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H Fakhrazadeh, R Pour-Ebrahim, M Nouri , R Heshmat, E Javadi, I Rahimi, B Larijani,
Volume 3, Issue 0 (Vol 5,Sup. 1, MONICA project 2004)
Abstract

Introduction: Urbanization, establishment of sedentary life style and unhealthy diet in association with environmental stress has led the cardiovascular risk factors to prevail in the metropolitan city of Tehran. Survey of lifestyle related cardiovascular risk factors is one of the priorities of Tehran university population laboratory in the 17th zone of Tehran.
Methods:1573 inhabitants of 17th zone of Tehran were recruited by one stage cluster random sampling according to the model of WHO MONICA project.
Results: 58.6% of men and 64% of women had BMI ≥ 25 kg/m2. 41.7% of men and 37.6% of women had hypertension. 8.9% of men and 12.2% of women had diabetes. 34.4% of men and 44.6% of women had total cholesterol ≥ 200 mg/dl. 34.1% of men and 32.6% of women had triglyceride ≥ 200 mg/dl. 34.7% of men and 4.2% of women were regular smokers. 21% of participants had positive family history of cardiovascular disorders.
Conclusion: The prevalence of hypertension in this region is high, that of dyslipidemia relatively lower than the other studies performed in Iran. The prevalence of Diabetes and overweight /obesity is high and comparable to other Iranian studies. It seems that the population of this zone is at high risk for stroke and then coronary heart disease. This fact must be considered in the future interventional programs to control cardiovascular risk factors in the region.
Maryam Razaghi-Azar, Nazanin Noori, Kamran Afsharian,
Volume 4, Issue 3 (17 2005)
Abstract

Background: The importance of feed controlling has been proved in metabolic control of diabetic patients. An appropriate metabolic control prevents later complications. Patients with diabetes mellitus are deprived from eating sweat foods. Considering the effect of different carbohydrates on blood sugar, physicians and patients confront a lot of questions about eating these foods. The aim of this study was to compare the effect of sugar cube and Date consumption on blood sugar in patients with type 1 diabetes.
Methods: As a clinical-trial, we selected 20 patients with type I diabetes mellitus sequentially. They were divided into two groups with 10 subjects in each group. The patient’s blood sugar was measured in 2 days with one week interval, before and after eating a Date (10gr) and a sugar cube (5gr). We measured blood sugar at 30, 60, 90 and 120 minutes after consumption. Data analysis was performed by SPSS software version 11, and the results were compared by paired t test.
Results: There was no significant difference between the blood sugar after eating Date and sugar cube. We also compared the surface under the curve of blood sugar after eating date and sugar cube in 2 hours, which was 1619.4 ± 614 mg.min/dL and 1572 ± 967 mg.min/dL for sugar cube and Date respectively, which the difference was not significant.
Conclusion: Rising in blood sugar after Date consumption has not significant difference in comparison with sugar cube consumption in patients with type I diabetes. So, eating Date in diabetic patients is not preferable to eating sugar cube.
Ali Jafarian, Fatemeh Shidfa, Alireza Parsapour, Hasan Emami Razavi,
Volume 5, Issue 0 (Vol5,Medical Ethics and History of Medicine 2005)
Abstract

Background: Kidney transplantation is one of the major progresses of medical science with many ethical debates. The shortage of organs and the increases in waiting list for cadaver transplantation has leaded to transplantation from living donors. In this article, we discuss the ethics of transplantation from living kidney donors.
Methods: For compiling this article, we searched in Pubmed and Ovid by the keywords of kidney transplantation, living donor, ethics.
Results: At the first, the history and statistics of kidney transplantation in Iran and other countries are reviewed. We discussed the living kidney transplantation regarding to principles of nonmaleficence, autonomy and justice. The ethical issues of different groups of living donors and the proponents and opponents opinions are expressed. Because of the importance of unrelated living donors, this group is discussed more briefly.
Conclusion: It is realistic to consider the living kidney transplantation as the last option. Arranging a legal and social organization to control the monetary relationship of the recipients and donors and to determine the preferences of kidney receipt in waiting list is reasonable. It is essential to increase the cadaver transplantation resources to decrease the need of kidney transplantation from living donors.
Ali Jafarian, Saeedeh Sadeghi, Alireza Parsapour, Hasan Emami Razavi,
Volume 5, Issue 0 (Vol5,Medical Ethics and History of Medicine 2005)
Abstract

Background: Nowadays, many progresses have been occurred in medical science and transplantation process. Transplantation is now a life- saving standard treatment for some end stage diseases. Although the organs from brain death donors, are the best resource for cadaverous transplantation, there are many controversies among physicians about it's definition. The other important issue in transplantation is disparity between the supply and demand of organs. Because of the increasing demand for cadaverous organs it is necessary to use some new methods to fascilitate the availability of these resources. What is noteworthy is that each of these methods has some essential ethical issues that should be observed. Surely regarding these issues would prevent the future harms to human being and society.
Methods: For compiling the article, we searched in pubmed and ovid databases for keywords of cadaverous transplantation, brain death, medical ethics, informed consent.
Results: In this article, after a review of transplantation statistics in Iran and other countries we presented a definition for brain death and some methods to expand donor pools. Then ethical views in brain death and informed consent process for cadaverous organs transplantation was discussed.
Conclusion: In using cadaverous organs for transplantation, informed consent and respect to autonomy are very important. All people in the society are authorized to accept or refuse organ donation after their death and , physicians can only encourage and support them.
Bagher Larijani, Farzaneh Zahedi, Seyed Hassan Emami Razavi,
Volume 6, Issue 2 (18 2006)
Abstract

Medical ethics has a long history worldwide, and the move towards a trans-cultural ethics must be based on an appreciation of the civilizations’ history. It is often thought that medical ethics history has begun by Hippocrates, however it is much older. It is clear that various cultures such as Babylonia, ancient Egypt, Greece, and the Persians have attempted to regulate medicine and to protect patients' rights in the known ancient world. One of the earliest written provisions in this field, which comes back to about 1750 BC, is the code of Hammurabi written by Babylonian. In this paper we aimed to explore the roots of medical ethics in Persian history, particularly, after adherence of Iranians to Islam. In this article, we used related books of great Iranian and non-Iranian historians, and examined some authentic articles collected through searches of databases such as Medline and Ovid and search engines such as Google Scholar. History of medicine in Iran has begun about fourth century BCE. Great Iranian physicians had paid special attention to ethics in their practices, teachings and manuscripts. There was a gap between the ancient civilizations and the Renaissance era in Europe, commonly called the dark ages (Medieval). The immense strides have been made by the Persians in that long interval which is briefly reviewed.
Nima Baziar, Kurosh Djafarian, Zhaleh Shadman, Mostafa Qorbani, Mohsen Khoshniat Nikoo, Farideh Razi,
Volume 13, Issue 5 (7-2014)
Abstract

Background: Vitamin D deficiency is associated with impaired insulin secretion, glucose intolerance and type 2 diabetes. This study was conducted to investigate the effects of supplementation with 50,000 IU vitamin D on improving serum vitamin D levels and insulin resistance in vitamin D insufficient or deficient type 2 diabetic patients. Methods: In this double blind randomized clinical trial, 81 type 2 diabetic patients with vitamin D levels between 10-30 ng/ml were randomly assigned to intervention (50,000 IU vitamin D3 once a week) and control (placebo once a week) groups according to gender. The study duration was 8 weeks. At the beginning and the end of study, blood samples were collected after 12 hours overnight fasting and fasting serum glucose, insulin and 25-hydroxyvitamin D were measured. Insulin resistance was obtained by HOMA-IR calculation. Results: After 8 weeks supplementation with vitamin D, 25-hydroxyvitamin D level was significantly increased and reached to normal levels in the intervention group. Fasting serum glucose and insulin concentrations and HOMA-IR were significantly decreased in the vitamin D group, but there were no significant changes in the placebo group. Conclusion: Supplementation with 50,000 IU vitamin D for 8 weeks compared to placebo can improve inadequate levels of vitamin D and glycemic indicators in vitamin D insufficient or deficient type 2 diabetic patients.
Fatemah Kharazmi, Nepton Soltani, Mansoor Keshavarz,
Volume 14, Issue 5 (7-2015)
Abstract

Background: Some studies showed that magnesium can prevent diabetes complications. The present study was designed to determine the role of calcium channels and adenosine receptors in Mg2+-induced relaxation in streptozotocin (STZ) induced diabetic rats' vessels.

Methods: Diabetes was induced by ip injection of 60 mg/kg STZ. Eight weeks after diabetes induction, superior mesenteric arteries were isolated and perfused according to the McGregor method. Prepared vascular beds were constricted with phenylephrine to induce 70–75% of maximal constriction. Mg2+ at concentrations of 10–4 to 10–1 M was added into the medium and perfusion pressure was recorded in intact and denuded endothelium. Glutamic acide (1 mM) and theophylline (1 mM), were added into medium 20 min before phenylephrine administration with intact and denuded endothelium.

Results: Mg could decrease perfusion pressure. Mg-induced vasorelaxation was not suppressed in the presence of glutamic acid, but in the presence of theophylline vasorelaxation induced was totally suppressed.

Conclusion: From the results of this study it may be concluded that Mg2+-induced relaxation is not mediated by calcium channel, but adenosine receptors play a role in Mg2+-induced vasorelaxation.


Tahereh Keramati, Farideh Razi, Mohammad Reza Mobinizadeh, Alireza Oliaei Manesh, Bagher Larijani,
Volume 15, Issue 1 (1-2016)
Abstract

Background: Diabetic patients need to be followed for glycemic index regularly and HbA1c test is one of the most important biochemical markers for patient monitoring.  HbA1c should be standardized based on international standards, but using internationally accepted assays are expensive. This study aimed to evaluate cost effectiveness of different assays which are currently used in Iran.

Methods: In this economic evaluation study, five HbA1c assays (Pars Azmoon, NycoCard, DS5, Biosystems and CERA STAT 2000) have been evaluated for cost, sensitivity and specificity, true score and also incremental cost-effectiveness ratios. Tosoh G8 has been considered as reference method.

Results: Although none of the assays can be a good alternative for reference method, DS5 and pars azmoon had better cost effectiveness results compared to other assays.

Conclusion: The quality of HbA1c assays need to be improved by using real tariff or the establishment of referral labs.


Farid Bahrpeyma, Mehdi Ebrahimi, Razieh Javadian Kotenaei,
Volume 15, Issue 2 (1-2016)
Abstract

Background: One of the most common complications of Diabetic Polyneuropathy (DPN) is decreased balance and Postural Control disorder. Balance has an important role in static and dynamic activities as a base of activities of daily living. The objective of this study was the evaluation and comparison of dynamic and functional balance in patients with DPN and healthy subjects.

Methods: In this study, dynamic and functional balance of 11diabetic patients with DPN (detected by Michigan questionnaire) and 11 healthy subjects were evaluated by Biodex Balance System (BBS) and Tandem Stance (TS) test in open and closed eyes conditions. The participants were matched by age and BMI. An independent t-test was used to compare balance parameters between patient and normal group. Furthermore, the correlation between dynamic balance parameters of BBS and TS tests were calculated using the Pearson’s Correlation Coefficient.

Results: The results of BBS in patients with diabetic peripheral neuropathy were significantly higher than normal subjects (P<0.05). The mean of time of TS test in diabetic group was significantly lower than healthy subjects (P<0.05). Also there was a significant (P=0.004) negative (r = 0.794) correlation between Medio-Lateral stability index (recorded from BBS) and TS with open eye, in diabetes group.

Conclusion: Older adults with DPN have an impaired functional balance in comparison with matched control subjects and this may expose the patients to danger of falling during daily activities.


Kourosh Sayehmiri, Abbass Sheykhi, Forghan Rabiei Fakhr , Alireza Yadegarazadi, Milad Azami,
Volume 15, Issue 4 (5-2016)
Abstract

Background: Patients with type 2 diabetes mellitus are more prone to depression. Prevalence of depression in the Iranian results of studies is different. Therefore, the present study aims to study the prevalence of depression in Iranian patients with type II diabetes mellitus.

Methods: This study is a systematic review based on PRISMA guideline for systematic reviews and meta-analyses study. Literature searches of, Scopus, MEDLINE, PubMed, Science Direct, Cochrane, EMBASE, Web of Science, Springer, Online Library Wiley, Google Scholar search engine and Iranians database for publications in Persian and English were conducted up to December 2015. Searches were performed by two researchers independently using standard keywords. Reviewers extracted data and assessed methodological quality in duplicate.  Meta-analysis was performed using STATA, version 11.1 to combine data through Random Effects Model.

Results: Sixteen studies and 3,284 subjects with a mean age of 48.6 years were included in the analysis.  The prevalence of depression in Iranian patients with type II diabetes was estimated 54.8% (95% CI: 43.5- 66.1). This range for males and females were calculated 32.2 %( 95% CI: 16.3-48.1) and 60% (95% CI: 46.4-73.7), respectively. The highest prevalence of depression was in the center of Iran (60%) and the lowest rate was in the west of Iran (38%).

Conclusion: Regarding to high prevalence of depression in patients with type II diabetes, Implementation of screening program for psychiatric disorders, especially depression as well as conducted psychiatric consultation routinely for diagnosis and treatment of depression in these patients it seems necessary.


Maryam Mortezaee, Abbasali Raz, Shole Mansouri, Zohreh Annabestani, Zahra Mirzaeezadeh, Bagher Larijani, Mehrdad Hashemi, Kobra Omidfar,
Volume 15, Issue 5 (7-2016)
Abstract

Background: Insulin resistance and progressive β-cells failure are the key factors in type 2 diabetes mellitus (T2DM) pathogenesis. Many studies support a primary role of RBP4 in insulin resistance and suggest that genetic variations which alter the expression level of RBP4 might influence the risk of T2DM and its complications. Diabetic foot is one of the main complications of diabetes leading to disability and hospitalization. In addition, it reduces quality of life and imposes great cost to patients. The purpose of this study was to evaluate the correlation between two single nucleotide polymorphisms (rs10882273 and rs10882283) of RBP4 genes with diabetic foot ulcer in order to identify a biomarker for prediction of diabetic foot ulcer.

Methods: This is a case-control study. Two single nucleotide polymorphisms of RBP4 genes were genotyped by hit Tetra ARMS PCR technique. In this study, 100 and 133 diabetic patients with and without foot ulcer were selected as the cases and controls, respectively.

Results: The Chi-square test revealed no significant difference in frequency of TT, CC and TC alleles of rsl0882273 between case and control groups (P=0.414). Also, Comparison of AA, CC and AC alleles of rsl0882283 in both groups did not show significant difference (P=0.85).
Conclusion: According to this study, there is no relationship between two single nucleotide polymorphisms of RBP4 genes (rs10882273 and rs10882283) with diabetic foot ulcer in type2 diabetes patients.

Sharare Hassanzade, Abbasali Raz, Masoumeh Mansouri, Zahra Mirzaeezadeh, Bagher Larijani, Mehrdad Hashemi, Kobra Omidfar,
Volume 16, Issue 1 (1-2017)
Abstract

Background: Type 2 diabetes is a metabolic disorder characterized by high blood sugar levels that can damage nerves. Many organs are affected ،especially the foot that leading to loss of sensation. These factors make favorable conditions for the development of diabetic foot ulcers. Polymorphisms (Thr399Ile) of Toll Like Receptor4 (TLR4) gene due to malfunction of TLR4 protein which plays an important role in immunity. The purpose of this study was to determine the parameters which are affecting the imbalance resulting in chronic inflammation and wound healing. By showing the relationship between single nucleotide polymorphism (Thr399Ile) of TLR4 gene with diabetic foot ulcer we can identify a biomarker for prediction of diabetic foot ulcer.
Methods: This is a case-control study. Single nucleotide polymorphisms of TLR4 gene were genotyped by hit Tetra ARMS PCR technique. In this study, 100 and 120 diabetic patients with and without foot ulcer were selected as the cases and controls, respectively.
Results: The Chi-square test revealed significant difference in frequency of TT, CC and TC alleles of (Thr399Ile) between case and control groups (P=0.021).
Conclusion: According to this study, there is a relationship between single nucleotide polymorphisms (Thr399Ile) of TLR4 gene with diabetic foot ulcer in type 2 diabetes patients
Nasimeh Sadat Razavi, Fereshteh Majlessi, Bahram Mohebbi, Azar Tol, Kamal Azam,
Volume 16, Issue 3 (3-2017)
Abstract

Background: Patient’s adherence to treatment regimen can predict treatment plan and decrease intensity and symptoms of sickness. This study aimed at determining the effect of educational intervention based on AIM (Ability, Information, Motivation) model on improving adherence of patients with type 2 diabetes.
Methods: This semi experimental interventional study was performed on 180 patients with type 2 diabetes as intervention and control groups. The patients selected using simple random sampling. Study instrument was a questionnaire including demographics (14 items) and AIM model questionnaire (10 items about information, 9items about motivation, 6 items for ability). After baseline, educational intervention was performed in intervention group and post test conducted after six months for both groups. Collected data was analyzed with SPSS software version 23using Mann–Whitney U, Wilcoxon and chi-squared tests. The significant level was considered less than 0.05.
Results: There was no significant difference in demographics and AIM model constructs between two groups (p>0.05). After educational intervention, intervention group revealed a significant difference with control group in terms of information (P<0.001), motivation (P<0.001), ability (P<0.001) and level of HbA1C (P<0.001).
Conclusion: study results revealed AIM model based educational intervention has an important role on treatment adherence among type2 diabetic patients.  With increasing patient information and belief regarding disease patient’s motivation will be improved.
 


Marzieh Arshadi Mashkani, Mahsa Mohammad Amoli, Iman Salahshorifar, Farideh Razi,
Volume 16, Issue 3 (3-2017)
Abstract

Background: Diabetes is the most common endocrine disorder that affects many people every year. Diabetic nephropathy is main complication of diabetes type 2. Renoprotective effects of vitamin “D” in chronic kidney disease have been reported that including diabetic nephropathy. The purpose of this study is to investigate the association between polymorphism (rs731236 (Taq1)) at gene receptor vitamin D (VDR), and the risk of diabetic nephropathy in patients with type 2 diabetes.
Methods In this case-control study, 104 patients with type 2 diabetes and nephropathy, 100 patients with type 2 diabetes and no nephropathy, and 98 people without diabetes and nephropathy who referred to the Diabetes Clinic of Tehran University of Medical Sciences were included .  Clinical data were obtained and biochemical parameters were measured. The DNA samples were extracted from blood samples by phenol chloroform method. TheTaqI polymorphism (rs731236) was studied by TaqMan specific genotypes.
Results: Urea, creatinine and urine albumin values were significantly higher and glomerular filtration rate was lower in nephropathy group. Although frequency of TT genotype and also T allele was higher in nephropathy group, the difference was not significant.
Conclusion: There was no association between Taq1 polymorphism and diabetic nephropathy in the studied population
 
Saeedeh Asgarbeik, Mahsa Mohammad Amoli, Seyed Abdolhamid Angaji, Farideh Razi, Ensieh Nasli Esfahani,
Volume 16, Issue 3 (3-2017)
Abstract

Background: Diabetic Nephropathy is one of the main microvascular complications of diabetic mellitus. Methylenetetrahydrofolate Reductase (MTHFR) is one of the candidate genes of diabetic nephropathy. MTHFR (C677T) polymorphism reduces catalytic activity of MTHFR and leads to increase level of plasma homocysteine. The aim of this study was to evaluate the association of C677T polymorphism with diabetic nephropathy.
Methods: In this case control study, 300 individuals, including type 2 diabetes mellitus with diabetic nephropathy (N=104), diabetes mellitus patients without diabetic nephropathy (N=100) and controls (N=96) participated. The MTHFR genotype was determined using PCR-RFLP technique and biochemical parameters were measured.
Results: Genotype frequencies were significantly different between patients with diabetic nephropathy and diabetes mellitus without nephropathy (TT+CT vs CC; P=0.02,OR:0.5,CI:0.3-0.9).The allele frequency was also significantly different between diabetic nephropathy and diabetics mellitus without nephropathy(P=0.013,OR:1.754,CI:1.123-2.740).
Conclusion: These findings suggest that there is an association between C677T polymorphism and nephropathy in patients with type 2 diabetes. Allele C increase the risk of nephropathy, and T allele has a protective role in susceptibility to disease.
Ali Jalili, Bagher Larijani, Farideh Razi, Ensieh Nasli, Mostafa Qorbani,
Volume 16, Issue 6 (10-2017)
Abstract

Background: Diabetic nephropathy is a chronic kidney disease and of more common complications of type 2 diabetes mellitus. The current diagnostic markers of diabetic nephropathy, albumin and creatinine, are only able to catch the disease in the stage of renal damage. The aim of this study is evaluation of targeted metabolomics of serum amino acids to identify the association of the changes of serum amino acid profile with diabetes and diabetic nephropathy.
Methods: This cross-sectional study was conducted in 2015-2016 on thirty patients with type 2 diabetes subsequent diabetic nephropathy and thirty type 2 diabetic patients without nephropathy attending diabetes clinic of endocrinology and metabolism institute and thirty non diabetic persons. Blood hemoglobin, HbA1c and BUN and also, serum albumin, uric acid and the albumin/creatinine ratio from a random urine specimen were measured by standard methods and serum amino acids level were identified using high performance liquid chromatography (HPLC). Statistical analysis ANOVA, Kruskal-Wallis, and nominal regression were used for the comparison of the investigated groups.  
Results: significant differences were seen in serum levels of 8 essential, branched-chains, aromatic and 8 non-essential amino acids alanine, aspartic acid, serine, glutamine, arginine, glycine, tyrosine and ornithine between three groups. Serum levels of arginine and isoleucine were higher in the diabetic group than non-diabetics. However, Levels of amino acids serine, glutamine, glycine, threonine, tyrosine, tryptophan, methionine, valine, ornithine, and lysine in 2 groups of diabetic nephropathy and diabetes were higher than non-diabetic patients.
For every standard deviation decrease in serum levels of amino acids serine, alanine and isoleucine, in comparison to diabetic patients, the risk of diabetic nephropathy were increased 3.257 (95%CI: 0.10- 0.94, P=0.039), 2.207 (95%CI: 0.18- 0.81, P=0.039) and 2.652 (0.21- 0.96, P=0.012), respectively.
Conclusion: Since this study was conducted in patients in the early stages of the disease, reduced serum levels of the amino acids serine, leucine and alanine may be associated with development and progression of diabetic nephropathy. and in the future with more studies in this field can be used in metabolic control and improvement of the prognosis of patients with diabetic nephropathy.
Sahar Shafiee, Abbasali Raz, Neda Adibi, Masoomeh Mansouri, Zohreh Annabestani, Zahra Mirzaeezadeh, Mehrdad Hashemi, Kobra Omidfar,
Volume 17, Issue 1 (3-2018)
Abstract

Background: Type 2 diabetes is the most common type of diabetes, and a complex endocrine metabolic disorder that one of its main complications is diabetic foot ulcers. Matrix metalloproteinases (MMPs) are one of the key enzymes in the reconstruction of extracellular matrix which have proteolytic activity. The aim of this research is based on evaluating relationship between -1562 C>T allele at MMP-9 gene promoter with diabetic foot ulcer in type II diabetic patients. If such correlation proves, it can be used as a prognostic biomarker in patients with high-risk.
 Methods: This is a case-control study. The single nucleotide polymorphism of -1562C>T allele of MMP9 gene promoter was genotyped by hit Tetra ARMS PCR technique in 100 diabetic patients with foot ulcer grade 1 or 2 as the case group according Wagner classification and in 100 diabetic patients without foot ulcer as the control group. Results: The Chi-square test revealed significant difference in genotype frequency of CC, CT and TT alleles of -1562C>T allele of MMP9 gene promoter between case and control groups (P=0.000).
Conclusion: According to this study, there is a relationship between -1562C>T allele of MMP9 gene promoter with diabetic foot ulcer in type2 diabetes patients. Thus we can introduce this biomarker for evaluation of risk and prognosis of diabetic foot ulcers.
 


Sima Zahedi, Ali Darvishpoor Kakhaki, Meimanat Hosseini, Zahra Razzaghi,
Volume 17, Issue 4 (5-2018)
Abstract

Background: Hemodialysis is the most common treatment in patients with end stage of renal disease (ESRD). Patients undergoing hemodialysis due to multiple drug treatments, special food programs and being able to cope with their illness need to self-care activities. Due to lack of information about the role of health literacy in effectiveness of self-care in these patients, this research aimed to determine the correlation between self-care and health literacy in patients undergoing hemodialysis in Valiasr Hospital of Arak in 2015.
Methods:  In this descriptive correlational study, 93 undergoing hemodialysis patients selected by objective sampling method. Data collecting instruments were "demographic questionnaire", "self-care questionnaire " and "Health Literacy for Iranian Adults questionnaire". The content and face validity of questionnaires was assessed. Reliability assessed through internal consistency (Cronbach's alpha) and Intra- Class Correlation Coefficient. Data were analyzed by SPSS, version 21, using, Kolmogorov–Smirnov test, Descriptive Statistics and Kolmogorov–Smirnov test. 
Results: The results showed that 79/6% of patients were male and 20/4% were female with an average age of 54/18 ± 13/9 year. The mean score of self-care and health literacy were 146/90± 45/46, 88/14± 36/42 and were at a moderate level. The lowest score of self-care and health education related to the field of fluid intake and decision-making and behavior. There was a significant positive correlation between self-care and health literacy (p<0/0001, r= 0/6).
Conclusion: The existence of a significant positive correlation between self-care and health literacy showed that the hospital managers and the nurses must pay more attention to what patients undergoing hemodialysis need. Considering the importance of health literacy in the care of patients undergoing hemodialysis, it seems necessary to nursing administrators and Politicians use educational programs tailored to the patient's health literacy level in order to promote their health and quality of life.
 
Negin Chehrazi, Minoo Bassami, Sajad Ahmadizad,
Volume 17, Issue 5 (7-2018)
Abstract

Background: Prevalence of obesity and overweight in women increases the possibility of metabolic syndrome and diabetes. Based on the variety of the effects of different type of exercise and the differences in the upper and lower body muscle volume involved in the exercise, the effects of high intensity interval exercise with arm and leg ergometer on metabolism and insulin resistance might be different. The aim of this study was to compare the effect of upper and lower body interval exercise on carbohydrate metabolism and insulin resistance in obese women.
Methods: Twelve obese and overweight women (body mass index, 31.1±5.5 kg/m2) performed two interval exercise trials of 30-min on arm and leg ergometer with one week intervening. Interval exercise included 5 sets of 6 min in which 2- min activity at 85% VO2max and 4 min active rest at 45% VO2max was performed. Two blood samples were taken before and immediately after exercise for measuring glucose and insulin. VO2 and VCO2m were collected during exercise and used to calculate the amount of carbohydrate oxidation.
Result: Although interval exercise reduced the insulin concentration, responses of insulin to upper and lower body exercises were not significantly different (P>0.05). Glucose level reduced following interval exercise, and this reduction was significantly (P<0.05) higher following lower body interval exercise than upper body exercise. Similarly the reductions in HOMA-IR were significantly (P<0.05) higher following lower body interval exercise than upper body exercise. Interval exercise resulted in increases in oxidation of carbohydrate, though; responses to upper and lower exercises were not significantly different.
Conclusion: It could be concluded that interval exercise in obese women leads to changes in carbohydrate metabolism and insulin resistance, and that the changes in insulin resistance are related to type of exercise (upper and lower body), though carbohydrate oxidation is not.
 
Samira Behboudi-Gandevani, Mojgan Modoodi, Razieh Bidhendi Yarandi, Mina Amiri, Amir Abbas Momenan, Fereidoun Azizi, Fahimeh Ramezani Tehrani,
Volume 19, Issue 1 (1-2020)
Abstract

Background: Although a positive association between type 2 diabetes and breast cancer has been reported, an association with gestational diabetes mellitus (GDM) is less clear. This study aimed to assess the relationship between the history of GDM and the incidence of BC a long term population based study.
Methods: To conduct this research, 4076 women aged 20-50 years who participated in the first phase of Tehran-Lipid-and-Glucose-Study, who had at-least one pregnancy were included. Each participants were asked about the history of GDM every 3 years. They was evaluated about the occurrence of breast cancer (BC). Cox-survival analysis was used to measure the Hazard-ratio (HR) for both groups with and without history of GDM
Results: The study population included 886 women with prior GDM and 3,909 women without history of GDM. The median duration of follow-up among women with and without the history of GDM were 12.12 and 11.62 years, respectively. The incidence of BC was 0.64 per 1,000 year-olds with confidence=interval of 95% (0.44-0.91). Among them, 4 cases were reported in women with GDM and 26 cases in women without GDM. (Incidence of 0.36 per 1000 person-years with confidence=interval 95% (0.11-0.99) in women with prior GDM and 0.73 per 1,000 person-years with confidence=interval 95% (0.49-1.1) in women without a history of GDM.
Conclusion: Our study showed that the history of GDM is not an independent risk factor for breast cancer.

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