The Relationship between Coronavirus Anxiety, Mindfulness and Spiritual Health in Patients with Cancer: A Survey in Southeast Iran

Objective@#The sudden outbreak of COVID-19 has caused major health problems, including anxiety in cancer patients worldwide. Spiritual health and mindfulness are considered as factors affecting anxiety. This study addressed the relationship between COVID-19 anxiety, spiritual health and mindfulness in patients with cancer. @*Methods@#One hundred and eighty-four cancer patients participated in this cross-sectional study. The data were collected with convenience sampling method from two oncology centers from 15 June to 15 July 2020 in the southeast Iran. Patients completed the Demographic and Clinical Characteristics Form, Corona Disease Anxiety Scale (CDAS), The Freiburg Mindfulness inventory-Short Form (FMI-SF) and Spiritual Health Scale. @*Results@#According to the psychological symptom subscale (CDAS), 61.4% of the participants had moderate to severe anxiety. According to the physical symptom subscale, 38% of the participants had moderate to severe anxiety. No significant association was found between corona disease anxiety and mindfulness/spiritual health (p>0.05). @*Conclusion@#The results of this study showed high levels of mental and physical anxiety and worries about COVID-19 disease in cancer patients, which led to challenges in their lives. It is necessary to review and implement effective interventions in future studies to prevent anxiety and its consequences in cancer patients.

The Relationship between Coronavirus Anxiety, Mindfulness and Spiritual Health in Patients with Cancer: A Survey in Southeast Iran

Objective@#The sudden outbreak of COVID-19 has caused major health problems, including anxiety in cancer patients worldwide. Spiritual health and mindfulness are considered as factors affecting anxiety. This study addressed the relationship between COVID-19 anxiety, spiritual health and mindfulness in patients with cancer. @*Methods@#One hundred and eighty-four cancer patients participated in this cross-sectional study. The data were collected with convenience sampling method from two oncology centers from 15 June to 15 July 2020 in the southeast Iran. Patients completed the Demographic and Clinical Characteristics Form, Corona Disease Anxiety Scale (CDAS), The Freiburg Mindfulness inventory-Short Form (FMI-SF) and Spiritual Health Scale. @*Results@#According to the psychological symptom subscale (CDAS), 61.4% of the participants had moderate to severe anxiety. According to the physical symptom subscale, 38% of the participants had moderate to severe anxiety. No significant association was found between corona disease anxiety and mindfulness/spiritual health (p>0.05). @*Conclusion@#The results of this study showed high levels of mental and physical anxiety and worries about COVID-19 disease in cancer patients, which led to challenges in their lives. It is necessary to review and implement effective interventions in future studies to prevent anxiety and its consequences in cancer patients.

Effectiveness of glargine insulin on recovery of patients with diabetic ketoacidosis

Background: Diabetic Ketoacidosis [DKA] is one of emergency conditions caused by acute hyperglycemia in diabetic patients. The main treatment is injection of rapid-acting Regular insulin. This study was aimed to investigate the effect of Glargine insulin on recovery of patients with DKA

Methods: A randomized clinical trial [RCT] conducted on 40 patients [twenty patients in each group] with DKA. Both groups received standard treatment regimen for DKA. In addition, the experimental group was given 0.4 U/kg of insulin glargine

Results: The mean duration of acidosis correction time and recovery from DKA was 13.77+/-6.10 hours in the case group and 16.91+/-6.49 hours in control group [p=0.123]. The mean dosage of regular insulin until recovery from DKA was 84.8+/-45.6 units in the case group and 116.5+/-91.6 units in control group [p=0.17]. Hypokalemia [p=l] and hypoglycemia [p=l] were not different between two groups. In 35% of samples in case group and 51% in controls, the blood sugar [BS] was more than 180 mg/dl for 24 hours after discontinuation of the insulin infusion [pFO.046]. The mean duration of hospitalization was 5.1+/-1.88 days in case and 5.9+/-2.19 days in control group [p=0.225]

Conclusion: Adding insulin Glargine to the standard treatment regimen of DKA significantly reduced rebound hyperglycemia without incurring episodes of hypoglycemia and hypokalemia

It also reduced the average time of recovery from DKA, regular insulin consumption and hospital length, although these changes were not statistically significant. It seems that the non-significant difference be related to the paucity of sample size and close monitoring of patients

[Clinical and pathological findings and prognostic factors in a long term follow up of patients with differentiated Thyroid Cancer]

Background and Objectives: Thyroid Cancer is the most common endocrine malignancy, and its incidence is increasing all over the world. It seems that patients' characteristics, distribution of different histopathological types, its clinical presentation, prognostic factors, and patients' outcome are significantly from study to study. In this study we examined the above factors in a group of patients with thyroid cancers

Materials and Methods: In a retrospective setting, medical records of 450 patients with thyroid cancer diagnosed between 1993-2014 in Tabriz Endocrinology Centre were studied and patient's demographic information, clinical/histopathological findings, treatments, and long-term outcome were recorded

Results: From total number of 450 patients 80.4% were female, the mean age of patients at the time of diagnosis were 37.15 +/- 11.72 years [range: 11-74]. Solitary thyroid nodule was the most common initial presentation [77.5%], followed by multiple thyroid nodules [20.9%], cervical lymphadenopathy [9.3%], and hoarseness [0.3%]. Fine-needle aspiration was carried out in 79.8% of the patients with the following findings: papillary carcinoma in [56.5%], benign nodule [15.3%], follicular carcinoma [12%], suspicious [9.7%], medullary carcinoma [2.2%], Hurtle cell carcinoma [2.2%], unsatisfactory [1.7%], and anaplastic carcinoma [0.3%]. In the future workups that were performance the distribution of the final diagnosis was papillary carcinoma [92%], medullary carcinoma [3.8%], hurtle cell carcinoma [2%], follicular carcinoma [2%], and anaplastic carcinoma in [0.2%]. Postoperative follow-up was achieved in 90.9% of patients, with a mean duration of 7.40 years. Cure was reported in 91.4%, local metastasis in 5.9%, concomitant local and distant metastases in 2%, and pare distant metastasis in 0.7%

Conclusion: Most aspects of thyroid cancers in the present study were compatible with previous reports. Excellent postoperative survival was an outstanding finding in our study

Risk factor profile and angiography findings in military and non-military patients with coronary artery disease

Military personnel come from the general population and have the same epidemiological style for coronary artery disease [CAD]. There are two significant questions: Is there a higher rate of premature CAD in military personnel in comparison with general population and does the risk factor profile in military personnel differ from that of the general population? The present study was designed to answer these questions. The present case control study was performed on all military and non-military patients referred to angiographic departments due to CAD symptoms between 2003 and 2005. We collected demographic data with major coronary risk factors such as diabetes mellitus, hyperlipidemia, hypertension, and smoking [cigarette or pipe]. We divided the recruited patients according the angiographic findings and the number of involved vessels into three groups. Among the patients, 9709 [81%] were affected by CAD. From this total, 3586 [36.93%] were military and 6123 [63.07%] were non-military patients. Premature CAD in the military personnel [868, 24.21%] was significantly higher in the non-military [503, 8.3%] persons [P=0.00]. Diabetes and hypertension were significantly lower in the military personnel in comparison with the non-military group. Smoking in the military personnel was significantly higher than in the non-military group. There was a significant association between the number of risk factors and involved vessels in our participants. In light of the fact that the rate of premature CAD was higher in the military personnel in our study, we suggest that screening programs with sensitive tools might be necessary for an earlier detection of the military personnel at a higher risk of CAD

Comparison of metformin and cyproterone-estrodiol compound effect on hs C-reactive protein and serum androgen levels in patients with poly cystic ovary syndrome

The aim of this study was comparison of the effects of Metformin and Cyproterone-estradiol compound on serum androgens and highly sensitive C-reactive protein levels. Sixty patients with Poly Cystic Ovary Syndrome [PCOS] were enrolled in this study conducted during a period of 16 months from December 2004 to March 2006. Thirty subjects were in each group and treated with Metformin one gram per day or Cyproterone-estradiol compound 21 days monthly and at the beginning and after 3 and 6 months, weight, height, testosterone, dehydroepiandrosterone sulfate [DHEA-S] and hs-CRP levels were measured. Mean age of patients was 23.5 +/- 8.7 years with the range of 15 to 49 years. In both groups significant decreases in DHEA-S levels and in Cyproterone-estradiol compound group a significant decrease in testosterone levels were seen after 6 months, but there were no significant decrease on hs-CRP levels. Comparison of two groups showed that there were no significant differences in the effects of these two drugs on serum testosterone, DHEA-S and hs-CRP levels. In our study the level of hs-CRP at the beginning of treatment were significantly higher in patients who were overweight and obese. Also we found that Cyproterone-estradiol compound causes significant decrease at the level of hs-CRP in overweight and obese patients. The results of this study are different from those of previous studies about beneficial effects of Metformin on hs-CRP levels but are similar to the results of studies that revealed probably obesity and overweight has important role in inducing inflammation and increasing CRP levels

Hyperhomocysteinemia and bone mineral density: a case - control study

To find out whether homocysteine has a direct effect on bone or it is an innocent bystander? The study was designed to investigate probable role of homocysteine on bone mineral density [BMD]. This a case-control study wherein, 30 patients with at Least one densitometry criterion of osteoporosis in femoral neck or Lumbar spine were enrolled as the case group along with another 30 normal subjects with normal BMD, as the control group. The patients of the two groups were matched for their ages and sex. In all eligible patients BMD was measured by DEXA and fasting serum homocysteine level were measured by Enzyme Immunoassay Kit. The mean of serum level of homocysteine were 11.67 +/- 4.38 and 11.97 +/- 3.09 imol/l in control and case groups respectively. The difference between two groups was not significant [P=0.761]. Serum homocysteine level and BMC of various areas in case and control groups had no significant correlation [lumbar spine in control group [r= 0.025, p=0.9], lumbar spine in case group [r=0.071, p=0.716], femoral neck in control group [r=0.276, p=0.147], femoral neck in case group [r=0.001, p=0.998fl. Despite numerous studies about direct effect of homocysteine on increase of osteoporotic fracture risk, our study did not show a correlation between serum Level of homocysteine and BMD. Due to multiplicity of factors affecting bone density, final conclusions need extensive investigations with attention to other confounding factors

[Importance of OGTT for diagnosis of diabetes in thalassemia major patients]

Thalassemia major is a genetic disorder. Blood transfusion is critical for survival in these patients. Over the course of the past two and three decade's hyper transfusion therapy in these patients has increased significant improvement in life expectancy and quality of life. Unfortunately this type of therapy increased the frequency of complication due to iron overloud. The aim of this study was to evaluate the prevalencey of diabetes, impaired fasting glucose and impaired glucose tolerance in patients with thalassemia major, with 10-27 years of age in Tabriz. This descriptive study was done on 56 patients between 10-27 years of age with thalassemia major. The demographic informaiton theraputic regiment, the age of first trasfussion. The level of blood transfusion, the history and dosage of familial history of diabetes, Fe, TIBC, ferritin levels were assessed and recorded. For each patient glucose tolerance test, blood glucose level are performed. In this study prevalence of diabetes mellitus, impaired fasting glucose and impaired glucose tolerance test were found in 8.9%, 28.6% and 7.1% of patients respectively. This study showed that despite recent therapy with Desferal in the management of beta-thalassemia major, the risk of secondary endocrine dysfunction remains high. Prevalence of diabetes mellitus, impaired fasting glucose and impaired glucose tolerance test are greater than general population. Endocrine evaluation in patients with thalassemia major must be carried out regularly especially in those patients over the age of 10 years

cross-sectional study of metabolic and endocrine complications in beta-thalassemia major

Iron overload is a major problem in patients with beta-thalassemia major, and it has many structural and metabolic consequences. The aim of this study was evaluation of endocrine distturbances in patients with beta-thalassemia major who were older than 10 years of age. In this cross-sectional study, investigators collected demographic data and medical histories, as well as menstrual history in females, from the medical records of 56 patients with beta-thalassemia major. Patients were examined to determine their pubertal status and the standard deviation score for height for evaluation of short stature. For evaluation of glucose tolerance, a fasting blood glucose and oral glucose tolerance test were performed. Evidence for diabetes mellitus was based on American Diabetes Association and World Health Organization criteria. Serum levels of calcium, phosphorous, thyroid-stimulating hormone, free thyroxin, luteinizing hormone and follicular-stimulating hormone, and estradiol in girls and testosterone in boys were measured. The mean and standard deviation for age in the 56 patients [36 males and 20 females] was 15.62 +/- 4.44 years. Diabetes mellitus was present in 5 patients [8.9%], impaired fasting glucose was found in 16 patients [28.6%] and an impaired glucose tolerance test was found in 4 patients [7.1%]. Short stature [standard deviation score <-2] was seen in 25 [70%] boys and 14 [73%] girls. Impaired puberty was found in 40 patients [71%]. Hypocalcaemia and primary overt hypothyroidism were present in 23 [41%] and 9 patients [16%], respectively. Only eight patients [14.3%] had no endocrine abnormalities. Despite therapy with deferoxamine to treat iron overload, the risk of secondary endocrine dysfunction remained high. Hypogonadism was one of the most frequent endocrine complications. Impaired glucose tolerance, short stature, hypocalcemia, subclinical and overt hypothyroidism are also frequent

[Serum levels of adiponectin in non-diabetic and diabetic obese individuals]

Adiponectin is an adipose tissue-derived hormone that low levels of this hormone are associated with obesity, insulin resistance, and type 2 diabetes. The aim of this study was to compare the serum levels of adiponectin in diabetic and non-diabetic obese individuals. As a cross-sectional study 35 obese individuals with type 2 diabetes mellitus and 35 non-diabetic obese subjects were enrolled. Two groups were matched for age, gender and body mass index. Fasting lipid profile was measured via the enzymatic methods. The Nyco Card HbA1c Kit was used to measure HbA1c. The Serum Adiponectin, insulin and glucose levels were measured via an enzyme immunoassay, using a commercially available kit and glucose oxidase methods, respectively. The HOMA and QUICKI indices were used to determine insulin resistance and insulin sensitivity, respectively. The mean of insulin resistance index [HOMA-IR], HbA1c, diastolic blood pressure, triglyceride and fasting glucose in diabetes were significantly higher than non-diabetics [P<0.05]. The serum Adiponectin levels was significantly lower in diabetes than non-diabetics [15.74 +/- 6.70 vs. 21.52 +/- 9.35] and was significantly higher in women than men [19.38 +/- 7.33 vs. 12.68 +/- 4.28] among diabetic and [24.63 +/- 10.52 vs. 17.83 +/- . 6.21] among non-diabetics groups. Type 2 diabetes mellitus is associated with low serum adiponectin concentrations and probably adiponectin involved in the pathophysiology linking obesity to type 2 diabetes

Pterygium surgery: amniotic membrane or conjunctival autograft transplantation / 国际眼科杂志(Guoji Yanke Zazhi)

· AIM: This study was conducted to compare the outcomes of amniotic membrane transplantation (AMT) with conjunctival autograft transplantation (CAT) in primary and recurrent pterygium. The main outcome measurement was the recurrence rate after surgery.· METHODS: This study was designed as a prospective study on consecutive cases of pterygium from April 2004 to Feb2006. The cases were randomly divided into two groups of AMT (26 cases) and CAT (24 cases). All subjects were operated with an extensive excision of the fibro vascular tissues with AMT or CAT approach. Patients were followed for recurrence and complications for 24 months. The surgical procedures were performed by a single surgeon.The associations between demographic variables, surgical techniques (AMT, CAT), recurrences and postoperative complications were analyzed.· RESULTS: The patients' male to female ratio was 4:1. Involvement of right to left eye ratio was 3:2. Pterygium in70% of cases was primary and in 30% was recurrent. The most common clinical signs were red eye and reduced visual acuity while the most common complications were recurrence and corneal scar. In the first month of follow up, the recurrence rates in AMT and CAT approaches were 3.8% vs 8.3%respectively and these rates increased to 46.2% vs 25% respectively after 24 months of follow up.· CONCLUSION: The success rate of 2 years follow up was better in CAT technique. The AMT technique for pterygium surgery has an unacceptably high recurrence rate.

[Evaluation of impaired glucose tolerance and type 2 diabetes mellitus prevalence in "PCOS" and necessity for screening in patients with "PCOS"]

Background: polycystic ovary syndrome [PCOS] which is characterized by menstrual irregularities [due to chronic anovulation] and hyperandrogenism is one of the most common endocrine disorders of women at reproductive age. The precise cause of PCOS is unknown, but it seems that several factors may have role in its pathogenesis. Insulin resistance and impaired insulin secretion are common findings in PCOS patients. Approximately 30 - 40 % of women with PCOS have impaired glucose tolerance or type 2 DM. According to my knowledge, there is no published study about prevalence of IGT and type 2 Diabetes Mellitus [type 2 DM] in Iranian women with PCOS. The aim of this prospective, controlled study was to determine the prevalence of abnormal glucose metabolism in women from North West part of the country

Methods: 302 PCOS women and 116 normal women as a control group were prospectively studied. The diagnosis of PCOS was made based upon the presence of chronic anovulation and hyperandrogenemia. Other causes of hyperandrogenism were excluded by appropriate clinical and laboratory evaluations. None of the patients were known diabetics prior to study. In all patients with PCOS and control women appropriate medical history was taken and physical examination was done. Blood pressure, body weight, height, BMI, waist/hip ratio, score of hirsutism and other signs of androgen excess were determined. Serum concentrations of total testosterone and DHEA-S were measured by RIA methods in both patients and control group. Standard Oral Glucose Tolerance Test [OGTT] with 75 grams oral glucose was performed between 8-9 AM after an overnight fast of 10-12 hours. Fasting and 2 - hour post - glucose plasma sugars were measured by glucose oxidase method

Results: results of OGTT were interpreted according to WHO criteria. Mean age and mean BMI were similar in both patients and controls. Serum levels of total testosterone and DHEA - S were significantly higher in PCOS women in comparison with controls. 65% of patients and 68% of controls had BMI of >/= 25 kg/m2. 55% of PCOS women and 51.6% of control women were obese [BMI >/= 27kg/m2]. 96 [31 -7%] of PCOS women had impaired glucose tolerance [IGT] and 27 [8.9%] were diabetics. The prevalence of IGT and diabetes in controls were 14.6% and 5.1% respectively. In non-obese PCOS women the prevalence of IGT and DM were 17.2% and 3.6% respectively, while only 8.9% of control women had IGT and 1.7% were diabetics. Finally, 44.1% of obese PCOS women were glucose intolerant and 13.5% had diabetes mellitus in comparison with 20% and 10% of controls

Conclusion: it is concluded that the prevalence of IGT and DM in both obese and non-obese PCOS women were significantly higher than in control women. Screening of all PCOS women for IGT and DM is highly recommended