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Abstract This study aimed to determine salivary concentrations of interleukin (IL)-1β, IL-2, IL-10, IL- 23, transforming growth factor (TGF)-β, tumor necrosis factor (TNF)-α, nitrate (a by-product of nitric oxide oxidation), and cortisol in patients with oral lichen planus (OLP). Twenty patients diagnosed with OLP and 20 sex-matched healthy volunteers (HV) were included in this cross-sectional study. Unstimulated whole saliva was collected in the morning. Salivary cytokine and cortisol concentrations were determined by enzyme-linked immunosorbent assays (ELISA). Nitrate was measured in a nitric oxide analyzer. We found higher salivary concentrations of IL-2 (p<0.003), IL-23 ( p<0.04), and TGF-β (p=0.05) in patients with OLP compared to HV. No significant differences were found in salivary levels of TNF-α, IL-1β, or IL-10. Nitrate concentrations were markedly increased in OLP patients (1,227.0 ± 738.8 µM/mg total protein) when compared to HV (261.6 ± 166.8 µM/mg; p<0.0001). Salivary cortisol levels were also higher in OLP patients (2.79 ± 1.39 vs. 1.94 ±1.21 ng/mg; p<0.048). The markedly increased salivary levels of nitric oxide in patients with OLP suggest a relationship of this molecule with the cell death and tissue damage observed in these lesions.
Resumen Este estudio tuvo como objetivo determinar las concentraciones salivales de interleucina (IL)-1β, IL-2, IL-10, IL-23, factor de crecimiento transformante (TGF)-β y factor de necrosis tumoral (TNF)-α, nitrato (subproducto de la oxidación del óxido nítrico) y cortisol en pacientes con liquen plano oral (OLP). En este estudio transversal se incluyeron veinte pacientes diagnosticados con OLP y 20 voluntarios sanos (HV) del mismo sexo. Saliva entera no estimulada Se recolectó por la mañana, se determinaron las concentraciones de citocinas y cortisol en saliva mediante ensayo inmunoabsorbente ligado a enzimas (ELISA), se determinó nitrato mediante un analizador de óxido nítrico, se encontraron concentraciones salivales mayores de IL-2 (p<0,003), IL- 23 (p<0,04) y TGF-β (p=0,05) en pacientes con OLP en comparación con HV. No se encontraron diferencias significativas en los niveles salivales de TNF-α, IL-1β e IL-10. Las concentraciones de nitrato fueron marcadamente aumentó en pacientes con OLP (1227,0 ± 738,8 µM/mg de proteína total), en comparación con HV (261,6 ± 166,8 µM/mg; p<0,0001). Los niveles de cortisol salival también fueron más altos en los pacientes con OLP que en los controles (2,79 ± 1,39 vs. 1,94 ±1,21 ng/mg; p<0,048). Los niveles de óxido nítrico en saliva aumentaron notablemente en pacientes con OLP, lo que sugiere una relación de esta molécula con la muerte celular y el daño tisular observado en las lesiones de OLP.
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Background: Suffering under stress and anxiety was a big challenge for the majority of nurse aid students and it was requisite to pass the 9 months training without attrition to become a qualified nurse aid. Methods: From 1st week of February to 4th week of May, 2023, 104 nurse aid training students (51 participants in intervention group and 53 participants in control group) from 7 tertiary hospitals in the Yangon Region were conducted by a quasi-experimental study. Data collection was done by asking questionnaire for stress and anxiety, and by collecting blood samples to test serum cortisol level. Data was analysed by using SPSS 23 and independent t-test, one-way repeated measures ANOVA and multiple linear regression with propensity score adjustment were applied. Results: The mean changes (before- after- followed up) in the Perceived Stress Scale (PSS) and in the Generalized Disorder Scale (GAD) were significantly different between the intervention and control groups displaying a difference in difference mean change of 4.13 (2.41, 5.86) at p<0.001, 3.02 (95%CI: 1.05, 4.99) at p=0.003 and that of 2.45 (95% CI: 1.24, 3.66), p<0.001, 1.49 (95%CI: 0.16, 2.83) at p=029 respectively. Moreover, there was a significant decrease (before-after 8 week intervention) in the serum cortisol level between two groups showing a difference in difference mean change of 39.66 (95% CI: 4.97, 74.34), p=0.026. Conclusions: This study might observe as supportive evidence of the mindfulness-based program to manage stress and anxiety among nurse aid students.
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Empty Sella syndrome (ESS) pertains to a phenomenon in which the Turkish sale seems through radiography to be larger and perhaps partially or entirely filled with brain fluids. It can be major illness/ develop as a result of pituitary medical procedures, radiation therapy cerebral infarction/bleeding process. A 50 years old female patient was admitted in emergency medicine ward with chief complaint of pain in abdomen, weakness and vomiting. MRI scan of pituitary cerebrospinal fluid (CSF) signal intensity is seen in Sella with no visible anterior pituitary gland tissue noted-likely suggestive of secondary empty Sella (SES). Long-term steroid use is principal therapy for adrenocorticotropic hormone deficiency (IAD). In this instance, ESS, which can be primary/secondary, also noticed.
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Background: The present study aimed to compare hemodynamic parameters (heart rate, blood pressure) and adverse effects (injection pain, myoclonus, postoperative nausea/vomiting) between Etomidate and propofol groups. Methods: Patients were divided into two groups: Etomidate Group E and a Propofol Group P. All hemodynamic data were measured during induction, intubation, and post-intubation up to 15 min. Intravenous cortisol levels were measured at baseline, just after induction and at 24 hours after induction. Results: At 3 min and 5 min SBP was decreased by 22.04% and 18.39% in Group P. At 3 min there was fall in DBP by 20.13% in group P whereas there was an increase in group E by 0.13% which is statistically significant (p<0.001). At 1 min, 3 min and 5 min after intubation, fall in the MAP by 26.07%, 21.08% and 18.60% in group P and 0.77%, 0.42% and 1.30% in group E (p value <0.001). Serum cortisol level immediate after surgery was decrease (54%) in Group E (p value <0.001). In Group P, 40% of the patients and in group E 16.66 % of the patients complained of pain on injection (p value 0.046). Conclusions: The cortisol suppression by Etomidate may be beneficial for intubation stress response. Etomidate is better for its hemodynamic stability over propofol.
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Objective To investigate the therapeutic effect of Huatan Jieyu Anshen Decoction(mainly with the actions of resolving phlegm,relieving depression and calming mind)combined with abdominal vibration tuina manipulations on chronic insomnia in the elderly.Methods Ninety-four cases of elderly patients with chronic insomnia of phlegm-heat harassing the interior type were randomly divided into the observation group and the control group,with 47 cases in each group.The control group was given Huatan Jieyu Anshen Decoction orally,while the observation group was given oral use of Huatan Jieyu Anshen Decoction combined with abdominal vibration tuina manipulations.The course of treatment for the two groups lasted for 4 weeks.Before and after the treatment,the two groups were observed in the changes of traditional Chinese medicine(TCM)syndrome scores,Pittsburgh Sleep Quality Index(PSQI)score,Athens Insomnia Scale(AIS)score,Fatigue Scale-14(FS-14)score,World Health Organization Quality-of-Life Brief Scale(WHOQOL-BREF)score,and the serum levels of melatonin(MT),dopamine(DA),and cortisol(CORT).After treatment,the clinical efficacy of the two groups was evaluated.Results(1)After 4 weeks of treatment,the total effective rate of the observation group was 97.88%(46/47),while that of the control group was 87.23%(41/47),and the intergroup comparison(tested by chi-square test)showed that the therapeutic efficacy of the observation group was superior to that of the control group(P＜0.01).(2)After treatment,the scores of primary and secondary TCM symptoms in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease of the scores of primary and secondary TCM symptoms in the observation group was significantly superior to that in the control group(P＜0.01).(3)After treatment,the PSQI scores,AIS scores,and FS-14 scores in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the WHOQOL-BREF scores were significantly increased compared with those before treatment(P＜0.05).The decrease of the PSQI scores,AIS scores and FS-14 scores as well as the increase of the WHOQOL-BREF scores in the observation group was significantly superior to that in the control group(P＜0.01).(4)After treatment,the serum MT level of both groups was significantly higher than that before treatment(P＜0.05),and the serum DA and CORT levels were significantly lower than those before treatment(P＜0.05).The increase in serum MT level and the decrease in serum DA and CORT levels of the observation group were significantly superior to those of the control group(P＜0.01).Conclusion The combined therapy of Huatan Jieyu Anshen Decoction combined with vibration tuina manipulations can achieve satisfactory efficacy in the elderly patients with chronic insomnia of phlegm-heat harassing the interior syndrome.The therapy is effective on regulating the central nervous system of the patients,improving the quality of the sleep,and promoting the relief of fatigue and the enhancement of the quality of life,which has great significance to the enhancement of the overall therapeutic efficacy of insomnia.
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Objective To observe the clinical efficacy of Xingnao Kaiqiao Acupuncture(with the functions of awakening the brain and opening the orifices)combined with acupuncture at pericardium meridian points in the treatment of post-stroke sleep reversal(PSSR).Methods Sixty patients with PSSR were randomly divided into observation group and control group,30 patients in each group.Both groups were given conventional treatment,the control group was given oral use of Alprazolam,and the observation group was given the combination of acupuncture a at pericardial meridian points,and 10 days of treatment was one course of treatment.After 10 days of treatment,the clinical efficacy of the two groups was evaluated.The changes in the Pittsburgh Sleep Quality Index(PSQI)and Ascens Insomnia Scale(AIS)scores,as well as the Hamilton Depression Scale(HAMD)scores were observed before and after treatment in the two groups.The changes in cortisol levels at 0,8,and 16 o'clock were compared before and after treatment between the two groups.Results(1)After treatment,the PSQI scores of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving PSQI scores,and the difference was statistically significant(P＜0.05).(2)After treatment,the AIS and HAMD scores of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the AIS and HAMD scores,and the difference was statistically significant(P＜0.05).(3)After treatment,the cortisol level of patients in the two groups at 0,8,and 16 o'clock was significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the cortisol level at 0,8,and 16 o'clock was significantly superior to the control group,and the difference was statistically significant(P＜0.05).(4)The total effective rate was 86.67%(26/30)in the observation group and 80.00%(24/30)in the control group.The efficacy of the observation group was slightly superior to that of the control group,but the difference was not statistically significant(P＞0.05).Conclusion Xingnao Kaiqiao Acupuncture combined with acupuncture at pericardium meridian points for the treatment of PSSR can significantly improve the clinical symptoms of the patients,so as to improve the quality of life of the patients,and the therapeutic efficacy is remarkable.
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This article reports a patient with typical Cushing syndrome′s manifestations and extremely low plasma cortisol level, indicating glucocorticoid hypersensitivity syndrome. After treatment with the glucocorticoid receptor antagonist mifepristone, the patient′s Cushing symptoms were significantly relieved, and cortisol levels returned to normal. The aim of this report is to enhance clinical awareness among physicians regarding glucocorticoid hypersensitivity syndrome.
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Objective:To explore the mediating role of working memory (WM) in the cortisol-awakening response (CAR) and multiple object tracking (MOT) in children with attention deficit hyperactivity disorder (ADHD).Methods:92 children with ADHD (ADHD group) and 94 typically developing children (control group) were selected from January 2022 to October 2022. Salivary cortisol levels were detected and analyzed in all children at four time points after awakening. Children's WM and MOT performance were assessed by the 1-back and MOT paradigms, respectively. SPSS 26.0 software was used for t-test and Pearson correlation analysis of the data, and plug-in PROCESS model 4 of SPSS 26.0 was used for mediated effects analysis. Results:(1) ADHD group showed significantly lower CAR, 1-back accuracy and MOT performance((30.97±5.63), (81.33±10.64) %, (2.36±0.37)) than the control group((32.41±3.48), (91.19±7.12) %, (2.62±0.28))( t=-2.09, -7.22, -5.31, all P<0.05). (2) Pearson analysis showed that CAR was positively correlated with 1-back accuracy ( r=0.293, P<0.01) and MOT performance ( r=0.740, P<0.01). 1-back accuracy was positively correlated with MOT performance ( r=0.368, P<0.01). (3) WM partially mediated the effect of CAR on MOT in children with ADHD, accounting for 6.13% (0.003/0.049) of the total effect. Conclusion:Children with ADHD have deficits in MOT.WM plays a mediating role between CAR and MOT performance in children with ADHD.
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ABSTRACT Objective: Enlargement of the adrenal glands and variable adrenocortical function have been reported in patients with pulmonary tuberculosis and, in a few studies, in patients with extrapulmonary tuberculosis (EPTB). However, none of the studies have evaluated the course of the adrenal morphology in these patients. Subjects and methods: Prospective study including 37 patients with EPTB and 37 healthy age- and sex-matched controls. The adrenal function was evaluated by measurement of cortisol levels at baseline and after stimulation with ACTH (Acton Prolongatum) before and 6 months after antituberculosis treatment. The size of both adrenal glands was evaluated using 64-slice computed tomography (CT) scanning before and 6 months after treatment. The findings were compared with those in a group of healthy matched controls. Results: Clinical and biochemical parameters were comparable between groups. The mean baseline serum cortisol level was significantly lower in the EPTB group (397.1 ± 184.9 nmol/L) compared with the control group (696.3 ± 101.8 nmol/L). Compared with controls, patients with EPTB had significantly lower mean cortisol levels at baseline and 1 hour after ACTH, both before (397 ± 184.9 nmol/L and 750.7 ± 176.8 nmol/L, respectively) and after (529.7 ± 100.4 nmol/L and 1017.2 ± 119.7 nmol/L, respectively) antituberculosis treatment. Both the length and thickness of the right and left adrenal glands were greater in patients with EPTB than in controls but became comparable to those in controls after treatment completion. Conclusions: Patients with EPTB have an enlarged adrenal size and low baseline and stimulated serum cortisol levels. After treatment completion, cortisol levels increased significantly, and the adrenal size normalized in these patients.
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Pesticides have been pointed out as hormone disruptors and may significantly affect the prognosis of hormone-dependent diseases such as breast cancer (BC). Here, we investigated the impact of occupational pesticide exposure on systemic cortisol levels in female rural workers diagnosed with BC. Occupational exposure was assessed by interviews with a standardized questionnaire. Plasma samples (112 from pesticide-exposed women and 77 from unexposed women) were collected in the afternoon, outside the physiological cortisol peak, and analyzed by a chemiluminescent paramagnetic immunoassay for the quantitative determination of cortisol levels in serum and plasma. The results from both groups were categorized according to patients' clinicopathological and exposure data. BC pesticide-exposed women presented higher levels of cortisol than the unexposed. Higher cortisol levels were also detected in the exposed group with more aggressive disease (triple-negative BC), with tumors over 2 cm, with lymph node metastases, and with high risk of disease recurrence and death. These findings demonstrated that there is an association between pesticide exposure and BC that affected cortisol levels and correlated to poor disease prognosis.
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Introduction: scientific evidence has highlighted the role of chronobiological disruptions in promoting obesity through mechanisms involving important circadian rhythm hormones: melatonin and cortisol. These hormones are present in human colostrum and serve as crucial maternal and child protection mechanisms against obesity and childhood infections, owing to the intense interaction between mother and child during pregnancy and breastfeeding. Consequently, the melatonin and cortisol hormones present in human colostrum hold promise as potential candidates for yielding clinically applicable results and supporting future intervention strategies aimed at reducing obesity and neonatal infections. However, there is a scarcity of literature on this subject. Objective: the objective of this study is to to analyze the impact of maternal obesity on the levels and functions of melatonin and cortisol in colostrum and breast milk. Methods: a systematic review of the scientific literature was conducted following the recommendations outlined in the PRISMA protocol. Original articles published in English were searched in the PubMed, Medline, Lilacs, and Scopus databases. There were no restrictions on the publication year. Results: a total of 37 articles were identified from the searched databases. After removing duplicates and applying the inclusion and exclusion criteria, only five studies were relevant to the topic: two studies addressing melatonin and three studies analyzing cortisol. This review revealed that melatonin levels are elevated in the colostrum of obese women, and for this particular group, it has the potential to restore phagocyte activity and increase lymphocyte proliferation. Studies on cortisol have demonstrated that maternal obesity does not alter the levels of this hormone in breast milk. Conclusion: breastfeeding should be encouraged for all populations, and further original research should be conducted to elucidate the protective mechanisms of colostrum and breast milk.
Introdução: evidências científicas enfatizam que disrupções cronobiológicas podem promover a obesidade por mecanismos envolvendo ação de importantes hormônios marcadores do ritmo circadiano: a melatonina e cortisol. Estes hormônios estão presentes no colostro humano e representam importante mecanismo de proteção materno infantil frente à obesidade e infecções infantis, devido à intensa interação entre mãe e filho durante a gravidez e amamentação. Assim, os hormônios melatonina e cortisol presentes no colostro humano representam promissores candidatos para fornecer resultados com capacidade de aplicação clínica e de embasamento de futuras estratégias de intervenção com enfoque na redução da obesidade e de infecções neonatais. Entretanto, são escassos os estudos na literatura sobre o tema. Objetivo: analisar as repercussões da obesidade materna sobre os níveis e as ações da melatonina e do cortisol no colostro e leite materno. Método: foi realizada uma revisão sistematizada da literatura científica seguindo as recomendações do protocolo Prisma. Foram pesquisados artigos originais, publicados em inglês, nas bases de dados PubMed, Medline, Lilacs e Scopus. Não houve restrição quanto ao ano de publicação. Resultados: foram identificados 37 artigos nas bases de dados pesquisados, 15 artigos foram excluídos por estarem duplicados, após aplicação do critério de inclusão e exclusão apenas 5 estudos tiveram relação ao tema, sendo 2 estudos abordando sobre melatonina e 3 pesquisas que analisaram o cortisol. Esta revisão mostrou que a melatonina está elevada em colostro de obesas e para este grupo ela possui potencial de restaurar atividade de fagócitos e de elevar a proliferação de linfócitos. Os estudos sobre o cortisol ilustraram que os níveis deste hormônio no leite materno não foram alterados pela obesidade materna. Conclusão: o aleitamento materno deve ser encorajado para todos os públicos, assim como mais pesquisas originais devem ser desenvolvidas para descrever os mecanismos protetores do colostro e leite materno
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Abstract Introduction There is a growing need to implement evidence-based psychological treatments for women victims of intimate partner violence (IPV) who commonly experience stress-related disorders such as anxiety, depression, or suicide risk, as well as altered cortisol reactivity. Objective 1. To compare the changes in depressive and anxious symptomatology, quality of life, and cortisol reactivity after two different interventions, Acceptance and Commitment Therapy (ACT, based on psychological flexibility) or Interpersonal Therapy (IPT, based on empowerment) in women exposed to IPV. 2. To compare the changes in relation to the presence of suicide thoughts. Method A clinical sample of 50 women (ages 21-74) randomly assigned to attend ACT or IPT, completed pre- and post-intervention questionnaires about intimate partner violence, quality of life, depression, anxiety, and measurements of salivary cortisol reactivity (basal, 15, 30, and 45 minutes after a cognitive challenge). We used Generalized Estimating Equation Models for data analysis. Results There was a significant improvement post-intervention in all variables, regardless of the type of psychotherapy or the presence of suicide thoughts. Before interventions, women that reported suicide thoughts had severe symptoms of depression, anxiety, worse quality of life, and a cortisol hyper-response profile, in contrast to women without suicide thoughts who had moderate symptoms and no cortisol response. Cortisol response to the cognitive test decreased in all women after both therapies. Discussion and conclusion Although different psychological approach, ACT, and IPT effectively improved mental health, quality of life, and changed cortisol reactivity of women exposed to IPV, including women at suicide risk.
Resumen Introducción Son necesarios tratamientos basados en evidencia para mujeres víctimas de violencia de pareja (IPV), con trastornos relacionados con estrés como ansiedad, depresión y riesgo suicida y alteraciones en la reactividad del cortisol. Objetivo Comparar los cambios en la sintomatología depresiva, ansiosa, calidad de vida y reactividad del cortisol después de aplicar Terapia de Aceptación y Compromiso (ACT, basada en la flexibilidad psicológica) o Terapia Interpersonal (IPT, basada en el empoderamiento) en mujeres expuestas a IPV y compararlos en función al pensamiento suicida. Método Una muestra clínica de 50 mujeres (entre 21 y 74 años) fueron asignadas aleatoriamente a recibir ACT o IPT, completaron antes y después, cuestionarios sobre IPV, calidad de vida, depresión y ansiedad, y mediciones de cortisol (basal, 15, 30 y 45 minutos después de un reto cognitivo) en saliva en respuesta a un reto cognitivo. Utilizamos modelos de Ecuaciones de Estimación generalizada para analizar los datos. Resultados Mejoraron significativamente todas las variables, independientemente del tipo de psicoterapia y del pensamiento suicida. Antes de la intervención, las mujeres con ideación suicida presentaron depresión y ansiedad severas, peor calidad de vida e hiper-respuesta de cortisol, en contraste con las mujeres sin ideación, quienes presentaron síntomas moderados y una respuesta de cortisol plana. El cortisol disminuyó en todas las mujeres después de ambas terapias. Discusión y conclusión Ambas terapias IPT y ACT mejoraron la salud mental y calidad de vida de las mujeres con IPV y modificaron la reactividad del cortisol, incluyendo a las pacientes que reportaron ideación suicida.
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Background: Studies have shown the adverse effects of stress on infertility. It has been reported that 40% of infertility cases are attributed to the men. Therefore, this study is aimed at determining the effects of stress biomarkers on sex hormones, sperm quality, and quantity in men investigating infertility. Method: A total of one hundred and fifty-two (152) participants were recruited into a case control study between September 2018 to August 2019. Prolactin, testosterone, follicle stimulating hormone (FSH), luteinizing hormone (LH), salivary cortisol and salivary alpha amylase were estimated using both competitive and non-competitive enzyme linked immunosorbent assay (ELISA) techniques; semen was examined directly after liquefaction according to world health organization criteria. Results: The mean and standard deviation of testosterone, FSH, sperm cells count and sperm activity (%) were significantly lower (p<0.05) in the men study group relative to the control group; while prolactin, salivary cortisol and alpha amylase were significantly higher (p<0.05) in the men study group relative to the control group. There was no significant difference in the value of LH in the men study group compared with the men control group (p>0.05). Conclusions: Stress in men affects sex hormones, semen quality and quantity. Both conditions of oligospermia and azospermia were observed in the men study group, with associated hormonal abnormalities, decrease in sperm quality, quantity and elevated stress biomarkers.
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Background: Globally prevalence of diabetes is gradually increasing in individual at reproductive stage. Uncontrolled blood sugar affects biological systems including reproductive. Thus, this study was aimed to analyze the association of diabetes and male infertility in and around Chennai.Methods: Fifty-four male participants who visited the fertility clinic was grouped in two based on the sugar value. An anthropometric measurement, clinical, blood, seminal parameters and life style behaviors was analyzed. All study variables was analyzed to examine the association of diabetes and semen quality.Results: Study results shows that people with diabetes had abnormal semen parameters as compared to non- diabetic study participants. Pearson抯 correlation between the semen parameters and blood sugar value of the study participants showed semen parameters: volume (r=-0.28, p<0.05), count (r=-0.22, p<0.05), and motility (r=-0.23, p<0.05), has a significantly week negative correlation with blood sugar level. Scatter plots also showed semen parameters: volume (r2=-0.079), count (r2=-0.048), and motility (r2=-0.053), had a significantly week negative linear correlation with blood sugar level.Conclusions: From the study it was concluded that the uncontrolled blood sugar levels affect the reproductive health of the study participants.
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Background: Yoga is a practice which amalgamates the emotional, mental, physical and spiritual aspects of the human body through physical postures(asanas), breathing exercises (pranayama), concentration and meditation (dharana and dhyana). Evaluation of databases suggests a positive role of yoga in pregnancies associated with depression, anxiety and lumbosacral pain and also in reducing antepartum complications and pain score during labor. These beneficial effects of yoga are suggested but more systematic researches are required to validate it. With the background of above researches, we undertook the study to evaluate the effect of prenatal yoga and meditation on maternal and fetal outcomes. Aim of the study was to determine the effect of antenatal meditation and yoga on obstetric and fetal outcome.Methods: This was a prospective randomized trial conducted in the antenatal OPD of the institute. Sixty primigravida women with low risk pregnancy between 18 to 26 weeks gestation were included in the trial.They were randomly divided into two equal groups; interventional group underwent meditation and yoga sessions of 30 minutes twice in a week till delivery. Obstetric outcomes including gestational age, antepartum and intrapartum complications, cord blood cortisol levels at delivery and neonatal outcomes were recorded.Results: Thirteen women went post-dated as compared to 3 in the interventional group which was statistically significant (p=0.0003). APGAR scores of neonates in the interventional group showed a highly significant improvement with p=0.0013 as compared to the control group. Cord blood cortisol levels were higher than 10 ng/ml in 16 women in the control group compared to 7 in the group who performed yoga and meditation with p=0.01. NICU admissions were significantly more (p=0.002) in the control group.Conclusions: Meditation and yoga during pregnancy improves maternal and neonatal outcomes.
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When the time lows of the psychological body, about the human mind, there is a vital relationship between the psychological and somatic body leading to stress and mishaps. This could be a lack of coherence among significant components in the body, which are characterized by hormones such as cortisol and adrenaline that come into play. Cortisol and adrenaline are released when there is usually a response of fight or flight, where these hormones get ready to handle the body’s reaction, and when this happens properly, it yields stress. Stress occurs through all age groups across every ethnicity and population, as the functioning of the mind is very similar. Managing this emerging stress and anxiety condition could be done through the easy way of the modern system of medicine, allopathy. Alternatively, the traditional method comes in handy to maintain such a condition with hardly any long-term side effects. A few conventional techniques like the practice of yoga, support of the proper nutrients, and certain medicinal herbs are bent to see a change in the perspective of coping mechanisms that results in a stress-free environment within the human mind. Many patterns of practices are noticed that there are specific nutrients and supplements formulated with medicinal herbs with significant pharmacological properties and the ancient activity of yoga aid in stress management. Using and practicing regularly can help in an integrated caliber of living. This review article sheds information and collation on such significant medicinal herbs, nutrients, and renounced practices of yoga that play together in the balance of the human body to overcome the distress of the mind. Many studies have noticed that medicinal herbs, nutrients, and specific yogic asanas help handle stress and anxiety, giving a holistic living pattern.
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This paper discusses the theoretical basis of traditional Chinese medicine （TCM） for the treatment of cancer-related fatigue （CRF） based on the principle of treating overstrain with warming in the Huangdi's Internal Classic 《黄帝内经》 and the role of hypothalamic-pituitary-adrenal （HPA） axis dysregulation in CRF， aiming to provide new ideas for the clinical treatment of CRF. In the pulsatile regulation of the HPA axis， cortisol， which is synthesized and released by the adrenal cortex， plays an essential role in the life activities. The abnormal circadian rhythm and reduced serum level of cortisol are major factors leading to CRF. Therefore， increasing the serum level and stimulating the biological activity of cortisol and restoring the normal function of HPA axis are important targets for the treatment of CRF and also the key to the TCM treatment of this disease. According to the TCM principle of treating overstrain with warming， we interpreted the etiology and clinical manifestations of overstrain and further explored the causes of CRF. It is believed that the depletion of Qi and blood， Yin and Yang， and fluid in the kidney， spleen， and liver is the key of the disease， which results in symptoms such as fatigue. Further， we elaborated on the theoretical connotation of warming and summarized the two main treatment principles of tonifying with warm-natured herbs and relieving fever with sweet- and warm-natured herbs. According to the different characteristics of the organs affected by pathogen， we proposed the treatment method of warming kidney to cultivate essence， warming stomach and nourishing spleen to replenish Qi， nourishing liver and tonifying blood to promote Qi movement， and relieving fever with sweet- and warm-natured herbs to alleviate fatigue. The warming method can elevate the serum level and invigorate the biological functions of cortisol in CRF patients， which provides a new theoretical basis for alleviating the symptoms and improving the quality of life of cancer patients in clinical practice.
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【Objective】 To explore a new treatment of primary bilateral macronodular adrenal hyperplasia (PBMAH) and its efficacy. 【Methods】 Clinical data of 20 PBMAH patients treated in our hospital during Mar.2010 and Apr.2021 were retrospectively analyzed. All patients underwent laparoscopic subcutaneous displacement of vascularized adrenal. The clinical symptoms, plasma free cortisol, adrenocorticotrophic hormone (ACTH), and 24 h urinary free cortisol were regularly monitored after surgery. 【Results】 Of all 20 patients, 19 were followed up for 18 to 120 months (median 60 months). Three months after surgery, reexamination showed 1 patient had decreased plasma free cortisol and increased ACTH, but had no symptoms of low corticosteroids. After another 3 months, the plasma free cortisol and ACTH returned to normal. After 4 to 48 months, the parameters recovered in all patients and the clinical symptoms disappeared. 【Conclusion】 Laparoscopic vascularized adrenal displacement is a new and effective method for the treatment of PBMAH. It can alleviate the Cushing syndrome with no obvious adverse reactions.
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OBJECTIVE@#To investigate the coagulation function indicators and identify influence factors of hypercoagulability in patients with adrenocorticotropic hormone (ACTH) independent Cushing syndrome (CS).@*METHODS@#In our retrospective study, the electronic medical records system of Peking University First Hospital was searched for the patients diagnosed with ACTH independent CS on discharge from January 2014 to June 2019. Nonfunctional adrenal adenoma patients were chosen as control group and matched 1 ∶1 by body mass index (BMI), gender, and discharge date. Clinical features and coagulation function indicators were compared between the two groups.@*RESULTS@#In the study, 171 patients were included in each group. Compared with control group, activated partial thromboplastin time (APTT), and prothrombin time (PT) in ACTH independent CS group were significantly lower [(29.22±3.39) s vs. (31.86±3.63) s, P < 0.001; (29.22±3.39) s vs. (31.86±3.63) s, P < 0.001], and both D-dimer and fibrin degradation products (FDP) levels were significantly higher (P < 0.05). Percentage of APTT levels under the lower limit of reference range in the CS patients was significantly higher than that in nonfunctional group (21.6% vs. 3.5%, P < 0.001). Percentage of D-dimer levels over the upper limit of reference range in the CS patients was significantly higher than that in nonfunctional group (13.5% vs. 6.6%, P=0.041). There were three patients with deep venous thrombosis and one patient with pulmonary embolism in CS group, however none was in control group. The area under curve (AUC) of serum cortisol rhythm (8:00, 16:00 and 24:00) levels was negatively associated with the levels of PT (r=-0.315, P < 0.001) and APTT (r=-0.410, P < 0.001), and positively associated with FDP (r=0.303, P < 0.001) and D-dimer levels (r=0.258, P < 0.001). There were no differences in coagulation function indicators among different histopathologic subgroups (adrenocortical adenoma, adrenocortical hyperplasia, oncocytic adenoma, adrenocortical carcinoma). With Logistic regression analysis, the AUC of cortisol and glycosylated hemoglobin A1c (HbA1c) levels were independent risk factors for hypercoagulability in the ACTH independent CS patients (P < 0.05).@*CONCLUSION@#ACTH independent CS patients were more likely in hypercoagulable state compared with nonfunctional adrenal adenoma, especially in ACTH independent CS patients with higher levels of cortisol AUC and HbA1c. These patients should be paid attention to for the hypercoagulability and thrombosis risk.