Blood pressure lowering effect of Nigella sativa L. seed oil in healthy volunteers: a randomized, double-blind, placebo-controlled clinical trial

Nigella sativa L. seeds (N. sativa) have been used as a traditional remedy for a wide range of diseases including hypertension. The present study was performed to explore the effects of N. sativa oil on blood pressure (BP) in healthy volunteers. In a double-blind, randomized study, 70 healthy volunteers aged 34 to 63 years with systolic BP from 110 to 140 mmHg and diastolic BP from 60 to 90 mmHg were randomly allocated to receive 2.5 mL N. sativa oil or placebo two times a day for 8 weeks. The systolic and diastolic BPs, body mass index and blood levels of aspartate transaminase, alanine transaminase, alkaline phosphatase, creatinine and blood urea nitrogen were determined at baseline and endpoint. Results showed that in N. sativa oil treated group the systolic and diastolic BPs decreased significantly compared with baseline and placebo group at the endpoint. Other parameters did not significantly change in both groups at the endpoint. No adverse effects were reported. In conclusion, oral daily administration of 5 mL N. sativa oil to healthy volunteers for 8 weeks lowers systolic and diastolic BPs without any adverse effects.

Growth and specialized growth charts of children with congenital hypothyroidism detected by neonatal screening in isfahan, iran

Objectives. The aim of the current study was to investigate the growth status of CH, generate specialized growth charts of CH infants, and compare them with their counterparts of regional normal infants. Methods. In this prospective cohort study, 760 (345 girls and 415 boys) neonates born in 2002-2009 diagnosed by neonatal CH screening program in Isfahan were followed up from the time of diagnosis. 552 healthy children were recruited as a control group. The empirical 3rd, 15th, 50th, 85th, and 97th percentiles for height, weight, and head circumference of both sexes were determined and compared with their counterpart values of the control group. The relative frequency of patients with impaired growth for each studied variable was determined. Also, specialized growth charts of CH patients were generated. Results. The percentiles of weight, height, and head circumference of studied patients are significantly different from regional healthy children (P < 0.001). The relative frequency of impaired head circumference was decreased to less than 3% at the 3rd year of age and for height it reached gradually 3% and 9% at the 5th year of age for boys and girls, respectively (P < 0.05); however for weight still it was statistically more than 3% in both sexes. Conclusion. CH patients had impaired growth development which was improved during follow up, but the catch-up time was earlier for head circumference and later for weight.

Incidence of type 2 diabetes by HbA1c and OGTT: the Isfahan Diabetes Prevention Study

The aim of this study was to estimate the incidence of type 2 diabetes using newly proposed hemoglobin A(1C) (HbA(1c)) and current oral glucose tolerance test (OGTT) definition in an Iranian non-diabetic population. A total of 923 non-diabetic first-degree relatives (FDRs) of patients with type 2 diabetes 30-70 years old in 2003-2005 were followed through 2009 for the occurrence of type 2 diabetes. At baseline and through follow-ups, participants underwent a standard 75 g 2-h OGTT and HbA(1c) measurements. Prediction of progression to type 2 diabetes by OGTT-defined or HbA(1c)-defined diabetes was assessed with area under the receiver operating characteristic (ROC) curves based upon measurement of fasting plasma glucose, 2-h post-load glucose values, and HbA(1c). The prevalence of type 2 diabetes was 9.2% (95% CI: 8.2, 10.2) by OGTT-defined diabetes and 7.9% (95% CI: 6.9, 9.0) by HbA(1c) ≥ 6.5. The incidence of type 2 diabetes was 2.0% (95% CI: 1.6, 2.4) (1.8% men and 2.1% women) per year by the current OGTT definition, whereas the incidence rates were 1.7% (95% CI: 1.3, 2.0) (1.6% men and 1.7% women) per year by HbA(1c) ≥ 6.5%. Of those diagnosed with type 2 diabetes by OGTT, 69.6% had HbA(1c) <6.5% and therefore would not have been classified as having type 2 diabetes. The incidence and prevalence of diabetes using newly proposed HbA(1c) threshold in this FDRs of patients with type 2 diabetes were slightly lower than using current OGTT definition.

Microtensile bond strength of self-etch adhesives in different surface conditionings

AIM

Self-etch bonding systems have been introduced recently and have the advantage of reduced operating time. Because of patient management and isolation difficulties in children, the present study aimed to evaluate microtensile bond strength of two self-etch bonding systems (AdheSE and Xeno® III) on cleaned only, ground and sandblasted enamel.

MATERIALS AND METHODS

Thirty intact primary molars were selected and randomly divided into two groups according to the type of bonding used (Xeno® III and AdheSE). The teeth were divided into three subgroups according to enamel surface conditioning method: prophylaxis with pumice, grinding with coarse finishing and polishing disc, and sandblasting with aluminum oxide particles. Tetric Ceram composite then was applied. Samples were sectioned coronally and axially. The interface area of dental sticks was measured and specimens were subjected to a tensile force of 0.5 mm/min until failure.

RESULTS

Microtensile bond strength of Xeno® III-sandblasting, AdheSE-sandblasting, AdheSE-grinding, and AdheSE- cleaned only were 25.5±7.7, 21.2±2.3, 12.9±2.2, and 9.1±1.1, respectively. During sectioning, all specimens of Xeno® III-cleaned only and Xeno® III-grinding groups were fractured.

CONCLUSIONS

Two step AdheSE yields higher mTBS in comparison to one step Xeno ® III. In regard to surface conditioning, sandblasting increases the mTBS relative to grinding with finishing and polishing disc, and the cleaned-only enamel has the lowest mTBS.

Associations of hip circumference and height with incidence of type 2 diabetes: the Isfahan diabetes prevention study

The aim of this study was to determine the effects of hip circumference (HC) and height on diabetes incidence in non-diabetic first-degree relatives (FDRs) of patients with type 2 diabetes. A total of 1,092 (254 men and 838 women) non-diabetics FDRs ≥ 30 years old in 2003-2005 were followed through 2010 for the occurrence of type 2 diabetes. At baseline and through follow-ups, participants were underwent a standard 75 g 2-h oral glucose tolerance test. The incidence of type 2 diabetes was 17.0 (95% CI: 13.7, 20.2) (13.0 men and 18.1 women) per 1,000 person-year based on 6,015 person-years of follow-up. Height was inversely associated with diabetes incidence. The age-, gender-, and waist-adjusted relative risk (95% CI) of diabetes was 0.54 (0.31, 0.93) for highest quartile of height and 0.59 (0.25, 1.37) for highest quartile of HC compared with lowest quartile. These data indicate that height was inversely associated with diabetes incidence, independently of gender among FDRs of patients with type 2 diabetes.

Serum levels of sodium valproate in patients suffering from bipolar disorders: comparing acute and maintenance phases of mania

OBJECTIVES

Bipolar disorders (BD) are characterized by episodes of mania and depression. There is evidence that states of psychiatric disorders impact on neurotransmitters, endocrine system and membrane transport and, therefore, it is possible that specific phases of BD differentially influence the pharmacokinetics of some drugs. The aim of the present study was to investigate the drug-disease interaction between sodium valproate, one of the major drugs used in the treatment of bipolar disorder, and acute versus maintenance states of manic episodes.

METHOD

37 patients (mean age ± SD = 37.54 ± 11.27 years; 23 males, 14 females) suffering from bipolar disorder completed the study. Blood samples were taken during both acute and maintenance states.

RESULTS

Neither the trough concentration (p = 0.567) nor the internal clearances (p = 0.729) of sodium valproate in the acute phase of mania differed statistically or descriptively from those in the maintenance phase. Marginally significant phase by gender interactions were observed.

CONCLUSION

No significant effect of the acute phase of mania was observed in bipolar patients and no relationship could be found between drug pharmacokinetics and disease phase. This may be explained by specific pharmacokinetic features of the drug such as low extraction ratio values. However, phase by gender interactions indicate possible gender-related issues.

Patterns and predictors of long-term glycemic control in patients with type 2 diabetes

Aims/Introduction. To describe patterns of long-term glycemic control among patients with type 2 diabetes in Isfahan, Iran and identify factors associated with glycemic control. Methods. During the mean (standard deviation (SD)) follow-up period of 8.4 (4.2) (range 1-18) years, 4,582 patients with type 2 diabetes have been examined to determine glycemic changes. Their glycated hemoglobin (GHb) at the last clinic visit was compared with the initial visit data. The mean (SD) age of participants was 49.3 (9.6) years with a mean (SD) duration of diabetes of 5.0 (5.1) years at initial registration. Results. Mean (SD) GHb was 8.7% (2.3) at baseline and 7.9% (1.9) at the study end and decreased by mean of 0.8% (95% confidence interval (CI) 0.74, 0.87; P < 0.001) and varied by the severity of baseline GHb. 74.6% at the initial visit versus 64.4% at the last clinic visit had GHb values above the target level of 7.0%. Using a stepwise multiple regression models, age, higher GHb, FPG, follow-up period, and number of follow-up visits increased and higher systolic BP and female gender significantly decreased the percent glycemic change. Conclusions. This study highlights that more than 64.4% of the patients have GHb values higher than 7.0% at last clinic visit andindicatesthe difficult challenges physicians face when treating their patients with type 2 diabetes. Clinical efforts should focus on more effective methods for glycemic control in diabetic patients.

Glycated hemoglobin as a predictor for metabolic syndrome in an Iranian population with normal glucose tolerance

BACKGROUND

The aim of this study was to determine the ability of glycated hemoglobin (GHb) to predict metabolic syndrome in an Iranian population with normal glucose tolerance (NGT).

METHODS

A cross-sectional study of first-degree relatives (FDRs) of patients with type 2 diabetes was conducted from 2003 to 2005. A total of 1386 FDRs of consecutive patients with type 2 diabetes 30-60 years old (355 men and 1031 women) with NGT were examined. All subjects underwent a standard 75-gram 2-h oral glucose tolerance test and GHb measurement. Consensus criteria in 2009 were used to identify metabolic syndrome. Unadjusted and adjusted multivariate logistic regression analysis was performed to assess the risk of metabolic syndrome. The mean [standard deviation (SD)] age of participants was 42.4 (6.3) years.

RESULTS

The prevalence of metabolic syndrome was 17.5% in men and 21.5% in women. The multivariate-adjusted odds ratio (95% CI) of metabolic syndrome was 2.01 (1.03, 3.93) for the highest quintile of GHb compared with lowest quintile. These data indicate that GHb was associated with metabolic syndrome, independently of gender among FDRs of patients with type 2 diabetes with NGT.

CONCLUSIONS

These data indicate that GHb below the level for prediabetes might be a predictive measure of metabolic syndrome in FDRs of patients with type 2 diabetes with NGT.

Metabolic syndrome in type 2 diabetes mellitus in isfahan, iran: prevalence and risk factors

BACKGROUND

Our goal was to estimate the prevalence and risk factors of metabolic syndrome (MetSyn) in people with type 2 diabetes mellitus (T2DM) using routinely collected data from a clinical information system at Isfahan Endocrinology and Metabolism Research Centre, Iran.

METHODS

Consecutive diabetic patients (9889 total, 4164 male and 5725 female) from Isfahan Endocrinology and Metabolism Research Centre outpatient clinics, Iran, have been examined. The mean (SD) age of participants was 52.0 (10.9) years with a mean (standard deviation) duration of diabetes of 6.4 (6.4) years at initial registration. A modified National Cholesterol Education Program-Adult Treatment Panel III definition with body mass index instead of waist circumference was used for the MetSyn.

RESULTS

The prevalence of MetSyn was 65.0% [95% confidence interval (CI) 64.0, 65.9], with higher rate in females than males (71.7 [95% CI: 70.5, 72.8] female and 55.8 [95% CI: 54.3, 57.3] male) and it was greater with older age. The age-adjusted prevalence rate of MetSyn was associated with female gender, duration of diabetes, fasting blood glucose, systolic and diastolic blood pressure, body mass index (BMI), smoking, proteinuria, insulin-treatment, triglyceride, cholesterol, HDL cholesterol, hypertension, and dyslipidemia. Using a stepwise binary logistic regression model, age, gender, fasting blood glucose, systolic and diastolic blood pressure, BMI, triglyceride, and cholesterol were significant predictors of MetSyn for T2DM patients.

CONCLUSIONS

These data suggest MetSyn in this population of Iranian type 2 diabetic patients is common, and with an estimated prevalence of 65%, MetSyn clearly poses a formidable health threat to Iranian diabetic patients. Lifestyle interventions in T2DM subjects are needed in Iran to halt the burden of macro- and micro-vascular complications in T2DM.

Candida parapsilosis as a Potent Biocontrol Agent against Growth and Aflatoxin Production by Aspergillus Species

BACKGROUND

Aflatoxin contamination of food and feed stuff is a serious health problem and significant economic concerns. In the present study, the inhibitory effect of Candida parapsilosis IP1698 on mycelial growth and aflatoxin production in aflatoxigenic strains of Aspergillus species was investigated.

METHODS

Mycelial growth inhibitions of nine strains of aflatoxigenic and non-aflatoxigenic Aspergillus species in the presence of C. parapsilosis investigated by pour plate technique at different pH, temperature and time of incubation. Reduction of aflatoxin was evaluated in co-cultured fungi in yeast extract sucrose broth after seven days of incubation using HPLC method. The data were analyzed by SPSS 11.5.

RESULTS

The presence of the C. parapsilosis at different pH did not affect significantly the growth rate of Aspergillus isolates. On the other hand, temperature and time of incubation showed to be significantly effective when compared to controls without C. parapsilosis (P≤0.05). In aflatoxigenic strains, minimum percentage of reductions in total aflatoxin and B1, B2, G1, G2 fractions were 92.98, 92.54, 77.48, 54.54 and 72.22 and maximum percentage of reductions were 99.59, not detectable, 94.42, and not detectable in both G1 and G2, respectively.

CONCLUSION

C. parapsilosis might employ as a good biocontrol agent against growth and aflatoxin production by aflatoxigenic Aspergillus species.

Comparison of glycated hemoglobin with fasting plasma glucose in definition of glycemic component of the metabolic syndrome in an Iranian population

AIMS

The aim of this study was to compare the utility of glycated hemoglobin (GHb) versus the fasting plasma glucose (FPG) in definition of glycemic component of the metabolic syndrome (MetS) in a non-diabetic Iranian population.

METHODS

A cross-sectional study of first-degree relatives (FDRs) of patients with type 2 diabetes was conducted from 2003 to 2005. A total of 2410 non-diabetic FDRs of consecutive patients with type 2 diabetes 30-60 years old were examined. All subjects underwent a standard 75 g 2-h oral glucose tolerance test and GHb measurement. Consensus criteria in 2009 were used to identify MetS. Glycemic component of MetS was defined as either FPG≥100 mg/dl or GHb≥5.7%. The mean (SD) age of participants was 43.6 (6.5) years.

RESULTS

The prevalence of MetS was 33.5% (95% confidence interval (CI): 31.6, 35.4) based on FPG criterion alone and 28.6% (95% CI: 26.8, 30.4) based on GHb criterion alone. Use of combination of both criteria increased the prevalence of MetS (36.7%; 95% CI: 34.8, 38.6). There was 88.7% (95% CI: 87.5, 90.0) agreement between the GHb and FPG when either was used to define MetS (κ coefficient=0.737).

CONCLUSIONS

These data indicate that using GHb may be an acceptable surrogate of FPG to define glycemic component of MetS.

Research priorities in medical education in the Eastern Mediterranean Region

Ways are needed to effect quality improvement in medical education research in the Eastern Mediterranean Region (EMR). This study aimed to determine the principle themes and to draw up a list of priorities in medical education research in EMR. Using the nominal group technique with a group of 30 experts, a list of major themes in medical education research was prepared. In a 2-round Delphi survey the list was sent to another 47 experts in the Region with a questionnaire that included open questions about change and reform in medical education. In the final list of 20, the 5 highest priorities identified were: training physicians to be effective teachers; community-driven models for curriculum development; clinical teaching models; education about professionalism and ethics; and education for evidence-based medicine. Themes determined by this survey can help researchers in EMR to focus on priority areas in research.

Incidence of Metabolic Syndrome and Its Risk Factors among Type 2 Diabetes Clinic Attenders in Isfahan, Iran

Aim. At present, little data exist about incidence and the risk factors associated with metabolic syndrome (MetS) in patients with type 2 diabetes mellitus (T2DM). The objectives of present study were to assess the incidence and risk factors of MetS in people with T2DM. Methods. During the mean (SD) follow-up period of 11.7 (4.8) years, 3,047 patients with T2DM and free of MetS at baseline have been examined to determine incidence and predictors of progression to MetS. A modified the National Cholesterol Education Program-Adult Treatment Panel III definition with body mass index (BMI) instead of waist circumference was used for the MetS. Results. The prevalence of MetS was 63.2% (95% CI: 62.3, 64.1). The incidence of MetS was 28.5 (95% CI: 26.8, 30.2) (25.9 men and 30.9 women) per 1,000 patient-years based on 35,677 patient-years of follow-up. Multivariate analysis revealed that higher BMI and education, lower HbA(1c) and treatment with oral agent or insulin were associated with MetS. Conclusion. These are the first estimate of incidence and risk factors of MetS in patients with T2DM in Iran. These findings showed that the natural course of MetS is dynamic. The clinical management of patients with T2DM will contribute significantly to MetS prevention.

Association of wrist circumference with cardio metabolic risk factors

OBJECTIVE

The current study aimed to investigate the association of wrist circumference with major cardio metabolic risk factors.

METHODS

This study was conducted in 2005-2007 among 3000 first-degree relatives of diabetic patients in Isfahan, Iran.

RESULTS

Overall, 1709 (386 males and 1323 females) participants were enrolled in this study. The association of wrist circumference with cardio- metabolic risk factors was significantly positive with waist circumference (p = 0.001), BMI (p = 0.001), and LDL-C (p = 0.01), but significantly inverse with HDL-C (p = 0.001). The corresponding figure was not significant for triglycerides (p = 0.13), total cholesterol (p = 0.13), systolic BP (p = 0.15), diastolic BP (p = 0.6), and HbA1c (p = 0.4).

CONCLUSION

Measurement of wrist circumference can serve as an easy-to-detect clinical marker to identify individuals at risk of cardio metabolic disorders, and can be used in large epidemiological studies.

Normal fasting plasma glucose and risk of prediabetes and type 2 diabetes: the Isfahan Diabetes Prevention Study

AIM

To determine the association of fasting plasma glucose (FPG) level within normal range and the risk of prediabetes and type 2 diabetes in an Iranian population.

METHODS

A total of 806 first-degree relatives (FDRs) of patients with type 2 diabetes who had FPG levels less than 5.6 mmol/l (100 mg/dl) in 2003 to 2005, and who did not have diabetes or impaired fasting glucose (IFG), were followed through 2010 for the occurrence of prediabetes or type 2 diabetes. At baseline and through follow-ups, participants underwent a standard 75 g 2-hour oral glucose tolerance test (OGTT).

RESULTS

The incidence of type 2 diabetes, impaired glucose tolerance (IGT), and IFG was 9.6 (95% confidence interval (CI): 6.8-12.4), 28.7 (23.8-33.6), and 33.0 (27.7-38.2) per 1,000 person-years based on 4,489 person-years of follow-up, respectively. FPG was associated with the incidence of diabetes, IGT, and IFG. The multivariate-adjusted hazard ratios (95% CI) for diabetes, IGT, and IFG were 1.36 (1.01-1.84), 1.45 (1.10-1.91) and 1.31 (1.00-1.71), for the highest quintile of FPG compared with the lowest quintile, respectively.

CONCLUSIONS

An increase in FPG in the normal range is associated with an increase in the incidence of IGT, IFG, and type 2 diabetes. These results prove FPG in the normal range to be useful in identifying apparently healthy FDRs of patients with type 2 diabetes at risk of developing prediabetes and diabetes.

Sleep Apnea Symptoms in Diabetics and their First Degree Relatives

BACKGROUND

Sleep apnea is associated with increased risk of diabetes mellitus. However, no studies have compared sleep apnea symptoms in diabetic patients and their first degree relatives. The purpose of our study was to investigate high risk for sleep apnea syndrome, in diabetics and their first degree relatives for prevention of diabetes in family.

METHODS

As a part of a cohort study, all of diabetic and their first degree relatives who came for glucose control in diabetes clinic were invited to take part in the survey. Two thousand, four hundred and sixty-two individuals (82% of invited) agreed to fill out the Berlin and Epworth sleep questionnaire. Participants consisted of 2462 subjects of 15-70 years of age, both males and females with diabetes and family history of type 2 diabetes mellitus. A total of 1234 participants had diabetes and 11,231 were relatives of diabetic patients. High risk for sleep apnea regarding Berlin questionnaire and Epworth sleepiness scale, diabetic and relative were analyzed.

RESULTS

Prevalences of high risk for sleep apnea were higher among diabetics than relatives (P-value<0.001). In a multiple regression analysis, "age, body mass index, education, high blood pressure" were risk factor for sleep apnea symptoms while isolated blood glucose level was not by Berlin questionnaire. By Epworth sleep scale only education level was a risk factor for sleep apnea symptoms while isolated blood glucose level was not risk factor.

CONCLUSIONS

Sleep apnea symptoms may not have significant difference between diabetics and their relatives. We need more study on sleep apnea in the family of diabetic patients. We hope that more studies on mentioned field may help prevention of diabetes in their family.

Impact of exercise on affective responses in female adolescents with type I diabetes

BACKGROUND

Adolescent is a time of profound biologic, intellectual, psychological, and socioeconomic change that they will face a crisis. Therefore, compatibility may be exposed to many hazards, such as depression, anxiety, and other emotional problems. Nevertheless, a planned regular exercise enhances physical and mental health of adolescent female with diabetes. The aim of this study was to determine the effect of exercise on emotional reactions of female adolescents with type I diabetes.

MATERIALS AND METHODS

This study was a quasi-experimental research conducted in Endocrine and Metabolism Research Centre. A total of 72 patients were randomly allocated in the two groups. The intervention group did aerobic exercise for 45 minutes, while the control group did not aerobic exercise. Data were collected using a Symptom Checklist (SCL)-90 questionnaire. Data were analyzed and using descriptive and inferential statistics methods and SPSS software.

RESULTS

The results showed that the mean score for physical symptoms, depression, obsession-compulsion, interpersonal sensitivity, aggression, phobia, paranoid ideation, psychosis, and anxiety in the test group significantly decreased after intervention than before intervention. The average score in the control group did not differ. The average total score of emotional reactions in the test group after the intervention decreased before the intervention significantly (P = 0.001). However, in the control group, the mean scores did not differ (P = 0.97).

CONCLUSION

The findings showed that regular exercise is effective on affective responses of adolescent females with type I diabetes.

Incidence of metabolic syndrome and its risk factors among type 2 diabetes clinic attenders in Isfahan, Iran

INTRODUCTION

At present, little data exists about the incidence of, and the risk factors associated with, metabolic syndrome (MetS) in patients with type 2 diabetes mellitus (T2DM). The aims of this present study were to assess the incidence and risk factors of MetS in people with T2DM using routinely collected data from a clinical information system at Isfahan Endocrine and Metabolism Research Centre, Iran.

MATERIAL AND METHODS

During the mean (SD) follow-up period of 11.7 (4.8) years, 3,047 patients with T2DM who were free of MetS at baseline were examined to determine the incidence and predictors of progression to MetS. The mean (SD) age of participants was 50.4 (11.0) years, with a mean (SD) duration of diabetes of 6.3 (6.2) years at initial registration. A modified National Cholesterol Education Programme- Adult Treatment Panel III definition (with body mass index [BMI] instead of waist circumference) was used for the MetS.

RESULTS

The prevalence of MetS was 63.2% (95% CI: 62.3, 64.1). The incidence of MetS was 28.5 (95% CI: 26.8, 30.2) (25.9 men and 30.9 women) per 1,000 patient-years based on 35,677 patient-years of follow-up. Multivariate analysis revealed that higher body mass index (BMI) and education, lower HbA1c and treatment with oral agent or insulin were associated with MetS.

CONCLUSIONS

These are the first estimates of the incidence and risk factors of MetS in patients with T2DM in Iran. These findings show that the natural course of MetS is dynamic. The clinical management of patients with T2DM will contribute significantly to MetS prevention.