Evaluation of Vitamin D3 and Calcium Deficiency after Recovery from Extensive Burn.

BACKGROUND: Previous studies in pediatric populations have demonstrated that vitamin D deficiency is common in patients with large burns. The aim of the current comparative study was to investigate the serum level of vitamin D in patients with large burns [>20% total body surface area (TBSA)] after 6 months of therapy. METHODS: This case control study was conducted during 6-month period from 2017 to 2018 in Amiralmomenin Hospital, Shiraz, Iran. Forty two patients with large burns (>20% TBSA) and at least 6 months' post-burn period were enrolled. Also, 42 healthy and age and sex matched controls from those referring for routine check-ups were included for comparison. None of the patients and controls received vitamin D supplements. The serum level of calcium (Ca), parathormone (PTH) and vitamin D were compared between the groups. RESULTS: There was no significant difference between the two study groups regarding the baseline characteristics including the age (p=0.085), gender (p=0.275) and duration of sun exposure (p=0.894). We found that those with major burns had significantly higher serum levels of PTH (50.48±26.49 vs. 33.64±15.80; p=0.001). In addition, the serum levels of vitamin D were significantly lower in burn patients compared to healthy controls (18.15±9.18 vs. 31.43±16.27; p<0.001). CONCLUSION: Major burns (≥20% TBSA) are associated with increased serum levels of PTH and decreased serum levels of vitamin D. However, serum levels of calcium are not affected by major burns.

Non-Carcinogenic Health Risk Assessment due to Fluoride Exposure from Tea Consumption in Iran Using Monte Carlo Simulation.

Excessive intake of fluoride can cause adverse health effects. Consumption of tea as a popular drink could be a potential source of fluoride exposure to humans. This research aimed to evaluate the fluoride concentration in tea among the Iranian people using the available data in the literature and to assess the health risk related to the consumption of tea in men, women, and children. The health risk assessment was conducted using the chronic daily intake and hazard quotient according to the approach suggested by the Environmental Protection Agency. The fluoride content in published studies varied noticeably, ranging from 0.13 to 3.27 mg/L. The results revealed that the hazard quotient (HQ) in age groups of women (21-72 years) and children (0-11 years) was within the safe zone (HQ < 1) which showed that there was no potential of non-carcinogenic risk associated with drinking tea in these groups. However, in one case of the men (21-72 years), the HQ > 1 which shows a probable risk of fluorosis. The order of non-carcinogenic health risks in the studied groups was in the order of men > women > children. The results of this can be useful for organizations with the responsibility of human health promotion.

Healing potential of injectable Aloe vera hydrogel loaded by adipose-derived stem cell in skin tissue-engineering in a rat burn wound model.

Adipose stem cells (ASCs) are a great promise in wound healing due to their potential in differentiating into various cell lineages and secreting growth factors. The purpose of this study is to evaluate the in vivo effects of Aloe vera hydrogel loaded by allogeneic ASCs on a rat burn wound model. The ASCs were isolated, cultured and mixed with 50% Aloe vera hydrogel and injected intradermally around the wound. Demineralized bone matrix (DBM) was used as dressing in the experiment. The burn wound-healing properties of different experimental groups were investigated by histopathological, molecular, scanning electron microscopic and biochemical analysis at the 7th, 14th and 28th days post-wounding. The Aloe vera and DBM-Aloe vera groups showed almost similar healing properties, while treatment by DBM-Aloe vera/ASCs significantly enhanced wound healing. The levels of transforming growth factor-ß1 (TGF-ß1) and interleukin-1ß markedly decreased at the 7th day post-injury, in the DBM-Aloe vera/ASC-treated group, suggesting that this treatment regime subsided the inflammatory responses. Angiogenesis, re-epithelialization and the level of TGF-ß1 in the wounds treated with DBM-Aloe vera/ASCs were also remarkably higher than those of other groups, at the 14th day post-injury. Besides, scar formation significantly decreased in the DBM-Aloe vera/ASC-treated wounds when compared with other groups. Our biochemical results were in agreement with the molecular and histopathological findings and strongly demonstrated that a DBM-Aloe vera/ASC composite can stimulate burn wound healing. These results suggest that the DBM-Aloe vera/ASC composite can be considered as a promising therapeutic strategy in the treatment of burn wounds.

The Effects of Selenium Supplementation on Glucose Metabolism and Lipid Profiles Among Patients with Metabolic Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to summarize the effect of selenium administration on glucose metabolism and lipid profiles among patients with diseases related to metabolic syndrome (MetS). We searched the following databases up to May 2017: MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. The relevant data were extracted and assessed for quality of the studies according to the Cochrane risk of bias tool. Data were pooled using the inverse variance method and expressed as standardized mean difference (MDs) with 95% confidence intervals (95% CI). Five studies were included in the meta-analyses. The results showed that selenium supplementation significantly reduced insulin levels (SMD -0.42; 95% CI, -0.83 to -0.01) and increased quantitative insulin sensitivity check index (QUICKI) (SMD 0.83; 95% CI, 0.58 to 1.09). Selenium supplementation had no beneficial effects on other glucose homeostasis parameters, such as fasting plasma glucose (FPG) (SMD -0.29; 95% CI, -0.73 to 0.15), homeostasis model assessment of insulin resistance (HOMA-IR) (SMD -0.80; 95% CI, -1.58 to -0.03), and lipid profiles, such as triglycerides (SMD -0.42; 95% CI, -0.83 to -0.01), VLDL- (SMD -0.42; 95% CI, -0.83 to -0.01), total- (SMD -0.42; 95% CI, -0.83 to -0.01), LDL- (SMD 0.02; 95% CI, -0.20 to 0.24), and HDL-cholesterol (SMD 0.16; 95% CI, -0.06 to -0.38). Overall, this meta-analysis showed that selenium administration may lead to an improvement in insulin and QUICKI, but did not affect FPG, HOMA-IR, and lipid profiles.

The effects of selenium supplementation on biomarkers of inflammation and oxidative stress in patients with diabetic nephropathy: a randomised, double-blind, placebo-controlled trial.

This study was carried out to assess the effects of Se supplementation on biomarkers of inflammation and oxidative stress in patients with diabetic nephropathy (DN). This randomised, double-blind, placebo-controlled clinical trial was conducted among sixty patients with DN. Patients were randomly divided into two groups to take either 200 µg/d Se supplements as Se yeast (n 30) or placebo (n 30) for 12 weeks. In unadjusted analyses, compared with the placebo, Se supplementation led to a significant reduction in high-sensitivity C-reactive protein (hs-CRP) (-1069·2 (sd 1752·2) v. -135·3 (sd 1258·9) ng/ml, P=0·02), matrix metalloproteinase-2 (MMP-2) (-612·3 (sd 679·6) v. +76·0 (sd 309·1) ng/ml, P<0·001) and plasma malondialdehyde (MDA) concentrations (-0·1 (sd 0·7) v. +0·4 (sd 0·9) µmol/l, P=0·01). In addition, a significant increase in plasma total antioxidant capacity (TAC) (+174·9 (sd 203·9) v. +15·8 (sd 382·2) mmol/l, P=0·04) was observed following supplementation with Se compared with the placebo. Subjects who received Se supplements experienced a borderline statistically significant decrease in serum protein carbonyl (PCO) levels (P=0·06) compared with the placebo. When we adjusted the analysis for baseline values of biochemical parameters, age and BMI, serum hs-CRP (P=0·14) and MDA levels (P=0·16) became non-significant, whereas plasma nitric oxide (NO) (P=0·04) and glutathione (GSH) (P<0·001) became statistically significant, and other findings did not change. Supplementation with Se had no significant effect on NO, transforming growth factor ß (TGF-ß), advanced glycation end products (AGE), PCO and GSH compared with the placebo. Overall, our study demonstrated that Se supplementation among DN patients had favourable effects on serum MMP-2, plasma NO, TAC and GSH, but did not affect hs-CRP, TGF-ß, AGE, PCO and MDA.

The effects of vitamin D, K and calcium co-supplementation on carotid intima-media thickness and metabolic status in overweight type 2 diabetic patients with CHD.

This study was conducted to examine the effects of vitamin D, K and Ca co-supplementation on carotid intima-media thickness (CIMT) and metabolic status in overweight diabetic patients with CHD. This randomised, double-blind, placebo-controlled trial was conducted among sixty-six diabetic patients with CHD. Participants were randomly allocated into two groups to take either 5µg vitamin D, 90 µg vitamin K plus 500 mg Ca supplements (n 33) or placebo (n 33) twice a day for 12 weeks. Fasting blood samples were obtained at the beginning of the study and after the 12-week intervention period to determine related markers. Vitamin D, K and Ca co-supplementation resulted in a significant reduction in maximum levels of left CIMT (-0·04 (sd 0·22) v. +0·04 (sd 0·09) mm, P=0·02). Changes in serum vitamin D (+6·5 (sd 7·8) v. +0·4 (sd 2·2) ng/ml, P<0·001), Ca (+0·6 (sd 0·3) v. +0·1 (sd 0·1) mg/dl, P<0·001) and insulin concentrations (-0·9 (sd 3·1) v. +2·6 (sd 7·2) µIU/ml, P=0·01), homoeostasis model for assessment of estimated insulin resistance (-0·4 (sd 1·2) v. +0·7 (sd 2·3), P=0·01), ß-cell function (-2·1 (sd 9·0) v. +8·9 (sd 23·7), P=0·01) and quantitative insulin sensitivity check index (+0·007 (sd 0·01) v. -0·006 (sd 0·02), P=0·01) in supplemented patients were significantly different from those in patients in the placebo group. Supplementation resulted in significant changes in HDL-cholesterol (+2·7 (sd 7·0) v. -2·5 (sd 5·7) mg/dl, P=0·002), high-sensitivity C-reactive protein (-1320·1 (sd 3758·3) v. +464·0 (sd 3053·3) ng/ml, P=0·03) and plasma malondialdehyde concentrations (-0·4 (sd 0·5) v. -1·0 (sd 1·1) µmol/l, P=0·007) compared with placebo. Overall, vitamin D, K and Ca co-supplementation for 12 weeks among diabetic patients with CHD had beneficial effects on maximum levels of left CIMT and metabolic status. The effect of vitamin D, K and Ca co-supplementation on maximum levels of left CIMT could be a chance finding.

Effect of the omega-3 fatty acid plus vitamin E supplementation on subjective global assessment score, glucose metabolism, and lipid concentrations in chronic hemodialysis patients.

SCOPE: This study was conducted to determine the effects of omega-3 fatty acid plus vitamin E supplementation on subjective global assessment (SGA) score and metabolic profiles in chronic hemodialysis (HD) patients. METHODS AND RESULTS: This randomized double-blind placebo-controlled clinical trial was conducted among 120 chronic HD patients. Participants were randomly divided into four groups to receive: (i) 1250 mg/day omega-3 fatty acid containing 600 mg eicosapentaenoic acid and 300 mg docosahexaenoic acid + vitamin E placebo (n = 30), (ii) 400 IU/day vitamin E + omega-3 fatty acids placebo (n = 30), (iii) 1250 mg omega-3 fatty acids/day + 400 IU/day vitamin E (n = 30), and (iv) omega-3 fatty acids placebo + vitamin E placebo (n = 30) for 12 wk. Fasting blood samples were taken at baseline and after 12-wk intervention to measure metabolic profiles. Patients who received combined omega-3 fatty acids and vitamin E supplements compared with vitamin E, omega-3 fatty acids, and placebo had significantly decreased SGA score (p < 0.001), fasting plasma glucose (p = 0.01), serum insulin levels (p = 0.001), homeostasis model of assessment insulin resistance (p = 0.002), and improved quantitative insulin sensitivity check index (p = 0.006). CONCLUSION: Omega-3 fatty acids plus vitamin E supplementation for 12 wk among HD patients had beneficial effects on SGA score and metabolic profiles.

Knowledge of burn wound healing: the heritage from traditional pharmacy of Persia.

The traditional pharmacy of Persia is based on numerous ancient manuscripts written by the elites of medicine and pharmacy. These references which belong to different centuries (mostly from the 9th to 19th century) represent vast information about pharmaceutical and therapeutic knowledge. Studying these works could be valuable in revealing the hidden parts of the history of science, especially pharmacy and medicine. Also, modernisation of the methods of treatment and the majority of formulations seems to be possible. It is obvious that setting ancient experiences besides recent studies makes pharmacists and physicians more powerful. This review aims to introduce traditional knowledge about different treatments for burn wounds which has been extracted from various Persian manuscripts.