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Background: The current study aims to assess cardiovascular risk factors (CVRFs) among diabetic versus nondiabetic nonalcoholic fatty liver disease (NAFLD) patients. NAFLD is the most common hepatic disorder worldwide which is directly associated with diverse CVRFs such as type 2 diabetes mellitus (T2DM) and metabolic syndrome (MS). Materials and Methods: The current cross-sectional population-based study has been conducted on 1031 NAFLD patients. After excluding 340 prediabetes patients, the NAFLD patients were divided into T2DM and normal blood glucose (NBG). Then, CVRFs were compared between the two groups. Results: Out of 691 NAFLD cases included in the study, 337 (48.8%) patients had T2DM. In the T2DM and NBG groups, the body mass index (BMI) was 31.2 ± 4.6 and 29.9 ± 4.3 kg/m2, respectively (P = 0.001). The waist circumference was 102.2 ± 10.2 and 97.6 ± 10.6 cm, respectively (P < 0.001). The systolic blood pressure was 123.3 ± 15.6 and 119.6 ± 13.6 mmHg, respectively (P = 0.043). The triglyceride levels were 191.9 ± 104.7 and 176.5 ± 89.6 mg/dL, respectively (P = 0.042). Generally, these factors were significantly higher among the diabetic patients. Besides, cardiovascular disease (CVD), hypertension, and MS were statistically more prevalent in NAFLD patients with T2DM (P < 0.001) than nondiabetic NAFLD patients. In multiple logistic regression models, the odds ratio of CVD, hypertension, and MS was 2.18, 2.12, and 6.63 for patients with T2DM compared with NBG, respectively. Adjustment was made for age, sex, BMI, smoking, and physical activity. Conclusion: CVRFs were higher in NAFLD patients with T2DM than NAFLD patients with NBG. [ABSTRACT FROM AUTHOR]

The potential link between dysbiosis, features of metabolic syndrome (MetS), inflammation, and sensation impairment has been recently recognized. However, in this context, there are few indications available regarding the effects of co‐supplementation with Bacillus indicus, Bacillus coagulans, and fructooligosaccharide (FOS) prebiotics on patients with MetS. Therefore, this study aimed to investigate the effects of synbiotic supplementation on glycemic indices, inflammatory biomarkers, and appetite among adults with MetS. This study is a randomized, double‐blind, placebo‐controlled clinical trial conducted in the Endocrine and Metabolism Research Center outpatient clinic in Isfahan, Iran. Fifty‐eight MetS patients were randomly assigned to receive either synbiotics (n = 29) or placebo (n = 29) supplementation twice per day for 8 weeks. Finally, 55 patients were recruited for analyses (28 in the intervention group and 27 in the placebo group). Random permuted blocks and a computer‐generated random number table were used for treatment allocation. No adverse effects were reported during the study. There were no significant differences in glycemic indices and inflammatory markers within‐ and between groups (all p >.05). However, a significant increase in the sensation of fullness was documented in the synbiotic group. In conclusion, the eight‐week treatment did not improve glycemic control and inflammatory markers. Nevertheless, it demonstrated potential efficacy in enhancing participants' appetite sensations, warranting further evaluation in longer intervention periods during future clinical trials. [ABSTRACT FROM AUTHOR]

Objectives: Herbals, as bioactive foods, have been one of the most popular alternatives and complementary treatments in preventing and controlling type 2 diabetes mellitus (T2DM). The aim of the present trial was to examine the effects of wheat germ consumption on mental health and brain-derived neurotrophic factor (BDNF) among patients with T2DM. Methods: Eighty participants with T2DM were randomly allocated to receive 20 g wheat germ (n = 40) or placebo (n = 40) in a randomized double-blind clinical trial for 12 weeks. Depression, anxiety, stress scale-21 (DASS-21) questionnaire was used to assess the mental health of study participants. Serum BDNF was assessed at the baseline and end of intervention. Anthropometric indices were measured at the baseline, 6 and 12 weeks during the intervention. Results: A total of 75 subjects completed the trial. Compared with the placebo, wheat germ consumption led to a significant reduction in depression (P =.03) and stress (P =.04) scores. Moreover, a significant increase in serum BDNF concentrations was observed in the wheat germ group (P =.004), while there was no significant difference between the groups. Wheat germ intake had no significant effects on anthropometric indices and anxiety scores between the groups. Conclusion: Our findings showed that wheat germ consumption for 12 weeks could significantly reduce the stress and depression scores but had no significant effects on anxiety scale and anthropometric outcomes in patients with T2DM. [ABSTRACT FROM AUTHOR]

Background: Parathyroidectomy, the standard treatment of primary hyperparathyroidism (PHP) due to parathyroid adenoma, is not suitable for all patients. We evaluated the efficacy of ultrasound-guided ethanol ablation of parathyroid adenoma in a group of patients with PHP. Materials and Methods: In a prospective self-controlled trial, 39 patients with parathyroid adenoma, who were not candidates for surgery, were enrolled. Ethanol injections were performed by two experienced interventional radiologists under the guidance of real-time ultrasonography. Adenoma size changes were assessed at about 1 month later. Serum levels of parathyroid hormone, calcium, phosphate, 25-OH Vitamin D, and alkaline phosphatase were evaluated at the baseline, 1, 3, 6, and 12 months after the injections. The treatment effects on outcome variables were assessed by repeated measures analysis. Results: Volume of the adenomas decreased during the study period from 1.87±6.45 cm3 to 0.38± 0.48cm3 (P < 0.001). Corrected serum calcium levels decreased from 10.40 ± 0.96 mg/dl to 8.82 ± 0.58 mg/dl (P < 0.001), and remained stable during one year follow-up. Serum levels of parathyroid hormone decreased gradually from 129.85 ± 63.37 to 72.58 ± 53.86 pg/mL after 3 months and to 44.78 ± 28.04 pg/mL after 1 year (P < 0.001). Overall, 46% of the patients improved after 1 month of ethanol ablation therapy which increased to 84.5% during 1-year follow-up. No major complications were observed. Conclusion: The current study showed the efficacy of ultrasound-guided ethanol injection in PHP and may be considered as a suitable alternative treatment in patients who are not candidates for the surgery. It has also a good safety profile without major complications if performed by experienced hands. [ABSTRACT FROM AUTHOR]

The aim of the present trial was to examine the effects of wheat germ (WG) consumption on metabolic control and oxidative stress status of type 2 diabetes mellitus (T2DM) patients. Eighty participants with T2DM were randomly allocated to receive 20-g WG (n = 40) or placebo (n = 40) in a randomized double-blind clinical trial for 12 weeks. Serum lipid profiles, glycaemic indices, total antioxidant capacity, and malondialdhyde (MDA) were assessed. A total of 75 subjects completed the trial. Compared with the placebo, WG consumption led to significant reduction in total cholesterol (TC) concentrations (p = .04). There was a trend regarding TC to high density lipoprotein ratio (p = .08) following 12 weeks WG consumption, although they were not statistically significant after correcting for multiple testing. In addition, within-group comparison revealed a significant rise in total antioxidant capacity concentration (p = .001) in WG group. We observed no significant effects of WG intake on glycaemic status, blood pressure, MDA, triglyceride, and low density lipoprotein levels. WG consumption for 12 weeks could decrease serum TC levels and had no significant effects on other metabolic variables and MDA in patients with T2DM. Though observed health benefit effects were small, it might lead to a major impact on wider public health. [ABSTRACT FROM AUTHOR]

Background: Rheumatoid arthritis (RA) is a common chronic autoimmune disorder that leads to damage of human joints. There are various treatment approaches in which different drugs are prescribed which have several alterations in serum lipids. This research aimed to study the effect of RA treatments on the serum lipids. Materials and Methods: Two hundred randomly selected patients with RA were randomly assigned to three different groups. The first group of patients was treated with a combination of prednisolone (PRD) and hydroxychloroquine (HCQ). The second group was treated with three drugs including PRD, HCQ, and methotrexate (MTX). The third group was treated with four medications including PRD, HCQ, MTX, and sulfasalazine. Within each group, the lipid factors such as triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), and high-density lipoprotein (HDL), erythrocyte sedimentation rate, and visual analog scale were measured at the beginning of the experiment and 6 months after exposing the treatments. For each group, we also calculated the Disease Activity Score-28 (DAS-28). The analysis of variance revealed that the overall DAS-28 was significantly different among the three groups. Results: In the first group, the level of TG and TC significantly decreased (P = 0.015 and P - 0.001, respectively). In the second group, the level of TG and LDL significantly decreased (P = 0.009). In the third group, the LDL level increased considerably (P < 0.001). The HDL level significantly increased in all three groups (P = 0.012, P = 0.014, and P = 0.028, respectively). Conclusion: The treatment PRD + HCQ + MTX was more effective in reducing the LDL level and increasing the HDL level. To reduce the risk of cardiovascular diseases in patients with RA, it is important to prescribe the combination of drugs which leads and normalizes the lipid profile levels. [ABSTRACT FROM AUTHOR]

Background: The people with prediabetes have insulin resistance (IR). IR may affect thyroid function, size and nodules. We investigated the effects of metformin on the thyroid gland in prediabetic people. Materials and Methods: In a randomized, double-blind placebo-control clinical trial, 89 people with prediabetes, aged 18-65 years were studied for 3 months. They were divided into two, metformin (n = 43) and placebo (n = 46) treated groups. Serum thyroid stimulating hormone (TSH) was measured and thyroid nodules and volume was studied by ultrasonography. The data were compared between and within groups, before and after the study. Results: Mean of the baseline characteristics in metformin and placebo-treated groups had no statistically significant difference. At the end of the study, serum TSH was not significantly different between the two groups. However, if the TSH range was divided into two low normal (0.3-2.5 μU/ml) and high-normal (2.6-5.5 μU/ml) ranges, significant decrease was observed in metformin-treated group with a high-normal basal serum TSH (P = 0.01). Thyroid volume did not change in metformin-treated group. However, in placebo-treated group, the thyroid was enlarged (P = 0.03). In 53.9% of participants, thyroid nodule was observed. There was just a decrease in the volume of small solid (not mixed) nodules from median of 0.07 ml to 0.04 ml in metformin-treated group (P = 0.01). Conclusion: In prediabetic people, metformin decreases serum TSH, only, in those people with TSH >2.5 μU/ml and reduces the size of small solid thyroid nodules. It also prevents an increase in the thyroid volume. [ABSTRACT FROM AUTHOR]

Takayasu's arteritis (TA), also known as pulseless disease or occlusive thromboaortopathy, is a form of vasculitis of unknown cause that chiefly affects the aorta and its major branches, most frequently in young women. We describe an 18-year-old female with a soft and pulsatile mass in the left side of her neck. [ABSTRACT FROM AUTHOR]

Takayasu's arteritis (TA), also known as pulseless disease or occlusive thromboaortopathy, is a form of vasculitis of unknown cause that chiefly affects the aorta and its major branches, most frequently in young women.We describe an 18-year-old female with a soft and pulsatile mass in the left side of her neck. [ABSTRACT FROM AUTHOR]

Background: Behcet's disease is a chronic, complex multisystemic disease characterized clinically by oral and genital aphthae, cutaneous lesions, and ophthalmic and gastrointestinal manifestations. Case report: We describe a 24-year-old woman with recurrent oral and genital aphthae, ophthalmic lesions, pseudofolliculitis lesions in skin of lower limbs, and positive result on pathergy testing. She was treated with methotrexate, azathioprine, prednisolone, folic acid and calcium. Despite using these drugs from 4 months ago, she also was complaining from a genital aphthae (2.8 × 18 mm in diameter) from 30 days before admission affected on gaiting. After using of topical FK-506, genial aphthae resolved after 20 days. [ABSTRACT FROM AUTHOR]

Background: Wegener is a granulomatous necrotizing vasculitis characterized by a predilection to affect the upper and lower respiratory tracts and, in most cases, the kidneys. Case Report: Our case was a 20-year-old female with a history of common-cold like signs and symptoms in October 2007. At first, she was referred to a clinic of otolaryngology. By the clinical suspicion to sinusitis, she treated with co-amoxiclav; after 7 days, ear discharge was seen and with suspicion to acute otitis media the patient treated more. Despite of these problems, grippe and common-cold like symptoms was continued and then with suspicion to allergic rhinitis beclometason nasal spray and apo-citrizine tablet was started. In April 2008, she was complaining from knee, tarsal and hip arthralgia accompanied with maculopapular eruptions in distal of legs. In July 2008 sweating, weight loss and anemia was added to other problems and she referred to an oncology clinic and treated with blood infusion, vitamin B12, and folic acid. In October 2008, gastrointestinal symptoms including epigastric pain, hematemesis and vomiting added to other problems and she referred to a gastroenterologist and treated with pantoprazole and plasil. At last in December 2008, since the patient had arthritis of proximal interfalanges, hemoptesia, high ESR levels, and positive CRP, she referred to a rheumatologist and the patient sent to the Al-zahra hospital; after physical and laboratory examination, because of skin lesions, paranchymal lung disease, kidneys involvement, and presence of C-ANCA the diagnosis of Wegener was made and the patient treated with medical treatment. [ABSTRACT FROM AUTHOR]

Background: The Isfahan Thyroid Cohort Study (ITCS) is one of the few population-based epidemiological studies in Iran that investigates the prevalence and incidence of thyroid disorders including hypothyroidism, hyperthyroidism, goiter, nodule, and iodine status. Methods: This cohort is located in Isfahan, Iran. The first phase was initiated in 2006 with 2523 participants (1275 males, 1248 females). The participants were selected using multi-stage cluster sampling from the general residents of Isfahan, Iran. The study had two phases (2006 and 2011) and its third stage is planned for 2020-2021. Results: The prevalence of thyroid function states was euthyroid (89.3%, 95% CI: 88%-90%), overt hypothyroidism (2.8%, 95% CI: 2%-3%), subclinical hypothyroidism (5.8%, 95% CI: 4%-6%), overt hyperthyroidism (0.8%, 95% CI: 0.4%-1%), and subclinical hyperthyroidism (0.99%, 95% CI: 0.6%-1%). Hypothyroidism and hyperthyroidism were significantly associated with goiter. The incidence of thyroid dysfunction was reported as follows: overt hypothyroidism (2.7, 95% CI: 1.6-3.7), subclinical hypothyroidism (20.6, 95% CI: 18-23), overt hyperthyroidism (1.9, 95% CI: 1-2.7) and subclinical hyperthyroidism (2.7, 95% CI: 1.6-3.7) per 1000 (person-year). Conclusion: We assessed the prevalence and incidence of thyroid disorders in Isfahan in the first and second phase, respectively. We are conducting the third phase of the ITCS in order to study the associations between thyroid peroxidase antibody (TPOAb) level and environmental factors such as infection. [ABSTRACT FROM AUTHOR]