ehsan sanati

Diabetes mellitus decreases reproductive and sexual function in men by causing oxidative stress in testis cells and decreasing antioxidant enzymes. Several recent studies have found the effects of Cornus mas and Galega officinalis extracts on improving spermatogenesis dysfunction caused by diabetes. This meta-analysis study aimed to investigate the impact of G. officinalis and C. mas extract on testicular oxidative stress indices and sperm parameters in diabetic laboratory animals compared to healthy animals.

A search using Scopus, PubMed, Web of Science, and Google Scholar databases was conducted on studies that investigated the effects of plant extracts of C. mas and G. officinalis on testicular tissue and sperm indices in diabetic animals. The first part included the investigation of malondialdehyde (MDA) (nmol/mg), rate of catalase antioxidant activity, and superoxide dismutase. In contrast, the results of the second part included total sperm count (×106 ), total sperm motility (%), and immobility. The mean difference (MD) (95% confidence interval [CI]) was selected to express the effect size.

Out of 154 identified articles, four studies on mice were included in the meta-analysis. The random effect size yielded an overall effect size for MDA (6.96) with a 95% confidence interval [-6.09; 20.00]. The random effect size yielded an overall effect size for SOD of -0.5076 with a 95% confidence interval [-0.62; -0.40]. The random effect size yielded an overall effect size for CAT of -1.68 with a 95% confidence interval [-1.88; -1.47]. Also, a significant decrease in total sperm count showed the random effect size yielded an overall effect size of -24.74 with a 95% confidence interval [-30.73; -18.74]. The random effect size yielded an overall effect size for sperm motility of -26.65 with a 95% confidence interval [-29.54; -23.76]. A significant increase was demonstrated in sperm immobile in diabetic animals compared to the control group. The random effect size yielded an overall effect size for this indicator is 6.5157 with a 95% confidence interval [-1.96; 14.99].

G. officinalis or C. mas extracts have reduced effects on MDA levels and tissue damage and increased antioxidant enzymes in laboratory animals with diabetes.

In this research, we evaluated the protective effect of hydroalcoholic extracts of Galega officinalis and Cornus mas on spermatogenesis and oxidative stress associated with diabetes in the testes of adult rats.

In this experimental study, a total of 64 adult male Wistar rats were divided into eight equal groups (n=8 in each) as follows: (1) control group, (2) diabetic control group, (3) diabetic group receiving Galega extract daily at a dose of 50 mg/kg, (4) healthy group receiving Galega extract daily at a dose of 50 mg/kg for 14 days, (5) diabetic group receiving Cornus mas extract daily at a dose of 100 mg/kg, (6) healthy group receiving Cornus mas extract daily, (7) diabetic group receiving Cornus mas and Galega daily, and (8) healthy group receiving Galega and Cornus mas extract daily. Diabetes was induced by single intraperitoneal injection of streptozotocin (50 mg/kg). At the end of treatment period, all animals were anesthetized and blood samples were taken to measure the serum levels of insulin, glucose, and oxidative stress markers. Finally, the testicles and epididymis were removed and sperm parameters were assessed.

Galega and Cornus mas extract significantly reduced the oxidative stress, sperm parameters, glucose, and insulin plasma levels (P=0.001). Furthermore, the malondialdehyde (MDA) level was increased in diabetic rats. The activity of superoxide dismutase (SOD) and catalase (CAT) enzymes decreased in testicular tissue (P=0.001). Administering Galega and Cornus mas extract significantly improved these parameters (P<0.05).

Our results confirmed the antioxidant effect of administering Galega extract and Cornus mas extract on improving the sperm parameters and testicular oxidative damage caused by diabetes.

Background Osteoporosis is a common condition among postmenopausal women, and one of the main medications for treatment is bisphosphonate compounds. The aim of this study was to investigate and compare the efficacy of the oral form (alendronate) with injectable form (zoledronic acid) of bisphosphonate compounds. This retrospective cohort study was carried out over three years (2010 to 2012) on patients referred to Physical Medicine Clinic of Tehran, Imam Reza Hospital, and two private rheumatology clinics in the cities of Gorgan and Shiraz, Iran. According to inclusion and exclusion criteria, 33 postmenopausal women were studied in each of the alendronate and zoledronic acid groups. Mean age and T-score of femur and lumbar spine before treatment showed no significant difference between the two groups (P = 0.223, 0.321 and 0.953, respectively). After a year of treatment, the T-score had improved and this improvement was statistically significant in both groups; however this improvement was higher in zoledronic acid group (P = 0.019 for femur and P = 0.011 for spine). The injectable form of bisphosphonates (zoledronic acid) compared to oral form (alendronate) has more effect on improving osteoporosis and T-score of postmenopausal women.

Socioeconomic indicators are the main factors that affect health outcome. Health price index (HPI) and households living costs (HLC) are affected by economic reform. This study aimed at examining the effect of subsidy targeting plan (STP) on HPI and HLC.

The social accounting matrix was used to study the direct and indirect effects of STP. We chose 11 health related goods and services including insurance, compulsory social security services, hospital services, medical and dental services, other human health services, veterinary services, social services, environmental health services, laundry& cleaning and dyeing services, cosmetic and physical health services, and pharmaceutical products in the social accounting matrix to examine the health price index. Data were analyzed by the I-O&SAM software.

Due to the subsidy release on energy, water, and bread prices, we found that (i) health related goods and services groups’ price index rose between 33.43% and 77.3%, (ii) the living cost index of urban households increased between 48.75% and 58.21%, and (iii) the living cost index of rural households grew between 53.51% and 68.23%. The results demonstrated that the elimination of subsidy would have negative effects on health subdivision and households’ costs such that subsidy elimination increased the health prices index and the household living costs, especially among low-income families. The STP had considerable effects on health subdivision price index.

The elimination or reduction of energy carriers and basic commodities subsidies have changed health price and households living cost index. Therefore, the policymakers should consider controlling the price of health sectors, price fluctuations and shocks.

Despite the introduction of new drug regimens with high effectiveness for the hepatitis C virus (HCV) patients, especially in HCV genotype 1, no cost-effectiveness study on the selection of the superior drug strategy in Iran has been conducted yet.
This study is aimed to assess the cost-effectiveness of the three drug regimens of pegylated interferon and ribavirin (PR), sofosbuvir (SOF) PR and ledipasvir and sofosbuvir (LDV/SOF) in patients with HCV genotype 1 in Iran in the year 2014.
A Markov micro-simulation model was used to evaluate the cost-effectiveness of the three drug strategies for a cohort of 10000 patients. Quality-adjusted life-years (QALYs) were extracted from published studies. Cost data was estimated through the review of medical records and obtaining experts opinion.
The results showed that the SOF PR drug compared with PR had a lower cost and was more effective, but compared with the LDV/SOF, in spite of its lower cost, it was less efficient. The QALY values obtained for PR, SOF PR and LDV/SOF, respectively, were 10.98, 12.08 and 12.28 and their costs were $ 41,741, $ 7,676 and $ 46,993. Moreover, the results obtained from acceptability curves showed that SOF PR were the most cost-effective treatment for thresholds below $ 45,270 PPP.
The use of SOF PR regimen or LDV/SOF can significantly reduce the incidence of complications associated with the disease. For example, short and long-term outcomes are better than the current drug regimens for HCV genotype 1 patients in all stages of the disease.

Carpal Tunnel Syndrome (CTS) is one of the main causes of disability. The diagnosis of CTS confirm by electrodiagnostic tests. Sonography is an alternative method for diagnosis of CTS that can investigate anatomy and probable pathology. The aim of this study is to investigate the multiple sonographic diagnostic criteria and compare its diagnostic value with electrodiagnosis. In this descriptive-cross sectional study, 84 wrists (42 patients with CTS and 42 individuals without any clinical signs in upper limb) were investigated. Symptomatic patients underwent clinical examination, standard electrodiagnostic evaluation of upper limb and sonographic investigation of median nerve in forearm and wrist. The control group underwent sonographic investigation. Cross Sectional Area (CSA) of Median nerve at distal wrist crease, at the level of Hamate hook and Trapezium, the amount of flexor retinaculum bowing, ratio of CSA at the forearm to distal wrist crease and ratio of CSA at the Pisiform level to distal wrist crease had significant difference in the case group compared to the control group (P-value<0.05). Among these criterion, the most sensitivity, NPV and accuracy was for CSA at distal wrist crease (73.8%, 72.5%, 71.4% respectively), the most specificity, PPV was at the level of Hamate hook and Trapezium (85.3%, 80% respectively). Our study reveals that sonography is a somehow sensitive and specific method in diagnosis of CTS and can be used as an adjuvant method in diagnosis of CTS but cannot substitute electrodiagnosis.

Back ground: Spinal manipulation is a manual technique commonly used for the treatment of low back pain. The physiologic mechanisms of spinal manipulation are largely unknown. One basic physiologic response to spinal manipulation (SM) is alternation in motoneuronal activity، as assessed by the Hoffmann reflex (H-reflex) technique. The purpose of this study was to determine the effect of spinal manipulation on amplitude and onset latency of H-reflexes and on H/M amplitude ratio in patients with low back pain. fifty eight patients with low back pain aged between 20-60 years، who had no exclusion criteria were included. Tibial nerve H reflex and M wave were recorded before and after Lumbosacral spinal manipulation. Lumbosacral manipulation significantly decrease amplitude of H reflex and H/M amplitude ratio (Pvalue<0. 05). It had not significantly effect on H reflex latency or M wave amplitude and latency (P value>0. 05). Lumbosacral manipulation produces attenuation of alpha motoneuronal excitability. These findings support of this theory that manual spinal therapy can lead to reduction in muscle tone.