مجله غدد درون ریز و متابولیسم ایران
سال بیست و پنجم شماره 1 (پیاپی 127، فروردین و اردیبهشت 1402)

There has been a remarkable rise in medical research in Iran during the last 40 years, improving the global ranking of the country in the production of research documents from 54th to 16th in 2022. The aim of this review was to summarize medical research activities in Iran during the last 40 years and present predictions on the outlook of this field in coming years.

Related articles were retrieved from the Iran Doc Engine, and selected sections of three editions of the book “Health in the Islamic Republic of Iran” were reviewed.

Between 1980 and 2000, there was a remarkable rise in the number of medical universities and related schools in Iran. The number of students, both undergraduate and postgraduate, as well as PhD courses and residency programs, considerably increased in the country, in parallel with the debut of numerous clinical subspecialty programs in various clinical fields. Research centers and institutes were developed in many universities. Between 2001 and 2020, there was an extraordinary increase in the number of annual publications in medical fields. Citations to Iranian research articles have also increased. For the next 20 years, innovations in research activities and productions are expected to resolve many problematic issues in Iran’s health sector. Activities such as nurturing young, talented, and distinguished researchers, supporting scholars, devising more appropriate tools for the evaluation of the output, impact, and effectiveness of scientific productions, increasing the share of research from Growth National Product (GNP), and enhancing targeted research programs will be needed to safeguard the emerging goals of research activities in the next two decades.

Diabetes is a chronic metabolic disease with a profound effect on the lives of couples. Thus, it is necessary to use interventions and training based on psychological approaches in couples.  This  study aimed to determine the effect of cognitive behavioral training on the marital adjustment of couples suffering from type 2 diabetes.

In this semi-experimental study, a convenience sample of 40 patients with type 2 diabetes and their spouses was selected. They were randomly assigned to two intervention and control groups. A couple training program based on the cognitive-behavioral approach was implemented for the intervention group. The participants of both groups were evaluated with the marital adjustment scale before and after the intervention. To analyze the data, independent t-test, paired t-test, and covariance analysis were used.

The mean marital adjustment scores of couples in all dimensions and the overall score of marital adjustment in the post-test were higher in the intervention group than in the control group. The ANCOVA test showed that these differences were statistically significant (p≤0.001).

Family training through the use of cognitive behavioral methods has a significant effect on the marital adjustment of couples with type 2 diabetes, and counselors and therapists can use this method when advising on how to improve the quality of marital relationships.

Type 1 diabetes is the second most common chronic disease in children and adolescents whose clinical manifestations are often associated with ketoacidosis. The objectives of this study were to describe the characteristics of patients with diabetic ketoacidosis, compare these characteristics among patients with known and newly diagnosed diabetes, and analyze subgroups based on the severity of the disease.

This retrospective cross-sectional study was performed on children and adolescents aged 2 to 18 who were admitted to Taleghani Hospital from April 2016 to March 2020 with a diagnosis of diabetic ketoacidosis. According to the severity of the disease, the patients were divided into three groups: mild, moderate, and severe. The data was statistically  analyzed using SPSS (version 23) software.. P-value<0.05 was considered the level of statistical significance.

Forty-nine children and adolescents diagnosed with diabetic ketoacidosis were hospitalized during the study period. The average age of patients was 10.12±3.59 years, and 32 (65.3%) were girls. About 61% of patients had previously known diabetes. A statistically significant difference was observed in the time to get out of ketoacidosis and creatinine level among the three groups of disease severity.

More than half of the patients had diabetes. The results showed that the more severe the disease, the longer the time needed to get rid of diabetic ketoacidosis.

Emotional distress and sleep quality are effective in controlling the disease and its complications in patients with diabetic foot ulcers.(Emotional distress and poor sleep quality negatively affect the management of diabetes and it’s complications in patients with diabetic foot ulcers. Therefore, the present study was conducted to determine the predictors of emotional distress and sleep quality in patients with diabetic foot ulcers.

This  descriptive cross-sectional study was conducted in 2022. One hundred and nine patients with diabetes referred to Velayat Hospital in Qazvin City, Iran, were included in the study following convenience sampling. The study tools included a demographic checklist, the University of Texas Wound Classification System, the Petersburg Sleep Quality Index (PSQI), and the Emotional Distress Questionnaire (IR-PAID-20). The data was analyzed using SPSS-v25 software.

The majority of the patients had grade 3 (48.6%) and stage A (47.7%) wounds. The total scores of emotional distress and sleep quality were 49.81±19.94 and 10.21±4.02, respectively. Factors such as sleep quality, wound grade, wound stage, type of treatment, blood sugar level, and duration of diabetic foot ulcer were identified as predictors of emotional distress (p<0.05). Emotional distress, wound grade, wound stage, and amputation history were identified as factors predicting the sleep quality of patients (p<0.05).

Wound status was identified as a common predictor of emotional distress and sleep quality in diabetic foot ulcer patients. It is recommended to focus on the factors affecting emotional distress and sleep quality to make interventions to improve these components in patients with diabetic foot ulcers.

The purpose of this study was to investigate the effect of exercise training with two different intensity levels on some structural parameters of the heart in mice with pre-diabetes and type 2 diabetes.

For this purpose, 39 male C57bl/6j mice were divided into two groups: High-fat Diet (HFD) and Normal Diet (ND). After 20 weeks of a 60% fat diet for HFD mice and normal food for ND mice, 12 of the HFD mice were injected with streptozotocin (STZ) and then divided into three subgroups: control (C), High-intensity Interval Training (HIIT), and Moderate-intensity Continuous Training (MICT). The mice of the exercise training groups were trained for eight weeks. Then, tissue factors, including heart weight, vascular density, fibrosis, steatosis, and degenerative changes in the heart, were examined . One-way analysis of variance and percentage frequency were used to analyze and report the results.

A high-fat diet decreased vascular density (30%) and degenerative changes, and STZ injection decreased vascular density (33%), myocardial fibrosis, and steatosis. Both exercise training types were associated with improvement of symptoms, including heart weight, fibrosis, steatosis, and degenerative changes. However, MICT had a stronger effect than HIIT on most factors.

A high-fat diet, with or without STZ, was associated with cardiac pathological changes. It seems that MICT can produce stronger effects in reducing these symptoms than HIIT.

A diabetic wound is a long-term diabetes complication increasing the risk of mortality and amputation-related disability and decreasing the quality of life. Due to incorrect and incomplete use of standard therapies, complementary therapeutic strategies, including elevation of wound nitric oxide (NO) level by using NO donors, precursors, and inducers, have received attention in in vitro studies, animal experiments, and clinical trials. Here, we aimed to review the potential clinical applications of NO in accelerating wound healing in diabetes. Exogenous NO in the gaseous form or as acidified nitrite-containing ointments, NO-containing sprays, and NO-containing hydrogels has been applied in wound healing. Although limited clinical trials have been conducted to assess the efficiency of NO in accelerating diabetic wound healing, 56-100% effectiveness was reported for NO-based treatments compared to standard care. The known physiological functions of NO in wound healing include increasing the local blood flow, inducing angiogenesis, collagen synthesis, re-epithelization, wound closure, and anti-inflammatory effects via enforcing immune responses, and promoting potent broad-spectrum antibacterial effects. Considering the limited existing evidence, clinical trials with predefined effect sizes, i.e., wound area reduction, wound healing rate, and length of hospital stay, are required to confirm the efficiency of NO-based therapies compared to standard treatment.

Alzheimer's disease (AD), a progressive neurodegenerative disease, is the most common type of dementia. Polycystic ovary syndrome (PCOS) is associated with metabolic and hormonal disorders, obesity, inflammation, gut microbiota dysbiosis, and an elevated risk of mood disorders and depression. Therefore, patients with this syndrome may be exposed to cognitive and memory disorders, followed by AD. The aim of this review was to focus on the cognitive function, memory, and the risk of dementia and AD in women with PCOS and to identify the factors affecting the risk of progression to these complications in women with this syndrome. Reviewing the literature on the relationship between PCOS and the occurrence of cognitive and memory disorders showed that several disorders linked with PCOS and some drugs used to treat these patients could positively or negatively affect the risk of the development of cognitive and memory disorders. While some reports have declared positive effects for androgens and oral contraceptive drugs on cognitive function and memory, others have argued that insulin resistance, obesity, inflammation, oxidative stress, gut microbiota dysbiosis, and depression may negatively affect cognitive and memory function in women with PCOS, predisposing them to AD. More studies are needed to estimate the risk of cognitive disorders, memory deficits, and AD in women with PCOS and to identify the factors involved in the development of these disorders. The early identification of PCOS patients at risk of developing these cognitive disorders can help prevent the progression of these conditions and appropriately treat them.