The Effects of Nano-curcumin Supplementation on Serum Level of hs-CRP, Adhesion Molecules, and Lipid Profiles in Hemodialysis Patients, A Randomized Controlled Clinical Trial.

INTRODUCTION: Hemodialysis (HD) patients are considered as a high-risk population for cardiovascular disease, within which morbidity and mortality have been determined to be associated with dyslipidemia, pro-inflammatory cytokines, increased levels of C-reactive protein (CRP), and adhesion molecules (ICAM-1, VCAM-1). Different markers have been investigated to detect inflammation in hemodialysis patients, as well as the prognostic values of these markers. METHODS: The present study aimed to investigate the effect of nano-curcumin (120 mg) over 12 weeks on hs-CRP levels, adhesion molecules (ICAM-1, VCAM-1), and serum lipid profiles on hemodialysis patients in a randomized controlled clinical trial. RESULTS: The results revealed that the mean serum hs-CRP level in the nano-curcumin group exhibited a decrease by the end of the study, when compared to mean serum hs-CRP level in the placebo group. However, this between-group trend was not found to be statistically significant (P > .05). Nevertheless, a significant difference was determined between the values in the group receiving nano-curcumin, in comparison with the placebo group, at the end of the study (P < .001). Based on the attained results, mean serum levels of VCAM-1 in the nano-curcumin group were significantly reduced at the end of the study, compared with the placebo group (P < .001). Furthermore, the between-group changes comparison showed significant reductions in serum levels of ICAM- 1 in patients treated with nano-curcumin at the end of the study (P < .05). Additionally, though decreases in mean triglycerides, total cholesterol, LDL-C were noted, there were no statistically significant between-group differences (P > .05). Moreover, between-group changes comparison of HDL-C levels and fasting blood sugar did not show any significant changes. CONCLUSION: The current study indicates that nano-curcumin may show beneficial effects in lowering inflammation and hs-CRP levels, as well as adhesion molecules (ICAM-1, VCAM-1), in hemodialysis patients. However, the evidence is still insufficient.

Occupational Safety and Health Measures in Micro-scale Enterprises (MSEs) in Shiraz, Iran.

OBJECTIVES: This study aimed to determine the extent of implementation of occupational safety and health measures in micro-scale enterprises (MSEs) and to assess the prevalence of occupational injuries and accidents and its relationship with occupational safety and health measures provided in the MSEs. METHOD: A cross-sectional study was conducted among 595 of MSEs. An index called the Safety and Health Requirement Index (SHRI) was created and used to calculate the percentage of provided occupational safety and health measures. The relationship between the SHRI and the occurrence of occupational accidents and injuries was investigated with the independent samples t-test and one-way ANOVA. RESULTS: The mean SHRI score was 60.43%, which was categorized into moderate level. Of the 30.9% of enterprises that had experienced accidents and injuries, the most common types of injuries were musculoskeletal disorders and cuts, and the least common types were pulmonary and hearing problems. Results of one-way ANOVA revealed a statistically significant relationship between the mean SHRI score and industrial branch, enterprise size, and type of accident and injury. The independent samples t-test showed that the occurrence of occupational accidents and injuries was not significantly influenced by provided health and safety measures in MSEs. CONCLUSION: Given the high percentage of enterprises with very poor to poor levels for the SHRI and the high prevalence of occupational accidents and injuries among the studied MSEs, feasible protective strategies and job safety training programs are required to promote occupational health and safety in the studied MSEs.

Systemic Inflammatory Response Syndrome and MELD Score in Hospital Outcome of Patients with Liver Cirrhosis.

BACKGROUND: The evidence saying that the rate of Systemic Inflammatory Response Syndrome (SIRS) is high in patients with advanced cirrhosis and portal hypertension, this could have negative outcome on patients prognosis. METHODS: This prospective study included 109 cirrhotic patients who were admitted to Imam Khomeini Hospital, affiliated with Orumieh University of Medical Sciences, during 2011-2012. The presence of SIRS and the model for end stage liver disease (MELD) were assessed on admission and during the hospital stay. SIRS was considered positive if patients had two or more of the following: temperature of >38ºC or <36ºC; heart rate >90 beats/min; respiratory rate >20/min or PaCO2 <32 mmHg or the use of mechanical ventilation; WBC >12000/mm(3) or <4000/mm(3) or more than 10% immature neutrophil count. MELD was calculated as: MELD = 3.8 [Ln serum bilirubin (mg/dl)] +11.2 [Ln INR] +9.6 [Ln serum creatinine (mg/dl)] +6.4. Hospital outcome was defined as death or hospital discharge. RESULTS: A total of 109 cirrhotic patients between the ages of 14 to 84 (mean: 54.6 ±18.4) years were included. There were 65 (59%) male patients. Of the 109 patients, 76 (69.8%) were SIRS-negative and 33 (30.2%) were SIRS-positive. The mean calculated MELD score for all patients was 15.5. There was a correlation noted between SIRS and high serum creatinine levels (p=0.01) and between SIRS and a high MELD score (p=0.00). During follow-up 19 (17.4%) patients died. SIRS was correlated with death (p<0.00) on multivariate analysis, SIRS was independently associated with hospital death. CONCLUSION: SIRS is a relatively frequent event in cirrhotic patients admitted to referral centers. It is closely related to the severity of liver disease as shown by the MELD score. SIRS independently and adversely affects the in-hospital outcome in patients with liver cirrhosis.