فهرست مطالب n. meftah

Diabetic macular edema (DME) is one of the common complications of diabetes which significantly accounts for preventable visual impairment and blindness. Central macular thickness (CMT) is a feature found in DME patients. This study aims to determine the relationship between optical coherence tomography (OCT)-measured CMT and visual acuity (VA) in patients with DME before and after intravitreal injection of bevacizumab.

This cross-sectional study was conducted on 100 patients with diabetic macular edema with involvement of both eyes referred to the Ophthalmology Department of Rouhani Hospital in Babol who underwent intravitreal injection of Bevacizumab. VA (measured by Snellen chart), CMT (measured by OCT), clinical and paraclinical factors (including the duration of diabetes, glycosylated hemoglobin (HbA1c), fasting blood sugar (FBS), hypertension, and smoking history data) were evaluated and compared among all patients just before and 45 days after Bevacizumab injection.

Before the injection of Bevacizumab in 200 eyes, the mean value of VA (letter score) and mean value of CMT (µm) were 36.83±12.73 and 425.48±85.18 µm, respectively (p<0.001, 95% CI=12.5 – 17.5 and 95% CI=-71.5 – -55.5, respectively). 45 days after Bevacizumab injection, the mean value of absolute VA changes was 15.24±10.16, and the mean value of absolute CMT changes was -67.83±43.08 µm (coefficient=-0.18, 95% CI=-0.39 – 0.05).

Although VA was correlated moderately with CMT and the polynomial regression model enhanced the predictive ability, it remains fully obvious that CMT and clinical factors could play an essential role as VA surrogates.

Diabetes is the most common endocrine disorder in the world. Understanding the cutaneous manifestations associated with diabetes can help in choosing the appropriate treatment approach in these patients. The aim of this study was to evaluate the frequency of cutaneous manifestations in diabetic patients referred to the endocrinology clinic of Babol University of Medical Sciences.

The present cross-sectional study was performed on 300 patients with diabetes referred to Rouhani Hospital in Babol in 2019. Age, gender, BMI, type and duration of diabetes, and patients’ diabetes control status (HbA1C) were recorded and patients were thoroughly examined by a dermatologist and divided into two groups of below and above 50 years. In terms of cutaneous manifestations, they were divided into two groups; with cutaneous manifestations and without cutaneous manifestations.

293 patients (97.76%) had type 2 diabetes. The mean age of patients was 55±12 years and the mean duration of diabetes was 9.73±1.20 years. In this study, 130 patients (43%) had cutaneous lesions, of which 76 patients (58.5%) were female. Pruritus, acrochordon, cherry angioma, diabetic dermatopathy, fungal skin infections with frequencies of 25.7%, 21%, 14.3%, 6% and 5.7% were the most common skin disorders, respectively. 68 patients (69.4%) had skin manifestations and had diabetes for more than 10 years. There was a significant difference between the two groups of with and without cutaneous manifestations, gender and duration of diabetes (p<0.001). There was no significant difference between the mean age, BMI and HbA1C in the two groups (p=0.07, p=0.09 and p=0.11, respectively).

The results of the study showed that pruritus and acrochordon are the most common cutaneous manifestations and long-term diabetes and female gender are the most important risk factors for cutaneous manifestations.

Paget’s disease is a progressive skeletal disorder, which involves the gradual destruction of the bones. Regarding the low prevalence of this disease in Iran, this study aimed to present a case of Paget’s disease in an asymptomatic patient. CASE REPORT: A 44-year-old male patient with elevated alkaline phosphatase (ALP) level in yearly examinations was referred to an internal medicine clinic. Considering the normal results of other examinations, high ALP level was found to be of an osseous origin. However, no bone deformity was detected in the patient. Bone scan and simple radiography were indicative of Paget’s disease considering the high osteoblastic activity in the right hip and right sides of T1 and L3 segments. Diagnosis of Paget’s disease was confirmed by bone biopsy. The patient was initiated on oral alendronate (35 mg daily) for six months. Following this period, ALP level reduced, and the treatment is still in progress.

According to the results of this study, although Paget’s disease is a skeletal disorder, it could remain asymptomatic and occur without any deformities.

Gastric cancer is the fourth most common cancer and the second most common cause of cancer deaths worldwide. This study was designed to compare demographic characteristics، clinical symptoms and endoscopy findings in patients diagnosed as gastric ulcer versus gastric cancer.

This cross sectional study was carried out on all patients underwent upper endoscopy in Shahid Beheshti hospital of Babol، Iran during the years 2005-2010. Demographic characteristics، BMI، smoking، opium addiction، H. pylori status، clinical symptoms like: dysphasia، weight loss، nausea and vomiting، dyspepsia، anemia، upper gastrointestinal tract bleeding، and anatomic location of lesion in different parts of the stomach were main variables for comparison.

Of these 961 patients، 601 (62. 5%) were men and 359 (37. 4%) were women. The mean age of the patients with gastric ulcer was 53. 9±17. 1 years old and in patients with gastric cancer was 66. 0±14. 3 years old (p<0. 001). The BMI of the patients with gastric ulcer was 24. 97±4. 58 kg/m2 and in patients with gastric cancer was 23. 21±4. 10 kg/m2 (p<0. 001). The most common symptoms in patients with gastric cancer were epigastric pain (44. 8%)، nausea and vomiting (15. 2%)، dysphagia (8. 7%)، weight loss (8. 8%) and upper gastrointestinal tract bleeding (23. 1%).

Clinical findings are not specific for the diagnosis of patients with cancer. Adoption of procedures for screening people in areas with high prevalence of gastric cancer should be a priority for future research.