Effect of Isoflavones and Genistein on Glucose Metabolism in Peri- and Post-Menopausal Women: An Overview of Meta-Analysis

The purpose of the present overview of meta-analysis is to summarize and critically assess the effect of isoflavones and genistein on glucose metabolism among the peri- and post-menopausal women. Two independent authors searched the databases of MEDLINE, Scopus and Cochrane Library for meta-analysis. Three databases were searched from inception to January 2018. Methodological quality of each meta-analysis of randomized controlled trials was evaluated using the AMSTAR (a measurement tool used to assess systematic reviews). Four meta-analyses were included to the current overview. Fasting insulin levels and homeostatic model assessment of insulin resistance (HOMA-IR) values were significantly lower in peri-menopausal and postmenopausal. Two meta-analyses showed that treatment with isoflavones could not alter fasting blood glucose. However, one meta-analysis depicted that isoflavones significantly improved blood glucose levels in non-Asian postmenopausal women. Treatment with genistein could have significant beneficial effects on fasting insulin, blood glucose and HOMA-IR in comparison to the control group. Regardless of the population, the treatment with genistein is effective in improving fasting insulin, HOMA-IR and glucose levels. Nevertheless, the high heterogeneity among studies and poor methodology of reviews made it difficult to draw a definite conclusion on the positive impacts of soy on glucose metabolism.

Diabetic peripheral neuropathy class prediction by multicategory support vector machine model: a cross-sectional study / 한국역학회지

OBJECTIVES: Diabetes is increasing in worldwide prevalence, toward epidemic levels. Diabetic neuropathy, one of the most common complications of diabetes mellitus, is a serious condition that can lead to amputation. This study used a multicategory support vector machine (MSVM) to predict diabetic peripheral neuropathy severity classified into four categories using patients' demographic characteristics and clinical features. METHODS: In this study, the data were collected at the Diabetes Center of Hamadan in Iran. Patients were enrolled by the convenience sampling method. Six hundred patients were recruited. After obtaining informed consent, a questionnaire collecting general information and a neuropathy disability score (NDS) questionnaire were administered. The NDS was used to classify the severity of the disease. We used MSVM with both one-against-all and one-against-one methods and three kernel functions, radial basis function (RBF), linear, and polynomial, to predict the class of disease with an unbalanced dataset. The synthetic minority class oversampling technique algorithm was used to improve model performance. To compare the performance of the models, the mean of accuracy was used. RESULTS: For predicting diabetic neuropathy, a classifier built from a balanced dataset and the RBF kernel function with a one-against-one strategy predicted the class to which a patient belonged with about 76% accuracy. CONCLUSIONS: The results of this study indicate that, in terms of overall classification accuracy, the MSVM model based on a balanced dataset can be useful for predicting the severity of diabetic neuropathy, and it should be further investigated for the prediction of other diseases.

Adverse perinatal outcomes in borderline amniotic fluid index

Background: Normal amniotic fluid predicts normal placental function, fetal growth and fetal well-being

Objective: To determine adverse pregnancy outcomes in borderline amniotic fluid index [API]

Materials and Methods: Pregnant women [37-40 wks] with diagnosis of borderline API between December 2012 and August 2014 were identified. Antepartum, intrapartum and neonatal data were collected and compared with those of pregnant women with normal API. An API less than 8 and more than 5 cm was defined for borderline API. Pregnancy outcomes included Cesarean section for non-reassuring fetal heart rate, rneconium stained amniotic fluid, 5-min Apgar score <7, low birth weight, umbilical cord blood pH at term and NICU admission

Results: Gestational age at delivery in pregnancies with borderline API was significantly lower than normal API. Cesarean section rate for non-reassuring fetal heart rate in women of borderline API was significantly higher and there was an increased incidence of birth weight less than 10th percentile for gestation age in borderline API group. Incidence of low Apgar score and low umbilical artery pH in pregnancies with borderline API was significantly higher than women with normal API. There were no significant difference in the rate of NICU admission and meconium staining in both groups

Conclusion: There are significant differences for adverse pregnancy outcomes, such as C. lion due to non-reassuring fetal heart rate, birth weight less; than 10[th] pertcentile for gestation age, low 5 min Apgar score and low umbilical artery pH between pregnancies with borderline and normal API

Ramadan fasting: do we need more evidence?

Over a billion Muslims fast worldwide during Ramadan each year. This religious practice, contributes to their health as well as their spiritual growth. However, available evidence regarding the health benefits of Ramadan fasting is scarce and highly contentious. Although Islam exempts patients from fasting, many conceivably fast, and their clinical condition is prone to deteriorate due to persistent gap between current expert knowledge and conclusive strong evidence regarding the pathophysiologic and metabolic alterations of fasting. In this article, we summarize the results of initial studies regarding the effects of Ramadan fasting on some clinical conditions, alterations of body composition and clinically important outcomes of patients with previous history of cardiovascular disease, asthma or renal colic disease. Our studies have shed light on several outcomes in favor of Ramadan fasting, and encourage those afflicted to consult their physicians and follow medical and scientific recommendations. In this review we aimed to present relevant evidence, clarify future scope and provide suggestions for future investigations

The effects of exposure to pesticides on the fecundity status of farm workers resident in a rural region of Fars province, southern Iran

<p><b>OBJECTIVE</b>To investigate the prevalence of fecundity and other reproductive problems among a group of farmers in Kavar district of Fars province, southern Iran.</p><p><b>METHODS</b>A total of 268 randomly selected married male farm workers were investigated. A questionnaire was devised and validated [Cronbach's α-coefficient (0.81)]. Subjects were directly interviewed and the questionnaire forms were completed for them.</p><p><b>RESULTS</b>The prevalence of current primary infertility among the studied population was about 7.4% (P=0.001). Similarly, 6.3% of farm workers had offsprings with congenital malformations. Finally, 1.5% and 9% of farmers' wives had a history of stillbirth and abortion, respectively. It was concluded that the prevalence of current primary infertility were higher among farm workers families than in the normal population (P<0.05). Additionally, stillbirth and spontaneous abortion were more common in the wives of farm workers than in the normal population, although the difference did not reach statistical significance.</p><p><b>CONCLUSIONS</b>These effects are likely to be attributed to the exposure of farm workers to pesticides.</p>

Ramadan fasting: evidence or expert opinion? results of preliminary studies

Each year, over a billion Muslims fast worldwide during the month of Ramadan. Through this religious practice, not only will one have spiritual growth, but can improve his/her diet, which is of pivotal importance in this month. Conversely, the available evidence regarding the health benefits of Ramadan fasting is scarce and highly contentious. Although Islam exempts patients from fasting, many of them fast conceivably and their clinical condition is prone to deteriorate. This is due to the persistent gap between current expert knowledge and conclusive, strong evidence regarding the pathophysiologic and metabolic alterations by fasting, and the consensus that healthcare professionals should reach, in order to manage various patient groups during this month. In this review, we summarize the results of our initial studies regarding the effects of Ramadan fasting on some clinical conditions including alterations of body composition. We also go through the important clinical results of patients who have had previous history of cardiovascular disease, type 2 diabetes, asthma and renal colic. Our studies have presented some evidence in favor of Ramadan fasting and encourage those with mentioned diseases to consult their physicians and follow medical and scientific recommendations. We attempt to present some relevant evidence clarify future scopes in this area of study, and provide suggestions for future investigations

Resiliency and quality of life in patients with cancer: moderating role of duration of awareness of cancer

Cancer detection always has a lot of stress and nervousness which, apart from physical injuries, will affect quality of life. The aim of this study was to investigate the relationship between resiliency and quality of life by moderating the role of duration of awareness of cancer. Population of the study included all patients with cancer who were under treatment in Yazd Forat hospital. Using convenience sampling method, 105 patients were selected to participate in this study. All subjects completed the Quality of Life Questionnaire specialized for cancer and resiliency Questionnaire. Data were analyzed by regression analysis model and Johnsen- Neyman technique. The findings of this study revealed that the time duration of awareness of cancer plays a moderating role in the relation between the general dimension of quality of life and resiliency. In patients who were aware of their disease for over 12 months, the relationship between resiliency and the general dimension of quality of life was significant. In addition, high levels of resiliency showed a positive and significant relationship with physical dimension of life quality. While in patients who were aware of their illness for less than 12 months, resiliency scores showed a significant relation with emotional dimension of quality of life. Awareness of disease has different mental effects on cancer patients, and resiliency and maintaining this feature for long-term is associated with the increase of quality of life in these patients. Theoretical implications of finding are discussed in detail

In vitro comparison of the effects of garlic juice and chlorhexidine mouthwash on oral pathogens

Mouthwash is used to complete the process of mechanical plaque removal. Chlorhexidine is the most common ingredient in mouthwash so we can use it as a gold standard to compare the effects of new products. Garlic is a strong antimicrobial agent and acts as an inhibitor on both Gram-positive and Gram-negative bacteria. The present study was conducted to compare the effect that garlic juice and Chlorhexidine mouthwash has on oral pathogens. Fresh garlic bulbs were used to extract the antibacterial juice. The yellow juice was separated from the pulp with Whatman filter paper. After filtration the liquid was freeze dried and stored at 4[degree]C until required. The bacteria that were tested were: Streptococcus mutans, S. sanguis, S. salivarius and Lactobacillus casei. After cultivation of the bacteria, the Minimal Inhibitory Concentration [MIC] of the garlic juice and Chlorhexidine were measured using the E-test method, then the Minimal Bactericidal Concentration [MBC] of the Chlorhexidine and garlic juice were measured by tube test. The lowest MIC of garlic juice was for S. mutans 0.25 microg/mL and the highest was for L. casei 2. 5 microg/mL. The MIC of Chlorhexidine for these two bacteria was 0.62 microg/mL and 5 microg/mL respectively. The MBC of Chlorhexidine and garlic for S. mutans had the lowest concentration compared with the other tested bacteria. The MBC of Chlorhexidine and garlic for S. mutans was 0.35 microg/mL and 0.3 microg/mL respectively. The highest MBC of Chlorhexidine was for S. salivarius 10 microg/mL. The MBC of garlic for S. sanguis was similar at 10. 4 microg/mL. The efficacy of garlic juice was higher than Chlorhexidine against target bacteria and could be used as an effective mouthwash, but its side effects need to be investigated.

Pharyngocutaneous fistula after laryngectomy: incidence, predisposing factors, and outcome

fistula is a common and troublesome postoperative complication after total laryngectomy. The objective of this report was to determine the incidence, predisposing factors, and outcome of postlaryngectomy pharyngocutaneous fistula in patients operated on in our department and to describe the management of the complication. The medical records of 146 consecutive patients who underwent laryngeal surgery for squamous cell carcinoma of the larynx between 1990 and 2005 were assessed. All patients had similar preoperative/postoperative care. We studied a number of factors that could influence fistula formation such as age, gender, smoking, systemic disease, preoperative radiotherapy, previous tracheotomy, site of tumor, surgical procedure, positive surgical margins, type of closure [T vs. vertical], concurrent neck dissection, suture material, clinical stage, histologic grade, and experience of surgeon [consultant vs. resident]. A pharyngocutaneous fistula was observed in 13% [19/146] of the patients within a mean time of 9.6 days from surgery. Spontaneous closure with local wound care was noted in 17 [89%] patients whereas a surgical closure was necessary in two. One patient required surgical closure by direct suture of the pharyngeal mucosa. Pectoralis major myocutaneous flap was used in another one. Our findings showed that fistula formation was significantly more common in patients who received previous radiotherapy or who had positive surgical resection margins or had a systemic disease. The mean healing time was 26 days. We concluded that pharyngocutaneous fistula remains a troublesome complication of the early postoperative period after total laryngectomy. There are many conflicting reports in the literature concerning the predisposing factors, but our data showed that the presence of systemic diseases, previous radiotherapy, and positive surgical margins can all be important predisposing factors, or at least underlying causes. Our experience confirmed that most fistulas can be successfully managed with conservative treatment