A Complementary Therapy with Whey Protein in Diabetes: A Double-Blind Randomized Controlled Clinical Trial

Type 2 diabetes (T2DM) and its complications can cause severe morbidity and mortality. The researchers and clinicians’ attention has been toward finding the efficient treatment for T2DM to decrease its heavy burden on the people and countries. Whey protein (WP) is a known glucose-lowering treatment of traditional Persian medicine. This randomized controlled clinical trial aimed to evaluate the efficacy of the WP on the improvement of the glycemic index of the patients with T2DM in Fars, Fasa, Iran. A total of 58 people with T2DM met the inclusion criteria and were randomly assigned to one of two groups: intervention or placebo. For 12 weeks, they were given 1 sachet of WP or 1 sachet of placebo. Before and after the trial, fasting blood sugar, lipid profile, and liver enzymes were tested. Finally, 35 patients completed the study (18 in the whey group and 17 in the placebo group). The mean ± standard deviation of age, BMI, and the disease duration in placebo group were: 52.1±9.2 years, 26.8±3.9 kg/m2 and 102.9±67.7 months and in WP group were 51.2±8.2 years, 25.7±3.7 kg/m2 and 74.2±51.1 months. There were no significant differences among the study groups at the beginning (P>0.05). Meanwhile, the WP and placebo groups were the same by means of the amount of anti-diabetic drugs that participants consumed (P=0.242). After 12 weeks: the fasting blood sugar (FBS) and hemoglobin A1C amounts showed important decreases in the WP group compared to its starting point (P=0.011 and P=0.001 respectively), while in the placebo group, there was no significant difference in this matter (P>0.05).  No severe complications were reported in both groups. In conclusion, we found that whey protein would be a promising complementary therapy to control hyperglycemia in the patients with T2DM

Correlation of resting heart rate with anthropometric factors and serum biomarkers in a population-based study: Fasa PERSIAN cohort study

BACKGROUND: There is a positive association between raised resting heart rate (RHR), and all causes of mortality and shorter life expectancy. Several serum biomarkers and some anthropometric factors can affect the resting heart rate. This study aimed to investigate the determinants of resting heart rate in a large random sample of the Iranian population. MATERIAL AND METHODS: It is a standardized, retrospective study and the subjects were chosen from the baseline survey of the Prospective Epidemiological Research Study in IrAN (PERSIAN) Fasa non-communicable disease cohort study. It was conducted from winter 2014 to summer 2019 and after obtaining informed consent from a random sample, all the eligible subjects were enrolled. All anthropometric factors and biologic laboratory factors were collected and analyzed by implement smoothly clipped absolute deviation (SCAD) linear regression and SCAD quantile regression. The comparisons between males and females were done via independent T-test. RESULTS & CONCLUSION: A total number of 9975 persons from 35 to 90 years old were included. The overall median resting heart rate was 74 (interquartile range:66-80). Mean age has no important difference between males and females (P = 0.79) but, resting heart rate was significantly higher in females (76.6 versus 71.4, P < 0.001). All anthropometric factors except wrist circumference were higher in females (P < 0.05). Age has an adverse effect on resting heart rate and also, there was a direct association between resting heart rate and systolic blood pressure and blood glucose. Alpha-blockers (coefficient = 5.2) and Beta1-blockers (coefficient = - 2.2) were the most effective drugs with positive and negative effects on resting heart rate respectively. Lower hemoglobin, obesity, and more body mass index, and more low-density lipoprotein were associated with more resting heart rate. Continuing the monitoring of this sample via our cohort study and put to action multinational prospective researches with large sample sizes and long follow-ups can lead to more precise results and better scientific judgments

Astigmatic Outcomes of Temporal versus Nasal Clear Corneal Phacoemulsification

&lt;!--[if gte mso 9]&gt;&lt;xml&gt; Normal 0 false false false MicrosoftInternetExplorer4 &lt;/xml&gt;&lt;![endif]--&gt;&lt;!--[if gte mso 9]&gt;&lt;xml&gt; &lt;/xml&gt;&lt;![endif]--&gt; &lt;!--[if gte mso 10]&gt; &lt;style&gt;&#13; /* Style Definitions */&#13; table.MsoNormalTable&#13; {mso-style-name:"Table Normal";&#13; mso-tstyle-rowband-size:0;&#13; mso-tstyle-colband-size:0;&#13; mso-style-noshow:yes;&#13; mso-style-parent:"";&#13; mso-padding-alt:0cm 5.4pt 0cm 5.4pt;&#13; mso-para-margin:0cm;&#13; mso-para-margin-bottom:.0001pt;&#13; mso-pagination:widow-orphan;&#13; font-size:10.0pt;&#13; font-family:"Times New Roman";&#13; mso-ansi-language:#0400;&#13; mso-fareast-language:#0400;&#13; mso-bidi-language:#0400;}&#13; &lt;/style&gt; &lt;![endif]--&gt; &lt;p&gt;PURPOSE: To compare the astigmatic outcomes of phacoemulsification cataract surgery using temporal versus nasal clear corneal incisions. METHODS: In a clinical trial, consecutive patients with senile cataracts underwent phacoemulsification and implantation of a hydrophobic acrylic foldable intraocular lens through a horizontal clear corneal incision (temporal in right and nasal in left eyes). Outcome measures included keratometric astigmatism and surgically induced astigmatism (SIA) calculated by the vector analysis method using the Holladay-Cravy-Koch formula. RESULTS: The nasal and temporal groups consisted of 20 eyes each. Mean preoperative keratometric astigmatism was 0.63±0.48 D and 0.38±0.39 D in the temporal and nasal incision groups respectively (P=0.09). Data on 10 eyes in each study group was available for the six-month analysis. Mean keratometric astigmatism was as follows in the temporal and nasal groups respectively: 0.85±0.47 D versus 1.95±0.45 D at 1 week (P &lt; 0.001), 0.73±0.46 D versus 1.79±0.55 D at 4 weeks (P &lt; 0.001), and 0.63±0.30 D versus 1.05±0.56 D at 6 months (P=0.053) after surgery. SIA at the same follow-up intervals was 0.71±0.20 D versus 1.80±0.22 D (P &lt; 0.001), 0.63±0.20 D versus 1.65±0.31 D (P &lt; 0.001) and 0.26±0.46 D versus 0.92±0.36 D (P=0.002) in the temporal versus nasal incision groups respectively. CONCLUSION: Temporal clear corneal phacoemulsification induces significantly less astigmatism as compared to similar surgery using the nasal approach.&lt;/p&gt; &lt;p&gt; &lt;/p&gt

Huge simultaneous trichobezoars causing gastric and small-bowel obstruction

Bezoars are concretions of foreign materials that impair gastrointestinal motility or cause intestinal obstruction in the stomach, small intestine or bowel of humans or animals. There are many types of them such as phyto, lacto and trichobezoars. Although bezoars are not rare, multiple giant bezoars which totally fill the stomach lumen and have extension to the small intestine (Rapunzel syndrome) are very rare. This is a case report of a young girl who had a history of trichophagia and presented with partial gastric and intestinal obstructive signs. The patient was healthy, and her physical exam was almost normal and the only positive thing in her past medical history was trichophagia from several years ago. She had a big trapped bobble in her stomach and several air-fluid levels in abdominal radiograph and was investigated with endoscopy which confirmed the diagnosis of a huge gastric trichobezoar

Unexplained infertility as primary presentation of celiac disease, a case report and literature review

Background: Celiac sprue (gluten sensitive enteropathy) is an autoimmune disease which is hereditary and its pathology mainly bases on immunologic intolerance to gluten. It has a vast variety of signs and symptoms and its clinical features range from a silent disease to a typical gastrointestinal disorder. In this study we reviewed and summarized some other related issues about this disease and its relation with infertility. Case: The case is a 26 years old lady who had referred to a gynecologist because of infertility for 2 years and later it revealed that she has celiac sprue. Conclusion: Screening for its silent or subtle types especially among suspicious cases such as unexplained infertility seems to be a cost effective action. Meanwhile, in time administration of a gluten-free diet can lead to an almost complete cur

Lipid profile dysregulation in opium users based on Fasa PERSIAN cohort study results

Abstract One of the main health problems in many societies is the increased opium abuse, which was found to be correlated with many problems like cardiovascular disease. This study aimed to evaluate the correlation of opium use with blood lipoproteins as the risk factor of CVD. This was a cross-sectional study conducted on participants of the first phase of the PERSIAN Cohort study who were aged between 35 and 70 years old. Demographic characteristics; history of smoking, alcohol, and opium consumption; medical history; and medications were asked and the related checklists were filled out. The levels of physical activity and fat intake were also registered. As well, lipoprotein profiles were investigated by blood sampling. The linear and logistic regression was used to analyze the relationship between opium and lipid profile and the statistical significant level was considered as < 0.05. Among 9300 participants with a mean age of 48.06 ± 9.44 years old, 49.6% of them were men. About 24.1% of the participants used opium. In the linear regression models, unlike TG (β = 2.2, p = 0.36), total cholesterol (β = − 2.5, p = 0.02), LDL (β = − 2.0, p = 0.04), and HDL (β = − 1.0, p = 0.04) were significantly lower in people who used opium compared to the others. In the logistic regression models, abnormal level of LDL (OR = 0.78, p = 0.003) and total cholesterol (OR = 0.82, p = 0.008) were less in people who used opium compared to the others. This study showed that there is a correlation between opium usage and lower levels of total cholesterol and LDL; however, the lower level of HDL in normal range was seen in opium users. Considering the current evidences, most of them showed the increased risks of ischemic heart disease, heart attack, hypertension, cerebrovascular disease, and cancer in opium users. Therefore, Healthcare providers and patients should be noticed about the deleterious effects of opium consumption on various vascular events. In addition, it is necessary for managers and policy makers of the health care system to take the necessary measures to raise the level of awareness and health literacy of the general public about the high-risk side effects of opium use and to take necessary and effective strategies to prevent and reduce its use