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Background: Obesity in the older adults is a health concern that increases the risk of several life-threatening diseases. Previous research has been revealed that alterations in the gut microbiota composition is related to obesity. So, understanding the gut microbiota changes in older adults' obesity may help to provide promising strategies for their health management. Objectives: Here we conducted a systematic review that investigate the alteration of gut microbiota composition in association with obesity and its indices in the older adults. Design: Systematic review. Setting: A comprehensive systematic search was performed through PubMed, Web of Science, Scopus and Embase databases for all relative studies up to 2023 with the main search concepts as Microbiota, Obesity and Elderly. The data about gut microbiota in association with obesity indices had been extracted. Participants: Older adults (≥60 years). Intervention: None. Measurements: None. Results: Within 10741 recordes, 11 studies met the inclusion criteria and were included in this systematic review. Most of them indicated the gut microbiota alterations in obese compared with non-obese older adults. However, the gut microbiome composition in obese older adults is affected by other underlying diseases like diabetes and metabolic syndrome. The most important taxa that had abundance alteration in association with obesity in older adults were Christensenellaceae, Porphyromonadaceae and Rikenellaceae, Akkermansia, Blautia, Prevotella, Ruminococcus, Bacteroides and Faecalibacterium. Conclusion: The gut microbiota composition is associated with obesity in older adults. Considering the other factors affecting the composition of gut microbiota, such as age, underlying diseases and lifestyle, a more accurate conclusion about this matter requires more future studies. [ABSTRACT FROM AUTHOR]

Objective: To review published evidences about using information technology interventions in diabetes care and determine their effects on managing diabetes. Design: Systematic review of information technology based interventions. Research design and methods: MEDLINE®/PubMed were electronically searched for articles published between 2004/07/01 and 2014/07/01. A comprehensive, electronic search strategy was used to identify eligible articles. Inclusion criteria were defined based on type of study and effect of information technology based intervention in relation to glucose control and other clinical outcomes in diabetic patients. Studies must have used a controlled design to evaluate an information technology based intervention. A total of 3613 articles were identified based on the searches conducted in MEDLINE from PubMed. After excluding duplicates (n = 6), we screened titles and abstracts of 3607 articles based on inclusion criteria. The remaining articles matched with inclusion criteria (n = 277) were reviewed in full text, and 210 articles were excluded based on exclusion criteria. Finally, 67 articles complied with our eligibility criteria and were included in this study. Results: In this study, the effect of various information technology based interventions on clinical outcomes in diabetic patients extracted and measured from selected articles is described and compared to each other. Conclusion: Information technology based interventions combined with the usual care are associated with improved glycemic control with different efficacy on various clinical outcomes in diabetic patients. [ABSTRACT FROM AUTHOR]

Due to the metabolic nature of osteoporosis, this study was conducted to identify metabolomic studies investigating the metabolic profile of low bone mineral density (BMD) and osteoporosis. A comprehensive systematic literature search was conducted through PubMed, Web of Science, Scopus, and Embase databases up to April 08, 2020, to identify observational studies with cross-sectional or case-control designs investigating the metabolic profile of low BMD in adults using biofluid specimen via metabolomic platform. The quality assessment panel specified for the "omics"-based diagnostic research (QUADOMICS) tool was used to estimate the methodologic quality of the included studies. Ten untargeted and one targeted approach metabolomic studies investigating biomarkers in different biofluids through mass spectrometry or nuclear magnetic resonance platforms were included in the systematic review. Some metabolite panels, rather than individual metabolites, showed promising results in differentiating low BMD from normal. Candidate metabolites were of different categories including amino acids, followed by lipids and carbohydrates. Besides, certain pathways were suggested by some of the studies to be involved. This systematic review suggested that metabolic profiling could improve the diagnosis of low BMD. Despite valuable findings attained from each of these studies, there was great heterogeneity regarding the ethnicity and age of participants, samples, and the metabolomic platform. Further longitudinal studies are needed to validate the results and confirm the predictive role of metabolic profile on low BMD and fracture. It is also mandatory to address and minimize the heterogeneity in future studies by using reliable quantitative methods. Summary: Due to the metabolic nature of osteoporosis, researchers have considered metabolomic studies recently. This systematic review showed that metabolic profiling including different categories of metabolites could improve the diagnosis of low BMD. However, great heterogeneity was observed and it is mandatory to address and minimize the heterogeneity in future studies. [ABSTRACT FROM AUTHOR]

Background: Serum uric acid concentration has been linked with metabolic abnormalities. The available evidence on the association of Sugar‐Sweetened Beverage (SSB) intake with serum uric acid concentrations is conflicting. The present study aimed to summarise earlier findings on the association of SSB consumption with serum uric acid concentrations in adults. Methods: Using relevant keywords, we conducted a search in PubMed (https://pubmed.ncbi.nlm.nih.gov), Scopus (https://www.scopus.com) and Google Scholar (https://scholar.google.com) up to September 2017 for all published papers assessing SSB intake and serum uric acid concentrations. SSBs were defined as the dietary intake of Sugar‐Sweetened Soft Drinks and Fruit Juice (FJ), or as Sugar‐Sweetened Soft Drinks, Diet Soft Drinks and Orange Juice or as Soda and FJ. Results: After excluding non‐relevant papers, five studies, with six effect sizes, remained in our systematic review. All studies included in the current systematic review were of cross‐sectional design that were published between 2007 and 2013. The number of participants ranged from 483 to 14 761 people. Most studies had controlled for age, body mass index, weight and sex. We found that individuals in the highest category of SSB intake had 0.18 mg dL–1 greater concentrations of serum uric acid compared to those in the lowest category (summary effect size: 0.18 mg dL–1; 95% confidence interval = 0.11–0.25). No significant between‐study heterogeneity was found (I2 = 0.0%, P = 0.698). In the sensitivity analysis, we found no particular study influence on the summary effect. There was no evidence of publication bias. Conclusions: We found that SSB consumption was significantly associated with increased serum uric acid concentrations in an adult population. [ABSTRACT FROM AUTHOR]

Summary: Based on the clinical, BMD, and TBS data of 2380 participants aged ≥ 60 which was gathered during the BEH program, stage II, we showed that MetS was positively associated with BMD, while a negative or no association was observed between MetS and TBS depending on the sex and the adjustment model. Introduction: The results of previous reports in regard to the effect of metabolic syndrome (MetS) on bone health are not conclusive. This study aimed to evaluate the association between MetS with bone mineral density (BMD) and trabecular bone score (TBS) as an indicator of bone quantity and quality, respectively. Methods: Using a cross-sectional design, this study was carried out based on the data collected during the BEH Program, stage II. MetS was defined according to NCEP-ATP III criteria. BMD (at the lumbar spine and the hip) and lumbar spine TBS were assessed by dual-energy X-ray absorptiometry device. Results: The data of 2380 participants (women = 1228, men = 1152) aged ≥ 60 were analyzed. In the fully adjusted regression models (including BMI), significant associations between MetS and mean BMD were observed across all locations in men (P values ≤ 0.001) and in the lumbar spine in women (P value = 0.003). In addition, the prevalence of osteoporosis (based on BMD) was significantly lower in those with MetS than those without MetS in both sexes, even after full adjustments (women, OR = 0.707, P value = 0.013; men, OR = 0.563, P value = 0.001). In contrast, in age-adjusted regression analyses, the prevalence of degraded bone microarchitecture (TBS ≤ 1.2) was significantly increased in those with MetS than those without, irrespective of the participants' sex (P values < 0.05). The mean TBS was also negatively associated with MetS in women (β = − 0.075, P value = 0.007) but not in men (β = − 0.052, P value = 0.077), in age-adjusted regression models. However, after including BMI in the adjusted models, all significant associations between TBS values and MetS disappeared. Conclusion: It seems that a positive association exists between MetS and BMD, while MetS is either not associated or negatively correlated with bone quality as measured by TBS. [ABSTRACT FROM AUTHOR]

Summary: We compared the utility of the current Iranian guidelines that recommend treatment in women with a T-score ≤ − 2.5 SD with a FRAX-based intervention threshold equivalent to women of average BMI with a prior fragility fracture. Whereas the FRAX-based intervention threshold identified women at high fracture probability, the T-score threshold was less sensitive, and the associated fracture risk decreased markedly with age. Introduction: The fracture risk assessment algorithm FRAX® has been recently calibrated for Iran, but guidance is needed on how to apply fracture probabilities to clinical practice. Methods: The age-specific ten-year probabilities of a major osteoporotic fracture were calculated in women with average BMI to determine fracture probabilities at two potential intervention thresholds. The first comprised the age-specific fracture probabilities associated with a femoral neck T-score of − 2.5 SD, in line with current guidelines in Iran. The second approach determined age-specific fracture probabilities that were equivalent to a woman with a prior fragility fracture, without BMD. The parsimonious use of BMD was additionally explored by the computation of upper and lower assessment thresholds for BMD testing. Results: When a BMD T-score ≤ − 2.5 SD was used as an intervention threshold, FRAX probabilities in women aged 50 years was approximately two-fold higher than in women of the same age but with an average BMD and no risk factors. The relative increase in risk associated with the BMD threshold decreased progressively with age such that, at the age of 80 years or more, a T-score of − 2.5 SD was actually protective. The 10-year probability of a major osteoporotic fracture by age, equivalent to women with a previous fracture rose with age from 4.9% at the age of 50 years to 17%, at the age of 80 years, and identified women at increased risk at all ages. Conclusion: Intervention thresholds based on BMD alone do not effectively target women at high fracture risk, particularly in the elderly. In contrast, intervention thresholds based on fracture probabilities equivalent to a "fracture threshold" target women at high fracture risk. [ABSTRACT FROM AUTHOR]

An Ugi four-component reaction was used to construct propargylamide starting materials for a subsequent domino Heck–Suzuki–Miyaura cross-coupling reaction to give derivatives of 4-benzylidene-1-oxo-3,4-dihydro-1 H -isoquinoline. [ABSTRACT FROM AUTHOR]

Introduction: No study is available summarizing earlier publications on the association between metformin use and risk of fracture. This systematic review and meta-analysis were conducted to summarize earlier findings on the association between metformin use and risk of fracture. Methods: We conducted a systematic search on all published articles up to October 2018 using online databases including PubMed/Medline, ISI Web of Science, and Scopus. Observational studies that considered metformin use as the exposure variable and bone fracture as the main outcome variable or as one of the outcome variables and participants included were 18 years and older were included in the systematic review. Publications in which hazard ratios (HRs), rate or risk ratios (RRs), or odds ratios (ORs) were reported as effect size were included in the meta-analysis. Results: Totally, three cohort studies, one cross-sectional study, one nested case-control study, and one case-control study were included in this systematic review and meta-analysis. When seven effect sizes from six studies were combined, a significant inverse association between metformin use and risk of fracture was observed (RR 0.82; 95% CI 0.72, 0.93). No significant between-study heterogeneity was found (I2 = 22.4%, Pheterogeneity = 0.25). In addition, no evidence of publication bias was seen using Egger's test (P = 0.99). Conclusion: We found that metformin use was inversely associated with the risk of fracture. [ABSTRACT FROM AUTHOR]

Summary: This study aimed to summarize earlier randomized controlled trials on the effects of resveratrol supplementation on body weight (BW), body mass index (BMI), waist circumference (WC) and fat mass (FM). We searched PubMed, SCOPUS, Cochrane Library and Google Scholar from inception to April 2018 using relevant keywords. All clinical trials investigating the effects of resveratrol supplementation on BW, BMI, WC and FM in adults were included. Overall, 28 trials were included. Pooled effect sizes suggested a significant effect of resveratrol administration on weight (weighted mean differences [WMD]: −0.51 kg, 95% confidence interval [CI]: −0.94 to −0.09; I2 = 50.3%, P = 0.02), BMI (WMD: −0.17 kg m−2, 95% CI: −0.32, −0.03; I2 = 49.6%, P = 0.02) and WC (WMD: −0.79 cm, 95% CI: −1.39, −0.2; I2 = 13.4%, P = 0.009), respectively. However, no significant effect of resveratrol supplementation on FM was found (WMD: −0.36%, 95% CI: −0.88, 0.15; I2 = 0.0%, P = 0.16). Findings from subgroup analysis revealed a significant reduction in BW and BMI in trials using resveratrol at the dosage of <500 mg d−1, those with long‐term interventions (≥3 month), and performed on people with obesity. Taken together, the data suggest that resveratrol supplementation has beneficial effects to reduce BW, BMI and WC, but not FM. [ABSTRACT FROM AUTHOR]

Background This meta-analysis investigated the association of diet quality indices, as assessed by HEI and AHEI, and the risk of all-cause, cardiovascular and cancer mortality. Methods We used PubMed, ISI Web of Science and Google Scholar to search for eligible articles published before July 2015. A total of 12 cohort studies (38 reports) and one cross-sectional study (three reports) met the inclusion criteria and were included in our meta-analysis. Results The highest level of adherence to the Healthy Eating Index (HEI) and Alternative Healthy Eating Index (AHEI) was significantly associated with a reduced risk of all-cause mortality [relative risk (RR) = 0.77, 95% confidence intterval (CI) = 0.76-0.78], cardiovascular mortality (RR = 0.77, 95% CI = 0.74-0.80) and cancer mortality (RR = 0.83, 95% CI = 0.81-0.86). Egger regression tests provided no evidence of publication bias. Conclusions The present study indicates that high adherence to HEI and AHEI dietary patterns, indicating high diet quality, are associated with reduced risk of all-cause mortality (as well as cardiovascular mortality and cancer mortality). [ABSTRACT FROM AUTHOR]

Background/objectives: Nowadays, metabolic syndrome (MetS) is deemed as a major public health challenge in both developed and developing countries. Therefore, the aim of this study was to determine the association between Healthy Eating Index-2010 (HEI-2010) score and MetS and its features among Iranian female nurses.Subjects/methods: This cross-sectional study was performed among 1036 Iranian women. A validated, self-administered, dish-based, semiquantitative food frequency questionnaire was used to assess the habitual intake of participants. HEI-2010 score was used to assess diet quality of participants. MetS was defined based on the guidelines of the National Cholesterol Education Program Adult Treatment Panel III (ATP III). Multivariate logistic regression adjusted for potential confounders was used to assess the relation between HEI-2010 and MetS.Results: After adjusting for potential confounders, participants in the highest quartile of HEI-2010 had the lowest risk of MetS compared with those in the first quartile (odds ratio: 0.72; 95% confidence interval: 0.50-0.96). Furthermore, the risk of MetS features including abdominal obesity, high blood pressure, high serum triacylglycerol and low serum high-density lipoprotein-cholesterol significantly decreased across HEI-2010 quartiles (P<0.05).Conclusions: Higher HEI-2010 scores were inversely associated with lower risk of MetS and its components among Iranian women. [ABSTRACT FROM AUTHOR]

As the prevalence of metabolic disorders increases dramatically, the importance of identifying environmental factors affecting metabolism control becomes greater accordingly. Gut microbiota, a complex ecosystem inhabiting the human gastrointestinal tract, is one of these potential factors. Recently, the evidence has shown the associations between alteration in gut microbiota composition and obesity, diabetes, and osteoporosis. However, the causality of gut microbiota on metabolic health has yet to be explored in intervention studies and the underlying mechanisms need to be investigated more in depth. Gut microbiota plays critical roles in the control of immunity, food intake, lipid accumulation, production of short chain fatty acids, insulin signaling, and regulation of bone mass. The gut microbiota represents a novel potential therapeutic strategy for the treatment of metabolic disorders. In this review, we provide insights into the role of the gut microbiota in metabolic disorders and its modulating interventions such as prebiotics, probiotics, and fecal microbiota transplantation. [ABSTRACT FROM AUTHOR]

Time and polarization-resolved stimulated emission depletion (STED) measurements are used to investigate excited state evolution following the two-photon excitation of enhanced green fluorescent protein (EGFP). We employ a new approach for the accurate STED measurement of the hitherto unmeasured degree of hexadecapolar transition dipole moment alignment α 40 present at a given excitation-depletion (pump-dump) pulse separation. Time-resolved polarized fluorescence measurements as a function of pump-dump delay reveal the time evolution of α 40 to be considerably more rapid than predicted for isotropic rotational diffusion in EGFP. Additional depolarization by homo-Förster resonance energy transfer is investigated for both α 20 (quadrupolar) and α 40 transition dipole alignments. These results point to the utility of higher order dipole correlation measurements in the investigation of resonance energy transfer processes. [ABSTRACT FROM AUTHOR]

In this work, we present a complete theoretical description of the excited state order created by two-photon photoselection from an isotropic ground state; this encompasses both the conventionally measured quadrupolar (K = 2) and the “hidden” degree of hexadecapolar (K = 4) transition dipole alignment, their dependence on the two-photon transition tensor and emission transition dipole moment orientation. Linearly and circularly polarized two-photon absorption (TPA) and time-resolved single- and two-photon fluorescence anisotropy measurements are used to determine the structure of the transition tensor in the deprotonated form of enhanced green fluorescent protein. For excitation wavelengths between 800 nm and 900 nm, TPA is best described by a single element, almost completely diagonal, two-dimensional (planar) transition tensor whose principal axis is collinear to that of the single-photon S0 → S1 transition moment. These observations are in accordance with assignments of the near-infrared two-photon absorption band in fluorescent proteins to a vibronically enhanced S0 → S1 transition. [ABSTRACT FROM AUTHOR]

Objective: To review published evidences about using information technology interventions in diabetes care and determine their effects on managing diabetes. Design: Systematic review of information technology based interventions. Research design and methods: MEDLINE®/PubMed were electronically searched for articles published between 2004/07/01 and 2014/07/01. A comprehensive, electronic search strategy was used to identify eligible articles. Inclusion criteria were defined based on type of study and effect of information technology based intervention in relation to glucose control and other clinical outcomes in diabetic patients. Studies must have used a controlled design to evaluate an information technology based intervention. A total of 3613 articles were identified based on the searches conducted in MEDLINE from PubMed. After excluding duplicates (n = 6), we screened titles and abstracts of 3607 articles based on inclusion criteria. The remaining articles matched with inclusion criteria (n = 277) were reviewed in full text, and 210 articles were excluded based on exclusion criteria. Finally, 67 articles complied with our eligibility criteria and were included in this study. Results: In this study, the effect of various information technology based interventions on clinical outcomes in diabetic patients extracted and measured from selected articles is described and compared to each other. Conclusion: Information technology based interventions combined with the usual care are associated with improved glycemic control with different efficacy on various clinical outcomes in diabetic patients. [ABSTRACT FROM AUTHOR]

Background: Fasting and malnutrition during pregnancy is associated with deleterious consequences such as hypoglycemia, ketonemia, impaired fetal IQ, low birth weight and even abortion. Comparison of pregnancy length and year duration shows that about 75% of pregnancies coincided with Ramadan. Also, fasting during Ramadan is not equivalent to hunger and malnutrition, however, knowledge of the effects of Ramadan fasting on pregnancy outcome is important. In this review, the results of all studies related to the possible effects of Ramadan fasting in pregnancy and lactation have been collected. Material and Methods: Keywords such as "Ramadan", "Ramadan Fasting", "Islamic Fasting", "Fasting in Ramadan "and Fasting with words Pregnancy, Birth Weight, Lactation, Preterm, Milk Composition, Breast Milk were searched in PubMed Database, SID (Scientific Information Database), and some regional journals and 40 related articles (descriptive cross - sectional, cohort, clinical trial and review articles) from 1968 to 2010 were studied. Results: Based on available information, if the maternal nutrition during Ramadan is good, the normal process of pregnancy will be maintained and Ramadan fasting would not have deleterious effects on fetal physical and mental growth. Conclusion: Considering nutritional tips, nursing mothers could also fast during Ramadan. [ABSTRACT FROM AUTHOR]

The efficacy and safety of transplanting autologous mesenchymal stem cells (MSCs), from granulocytecolony- stimulating factor (G-CSF)-mobilised peripheral blood, was investigated in diabetic patients with critical limb ischaemia (CLI). After 3 months, the transplanted group of patients (n = 7) showed a significant improvement in ischaemia manifestations, including pain and neurological signs, wound healing and the rate of lower-limb amputation, compared to the control group of patients (n = 14). Pain was significantly reduced in the transplanted group compared to controls (P = 0.014). The ankle-brachial index (ABI) and the pulse strength within ischaemic tissues of the transplanted group were signifi- cantly improved (P = 0.035 and P = 0.01, respectively). Importantly, 50 % of the control group (7/14 patients) faced major amputation of a limb at the study's conclusion, compared to none of 7 patients in the transplanted group (P = 0.047).The safety of transplantation was confirmed by observing no adverse reactions among the transplanted group, including infection and immunological rejection. Hence, this study provides further evidence that transplantation of autologous peripheral blood MSCs, mobilised by G-CSF, induces angiogenesis and improves the wound healing process in diabetic patients with CLI. [ABSTRACT FROM AUTHOR]

Purpose: Non-viral vectors have been widely proposed as safer alternatives to viral vectors, and cationic polymers have gained increasing attention because they can form self-assembly with DNA. Chitosan is also considered to be a good candidate for gene delivery systems, since it is already known as a biocompatible, biodegradable, and low toxic material with high cationic potential. However, low solubility and transfection efficiency need to be overcome prior to clinical trial. In this work, we focus on alkyl modified chitosan which might be useful in DNA condensing and efficient gene delivery. Methods: N, N- Diethyl N- Methyl (DEMC) and N- Triethyl Chitosan (TEC) were synthesized from chitosan polymer. In order to optimize the polymers for gene delivery, we used FITC-dextran (FD). Then the optimized polymer concentrations were used for gene delivery. Fluorescent microscope was used, in order to evaluate the polymers' efficiency for gene delivery to human embryonic kidney epithelial cells (HEK 293T). Results: This modification increased chitosan's positive charge, thus these chitosan derivatives spontaneously formed complexes with FD, green fluorescence protein plasmid DNA (pEGFP), red fluorescence protein plasmid DNA (pJred) and fluorescent labeled miRNA .Results gained from fluorescent microscope showed that TEC and DEMC were able to transfer FD, DNA and miRNA (micro RNA) to HEK cell line. Conclusion: We conclude that these chitosan derivatives present suitable characteristics to be used as non-viral gene delivery vectors to epithelial cells. [ABSTRACT FROM AUTHOR]

Background: Life style Changes during Ramadan month could possibly affect sleep-related behaviors such as total daily sleep time, sleep and wake up time and brain waves. In addition, Spirituality and religiosity have a marvelous influence on mental health and effective solutions against stress are being religious and believe in God. This review discusses the results of all related studies about possible effects of Ramadan fasting on various aspects of sleep pattern and mental health. Methods: Keywords such as 'Ramadan', 'Ramadan Fasting', 'Islamic Fasting', 'Fasting in Ramadan' and Fasting along Sleep, Chronotype, Sleep Latency, REM, NREM, Brain Wave, Psychology, Mental health, Religion, Mood, Depression, Social interaction, Depressive illness, Psychomotor performances, Bipolar disorders, Accident, Mania, Anxiety and Stress were searched via PubMed database, Scientific Information Datebas (SID) and also some local journals, hence, 103 related articles from 1972 until 2010 were studied. Results: The results of studies about the effects of Ramadan fasting on sleep pattern is not similar and these differences could be due to cultural and life style discrepancy in several countries. Fasting during Ramadan could lead to delay in sleep-wake cycle, decrease in deep sleep and lack of awareness during the day. Conclusion: There are various reasons such as dietary pattern, hormonal changes and also stress which could alter the quantity and quality of sleep during Ramadan. Also, according to the available information, there is a relationship between fasting and mental health. [ABSTRACT FROM AUTHOR]

Insulin has an important role in the treatment of diabetic patients. Further, it can result in undesirable side effects. One of the problems that are associated with insulin therapy is allergic reactions. Although insulin allergy is uncommon, especially in patients with type-2 diabetes, but when it occurs, its management can be difficult. We report a 55-year-old woman with poorly controlled type-2 diabetes and insulin allergy. She revealed hypersensitivity reactions including urticaria and respiratory symptoms, immediately after injection. So, specific immunotherapy with other insulin preparations was done. Finally, after specific immunotherapy, we were able to treat the patient with short- and long-acting analogs successfully. [ABSTRACT FROM AUTHOR]

Assessment of patients' views about the observance of patients' rights in the health system is of great importance for evaluation of such systems. Comparing views of patients (recipients of health services) and physicians and nurses (health care providers) regarding the observance of various aspects of patients' rights at three hospitals representing three models of medical service provision (teaching, private, and public) is the main objective of this study. This was a cross-sectional descriptive and analytical study, and the information needed was gathered through questionnaires. They were filled out by an interviewer for patients, but self administered by physicians and nurses. The field of study consisted of three hospitals including a general teaching hospital, a private hospital, and a public hospital, all located in Tehran. The questionnaires contained some general questions regarding demographic information and 21 questions concerning the necessity of observing patient's rights. The questionnaires were initially filled out by a total of 143 patients, and then consigned to 143 nurses (response rate = 61.3%) and 82 physicians (response rate = 27.5%) to be completed. The rate of observance of each right was measured on a Likert scale ranging from zero (non-observance) to 10 (full observance). Considering abnormal distribution of the information, it was analyzed with non-parametrical tests using SPSS 11.5 software package. The results of this study showed that the study groups had different views about how well different aspects of patients' rights were observed. The highest level of disagreement was related to the right of choosing and deciding by the patients, which was not satisfactory in the teaching hospital. According to the results, it seems that healthcare providers, especially physicians, should be better informed of patients' right of access to information and right of choosing and deciding. Based on the observed disagreement between the views of the patients and those of the physicians in the present study, it can be asserted that the patients thought that the level of observance of these rights was lower in comparison with what the physicians thought. [ABSTRACT FROM AUTHOR]

Studying the situation of observance of patients' rights and interaction of those individuals who provide and/or receive health services are regarded as the most significant and salient parameters of qualitative evaluation of health services. The main aim of this study is to compare the attitudes of patients as recipients of healthcare services with those of physicians and nurses as representatives of healthcare providers regarding the necessity of observance of various aspects of patients' rights in three hospitals selected as representing the three models of providing medical service (teaching, private and public). This was a cross-sectional descriptive analytical study and the data were gathered using a questionnaire. Researchers helped the patients to fill in the questionnaire through interviewing and the physicians and nurses filled in their own questionnaires. The field consisted of three hospitals (a teaching general hospital, a private hospital and a public general one) all located in Tehran. The questionnaires included a set of general questions regarding demographic information and 21 questions about the necessity of observance of patients' rights. They were filled in by the interviewer for 143 patients and, after being sent to other groups, 143 nurses (response rate = 61.3%) and 82 physicians (response rate = 27.5%) filled them in. The criterion for necessity of each right was measured according to the Likert Scale [from 0 (not necessary) to 10 (absolutely necessary]. The data were analyzed using SPSS 11.5 software. Given the abnormal distribution of the data, non-parametrical tests were used. The results of this study showed that all of the study groups agreed with the necessity of almost all aspects of patients' rights and the highest level of disagreement between groups was related to patients' right of access to information and right of choosing provision provider and deciding on treatment plan. However, these disagreements were not significant altogether. According to the results, it seems that healthcare providers, especially physicians, should be better familiarized with patients' right of access to information and right of choosing and deciding. Based on the disagreement between the attitudes of the patients and physicians in this study, it seems that the patients had a higher level of expectations concerning their rights compared to physicians. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented regarding the mutations of wolframin or gene product in protein structure.

Dextromethorphan ( DXM) is an antitussive (cough Hyj/UA suppressant) drug found in many cough medicines. Dextromethorphan has also found other uses in medicine, ranging from pain relief to psychoactive applications. In this study, a potentiometric liquid membrane sensor for simple and fast determination of dextromethorphan hydrobromide in pharmaceutical formulation and urine was constructed. For the membrane preparation, DXM-tetraphenylborate complexes were employed as electroactive materials in the membrane. The wide linear range (10-10 M), low detection limit (1 × 10 M), and fast response time (∼5 s) characterize the proposed sensors. Validation of the method shows suitability of the sensors for applications in the determination of dextromethorphan hydrobromide in pharmaceutical formulation and urine. [ABSTRACT FROM AUTHOR]

Aim: Our objective was to investigate the effects and tolerability of fixed-dose combination therapy on blood pressure and LDL in adults without elevated blood pressure or lipid levels. Methods: This was a double-blind randomised placebo-controlled trial in residents of Kalaleh, Golestan, Iran. Following an 8-week placebo run-in period, 475 participants, aged 50 to 79 years, without cardiovascular disease, hypertension or hyperlipidaemia were randomised to fixed-dose combination therapy with aspirin 81 mg, enalapril 2.5 mg, atorvastatin 20 mg and hydrochlorothiazide 12.5 mg (polypill) or placebo for a period of 12 months. The primary outcomes were changes in LDL-cholesterol, systolic and diastolic blood pressure and adverse reactions. Analysis was by intention-to-treat basis. Results: At baseline, there were differences in systolic blood pressure (6 mmHg). Taking account of baseline differences, at 12 months, polypill was associated with statistically significant reductions in blood pressure (4.5/1.6 mmHg) and LDL-cholesterol (0.46 mmol/l). The study drug was well tolerated, but resulted in the modest reductions in blood pressure and lipid levels. Conclusion: The effects of the polypill on blood pressure and lipid levels were less than anticipated, raising questions about the reliability of the reported compliance. There is a case for a fully powered trial of a polypill for the prevention of cardiovascular disease. [ABSTRACT FROM AUTHOR]

Aim: Our objective was to investigate the effects and tolerability of fixed-dose combination therapy on blood pressure and LDL in adults without elevated blood pressure or lipid levels. Methods: This was a double-blind randomised placebo-controlled trial in residents of Kalaleh, Golestan, Iran. Following an 8-week placebo run-in period, 475 participants, aged 50 to 79 years, without cardiovascular disease, hypertension or hyperlipidaemia were randomised to fixed-dose combination therapy with aspirin 81 mg, enalapril 2.5 mg, atorvastatin 20 mg and hydrochlorothiazide 12.5 mg (polypill) or placebo for a period of 12 months. The primary outcomes were changes in LDL-cholesterol, systolic and diastolic blood pressure and adverse reactions. Analysis was by intention-to-treat basis. Results: At baseline, there were differences in systolic blood pressure (6 mmHg). Taking account of baseline differences, at 12 months, polypill was associated with statistically significant reductions in blood pressure (4.5/1.6 mmHg) and LDL-cholesterol (0.46 mmol/l). The study drug was well tolerated, but resulted in the modest reductions in blood pressure and lipid levels. Conclusion: The effects of the polypill on blood pressure and lipid levels were less than anticipated, raising questions about the reliability of the reported compliance. There is a case for a fully powered trial of a polypill for the prevention of cardiovascular disease. [ABSTRACT FROM AUTHOR]

A variety of human tumors like prostate and breast cancer express bombesin receptors. Due to this a new bombesin analogue was labeled with 99mTc via HYNIC and tricine as a coligand and investigated further. Peptide was synthesized on a solid phase using Fmoc strategy. Labeling with 99mTc was performed at 100 °C for 10 min and radiochemical analysis involved ITLC and HPLC methods. The stability of radiopeptide was checked in the presence of human serum at 37 °C up to 24 h. Internalization was studied with the human GRP receptor cell line PC-3. The biodistribution was studied in mice. Labeling yield of >98% was obtained corresponding to a specific activity of ~80.9 GBq/μmol. Radiopeptide internalization into PC-3 cells was moderate and specific (10.7 ± 1.2% at 4 h). A high and specific GRP receptor expressing mouse tumor and pancreas uptake (1.12 ± 0.08 and 1.04 ± 0.11% ID/g after 1 h respectively) was also determined. [ABSTRACT FROM AUTHOR]

Background & Aim: Regarding the importance of determining the determinants of diabetes self-care, this study aimed to examine two major determinants of self-care activities, i.e. perceived barriers, and perceived self-efficacy among type two diabetic patients in Tehran, Iran. Methods & Materials: In this cross-sectional study, 128 patients were recruited to the study using convenience sampling. The validated diabetes instruments were completed by the patients. The included participants aged older than 18 years. Data were analyzed using bivariate correlation and path analysis. Results: The mean score of the perceived barriers and perceived self-efficacy were 3.05 and 2.18, respectively. The maximum score of self-care was 4.18. There was a positive correlation between self-efficacy and the self-care (r=0.22; P<0.01). Positive correlations were also found between education with self-efficacy and self-care (r=0.28; P<0.05), (r=0.29; P<0.05). There was a negative correlation between perceived barriers and self-care behaviors (r=-0.68; P<0.000). Using serial multiple regressions and path analysis, we had a final model (RMSEA=0.05; GFI=0.95; CFI=0.98; P=0.44; and Chi-Square=26.5). This model showed that perceived barriers were the strongest predictor for self-care behaviors. Perceived barriers mediated the effect of self-efficacy on the self-care behaviors. Conclusion: The intervention efforts that address the studied determinants related to self-care behavior could potentially impact type two diabetic patients' self-care activities. These determinants should be mentioned in the program developing. [ABSTRACT FROM AUTHOR]

Citrullus colocynthis (L.) Schrad fruit is an herbal medicine used by traditional herbalists for the treatment of diabetes in Iran. To determine its efficacy and toxicity, a 2 month clinical trial was conducted in 50 type II diabetic patients. Two groups of 25 each under standard antidiabetic therapy, received 100 mg C. colocynthis fruit capsules or placebos three times a day, respectively. The patients were visited monthly and glycosylated hemoglobin (HbA1c), fasting blood glucose, total cholesterol, LDL, HDL, triglyceride, aspartate transaminase, alanine transaminase, alkaline phosphatase, urea and creatinine levels were determined at the beginning and after 2 months. The results showed a significant decrease in HbA1c and fasting blood glucose levels in C. colocynthis treated patients. Other serological parameters levels in both the groups did not change significantly. No notable gastrointestinal side effect was observed in either group. In conclusion, C. colocynthis fruit treatment had a beneficial effect on improving the glycemic profile without severe adverse effects in type II diabetic patients. Further clinical studies are recommended to evaluate the long-term efficacy and toxicity of C. colocynthis in diabetic patients. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: There are conflicting data about bone density alterations in type 2 diabetic patients. Regarding the role of adipokines in glucose metabolism, they may have metabolic effects on bone mineral density (BMD) changes. The aim of this study was to determine the relationship between circulating visfatin, adiponectin and the visfatin genotype with BMD in type 2 diabetes (T2DM). Methods: Thirty-two patients with T2DM participated in this cross-sectional study. Laboratory measurements were included FBS, HbA1C, lipid Profile, fasting serum visfatin and adiponectin. Hip and spine BMD were measured using DEXA. Genotyping for visfatin gene SNP (rs2110385) was performed by using the PCR- RFLP method. Results: Genotype distributions of GG, GT and TT were 37.5%, 43.8% and 18.8%, respectively. Prevalence of osteoporosis in patients with GG genotype was 33.3%; whereas, not observed in other two genotypes. Hip BMD and Z-score were significantly lower in GG genotype. We found significant correlation between circulating visfatin and hip BMD (r=-0.31). Circulating adiponectin and visfatin levels had significant correlation with hip BMD independent of BMI and age. Conclusion: Our results suggest that adipokines may contribute to BMD changes in type 2 diabetes mellitus patients. Genotype variations may explain inconsistent BMD changes among these patients. [ABSTRACT FROM AUTHOR]

Background: The association of MTHFR and metabolic syndrome (MS) has been shown in special groups of diabetic and schizophrenic subjects, but no single study has investigated this relation in metabolic syndrome subjects. Our aim was to examine the association of MTHFR gene polymorphism with metabolic syndrome, type II diabetes mellitus and hypertension in an Iranian population. Methods: As a cross-sectional study, the relevance of metabolic syndrome, hypertension and type II diabetes was investigated. Subjects were recruited from Tehran Homocysteine survey. Fasting serum levels of blood sugar, triglyceride (TG), total cholesterol (TC), HDL-Cholesterol (HDL-C) and LDL-Cholesterol (LDL-C), homocysteine, folic acid, and B12 were measured. MTHFR polymorphism was determined using PCR-RFLP. Results: Of participants, 150, 191, 160 subjects met the criteria for metabolic syndrome, hypertension and diabetes, respectively. Compared to control group, frequency of CC, CT, and TT genotypes were not significantly different. In control and hypertensive groups, serum homocysteine levels were significantly higher in TT than CC and CT genotypes (P<0.05), serum folic acid was significantly lower in TT than CC genotype in hypertensive group (P<0.001). In diabetic subjects, serum homocysteine levels were significantly lower in CC than TT genotype (P<0.01), and reverse was true for serum folic acid (P<0.05). In hypertensive and diabetic subjects, serum folic acid levels and difference between C and T alleles were significant (P< 0.001 for both), whereas in MS group only homocysteine levels differed significantly between C and T alleles (P< 0.001). Conclusion: We found no significant association between MTHFR polymorphism and metabolic syndrome, hypertension, and diabetes in this Iranian population. Results of present the study should be confirmed in larger population-based studies. [ABSTRACT FROM AUTHOR]

Background: According to the importance of the screening and treatment of gestational diabetes mellitus (GDM) in preventing adverse maternal and fetal complications, awareness of GDM prevalence in different parts of Iran seems to be necessary. Methods: We reviewed studies which have been assessed the prevalence of gestational diabetes mellitus in different regions of Iran. For collecting data, online resources and local databases were searched and researchers in this field were questioned. Results: The information was available in 11 out of 30 provinces of Iran. Collectively 18 surveys were assessed from 1992 to 2007. The prevalence of GDM ranged between 1.3% and 10%. Conclusion: A wide range of GDM prevalence was reported in different regions of Iran. For enhancement the accuracy of evaluations of the GDM prevalence, also to facilitate the comparison of data, it is suggested to apply similar protocols for definition and screening of GDM in local researches of different regions of the country. [ABSTRACT FROM AUTHOR]

Background: There are conflicting data about bone density alterations in type 2 diabetic patients. Regarding the role of adipokines in glucose metabolism, they may have metabolic effects on bone mineral density (BMD) changes. The aim of this study was to determine the relationship between circulating visfatin, adiponectin and the visfatin genotype with BMD in type 2 diabetes (T2DM). Methods: Thirty-two patients with T2DM participated in this cross-sectional study. Laboratory measurements were included FBS, HbA1C, lipid Profile, fasting serum visfatin and adiponectin. Hip and spine BMD were measured using DEXA. Genotyping for visfatin gene SNP (rs2110385) was performed by using the PCR- RFLP method. Results: Genotype distributions of GG, GT and TT were 37.5%, 43.8% and 18.8%, respectively. Prevalence of osteoporosis in patients with GG genotype was 33.3%; whereas, not observed in other two genotypes. Hip BMD and Z-score were significantly lower in GG genotype. We found significant correlation between circulating visfatin and hip BMD (r=-0.31). Circulating adiponectin and visfatin levels had significant correlation with hip BMD independent of BMI and age. Conclusion: Our results suggest that adipokines may contribute to BMD changes in type 2 diabetes mellitus patients. Genotype variations may explain inconsistent BMD changes among these patients. [ABSTRACT FROM AUTHOR]

Background: Treatment of diabetes with oral antidiabetic agents is accompanied by considerable variability in pharmacokinetics and clinical efficacy. Genetic factors may contribute to individual differences in bioavailability, drug transport, metabolism and drug action. We investigated the role of visfatin gene polymorphism (rs2110385) on required dosage of oral antidiabetic agents in type2 diabetic patient. Methods: As a cross-sectional study, we recruited 94 patients with type 2 diabetes. Laboratory measurements were FBS, OGTT, HbA1C, fasting serum visfatin and Insulin. HOMA-IR and QUICKI indices were calculated. Genotyping for SNP was performed using the PCR-RFLP method. We recorded the amount of antidiabetic agents in the last 8 weeks before the survey according to drug dose (metformin 500mg and glibenclamide 5 mg). Results: We found no significant difference in FBS, G2h, HbA1C levels, Fasting insulin concentration, and HOMA and QUICKI indices between various genotypes. The required dose of glibenclamide for adjustment of glucose homeostasis was lower in genotype GG compared to others, but there was no difference in required dose of metformin between various genotypes. Conclusion: It seems that visfatin gene variation modifies the insulin secretion by glibenclamide treatment. [ABSTRACT FROM AUTHOR]

Background: Women with history of gestational diabetes mellitus (GDM) have higher risk for developing diabetes in the future life. The aim of the current study was to examine the association between GDM and susceptibility to type 2 diabetes and Impaired Glucose Tolerance (IGT) after pregnancy.Methods: As a cohort study, 2416 women who had consecutively referred to five university educational hospitals in Tehran, Iran for antenatal care, were recruited. The universal screening was performed with a GCT-50g and those with plasma glucose level >/= 130mg/dl were diagnosed as GDM if they had an impaired GTT-100g based on Carpenter and Coustan criteria. All participants followed by 6-12 weeks after delivery for OGTT-75g. Concerning American Diabetes Association criteria was diagnosed post-partum diabetes mellitus and IGT.Results: The prevalence of overt postpartum diabetes mellitus and IGT were 8.1% (CI 95%: 3.5-15.4) and 21.4% (CI 95%: 13.7-30.8), respectively. We found a significant difference in the prevalence of hyperglycemia (FBG>105 mg/dl during pregnancy), necessity to use insulin during pregnancy and BMI>/=27 kg/m2 before pregnancy in patients who developed diabetes after delivery as compared with normal controls. Results of multivariate analysis suggested that gestational necessity for insulin prescribing and BMI>/=27 kg/m2 were the two best predictors for developing postpartum diabetes. As well our findings demonstrated that the best predictors for postpartum IGT were history of abortion, gestational insulin therapy and BMI>/=27 kg/m2. This correlation was present after adjusting for the age.Conclusion: It seems that high glucose levels during pregnancy, necessity for insulin therapy during pregnancy, history of abortion and BMI>/=27 kg/m2 are the best predictors for postpartum development of diabetes and IGT. [ABSTRACT FROM AUTHOR]

Background: Fetal macrosomia is associated with increased maternal and fetal complications. Various factors may predispose a fetus to macrosomia. The aim of the present study was to evaluate the association between serum and amniotic fluid (AF) insulin, C-peptide, and glucose and macrosomia. Methods: Thirty-eight neonates were enrolled in this case-control study. Ten macrosomic neonates were considered as the case group, and 28 normal weight neonates were designated as the control group. AF C-peptide, insulin, and glucose were measured in both groups; also maternal and neonatal serum C-peptide, insulin, and glucose were simultaneously measured during delivery. Results: There was a significant correlation between neonatal (P=0.01) and maternal (P=0.006) serum C-peptide levels and macrosomia. The serum glucose levels of the mothers in the macrosomic group were also significantly higher than those of the control group. The AF insulin and C-peptide levels in the macrosomic group were higher than those of the control group; however, the difference was not significant. There was no significant correlation between macrosomia and the other factors such as placental weight, gender, neonatal Apgar score, and gestational age. Conclusion: The results demonstrated that AF C-peptide and also maternal and neonatal serum C-peptide were factors that could influence fetal weight and predict macrosomia. [ABSTRACT FROM AUTHOR]

Background: Women with history of gestational diabetes mellitus (GDM) have higher risk for developing diabetes in the future life. The aim of the current study was to examine the association between GDM and susceptibility to type 2 diabetes and Impaired Glucose Tolerance (IGT) after pregnancy. Methods: As a cohort study, 2416 women who had consecutively referred to five university educational hospitals in Tehran, Iran for antenatal care, were recruited. The universal screening was performed with a GCT-50g and those with plasma glucose level ≥ 130mg/dl were diagnosed as GDM if they had an impaired GTT-100g based on Carpenter and Coustan criteria. All participants followed by 6-12 weeks after delivery for OGTT-75g. Concerning American Diabetes Association criteria was diagnosed post-partum diabetes mellitus and IGT. Results: The prevalence of overt postpartum diabetes mellitus and IGT were 8.1% (CI 95%: 3.5-15.4) and 21.4% (CI 95%: 13.7-30.8), respectively. We found a significant difference in the prevalence of hyperglycemia (FBG>105 mg/dl during pregnancy), necessity to use insulin during pregnancy and BMI≥27 kg/m2 before pregnancy in patients who developed diabetes after delivery as compared with normal controls. Results of multivariate analysis suggested that gestational necessity for insulin prescribing and BMI≥27 kg/m2 were the two best predictors for developing postpartum diabetes. As well our findings demonstrated that the best predictors for postpartum IGT were history of abortion, gestational insulin therapy and BMI≥27 kg/m2. This correlation was present after adjusting for the age. Conclusion: It seems that high glucose levels during pregnancy, necessity for insulin therapy during pregnancy, history of abortion and BMI≥27 kg/m2 are the best predictors for postpartum development of diabetes and IGT. [ABSTRACT FROM AUTHOR]

Background: Treatment of diabetes with oral antidiabetic agents is accompanied by considerable variability in pharmacokinetics and clinical efficacy. Genetic factors may contribute to individual differences in bioavailability, drug transport, metabolism and drug action. We investigated the role of visfatin gene polymorphism (rs2110385) on required dosage of oral antidiabetic agents in type2 diabetic patient. Methods: As a cross-sectional study, we recruited 94 patients with type 2 diabetes. Laboratory measurements were FBS, OGTT, HbA1C, fasting serum visfatin and Insulin. HOMA-IR and QUICKI indices were calculated. Genotyping for SNP was performed using the PCR-RFLP method. We recorded the amount of antidiabetic agents in the last 8 weeks before the survey according to drug dose (metformin 500mg and glibenclamide 5 mg). Results: We found no significant difference in FBS, G2h, HbA1C levels, Fasting insulin concentration, and HOMA and QUICKI indices between various genotypes. The required dose of glibenclamide for adjustment of glucose homeostasis was lower in genotype GG compared to others, but there was no difference in required dose of metformin between various genotypes. Conclusion: It seems that visfatin gene variation modifies the insulin secretion by glibenclamide treatment. [ABSTRACT FROM AUTHOR]

Background: The association of MTHFR and metabolic syndrome (MS) has been shown in special groups of diabetic and schizophrenic subjects, but no single study has investigated this relation in metabolic syndrome subjects. Our aim was to examine the association of MTHFR gene polymorphism with metabolic syndrome, type II diabetes mellitus and hypertension in an Iranian population. Methods: As a cross-sectional study, the relevance of metabolic syndrome, hypertension and type II diabetes was investigated. Subjects were recruited from Tehran Homocysteine survey. Fasting serum levels of blood sugar, triglyceride (TG), total cholesterol (TC), HDL-Cholesterol (HDL-C) and LDLCholesterol (LDL-C), homocysteine, folic acid, and B12 were measured. MTHFR polymorphism was determined using PCR-RFLP. Results: Of participants, 150, 160, 191 subjects met the criteria for metabolic syndrome, hypertension and diabetes, respectively. Compared to control group, frequency of CC, CT, and TT genotypes were not significantly different. In control and hypertensive groups, serum homocysteine levels were significantly higher in TT than CC and CT genotypes (P<0.05), serum folic acid was significantly lower in TT than CC genotype in hypertensive group (P<0.001). In diabetic subjects, serum homocysteine levels were significantly lower in CC than TT genotype (P<0.01), and reverse was true for serum folic acid (P<0.05). In hypertensive and diabetic subjects, serum folic acid levels and difference between C and T alleles were significant (P< 0.001 for both), whereas in MS group only homocysteine levels differed significantly between C and T alleles (P< 0.001). Conclusion: We found no significant association between MTHFR polymorphism and metabolic syndrome, hypertension, and diabetes in this Iranian population. Results of present the study should be confirmed in larger population-based studies. [ABSTRACT FROM AUTHOR]