Iron-Status Indicators and HFE Gene Polymorphisms in Individuals with Amyotrophic Lateral Sclerosis: An Umbrella Review of Meta-analyses and Systematic Reviews.

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by the progressive loss of motor neurons. Recent meta-analyses and systematic reviews suggest that HFE gene polymorphisms and iron-associated biomarkers may play a key role in the risk and occurrence of ALS. This umbrella study aimed to explore the roles of HFE gene polymorphisms and iron-associated biomarkers in individuals with ALS. A thorough search of three online scientific databases, namely Scopus, Web of Science, and PubMed, was conducted from their inception until September 13, 2024. The screening and selection processes were executed based on the PICO framework and eligibility criteria, followed by two independent reviewers. The Assessment of Multiple Systematic Reviews (AMSTAR)-2 and GRADE tools were utilized to assess the methodological quality and the certainty of evidence. Through an advanced search, 101 records were retrieved, of which eight meta-analyses and systematic reviews were selected for this umbrella review. A significant increase in iron concentrations was found in individuals with ALS compared to healthy controls (SMD, 0.26; 95% CI - 0.05, 0.57). Conversely, selected meta-analyses reported that serum transferrin concentrations in ALS patients were lower compared to healthy controls (SMD, - 0.15; 95% CI - 0.36, 0.05). Furthermore, mutations in H63D polymorphisms resulted in a 13% significant increase in the risk of ALS (OR, 1.13; 95% CI 1.05, 1.22). Our umbrella study of meta-analyses and systematic reviews reveals that individuals with ALS have lower serum concentrations of transferrin compared to healthy controls. Additionally, the H63D polymorphism in the HFE gene is associated with a slight increase in the risk of ALS. Future research should investigate broader aspects of iron-related biomarkers and HFE genes to elucidate their roles in ALS pathogenesis. Registration: Our umbrella study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the identification number CRD42024559032 ( https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024559032 ).

Exploring the efficacy and safety of cannabidiol in individuals with epilepsy: an umbrella review of meta-analyses and systematic reviews.

BACKGROUND: Epilepsy ranks among the most prevalent neurological conditions worldwide. Cannabidiol (CBD) has received authorization for epilepsy treatment, yet utilizing CBD is linked to a variety of adverse events (AEs). This umbrella review aims to explore risk and frequency of AEs in epilepsy patients undergoing treatment with CBD. METHODS: International electronic databases comprising Scopus, PubMed, and Web of Science were extensively searched from the most ancient data accessible until May 2024. In line with fundamental principle of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA), this umbrella review was executed. RStudio software version 2023.03.1 along with R software 4.3.2 was used for our statistical analyses. RESULTS: Thirteen meta-analyses and systematic reviews were included. CBD use in epileptic patients compared to controls can be meaningfully linked with 10.87% becoming seizure-free (RD: 10.87%, 95%CI: 2.39%, 19.34%; I2 = 80%). Compared to controls, a meaningful 73% increase in 50% or greater reduction in seizure frequency was observed (RR: 1.73, 95%CI: 1.47, 2.03; I2 = 0%). In epileptic individuals who using CBD with the dosage of 20 mg/kg/d, a higher incidence of treatment withdrawal was detected (RR: 4.39, 95%CI: 2.46, 7.83; I2 = 0%). CONCLUSION: In this umbrella review of meta-analyses and systematic reviews, CBD use in epileptic patients was linked to an increased risk of ample AEs. Further research, specifically targeting various epilepsy categories, is essential to fully understand the effectiveness and potential side effects of CBD across different epilepsy forms.

Shining a Light on Trace Elements: A Systematic Review and Meta-analysis of Serum Concentrations in Febrile seizure.

Febrile seizures (FS) are a common occurrence in pediatric patients and are typically triggered by high fevers above 100.4°F (38°C), often associated with viral or bacterial infections such as respiratory or gastrointestinal infections. Recent research suggests that the serum concentration of trace elements may play a role in the occurrence of FS. This study aimed to assess the association between serum levels of trace elements and FS in pediatric patients. A comprehensive search of four databases, including Scopus, Web of Science, PubMed, and Google Scholar, was conducted up to February 2024. The study followed the PICO structure, focusing on the Population (pediatric patients with FS), Intervention (serum concentrations of selenium, zinc, magnesium, and copper), Comparison (with or without controls), and Outcome (occurrence of FS). The methodological quality of the included observational studies was assessed using the Newcastle-Ottawa Scale (NOS) tool. Out of a total of 168 papers, 37 met the inclusion criteria for this meta-analysis, covering studies published between 2018 and 2023. Lower serum zinc levels were observed in pediatric patients with FS compared to control groups (SMD: -1.25, 95% CI: -1.47, -1.03). Conversely, higher serum copper levels were found in control groups compared to those with FS (SMD: 0.43, 95% CI: 0.04, 0.82). Additionally, lower serum magnesium levels were detected in the FS group compared to controls (SMD: -0.76, 95% CI: -1.57, 0.05), while serum selenium levels were approximately two times lower in the FS group than in controls (SMD: -2.23, 95% CI: -2.76, -1.70). Our meta-analysis suggests that pediatric patients with FS have lower serum concentrations of trace elements compared to controls. Further research is warranted to elucidate the potential role of trace elements in the pathogenesis of FS. This meta-analysis and systematic review was registered in the International prospective register of systematic reviews (PROSPERO ID: CRD42024519163). Registry URL: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024519163 registry number: CRD42024519163.

Therapeutic Effectiveness of Sesame Preparations and its Bioactive Ingredients in Management of Cardiometabolic Syndrome in Diabetes Mellitus: A Systematic Review.

AIM: This systematic review aimed to appraise and recapitulate all research investigations to elucidate the effects of Sesamum indicum preparations on managing the cardiometabolic syndrome of Diabetes mellitus (DM) and metabolic syndrome (MetS). METHODS: A systematic review was carried out in a Cochrane fashion and in compliance with the PRISMA checklist using the published academic works in PubMed/MEDLINE, WOS, SCOPUS, and EMBASE databases that were searched up to June 2021. Abstracts that met PICO criteria for qualitative studies were duplicate reviewed for data extraction to assess the quality and details of the study. RESULTS: Sesamum indicum preparations and its bioactive lignans, such as sesamin, sesamol, and pinoresinol, were found to possess anti-hyperglycemic, anti-hyperlipidemia, anti-inflammatory, antioxidative, anti-hypertensive, cardioprotective, and hepatoprotective effects both in patients with T2DM as well as in experimental animal models with T1DM and MetS. The incorporation of sesame oil as a natural adjuvant can be effective in improving vascular reactivity and aortic permeability, reproductive parameters, and diabetic nephropathy, as well as modification of anthropometry indices. Therefore, sesame oil and bioactive lignans as combination therapy with drugs can exhibit synergistic effects and provide a favorable preference in clinical settings. CONCLUSION: Sesame oil and lignans present in it act in a dose-dependent manner. The best dosage to improve risk biomarkers of patients with T2DM and MetS is 30-35 ml daily of sesame oil or inclusion of sesame oil in daily dietary patterns up to 30% of total energy for 8-12 weeks and/or 200 mg daily of sesamin supplementation for eight weeks.

Review of Clinical Spectrum of Gastroesophageal Reflux Disease in a General Population; A Study from South-East Iran.

BACKGROUND Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal problems worldwide. The aim of this study was to evaluate the clinical spectrum, prevalence, and some of the variables that are supposed to be the risk factors of this chronic disorder. METHODS This population- based cross-sectional study was conducted in a one-stage randomized clustered sample of adult inhabitants in Kerman city in 2011-2012. A total of 2265 subjects with age range of 15-85 years were enrolled. Face to face interview was performed for all the subjects. GERD was defined as at least weekly heart burn and/or acid regurgitation during the past year. Association of GERD with factors like demographic variables, medical condition, diet and life habits were analyzed. RESULTS A total of 2265 subjects including 988 (43.8%) male and 1275 (56.3%) female patients were evaluated. The prevalence of GERD was 28%. The prevalence was higher in female patients and with aging. There was also a significant association between GERD and the following risk factors: lower educational level (p <0.0001), higher body mass index (p =003), presence of depression(p<0.0001), and anxiety (p <0=0001). CONCLUSION GERD as a common disorder in our region was seen more in elderly and female patients and was associated with some anthropometric, metabolic, medical conditions, and behavioral habits.

A Rare Presentation of Ménétrier's Disease as Gastroduodenal Intussusception.

Ménétrier's disease is a rare cause of hypertrophic gastropathy that is usually confined to the gastric body and fundus. It is characterized by giant rugae, hypoalbuminemia, and foveolar hyperplasia. Here we report the case of a 26-year-old woman who presented with epigastric pain, postparandial nausea-vomiting, and weight loss. Paraclinic evaluation revealed hypoalbuminemia and hypochromic microcytic anemia. Gastroscopy and barium meal study showed diffuse polypoid, nodular lesions that affected the entire stomach, invaginating into the duodenum, leading to partial duodenal obstruction. The histologic, radiologic and endoscopic findings fulfilled the diagnosis of Ménétrier's disease. To the best of our knowledge, gastroduodenal intussusception by Ménétrier's disease has been rarely described in the literature.

Lead serum levels in opium-dependent individuals.

BACKGROUND: Drug abuse, especially opium abuse, is a major public health problem in Iran. Recent reports suggest that opium sellers cheat their customers by adding lead to the opium. Contaminated opium can threaten the health of consumers. The present study aimed to compare the serum level of lead between opium dependents and a control group. METHODS: This was a cross-sectional study in which 50 opium dependents aged 20 to 60 years old were compared with a control group of 43 non-dependents who were matched with the case group in terms of sex and age. The serum level of lead and liver function tests including serum total bilirubin, AST, ALT, Alkaline-phosphatase and hemoglobin were measured for all subjects. FINDINGS: The mean level of serum lead concentration in opium dependents and controls was 3929.358 ± 147.67 and 3532.721 ± 1141.53, respectively and the difference was not statistically significant. There was no significant correlation between serum level of lead and age, duration of opium dependency, serum total bilirubin, hemoglobin, AST, ALT, and Alkaline-phosphate. CONCLUSION: Although there was no significant relationship between opium consumption and serum level of lead, the concentration of lead in dependents' serum was higher than controls. Further studies are needed to approve this relationship to be used for screening and on time diagnosis of opium dependents.