[ prevalence of limited joint mobility in patients with type 1 diabetes mellitus in Kerman]

Limited joint mobility [LJM] is a complication of diabetes mellitus, which usually begins from the small joints of hands and is associated with long-term complications of diabetes, such as retinopathy and nephropathy. The aim of this study was to find the prevalence of Limited Joint Mobility in patients with type 1 diabetes mellitus in Kerman in 2003. Sixty-six patients with type I diabetes mellitus [case group] and 66 sex- and age-matched, healthy subjects [control group] were enrolled into the study. LJM was diagnosed with "prayer sign" and its severity was categorized into 3 levels of mild, moderate, and severe. The results of measurements of glycosylated hemoglobin [HbA1c], date of birth, date of onset of diabetes, sex, weight, and height were recorded, as well. Anthropometric indices were calculated using the reference data of NCHS and WHO. Case and control groups had similar gender and age distributions. Anthropometric indices were significantly lower in cases than in controls [P<0.05]. LJM was observed in 25 ones in case group [37.9%] and in 5 ones in control group [7.6%] that shows statistically significant difference [P<0.001]. LJM in diabetic patients was positively correlated with age [P=0.047] and duration of diabetes [P<0.003], but not with age of onset of diabetes [P>0.05]. Mean level of HbA1c was significantly higher in diabetics with LJM than in those without LJM [P<0.001]. The presence and severity of LJM was inversely correlated with height for age and weight for age indices in the study group [P<0.05]. The observed results are in accordance with prevalence rates reported previously. Since LJM has been associated with more serious long-term complications of diabetes in cross-sectional studies, we believe diabetic patients should be tested routinely for this forgotten sign and appropriate preventive measures should be taken

cross-sectional controlled study of gonadal function and pubertal development in thalassemia major

Early and regular blood transfusion therapy in patients with homozygous beta-thalassemia decreases the complications of severe anemia and prolongs survival. In the long term, however, the beneficial effects of transfusions are limited by the organ damage resulting from iron overload. Endocrine complications in patients with thalassemia major in developing countries may be frequent due to suboptimal iron chelation. The goal of this study was to investigate the gonadal function and secondary sex characteristics in thalassemic patients. We studied 71 randomly selected adolescent thalassemic patients and 30 age- and sex-matched controls. Sexual maturity rating [SMR], height and weight, and gonadotropin, sex steroid, and ferritin levels were evaluated. Cases had significantly lower mean height and weight. Also, serum levels of gonadotropins and sex hormones were significantly lower in cases with thalassemia than in controls. Gonadotropin and sex steroid levels were lower in cases with thalassemia who had not used deferoxamine regularly compared to those with a regular chelation therapy regimen. All of the control subjects had sexual maturity ratings of II or above, while 36.6% of thalassemic cases were in Tanner stage I. About 53.3% of controls had surpassed all levels of sexual maturity, while only 2.8% of cases were in the stage SMR V. Distribution of SMR ratings was significantly different in cases and controls. These findings clearly show that a high percentage of thalassemic patients in this part of the country suffer from various endocrine abnormalities, especially impairment in height, growth and sexual maturity. It is wise to consider more sophisticated treatment modalities in these patients, including the administration of sex hormones for the compensation of hormonal abnormalities resulting from hemosiderosis