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Background: Despite evidence about the relationship between diabetic ketoacidosis (DKA) and infectious diseases, our knowledge of DKA during the coronavirus disease 2019 (COVID-19) pandemic remains unclear. Objectives: This study aimed to compare the DKA situation among individuals with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) during the COVID-19 pandemic compared to pre-pandemic. Methods: This retrospective-longitudinal study included individuals with T1DM and T2DM hospitalized with newly diagnosed DKA before (March to August 2018 and 2019) and during (March to August 2020 and 2021) the COVID-19 pandemic. Demographics, the frequency of new-onset diabetes mellitus (DM) and new-onset DKA, days of hospitalization, DKA severity, laboratory tests, and mortality were assessed. Results: Of 162 patients with DKA, 139 patients were newly diagnosed. The frequency of individuals with new-onset DM had increased during the pandemic compared to pre-pandemic (P = 0.047). Moreover, new-onset DKA was higher in 2020 and 2021 versus 2019 and 2018 (P = 0.002). Significantly, there were no T2DM patients with DKA in pre-pandemic, but DKA admissions in people with T2DM increased in 2021 (P < 0.001). The severity of new-onset DKA had increased during the pandemic compared to pre-pandemic (P = 0.000). However, there was no significant difference between pre-and the pandemic regarding mortality (P = 0.981). Additionally, hospitalization length (P = 0.043) and mortality (P = 0.038) were higher in patients with T2DM compared to T1DM. Conclusions: During the COVID-19 pandemic, the frequency of DKA and its severity was higher than in pre-pandemic, and COVID-19 can be more life-threatening in patients with T2DM. Therefore, healthcare providers should be alert to DKA, especially in patients with T2DM.
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Background: The aim of this study was to evaluate the predictors of osteoporosis in women in Yazd, Iran. Methods: This hospital-based case-control study was performed on 270 women 35-65 yr old (135 case and 135 control) from Mar 2016 to Mar 2017. Case and control were matched in terms of age ± 2 (year) as a group matching. Osteoporosis is defined as a T-score of bone mineral density (BMD) below -2.5 SD. Data were analyzed using SPSS 20 software. Statistical tests included chi-square, student t test and Mann Whitney test .Multiple logistic regression (MLR) which forward method was used for modeling. Results: Odds ratio (OR) of osteoprosis were menarche age>12 yr (OR=3.37, CI:2.29-15.89), history of hysterectomy (OR=13, CI:3.81-44.82), rheumatoid arthritis (RA) (OR=6.58, CI:2.29-18.91) calcium supplements (OR=0.14, CI:0.04-0.41), menopause age <40 (OR=11.84, CI:1.54-90), second smoking (OR=3.38, CI:1.16-9.81) and increase of weight (OR=0.86, CI:0.80-0.94). Conclusion: Predictors of osteoporosis was menarche age >12 yr (3 times), history of hysterectomy (13 times), RA (6.5 times), menopause age <40 (12 times), second smoking (more than 3 times), calcium supplements and weight (protective).
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Background: The deadly novel Coronavirus Disease 19 (COVID-19) epidemic has sickened and killed millions of people around the world. Accordingly, Iran has had the second highest incidence rate of COVID-19 deaths in the world. Because this disease affects all individual, familial, and social aspects, there is not enough information about experiences of COVID-19 patients. However, these experiences could be a missing link in explaining their attitudes, beliefs, and concerns for improving care and treatment processes during and after the disease. Materials and Methods: Descriptive phenomenological research was conducted in 2020 to explain experiences of 21 COVID-19 patients after post-hospitalization recovery. Semi-structured interviews were used as the data collection tool via purposeful sampling, which were continued until data saturation and analyzed using Colaizzi's seven-step method. Results: The main theme of "value of health" and the seven categories of (1) inefficient self-care, (2) overcoming the catastrophic crisis, (3) the shadow of death, (4) coping behaviors and resilience, (5) the need for support and accountability, (6) sympathy, and (7) new insights as well as 38 main codes were extracted. The patients' general explanation in the early stages of the disease, recovery, and subsequent periods included transition from the crisis to new insights into physical, mental, sexual, familial, and economic dimensions that finally led to the review value and concept of their life. Conclusions: The findings of this study can be used to fulfil care and treatment needs of the patients, their families as well as caregivers, psychologists, counselors, health planners, and managers presently and in the future for similar diseases.
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Background: The appropriate insulin injection skill is essential for optimal blood sugar control in patients with diabetes. However, the art of insulin injection is still not well understood in numerous medical centers. Objectives: This study was designed to determine the association between appropriate insulin injection and blood glucose control in patients with type 2 diabetes in Yazd, Iran. Methods: This cross-sectional study was conducted on 301 patients with type 2 diabetes who referred to Diabetes Research Center in Yazd within August 2020 to February 2021. Based on simple random sampling, the subjects with inclusion criteria, such as age >18 years, using an insulin pen for at least 3 months, and self-injection, were selected. The insulin injection technique was evaluated by a 13-item researcher-made questionnaire. The total score of this questionnaire was 26, and its validity and reliability were confirmed. The data were analyzed using SPSS software (version 20). Results: The mean age of the participants was 59.83 ± 10.26 years, and 60.1% had primary school or less education. Most participants (87%) used a needle more than five times, and almost half of them (53.5%) did not rotate the injection sites properly. The patients who reported pain during injection had statically lower injection scores than others (17.90 vs. 19.38, P = 0.001). There was a significant negative correlation between insulin injection score with fasting blood sugar (ß = -0.232, P < 0.001), two-hour postprandial glucose (ß = -0.164, P = 0.005), and hemoglobin A1c (HbA1c) level (ß = -0.263, P < 0.001). Conclusions: None of the patients in this study fully followed the principles of a proper injection, which can lead to pain during injection, lipohypertrophy, hyperglycemia, and increased HbA1c levels.
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BACKGROUND AND AIM: Despite the importance of breakfast, especially for students, unfortunately, this meal is usually ignored in daily routine. The aim of this study was to identify determinants among female high school students of Yazd province based on the Pender Health Promotion Model. METHODS: This was a cross-sectional study conducted to examine 200 female high school students of Yazd, selected by cluster sampling method in 2016. A researcher-made questionnaire, based on Pender's Health Promotion Model, was used as a data collection tool. A panel of experts and Cronbach's alpha coefficient were used to confirm the questionnaire validity and reliability. In order to analyze descriptive data, SPSS version 22 was used. AMOS software (v.23) was employed for path analysis. RESULTS: Direct impact of activity -related affect (0.300), interpersonal influences (0.276), and perceived barriers to eating breakfast (-0.223) were approved at significance level p<0.000. By influencing perceived barriers, perceived self-efficacy and previous related behavior indirectly affected breakfast consumption. These components determined 33% of breakfast consumption. CONCLUSION: By planning to create a positive feeling in students to have breakfast, to involve family and friends to encourage students to eat breakfast, to reduce barriers to have breakfast by increasing students' self-efficacy, the behavior of having breakfast among students can be improved.
