Comparison of hook plate versus T-plate in the treatment of Neer type II distal clavicle fractures: a prospective matched comparative cohort study.

BACKGROUND: This study aimed to compare the clinical and radiological outcomes of distal clavicle fracture fixation with a hook plate versus the standard non-locking T-plate for unstable Neer type II fractures. METHODS: A prospective matched cohort study including two groups of hook plates and T-plates fixation was conducted in our two tertiary trauma centers. Patients with distal clavicle fractures Neer type II were assessed for union and the Constant-Murley score (CMS) at 1-, 3-, and 6-month follow-ups. Inadequate radiographic consolidation > 6 months after surgery was defined as non-union. Subscales of CMSpain, CMSactivities of daily living, CMSrange of motion (ROM), and CMSstrength were also compared between groups. According to recommendations, the implant was removed after union confirmation in the hook plate at a planned second surgery. RESULTS: Sixty consecutive patients were enrolled: 30 in the T-plate group and 30 in the hook plate group. CMS showed similar functional outcomes for T-plates and hook plates at all follow-ups (Month 6: 92.0 vs. 91.7, P = 0.45). However, on the month 1 follow-up, the T-plate group scored higher than the hook plate group for ROM and pain (CMSpain = 13.0 vs. 12.3, P = 0.03; CMSROM = 35.2 vs. 33.2, P = 0.002). Despite this, Pain, ROM, and other CMS domains were comparable between groups (P > 0.05). The mean time to union was 2.5 + 1.4 months for the T-plate group and 2.3 + 1.6 months for the hook plate group (P = 0.44). There was one fixation failure in each group and one periprosthetic fracture in the hook plate group (two revisions for the hook plates and one for T-plates, P = 1.00). Non-union and other complications were not observed. CONCLUSION: Both surgical approaches resulted in full recovery and good function. However, in the hook plate group ROM and pain scores were lower at 1 month. Standard non-locking T-plates are a viable alternative to hook plates with low cost and promising outcomes for treating displaced distal clavicle fractures.

Association between serum potassium and risk of all-cause mortality among chronic kidney diseases patients: A systematic review and dose-response meta-analysis of more than one million participants.

We aimed to perform a meta-analysis, using prospective cohort studies, to test the association between serum potassium and all-cause mortality among chronic kidney diseases (CKD) patients. A systematic search was performed using PubMed-MEDLINE and Scopus, up to July 2020. Prospective cohort studies which reported risk estimates of all-cause mortality in CKD patients with different serum potassium levels were included in the present meta-analysis. Thirteen studies were included in the analysis. A nonlinear dose-response meta-analysis suggested that there is a J-shaped association between serum potassium levels and the risk of all-cause mortality, with a nadir at serum potassium of 4.5 mmol/L. Subgroup analyses indicated that the strength and shape of the association between serum potassium and all-cause mortality may be influenced by age. Our meta-analysis provides supportive evidence that there is a J-shape association between serum potassium and all-cause mortality among CKD patients.

The Effect of Saffron Consumption on Liver Function: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials.

BACKGROUND AND AIMS: The present systematic review and meta-analysis of randomized controlled trials aimed to determine the effects of saffron supplementation on liver function tests among adults. METHODS: Electronic databases including PubMed, ISI Web of Science, and Scopus were searched up to January 2021. The risk of bias in individual studies was assessed using the Cochrane Collaboration tool. The overall estimates and their 95% CIs were calculated using random-effects models. Egger's test and Begg's rank-correlation were run to assess the presence of publication bias. p < 0.05 was considered statistically significant. RESULTS: A total of 12 trials involving 608 participants were included in this systematic review and meta-analysis. Saffron supplementation had no significant effect on liver function tests including aspartate transaminase (AST) (weighted mean difference [WMD] = 0.23 U/L; 95% CI -2.22 to 2.69; p = 0.851; I2 = 74.0%), alanine aminotransferase (ALT) (WMD = -1.49 U/L; 95% CI -3.84 to 0.86; p = 0.213; I2 = 60.2%), and alkaline phosphatase (ALP) (WMD = -0.70 U/L; 95% CI -11.35 to 9.95; p = 0.898; I2 = 40.8%) compared to placebo. CONCLUSION: Based on what was discussed, it seems that saffron supplementation could not improve liver function tests including AST, ALT, and ALP among the adult population. Further clinical trials with larger sample size, longer duration, and higher doses of saffron should be conducted exclusively among patients with liver dysfunction to elucidate the beneficial role of saffron consumption on liver function.

The effect of cumin (Cuminum cyminum L.) supplementation on glycemic indices: A systematic review and meta-analysis of randomized controlled trials.

We aimed to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to examine the effect of cumin supplementation on markers of glycemic control in adults. A comprehensive literature search was conducted up from inception to November 2020 on PubMed, Scopus, Web of Sciences, and Cochrane electronic databases. Studies that compared the effect of cumin with placebo on fasting blood sugar (FBS), serum insulin, and homeostasis model assessment-estimated insulin resistance (HOMA-IR) index in adults were considered eligible. Weighted mean difference (WMD) (with 95% confidence intervals) for endpoints were calculated using the random-effects model. Finally, a total of eight RCT studies involving 552 participants were included in the review. The results of the meta-analysis suggest that cumin supplementation did not significantly alter serum FBS (WMD: -17.77 mg/dl; 95% CI: -36.42 to 0.87, p = .06), insulin (WMD: -0.49 Hedges' g; 95% CI: -1.19 to 0.21, p =.16) levels and HOMA-IR (WMD: -0.06; 95% CI: -0.21 to 0.10, p = 0.48) index. These results do not support the use of cumin supplementation for improving glycemic markers in adults. However, further high-quality trials are still needed to confirm these results.

Effect of sour tea supplementation on liver enzymes, lipid profile, blood pressure, and antioxidant status in patients with non-alcoholic fatty liver disease: A double-blind randomized controlled clinical trial.

The aim of this study was to evaluate the efficacy of sour tea supplementation in patients with nonalcoholic fatty liver disease (NAFLD). Seventy NAFLD patients were enrolled in this randomized, double-blind, placebo-controlled clinical trial. Participants received sour tea in the form of a 450 mg capsule or a placebo capsule daily for 8 weeks. Anthropometric indices, liver enzymes, lipid profile, blood pressure, and antioxidant status were evaluated at the baseline and at the end of the study. Sixty-one participants completed the study. After 8 weeks, sour tea administration significantly decreased serum triglyceride (TG) (p = .03), alanine aminotransferase (ALT) (p = .01), and aspartate aminotransferase (AST) (p = .004) levels compared with the placebo. In addition, sour tea supplementation resulted in a significant reduction in systolic blood pressure (SBP) (p = .03) and diastolic blood pressure (DBP) (p = .04), and a significant increase in serum total antioxidant capacity (TAC) levels (p ˂ .001) compared with the placebo. However, no significant changes in anthropometric measures, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c) levels were observed after sour tea supplementation compared with the placebo (p > .05). Sour tea supplementation may be effective in improving serum TG, liver enzymes, and blood pressure in patients diagnosed with NAFLD. Further studies are needed to address the exact mechanism of action of these effects.

Effects of resveratrol supplementation on liver enzymes: A systematic review and meta-analysis of randomised controlled trials.

BACKGROUND: The available evidence regarding the possible effects of resveratrol on liver function is inconsistent. Therefore, the present meta-analysis was performed to investigate the overall effects of resveratrol supplementation on liver enzymes in adults. METHODS: A systematic and comprehensive search of the online medical databases including PubMed, Scupos, Web of Science and Cochran Library was performed up to February 2020. All RCTs using resveratrol supplements in adults were included in this systematic review and meta-analysis. The overall effect was presented as weighted mean difference (WMD) and 95% confidence interval (CI) in a random-effects meta-analysis model. RESULTS: Finally, 15 randomised trials including 714 participants were selected for the present meta-analysis. Pooled analysis did not show any significant changes in alanine aminotransferase (ALT) (WMD: 0 IU/L, 95% CI: -3.17 to 3.17, P = .99; I2 = 74.2%), aspartate aminotransferase (AST) (WMD: -2.40 IU/L, 95% CI: -5.45 to 0.65, P = .11; I2 = 82.9%), gamma-glutamyl transferase (GGT) (WMD: -1.26 IU/L, 95% CI: -4.64 to 2.13, P = .64; I2 = 23.7%), alkaline phosphatase (ALP) (WMD: 3.80 IU/L, 95% CI: -4.65 to 12.25, P = .37; I2 = 29.9%) and bilirubin (WMD: 0.13 IU/L, 95% CI: -0.43 to 0.17, P = .39; I2 = 8.9%) after supplementation with resveratrol. CONCLUSION: Overall, in our study, resveratrol does not affect liver enzyme levels significantly, but subgroup analysis indicates that these results may be influenced by resveratrol dose, duration of the study and population status, so future high-quality studies are necessary to get definitive results.

Effect of Nigella sativa L. supplementation on inflammatory and oxidative stress indicators: A systematic review and meta-analysis of controlled clinical trials.

AIMS: The objective of the present study was to perform a systematic review and meta-analysis on randomized controlled trials (RCTs) assessing the effects of Nigella sativa L. supplementation on the circulating inflammatory and oxidative stress markers, including C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), total antioxidant capacity (TAC) and malondialdehyde (MDA). METHODS: Systematic search was performed up to March 2020 using PubMed, Scopus, and ISI web of science databases. Two reviewers independently assessed study eligibility, extracted data, and evaluated methodological quality of included primary studies. Statistical heterogeneity was assessed using I-square (I2) statistic. Data were pooled by using the random-effect model and standardized mean difference (SMD) was considered as the summary effect size. RESULTS: Twelve trials were identified to be suitable for our meta-analysis. The pooled results using random effects model indicated that Nigella sativa supplementation significantly reduced CRP (SMD: -0.35; 95% CI: -0.59, -0.12, P < 0.001, I2 = 10.5%) and MDA concentrations (SMD: -0.56; 95% CI: -0.98, -0.15, P < 0.001, I2 = 64.7%). Moreover, Nigella sativa supplementation increased TAC (SMD: 0.48; 95% CI: 0.09, 0.87, P = 0.01, I2 = 65.6%) levels; however, it did not affect TNF-α (SMD: -0.35; 95% CI: -0.70, 0.01, P = 0.05, I2 = 58.2%). CONCLUSION: Nigella sativa supplementation is associated with improved inflammation and oxidative status. Additional prospective studies are recommended using higher supplementation doses and longer intervention period.

The effect of barberry (Berberis vulgaris L.) on glycemic indices: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: We performed a meta-analysis to evaluate the efficacy of barberry (Berberis vulgaris L.) supplementation on glycemic indices in adults. METHODS: A comprehensive search was conducted in PubMed, Scopus, Cochrane Library, and ISI Web of Science from inception up to January 2020, to identify randomized controlled trials (RCTs) investigating the effect of barberry supplementation on glycemic markers including fasting blood sugar (FBS) concentrations, insulin levels, homeostatic model assessment for insulin resistance (HOMA-IR), and glycosylated hemoglobin (HbA1c) percentage. The results of this meta-analysis were reported, based on the random effects model. RESULTS: In total, 7 studies, comprising 452 participants, were included in the systematic review. The meta-analysis revealed that barberry significantly reduces insulin levels (Hedges's: -0.67; 95% CI: -1.31 to -0.03, P = 0.04, I2 = 73.3%). However, no considerable changes was observed for FBS levels (WMD: -8.06 mg/dL; 95% CI: -20.46 to 4.33, P = 0.23, I2 = 96.1%), HbA1c percentage (WMD: -0.83 %; 95% CI: -2.33 to 0.67, P = 0.27, I2 = 88.3%), and HOMA-IR index (WMD: -0.55; 95% CI: -1.60 to 0.50, P = 0.30, I2 = 99.4%). CONCLUSION: The present study suggests that although barberry supplementation significantly improves insulin levels; however, other glycemic indices might not be affected. However, more high-quality RCTs with longer duration are needed to further clarify the effects of barberry on blood glucose control, especially among patients with diabetes.