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The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Summary Background Cirrhosis and other chronic liver diseases (collectively referred to as cirrhosis in this paper) are a major cause of morbidity and mortality globally, although the burden and underlying causes differ across locations and demographic groups. We report on results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 on the burden of cirrhosis and its trends since 1990, by cause, sex, and age, for 195 countries and territories. Methods We used data from vital registrations, vital registration samples, and verbal autopsies to estimate mortality. We modelled prevalence of total, compensated, and decompensated cirrhosis on the basis of hospital and claims data. Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost due to premature death and years lived with disability. Estimates are presented as numbers and age-standardised or age-specific rates per 100 000 population, with 95% uncertainty intervals (UIs). All estimates are presented for five causes of cirrhosis: hepatitis B, hepatitis C, alcohol-related liver disease, non-alcoholic steatohepatitis (NASH), and other causes. We compared mortality, prevalence, and DALY estimates with those expected according to the Socio-demographic Index (SDI) as a proxy for the development status of regions and countries.

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Coenzyme Q(10) supplemenA randomized, double-blind clinical trial studytation effects on lipid ratios in women with type 2 diabetes mellitus:

Abstract: Objective: This study had been designed to evaluate the effects of Coenzyme Q10 (CoQ10) supplementation on the lipid ratios in women with type 2 diabetes mellitus (T2DM). Materials and Methods: Sixty-eight women with T2DM were enrolled and randomly divided into two groups.While one group received 100mg/day ofCoQ10 supplementfor 12 weeks(n=34)the other was given placebo for the same time duration (n=34). Lipid profile including triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were evaluated at the beginning and at the end of the intervention and lipid ratios were calculated. Results and Discussion: After the intervention, values of non-HDL-C (p=0.001), TG/HDL-C (p=0.03) and LDL-C/HDL-C (p=0.001) were significantly decreased in CoQ10 group. Values of HDL ratio (p=0.002) were increased significantly in CoQ10 group. Conclusion: This study showed that daily supplementation with 100 mg of CoQ10 in women with T2DM could improve some atherogenic lipid ratios that might be useful in preventing cardiovascular diseases in them.

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Risk Factors for Addiction Potential among College Students

Abstract Background: Tendency toward addiction is provided before drug use begins. The present study aimed to identify the risk factors for addiction potential in the students of Arak University of Medical Sciences. Methods: We conducted this cross‑sectional study among 305 students from Arak University of Medical Sciences, Iran in 2016. We selected the students by stratified random sampling and collected the data by family and sociodemographic factors questionnaires and Addiction Potential Scale. Results: Male students, students with low economic status and high family members were more prone to addiction. We identified variable; addiction in close friends, adverse family conditions (dispute with the family), poor economic condition of families, and family size by controlling the effect of other variables, as risk factors for addiction potential. Conclusions: Preventive and intervention actions appear necessary considering the mentioned factors.Author: Mehdi Ranjbaran

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Association between chemerin rs17173608 and rs4721 gene polymorphisms and gestational diabetes mellitus in Iranian pregnant women

Gestational diabetes mellitus (GDM) is defined as hyperglycemia detected during pregnancy and its risk is increased with obesity. Chemerin, an adipokine, has been proposed as potential mediators of insulin resistance in GDM. This case-control study was designed to assess the relation between chemerin SNPs rs4721 (or rs10278590) and rs17173608 and the development of GDM. One hundred thirty GDM pregnant women with GDM and 160 healthy pregnant women were enrolled in this study. The diagnosis of GDM was based on the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria. Chemerin rs4721 polymorphism gene was amplified through PCR, and SNP was detected using restriction enzyme AluI. Genotyping for chemerin rs17173608 polymorphism was performed by using tetra-amplification refractory mutation system polymerase chain reaction (T-ARMS-PCR). Blood glucose level was measured by an enzymatic method. Our finding showed that the genotypes frequency of chemerin rs4721 polymorphism was significantly different between GDM and non-GDM groups (χ2=7.44, P=0.02). The genotype of rs4721 was significantly associated with GDM in co-dominant and dominant genotypes (GG vs GT, OR=2.3, 95%CI=1.24–4.24, P=0.008, and GG vs GT+TT, OR=2.21, 95%CI=1.23–3.99, P=0.008, respectively). No significant difference was observed in allele frequency between case and control groups (P=0.62). Moreover, the genotypes and allele frequencies of chemerin rs17173608 polymorphism did not show significant differences between GDM and non- GDM (P > 0.05). We concluded that the genotype of rs4721 was found to contribute significant risk to GDM while genotype of rs17173608 could not predict the risk of GDM

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Comparing the efficacy and safety of laryngeal mask airway,streamlined liner of the pharyngeal airway and I-gel following tracheal extubation

Abstract Adverse events following surgical operations are common complications due to removal of tracheal tube in contrast to the tracheal intubation. Awareness about the new methods and strategies for tracheal tube extubation is necessary for a safe and successful extubation. Therefore, we aimed to assess the safety and efficacy of laryngeal mask airway (LMA), streamlined liner of the pharyngeal airway (SLIPA) and I-gel in extubation time of tracheal tube. A one-single randomized clinical trial was conducted in 105 eligible patients in three groups including LMA, SLIPA and I-gel. The patients were under surgery after general anesthesia with propofol (2-3 mg/kg) and fentanyl (1-2 μg/kg). Hemodynamic responses and extubation consequences including coughing rate, laryngospasm, airway obstruction, apnea, breath holding and straining of patients, vomiting, and need for re-intubation were recorded every 5 minutes since inserting of supraglottic airway devices (SADs) until patients restore consciousness. Analysis of data was conducted in SPSS software by analysis of variance (ANOVA) and ANOVA for repeated measurements tests. The overall successful insertion was 100% for LMA and I-Gel and this rate was 97.1% for SLIPA method. A significant decrease was observed in trend of hemodynamic responses in all three groups. Nevertheless, the MBP was lower in LMA group and lower HR was observed in I-Gel and higher HR occurred in SLIPA (P < 0.05). Three groups was same statistically regarding sore throat, vomiting, coughing, breath holding, apnea, laryngospasm, and re-intubation need (P > 0.05). However, the incidence rate of apnea, and laryngospasm, as well as re-intubation need in SLIPA group was 2.9%, respectively. LMA, I-GEL and SLIPA could be considered as useful and safe devices for ventilation control after tracheal tube removal at the end of operation. Three devices were same regarding to sore throat, vomiting, coughing, and breath holding. However, LMA showed lower side effects while SLIPA was related to more occurrences of apnea, laryngospasm, and re-intubation need

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