The effect of strengthening and endurance training on metabolic factors, quality of life and mental health in women with type П diabetes

زمینه و هدف: دیابت شیرین گروهی هتروژن از بیماری های متابولیک است که مشخصه آنها افزایش مزمن قند خون و اختلال متابولیسم کربوهیدارات، چربی و پروتئین می باشد. این تحقیق به منظور تاثیر یک دوره تمرینات قدرتی و استقامتی بر فاکتورهای متابولیک، کیفیت زندگی و سلامت روان زنان مبتلا به دیابت نوع II انجام گردید. روش بررسی: در این تحقیق نیمه تجربی از بین زنان مبتلا به دیابت نوع Π مراجعه کننده به کلینیک شرکت نفت اراک، تعداد 19 نفر به روش در دسترس انتخاب شدند. بیماران به صورت تصادفی در دو گروه قدرتی (9 نفر) و استقامتی (10 نفر) قرار گرفتند و علاوه بر درمان روتین به مدت 8 هفته (3 جلسه در هفته و هر جلسه 50-30 دقیقه) تمرینات را اجرا نمودند. قبل و پس از مداخله فاکتورهای متابولیک (شامل کلسترول تام، تری گلیسیرید، کلسترول HDL و VLDL و LDL، FBS، HbA1C و انسولین سرم)، کیفیت زندگی (SF-36) و سلامت روان (GHQ) بیماران بررسی و داده ها با استفاده از آزمون آماری t همبستگی تجزیه و تحلیل شد. یافته ها: انجام تمرینات قدرتی و استقامتی باعث کاهش FBS، HbA1c، انسولین سرم، و افزایش میانگین کیفیت زندگی در کلیه ابعاد و سلامت روان گردید (05/0P). نتیجه گیری: تمرینات قدرتی و استقامتی به میزان یکسان بر بعضی از فاکتورهای متابولیک، کیفیت زندگی و سلامت روان بیماران دیابتی نوع 2 تأثیر دارد و باعث بهبود آن ها می شود

Oral health related quality of life in patients with diabetes mellitus type 2 in the year 2012

BACKGROUND AND AIM: The aim of this study was investigation of oral and dental side effects of diabetes mellitus (DM) on oral health-related quality of life (OHQoL) in patients with DM type 2. METHODS: In this descriptive, analytic study 121 patients were participated by consecutive method based on the type of diabetes and the age. After the subjects received adequate explanations about the necessity of carrying out such a study, a questionnaire was handed into each patient who gave their consent to take part in the study. Oral lesions consisted of ulcers, erythema, leukoplakia, erythroplakia, candidiasis, angular cheilitis, median rhomboid glossitis, and denture stomatitis based on oral examination. The OHQoL were surveyed by oral health impact profile (OHIP-14) questionnaire. Data were analyzed by Pearson’s correlation test, T-test, and χ2 by SPSS software. RESULTS: A total of 121 patients with diabetes were evaluated in this study [31 males (25.6%) and 90 females (74.4%)]. In this study, there was no significant correlation between OHQoL and decayed, missing, and filled teeth (DMFT), periodontal disease index (PDI). OHQoL was associated with higher ages and higher levels of blood sugar (P = 0.002, P = 0.016). The average of OHIP score significantly was increased by xerostomia experience (P = 0.010). CONCLUSION: In this survey, the influence of oral manifestation on OHQoL was low. Xerostomia was the most important symptom in diabetic patients that causes decreasing OHQoL. Age and blood sugar had more influence on this matter as well. KEYWORDS: Diabetes Mellitus; Oral Manifestation; Oral Health Related Quality of Lif

The Experiences of Medical and Dental Personnel Regarding Informing their Patients about the Diagnosis of Head and Neck Cancer

Introduction: One of the main challenges regarding the patients with cancer, is to inform them about their disease. The aim of this study was to evaluate outlooks and experiences of medical and dental staff experts in Kerman, Iran, regarding the method of informing the diagnosis of head and neck (HN) cancer to patients and their relatives. Method: In this qualitative study, the data were obtained through deep interviews, and focus group discussions. The target groups were faculty members of the departments of oral medicine, oral and maxillo-facial surgery, and oncology, nurses of the departments of oral diseases and oncology, and postgraduate students of the department of oral medicine in Kerman university of Medical Sciences, Kerman, Iran (25 individuals). Aim-based sampling was carried out and continued till the saturation of data. The data were analyzed using content analysis method. Results: Two major classifications were derived. “Truth-telling improving factors” of them, “giving the patients an opportunity for decision making for treatment plan” was the most important factor; and “truth-telling avoiding factors” of them, "close relatives insist to avoid telling the truth to the patients” was the most important factor. Conclusion: In spite of the fact that most of the interviewees believed in telling the truth to the patients, practitioners should consider several factors such as patient's family preference, as well as patients’ anxiety and physical and psychological conditions. It would be reasonable if health care workers train to deal with the patients having cancer. Keywords: Medicine, Dentistry, Head and neck cancer, Qualitative researc

Evaluating the life quality of patients with diseases of oral mucosa referred to Kerman Dental School, Kerman, Iran, in 2014-2015

BACKGROUND AND AIM: This study evaluated the quality of life (QOL) of patients with diseases of oral mucosa referred to Kerman Dental School, Kerman, Iran during 2014-2015. METHODS: Total of 101 patients seen in the Kerman Department of Oral Medicine with chronic oral mucosal diseases were included in the study. They completed the designed questionnaire to assess their QOL. After the final edit, the questionnaire was filled by the subjects. Data were analyzed by t-test, chi-square, Pearson’s correlation, analysis of variance, and post-hoc analysis using SPSS. The level of significance for all data analysis was < 0.05. RESULTS: In this study, 101 patients with oral lesions were studied, [57 women (56.4%) and 44 men (43.6%)]. The patients’ age range was 19-65 years and the average age was 32.4 ± 5.6 years. Patients older than 35 years of age reported significantly lower QOL in the domain of social and emotional status. Significant age-related differences in QOL were not observed in other domains. Men reported significantly better oral health-related QOL in pain and functional limitation than women. Significant differences were observed between the disease groups only for recurrent aphthous ulcers and pemphigus. CONCLUSION: The present study indicated that chronic oral mucosal diseases affect patients’ QOL. Therefore, it seems that oral disease specialists play a key role in the treatment of these patients, including the disease management and symptomatic treatment, and in managing all issues affecting patients’ living conditions. KEYWORDS: Quality of Life; Chronic Diseases; Mouth Mucos

Protective effects of an interaction between vagus nerve and melatonin on gastric ischemia/reperfusion: the role of oxidative stress

Objectives: Vagal pathways in gastrointestinal tract are the most important pathways that regulate ischemia/reperfusion (I/R). Gastrointestinal tract is one of the important sources of melatonin production. The aim of this study was to investigate probable protective effect of the interaction between vagus nerve and melatonin after I/R. Materials and methods: This study was performed in male rats that were divided into six groups. Cervical vagus nerve was cut bilaterally after induction of I/R and the right one was stimulated by stimulator. Melatonin or vehicle was injected intraperitoneally. The stomach was removed for histopathological and biochemical investigations. Results: A significant decrease in infiltration of gastric neutrophils and malondialdehyde (MDA) level after I/R was induced by melatonin and was disappeared after vagotomy. The stimulation of vagus nerve significantly enhanced these effects of melatonin. However, a stimulation of vagus nerve alone increased neutrophils infiltration and MDA level. Melatonin significantly increased the activities of catalase, glutathione peroxidase (GPx), superoxide dismutases (SOD). Unlike stimulation of vagus nerve, vagotomy decreased these effects of melatonin. Conclusion: According to these results, it is probable that protective effects of melatonin after I/R may be mediated by vagus nerve. Therefore, there is an interaction between melatonin and vagus nerve in their protective effects

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks