Iranian Traditional Medicine for Treatment of Attention Deficit Disorder with Hyperactivity in Children: A Systematic Review of Randomized Controlled Trials.

Background: Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with a complex etiology. Stimulants as a first-line treatment are not effective in some cases. In this study, we conducted a systematic review to evaluate the efficacy of traditional Persian Iranian medicine (TIM) for children and adolescents with ADHD. Methods: Data were collected mainly from PubMed, Google Scholar, Web of Science, ProQuest, and Scopus databases until Dec 2022. The keywords related to ADHD, traditional Persian medicine (TPM), and (TIM) were searched. Two reviewers independently screened 714 abstracts and eventually, eight trials were included in the systematic reviews. Changes in the severity of ADHD symptoms were considered based on the validated cutoff on recognized rating scales as the result of the effect of TIM on ADHD. Results: Interventions included herbal extracts of Passiflora incarnate, whey protein, Ginkgo biloba, Crocus sativus L, sweet almond syrup, and horse milk. In all studies, except G. biloba, there was evidence of a reduction in the severity of ADHD. Low evidence could be found for G. biloba. Conclusion: Herbal and traditional remedies are an efficient and safe solution to alleviate the symptoms of ADHD. In future studies, TIM as a complementary therapy may be useful to alleviate ADHD symptoms, especially in children who are resistant to stimulant medications.

A randomized controlled trial of Vitamin D supplementation in Iranian patients with schizophrenia: Effects on serum levels of glycogen synthase kinase-3ß and symptom severity.

BACKGROUND: Growing evidence has shown that hypovitaminosis D is a risk factor for developing schizophrenia and comorbid conditions. Therefore, this study aimed to examine the effect of vitamin D supplementation on serum levels of vitamin D, metabolic factors related to insulin resistance (IR) and the severity of the disorder in patients with schizophrenia. METHODS: Forty-eight chronic male patients with schizophrenia with vitamin D deficiency (≤20 ng/mL= (≤50 nmol/l) were selected and randomly assigned to vitamin D treatment and placebo groups. Subjects were supplemented for 8 weeks with vitamin D (2000 IU/day) or placebo. RESULTS: Within-group comparison revealed that the vitamin D group had a significant reduction in waist circumference, Positive and Negative Syndrome Scale - total score (PANSS-TS), and glycogen synthase kinase 3 beta (GSK-3ß) levels (P = .022, P = <.001 and P = .013, respectively). On the other hand, the placebo group showed a significant increase in the level of fasting serum insulin and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) (P = .003 and P = .003). The between-group comparison showed a significant difference in terms of PANSS-TS, GSK-3ß, fasting serum insulin (FSI), and HOMA-IR (P = .022, P = .048, P = .013 and P = .014 respectively). CONCLUSIONS: Among vitamin D deficient patients with schizophrenia, vitamin D supplementation may affect GSK-3 ß, an important biomarker in schizophrenia and insulin resistance. In addition, vitamin D supplementation in such patients may reduce the disorder's symptom severity.

The effect of Chlorella vulgaris on obesity related metabolic disorders: a systematic review of randomized controlled trials.

OBJECTIVES: Chlorella vulgaris (CV) as a unicellular algae is a dietary supplement with beneficial nutritious content, used for decades in some countries. Positive effects for CV supplementation on metabolic parameters has been established in animal and human studies. However there is a gap for this results summary for a definite conclusion announce. This systematic review aimed to summarize the effects of CV on body weight, lipid profile, and blood glucose. CONTENT: PRISMA guidelines were charted in this review. Subject search was performed in MEDLINE, ProQuest, PubMed, ISI web of sciences, Google scholar, Cochrane and Scopus databases for randomized clinical trials published in English languages, until December 2020, which assessed the effects of CV on metabolic syndrome related symptoms in clinical trials. SUMMARY: Out of 4,821 records screened, after duplicate and irrelevant exclusion by title and abstract, 20 articles remained for full text screening. Finally a total of 12 articles met the study inclusion criteria and were assessed for study method and results. OUTLOOK: The findings showed controversies in anthropometric, glycemic and lipid profile effects. CV may have beneficial effects on obesity-related metabolic disorders; however, collected studies lacked statistical power to reach a definite conclusion. More well-designed studies are required.

The relationship between brain-derived neurotrophic factor and metabolic syndrome in patients with chronic schizophrenia: A systematic review.

BACKGROUND & AIMS: Schizophrenia is a serious long-term disorder in which the metabolic complications and abnormalities of the brain-derived neurotrophic factor (BDNF) can be found. In this study, we conducted a systematic review of the relationship between BDNF, metabolic syndrome (MetS) and its components in schizophrenic patients. METHODS: Data were collected mainly from PubMed, Google Scholar, Scopus, and ProQuest databases. The keywords related to the BDNF, MetS, schizophrenia were searched. Two reviewers independently screened 1061 abstracts. And eventually, a total of 7 studies (6 observational and 1 interventional) was included in the systematic reviews. RESULTS: Four of the 7 study ascertained statistically significant inverse relationship between serum BDNF levels and MetS in schizophrenic patients. While in the other two studies, there was no inverse relationship. In the last selected study, the researchers found a weak association between the Val66Met polymorphism in BDNF Gene and clozapine-induced MetS. CONCLUSION: Although this relationship could not be determined but BDNF levels appear to be reduced in schizophrenic patients with MetS and factors such as sex and antipsychotic class differentiation, sampling and methodology and episodes of illness could play a role in the results and outcomes.

The efficacy of zinc augmentation in children with attention deficit hyperactivity disorder under treatment with methylphenidate: A randomized controlled trial.

INTRODUCTION: Regarding to the role of the zinc in the metabolism of the central nervous system and the correlation of zinc supplementation in the treatment of any Attention deficit hyperactivity disorder (ADHD) symptoms, this study was conducted to evaluate the complementary effects of this nutrient. METHOD: This was a double-blind randomized clinical trial study and 60 children with ADHD who were treated with methylphenidate were chosen by random allocation and were divided in the two groups: 30 for the case and 30 for the control group. The treatment in case group was augmented with zinc. Duration of study was six weeks. RESULT: Forty eight (80%) of participants were boy and 12 (20%) were girl. The mean age of patients was 9.6 ± 1.70 years. There was no significant difference between the two groups after the intervention in terms of total score, hyperactivity and impulsivity subscales during variance analysis, but there was a significant difference between the mean of inattention score. CONCLUSION: Augmentation with zinc can enhance the improvement of inattention.

Geriatric nutritional risk index as a simple tool for assessment of malnutrition among geriatrics in Northwest of Iran: comparison with mini nutritional assessment.

BACKGROUND: Older people are more likely to develop nutritional problems and timely diagnosis of malnutrition is crucial to prevent hazardous consequences following poor nutrition. AIMS: To evaluate the efficacy of Geriatric Nutritional Risk Index (GNRI) to assess nutritional status among non-hospitalized elderly, compared to mini nutritional assessment (MNA) among Iranian seniors. METHODS: One hundred and sixty-four subjects, aged ≥ 65 years old were recruited to our cross-sectional study from various districts of Tabriz (Tabriz, Iran). Anthropometric and biochemical measurements were performed, short- and long-form MNAs and GNRI were assessed in our study subjects. Sensitivity, specificity and predictive values of the three indices, agreement between them, and their correlation with anthropometric and biochemical parameters were evaluated. Receiver-operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off point for GNRI in our study population. RESULTS: GNRI had lower sensitivity (50, 57%), but optimal specificity (94, 93%) and lower negative predictive value (NPV; 68, 71%) compared to MNA-LF and MNA-SF, respectively. We found a moderate agreement between GNRI and MNA-SF (K = 0.52) and MNA-LF (K = 0.46) scores. Significant correlations were observed between re-categorized MNAs as well as GNRI scores, and age, weight, MAC, CC, WC, albumin, and pre-albumin. The cut-off point of 110.33 was obtained for GNRI, according to the ROC curve. CONCLUSIONS: Although GNRI may not be an efficient tool for screening malnutrition due to its lower sensitivity, it is moderately correlated with MNAs and also more useful when limited funding needs to target the truly malnourished seniors.

Plasma levels of serotonin, gastrointestinal symptoms,and sleep problems in children with autism.

BACKGROUND/AIM: Autism is a neurodevelopmental disorder identified with higher frequency of serotonin abnormalities and gastrointestinal (GI) and sleep problems. This study aimed to evaluate the plasma levels of serotonin, GI symptoms, and sleep problems, and their relationship with autism severity in children with autism. MATERIALS AND METHODS: Thirty-five children with autism and 31 healthy subjects were studied. GI problems, sleep disorders, and severity of disorder were assessed. Plasma serotonin was determined using ELISA. RESULTS: There was no significant association between GI problems and autism severity, but a significant positive correlation was seen between different indicators of sleep disorder and severity of autism. Plasma levels of serotonin were significantly higher in autistic children and a significant negative correlation was observed between plasma levels of serotonin and autism severity (r = -0.39, P = 0.02). CONCLUSION: Elevated plasma serotonin in autistic children and its negative correlation with disease severity may indicate involvement of the neurotransmitter in the neurophysiologic mechanism of autism.