Evaluation of Xerostomia and salivary flow rate in Hashimoto’s Thyroiditis

Background: One of the most common causes of hypothyroidism is Hashimoto´s Thyroiditis (HT). Early detection of dry mouth is critical in preserving and promoting systemic and oral health. In this study we have assessed, for the first time, salivary function and xerostomia in HT patients who have not been involved with Sjögren´s syndrome. Material and Methods: HT was diagnosed in 40 patients based on clinical findings and positive anti-thyroid peroxidase antibodies (anti-TPO). Controls, matched by sex, age and body mass index (BMI), and with no history of thyroid disease, were selected. A questionnaire was used for diagnosis of xerostomia. Saliva samples were taken between 8 a.m. and 9 a.m., and at least 2 hours after the last intake of food or drink. The flow rate was calculated in milliliters per minute. Results: Xerostomia was significantly higher in patients with HT. Unstimulated salivary flow rate was significantly lower in the HT group. Stimulated salivary flow rate was lower in HT group, but the difference was not significant. Conclusions: The patients with HT experienced xerostomia, and their salivary flow rate was diminished. Spitting the saliva then assessing salivary flow rate based on milliliter per minute is non-invasive, fast, and simple for chair-side diagnosis of dry mouth. Autoimmune diseases can be accompanied by salivary gland dysfunction. This may be due to the effect of cytokines in the autoimmune process or because of thyroid hormone dysfunction

Rzadki przypadek współwystępowania nadczynności przytarczyc i zespołu Turnera - opis przypadku

Przedstawiony przez autorów opis przypadku zawiera ocenę kliniczną, wyniki badań laboratoryjnych, radiologicznych, patomorfologicznych 37-letniej kobiety, u której początkowo rozpoznano osteomalację przebiegu zespołu Turnera i zastosowano suplementację wapnia i witaminy D. Ze względu na szybką progresję Ca we krwi rozszerzono diagnostykę, rozpoznając dodatkowo nadczynność przytarczyc spowodowaną gruczolakiem tego narządu.We present the clinical, laboratory, radiological and pathological findings in the case and review the literature. Our patient, a 37-year-old woman of short stature, was referred because of musculoskeletal pain. After primary evaluation, she underwent treatment with calcium and vitamin D supplement with the diagnosis of osteomalacia in Turner’s syndrome. The rise of serum calcium during medical therapy, which was an unusual finding, attracted the clinician’s attention to another underlying disorder. Further evaluation revealed primary hyperparathyroidism due to an adenoma of the parathyroid gland. Even though this is a rare diagnosis, its presence should be considered in any patient with Turner’s syndrome presenting with severe osteoporosis and a rise in serum calcium during treatment

Microbiome alterations in women with gestational diabetes mellitus and their offspring: A systematic review

AimsGestational diabetes mellitus (GDM) is a metabolic disorder that might predispose pregnant women to develop type 2 Diabetes Mellitus or lead to severe adverse outcomes in their offspring. One of the factors that have been thought to be involved in the pathology behind this disorder is the microbiome. In this systematic review, we comprehensively review the documents regarding the microbiota alterations in different tracts of pregnant women with GDM and their offspring.MethodsA comprehensive search was conducted in major databases including MEDLINE (PubMed), Scopus, and Web of sciences up to August 2021. Data on the demographics, methodology, and microbiome alterations were extracted and classified according to the type of microbiome in pregnant women with GDM and their offspring. The quality of studies was assessed using the Newcastle-Ottawa Scale (NOS).ResultsIn 49 articles which were retrieved, the findings were variable on the level of changes in alpha and beta diversity, enrichment or depletion in phyla, genera, species and OTUs, in each microbiome type. Although there were some inconsistencies among the results, a pattern of significant alterations was seen in the gut, oral, vaginal microbiome of women with GDM and gut, oral, and placental microbiome of their offspring.ConclusionEven though the alteration of the microbiome of the different tracts was seen in the cases of GDM, the inconsistency among the studies prevents us from identifying unique pattern. However, the results seem promising and further studies that overcome the confounding factors related to the demographics and methodology are needed

The Effect of Diet Based on Body Mass Index on Pregnancy Outcomes in 20 – 35 Year Old Pregnant Mothers with Gestational Diabetes Mellitus (GDM) Referred to Arash Hospital

Background: Gestational diabetes can cause macrosomia, fetal abnormalities, and increased prevalence of hypertension, which unreasonably increases fetal mortality rate. Nutrition plays a crucial role in the complications of pregnancy in these patients. The purpose of this study was to investigate the effect of a BMI (Body Mass Index) based diet on pregnancy outcomes in diabetic pregnant women aged between 20-35 years referred to Arash Hospital. Materials and Methods: In this randomized, double-blind clinical trial, 70 diabetic pregnant women aged between 20-35 years were divided into two groups as case and control. The control group received a diet including 30 kilocalories per kilogram energy regardless of their BMI. The first group, including participants with the BMI ranged between 19-24.9 received 30 kilocalories per kilogram energy diet, and the second group including participants with the BMI between 25-29.9 received 25 kilocalories per kilogram diet. The SPSS software version 23 was used for analyzing the data and P-value<0.05 was considered as significant. Results: There was no significant difference between the cases and control group in the mean of gaining weight at the end of pregnancy (p=0.3). There was also no significant difference between the mean birth weight (p=0.05), Insulin requirement (p=0.7), macrosomia (p=0.2), hypertension (p=0.1), intrauterine growth retardation (p=0.3), gestational age in delivery (p=0.3), and infant blood calcium (p=0.3) between the groups.However, the mean newborn blood sugar level in case group was significantly lower than the control group (p=0.01). Conclusion: BMI based calorie intake restriction in diet during pregnancy did not affect the main pregnancy outcomes such as average weight gain at the end of pregnancy, insulin requirement, newborns birth weight risk of fetal macrosomia r, maternal high blood pressure, intrauterine growth retardation, gestational age in delivery, infant blood calcium. However, newborn blood sugar was significantly lower in the case group compared to control group

Med Oral Patol Oral Cir Bucal

Abstract Background: One of the most common causes of hypothyroidism is Hashimoto´s Thyroiditis (HT). Early detection of dry mouth is critical in preserving and promoting systemic and oral health. In this study we have assessed, for the first time, salivary function and xerostomia in HT patients who have not been involved with Sjögren´s syndrome. Material and Methods: HT was diagnosed in 40 patients based on clinical findings and positive anti-thyroid peroxidase antibodies (anti-TPO). Controls, matched by sex, age and body mass index (BMI), and with no history of thyroid disease, were selected. A questionnaire was used for diagnosis of xerostomia. Saliva samples were taken between 8 a.m. and 9 a.m., and at least 2 hours after the last intake of food or drink. The flow rate was calculated in milliliters per minute. Results: Xerostomia was significantly higher in patients with HT. Unstimulated salivary flow rate was significantly lower in the HT group. Stimulated salivary flow rate was lower in HT group, but the difference was not significant. Conclusions: The patients with HT experienced xerostomia, and their salivary flow rate was diminished. Spitting the saliva then assessing salivary flow rate based on milliliter per minute is non-invasive, fast, and simple for chair-side diagnosis of dry mouth. Autoimmune diseases can be accompanied by salivary gland dysfunction. This may be due to the effect of cytokines in the autoimmune process or because of thyroid hormone dysfunctions

Analysis of the expression of mir-34a, mir-199a, mir-30c and mir-19a in peripheral blood CD4+T lymphocytes of relapsing-remitting multiple sclerosis patients

Background: Multiple sclerosis is an immune-mediated inflammatory disease of central nervous system. MicroRNAs play important roles in autoimmune diseases such as MS. Objectives: The aim was to evaluate the expression pattern of miR-34a, miR-199a, miR-30c and miR-19a in peripheral blood derived CD4+ T lymphocytes of both relapsing and remitting phases of MS. Methods: Blood samples from 40 RRMS patients (20 in relapsing and 20 in remitting phase) and 20 healthy volunteers were taken. CD4+ T cells were isolated. The expression level of miR-34a, miR-199a, miR-30c and miR-19a, and the percentage of Th17 and Treg cells were measured. Expression of master transcription factors of Th17 and Treg cells and several targets of these miRNAs were also evaluated. Results: Data indicated an increased expression of miR-34a, miR-30c and miR-19a in relapsing phase and decreased expression of miR-199a in remitting phase. ROC curve data add other prestigious information of miR34a, miR-199a, miR-30c and miR-19a by defining relapsing and remitting phase and also healthy cases with high specificity and sensitivity at a proposed optimum cut-off point. Conclusion: Collectively, we showed a correlation between the four miRNAs with different phases of MS and their possible involvement in differentiation pathways of Th17 cells, as the most important players in MS

Prediction of probable impact of miR-34a and miR-215 on differentiation of naive CD4+ T cells to Th17 cells in multiple sclerosis

Background and aims: miRNAs, as a class of non-coding RNAs, take part in different cellular processes. Dysregulation of different miRNAs has been reported in numerous disorders to date. Multiple sclerosis (MS) is an autoimmune disease with high prevalence in Iran and Th17 cells play an important role in its pathogenesis. In the current study, we aimed to predict the possible role of miR-34a and miR-215 in the process of controlling Th17 differentiation, and hence, their possible impact on the onset and progression of MS. Methods: We investigated probable interactions of miRNAs and genes that participate in Th17 cells differentiation using miRwalk database as an integrative one which utilizes 10 different algorithms to predict miRNA-mRNA interaction. Results: Based on our findings, miR-34a and miR-215 were predicted to have a potential role in the induction of Th17 cells differentiation. Conclusion: Conclusively, miR-34a and miR-215 may up-regulate Th17 cells of MS patients. Since bioinformatics data have shown that these miRNAs suppress negative regulatory genes in Th17 cells differentiation, we suppose that down-regulation of these miRNAs could ameliorate MS symptoms. Therefore, several therapeutic approaches may be considered for these miRNAs besides their application as valuable prognostic/diagnostic biomarkers in detection of various stages of MS. Keywords: Multiple sclerosis, miRNA, Th17 cell

Effect of Juglans regia L. Ridge on Blood Lipids in Type 2 Diabetic Patients with Dyslipidemia: A Double-blind Placebo-Controlled Randomized Clinical Trial

Background: Dyslipidemia and diabetes mellitus are two important risk factors for coronary artery disease and stroke. Traditionally, herbal remedies like walnut were used to treat dyslipidemia. The study aimed to evaluate the effect of Juglans regia L. (J. regia L.) internal septum extract (ISE) on lipid profile of patients with type 2 diabetes. Methods: After preparing hydroalcoholic ISE, Folin-Ciocalteau (FC) and AlCl3 colorimetric methods were used to determine total phenolic content (TPC) and total flavonoid content (TFC), respectively. In a randomized, double-blind placebo-controlled trial, 86 diabetic patients with dyslipidemia were randomly divided into equal groups and received ISE or placebo capsules 1500 mg/day for 12 weeks. Lipid profile, LFT, SCr, urea, hemoglobin A1c (HbA1c), blood pressure (BP), weight, waist and waist to hip ratio (WHR) were determined at baseline and after 12 weeks. The paired sample t-test and independent sample t-test were performed to compare the differences within and among the groups, respectively. This study was registered in the Iranian registry of clinical trials (IRCT ID: IRCT20201227049850N1). Results: The mean (SD) of TPC and TFC were measured based on 74.57 (5.20) milligram gallic acid equivalent/gram of dry extract (mg GAE/g DE) and 14.11 (2.73) mg quercetin equivalent/g of DE (mg QE/g DE), respectively. During the trial, 26 patients lost follow-up, and the study continued with remaining 60 patients. After intervention, there were no significant differences in LDL-C (p=0.44), total cholesterol (TC) (p=0.42), high-density lipoprotein cholesterol (HDL-C) (p=0.99), triglyceride (TG) (p =0.32) and Lp(a) (p=0.55) between two groups. Moreover, no significant (p>0.05) changes were observed in HbA1c, LFT, SCr, urea, BP, weight, waist, and WHR among the groups after 12 weeks. Conclusion: Our findings showed J.regia L. ISE had no significant effect on lipid profile compared to placebo. Moreover, no adverse effect was observed on liver and kidney function tests

The hypoglycemic effects of Juglans regia L. internal septum in type 2 diabetic patients: A double-blind, randomized, placebo-controlled clinical trial

Introduction: The internal septum of J.regia is traditionally used to control diabetes, and its effectiveness has been shown in animal studies. Accordingly, human clinical trials are needed to confirm its effectiveness on hemoglobin A1c (HbA1c), fasting blood sugar (FBS), blood insulin level, and insulin resistance as a complementary for better control of type 2 diabetes. Methods: This study was a randomized, double-blinded, controlled trial. The lyophilized powder of extract of the internal septum of J.regia was used to fill the capsules. Sixty type 2 diabetic patients were randomly divided into two groups. 500 mg capsules three times daily before meal was added to their routine drug regimen, and HbA1c, FBS, and blood insulin level were checked at the baseline and after three months. Results: Sixty patients completed the study. The mean(±SD) age of patients was 49.1(10.2) and 50.9(12.7) years in the placebo and J.regia groups, respectively. We observed that J.regia internal septum increases the level of HbA1c by about 0.02 units, but this effect was not significant (MD=0.02,95%CI=-0.36 to 0.40, P=0.93). Regarding the impact of capsules on insulin level, it seems that J.regia-containing capsules can raise insulin level by one unit. However, it was not significant (MD=1.01,95%CI=-0.86 to 2.88, P=0.28). As for FBS, it can cause a decrease of four units, but this effect is also not significant (MD=-3.98,95%CI=-18.33 to 10.37, P=0.58). Conclusion: Based on our study, the internal septum of J.regia has no significant effect on HbA1c, FBS, and insulin resistance. Moreover, no specific adverse reaction was observed in any of the patients