The effect of saffron (Crocus sativus L.) hydroalcoholic extract on metabolic control in type 2 diabetes mellitus: A triple?blinded randomized clinical trial

Journal of Research in Medical Sciences1735-199523220180224The effect of saffron (Crocus sativus L.) hydroalcoholic extract on metabolic control in type 2 diabetes mellitus: A triple?blinded randomized clinical trial1075510755EN20180224Background: Metabolic control is a major concern in preventing diabetic complications. Sa?ron as a natural source of antioxidants <table class="NormalTable"><tbody><tr><td width="550">could play a role in alleviating diabetes insults. Te aim of this study was to investigate e?ect of sa?ron hydroalcoholic extract on metabolic control in type 2 diabetes (T2D) mellitus. Materials and Methods: Tis randomized triple blind study was included 54 T2D patients which randomly received either sa?ron (Group 1) or placebo (Group 2) twice daily other than routine antidiabetic treatments for 8 weeks. Serum concentration of fasting blood sugar (FBS), 2?h plasma glucose, hemoglobin A1c (HbA1c), total cholesterol, triglyceride (TG), low?density lipoprotein, and high?density lipoprotein were measured as the markers of metabolic control. Anthropometric measures and blood pressure were also measured at the baseline, every 2 weeks during the intervention and the end of the study. Data analyzed using repeated measure analysis of variance test. Results: Te baseline metabolic parameters were the same in two group (P > 0.01). FBS serum level signifcantly decreased within 8 weeks in the sa?ron group (128.84 ± 31.86) as compared to the placebo (153.76 ± 41.23), (P < 0.001). Tere was no statistical di?erence in other metabolic parameters such as serum lipids, blood pressure, and HbA1c (P > 0.01). Conclusion: Sa?ron hydroalcoholic extract may improve blood glucose control by reducing FBS in T2D patients. However, sa?ron extract has no signifcant e?ect on other aspects of diabetic control in diabetic patients.</td></tr></tbody></table> <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;" />http://jrms.mui.ac.ir/index.php/jrms/article/view/10755http://jrms.mui.ac.ir/index.php/jrms/article/download/10755/5596

Journal of Research in Medical Sciences1735-199523220180224The effect of nitrous oxide in comparison to oxygen combined with fentanyl on the hospitalization time and pain reduction in renal colic patients at emergency department1075610756EN20180224Background: Renal colic is a painful medical emergency, needs urgent intervention to reduce pain. Nonsteroidal anti?in?ammatory drugs, opioids, and entonox are pain?relieving agents. Tis study was aimed to compare fentanyl + entonox (nitrous oxide + O2) versus fentanyl + oxygen. Materials and Methods: One hundred and twenty patients with acute renal colic presenting to the emergency department were enrolled. First, 50 µg fentanyl was infused for all patients. Ten, patients divided into two groups receiving masks of entonox and oxygen, respectively. Quantitative measurement of pain was performed by visual analog scale, before the intervention, after 3, 5, 10, and 30 min of that. If the pain was not relieved after 30 min, 50 µg fentanyl was infused. If the pain was still continued, ketorolac and ketamine were used. Hospitalization duration and severity of pain at specifed times were compared between patients in two groups. Results: Te mean (standard deviation) time of hospitalization was 211 (59) and 236 (61) min in fentanyl + entonox and fentanyl + O2 groups, respectively (P = 0.024). Te decrease in pain severity after 10 and 30 min in fentanyl + entonox group were signifcantly greater than fentanyl + O2 group (P = 0.002 and 0.001, respectively). Mean (standard error) of needed time for renal colic pain to get better was 11.27 (1.23) and 20.47 (1.71) min in fentanyl + entonox and fentanyl + O2 groups, respectively (P < 0.001). Proportion of patients relief from pain in fentanyl + entonox in the second, third, and fourth measurements were signifcantly more than fentanyl + O2 group (P = 0.036, P < 0.001, and P < 0.001, respectively). Conclusion: Entonox is more e?ective to decrease the duration of hospitalization and reduction of pain than O2 in renal colic patients <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;" /> <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;" />http://jrms.mui.ac.ir/index.php/jrms/article/view/10756http://jrms.mui.ac.ir/index.php/jrms/article/download/10756/5597

Journal of Research in Medical Sciences1735-199523220180224Lipid regulatory genes polymorphism in children with and without obesity and cardiometabolic risk factors: The CASPIAN?III study1075710757EN20180224<table class="NormalTable"><tbody><tr><td width="550">Background: Genetically, predisposed children are considered as at?risk individuals for cardiovascular disease. In this study, weaimed to compare the frequency of four?lipid regulatory polymorphism in obese and normal?weight children with and withoutcardiometabolic risk factors. Materials and Methods: In this nested case–control study, 600 samples of four groups of participantsconsisted of those with normal weight with and without cardiometabolic risk factors and obese with and without cardiometabolic risk factors. Allelic and genotypic frequencies of GCKR (rs780094), GCKR (rs1260333), MLXIPL (rs3812316), and FADS (rs174547)polymorphisms were compared in the four studied groups. Results: Data of 528 samples were complete and included in this study. Te mean (standard deviation) age of participants was 15.01 (2.21) years. Frequency of tt allele (minor allele) of GCKR (rs1260333)polymorphism was significantly lower in normal weight metabolically healthy participants than metabolically unhealthynormal weight (MUHNW) and obese children with and without cardiometabolic risk factor (P = 0.01). Frequency of ga allele ofGCKR (rs780094) polymorphism was signifcantly higher in normal weight children with cardiometabolic risk factor than in theirobese counterparts with cardiometabolic risk factor (P = 0.04). Frequency of cg and gg alleles (minor type) of MLXIPL (rs3812316)polymorphism in normal weight metabolically healthy participants was signifcantly higher than MUHNW (P = 0.04) and metabolicallyhealthy obese children (P = 0.04). Conclusion: Te fndings of our study indicated that the minor allele of GCKR (rs1260333)single nucleotide polymorphisms (SNPs) could have pathogenic e?ect for obesity and cardiometabolic risk factors. Ga allele of GCKR (rs780094) SNPs had a protective e?ect on obesity. Minor alleles of MLXIPL (rs3812316) could have a protective e?ect forobesity and cardiometabolic risk factors.</td></tr></tbody></table> <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;" />http://jrms.mui.ac.ir/index.php/jrms/article/view/10757http://jrms.mui.ac.ir/index.php/jrms/article/download/10757/5598

Journal of Research in Medical Sciences1735-199523220180224A comparison of pain control and complications using three different ways of anesthesia in patients undergoing transrectal ultrasound?guided prostate biopsy1075810758EN20180224Background: We aim to compare the degree of pain control and complications in three types of anesthesia using periprostatic nerve block (PPNB) plus intrarectal local anesthesia (IRLA), low?dose spinal anesthesia, and intravenous (IV) sedation in patients undergoing transrectal ultrasound (TRUS)?guided prostate biopsy. Materials and Methods: In this clinical trial study, 106 patients were participated from December 2015 to December 2016 at Alzahra Hospital, Isfahan, Iran. Patients were randomly allocated into three groups to receive PPNB plus IRLA (n = 36), low?dose spinal anesthesia (n = 35) and IV sedation (n = 35) before TRUS?guided prostate biopsy. Pain scores were recorded using a 10 point visual analog scale right after the biopsy was done. Early and late complications were assessed using a questionnaire after the procedure and in follow?up of patients. Results: Overall, the pain score in the low?dose spinal anesthesia group was signifcantly lower than PPNB plus IRLA and IV sedation groups (P < 0.001). Te di?erences in pain scores between PPNB plus IRLA group and IV sedation group were not signifcant (P = 0.30). Urinary retraction and fever were signifcantly more frequent in low?dose spinal anesthesia and IV sedation, retrospectively (P = 0.04, P = 0.03). No signifcant di?erence in late complications was found among the groups. Conclusion: Tis study demonstrates that low?dose spinal anesthesia is superior to PPNB plus IRLA and IV sedation in terms of pain controlling and was associated with higher tolerance of the examination and patient comfort. <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;" />http://jrms.mui.ac.ir/index.php/jrms/article/view/10758http://jrms.mui.ac.ir/index.php/jrms/article/download/10758/5599

Journal of Research in Medical Sciences1735-199523220180224Efficacy of combined endurance?resistance training versus endurance training in patients with heart failure after percutaneous coronary intervention: A randomized controlled trial1075910759EN1, 2, 3,20180224Background: This study aimed to compare the effects of combined endurance?resistance training (CT) versus endurance training (ET) on some cardiovascular markers in patients with heart failure after percutaneous coronary intervention (PCI). Materials and Methods: Te study applied a randomized, controlled design in which 75 patients with heart failure who had undergone PCI were randomly assigned to one of three groups: ET, CT, and control. Te ET group performed ET for 45 min, three times a week for 7 weeks. Te CT group performed the same ET for 30 min followed by a resistance exercise protocol. Te control group received usual care. Functional capacity, N?terminal pro?brain natriuretic peptide (NT?pro BNP), and high sensitivity C?reactive protein (hs?CRP) levels were measured. Results: After the intervention, functional capacity was improved (P < 0.001) and NT?pro BNP level was signifcantly reduced (P = 0.004 in the CT group, P = 0.002 in the ET group). Hs?CRP level was signifcantly reduced only in the ET group (P = 0.030). Te control group showed no signifcant changes in any cardiovascular parameters (P ? 0.05). Changes in functional capacity (P < 0.001) in both training groups were signifcantly di?erent from the control group. No signifcant di?erences were found between the ET and CT groups regarding changes in all outcomes after exercise training (P ? 0.05). Conclusion: Exercise training is safe and feasible in post?PCI patients, even in those with reduced ejection fraction. CT was as e?ective as ET in reducing NT?pro BNP level and improving functional capacity in heart failure patients after PCI. <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;" />http://jrms.mui.ac.ir/index.php/jrms/article/view/10759http://jrms.mui.ac.ir/index.php/jrms/article/download/10759/5600

Journal of Research in Medical Sciences1735-199523220180224Evaluation of the predictive value of fetal Doppler ultrasound for neonatal outcome from the 36th week of pregnancy1076210762EN20180224Background: Early prediction of adverse neonatal outcome would be possible by Doppler impedance indices of middle cerebral artery (MCA), umbilical artery (UmA), and descending aortal artery (AO) that result in decrease neonatal morbidity and mortality rate. Te aim of the present study was a determination of optimal value for the ratio of MCA to descending aorta blood ?ow (MCA/AO) impedance indices and its comparison with the ratio of MCA to UmA (MCA/UmA) impedance indices and their relationship with neonatal outcome. Materials and Methods: Tis was a prospective cohort study on 212 pregnant women with gestational age 36 weeks or more, in three hospitals in Tehran, from April 2012 to April 2013. We investigated AO, MCA, and UmA impedance indices Doppler ultrasound every 2 weeks till delivery. Te mother was monitored for adverse pregnancy outcome (hypertension [HTN], fetal growth tardation, and other maternal complications) then infant birth weight, cord blood of pH, and Neonatal Intensive Care Unit (NICU) admission during the frst 24 h after delivery were assessed. Finally, we investigated relationships between Doppler indices and neonatal outcomes include neonatal body weight (NBW), cord blood of pH, and NICU admission. Results: MCA/AO resistance index (RI) and MCA/AO pulsatile index (PI) showed an area under the receiver operating characteristics curve (area under the curve) of 0.905 (95% confdence interval (CI): 0.850, 0.959) and 0.818 (95% CI: 0.679, 0.956), respectively. Te cuto? values for pH (?7.2 vs. <7.2) based on MCA/AO RI and MCA/AO PI indices were 0.951 (sensitivity, 80% and specifcity, 86%) and 0.853 (sensitivity, 91% and specifcity, 83%), respectively. Te cuto? value for NBW (?2500 vs. <2500 g) based on MCA/UmA PI index was 1.467 (sensitivity, 73% and specifcity, 63%). Te cuto? value of NICU admission of child based on MCA/AO PI index was 1.114 (sensitivity, 73% and specifcity, 54%). Conclusion: In the end of third?trimester pregnancies with the assessment of MCA and AO artery Doppler ultrasonography, it is possible to prevent many cases of neonatal acidosis caused by prenatal asphyxia as well as inappropriate interventions which are applied on mother. If MCA/AO PI was <0.85, the fetus needs to be evaluated further because it is at risk for acidosis. <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;" />http://jrms.mui.ac.ir/index.php/jrms/article/view/10762http://jrms.mui.ac.ir/index.php/jrms/article/download/10762/5603

Journal of Research in Medical Sciences1735-199523220180224Incidence of nonmelanoma skin cancer in renal transplant recipients: A systematic review and meta?analysis1076010760EN20180224Background: Nonmelanoma skin cancer (NMSC) in renal transplant recipients is common and associated with signifcant morbidity and mortality. Te aim of the present systematic review and meta?analysis was to estimate the incidence of NMSC among renal transplant recipients. Materials and Methods: We systematically searched PubMed, Medline, Scopus, and Web of Science databases for studies that assessed the incidence of NMSC in renal transplant recipients using a combination of relevant keywords. Two independent investigators included studies and extracted necessary information. Random e?ect meta?analysis was used to estimate pooled incidence of NMSC with 95% confdence intervals (CIs). Results: Twenty?nine studies comprising 36,021 patients meet the criteria for the systematic review. Te pooled incidence of NMSC in renal transplant recipients was 12.6% (95% CI: 12%–14%) with a majority of squamous cell carcinoma (SCC) 55% (95% CI: 47%–63%). Te pooled estimate of the incidence rates of SCC and basal cell carcinoma was 2.7% (95% CI: 2%–3.4%) and 2.2% (95% CI: 1.5%–2.8%), respectively. Subgroup analysis per geographic location showed that pooled incidence of NMSC was 39.1% (95% CI: 26.3%–51.8%), 12.4% (95% CI: 8.8%–16%), and 1.2% (95% CI: 0.4%–2%) in Australia and New Zealand, Europe, and Middle East, respectively. Conclusion: Te results of the current meta?analysis demonstrated that the incidence of NMSC in renal transplant recipients varies widely. Regarding the high incidence of NMSC among renal transplant recipients, awareness of associated risk factors and early diagnosis of the malignancy in the population is a major clinical need. <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;" />http://jrms.mui.ac.ir/index.php/jrms/article/view/10760http://jrms.mui.ac.ir/index.php/jrms/article/download/10760/5601

Journal of Research in Medical Sciences1735-199523220180224Hidden cost of disability: What policy makers usually forget1076110761EN20180224---http://jrms.mui.ac.ir/index.php/jrms/article/view/10761http://jrms.mui.ac.ir/index.php/jrms/article/download/10761/5602