Modified Atkins Diet for Intractable Childhood Epilepsy

ObjectiveThe aim of the present study was to evaluate the efficacy and tolerability of a modified Atkins diet for intractable childhood epilepsy.Materials & MethodsTwenty one children with medically intractable epilepsy were enrolled in the study. Inclusion criteria were at least four seizures per month and a trial of at least three anticonvulsants without becoming seizure-free. The subjects received the diet over a 6-month period.ResultsThree months after diet initiation, 15 patients (71.4%) remained on the diet and 12 (57.1%) had >50% seizure reduction. Eleven patients (52.4%) completed the 6-month study and 8 (38.1%) chose to remain on the diet afterward. At 6 months, 9 patients (42.8%) had >50% seizure reduction. The diet was more effective in cryptogenic epilepsy (p=0.032). Most complications were transient and successfully managed by careful follow-up and conservative strategies.ConclusionThe modified Atkins diet is an effective and well- tolerated therapy for intractable childhood epilepsy.

Correlation between Body Mass Index and Central Adiposity with Pregnancy Complications in Pregnant Women

Background: The prevalence of obesity is increasing throughout the world. Obesity assessed by body mass index (BMI) has shown to be associated with gestational complications while the relationship using waist circumference (WC) is not clear yet. The present study was aimed to determine the relationship be-tween WC and adverse pregnancy complications.Methods: In this prospective cohort study, 1140 nulliparous pregnant women at 1st trimester of pregnancy referred to health care centers in Tabriz, Iran were enrolled in 2009-2010. Anthropometric indexes including (weight, height and WC) were measured using standardized measures and methods. BMI was clas-sified into normal, overweight and obesity based on WHO classification. Ab-dominal obesity was defined as WC ≥ 88 cm. Pregnancy complication including gestational diabetes, hypertension and preeclamsia. Data were analyzed using SPSS, version 16.Results: Mean of BMI and WC were 24.32±4.08 kg/m2, 81.84±9.25cm at 1st trimester of pregnancy, respectively. Prevalence of overweight (BMI=25-29.9 kg/m2) and obesity (BMI>29.9 kg/m2) was 27.6%, 8.8%, respectively. Abdo-minal obesity based on WC was 34.8%. Significant correlations were found between BMI and WC (r=0.73, P =0.0001). Women with BMI>29.9 kg/m2 and WC>88 cm were more likely to suffer from gestational pregnancy and hyper-tension, as well as preeclampsia and preterm delivery.Conclusion: Early maternal WC similar to BMI is related with pregnancy complications

The Effect of Chlorella vulgaris Supplementation on Liver Enzymes, Serum Glucose and Lipid Profile in Patients with Non-Alcoholic Fatty Liver Disease

Background: Non-alcoholic fatty liver disease (NAFLD) is becoming a public health problem worldwide and using microalgae is a new approach on its treatment. The aim of this study was to investigate the effect of Chlorella vulgaris supplementation on liver enzymes, serum glucose and lipid profile in patients with NAFLD. Methods: This double-blind randomized placebo-controlled clinical trial was conducted on 60 NAFLD patients from specialized clinics of Tabriz University of Medical Sciences from December 2011 to July 2012. The subjects were randomly allocated into 2 groups: 1) “intervention” (n=30) received 400 mg/day vitamin E plus four 300 mg tablets of Chlorella vulgaris and, 2) “placebo” (n=30) received 400 mg/day vitamin E and four placebo tablets per day for 8 weeks. Weight, liver enzymes and metabolic factors were assessed in fasting serum and dietary data was collected at baseline and end of the study. Results: Weight, liver enzymes, fasting blood sugar (FBS) and lipid profile decreased significantly in both groups (P<0.05). The differences in weight, ALP and FBS between the two groups were statistically significant (P=0.01, P=0.04 and P=0.02, respectively). Conclusion: C. vulgaris seems to improve FBS and lipid profile and therefore could be considered as an effective complementary treatment in NAFLD

Cachexia index and its relationship with resection operability in patients with gastric adenocarcinoma

Introduction: Gastric cancer is one of the relatively common malignancies all over the world, and is one of major problems of health care system. Nowadays, importance of cachexia is demonstrated in prognosis of various malignancies. The aim of the present study was to evaluate frequency of cachexia index and its relationship with resection operability in patients with gastric adenocarcinoma. Methods: In a descriptive-analytical study, 36 patients with gastric adenocarcinoma who referred to Imam Reza and Sina educational medical centers of Tabriz University of Medical Sciences, Tabriz, Iran, for surgery procedures, were included and evaluated in the study. Skeletal muscle index (SMI) was calculated using computed tomography (CT)-scan before performing surgery, patients’ cachexia index was calculated by the following formula: . Cachexia syndrome, patients’ weight loss, resection operability, and cachexia index were evaluated in patients. Results: Among 36 patients whom were studied, 25 patients (69.4%) were men, and 11 patients (30.6%) were women. Cachexia was seen in 5 patients (13.9%). In terms of gastrostomy operability, 26 patients (72.2%) were operable, and 10 patients (27.8%) were non-operable. Gastrostomy operability in patients with cachexia were significantly less than patients without cachexia syndrome (P = 0.001). No significant differences were seen in cachexia index of operable and non-operable patients (P = 0.105). Conclusion: Based on the findings of the present study, gastrostomy operability in patients with cachexia was significantly less than patients without cachexia syndrome; but operable and non-operable patients do not have significant differences in cachexia in comparison to each other

Iodine status, and knowledge about iodine deficiency disorders in adolescent school girls aged 14-19 years, 2016

Background: Adequate iodine intake by women in child-bearing age affects fetus neurodevelopment during pregnancy. A majority of previous studies has investigated iodine status among children, and there is limited data on female adolescents who are more exposed to consequences of iodine deficiency (ID) in their near-future pregnancies; thus, we aimed to assess iodine status, and knowledge on iodine deficiency disorders (IDDs) among adolescent school girls (14-19 years old) in Shahriar, Iran. Methods: This cross-sectional study was conducted among 223 female students selected through multi-stage cluster sampling from 12 schools. Iodine and creatinine concentrations were measured in casual urine samples. Iodine content of household salts was also assessed.Data on intake of salt and iodine-rich food sources were collected applying a food frequency questionnaire (FFQ), and knowledge about iodine and IDDs were assessed by a questionnaire. Results: Median and Mean (95% CI) concentrations of urinary iodine and creatinine were 129 µg/L, 137.62 µg/L (95% CI: 126.28, 148.95) and 1.72 g/L, 1.86 g/L (95% CI: 0.55-3.17),respectively. The frequency of mild, moderate and severe ID were 22.4%, 14.3% and 0%,respectively; 43.5% had adequate, and 3.1% had excessive urinary iodine levels. Mean saltiodine concentration was 21.69 (SD=10.56) ppm. Mean knowledge score was 12.7 (SD=3.44).About half of the students had a poor (25.1%) or fair (24.2%) knowledge about iodine deficiency.Adjusting for the confounders, no significant positive association was found between knowledge about iodine-rich food sources and goitrogens with urinary iodine excretion. Conclusion: Adolescent girls in Shahriar had relatively poor knowledge of iodine, and about one third of them suffered from ID

Conjugated linoleic acid improves glycemic response, lipid profile, and oxidative stress in obese patients with non-alcoholic fatty liver disease: a randomized controlled clinical trial

Aim To investigate if conjugated linoleic acid supplementation (CLA) affects metabolic factors and oxidative stress in non-alcoholic fatty liver disease (NAFLD). Methods The study was a randomized, controlled clinical trial conducted in specialized and subspecialized clinics of Tabriz University of Medical Sciences from January 2014 to March 2015. 38 obese NAFLD patients were randomly allocated into either the intervention group, receiving three 1000 mg softgel of CLA with a weight loss diet and 400 IU vitamin E, or into the control group, receiving only weight loss diet and 400 IU vitamin E for eight weeks. Dietary data and physical activity, as well as anthropometric, body composition, metabolic factors, and oxidative stress were assessed at baseline and at the end of the study. Results Weight, body composition, and serum oxidative stress, insulin, and lipid profile significantly improved in both groups, while hemoglobin A1c (HbA1c) levels (P = 0.004), total cholesterol to high density lipoprotein ratio (P = 0.008), low density lipoprotein to high density lipoprotein ratio (LDL/HDL) (P = 0.002), and alanine aminotransferase to aspartate aminotransferase (ALT/AST) ratio (P = 0.025) significantly decreased in the intervention group. At the end of the study, fat mass (P = 0.001), muscle mass (P = 0.023), total body water (P = 0.004), HbA1c (P < 0.001), triglycerides (P = 0.006), LDL/HDL ratio (P = 0.027), and ALT/ AST ratio (P = 0.046) were significantly better in the CLA group than in the control group. Conclusion CLA improved insulin resistance, lipid disturbances, oxidative stress, and liver function in NAFLD. Therefore, it could be considered as an effective complementary treatment in NAFLD

Dietary Regulation of miR-33b and miR-29a in Relationship to Metabolic Biomarkers of Glucose and Lipids in Obese Diabetic Women: A Randomized Clinical Controlled Study

Background: MicroRNAs have recently been introduced as epigenetic regulators of glucose and lipid metabolic pathways, which are impaired in obesity and diabetes. Objectives: We evaluated the effects of calorie-restricted diet therapy on the circulating levels of miR-33b and miR-29a in relationship to glucose and lipid metabolic parameters in obese patients with type 2 diabetes mellitus (T2DM). Methods: This randomized clinical controlled trial was performed on 30 eligible obese women with T2DM, randomly divided into two groups (control group, n = 15; diet therapy group, n = 15) for 10 weeks. Ten healthy women with normal weight were enrolled at the baseline of the study as controls. Demographic information, dietary intake, and anthropometric and biochemical indices were obtained before and after the study. Circulating miR-33b and miR-29a were assessed for all subjects using quantitative RT-PCR, and the fold change of each circulating miRNA was compared between groups. Results: The circulating levels of miR-29a and miR-33b in the diabetic women were higher (0.40-fold) and lower (1.43-fold), respectively, than normal levels. Diet therapy significantly increased the circulating level of miR-33b (P = 0.023, 0.97-fold upregulation) to normal levels. This increase was independently correlated with caloric restriction (95%CI: -0.004 to -0.0001, P = 0.022) and 2hPPBS (95%CI: -0.009 to -0.001, P = 0.035). No remarkable change was observed in circulating levels of miR-29a. Conclusions: Our findings introduced a novel therapeutic effect of diet therapy on circulating miRNAs in obese patients with T2DM. MiR-33b is an important therapeutic target in the treatment and prevention of T2DM and its complication

A longitudinal study of eating behaviour and weight change in West of Scotland adults : association with socio-demographic and lifestyle factors

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

The effect of pomegranate juice (no added sugar) consumption on fast blood sugar, lipid profile, antioxidant factors in Type 2 diabetes

Background : Diabetes mellitus is one of the prevalence metabolic disorders in the worldwide. Studies have shown that fruits, vegetables and drinks that are rich in phenolic and antioxidants components may reduce cardiovascular and diabetes diseases. One of these fruits is Pomegranate that is rich in phelavonoid. Therefore, this study was designed to determine pomegranate juice effect on fast blood sugar, lipid profile, anthropometry, total antioxidant capacity and blood pressure in diabetic patients. Materials and Methods: In the present study, 50 patients with diabetes aged 30-50 were recruited into the study and randomly assigned into 2 groups:1) intervention group (n=25) that fed 240cc pomegranate juice daily, 2) control group (n=25) that fed 240cc water daily. Weight, hip circumstance, waist circumstance, lipid profile (HDL-C, LDL-C, TG, TC) glucose, HbA1C, GPX, total antioxidant capacity, systolic and diastolic blood pressure were measured at the baseline and end of 8 weeks. Results: Insulin resistance, systolic and diastolic blood pressure, body weight, hip circumstance, waist circumstance decreased significantly and GPX increased in intervention group whereas pomegranate juice had no significant effect on glucose, HbA1C, lipid profile and total antioxidant capacity. Conclusion: These findings indicate that beneficial effect of pomegranate juice on insulin resistance, systolic and diastolic blood pressure, body weight, hip circumstance, waist circumstance, GP

Serum ferritin and liver enzymes ratio and their agreement with NAFLD severity

Background : Non-Alcoholic Fatty Liver Disease (NAFLD) is the most common liver disease. NAFLD is characterized by elevated liver enzymes and serum ferritin concentration due to damage and abnormal function of liver cells. Increased level of serum ferritin as a parameter of liver function is commonly observed .The aim of this study was to determine the agreement between serum liver with liver and ferritin echogenicity in NAFLD patients. Materials and Methods: This cross-sectional study was carried out on 60 NAFLD patients confirmed by ultrasonography in Tabriz. Fasting blood samples were taken for assessment of Alanin aminotransferase, Aspartat aminotransferase and ferritin level. Weight and height were measured. Liver enzymes ratio were estimated and classified into tertile. Results: The mean of serum ferritin was126.34±108.25 ng/ml and was significantly associated with severity of liver echogenisity (p=0.016). Significant relationship was observed between fatty liver severity and ALT/AST ratio (p=0.004) with good agreement (Kappa value= 68.3%) while the ratio of ferritin to liver enzymes was not significantly associated with the severity of NAFLD. Conclusion: This study suggests significant agreement between severity of fatty liver and ferritin and liver enzymes ratio in NAFLD patients but not with the ratio of ferritin to liver enzymes