Comparison of anti-Mullerian Hormone average between laparoscopic and treatment with clomiphene citrate in patients with polycystic ovarian syndrome

زمینه و هدف: آنتی مولرین هورمون (AMH) در پاتوژنز سندرم پلی کیستیک تخمدان درگیر می باشد. هدف ما مقایسه میانگین AMH در 2 روش لاپاروسکوپی و درمان با کلومیفن سیترات جهت سنجش پاسخ تخمدانی بود. روش بررسی: این مطالعه کارآزمایی بالینی بر روی زنان با سندرم پلی کیستیک تخمدان بدون تخمک گذاری انجام شد. بیماران به 2 گروه تحت مداوا با روش لاپاروسکوپی (49 نفر) و تحت درمان با کلومیفن سیترات (20 نفر) تقسیم گردیدند. غلظت های پلاسمایی AMH قبل از عمل و یک هفته بعد از آن و همچنین 3 و 6 ماه بعد از درمان انداره گیری شد. برای مقایسه میانگین ها در بین گروه ها از آنالیز ANOVA استفاده شد. یافته ها: میزان AMH قبل از مداوا در زنان تحت درمان با لاپاراسکوپی (1/4±1/6) و کلومیفن سیترات (2/3±7/5) تفاوت معنی دار نداشت (05/0<P). بعد از لاپاروسکوپی میزان AMH در بیماران پاسخ دهنده به درمان (1/2±6/5) در مقایسه با بیمارانی که به درمان پاسخ ندادند (3/1±9)، تفاوت معنی داری نشان داد (05/0>P). میزان AMH در بیماران تحت درمان کلومیفن سیترات در این مدت کاهش معنی داری نداشت. نتیجه گیری: درمان لاپاروسکوپی در بیمارانی که سطح AMH آن ها قبل از درمان پایین تر است، موفقیت آمیز می باشد

Rapid detection of pathogenic bacteria in whole blood samples using 23S rRNA PCR assays

Purpose: Bloodstream infections are a general cause of death among hospitalized patients. Rapid diagnosis and timely treatment can reduce mortality. The aim of this investigation was to evaluate the 23S rRNA PCR assays as a rapid detection method for diagnose of sepsis in patients with suspected bacteremia. Methods: A cross-sectional study was conducted at Shahid Beheshti University Hospital in Kashan from November 2017 to December 2018. The blood samples of 265 patients with suspected bacteremia were studied by blood culture and 23S rRNA PCR techniques. The results were analyzed using SPSS version 16 and Chi-square test. Results: Eighty (30.2) blood samples of 265 suspected patients, were identified as positive by PCR assays, whereas 27 (10.2) were identified as positive by the blood culture technique. The statistical analysis showed a significant association between the results of PCR assays and blood culture and factors such as prior antibiotic use and underlying diseases (P <0.05). Also a significant correlation was observed between laboratory and clinical criteria and the results of both PCR assays and blood culture (P < 0.05). Conclusion: The 23S rRNA PCR method is a rapid and sensitive technique specially for diagnosing sepsis among patients in whom bacteremia is difficult to diagnose with culture method including neonates and patients who have taken antibiotics before microbial culture. © 2019 Firoozeh et al. All rights reserved

Effects of curcumin on body weight, glycemic control and serum lipids in women with polycystic ovary syndrome: A randomized, double-blind, placebo-controlled trial

Objective: The aim of this study was to evaluate the effect of curcumin on body weight, glycemic control and serum lipids in women suffering from polycystic ovary syndrome (PCOS). Methods: The current randomized, double-blinded, placebo-controlled clinical trial was performed on 60 subjects with PCOS, aged 18�40 years old. Subjects were randomly allocated to take 500 mg/day curcumin (n = 30) or placebo (n = 30) for 12 weeks. Glycemic control and serum lipids were measured at baseline and after the 12-week intervention. Using RT-PCR method, gene expression related to insulin and lipid metabolism was evaluated. Results: Curcumin significantly decreased weight (�0.8 ± 0.9 vs. �0.2 ± 0.8 kg, P = 0.03) and BMI (�0.3 ± 0.4 vs. �0.1 ± 0.3 kg/m2, P = 0.03). Curcumin, compared with the placebo, significantly reduced fasting glucose (β �2.63 mg/dL; 95 CI, �4.21, �1.05; P = 0.002), serum insulin (β �1.16 μIU/mL; 95 CI, �2.12, �0.19; P = 0.02), insulin resistance (β �0.26; 95 CI, �0.48, �0.03; P = 0.02), and significantly increased insulin sensitivity (β 0.006; 95 CI, 0.001, 0.01; P = 0.02). In addition, taking curcumin was associated with a significant reduction in total cholesterol (β �15.86 mg/dL; 95 CI, �24.48, �7.24; P = 0.001), LDL-cholesterol (β �16.09 mg/dL; 95 CI, �25.11, �7.06; P = 0.001) and total-/HDL-cholesterol ratio (β �0.62; 95 CI, �0.93, �0.30; P &lt; 0.001), and a significant increase in HDL-cholesterol levels (β 2.14 mg/dL; 95 CI, 0.36, 3.92; P = 0.01) compared with the placebo. Additionally, curcumin administration up-regulated gene expression of peroxisome proliferator-activated receptor gamma (PPAR-γ) (P = 0.03) and low-density lipoprotein receptor (LDLR) (P &lt; 0.001) compared with the placebo. Conclusions: Overall, curcumin administration for 12 weeks to women with PCOS had beneficial effects on body weight, glycemic control, serum lipids except triglycerides and VLDL-cholesterol levels, and gene expression of PPAR-γ and LDLR. Registered under Clinical Trials.gov Identifier no. http://www.irct.ir: IRCT20170513033941N50. © 2020 European Society for Clinical Nutrition and Metabolis

Effects of Long-Term Vitamin D Supplementation on Regression and Metabolic Status of Cervical Intraepithelial Neoplasia: a Randomized, Double-Blind, Placebo-Controlled Trial

We are not aware of any study examining the effects of long term vitamin D administration on regression and metabolic status of patients with cervical intraepithelial neoplasia grade 1 (CIN1). This study was performed to evaluate the effects of long-term vitamin D administration on regression and metabolic status of patients with CIN1. This randomized, double-blind, placebo-controlled trial was performed among 58 women diagnosed with CIN1. CIN1 diagnosis was performed based on specific diagnostic procedures of biopsy, pathological diagnosis, and colposcopy. Patients were randomly allocated into two groups to take 50,000 IU vitamin D3 supplements (n = 29) or placebo (n = 29) every 2 weeks for 6 months. Fasting blood samples were taken at the beginning of the study and end-of-trial to measure related markers. After 6 months of vitamin D administration, greater percentage of women in the vitamin D group had regressed CIN1 (84.6 vs. 53.8%, P = 0.01) than those in the placebo group. Long-term vitamin D supplementation increased serum-25(OH) vitamin D levels in the intervention group compared to the placebo group (+12.3 ± 11.4 vs. -0.1 ± 3.7 ng/mL, P < 0.001). In addition, vitamin D intake led to significant decreases in serum insulin levels (−5.3 ± 7.3 vs. +2.4 ± 5.9 μIU/mL, P < 0.001), homeostasis model of assessment-insulin resistance (−1.2 ± 1.6 vs. +0.5 ± 1.2, P < 0.001), homeostatic model assessment-Beta cell function (P = 0.005) and a significant elevation in quantitative insulin sensitivity check index (+0.03 ± 0.04 vs. -0.007 ± 0.02, P < 0.001) compared with the placebo group. Additionally, significant increases in plasma nitric oxide (NO) (+15.5 ± 10.3 vs. +4.0 ± 13.4 μmol/L, P = 0.001), total antioxidant capacity (TAC) (P = 0.04), total glutathione (GSH) (+11.8 ± 153.5 vs. -294.2 ± 595.1 μmol/L, P = 0.01) and a significant reduction in plasma malondialdehyde (MDA) levels (−0.8 ± 1.0 vs. -0.03 ± 1.4 μmol/L, P = 0.03) were observed following the administration of vitamin D supplements compared with the placebo group. In conclusion, vitamin D3 administration for 6 months among women with CIN1 resulted in its regression and had beneficial effects on markers of insulin metabolism, plasma NO, TAC, GSH and MDA levels. Clinical trial registration numberwww.irct.ir: IRCT201412065623N30

Effects of Selenium Supplementation on Gene Expression Levels of Inflammatory Cytokines and Vascular Endothelial Growth Factor in Patients with Gestational Diabetes

Selenium is known to exert multiple beneficial effects including anti-inflammatory actions. The aim of the study was to evaluate the effects of selenium supplementation on gene expression levels of inflammatory cytokines and vascular endothelial growth factor (VEGF) in women with gestational diabetes (GDM). This randomized double-blind, placebo-controlled trial was carried out among 40 subjects diagnosed with GDM aged 18–40 years old. Subjects were randomly allocated into two groups to receive either 200 μg/day selenium supplements (n = 20) or placebo (n = 20) for 6 weeks. Gene expression of inflammatory cytokines and VEGF were assessed in lymphocytes of GDM women with RT-PCR method. Results of RT-PCR indicated that after the 6-week intervention, compared with the placebo, selenium supplementation downregulated gene expression of tumor necrosis factor alpha (TNF-α) (P = 0.02) and transforming growth factor beta (TGF-β) (P = 0.01), and upregulated gene expression of VEGF (P = 0.03) in lymphocytes of patients with GDM. There was no statistically significant change following supplementation with selenium on gene expression of interleukin (IL)-1β and IL-8 in lymphocytes of subjects with GDM. Selenium supplementation for 6 weeks in women with GDM significantly decreased gene expression of TNF-α and TGF-β, and significantly increased gene expression of VEGF, but did not affect gene expression of IL-1β and IL-8

The effects of nano-curcumin on metabolic status in patients with diabetes on hemodialysis, a randomized, double blind, placebo-controlled trial

Introduction. This study evaluated the effects of nano-curcumin intake on metabolic status in patients with diabetes on hemodialysis (HD). Methods. This randomized, double-blind, placebo-controlled clinical trial was performed on 60 patients with diabetes on HD. Participants were randomly divided into two groups to take either 80 mg/d nano-curcumin (n = 30) or placebo (n = 30) for 12 weeks. Results. Nano-curcumin significantly decreased fasting plasma glucose (β =-19.68 mg/dL, 95 CI:-33.48 to-5.88; P <.05) and serum insulin levels (β =-1.70 µIU/mL, 95 CI:-2.96 to-0.44; P <.05) when compared with patients who received placebo. Nano-curcumin treatment was associated with a significant reduction in triglycerides (β =-16.13 mg/dL, 95 CI:-31.51 to-0.75; P <.05), VLDL-cholesterol (β =-3.22 mg/dL, 95 CI:-6.30 to-0.15; P <.05), total cholesterol (β =-17.83 mg/dL, 95 CI:-29.22 to-6.45; P <.05), LDL-cholesterol (β =-15.20 mg/dL, 95 CI:-25.53 to-4.87; P <.05), and total-cholesterol/HDL-cholesterol ratio (β =-1.15, 95 CI:-0.2.10 to-0.21; P <.05) when compared with the placebo. Nano-curcumin also resulted in a significant reduction of serum high sensitivity CRP (β =-0.78 mg/L, 95 CI:-1.41 to-0.15; P <.05), and plasma malondialdehyde (β =-0.25 µmol/L, 95 CI:-0.45 to-0.04; P <.05); but also with a significant increase in plasma total antioxidant capacity (β = 52.43 mmol/L; 95 CI: 4.52 to 100.35; P <.05) and total nitrite levels (β = 3.62 µmol/L, 95 CI: 2.17 to 5.08; P <.001) when compared with placebo. Conclusion. Nano-curcumin intake for 12 weeks had beneficial effects on metabolic profile in patients with diabetes on HD. © 2020, Iranian Society of Nephrology. All rights reserved

The influences of vitamin D and omega-3 co-supplementation on clinical, metabolic and genetic parameters in women with polycystic ovary syndrome

Objective: The aim of this study was to evaluate the effect of the co-administration of vitamin D and omega-3fatty acid on clinical, metabolic and genetic parameters in women with polycystic ovary syndrome (PCOS). Methods: This randomized, double-blinded, placebo-controlled clinical trial was conducted on 60 subjects, aged 18–40 years old with PCOS. Subjects were randomly allocated to take either 50,000 IU vitamin D every 2 weeks plus 2000 mg/day omega-3 fatty acid from fish oil (n=30) or placebo (n=30) for 12 weeks. Gene expression analysis of inflammatory cytokines was conducted on peripheral blood mononuclear cells (PBMCs) of PCOS women using RT-PCR method. Results: Vitamin D and omega -3 fatty acid co-supplementation significantly decreased serum total testosterone levels (−0.2 ± 0.5 vs.+0.1 ± 0.4 ng/mL, P=0.02) compared with the placebo. In addition, vitamin D and omega-3 fatty acid co-supplementation resulted in a significant improvement in beck depression inventory (−1.4 ± 1.6 vs. −0.5 ± 0.6, P=0.01), general health questionnaire scores (−4.5 ± 4.3 vs. −1.9 ± 2.3, P=0.005) and depression anxiety and stress scale scores (−5.0 ± 5.1 vs. −2.3 ± 3.5, P=0.01) compared with the placebo. Additionally, vitamin D and omega-3 fatty acid co-administration significantly decreased serum high-sensitivity C-reactive protein (hs-CRP) (−1.2 ± 1.9 vs.+0.1 ± 0.7 mg/L, P=0.001) and malondialdehyde (MDA) levels (−0.4 ± 0.4 vs.+0.2 ± 0.6 μmol/L, P<0.001), and significantly increased plasma total antioxidant capacity (TAC) levels (+ 114.6 ± 122.2 vs. -2.4 ± 168.2 mmol/L, P=0.003) compared with the placebo. Results of RT-PCR demonstrated that vitamin D and omega-3 fatty acid co-supplementation significantly downregulated gene expression of interleukin-1 (IL-1) (P=0.03), and upregulated vascular endothelial growth factor (VEGF) (P=0.004) in PBMCs of subjects with PCOS, when compared with placebo. Conclusions: Overall, the co-administration of vitamin D and omega-3 fatty acid for 12 weeks had beneficial effects on mental health parameters, serum total testosterone, hs-CRP, plasma TAC and MDA levels, and gene expression of IL-1 and VEGF among women with PCOS

The effects of expression of different microRNAs on insulin secretion and diabetic nephropathy progression

MicroRNAs (miRNAs) have recently become well-known efficacious biomarkers for the diagnosis of diabetic nephropathy (DN). MiRNAs, short noncoding RNAs, are posttranscriptional regulators of gene expression, which regulate several biological cell functions, including insulin production and secretion, as well as insulin resistance in tissues. Today, the focus of the medical world is centered on the role of miRNAs as mediators for different diseases, such as DN and end-stage renal diseases (ESRD). MiRNAs are stable and detectable in human biological fluids, so their detection for early diagnosis of different diseases is highly sensitive and specific. Previous reports have shown that the alteration of miRNA profiles significantly correlates with specific stages of DN, kidney fibrosis, and renal dysfunction. This review was aimed at assessing the pathway of different miRNA expressions responsible for insulin secretion disorder and DN progression. © 2018 Wiley Periodicals, Inc

Effects of Chromium and Carnitine Co-supplementation on Body Weight and Metabolic Profiles in Overweight and Obese Women with Polycystic Ovary Syndrome: a Randomized, Double-Blind, Placebo-Controlled Trial

The primary aim of our study was to determine the influence of taking chromium plus carnitine on insulin resistance, with a secondary objective of evaluating the influences on lipid profiles and weight loss in overweight subjects with polycystic ovary syndrome (PCOS). In a 12-week randomized, double-blind, placebo-controlled clinical trial, 54 overweight women were randomly assigned to receive either supplements (200 μg/day chromium picolinate plus 1000 mg/day carnitine) or placebo (27/each group). Chromium and carnitine co-supplementation decreased weight (� 3.6 ± 1.8 vs. � 1.0 ± 0.7 kg, P &lt; 0.001), BMI (� 1.3 ± 0.7 vs. � 0.3 ± 0.3 kg/m 2 , P &lt; 0.001), fasting plasma glucose (FPG) (� 5.1 ± 6.0 vs. � 1.1 ± 4.9 mg/dL, P = 0.01), insulin (� 2.0 ± 1.4 vs. � 0.2 ± 1.2 μIU/mL, P &lt; 0.001), insulin resistance (� 0.5 ± 0.4 vs. � 0.04 ± 0.3, P &lt; 0.001), triglycerides (� 18.0 ± 25.2 vs. + 5.5 ± 14.4 mg/dL, P &lt; 0.001), total (� 17.0 ± 20.3 vs. + 3.6 ± 12.0 mg/dL, P &lt; 0.001), and LDL cholesterol (� 13.3 ± 19.2 vs. + 1.4 ± 13.3 mg/dL, P = 0.002), and elevated insulin sensitivity (+ 0.007 ± 0.005 vs. + 0.002 ± 0.005, P &lt; 0.001). In addition, co-supplementation upregulated peroxisome proliferator-activated receptor gamma (P = 0.02) and low-density lipoprotein receptor expression (P = 0.02). Overall, chromium and carnitine co-supplementation for 12 weeks to overweight women with PCOS had beneficial effects on body weight, glycemic control, lipid profiles except HDL cholesterol levels, and gene expression of PPAR-γ and LDLR. Clinical trial registration number: http://www.irct.ir: IRCT20170513033941N38. © 2019, Springer Science+Business Media, LLC, part of Springer Nature

Diagnosis of bacteremia in patients with suspected septicemia using polymerase chain reaction method

Background: Sepsis or blood stream infection is a clinical lethal syndrome with severe systemic inflammatory response to infection, if not treated quickly, is associated with dangerous consequences and high morbidity and mortality. The traditional and conventional method for identification of sepsis is blood culture method which is so time-consuming and long that it eliminates the possibility of rapid treatment. Although, new molecular methods, due to their high sensitivity, specificity, and speed, lead to the rapid and accurate and exact detection of bacterial sepsis within only a few hours. The aim of this study was diagnosis of bacteremia in patients with suspected sepsis using amplification of 23S rRNA gene by polymerase chain reaction (PCR). Methods: This cross-sectional study was performed in two clinical and analytical steps at Shahid Beheshti University Hospital in Kashan City, Iran, in twelve months from November 2016 to December 2017. The blood samples of two hundred and fifty-six patients with suspected sepsis admitted to Shahid Beheshti Hospital were studied by PCR method using specific primers of 23S rRNA gene of the bacteria. Results: The finding of molecular assays using PCR showed that of 256 blood samples that were collected from patients with clinical signs and symptoms of sepsis, 80 (30.2) diagnosed with bacteremia. Of these patients diagnosed with sepsis, 46 out of 80 (57.5) were male while 34 out of 80 (42.5) were female. The most PCR positive results were obtained among patients with diabetes and bedsore as underlying diseases (21.3). Statistical analysis showed that there was a significant correlation between results of molecular methods by PCR assays and history of antibiotic use. Conclusion: Overall, the results of the present study showed that the molecular methods such as polymerase chain reaction using universal 23S rRNA primers is an appropriated test for diagnosis of bacteremia in blood samples of patients with suspected sepsis. © 2020 Tehran University of Medical Sciences. All rights reserved