Effects of Zamzam water on glycemic status, lipid profile, redox homeostasis, and body composition in rats.

OBJECTIVES: Previous studies have demonstrated that Zamzam water exerts beneficial effects on several ailments such as diabetes mellitus, nephrotoxicity, hepatotoxicity, and stress. The present study aimed to assess the effects of Zamzam water on glycemic status, lipid profile, redox homeostasis, and body composition in healthy rats. METHODS: Twenty-four rats were divided into two equal groups. Rats were fed a chow diet along with either tap or Zamzam water as the only fluid source. After ten weeks, fasting blood glucose, serum insulin, insulin resistance, low density lipoproteins (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, superoxide dismutase, and lipid peroxidation were measured. Adipose pads and carcass (musculoskeletal only) were weighed and residual body weight was calculated. The groups were compared using independent sample t test (unpaired). RESULTS: The following parameters were significantly reduced in the Zamzam water group compared to the tap water group: fasting blood sugar, 96.5 vs. 147.1 mg/dl (p = 0.00); serum insulin, 0.44 vs. 1.31 µU/l (p = 0.00); and insulin resistance, 1.89 vs. 8.40 (p = 0.00). LDL cholesterol, HDL cholesterol, superoxide dismutase, lipid peroxidation, weight of the body, fat pads, and carcass, as well as residual body weight (both absolute and relative) showed no significant changes. CONCLUSION: Zamzam water intake for ten weeks decreases fasting blood sugar, serum insulin, and insulin resistance. However, Zamzam water has no effect on lipid profile, redox homeostasis, and body composition.

Determining the effectiveness of a cell phone-based student response system.

OBJECTIVES: This study aimed to explore the responses and understanding of students and teachers about the cell phone-based Socrative® application. Additionally, we compared the academic performance of the groups using Socrative with the one group that did not make use of this application. METHODS: During the 50 min of each endocrine physiology lecture, traditional teaching took 40 min, whereas the last 10 min were reserved for Socrative. Following the lecture, students completed small Socrative-based quizzes on their smartphones. At the end of the module, students and teachers were asked for feedback and the students' test performances were evaluated. Data were examined by the SPSS version 20 for frequencies and gender/academic performance comparison. RESULTS: As many as 87% of the students responded positively to Socrative; 85% felt that the activity was fun, 84% were more actively engaged, and 71% felt more motivated. Furthermore, 90% of the students agreed that this exercise enhanced their learning. Most students agreed that Socrative helped them enhance peer-to-peer and class discussions. Students' attitudes towards Socrative activity did not vary with respect to their gender or total screen time per day. Approximately 99% of the students preferred multiple-choice questions to true/false and short answers. Instructors perceived Socrative as an easy-to-use tool to generate discussions and assess the degree of understanding of their students. Socrative significantly enhanced exam performance. CONCLUSION: Course instructors are encouraged to incorporate mobile-based applications in their lectures, which may make students' learning more active, effective, and enjoyable, without increasing institutional expenses.

Comparing levels of psychological stress and its inducing factors among medical students.

OBJECTIVE: This study aimed to determine and compare degrees of psychological stress and inducing factors thereof among first to fifth year medical students (MS). METHODS: This cross-sectional study was conducted on 468 female MS. We used the Kessler 10 Psychological Distress Inventory consisting of questions on a range of stress-inducing factors. RESULTS: A total of 67.9% students reported physiological stress. The percentage of MS without stress and with mild, moderate, and severe stress was 32%, 24%, 22%, and 21.8%, respectively. The highest prevalence of physiological stress was found among first-year students (82.6%). Stress scores significantly decreased with advancement in the year of study, except for the final year (p = 0.001). We found that the first year of medical studies (0.022), academic stress (0.001), the presence of a physical problem (0.001), and being married (0.002) were independent risk factors for high perceived stress (HPS), as shown by K10 scores >24. A total of 11.1% students consulted a psychiatrist, whereas 3.4% admitted taking some medication for stress. CONCLUSION: This study infers that the first year of medical studies, academic stress, the presence of a physical problem, and being married are independent risk factors for HPS. We recommend mandatory stress screening for MS in all medical colleges. Ideally, the screening should be repeated every six months and students identified as having HPS should be provided with counselling, mental health services, and a proper follow-up.

Molecular and pathological studies in the posterior interosseous nerve of diabetic and non-diabetic patients with carpal tunnel syndrome.

AIMS/HYPOTHESIS: We sought to establish the molecular and pathological changes predisposing diabetic and non-diabetic patients to the development of carpal tunnel syndrome (CTS). METHODS: The posterior interosseous nerve (PIN) was biopsied in 25 diabetic and 19 non-diabetic patients undergoing carpal tunnel decompression for CTS. Detailed morphometric and immunohistological analyses were performed in the nerve biopsy. RESULTS: In diabetic patients median nerve distal motor latency was prolonged (p < 0.05 vs non-diabetic patients), PIN myelinated fibre density (p < 0.05), fibre area (p < 0.0001) and axon area (p < 0.0001) were reduced, the percentage of unassociated Schwann cell profiles (p < 0.0001) and unmyelinated axon density (p < 0.0001) were increased and the axon diameter was reduced (p < 0.0001). Endoneurial capillary basement membrane area was increased (p < 0.0001) in diabetic patients, but endothelial cell number was increased (p < 0.01) and luminal area was reduced (p < 0.05) in non-diabetic patients with CTS. There was no difference in the expression of hypoxia-inducible factor 1α between diabetic and non-diabetic patients with CTS. However, the expression of vascular endothelial growth factor A (VEGF) (p < 0.05) and its receptors VEGFR-1 (p < 0.01) and VEGFR-2 (p < 0.05) was significantly increased in diabetic patients, particularly those with type 1 diabetes, and related to the severity of nerve fibre pathology. CONCLUSIONS/INTERPRETATION: This study demonstrates increased nerve fibre and microvascular pathology in relation to enhanced expression of VEGF and its receptors in a non-compressed nerve in diabetic compared with non-diabetic patients with CTS. It therefore provides a potential molecular and pathological basis for the predisposition of diabetic patients to the development of CTS.

Effects of chocolate intake on Perceived Stress; a Controlled Clinical Study.

BACKGROUND: Cocoa polyphenols have been shown to reduce stress in highly stressed, as well as normal healthy individuals, we wondered whether commercially available chocolate could reduce perceived stress in medical students or not, so we decided to conduct this study. METHODS: Sixty students were divided into 3 groups (10 males + 10 females/group): i) Dark chocolate (DC) ii) Milk chocolate (MC) iii) White chocolate (WC). Subjects answered a PSS-10 (Perceived Stress Scale) questionnaire at baseline and after consumption of chocolate (40 g/day) for 2 weeks. Data were analyzed by using Microsoft Excel and SPSS version 20. Descriptive analyses were conducted. Means were compared across the study groups by One-Way ANOVA and within the same group by paired 't' test. RESULTS: Mean stress scores compared between the groups by ANOVA revealed statistically not significant differences before (F =0.505; P=0.606) and after chocolate consumption (F=0.188; P=0.829). Paired 't' test compared stress scores means before and after chocolate supplementation within the same group and exhibited statistically significant decrease in DC (t = 2.341; p value = 0.03) and MC (t = 3.302; p value = 0.004) groups. Mean stress scores decreased, on average, by approximately 2 and 3 points in DC and MC groups, respectively, at 95% Confidence Interval. The difference was more evident and statistically significant in female students as compared to the males. CONCLUSION: Consumption of 40 g of Dark and Milk chocolate daily during a period of 2 weeks appear to be an effective way to reduce perceived stress in females.

Diabetic cardiomyopathy.

Diabetic cardiomyopathy is a distinct primary disease process, independent of coronary artery disease, which leads to heart failure in diabetic patients. Epidemiological and clinical trial data have confirmed the greater incidence and prevalence of heart failure in diabetes. Novel echocardiographic and MR (magnetic resonance) techniques have enabled a more accurate means of phenotyping diabetic cardiomyopathy. Experimental models of diabetes have provided a range of novel molecular targets for this condition, but none have been substantiated in humans. Similarly, although ultrastructural pathology of the microvessels and cardiomyocytes is well described in animal models, studies in humans are small and limited to light microscopy. With regard to treatment, recent data with thiazolidinediones has generated much controversy in terms of the cardiac safety of both these and other drugs currently in use and under development. Clinical trials are urgently required to establish the efficacy of currently available agents for heart failure, as well as novel therapies in patients specifically with diabetic cardiomyopathy.