International Journal of Preventive Medicine
Volume:10 Issue: 6, Jun 2019

Leishmaniasis is considered as a zoonotic infection and neglected tropical disease. Leishmania treatment is not totally successful and imposes high expenditures, especially in developing countries. Since the natural infection leads to the robust immunity in most of the human cases, many bodies of research have been focusing on Leishmania vaccines, being capable to control Leishmania infection. First generation vaccines (such as Leishmune and CaniLeish) have proved robust protective immunity in dogs. In human, recombinant vaccines, including Leish‑F1 could confer some degrees of protective immunity against natural infection. Recently, ChAd63‑KH DNA vaccine has been accomplished in providing prevention against Leishmania infection; however, this vaccine should be further evaluated in other clinical trials.

Altmetrics is a newly emerging scholarly tool measuring online attention surrounding scientifc research outputs. With respect to increasing demand of disseminating research fndings on the World Wide Web, this study aims to analyze the altmetric statues of Iranian medical journals. On February 27, 2019, the list of Iranian medical journals extracted from http://journals. research.ac.ir/ and consequently altmetric data token out from Altmetric database (Altmetric LLP, London, UK). The science mapping done via keyword co-occurrence, co-citation and co-authorship, network analysis using the VOSviewer. The Pearson coeffcient was then employed for the correlation analysis using R. Among a total of 104 journals, 7518 articles were mentioned in Altmetric
data resources (Mean: 72.28, Confdence Level (95.0%): 16.8), total mentions were 27577 (Mean: 265.16, Confdence Level (95.0%): 79.9). Considering the total mentions of articles, International Journal of Preventive Medicine achieved the frst rank, followed by Journal of Research in Medical Sciences and Iranian Journal of Public Health. Notably, Twitter was the most popular altmetric resource followed by Facebook and news outlets. Tweets were generally from the United States and United Kingdom. Among top 5% popular Iranian medical articles multiple sclerosis, cancer, and anxiety was hot topics. Iranian biomedical journal editors and research scientists needs
to be more dynamic in World Wide Web using social media, post-publication peer review tools, Stack Exchange (Q and A) sites, research highlight tools, Wikipedia, and etc. In spite, more attention to the concept of evidence-based policymaking, by Iranian government along with the health policymakers seems necessary.

Theory‑based tobacco use prevention programs in schools were implemented to evaluate the effectiveness of this peer‑led intervention on tobacco use‑related knowledge, attitude, normative beliefs, and intention to tobacco use of school children aged 14–17 years old. A school‑based cluster randomized controlled intervention study was conducted among 1st, 2nd, and 3rd grade high school children in Sanandaj City, Iran. 4‑h integrated tobacco use prevention program comprising of four structured modules was developed and delivered to the intervention group by trained peer educator. Outcome measures comprised changes in students’ smoking‑related knowledge, attitude, normative beliefs, and intention to tobacco use from baseline to 6‑month follow‑up through validated anonymous questionnaire. The present study showed an intervention effect on tobacco use‑related knowledge, normative beliefs, and intention to tobacco use but not attitude. The results indicated that there was signifcant decrease in intention to tobacco
use (P ≤ 0.013) observed after 6‑month postintervention. The intervention module was also effective in improving smoking knowledge (P ≤ 0.001), normative beliefs with regard to perceived prevalence of cigarette smoking and water‑pipe use among adults and adolescents (P ≤ 0.001) in intervention group 6‑month postintervention. Participation in the peer‑led education program to tobacco use prevention may have improvement in knowledge, normative beliefs, and intention to
tobacco use. An implementation of the peer‑led behavioral intervention components in the school setting may have a benefcial effect on public health by decreasing intention to tobacco use among nonsmoker adolescents.

In this study, the anti‑Streptococcus mutans and anti‑Lactobacillus casei properties of a restorative glass‑ionomer cement (GIC) modifed with extract powder of Salvia offcinalis as a safe and effective herbal extract at weight concentration levels of 0.5%, 0.75%, 1%, and 1.25% are investigated. The S. offcinalis extract powder is provided by doing a multistep laboratory procedure and is fltered to obtain particles smaller than 50 µ. The GIC powder is modifed by adding extract powder in weight concentrations of 0.5% (Group II), 0.75% (Group III), 1% (Group IV), and 1.25% (Group V) to form experimental groups, each of 1 g. Five disk‑shaped samples, 1 cm in diameter and 2 mm height, of each group (including control group [Group I]) are prepared for each bacterial category of S. mutans and L. casei. The twenty‑fve samples for each category are tested in vitro against strains of S. mutans and L. casei. Following Agar diffusion tests, the inhibition zone diameters are recorded. The data are tested for normality by means of Kolmogorov–Smirnov procedure. The Kruskal–Wallis and Mann–Whitney tests are used to perform a one‑way ANOVA and to do pair‑wise comparisons, respectively, at 5% signifcance level. The mean diameter of the inhibition zones are signifcantly different among the test groups and also the test groups and the control group except for the group with 0.5% in L. casei category which shows no signifcant difference with the control group. The present study revealed direct inhibitory activitiesof S. offcinalis‑containing GIC against S. mutans and L. casei in a dose‑response manner.

Brucellosis is a serious disease affecting many individuals in the world and in Iran. The aim of this study was to investigate the epidemiological and clinical features of patients diagnosed with brucellosis in Kohgilouyeh and Boyerahmad province, southwest of Iran. This retrospective descriptive‑analytic study included all individuals diagnosed with brucellosis during 2009–2015. The clinical and epidemiological information were gathered from recorded data available in the health center of Kohgilouyeh and Boyerahmad province, the southwest of Iran. The total number of patients diagnosed with brucellosis during the study period was 658, of whom, 339 (51.5%) were males. A total of 541 (82.2%) patients resided in rural and tribal areas, and the others lived in urban regions. The mean age of diagnosis was 39.59 ± 17.28 years and the most prevalent age groups were 31–50 (277, 42.1%) and 11–30 (178, 27.1%)‑year olds. The most affected groups were housekeeper women (229, 34.8%) and ranchers (152, 23.1%). The
relationship between jobs and disease was signifcant (P < 0.001). Transmission through either suspected dairy products (582, 88.4%) or close contact with infected livestock (537, 81.6%) comprised the most common routes of brucellosis dissemination. The clinical presentation was acute in the majority (581, 88.3%) of the patients. The highest titer for both wright and Coombs wright tests was 1:320. The most frequently administrated drugs were doxycycline and streptomycin (183,
27.8%). The most commonly observed clinical symptom was bone pain (477, 72.5%). Arthritis (12, 1.8%) comprised the most frequent drug‑associated complication. Either relapse or treatment failure was recorded collectively in four (0.6%) patients. Due to the prevalence of the disease in the nomadic areas, timely detection and control of the disease is essential. Furthermore, livestock
vaccination along with educating farmers and physicians about brucellosis can be helpful.

Nowadays, stress has been tagged a global phenomenon. Many undergraduate students undergo considerable stress, and a variety of sources of stress have been identifed among university students. The aim of this study is to identify the level of perceived stress and its predictors among medical and nonmedical Minia University students. This was a cross‑sectional study comparing between medical and nonmedical students in Minia University, conducted during the period from March to April 2017. The sample consisted of 314 medical and 291 nonmedical students chosen through cluster random sampling as a section was chosen randomly from each academic year and collectively form the fnal sample. Data were collected through interview by a questionnaire inquiring about sociodemographic data, common stressors as academic, fnancial, family, and transportation stressors and Cohen Perceived Stress Scale 10. The prevalence of perceived stress was slightly higher (88.9%) among medical students than among nonmedical students (83.5%). Severe stress was found among (18.8%) of medical students compared to (12.4%) among nonmedical students (P < 0.05). The signifcant predictors of perceived stress were academic
stressors, no exercise and being female among medical students, and were academic and fnancial stressors among nonmedical students. Medical students perceived more stress than nonmedical students. The academic stressors were signifcant predictors among all students; hence, there is a need for the establishment of students counseling unit, to facilitate coping with the stress of study and examination.

Peripheral arterial disease (PAD) is an important marker of cardiovascular (CV) risk and the risk of PAD is markedly increased in patients with type 2 diabetes mellitus (T2DM). Consequently, early diagnosis and treatment of PAD in patients with T2DM are critically important to reduce the risk of CV events. The aim of this study was to determine the prevalence of asymptomatic PAD in patients with T2DM and to investigate the demographic and clinical associations of PAD among them. This cross‑sectional study included 2423 diabetic patients >20 years old, who were regularly followed up at the regional diabetes clinic, Galle, Sri Lanka. Data were obtained using structured questionnaires for information on demographic characteristics and risk factors. Assessment of ankle‑brachial pressure index (ABPI) was performed in all. PAD was diagnosed when ABPI was < 0.9 on either leg. The overall prevalence of PAD was 15.3% with no signifcant age
or gender difference. Patients with PAD had signifcantly higher systolic blood pressure (SBP) (127 vs 125 mmHg, P = 0.002) and diastolic blood pressure (DPB) (80 vs 78 mmHg, P = <0.001) and signifcantly lower estimated glomerular fltration rate (eGFR) (80 vs 84 ml/min, P = 0.007) than those without PAD. No signifcant relationships were found between the duration of diabetes mellitus, hypertension, dyslipidemia, and PAD. Prevalence of PAD was relatively high in the
diabetic population of this study when compared with fndings from other countries. There is a signifcant association of subclinical PAD with reduced eGFR among patients with T2DM.

We aimed to explore the association between resting heart rate (RHR) and the severity and complexity of atherosclerosis in coronary artery disease (CAD). Clinical and laboratory data of 388 patients who underwent coronary angiography were evaluated retrospectively. SYNTAX and Gensini scores were calculated based on angiographic fndings. These scores which indicate the severity of atherosclerosis was calculated for all the patients. Patients were divided
into three main groups according to RHR. Group 1 composed of patients with RHR ≤70 (n = 217), group 2 composed of patients with RHR between 70 and 89 (n = 133), and group 3 composed of patients with RHR ≥90 beats per min (bpm) (n = 38). Gensini and SYNTAX score values of the three study groups were compared. Also, Gensini score was tested for whether it showed a positive correlation with RHR and SYNTAX scores. All patients had an average age of 61.3 years, and the mean for RHR was 72 bpm. Mean Gensini score in the general CAD population was 24.4 ± 22.5, and mean SYNTAX score was 13.6 ± 8.1 points. The Gensini and Syntax score values of the group 3 were signifcantly higher than that of the other two groups (59.8 ± 31.2, P < 0.001 and 26.0 ± 6.5, P < 0.001, respectively). There was a signifcant correlation with Gensini score and RHR, SYNTAX score, C‑reactive protein (CRP), and left ventricular ejection fraction [(r = 0.725, P < 0.001), (r = 0.680, P < 0.001), (r = 0.543, P < 0.001), (r = -0.224, P < 0.001), respectively]. RHR is an effective easily available marker for the assessment of severity and complexity of CAD.

Today, the importance of physical activity as a preventative way for cardiovascular disease has attracted much attention.The aim of this study is to investigate the effect of 6 weeks of interval training with or without extract of Ziziphus jujuba on lipocalcin‑2 (LCN2) and adiponectin levels in heart tissue in male Wistar rats with myocardial infarction. Thirty male Wistar rats (mean weight, 180–220 g and age, 2–3 months) were divided into fve groups, including (1) Healthy control; (2) Isoprenaline‑treated group (ISO); (3) ISO + jujube extracts (JE); (4) Trained ISO rats; and (5) Trained ISO rats + JE. Exercise was performed (5 days/week, for 6 week including 54‑min cycles with speed of 23 m/min and 54‑min cycles with speed of 15 m/min). After 48 h of the last training session, the rats were sacrifced, and their heart tissue was excised. The signifcant level of statistical data was analyzed by one‑way ANOVA
test. LCN2 levels signifcantly decreased in trained ISO rats + JE group after 6 weeks of interval training with JE consumption, compared to ISO group. However, the consumption of jujuba extracts with and without interval training did not show any signifcant changes in adiponectin levels of rat’s heart tissue, compared to ISO (P < 0.05). Because the LCN2 inflammatory factor decreased after 6 weeks of exercise and consumption of the extract, it seems that performing interval training with JE consumption can be an effective method in the cardiac rehabilitation phase after a heart attack.

Epilepsy surgery is a fundamental treatment in refractory epilepsy. Video electroencephalographic (v‑EEG) monitoring plays an essential role in presurgical evaluation of patients. However there are reports of favorable outcome based on interictal and magnetic resonance imaging (MRI) fndings without any need for v‑EEG monitoring in patients with temporal lobe epilepsy (TLE). This study aimed to investigate the prognostic effect of concordance between
interictal fndings and ictal and MRI data on postsurgical outcome of TLE and extratemporal lobe epilepsy (ETLE). A retrospective study was conducted on 199 patients with refractory focal epilepsy who were admitted for presurgical evaluation. The concordance between irritative zone (IZ) and seizure onset zone (SOZ) and also IZ and MRI lesion was registered, and subsequently the prognostic effect of relevancy on 1‑year follow‑up result based on Engel criteria was investigated. In TLE and ETLE regarding relevancy between IZ and SOZ, 77.8%
and 73.2% were concordant, 2.5% and 0% were discordant, and 19.6% and 26.8% had overlap, respectively. Concordance between IZ and MRI lesion was found in 76.6% and 51.2% of patients with TLE and ETLE while discordance was recorded in 2.5% and 12.2% and overlap registered in 20.9% and 36.6%, respectively. The concordance of interictal fndings had no effect on postsurgical
outcome of patients with TLE and ETLE. Our study showed that concordance of IZ with SOZ and MRI has no independent effect on postsurgical outcome of patients with TLE and ETLE. We suggest that excluding exceptional cases, v‑EEG monitoring should be considered as the mainstay of presurgical evaluation.

There has been no report of the vitamin D status of the professional athletes from Iran to date. This study was performed to evaluate the effcacy of weekly vitamin D supplementation on athletic performance in Iranian athletes expedited to Asian competition in Taipei, China, 2015. This study was a randomized controlled clinical trial. Seventy subjects were enrolled in the study. The athletes were randomly divided into two groups: vitamin D supplement (D; received 50,000 IU of vitamin D supplement weekly) and control (P, received a placebo weekly). Duration of the study was 8 weeks. Anthropometric, dietary, athletic performance, and biochemical evaluations were performed for all subjects in the beginning and in the end of the intervention period. A signifcant rise in circulating 25(OH)D concentration was observed in D
group (17.3 ± 16.9 ng/mL, P < 0.001), whereas in P group, there was a statistically signifcant decrement (-3.1 ± 8.4 ng/mL, P = 0.040). There were no either within‑ or between‑group signifcant differences in Ergo jump, vertical jump, and agility tests. In strength leg press tests, both groups showed a signifcant improvement. However, comparisons of changes revealed that the improvement in D group was signifcantly higher than in P group (P = 0.034). Moreover, in sprint test (one repetition‑Max, 1RM), only D group had a signifcant within‑group improvement (P = 0.030). Weekly supplementation with 50,000 IU vitamin D resulted in nearly 17 ng/mL increment in circulating calcidiol. This increase was associated with signifcant improvement of power leg press and sprint tests in D‑supplemented group.

Tobacco use in pregnancy is linked with various negative health effects. The aim of this study was to examine the prevalence of maternal tobacco use during pregnancy and sociodemographic and health correlates. Data of ever pregnant women from the cross‑sectional “South African National Health and Nutrition Examination Survey (SANHANES‑1) 2011‑12” were analyzed. The sample included 5089 adolescents and adult women aged 15–55 years. They responded to questions on tobacco use, sociodemographic and health indicators. Results indicate that 5.0% [95% confdence interval (CI) = 4.3, 5.9] of South African women had engaged in tobacco use during their pregnancy. In adjusted analysis, being Colored and White population groups, poor self‑rated health status, and having chronic medical conditions were associated with tobacco use during pregnancy. Findings suggest links between sociodemographic and health variables and prenatal tobacco use, which may have public health policy implications.

Traffc injuries are considered as the most important health issues for different countries in the world, especially developing countries that are experiencing rapid social changes. The purpose of this study was to investigate the prevalence of road traffc injuries (RTIs) and its socioeconomic differences among road users in Iran as it is one of the countries with high rates of accidents in the world. The study population included all people in Iran. The target sample was 3,096 clusters consisting of 2,187 urban and 909 rural households. Source of the raw data was the Iran’s Multiple Indicator Demographic and Health Survey (IrMIDHS) 2010, which is a multi‑stage stratifed cluster‑random cross‑sectional study. The logistic regression has been performed for investigating the socioeconomic determinants which influence the RTIs among pedestrian,
vehicle, and motorcycle users. The prevalence of RTIs is 13.8 (95% CI: 13.1, 14.5) per 1,000 people in the year leading up to the study. The injured groups included pedestrians (14.37%),
vehicles (38.36%), motorcyclists (43.37%), and 3.9% of users injured with other vehicles. A total of 78.3% of the injured people underwent outpatient treatment or were hospitalized. The mean age in these three groups was signifcantly increased (27.9, 32.5, 33.4, respectively), and the proportion of men decreased (89.2, 75.2, and 60.6). RTIs in Iran are higher than previous estimates due to consideration of non‑hospitalized cases. Considering the high contribution of human factors in
developing countries, these measures should prioritize vulnerable groups.

The nicotine content of cigarettes plays a key role in the pathogenesis of kidney disease. Harmine is a harmal‑derived alkaloid with antioxidant properties. This study was designed to evaluate the effects of harmine against nicotine‑induced damage to the kidneys of mice. In this study, 64 male mice were randomly assigned to eight groups: saline and nicotine‑treated groups (2.5 mg/kg), harmine groups (5, 10, and 15 mg/kg), and nicotine (2.5 mg/ kg) + harmine‑treated groups (5, 10, and 15 mg/kg). Treatments were administered intraperitoneally daily for 28 days. The weights of the mice and their kidneys, kidney index, glomeruli characteristics, thiobarbituric acid reactive species, antioxidant capacity, kidney function indicators, and serum nitrite oxide levels were investigated. Nicotine administration signifcantly improved kidney malondialdehyde (MDA) level, blood urea nitrogen (BUN), creatinine, and nitrite  oxide levels and decreased glomeruli number and tissue ferric reducing/antioxidant power (FRAP) level compared to the saline group (P < 0.05). The harmine and harmine + nicotine treatments at all doses signifcantly reduced BUN, kidney MDA level, creatinine, glomerular diameter, and nitrite oxide levels and increased the glomeruli number and tissue FRAP level compared to the nicotine group (P < 0.05). It seems that harmine administration improved kidney injury induced by nicotine in mice.

Tobacco is one of the world’s leading avoidable causes of premature death, disease, and disability. According to the World Health Organization (WHO) survey 2020, there are about 120 million tobacco users in India, and WHO estimates that about 4.9 million die due to tobacco annually, and that by 2020 it will be the principal cause of death and disability. This study is done with objectives to access the prevalence of tobacco consumption, evaluate the impact of health
education and intervention. It was community‑based health educational interventional study conducted in urban slum setting in Bhopal India, comprising 1598 subjects, and out of these 520 participants were assessed for fnal outcome with 3 months study duration. A predesigned, pretested questionnaire proforma was developed containing the study variables including socio‑demographic, education, age, occupation, type of tobacco product consumed and so on and distributed to all study participants in pre‑interventional phase and only in tobacco consumers of
post‑interventional phase and then was fnally evaluated. The prevalence of tobacco use was 32.50% among the tobacco user; 87% were males and rest were females. In post‑interventional phase there was a signifcant difference (P < 0.0001) observed in tobacco consumption frequency,
impact of staring with criticism, condemnation, denigration and total number of tobacco quitter. After the health educational interventional motivation, majority of users are ready to quit, so we have to help them in quitting which must include the effectual intervention to control the tobacco use by making an effective strong policy by increasing their knowledge by means of IEC and health education.

Obesity is a worldwide problem. The Arab world, and particularly the Middle East, has witnessed a recent dramatic rise in obesity and obesity‑related diseases. Yet, little is known about physician attitudes toward or management of obesity in this region of the world. The purpose of this study is to explore physician perceptions and attitudes toward obesity in the United Arab Emirates (UAE). A cross‑sectional, self‑administered anonymous survey of primary
care physicians was performed between December 2015 and January 2017 at academic medical centers in the UAE. A total of 573 of 698 physicians (82% response rate) completed the survey. Thirty‑seven percent of respondents met body mass index (BMI) criteria for overweight and 12% for obesity. Physicians had suffcient knowledge but lacked training in obesity management. Physician subspecialty impacted knowledge with internal medicine physicians showing better obesity knowledge (Chi‑square 392, df 210, P = 0.00). There was no signifcant relationship between knowledge and attitudes with physician age, gender, or nationality. Attitudinal responses toward obesity management were generally positive. However, there was an inverse correlation between physician BMI and positive attitudes toward obesity management (Chi‑square 1551, df 323, P = 0.00). Although our study did not fnd signifcant weight bias, negative
attitudes were directly correlated with physician BMI, a signifcant concern as half of physicians surveyed reported BMIs consistent with overweight and obesity.

Breast cancer is one of the most frequent women malignancies in the world. The cytochrome P450 1A1 (CYP1A1) is a key enzyme in xenobiotics metabolism. Moreover, CYP1A1 plays a critical role in the etiology of breast cancer by involving in 2‑hydroxylation of estrogen. Therefore, single‑nucleotide polymorphisms (SNPs) of its coding gene have been verifed to be important in cancer susceptibility. The aim of the study was to evaluate the association of CYP1A1 M2 (A2455G) includes rs1048943 of this SNP polymorphism with the risk of breast cancer in Mazandaran province. Ninety‑six breast cancer patients with known clinicopathological
characters and 110 healthy women as control were genotyped for CYP1A1 M2 polymorphisms by the restriction fragment length polymorphism technique. The analysis of CYP1A1 gene (polymorphism M2) showed that the frequency of homozygous wild genotypes (AA), heterozygous (AG), and mutant genotype (GG) in the patient group, respectively, 78%, 22%, and 0%, and also the frequency of genotypes AA, AG, and GG in healthy included 82%, 16%, and 2%, respectively. Statistical analysis by Logistic regression model at P < 0.05 showed no
signifcant correlation between polymorphisms in CYP1A1M2 and breast cancer risk (odds ratio = 0.84, confdence interval = 0.33–2.17). The results indicated that the M2 allelic genotypes were signifcantly associated neither with breast cancer risk nor with clinicopathological characteristics in Mazandaran province.

The objective of the study is to evaluate elastography ultrasound fndings in patients with scleroderma (SS) and to clarify the effectiveness of elastosonography to differentiate scleroderma lesions from any skin lesion considering tissue elasticity. Thirty‑six SS patients defnite diagnosis of systemic sclerosis according to American College of Rheumatology criteria and 36 healthy subjects were enrolled. Volar aspect of the middle forearm and arm in addition to the dorsal aspect of the fngers were evaluated by sonoelastography. The RGB (red, green, blue) image is a three‑dimensional matrix. A color image RGB is an M × N × 3 array of color pixels. The total pixels, total blue pixels, and blue index compared between SS cases and controls. Mean age of patients was 41.3 ± 10.3 years and mean age of controls was 39.8 ± 9.3 years. Mean‑modifed Rodnan skin score of the whole body was 11.9 and mean duration of disease was 6.2 years. Mean total blue pixels in the arm were signifcantly different between cases and controls. Mean total image pixels, total blue pixels, and blue index in the forearm were signifcantly different between cases and controls. Elastography fndings in the fnger were not signifcantly different between cases and controls. Sonoelastography could be used for evaluating skin of forearm in sclerodermic cases which will be helpful for disease evaluation in clinical course.

This study was performed to evaluate the effects of carnitine administration on carotid intima‑media thickness (CIMT) and inflammatory markers in women with polycystic ovary syndrome (PCOS). This randomized, double‑blind, placebo‑controlled trial was conducted among 60 women diagnosed with PCOS according to the Rotterdam criteria, aged 18–40 years. Participants were randomly allocated into two groups to intake either 250 mg/day carnitine (n = 30) or placebo (n = 30) for 12 weeks. High‑resolution carotid ultrasonography was conducted at baseline and after the 12‑week intervention. After the 12‑week intervention, compared with the placebo, carnitine supplementation resulted in a signifcant decrease in maximum levels of the left CIMT (-0.01 ± 0.02 vs. +0.002 mm ± 0.006 mm, P = 0.001), mean levels of the left CIMT (-0.01 ± 0.02 vs. +0.001 mm ± 0.01 mm, P = 0.001), maximum levels of the right CIMT (-0.01 ± 0.02 vs. +0.006 mm ± 0.01 mm, P < 0.001), and mean levels of the right CIMT (-0.01 ± 0.02 vs. +0.002 mm ± 0.01 mm, P = 0.001). Change in plasma nitric oxide (NO) (+2.4 ± 3.6 vs. +0.2 ± 2.3 μmol/L, P = 0.007) was signifcantly different between the supplemented patients and placebo group. We did not see any signifcant effect in serum high sensitivity C‑reactive protein (hs‑CRP) following the supplementation of carnitine compared with the placebo. Overall, carnitine administration for 12 weeks to participants with PCOS had benefcial effects on CIMT and plasma NO, but did not affect serum hs‑CRP levels.

In recent decade the prevalence of antibiotic associated diarrhea was increased because of more antibiotic usage. Colstridum diffcile is a microorganism which can cause mild to severe colitis. But the only cause of colitis related to Antibiotics is not colstridum diffcle. In this case report we explain a child whit antibiotic associated colitis due to klebsiella oxtyoca.