Iranian National Clinical Practice Guideline for Exercise in Patients with Diabetes.

CONTEXT: Growing evidence highlights the importance of physical activity as a critical element for the prevention and control of diabetes. However, there is no clinical practice guideline focusing on the different aspects of exercise in patients with diabetes, especially for the Iranian population. OBJECTIVE: We aimed to prepare and adopt a clinical practice guideline to provide well-defined, simple, and concise responses to certain questions related to physical activity and exercise in all patients with diabetes, including type 1, 2, and gestational diabetes mellitus (GDM). EVIDENCE ACQUISITION: A multidisciplinary team of experts in various fields (sports medicine specialists, endocrinologists, and cardiologists) developed the guideline. This group did the task in four stages: (1) identifying and refining the subject area using 17 clinical questions; (2) appraising evidence through a systematic review of the literature; (3) extracting recommendations from evidence and grading them as A, B, C, or D based on the quality, quantity, and consistency of existing evidence; and (4) subjecting the guideline to external review and finally selecting the recommendations with high scores of appropriateness and agreement. The final version was evaluated and approved by the National Deputy for Curative Affairs - Ministry of Health and Medical Education and has also been endorsed by the Iran Endocrine Society (IES) and Iranian Association of Sports and Exercise Medicine (IASEM). RESULTS: The guideline consists of 52 recommendations addressing 17 important questions concerning different aspects of exercise prescription in Iranian patients with diabetes. CONCLUSIONS: The guideline provides evidence-based information that may help physicians to prescribe exercise for Iranian patients with diabetes safely and effectively.

Prevalence of Cardiovascular Disorders Among Iranian Elite Athletes.

BACKGROUND: Athletes' health is an important issue and for promoting it, pre-participation examination (PPE) is widely performed by responsible bodies around the world. OBJECTIVES: This study was to determine prevalence of cardiovascular disorders among athletes participating in the Asian games and answering the question whether the electrocardiogram (ECG) is a necessary part of pre-participation examination (PPE) for prevention of sudden cardiac death. MATERIALS AND METHODS: All athletes participated at Asian games came to sports medicine federation for a PPE including a comprehensive questionnaire, physical examination and ECG. In this retrospective study all profiles of 338 athletes have been studied as well as their electrocardiograms. Multiple logistic regressions as well as Firth's bias reduction were used with R statistical software and SPSS. For predicting the changes in ECG, receiver operating characteristic (ROC) curve has done. RESULTS: Among 388 athletes, 80 (20.6%) were female and 308 (79.4%) male with mean age of 23.2 + 8 years. Nine athletes (2.3%) were smokers, 28 of them (7.2%) experienced chest pain and discomfort, 45 of them (13.3%) had palpitations and 28 (7.2%) had history of anemia. Study of their electrocardiograms showed that long Q-T interval was not seen for anyone, but evidence of left ventricular hypertrophy was seen in 12 (3.1%), inverted T wave in 6 (1.5%), and right bundle branch block in 45 (13.3%). CONCLUSIONS: PPE provides very important information of athletes' health. This study has shown that there was not any significant relation between current examination and electrocardiogram changes but regarding the ECG changes we recommend it as a routine part of PPE.

Relations between lateral abdominal muscles thickness, body mass index, waist circumference and skin fold thickness.

In light of provided progresses in ultrasound measurements of lateral abdominal muscles, an important role for these muscles, particularly transverse abdominis (TrA) muscle in stability of the spine has been suggested. Some authors have found significant correlations between body mass index (BMI) and thickness of these muscles. The aim of this study was to examine possible association between different methods of measurements of fatness and lateral abdominal muscles thicknesses, employing ultrasound imaging in healthy subjects. Ninety healthy male volunteers aged 18 to 38 (mean= 31.37, standard deviation=5.09) who met our inclusion criteria participated in this study. BMI, skin fold thickness, weight and waist circumference were assumed as the major outcomes for measurement of fatness of the subjects. Employing ultrasound measurements, the thickness of TrA, internal oblique (Int Obl) and external oblique (Ext Obl) muscles were also measured. We found positive significant relation between Ext Obl muscle thickness and all methods of measurements of fatness. Reversely, the results show that Int Obl muscle thickness significantly decreases with the rise of all methods of fatness measurement except weight which had no significant correlation with Int Obl thickness. No significant relation between the TrA muscle thickness and different measurements of the fatness of the subjects were found. In the studies investigate the thickness of lateral abdominal muscles; the authors try to match the participants of different groups of their study regarding the BMI. We found that both waist circumference and skin fold thickness measurements might be assumed as surrogate of BMI, in aim of matching the participants on Ext Obl muscle thickness.