Ecological Model of Adaptation with Diabetes type 2: Development and Study of Empiric Fitness

Introduction: The present study aimed at presenting and testing a model to describe the adaptation phenomenon among the patients engaged with type 2 diabetes (T2D).Methods: This is a correlational research design wherein a total of 350 individuals referring to four special medical centers for diabetes at Tehran (Iran). The research instruments included the Jackson’s five-factor questionnaire, demographic and social support subscales of diabetes care profile, cognitive appraisal of diabetes scale, problem areas in diabetes survey, Billings and Moos coping strategies scale, appraisal of adaptation to diabetes scale, and HbA1C level.Results: The outputs of the tests on the final model of the research showed that the behavior activating system, fight, flight and freeze system, global social support, and “Get” social support impose significant effects on the cognitive appraisal. Moreover, the “Get-Want” & Global Social support, Fight, Flight & freeze System and the cognitive appraisal affected the adaptive tasks significantly. The Fight, Flight & freeze System and the adaptive tasks imposed significant effects on the problem-focused emotional-physical coping. The Problem focused socio-cognitive coping and the emotional-physical coping affected the initial adaptation significantly. Behavior inhibition system, all the three components of social support, and Problem focused Socio-cognitive coping imposed significant effects on the secondary adaptation. And finally, Global social support and initial adaptation affected the HbA1C significantly. In addition, a number of intermediate effects were verified.Conclusion: Upon accessing the model of adaptation to disease for a particular individual, one can access his/her adaptation profile and evaluate the strengths and weaknesses of his/her adaptation structure and formulate the required interventions accordingly.Declaration of Interest: Non

The Effect of Thyroid Hormone Replacement on the Metabolic Control and Insulin Resistance in Patients with Subclinical Hypothyroidism

Introduction: Studying the treatment effect of subclinical hypothyroidism in decreasing metabolic syndrome risk factors and cardiovascular diseases is necessary and can be helpful to control future disorders. In spite of various studies, the relationship between subclinical hypothyroidism and cardiovascular diseases remain controversial. Studies which consider the effects of subclinical hypothyroidism treatment on metabolic control and insulin resistance have not been done in the Islamic Republic of Iran yet. Materials and methods: In this interventional study, 153 patients with subclinical hypothyroidism (thyroid stimulation hormone (TSH) >5, normal T3 and T4 at least 2 times) were selected from Labbafinejad endocrine clinic. Laboratory tests were performed at 8 a.m. after 12-14 hours fasting. Patients were then treated with levothyroxine (25-50 µg daily). To adjust the dose, thyroid function tests (TFT) were checked every 2 months for 6 months. Collected data was used for analysis by spss18 software. Results: After 6 months treatment of subclinical hypothyroidism mean values improved in factors such as insulin resistance profile (fasting blood sugar (FBS), 2 hours post prandial (2hPP), fasting insulin and homeostasis model assessment estimated insulin resistance (HOMA-IR index), lipid profile (total cholesterol, low density lipoprotein (LDL) and high density lipoprotein (HDL), decreased c-reactive protein (CRP) and weight (all had P value<0.05). Treatment did not have significant effect on triglycerides (TG), waist circumference, body mass index (BMI), uric acid ad systolic/diastolic blood pressure (p values>0.05). But the number of cases with high systolic/diastolic blood pressure decreased significantly after 6 months treatment (P values=0.007 and 0.01). Conclusion: Subclinical hypothyroidism treatment is suggested according to mentioned effects, especially in cases with insulin resistance, lipid profile disturbance, obesity, and high blood pressure

The Evaluation of the Effect of Hypothyroidism Treatment on Non-Alcoholic Fatty Liver Disease

Introduction: There is still controversy over the existence of a relation between hypothyroidism and fatty liver disease. The scale by which hypothyroidism can affect fatty liver disease progression is also to be determined. Therefore, our study aims to contribute in the determination of this relation. Materials and methods: This observational analytical-before and after study with 53 patients was conducted. The subjects were categorized as having either primary or subclinical hypothyroidism. The serum levels of thyroid stimulation hormone (TSH), free T3 (FT3), free T4 (FT4), alanine transaminase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were measured and liver ultrasound was done to screen nonalcoholic fatty liver disease (NAFLD). Results: The study consisted of 41 women and 12 men with the mean age of 48.3 years. The mean TSH levels decreased after hypothyroidism treatment in patients. The mean levels of FT4 did not have a significant increase after treatment, although in patients with subclinical hypothyroidism this increase was significant. T3 levels increased significantly after treatment. Statistical studies showed that there was a significant change in the degree of fatty liver before and after hypothyroidism treatment. Conclusion: There was an explicit relation between hypothyroidism and non-alcoholic fatty liver disease as Hypothyroidism treatment can prevent non-alcoholic fatty liver disease progression

Evaluation of type 2 Diabetes Mellitus Risk in Patients with post Trauma Splenectomy

Introduction: Recent studies suggest that the spleen has an important role as a source of multipotent stem cells and precursors of beta cells of pancreas islets. In addition, increased risk of developing hyperglycemia was reported in patients who underwent splenectomy due to trauma in long-term follow up. Therefore, there might be an association between splenectomy and an increased risk of type 2 diabetes mellitus. In this study, we evaluated the risk of type 2 diabetes and its risk factors including hyperglycemia, dyslipidemia, obesity and hypertension in trauma patients with splenectomy. Materials and methods: In this study, 221 patients who underwent splenectomy surgery due to trauma in the surgical ward of Imam Hossein Hospital 5 to 10 years ago were selected. Those with a history of diabetes, cancer, hyperthyroidism, Cushing's syndrome, pancreatitis, renal failure, and cirrhosis were excluded from the study. Then fasting plasma glucose, hemoglobin A1c (HbA1c), triglyceride, cholesterol and high density lipoprotein (HDL), body mass index and blood pressure have been evaluated in 90 patients who had had a history of splenectomy due to trauma from 2007, July 23 to 2012, July 22. Results: The results indicate that none of these patients has diabetes, 14.4 percent are in pre-diabetic stage, 56.6 percent has dyslipidemia, 57.7 percent has obesity and 20 percent has hypertension. Conclusion: The results of this study suggest that splenectomy does not increase the risk of type 2 diabetes. Prevalence of diabetes risk factors was approximately the same with those of Tehran population

Effect of Vitamin D Administration on Glycemic Control in Patients with Type II Diabetes Mellitus and Vitamin D Deficiency

Introduction: The prevalence of diabetes mellitus (DM) and its morbidity and mortality are prominent all over the world. Observational data suggest that vitamin D deficiency is associated with insulin resistance. In this study, we aimed to assess this association. Methods:  This study was a clinical trial consisting of 42 patients with type 2 DM who had vitamin D deficiency. The patients underwent vitamin D replacement with vitamin D pearls (50,000 iu) weekly for 10 weeks. The level of low-density lipoprotein (LDL), high-density lipoprotein (HDL), cholesterol (Chol), triglycerides (TG), hemoglobin A1c (HbA1C), 2 hour post prandial (2HPP), fasting blood sugar (FBS), body mass index (BMI), blood pressure (BP), and 25oHVitD3 were measured before and after the treatment in all patients. Data were analyzed with paired t test. Results:  100% of patients reached acceptable vitamin D level (above 30 mg/dl). No toxicity was reported. Changes in FBS, 2Hpp, HbA1C, Chol, SBP were significant and there was no significant change in LDL, HDL, and DBP. Conclusion:  Screening for vitamin D deficiency and its replacement may have a beneficial effect on type 2 DM management and its associated risk factors. More studies with larger sample size and use of placebo are recommended

Effect of Proton Pump Inhibitor Administration on Glycemic Parameters in Patients with Type 2 Diabetes Mellitus

Introduction: Proton pump inhibitors can influence glucose-insulin homeostasis by elevating plasma gastrin. Considering the few clinical trials and contradictory results of previous studies, we aimed to evaluate the effect of omeprazole, a proton pump inhibitor, on glucose-insulin homeostasis in patients with type 2 diabetes mellitus (T2DM). Materials and Methods: In this before-after clinical trial, 40 patients with T2DM received omeprazole treatment for 12 weeks. Patients were asked to continue their diet, lifestyle, and physical activity throughout the study period. Glycosylated hemoglobin (HbA1c), fasting plasma sugar (FBS), insulin level, C-peptide and 2 hours post prandial blood sugar (2hppBS) were measured at baseline and after 12 weeks. Homeostatic model assessment of Insulin resistance (HOMA-IR) and homeostatic model assessment of β-cell dysfunction (HOMA-B) indices were also calculated at baseline and after 12 weeks of omeprazole administration. Results: After 12 weeks of omeprazole administration, there was a clear decrease in the mean HbA1C before (8.11±0.96) and after (7.13±0.68) the treatment (P<0.001). Similarly, a decrease in mean FBS and 2HPPBS before and after treatment was observed, which was statistically significant for FBS (P=0.01) but not for 2HPPBS (P=0.1). There was a clear increase in the level of Insulin (P=0.001) and C-peptide (P=0.003). The mean activity index of HOMA-B before and after receiving omeprazole was 54.41 27.06 and 79.24 45.32, respectively (P=0.007). Also, HOMA-IR index was 5 before, and 6 after receiving omeprazole (P=0.001). Conclusion: Administration of omeprazole, increases insulin levels and decreases the levels of HbA1c, FBS, thus improving glycemic status and can be combined with other drugs used to manage DM, especially in patients with gastrointestinal problems; but more studies are needed

Governance matter: Morningstar stewardship grades and mutual fund performance

<p>Semiquantitative (A) and Quantitative (B) expression analysis of <i>AREB/ABF</i> and <i>DREB/CBF</i> genes in the leaf tissues of five different varieties of grape under salt stress.</p

Effects of Photobiomodulation With Two Wavelengths of 630 and 810 nm on Diabetic Neuropathy: Photobiomodulation and diabetic neuropathy

Introduction: Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes patients. Among different therapeutic approaches for treating DPN, low-level laser therapy (LLLT) or photobiomodulation (PBM) is a new promising non-invasive technique. This study aims to evaluate the effect of visible and infrared LLLT on DPN.Methods: Sixty DPN patients enrolled in a randomized-controlled study. The patients were randomly divided into the same population of control and laser groups. The patients in the laser group received LLLT with two wavelengths of 630 and 819 nm and conventional therapy, and those in the control group received conventional therapy alone. Irradiation of the patients lasted 15 minutes per session, and it was performed over the surface of each foot three times a week for 12 sessions. The patients were evaluated at baseline and at the end of the study with the Michigan Neuropathy Screening Instrument (MNSI) and microfilament test.Results: Patients’ sensation in the right foot in the monofilament test had increased from 22 (84.6%) to 26 (86.7%) (P=0.000), and in the left foot it had increased from 20 (80%) to 25 (86.2%) (P=0.001). The mean and standard deviation of the scores of section A of the Michigan questionnaire showed a statistically significant difference between the two groups (P&lt;0.05), but the B part scores of the Michigan test did not show a significant difference.Conclusion: This study showed that the visible and infra-red LLLT significantly improved the symptoms of diabetic neuropathy without any side effects

Olfactory and Gustatory Dysfunctions as Prognostic Factors in Patients with the SARS-CoV-2 Virus: COVID-19 and olfactory and gustatory dysfunction

Background: COVID-19 neurologic symptoms such as anosmia and ageusia are considered the most challenging issues for patients in the first steps of viral infection. Herein, we aimed to investigate the olfactory and gustatory dysfunction and their association with prognostic factors in patients with COVID-19. Materials and Methods: The current retrospective study was performed on patients admitted to a hospital with a definite diagnosis of COVID-19 between March and November 2020. Based on the study criteria, information of 150 eligible participants (89 males and 61 females) was completely collected. The olfactory and gustatory symptoms including anosmia, hyposmia, ageusia, and dysgeusia were assessed, and five main COVID-19 prognostic factors including level of D-dimer, C-reactive protein (CRP), lymphocyte count (LC), lactic acid dehydrogenase (LDH) and COVID-19 related lung involvement were measured. Results: Among all patients, 102 (68%) participants were completely treated and 48 (32%) died. Compared to treated patients, all prognostic factors including CRP, LDH, LC, D-dimer, and lung involvement were significantly higher in death cases. We found that 97 (64.7%) patients experienced at least one olfactory or gustatory dysfunction. The level of CRP, LC, D-dimer, and lung involvement showed a better prognosis among patients with at least one sensory dysfunction. Moreover, a better outcome was observed in patients with sensory dysfunction. Conclusion: It can be concluded the evaluation of CRP, LDH, D-dimer, and LC together with the HRCT scan score contributes to a better prognosis in COVID-19 patients with sensory dysfunction

THC and CBD Fingerprinting of an Elite Cannabis Collection from Iran: Quantifying Diversity to Underpin Future Cannabis Breeding

Cannabis (Cannabis sativa L.) has a rich history of human use, and the therapeutic importance of compounds produced by this species is recognized by the medical community. The active constituents of cannabis, collectively called cannabinoids, encompass hundreds of distinct molecules, the most well-characterized of which are tetrahydrocannabinol (THC) and cannabidiol (CBD), which have been used for centuries as recreational drugs and medicinal agents. As a first step to establish a cannabis breeding program, we initiated this study to describe the HPLC-measured quantity of THC and CBD biochemistry profiles of 161 feral pistillate cannabis plants from 20 geographical regions of Iran. Our data showed that Iran can be considered a new region of high potential for distribution of cannabis landraces with diverse THC and CBD content, predominantly falling into three groups, as Type I = THC-predominant, Type II = approximately equal proportions of THC and CBD (both CBD and THC in a ratio close to the unity), and Type III = CBD-predominant. Correlation analysis among two target cannabinoids and environmental and geographical variables indicated that both THC and CBD contents were strongly influenced by several environmental–geographical factors, such that THC and CBD contents were positively correlated with mean, min and max annual temperature and negatively correlated with latitude, elevation, and humidity. Additionally, a negative correlation was observed between THC and CBD concentrations, suggesting that further studies to unravel these genotype × environment interactions (G × E interactions) are warranted. The results of this study provide important pre-breeding information on a collection of cannabis that will underpin future breeding programs