mansour siavash

Given that HbA1C is a critical indicator in the diagnosis and control of diabetes, various methods exist for its measurement. This study aimed to determine the accuracy of the HbA1C index measured by the Clover A1c self analyzer device in health centers of Isfahan province compared to the HPLC method.

In this cross-sectional study, samples were taken from 99 patients. Three blood samples were taken from each patient: one venous blood sample and two capillary blood samples. The HbA1C measurement from the venous blood sample was performed using the standard HPLC method, while the capillary blood samples from the right and left hands were measured using the Clover A1c self analyzer device. The concordance of the measurements from the two devices was assessed using the Intra-cluster correlation coefficient (ICC) and the Bland-Altman method.

A comparison of the results reported by the two devices showed that the mean serum HbA1C measured by the reference device was 7.97 ± 1.50. The mean HbA1C measured by the Clover Self device on the right hand was 7.51 ± 1.29, and the mean on the left was 7.59 ± 1.28. The concordance of the measurements from both hands by the Clover Self device with the reference device was ICC = 0.938 with a 95% confidence interval (0.913 - 0.957) (P < 0.001).

The results of the present study indicate excellent concordance between the results obtained from the two devices, confirming the validity of the Clover Self device.

Type 2 diabetes is a common disease, which is associated with psychological problems. This study aimed to compare the effectiveness of self-healing on difficulties in emotion regulation and blood sugar index in patients with type 2 diabetes.

This research was semi-experimental (pre-test, post-test, follow-up with control group). The statistical population consisted of 300 people with type 2 diabetes who visited Sedighe Tahereh Clinic in Isfahan in 2021. Of these, 40 people were selected through purposive sampling and were assigned randomly in the experimental and control groups. Data collection tool was Gratz and Romer’s (2004) Difficulties in Emotion Regulation Scale (DERS) and laboratory equipment to measure blood sugar index. the experimental groups underwent 12 sessions of self-healing therapy and the control group did not receive any treatment. Analysis of variance with repeated measures and Bonferroni’s post hoc test were used to analyze the data. SPSS version 24 was used to analyze the data

The results showed that self-healing has an effect on difficulties in emotion regulation and blood sugar index (P<0.05) and this result is continuous (P<0.05).

According to the results, it can be said that self-healing is effective in manegment of blood sugar of people with type 2 diabetes.

 Regarding the importance of the prevention of non-communicable diseases (NCDs) and higher consumption of salt among the Iranian population than the level recommended by the World Health Organization, the aim of this study was to evaluate the accuracy of the salt mentioned in the traffic light labelling of nuts and seeds.

Study Design:

 A cross-sectional study.

 A total of 53 packaged nuts and seeds, including 7, 8, 9, 9, 10, and 10 samples of pumpkin, pistachios, almond, sunflower, peanut, and watermelon nuts and seeds, respectively, with traffic light labelling, were randomly purchased from several local markets in Isfahan, Iran. The amount of sodium was measured by the inductively coupled plasma-optical emission spectroscopy technique and then multiplied by 2.5 to achieve the amount of salt.

 Varying levels of traffic light labeling value accuracy were observed in most of the samples. In the almond, pistachio, peanut, and watermelon groups, the average amount of laboratory value had a statistically significant difference with the label value (P<0.05).

 The results demonstrated that the salt content of 82% of the studied samples had discrepancies with the values stated on the traffic light labelling. The presentation of an accurate amount of salt content is essential for promoting healthy eating habits and enabling individuals to make informed choices about their diet. It is recommended that regulatory authorities should review labelling guidelines and enforce stricter compliance to ensure accurate representation of salt content on packaged foods.

This study aims to explore the relationship between attachment styles, psychological well-being, and treatment adherence. Also, it examines the mediating role of mentalization in the connection between attachment, well-being, and adherence to treatment. This cross-sectional study included 230 diabetic patients aged 20 to 65 who sought treatment at the Isfahan endocrinology and metabolism clinics from July to October 2021. Demographic and clinical data were recorded. All participants completed Ryff’s Psychological Well-Being Questionnaire, Collins and Read Attachment Style Questionnaire, Mentalization Questionnaire (Ments), and Tobert's Self-Care Questionnaire. Data analysis was conducted using correlation and structural equation modeling methods. A secure attachment style and psychological well-being were found to have a positive correlation with treatment adherence (p<0.05, T=4.32, p<0.05, T=2.79). Furthermore, mentalization was identified as a significant mediator in the relationship between psychological well-being, avoidant attachment style, and treatment adherence (p<0.05, T=4.38, p<0.05, T=2.05). The study highlights the significant mediating role of mentalization between treatment adherence, psychological well-being, and avoidant attachment. It emphasizes the potential of mentalization to improve treatment adherence, especially among individuals with an avoidant insecure attachment style.

The health assistant and treatment assistant in the Ministry of Health and Medicine are in charge of educating people with diabetes and empowering them to achieve self-management of diabetes. The present study was conducted with the aim of determining the status of education and support for diabetes self-management in comprehensive health service centers and diabetes clinics in Isfahan province.

The diabetes education units of 20 comprehensive health service centers and 11 diabetes clinics in Isfahan province formed the sample size. The data collection tool was a checklist with 107 items, which was completed by observing and reviewing 170 paper/electronic files of patients with diabetes.

In more than two-thirds of the files of diabetes centers/clinics, initial assessment were neither performed nor recorded. Educational needs assessment was recorded in 5% of the files and educational planning was not recorded in nearly 100% of them. In more than a third of the files (36.5%), diet education was recorded once when the case was filed. In 3.4% of files, educational effectiveness evaluation was recorded and in three quarters of files (75.78%), continuous support for self-management was not recorded.

There is a significant gap between the status of education and support for diabetes self-management and the process and outcome standards of DSMES in the educational units covered by the provincial health and treatment department. This gap seriously and negatively affects the results of this approach.

Type II diabetes is one of the chronic diseases, and diabetes distress is one of the psychological factors affecting its management. Therefore, this study was performed to compare the effectiveness of self-healing with mindfulness-integrated cognitive behavior therapy on diabetes distress and control of glycemic in type II diabetic patients

This semi-experimental research was conducted on 60 people with type II diabetes who were selected purposefully. People were randomly divided into two intervention groups and one control group. The intervention groups received twelve 90-minute sessions (one session per week) of mindfulness-integrated cognitive behavior therapy and self-healing. The research tools were Polonsky et al.'s Diabetes Distress Scale (2005), which has content validity and reliability with a Cronbach's alpha of 0.87, and laboratory equipment to measure hemoglobin glycoside. The data were analyzed using variance analysis with repeated measurements and post hoc tests in SPSS-24 software.

Between the two methods of intervention, only self-healing could effectively reduce glycosidic hemoglobin (P≤0.01). Moreover, both methods of intervention reduced diabetes distress; however, the effect of self-healing remained stable over time (P≤0.01).

The results indicated that self-healing was able to reduce hemoglobin glycoside in addition to diabetes distress and its effect remained constant over time. It is suggested to investigate the effect of self-healing in other areas related to diabetes.

A lot of the adult Muslim population will fast during Ramadan while many of those suffering from diabetes mellitus (DM). Risks of fasting for people with DM include hypoglycemia, hyperglycemia, ketoacidosis, and dehydration. Physicians should assess the likelihood of these risks in each patient and recommend him/her accordingly. With the right management and correct intervention, many people with diabetes can fast safely during Ramadan, but some of them need to be closely monitored and educated for the appropriate action. By quantifying multiple risk factors, a risk score is calculated that plays an important role in the decision/permission to fast for each patient. The new risk stratifying system defines three risk groups.  People, who fast against the advice of their physician/health care provider, should carefully follow the instructions of the expert to prevent serious complications. In this article, first, we discuss the risks of fasting in patients with diabetes mellitus, based on recent international guidelines and scientific pieces of evidence. Then we present dietary and lifestyle instructions for patients with diabetes mellitus during Ramadan, based on traditional Iranian medicine and also according to the latest pieces of evidence.

Disturbed biochemical factors have been observed in viral infections including SARS, Ebola virus, and now COVID‑19. This study aimed to evaluate the association between Calcium axis’ derangements and hospital duration, ICU admission, mechanical ventilation, and death in patients with COVID‑19.

428 hospitalized patients with COVID‑19 were included in this study. On the first day of admission, the patients were extensively evaluated for biochemical and hormonal factors and followed up until discharge/death. The association between hyperphosphatemia, hypoalbuminemia, and hypocalcemia and major outcomes, including hospital duration, ICU admission, mechanical ventilation, and death, was investigated by logistic regression analysis.

Hyperphosphatemia and hypoalbuminemia were present in 27 (6.3%) and 59 (13.8%) cases, respectively in the study population. The results of the present study reveal the relation of these factors with worse outcomes in COVID‑19 patients; such as hospital duration, ICU admission, mechanical ventilation, and death. On the other hand, high frequency of hypocalcemia (59.1%, 253 subject) has no significant influence on the mentioned outcomes (All P values were greater than 0.05).

Poor outcomes were associated with hyperphosphatemia and hypoalbuminemia. It seems that we should evaluate the patients for derangements of phosphate, albumin, and calcium and try to treat them for all COVID‑19 patients.

Gestational diabetes (GDM) refers to diagnosis of diabetes at 24 to 28 weeks of pregnancy. GDM fetuses and mothers are at risk for numerous adverse outcomes. Diabetes screening should be done before pregnancy in all high-risk women who plan to become pregnant. GDM screening at 24 to 28 weeks of pregnancy with one-stage or two-stage method is recommended in all women. The criteria for diagnose of diabetes in the first perinatal visit and before the 15th week of pregnancy to detect undiagnosed diabetes are the same as the standard criteria for diagnosing diabetes in non-pregnant people. Women who have a glucose metabolism disorder before the 15th week of pregnancy are at a higher risk for maternal and infant complications. In addition, with the progress of pregnancy, they may need insulin and the risk of GDM is higher in them. Fasting glucose of 110-125 mg/dl and HbA1C of about 5.9-6.4% before the 15th week of pregnancy is known as glucose metabolism disorder, blood glucose monitoring is recommended in these women. Women with GDM should have a glucose tolerance test 4 to 12 weeks after delivery. The criteria for diagnose of diabetes at this time are the same as for non-pregnant people. All women with GDM should be screened for diabetes and prediabetes every 3 years.

Type 2 diabetes is a common disease that could be prevented or managed with a healthy lifestyle. This study was conducted to determine the effects of self-healing with mindfulness-integrated cognitive behavior therapy on the health-promoting lifestyle profile of patients with type 2 diabetes.

This clinical trial was done on 45 patients with type 2 diabetes who had been referred to the Sedigeh Tahereh Clinic in Isfahan (Iran) in 2021. The patients were randomly divided into 3 groups of 15 patients: a control group, a self-healing group (first intervention) and a mindfulness-integrated cognitive behavior therapy group (second intervention). Interventions for each treatment were held as a weekly 90-minute online session. Posttest was After 12 sessions and three months after the test was followed up. The research tool was a health-promoting lifestyle profile questionnaire with nutrition, exercise, health responsibility, stress management, interpersonal support and self-fulfillment components. The questionnaire was filled out by each group after the 12 sessions and three months after the last session.

Both the self-healing methods and the mindfulness-integrated cognitive behavior therapy increased the lifestyle scores of patients with type 2 diabetes compared to the control group (P<0.05), and the effect was maintained in both intervention groups in the follow-up phase. No difference was observed between the two treatment methods compared with the control group.

Self-healing and mindfulness-integrated cognitive behavior therapy is both effective in improving the health-promoting lifestyle profile of patients with type 2 diabetes.

Osteoporosis, the fourth most common disease in the world, affects the elderly and postmenopausal women and imposes a great financial and social burden on individuals and society. Furthermore, it has a significant impact on the quality of patients’ life. This study tries to take an effective step toward improving the quality of patients’ life by developing and evaluating the self‑care program of women with osteoporosis.

In this research, a hybrid sequential design of quantitative and qualitative type consisting of three phases is used. This mixed‑method study aimed to develop and evaluate a self‑care program for women with osteoporosis.

Familiarity with the needs of these patients and the use of self‑care programs and considering social, cultural, and psychological factors could be effective steps to improve the health of women with osteoporosis. These steps can improve the quality of life and reduce the costs of treatment for this group of women.

Today, Glycosylated hemoglobin A (HbA1c) is used as a diagnostic criterion for diabetes and long-term monitoring of plasma glucose level. Therefore, it is essential that HbA1c be measured accurately. The aim of this study was to investigate the common HbA1c index measurement methods in laboratories in Isfahan and compare the accuracy of their results with the reference method.

In this cross-sectional study, three blood sample of a volunteer had been sent to 37 laboratories. Among them, two laboratories measured this parameter by HPLC method and were considered as a reference. For each laboratory, the coefficient of variation (CV) was calculated. One-way ANOVA and Bonferroni post hoc test were used to compare the results of different methods of measuring HbA1c with the reference method.

Comparison of the laboratories results with the reference method showed that 60% of the laboratories reported the percent of HbA1c index beyond the permitted range with an unfavorable report. The mean and standard deviation and CV index range were 2.8 and 4.4, (from 0.65 to 25.18%), respectively. Comparison of the different methods results with the reference method showed that capillary electrophoresis and immunoturbidometry and enzymatics had good accuracy. The highest accuracy was related to capillary electrophoresis. The methods with the lowest measurement accuracy were nephelometry and column chromatography, respectively.

Despite the standardization of methods for measuring HbA1c, it was noted that different results of the same blood sample was reported. In addition to the High Performance Liquid Chromatography method, the capillary electrophoresis seems to provide a more acceptable result than other methods.

The purpose of this study is to compare oral betamethasone pulse therapy, methotrexate therapy and a combination of the two for patients with Alopecia Areata (AA) as an autoimmune disorder. In this study, 36 patients with severe AA were selected and classified into three groups of 12: 1- Oral betamethasone therapy (3 mg, once a week) with placebo; 2- Oral methotrexate (15 mg, once a week) with placebo; and 3- A combination of methotrexate (15 mg, once a week) and betamethasone (3 mg, once a week). The Severity Alopecia Tool (SALT) was used to measure improvements in the lesions through photographs, and the patients also rated their condition on the Visual Analogue Scale (VAS). Assessments were performed, and the results were compared at baseline and then at intervals of three months for nine months. The demographics and SALT score were similar in the three groups (P > 0.05). All the groups showed improvements in SALT, VAS and photographic scores three months after beginning the treatment (P < 0.001). Betamethasone therapy (P = 0.006) and combination therapy (P < 0.001) provided greater SALT improvement than methotrexate, and combination therapy led to a greater improvement in VAS and photographic findings compared to the two other groups (P < 0.05).Oral steroid, methotrexate and combination pulse therapy were effective treatments for AA, while oral steroid pulse therapy and combination therapy were superior to methotrexate.

Low vitamin D status may contribute to the pathogenesis of heart failure (HF), but therapeutic roles of vitamin D on cardiac performance are not well known. We evaluated vitamin D effects on left ventricular ejection fraction (LVEF) and New York Heart Association (NYHA) functional class in patients with HF for the first time.

This study was a double-blind, randomized, placebo-controlled trial. 110 patients with HF admitted to Shahid Chamran and Khorshid Hospitals, Isfahan, Iran, randomly received 500 mg calcium daily plus either 50000 IU vitamin D3 per week (case group) or placebo (control group) for 6 months. Biochemical variables, LVEF, and NYHA functional class were assessed at baseline and after 6 months.

81 patients completed the study. Vitamin D supplementation increased mean serum 25-hydroxyvitamin D [25(OH)D] concentration in the case group by 33.9 ng/ml (P < 0.001). After 6 months of treatment, both groups showed improvement in LVEF, but the extent of improvement was significant only in the case group (5.48% versus 0.44%, P < 0.001). The NYHA functional class improved in the case group but remained constant in the control group (P < 0.001).

Vitamin D3 improved LVEF and NYHA functional class in patients with HF and might serve as a new agent for the future treatment of this disease.

Parathyroidectomy, the standard treatment of primary hyperparathyroidism (PHP) due to parathyroid adenoma, is not suitable for all patients. We evaluated the efficacy of ultrasound‑guided ethanol ablation of parathyroid adenoma in a group of patients with PHP.

In a prospective self‑controlled trial, 39 patients with parathyroid adenoma, who were not candidates for surgery, were enrolled. Ethanol injections were performed by two experienced interventional radiologists under the guidance of real‑time ultrasonography. Adenoma size changes were assessed at about 1 month later. Serum levels of parathyroid hormone, calcium, phosphate, 25‑OH Vitamin D, and alkaline phosphatase were evaluated at the baseline, 1, 3, 6, and 12 months after the injections. The treatment effects on outcome variables were assessed by repeated measures analysis.

Volume of the adenomas decreased during the study period from 1.87±6.45 cm3 to 0.38± 0.48cm3 (P < 0.001). Corrected serum calcium levels decreased from 10.40 ± 0.96 mg/dl to 8.82 ± 0.58 mg/dl (P < 0.001), and remained stable during one year follow‑up. Serum levels of parathyroid hormone decreased gradually from 129.85 ± 63.37 to 72.58 ± 53.86 pg/mL after 3 months and to 44.78 ± 28.04 pg/mL after 1 year (P < 0.001). Overall, 46% of the patients improved after 1 month of ethanol ablation therapy which increased to 84.5% during 1‑year follow‑up. No major complications were observed.

The current study showed the efficacy of ultrasound‑guided ethanol injection in PHP and may be considered as a suitable alternative treatment in patients who are not candidates for the surgery. It has also a good safety profile without major complications if performed by experienced hands.

This study was designed to compare the severity of gastrointestinal (GI) side effects in Type 2 diabetes mellitus (DM) patients receiving tablet or capsule forms of metformin.

In this prospective interventional study, patients were evaluated from June to November 2016 at DM clinics affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. Adult patients with Type 2 DM who were eligible for inclusion criteria switched from metformin tablet to metformin capsule. Hemoglobin A1c (HbA1c), GI side effects, and patient satisfaction based on visual analog scale (VAS) were assessed during a 6‑week follow‑up of receiving metformin capsule.

One hundred and three patients were evaluated, and 75 patients participated in this study. At the baseline, 40 patients (53.3%) had GI side effects due to metformin tablet which was reduced to 16 patients (21.3%) after switching to metformin capsule (P = 0.001). There was also an improvement in HbA1c (from 7 to 6.8, P < 0.0001). The results of patients’ satisfaction based on VAS and numeric rating scale indicated that in 59 patients (78.67%), GI side effects were reduced after switching to metformin capsule (mean score: 7.2 with the range of 6–9) while 16 patients stated no treatment preference.

Switching to metformin capsule may result in less GI side effects, with no further side effect complications.

This study was conducted to evaluate the combination of oral supplements with 2% minoxidil solution in four groups of women with hair loss.

A prospective, randomized controlled trial was conducted from July to December 2016 in dermatology clinics affiliated to Isfahan University of Medical Sciences. A total of 73, 15–45‑year‑old, women with hair loss participated in this 4‑month study. Simple randomization using Random Allocation Software was done to put the participants in four groups to receive coadministration of zinc sulfate and calcium pantothenate, zinc sulfate, calcium pantothenate, and 2% minoxidil solution. The primary endpoint was the change in hair density and diameter measured by dermatoscope. Secondary endpoints included the researcher’s evaluation, dermatologist’s opinion ‑ which was blinded to the study ‑ from comparing the participants’ photographs before and after treatment and finally, overall changes in hair density measured by participants’ self‑assessment.

Seventy-three women participated in this study. Primary hair count and thickness were 118.5 ± 10 hairs/cm2 and 58.8 ± 5.8 µ that changed to 124 ± 11 hairs/cm2 and 62.3 ± 4.3 µ respectively (P < 0.001) which in the zinc plus pantothenate group these changes were from 118.6 ± 9.9 hairs/cm2 to 121.9 ± 11.1 hairs/cm2 (P = 0.042) and from 62.2 ± 6.6 µ to 64.0 ± 5.0 µ (P = 0.126), respectively. Hair density increments were more obvious in the minoxidil group, and hair thickness increments were more obvious in pantothenate group. Participants’ satisfaction was 85% in the combination therapy which was more than other groups. Participants’ satisfaction, author’s and blind dermatologist’s opinion showed a significant correlation (P = 0.0001).

Based on the participants’ satisfaction, the combination of zinc sulfate and calcium pantothenate when administered in a pulse therapy way could be a good choice for hair loss controlling in initial stages.

Type 2 diabetes mellitus (DM‑T2) is commonly associated with increased triglycerides (TG), low‑density lipoprotein cholesterol (LDL‑C) and low high‑density lipoprotein cholesterol (HDL‑C) levels. Fibrates like gemfibrozil are frequently used in diabetic patients to decrease TG and increase HDL‑C levels. We compared the efficacy of Vitamin C, an antioxidant vitamin, with gemfibrozil on serum HDL‑C in diabetic patients.

Type 2 diabetic patients, referred to our out‑patient clinic were randomly divided into three groups. After 1 month of lifestyle and diet modifications, groupsA, B, and C were prescribed 1000 mg Vitamin C, 600 mg gemfibrozil and combination of both, respectively. Before the study initiation and after 6th week of drug prescription, the blood samples were taken and analyzed for total cholesterol (Total‑C), HDL‑C, TG, fasting blood sugar (FBS), and hemoglobin A1c (HbA1c) levels.

Sixty‑seven patients entered, and 50 patients (18 male, 32 female) finished the study. Overall, serum HDL‑C increased significantly from 39.8 to 45.2 mg/dL in the participants (P = 0.001). HDL‑C increased 6.3, 4.4 and 5.0 mg/dL in groups A, B and C, respectively (related significances were 0.017, 0.022 and 0.033, respectively). Significant decrease of serum TG and Total‑C occurred in gemfibrozil and combination groups, but not in Vitamin C group. Changes in serum HDL‑C between three groups were not significant (P = 0.963). We found a significant decrease in TG and Total‑C in the groups B and C (P < 0.05), but no significant changes of TG, Total‑C, LDL‑C, FBS and HbA1c in group A (P > 0.05).

The results demonstrated that Vitamin C may have beneficial effects on HDL‑C in diabetic patients without significant effects on plasma glucose or other lipid parameters; however, its role for the treatment of low HDL‑C patients should be evaluated in larger studies.

Diabetes is one of the major causes of morbidity and mortality. Diabetes and hyperglycemia are leading causes for cardiovascular diseases, chronic infections, and other serious problems. The use of smartphone is dramatically increasing, and as such, it is sensible to use an application for management of hospitalized patients with diabetes or hyperglycemia. We designed a software for physicians by use of which they educate to take appropriate decisions in management of patients with diabetes and evaluated the quality of the application using a questionnaire.

Application is designed in a cascade framework to help in management of patients with diabetes and hyperglycemia. The treatment protocols presented in the program were extracted from diabetes management guidelines and valid review articles. Furthermore, we developed a questionnaire to assess the quality of the program. Physicians (n = 36) used this program for 1 week after which they completed the questionnaire.

The physicians described the application to be useful and understandable.

A high percentage of physicians and health providers are aware of the problems when it comes to hospitalized patients with diabetes and our application was designed to resolve the associated difficulties.

Diabetes mellitus (DM), named Ziabites in Persian medicine (PM), was categorized as hot or cold Ziabites according to the Mizaj of patients. This study aimed to compare the Mizaj of patients with newly diagnosed type 1 DM (T1DM) with chronic cases and healthy children. In a case–control study, three groups including chronic T1DM patients (n = 31), newly diagnosed T1DM patients (n = 37), and healthy children as the control group (n = 80) were recruited. Mojahedi Mizaj Questionnaire was used to measure two subscales, hot/cold and wet/dry, of Mizaj for participants. The mean scores of the Mizaj subscales were compared between the groups. Cutoff values were determined using receiver operating characteristic analysis, and the corresponding odds ratio (OR) for each subscale was identified. Overall 148 participants, with a mean age of 10.0 ± 6.2 years, were enrolled in the study. Analysis showed that the mean total heat and total dryness scores were significantly higher in new T1DM than that of chronic patients and healthy children (19.59 ± 1.7 vs. 16.6 ± 2.1 and 18.17 ± 1.9, P < 0.001 for hot/cold and 4.70 ± 1.0 vs. 4.09 ± 0.9 and 4.31±0.8, P = 0.02 for wet/dry). “Extra heat” based on the cutoff value of >18.5 was found to be a risk factor for T1DM (OR = 3.62, 95% confidence interval = 1.52–8.63). New T1DM patients have higher frequency of hot and dry Mizaj, which is consistent with the concept of hot Ziabites in PM. Most importantly, we found that “extra heat” in children can be considered as a risk factor for T1DM.

Wound healing is a complex biological process. Some injuries lead to chronic nonhealing ulcers, and healing process is a challenge to both the patient and the medical team. We still look forward an appropriate wound dressing.
In this study, starch?based nanocomposite hydrogel sca?olds reinforced by zeolite nanoparticles (nZ) were prepared for wound dressing. In addition, a herbal drug (chamomile extract) was added into the matrix to accelerate healing process. To estimate the cytocompatibility of hydrogel dressings, fbroblast mouse cells (L929) were cultured on sca?olds. Ten, 3?(4, 5?dimethylthiazol?2?yl)?2, 5?diphenyltetrazolium?bromide assay test and interaction of cells and sca?olds were evaluated. For evaluating healing process, 48 male rats were randomly divided into four groups of four animals each (16 rats at each step). Te ulcers of the frst group were treated with the same size of pure hydrogels. Te second group received a bandage with the same size of hydrogel/extract/4 wt% nZ (hydrogel NZE). Te third group was treated with chamomile extract, and the fourth group was considered as control without taking any medicament. Finally, the dressings were applied on the chronic refractory ulcers of fve patients.
After successful surface morphology and cytocompatibility tests, the animal study was carried out. Tere was a signifcant di?erence between starch/extract/4 wt% nZ and other groups on wound size decrement after day 7 (P Starch?based hydrogel/zeolite dressings may be safe and e?ective for chronic refractory ulcers.

Diabetic patients are more susceptible to cutaneous fungal infections. The higher blood sugar levels cause increasing the cutaneous fungal infections in these patients. The main objective of this study was to find the frequency of fungal infections among cutaneous lesions of diabetic patients and to investigate azole antifungal agent susceptibility of the isolates.

In this study, type 1diabetes (n = 78) and type 2 diabetes (n = 44) comprised 47 cases (38.5%) with diabetic foot ulcers and 75 cases (61.5%) with skin and nail lesions were studied. Fungal infection was confirmed by direct examination and culture methods. Antifungal susceptibility testing by broth microdilution method was performed according to the CLSI M27‑A and M38‑A references.

Out of 122 diabetic patients, thirty (24.5%) were affected with fungal infections. Frequency of fungal infection was 19.1% in patients with diabetic foot ulcer and 28% of patients with skin and nail lesions. Candida albicans and Aspergillus flavus were the most common species isolated from thirty patients with fungal infection, respectively. Susceptibility testing carried out on 18 representative isolates (13 C. albicans, five C. glabrata) revealed that 12 isolates (10 C. albicans and two C. glabrata isolates) (66.6%) were resistant (minimum inhibitory concentration [MIC] ≥64 mg/ml) to fluconazole (FCZ). Likewise, eight isolates (80%) of Aspergillus spp. were resistant (MIC ≥4 mg/ml), to itraconazole.

Our finding expands current knowledge about the frequency of fungal infections in diabetic patients. We noted the high prevalence of FCZ‑resistant Candida spp., particularly in diabetic foot ulcers. More attention is important in diabetic centers about this neglected issue.

Obesity is a worldwide health problem which is associated with a lot of complications. One of these comorbidities is the metabolic syndrome that is in correlation with abdominal fat thickness and waist circumference. Various methods were used to reduce abdominal fat thickness such as liposuction. A noninvasive method is the topical agent. In this study, we investigated the effectiveness of Arnebia euchroma (AE) ointment on the abdominal fat thickness.
This study was a double-blind clinical trial which was done at the endocrinology clinic in Khorshid Hospital, Isfahan, Iran, in 2014. After explaining the procedure and obtaining informed consent, the candidates were randomly divided into the case and control groups. The participants of the case and control groups applied AE ointment or placebo for 6 weeks on their abdominal area. Body mass index, waist and buttock circumference, and abdominal fat thickness were measured in both case and control groups at their first visit and then at the next 2,4, and 6 weeks. We used t-test for comparing parametric variables between groups, paired t-test for changes from baseline to final,and repeated measure ANOVA for changes at different steps.
Sixty female candidates participated in this study (thirty in each group). Ten patients left the study and fi fty participants fi nished the trial. At the end of the study, participants had a significant weight loss (2.96 ± 1.6 kg, P Topical AE ointment can reduce the abdominal fat thickness as well as the waist circumference without causing any side effect.