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This systematic review was conducted to summarize and clarify the evidence on the association between 25-hydroxyvitamin-D [25(OH)D] concentrations and coronavirus disease 2019 (COVID-19) risk and outcomes. PubMed, Scopus, and Web of Science databases and Google Scholar were searched up to 26 November 2020. All retrospective and prospective cohort, cross-sectional, case-control, and randomized controlled trial studies that investigated the relation between 25(OH)D and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and COVID-19 severity were included. Thirty-nine studies were included in the current systematic review. In studies that were adjusted (OR: 1.77; 95% CI: 1.24, 2.53; I2: 44.2%) and nonadjusted for confounders (OR: 1.75; 95% CI: 1.44, 2.13; I2: 33.0%) there was a higher risk of SARS-CoV-2 infection in the vitamin D deficiency (VDD) group. Fifteen studies evaluated associations between VDD and composite severity. In the studies that were adjusted (OR: 2.57; 95% CI: 1.65, 4.01; I2 = 0.0%) and nonadjusted for confounders (OR: 10.61; 95% CI: 2.07, 54.23; I2 = 90.8%) there was a higher severity in the VDD group. Analysis of studies with crude OR (OR: 2.62; 95% CI: 1.13, 6.05; I2: 47.9%), and adjusted studies that used the Cox survival method (HR: 2.35; 95% CI: 1.22, 4.52; I2: 84%) indicated a significant association of VDD with mortality, while in adjusted studies that used logistic regression, no relation was observed (OR: 1.05; 95% CI: 0.63, 1.75; I2: 76.6%). The results of studies that examined relations between VDD and intensive care unit (ICU) admission, pulmonary complications, hospitalization, and inflammation were inconsistent. In conclusion, although studies were heterogeneous in methodological and statistical approach, most of them indicated a significant relation between 25(OH)D and SARS-CoV-2 infection, COVID-19 composite severity, and mortality. With regard to infection, caution should be taken in interpreting the results, due to inherent study limitations. For ICU admission, inflammation, hospitalization, and pulmonary involvement, the evidence is currently inconsistent and insufficient.

Religious fasting is practiced by people of all faiths, including Christianity, Islam, Buddhism, Jainism, as well as Hinduism, Judaism, and Taoism. Individual/clinical, public, global, and planetary health has traditionally been studied as separate entities. Nevertheless, religious fasting, in conjunction with other religious health assets, can provide several opportunities, ranging from the individual to the population, environmental, and planetary levels, by facilitating and supporting societal transformations and changes, such as the adoption of healthier, more equitable, and sustainable lifestyles, therein preserving the Earth's systems and addressing major interconnected, cascading, and compound challenges. In this review, we will summarize the most recent evidence on the effects of religious fasting, particularly Orthodox and Ramadan Islamic fasting, on human and public health. Further, we will explore the potential effects of religious fasting on tackling current environmental issues, with a special focus on nutrition/food restriction and planetary health. Finally, specific recommendations, particularly around dietary intake during the fasting rituals, will be provided to ensure a sustainable healthy planet.

Background The aim of this systematic review and meta-analysis was to determine the effect of olive leaf extract (OLE) supplementation on cardiovascular-related variables, including lipid, glycemic, inflammatory, liver and renal-related factors, as well as blood pressure. Methods PubMed, ISI Web of Science, Scopus, and Cochrane library were searched, up to October 2021, for relevant controlled trials. Mean differences and standard deviations were pooled for all outcomes, using a random-effects model. The methodological quality, as well as quality of evidence were assessed using standard tools. Results Twelve studies (n = 819 participants) were included in our analyses. Overall analyses showed that OLE supplementation significantly decreased triglyceride (TG) levels (WMD = − 9.51 mg/dl, 95% CI − 17.83, − 1.18; P = 0.025; I2 = 68.7%; P-heterogeneity = 0.004), and systolic blood pressure (SBP) (WMD = − 3.86 mmHg, 95% CI − 6.44, − 1.28 mmHg; P = 0.003; I2 = 19.9%; P-heterogeneity = 0.28). Subgroup analyses also revealed a significant improvement in SBP (− 4.81 mmHg) and diastolic blood pressure (− 2.45 mmHg), TG (− 14.42 mg/dl), total cholesterol (TC) (− 9.14 mg/dl), and low-density lipoprotein-C (LDL-C) (− 4.6 mg/dl) measurements, in patients with hypertension. Significant reductions were also observed in TC (− 6.69 mg/dl), TG (− 9.21 mg/dl), and SBP (− 7.05 mmHg) in normal-weight individuals. However, no meaningful changes were seen in glucose hemostasis, liver and kidney, or inflammatory markers. Conclusion The present study revealed that supplementation with OLE yielded beneficial effects for blood pressure and lipid profile in adults, especially in patients with hypertension. As the quality of evidence for glucose hemostasis variables, liver, kidney, and inflammatory markers, were low-to-very low, higher quality RCTs may impact the overarching results. This study was registered at PROSPERO with the code CRD42022302395.

The resting metabolic rate (RMR) represents the largest component of total daily energy expenditure. The sale of ultra-processed foods (UPF) is increasing globally; however, UPF can have many adverse effects, including increasing inflammatory markers and altering RMRs. This cross-sectional study included 285 healthy overweight and obese women. Anthropometric measurements were evaluated using a bioelectrical impedance analyzer InBody 770 scanner. High-sensitivity C-reactive protein (hs-CRP), plasminogen activator-1 (PAI-1), monocyte chemoattractant protein (MCP-1), and interleukin-1 beta (IL-1β) blood levels were measured after a 12-h fasting. Indirect calorimetry was used to evaluate the RMR by using the Weir equation, and RMR deviation (RMR estimated - RMR actual), RMR per body mass index (BMI), and free fat mass (FFM) were estimated. A validated food frequency questionnaire (FFQ) was used, and seven groups of UPFs were extracted based on the NOVA method. A negative association between the RMR [β = −0.159, 95% confidence interval (CI): −0.471, −0.052, P = 0.044], RMR per BMI (β = −0.014, 95% CI: −0.025, −0.006, P = 0.036), and RMR per FFM (β = −0.241, 95% CI: −0.006, −0.000, P = 0.041) using the NOVA score was observed after adjusting for confounders. This association disappeared after inclusion of each inflammatory marker. All the markers may inversely mediate the relationship between the mentioned variables and the NOVA score. hs-CRP and MCP-1 also had a negative effect on the relationship between the NOVA score and RMR deviation. Finally, UPF intake is likely related with the RMR, mediated through changes in the production of hs-CRP, PAI-1, MCP-1, and IL-1β.

Background Critically ill patients must be monitored constantly in intensive care units (ICUs). Among many laboratory variables, nutritional status indicators are a key role in the prognosis of diseases. We investigated the effects of l-carnitine adjunctive therapy on monitoring variables in critical illness. Method A prospective, double-blind, randomized controlled trial was implemented in a medical ICU. Participants were 54 patients, aged > 18 years, with multiple conditions, randomly assigned to receive 3 g l-carnitine per day or placebo, along with enteral feeding, for 1 week. Primary outcomes included monitoring variables related to nutritional status. Result Of 54 patients randomly assigned, 51 completed the trial. Serum albumin (Alb) (P-value: 0.001), total protein (P-value: 0.003), and calcium (Ca) (0.044) significantly increased in the intervention vs. control group. Alanine transaminase (ALT) (0.022), lactate ( Conclusion l-Carnitine supplementation in critically ill patients can improve several parameters including INR, Cr, ALT, lactate, Ca, Alb, and total protein. Trial registration Iranian Registry of Clinical Trials IRCT 20151108024938N2. This trial was approved by the Research Ethics Committee of Mashhad University of Medical Sciences (registration code: IR.MUMS.fm.REC.1396.671) (available at https://en.irct.ir/trial/30748, May 2018).

Background: This study investigated the acute effects of two physical activity (PA) bouts on children’s cognitive and affective responses. Methods: Twenty-nine participants (16 boys and 13 girls; Mage = 9.34 years, SD = 0.48), using a within-subjects crossover design, performed three 15-min conditions: (a) TDM—The Daily Mile™; (b) 12 repeated 30–45-s shuttle runs at ≥ 85% HRMAX; and (c) a sedentary control condition. Cognitive performance (i.e., Stroop, Digit Span, and Corsi blocks) was measured before PA and 1 and 30 min post-PA. Felt Arousal and Feeling Scale self-report scales were administered before, during, and after PA. Results: The results show no changes following the TDM condition relative to the sedentary control condition in cognitive responses. However, when comparing the shuttle runs condition to the sedentary control condition, participants showed higher arousal, an improved reaction time, and lower self-reported pleasure at 1 min post-PA. Nevertheless, at 30 min post-PA, participants’ pleasure values were higher in the shuttle runs condition than they were before PA. Conclusions: When comparing PA conditions, shuttle runs enhanced reaction time and might thus be seen as an option to implement or modify PA opportunities in school settings.

Background: Due to the increasing prevalence of cancer and the inadequacy of current therapies, the development of novel antitumor pharmaceutics with higher efficacies and lower adverse effects is considered a fundamental tenet of contemporary cancer management. Poly-Ethylene-Glycol (PEG) attachment is a novel pharmaceutical technology to improve the efficacy and safety of chemotherapies. Etirinotecan Pegol (EP), also known as NKTR-102, is the PEGylated form of Irinotecan (CPT-11), which causes cancer cell apoptosis by inhibiting the topoisomerase I enzyme. Objectives: The present study reviews and evaluates various reports of the EP’s anti-tumor activity in various cancers. Data Sources: Studies were identified using the Scopus database, with no exclusions. The search terms included Etirinotecan Pegol and NKTR-102, which yielded 125 articles (66 and 59 articles, respectively). In addition, the clinicaltrials.gov website was used to find ongoing studies, which resulted in the addition of two studies. Study Eligibility Criteria: Subsequently, we excluded studies that were published in languages other than English, duplicate articles, and studies with no data. Results: This systematic review clarifies that EP possesses numerous advantages over many other medications, such as safety, efficacy, increased half-life, increased health-related quality of life, increased overall survival, increased progression-free survival, and decreasing the adverse events in the treatment of various cancers. Conclusion: Therefore, Etirinotecan Pegol may represent a major contribution to the treatment of various cancers in the future.

In the present study we investigated the effects of manipulating task difficulty (constant vs. progressive difficulty) and frequency of knowledge of results (KR) on the accuracy and consistency of children’s performance of a novel fine motor coordination task (dart throwing). We assigned 69 right-handed physical education (PE) students ( M age = 10.73, SD = 0.89 years) to progressive (PDG) or constant difficulty (CDG) groups. PDG and CDG were each split into three subgroups who received varying KR frequency (100%KR, 50%KR, and 33%KR), creating a total of six groups. We increased difficulty in the PDG by manipulating the distance to the target (2 m, 2.37 m, and 3.56 m), while distance to the target was constant for CDG throughout the experiment (2.37 m). We conducted performance assessments during familiarization (pre-test), acquisition (post-test), and retention (retention testing) learning phases under both normal condition (NC) and a time pressure condition (TPC). Repeated-measures analysis of variance revealed a significant effect of difficulty manipulation on skill learning under both NC and TPC. Further analyses revealed that skill learning was enhanced by progressive difficulty manipulation. However, learning was not affected by KR frequency changes. Progressive difficulty practice enhanced both accuracy and consistency, specifically at retention testing. These results suggest that motor learning in children may be enhanced by practicing with progressive increases in difficulty. PE teachers are encouraged to gradually introduce difficulty levels in motor learning tasks that require high accuracy.

Background:Current evidence suggests that adherence to the Mediterranean diet (MeD) can reduce inflammation in chronic diseases; however, studies pertaining to relapsing-remitting multiple sclerosis (RRMS) are limited. Therefore, the aim of this study was to investigate the potential of the modified MeD (mMeD) in improving Dietary Inflammatory Index (DII) scores, disability and fatigue severity, compared with traditional Iranian diet (TID), in RRMS patients.Results:Of the 180 patients enrolled, 147 participants were included in the final analysis (n of mMeD = 68; n of TID = 79). Self-reported adherence was good (˜81 %). Dietary intakes of forty-five food parameters were assessed through the FFQ. The mMeD significantly reduced DII scores after 6 months (2·38 ± 0·21 to −1·87 ± 0·86, P < 0·001), but TID did not elicit any changes (2·21 ± 0·44 to 2·14 ± 1·01, P = 0·771). Additionally, Modified Fatigue Impact Scale (MFIS) total score decreased significantly (72·4 ± 17·2 to 63·9 ± 14·2, P < 0·001), whereas there was no considerable improvement for Expanded Disability Status Scale (EDSS) in the mMeD group.Methods:After initial screening (n 261), 180 RRMS patients were randomised to receive mMeD or TID (as control) for 6 months. DII score, EDSS and twenty-one-item MFIS were evaluated at baseline and trial cessation. Multivariate ANCOVA was conducted and adjusted for age, gender, body weight, BMI, education level, supplement use, family history and duration of MS.Conclusion:Adherence to mMeD, for 6 months, improved dietary inflammatory status and fatigue severity in RRMS patients; however, the TID did not positively impact dietary inflammation and MFIS score.

Recent pharmacovigilance reports suggested that thionamide compounds can increase the risk of acute pancreatitis (AP). Through this systematic review and meta-analysis, we comprehensively evaluated the association between methimazole use and new-onset AP. PubMed/MEDLINE, Embase, Cochrane Library, and Scopus/Web of Science databases were searched from inception to August 2020. The pooled estimates were expressed as odds ratios (ORs) with 95% confidence intervals (CIs). Four observational studies, consisting of 202,800 participants and 15,721 cases of AP, were included in the analysis. Methimazole use increased the odds of new-onset AP by 47% (OR 1.47; 95% CI 0.89–2.43), but this association was not significant (p = 0.134). This suggests that the use of methimazole might slightly increase the risk of AP. Because the evidence for this association is limited, caution is advised for active interventions, and further investigation is warranted.

We aimed to assess the dietary composition of lunch meal using a posteriori-derived dietary patterns and to determine the association of lunch composition with obesity in a sample of Iranian adults. This cross-sectional study was conducted on 850 men and women in Tehran (aged 20–59 years). Dietary intakes were assessed using three 24-h dietary recalls, and dietary patterns were identified via principal component factor analysis. For each identified pattern, scores were calculated for each participant and then classified into tertiles. Central obesity was defined WHO criteria. General obesity was defined as a BMI of more than 30 kg/m2. Three major dietary patterns were identified at lunch meal using twelve food groups: ‘Bread, grains and fat’, ‘Western’ and ‘Potato and eggs’. After adjustment for potential confounders, participants at the top tertile of the ‘Bread, grains and fat’ dietary pattern had greater odds for a higher waist-to-hip ratio (WHR), compared with those in the lowest tertile (OR: 1·44, 95 % CI 1·01, 2·07). However, we found no association between ‘Western’ or ‘potato and eggs’ patterns and WHR (OR: 0·89, 95 % CI 0·62, 1·28 and OR: 1·16, 95 % CI 0·69, 1·42, respectively). None of the identified dietary patterns was associated when defining obesity with waist circumference or BMI. In conclusion, participants had a greater chance of central obesity defined based on WHR following a lunchtime pattern with a higher and positive loading factor for ‘Bread, grains and fat’.

Objective This study sought to investigate the effect of Spirulina on cardiometabolic risk factors, oxidative stress biomarkers, glycemic profile, and liver enzymes in nonalcoholic fatty liver disease (NAFLD) patients. Methods This randomized, double‐blind clinical trial was performed on 46 NAFLD patients. Subjects were allocated to consume either Spirulina sauce or placebo, each 20 g/day for 8 weeks. Fatty liver grade, liver enzymes, anthropometric parameters, blood pressure, and serum lipids, glucose, insulin, malondialdehyde, and antioxidant capacity were assessed pre‐ and postintervention. Results Fatty liver grade was significantly different between the two groups. A significant change for ALT (alanine aminotransferase) and AST (aspartate aminotransferase) was seen between the two groups (p = .03 and .02, respectively), while ALP (alkaline phosphatase) serum levels were not significantly different within or between groups. Pertaining to glycemic profile, all variables, except HOMA‐IR, were not significantly different within or between groups. Finally, statistically significant changes were seen in both MDA (malondialdehyde) and TAC (total antioxidant capacity) among the groups (p = .04 and

Abstract. Background and Objective: The aim of present study was to compare, and determine, the effects of a modified alternate-day fasting diet vs. calorie restriction on inflammatory indices and coagulation factors. Methods: This was a randomized clinical trial consisting of 80 metabolic syndrome patients, who were enrolled and randomly dichotomized into a modified alternate-day fasting diet or calorie restriction group for 4 months. We measured weight, body mass index (BMI), waist circumstance (WC), waist-hip-ratio (WHR) and fat mass as primary outcomes and assessed high sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α) and coagulation factors levels as secondary outcomes before and after intervention. Results: Compared to the calorie restriction diet, following a modified alternate-day fasting diet led to a greater reduction in body weight (kg) (–6.43 ± 4.34 vs –4.11 ± 4.27; P = 0.02), BMI (kg/m2) (–3.19 ± 2.90 vs –1.43 ± 2.72; P = 0.01), fat mass (kg) (–4.88 ± 2.09 vs –3.72 ± 2.43; P = 0.03), WC (cm) (–5.57 ± 5.64 vs –2.32 ± 5.95; P = 0.01) and WHR (–0.05 ± 0.06 vs –0.02 ± 0.07; P = 0.04). Furthermore, a greater change was found in hs-CRP levels (mg/L) (–2.06 ± 1.18 vs –0.97 ± 0.82; P = 0.03), prothrombin time (s) (1.41 ± 2.34 vs –0.41 ± 2.17; P 0.05). Conclusions: These findings suggest that a modified alternate-day fasting diet can be a beneficial alternative for the management of body weight, fat mass and WC as well as hs-CRP and coagulation factors levels among metabolic syndrome patients.

Summary Background The current evidence-base regarding the effect of hesperidin (a flavanone found in citrus fruits) on body composition is equivocal. Objective We conducted a meta-analysis on the effect of orange juice and/or hesperidin supplementation on anthropometric measures in randomized controlled trials (RCTs). Materials and methods A systematic search of PubMed and Scopus was performed up to February 2020. The overall estimates and their 95% confidence intervals (CIs) were calculated using a random-effects model. Results Eleven eligible RCTs, with 512 individuals, were included in this study. The meta-analysis showed that orange juice and/or hesperidin had no significant effect on body weight [weighted mean difference (WMD) = −0.31 kg; 95% CI, −1.44 to 0.82, P = 0.592], body mass index [WMD = 0.11 kg/m2; 95% CI, −0.33 to 0.56, P = 0.617], fat mass [WMD = 0.14 kg; 95% CI, −0.95 to 1.22, P = 0.807], percentage body fat [WMD = −0.70%; 95% CI, −2.58 to 1.18, P = 0.463] and waist circumference [WMD = 0.07 cm; 95% CI, −1.16 to 1.30, P = 0.588]. Conclusion The present study revealed that there is no significant beneficial effect of orange juice and/or hesperidin supplementation on anthropometric measures. The authors advocate that more high-quality clinical trials are needed to better discern the potential efficacy of orange juice and/or hesperidin.

Introduction: Accurate diagnosis of the COVID-19 disease is important. Currently, chest computed tomography (CT) and reverse polymerase chain reaction (RT-PCR) are being used for the diagnosis of the COVID-19 disease. This study was performed to evaluate the Chest computed tomography (CT) diagnostic value in comparison with the RT - PCR method among COVID-19 patients. Methods: This cross-sectional study was performed on suspected cases of COVID-19 in Imam Khomeini Hospital, Jiroft, Iran. Studied patients were evaluated via both a chest CT scan and nasopharyngeal swab for SARS-CoV-2 detection. Data was collected using a self-administered checklist, including demographic information, medical history, and symptoms of COVID-19, chest CT scan, and RT-PCR findings. Data were analyzed using SPSS-V21. Results: One thousand and ninety (1090) cases participated in the study; the mean age of the cases of COVID-19 was 48.20± 7.31 years old. The results of the RT-PCR test were 410 (37.6%) positive and 680 (62.4%) negative cases. According to the results of RT-PCR, which is the gold standard method, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive values of chest CT were 98.5%. (99.4-96.8 CI: 95%), 55.7% (59.5 – 51.9 CI: 95%), 71.5% (74.4 -69.0 CI: 95%), 57.3% (60.9 – 53.5 CI: 95%), and 98.4% (99.4% - 99.6 CI: 95%), respectively. Discussion: The results of the present study showed that a chest CT scan is highly sensitive for the diagnosis of the COVID-19 disease. Therefore, it can be used as a suitable method for screening and early detection, which requires knowledge of its common radiologic patterns. However, the results showed that the use of this method has low specificity, so it cannot be used for definitive diagnosis and should be used as a complementary method concomitant to the RT - PCR test.

This study aimed to examine the effects of two high-intensity interval training programs (HIIT) on maximal aerobic velocity (MAV), hematological variations and muscle damage markers in young healthy adults. Twenty-nine male physical education students, aged 20.3 ± 3.3 years, volunteered to participate in this study, and were randomly assigned to a control group (CG, n = 9) or two intervention groups (group 1 or 2). Intervention group 1 (n = 10) exercised at 100% of their MAV (EG100) while group 2 (n = 10) exercised at 110% MAV (EG110). Before and after the eight week training program, blood samples were drawn at rest, before, and after an intermittent exercise. Aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), C reactive protein (CRP), creatine kinase (CK) concentrations and hematological parameters (white blood cells [WBC], monocytes [MO], lymphocytes [LY], neutrophil [NE]) and lactate dehydrogenase (LDH) were measured. Post-hoc tests showed that MAV was significantly higher in EG110 compared to EG100 after HIIT (p p2 = 0.05), whilst ALAT, ASAT, and CPR were significantly lower (p p2 110 compared to EG100. Moreover, post-hoc tests indicated that LY decreased significantly (p p2 = 0.21) only for EG110. Furthermore, there were significant positive correlations for both EG100 and EG110 between MAV and ALAT (r = 0.66, p = 0.044 and r = 0.64, p = 0.041 respectively), CK (r = 0.67, p = 0.031 and r = 0.86, p = 0.030, respectively), LDH (r = 0.74, p = 0.014, and r = 0.071, p = 0.021, respectively). In addition, there was a significant positive correlation for both, EG100 and EG110 between MAV and LY (r = 0.79, p p p 110. Findings from this study revealed that HIIT at 110% MAV was more efficient to improve MAV and reduce muscle damage. In addition, we observed significant associations between performance improvements (MAV) and markers of muscle damage.

Polycystic ovary syndrome (PCOS) is one of the common endocrine disorders in women, which causes numerous symptoms in women. The relationship of many micronutrients with this syndrome has been investigated. This study was conducted to examine the effects of magnesium supplementation on hyperandrogenism, hirsutism, and sleep quality in women with PCOS.In this parallel randomized clinical trial, 64 women with PCOS were randomly assigned to the magnesium group (Magnesium supplementation had no significant effect on hyperandrogenism (The present study showed that a single dose of magnesium supplementation elicited no beneficial effects on the mentioned symptoms in polycystic women. It is possible that the positive effects of magnesium observed in the former studies were due to the synergistic effects of other vitamins or minerals. More studies are needed in this area.

The favorable influence of grape consumption on metabolic diseases has previously been shown in studies. We sought to assess the effects of grape intake on liver enzymes, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP), in adults. We performed literature search in online databases, to find eligible randomized controlled trials (RCTs). we considered RCTs that met the following criteria: RCTs consisted of use of grape products on ALT, AST, and ALP in adults (≥18 years) with at least 2 weeks intervention duration. Pooling data from 11 trials showed that grape products intake significantly reduced ALP (p = .010), without any significant changes in ALT (p = .234) and AST (p = .300). In subgroup analysis, we found a significant reduction in ALP, ALT, and AST when the duration of intervention was ≥12 weeks, and when grape seed extract (GSE) was administered. The variable duration and dosage of intervention was one of the sources of bias in our meta-analysis. Additionally, participants involved in included studies had different physiological status and various age groups. Grape products administration may significantly improve ALT, AST, and ALP in adults in long-term interventions and/or when GSE is administered. It should be noted that the favorable effects of grape consumption were small and may not reach clinical importance.

Sparse data are available regarding the efficacy and safety of single anastomosis sleeve ileal (SASI) bypass surgery, where most available studies utilized short-term follow-ups. Therefore, this study was conducted to evaluate the safety and outcomes of this procedure in three consecutive years after the surgery.This retrospective study was carried out with 116 patients who underwent SASI from October 2016 to September 2021. Anthropometric, clinical, and biochemical data were recorded before, 1, 2, and 3 years after surgery.The 1, 2, and 3-year percentage of excess weight loss (%EWL) were 87.37%, 90.7%, and 80.6%, respectively. Remission or improvement was recorded for diabetes mellitus in 90.9%, hypertension in 80.0%, hyperlipidemia in 100%, sleep apnea in 100%, and irregular menstruation in 58.06 at 3 years after surgery. No mortality and 5.1% early major postoperative complications were recorded. Eight patients (6.8%) had reversal surgery due to EWL gt; 100%.The SASI bypass is an effective bariatric surgery that achieved sequential weight loss and improvement in medical comorbidities three years after the surgery; however, standardization of SASI procedure technique is needed to ameliorate nutritional deficiencies.

Background Women with GDM have a higher risk of future cardiovascular diseases (CVD). Meanwhile, synbiotics have been demonstrated to have favorable impacts on atherogenic indices, and inflammatory and oxidative stress indicators, all of which are known to be CVD-predictive factors. The aim of this randomized controlled trial was to evaluate the effects of synbiotic supplementation on the atherogenic indices of plasma, high-sensitivity C-reactive protein (hs-CRP), and plasma malondialdehyde (MDA) in women with GDM. Methods Eligible pregnant women with GDM were randomized into two groups to receive a daily synbiotic capsule [500 mg of L.acidophilus(5 × 1010 CFU/g), L.plantarum(1.5 × 1010 CFU/g), L.fermentum(7 × 109 CFU/g), L.Gasseri(2 × 1010 CFU/g) and 38.5 mg of fructo-oligo-saccharides], or placebo, for 6 weeks. The ratios of TC/HDL-C, LDL/HDL-C, and logTG/HDL-C were calculated as the atherogenic indices. Serum hs-CRP and MDA concentrations were quantified before and after the intervention. Cohen’s d(d) was used to calculate the magnitude of the effect. Results Ninety participants completed the study. There was no significant difference in dietary antioxidant and mineral intakes between the two groups. Compared with placebo, synbiotic supplementation resulted in a significant decrease in logTG/HDL-C ratio with a medium–low effect size (mean difference = −0.11; 95% CI −0.21, 0; P values for the placebo and the intervention groups were 0.02, and 0.042, respectively; P between groups = 0.003; d = 0.25). No significant changes were observed in other parameters. Conclusions Overall, 6 weeks of synbiotic supplementation in women with GDM resulted in a significant improvement in logTG/HDL-C, suggesting that synbiotics may have a beneficial role in reducing the risk of future CVDs associated with GDM. Nevertheless, more studies are needed to confirm the veracity of these results. Trial Registration IRCT201511183140N16 (December 29th, 2015).

Purpose The purpose of this systematic review and meta-analysis was to investigate the efficacy of propolis on glycemic indices in type 2 diabetic patients. Design/methodology/approach Web of science (ISI), Embase, Scopus and PubMed were systematically searched to find randomized controlled trials (RCTs) assessing the effects of propolis intake on glycemic controls in type 2 diabetic patients, from inception up to September 1, 2020. A random-effects model was used to pool weighted mean difference (WMD). Meta-regression was performed to detect the potential sources of inter-study heterogeneity. Findings Seven trials were included in the meta-analysis. Compared to controls, propolis intake significantly improved serum fasting blood sugar (FBS) (WMD = −13.62 mg/dl, 95% CI = [−23.04, −4.20], P = 0.005, I2 = 58.5%) and hemoglobin A1C (HbA1c) (WMD = −0.52%, 95% CI = [−0.86, −0.18], P = 0.002, I2 = 64.0%). In contrast, receiving propolis did not change serum insulin (WMD = −1.46 (uIU/ml), 95% CI = [−2.94, 0.02], P = 0.05, I2 = 75.0%) and homeostatic model assessment for insulin resistance (HOMA-IR) (WMD = −0.98 (%), 95% CI = [−2.00, 0.04], P = 0.06, I2 = 82.3%) compared to controls. Originality/value The present meta-analysis demonstrated that propolis intake significantly reduces serum FBS and HbA1c in diabetic patients but does not alter serum insulin and HOMA-IR. Further large-scale RCT’s are needed to approve these effects.

Peritoneal adhesion represents a severe complication following surgery. Punica granatum (pomegranate) possesses several anti-oxidative and anti-inflammatory properties. Pomegranate peel extract (PPEx) can alleviate the production of various inflammatory factors and cytokines. Thus, we sought to evaluate the anti-adhesion effects of pomegranate in rats. Thirty male Wistar rats (6-week-old, 220 ± 20 g) were divided into five groups (n = 6): normal group without any surgical procedures, control group, and experimental groups receiving 2 ml of 1%, 2%, and 4% w/v PPEx, respectively. Peritoneal adhesions were examined macroscopically. Furthermore, we evaluated inflammatory cytokines levels [interleukin 6 (IL-6), and tumour necrosis factor-α (TNF-α)], growth factors [transforming growth factor- β1 (TGF-β1), and vascular endothelial growth factor (VEGF)], and oxidative stress parameters [nitric oxide metabolites (NO), and malondialdehyde (MDA), and glutathione (GSH)] using biochemical methods. Our results showed that the adhesion score and IL-6, TNF-α, TGF-β1, VEGF, NO, and MDA levels were increased in the control group. In contrast, the GSH level was diminished in the control group compared with the normal group (P