مجله دانشکده پزشکی اصفهان
پیاپی 797 (هفته اول اسفند 1403)

Each year, millions of Muslims with diabetes fast during Ramadan, which brings with it specific metabolic challenges such as hypoglycemia, hyperglycemia, dehydration, and ketoacidosis.

We reviewed diabetes management during Ramadan based on the American Diabetes Association's latest recommendations in 2025 and other authoritative sources.

Conducting a comprehensive risk assessment and educating diabetic patients before fasting are crucial for reducing metabolic risks. Careful adjustment of the medication regimen and continuous glucose monitoring, especially in the final hours of fasting, are essential to prevent complications such as hypoglycemia, dehydration, and ketoacidosis. Adopting a person-centered approach to managing fasting and avoiding strenuous physical activity in the final hours will increase safety and improve health outcomes in fasting diabetic patients.

The increase in Muslim patients with diabetes who fast during Ramadan has increased the willingness of reputable scientific communities to collect evidence and provide clinical guidelines based on it and has contributed significantly to improving the management of these patients.

Surgical treatment for gynecomastia correction in men combines liposuction and surgical excision. The present study was conducted to compare the outcomes after surgery and liposuction in patients with a history of gynecomasti.

In a cross-sectional study, the data in the files of 92 patients in Isfahan Plastic Surgery Clinic who underwent gynecomastia correction surgery alone or combined with liposuction, in terms of gynecomastia grade, type of surgical technique (Webster, Lolande, LeJour, and Inverted-T excision), postoperative complications, wound scar score, patient satisfaction score, and expert panel satisfaction were analyzed at intervals of one month to 12 months.

5 (5.4%) of the patients in grade II A, 42 (45.7%) in grade II B, and 45 (48.9%) in grade III gynecomastia underwent surgery. The most common surgical technique used in grade IIA and IIB patients was the Webster technique and, in grade III, the Lolande (Dermoglandular) technique. The most common postoperative complications observed include breast flattening, paraesthesia, and nipple numbness. More than a quarter of the patients experienced a recurrence of gynecomastia. The most complications occurred after using the Webster technique and in the group of patients with grade III gynecomastia. The patients who were operated on with the Lejour technique and the Lolande technique (Dermoglandular) showed significantly the highest and lowest scar scores, respectively.

In gynecomastia correction surgery, the use of the Lolande (Dermoglandular) surgical technique resulted in the lowest frequencies of either complications or scar scores.

Considering the importance of the key role of mothers in the family and their significant impact on the health of the family and children and the prevention of maternal mortality, we designed a study to determine the analysis of maternal mortality in the last ten years in North Khorasan province.

This is a descriptive cross-sectional study that examined all the deaths of pregnant mothers in North Khorasan from 2013 to 2023. In this study, the researcher referred to the health centers and teaching hospitals of the province, examined the health records and hospital records of all deceased mothers, and the cause of death checklist was completed. Data analysis was done in descriptive analysis.

The findings showed that in the last 10 years, 48 cases of maternal death have been recorded in North Khorasan province. The maternal death index in North Khorasan province had a downward trend from 2012 to 2015, then an upward trend from 2016 to 2018, and with the COVID epidemic in 2019, it reached its maximum, i.e., 64 per hundred thousand live births. After that, it had a decreasing trend until 2023. The most common cause of maternal death is blood pressure disorders during pregnancy, delivery, and after delivery and in second place is obstetric bleeding.

Maternal mortality increased in North Khorasan province with the COVID epidemic, excluding COVID-19 blood pressure disorders was the most common cause of maternal death in North Khorasan province. Considering the high level of pregnancy blood pressure in North Khorasan province, better management of blood pressure and pre-eclampsia in pregnancy can help in reducing maternal mortality.