objective of this study was to estimate the burden of disease and injury in Iran for the year 2003, using Disability-Adjusted Life Years (DALYs) at the national level and for six selected provinces.

Breastfeeding and maternal and infant iodine nutrition

Abstract: Summary Objective The aim of this review is to explore information available regarding iodine secretion in milk, both mothers and infants iodine nutrition during breastfeeding and to make recommendations for appropriate iodine supplementation during lactation. Design MEDLINE was queried for studies between 1960 and 2007 that included lactation and breastfeeding with iodine and iodine deficiency. Studies were selected if they studied (i) Secretion of iodine in breast milk; (ii) breastfeeding and iodine nutrition; (iii) factors affecting maternal iodine metabolism and (iv) recommendations for iodine supplementation during breastfeeding. Results Thirty-six articles met the selection criteria. The iodine content of breast milk varies with dietary iodine intake, being lowest in areas of iodine deficiency with high prevalence of goitre. Milk iodine levels are correspondingly higher when programs of iodine prophylaxis such as salt iodization or administration of iodized oil have been introduced. The small iodine pool of the neonatal thyroid turns over very rapidly and is highly sensitive to variations in dietary iodine intake. Expression of the sodium iodide symporter is up-regulated in the lactating mammary gland which results in preferential uptake of iodide. In areas of iodine sufficiency breast milk iodine concentration should be in the range of 100–150 µg/dl. Studies from France, Germany, Belgium, Sweden, Spain, Italy, Denmark, Thailand and Zaire have shown breast milk concentrations of < 100 µg/l. Adequate levels of iodine in breast milk have been reported from Iran, China, USA and some parts of Europe. Conclusions Adequate concentration of iodine in breast milk is essential to provide for optimal neonatal thyroid hormone stores and to prevent impaired neurological development in breast-fed neonates. In many countries of the world, low iodine content of the breast milk indicates less than optimum maternal and infant iodine nutrition. The current WHO/ICCIDD/UNICEF recommendation for daily iodine intake (250 µg for lactating mothers) has been selected to ensure that iodine deficiency dose not occur in the postpartum period and that the iodine content of the milk is sufficient for the infant's iodine requirement.

Comparison of effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea

Abstract: Objectives: To compare the effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea. Methods: This was a double-blind comparative clinical trial conducted from September 2006 to February 2007. Participants were 150 students (18 years old and over) with primary dysmenorrhea from the dormitories of two medical universities who were alternately divided into three equal groups. Students in the ginger group took 250 mg capsules of ginger rhizome powder four times a day for three days from the start of their menstrual period. Members of the other groups received 250 mg mefenamic acid or 400 mg ibuprofen capsules, respectively, on the same protocol. A verbal multidimensional scoring system was used for assessing the severity of primary dysmenorrhea. Severity of disease, pain relief, and satisfaction with the treatment were compared between the groups after one menstruation. Results: There were not significant differences between groups in baseline characteristics, p > ...

Comment on ``Band structure engineering of graphene by strain: First-principles calculations''

Abstract: In their first-principles calculations of the electronic band structure of graphene under uniaxial strain, Gui, Li, and Zhong, [Phys. Rev. B 78, 075435 (2008)] have found opening of band gaps at the Fermi level. This finding is in conflict with the tight-binding description of graphene which is closed gap for small strains. In this Comment, we present first-principles calculations which refute the claim that strain opens band gaps in graphene.

Effects of ginger capsules on pregnancy, nausea, and vomiting.

Abstract: Objective: The aim of this study was to determine the effects of ginger in nausea and vomiting of pregnancy. Design: This was a single blind clinical trial study, Setting: The study was conducted in a selected prenatal care clinic of Isfahan City hospitals Subjects: The subjects included 67 pregnant women who complained of nausea and vomiting from Isfahan city hospitals participated in the study. Intervention: The participants were randomly assigned to two groups, an experimental group and a control group. The groups were matched according to the age, gestational age, parity, occupational status, and educational level of the participants. The experimental group received ginger 250 mg capsules for 4 days, and the control group received placebo with the same prescription form. Outcome measures: Effects of treatment of nausea were evaluated twice daily for 4 days by a before-and-after treatment questionnaire. Results: The mean ages of the experimental and control groups were 24.1 ± 4.8 and 23.3 ± 5 ...

Anti-Candida albicans activity of some Iranian plants used in traditional medicine

Abstract: Summary Objective To screen anti- Candida albicans activity of the essential oils of 16 Iranian medicinal plants. Materials and methods Anti- C. albicans effect of plant oils, amphotericin B, nystatin and ketoconazole were determined by disc diffusion and broth macrodilution methods. Results Fourteen (87%) out of the 16 plants were found to be active. These oils confirmed the existence of a significant activity against C. albicans tested with minimal inhibitory concentration (MIC) values ranging from 150 to 2300 μg/ml using broth macrodilution method and the growth inhibition zone ranging from 16 to 55 mm using disc diffusion method. The essential oils of Zataria multiflora, Thymus kotschyanus, Cuminum cyminum and Plargonium graveolens showed significant activity against C. albicans ( P Conclusion The oils that showed strong anti- Candida activity are worth of further investigations in order to identify the active compounds and their clinical applications for the treatment of candidiasis.

Implant placement in patients with oral bisphosphonate therapy: a case series.

Abstract: Background: Although the effect of bisphosphonates on dental implant osseointegration is not clear, dental implant failures attributable to oral bisphosphonate therapy have been reported in patients with osteoporosis. Purpose: The aim of this study was to evaluate implant survival in patients with a history of bisphosphonate therapy in a retrospective survey. Materials and Methods: A total of 46 ITI implants placed in 21 osteoporotic patients (females; average age 53 years, range 42–79 years) were evaluated with regard to probing depth, mobility, thread exposure, and bleeding on probing. All patients were under oral bisphosphonate therapy. Results: None of implants showed mobility and all patients could be considered free from peri-implantitis. Time of bisphosphonate therapy before and after implant insertion showed no statistically significant influence on PD, BOP, and TE. Likewise, implant location, prosthetic type, and opposing dentition had no statistically significant influence on the clinical and radiological parameters of implants. Conclusion: Within the limitations of this study, it could be concluded that neither being on oral bisphosphonate treatment before implant placement nor starting bisphosphonate therapy after implant installation might jeopardize the successful osseointegration and clinical and radiographic condition of the implants.

Appropriate cutoff values of anthropometric variables to predict cardiovascular outcomes: 7.6 years follow-up in an Iranian population.

Abstract: To determine cutoff points of anthropometric variables for predicting incident cardiovascular disease (CVD) in Iranian adults. It is a population-based longitudinal study. A total of 1614 men and 2006 women, aged ⩾40 years, free of CVD at baseline were included in the study. Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and cardiovascular risks were assessed. Incident CVD was ascertained over a median of 7.6 years follow-up. The adjusted hazard ratios (HRs) for CVD were calculated for 1 s.d. change in all obesity variables using Cox proportional hazards regression analysis. Receiver operator characteristic (ROC) curve analysis was used as the method of defining the points of the maximum sum of sensitivity and specificity (MAXss) of each variable as a predictor of CVD. We found 333 CVD events during follow-up. The risk-factor-adjusted HRs were significant for all anthropometric variables in males and WHR in females and were 1.19, 1.24, 1.21 and 1.24 for BMI, WC, WHR and WHtR in males and 1.27 for WHR in females, respectively (all P 60 years old, all the anthropometric variables showed same CVD predicting power. The cutoff values (MAXss) for CVD prediction in males and females were BMIs 26.95 and 29.19 kg m−2,WCs 94.5 and 94.5 cm, WHRs 0.95 and 0.90, and WHtR 0.55 and 0.62, respectively. There was no difference between central obesity variables in predicting CVD in males, whereas in females WHR and WHtR were more appropriate. The cutoff values of anthropometric variables were higher in the Iranian than in other Asian populations.

Secondary repair of alveolar clefts using human mesenchymal stem cells

Abstract: Recently tissue engineering has become available as a regenerative treatment for bone defects; however, little has been reported on the application of tissue engineering for regeneration of cleft defect tissues. Mesenchymal-derived stem cells were applied to different kinds of bone substitute and compared in different animal models, but their usage in human critical defects remained unclear. In this study we report 2 patients with unilateral alveolar cleft, treated with the composite scaffold of demineralized bone mineral and calcium sulphate (Osteoset) loaded with mesenchymal stem cells (MSCs). Computed tomograms showed 34.5% regenerated bone, extending from the cleft walls and bridging the cleft after 4 months in one case and in the other there was 25.6% presentation of bone integrity. The available data revealed the conventional bone substitute was not a suitable scaffold for the MSC-induced bone regeneration.

Postnatal quality of life in women after normal vaginal delivery and caesarean section

Abstract: Caesarean section might increase the incidence of surgical interventions and problems resulting from hospitalization and thus affecting quality of life in women after delivery. This study aimed to compare quality of life in women after normal delivery and caesarean section. This was a prospective study. A sample of women with normal delivery and caesarean section from 5 health care centers in Isfahan, Iran were entered into the study. Quality of life was measured using the SF-36 at two points in time (time 1: 6 to 8 weeks after delivery; time 2: 12 to 14 weeks after delivery). Data were analyzed to compare quality of life in the two study groups. In all 100 women were interviewed (50 with normal delivery and 50 with caesarean section). Postnatal quality of life in both groups was improved from time1 to time 2. However, comparing the mean scores between the normal and caesarean delivery groups the results showed that in general the normal vaginal delivery group had a better quality of life for almost all subscales in both assessment times. The differences were significant for vitality (mean score 62.9 vs. 54.4 P = 0.03) and mental health (mean score 75.1 vs. 66.7, P = 0.03) at first assessment and for physical functioning (mean score 88.4 vs. 81.5, P = 0.03) at second evaluation. However, comparing the findings within each group the analysis showed that the normal vaginal delivery group improved more on physical health related quality of life while the caesarean section group improved more on mental health related quality of life. Although the study did not show a clear cut benefit in favor of either methods of delivery that are normal vaginal delivery or caesarean section, the findings suggest that normal vaginal delivery might lead to a better quality of life especially resulting in a superior physical health. Indeed in the absence of medical indications normal vaginal delivery might be better to be considered as the first priority in term pregnancy.

Prevalence of diabetic retinopathy in Tehran province: a population-based study

Abstract: To determine the prevalence and characteristics of diabetic retinopathy (DR) among Iranian patients with diabetes. Design: population-based cross-sectional study. Participants: patients with diabetes aged 25 to 64 years in Tehran province, Iran. This survey was conducted from April to October 2007. The study sample was derived from the first national survey of risk factors for non-communicable disease. Diabetes mellitus was defined as a fasting plasma glucose of ≥ 7.0 mmol/l (126 mg/dl) or more, use of diabetic medications, or a physician's diagnosis of diabetes. All patients known to have diabetes underwent an eye examination by bio-microscope and indirect ophthalmoscope to check for any signs of DR through dilated pupils by + 78 lens. Participants were also interviewed and examined to determine their demographic characteristics, medical conditions and the regularity of their eye visits. Among 7989 screened patients, 759 (9.5%) had diabetes. Of them, 639 patients (84.2%) underwent eye examination. Five patients (0.7%) with media opacity were excluded. Of 634 examined patients with diabetes, 240 had some degree of diabetic retinopathy, and the overall standardized prevalence of any retinopathy was 37.0% (95% CI: 33.2-40.8), including 27.3% (95% CI: 23.7-30.8) (n = 175) with non-proliferative and 9.6% (95% CI: 7.3-11.9) (n = 65) with proliferative diabetic retinopathy. Clinically significant macular edema and vision-threatening retinopathy were detected in 5.8% (95% CI: 4.0-7.7) (n = 38) and 14.0% (95% CI: 11.3-16.7) (n = 95) of patients, respectively. Only 143 patients (22.6%) with diabetes had a history of regular eye examination. This study demonstrated a high prevalence and poor control of DR in Tehran province. This suggests the need for adequate prevention and treatment in patients with diabetes.

A retrospective 7-years study of aluminum phosphide poisoning in Tehran: opportunities for prevention

Abstract: The objective of this study was to survey aluminum phosphide (AIP) poisoning in a referral poisoning hospital in Tehran servicing an estimation of 10,000,000 populations Records of all patients admitted and hospitalized during a period of 7 years from January 2000 to January 2007 were collected and analyzed according to gender, age, cause of intoxication, amount of AIP consumed, route of exposure, time between exposure and onset of treatment, signs and symptoms of intoxication at admission, therapeutic intervention, laboratory tests, and outcome During the studied years, 471 patients were admitted to the hospital with AIP poisoning; 50% of them were men The overall case fatality ratio was 31% The mean age was 271 years, and most of the patients were between 20 and 40 years old Self-poisoning was observed in 93% of cases The average ingested dose was 51 g, and most of the patients (73%) consumed 1–3 tablets of AIP A wide range of symptoms and signs was seen on admission, but the most common one was cardiovascular manifestations (7812%) The majority (65%) of patients were from Tehran Poisoning in spring and winter (34% and 24%, respectively) was more common than other seasons Gastric decontamination with potassium permanganate, and administration of calcium gluconate, magnesium sulfate, sodium bicarbonate, and charcoal were considered for most of the patients Mean arterial blood pH was 723 and bicarbonate concentration was 127 mEq/L One-hundred percent of patients with blood pH <7 died and 100% of patients with blood pH ≥ 735 survived Electrocardiogram (EKG) abnormalities were noted in 656% of cases There was a significant difference between survival and non-survival according to pH, HCO3 concentration, and EKG abnormality Even without an increase in resources, there appears to be significant opportunities for reducing mortality by better medical management and further restrictions on the AIP tablets usage Arterial blood pH seems to be a prognostic factor for the outcome of AIP-poisoned patients

A single test of antimullerian hormone in late reproductive-aged women is a good predictor of menopause.

Abstract: Objective: The aim of this study was to assess the capability of a single measurement of antimullerian hormone (AMH) to predict menopause status in late reproductive-aged women. Methods: A group of 147 women, naturally fertile, aged 40 to 50 years with regular menstrual cycles were selected from the Tehran Lipid and Glucose Study cohort. Participants were assessed three times at 3-year intervals (TI-T3), and their blood levels of AMH were measured. The World Health Organization classification was used to define menopause status. The area under the receiver operating characteristics curve was calculated to assess the ability of AMH at T1 to discriminate between women who have reached menopause status and those who have not. Cutoff points and their relevant sensitivity, specificity, and positive and negative predictive values were calculated. Results: Of 147 women, menopause occurred in 60. With use of the AMH level at Tl, the probability of an accurate prediction of not reaching menopause status within the next 6 years for women aged 40 to 50 years was 88% (area under the receiver operating characteristics curve, 0.88; 95% CI, 0.83-0.94; P < 0.001). A threshold of 0.39 ng/mL for AMH had the optimal combined sensitivity and specificity for prediction with a positive predictive value of 0.90 (95% CI, 0.81-0.96) and negative predictive value of 0.76 (95% CI, 0.65-0.86). Results for a slightly lower (0.365 ng/mL) and higher (0.49 ng/mL) AMH threshold had negligible effect. Stratified analysis for women aged 40 to 44 and 45 to 49 years produced similar results. Conclusions: Of every 10 women in late reproductive age with AMH levels greater than 0.39 ng/mL, only one will reach menopause status within the next 6 years. A single AMH measurement is a good predictor for the onset of menopause.

Anti-inflammatory effects of 5-HT receptor antagonist, tropisetron on experimental colitis in rats.

Abstract: Background There is a pressing need for research that will lead to the development of new therapeutic approaches for treating inflammatory bowel disease (IBD). The aim of this study was to investigate the effects of tropisetron, a 5-Hydroxytryptamine (5-HT)-3 receptor antagonist with anti-inflammatory properties in a model of experimental colitis in rat. Materials and methods Acetic acid model of colitis in rats was used. Colitis was induced by intracolonal instillation of 4% (v/v) acetic acid. One hour after induction of colitis, intraperitoneal (IP) or intrarectal (IR) tropisetron (2 mg kg−1, either route) or dexamethasone (1 mg kg−1, either route) was administered. The severity of colitis was assessed 24 h later using macroscopic and microscopic changes of damaged colon, measurement of inflammatory cytokines interleukin-1β, interleukin-6 and tumour necrosis factor-α levels and oxidative stress markers myeloperoxidase (MPO) and malondialdehyde (MDA) in colonic tissues. Results Tropisetron decreased colonic macroscopic and microscopic damage scores. This was associated with significant reduction in both neutrophil infiltration indicated by decreased colonic MPO activity and lipid peroxidation measured by MDA content, as well as a decreased colonic inflammatory cytokines. IR tropisetron decreased colonic damage that was associated with decreased neutrophil infiltration, lipid peroxidation and colonic inflammatory cytokines. Beneficial effects of tropisetron were lower than those of dexamethasone. No significant differences were observed between IP and IR administration with the exception of MDA level more diminished by IP tropisetron and dexamethasone. Conclusions Tropisetron exert beneficial effects in experimental rat colitis and therefore might be useful in the treatment of IBD.

Trends of obesity and abdominal obesity in Tehranian adults: a cohort study.

Abstract: Considering the increasing trend of obesity reported in current data, this study was conducted to examine trends of obesity and abdominal obesity among Tehranian adults during a median follow-up of 6.6 years. Height and weight of 4402 adults, aged 20 years and over, participants of the Tehran Lipid and Glucose Study (TLGS), were measured in 1999-2001(phase I) and again in 2002-2005(phase II) and 2006-2008 (phase III). Criteria used for obesity and abdominal obesity defined body mass index (BMI) ≥ 30 and waist circumference ≥ 94/80 cm for men/women respectively. Subjects were divided into10-year groups and the prevalence of obesity was compared across sex and age groups. The prevalence of obesity was 15.8, 18.6 and 21% in men and 31.5, 37.7 and 38.6% in women in phases I, II and III respectively (p < 0.001). The prevalence of abdominal obesity in men was 36.5, 57.2 and 63.3% and in women was 76.7, 83.8 and 83.6% in the three periods mentioned (p < 0.001). Men aged between 20-29 years had highest increase rates of obesity and abdominal obesity in phase III in comparison with phase I (with a respective rates of 2.2- and 3.3-fold). In both sexes, an increased trend was observed between phases I and II, whereas between phases II and III, this trend was observed in men, but not in women. This study demonstrates alarming rises in the prevalences of both obesity and abdominal obesity in both sexes especially in young men, calling for urgent action to educate people in lifestyle modifications.

Risk Factors Associated With Injury Attributable to Falling Among Elderly Population With History of Stroke

Abstract: Background and Purpose— Stroke survivors are at high risk for falling. Identifying physical, clinical, and social factors that predispose stroke patients to falls may reduce further disability and life-threatening complications, and improve overall quality of life. Methods— We used 5 biennial waves (1998–2006) from the Health and Retirement Study to assess risk factors associated with falling accidents and fall-related injuries among stroke survivors. We abstracted demographic data, living status, self-evaluated general health, and comorbid conditions. We analyzed the rate ratio (RR) of falling and the OR of injury within 2 follow-up years using a multivariate random effects model. Results— We identified 1174 stroke survivors (mean age±SD, 74.4±7.2 years; 53% female). The 2-year risks of falling, subsequent injury, and broken hip attributable to fall were 46%, 15%, and 2.1% among the subjects, respectively. Factors associated with an increased frequency of falling were living with spouse as compared to living alone (RR, 1.4), poor general health (RR, 1.1), time from first stroke (RR, 1.2), psychiatric problems (RR, 1.7), urinary incontinence (RR, 1.4), pain (RR, 1.4), motor impairment (RR, 1.2), and past frequency of ≥3 falls (RR, 1.3). Risk factors associated with fall-related injury were female gender (OR, 1.5), poor general health (OR, 1.2), past injury from fall (OR, 3.2), past frequency of ≥3 falls (OR, 3.1), psychiatric problems (OR, 1.4), urinary incontinence (OR, 1.4), impaired hearing (OR, 1.6), pain (OR, 1.8), motor impairment (OR, 1.3), and presence of multiple strokes (OR, 3.2). Conclusions— This study demonstrates the high prevalence of falls and fall-related injuries in stroke survivors, and identifies factors that increase the risk. Modifying these factors may prevent falls, which could lead to improved quality of life and less caregiver burden and cost in this population.

Development and optimization of solid lipid nanoparticles of amikacin by central composite design.

Abstract: Solid lipid nanoparticles (SLNs) have been studied as a drug-delivery system for the controlling of drug release. These colloidal systems have many important advantages, such as biocompatibility, good tolerability, and ease of scale-up. In the preparation of SLNs, many factors are involved in the characteristics of the particles, such as particle size, drug loading, and zeta potential. In this study, fractional factorial design was applied to examine which variables affect the physicochemical properties of amikacin SLNs. Study was continued by a statistical central composite design (CCD) to minimize particle size and maximize drug-loading efficiency of particles. The results showed that three quantitative factors, including the amount of lipid phase, ratio of drug to lipid, and volume of aqueous phase, were the most important variables on studied responses. The best predicted model for particle size was the quadratic model, and for drug-loading efficiency, was the linear model without any significant lack of fit. Optimum condition was achieved when the ratio of drug to lipid was set at 0.5, the amount of lipid phase at 314 mg, and the volume of aqueous phase at 229 mL. The optimized particle size was 149 +/- 4 nm and the drug-loading efficiency 88 +/- 5%. Polydispersity index was less than 0.3. The prepared particles had spherical shape, and the drug release from nanoparticles continued for 144 hours (6 days) without significant burst effect.

The antecedents of biliary cancer: a primary care case-control study in the United Kingdom.

Abstract: In a case–control study using a large UK primary care database, we found that non-steroidal anti-inflammatory drugs had no protective effect against biliary carcinomas (cholangiocarcinoma and gall bladder cancer). Increased risks were observed for cigarette smoking, diabetes, gallstone disease and obesity.

School-based intervention to promote preadolescents' gingival health: a community trial.

Abstract: Objectives: Evaluation of the effectiveness of a school-based oral health promotion intervention on preadolescents' gingival health. Methods: A community trial designed for a 3-month intervention study in a representative sample of 9-year-olds (n = 457) in 16 schools in Tehran, Iran. The schools were randomly assigned to three intervention groups and one control group, each group comprising two boys' and two girls' schools. The first group of children (n = 115) received intervention via class work, solving a set of puzzles containing oral health messages, under supervision of their health counsellor. The second group (n = 114), intervention via parents, included an oral health education leaflet and a brushing diary for supervising the child's tooth-brushing; the third group (n = 111) received a combination of both these interventions. The control group (n = 117) had no intervention. Effects of the intervention were assessed as changes in dental plaque and gingival bleeding. Improvements in gingival health were recorded when half of the index teeth with plaque at baseline became clean (acceptable oral hygiene) or when all index teeth with bleeding at baseline became healthy (healthy gingiva). Statistical analysis included chi square, anova, t-test, Number Needed to Treat (NNT) and generalized estimating equations (GEE). Results: At baseline, none of the children were free of plaque and all except for three boys had bleeding. After the trial, acceptable oral hygiene was more frequent in the parental-aid (P < 0.001) and the combined groups (P < 0.05), and healthy gingiva in both groups (P < 0.001) in comparison with the control group. Outcomes in the class- work group did not differ from those in the control group. The GEE models confirmed a strong intervention effect on healthy gingiva in both groups where parents were involved: parental-aid group (OR = 7.7, 95% CI: 2.2-27.7) and combined group (OR = 6.6, 95% CI: 2.0-22.1). In all intervention groups more girls than boys achieved healthy gingiva (OR = 2.5-2.6). Parents' education showed no impact on the outcome. Conclusions: When a school-based oral health intervention involves parents it may result in a significant improvement in the gingival health of preadolescents with poor gingival health at baseline.

Energy gap opening in submonolayer lithium on graphene: Local density functional and tight-binding calculations

Abstract: The adsorption of an alkali-metal submonolayer on graphene occupying every third hexagon of the honeycomb lattice in a commensurate $(\sqrt{3}\ifmmode\times\else\texttimes\fi{}\sqrt{3})R30\ifmmode^\circ\else\textdegree\fi{}$ arrangement induces an energy gap in the spectrum of graphene. To exemplify this type of band gap, we present ab initio density functional theory calculations of the electronic band structure of ${\text{C}}_{6}\text{Li}$. An examination of the lattice geometry of the compound system shows the possibility that the nearest-neighbor hopping amplitudes have alternating values constructed in a Kekul\'e-type structure. The band structure of the textured tight-binding model is calculated and shown to reproduce the expected band gap as well as other characteristic degeneracy removals in the spectrum of graphene induced by lithium adsorption. More generally we also deduce the possibility of energy gap opening in periodic metal on graphene compounds ${\text{C}}_{x}M$ if $x$ is a multiple of 3.