Lipids in association with serum magnesium in diabetes mellitus patients

Aim: To investigate whether and how serum Magnesium (Mg) concentrations influence the serum lipids in diabetes mellitus (DM) patients. The cross-sectional study was conducted on diabetic mellitus (DM) patients with various kidney functions not yet on dialysis. Patients and methods: Serum lipoprotein(a), glycosilated hemoglobin (HbA1c), serum magnesium (Mg), serum creatinine (creat), serum lipids consisting of triglycerids (Tg), cholesterol (Chol), high-density lipoprotein (HDL) were measured. Results: Study patients included 122 patients (82F, 40M). The mean patients' age was 63 ( 10) years. The mean length of time they were diabetic was 7.4 ( +/- 5.8) years (median: 6 years). The mean serum Mg was 2 (+/- 0.4) mg/dl (median: 1.99 mg/dl). The mean creatinine clearance was 64 (+/- 24) cc/min (median: 64 cc/min). In this study significant inverse correlations of serum Mg with serum cholesterol and LDL as well as nonsignificant correlations of serum Mg with serum Lp(a), HDL, Tg and with serum HgbA1c were seen. More over a significant inverse correlation of serum Mg with ages of the patients and a significant positive correlation of serum Mg with serum creatinine were seen too. Conclusions: It seems that in diabetic patients, kidney function is a key role in the regulation of serum Lp(a) levels instead of other factors like serum Mg level. Our finding further supports the importance of Mg supplementation in diabetes mellitus patients. In our study no significant correlation between serum Mg with serum HDL and Tg were found, which needs further investigation (Tab. 1, Fig. 4, Ref. 53)

Erratum: Correction to: Comprehensive 5P framework for active aging using the ecological approach: an iterative systematic review (BMC public health (2020) 20 1 (33))

It was highlighted that the original article 1 contained a spelling mistake in the name of Hamid R. Baradaran. This was incorrectly captured as Bradaran. The original article has been updated

Comparison of quality of clinical supervision as perceived by attending physicians and residents in university teaching hospitals in Tehran

Background: Clinical supervision is an important factor in the development of competency in residency program. Attending physicians play a key role in supervision of residents. However little is known about how attending physicians and residents perceive the quality of clinical supervision. The aim of this study was to explore the differences between perceived qualities of supervision in these two groups in different wards in teaching hospitals in Tehran, Iran. Methods: A valid questionnaire were completed by 219 attending physicians and residents from surgery, psychiatry, gynecology, pediatrics, internal medicine, orthopedics and radiology wards in two teaching hospital affiliated to Iran University of Medical Sciences. This questionnaire contained 15 items in regards to supervisory roles, rated on a five point Likert scale (1=never, 2=seldom, 3=sometimes, 4=often, 5=always). Results: Out of 219 participants, 90 (41) were attending physicians and 129 (59) were residents. The overall mean±SD scores of perceived clinical supervision achieved by attending physicians and residents were respectively, 4.20±0.5 and 3.00±0.7 which was statistically significant (p<0.05). Attending physicians and residents acquired minimum scores (mean=4.06 and 2.7, respectively) regarding expectation from their supervisor to know and do during training period of residency. Conclusion: It seems that the clinical supervisory does not have an efficient performance in teaching hospitals which needs to be more assessed and improved. Therefore it is suggested that policymakers in medical education system pay more attention to this important issue and enhance some faculty development programs for clinical educators in Iran

Health system responsiveness for outpatient care in people with diabetes Mellitus in Tehran

Background: World Health Organization (WHO) defines three goals to assess the performance of a health system: the state of health, fairness in financial contribution and responsiveness. We assessed the responsiveness of health system for patients with diabetes in a defined population cohort in Tehran, Iran. Methods: Total responsiveness and eight domains (prompt attention, dignity, communication, autonomy, confidentiality, choice, basic amenities and discrimination) were assessed in 150 patients with diabetes as a representative sample from the Tehran Glucose and Lipid Study (TLGS) population cohort. We used the WHO questionnaire and methods for analysis of responsiveness. Results: With respect to outpatient services, 67 (n=100) were classified as Good for total responsiveness. The best and the worse performing results were related to information confidentiality (84 good responsiveness) and autonomy (51 good responsiveness), respectively. About 61 chose "communication" as the most important domain of responsiveness; it was on the 4th rank of performance. The proportions of poor responsiveness were higher in women, individuals with lower income, lower level of education, and longer history of diabetes. "Discrimination" was considered discrimination as the cause of inappropriate services by 15, and 29 had limited access to services because of financial unaffordability. Conclusion: Health system responsiveness is not appropriate for diabetic patients. Improvement of responsiveness needs comprehensive planning to improve attitudes of healthcare providers and system behavior. Activities should be prioritized through considering weaker domains of performance and more important domains from the patients' perspective

Psychometric properties of the Iranian version of the diabetes numeracy test�15

Background: Low health literacy (HL) of patients has obtained more attention as a risk factor for poor adherence to treatment and adverse outcomes in chronic disease�s management particular in diabetes care. Diabetes Numeracy Test-15 (DNT-15) has been developed specifically for this purpose. The objective of the current study is to evaluate psychometric properties of Iranian (Persian) version of the DNT-15. Methods: The shortened version of the DNT (15-items) was completed by 120 patients with diabetes. The Kuder�Richardson Formula 20 for internal consistency was conducted. Content validity, criterion-related validity, and construct validity were also evaluated. Results: The average score on the DNT was 72 and took an average of 25 minutes to complete. The DNT-15 had a very good internal reliability (KR-20 = 0.90) and also content validity (content validity ratio: 089 and content validity index: 0.86). Conclusions: The DNT-15 (Persian version) is a reliable and valid measure of diabetes-related numeracy skills for Iranian patients with diabetes; however, additional studies are needed to further explore the association between diabetes-specific numeracy and acculturation and their impact on diabetes-related outcomes in Iranian population. © 2016 International Journal of Preventive Medicine

Depression and diabetes in Iranian patients: a comparative study

Objective: The aim of the present study was determine the rate of depression in people with diabetes in an Iranian population. Method: A hospital-based prospective study with a comparison group was conducted in Firozgar Teaching Hospital in Tehran, Iran. The condition of depression and relationship to diabetes was assessed among 375 individuals (206 people with diabetes and 169 without diabetes) who consecutively presented for this prospective study. Results: Of the total participation, 206 (54.9) had diabetes (type 1 = 66 and type 2 = 140). Female made up 63.7 (n = 239). The mean age of entire study was 47.2 years (SD = 16.3 range, 15-87 years). Major depression was present among 71.8 of this sample with diabetes (both types; type 1 and type 2). Depression was more prevalent among women with diabetes than men (Adjusted OR = 2.1 (95 CI 1.4-3.2)). Of the 375 participants, 135 (36) had BID scores lower than 11 and 240 (64) had BDI scores indicating moderate to severe depression (> 16). Conclusions: Diabetes appears to increase the risk of developing depression; therefore early detection and treatment intervention provide the best protective mechanisms available against the effects of depression on diabetes outcomes, and a psychological service provision for people with diabetes is needed. © 2007, Baywood Publishing Co., Inc

Knowledge and practice of foot care in Iranian people with type 2 diabetes

The aim of this study was to determine the knowledge and practice of foot care in people with type 2 diabetes. We carried out a cross-sectional study. A questionnaire was completed by 148 patients with type 2 diabetes in Tehran, Iran. Knowledge score was calculated and the current practice was determined. The mean knowledge score was 6.6 (standard deviation ±3.0) out of a possible 16. Illiterate patients were the least knowledgeable (P = 0.008). Lack of adequate knowledge includes the following: 56 not aware of the effect of smoking on the circulation to the feet, 60 failed to inspect their feet and 42 did not know to trim their toenails. High risk practices including use of irritants to water (66.5) and walking barefoot (62). The results of this study highlight the patients' inadequate knowledge of self-care about their foot and lack of optimal podiatry service in Iran. These findings have implications for further evaluation, planning and management of patient care in diabetic foot disease. © 2007 Blackwell Publishing Ltd and Medicalhelplines.com Inc

Evaluation of protective effects of non-selective cannabinoid receptor agonist WIN 55,212-2 against the nitroglycerine-induced acute and chronic animal models of migraine: A mechanistic study

Aim: Migraine is a neurological debilitating disorder. Previous studies have shown that cannabinoid receptor agonists have analgesic effects in various models of pain. In this study, therefore, we investigated anti-nociceptive effects of WIN 55,212-2, and the role of either CB1 or CB2 receptors in nitroglycerine (NTG)-induced animal model of migraine. Methods: The present study was conducted on both male and female rats receiving NTG (10 mg/kg, i.p.) to induce acute (single dose of NTG) and chronic (repetitive doses of NTG) models of migraine. Additionally, three groups received WIN 55,212-2 (0.33, 1, 3 mg/kg, i.p.) 45 min before behavioral tests. Additionally, AM251 and AM630 (CB1 and CB2 receptor antagonist, respectively, 1 mg/kg, i.p.) were used to evaluate the possible involvement of CB1 and CB2 receptors during the protective effects of WIN 55,212-2. Key findings: We found that NTG (10 mg/kg, i.p.) in both acute and chronic models increased sensitivity to pain. In acute model, we found that WIN 55,212-2 (almost high doses) decreases the level of pain mainly through CB1 receptor due to CB1 antagonist abrogates its protective effects, however, in formalin test CB2 receptors also had crucial roles in both phases at 3 mg/kg of WIN 55,212-2. In chronic model, WIN 55,212-2 (0.33, 1 and 3 mg/kg) significantly attenuated NTG-induced hyperalgesia through both CB1 and CB2 receptors. Significance: Our data supported the argument that activation of CB1 and CB2 receptors by WIN 55,212-2 may be considered a new medication for migraine, however in lack of each receptor leads to different responses from deletion to the reduction of analgesic effects. © 2019 Elsevier Inc

The effects of hydro-ethanolic extract of Capparis spinosa (C. spinosa) on lipopolysaccharide (LPS)-induced inflammation and cognitive impairment: Evidence from in vivo and in vitro studies

Ethnopharmacological relevance: Capparis spinose (C. spinosa) belonging to Capparaeae, originates from dry areas in the west or central Asia and Mediterranean basin. For thousands of years, C. spinosa has been reported to be used as a therapeutic traditional medicine to relieve various ailments including rheumatism, pain and inflammatory diseases. Aim of the study: There are several studies mentioning that systemic inflammation results in learning and memory impairments through the activation of microglia. The objective of this study was to investigate the effect of C. spinosa on both in vivo and in vitro models of neuroinflammation and cognitive impairment using lipopolysaccharide (LPS). Materials and methods: In vivo: 40 male rats were used in the present study. Cognitive impairment was induced using LPS (1 mg/kg/d; i.p.) for 4 weeks. Treatment with C. spinosa (100 and 300 mg/kg/d; p.o.) was performed 1 h before LPS administration. At the end of the experiment, rats were undergone for behavioral and biochemical analysis. In vitro: Primary microglia isolated from mouse was used in the present study. The cells were pretreated with C. spinosa extract (10�300 μg/ml) and then stimulated with LPS (1 μg/ml). The expression levels of inflammatory and anti-inflammatory cytokines were elucidated using Real-Time PCR and ELISA methods. Results: The escape latency in the Morris water maze test in the LPS group was significantly greater than the control group (p < 0.001), while, in extract-treated groups, it was less than the LPS group (p < 0.001). Additionally, we found that the levels of IL-1β, TNF-α, and iNOS/Arg-1 ratio was also significantly lower in extract-treated groups than the LPS group (p < 0.001). The results revealed that C. spinosa extract significantly reduced the levels of TNF-α, iNOS, COX-2, IL-1β, IL-6, NO and PGE2, and the ratios of iNOS/Arg-1 and NO/urea, following the LPS-induced inflammation in microglia (p < 0.001). Conclusions: Our finding provides evidence that C. spinosa has a neuroprotective effect, and might be considered as an effective therapeutic agent for the treatment of neurodegenerative diseases that are accompanied by microglial activation, such as AD. © 202

Clinical manifestation and maternal complications and neonatal outcomes in pregnant women with COVID-19: a comprehensive evidence synthesis and meta-analysis

Objectives: There is little known about pregnancy-related complications and comorbidity in this group of women. Therefore, this systematic review and meta-analysis were performed to find out whether COVID-19 may cause different manifestations and outcomes in the antepartum and postpartum period or not. Material and methods: We searched databases, including Medline (PubMed), Embase, Scopus, Web of sciences, Cochrane library, Ovid, and CINHAL to retrieve all articles reporting the prevalence of maternal and neonatal complications, in addition to clinical manifestations, in pregnant women with COVID-19 that published with English language January to November 2020. Results: Seventy-four studies with total 5560 pregnant women included in this systematic review. The results show that the pooled prevalence of neonatal mortality, lower birth weight, stillbirth, premature birth, and intrauterine fetal distress in women with COVID-19 was 4 (95 Cl: 1 � 9), 21 (95 Cl: 11 � 31), 2 (95 Cl: 1 � 6), 28 (95 Cl: 13 � 43), and 14 (95 Cl: 4 � 25); respectively. Moreover, the pooled prevalence of fever, cough, diarrhea, and dyspnea were 56 (95 Cl: 32 � 81), 29 (95 Cl: 21 � 38), 9 (95 Cl: 2 � 16), and 3 (95 Cl: 1 � 6) in pregnant women with COVID-19. Two studies reported that pregnant women with severe COVID pneumonia have higher levels of d-dimer. Also, COVID pneumonia is more common in pregnant women than non-pregnant. Conclusion: According to this meta-analysis, pregnant women with COVID-19 with or without pneumonia, are at a higher risk of preeclampsia, preterm birth, miscarriage and cesarean delivery. Furthermore, the risk of LBW and intrauterine fetal distress seems to be increased in neonates. In addition, our evaluations are investigative of higher risk of COVID-19 in the third trimester in pregnant women comparing to the first and second trimester. It can be due to higher BMI in the third trimester causing to increase the likelihood of disease deterioration, which can trigger a cascade of side effects starting with coagulation, pneumonia, hypoxemia affecting the placenta leading to ICU admission, fetal distress, premature birth and higher rates of C-section. © 2021 Informa UK Limited, trading as Taylor & Francis Group