مجله‌ي بین المللی غدد درون‌ريز و متابوليسمInt J Endocrinol MetabMedical Scienceshttp://www.ijem.org1726-913Xen

Maternal and Neonatal Outcomes in Gestational Diabetes MellitusFarooq MU^a, Ayaz A^b, Ali Bahoo L^b, Ahmad I^aFarooq MU^a Ayaz A<sup>b</sup> Ali Bahoo L<sup>b</sup> Ahmad I<sup>a</sup><sup>a </sup>Al-Noor Specialist Hospital Makkah, Kingdom of Saudi Arabia <sup>b</sup>Bahawal Victoria Hospi-tal, Bahawalpur, Pakistan Original ArticleTo describe antenatal maternal complications and neonatal outcomes caused by gestational diabetes mellitus. Materials and Methods: This descriptive observa-tional study was conducted in the Department of Obstetrics and Gynaecology (Obs &amp; Gynae), Baha-wal Victoria Hospital, Bahawalpur, Pakistan, over a the period of one year, from January 1 to December 31, 2003. Fifty pregnant women diagnosed by glu-cose tolerance tests as diabetics were enrolled as study subjects and followed regularly at the Obs &amp; Gynae out-patient department. Blood glucose levels were controlled by diet per se or with insulin and subjects were hospitalized for insulin dose adjust-ment and management of complications. Feotal well being was assessed by ultrasound, kick count and cardiotocography. Time and mode of delivery was decided upon at 36th week of gestation. Intra-partum maternal blood glucose level was monitored and fetal monitoring was done by external cardioto-cography. Results: Out of a total of 1429 women delivered, 50(3.5%) were diagnosed as GDM and studied. Forty-four (88%) patients were above 25 years of age and 38(76%) were multiparous. Thirty-two (64%) subjects required insulin to control GDM. Most fre-quent maternal and feotal complications were poly-hydramnios 9(18%) and macrosomia 18(36%), respec-tively. One out of fifty subjects had a spontaneous miscarriage and one had intrauterine death. Caesar-ean section was done in 29(58%) patients. Total number of babies delivered alive were 48(96%). Conclusion: GDM was diagnosed in 3.5% of preg-nant women. Most of the subjects were above 25 years and multiparous. Most common maternal complication was polyhydramnios and caesarean section was a common mode of delivery. Macro-somia and jaundice were most prominent complica-tions among neonates. Bahawal, Pregnancy, Gestational diabetes mellitus, Maternal outcome, Neonatal outcome, Complications Maternal and Neonatal Outcomes in GestationalMian Usman Farooq2/13/2007 12:00:00 AM8/17/2007 12:00:00 AMdrus76@yahoo.com3109115http://www.ijem.org/Default.aspx

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Clinical and Laboratory Features of Patients with Impaired Glucose Tolerance (IGT) in Adults of District 13 of Eastern TehranIranparvar Alamdari M^a, Habibi Moini AS^b, Ebady A^c, Azizi F^bIranparvar Alamdari M^a Habibi Moini AS<sup>b</sup> Ebady A<sup>c</sup> Azizi F<sup>b</sup><sup>a</sup>Ardebil University of Medical Sciences, Ardebil;<sup> b</sup>Endocrine and Metabolism Research Center, Shaheed Beheshti University of Medical Sciences, Tehran; Kashan, I.R.IranOriginal ArticlePatients with IGT have increased risk of developing DM type II and non-communicable diseases in the future. The aim of this study was to determine the features of patients with IGT in Tehran and the cor-relation of IGT with other variables and risk factors of non communicable diseases. Materials and Methods: This study was a descriptive analytical and cross–sectional one, in which 960 of 9204 persons, participants of the first phase of Te-hran Lipid and Glucose Study (TLGS) were found to have IGT in the initial assessment; eight weeks later, a second OGTT was done, and 331 had IGT. DM and IGT diagnosis were based on WHO crite-ria; in this group, anthropometric indices, BP, serum glucose, and lipid level were assessed after 12 hours of fasting. Obesity was defined as BMI≥30 kg/m2 and over weight as BMI between 25 and 29.9 kg/m2. WHR over 0.8 in females and 0.95 in males were de-fined as truncal obesity. Hypertension was defined as SBP≥140 or DBP≥90 mmHg or taking anti hyper-tensive drugs. Statistical analyses were performed using independent T-test, and ANOVA. Results: Totally 331 patients with IGT were studied, of whom 232 (70%) were female and 99 (30%) were male. In 43% of cases, BMI was ≥30. WHR was ab-normal in 83.7%; total cholesterol level in 32% was ≥240 mg/dL, LDL in 28.1% was ≥130 mg/dL and ≥ 160 g/dL in 24.8%; HDL in 32.9% of cases was &lt;35 mg/dL. In 43.2% of cases, TG was ≥200 mg/dL. As-sessment of parameters according to BMI showed that mean cholesterol and triglyceride levels in obese patients were higher than the rest (p&lt;0.05, p&lt;0.001) and mean HDL cholesterol in obese pa-tients was lower (p&lt;0.014). Exercise tolerance test (ETT) was performed in 199 patients, and was posi-tive in 14% . Conclusion: According to the results of this study, patients with IGT have a high risk of cardiovascular events because of multiple risk factors such as obe-sity, hypertension, smoking, and hyper lipidemia. Impaired glucose tolerance, cardio-vascular disease risk factors, obesity, hyperten-sion, lipid disordersFeatures of patient with IGTManocher Iranparvar Alamdari5/27/2007 12:00:00 AM7/27/2007 12:00:00 AMAlamdar95@Yahoo.com3116122http://www.ijem.org/Default.aspx

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Does End Stage Renal Disease or Type of Renal Replacement Therapy Affect Marital Relationship in Diabetics? A Preliminary ReportNouhi S^a, Tavallaie SA^a, Abadi Farahani MA^b, Assari SH^b, Einollahi B^cNouhi S^a Tavallaie SA<sup>a</sup> Abadi Farahani MA<sup>b</sup> Assari SH<sup>b</sup> Einollahi B<sup>c</sup><sup>a</sup> Baqiyatallah University of Medical Sciences <sup>b</sup>Clinical Research Unit, Baqiyatallah Medi-cal University, NephrologistOriginal ArticleSeveral studies have assessed marital relationship in patients with different chronic diseases. However, literature lacks data regarding this issue in diabetic patients receiving renal replacement therapy. Here, we report our preliminary findings regarding the differences of marital relationship between diabetics being treated for End-Stage Renal Disease (ESRD) and diabetics with normal kidney function. Mateirlas and Methods: In a case-control study, 94 diabetic patients were divided into three groups ac-cording to renal replacement therapy: group I, renal transplanted subjects (n=38); group II, hemodialysis patients (n=20); group III, diabetics without ESRD (n=36). The groups were matched for gender, age and educational levels. Group I and II were also matched with regard to the duration of ESRD. In-formation on parameters, clinical data, and marital relationship measures was gathered. Marital rela-tionship was evaluated with the Revised Dyadic Ad-justment Scale, which includes four domains of Dy-adic Consensus, Affection Expression, Dyadic Satis-faction and Dyadic Cohesion, with lower scores in-dicating greater impairment in marital relationship. Scores of different subscales were compared be-tween the groups. Results: No significant difference was found be-tween the groups with respect to any of the study subscales. In group I, marital relationship and scores of the four marital quality measures were better in patients without any history of renal graft rejection than subjects with such a history. Conclusion: We did not find any difference regard-ing marital relationship between diabetic patients with and without ESRD. It also seems that the qual-ity of marital relationship is independent of the type of renal replacement therapy. Diabetes, Renal replacement ther-apy, Marital relationship, Kidney transplantation, HemodialysisESRD and Marital RelationshipSima Nouhi1/16/2007 12:00:00 AM8/13/2007 12:00:00 AMcru_common@yahoo.com3123129http://www.ijem.org/Default.aspx

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Efficacy and Safety of Oral Versus Intravenous Vitamin C in Hemodialysis Patients with Functional Iron DeficiencyEspahbodi F, Kashi Z, Ala S, Hendoii N.Espahbodi F Kashi Z Ala S Hendoii N.Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, I.R. IranOriginal ArticleHemodialysis patients (HD) with functional iron deficiency (FID) often develop resistance to re-combinant human erythropoietin (rHuEpo). Re-cent studies suggest that intravenous ascorbic acid (IVAA) may circumvent rHuEpo resistance, while oral AA is readily attainable. The aim of this study was to evaluate efficacy and safety of oral versus intravenous vitamin C in FID and whether this can improve anemia in hemodialy-sis patients. Materials and Methods: In this study, 31 hemo-dialysis patients with serum ferritin >100 µg/L, transferin saturation (Tsat) <30% and Hb<11g/dL were selected and randomly divided into the oral and IV groups. The IVAA group received vi-tamin C 1.5 g, administered weekly and the oral group, 125 mg vitamin C daily for two months. Hb, ferritin, serum iron, Tsat and serum oxalate were measured at the beginning of the study and 2 months later. Independent–sample T-Test were used for intergroup comparison. P value <0/05 was considered significant. Results: Mean Hb difference was 1.1±0.7 g/dL in the oral and 0.1±1 g/dL in the IVAA group, being significantly higher in the oral group (p=0.02). There were no significant differences between the two groups in the delta means of ferritin & Tsat (p=0.5, p=0.3). Delta means of serum oxalate in the 2 groups were 0.05±0.4 mg/L, and 0.1± 0.3 mg/L respectively, difference not significant (p=0.3). Conclusion: Oral AA significantly increased Hb in HD patients suffering from FID. Considering the feasibility and cost-effectiveness, clinicians could consider oral instead IVAA in rHuEpo hy-poresponsive patients undergoing HD. Anemia, Functional iron deficiency, Oral, IV, Vitamin C, HyperoxalatemiaOral versus vitamin C in hemodialysis patientsFatemeh Espahbodi5/17/2007 12:00:00 AM8/12/2007 12:00:00 AMftespahbodi@yahoo.com3130134http://www.ijem.org/Default.aspx

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Obesity Prevalence and its Nutritional Related Lifestyle Pattern in Jundi-Shapour University Female Staff, Ahvaz, IranAmani R.Amani R.Department of Nutrition; Faculty of Paramedicine; Jundi-Shapour University of Medical Sciences, Ahvaz, I.R. IranOriginal ArticleIranians have recently showed a rapid nutritional transition toward a more sedentary lifestyle and un-healthy dietary practices, these changes being more obvious in younger adults. Limited information however exists on different sub-classes. The main objective of this study was to evaluate the obesity prevalence and its lifestyle related behaviors in all female personnel working in administrative posi-tions at Ahvaz Jundi-Shahpour University, Iran. Materials and Methods: In this cross-sectional study, all 101 female staff of the university, aged 20-45y, were interviewed and data on their food frequency, physical activity, drug and medical histories, was documented and anthropometric questionnaires were also completed and scored. Data collection was carried out during spring 2005. Percent of body fat was measured using the bioelectrical impedance analysis (BIA) method. Results: Based on the BIA method, overweight and obesity rates were determined in 34.6 and 40.6 per-cent of women, respectively, and central obesity was prevalent in 27% of them. Women with bachelor de-grees had less body fat percentage and body mass index (BMI) than those with lower degrees (31.8±5.6 vs 35.5±5.8 percent; p<0.002 and 25.5±3.9 vs 28.5±4.5 kg/m²; p<0.003). About 30% of the subjects ate bis-cuits and dates during working hours as snacks. Moreover, except for breads, the score of consuming other food groups based on food guide pyramid was low. The higher vegetable oil intake, the higher the body fat percentage (p<0.05). There were no rela-tionships between consumption of other food groups with anthropometric and clinical parameters. However, 83% of individuals did not engage in ei-ther daily of weekly physical activity programs. Re-peated weight loss programs were associated with increase in body fat percentage (p<0.05). Conclusion: Obesity and overweight rates are highly prevalent in female university staff, and the higher educational levels are associated with less body fat percentage. High-calorie snacks and sedentary life-style seem to be the main reasons of gaining weight in women working in administrative jobs; they need to control their snacks and to include more physical activity programs in their daily schedules. Obesity, Lifestyle, Ahvaz Univer-sity, Female staffObesity Prevalence and its Nutritional Related LifestyleReza Amani3/27/2007 12:00:00 AM8/20/2007 12:00:00 AMRezaamani@hotmail.com3135140http://www.ijem.org/Default.aspx

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Thyroid Function and Volume Changes in Patients with End Stage Renal Disease, Before and After Kidney TransplantationSarvghadi F^a, Khalili S^a, Tara A^b, Najafi J^c, Aliasgari A^a, Kolahi AS^dSarvghadi F^a Khalili S<sup>a</sup> Tara A<sup>b</sup> Najafi J<sup>c</sup> Aliasgari A<sup>a</sup> Kolahi AS<sup>d</sup><sup>a</sup>Department of Internal Medicine, Loghman Hakim General Hospital, <sup>b </sup>Deptartment of Nephrology, Shaheed Modarres General Hospital, <sup>c</sup> Department of Radiology, Shaheed MoOriginal ArticleDisturbances of thyroid hormones metabolism and morphology are common in ESRD (End Stage Renal Disease) but data available shows discrepancies re-garding the post transplantation status of kidney re-cipients . The aim of this study was to assess thyroid function and morphology after kidney transplanta-tion surgery. Materials and Methods: Thirty-two kidney recepient patients, without previous history of thyroid disor-ders, were enrolled. Serum levels of creatinine TT3, TT4, RT3U, TSH and thyroid staging were obtained and echogenicity were determined by ultrasonogra-phy one week before and 1, 3 and 6 months after kidney transplant surgery. Results: Thirty-two patients (22 males, 10 females) with mean&#177;SD of age 38.2&#177;12.6 years were evalu-ated. TT3, TT4 and RT3U levels significantly in-creased by improvement of graft function (p&lt; 0.05) but in 7 patients with delayed graft function those values remained at lower levels. No cases with hy-perthyroidism or hypothyroidism were detected. Thyroid volume decreased and echogenicity in-creased after transplantation (p&lt;0.05). Six patients had thyroid nodules and cysts before surgery and 2 new cysts were detected after surgery. There was no relationship between age, sex, type and duration of dialysis and thyroid function after transplantation. Conclusion: This study reveals a clear correlation be-tween thyroid function and morphology (volume and echogenicity) and improvement of kidney func-tion after transplantation; long-term follow-up is however required for evaluation of occurrence of thyroid nodules and malignancies following trans-plantation. Kidney transplantation, Thyroid Volume, Thyroid hormone, GoiterThyroid function and volume after kidney transplantationFarzaneh Sarvghadi3/27/2007 12:00:00 AM8/20/2007 12:00:00 AMF.Sarvghadi@Yahoo.com3141148http://www.ijem.org/Default.aspx

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Diabetic Retinopathy and Pregnancy in Type 1 Diabetes Mellitus: A Non Systematic Evidence Based ReviewAljabri KS^a, Thompson DM^bAljabri KS^a Thompson DM<sup>b</sup><sup>a</sup>Division of Endocrinology and Department of Medicine, King Fahad Armed Forces Hospi-tal, Taif, Kingdom of Saudi Arabia; <sup>b</sup> Division of Endocrinology, Vancouver Hospital, UniversiReview ArticleWorld-wide it is estimated that over 2.5 million peo-ple are blind due to diabetes mellitus. The exact pathogenesis of diabetic retinopathy is not fully un-derstood. Some factors may act simultaneously in the pathogenesis diabetic retinopathy. Although ma-jor advances in the clinical diagnosis and treatment of diabetic retinopathy and its associated complica-tions have been achieved over the past 5 decades, diabetic retinopathy remains the leading cause of new blindness among working-age coincides with peak fertility and childbearing years, individuals in developed countries. Understanding the risk factors that may lead to progression among diabetic women in pregnancy is of great important in the manage-ment of diabetic retinopathy. Patients who are in good glucose control at the start of pregnancy and who maintain tight control during pregnancy have little risk of progression of retinopathy. Slowing the progression of retinopathy and reducing visual loss in pregnancy seems to be by the use of laser photo-coagulation before pregnancyDiabetic Retinopathy, Pregnancy, Type 1 Diabetes MellitusDiabetic retinopathy and pregnancyKhalid S. Aljabri4/4/2007 12:00:00 AM8/7/2007 12:00:00 AMkhalidsaljari@yahoo.com3149159http://www.ijem.org/Default.aspx

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Detection of Thyroid Carcinoma During Surgical Exploration of the Neck for Primary HyperparathyroidismMohammad Zadeh F, Mohajeri Tehrani MRMohammad Zadeh F Mohajeri Tehrani MREndocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, I.R. IranCase ReportAlthough the pathological association of thyroid and parathyroid diseases are common, an association be-tween parathyroid adenoma and thyroid cancer is rare. Concomitant thyroid cancer in patients with pHPT has been reported at varying frequencies. We report here a case of a 55 year–old man who was diagnosed with primary hyperparathyroidism (pHPT) due to a single parathyroid adenoma, con-firmed biochemically and radiologically. At operation, a nodule in the right thyroid lobe was found incidentally and excised. Histology of the nodule revealed papillary thyroid carcinoma (fol-licular variant). Primary hyperparathyroidism, Thy-roid diseases, Papillary thyroid carcinomaDetection of Thyroid CarcinomaMohammad Reza Mohajeri4/4/2007 12:00:00 AM8/7/2007 12:00:00 AMemrc@sina.tums.ac.ir3160162http://www.ijem.org/Default.aspx

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