Background: Diabetic foot ulcers (DFUs) are common problems in diabetes. One of the most important factors affecting the quality of diabetes care is knowledge and practice. The current study aimed at determining the knowledge and practice of patients with diabetes regarding the prevention and care of DFUs. Methods: The current analytical, cross sectional study was conducted in Guilan Province (north of Iran) on 375 patients registered in the medical records as type 2 diabetes mellitus. Demographic characteristics, knowledge, and practice of participants were recorded in a questionnaire during face-to-face interviews conducted by the researcher. Descriptive and inferential statistics were performed using SPSS version18. Results: The mean score of knowledge was 8.63 ± 2.5 out of 15, indicating that the majority of participants had a poor knowledge (84.8%). The mean practice score was 7.6 ± 2.5 out of 15, indicating that a half of them had poor performance (49.6%). There was a significant and direct correlation between knowledge and practice. Knowledge level, place of residence, marital status, and history of admission due to diabetic foot were predictors of practice score. Conclusions: According to the low level of knowledge and practice in patients with diabetes regarding the prevention and care of DFUs, and considering the significant relationship of some demographics of patients with knowledge and practice scores, a targeted educational program is needed to promote knowledge of patients with diabetes.

Objective This study was performed in Razi Hospital, Rasht, Iran, between March 2016 and August 2018 on a population of chronic obstructive pulmonary disease (COPD) patients (56 as COPD exacerbation group and 56 as COPD stable group). Study variables include age, sex, occupation, body mass index (BMI), cigarette consumption, duration of COPD, annual hospitalization, dyspnea, glycated hemoglobin (HbA1c), FEV1, and FEV1/FVC indices. Result The mean age of the participants was 63.92 ± 10.75 years. There was a significant difference in the hospitalization between the patients with both exacerbation and normal state of COPD (P ≤ 0.001). HbA1c in the patients with exacerbation of COPD was significantly higher than stable status (P = 0.001). Logistic regression showed that HbA1c levels and hospitalization were predictors of exacerbation of COPD. HbA1c levels were statistically significant in terms of hospitalization in patients with COPD exacerbation. There was a significant difference between the HbA1c levels and MMRC in patients with COPD. The percentage of HbA1c was associated with exacerbation of COPD and HbA1c is a good predictor of disease severity in patients with COPD. It also shows that patients with COPD exacerbation and severe COPD are at the higher risk of hyperglycemia.

Objective: Uncertainties exist regarding the causal relationship between thyroid function tests (TFT) within the euthyroid range and anthropometric measures. This longitudinal cohort is aimed to examine the relationship between the two conditions. Subjects and methods: Euthyroid participants of Tehran Thyroid Study (TTS) attending phase I (1999-2001) were included in this study and were followed up to phase IV (2008IV ( -2011. TSH and free T 4 (fT 4 ) levels as well as weight (Wt), waist circumference (WC), hip circumference (HC) and waist-to-hip ratio (WHR) were measured at both phases. Results: 971 women and 784 men were included in the analysis. During 9.7 years of follow-up, increases in TSH levels, Wt and WHR as well as a decrease in fT 4 level were observed. Multivariable regression analysis showed a significant relationship between TSH changes and alterations in WC in women (β = 0.69, P = 0.021) and men (β = 0.61, P = 0.038). Moreover, a significant negative association of ΔfT 4 with changes in weight was documented (β = −0.49, P = 0.001 in women and β = −0.56, P < 0.001 in men). Additionally, we found a negative relationship between ΔfT 4 and ΔHC in men (β = −0.36, P = 0.001). Conclusion: In both genders, there was a positive relationship between changes in TSH and waist circumference and conversely a negative association of changes of fT 4 levels with weight over time.

Background: Thyroid hormones are essential in the growth and maintenance of hair follicles. Numerous studies have evaluated the relationship between thyroid disorders and hair loss. However, no study has assessed the dermoscopic results in patients with hypothyroidism and hair loss. Objectives: This study aimed to investigate dermoscopic findings of alopecia in patients with hypothyroidism and its probable relevance in the future. Methods: This analytic cross-sectional study was performed on patients with hair loss referred to dermatology clinics of Guilan University of Medical Sciences, Iran. Hypothyroid patients and an equal number of euthyroid individuals were compared. After recording the demographic and clinical characteristics, all patients were subjected to hair dermoscopy. Results: A total of 164 patients with and without hypothyroidism with hair loss were studied. The frequency of hair shaft abnormalities (P < 0.001) and vellus hair (P < 0.001) significantly differed between the two groups. Dermoscopic findings related to scale abnormalities (P = 0.002) and their perifollicular type (P < 0.001) significantly differed between the groups. Vascular changes (P < 0.001), perifollicular concentric type (P = 0.012), and interfollicular red loops type (P = 0.005) were significantly higher in patients with hypothyroidism. Also, based on the multiple logistic regression model, the chance of abnormalities of the hair shaft, scales, and vascular changes increased by 3.24, 2.73, and 3.53, respectively, in hypothyroidism compared to euthyroidism. Conclusions: Regarding the promising results of this study, we could detect possible dermoscopic signs of inflammation in hypothyroid patients with hair loss. Further investigations are needed because there is a shortage of evidence on this novel diagnostic method.

Abstract Objective: Vitamin D plays a crucial role in calcium metabolism through the Parathyroid hormone (PTH) dependent process. The deficiency of this important nutrient may be associated with hypocalcemia after thyroidectomy. To evaluate the role of vitamin D in predicting hypocalcemia following total thyroidectomy.Results: sixty-two patients who underwent total thyroidectomy for benign or malignant thyroid disease were included in this prospective study. Preoperative vitamin D serum levels and PTH levels were determined. The results of our study showed In both groups with and without vitamin D deficiency, calcium levels decreased significantly (P = 0.01). In our study, it was found that there was no significant relationship between postoperative hypocalcemia and vitamin D deficiency. (P = 0.441). After reviewing the data and according to Spearman correlation statistical test, no significant relationship was observed between serum PTH and calcium after thyroidectomy (P = 0.340).Vitamin D deficiency is a risk factor of hypocalcemia after total thyroidectomy for benign goiter. Although post thyroidectomy hypocalcemia is multifactorial, vitamin D deficiency, particularly severe form, is significantly associated with the development of biochemical and clinical hypocalcemia vitamin D supplementation can prevent this unwanted complication in such patients.

Vitamin D plays a crucial role in calcium metabolism through the parathormone-dependent process. The deficiency of this important nutrient may be associated with hypocalcemia after thyroidectomy. To evaluate the role of vitamin D in predicting hypocalcemia following total thyroidectomy. In this study, sixty-two patients who underwent total thyroidectomy for benign or malignant thyroid disease were included in this prospective study. Preoperative vitamin D serum levels and parathormone (PTH) levels were determined. The association between preoperative vitamin D status and the development of hypocalcemia was investigated. In this study, 62 patients were evaluated. The mean age of the subjects was 47 years. Of the 62 patients studied, of which 9 were male patients (14.5%), and 53 were female (85.5%), the results of our study showed. In both groups with and without vitamin D deficiency, calcium levels decreased significantly (P=0.01). In our study, it was found that there was no significant relationship between postoperative hypocalcemia and vitamin D deficiency. (P=0.441). After reviewing the data and according to Spearman correlation statistical test, no significant relationship was observed between serum parathyroid hormone (PTH) and calcium after thyroidectomy (P=0.340). Vitamin D deficiency is a risk factor of hypocalcemia after total thyroidectomy for benign goiter. Although post thyroidectomy hypocalcemia is multifactorial, vitamin D deficiency, particularly severe form, is significantly associated with the development of biochemical and clinical hypocalcemia. Vitamin D supplementation can prevent this unwanted complication in such patients.

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Introduction: Post-transplantation diabetes mellitus (PTDM) is a metabolic complication following transplantation, which is associated with cardiovascular disease and leads to increased post-ttransplantation morbidity and mortality. Objectives: To identify the incidence of PTDM and its risk factors in kidney recipients at a single-center in Iran. Patients and Methods: This retrospective study was conducted on 379 kidney recipients with a negative history of diabetes mellitus who underwent transplant before January 2017. PTDM was defined according to the diagnostic criteria of the American Diabetes Association (ADA) and the World Health Organization (WHO). Data on demographic, clinical characteristics and laboratory parameters were collected. Kaplan-Mayer analysis was used to evaluate the cumulative incidence of PTDM. The association between risk factors and PTDM incidence was identified with stepwise Cox regression. Results: The cumulative incidence of PTDM during a 24-month follow-up was 30.1% (95% CI: 25.6-34.8). By univariate analysis, modifiable or non-modifiable risk factors for PTDM development included recipient age, body mass index (BMI), marital status, family history of diabetes, smoking, type of transplant, hepatitis C virus (HCV), cytomegalovirus (CMV), transplant rejection, TG, tacrolimus, cyclosporine and beta blocker. In this study, family history of diabetes, type of transplant, HCV, CMV, TG, tacrolimus, and beta blocker were predictors of development of PTDM in Cox proportional hazard models. Conclusion: The incidence of PTDM was high. Identification of risk factors determines appropriate strategies for PTDM incidence risk reduction.