[ effect of L-thyroxine treatment on memory quotient in adults with subclinical hypothyroidism: a randomized double blind controlled trial]

Introduction: Verbal memory and executive function might be disturbed in subclinical hypothyroidism. The aim of this study was to explore the effect of levothyroxine treatment on the memory quotient of Anti-TPO-Ab positive subjects with subclinical hypothyroidism

Materials and Methods: Sixty Anti-Tpo-Ab positive subjects [51 female, 9 male] with subclinical hypothyroidism with a mean age of 34 were enrolled in this randomized double blind placebo controlled trial. Subjects were randomized into two groups, i.e. the case [26 females-4 males] and the controls [25 females, 5 males] groups. Using the Weschler memory test, memory quotient was assessed at the beginning and three months after initiation of levothyroxine treatment

Results: The mean age of subjects was 34.22 +/- 10.75 y and the mean TSH level was 8.25 +/- 3.64 mIU/l. There was no difference between two groups in relation to the memory quotient at the beginning of the study [10.5.70 +/- 11.66 vs 105.87 +/- 11.49, P=0.83]. Following treatment the mean for the memory quotient rose by 9.9 +/- 8.01 in the cases and 3.23 +/- 7.63 in the controls [P=0.002]

Conclusion: In this study we observed an increase in the memory quotient after treatment with levothyroxine in individuals with subclinical hypothyroidism, demonstrating that levothyroxine treatment could be recommended to improve verbal memory and executive function in this group of subjects

Prevalence of type 2 diabetes in the Islamic Republic of Iran: systematic review and meta-analysis

We estimated the prevalence of type 2 diabetes in the Islamic Republic of Iran by systematic review of all available studies in the country between 1996 and 2004 and aggregation of the data using meta-analysis and meta-regression methods. In those > 40 years the prevalence was 24% and it increased by 0.4% with each year after 20 years of age. The risk of type 2 diabetes was 1.7% greater in women than men [P < 0.001]. The prevalence of type 2 diabetes appears higher in the Islamic Republic of Iran than in other developing countries but because of differences in age pyramids, the crude prevalence is not an appropriate indicator and age-adjusted or age-specific prevalences should be used

concept of palliative care practice among Iranian general practitioners

General Practitioners [GPs] have the main responsibility in medical and particularly palliative care provision in most of countries, though this is not the current case in Iran. Development of 'family physician' approach in rural and most of the urban areas in Iran, GPs will have the main role in care provision. There is no formal palliative care education during general medical training in the country so far. Regarding the increasing number of people in need of palliative care services, it is essential to assess GPs' knowledge about palliative care to develop special palliative care educational programmes. A cross-sectional questionnaire survey was conducted on general practitioners participated in a formal Continuous Medical Education programme, using three scales. 216 GPs returned the completed questionnaires. More than half scored their knowledge about palliative care as weak, which was significantly related to their previous experience in caring of a terminally ill patient [p=0.001]. Less than one third stated their good ability to either assess or manage pain in end of life. Major gender differences were seen in different subscales such as communication with patients and carers, patient management, palliative care knowledge and skills, and psychological stress. This study revealed a profound lack of knowledge and experience among Iranian general practitioners about palliative care which was mostly in more complicated areas rather than common symptoms relief

Diabetic foot risk factors in patients with diabetes at the Kamkar hospital diabetes clinic in Qom, iran 2006

Diabetic foot problems are one of the major causes of mortality and disability in diabetic patients. It is considered one of the costliest conditions for health care systems. This study is designed to identify diabetic foot risk factors in patients with diabetes mellitus at Kamkar Hospital diabetes clinic in Qom, Iran during 2006. This study was performed on 140 diabetes mellitus patients at the Kamkar Hospital diabetic clinic. International working Group on the Diabetic Foot [IWGDF] guidelines were used for physical exam of diabetic foot in these patients. The physical exam consisted of inspection of foot appearance for deformity, skin keratosis and ulcer, and neurological and arterial pulse exam of the lower extremities of these patients. Patients in this study were divided into four risk groups based on the IWGDF guidelines. ANOVA method was used for analysis and comparison of the results with P < 0.05 considered as significant. Mean age of the participants in this study was 52.4'11.2 years old from which 67.1% were female, 37.1% of patients were illiterate, and 10% were active smokers. Mean duration of diabetes in these patients was 8.9 years. Mean body mass index [BMI] was 29.4 +/- 4.4 and HbA1C was 9.3 +/- 1.9. Percentages of the patients with retinopathy and nephropathy were 33.6% and 17.7% respectively. 95% of the patients did not know the correct way of nail clipping, 95.5% were wearing uncomfortable shoes, and 14.3% of patients had history of foot ulcer. None of the them had any education about foot care. Physical examination with monofilament, ankle reflex and vibration perception were defected in 28.6%, 52.5%, and 32.1% of patients respectively. 37.7% of patients had a decreased lower extremity pulse that was not felt by touch. Based on the IWGDF classifications, 70% of the patients were in the higher-risk group for diabetic foot ulcer. In the high risk group, age, duration of diabetes, illiteracy was significantly increased [p values of 0.03, 0.001, and 0.02 respectively]. The result of this study emphasizes importance of early detection of diabetic foot complications in diabetic patients and need for implementing preventive strategies, especially education, to decrease the burden of diabetic foot problems and to improve the quality of life for people with diabetes