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Background Primary hypothyroidism is a common endocrine disorder caused by impaired production of thyroid hormones. Recent studies have shown that dietary habits, oxidative stress, and inflammation may play roles in thyroid hypofunction. Thus, the present article aimed to determine the relationship between major dietary patterns and oxidative stress and inflammation in primary hypothyroid patients and healthy people in Iranian adults. Methods This matched case-control study was conducted on 200 participants (100 cases and 100 controls). The presence of primary hypothyroidism was determined by endocrinologists based on American Thyroid Association (ATA) criteria. Dietary intake was assessed using a validated 168-item, semi-quantitative food frequency questionnaire (FFQ). The principal component analysis (PCA) method was used to derive major dietary patterns. Statistical analysis was performed using logistic regression analysis, and the findings were reported using odds ratios (ORs) with 95% CIs. Results We identified 2 major dietary patterns (i.e., healthy and Western dietary patterns). After adjusting for confounding variables, participants in the highest tertile of the healthy eating pattern had lower odds of primary hypothyroidism. Also, there was a significant relationship between total antioxidant capacity (TAC) levels and thyroid hypofunction; however, no significant correlation was seen between the Western dietary pattern and malondialdehyde (MDA) and C-reactive protein (CRP) with hypothyroidism. Conclusions There were statistically direct associations between healthy dietary patterns (loaded with vegetables, nuts and seeds, fruits, dried fruits, olives, garlic, black pepper, starchy vegetables, low-fat dairy, and legumes) and increased TAC levels with a decreased risk of thyroid hypofunction. However, Western dietary patterns and MDA and CRP levels did not associate with an underactive thyroid.

Metabolic syndrome (MeS) is a common multifaceted disorder. Plants contain antioxidant bioactive compounds, which are beneficial to improve the health condition of patients with MeS. Propolis is a hive natural product that is composed of various constituent. We aimed to assess the effects of Iranian propolis as a natural and safe agent on indicators of MeS, quality of life and mood status in individuals with MeS. In total, 66 interested eligible patients recruited to the present study. Participants were randomly assigned to consume a tablet at dose of 250 mg of propolis extract, twice daily for 12 weeks or placebo. Propolis supplementation could lead to a significant reduction in waist circumference (WC), increase in physical functioning, general health and the overall score of SF-36 compared with placebo group (P-value 0.05). The current study indicated that propolis can be effective in decreasing WC and improving physical health and quality of life, while had no significant effects on other components of MeS among subjects with this syndrome. Clinical trials registration Iran Registry of Clinical Trials.ir IRCT20121216011763N49, registration date 23/12/2020.

Background Observational studies have reported that dietary renal acid load has an important role in insulin resistance and metabolic factors. The aim of the present study was to assess the effect of a low renal acid load diet (LRALD) on blood pressure, lipid profile, and blood glucose indices in patients with type 2 diabetes. Methods In this parallel randomized clinical trial, 80 patients with type 2 diabetes were randomly assigned to the LRALD (n = 40) or control (n = 40) groups, for 12 weeks. Both groups received a balanced diet and a list of nutritional recommendations based on healthy eating behaviors. In the LRALD group, food items with low renal acid load were prescribed. Primary outcomes including: fasting blood glucose (FBG), hemoglobin A1c (HbA1c), fasting serum insulin, quantitative insulin sensitivity check index (QUICKI), homeostatic model assessment for insulin resistance (HOMA) and secondary outcomes including: weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), and high-density lipoprotein (HDL). were measured at baseline and end of the study. The present trial was registered at IRCT.ir (IRCT20130903014551N5). Results Seventy subjects completed the study (n = 35 in control group and n = 36 in LRALD). Weight (P P P P P = 0.004), and TG (P = 0.049) were reduced and HDL (P = 0.002) was increased in both groups, compared with baseline. After adjusting for baseline values, DBP (P = 0.047) was reduced in the LRALD group compared with control group. Results had no changes after using intention to treat analysis. Conclusion A LRALD may decrease DBP in type 2 diabetic patients. However, it elicited no significant effect on lipid profile compared with a healthy diet. Trial registration This randomized clinical trial was registered at IRCT.ir (IRCT20130903014551N5).

Background Literature suggests a relationship between estrogen levels and migraine headache pathogenesis. However, the effect of soy isoflavones on migraine characteristic remains unclear. This study aimed to investigate the effect of soy isoflavones on migraine characteristics and calcitonin gene-related peptide (CGRP) levels in women with migraine. Methods Eighty-three participants completed a randomized double-blind controlled trial, receiving 50 mg per day soy isoflavones or placebo supplementation for 8 weeks. Migraine severity, migraine days per month, frequency and duration of attacks, mental status, quality of life and serum CGRP levels were measured at baseline and the end of the intervention. Bivariate comparison and intention-to-treat (ITT) were used for analysis. Results Soy isoflavones intake resulted in a significant decrease in mean frequency (-2.36 vs -0.43, P P P = 0.002) in compared to placebo group. Also, a significant improvement was found in quality of life (16.76 vs 2.52, P P > 0.05). Conclusion soy isoflavones supplementation may be considered as a complementary treatment for women with migraine to improve migraine characteristics and reduce the burden of disease.

Background COVID-19 pandemic has made the disease a major global problem by creating a significant burden on health, economic, and social status. To date, there are no effective and approved medications for this disease. Curcumin as an anti-inflammatory agent can have a positive effect on the control of COVID-19 complications. This study aimed to assess the efficacy of curcumin-piperine supplementation on clinical symptoms, duration, severity, and inflammatory factors in patients with COVID-19. Methods Forty-six outpatients with COVID-19 disease were randomly allocated to receive two capsules of curcumin-piperine; each capsule contained 500 mg curcumin plus 5 mg piperine or placebo for 14 days. Results Mean changes in complete blood count, liver enzymes, blood glucose levels, lipid parameters, kidney function, and c-reactive protein (CRP) were not significantly different between the two groups. There was a significant improvement in health status, including dry cough, sputum cough, ague, sore throat, weakness, muscular pain, headache, and dyspnea at week 2 in both curcumin-piperine and placebo groups (P value < 0.05); however, the improvement in weakness was more in the curcumin-piperine group than with placebo group (P value 025). Conclusion The present study results showed that curcumin-piperine co-supplementation in outpatients with COVID-19 could significantly reduce weakness. However, in this study, curcumin-piperine co-supplementation could not significantly affect the other indices, including biochemical and clinical indices. Trial registration Iranian Registry of Clinical Trials IRCT20121216011763N46. 2020-10-31

Pomegranate peel, as the major part of pomegranate fruit, contains several important bioactive chemical compounds that are unstable and must be protected. In this study, ethanolic pomegranate peel extract (EPPE) was encapsulated with gelatin by electrospinning. First, based on the results, the lowest fiber diameter was obtained at 20% wt/v gelatin in 30:70 (water/acetic acid) ratio and operating conditions (applied voltage 20 kV, distance 10 cm, and flow rate 0/1 mL/h). To investigate the possibility of encapsulation of EPPE in optimum gelatin fibers, two ratios of EPPE/gelatin (25:75, 50:50) were used. 50:50 ratio was selected as the best ratio because of its encapsulation efficiency for further analyses, including the simulated gastrointestinal digestion, Fourier transform infrared (FTIR) spectroscopy, and X-ray diffraction. The in vitro digestion showed that the fibers could protect the extract.

Objectives Based on a comprehensive search, we realized that there is no previous study conducted among migraine patients to assess the association between major dietary patterns and mental health. Therefore, the present study aims to explore the relationship between empirically-derived dietary patterns and depression, anxiety, and stress in a sample of Iranian migraine patients. Methods A total of 262 migraine patients (20–50 years) were selected through simple random sampling method for this study. Dietary intake during the previous year was determined using a validated 168-item, semi-quantitative food frequency questionnaire (FFQ), and major dietary patterns were derived using principal component analysis (PCA). For mental health evaluation, authors used the Depression, Anxiety, and Stress Scales (DASS- 21) questionnaire. Statistical analysis included multinomial logistic regression analysis and results were expressed as odds ratio (OR) with a 95% confidence interval (CI). Results We identified three major dietary patterns including “traditional”, “western”, and “healthy”. After controlling for potential confounders, those in the highest tertile of the healthy dietary pattern had lower odds of depression (OR = 0.44, 95% CI: 0.22, 0.88; P for trend: 0.030) and stress (OR = 0.50, 95% CI: 0.25, 0.99; P for trend: 0.049). However, no significant association was observed between western and traditional dietary patterns and mental disorders. Conclusions In summary, significant associations were documented between healthy dietary patterns and risk of depression and stress. Current findings urge migraine patients to increase their intakes of fruits, vegetables, eggs, whole grains, nuts and seeds, meat, and poultry and reduce the intake of fast foods and snacks, processed meat, fish, cola drink, condiments, dairy, and vegetable pickles to diminish the chance of depression and stress.

Reinforced edible gluten film was successfully prepared by the addition of polylactic acid (PLA) nano-fibers to improve their mechanical and barrier properties. Scanning electron microscopy (SEM) of the transverse cross-section of gluten film was performed to investigate the binding of PLA fibers to the surface of gluten film. It was observed that the nano-fibers attached to the surface of the gluten film could improve by 13.9% in the barrier properties and up to 29.3% in the mechanical properties compared to the control gluten film. The effect of ultraviolet light exposure on the tensile strength and water vapor barrier properties, as well as the stability of lycopene encapsulated in PLA nano-fibers, was investigated. It was shown that PLA nano-fibers in gluten film reduce UV light’s harmful effect on the water vapor barrier properties by up to 6.8% and on the tensile strength up to 23.5% compared to the control film. The results also showed that the treatment of lycopene with ultraviolet light, unlike the control sample (55.7% degradation in lycopene), had no destructive effect on the antioxidant activity of lycopene. Finally, the rate of release of lycopene was studied in fatty food simulants. It was observed in gluten/PLA film that the encapsulation of lycopene in PLA nano-fibers has a much lower rate of release than the direct addition of lycopene to gluten film. Gluten film containing electrospun nano-fibers showed a release rate of lycopene about 31.8% at approximately 90 h. However, the sample of nano-fibers-free gluten film had a release rate of 48.5% at the same time. This result is beneficial for active food packaging because it allows food to be stored for longer in the packaging.

Magnesium (Mg) is the second most frequent intracellular cation in humans with a critical role in insulin metabolism and glucoregulation. Women with polycystic ovary syndrome (PCOS) often present with insulin resistance and impaired glucoregulatory status; however, their Mg status remains unclear. Therefore, we aimed to conduct a systematic review and meta-analysis to evaluate serum Mg concentration in women with PCOS and compare it with that of controls without PCOS. Online databases of PubMed, Scopus, Cochrane Library, and ISI Web of Science were searched for studies evaluating the relationship between Mg concentrations and PCOS status until October 2019. Pooled weighted mean differences (WMDs) of serum Mg levels were calculated using random effects models. A total of eight studies (10 arms; n = 2026 women) were included. Pooled effect sizes, expressed as WMD and 95% CI, revealed decreased serum Mg concentrations in women with PCOS compared with controls (− 0.09 (− 0.17, − 0.02) mmol/L; P = 0.01). However, significant heterogeneity was detected across the studies (I 2 = 98.0%, P

Background Sepsis is a common cause for admission to the intensive care unit (ICU), and its incidence has been increasing. It is associated with a significant increase in serum inflammatory biomarkers such as C-reactive protein (CRP) and cytokines such as interleukin 1 (IL-1), IL-6, and tumor necrosis factor (TNF). Sepsis is also associated with pathophysiological changes that include fluid accumulation in the lungs, eventually leading to acute respiratory distress syndrome (ARDS), tissue edema, hypotension, and acute kidney injury (AKI). Conventional therapies include antibiotics, but these may have important adverse effects, so novel therapeutic approaches are required. In animal studies, l-carnitine improves antioxidant status, and in some clinical trials, it has been shown to reduce inflammation. It has also been shown to improve respiratory distress and help maintain coenzyme A homeostasis, metabolic flexibility, promoting the normal function of the tricarboxylic acid (TCA) cycle, and oxidation of fatty acids by peroxisomes. We aim to determine the effects of very high doses of l-carnitine on inflammatory factors, oxidative stress, and clinical outcomes of patients with sepsis in ICU. Method and design In this double-blind, randomized controlled clinical trial, we will use block randomization of 60 patients with sepsis, aged between 20 and 65 years from Al-Zahra Hospital, Isfahan, Iran. The intervention group (n = 30) will receive three capsules of l-carnitine (each capsule contains 1000 mg l-carnitine; totally 3000 mg/day) for 7 days, and a control group (n = 30) will receive a placebo with the same dose and for the same duration in addition to usual care. At baseline, scores for clinical and nutritional status (Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), Quick SOFA (qSOFA), and NUTRIC Score) will be assessed. At beginning and end point of the study, inflammatory markers (CRP, erythrocyte sedimentation rate (ESR)), oxidative stress status (total oxidative stress (TOS), total antioxidant capacity (TAC)), and clinical variables will be evaluated also. The mortality rate will be assessed within 28 days of the beginning of the intervention. Discussion Because of the anti-inflammatory and antioxidant properties of l-carnitine, it is possible that using a high dose of 3000 mg daily of this nutritional supplement may reduce inflammation and oxidative stress and improve subsequent mortality of critically ill patients with sepsis. Trial registration Iranian Registry of Clinical Trials IRCT20201129049534N1. Registered on 2 May 2021.

Despite a large body of literature on the association between the dietary inflammatory index (DII) and various chronic diseases, limited knowledge is available regarding the association between DII and migraine. Therefore, we assessed the relationship between the DII and migraine characteristics, including duration, frequency, and severity of migraine headaches, Headache Impact Test-6 (HIT-6), and serum levels of nitric oxide (NO). This population-based cross-sectional study was conducted from August 2019 to June 2020 among 262 patients (38 men and 224 women; 20–50 years). A 168-item semiquantitative food frequency questionnaire (FFQ) was gathered to evaluate dietary intake, and subsequently, an energy-adjusted DII score was calculated. After controlling for potential confounders, an increase of 3.48 in headache frequency was observed when the DII score increased from − 4.04 to − 1.83 (β = 3.48; 95% CI 1.43, 5.54). In the crude model, headache duration tended to be inversely associated with DII in the subjects with the pro-inflammatory diet compared to those with the anti-inflammatory diet (β = − 0.22; 95% CI − 0.46, 0.02). After adjustment for confounders, those with the highest DII values were at a higher risk of severe headaches than those with the lowest values (OR = 2.25; 95% CI 1.17, 4.32). No other significant results were found in terms of the association between DII and HIT-6 or serum NO levels. We found evidence suggesting that higher adherence to a diet with anti-inflammatory properties was significantly and inversely related to headache frequency. Furthermore, our results suggest that the DII score is substantially related to migraine severity.

Objectives This study aims to investigate the efficacy of curcumin-piperine co-supplementation on oxidative stress factors, clinical symptoms, and mortality rate in patients with coronavirus (COVID-19) admitted to the intensive care unit (ICU). Trial design This study is a randomized, placebo-controlled, double-blind, parallel-arm clinical trial. Participants The study participants will be recruited from patients admitted to the ICU of Al-Zahra hospital with a definitive diagnosis of COVID-19. The inclusion criteria are aged between 20 and 75 years, confirmation of COVID-19 based on the PCR test, and admitted to the ICU. The exclusion criteria include the present use of parenteral nutrition support, a history of underlying diseases such as congenital disorders, immune diseases, renal and hepatic insufficiency, and pancreatitis, a history of sensitivity to herbal remedies such as turmeric and pepper, and regular use of anticoagulant drugs such as warfarin. This study will be performed in the Al-Zahra hospital, an academic hospital affiliated with Isfahan University of Medical Sciences, Isfahan, Iran. Intervention and comparator Sixty eligible patients will be randomly assigned, in a 1:1 ratio, to receive curcumin-piperine capsules (three capsules/day; each capsules containing 500 mg curcumin plus 5 mg piperine; in total 1500 mg curcumin and 15 mg piperine/daily) for seven days (n=30) or matching placebo capsules (three capsules/day; each capsules containing 505 mg maltodextrin; totally 1515 mg, maltodextrin/ daily) for same duration (n=30). Capsules will be administered after oral or enteral feeding at 9, 15 and 21 o’clock. Main outcomes The primary outcome is the time from initiation of supplementation (curcumin-piperine or placebo) to normalization of fever, respiratory rate, and blood oxygen saturation. The secondary outcomes are the mortality rate, length of stay in ICU, temperature, levels of blood oxygen saturation, ventilator dependency, respiratory rate, levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), levels of liver markers (ALT, AST, LDH), and levels of kidney function markers (BUN, Creatinine). Follow up All of the parameters will be assessed at baseline and end of the study (7 days intervention). In addition, the rate of mortality will be collected after 4 weeks (28 days’ mortality in the ICU, 4 weeks follow up). Randomisation Eligible patients will be randomly assigned to either the intervention group (Curcumin-piperine) or the control group (Placebo). Randomization sequences will be generated using an electronic table of random numbers to allocate the included participants into either control or intervention groups (in a 1:1 ratio) using the stratified block randomization method. Stratification was conducted according to sex (male and female), with a block size of four. The allocation sequences will be prepared by an independent statistician and will be kept inside sealed, opaque, and consecutively numbered envelopes. Participants, investigators, nurses, and physicians will be unaware of the trial-group assignment. Blinding (masking) This study is a double-blind clinical trial (participants, investigators, nurses, and physicians). The curcumin-piperine and placebo supplements will be similar in the terms of texture, taste, color, odor, and weight. Both tablets will be provided in containers that are completely identical in weight, shape, labeling, and packaging. All participants, investigators, nurses, and physicians will be unaware of the trial-group assignment. Numbers to be randomised (sample size) The sample size is estimated at 60 participants, including 30 patients in the intervention group and 30 patients in the placebo group. Trial Status The protocol is Version 2, registered on May 13, 2021. Recruitment began May 20, 2021, and is anticipated to be completed by September 20, 2021. Trial registration This trial has been registered in Iranian Registry of Clinical Trials (IRCT) with the title of “Evaluation of the effect of curcumin-piperine supplementation in patients with coronavirus admitted to the intensive care unit (ICU): a double-blind clinical trial study”. IRCT registration number is IRCT20121216011763N52. The registration date was May 13, 2021. Full Protocol The full protocol is attached as an additional file, accessible from the Trials website (File 1). In the interest of expediting the dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.

Objectives This study aims to investigate the efficacy of curcumin-piperine co-supplementation on disease duration, severity and clinical symptoms, and inflammatory mediators in patients with coronavirus (COVID-19). Trial design This is a randomized, placebo-controlled, double-blind, parallel arm clinical trial. Participants All patients aged 20-75 years with the diagnosis of Covid-19 based on the PCR test. The exclusion criteria will include an age less than 20 and more than 75 years, current use of warfarin or other anticoagulant drugs, and the presence of sensitivity to herbal products such as turmeric and pepper. This study will be conducted in academic hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. Intervention and comparator Fifty outpatients will be randomly allocated in a ratio of 1:1 to receive a capsule of curcumin-piperine containing 500 mg curcumin plus 5 mg piperine or matching placebo containing 505 mg maltodextrin twice a daily, after lunch and dinner, over a period of 2 weeks. Similarly, 50 inpatients who are admitted to hospital wards excluding intensive care unit (ICU) will be randomly assigned in a ratio of 1:1 to receive a capsule curcumin-piperine or matching placebo (provided by the Sami Labs company) twice a daily, after lunch and dinner, over a period of 2 weeks. Main outcomes The main outcomes of this study are the efficacy of curcumin-piperine on coronavirus disease’s clinical symptoms, duration, severity, and inflammatory mediators after 2 weeks of curcumin-piperine co-supplementation. Randomisation Randomization sequences will be generated with the use of a random-number table with a permuted block design (block size of 4) and stratification according to the gender variable (male vs. female). These sequences will be prepared by an independent statistician and will be kept in opaque, sealed, numbered envelopes which will be opened only at the time of enrollment. The allocation ratio in intervention and control groups is 1:1. Researchers and all patients will be unaware of the study-group assignment until the completion of data analyses. Blinding (masking) This study is a double-blind clinical trial (participant, researcher). The curcumin-piperine and placebo supplements are packaged in similar numbered drug containers, and the researcher and all patients will be unaware of the study assignment until the end of the study. Numbers to be randomised (sample size) The calculated total sample size is 100 patients, with 25 patients in each group. Trial Status The protocol is Version 2.0, May 24, 2020. Recruitment began May 4, 2020, and is anticipated to be completed by April 19, 2021. Trial registration This trial has been registered by the title of “Effect of curcumin-piperine co-supplementation on disease duration, severity and clinical signs, and inflammatory factors in patients with coronavirus (COVID-19): A randomized, double-blind, placebo-controlled clinical trial study” in the Iranian Registry of Clinical Trials (IRCT) with code “IRCT20121216011763N46”, https://www.irct.ir/trial/47529. The registration date is May 4, 2020. Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.

Premenstrual syndrome (PMS) is a common disorder in the reproductive age that negatively significant impacts on women’s quality of life. This randomized clinical trial study was undertaken to investigate the effect of vitamin D supplementation on inflammatory and antioxidant markers in 44 vitamin D deficient (25(OH)D 3, Interleukin10 and 12 (IL-10, IL-12) and total antioxidant capacity (TAC). In vitamin D group, serum levels of IL-10 and IL-12 significantly decreased while TAC significantly increased post-intervention. There were significant differences regarding serum IL-12 and TAC levels between the two groups. Mean score of the total PMS symptoms showed significant improvement in 25(OH)D. Vitamin D supplementation seems to be an effective strategy to improve inflammation and antioxidant markers in vitamin D deficient women with PMS. This clinical trial was registered at Iranian Registry of Clinical Trials on 20/06/2018 (IRCT20180525039822N1).

The feasibility of sweet cherry gum as a bio-based film-forming material and effect of hydrogen peroxide as a chemical modifier investigated. The influence of film compositions (gum, glycerol) and hydrogen peroxide on the physical properties of films, including solubility in water, permeability to water vapor (WVP), mechanical properties, and transparency, thermal and microstructural properties evaluated. The results showed that WVP and thickness increased by gum and glycerol concentration, but significantly decreased by hydrogen peroxide. As expected, elongation-at-break and solubility, increased at higher concentration of glycerol but the tensile strength decreased at the same condition. The film transparency was influenced by the dry weight content and was improved by higher concentrations of hydrogen peroxide. The partial degradation of polymer chain by hydrogen peroxide was observed by FTIR analysis.

Recently Eshaghi et al. introduced orthogonal sets and proved the real generalization of the Banach fixed point theorem on these sets. In this paper, we prove the real generalization of Diaz–Margolis fixed point theorem on orthogonal sets. By using this fixed point theorem, we study the stability of orthogonally $$*$$ -m-homomorphisms on Lie $$C^*$$ -algebras associated with the following functional equation: $$\begin{aligned} \begin{aligned}&f(2x+y)+f(2x-y)+(m-1)(m-2)(m-3)f(y)\\&\quad =2^{m-2}[f(x+y)+f(x-y)+6f(x)]. \end{aligned} \end{aligned}$$ for each $$m=1,2,3,4.$$ . Moreover, we establish the hyperstability of these functional equations by suitable control functions.

Pomegranate juice was concentrated by conventional heating and microwave heating at different operational pressures (12, 38.5, and 100 kPa), and their effects on evaporation rate and quality attributes of concentrated juice were investigated. The final juice concentration of 40° Brix was achieved in 140, 127, and 109 min at 100, 38.5, and 12 kPa, respectively, by using conventional heating. Applying microwave energy decreased required times to 118, 95, and 75 min. The changes in color, anthocyanin content, and antioxidant capacity during concentration processes were investigated. L*, a*, and b* parameters were measured to estimate the intensity of color loss. All Hunter color parameters decreased with time. Results showed that the degradation of color, anthocyanins, and antioxidant activity were more important in conventional heating compared to microwave heating method. Degradation rates increases by increasing process pressure. A first-order kinetics model was applied to modeling changes in total solid content, anthocyanin content, and antioxidant capacity.