Comparison of glycemic control status before and after the use of artificial sweeteners with conventional nutrition in patients with type 2 diabetes

Background and Objective: Artificial sweeteners are chemical or natural substances used in foods and beverages. The aim of this study was to compare the glycemic control status before and after the use of artificial sweeteners with conventional nutrition in type 2 diabetic patients. Methods: This quasi-experimental study was performed on 30 patients with type 2 diabetes (10 males and 20 females) whom referred to the endocrinology clinic in Tabriz in west of Iran. At the beginning of the study, patients were asked to refrain from using dietary supplements containing artificial sweeteners for three months and continue their usual diabetic diet. Then, each patient was received nutritional supplements containing artificial sweeteners including sugar, special biscuits and candy under a dietitian for three months. Results: Mean glucose level of fasting serum and serum glucose 2 hours after meals in patients during the second trimester increased significantly with the use of artificial sweeteners compared to the first three months (P<0.05). The mean fasting glucose in patients with diabetes mellitus was 121.33±25.3 mg/dl at the end of the first trimester and it was 152±42 mg/dl at the end of the second trimester. The mean serum glucose level increased from 164.44±44.44 mg/dl to 222±7.2 mg/dl 2 hours after meals. The mean of HbA1C in the first trimester was 6.89±0.9% and in the second quarter it was 7.4±1%. Conclusion: The use of artificial sweeteners in diabetic patients may result serum glucose increase

Prevalence of Clarithromycin-Resistant Helicobacter pylori in Patients With Chronic Tonsillitis by Allele-Specific Scorpion Real-Time Polymerase Chain Reaction Assay

Objectives/Hypothesis: To investigate the allelic prevalence of resistance to clarithromycin in the DNA of clinical isolates of Helicobacter pylori obtained from biopsy specimens of patients with chronic tonsillitis by Scorpion real-time polymerase chain reaction (PCR). Study Design: Pathologic specimens of patients with chronic tonsillitis were used for rapid urease test, and blocks of paraffin-embedded tonsillar tissue were used for McMullen staining, rapid urease test, and Scorpion real-time PCR test. Methods: A total of 103 biopsy samples were obtained from patients with chronic tonsillitis and examined for the presence of clarithromycin resistant H. pylori. Modified McMullen staining and rapid urease test were done on the all the samples. The DNA of specimens was extracted from the pathology blocks, and Scorpion real-time PCR was performed on a final volume of 25 lL. Results: Of 103 biopsy specimens, 22 samples were identified as infected by H. pylori, of which none were sensitive to clarithromycin. One had the A2143G genotype, and four had the A2142G genotype. Two had a mixed sensitive and the A2143G genotype, and five had a mixed sensitive and A2142G genotype. One strain had a mixed genotype of sensitive, A2143G, and A2142G. Conclusions: The reported rate of resistance to clarithromycin is of great variation among H. pylori strains isolated from specimens in different countries. Our study showed that the most prevalent genotypes in our H. pylori-positive specimens was A2142G followed by A2143G, which is different from reported results of allele-specific genotyping of H. pylori strains isolated from gastric biopsy and may be a result of cross-resistance to erythromycin and other macrolides. Key Words: Scorpion real-time polymerase chain reaction, chronic tonsillitis, clarithromycin

Effects of lecithin on growth and hematological indices in juveniles of Siberian sturgeon (Acipenser baeri Brandet 1869)

This study was carried out to evaluate the effects of dietary lecithin on growth performance and hematological indices in juveniles of Siberian sturgeon (Acipenser baeri). Fish with initial average weight of 32.9±0.3 grams were fed five isoproteic and isolipidic formulated diets with different soybean lecithin levels including 0, 2.5, 5, 7.5 and 10% in triplicate groups for 8 weeks. Results showed that lecithin supplementation to 7.5% significantly increased some growth indices such as body weight increase (BWI), specific growth rate (SGR), feed conversion ratio (FCR ) final weight (Wf), condition factor (CF) and protein efficiency ratio (PER). Also, increasing dietary lecithin to the level of 10% significantly decreased growth indices. According to the results of hematological assays, hemoglobin (Hb) in treatments of 5% and 7.5% in comparison to other treatments had higher value. Hematocrit (Hct) in fish fed with 7.5% lecithin was higher than those fed with 0 and 2.5% lecithin in the diets. Other hematological indices such as WBC, RBC, MCV, MCH and MCHC showed no significant differences among the treatments. In conclusion, the results of this study indicated that Siberian sturgeon juveniles have a relatively moderate lecithin requirement (between 5 and 7.5 percent of the diet) and these levels of lecithin in diet induces increase of growth performance and improves health status of this species

Inadequate control of diabetes and metabolic indices among diabetic patients: A population based study from the Kerman Coronary Artery Disease Risk Study (KERCADRS)

Background: The goal of diabetes control should be feasible in order to minimize the risk of its adverse events and to reduce its burden and cost on patients. The current study aimed to assess the status of glycemic control in male and female patients with Type 2 Diabetes Mellitus (T2DM) in Kerman, Iran. Methods: In the present study, 500 T2DM (300 women and 200 men) from the Kerman Coronary Artery Disease Risk Study (KERCADRS), a population-based study from 2009 to 2011, were selected. Patients were >18 years old, had Fasting Blood Sugar (FBS) higher than 126 mg/dl, and had been through treatment for their diagnosed disease. All participants underwent Glycosylated Hemoglobin (HbA1c) analysis. HbA1c less than 7% was considered as good glucose control. Other metabolic indices based on American Diabetes Association (ADA) target recommendations were considered. Results: The mean level of HbA1c in total subjects was 8.56 ± 4.72% that only 31.66% of men and 26.00% of women had controlled level of HbA1c. Total cholesterol less than 200 mg/dl was reported in 64.50% of men and 44.00% of women, High Density Lipoprotein (HDL) more than 40 mg/dl was revealed in 20.50% of men and 34.67% of women, and Low Density Lipoprotein (LDL) less than 100 mg/dl was reported in 41.50% of men and 25.33% of women. In multivariate logistic regression model, longer duration of disease and higher Waist Circumference (WC) were positively associated with uncontrolled diabetes status. Conclusion: The findings of the present study revealed that diabetes control in T2DM was inadequate. Changing the policy of treatment in individual patient and establishing better diabetes clinic to decrease the frequency of uncontrolled T2DM are crucial. Paying attention to other affecting metabolic components such as WC in the process of T2DM management is important

The effect of opium addiction on serum adiponectin and leptin levels in male subjects

Serum adiponectin and leptin levels have been shown to be related to obesity, insulin resistance and cardiovascular diseases (CVD). Opium addiction has a positive association with endocrine system disorders. The relationship between adipokines and opium addiction is unclear. In the present study, we aimed to determine serum adiponectin and leptin levels in opium addicted subjects. Methods: 176 men, 88 opium addicts and 88 non-addicts were randomly selected from subjects who participated in Kerman Coronary Artery Disease Risk factors Study (KERCADRS); a population-based study. Serum adiponectin and leptin levels were measured using ELISA and compared between two groups. We adjusted the effect of some confounding factors such as the patients’ demographic, clinical and medical history in multivariate analysis model. Results: The serum level of adiponectin in opium addicts was significantly lower than control group (6.5±3.6 vs. 9.8±8.1 μg/ml, P<0.001). There was no significant difference in serum leptin level between two groups (11.8±10.3 ng/ml in control group vs. 11.5±10.8 ng/ml in opium addicts, p = 0.80). In the multivariate analysis, after adjusting for age, cigarette smoking, body mass index, type 2 diabetes, hypertension, cholesterol, triglyceride and high and low density lipoproteins, the negative association between opium addiction and decreased adiponectin level was still present (β = -0.144, P value = 0.005). Conclusions: The results showed that opium addiction reduces serum adiponectin level. Since adiponectin has been shown to have anti-diabetic and anti-atherogenic effects, its reduction may account for increase in the risk of metabolic disorders such as insulin resistance and CVD amongst opium addicted patients

Neural and Local Regulation of Blood Flow and Synovial Fluid PO2 in the Rabbit Knee Joint

Synovial fluid, in addition to its lubricating action of moving structures, provides nutrients to avascular structures such as articular cartilage (McKibbin & Maroudas, 1979), and also to the knee ligaments (Renzoni et aL, 1984), within the joint. As synovial fluid formation is critically dependent on synovial blood flow (Levick, 1987), those factors which regulate flow in the synovial vascular bed are clearly important in this process. The first objective of this research was to measure knee joint blood flow quantitatively and also assess the effect of sympathetic nerves in the regulation of joint blood flow. Secondly, to investigate and characterize the type of adrenoceptors mediating the sympathetic control of joint blood flow, and other mediators involved in nerve mediated changes in articular blood flow. Thirdly, to assess the possible role of the endothelium in regulation of joint blood flow and modulation of sympathetic nerve-mediated changes in joint blood flow. Finally to perform all the mentioned procedures in an experimentally induced acutely inflamed knee joints to determine the effect of inflammation on these regulatory mechanisms and factors. The second objective of this study was to measure, in both normal and inflamed knee joints, the synovial PO2 directly in its place; and also assess the correlation between the joint blood flow and oxygen tension in the synovial fluid and the extent to which this correlation may be affected by the process of inflammation. Experiments were performed on rabbits. Acute inflammation was induced by intra-articular injection of carrageenan. Quantitative measurement of joint blood flow was conducted by the radiolabelled microsphere technique. Relative changes in blood flow were assessed by laser Doppler flowmetry, and a polarographic oxygen elecrode (and oxygen meter) was used to measure synovial PO2 and its changes during the course of experiments. The results of this investigation indicate that: 1). The microsphere technique and laser Doppler flowmetry are suitable methods for quantitative and continuous measurement of joint blood flow respectively, and the process of inflammation increases joint blood flow significantly. Despite this increase in blood flow, synovial PO2 which in normal joint is much lower than the arterial PO2, even decreases more in the inflamed joints. 2). Sympathetic nerves innervate the blood vessels of the posterior capsule of the knee joint and play an important role in regulation of joint blood flow. alpha2 adrenoceptors predominate in this vascular bed and mediate vasoconstrictor responses to nerve stimulation. No evidence of pimergic co-transmission was obtained. The process of inflammation reduced the effectiveness of sympathetic nervous system in regulation of joint blood flow. 3). Nerve-mediated vasodilator responses appeared to have two components, a beta-adrenoceptor component which is mediated by postjunctional beta1 adrenoceptors which found to predominate in this vascular bed, and a substance P mediated component which is produced by the release of neuropeptide, substance P, presumably from the unmyelinated sensory nerve endings. 4). Vascular endothelium keeps the joint blood vessels of both normal and inflamed joints in a state of active dilatation by release of nitric oxide (NO) and therefore plays a major role in local regulation of joint blood flow. NO also counteracts the sympathetic vasoconstrictor responses, but it showed no modulatory effect on nerve-mediated vasodilator responses. 5). Prostaglandins are important local factors in regulation of joint blood flow in both normal and inflamed joints. They seemed to have no modulatory effect on sympathetic regulation of blood flow to this vascular bed. PGE2 receptors are present on knee joint blood vessels but they down regulate during the process of inflammation. 6). A polarographic oxygen electrode provided a new and suitable method for quantitative and continuous measurement of oxygen partial pressure in the synovial fluid of both normal and inflamed knee joints. A high correlation between changes in joint blood flow and synovial PO2 was found in both joints

Cytogenetic Evaluation of Couples With Spontaneous Abortion, Still Birth and Recurrent Miscarriage in Qazvin: Report and Review

Background: Chromosomal abnormality plays an important role in different types of miscarriages. Objectives: The present study was designed to investigation chromosomal anomalies in three groups of couples with recurrent abortion (RA), spontaneous abortion (SA) and still birth (SB). PatientsandMethods: In this retrospective study, the frequency of chromosomal aberrations was investigatedamong 260 couples with miscarriage, which had referred to the cytogenetic section of a reference laboratory in Buali hospilal, Qazvin, Iran from 2009 to 2014. Metaphase spreads were analyzed using G-banding. Results: In this study, 7.6% of couples had chromosomal aberrations including, balanced reciprocal translocations, robertsonian translocations, inversions and sex chromosome aneuploidy. Frequency of balanced translocations was higher, specifically in couples with SA. Conclusions: In this investigation we showed that chromosomal abnormalities could be one of the important causes of miscarriages. Cytogenetic evaluation of couples, which experienced different types of miscarriage, may prevent unnecessary treatments. Keywords: Recurrent Abortion, Spontaneous Abortion, Still Birth, Chromosome Abnormalit

SIRT1 and Klotho expression in the heart and kidneys of rats with acute and chronic renovascular hypertension

Aim To evaluate Klotho and SIRT1 expression in the heart and kidneys of rats with acute and chronic renovascular hypertension. Methods Four and sixteen weeks after the induction of renovascular hypertension by clipping the left renal artery, systemic blood pressure, serum angiotensin II level, and the expression of Klotho and SIRT1 proteins and oxidative stress indices in the heart and kidneys were assessed. Results SIRT1 level was significantly reduced in the ischemic (left) kidney in acute and chronic phases of hypertension. In the heart, it decreased in the acute phase, but increased in the chronic phase. Klotho levels in the heart and kidneys did not change significantly in either hypertension phase. Superoxide dismutase (SOD) activity in the heart significantly decreased, and SOD, total antioxidant capacity, and malondialdehyde in the ischemic kidney significantly increased during the development of hypertension. Serum angiotensin II level significantly increased in the acute phase of hypertension. Conclusion Development of renovascular hypertension was associated with a reduction of SIRT1 expression in the heart and ischemic kidney. As angiotensin II and SIRT1 counteract each other’s expression, a SIRT1 reduction in the heart and kidney, along with the influence of systemic/ local angiotensin II, seems to be partly responsible for hypertension development. A combination of SIRT1 agonists and angiotensin II antagonists may be considered for use in the treatment of renovascular hypertension