Journal of Research in Medical Sciences
Volume:26 Issue: 1, Jan 2021

Background:

The concurrence of metabolic syndrome (MS) and diabetes mellitus (DM) is increasing worldwide. The long‑term complications of these chronic diseases are a threat to patients’ well‑being. Oxidative stress is involved in the pathogenesis of several diseases. To understand the basic pathophysiological mechanisms of Type‑2 DM (T2DM) and its related complications, we aimed to investigate the oxidant/antioxidant status and Na+‑K+ ATPase activity in T2DM with MS.

Materials and Methods:

A population of ninety individuals including fifty patients diagnosed with T2DM and MS, but without overt diabetes complications, and forty individuals without T2DM or MS as control group participated in this study. Plasma malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx) activities, total antioxidant capacity (TAC), and Na+‑K+ ATPase activity were assessed by standard laboratory methods. Results Plasma MDA in patients group was statistically significantly higher than that of controls (P ≤ 0.05). Whereas, Na+‑K+ ATPase activity was statistically significantly lower in patient group (P ≤ 0.05). TAC, CAT, SOD, and GPx enzyme activities were not statistically significantly different between two groups (P > 0.05).

Results: 

from the patient group showed positive correlations between CAT activity and triglyceride and positive correlations between GPx activity and weight, body mass index (BMI), and waist circumference. In addition, there was a positive correlation between MDA results with high‑density lipoprotein‑cholesterol (HDL‑C) and total cholesterol and a negative correlation with TAC, BMI, and weight (P ≤ 0.05) in controls.

Conclusion: 

Because T2DM patients were without any vascular complications, antioxidant defense results may reflect the lack of progression of diabetes complications in these patients. These results emphasize the need for initial and continued assessment of cardiovascular disease risks in diabetic individuals. Implementation of timely interventions may improve the management of diabetes and prevent the progression of diabetes complications.

We investigated the impact of a home‑based exercise intervention (HBEI) on cardiac biomarkers, liver enzymes,
cardiometabolic outcomes, and health‑related quality of life (HRQL) in clinically stable patients after coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI).

The study was a nonrandomized clinical trial conducted in Tehran, Iran, from July 2019 to January 2020. Forty cardiac patients (after the cardiac intervention, CABG, n = 32; PCI, n = 8) were recruited based on the study inclusion criteria and were allocated consecutively to one of two groups: (1) HBEI (n = 18) and (2) conventional center‑based exercise program (CBEP, n = 22). The CBEP group performed the routine exercise program of Sadr Heart Clinic, and the HBEI group performed a home‑based remotely monitored exercise protocol, both three times per week, for 8 weeks. The following variables were assessed before and after the intervention: anthropometric measures; blood pressure; lipid profile; cardiac biomarkers including cardiac troponin I, creatine kinase, and total and Mb isozyme; liver enzymes including aspartate aminotransferase and alanine aminotransferase; creatinine; urea; exercise capacity; and HRQL.

In comparison with pretest in both CBEP and HBEI groups, a significant improvement in all of the measured variables (P < 0.05), but not in ejection fraction was observed (P > 0.05). Moreover, in the CBEP group, a more significant decline in troponin I levels (P = 0.03), and in the HBEI group, a greater reduction in weight (P = 0.01) and body mass index (P = 0.04) occurred.

The findings suggest that a properly designed and monitored HBEI may be as effective as conventional  enter‑based cardiac rehabilitation (CR) exercise programs and should be encouraged in those cardiac patients who are unable or uninterested in conventional center‑based CR exercise programs.

Hyperglycemia over‑activates glucose reduction to sorbitol by aldose reductase (ALR) leading to osmoregulation
disruption and cellular damage that cause diabetic complications. We investigated the association of C106T polymorphism of ALR2 gene with the severity of diabetic retinopathy (DR) in Jordanian Type 2 diabetic patients in this case-control study at the Ophthalmology clinic of the National Centre of Diabetes, Endocrinology, and Genetics.

A total of 277
subjects participated in the study (100 diabetics without retinopathy, 82 diabetics with retinopathy, and 95 controls). Blood samples were withdrawn followed by DNA extraction. C106T polymorphism was examined by polymerase chain reaction followed by restriction fragment length polymorphism and gel electrophoresis. Statistical analysis was performed by SPSS software using analysis of variance, multiple logistic regression or Chi‑square test.

The CT and TT genotypes were significantly more prevalent in DR patients than those without DR (CT 50% vs. 38%, TT 16.7% vs. 8%, P = 0.02 and 0.01, respectively). DR patients had T allele more frequently than those without it (41.7% vs. 27%, P = 0.007). Diabetics without retinopathy showed similar genotype and allele frequency to those of nondiabetic controls. No correlation between CT/TT genotypes and the severity of DR in affected subjects was found (χ2: 3.049, P = 0.550).

C106T polymorphism increased the risk to develop retinopathy in Jordanian Type 2 diabetic patients. T allele of ALR2 was associated with DR. The severity of DR did not show an association with this polymorphism.

Insertion of the advanced airway during induction of general anesthesia can cause undesirable sympathetic stimulation such as increased intraocular pressure (IOP) and hemodynamic parameters. In this study, we compared insertion of three different advanced airway devices; endotracheal tube (ETT), laryngeal mask airway (LMA) and I‑gel in terms of IOP, hemodynamic changes and postoperative nausea and vomiting (PONV) following induction of general anesthesia with propofol and remifentanil in children undergoing strabismus surgery.

A total of 90 children (5.68 ± 1.49 years old) were randomly assigned to one of the three groups, ETT, LMA, or I‑gel insertion as advanced airway devices IOP and also hemodynamic variables were measured before (T0 and T1) and immediately after (T2) the insertion of these airway devices, although 2 min (T3) and 5 min (T4) after it. PONV was assessed about 2 h after the completion of surgery in the recovery room.

The mean arterial pressure (MAP), IOP, and systolic and diastolic blood pressures were significantly different between the three groups immediately (T2), 2 min (T3), and 5 min (T4) after the insertion of airway devices. The heart rate (HR) was significantly different between the three groups in all measurement times except of T0. Within‑group comparisons showed that the three groups had significant changes in MAP, IOP, HR, systolic and diastolic pressure before and after airway insertion (T1 and T2). The trend in the LMA and ETT groups was
descending‑ascending‑descending, whereas in the I‑gel group, it was quite descending. There was no significant difference among the three groups in terms of PONV.

As a result, our study showed that, compared with LMA and ETT, the I‑gel had less impact on undesirable stress responses and seems to be superior to LMA and ETT in children undergoing strabismus surgery.

Gastroesophageal reflux disease (GERD) is a common upper gastrointestinal disorder with a negative impact on the
quality of life. This study was aimed to assess the effect of adding duloxetine to lansoprazole on the symptom and quality of life improvement in GERD patients.

Seventy adult patients with a complaint of heartburn and regurgitation were enrolled in this randomized trial. Patients with a history of atypical symptoms, advanced systemic disease, medication‑induced symptom, structural lesion in endoscopy, allergy to the medication, and unco‑operative were excluded. The patients randomly (computer generated table) assigned in Groups A who received lansoprazole 30 mg plus placebo daily and Group B, in which
duloxetine 30 mg daily replaced by placebo during 4 weeks. All of participants, care‑givers, and outcomes assessors were blinded.
Basic demographic data, symptom severity score, depression and anxiety Beck score, and quality of life questionnaire were recorded at the starting and ending of treatment.

Fifty‑four patients have completed the study. The mean difference of Anxiety Beck score (13, 95% confidence interval [CI] [10–16], P = 0.001) and total raw score of quality of life (7, 95% CI [3.89–10.11], P = 0.043) were significantly improved in Group B. Complete and overall heartburn improvement rates were significantly better in Group B (odds ratio [OR] Adj: 2.01, 95% CI [1.06–2.97] and OR Adj: 1.31, 95% CI [1.05–1.57], respectively).

We found that the combination of duloxetine and lansoprazole is a safe and tolerable regimen, and it can significantly improve anxiety, heartburn, coffee consumption, the quality of sleep, and life in patients who suffer from the symptoms of GERD.

We investigated the effects of spirulina under high‑intensity interval training (HIIT) on levels of nesfatin‑1, omentin‑1,
and lipid profiles in overweight and obese females.

This is a randomized, quasi‑experimental controlled, single‑blind with a pre‑ and post‑test design, in which twenty overweight and obese women (body mass index = 29.32 ± 3.01 kg/m2, age = 21.55 ± 1.76 years), were randomly divided into the following groups: HIIT + spirulina (n = 10) and HIIT + placebo (n = 10). Running anaerobic sprint test was used for HIIT protocol consisting of six intervals at 35 m maximal speed runs, with a rest of 10 s in each trial (3 times/week, 4 weeks). HIIT + spirulina group received 500 mg of the spirulina pills twice daily for 4 weeks and the second group took placebo.

There was a significant increase in serum levels of nesfatin‑1 in HIIT + spirulina (P < 0.0001) but not in HIIT + placebo (P = 0.61) group. Furthermore, results indicated a significant difference between two groups with respect
to serum levels of nesfatin‑1 (P = 0.04). Serum levels of omentin‑1 significantly increased in both groups (P < 0.05). However, there was no significant difference between two groups (P = 0.49). In addition, results showed no significant inter‑ and intra‑group differences in total cholesterol levels, triglycerides, low‑density lipoprotein cholesterol, and high‑density lipoprotein cholesterol between groups (P > 0.05).

The spirulina under HIIT increased levels of nesfatin‑1 and omentin‑1 with no effects on the levels of lipid profiles in overweight and obese females.

E‑cadherin (CDH1 gene) is a protein involved in cell‑cell adhesion. There are reports on the association of –160C > A (rs16260) and –347GA > G (rs5030625) polymorphisms in the 5′‑promoter region of the CDH1 gene with tumor
development and progression of gastric cancer. This study aimed to examine the potential relationship between these two polymorphisms and gastric cancer in patients from Mazandaran province, Northern Iran.

A case–control study was conducted to test 97 patients and 95 healthy controls. Genomic DNA was extracted from peripheral blood followed by polymerase chain reaction amplification. Genotyping analysis was carried out using restriction fragment length polymorphism analysis for two potentially functional polymorphisms.

Heterozygous genotype GA/G versus GA/GA of rs5030625 (–347 GA > G) was found to be associated with increased risk of gastric cancer in the people studied (odds ratio = 5.73, 95% confidence interval = 2.11–15.56, P = 0.001). Furthermore, AA or CA genotype in –160C > A polymorphism did not show any increased risk of gastric cancer (P = 0.559).

The present study revealed that GA/G genotype of rs5030625 (–347 GA > G) polymorphism is associated with gastric cancer in Northern Iran.

Hydatid cyst (HC) is a serious health problem in endemic areas. Liver and lung are the most common involved organs while the involvement of muscles, heart, kidney, brain, and spleen is rare. The involvement of these rare locations for HC is mostly in association with infestation of common sites. We report a case of 43‑year‑old man with a history of surgery of HC in brain and heart who complained from chest pain. In imaging modalities, three cystic lesions were seen in heart and kidney which were confirmed to be recurrence of HC by serologic tests. However, no evidence of involvement of liver and lungs as the most common infected organs of HC was seen in recent and previous imaging mo®dalities. The patient refused another surgery and just accepted anthelmintic drugs. The practical point of this case report is that when we see any cystic lesion in imaging modalities in uncommon sites for HC, while common sites are spare, we should still consider the possibility of HC and not rule out it just because of lack of simultaneous infestation of its common involved organs.