The effects of curcumin-containing supplementations on inflammatory markers and lipid profiles in patients with chronic kidney diseases: a systematic review and meta-analysis of randomized controlled trials

OBJECTIVES

An evaluation the effects of curcumin on inflammatory markers and lipid profiles among patients with chronic kidney diseases (CKD).

METHODS

The electronic databases such as PubMed, and Scopus were searched systematically up until 12 December 2021. To evaluate the quality of the included studies, the Cochrane risk-of-bias tool for randomized trials was utilized. Likewise, data pooling was performed using a random effects model, also called a variance components model. Also, the findings were calculated as weighted mean difference (WMD) with a 95% confidence interval (CI).

RESULTS

In the end, this meta-analysis comprised a total number of nine studies. Curcumin intake significantly reduced total cholesterol (TC) (WMD=-13.77 mg/dL; 95% CI, -26.77, -0.77; p=0.04) and tumor necrosis factor alpha (TNF-α) (WMD=-18.87 pg/mL; 95% CI, -28.36, -9.38; p<0.001) compared with controls. The results did not confirm the significant effect of curcumin intake on triglyceride (TG) (WMD=-6.37 mg/dL; 95% CI, -26.59, 13.85; p=0.54), low-density lipoproteins (LDL-C) (WMD=-5.65 mg/dL; 95% CI, -20.81, 9.50; p=0.46), high-density lipoprotein (HDL-C) (WMD=0.16 mg/dL; 95% CI, -2.55, 2.88; p=0.91), and C-reactive protein (CRP) (WMD=-0.13 mg/L; 95% CI, -3.25, 3.30; p=0.93).

CONCLUSIONS

Our study showed that curcumin significantly impacts TC and TNF levels in CKD patients.

Opium use reporting error in case-control studies: neighborhood controls versus hospital visitor controls

Background: There are relatively scant data to determine whether hospital visitors could serve as a proper source of controls in case-control studies of illicit drug use. The aim of this study was to evaluate using neighborhood versus hospital visitor controls in reporting opium use. Methods: We used data from 2 independent case-control studies of cancer in Iran. In the first study, controls were selected from neighborhoods of the patients. For the second one, controls were selected from among hospital visitors. In the latter study, hospital visitors were companions of the patients or others visiting the hospital for reasons other than disease treatment. We used stata (version 12; Stata Corp( for all analyses and with a significance level of 0.05. Results: Data from 616 of neighborhood controls and 414 of hospital visitor controls were analyzed. Opium point prevalence among men was significantly higher in hospital visitors than neighborhood controls (43.3% vs 32.2%; P = 0.047), while the prevalence of cigarette smoking was very similar in both control groups (46.3% vs 47.2%; P =.847). Using a logistic regression analysis, in an unadjusted analysis, neighborhood controls were less likely to report opium use in both genders, with (unadjusted OR = 0.77; 95% CI: 0.59,1). After adjusting for potential confounders, the differences of opium use between the 2 control groups became more pronounced (Adjusted OR = 0.26; 95% CI: 0.10, 0.69). Conclusion: Because of the similarity of reporting cigarette smoking among neighborhood controls but substantially lower reporting of opium use among them, we concluded that neighborhood controls underreport opium use-a sensitive question- and that using neighborhood control biases the findings in case-control studies. Hospital visitor controls may be more appropriate than neighborhood controls for case-control studies of illicit drugs.

Opium use and the risk of head and neck squamous cell carcinoma

Scant evidence exists to support the association of opium use with head and neck cancer, limited to the larynx and oral cavity. In a multicenter case-control study-Iran Opium and Cancer study, we recruited 633 cases of head and neck squamous cell carcinoma (HNSCC) (254 lip and oral cavity, 54 pharynx, 327 larynx and 28 other subsites within the head and neck) and 3065 frequency-matched controls from April 2016 to April 2019. Odds ratios (ORs) for opium use and 95% confidence intervals (95% CIs) were obtained using mixed-effects logistic regression because of heterogeneity among centers. The adjusted OR (95% CI) for regular opium use was 3.76 (2.96-4.79) for all HNSCC combined. Strong dose-response effects were observed by frequency or amount of use, and duration of use. Regular opium uses significantly increased the risk of HNSCC of the pharynx, larynx and other subsites within the head and neck with OR (95% CI) of 2.90 (1.40-6.02), 6.55 (4.69-9.13) and 5.95 (2.41-14.71), respectively. The observed associations were significant even among never tobacco smokers (including cigarette and water-pipe smoking). Moreover, by the multiplicative interaction scale, the effect of opium use could be varied by cigarette smoking on HNSCC, 8.16 (6.20-10.74). For the first time, the current study showed opium users have an increased risk of several anatomic subsites of HNSCC.

Opium Use and Head and Neck Cancers: A Matched Case-Control Study in Iran

Background:

Head and Neck (H and N) cancers include malignant tumors of the nasal cavity, pharynx, paranasal sinuses, oral cavity, larynx and salivary glands. Opium use might be related to these cancers. The aim of this study was to investigate the relation between Opium and its Derivatives (O and D) use and the incidence of H and N cancers.

Methods:

In this case-control study conducted in Kerman, 140 patients with H and N cancers and 280 healthy controls (matched for age, gender, and place of residence) were included. Information about their use of O and D, cigarette smoking, alcohol and diet were collected using a structured questionnaire. Conditional logistic regression was used to investigate the relation between variables.

Results:

The use of opioids was associated with an increased risk of HandN cancers (Adjusted OR: 8.13; CI: 4.08-16.2). A significant dose-response relation between O and D use was observed, with high use Adjusted OR=8.91; 95% CI: 4.03-19.65 and low use Adjusted OR=6.52; 95% CI: 3.18- 13.36. This dose-response association was stronger in patients with laryngeal cancer and opioids use, with high use Adjusted OR = 11.17; 95% CI=4.48-28.09 and low use Adjusted OR = 9.46; 95% CI= 3.97- 22.52.

Conclusion:

The results show that opium use can be considered as an important risk factor for H and N cancers. Also in Iran, opium seems to play a more important role than cigarette smoking.

Copper and Zinc Levels in Myelodysplastic Syndrome Patients versus Healthy Subjects

Background:

Myelodysplastic syndrome (MDS) is a heterogeneous hematological disease and certain serum factors are assumed to be involved in its pathogenesis and progression. Given this, our aim was to comparatively investigate the copper, zinc, and iron levels in MDS patients and healthy individuals.

Methods:

This case-control study was conducted on 31 patients with MDS (according to the WHO criteria after investigating laboratory tests such as peripheral blood smear and bone marrow aspiration) attending Bahonar Hospital, Kerman, Iran, and 31 healthy subjects from 2016 to 2018. The levels of copper, ceruloplasmin, zinc, ferritin, and iron were compared between the two groups.

Results:

Among the MDS patients, five individuals (16.13%) had low serum copper level (mean: 67.8 ± 4.35 µg/dl). Serum copper level was 111.3 ± 27.7 and 138.3 ± 26.6 in case and control groups, respectively (P = 0.0001). The serum zinc level and bone marrow iron level were also significantly different between the two groups (P < 0.05).

Conclusion:

Overall, it can be concluded that because only a small proportion of the MDS patients enrolled in this study were found to have lower copper levels compared with the MDS patients population, further studies with a larger sample size and also clinical trials in MDS patients with serum zinc, and copper deficiency are recommended, and post-treatment hematological reassessment would also be beneficial to achieving more definitive results.

Prevalence of elder abuse and associated factors among community-dwelling older adults in Iran

The aim of this study was to investigate the prevalence of elder abuse and associated factors among community-dwelling older adults Kerman province, Iran. In this cross-sectional descriptive study, 200 elderly people in Kerman were included using multi-stage sampling. 51.4% of the elderly reported abuse. 17.5% reported physical abuse, 20.9% reported verbal abuse, and 26.4% reported non-verbal abuse. Also, 11.5% reported self-neglect and 6.5% were neglected by others. 11.4% of the elderly reported abandonment and 14.9% reported financial abuse. There was a significant relationship between economic stress and neglect (P = .01), the risk of abuse in the elderly with a very good health status was about 50% less than that in others (P < .001). Elderly experience different types of abuse. Therefore, proper knowledge of elder abuse, especially emotional abuse and its related factors, including economic stress and health status, can increase knowledge and sensitivity of society, in order to avoid this dilemma.

Predictors of Self-care among the Elderly with Diabetes Type 2: Using Social Cognitive Theory

INTRODUCTION

Diabetes is one of the most common chronic diseases among the elderly and is also a very serious health problem. Adopting theory-based self-care behaviors is an effective means in managing such diseases. This study aimed to determine the predictors of diabetes self-care in the elderly in Kerman based on a social cognitive theory.

MATERIAL AND METHODS

In this cross-sectional study, 384 elderly diabetic patients who had referred to health screening centers in Kerman were chosen via cluster sampling. To collect information about self-care and its predictors, Toobert Glasgow's diabetes self-efficacy scale as well as a questionnaire was used which was based on social cognitive theory constructs. The validity and reliability of the questionnaire was confirmed. The data were analyzed using Pearson correlation and linear regression analysis in SPSS software 17.

FINDINGS

Among the subjects, 67.37% (252) had poor self-care ability; 29.14% (109) had average ability, and 3.40% (13) enjoyed a proper level of self- care ability. There was a significant relationship between the constructs of the social cognitive theory (knowledge, self- efficacy, social support, outcome expectations, outcome expectancy and self-regulation) and the self-care score. Furthermore, the mentioned constructs could predict 0.47% of the variance of the self-care behaviors.

CONCLUSION

self-care behaviors in this study were poor. Therefore, it is necessary to develop an educational intervention based on cognitive theory constructs with the goal of properly managing diabetes in the elderly patients.

Estimation of iron deficiency anemia in Iranian children and adolescents: a systematic review and meta-analysis

OBJECTIVES

Iron deficiency anemia (IDA) is a major health issue in those aged less than 18 years old with high impact on their development. There are several reports from Iran with variable results. Systematic review and met analysis of these data would reveal a more realistic view of the prevalence of iron deficiency (ID).

METHODS

We conducted a systematic search of national and international databases from December 1990 to 31 January 2016 for population-based studies providing estimates on the prevalence of IDA in Iran. From the extracted crude prevalence rates, the heterogenic index of the studies was determined using the Cochran's test (Q) and I₂. Then, based on the heterogenetic results, a random effects model for estimate pooled prevalence of IDA was used. Meta-regression was applied to determine heterogeneity suspected factors.

RESULTS

The overall prevalence of IDA in Iranian population with age less than 18 years was estimated to be 13.9% (95% CI: 10.8-17.1) and the overall prevalence of ID was 26.9% (95% CI: 19.7-34.1). The prevalence of IDA was 7.9% (95% CI: 4.1-11.7) in males and 8.5% (95% CI: 6.1-10.8) among females aged under than 18 years.

DISCUSSION

Despite the efforts of ministry of health and medical education of Iran in implementing free iron supplements for infants and for girls, the prevalence of ID and resultant anemia is considerable. Further interventions to increase use of supplements when they are provided and special programs for non-covered groups including boys under six are in great need.