Correlation Between the 8-hydroxy-2'-deoxyguanosine Level in the Peritoneal Solution of Patients Undergoing Peritoneal Dialysis and the Peritoneal Equilibration Test, Kt/V, Ferritin, and Albumin Levels.

INTRODUCTION: Peritoneal dialysis (PD) is an effective treatment  modality for advanced kidney failure, offering patients a significant  degree of independence. However, the long-term use of PD is  limited due to the degeneration of the peritoneal membrane,  resulting in reduced dialysis adequacy. Evaluating the peritoneal  membrane condition in patients with advanced kidney failure  who are undergoing PD is challenging with existing methods.  Therefore, this study aimed to investigate the correlation between  8-hydroxy-2'-deoxyguanosine (8OHDG) levels in the peritoneal  solution of patients undergoing PD and various factors, such  as peritoneal equilibration test (PET), dialysis adequacy (Kt/V),  underlying diseases, serum ferritin, and albumin levels. 8OHDG  is a sensitive marker of oxidative stress caused by DNA damage. METHODS: A total of 56 patients were included in this cross-sectional  study. Five milliliters of PD fluid were collected from the patients,  and 8-OHdG levels were measured using ELISA method. Then, they  were compared with PET, Kt/V, albumin, and ferritin markers in  the patients' files, and the results were analyzed by statistical tests. RESULTS: The study examined the correlation between 8OHDG  and other markers. It was found that this index had significant  associations with PET and underlying HTN (P < .05), whereas no  significant associations were identified with the other markers. CONCLUSION: The results of the present study demonstrate that  the level of 8OHDG, as one of the oxidative stress markers, could  be used to evaluate the function of the peritoneum in patients  undergoing PD. DOI: 10.52547/ijkd.7654.

A Comparative Analysis of Patients' Quality of Life, Body Image and Self-confidence Before and After Aesthetic Rhinoplasty Surgery.

OBJECTIVE: Having desired facial features creates a better mental image, results in increased self-confidence and boosts social activities to a more acceptable level. The goal of the current study is to investigate how rhinoplasty surgery affects patients admitted to Shahrekord surgical clinic. METHODS: The study was conducted on 100 patients randomly selected and referring for rhinoplasty surgery. The required information was collected through demographic questionnaires of rhinoplasty outcomes F 36 and Rosenberg's self-esteem scale. The questionnaires were filled out by patients before surgery and 3 months after surgery. The data were analyzed using SPSS and data mining software. FINDINGS: Out of the hundred participants, 63% were female and 37% were male. The number of individuals in the studied groups decreased in older age groups so that most of the participants were in the 20-24-year group followed by 25-30 y/o group. Patients from other age groups were less frequent. In terms of educational attainment, the highest frequency was associated with a BSc and the lowest with a diploma. In terms of employment status, the highest frequency was among students and the unemployed and employees and the self-employed followed. Body image and self-esteem were significantly improved after surgery (p < 0.005). Although not statistically significant, quality of life was improved too after surgery. CONCLUSION: According to the results of this study, physicians and patients should measure the pros and cons of the surgery before making a treatment decision. It also showed that rhinoplasty leads to an increase in quality of life and self-esteem. Prior to surgery, specialist consultation should be performed, and rhinoplasty should be performed if a specialist physician allows it. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the Online Instructions to Authors www.springer.com/00266.

Effect of Palliative Care on Quality of Life and Survival after Cardiopulmonary Resuscitation: A Systematic Review.

BACKGROUND: Cardiac and respiratory arrest is reversible through immediate cardiopulmonary resuscitation (CPR). However, survival after CPR is very low for various reasons. This systematic review study was conducted to assess the effect of palliative care on quality of life and survival after CPR. METHODS: In the present meta-analysis and systematic review study, two researchers independently searched Google Scholar and MagIran, MedLib, IranMedex, SID, and PubMed for articles published during 1994-2016 and containing a number of relevant keywords and their Medical Subject Headings (MeSH) combinations. A total of 156 articles were initially extracted. RESULTS: The success of initial resuscitation was reported to be much higher than the success of secondary resuscitation (survival until discharge). Moreover, the early detection of cardiac arrest, a high-quality CPR, immediate defibrillation, and effective postresuscitation care improved short- and long-term outcomes in these patients and significantly affected their quality of life after CPR. Most survivors of CPR can have a reasonable quality of life if they are given proper follow-up and persistent treatment. CONCLUSIONS: Concerns about the low quality of life after CPR are therefore not a worthy reason to end the efforts taken for the victims of cardiac arrest. More comprehensive education programs and facilities are required for the resuscitation of patients and the provision of post-CPR intensive care.

Antagonistic effect of isolated probiotic bacteria from natural sources against intestinal Escherichia coli pathotypes.

BACKGROUND: Probiotics are live microorganisms which are beneficial bacteria that are normal flora of the digestive system which, in determined amounts, show beneficial effects on host health, and can balance gastrointestinal microflora. Digestive tract diseases such as diarrhea are one of the major causes of child mortality in developing countries. Different pathotypes of Escherichia coli cause diarrhea that affects children, therefore reduction of these colonization strains in humans or animals can decline gastrointestinal disorders such as diarrhea. OBJECTIVE: The aim of this study was to determine the antimicrobial effect of probiotic bacterial strains isolated from different natural sources against 4 pathotypes of pathogenic E. coli using disk and well diffusion methods. METHODS: This cross-sectional study was conducted from December 2013 to July 2014 on Martyr Chamran University in Ahwaz city. A total of 13 probiotic colonies isolated from 20 samples of traditional dairy products including yogurt, cheese and milk, and 20 samples of vegetables including carrots and cabbages (red and white), of which 5 isolates were selected to determine the antimicrobial effect against 4 Escherichia coli pathotypes, randomly. The antimicrobial effect was evaluated using two methods: disk diffusion and well diffusion tests and measuring growth inhibition zones of probiotics against 4 pathotypes of pathogenic E. coli. RESULTS: Obtained results showed growth inhibition effects of all 5 probiotic strains against Escherichia coli pathotypes in both used methods. But in comparison Lactobacillus plantarum had higher growth inhibitory effects in both methods. CONCLUSION: results of this study demonstrated high antimicrobial effect of probiotic bacteria against pathogenic Escherichia coli strains. It indicated a positive and beneficial role of probiotics in human health and prevention of illness.

The antimicrobial activity of probiotic bacteria Escherichia coli isolated from different natural sources against hemorrhagic E. coli O157:H7.

BACKGROUND: Diarrheal diseases have been seen in all geographical areas throughout the world. Therefore, considering treatment, could be deemed a necessary action. OBJECTIVE: The aim of this study was to determine the antimicrobial effect of probiotic bacterial strains isolated from different natural sources against 2 pathotypes of pathogenic E. coli. METHODS: This cross-sectional study of Martyr Chamran University of Ahvaz was carried out from December 2013 to July 2014. A total of 13 probiotic colonies isolated from 20 samples of traditional dairy products including (yogurt, cheese, milk) and 20 samples of vegetables including carrots and cabbages (red and white) of which 5 isolates were selected to evaluate the antimicrobial effect against 2 Escherichia coli pathotypes, randomly. Antimicrobial effect was evaluated using two methods: disk diffusion and well diffusion tests and measuring growth inhibition zones of probiotics against 2 pathotypes of pathogenic E. coli. RESULTS: Obtained results showed growth inhibition effects of all 5 probiotic strains against Escherichia coli pathotypes in both used methods. All selected strains showed considerable antimicrobial effect on Escherichia coli O157:H7 strain, but had no inhibitory effect against Enterohemorrhagic Escherichia coli. CONCLUSION: This study demonstrated considerable antimicrobial effect against E. coli O157:H7 strain. Due to this, characteristic and similar antimicrobial effects of probiotics bacteria, increasing use of the probiotics as a natural and modern method for prevention of different diseases is recommended.

Vitamin D ameliorates systolic but not diastolic blood pressure in patients with type 2 diabetes: Results from a meta-analysis of randomized controlled trials.

Inconsistent findings have been reported regarding the effects of vitamin D on blood pressure in patients with type 2 diabetes (T2D). This study aimed to evaluate the subject through a meta-analysis. A computerized literature search on five databases was performed and randomized controlled trials (RCTs) published until March 2016 were identified. The eligibility criteria for articles to be selected were parallel-group RCTs in which consumption of a kind of vitamin D was compared with placebo in patients with T2D. Un-standardized mean difference and its corresponding 95 % confidence interval (CI) was calculated from the effect sizes by using random effects model. Studies comparing intervention group (received vitamin D) with control group (received placebo) were enrolled in meta-analysis. Meta-analysis on 26 studies with 1789 type 2 diabetic subjects showed that vitamin D significantly reduced systolic blood pressure (SBP; -0.97 mmHg, 95 % CI: -1.94, -0.001, P = 0.050), but not diastolic blood pressure (DBP; -0.10 mmHg, 95 % CI: -0.22, 0.02, P = 0.087). Subgroup analyses showed that administration of vitamin D in patients with baseline serum 25-hydroxy vitamin D < 50 nmol/l and baseline SBP < 140 mmHg significantly reduced SBP. Moreover, the patients who received vitamin D without Ca co-supplementation showed significant reduction in SBP. Vitamin D doses (≤ 2000 or > 2000 IU/day) and method of vitamin D application (Supplementation or food fortification) did not affect the blood pressure. This study demonstrated that vitamin D improved SBP in type 2 diabetic patients. Therefore, this vitamin can be considered as an adjuvant therapy in these patients.

Effect of Chlorella supplementation on cardiovascular risk factors: A meta-analysis of randomized controlled trials.

BACKGROUND & AIMS: The effect of Chlorella supplementation on cardiovascular risk factors of subjects with different health status has not been conclusively studied. Therefore, the efficacy of Chlorella supplementation on cardiovascular risk factors was assessed through a meta-analysis. METHODS: A literature search on five electronic databases was performed and related randomized controlled trials (RCTs) published until 15 January 2017 were identified. For each study, the effect size of each outcome was presented as Un-standardized mean difference and 95% confidence interval (CI). The overall effect for each outcome was calculated using random effects model. RESULTS: Meta-analysis on 19 RCTs with 797 subjects indicated that Chlorella administration significantly decreased the levels of total cholesterol (TC; -9.09 mg/dl, 95% CI: -12.91 to -5.26, P < 0.001), low-density lipoprotein cholesterol (LDL-C; -8.32 mg/dl, 95% CI: -12.22 to -4.42, P < 0.001), systolic blood pressure (SBP; -4.51 mmHg, 95% CI: -6.53 to -2.48, P < 0.001), diastolic blood pressure (DBP, -1.64 mmHg, 95% CI: -3.28 to -0.01, P = 0.049), and fasting blood glucose (FBG; -4.23 mg/dl, 95% CI: -8.29 to -0.17, P = 0.041) whereas changes in triglycerides (TG; 1.73 mg/dl, 95% CI: -7.25 to 10.70, P = 0.706), high-density lipoprotein cholesterol (HDL-C; 1.54 mg/dl, 95% CI: -2.40 to 5.48, P = 0.443), and body mass index (BMI; -0.23 kg/m2, 95% CI: -0.97 to 0.51, P = 0.545) was not statistically significant. Subgroup analyses based on intervention duration and Chlorella doses revealed that administration of Chlorella for 8 weeks or higher and doses higher than 4 g/day significantly reduced TC, LDL-C, SBP, and DBP levels in the participants. Moreover, Chlorella supplementation significantly reduced TC and LDL-C levels in unhealthy individuals, and also reduced SBP and DBP in hypertensive ones. CONCLUSIONS: The results indicated that Chlorella supplementation improved levels of TC, LDL-C, SBP, DBP, and FBG but the changes in TG, HDL-C, and BMI were not satisfactory. More precise RCTs on subjects with different health status is recommended to clarify the effect of Chlorella supplementation on cardiovascular risk factors.

On the occasion of world kidney day 2017; obesity and its relationship with chronic kidney disease.

CONTEXT: Numerous studies have reported the impact of obesity in the incidence of chronic kidney disease (CKD). Some studies have suggested the direct role of obesity in the incidence of CKD, while some other studies suggest an indirect effect caused by the effects of obesity on blood pressure and diabetes. EVIDENCE ACQUISITION: PubMed, EBSCO, Web of Science, directory of open access journals (DOAJ), EMBASE, and Google Scholar have been searched. RESULTS: Recent studies have presented more strong evidences on the role of obesity on the incidence of CKD. The double role of obesity in the incidence of CKD has also been mentioned in some studies. CONCLUSIONS: Such an additional effect arises from the impact of obesity on the incidence of some conditions and diseases such as cardiovascular disease, hypertension, and diabetes, which in turn are involved in the incidence of CKD and are considered as its risk factors.

Traditional uses of medicinal plants to prevent and treat diabetes; an updated review of ethnobotanical studies in Iran.

BACKGROUND: Obesity and physical inactivity are currently on the rise due to industrialization of the communities, which has recently led to increased incidence of different diseases such as diabetes. Epidemiological studies and figures have demonstrated the growing incidence of diabetes. Relevantly, the side effects of chemical drugs have led patients to use medicinal plants and traditional approaches despite advances in development of chemical drugs. The aim of this review article is to report the medicinal plants and their traditional uses to prevent and treat diabetes according to the findings of ethnobotanical studies conducted in different regions of Iran. EVIDENCE ACQUISITIONS: The search terms including ethnobotany, ethnomedicine, ethnopharmacology, phytopharmacology, phytomedicine, Iran, and traditional medicine in combination with diabetes, blood sugar and hyperglycemic were searched from scientific databases. RESULTS: The results of this article can be a comprehensive guideline, based on ethnobotany of different regions of Iran, to prevent and treat diabetes. According to this review article, certain plant species such as Urtica dioica L., popularly called nettle, in eight regions, Teucrium polium L., popularly called poleigamander, in five regions, and Trigonella foenum-graecum L., Citrullus colocynthis (L.), Schrad., and Juglans regia L. in four regions, were reported to be frequently used to prevent and treat diabetes. CONCLUSIONS: The introduced medicinal plants in this review can be investigated in further research and produce new drugs with limited side effects.

Ameliorative effect of lycopene effect on cisplatin-induced nephropathy in patient.

BACKGROUND: Nephrotoxicity is one of the most important limitations of cisplatin-based chemotherapies which associated with many complications and high mortality rate. OBJECTIVES: To investigate the effect of lycopene on cisplatin-induced nephrotoxicity in patients with cancer. PATIENTS AND METHODS: In this double-blind, randomized clinical trial, 120 patients were randomly assigned to two groups, case (treated with lycopene + standard regimen of kidney injury prevention) and control (treated with only the standard regimen of kidney injury prevention). Lycopene was orally taken from 24 hours before to 72 hours after cisplatin administration. Blood urea nitrogen (BUN), serum creatinine (Cr), and glomerular filtration rate (GFR) were measured and recorded. The data were analyzed using SPSS. RESULTS: Changes in Cr were not significantly different between the two groups (P = 0.131). However, a significant decreasing trend was seen in GFR during the study, which was more marked in the control group (P = 0.004). BUN significantly decreased during the study (P = 0.002), and a significant decrease of BUN on the day three in both groups was seen (P = 0.001). However, BUN increased in the case group on the day 21 of treatment. The corresponding increase was less marked in the control group. CONCLUSIONS: Lycopene can be considered a useful adjuvant therapy to decrease the complications due to cisplatin-induced nephrotoxicity in patients with cancer.

Antifungal effects of Lactobacillus species isolated from local dairy products.

OBJECTIVE: The Lactobacillus is a genus of lactic acid bacteria which are regularly rod-shaped, nonspore, Gram-positive, heterogeneous, and are found in a wide range of inhabitants such as dairy products, plants, and gastrointestinal tract. A variety of antimicrobial compounds and molecules such as bacteriocin are produced by these useful bacteria to inhibit the growth of pathogenic microbes in the food products. This paper aims to examine the isolation of Lactobacillus from local dairies as well as to determine their inhibition effect against a number of pathogens, such as two fungi: Penicillium notatum and Aspergillus fulvous. MATERIALS AND METHODS: Twelve Lactobacillus isolates from several local dairies. After initial dilution (10-1-10-3) and culture on the setting, de Man, Rogosa and Sharpe-agar, the isolates were recognized and separated by phenotypic characteristics and biochemical; then their antifungal effect was examined by two methods. RESULTS: Having separated eight Lactobacillus isolates, about 70% of the isolates have shown the inhabiting areas of antifungus on the agar-based setting, but two species Lactobacillus alimentarius and Lactobacillus delbrueckii have indicated a significant antifungal effect against P. notatum and A. fulvous. Except bacteriocin, lactic acid, and acetic acid, the inhibitor substance is produced by these bacteria. CONCLUSION: Given the vitality of Lactobacillus in human health, recognition and isolation of the species producing compound in antagonist to the pathogens existing in the food products can be a helpful and effective step toward maintaining the valuable native Lactobacillus and using them in the dairy industries.

Relationship between serum irisin, glycemic indices, and renal function in type 2 diabetic patients.

Introduction: Irisin is a novel peptide that plays notable role in human and animal biology and physiology. It has been reported that irisin may improve insulin resistance and related disturbances. Objectives: The aim of this investigation was to assess the relationship between serum irisin, glycemic indices, and renal function in diabetic subjects. Patients and Methods: In this cross-sectional study, a total of 102 type 2 diabetes mellitus (T2DM) patients were recruited. Blood biochemical parameters, including fasting plasma sugar (FBS), glycosylated hemoglobin (HbA1C), serum uric acid (sUA), creatinine concentration and glomerular filtration rate (GFR) were measured. All statistical analysis was performed with SPSS 16.0. Results: There was a positive correlation between irisin and age (P=0.05, r=0.19) and a negative correlation between irisin and body mass index (BMI) (P=0.01, r=-0.25) was detected. There was a significant difference of serum irisin level between patients with normal and abnormal FBS too. Conclusion: In this study we found, irisin concentration was increased with age, decreased with BMI, and it was higher in subject with abnormal FBS. Thus further research is needed to provide inclusive understanding of irisin associated physiological effects and possible implications in clinical conditions.

An update on diabetic kidney disease, oxidative stress and antioxidant agents.

Diabetes mellitus is a metabolic disease that is defined by relative or absolute deficiency of insulin secretion. Diabetic kidney disease seems to be one of the most frequent complications of diabetes mellitus. Based on evidence, increased free-radical formation and/or diminished antioxidant defenses induce oxidative stress that is implicated in the pathogenesis of diabetic kidney disease. It is evident that diabetic state induces oxidative stress through different signaling pathways as well as reactive oxygen species (ROS) formation that attributes to the activation of various downstream signaling cascade leading to structural the way to structural and functional changes in kidney.

Sleep apnea syndrome and restless legs syndrome in kidney transplant recipients.

BACKGROUND: This study was aimed to evaluate the prevalence of obstructive sleep apnea (OSA) and restless legs syndrome (RLS) in patients with end-stage renal disease (ESRD) after kidney transplantation. MATERIALS AND METHODS: Two hundred kidney transplant recipients were enrolled in this cross-sectional study. Data on age, gender, etiology of ESRD, history of previous kidney transplantation, serum creatinine, and the presence or absence of OSA and RLS were collected. Symptoms of RLS were identified using the RLS questionnaire which was completed by the patients. The Berlin questionnaire and polysomnography were used for diagnosing OSA. RESULTS: The mean age of the studied patients was 45.86 ± 10.24 years. The prevalence of OSA was 26% (52 of 200 studied patients) and of RLS was 51.5% (103 of 200 studied patients). Majority of the patients with high-risk OSA were male and significantly older than the patients with low-risk OSA (P < 0.05). The prevalence of RLS was higher in patients with high-risk OSA and a higher level of creatinine compared to that in those with a low risk of OSA (P < 0.0001). Level of creatinine in patients with positive RLS was significantly higher than in those with negative RLS (P < 0.0001). OSA was observed in almost 42% of patients with positive RLS, compared to 9% of patients with negative RLS (P < 0.0001). CONCLUSION: In summary, our results indicate that the prevalence of OSA and RLS in kidney transplant recipients was higher than in the general population. Also, there was a significant association between OSA and RLS in these patients.