BackgroundGlycaemic control is the main goal of treatment for type 2 diabetic patients. Hyperglycaemia may result in cognitive decline. More family support may increase medication adherence and decrease glycaemic level. The purpose of this study was to determine the impact of family support improvement behavior on anti diabetic medication adherence and cognition in type 2 diabetic patients.MethodThe randomized control trial study was conducted on 91 patients from an outpatient diabetes clinic. They were randomly divided to intervention (n = 45) and control (n = 46) group. Data on the patients’ demographic information and their family gathered using a questionnaire, For two groups Morisky Medication Adherence Scale (MMAS), drug administration part of Diabetes Social Support Questionnaire – family version (DSSQ), Number Connection Test (NCT) were applied and hemoglobin A1C was measured two times in the onset of study and three months later for control group and before and after intervention for intervention group. The key family members of the intervention group were taught according to their educational needs in small groups.ResultIn intervention group mean of NCT score was significantly decreased after intervention (P = 0.006) however in the control group there was no significant difference after three months. In intervention group a significant correlation was noted between DSSQ scores and MMAS scores after intervention(r =0.67, P < 0.001) but, there was no significant correlation in the control group.ConclusionFamily support instruction based on the educational needs of family members, may improve medication adherence through direct effect and cognitive status with indirect effect.

Results suggest that breastfeeding during normal pregnancy does not increase chance of untoward maternal and newborn outcomes. Nurses and midwives should give expectant mothers appropriate evidence-based guidance and focus attention on promoting proper nutritional intake based on lactation status during pregnancy.

Received: February 2013, Accepted: October 2013 Background: Cigarette smoking has been linked with the suppression of immune responses and increased susceptibility to numerous infections in humans. Tetanus is also a major public health problem in many countries. The aim of the present study was to evaluate the serum levels of antitetanus toxin antibodies in cigarette smoking and healthy non-smoking people. Materials and Methods: A total of 100 cigarette smokers and 100 age-matched healthy nonsmoker individuals were enrolled in this descriptive study. A blood sample was collected from each participant. The samples were tested for the levels of anti-tetanus toxin antibodies by use of enzyme linked immunosorbent assay. Results: The seroprotective rate of anti-tetanus toxin antibodies in non-smoking group (99%) was significantly higher than that observed in cigarette smoking group (78%, P<0.0001). The mean titer of anti-tetanus toxin antibodies in non-smoking group (5.32± 0.26 IU/ml) was also significantly higher than that in smoker subjects (1.03 ± 0.16 IU/ml; P<0.0001). The mean titer of anti-tetanus toxin antibodies in individuals with smoking duration >10 years was significantly lower than that among smokers with smoking duration ≤10 years (0.59 ± 0.12 IU/ml vs 1.98 ± 0.41 IU/ml; P<0.001). The seroprotection rate was also significantly lower in persons with smoking duration >10 years in comparison to smokers with smoking duration ≤10 years (72.1% vs 90.6%; P=0.037). The mean titer of anti-tetanus toxin antibodies in individuals with daily smoking >10 cigarettes was also significantly lower in comparison to smokers with daily smoking ≤10 cigarettes (0.68 ± 0.15 IU/ml vs 1.63 ± 0.36 IU/ml; P<0.001). Conclusion: These results showed lower levels of anti-tetanus toxin antibodies in cigarette smokers which represents cigarette smoking as a risk factor for susceptibility to tetanus. A negative association was also observed between the immunity to tetanus and smoking burden.

BackgroundType 2 diabetes along with chronic hyperglycemia may result in cognitive impairment. This can negatively affect the patient’s adherence to diabetes treatment. The purpose of this study was to compare the cognitive status and foot self care practice in overweight type 2 diabetic patients who exercised regularly and those who did not.MethodsThe comparative study was conducted on 160 consecutive patients from an outpatient diabetes clinic. They were divided into two groups: The active group comprised of 80 patients engaged in regular exercise for at least 15–30 minutes, three times per week during the past 6 months. The control group included 80 patients who had not exercised regularly for the past 12 months, matched for sex, age, education, diabetes duration, hemoglobin A1C and body mass index (BMI: 25–29.9Kg/m2). Data on the patients’ demographic information, foot care practice and physical activity habits were gathered using a questionnaire. The Mini Mental Status examination (MMSE) was applied to assess cognitive status.ResultsMMSE score was significantly higher in the active group. A significant negative correlation was noted between MMSE scores and BMI in the control group (r = −0.2, P = 0.03). A significant difference was noted in the four domains of foot self care practice between the active (4.77 ± 0.77) and control (4.45 ± 0.83) groups (P < 0.01).ConclusionsRegular physical activity can help promote cognitive status and foot self care practice in overweight patients with type 2 diabetes.