محمدرضا شفیع پور

Hypogonadism is a common complication in men with type 2 diabetes. The present study aimed to determine the frequency of hypogonadism and some related factors in men with type 2 diabetes referred to the Endocrinology Clinic of Ali Ibn Abi Talib Hospital of Rafsanjan University of Medical Sciences in 2021.

In this descriptive study, 111 men with type 2 diabetes were examined. After completing the questionnaire and measuring blood pressure and waist circumference, 10 cc of fasting blood was taken to measure serum levels of total testosterone (TT), follicle stimulating hormone (FSH), luteinizing hormone (LH), and glycosylated hemoglobin (HbA1c). Data was analyzed using chi-square test, independent t-test, Pearson’s correlation test, and logistic regression.

The mean and standard deviation of age of patients was 58.61±10.62 years. Twenty six patients (23.42%) had hypogonadism. With increasing body mass index, the TT levels (p=0.034), LH (p=0.008) and FSH (p=0.028) significantly decreased. With increasing HbA1c, the levels of TT (p=0.035), LH (p=0.004) and FSH (p=0.001), with increasing systolic blood pressure, the level of LH (p=0.025), and with increasing age, the levels of LH and FSH (p<0.001) significantly increased; however, with increasing waist circumference, the levels of TT (p=0.006), LH and FSH (p<0.001) significantly reduced. Mean TT (p=0.011), LH (p=0.017), and FSH (p=0.014) levels were significantly higher in those taking the drug.

With an increase in waist circumference, disease duration, and follicle stimulating hormone, the odds of hypogonadism increased. It is recommended to the health officials to take the necessary preventive measures including increasing the awareness of the male community.

According the importance of iodine monitoring in the prevention of iodine deficiency disorders, this study aimed to evaluate the clinical iodine and goiter deficiency in 7-12 year-old students in Rafsanjan in 2018-19.

The statistical population of this cross-sectional study included all students of 7-12 years old who were covered by Rafsanjan Education Management in 2018. From 21218 students aged 7 to 12 years living in the city, 1203 students (601 boys and 602 girls) based on inclusion criteria were enrolled in the study. After obtaining informed consent from the parents, the students were examined clinically by an internal trained resident. In this study, the presence and severity of goiter were evaluated based on the World Health Organiaztion classification. Then, 10 ml of the morning urine sample of 10% of all samples was taken to measure iodine by acid digestion method.

The mean and standard deviation of age of participants was 9.48±1.71. In addition, mean and standard deviation of urinary iodine was 183.33±80.52 Ug / dl. In the study of the prevalence of goiter in the community, 87.1% (1047 samples) had no goiter, 9.7% (117 samples) had D1 grade and 3.2% (39 samples) had D2 grade. It was also found that the prevalence of goiter was not statistically significant in terms of age and sex.

The findings of this study indicate that the iodine deficiency control program and consumption of iodized salt has caused a significant decrease in the prevalence and severity of goiter, and also adequacy of the received iodine, given a marked increase in urinary iodine excretion in Rafsanjan city.

  Diabetes is one of the most common diseases in the world. On the other hand, stress, anxiety, and depression are exacerbated by diabetes. Given psychological complications of diabetes, together with the education importance concerning the tactics to cope with, the present study aims to determine the effect of psychological training with progressive muscle relaxation on stress, anxiety, and depression in Diabetes Type 2 patients.   In this study, the educational trial control group included 60 patients with Diabetes Type 2 who were affiliated with the Diabetes Clinic of Rafsanjan University of Medical Sciences. They were selected based on systematic random sampling from the records in the clinic and then divided randomly into two groups of intervention and control (30 in each). For the former, 12 sessions of psychological training with a progressive muscle relaxation technique were held, two sessions each weeks, and no intervention was performed for the latter. Data were collected using demographic (disease information) and DASS21 questionnaires. Data were analysed using Chi-square, Fisher's, Independent t-test, and Two-way ANOVA with Repeated Measurements before, immediately after, and three months follow-up. Results showed that there was a significant difference between the mean scores of stress, anxiety, and depression before, immediately after, and three months follow-up in the experimental group (p<0.050); however, no significant difference was found in the control group (p>0.050).   Psychological training intervention with a progressive muscle relaxation technique can improve depression, anxiety, and stress. Thus, the results of the study provide empirical support for the treatment in order to improve anxiety, depression, and stress.

Resistin is an adipokin secreted from adipose tissue and immunity cells. Relationship between resistin and metabolic syndrome and its components is controversial. The aim of this study is measurement of serum resistin level, insulin resistance and other factors in subjects with and without metabolic syndrome. this cross-sectional study was conducted in 2015, 56 availableperson including; 31subjects were enrolled as the study group and 25 subjects were recruited as the control group of the study. Serum resistin concentrations were measured by ELISA and its association with metabolic syndrome markers was measured. Data were Analyzed using independent T test, Pearson correlation Test and, Chi-squared Test Serum resistin levels were significantly higher in the metabolic syndrome subject compared with control group (p-value=0.002). Correlation analysis revealed body mass index (p=0.018; r=0.480), waist circumference (p=0.015; r=0.431), systolic blood pressure (p=0.008; r=0.467), diastolic blood pressure (p=0.001; r=0.562), cholesterol (p=0.018; r=0.421) and LDL (p=0.003; r=0.515) were positively correlated with plasma resistin. Serum resistin levels are elevated in subjects with metabolic syndrome and are associated with some of its components in metabolic syndrome patients, resistin may be associated with the severity of this syndrome and its complications.

Type 1 diabetes (diabetes mellitus) is a disease associated with metabolism. The most common form of type 1 diabetes is its autoimmune type. Alpha-1-antitrypsin (AAT) is a member of the serine protease inhibitors family and its role is to protect tissue degradation by protease. Hence, its defect or deficiency significantly increases the risk of various diseases. This study aimed to compare the activity of alpha-1 antitrypsin protein in patients with type 1 diabetes with healthy individuals.

This descriptive study carried out on 42 patients with type 1 diabetes between the ages of 18-28 years old who referred to the Diabetes Clinic in the city of Rafsanjan in 2015. Healthy people were chosen among native male and female students aged from 18 to 28 years of Rafsanjan University of Medical Sciences who were matched for age and sex with the patients. AAT activity by trypsin inhibitory capacity (TIC) was studied. For statistical analysis the chi-square test, t-test, and Pearson correlation coefficient were used.

The amount of TIC in the patients with type 1 diabetes was 2.35 ±0.40 (μmol/min/ml) which was significantly lower than the amount in the healthy individuals that was 3.36 ±0.36 (μmol/min/ml) (P-value

The results of this study revealed that AAT activity in the patients with type 1 diabetes was lower than the healthy individuals. Therefore, it can be stated that AAT can be introduced as a potential target for treatment of type 1 diabetes.

Shoulder pain is one of the most common complaints after cesarean section that sometimes may be serious and cause malfunction of mothers in breastfeeding and neonatal care. As one of the causes of shoulder pain is referred pain caused by diaphragm irritation due to existence of blood and amniotic fluid in the peritoneal cavity after surgery، we decided to investigate the comparison between placing surgical sponges on both sides of uterus and reverse trendelenburg position of 30 degree to reduce the incidence of shoulder pain after cesarean section with spinal anesthesia. This three blind clinical trial was conducted on 201 women undergoing cesarean section in Niknafas hospital of Rafsanjan، Iran in 2011. Women were randomly divided into three groups. Surgeries were performed by two surgeons equally in each group. In group A، spinal anesthesia was performed and 2 surgical sponges with a radio opaque line impregnated with normal saline were placed on both sides of uterus and operation continued in supine position with no angle with horizon line. In group B، patients were operated in reverse trendelenburg position of 30 degree to horizon line without placing surgical sponges. In group C، cesarean was performed without any surgical sponges and in supine position. Severity of shoulder pain was assessed 24 hours after surgery in right، left or both shoulders in all patients. Data were analyzed using SPSS software (version 18) and one way ANOVA، chi-square، Post-hoc tests and t-test. P value less than 0. 05 was considered significant. Mean of pain severity had no significant differences between the three sites of pain (p=0. 728). No significant differences were observed in pain severity between the three groups (p=0. 111) and between the operations were performed by the two surgeons (p=0. 430). According to no statistically significant difference between groups in pain severity، there might be another agent exclusive of blood and amniotic fluid that irritates diaphragm and cause shoulder pain.

Hyperlipidemia is an important metabolic disorder that is common among renal transplant recipients and contributes to the development of post-transplant accelerated coronary artery diseases. This study investigates the prevalence and risk factors of post transplant dyslipidemia in our center. Retrospectively the records of 103 renal transplant recipients were evaluated at Sina Hospital in Tehran (Iran) between the years 2004 and 2007. The Patients’ demographic data, underlying renal disorder and immunosuppressive drugs regimen along with their laboratory data including total cholesterol (TC), Triglyceride (TG), serum creatinin (Cr) and fasting blood sugar were recorded. Among the patients, there were 43 (41.7%) females and 60 (58.3%) males. The mean age (±SD) was 39.25± 13.9 years. The respective pre versus post transplantation lipid profile findings were: TC, 158±41 mg/dl versus 198±43 mg/dl, p<0.001; TG 152±78 mg/dl versus 195±83 mg/dl; p<0.001. Increased lipid levels were found to be independent of the patients’ age, gender, underlying renal disorder, duration of dialysis before the transplant, graft function, post transplant diabetes mellitus (PTDM) and immunosuppressive drugs regimen. Renal transplant recipients are at a high risk of developing hyperlipidemia; therefore, they should be evaluated for risk factors.