فهرست مطالب mojtaba mehrdad

Obstructive sleep apnea (OSA) is the most common sleep‑realted respiratory disorder. It is frequently comorbid with cardiovascular, cerebrovascular, and metabolic diseases and is commonly observed in populations with these comorbidities. Investigators aimed to assess the effect of OSA on glycemic control in patients with diabetes.

In this cross‑sectional study, 266 adult patients with diabetes mellitus (DM) attending the outpatient endocrinology clinic at the Guilan University of Medical Sciences were enrolled. Patients completed a checklist that included demographic characteristics, factors, and laboratory results in addition to Berlin and STOP‑BANG questionnaires to evaluate the risk of OSA. Data were analyzed by independent t‑test, Mann–Whitney U test, and Chi‑squared or Fisher’s exact tests using the Statistical Package for the Social Sciences (SPSS) version 17.

A total of 266 patients with DM were enrolled in this study (34.6% males, mean age 47.00 ± 19.04 years). Based on the Berlin Questionnaire, 38.6% of all participants were at high risk of developing OSA. Based on the STOP‑BANG Questionnaire (SBQ), 45.1% were at moderate and high risks. Additionally, this questionnaire showed a significant difference between low and moderate‑to‑severe groups regarding sex, age, body mass index (BMI), neck size, other chronic diseases, types of DM, use of insulin, Berlin Questionnaire, fasting blood sugar (FBS), and mean HbA1c.

Based on the SBQ, our results indicated a significant relationship between OSA and glycemic control according to mean HbA1c and FBS. Therefore, by controlling the OSA, we may find a way to acheieve better glycemic control in diabetic patients.

Diabetes is a prevalent chronic medical comorbid condition worldwide. Diabetes mellitus is associated with various sleep disorders.

We aimed to determine the prevalence of poor sleep and the main factors of sleep interruptions in patients with diabetes mellitus. We further evaluated the association of sleep interruptions with glycemic control in this cohort.

We conducted a cross-sectional study on 266 patients with type 1 and type 2 diabetes who were recruited from a university outpatient endocrinology clinic. Patients completed a checklist including demographic and disease-related characteristics in addition to the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality. Using the PSQI cutoff score of 5, we created two subgroups of good sleepers (GS) and poor sleepers (PS).

Our results showed that good sleeper and poor sleeper diabetic patients were significantly different regarding sex, employment status, BMI, presence of diabetes-related complications, HbA1c, and 2-hour postprandial blood sugar (2HPPBS) (all significant at P < 0.05). The most prevalent factors of sleep interruptions were “waking up to use a bathroom”, “feeling hot”, “pain”, “having coughs or snores”, and “bad dreams”. Among the subjective factors of sleep interruption, problems with sleep initiation, maintenance, or early morning awakenings in addition to having pain or respiratory problems such as coughing or snoring had the most effects on HbA1c.

Our study showed significant subjective sleep disturbances (both quality and quantity) in patients with diabetes mellitus (both type I and II) and its association with diabetes control. We further identified the main factors that led to sleep interruptions in this cohort.

Thyroid cancer is the most prevalent endocrine malignancy tumor, and its incidence is increasing. Chemotherapy drugs like Paclitaxel (PTX) are a common treatment for cancer; however, they have many adverse effects. Plants are a source of anticancer agents. The present study assessed the cytotoxic effects of hydro-alcoholic extract in comparison with those of paclitaxel on Papillary Thyroid Cancer (PTC) cell line.

PTC cell line was treated by different concentrations of extract and paclitaxel for 24, 48, and 72 h. Cytotoxicity was examined through Trypan blue and clonogenic assays. Acridine Orange/Ethidium Bromide (AO/EB) staining was used for detecting apoptotic cells. The observations were statistically tabulated and analyzed. 

The Trypan blue staining results suggested that hydro-alcoholic extract had a cytotoxic effect on PTC cells. Our results of AO/EB staining revealed that the hydro-alcoholic extract of Hull-Less Seed Pumpkin (HLSP) in the concentration of ≥100 μl/mL induced significant apoptosis in the PTC cultured cell (P<0.05). In addition, the AO/EB staining data suggested an increase in the number of apoptotic cells with increasing the concentration of extract and paclitaxel. The clonogenic assay results indicated a decrease in colonies by increasing the concentration. Comparing the groups treated by paclitaxel or HLSP extract, with the control group revealed significant differences between them (P<0.05).

The HLSP extract had a cytotoxic effect on the human PTC cell line. Based on the adverse effects of chemotherapy drugs, this extract can be considered as a beneficial agent for PTC treatment.

Introduction According to retrospective studies on hospitalized patients, there is a clear association between hyperglycemia (with or without a known history of diabetes) and hypoglycemia with increased mortality and health consequences. These studies also showed that appropriate control of blood sugar and preventing hyper/hypoglycemia is not only associated with reduced mortality rate but also can prevent consequences of the disease. However, there is no unique evidence-based guideline, based on common practices in hospitals, to manage such conditions. Hence, currently, providers mostly use their knowledge or different guidelines without any support for potential problems such as general use of insulin tables with no planned prescription. The present study aimed to firstly review the prevalence of hyperglycemia in hospitalized patients with both critical and non-critical conditions, and secondly to provide practical measures for treating such conditions in order to prevent negative consequences.

It seems that diabetes mellitus (DM) can affect the auditory system due to neuropathy, micro-vascular complications, and hearing cell damage during hyperglycemic states. In the current study, we aimed to compare hearing status in patients with type 2 DM (T2DM) according to their blood-sugar control status.
This cross-sectional study was carried out in 104 patients with T2DM attending the diabetic clinics of Guilan University of Medical Sciences within a period of 1 year (2014–2015). One group consisted of 52 patients with poor control and the other consisted of patients with moderate-to-good control (according to glycated hemoglobin [HbA1c] level). All subjects underwent pure tone audiometry (PTA) and distortion product otoacoustic emission (DPOAEs) assessments. A hearing threshold higher than 20 dB and a signal-to-noise ratio ≤3 in each frequency were considered abnormal.
In PTA, poorly controlled patients showed more frequent hearing loss compared with the well-controlled group, especially at higher frequencies (8 kHz: 67.3% vs 46.2% [P=0.029]; 10 kHz: 46.2% vs 21.2% [P=0.025]). Also, patients in the poorly controlled group had worse cochlear function according to the DPOAE test (4 kHz: 32.7% vs 17.3% [P= 0.002] and 8 kHz: 70.6% vs 40.4% [P=0.006]).
DM and poor control status of diabetes can affect hearing sensation and cause hearing loss, especially at high frequencies. According to our findings, it seems that diabetic patients with a duration of diabetes >10 years, diabetic complications, poor control status or comorbidities should undergo both endocrine and audiologic follow-up to prevent greater sensory neural hearing loss.

Background and The medical educational environment is increasingly becoming the focus of research globally. It is commonly understood that educational environments are an important factor for efficient learning. The present study was done with the aim to evaluation of clinical phase student's perception of learning environment of our teaching hospital and comparing it with the previous study and other similar studies of other medical teaching centers in Iran and other countries.
The Persian version of DREEM questionnaire was submitted to clinical phase medical students consisted of stagers and interns educating in internal medicine and infectious diseases, dermatology and urology wards rotations of Razi teaching hospital.
Among 5 domains,the best scored domain by stagers and interns was “student's perception of teachers” (57.75%) and the least scored domain was “student perception of learning“ (52.43%). The total mean score of our study (110.42±19.44) and the mean scores of all 5 domains in our study were higher than previous study. The increase of score in 1 domain: student perception of learning was statistically significant.
The present study shows that our clinical educational environment has improved as perceived by medical students in comparison to previous study, but we need more effort to improve our clinical educational environment to approach to other excellent education centers around the world.

Infants of diabetic mothers are significantly at higher risk for major congenital malformations, with cardiovascular anomalies that is the most frequent. In this study, we presented a rare case of dextrocardia and situs inversus totalis (mirror-image dextrocardia) with multiple congenital heart anomalies who was born from a diabetic mother.