The effects of curcumin on weight loss among patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized controlled trials

Background and objective: The current systematic review and meta-analysis of randomized controlled trials (RCTs) was carried out to assess the influence of curcumin intake on weight among patients with metabolic syndrome and related disorders. Methods: We searched the following databases up until January 2018: MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. The relevant data were extracted and evaluated for quality of the studies in accordance with the Cochrane risk of bias tool. Data were pooled using the inverse variance method and expressed as standardized mean difference (SMD) with 95 confidence intervals (95 CI). Results: Eighteen articles (21 studies) that comprised a total of 1,604 individuals were finally included in the meta-analysis. Curcumin intake significantly reduced body mass index (BMI) (SMD �0.37; 95 CI, �0.61, �0.13; P < 0.01), weight (SMD �0.23; 95 CI, �0.39, �0.06; P < 0.01), waist-circumference (WC) (SMD �0.25; 95 CI, �0.44, �0.05; P = 0.01), leptin levels (SMD �0.97; 95 CI, �1.18, �0.75; P < 0.001) and increased adiponectin levels (SMD 1.05; 95 CI, 0.23, 1.87; P = 0.01). We found no significant effect of curcumin intake on hip ratio (HR) (SMD �0.17; 95 CI, �0.42, 0.08; P = 0.18). Conclusions: Overall, we have found that curcumin intake among patients with metabolic syndrome and related disorders was correlated with a significant reduction in BMI, weight, WC, and leptin, and a significant increase in adiponectin levels, but did not affect HR. Copyright © 2019 Akbari, Lankarani, Tabrizi, Ghayour-Mobarhan, Peymani, Ferns, Ghaderi and Asemi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms

The effects of inositol supplementation on lipid profiles among patients with metabolic diseases: A systematic review and meta-analysis of randomized controlled trials

Background Several studies have evaluated the effect of inositol supplementation on lipid profiles among population with metabolic diseases; however, the findings are controversial. This review of randomized controlled trials (RCTs) was performed to summarize the evidence of the effects of inositol supplementation on lipid profiles among population with metabolic diseases. Methods Relevant RCTs studies were searched in Cochrane Library, EMBASE, MEDLINE, and Web of Science until October 2017. Two researchers assessed study eligibility, extracted data, and evaluated risk of bias of included primary studies, independently. To check for the heterogeneity among included studies Q-test and I2 statistics were used. Data were pooled by using the random-effect model and standardized mean difference (SMD) was considered as summary of the effect size. Results Overall, 14 RCTs were included into meta-analysis. Pooled results showed that inositol supplementation among patients with metabolic diseases significantly decreased triglycerides (SMD − 1.24; 95% CI, − 1.84, − 0.64; P < 0.001), total- (SMD − 1.09; 95% CI, − 1.83, − 0.55; P < 0.001), and LDL-cholesterol levels (SMD − 1.31; 95% CI, − 2.23, − 0.39; P = 0.005). There was no effect of inositol supplementation on HDL-cholesterol levels (SMD 0.20; 95% CI, − 0.27, 0.67; P = 0.40). Conclusions Inositol supplementation may result in reduction in triglycerides, total- and LDL-cholesterol levels, but did not affect HDL-cholesterol levels among patients with metabolic diseases. Additional prospective studies regarding the effect of inositol supplementation on lipid profiles in patients with metabolic diseases are necessary. Keywords: Inositol Lipid profiles Metabolic diseases Meta-analysi

Affordability assessment from a static to dynamic concept: A scenario�based assessment of cardiovascular medicines

The out�of�pocket payments for prescription medications can impose a financial burden on patients from low� and middle� incomes and who suffer from chronic diseases. The present study aims at evaluating the affordability of cardiovascular disease (CVD) medication in Iran. This includes measuring affordability through World Health Organization/Health Action International (WHO/HAI) methodology. In this method, affordability is characterized as the number of daysʹ wages of the lowest�paid unskilled government worker. The different medication therapy scenarios are defined in mono�and combination therapy approaches. This method adds on to WHO/HAI methodology to discover new approaches to affordability assessments. The results show the differences in the medicines affordability when different approaches are used in mono�and combination therapy between 6 main sub�therapeutic groups of CVD. It indicates the medicine affordability is not a static concept and it changes dynamically between CVD therapeutic subgroups when it used alone or in combination with other medicines regarding patients� characteristics and medical conditions. Hypertension and anti�arrhythmia therapeutic groups had the most non-affordability and hyperlipidemia had the most affordable medicines. Therefore, affordability can be considered as a dynamic concept, which not only affected by the medicine price but significantly affected by a patient�s characteristics, the number of medical conditions, and insurance coverage. © 2020 by the authors. Licensee MDPI, Basel, Switzerland

Molecular survey of aminoglycoside-resistant Acinetobacter baumannii isolated from tertiary hospitals in Qazvin, Iran

Aminoglycoside-modifying enzymes (AMEs) and 16S rRNA methylases (16S RMTase) are two main resistance mechanisms against aminoglycosides. This study aimed to evaluate the frequency of AMEs and 16S rRNA methylase genes among aminoglycoside nonsusceptible Acinetobacter baumannii isolates and to assess their clonal relationship using repetitive extragenic palindromic-PCR (rep-PCR). In this cross-sectional study, a total of 192 A. baumannii isolates were collected from the patients hospitalized in Qazvin, Iran (January 2016 to January 2018). Identification of isolates was performed by standard laboratory methods and API 20E strips. Antimicrobial susceptibility was determined by Kirby–Bauer method followed by examination of the genes encoding the AMEs and 16S RMTase by PCR and sequencing methods. The clonal relationship of isolates was carried out by rep-PCR. In total, 98.4% of isolates were nonsusceptible to aminoglycosides, 98.4%, 97.9% and 83.9% of isolates were found to be non-susceptible against gentamicin, tobramycin and amikacin, respectively. The frequencies of aph(30 )-VI, aac(60 )-Ib, aac(3)-II, aph(30 )-Ia and armA genes were 59.3%, 39.2%, 39.2%, 31.7% and 69.8%, respectively, either alone or in combination. Rep-PCR results showed that the aminoglycoside non-susceptible isolates belonged to three distinct clones: A (79.4%), B (17.5%) and C (3.2%). The findings of this study showed a high frequency for AMEs with the emergence of armA genes among the aminoglycoside non-susceptible A. baumannii isolates. Rational administration of aminoglycosides as well as using an appropriate infection control policy may reduce the presence of resistance to antibiotics in medical centres

The effects of resveratrol supplementation on biomarkers of inflammation and oxidative stress among patients with metabolic syndrome and related disorders: a systematic review and meta-analysis of randomized controlled trials

There are several current trials investigating the effect of resveratrol supplementation on biomarkers of inflammation and oxidative stress among patients with metabolic syndrome (MetS); however, their findings are controversial. This systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to summarize the existing evidence and collectively determine the effects of resveratrol supplementation on biomarkers of inflammation and oxidative stress among patients with MetS and related disorders. Two authors independently searched electronic databases, including MEDLINE, EMBASE, Cochrane Library, and Web of Science databases, until May 2018 in order to find relevant RCTs. The quality of the selected RCTs was evaluated using the Cochrane Collaboration risk of bias tool. Cochran's Q test and I-square (I2) statistic were used to determine whether heterogeneity exists across included trials. Standardized mean difference (SMD) and 95 CI between two intervention groups were used to determine pooled effect sizes. Out of 317 potential citations selected based on keywords, 24 RCTs met the inclusion criteria and were eligible for the current meta-analysis. The pooled results obtained by using the random-effects model showed that resveratrol supplementation significantly decreased C-reactive protein (CRP) (SMD = -0.55; 95 CI, -0.84, -0.26; P < 0.001; I2: 84.0) and tumor necrosis factor-α (TNF-α) (SMD = -0.68; 95 CI, -1.08, -0.28; P = 0.001; I2: 81.3) concentrations among patients with MetS and related disorders. Interleukin 6 (IL-6) (SMD = 0.05; 95 CI, -0.31, 0.41; P = 0.79; I2: 85.0) and superoxide dismutase (SOD) (SMD = 0.21; 95 CI, -3.16, 3.59; P = 0.90; I2: 97.7) concentrations did not significantly change following resveratrol supplementation. Resveratrol supplementation showed a promising lowering effect on some of the inflammatory markers among patients with MetS and related disorders. Additional prospective studies regarding the effect of resveratrol supplementation on biomarkers of inflammation and oxidative stress by using higher doses of resveratrol and longer duration of supplementation are necessary

The Effects of Probiotic Supplementation on Clinical Symptom, Weight Loss, Glycemic Control, Lipid and Hormonal Profiles, Biomarkers of Inflammation, and Oxidative Stress in Women with Polycystic Ovary Syndrome: a Systematic Review and Meta-analysis of Randomized Controlled Trials

The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) is to determine the effectiveness of probiotic supplementation on clinical symptoms, weight loss, glycemic control, lipid and hormonal profiles, and biomarkers of inflammation and oxidative stress in women with polycystic ovary syndrome (PCOS). Eligible studies were systematically searched from Cochrane Library, Embase, Medline, and Web of Science databases until January 2019. Cochran (Q) and I-square statistics were used to measure heterogeneity among included studies. Data were pooled by using random-effect model and expressed as standardized mean difference (SMD) with 95 confidence interval (CI). Eleven articles were included in this meta-analysis. Probiotic supplementation significantly decreased weight (SMD � 0.30; 95 CI, � 0.53, � 0.07; P = 0.01), body mass index (BMI) (SMD � 0.29; 95 CI, � 0.54, � 0.03; P = 0.02), fasting plasma glucose (FPG) (SMD � 0.26; 95 CI, � 0.45, � 0.07; P < 0.001), insulin (SMD � 0.52; 95 CI, � 0.81, � 0.24; P < 0.001), homeostatic model assessment for insulin resistance (HOMA-IR) (SMD � 0.53; 95 CI, � 0.79, � 0.26; P < 0.001), triglycerides (SMD � 0.69; 95 CI, � 0.99, � 0.39; P < 0.001), VLDL-cholesterol (SMD � 0.69; 95 CI, � 0.99, � 0.39; P < 0.001), C-reactive protein (CRP) (SMD � 1.26; 95 CI, � 2.14, � 0.37; P < 0.001), malondialdehyde (MDA) (SMD � 0.90; 95 CI, � 1.16, � 0.63; P < 0.001), hirsutism (SMD � 0.58; 95 CI, � 1.01, � 0.16; P < 0.001), and total testosterone levels (SMD � 0.58; 95 CI, � 0.82, � 0.34; P < 0.001), and also increased the quantitative insulin sensitivity check index (QUICKI) (SMD 0.41; 95 CI, 0.11, 0.70; P < 0.01), nitric oxide (NO) (SMD 0.33; 95 CI 0.08, 0.59; P = 0.01), total antioxidant capacity (TAC) (SMD 0.64; 95 CI, 0.38, 0.90; P < 0.001), glutathione (GSH) (SMD 0.26; 95 CI, 0.01, 0.52; P = 0.04), and sex hormone binding globulin (SHBG) levels (SMD 0.46; 95 CI, 0.08, 0.85; P = 0.01). Probiotic supplementation may result in an improvement in weight, BMI, FPG, insulin, HOMA-IR, triglycerides, VLDL-cholesterol, CRP, MDA, hirsutism, total testosterone, QUICKI, NO, TAC, GSH, and SHBG but did not affect dehydroepiandrosterone sulfate levels, and total, LDL, and HDL cholesterol levels in patients with PCOS. © 2019, Springer Science+Business Media, LLC, part of Springer Nature

The effects of statin use on inflammatory markers among patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized controlled trials

Current evidence suggests that statin use decreases the incidence of cardiovascular diseases (CVD) through reducing LDL cholesterol and decreasing inflammation. Metabolic syndrome (MetS) is usually associated with increased inflammatory markers and increased risk of CVD. We conducted a systematic review and meta-analysis to determine the effect of statin use on inflammatory markers including C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-1 (IL-1) among patients with MetS and related disorders. PubMed, EMBASE, Web of Science databases, and Cochrane Library were searched for randomized controlled trials (RCTs) through April 2018. Three independent investigators evaluated study eligibilities, extracted data, and assessed study quality using the Cochrane Collaboration risk of bias tool and Jadad's quality scales. Heterogeneity was determined using Cochran's Q statistic and I-square (I 2 ) test. Based on the heterogeneity results, we pooled data using random-effect or fixed effect models presented as standardized mean differences (SMD) and corresponding 95 confidence intervals (CI). One hundred thirteen RCTs (19,644 patients) were included in our meta-analysis. The pooled results using random effects model showed that statin use statistically significantly decreased CRP level (SMD= -0.97; 95 CI, -1.10, -0.85; P &lt; 0.001; I 2 : 95.1), TNF-α (SMD= -1.88; 95 CI, -2.40, -1.38; P &lt; 0.001; I 2 : 97.2), IL-6 (SMD= -1.67; 95 CI, -1.98, -1.34; P &lt; 0.001; I 2 : 96.5), and IL-1 concentrations (SMD= -8.35; 95 CI, -10.49, -6.22; P &lt; 0.001; I 2 : 98.4) among patients with MetS and related disorders. Our meta-analysis showed beneficial effects of statin use on reducing inflammatory markers in patients with MetS and related disorders. © 2018 Elsevier Lt

COVID-19-associated glomerulopathy and high-risk apol1 genotype; basis for a two-hit mechanism of injury? A narrative review on recent findings

Kidney is one of the most common organs affected by coronavirus disease 2019 (COVID-19) after the respiratory and immune systems. Among the renal parenchymal components, the tubulointerstitial compartment is presumed to be the prime target of injury in COVID-19. The main mechanism of renal tubular damage by COVID-19 is considered to be indirect, i.e., cytokine-mediated injury. A proportion of infected individuals mount a strong inflammatory response to the virus by an exaggerated immune response of the body, namely cytokine storm. Sudden and massive release of cytokines may lead to serious systemic hyper-inflammation and renal tubular injury and inflammation resulting in acute renal failure. In addition, a number of cases of glomerulopathies, particularly collapsing glomerulopathy (CG) have been reported, predominantly in people of African ancestry, as a rare form of kidney involvement by SARS-CoV-2 that may originate from the background genetic susceptibility in this population complicated by the second hit of SARS-CoV-2 infection, either directly or indirectly. It is noteworthy that renal injury in COVID-19 could be severe in individuals of African origin due to the aforementioned genetic susceptibility, especially the presence of high-risk apolipoprotein L1 (APOL1) genotypes. Although the exact mechanism of kidney injury by SARS-CoV-2 is as yet unknown, multiple mechanisms are likely involved in renal damage caused by this virus. This review was aimed to summarize the salient points of pathogenesis of kidney injury, particularly glomerular injury in COVID-19 disease in the light of published data. A clear understanding of these is imperative for the proper management of these cases. For this review, a search was made of Google Scholar, Web of Science, Scopus, EBSCO and PubMed for finding English language articles related to COVID-19, kidney injury and glomerulopathy. From the information given in finally selected papers, the key aspects regarding glomerular involvement in COVID-19 were drawn out and are presented in this descriptive review

Plasmid-Mediated Quinolone Resistance in Pseudomonas aeruginosa Isolated from Burn Patients in Tehran, Iran.

Abstract INTRODUCTION: Plasmid-induced quinolone resistance has raised a great concern in the treatment of serious infections worldwide. The aims of this study were to determine the antibiotic susceptibility, the frequency of qepA, aac(6&#039;)-Ib, and qnr genes by PCR and sequencing, and typing of the resistant isolates using repetitive extragenic palindromic sequence-based PCR (REP-PCR) in Pseudomonas aeruginosa isolated from burn wound infections. MATERIAL AND METHODS: In the current cross-sectional study, 149 P. aeruginosa were isolated from the burn wound samples of patients admitted to Motahari hospital in Tehran, Iran, from February to December 2016. The bacterial isolates were identified using standard laboratory methods and their antibiotic susceptibility to quinolones was evaluated using the standard Kirby-Bauer method, according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. The presence of aac(6&#039;)-Ib, qepA, qnrA, qnrB4, qnrB, and qnrS genes was assessed using PCR and sequencing methods and clonal relationship of the resistant isolates was evaluated using REP-PCR method. RESULTS: All (100%) isolates showed complete resistance to used quinolone compounds in this study. The qnr and qepA genes were not found, but all (100%) isolates were positive for the presence of aac(6&#039;)-Ib gene and the sequencing revealed that all (100%) belong to the aac(6&#039;)-Ib-cr variant. REP-PCR showed that the studied isolates belonged to three distinct clones of A (77.9%), B (18.1%), and C (4%). CONCLUSION: The findings of the present study indicated the presence of aac(6')-Ib-cr variant and lack of the contribution of qnr and qepA in the emergence of resistance to quinolones in P. aeruginosa isolated from burn patients. Considering the importance of clonal spread of these resistant isolates and their significant role in the development of clinical infections, especially in patients with burns, more attention should be paid to the prevention of the dissemination of these resistant isolates