massoud amini

In this paper,  we show that a shift operator on a separable Hilbert space with infinite multiplicity is strongly approximated by shift operators with finite multiplicities. Moreover, for an arbitrary shift operator $S$, we introduce the notion of an (asymptotic) $S$-Hankel operator and study its relation to the class of (asymptotic) $S$-Toeplitz operators.

Increasing incidence rates of diabetes related to air pollution have been reported in high‑income countries. However, few studies evaluated air pollution effect on plasma glucose indices, in addition to diabetes and prediabetes incidence in developing countries. This study investigated the association between exposure to common air pollutants and the changes plasma glucose indices over time. The incidence of type 2 diabetes (T2D) and prediabetes in future were also examined in association with exposure to air pollution.

A total of 3828 first‑degree relatives of patients with T2D who were prediabetes or had normal glucose tolerance (NGT) were enrolled in this study. Cox regression was used to assess the relationships between particulate matter (PM2.5 and PM10), nitrogen monoxide (NO), nitrogen dioxide, nitric oxides, sulfur dioxide (SO2), and ozone exposure and the incidence of T2D and prediabetes. We also applied a linear mixed model to assess the association between exposure to these air pollutants and changes in plasma glucose indices over time.

Air pollutants showed a significant positive association with changes in fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), and 2 h oral glucose tolerance (OGTT) in participants with NGT and prediabetes. The maximum increase in plasma glucose indices was associated with NO concentration. Our study also showed exposure to all air pollutants except SO2 was significantly associated with an increased risk of developing T2D and prediabetes (Hazard ratio > 1, P < 0.001).

According to our results, exposure to air pollution increases the risk of T2D and prediabetes incidence in our population. The exposure to air pollutants was also associated with increasing trend in FPG, HbA1c, and OGTT levels in both groups of NGT and prediabetic participants.

Prediabetes is a high‑risk state for developing diabetes at an annual rate of 5%–10%. Early intervention can prevent further complications, including metabolic syndrome. Bisphosphonates are commonly used for osteoporotic postmenopausal women. The purpose of this study was to assess the effects of bisphosphonates on lipid profile including triglyceride (TG), total cholesterol, low‑density lipoprotein (LDL), and high‑density lipoprotein (HDL) of prediabetic postmenopausal women with osteopenia.

In this triple‑blind randomized controlled trial, sixty prediabetic, postmenopausal women with sufficient Vitamin D and osteopenia, aged 45–60 years, were randomly enrolled in two groups of intervention (receiving 70‑mg alendronate for 12 weeks [duration for maximum metabolic effect of bisphosphonates], n = 30) and control (receiving placebo, n = 30) according to a randomized block procedure of size 2 and 1:1 allocation ratio. The primary outcome of the study, the lipid profile, was evaluated before and after the interventions. The effect of the intervention was assessed using analysis of covariance.

The lipid profiles showed no significant differences to the mean values at the baseline in both the groups (all P > 0.05). At the end of the study, the differences between the groups were not significant for 25(OH) D3 (mean difference: −11.09, 95% confidence interval: −32.43–10.25), T (4.19, −30.58–38.97), cholesterol (8.13, −13.07–29.33), LDL‑cholesterol (5.07, −10.18–20.31), and HDL‑cholesterol (−0.86, −6.04–4.31) when the baseline values and confounders were adjusted (all P > 0.05).

No statistically significant difference was detected in the serum lipid profile of prediabetic postmenopausal women with osteopenia as a result of alendronate intervention. More studies with larger sample sizes and longer intervention periods are recommended.

The Kolmogorov-Sinai entropy is a far reaching dynamical generalization of Shannon entropy of information systems. This entropy works perfectly for probability measure preserving (p.m.p.) transformations. However, it is not useful when there is no finite invariant measure. There are certain successful extensions of the notion of entropy to infinite measure spaces, or transformations with infinite invariant measures. The three main extensions are Parry, Krengel, and Poisson entropies. In this survey, we shortly overview the history of entropy, discuss the pioneering notions of Shannon and later contributions of Kolmogorov and Sinai, and discuss in somewhat more details the extensions to infinite systems. We compare and contrast these entropies with each other and with the entropy on finite systems.

Considering the physiologic roles of vitamin D on insulin regulation, the effects of vitamin D treatment on insulin sensitivity and resistance indexes and beta cell function in pre‑diabetic vitamin D deficient patients were investigated.

In a randomized open clinical trial, 61 pre‑diabetic vitamin D deficient patients who were the first degree relatives of type 2 diabetic patients, were enrolled and randomized into three groups (A, B and C). GroupA (n = 21) were treated with intramuscular injection of 300,000 units of vitamin D at the beginning of the study and one month later. In group B (n = 20), injection of vitamin D plus 500 mg/d calcium and in group C (n = 20), just calcium was administered for two months. At baseline and two months later, oral glucose tolerance test was done. Homeostasis Model of Assessment-Insulin Resistance (HOMAIR), insulin resistance index, Homeostasis Model of Assessment-B (HOMA-B) which is a beta cell function index, and Matsuda index, an insulin sensitivity index, were calculated and compared before and after intervention and between three groups.

In vitamin D treated groups (A + B), the mean (SD) of HOMA‑IR increased from 2.46 (1.36) to 3.1 (2.3) (P = 0.02), and Matsuda index decreased from 11 (3) to 9.0 (2.3) (P = 0.001).

Injection of vitamin D increased insulin resistance and decreased insulin sensitivity indexes.

The complications in thyroid surgery have been reported variable in literature. The aim of this study was to evaluate the early and late (3 months after surgery) complication rates of thyroidectomy in a cohort of patients undergoing thyroid surgery at two hospitals of Isfahan University of Medical Science, Iran.

This study included 204 patients who candidates for thyroidectomy presenting at Medical Educational Centers of Al-Zahra and Kashani hospitals in Isfahan between March 2016 and March 2017. Clinical data are collected for all patients by continuous enrollment. The patients examined before and after thyroid surgery and the findings were recorded.

The highest prevalence of thyroidectomy was in women (81.9%). The most frequent thyroid surgery was total thyroidectomy and the most common indication for thyroid surgery was suspicious fine-needle aspiration for thyroid malignancy. Hypocalcemia was the most common complication with a frequency of 54.4%. The odds ratios for early complications were 2.375 and 2.542 for intermediate- and low-volume surgeons, respectively, compared to high-volume surgeons.

According to the results of this study, the high level of surgeon's skill is effective to reduce the likelihood of late and early complications; furthermore, the chance of late complications increases with age.

Tis paper presents the protocol and primary fndings of pregnancy cohort population?based study in Isfahan,
Iran. In this cohort, 418 pregnant and 438 nonpregnant women were enrolled. In the frst phase, serum
concentrations of thyroid?stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), thyroid peroxidase antibody,
and urinary iodine concentration (UIC) were measured. Furthermore, the thyroid ultrasound was also performed. According to the results of thyroid function tests in the frst phase, local reference range for TSH, FT4, and FT3 in pregnant and nonpregnant women are determined. Te 2.5th and 97.5th percentiles are determined as limits of the reference ranges. In the second phase, all pregnant women underwent prenatal care visits in each trimester and they followed for 7 days after delivery and the pregnancy outcomes
data are reported. Te mean ± standard deviation for TSH, FT4, FT3, and UIC in the frst trimester of gestation was 1.84 ± 1.32 mIU/L, 1.01 ± 0.15 ng/dL, 4.50 ± 0.64 pmol/L, and 172.0 ± 90.29 ?g/L, respectively. In nonpregnant women, these values for TSH, FT4, FT3, and UIC were 2.58 ± 1.77 mIU/L, 1.10 ± 0.21 ng/dL, 4.49 ± 0.57 pmol/L, and 190.0 ± 109.6 ?g/L, respectively. Te results of the present study could contribute to establish a local thyroid function tests reference ranges in the frst trimester of pregnancy. It could possibly be e?ective on making a local reference value to prevent of thyroid disease misdiagnosis
during pregnancy and adverse pregnancy outcomes.

Te link between autoimmune thyroid diseases and Vitamin D defciency has been reported. However, there are controversies in this regard. We conducted a double?blind randomized placebo?controlled clinical trial to investigate the e?ect of Vitamin D defciency treatment on thyroid function and autoimmunity marker (thyroid peroxidase antibody [TPO?Ab]) in patients with Hashimoto’s thyroiditis.
ifty?six patients with Hashimoto’s thyroiditis and Vitamin D defciency (25?hydroxyvitamin D level ?20 ng/mL) were randomly allocated into two groups to receive Vitamin D (50000 IU/week, orally) or placebo for 12 weeks, as Vitamin D?treated (n = 30) and control (n = 26) groups, respectively. TPO?Ab, thyroid?stimulating hormone (TSH), parathormone, calcium, albumin, and creatinine concentrations were compared before and after trial between and within groups. Te data were presented as mean (standard error [SE]) and analyzed by appropriate tests.
Mean (SE) of Vitamin D was increased in Vitamin D?treated group (45.5 [1.8] ng/mL vs. 12.7 [0.7] ng/mL, P = 0.01). Mean (SE) of TPO?Ab did not signifcantly change in both groups (734 [102.93] IU/mL vs. 820.25 [98.92] IU/mL, P = 0.14 in Vitamin D?treated and 750.03 [108.7] [IU/mL] vs. 838.07 [99.4] [IU/mL] in placebo?treated group, P = 0.15). Mean (SE) of TSH was not changed in both groups after trial, P = 0.4 and P = 0.15 for Vitamin D?treated and control groups, respectively. No signifcant di?erence was observed between two study groups in none studied variables (P > 0.05).
Vitamin D treatment in Vitamin D defcient patients with Hashimoto’s thyroiditis could not have signifcant e?ect on thyroid function and autoimmunity.

The aim of the current trial was to investigate the effect of Vitamin D treatment on metabolic markers in people with Vitamin D deficiency and thyroid autoimmunity.
In this double‑blind, randomized, placebo‑controlled clinical trial, 65 Vitamin D deficient euthyroid or hypothyroid patients with positive TPO‑Ab were enrolled. They randomly allocated into two groups to receive oral Vitamin D3 (50000 IU weekly) and placebo for 12 weeks. Serum concentration of calcium, phosphorus, albumin, C‑reactive protein, blood urea nitrogen, creatinine, glycated hemoglobin (HbA1c), insulin, fasting plasma glucose (FPG), triglyceride (TG), total cholesterol, and high‑density lipoprotein were measured in both groups before and after the trial. Homeostasis model assessment estimates of beta cell function (HOMA‑B) and HOMA‑insulin resistance (HOMA‑IR) were calculated before and after trial in both groups.
Thirty‑three and thirty‑two participants were allocated to Vitamin D‑treated and placebo‑treated groups, respectively. Mean (standard error) level of Vitamin D increased significantly in Vitamin D‑treated group (45.53 [1.84] ng/mL vs. 12.76 [0.74] ng/mL, P = 0.001). The mean of HbA1c and insulin was increased significantly both in Vitamin D‑treated and placebo‑treated groups (P  Our findings showed that weekly 50000 IU oral Vitamin D3 for 12 weeks did not improve metabolic markers, IR, or insulin secretion in Vitamin D deficient patients with Hashimoto thyroiditis.

The present study was designed to evaluate hypertension and dyslipidemia in prediabetic subjects with a family history of type 2 diabetes (first‑degree relatives), and they were compared with the normal glucose‑tolerance subjects.

Three thousand and eighty‑six (788 men and 2298 women) subjects were selected from a consecutive sample of patients with Impaired Glucose Tolerance (IGT), Impaired Fasting Glucose (IFG), and Combined (IFG and IGT), and their first‑degree relatives formed the control group. Potential risk factors for diabetes including age, gender, body size, HbA1c, cholesterol, low‑density lipoprotein (LDL), high‑density lipoprotein (HDL), triglycerides, blood pressure (BP), urine microalbumin, and family and personal medical history were assessed.

The studied participants included 300 IGT patients (9.7%), 625 IFG patients (44.9%), 411 combined patients (13.3%), and 1750 (56.7%) normal subjects. Aging led to increase in hypertension. Increase in body mass index (BMI) led to an increase in the prevalence of hypertension significantly in all groups. The mean triglyceride in the normal group was different in comparison with that of the IGT (P < 0.05) and combined (P < 0.001) groups. Differences in total cholesterol were observed in the normal group when compared with the IGT (P < 0.05) and combined (P < 0.001) groups, and of the combined group in comparison with the IGT (P < 0.05) group. The difference in LDL level was related to the combined group in comparison with IGT, marginally (P < 0.1), and normal in comparison with the combined group (P < 0.05).

Prevalence of hypertension was not significantly different between the groups, however, in prediabetic patients it was higher than in the normal group, and prevalence of dyslipidemia in prediabetic subjects was significantly higher than in the normal group.

The people with prediabetes have insulin resistance (IR). IR may affect thyroid function, size and nodules. We investigated the effects of metformin on the thyroid gland in prediabetic people. In a randomized,double-blind placebo-control clinical trial, 89 people with prediabetes, aged 18-65 years were studied for 3 months. They were divided into two, metformin (n = 43) and placebo (n = 46) treated groups. Serum thyroid stimulating hormone (TSH) was measured and thyroid nodules and volume was studied by ultrasonography. The data were compared between and within groups, before and after the study. Mean of the baseline characteristics in metformin and placebo-treated groups had no statistically significant difference. At the end of the study, serum TSH was not significantly different between the two groups. However, if the TSH range was divided into two low normal (0.3-2.5? U/ml) and high-normal (2.6-5.5? U/ml) ranges,significant decrease was observed in metformin-treated group with a high-normal basal serum TSH (P = 0.01). Thyroid volume did not change in metformin-treated group. However, in placebo-treated group, the thyroid was enlarged (P = 0.03). In 53.9% of participants, thyroid nodule was observed. There was just a decrease in the volume of small solid (not mixed) nodules from median of 0.07 ml to 0.04 ml in metformin-treated group (P = 0.01). In prediabetic people, metformin decreases serum TSH, only, in those people with TSH >2.5? U/ml and reduces the size of small solid thyroid nodules. It also prevents an increase in the thyroid volume.

This study explored the strategies to overcome diabetes-related social stigma in Iran. This paper is part of an action research study which was designed in Iran in 2012 to plan and implement a program for overcoming diabetes-related stigma. Participants were people with type 1 diabetes, their family members, people without diabetes, and care providers in a diabetes center. Data collection was done through unstructured in-depth interviews, focus groups, e-mail, Short Message Service (SMS), and telephone interview. Data were analyzed using inductive content analysis approach. Participants believed that it is impossible to overcome the stigma without community-based strategies. Community-based strategies include education, advocacy, contact, and protest. The anti-stigma strategies obtained in the study are based on the cultural context in Iran. They are extracted from statements of a wide range of people (with and without diabetes). However, during planning for stigma reduction, it is necessary to note that the effectiveness of social strategies varies in different studies and in different stigmatizing conditions and many factors are involved. These strategies should be implemented simultaneously at different levels to produce structural and social changes. It should be accepted that research on reducing health-related stigma has shown that it is very difficult to change beliefs and behavior. Evidence suggests that individuals and their families should be involved in all aspects of the program, and plans should be made according to the local conditions.

In this study, we evaluated the quality of care and control of cardiovascular risk factors in newly diagnosed diabetic patients, identified during diabetes screening program, 1 year after diagnosis. In this prospective study, 83 newly diagnosed diabetic patients identified at screening in Isfahan, were studied. Height, weight, blood pressure, plasma glucose, lipids, and hemoglobin A1c (HbA1c) of these patients were measured 2 times, first at the time of diagnosis and then 1 year later, and the results were compared between two groups, with and without regular course of treatment. Nearly 46.99% and 53.1% of the studied patients have regular and irregular course of treatment. After 1 year, significant improvement in the mean of plasma glucose, cholesterol, triglyceride, low density lipoprotein (LDL), high density lipoprotein and HbA1c was seen in patients with regular course of treatment except for blood pressure (P < 0.05). Frequency of controlled cardiovascular risk factors including fasting plasma glucose, HbA1c, cholesterol and LDL was significantly improved in patients with regular course of treatment (P < 0.05). Mentioned changes were not seen in patients with irregular course of treatment. The findings of the current study demonstrated that though diabetes screening program result in earlier diagnosis of patients with type 2 diabetes, but it seems that regular follow-up and proper management of newly diagnosed patients is crucial for appropriate glycemic and metabolic control and preventing its related micro and macrovascular complication.

The first step in diagnosis of diabetic nephropathy is measurement ofalbumin in a spot urine sample. The aim of this study was assessment of the accuracy of urinary albumin to creatinine ratio (UACR) in random urine specimens (RUS) for microalbuminuria and macroalbuminuria screening in Iranian diabetic patients.A total of 200 diabetic patients participated to our study. 24 h timed urine specimens followed by RUS were collected. 24-h urine albumin excretion (24-h urinary albumin excretion (UAE)) and UACR in RUS were measured. Data were analyzed by Pearson’s correlation, receiver operating characteristic (ROC) curve and McNemar test.A total of 165 patients finalized the study. Pearson’s correlation ofcoefficient for 24-h UAE versus UACR was 0.64. The area under ROC curve for UACR was 0.83 in microalbuminuria and 0.91 in macroalbuminuria. The cutoff point of 30 mg/g in UACR method had 86% sensitivity and 60% specificity for microalbuminuria screening and cut-off point of 300 mg/g had 75% sensitivity and 99% specificity for macroalbuminuria screening respectively.UACR in RUS showed acceptable performance as a screening test for diagnosis ofboth micro and macroalbuminuria in Iranian diabetic patients.

Some epidemiological and interventional studies have shown the role of vitamin D on insulin secretion and resistance. A previous study in our center showed that intramuscular vitamin D decreases insulin sensitivity in pre-diabetic patients. We investigated the role of oral vitamin D on the insulin sensitivity index and insulin resistance in pre-diabetic patients. In a randomized clinical trial, we divided 45 people with pre-diabetes aged 47.4 ± 6.6 (range 33–61) years into three groups: group A subjects treated with 50,000 IU oral vitamin D and 500 mg calcium carbonate (n = 21), group B subjects treated with a single 300,000 IU intramuscular vitamin D and 500 mg calcium carbonate (n = 9), and group C subjects treated with 500 mg calcium carbonate alone (n = 15). Serum 25-hydroxyvitamin D [25(OH)D] was measured at baseline. If it was less than 75 nmol/l, 50,000 IU vitamin D was given weekly, and if serum 25(OH)D was more than that, vitamin D was administered every 2 weeks. Before and after 12 weeks of treatment, a 75-g glucose tolerance test was performed. We used paired t-test and analysis of variance (ANOVA) to analyze the data. P values less than 0.05 were considered significant. Mean (SD) of serum vitamin D increased from 77.5 ± 39.2 to 118.8 ± 56.3 nmol/l (P = 0.009) in group A and from 80 ± 36 to 102.8 ± 43.3 nmol/l (P = 0.053) in group B, and decreased from 44.8 ± 18.3 to 34.6 ± 13.9 nmol/l (P = 0.06) in group C. Insulin sensitivity index (Matsuda) decreased from 11.4 ± 3 to 9.9 ± 3.2 (P = 0.046) in group A, but in comparison with other groups, it was not significant. Oral vitamin D had no effect on insulin sensitivity in pre-diabetes patients in 12 weeks treatment. A randomized double-blind study with a longer duration of treatment is suggested to investigate the effect of vitamin D on insulin resistance.

To determine whether uric acid levels are associated with the components of metabolic syndrome and whether uric acid is a significant factor for development of metabolic syndrome in the first-degree relatives of type 2 diabetic patients as high risk group. A total of 694 (182 male and 512 female, aged 30-69 years) first-degree relatives of type 2 diabetic patients during 2007-2011 were enrolled. The height, weight, waist circumference, blood pressure, fasting plasma glucose, lipid profile and uric acid concentrations were measured. Metabolic syndrome was defined by NCEP-ATP III. Uric acid was associated with waist circumference, blood pressure, triglyceride and HDL-cholesterol level in both sexes (r=0.1-0.3, P<0.05). The prevalence of metabolic syndrome in the fourth quartile of uric acid (64.4% of male and 60.2% of female population) was significantly more than those in the first (25.5% of male and 31.2% of female population) and second quartiles (33.3% of male and 32.0% of female population). The mean of uric acid in people with metabolic syndrome was significantly higher than in those without (6.6±1.2 mg/dL vs. 5.8±1.2 mg/dL; P=0.0001).The age-adjusted odds ratios (95% confidence interval) of uric acid for metabolic syndrome in univariate analysis were [1.60 (1.23-2.07); P=0.008] for men and [1.61 (1.34-1.92); P=0.0001] for women but the effect of uric acid in multivariate logistic regression was not significant. Uric acid is associated with majority of the metabolic syndrome components. People with metabolic syndrome have higher uric acid levels. However, uric acid probably is not an independent factor to predict the metabolic syndrome.

The purpose of this study was to describe the first attempts and performance of health system in Iran in training specialist nurses in the field of diabetes- related care and education. This was a qualitative content analysis. Three diabetes management planners in the Ministry of Health and Medical Education, three provincial executive authorities of diabetes in the health system and ten nurses who worked as diabetes nurse educators (DNEs) participated in this study. Data obtained through semi-structured face-to-face interviews, a focus group, existing documents, field notes, and multiple observations. Data analysis was guided by the conventional approach of qualitative content analysis. Three major themes and six sub-themes were emerged through data analysis. Main themes were: (a) decentralization diabetes nurse educator training without any management (stop education due to transition training responsibility to provincial health authorities and lack of supervision of managers on training); (b) try to reform nursing education infrastructures (try to train qualified educators who were candidate for teaching to DNEs, try to reform undergraduate nursing curriculum); (c) failure of DNE curriculum (lack of consistency between content and timing with the curriculum objectives and lack of attention to learn evaluation process). The findings of this study reflected the failure and multiple challenges in educating nurses working in diabetes units. Despite the fact that important roles were defined for nurses in the action plan for preventing and controlling diabetes, any specific action was not done in preparing nurses for these roles.

We investigated the effect of acute hypothyroidism on lipid concentrations especially on high density lipoprotein (HDL-cholesterol) level in athyroatic patients. Thirty-one patients, with a history of differentiated thyroid carcinoma and total thyroidectomy, who were candidates of radioiodine therapy, enrolled in the study. Their lipid profiles and serum thyrotropin stimulating hormone (TSH) levels were measured before and two-to-six weeks after thyroid hormone withdrawal. The lipid concentrations were compared with the paired t test and serum TSH using the Wilcoxon singed rank test. P values < 0.05 were considered statistically significant. The median of TSH concentration was 0.06 mU / liter on thyroid hormone suppressive therapy and 102 mU / liter at the thyroid hormone withdrawal phase (P < 0.0001). The serum concentrations of all lipids were significantly increased after withdrawal (P < 0.0001). The mean (SD) of the HDL-cholesterol concentration rose from 44 ± 9 mg / dL to 58 ± 17 mg / dL. The levels of total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride increased by 58, 75, 30, and 59%, respectively, during acute hypothyroidism. The present study showed that thyroid hormone withdrawal altered the lipid concentrations significantly, in a short period of time. The levels of both atherogenic (LDL-cholesterol) and cardioprotective (HDL-cholesterol) particles increased concurrently. Their clinical importance should be investigated in future.

Reforming and improving the patient education process need more insight into the strengths and weaknesses of the existing education process. There is little documentation on patient education in National Diabetes Prevention and Control Program in Iran, so the present study aimed to describe patient education process in diabetes centers in one of the provinces of Iran. This is a qualitative content analysis. Twelve nurses who work as diabetes nurse educators (DNEs) and an internal medicine specialist participated in this study. Data was obtained through semi-structured face-to-face interviews, a focus group, existing documents, field notes, and multiple observations. Data analysis was guided by the conventional approach of qualitative content analysis. Three main themes including unequipped trainers (insufficient knowledge and experience, lack of appropriate educational facilities, lack of time, lack of patient’s interest), unstructured education (lack of educational need assessment, lack of evaluation, lack of continuing patient education), unmanaged education (lack of official planning for patient education and supervising the education process) emerged from qualitative content analysis. Although patient education is one of the important strategies in National Diabetes Prevention and Control Program, there however has not been necessary investment and adequate space to achieve it. Patient education was not structured and based on scientific principles. Training of diabetes nurse educators (DNEs) is neglected, and there is no supervision on patient education process.

Low testosterone, with or without symptoms, reported in diabetic men in some studies. We investigated the prevalence of hypogonadism in Iranian type 2 diabetic men. Total testosterone (TT) and sex hormone binding globulin (SHBG) concentrations were measured in 247 diabetic men >30 years who had symptoms of androgen deficiency, according to ADAMs questionnaire. The correlation between some parameters and total, free and bioavailable testosterone levels was determined using Pearson correlation coefficient. Free and bioavailable testosterone were calculated by electronic calculator. Four patients were excluded because of high testosterone level, due to unreported androgen use. Overt hypogonadism was defined as total testosterone ≤8 nmol/l or calculated bioavailable testosterone (cBT)≤2.5 nmol/l and borderline hypogonadism was considered as TT 8-12 nmol/l or cBT 2.5-4nmol/l. The mean and SD of age was 59 (9.3) years. The mean TT, calculated free testosterone (cFT), and cBT and SHBG levels were 4.81 (1.7) nmol/l, 0.11 (0.06) nmol/l, 2.42 (1.17) nmol/l and 36.15 (18.3) nmol/l, respectively. According to TT and cBT, overt hypogonadism observed in 7.4% and 61.6% of men, respectively, and the prevalence of borderline hypogonadism was 9.9% and 36%, respectively. cFT ≤0.16 nmol/l found in 227 diabetic men (96%). Hypogonadism (TT ≤12 nmol/l) was not correlated with obesity, smoking, age, duration of diabetes, blood pressure, and HbA1c. Hypogonadism is highly prevalent in type 2 diabetes men.

Thyroid transcription factor 2 (TTF2) or forkhead box E1 (FOXE1) is a polyalanine domain protein with an important role in the morphogenesis and development of thyroid gland. Mutations of TTF2 gene have been identified in neonates with congenital hypothyroidism caused by thyroid dysgenesis. In this study, the mutations of TTF2 gene were studied among these patients. In this study, the entire TTF2 gene of 50 neonates with congenital hypothyroidism due to thyroid dysgenesis who referred to Isfahan Endocrine and Metabolism Research Center (Isfahan, Iran) was studied by direct DNA sequencing. The mutations were assessed after amplification of TTF2 gene by polymerase chain reaction (PCR) method. Mutations of each exon of TTF2 gene were evaluated by the adjacent primers of the whole encoding region. We did not find any mutation in TTF2 gene. There was a serotonin polymorphism among 74% of studied patients. The length of TTF2 polyalanine tract was 14 amino acids in most patients. The findings of this study indicated the possible correlation between TTF2 polyalanine tract length polymorphism and genetic susceptibility to thyroid dysgenesis among patients with congenital hypothyroidism.

This study aimed to compare different body mass index (BMI) categories in individuals with diabetes, prediabetes and normal glucose tolerance among the first degree relatives of type 2 diabetic patients. A cross-sectional study was conducted during 2005-2007 in Isfahan, Iran. It evaluated 3323 first-degree relatives of diabetic patients selected by consecutive convenient sampling method. Participants were classified as diabetic, prediabetic, and normal glucose tolerance test groups according to the results of 75 g oral glucose tolerance test (OGTT). The analysis of variance (ANOVA) was used for comparison of quantitative variables, and chi square test for comparison of categorical parameters The study population consisted of 3323 individuals including 306 diabetics (98 males and 208 females), 1309 prediabetics (337 males and 972 females), and 1708 normal subjects (430 males and 1278 females). Among diabetic patients, the prevalence of obesity was 48.5% in women and 27.6% in men. Among prediabetics, the corresponding figures were 45.6% and 27.3%, respectively. Our findings suggest that men are diagnosed with T2DM at lower BMI than women. Moreover, the alarming high prevalence of overweight and obesity among females necessitates preventing and controlling this underlying problem among females.

Dietary habits play an important role in the prevention of chronic disease; however, few studies have assessed the major dietary patterns in Middle Eastern countries. This study identifies major dietary patterns among Iranian people with abnormal glucose homeostasis. This cross-sectional study was conducted at the Diabetes Research Center, Isfahan, Iran among 425 subjects with abnormal glucose homeostasis. Patients were of ages 35 – 55 years and had family histories of diabetes. We assessed dietary intake by the use of a food frequency questionnaire (FFQ) that contained 39 food items. General obesity was defined as a BMI ≥ 30 kg/m2 and central obesity was defined as waist circumference (WC) ≥ 88 in women and WC ≥ 102 in men. Five major dietary patterns were revealed by factor analysis: ‘ western’, ‘ healthy’, ‘ vegetarian’, ‘high-fat dairy’, and ‘chicken and plants’. Those in the top tertile of the ‘western pattern’ had greater odds for general (OR = 1.73; 95% CI = 1.07 – 2.78) and central obesity (OR = 2, 95% CI = 1.24 – 3.22), however these associations were not significant after adjustment for confounding variables. The ‘high-fat dairy pattern’ was associated with greater odds of general obesity only after adjusting for confounding variables (OR = 1.73; 95%CI = 1.01 – 2.96). CONCLUTION: The dietary pattern characterized by high intake of hydrogenated fat and sugar was shown to be positively associated with a risk of general and central obesity, however further prospective studies are required to confirm our findings.

Action research is a means for creating meaning and promoting understanding of complex social situations, and improving the quality of human interactions and performance in those situations. Action research is one of the words that can be heard now frequently in the educational cycle, but there are several definitions for it. Literature review shows that several writers have referred to this concept and have mentioned several categories of action research. They identify its models, types, approaches, typologies, and taxonomy or action research views. In general, action research is an umbrella that encompasses a range of research traditions and several established methodology. This paper deals with describing them.

Considering the high prevalence of congenital hypothyroidism (CH) in Iran and particularly Isfahan, Iran, and according to the findings of CH screening program which was implemented during recent years and lack of studies evaluating the treatment outcome of diagnosed patients, the aim of this study was to descriptively evaluate the growth status of children with CH. In this prospective cohort study, 760 CH neonates who were diagnosed and followed up during CH screening program (2002-9) in Isfahan were enrolled. They were selected by convenient sampling method. Height, weight, head circumferences and body mass index (BMI) of the studied patients were measured. In addition, the 3rd, 15th, 50th, 85th and 97th percentiles of the studied variables according to sex and age groups were determined and descriptively compared with corresponding values suggested by the World Health Organization (WHO). The percentiles of weight, height and head circumferences of the studied children with CH were significantly different from the WHO values. The observed differences were less significant in higher percentiles. The differences reduced during the follow-up and they were lower in older ages. The findings of this study indicated that proper treatment of neonates with CH would improve the growth delay of patients during follow-up. However, normal growth of head circumference would be achieved earlier than weight.