Abstract- Due to high prevalence of diabetes in our region (16.3%) and no data on the frequency of gastrointestinal (GI) symptoms in this population, we performed a cross-sectional study to evaluate ...the frequency of GIsymptoms in diabetic patients and its association between microvascular complications (retinopathy and nephropathy) and gastrointestinal symptoms in diabetic subjects.This analytical crosssectional study was conducted from 2014 to 2016 on 233 patients with type 2 diabetes mellitus (T2DM), 3065-year, referred to Yazd diabetic research center. They were selected by convenient sample method. A questionnaire according to Rome III Criteria was used to collect digestive information related to diabetes. Last HbA1c (Since 2-3 months ago) was available in the patient's medical folder. Diabetic nephropathy defines to increased excretion rate of albumin in the urine in the range of above 30 mg/g creatinine. Diabetic retinopathy was examined by an expert ophthalmologist (retinal specialist). For the current study, 233 patients (age 30-65 years with mean age of 57.43±10.49 years, 102 (43.8%) males and 131 (56.2%) females) were included. Among 233 patients, 91 cases (39.1%) had nephropathy,and 111(47.6%) subjects had different degrees of retinopathy. Bloating and early satiety and upper GI symptoms were higher in the subjects with retinopathy than another group. In summary, this study provides evidence that GI symptoms in diabetic subjects are independently linked to diabetic complications, particularly to retinopathy.
Background: Childhood obesity can affect life in three aspects, including continuing obesity after childhood, increased risk of chronic diseases, and mortality. Over the last year, students' ...lifestyles have changed due to the COVID-19 pandemic. In order to plan educational interventions to improve students' health, this study aimed to investigate the prevalence of obesity among elementary students during COVID-19 pandemic in Yazd, Iran. Methods: This cross-sectional study was conducted on 583 elementary students in 4th-6th grades (aged 10-12 years) in Yazd in 2021. The participants were recruited using multistage sampling (cluster, stratified, and random) method. Data collection tools included the physical activity questionnaire for older children (PAQ-C) and a validated researcher-made questionnaire in terms of fast food and carbonated sweet beverages consumption. Body mass index (BMI) was calculated using the students’ height and weight information registered in student electronic registration system (SANAD). Results: The prevalence of overweight and obesity among primary school students was 23.9% and 14.5%, respectively. Gender (P < 0.0001), type of school (P < 0.0001), mother’s education level (P = 0.03), amount of carbonated sweet beverages (P < 0.0001), and level of physical activity (P = 0.04) were associated with BMI status. There was no significant association between frequency of students’ consumption of fast food (P = 0.41) or soft drinks and BMI status (P = 0.48). Conclusion: During the COVID-19 outbreak, students’ weight gain has been more affected by reducing physical activity than consuming high-calorie foods. Therefore, it is required to create new infrastructure and opportunities for improving physical activity among students
Objective: Psoriasis is an inflammatory disease of the skin and the joints. Psoriatic patients sometimes suffer from vitamin D deficiency and hypocalcemia. The aim of our study was to evaluate the ...level of calcium and vitamin D in patients with psoriasis.
Materials and Methods: In this analytical cross sectional study, 110 cases of psoriasis that were referred to Shohadaye Mehrab clinic during 2015 and 110 non-psoriatic patients enrolled. Serum levels of calcium, phosphorus, parathyroid hormone (PTH), alkaline phosphatase (ALK) and 25- hydroxy vitamin D3 (25OH) D3 were measured in both groups. Data were analyzed using SPSS software version 19. Chi square test and T-test were used for statistical analysis.
Results: Among110 patients with psoriasis 74 (67.3%) were men and 36 (32.75%) were women. There was no significant difference in the serum level of calcium (P-value: 0.563), phosphorus (P-value: 0.381), PTH (P-value: 0.364) and ALK (P-value: 0.639) between two groups. Vitamin D deficiency was found in 64.5% of psoriatic patients and 60% of the controls (P-value= 0.45); However 30.9% of psoriatic and 17.3% of the controls suffered from severe hypovitaminosis D. This difference was statistically significant (Pvalue= 0.014).Conclusion: We found a significant relationship between severe hypovitaminosis D and psoriasis. This finding revealed the need for evaluation of psoriatic patients for the presence of vitamin D deficiency.
Intrauterine growth restriction (IUGR) refers to fetuses with an estimated ultrasonography weight below the 10% percentile. Hypoglycemia is a major concern in neonates with IUGR.
To investigate the ...relationship between umbilical artery (UA) Doppler ultrasonography and neonate hypoglycemia and IUGR.
This was a longitudinal follow-up study consisting of 114 neonates (gestational age of 28-40 wk) born with IUGR in the third trimester of pregnancy at Shahid Sadoughi Hospital, Yazd, Iran between May 2016 and October 2017. The neonates were assigned into three subgroups of normal UA Doppler, absent end-diastolic flow (EDF) in UA Doppler, and reverse EDF in UA Doppler. The blood glucose of the neonates was checked one, two, three, six, 12, 24 and 48 hr after birth, and the neonates were placed in the hypoglycemia or euglycemia groups according to guidelines.
Out of the 114 neonates included in the study, 75 (65.8%) had normal UA Doppler, 29 (25.4%) had absent EDF in UA Doppler, and 10 (8.8%) had reverse EDF in UA Doppler. There was a significant difference in the mean blood glucose in the first hr between the normal UA Doppler group and the reverse EDF in UA Doppler group (p
0.01).
Postnatal hypoglycemia in neonates with IUGR is associated with the result of UA Doppler ultrasonography during pregnancy.
Objective: The aim of this study was registration of type 1 diabetes mellitus (T1DM) in Yazd (the first phase of registration).
Materials and Methods: This study was a cross-sectional study on the ...first phase registration of T1DM in Yazd, Iran. Participants in this study included all patients diagnosed with T1DM by an endocrinologist. Data were analyzed by SPSS20 statistical software. Non-parametric tests were used in this study. Median ± Range was used to describe the data. Stata 13 software was used to calculate the confidence interval for the prevalence.
Results: Yazd T1DM registry (YT1DMR) was conducted from June 2018 to August 2020. All new and old cases of T1DM were registered. YT1DMR was able to identify 158 T1DM and it registered the data of 128 patients. The age of the participants was between 2.5 - 57 years old. Median ± Range of age in these participants was calculated 17 ± 54.5. In terms of gender, (57.81%, CI= 48.76-66.48) of these patients were male. The prevalence of overweight and obesity in these patients was 17.32 (CI= 11.18- 25.04) and 6.29% (CI= 2.75-12.03), respectively.
Conclusion: In the future, all patients with T1DM in Yazd province are expected to enroll in the YT1DMR and be followed up.
BACKGROUNDIn several countries such as Iran, the use of complementary and alternative medical products like herbal medicine is growing. There is, however, a lack of research on the prospects of ...herbal medicine patrons regarding facilitators and herbal medicine use barriers. The aim of this study was to explain the facilitators and the barriers of herbal medicine use in type 2 diabetes mellitus (T2DM) patients. MATERIALS AND METHODSQualitative one-to-one in-depth interviews were conducted with patients with T2DM from the Yazd Diabetes Research Center, using a semi-structured guide. For the recruitment of T2DM participants who used herbal medicine beside conventional medicine, purposeful sampling was used. Analysis of the data was carried out using the steps proposed by Graneheim and Landman strategies. RESULTSSixteen patients were interviewed. There were 2 subjects (facilitators and barriers herbal medicine use), 8 categories, and 89 initial codes. The facilitators included individual preferences, preparation skills, and family support and the factors obstructing the use of herbal medicine included insufficient skills about preparing, lack of easy access to consumption, insufficient of efficacy of herbal medicine, and negative properties of herbal medicine and taking time in preparing herbal medicine. CONCLUSIONAlthough some people use herbal medicine, the interest in use of herbal medicine is limited because of inadequate awareness of the impact and usage them. Therefore, the use of effective strategy in the integration of herbal remedies with conventional medicine can promote well-being of patients.
Background: Diagnosis of prediabetic stage is very important for prevention of diabetes and complications. This stage may be associated with some oral lesions. Only a few studies are available on the ...oral status of prediabetic patients and incidence of oral lesions in this population. This study aimed to compare some oral complications between prediabetic and healthy control groups. Methods: The present two-group cross-sectional study was carried out on 302 prediabetic and non-diabetic (healthy) 20- to 60-year-old subjects. In this study, data on age, gender, educational level, medications use, smoking, and some other variables were extracted through history taking. In addition, orodental examination was carried out by an oral medicine specialist to diagnose oral lesions including candidiasis, lichen planus, periodontitis, gingivitis, xerostomia, delayed wound healing, geographic tongue, fissured tongue, and burning mouth sensation. Data entry and analysis was performed by SPSS version 22 software, and P value and odds ratio (OR) were calculated to show statistical relationship between variables. Results: The most common oral lesion in prediabetic subjects was periodontitis (27.2%), followed by gingivitis (14.7%) and xerostomia (11.3%). In the control group, gingivitis (20.5%) followed by periodontitis (11.3%) are common oral lesions. Candidiasis (P = 0.036), periodontitis (P < 0.001), and xerostomia (P < 0.001) in prediabetic subjects were higher than control group that is statistically significant. Regression analysis showed that in the prediabetic group, periodontitis OR = 2.91, confidence interval (CI): 1.54-5.49 and xerostomia (OR = 18.51, CI = 2.42-141.45) were significantly more prevalent than healthy subjects. Conclusion: Based on the results, glucose intolerance stage exhibited a significantly higher oral problems such as periodontitis and xerostomia than healthy euglycemic stage.
Background and objectives: An effective factor in choosing the correct place for the dental implant and performing surgical procedures in the posterior regions of mandible is the position of the ...mandibular canal. Failure to consider this important landmark will damage the inferior alveolar nerve. Considering the widespread use of implants and the precision of the images obtained from CBCT. The aim of this study was to evaluate the rate of visibility of mandibular canal by CBCT in order to prevent damage to the inferior alveolar nerves and arteries. Methods: In this study, 90 archived CBCT images of patients from a private center of oral and maxillofacial radiology in Yazd that was taken by technician was evaluated during 2012-2019. The visibility of the mandibular canal in reconstructed panoramic images of CBCT was assessed by a dentistry student trained by the maxillofacial radiologist in five areas in different thicknesses on each side. Data were analyzed using SPSS 17 software. Chi-square, and correlation coefficient were done. Results: In total, in 53.38% of CBCT images both borders of mandibular canal were visible, in 17.95%, only one border was visible (difficult observation) and in 28.7% of cases, lack of visibility of mandibular canal was reported. There was no significant difference between sex, age, side and thickness in mandibular canal visibility (P >0.05). Conclusion: In more than half of CBCT images, both borders were clearly visible in both right and left sides; therefore we can conclude that CBCT is a useful tool for the observation of mandibular canal before surgeries.
Background and aims: Cardiovascular diseases are one of the most important causes of death around the world.
Coronary artery revascularization is one the most common non-medical methods for treatment ...of coronary artery
diseases. Restenosis and ischemia are the most important consequence of revascularization. Based on recent literature,
up to 60% of patients experience silent ischemia after revascularization. Myocardial perfusion imaging (MPI) is reported
to be a good modality in diagnosis of silent ischemia. In this study we aimed to investigate prevalence of silent ischemia
detected via MPI in patients with history of revascularization.
Patients and methods: In this descriptive analytic study, we enrolled 340 asymptomatic patients referred for MPI to Afshar
or Shahid Sadoughi hospital, Yazd, Iran with history of revascularization. Patients demographic and past medical history
along with their MPI results were recorded in a questionnaire and data were finally analyzed using SPSS 21 software.
Results: This study population consist of 206 (60.6%) men and 134 (39.4%) women with mean age of 62.3±9.9 ranged
between 35 and 86 years. Based on our results only 40.6% of patients had normal MPI results. In this study, normal MPI was
observed in 110 (32.4%) patients with percutaneous coronary intervention (PCI) while only 28 (8.2%) of patients with
coronary artery bypass grafting (CABG) had normal MPI results. Based on results of Chi-square test, this difference was
statistically significant (P-value=0.020).
Conclusion: Prevalence of silent ischemia is high in patients with history of revascularization specially in patients with
history of CABG aged between 50 and 70 years. Considering high prevalence of silent ischemia, a closer follow up is
logical for patients undergoing coronary revascularization for early diagnosis of restenosis and ischemia.
Antecedentes y objetivos: Las enfermedades cardiovasculares son una de las causas más importantes de muerte en
todo el mundo. La revascularización de la arteria coronaria es uno de los métodos no médicos más comunes para el
tratamiento de enfermedades de la arteria coronaria. La reestenosis y la isquemia es la consecuencia más importante
de la revascularización. Según la literatura reciente, hasta el 60% de los pacientes experimentan isquemia silenciosa
después de la revascularización. Se informa que la imagen de perfusión miocárdica (IPM) es una buena modalidad en
el diagnóstico de isquemia silenciosa. En este estudio, nuestro objetivo fue investigar la prevalencia de isquemia
silenciosa detectada mediante IPM en pacientes con antecedentes de revascularización.
Pacientes y métodos: En este estudio analítico descriptivo, inscribimos a 340 pacientes asintomáticos remitidos para IPM
al hospital Afshar o Shahid Sadoughi, Yazd, Irán, con antecedentes de revascularización. Los datos demográficos y el
historial médico pasado de los pacientes junto con sus resultados de IPM se registraron en un cuestionario y los datos
finalmente se analizaron utilizando el software SPSS 21.
Resultados: La población de este estudio consiste en 206 (60,6%) hombres y 134 (39,4%) mujeres con una edad media
de 62,3±9,9, con un rango entre 35 y 86 años. Según nuestros resultados, solo el 40,6% de los pacientes tuvieron
resultados normales de IPM. En este estudio, se observó IPM normal en 110 (32,4%) pacientes con intervención coronaria
percutánea (ICP), mientras que solo el 28 (8,2%) de los pacientes con injerto de derivación de la arteria coronaria
(IDAC) tuvieron resultados normales de MPI. En base a los resultados de la prueba de Chi-cuadrado, esta diferencia fue
estadísticamente significativa (valor de P=0,020).
Conclusión: La prevalencia de isquemia silenciosa es alta en pacientes con antecedentes de revascularización,
especialmente en pacientes con antecedentes de IDAC de edades comprendidas entre 50 y 70 años. Teniendo en
cuenta la alta prevalencia de isquemia silenciosa, es lógico un seguimiento más cercano para los pacientes sometidos
a revascularización coronaria para el diagnóstico temprano de reestenosis e isquemia.
Objective: Diabetes Mellitus (DM) is one of the most common endocrine diseases with many systemic complications such as oral manifestations. The present study aimed to compare the oral manifestations ...frequency in diabetic patients and healthy subjects.
Materials and Methods: This cross sectional study was conducted during 2016-17 on subjects came to Yazd Diabetic Research Center. In this study, 181 type 2 diabetic patients (T2DM) and 181 healthy individuals, based on convenient sample method, were included. Two groups were compared for basic information and oral manifestations including candidiasis, oral lichen planus (OLP), periodontitis, xerostomia, delayed oral wound healing, geographic tongue, gingival hyperplasia, fissured tongue, burning mouth and finally at least one of these lesions.
Results: The frequency of candidiasis, OLP, periodontitis, delay oral wound healing, geographic tongue, xerostomia and at least one of lesions in diabetics were significantly higher than control group (P-value< 0.001). After regression analysis and adjusting for confounding factors, candidiasis, periodontitis and xerostomia in diabetics were significantly more prevalent than non-DM patients with odds ratio of 15.16 (1.80-127.57), 9.58 (4.68-19.63) and 78.639 (10.05-615.231) respectively.
Conclusion: Xerostomia, candidiasis and periodontitis were significantly more prevalent in T2DM than Non-T2DM persons. Therefore, increasing awareness on oral manifestations in this group is recommended for timely diagnosis and referring to an oral medicine.
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