Effect of fenugreek extract supplement on testosterone levels in male: A meta-analysis of clinical trials.

Different types of glycosides extract of fenugreek have shown androgenic and anabolic effect in male. The aim of the study was to evaluate the effect of fenugreek extract on total testosterone levels in male. Medline via PubMed, Scopus databases, Cochrane Library, Web of Science, and Google Scholar were searched up to November 2018 for randomized clinical trials comparing intake of fenugreek extract with control group. Data on change in serum total testosterone were pooled using random-effects models. A total of four trials were included. Fenugreek extract has a significant effect on total serum testosterone. Results from clinical trials suggest that fenugreek extract supplement has an effect on serum total testosterone levels in male.

Red vine leaf extract (AS 195) can improve some signs and symptoms of chronic venous insufficiency, a systematic review.

AIM: Chronic venous insufficiency (CVI) is common in adults. Some complications include skin changes, edema, heavy legs, muscle cramps, pain, and varicose veins. In traditional medicine, red vine leaf extract (AS 195) has been used to cure the symptoms of CVI. This systematic review was aimed to assess the effects of AS 195 in patients with CVI. MATERIAL AND METHODS: A systematic literature search was performed to identify trials that reported the impact of red vine leaf extract on CVI. The primary outcomes investigated were Leg (limb) volume, calf circumference, ankle circumference, tired and heavy legs, a sensation of tension, tingling sensation, and pain. RESULTS: From the 56 studies, 5 trials were selected according to our inclusion criteria. Red vine leaf extract significantly improved numbers of outcomes (lower leg volume, calf and ankle circumference, tired, heavy legs, tingling sensation, pain, the sensation of tension in the legs, cutaneous microcirculation, and transcutaneous oxygen pressure) in only some trials. The tolerability for red vine leaf extract was reported good or satisfactory. CONCLUSIONS: Red vine leaf extract had a beneficial therapeutic role in patients with CVI. Further high-quality trials are required to be carried out to provide strong evidence.

The effects of soy isoflavones on total testosterone and follicle-stimulating hormone levels in women with polycystic ovary syndrome: a systematic review and meta-analysis.

OBJECTIVES: The aims of this systematic review and meta-analysis were to evaluate the effectiveness of soy isoflavones on serum levels of total testosterone (TT) and follicle-stimulating hormone (FSH) in women with polycystic ovary syndrome (PCOS). METHODS: A meta-analysis was performed by searching for relevant randomised controlled trials (RCTs) in several databases. Of the four trials found, the eligibility criteria to evaluate the efficacy of soy isoflavones on serum levels of FSH were met by three trials and of TT by four trials. The Cochrane scale was used to evaluate the risk of bias. Fixed-effects and random-effects models were used to evaluate overall effect. The χ 2 test (Cochran's Q test) and the I 2 index were used to assess the heterogeneity of RCTs. RESULTS: Our results showed that soy isoflavones significantly decreased TT (weighted mean difference [WMD] - 0.14; 95% confidence interval [CI] - 0.2, -0.02; p = 0.016; I 2 = 89%, p < 0.001) but had no significant effect on FSH levels (WMD -0.25; 95% CI -0.54, 0.02; p = 0.06; I 2 = 0%, p = 0.85). CONCLUSION: Although the results of this meta-analysis showed that soy isoflavones in women with PCOS decreased TT and had no significant effect on FSH, better and more valid studies are needed to confirm these results.

An evaluation of the effects of saffron supplementation on the asthma clinical symptoms and asthma severity in patients with mild and moderate persistent allergic asthma: a double-blind, randomized placebo-controlled trial.

BACKGROUND: Asthma is a heterogeneous disease which is usually associated with chronic airway inflammation. Saffron has anti-inflammatory effects and may has beneficial effects on asthma. HYPOTHESIS: The present study was intended to survey the effects of saffron supplementation on blood pressure, lipid profiles, basophils, eosinophils and clinical symptoms in patients with allergic asthma. STUDY DESIGN: Our study was a clinical trial. METHODS: Subjects (N = 80, 32 women and 48 men, 41.25 ± 9.87 years old) with mild and moderate allergic asthma were randomized into two groups: the intervention group who received two capsules of saffron (100 mg/d), and the control group who received two capsules of placebo for 8 weeks. SPSS software (version 16.0) was used for the data analysis. RESULTS: Saffron improved the frequency of clinical symptoms of the patients (i.e., frequency of the shortness of breath during the day and night time, use of salbutamol spray, waking up due to asthma symptoms and activity limitation) in comparison to the placebo (p < 0.001). Besides, asthma severity decreased almost significantly in the saffron group (p = 0.07). It was also found that saffron, in comparison with the placebo, significantly reduced the systolic and diastolic blood pressure, triglycerides and low density lipoprotein cholesterol. Moreover, eosinophils and basophils concentration reduced in the saffron group (p = 0.06 and 0.05 respectively). CONCLUSION: Saffron seems to be an effective and safe option (in 8 weeks supplementation) to improve clinical symptoms of patients with allergic asthma but the toxicity and/or long-term effects of saffron intake are not known. Registration ID in IRCT (IRCT2017012132081N2).

Barberry treatment reduces serum anti-heat shock protein 27 and 60 antibody titres and high-sensitivity c-reactive protein in patients with metabolic syndrome: a double-blind, randomized placebo-controlled trial.

Metabolic syndrome is an important risk factor for cardiovascular disease (CVD). The heat shock proteins (HSPs) are associated with risk factors for CVD. The aim of the present study was to survey the effect of barberry on antibody titres to HSPs and high-sensitivity C-reactive protein (hs-CRP) in patients with metabolic syndrome. In our study, subjects (N=106, 79 women and 27 men, 18-65 years old) with metabolic syndrome were randomized into two groups: a group of patients who received three capsules of barberry and a control group who received three capsules of placebo for 6 weeks. Antibodies against HSPs 27, 60/65 and 70, hs-CRP and lipid profile were determined in patients before (week 0) and after (week 6) intervention. spss software (version 16.0; Inc, Chicago, IL) was used for data analysis. Results showed that barberry had no significant effect on serum level of anti-HSPs 65 and 70. But there was a significant decrease in anti-HSP 27 in both case and control groups (p=0.001 and p<0.001, respectively, in the case and control groups). Barberry decreased significantly anti-HSP 60 in the case group (p=0.03). High-sensitivity CRP was decreased non-significantly (p=0.17) in the case group and increased significantly (p=0.04) in the control group. Barberry decreased significantly low-density lipoprotein and total cholesterol and increased significantly high-density cholesterol (p<0.05). Results of the present study suggested that barberry supplementation in patients with metabolic syndrome decreased significantly anti-HSPs 27 and 60 and hs-CRP levels and improved lipid profile.

Comparison of Dietary Macro and Micro Nutrient Intake between Iranian Patients with Long-term Complications of Sulphur Mustard Poisoning and Healthy Subjects.

BACKGROUND: Patients with long-term complications of sulfur mustard (SM) poisoning are often less able to undertake optimum levels of physical activity and adequately control their dietary intake. The aim of present study was to investigate the dietary intake of patients with SM poisoning in comparison to a control group Methods: The study was undertaken on 55 Iranian male veterans, who had > 25% disabilities due to long-term complications of SM poisoning and 55 men age-matched healthy subjects. A previously validated food frequency questionnaire (FFQ) was used for measuring dietary macro/micro nutrient intake for both groups; and the results were analysed using Dietplan6 software. RESULTS: Analysis of macro/micro nutrients in dietary intakes of the patients versus the controls showed a significantly lower intake of several nutrients including selenium and carbohydrate. On the other hand, the dietary intake of trans-fatty acids and iodine were significantly higher in these patients. CONCLUSION: Long-term complications of SM poisoning in the Iranian veterans induce both chemical and physical disabilities. Macro/micro nutrient intake in these patients was significantly different in comparison with matched, healthy subjects. Dietary advice for these patients should be strongly recommended to these patients in order to prevent other chronic diseases.

Does pomegranate extract supplementation improve the clinical symptoms of patients with allergic asthma? A double-blind, randomized, placebo-controlled trial.

Background: Asthma essentially represents a chronic inflammatory disease that manifests as a lifelong condition with different severity throughout the life of patients with asthma. Pomegranate holds three times the antioxidant activity compared to other polyphenol-rich food sources like green tea, which may positively impact asthma. Aim of the study: This research aimed to investigate the pomegranate supplementation influences clinical symptoms, eosinophil, basophil, and neutrophil counts in patients with allergic asthma. Materials and Methods: Participants (n = 64) suffering from mild to moderate allergic asthma were randomly divided into two groups: The control group received placebo capsules and the intervention group received 250 mg pomegranate extract capsules twice a day (for 8 weeks). To analyze the data, we used SPSS software (version 22). The significance level of p-value was considered less than 0.05. Results: The findings showed that the pomegranate extract improved patients' clinical symptoms like daily breath shortness, nocturnal breath shortness, and limitation of asthma-related activity in the intervention group compared to the control group. Furthermore, eosinophil, basophil, and neutrophil counts were significantly decreased in the intervention group. Also, by comparing the two groups, the levels of change in neutrophils and eosinophils were statistically significant. Conclusion: It appears that the pomegranate extract can ameliorate some clinical symptoms and reduce neutrophils, basophils, and eosinophils in allergic asthma patients. Clinical Trial Registration: https://www.irct.ir/trial/45612; identifier: IRCT20200205046384N1.

Pomegranate extract supplementation improves lung function parameters and IL-35 expression in participants with mild and moderate persistent allergic asthma: A randomized, double-blind, placebo-controlled trial.

Existing asthma treatments are associated with side effects and limitations, which has led to an interest in alternative and complementary therapies. Given the anti-inflammatory properties of pomegranate, the present study aimed to determine the impact of pomegranate extract supplementation on lung function parameters evaluated through spirometry, high-sensitivity C-reactive protein (hs-CRP), pro-oxidant antioxidant balance, and interleukin 35) (IL-35) in participants with mild and moderate allergic asthma (based on forced expiratory volume in 1 second (FEV1) and clinical symptoms). Participants with mild and moderate allergic asthma (n = 64) were randomly assigned to two groups: the intervention group, which received two pomegranate extract capsules (500 mg/day), or the control group for eight weeks. Also, the physician prescribed similar drugs to the participants in the study. Independent samples T-test and Mann-Whitney U were used to compare the quantitative outcomes between the intervention group and the comparison group. The Wilcoxon test and the paired T-test were applied for within-group comparisons. A p-value <0.05 was considered significant. At the end of the study, the change levels of IL-35 in the intervention group increased significantly compared to the control group. In terms of the lung function parameters, FEV1/ forced vital capacity (FVC) (FEV1/FVC) ratio enhanced significantly in the intervention group compared to the control group. Also, the pomegranate extract significantly improved forced expiratory flow 25-75% (FEF25-75%), FEV1/FVC ratio, and FEV1 in the intervention group. No significant changes in FEV1 values were observed between the two groups at the end of the study. Also, no significant changes were seen in other indicators. It seems that pomegranate extract can improve lung function parameters and IL-35 expression in mild and moderate allergic asthma. Clinical trial registration: https://www.irct.ir/trial/45612; identifier: IRCT20200205046384N1.

Serum and follicular fluid chemerin and chemerin mRNA expression in women with polycystic ovary syndrome: Systematic review and meta-analysis.

INTRODUCTION: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. Chemerin, a novel adipokine, is involved in inflammation, energy metabolism, adipogenesis, angiogenesis and insulin secretion in the adipose cells and ovary. This systematic review with meta-analysis aimed to compare serum and follicular fluid (FF) chemerin and ovarian chemerin mRNA expression among women with PCOS and non-PCOS. METHODS: Electronic databases including Web of Science, PubMed, Google Scholar, Scopus, Cochrane and CINAHL were used for a comprehensive search through April 2021. Of the 174 articles initially identified, 22 studies met the eligibility criteria. A random-effects model with a weighted mean difference (WMD) and 95% confidence interval (CI) was performed to compare the outcomes between groups. Subgroup and sensitivity analyses were performed to detect the sources of heterogeneity. RESULTS: Women with PCOS compared to without PCOS showed significantly higher serum chemerin [WMD: 12.02 pg/ml (95% CI: [10.92, 13.13]), p < .001], chemerin mRNA expression [WMD: 0.38% (95% CI [0.25, 0.52]), p = .001] and FF chemerin [(WMD): 41.7 pg/ml (95% CI [17.89, 65.5]) p < .001]. Further, serum chemerin remained high in PCOS women even with subgroup analysis based on body mass index (BMI) or sample size (p < .001). Serum chemerin was higher in women with PCOS and higher BMI [(WMD): 3.29 pg/ml (95% CI: [2.73, 3.384]), p < .001]. The expression of chemerin mRNA was significantly higher in the PCOS group compared to the control group [WMD: 0.38% (95% CI [0.25, 0.52]), p < .001]. CONCLUSION: Serum and FF chemerin and mRNA expression were higher in the PCOS group compared to the controls. Further, serum chemerin was higher in PCOS women with higher BMI compared to lower BMI. The present findings illustrate that chemerin may be associated with PCOS status and BMI, independently.

Neural Network-Based Clinical Prediction System for Identifying the Clinical Effects of Saffron (Crocus sativus L) Supplement Therapy on Allergic Asthma: Model Evaluation Study.

BACKGROUND: Asthma is commonly associated with chronic airway inflammation and is the underlying cause of over a million deaths each year. Crocus sativus L, commonly known as saffron, when used in the form of traditional medicines, has demonstrated anti-inflammatory effects which may be beneficial to individuals with asthma. OBJECTIVE: The objective of this study was to develop a clinical prediction system using an artificial neural network to detect the effects of C sativus L supplements on patients with allergic asthma. METHODS: A genetic algorithm-modified neural network predictor system was developed to detect the level of effectiveness of C sativus L using features extracted from the clinical, immunologic, hematologic, and demographic information of patients with asthma. The study included data from men (n=40) and women (n=40) individuals with mild or moderate allergic asthma from 18 to 65 years of age. The aim of the model was to estimate and predict the level of effect of C sativus L supplements on each asthma risk factor and to predict the level of alleviation in patients with asthma. A genetic algorithm was used to extract input features for the clinical prediction system to improve its predictive performance. Moreover, an optimization model was developed for the artificial neural network component that classifies the patients with asthma using C sativus L supplement therapy. RESULTS: The best overall performance of the clinical prediction system was an accuracy greater than 99% for training and testing data. The genetic algorithm-modified neural network predicted the level of effect with high accuracy for anti-heat shock protein (anti-HSP), high sensitivity C-reactive protein (hs-CRP), forced expiratory volume in the first second of expiration (FEV1), forced vital capacity (FVC), the ratio of FEV1/FVC, and forced expiratory flow (FEF25%-75%) for testing data (anti-HSP: 96.5%; hs-CRP: 98.9%; FEV1: 98.1%; FVC: 97.5%; FEV1/FVC ratio: 97%; and FEF25%-75%: 96.7%, respectively). CONCLUSIONS: The clinical prediction system developed in this study was effective in predicting the effect of C sativus L supplements on patients with allergic asthma. This clinical prediction system may help clinicians to identify early on which clinical factors in asthma will improve over the course of treatment and, in doing so, help clinicians to develop effective treatment plans for patients with asthma.

An evaluation of the effect of saffron supplementation on the antibody titer to heat-shock protein (HSP) 70, hsCRP and spirometry test in patients with mild and moderate persistent allergic asthma: A triple-blind, randomized placebo-controlled trial.

BACKGROUND: Asthma is a heterogeneous disease, which usually associated with chronic airway inflammation. The anti-heat shock protein (anti-HSP) 70 is a novel risk factor for asthma. The aim of the present study was to survey the effect of saffron supplementation on anti-HSP70, high-sensitivity C-reactive protein (hs-CRP) and spirometry test in patients with allergic asthma. BASIC PROCEDURES: In this clinical trial, patients (N = 80, 32 women and 48 men, 18-65 years old) with mild and moderate allergic asthma were randomized into two groups: a group of patients who received two capsules of saffron (100 mg/d) and a control group who received two capsules of placebo for 8 weeks. Anti-HSP70, hs-CRP and spirometry test were determined in patients before (week 0) and after (week 8) intervention. SPSS software (version 16.0; Inc, Chicago, IL) was used for data analysis. MAIN FINDINGS: Saffron in comparison with placebo significantly reduced the hs-CRP (p < 0.001) and anti-HSP70 (p < 0.001) concentrations. In spirometry test, forced expiratory volume in first second(FEV1), forced vital capacity (FVC), FEV1/FVC ratio and forced expiratory flow 25-75%.(FEF 25-75) increased significantly in saffron in comparison to placebo group (p < 0.05). PRINCIPAL CONCLUSIONS: Results of the present study suggested that saffron supplementation in patients with allergic asthma decreased significantly anti-HSPs 70 and hs-CRP and also improved some spirometry test factors.

Heat Shock Proteins and Diabetes.

Diabetes is a chronic disease, and its prevalence continues to rise and can increase the risk for the progression of microvascular (such as nephropathy, retinopathy and neuropathy) and also macrovascular complications. Diabetes is a condition in which the oxidative stress and inflammation rise. Heat shock proteins (HSPs) are a highly conserved family of proteins that are expressed by all cells exposed to environmental stress, and they have diverse functions. In patients with diabetes, the expression and levels of HSPs decrease, but these chaperones can aid in improving some complications of diabetes, such as oxidative stress and inflammation. (The suppression of some HSPs is associated with a generalized increase in tissue inflammation.) In this review, we summarize the current understanding of HSPs in diabetes as well as their complications, and we also highlight their potential role as therapeutic targets in diabetes.

Early Post Operative Enteral Versus Parenteral Feeding after Esophageal Cancer Surgery.

INTRODUCTION: The incidence of malnutrition in hospitalized patients is reported to be high. In particular, patients with esophageal cancer are prone to malnutrition, due to preoperative digestive system dysfunctions and short-term non-oral feeding postoperatively. Selection of an appropriate method for feeding in the postoperative period is important in these patients. MATERIALS AND METHODS: In this randomized clinical trial, 40 patients with esophageal cancer who had undergone esophagectomy between September 2008 and October 2009 were randomly assigned into either enteral feeding or parenteral feeding groups, with the same calorie intake in each group. The level of serum total protein, albumin, prealbumin, transferrin, C3, C4 and hs-C-reactive protein (hs-CRP), as well as the rate of surgical complications, restoration of bowel movements and cost was assessed in each group. RESULTS: Our results showed that there was no significant difference between the groups in terms of serum albumin, prealbumin or transferrin. However, C3 and C4 levels were significantly higher in the enteral feeding group compared with the parenteral group, while hs-CRP level was significantly lower in the enteral feeding group. Bowel movements were restored sooner and costs of treatment were lower in the enteral group. Postoperative complications did not differ significantly between the groups. There was one death in the parenteral group 10 days after surgery due to myocardial infarction. CONCLUSION: The results of our study showed that enteral feeding can be used effectively in the first days after surgery, with few early complications and similar nutritional outcomes compared with the parenteral method. Enteral feeding was associated with reduced inflammation and was associated with an improvement in immunological responses, quicker return of bowel movements, and reduced costs in comparison with parenteral feeding.

Heat shock proteins and cardiovascular disease.

Atherosclerosis is the leading global cause of mortality, morbidity, and disability. Heat shock proteins (HSPs) are a highly conserved family of proteins with diverse functions expressed by all cells exposed to environmental stress. Studies have reported that several HSPs may be potential risk markers of atherosclerosis and related cardiovascular diseases, or may be directly involved in the atherogenic process itself. HSPs are expressed by cells in atherosclerotic plaque and anti-HSP has been reported to be increased in patients with vascular disease. Autoimmune responses may be generated against antigens present within the atherosclerotic plaque, including HSP and may lead to a cycle of ongoing vascular injury. It has been suggested that by inducing a state of tolerance to these antigens, the atherogenic process may be limited and thus provide a potential therapeutic approach. It has been suggested that anti-HSPs are independent predictors of risk of vascular disease. In this review, we summarize the current understanding of HSP in cardiovascular disease and highlight their potential role as diagnostic agents and therapeutic targets.