farid abolhasani

Colorectal cancer is the second and fourth most common cancer in Iranian women and men, respectively. This cancer ranks fourth and fifth in men and women, respectively, among Yazd population. This study aimed to estimate the burden of colorectal cancer in Yazd province in 2016.

This descriptive cross-sectional study was performed on the population of Yazd province in 2016. CanMod software was used to calculate the burden of colorectal cancer. The required information included the population of Yazd province, the incidence of colorectal cancer, the death rate due to colorectal cancer, the death rate due to all causes and the survival rate of patients; The Cancer Registration System, the Provincial Death Registration System and the opinions of provincial experts were collected and included, respectively.

The total burden of colorectal cancer in Yazd province was 632 years (382 years in men and 250 years in women); The YLL and YLD of colorectal cancer in both genders were 478 years and 154 years, respectively. The burden of colorectal cancer in men was 65 years and in women 45 years (per 100,000 population). The peak age of disease burden was estimated in the age group over 60.

Due to the high incidence and treatment in the early stages of the disease, screening and diagnosis in the early stages can be one of the health priorities of the province. However, the final judgment is made when the burden of other diseases and injuries is calculated in the province.

Spermatogonial stem cells (SSCs) are considered as special stem cells since they have the ability of self-renewal, differentiation, and transferring genetic information to the next generation. Also, they considered as vital players in initiating and preserving spermatogenesis. The fate decisions of SSCs are mediated by intrinsic and extrinsic factors, among which microRNAs (miRNAs) are one of the most essential factors in spermatogenesis among endogenous regulators. However, the mechanisms by which individual miRNAs regulate self-renewal and differentiation of SSCs are unclear. The present study aimed to evaluate the impact of miRNA-30 mimic on fate determinations of SSCs.

The obtained SSCs from neonatal mice (3-6 days old) were purified by MACS and flow cytometry with a promyelocytic leukemia zinc-finger marker. Then, the cultured cells were transfected with miRNA- 30 mimic, and finally, the changes in expressing ID4 and c-kit proteins were assessed by western blot analysis.

According to flow cytometry findings, the percentage of SSC purity was about 98.32. The expression of ID4 protein and colonization increased significantly through the transfection of miRNA-30 mimic (P<0.05).

The miRNA-30 controls spermatogonial stem cell self-renewal and differentiation, which may have significant implications for treating male infertility.

Objective (s): Decision making about characteristics of reward system is one of the main challenges in organizations. The current study was carried out in order to design and provide a reward system for staff working in hospital affiliated to Tehran University of Medical Sciences (TUMS) hospitals.
Methods This study was performed in two steps from May 2014 to January 2016 in Tehran. First, the research team identified the main axes of reward system using semi-structured interviews with experts and stakeholders. Then the list of final criteria for rewarding was prepared in addition to weight for each criterion using ‘pairwise comparison analysis’. Secondly, in order to identify the executive requirements, the model was implemented in one hospital as a pilot. The main aspects of reward system were scoring method; type of reward; awareness program; evaluation; executive requirements (including structure and process). After pilot study criteria and scoring method were improved. Although the findings were promising, it seems for model success defining executive requirements (including process and structure) proportionate to available capacities and advocacy from head and senior managers is essential.

The current research aims at investigating the effect of demographic features such as educational level, gender, type of disorder, and physician's empathy and emotional intelligence on Community Mental Health Centers (CMHC) patients’ treatment dropout.
A sample of 4101 patients and 26 physicians were selected. Patients’ information was collected through CMHC registration software (information was already saved on the software since the centers have been established). Information related to physicians was also collected via two questionnaires, namely Bar-On EQ Inventory, and Jefferson Scale of Physician Empathy (JSPE), merely after consent forms were filled out. Based on the type of data, the collected information was transferred into nominal data, and later analyzed through Chi-square test via SPSS software.
The results of the current research suggested that the more empathetic a physician is, the less likely patients’ treatment dropout would be. Moreover, there was no significant relationship between the EI average score and treatment dropout. There was only a significant relationship between treatment dropout and adaptability, an EI competency. The findings of the current research indicated that none of the patients’ demographic variables (gender, educational level, and type of disorder) had a significant relationship with treatment dropout.
Based on the findings of this study, physicians’ communication skills, empathy, and adaptability did not significantly contribute to their patients’ treatment dropout.

Today, health care is supported by new technologies, namely Health Electronic Records.key element in patient care improvement and support of taken decisions.
The aim of this study is to identify affecting factors and risk factors on IT Service Management in health-oriented organization based on ITIL framework.The study sample in index determining stage included IT Management academic experts fluent in ITIL and in case study include experts and elites of health care centers of Tehran University of Medical Sciences.After a review of maturity models of health IT services and extracting dimensions and effecting factors, opinions of academic experts; finally we tested the extracted factors. The results indicated that the components of the maturity of IT services based on ITIL framework in two dimensions of delivery and support of IT Service Management.The results showed that the Configuration Management Process and related indicators along with financial management and release in IT,must improved.

Spermatogenesis is a complex and highly organized process of proliferation and differentiation of spermatogonial stem cells. Spermatogonial stem cells (SSCs) as a unique stem cell have the potential to self-renewal, differentiation and transmit genetic information to the next generation and play a vital role in maintaining fertility. Sertoli cells as the only somatic cells within the seminiferous epithelium play central roles in the formation of niche and balance between self-renewal and differentiation by secrete many growth factors. Given the importance and widespread use of SSCs, particularly in the treatment of infertility, the aim of this study was to create an optimal environment for the proliferation of SSCs. So we decided to study of undifferentiated (ID4) and differentiated (c-Kit) gene expression in SSCs followed by co-culture with Sertoli cells for a one-month.
This experimental study was conducted from November 2013 to December 2014 in Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, on immature NMRI mouse (6-3 days old). Initially, Sertoli cells and SSCs were isolated from neonates mouse testes during the two-step enzymatic digestion characteristics Sertoli cells with vimentin marker and SSCs with promyelocytic leukemia zinc-finger (PLZF) marker were confirmed. Then SSCs were cultured in two groups: co-culture with Sertoli and without co-culture (control). Undifferentiated (ID4) and differentiation (c-Kit) gene expression were evaluated by Real-time PCR technique.
Spermatogonial stem cells purity was obtained 66.91% by flow cytometry. The relative expression levels of gene ID4 in co-culture group at the end of each week, compared to the control group showed a significant increase (P According to the results of this study, co-culture with Sertoli cells maintains SSCs in the prolifration stage for long-term, so can be used to optimize the culture medium at the clinic.

The brachial plexus is responsible for the innervation to the upper limb and some parts of the thorax. Variations in the branching of the brachial plexus are common and have been reported in 65.3% of the population. The variations (Atypical communication) of brachial plexus have significant clinical and surgical importance. In this study 10 upper limbs which belonged to 5 adult human cadavers of known sex are used. In the present study, three cases (in two cadavers) of 10 cases (in five cadavers) have connections between the musculocutaneous and median nerve and seven cases are normal. Knowledge about the connections between the musculocutaneous nerve and the median nerve could be very useful in surgical operations on the humerus bone and shoulder joint. So, the more information we could collect about these structures and their variations, the safer the surgical operations could be done.

Awareness toward peoples’ utilization of health care facilities is a very important issue in the programming and resource allocation process. With implementation of family physician project in Iran and attempts for reforming health referral system, patients’ mobility between regions and its related factors have found more importance. In this research by using the logit economic model and through retrospective design, the relationship of patient migration with patients’ demographic features, type of health insurance, distance from the health care center and hospitals’ features was determined in 21 disease groups, based on the final diagnosis recorded in patients’ medical files and ICD10 codes. Eviews 6 software was used for all estimations. About 40 percent of inpatients in Kerman hospitals had migrated from other cities where the same services had been available, but the patients were not satisfied of the quality of them. Negative effects of geographical distance, physician and hospital bed count and the positive effect of insurances were constant in all groups, showing similar effects of these variables on patient migration in all disease groups. Results show that factors like distance and kind of disease have no more effect on patient migration than patient perception of the health care center; and ignoring this item, especially in planning the referral system in the big project of family physician, can result in problems in relation to patient equity, patient satisfaction and health organizations’ financial support.

Low quality of life in hemodialysis patients is a major factor leading to cardiovascular diseases and other important outcomes such as hospitalization and death. The present study attempted to examine the impacts of training intervention on perceived psychological health and quality of life among hemodialysis patients. In this cross-sectional intervention study, 51 hemodialysis patients were examined using census sampling method. The Short Form (SF-36) Health Survey was used to assess psychological quality of life for these patients. For 7 patients with psychological health scores (1SD) lower than the mean score, a supplementary questionnaire (Hamilton rating scale for depression and anxiety) was administered by a psychologist, to confirm existence of and identify the type of a psychological disorder. Then a training course on coping and communicating skills was developed and implemented. The effect of training program on patients’ targeted skills was examined by post-intervention administration of the Hamilton rating scale. T-test was used for comparison of the mean values between the two genders. While women gained higher mean scores than men in role physical, role emotional, vitality, mental health, social functioning, and bodily pain, and men scored higher in physical functioning and general health. No significant difference in HRQOL dimensions was found between the two genders, but in bodily pain (P < 0.05). After training, a 20% enhancement in the coping and communicating skills was achieved. Training of hemodialysis patients can lead to improvement of their coping and communicative skills, thereby enhancing their quality of life. Hence this study recommends systematic inclusion of training-based HRQOL improvement interventions as an integral part of a comprehensive hemodialysis patient treatment strategy.

Service delivery through Community Mental Health Centers (CMHCs) is a strategy for improving urban mental health. The current paper presents the process of designing structure and planning the services for CMHCs through an evidence-based approach. Using a systematic review approach, the needs and available mental health services in urban areas, and effectiveness and cost-effectiveness of mental health services for addressing those needs were identified and accordingly urban mental health services plan was devised as CMHCs. Depression, schizophrenia and other psychotic disorders, bipolar disorders and anxiety disorders respectively comprise the top four psychiatric disorders, according to burden of diseases, in Iran. Urban areas have richer resources than rural areas in the country, though there are no out-of-hospital and out-of-office mental health services and the network system and the primary care for presenting mental health services are ineffective due to the current restrictions. Therefore, it was arranged that the CMHCs’ services being delivered to two groups of patients including patients with neurotic (depressive and anxiety) disorders and patients with severe mental and psychotic disorders. The services for neurotic patients were presented according to improving recognition style and the management of neurotic disorders conducted by general practitioners (GP) using collaborative care model and forming collaborative units. The services for patients with severe psychiatric disorders included home visiting and telephone follow up accompanied with the patient and the family psychological education provided by specialized team from the CMHCs. The CMHCs’ services based on scientific evidence available across the world and using national experiences and infrastructures was designed for two groups of disorders which comprised a large burden of disease in the country. These services are currently being piloted in Tehran and Zanjan.

Glioblastoma is the most common and the most lethal primary brain cancer. This malignancy is highly locally invasive, rarely metastatic and resistant to current therapies. Little is known about the distinct molecular biology of glioblastoma multiforme (GBM) in terms of initiation and progression. So far, several molecular mechanisms have been suggested to implicate in GBM development. Homeodomain (HD) transcription factors play central roles in the expression of genomic information in all known eukaryotes. The TGIFX homeobox gene was originally discovered in human adult testes. Our previous study showed implications of TGIFLX in prostate cancer and azoospermia, although the molecular mechanism by which TGIFLX acts is unknown. Moreover, studies reported that HD proteins are involved in normal and abnormal brain developments. We examined the expression pattern of TGIFLX in different human brain tumor cell lines including U87MG, A172, Daoy and 1321N1. Interestingly, real time RT-PCR and western blot analysis revealed a high level of TGIFLX expression in A172 cells but not in the other cell lines. We subsequently cloned the entire coding sequence of TGIFLX gene into the pEGFP-N1 vector, eukaryotic expression vector encoding eGFP, and transfected into the U-87 MG cell line. The TGIFLX-GFP expression was confirmed by real time RT-PCR and UV-microscopic analysis. Upon transfection into U87 cells, fusion protein TGIFLX-GFP was found to locate mainly in the nucleus. This is the first report to determine the nuclear localization of TGIFLX and evaluation of its expression level between different brain tumor cell lines. Our data also suggest that TGIFLX gene dysregulation could be involved in the pathogenesis of some human brain tumors.

Revising medical curricula & establishing reformed programs result in refined educational methods which are accompanied by development of active & student-based teaching methods such as Team Based Learning (TBL). This paper describes an experience of implementation and evaluation findings of TBL according to medical students’ viewpoints. This action research was planned for a census sample (n=187) basic science students of Tehran University of Medical Sciences with the new curriculum. After briefing the students about TBL and forming teams we did TBL in the following steps: Individual Readiness Assurance Test (IRAT)، Team Readiness Assurance Test (TRAT)، appeal، Team Application (TAP)، and peer assessment; in 15% of each program block. Data gathered by observation recording sheets، and a researcher-made questionnaire، and analyzed using descriptive statistics. A major part of the students (63. 8%) have admitted TBL as a deep learning approach. Students believed that TRATs were useful (46. 2%)، team application was a learning facilitator in TBL classes (51. 7%) and the class management was suitable (60. 5%). The observational data showed that the students changed their seats in order to take part in group discussions. They were listening carefully، asking questions and giving reference to support their claims. Some were against this method because it increased their study workload. It seems TBL has a positive effect on deep learning and facilitates learning. The results indicate that TBL results in cooperative & active learning، and it improves class activity and may be، because of the developed interaction between students، it can promote communication skills. We recommend the use of TBL as a teaching method، beside other teaching methods، in medical sciences education.

The study aimed at reviewing evidence of effectiveness and cost-effectiveness of community-based services for psychiatric disorders. Cochrane and PubMed bibliographic databases and reference lists of relevant studies were investigated. Systematic reviews and controlled randomized clinical trials were analyzed. The inclusion criteria were having effectiveness and cost-effectiveness scales for community-based services models. These scales were compared for services delivered to patients with mild severe and mild psychiatric disorders. Provided services were assertive community treatment، case management، home visit، crisis intervention services، prompting، patient and family education and supported employment. The effectiveness and cost-effectiveness of assertive community treatment and family education had the strongest evidence and were effective on hospital admission rate، duration of hospital stay and maintaining contact with treatment system. The evidence for other services were insufficient or contradictory. For the mild psychiatric disorders، the service models included screening of disorders and feedback alone، continuous medical education، using practice guidelines، telephone-based intervention/care، referral system and consultation- liaison service، internet-based prevention and treatment programs، school-based prevention program and collaborative care. The most effective and cost-effective models were collaborative and internet-based care programs. Some of the positive outcomes of interventions were symptom reduction، patient’s satisfaction and decrease in economic burden of disease on family. The evidence for the models of delivering services to patients with mild psychiatric disorders mainly support collaborative models for delivering services and for more severe disorders support active follow-up and family education. These models are effective and feasible to clinical outcomes with a desirable cost - effectiveness.

Studies have shown that environment has a meaningful effect on quality of life in patients with type 2 diabetes. One of the important environmental factors is place of living. This study conducted to estimates health related quality of life of diabetic patients based on their place of living. This study was a secondary data analysis. We used data from a national cross sectional study conducted in 2006 using random cluster sampling. Data were collected by face to face interviews using a structured questionnaire. We analyzed s data on health related quality of life (HRQoL) by gender and patient’s residency. Mean values of HRQoL were calculated for each province and then compared with other provinces by statistical tests including ANOVA and distance based classifying methods. Comparison of mean values showed that HRQoL were highest in the Qom، Semnan and Gilan، and were lowest in Kerman، Yazd and Ardabil، respectively. HRQoL was significantly differed between provinces at 0. 05 levels. The findings confirm the meaningful differences in HRQoL among diabetic patients living in different provinces. It remains to investigate about such observations. This might help to implement a better care for this population living in different places.

Spermatogonial Stem Cells (SSCs) maintain spermatogenesis throughout the life of the male. Because of the small number of SSCs in adult, enriching and culturing them is a crucial step prior to differentiation or transplantation. Maintenance of SSCs and transplantation or induction of in vitro spermio-genesis may provide a therapeutic strategy to treat male infertility. This study investigated the enrichment and proliferation of SSCs co-cultured with STO cells in the presence or absence of growth factors. Spermatogonial populations were enriched from the testis of 4-6 week-old male mice by MACS according to the expression of a specific marker, Thy-1. Isolated SSCs were cultured in the presence or absence of growth factors (GDNF, GFRα1 and EGF) on STO or gelatin-coated dishes for a week. Subsequently, the authors evaluated the effects of growth factors and STO on SSCs colonization by alkaline phosphates (AP) activity and flow cytometery of α6 and β1 integrins. SSCs co-cultured with STO cells and growth factors developed colonization and AP activity as well as expression of α6 and β1 integrins (P≤0/05). Our present SSC-STO co-culture provides conditions that may allow efficient maintenance and proliferation of SSCs for the treatment of male infertility.

Conventional tomography is a cross sectional imaging modality that provides information about the width of the alveolar bone and the position of the critical anatomical structures such as mandibular canal in the lower jaw. In comparison with conventional CT, it is less expensive, more accessible and patients are exposed to much less radiation. The purpose of this study was to compare the accuracy and validity of spiral computed tomography and spiral conventional tomography. Ten fully or partially edentulous cadaver mandibles were selected. The specific points in anterior, canine, premolar, and molar regions were selected and imagings were performed with both radiographic systems. The distance between alveolar crest to superior border of mandibular canal, as well as mandibular height and width were measured by one oral and maxillofacial radiologist in two successive sessions. The tomography and CT scan (as gold standard) measurements were compared. This evaluation revealed that the absolute mean differences in measuring the vertical dimension in the anterior, canine, premolar, and molar regions were 1.43, 0.74, 0.87, and 0.81 millimeters respectively. The horizontal dimension measurements were 1.21, 0.92, 0.76, and 0.82 millimeters respectively. The absolute mean differences in measuring the vertical and horizontal dimensions were 0.65 and 0.91 millimeters respectively. All these measurements were with in limits of ±1 mm error except in the anterior region. Both measurements of vertical and horizontal dimensions had the tendency to be underestimated in anterior region. In measuring the vertical and horizontal dimensions, the validity of spiral conventional tomography were 90.49% and 73.02% respectively, and both were statistically significant (P < 0.001). From the results of present study it can be concluded that the spiral conventional tomography is an accurate and reliable technique for measuring the vertical and horizontal dimensions in mandible. Key words: Spiral tomography - Spiral CT scan - Dental implant. Corresponding Author: Dr. Shahab Sh., Assistant Professor, Oral & Maxillofacial Radiology Department, Faculty of Dentistry, Shahed University. Tehran, Iran.

Life expectancy is one of the summary measures of population health, whose values and trend of changes over time show the main outcome of health system performance. Estimation of life expectancy is performed with direct or model-based methods. In this study direct estimation of life expectancy for Iran’s population in year 2003 is performed. In an ecologic study, for calculation of abridged period life table for 23 out of 28 provinces of Iran in year 2003, numbers of registered deaths for age and sex specific groups in these 23 provinces by death registration system of Ministry of Health (MOH) were used. Undernumeration of over-four year's deaths was estimated and corrected with Brass Growth-Balance method. For mortality rates of under-one and 1-4 years, similar rates from Demographic and Health Survey (DHS) 2000 with live births denominators were substituted. For total number of population of 23 provinces, information from MOH was used. Distribution of population by age and sex was taken similar to that from DHS 2003 results, and also taken as result of graduation of whole country population from 1375 census. Population of these 23 provinces was equal to 73% of total population of country in year 2003. Life expectancy was estimated by age and sex with the obtained population and death numbers. It was assumed that distributions of population and death in 23 provinces were similar to those for the whole 28 provinces of Iran in year 2003 and hence, the estimated life expectancy for 23 provinces is equal to that for all 28 provinces in 2003. Sensitivity of the results to assumptions was analyzed. Confidence intervals were calculated with Monte Carlo method. Life expectancy at birth was estimated as 71.56 years for total population (95% CI: 71.52 – 71.62), 70.09 years for males (70.02 – 70.16), and 73.17 (73.10 – 73.24) for females of Iran in year 2003. Sensitivity of results to assumptions was less than 0.5%. Values of life expectancy estimates for year 2003 with direct method are higher than those based on statistical modeling approaches performed by Statistical Center of Iran and by different United Nations agencies, due to difference in estimation methods for age and sex specific mortality rates.

Since by considering increases worldwide prevalence of diabetes mellitus, and its management in the short and long–term requires significant expenditure on the part of patients and healthcare providers alike, and on the other hand existing resources fall short of the country's needs in this domain, diabetes has become one of the major health priorities in our country, as it has across the globe. Assessment of injuries due to diabetes mellitus and complications are divided to two sections: 1– economic cost of diabetes mellitus and 2 – burden of diabetes mellitus. In this study we assessed burden of diabetes mellitus and complications in Iran in year 2000. We used ten years ago studies about prevalence of diabetes and complications in Iran, associated DALYs index by helping computer model (DisMod) for assessment of burden of diabetes and complications in Iran in year 2000. Burden of diabetes in Iran was 306440 years in year 2000. Burden of diabetic retinopathy, nephropathy, neuropathy, diabetic foot and lower limb amputation were 20532, 20532, 33286, 5848 and 1573 years, respectively. Pay attention to this study, we will need to reduce diabetes's burden by setting serious programs about prevention and treatment of diabetes mellitus and complications. Thus, we suggest, other studies are planning for assessment of burden of other diseases. Then after comparing burden of diabetes to other diseases, government politicians are performance priorities setting for using of our country resource.

Foot complications are among the important problems of diabetic patients. Vascular and neurological involvements are two major causes for such complications. We studied 142 diabetic outpatients referred to diabetes clinic of Dr.Shariati Hospital from Dec. 2003 to Sep. 2004. We performed different neurological and vascular tests to assess the diabetic foot and data were analyzed by SPSS software. 54.9% of the cases reached the symptom score of 5 and upper so they had neuropathy regarding the Michigan Neuropathy Disability Score (MNDS). By analyzing the overall symptom and sign scores, 61% had neuropathy. Regarding MNDS, 42.7% of the subjects were neuropathic. Finally 23.9% were unable to sense at least one point from 12 points of monofilament examination. 16.9% of the patients had the complaint of intermittent claudication, in 8.8% at least one of the peripheral pulses was not palpable, whereas 10.6% had some degree of PAD regarding to ABI and toe pressure. Using a monofilament is the most reliable method for screening of the neuropathy in diabetic patients. On the other hand, relying on symptoms like intermittent claudication and physical examination in order to find peripheral arterial disease in diabetic patients may lead to miss many cases, thus, performing some more precise diagnostic tests, such as ABI and toe pressure are highly recommended and reliable.

Diabetes mellitus is one of the chronic metabolic diseases with several organ damages that dearese life span. Prevalence of known diabetes appears to be increasing in most countries, presumably due to increasing the prevalence of risk factors such as obesity, lower physical activity and improved diagnosis. WHO expect the number of adults (20 years and older) with diabetes rises up to 300 millions in 2025. In view of the worldwide geographic differences in diabetes and lack of documented informations about prevalence of diabetes in Iran, we assigned this study. The base of our study for assessment of prevalence of diabetes in Iran was results of ״Health and Disease Study in Iran, 1999״. We used epidemiologic model (DisMod) for estimating the incidence of diabetes in Iran. The prevalence of diabetes in over 20 years of Iranian population in 2000, was 1. 6 million or 4. 67%. Also it is estimated up to 100000 persons have been affected by type II diabetes. The true limitation of our study was limitations of documents about estimated of proportion of true prevalence to prevalence of known diabetes.

Since by considering increases worldwide prevalence of diabetes mellitus, and its management in the short and long-term requires significant expenditure on the part of patients and healthcare providers alike, and on the other hand existing resources fall short of the country's needs in this domain, diabetes has become one of the major health priorities in our country, as it has across the globe. Assessment of injuries due to diabetes mellitus and complications are divided to two sections: 1- economic cost of diabetes mellitus and 2 - burden of diabetes mellitus. In this study we assessed burden of diabetes mellitus and complications in Iran in year 2000.
We used ten years ago studies about prevalence of diabetes and complications in Iran, associated DALYs index by helping computer model (DisMod) for assessment of burden of diabetes and complications in Iran in year 2000.
Burden of diabetes in Iran was 306440 years in year 2000. Burden of diabetic retinopathy, nephropathy, neuropathy, diabetic foot and lower limb amputation were 20532, 20532, 33286, 5848 and 1573 years, respectively.
Pay attention to this study, we will need to reduce diabetes's burden by setting serious programs about prevention and treatment of diabetes mellitus and complications. Thus, we suggest, other studies are planning for assessment of burden of other diseases. Then after comparing burden of diabetes to other diseases, government politicians are performance priorities setting for using of our country resource.

Foot complications are among the important problems of diabetic patients. Vascular and neurological involvements are two major causes for such complications.
We studied 142 diabetic outpatients referred to diabetes clinic of Dr.Shariati Hospital from Dec. 2003 to Sep. 2004. We performed different neurological and vascular tests to assess the diabetic foot and data were analyzed by SPSS software.
54.9% of the cases reached the symptom score of 5 and upper so they had neuropathy regarding the Michigan Neuropathy Disability Score (MNDS). By analyzing the overall symptom and sign scores, 61% had neuropathy. Regarding MNDS, 42.7% of the subjects were neuropathic. Finally 23.9% were unable to sense at least one point from 12 points of monofilament examination. 16.9% of the patients had the complaint of intermittent claudication, in 8.8% at least one of the peripheral pulses was not palpable, whereas 10.6% had some degree of PAD regarding to ABI and toe pressure.
Using a monofilament is the most reliable method for screening of the neuropathy in diabetic patients. On the other hand, relying on symptoms like intermittent claudication and physical examination in order to find peripheral arterial disease in diabetic patients may lead to miss many cases, thus, performing some more precise diagnostic tests, such as ABI and toe pressure are highly recommended and reliable.

The aim of this study was to evaluate changes that occur in motility parameters of progesterone treated mouse spermatozoa during course of hyperactivation. Mouse spermatozoa treated with different doses of progesterone were videotaped after 10 min and 90 min of incubation. For each sperm, one second of movement of the head-midpiece junction was traced from the videotape and for each tracing; seven motility parameters were studied using computer assisted image analysis. For all progesterone treated spermatozoa, motility rate differed significantly from control group after 90 min of incubation. Motility parameters for high doses of progesterone 10 and 100 µg/ml showed hyperactivation occurred during 10 min of incubation. With treatment of 1 µg/ml progesterone, hyperactivated motility pattern of spermatozoa occurred 90 min after incubation similar to the control group showing that low dose of progesterone is unable to induce hyperactivation. In conclusion, progesterone induces hyperactivation in mouse sperm and reduces the motility rate during the time. Iran. Biomed.

Diabetes mellitus is one of the chronic metabolic diseases with several organ damages that dearese life span. Prevalence of known diabetes appears to be increasing in most countries, presumably due to increasing the prevalence of risk factors such as obesity, lower physical activity and improved diagnosis. WHO expect the number of adults (20 years and older) with diabetes rises up to 300 millions in 2025. In view of the worldwide geographic differences in diabetes and lack of documented informations about prevalence of diabetes in Iran, we assigned this study.
The base of our study for assessment of prevalence of diabetes in Iran was results of ״Health and Disease Study in Iran, 1999״. We used epidemiologic model (DisMod) for estimating the incidence of diabetes in Iran.
The prevalence of diabetes in over 20 years of Iranian population in 2000, was 1. 6 million or 4. 67%. Also it is estimated up to 100000 persons have been affected by type II diabetes.
The true limitation of our study was limitations of documents about estimated of proportion of true prevalence to prevalence of known diabetes.