People awareness about diabetes disease and its complications among aged 18 years and older in Bushehr port inhabitants (Iran)

Introduction: One of the most prevalent metabolic disease is diabetes and it can lead to enormous medical as well as socio-economic consequences. The Iranian diabetes population is estimated to be around 1.5 million. Studies show that approximately half of the people with type 2 diabetes (T2DM) are undiagnosed and thus unaware that they have the disease. This lack of awareness can lead to presentation with complications and its consequences. The aim of this survey was to determine the level of population awareness in Bushehr port, based on the available education programs. Material and methods: The cross-sectional study was assessed upon 719 subjects aged over 18 years old, without diabetes and inhabitant in Bushehr port in 2005. Multistage random simple sampling was used in this study. A questionnaire was prepared with validity checked by researchers in Yazd Diabetes Research Center and reliability alpha-cronbach = 75%. The questionnaire was included 39 questions: demographics indices, fundamentals about diabetes, its presenting signs and symptoms, the early and late complications, means of management as well as looked into the source of the information. The data was analyzed with independent t-test, Pearson’s correlation coefficient, ANOVA and multiple-regression models by SPSS package ver. 10.05. Results: In this study, 719 subjects (417 male and 302 female) that mean age was 40.13 � 11.48 years (40.8 � 12.93 for male and 39.19 � 9.03 for female) were assessed. The male awareness rate was more than of female (P = 0.001). There was indirect relation between subjects’ awareness and their age (r = �0.203, P = 0.001). There was direct relation between awareness and the level of education of subjects (P = 0.01, r = 0.07). The mean of awareness scores of subjects was not same between singles and married (P = 0.042). Studies population awareness about fundamental diabetes disease, primary symptoms, early complications, delay complications, diet awareness was low and about controlling methods of diabetes was high. Conclusion: The results indicate that most subjects’ awareness about fundamental and complications of diabetes disease were low, so the people need more education about diabetes

Automated deep learning-based segmentation of COVID-19 lesions from chest computed tomography images

Purpose: The novel coronavirus COVID-19, which spread globally in late December 2019, is a global health crisis. Chest computed tomography (CT) has played a pivotal role in providing useful information for clinicians to detect COVID-19. However, segmenting COVID-19-infected regions from chest CT results is challenging. Therefore, it is desirable to develop an efficient tool for automated segmentation of COVID-19 lesions using chest CT. Hence, we aimed to propose 2D deep-learning algorithms to automatically segment COVID-19-infected regions from chest CT slices and evaluate their performance. Material and methods: Herein, 3 known deep learning networks: U-Net, U-Net++, and Res-Unet, were trained from scratch for automated segmenting of COVID-19 lesions using chest CT images. The dataset consists of 20 labelled COVID-19 chest CT volumes. A total of 2112 images were used. The dataset was split into 80% for training and validation and 20% for testing the proposed models. Segmentation performance was assessed using Dice similarity coefficient, average symmetric surface distance (ASSD), mean absolute error (MAE), sensitivity, specificity, and precision. Results: All proposed models achieved good performance for COVID-19 lesion segmentation. Compared with Res-Unet, the U-Net and U-Net++ models provided better results, with a mean Dice value of 85.0%. Compared with all models, U-Net gained the highest segmentation performance, with 86.0% sensitivity and 2.22 mm ASSD. The U-Net model obtained 1%, 2%, and 0.66 mm improvement over the Res-Unet model in the Dice, sensitivity, and ASSD, respectively. Compared with Res-Unet, U-Net++ achieved 1%, 2%, 0.1 mm, and 0.23 mm improvement in the Dice, sensitivity, ASSD, and MAE, respectively. Conclusions: Our data indicated that the proposed models achieve an average Dice value greater than 84.0%. Two-dimensional deep learning models were able to accurately segment COVID-19 lesions from chest CT images, assisting the radiologists in faster screening and quantification of the lesion regions for further treatment. Nevertheless, further studies will be required to evaluate the clinical performance and robustness of the proposed models for COVID-19 semantic segmentation

Bezpieczeństwo i skuteczność dwufazowej insuliny aspart 30 (BIAsp30) u Irańczyków chorych na cukrzycę typu 2: otwarte, nierandomizowane, wieloośrodkowe badanie - irańska podgrupa badania IMPROVE™

Introduction: To evaluate the clinical profile of BIAsp 30 (30% soluble insulin aspart, 70% protamine-crystallized insulin aspart) (NovoMix®30) in type 2 diabetes patients in routine clinical practice in Iran. Material and methods: IMPROVE&#8482; was a 26-week, multinational, open-label, non-randomized study in patients with type 2 diabetes. The safety and efficacy of BIAsp 30 were assessed at baseline and at 13 and 26 weeks. The titration of BIAsp30 was at the physician&#8217;s discretion. Results: In Iran, 478 patients (47% male) previously treated with oral antidiabetic drugs (OADs) (N = 159, 33.3%) and/or insulin other than BIAsp30 (N = 317, 66.3%) or a few who were treatment-na&#239;ve (N = 2, 0.4%) participated in the study. After 26 weeks of treatment with BIAsp 30, the rate of reported major hypoglycaemic episodes was reduced by 88.1% from baseline (baseline v. Week 26: 0.303 v. 0.037 episodes/pt-year; p < 0.001). No significant differences in minor hypoglycaemic episodes between baseline and Week 26 were found. Glycaemic control was significantly improved from baseline to Week 26 with a mean HbA1c reduction of 1.2 &#177; 1.9%. Patients&#8217; quality of life as measured by the DiabMedSat questionnaire significantly improved from baseline (58.1) to the end of the study (75.4, p < 0.001). Conclusions: BIAsp 30 therapy appeared safe and effective and improved quality of life in Iranian patients with type 2 diabetes after 26 weeks of treatment. (Pol J Endocrinol 2010; 61 (4): 364-370)Wstęp: Celem badania była ocena profilu działania insuliny BIAsp 30 (30% rozpuszczalnej insuliny aspart, 70% insuliny krystalizowanej z protaminą) (NovoMix®30) u chorych na cukrzycę typu 2 w warunkach standardowej opieki zdrowotnej w Iranie. Materiał i metody: IMPROVE&#8482; było 26-tygodniowym, wieloośrodkowym, międzynarodowym, otwartym i nierandomizowanym badaniem z udziałem chorych na cukrzycę typu 2. Bezpieczeństwo i skuteczność insulin BIAsp 30 oceniano na początku badania oraz po 13 i 26 tygodniach. Dawkowanie insuliny BIAsp30 było zależne od zaleceń lekarskich. Wyniki: W irańskiej części badania uczestniczyło 478 chorych (47% stanowili mężczyźni) leczonych dotychczas doustnymi lekami hipoglikemizującymi (N = 159, 33,3%) i/lub insuliną inną niż BIAsp30 (N = 317, 66,3%) oraz nieliczna grupa pacjentów niestosujących wcześniej farmakoterapii (N = 2, 0,4%). Po 26 tygodniach leczenia insuliną BIAsp 30, częstość epizodów ciężkiej hipoglikemii zmniejszyła się o 88,1% (wartości wyjściowe v. tydzień 26: 0,303 v. 0,037 epizodów/pacjenta-rok; p < 0,001). Dane dotyczące częstości epizodów lekkiej hipoglikemii na początku badania i po 26 tygodniach leczenia nie różniły się istotnie. Odnotowano natomiast poprawę kontroli glikemii; po 26 tygodniach odsetek HbA1c obniżył się średnio o 1,2 &#177; 1,9% w stosunku do wartości wyjściowej. W okresie od rozpoczęcia do zakończenia badania nastąpiła istotna poprawa jakości życia chorych, oceniana przy użyciu kwestionariusza DiabMedSat; punktacja wynosiła odpowiednio 58,1 i 75,4 (p < 0,001). Wnioski: Terapia insuliną BIAsp 30 stosowana przez 26 tygodni u Irańczyków chorych na cukrzycę typu 2 okazała się bezpieczna i skuteczna, a ponadto spowodowała poprawę jakości życia pacjentów. (Endokrynol Pol 2010; 61 (4): 364-370

Effect of metformin and folic acid on plasma homocysteine level in type 2 diabetic patients

Hyperhomocysteinemia is associated with an increased risk of cardiovascular disease in diabetic patients. The aim of this study was to evaluate effects of metformin and folic acid on plasma homocysteine level in diabetic patients. In this clinical trial 47 new cases of type 2 diabetes were randomized to two groups. We treated patients in trial group with metformin and 1 mg folic acid, whereas patients in control group treated with metformin and placebo for 16 weeks. There was no significant difference in plasma homocysteine level and glycosylated hemoglobin (HbA1c) between two groups at the start of study. After 16 weeks plasma homocysteine level in the trial group did not change. In contrast plasma homocysteine level increased in the placebo group. There was significant difference in mean plasma homocysteine level between two groups (P-value &lt; 0.01). This difference was highly significant in males (P-value &lt; 0.0001). Correlation between glycosylated hemoglobin and plasma homocysteine level at start and end of study was not significant. This finding indicated that metformin increases plasma homocysteine level in diabetic patients especially males, whereas administration of folic acid with metformin can prevent this process

The effects of vitamin D supplementation on adiponectin level and insulin resistance in first-degree relatives of subjects with type 2 diabetes: a randomized double-blinded controlled trial

Background: Despite the certain role of both vitamin D and adiponectin in the regulation of insulin sensitivity, the interaction between these two agents has remained uncertain. Objective: The present study aimed to determine whether vitamin D is able to change plasma adiponectin and affect glucose homeostasis and insulin sensitivity in first-degree relatives of subjects with type 2 diabetes. Methods: This randomized clinical trial was conducted at Clinic of Shahid Sadoughi Hospital in Yazd, Iran, from January 25, 2012 to December 25, 2014. In this randomized, double-blinded controlled trial, 64 first-degree relatives of type 2 diabetic patients were assigned randomly to receive either vitamin D supplement (50000 IU vitamin D tablet weekly) plus lifestyle change as the intervention group (n = 32) or placebo plus lifestyle change as the control group (n = 32) for twelve weeks (three months). Results: Fifty-three patients (28 in the intervention group and 25 in the control group) completed the study. Serum levels of vitamin D increased while insulin level and consequently insulin resistance (calculated by HOMA formula) significantly decreased in the case group (p-value <0.001 for all variables). Although the values of these three biomarkers showed a slight increase in control group, the changes were not statistically significant. The levels of the changes in other markers including adiponectin, Fasting Blood Sugar (FBS), triglyceride, and total cholesterol remained insignificant in both study groups after completing interventions compared with before interventions. Conclusion: This study showed that decreased insulin resistance is expected by administrating vitamin D supplement in first-degree relatives of the patients with diabetes mellitus. Trial Registration: The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCT ID: 201105176430N1. Funding: The authors received no financial support for the research or publication of this article

Influence of Physiological Factors on Thyroid Size Determined by Ultrasound

According to its superficial anatomical location, the thyroid gland is easily accessible by sonography. Sonography allows an exact documentation of the size and thyroid volume. The relationship between thyroid volume and anthropometric characteristics is a matter of controversy. The aim of this study was to investigate thyroid volume and its determinants in healthy adult. A cross-sectional study was performed from June2003 until April 2005 in 314 healthy adults aged over 18 years old in Yazd, Iran. Data were collected on age, sex, and weight and thyroid size by sonoraphy. Mean of thyroid volume in male and female was 9.08 ± 2.49 and 7.93 ± 3.2 milliliter which the differences was significant (P<0.003).Differences between thyroid volume and weight was significant (P=0.001). Mean of female weight and proportion of thyroid volume to their weight was 61.83 ± 12.09kg and 0.130 ± 0.33. Mean of male weight and proportion of thyroid volume to their weight was 71.41 ± 9.05kg and 0.126 ± 0.028 (P<0.003). Results of study is similar to other studies .Mean of thyroid volume in Yazd citizens is not differ from other Iranian but is different from other countries. This difference could be related to food intake habit, geographical region and daily oral iodine consumptio

Effect of Oral Supplementation of L-arginine on Sexual Function in Men with Type 2 Diabetes: A Double-blind Clinical Trial

Background: Sexual dysfunction is an important health problem which prevalence in patients with type 2 diabetes (T2D) is higher than other people. The aim of this study was to evaluate the effect of L-arginine oral supplementation on sexual function in men with T2D and mild-to-moderate erectile dysfunction (ED). Methods: Eighty men with T2D, suffering from mild-to-moderate erectile dysfunction participated in this double-blind clinical trial. They were randomly assigned in to two groups; receiving 5 g/day L-arginine (AG) or placebo group (PG) for 4 weeks. Sexual functions were recorded with international index of erectile function questionnaire at the beginning and end of the intervention. Total testosterone concentrations were measured too. Results: The total mean score of sexual function parameters significantly increased only in AG than PG (43.2 &plusmn; 6.2 vs. 39.4 &plusmn; 4.0, P = 0.003). Against PG, the mean of all parameters significantly improved in AG after intervention. Only the mean score of erectile function in AG had a significant increase compared to PG. Mean of other sexual activity scores between the two groups had no significant differences. The mean of testosterone concentration had a significant increase in both groups after the intervention, but the mean of changes was significantly higher in AG than in PG (1.91 &mu;g/L vs. 0.53 &mu;g/L, P = 0.004). Conclusions: The present trial showed that daily consumption of 5 g L-arginine for four weeks in T2D men with mild-to-moderate sexual dysfunction improved various parameters such as erectile function, sexual satisfaction, sexual desire, pleasure from sexual intercourse, and testosterone level

Risk of Postoperative Hypocalcemia in Patients Underwent Total Thyroidectomy, Subtotal Thyroidectomy and Lobectomy Surgeries

The main objective of this study was to identify the incidence of post-thyroidectomy hypocalcemia in patients underwent lobectomy, subtotal thyroidectomy or total thyroidectomy. This randomized trial study was performed from May 2010 to July 2011 among 108 consecutive patients undergoing thyroidectomy. Patients were allocated into 3 groups based on the 3 common type of thyroidectomy. Pre and postoperative serum calcium levels were determined by using standard protocol for all patients. All patients' preoperative serum calcium levels were normal. Post-thyroidectomy hypoglycemia occurred in 0%, 8.3% and 8.3% of patients who underwent total hypocalcemia, subtotal thyroidectomy and lobectomy, respectively, which represents 5.6% of all patients who shown hypocalcemia (P=0.58). Serum calcium levels were fall in 93% patients, however within several days were returned to normal ranges. We did not find a significant relation between the hypocalcemia and thyroidectomy types. We recommended determination other alternative factors as a more effective prediction for postoperative hypocalcemia