The prevalence of zinc deficiency in morbidly obese patients before and after different types of bariatric surgery.

BACKGROUND: The prevalence of obesity is considered to be increased worldwide. Lack of mineral elements is one of the essential side effects of bariatric surgery as a trending treatment for obesity. We aimed to assess zinc deficiency among morbidly obese patients before and following different types of bariatric surgical procedures. METHODS: In the present retrospective cohort study, 413 morbidly obese patients (body mass index (BMI) ≥ 40 kg/m2 or BMI ≥ 35 kg/m2 with a complication or risk factor, e.g., diabetes mellitus) were enrolled who received bariatric surgery, aged between 18 and 65 years old, and had a negative history of active consumption of alcohol and illicit drugs. Patients were assigned into three groups of bariatric surgeries: mini-gastric bypass, Roux-en-Y gastric bypass (RYGB), and sleeve gastrectomy (SG). We recorded baseline clinical and demographic characteristics and zinc serum levels during the preoperative and postoperative follow-up periods at three, six, and 12 months after the operation. RESULTS: All patients with a mean age of 40.57 ± 10.63 years and a mean preoperative BMI of 45.78 ± 6.02 kg/m2 underwent bariatric surgery. 10.2% of the bariatric patients experienced zinc deficiency before the surgery, and 27.1% at 1 year after the surgery. The results showed that 27.7% of mini-gastric bypass patients, 29.8% of RYGB, and 13.3% of SG experienced zinc deficiency 12 months following surgery. We observed no statistical differences in the preoperative and postoperative zinc deficiency between different types of surgeries. CONCLUSION: A high prevalence of preoperative zinc deficiency among morbidly obese patients who underwent bariatric surgery was observed, which increased during the postoperative periods. We recommend assessing zinc serum levels and prescribing zinc supplements before the bariatric operation to alleviate the prevalence of zinc deficiency after the operation.

How to improve Iranians' vision health: on the national policy of preventing Iranians' blindness.

AIM: To review vision health situation of Iranian community, analyze its determinants, and discuss the adopted improvement strategies by the Iran Ministry of Health and Medical Education (MOHME). METHODS: This was a rapid situation analysis with a qualitative approach in three parts of recognition, orientation and implementation. The data were gathered via review of upstream documents, national and international experiences, and experts and stakeholders' opinions. RESULTS: Eradicating trachoma, increasing human resources, increasing educational and research centers and promotion of ophthalmic technologies were important achievements in the field of vision health in Iran. Through these achievements, it seemed that the pattern of causes of blindness and low vision was similar to that of the developed countries. However, the review of Iranians' vision health indicators showed that a considerable percent of the blindness and low vision was avoidable through a national program demanding 3 types of interventions in social determinants of health (SDH), community education, and increasing the access to health care services by integrating the necessary services in primary health care system. CONCLUSION: Managing the issue requires attentions from a national committee for preventing blindness with participation of all stakeholders, implementing a national survey on vision health, preparation of the primary level health centers including employment and education of community health workers (Behvarzes), optometrists and general practitioners, fair distribution of specialized human resources and establishing at least one specialized center in each province for referring patients from the primary levels.

The Impact of Future World Events on Iranians' Social Health: A Qualitative Futurology.

BACKGROUND: Social health is a dimension of health affected and interacts with other dimensions. Considering the rate of world changes, foresighting the influence of future events and possible trends on social health could bring about advantageous information for social policy makers. METHODS: This is a qualitative study of futurology with cross impact analysis approach. After studying possible trends and events in future, they were categorized in four domains including population, resources, climate changes, and globalization and 12 groups of events; and they were used to design a questionnaire. It was given to experts and their opinions were collected through depth interviews between May 2013 and Sep 2013. RESULTS: Analysis of experts' opinions reveals that future trends in four main potential domains may have some positive and more negative impacts on Iranians' social health. CONCLUSION: The global "resource challenge" is the most important incoming event, considering to the four domains of global events and its final and potential effects will be the increase of inequalities leading to social threat. Since inequalities are considered the most important risk factor of health in the societies, the solution for dispel the impact of world trends on Iranians' social health is managing the crisis of inequalities which is started with fore sighting and adopting preventive strategies in all four domains.

Role of the basolateral amygdala dopamine receptors in arachidonylcyclopropylamide-induced fear learning deficits.

There is much evidence suggesting that the mesoamygdala dopaminergic (DAergic) system plays a crucial role in the formation and expression of fear conditioning, with both D1 and D2 receptors being involved. In addition, cannabinoid CB1 receptor (CB1R) signaling modulates DAergic pathways. The present study sought to determine the involvement of basolateral amygdala (BLA) dopamine receptors in arachidonylcyclopropylamide (ACPA)-induced fear learning deficits. Context- and tone-dependent fear conditioning in adult male NMRI mice was evaluated. Pre-training intraperitoneal administration of ACPA (0.1 mg/kg) decreased the percentage of freezing in context- or tone-dependent fear conditioning, suggesting an acquisition impairment. Pre-training intra-BLA microinjection of a subthreshold dose of SKF38393 (D1-like receptor agonist), SCH23390 (D1-like receptor antagonist), quinpirole (D2-like receptor agonist), or sulpiride (D2-like receptor antagonist) did not alter the context-dependent fear learning deficit induced by ACPA, while SKF38393 or quinpirole restored ACPA effect on tone-dependent fear learning. Moreover, SKF38393 (1 µg/mouse), SCH23390 (0.04 and 0.08 µg/mouse), or quinpirole (0.1 µg/mouse) all impaired context-dependent fear learning. It is concluded that D1 or D2 dopamine (DA) receptor activation restores tone- but not context-dependent fear learning deficit induced by CB1 activation using ACPA.

Stroke in a Young Swimmer.

INTRODUCTION: Arterial dissections are important causes of stroke in the young population. Dissection has been reported in association with some sports. It seems that this report is among the first ones of the cervical arterial dissection in a young swimmer. CASE PRESENTATION: A 30-year-old male professional swimmer with no history of any major disease suddenly complained of severe ataxia, moderate headache, neck pain, unilateral left facial weakness, and feelings of tingling and paresthesia on the left side of his body and face a few minutes following head and body stretching exercises in land. There was no history of major head or neck trauma, manipulation, and practicing diving skills in the past. Acute infarction of the left cerebellum was diagnosed after performing brain computed tomography and magnetic resonance imaging (with contrast) studies. Cervical magnetic resonance angiography confirmed left vertebral artery dissection as the cause of infarction. CONCLUSIONS: Important differential diagnoses of cervicocephalic arterial dissection include other vascular or neurological causes of head and neck pain and/or local neurological syndromes and other causes of brain ischemia such as cardiac emboli, atherosclerosis, and vasculopathy of brain vessels. It is important that sports medicine practitioners pay attention to this less-diagnosed cause of stroke in young athletes.