The effects of citrus flavonoids supplementation on endothelial function: A systematic review and dose-response meta-analysis of randomized clinical trials

The present systematic review and dose-response meta-analysis was conducted to synthesize existing data from randomized clinical trials (RCTs) concerning the impact of citrus flavonoids supplementation (CFS) on endothelial function. Relevant RCTs were identified through comprehensive searches of the PubMed, ISI Web of Science, and Scopus databases up to May 30, 2023. Weighted mean differences and their corresponding 95% confidence intervals (CI) were pooled utilizing a random-effects model. A total of eight eligible RCTs, comprising 596 participants, were included in the analysis. The pooled data demonstrated a statistically significant augmentation in flow-mediated vasodilation (FMD) (2.75%; 95% CI: 1.29, 4.20; I2 = 87.3%; p < 0.001) associated with CFS compared to the placebo group. Furthermore, the linear dose-response analysis indicated that each increment of 200 mg/d in CFS led to an increase of 1.09% in FMD (95% CI: 0.70, 1.48; I2 = 94.5%; p < 0.001). The findings from the nonlinear dose-response analysis also revealed a linear relationship between CFS and FMD (Pnon-linearity = 0.903, Pdose-response <0.001). Our findings suggest that CFS enhances endothelial function. However, more extensive RTCs encompassing longer intervention durations and different populations are warranted to establish more precise conclusions.

Consumption of ultra-processed foods could influence the metabolic syndrome odds: A cross-sectional study

Metabolic syndrome (MetS) prevalence has augmented globally during recent decades. Over the past years, the consumption of ultra-processed foods (UPFs) has grown significantly worldwide. So, the present research investigated the association between UPFs and MetS in an Iranian sample. This cross-sectional research was conducted on people (n = 8841) in the Fasa cohort study, Fars province, Iran. The participants' dietary consumption over a year, UPF consumption, and MetS diagnosis were evaluated through a 125-item modified food frequency questionnaire, the NOVA food group classification, and the Adult Treatment Panel III of the National Cholesterol Education Program, respectively. The association between the quartiles (Q) of UPF intake and the odds of MetS was estimated using the backward LR method of multivariate analysis. In the multivariate model, after adjusting potential confounders, the association between UPF intake and the odds of MetS was significant (Q4: odds ratio (OR = 3.27; 95% confidence interval (CI): 2.76-3.89). Also, the odds of increasing triglycerides (TG), blood pressure, and fasting blood sugar (FBS) and decreasing high-density lipoprotein cholesterol (HDL-C) were significantly higher in the last quartile compared to the first quartile of UPFs (TG: OR = 1.71; 95% CI: 1.49-1.97, blood pressure: OR = 1.53; 95% CI: 1.30-1.79, FBS: OR = 1.30; 95% CI: 1.10-1.54, and HDL-C: OR = 1.22; 95% CI: 1.08-1.39). The current research found a relationship between UPF intake and MetS and its components, indicating a diet-containing UPFs can be related to the occurrence of noncommunicable diseases.

Microbiomes and Pediatric onset multiple sclerosis (MS): A systematic review

Background

Gut microbiomes play a role in developing and regulating autoimmune diseases such as multiple sclerosis (MS). We designed this systematic review to summarize the evidence of the effect of gut microbiota in developing pediatric-onset MS.

Methods

PubMed, Scopus, EMBASE, Web of Science, Google Scholar, references of the references and conference abstracts were comprehensively searched by two independent researchers. The search was done on January 1st, 2023. Data regarding the total number of patients, the name of the first author, publication year, country of origin, mean age, duration of the disease, body mass index (BMI), type of MS, Expanded Disability Status Scale (EDSS), age at disease onset and stool composition were extracted.

Results

A literature search revealed 4237 published studies. After removing duplicates, we had 2045 records for evaluation. Twenty-three full texts were evaluated, and four case-control studies remained for systematic review. Three studies were conducted in the United States and one in the Netherlands. The number of participants in included studies ranged between 24 and 68. The mean age of patients at the time of study varied between 11.9 and 17.9 years, and the mean age at the onset of the disease ranged between 11.5 and 14.3 years. Most included patients were female. The results show that median richness (the number of unique taxa identified, which was provided by two studies) was higher in controls, and also Margalef index, which was reported by one study was higher in control group than the case group. The results of two studies also demonstrated that median evenness indexes (taxon distribution, Shannon, Simpson) were higher in control groups, as well as PD index (Faith's phylogenic diversity metric).

Conclusion

The result of this systematic review (including four studies) showed disruption of the microbiota-immune balance in pediatric-onset MS cases.

Dietary and lifestyle indices for hyperinsulinemia and colorectal cancer risk: a case-control study

BACKGROUND

The incidence of colorectal cancer (CRC) has increased in Iran, and determining the dietary patterns that can contribute to reducing or increasing the risk of CRC will help better control this disease. Therefore, in the current study, we assessed the association between the empirical lifestyle index for hyperinsulinemia (ELIH) and the empirical dietary index for hyperinsulinemia (EDIH) with the CRC odds.

METHODS

The present case (n = 71)-control (n = 142) study was carried out in several CRC surgical units of hospitals in Tehran, Iran. A semi-quantitative food frequency questionnaire containing 168 items was used to assess participants' dietary intakes. The EDIH and ELIH scores were calculated by food groups and some variables such as body mass index and physical activity. Logistic regression models were applied to evaluate the association between the EDIH and ELIH scores with CRC odds.

RESULTS

According to baseline features of the study participants, there were significant differences between the controls and cases in ELIH score, fiber intake, taking aspirin, and family history of CRC in first- and second-degree relatives. Also, we found that the odds of CRC increased significantly in the last tertile compared to the first tertile in EDIH and ELIH in the adjusted model (odds ratio (OR) = 3.12; 95% confidence interval (CI): 1.30-7.48 and OR = 4.72; 95% CI: 1.15-19.39, respectively).

CONCLUSIONS

In conclusion, the result of this study indicated that CRC odds was significantly greater in subjects with higher EDIH and ELIH scores. Also, according to the results of this study, lifestyle and diet with insulinemic potential can influence the CRC risk.

The association of ultra-processed food consumption with adult mental health disorders: a systematic review and dose-response meta-analysis of 260,385 participants

OBJECTIVE

We aimed to conduct a systematic review and meta-analysis of observational studies examining the relationship between ultra-processed food (UPF) consumption and the risk of mental health disorders.

METHODS

The ISI Web of Science, PubMed/MEDLINE, and Scopus databases were searched without date restriction until 28 December 2021. Data were extracted from 26 studies, including 260,385 participants from twelve countries. Risk ratios for mental health disorders were pooled by a random-effects model.

RESULTS

Meta-analyses suggested that UPF consumption was associated with an increased risk of depression (RR = 1.28; 95% CI: 1.19, 1.38; I2 = 61.8%; p = 0.022) but not anxiety (RR = 1.35; 95% CI: 0.86, 2.11; I2 =  77.8%; p = 0.198). However, when analyzed for the dietary assessment method, UPF consumption was significantly associated with an enhanced risk of depression among studies utilizing food frequency questionnaires (RR = 1.31; 95% CI: 1.21, 1.41; I2 = 60.0%; p < 0.001) as opposed to other forms of dietary recall approaches. Additionally, for every 10% increase in UPF consumption per daily calorie intake, 11% higher risk of depression (RR = 1.11; 95% CI: 1.01, 1.17; I2 = 88.9%; p < 0.001) was observed among adults. Dose-response analysis further emphasized a positive linear association between UPF consumption with depression risk (p-nonlinearity = 0.819, p-dose-response = p < 0.001).

CONCLUSION

Our findings indicate that UPF consumption is related to an enhanced depressive mental health status risk. There may be different causes for this increased risk, and further studies are needed to investigate if there is a causal relationship between consumption of UPF and mental health.

Psychological Stress and Gut Microbiota Composition: A Systematic Review of Human Studies

INTRODUCTION

The associations between psychological stress and gut microbiota composition are not fully understood. This study investigated associations between psychological stress and gut microbiota composition and examined the potential modifying effects of age, sex, and ethnicity on such associations.

METHODS

A systematic literature search was conducted using PubMed, Web of Science, PsycINFO, and Embase databases for studies published until November 2021 which examined associations between psychological stress and gut microbiota composition.

RESULTS

During the search process, 10,790 studies were identified, and after screening, 13 met the eligibility criteria and were included. The median sample size was 70, and the median age of participants was 28.0 years. Most of the included studies did not report associations between measures of alpha- and beta diversity of the gut microbiota composition and psychological stress. A few studies reported that the Shannon index, Chao 1, Simpson index, and weighted UniFrac were negatively associated with psychological stress. Significant reductions in several taxa at the phyla-, family-, and genus-levels were observed in participants with higher psychological stress. At the phylum level, the abundance of Proteobacteria and Verrucomicrobia were negatively associated with psychological stress. At the family-level, no more than two studies reported associations of the same microbiota with psychological stress. At the genus level, the following results were found in more than two studies; psychological stress was negatively associated with the abundance of Lachnospira, Lachnospiraceae, Phascolarctobacterium, Sutterella, and Veillonella, and positively associated with the abundance of Methanobrevibacter, Rhodococcus, and Roseburia. However, it was not possible to determine the influence of age, sex, or ethnicity due to the limited studies included.

CONCLUSION

Our findings provide evidence that psychological stress is associated with changes in the abundance of the gut microbiota. Larger sample longitudinal studies are needed to determine the causal relationship between psychological stress and the gut microbiota.

The association of ultra-processed food consumption with adult inflammatory bowel disease risk: a systematic review and dose-response meta-analysis of 4 035 694 participants

CONTEXT

There is an inconsistency between the results obtained from observational studies regarding intake of ultra-processed foods (UPFs) and the risk of inflammatory bowel disease (IBD).

OBJECTIVES

A dose-response meta-analysis was performed to evaluate the relationship between UPF intake and the risk of IBD.

DATA SOURCES

Searches were performed in the PubMed, ISI Web of Science, and Scopus databases up to November 2, 2022.

DATA EXTRACTION

Data were available from 24 studies including a total of 4 035 694 participants from 20 countries.

DATA ANALYSIS

Risk ratios for IBD were analyzed by a random-effects model. Outcomes indicated that UPF intake was linked to an increased risk of IBD (relative risk [RR], 1.13; 95%CI, 1.06-1.21; P = 0.001; I2 = 73.2%; n = 59; N = 4 035 694). This association was significant, especially for the risk of Crohn's disease (CD) (RR, 1.19; 95%CI, 1.00-1.41; I2 = 78.2%; P = 0.046; n = 23; N = 2 167 160), unlike the risk of ulcerative colitis (UC) (RR = 1.11; 95%CI, 0.99-1.26; P = 0.085; I2 = 60.3%; n = 27; N = 2 167 918). Also, results revealed that each 10% enhancement in daily UPF intake was not related to the risk of IBD (RR, 1.05; 95%CI, 0.98-1.14; P = 0.168; I2 = 31.9%; n = 4) or the risk of UC (RR, 1.01; 95%CI, 0.92-1.11; P = 0.876; I2 = 34.7%; n = 2) in adults. However, results suggested that for every 10% increase in daily UPF intake, there was a 19% increase in the risk of CD (RR, 1.19; 95%CI, 1.01-1.32; P = 0.021; I2 = 0.0%; n = 2) among adults. In addition, the results showed a positive linear relation between UPF intake with CD risk (Pnonlinearity = 0.431; Pdose response = 0.049) but not risk of IBD or UC.

CONCLUSION

High intake of UPFs was linked with an enhanced IBD risk, a specific risk of CD. However, conducting more observational studies among several ethnicities and using specific tools that accurately assess the amount of UPF consumption, components of UPFs, and food additives may be necessary. Systematic Review Registration: PROSPERO registration no. CRD42023390258.

Prediction of blood cancer using leukemia gene expression data and sparsity-based gene selection methods

Background: DNA microarray is a useful technology that simultaneously assesses the expression of thousands of genes. It can be utilized for the detection of cancer types and cancer biomarkers. This study aimed to predict blood cancer using leukemia gene expression data and a robust ℓ2,p-norm sparsity-based gene selection method. Materials and Methods: In this descriptive study, the microarray gene expression data of 72 patients with acute myeloid leukemia (AML) and lymphoblastic leukemia (ALL) was used. To remove the redundant genes and identify the most important genes in the prediction of AML and ALL, a robust ℓ2,p-norm (0 < p ≤1) sparsity-based gene selection method was applied, in which the parameter p method was implemented from 1/4, 1/2, 3/4 and 1. Then, the most important genes were used by the random forest (RF) and support vector machine (SVM) classifiers for prediction of AML and ALL. Results: The RF and SVM classifiers correctly classified all AML and ALL samples. The RF classifier obtained the performance of 100% using 10 genes selected by the ℓ2,1/2-norm and ℓ2,1-norm sparsity-based gene selection methods. Moreover, the SVM classifier obtained a performance of 100% using 10 genes selected by the ℓ2,1/2-norm method. Seven common genes were identified by all four values of parameter p in the ℓ2,p-norm method as the most important genes in the classification of AML and ALL, and the gene with the description “PRTN3 Proteinase 3 (serine proteinase, neutrophil, Wegener granulomatosis autoantigen” was identified as the most important gene. Conclusion: The results obtained in this study indicated that the prediction of blood cancer from leukemia microarray gene expression data can be carried out using the robust ℓ2,p-norm sparsity-based gene selection method and classification algorithms. It can be useful to examine the expression level of the genes identified by this study to predict leukemia.

Role of the World Health Organization in Management of Gastrointestinal Diseases Caused by Contaminated Water in Children in the Middle East: A Review Article

Background: The world health organization (WHO), as the international authority on public health and water quality, directs and monitors global efforts to prevent the transmission of waterborne diseases and advises governments on the development of health-based goals and regulations. Objectives: This review study aims to investigate the management methods, including control, prevention, and treatment of gastrointestinal (GI) diseases in children in the Middle East caused by contaminated water through WHO. Methods: For this purpose, Scopus, Google scholar, PubMed, SID, Irandoc, and up-to-date databases were searched without time limitation. Keywords included contaminated water, pediatric, GI diseases, and WHO. In this study, the full text of various articles in Persian and English was used. After removing duplicate articles and articles that did not fit the topic of the study, 54 articles were finally selected. Results: Based on the findings, the world health organization has reported that diarrhea, polio, hepatitis A, and cholera are the most common GI infectious diseases caused by contaminated water in children in the Middle East. The present reports of waterborne disease represent only a small proportion of the total number of cases of this disease in the population. In some areas, it has been shown that investments in water and wastewater supply by responsible institutions can provide a net economic gain by reducing negative health impacts and healthcare costs. Results The results of this study indicate that most of the diseases caused by contaminated water affect children, due to low ability to observe personal hygiene and the state of the child’s immune system, which often leads to the death of children. Conclusions: The lack of diagnosis and insufficient prevalence of these diseases in some Middle Eastern countries, followed by the lack of attention to the prevention and control of waterborne diseases, threatens the health policies of these countries. International organizations, especially the world health organization and the united nations children’s fund, play a vital role in addressing and controlling this problem.

Evaluating the effect of digital game-based nutrition education on anemia indicators in adolescent girls: A randomized clinical trial

Iron deficiency anemia is the most common type of micronutrient deficiency in the world. Adolescence represents a period of increased risk of iron deficiency. Therefore, we aimed to determine the impact of nutrition education by a digital game on markers of iron-deficient anemia in adolescent girls. In this study, 176 adolescent girls were randomly dichotomized into the intervention and control groups. At the beginning and the end of the intervention, knowledge, attitude, and practice of both groups were assessed by a questionnaire. Girls in the intervention group received the necessary education through a digital game during a 14-week period, while those in the control group received basic nutritional education through PowerPoint and pamphlets. Additionally, serum transferrin, serum iron, transferrin saturation, ferritin, CBC difference, and total iron binding capacity (TIBC) tests were checked. In this study, nutrition education significantly increased the level of knowledge, attitude, and practice of adolescent girls regarding their diet (p ˂ .05). Hemoglobin level was also significantly raised (p ˂ .05). However, no significant effect was observed on other markers of iron-deficient anemia, such as serum iron, TIBC, and hematocrit, in the intervention group compared with the control group (p ˃ .05). The results of this study indicated the positive impact of nutrition education based on digital game on knowledge, attitude, and practice scores, as well as a significant difference in hemoglobin. It is recommended that educational games be designed for students in the future to promote health and nutrition information.

Food groups and nutrients consumption and risk of endometriosis: a systematic review and meta-analysis of observational studies

Dietary factors may play a role in the etiology of endometriosis and dietary intake of some food groups and nutrients could be associated with endometriosis risk. This systematic review and meta-analysis of observational studies was conducted to summarize the findings on the association between dietary intakes of selected food groups and nutrients (dairy, fats, fruits, vegetables, legumes, and animal-derived protein sources), and the risk of endometriosis among adult women. PubMed, Scopus, and ISI Web of Science were systematically searched up to September 2022. The inverse variance-weighted fixed-effect method was used to estimate the effect size and corresponding 95% CI. A total of 8 publications (4 studies) including 5 cohorts and 3 case-control with a sample size ranging from 156 to 116,607 were included in this study. A higher intake of total dairy [all low-fat and high-fat dairy foods] was associated with decreased risk of endometriosis (RR 0.90; 95% CI, 0.85 to 0.95; P < 0.001; I² = 37.0%), but these associations were not observed with intakes of low or high-fat dairy, cheese or milk. Increased risk of endometriosis was associated with higher consumption of red meat (RR 1.17; 95% CI, 1.08 to 1.26; P < 0.001; I² = 82.4%), trans fatty acids (TFA) (RR 1.12; 95% CI, 1.02 to 1.23; P = 0.019; I² = 73.0%), and saturated fatty acids (SFA) (RR 1.06; 95% CI, 1.04 to 1.09; P < 0.001; I² = 57.3%). The results of this meta-analysis suggest that there may be differing associations between dietary intake of dairy foods, red meat, SFAs, and TFAs and the risk of endometriosis. It may be useful to extend the analysis to other types of food groups and dietary patterns to obtain a complete picture. Additionally, further investigations are needed to clarify the role of diet in the incidence and progression of endometriosis.Trial registration: PROSPERO, CRD42020203939.

Diet cost plays a key role in determining the risk of pediatric attention deficit hyperactivity disorder: Findings from a case-control study

The aim of our study was to assess the association between diet cost and attention deficit hyperactivity disorder (ADHD) in children. This study was a case-control study conducted in Isfahan, Iran. Based on the Diagnostic and Statistical Manual of Mental Disorders-V criteria, a total of 200 children aged 4-12 years with ADHD and 300 age- and sex-matched children without ADHD, respectively, participated in case and control groups. A validated food frequency questionnaire that contained 168 food items was used to assess the dietary intake. The cost of food items was obtained from licensed markets. The food price was corrected for edible portion sizes as well as food weight changes due to cooking process. Our results indicated that diet cost per 1000 kcal was significantly lower in the case group compared with the control group (60,843.48 ± 6987.83 vs. 67,828.33 ± 8989.48 Rials, p < .01). In the crude model, a significantly lower risk of ADHD was observed in the higher quartiles of diet cost per 1000 kcal (odds ratio (OR) = 0.06; 95% confidence interval (CI) = 0.03, 0.13; p < .001). This finding remained significant, even after adjustment for potential confounders such as age, gender, body mass index (BMI), socioeconomic status (SES), and intakes of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and saturated fatty acids (SFA). Therefore, it seems that the risk of ADHD is inversely associated with diet cost in children. Further studies, particularly longitudinal ones, are warranted.

Effect of a multi-disciplinary program on anthropometric and biochemical parameters in obese and overweight elementary school girls: A randomized clinical trial

BACKGROUND AND AIMS

Obesity and overweight in children are associated with an increased risk of several health issues. The present study aimed to assess the effects of a multi-disciplinary program (including nutrition education using a smartphone game, physical activity, and cognitive behavioral therapy [CBT]) on the management of obesity and overweight in elementary school girls.

METHODS AND RESULTS

Sixty-two school girls above the 85th percentile of body mass index (BMI) for age were randomly assigned to two groups. During 10 weeks of study, the intervention group received a multi-disciplinary intervention, including nutrition education using a smartphone game, aerobic exercise, and CBT. The control group received usual traditional nutritional education. Biochemical and metabolic factors were assessed, including fasting blood sugar (FBS), lipid profile, serum leptin, and anthropometric measurements. The Dutch Eating Behavior Questionnaire (DEBQ) and metabolic equivalent test (MET) were also conducted. The intervention group showed more promising results in weight loss, waist circumference (WC), hip circumference (HC), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and FBS compared to the control group (P < 0.05). In addition, MET and DEBQ scores in all three sections of emotions, stimuli, and restriction were better in the intervention group than in the control group (P < 0.05). However, there was no significant difference between groups regarding the results of serum leptin and waist-to-hip ratio (WHR; p > 0.05).

CONCLUSIONS

The results indicated that education through smartphone games could possibly affect performance in real life. In addition, the multi-disciplinary approach to childhood obesity might have better performance in most areas than the single-intervention approach in obesity management.

The association between dietary fat and mineral intake with semen parameters: A cross-sectional study in infertile men

Background: Infertility has been a significant problem for couples in recent decades, and the issue can often lie with the male rather than the female. Objective: This study aimed to investigate the effects of fats and minerals intake on semen parameters in infertile men. Materials and Methods: This cross-sectional study was performed on 260 infertile men referred to Isfahan Infertility Clinic, Isfahan, Iran in the summer of 2018. Semen parameters regarding sperm concentration, total motility, normal morphology, and sperm volume were considered. To assess dietary intakes, a validated food frequency questionnaire was used. Results: In the adjusted model, the prevalence of abnormal concentration was 5.23 times higher in the top quartile of calcium intake, compared with the bottom quartile (p = 0.03). Also, the prevalence of abnormal morphology was 68% lower in the third quartile of calcium intake (p = 0.03). Additionally, the prevalence of abnormal concentration was 84% lower in the top quartile of folate intake in comparison to the bottom quartile (p = 0.01) and the prevalence of abnormal morphology was 70% lower in the top quartile of folate intake (p = 0.03). Additionally, the prevalence of abnormal concentration was 72% lower in the top quartile of selenium intake in comparison to the bottom quartile (p = 0.04). Furthermore, in the crude model, the prevalence of abnormal volume was 64% lower in the second quartile of linoleic acid intake rather than the first quartile (p = 0.01). Conclusion: In conclusion, diets containing higher amounts of folate and selenium, and lower amounts of cholesterol, saturated fatty acid and calcium were associated with more favorable semen quality parameters. Key words: Infertility, Semen quality, Minerals, Fats, Cross-sectional study. 

Effect of curcumin on body mass index and glycemic indices in females with PCOS: a systematic review and meta-analysis of randomized controlled trial

Purpose

This paper aims to assess the impact of curcumin supplementation body mass index and glycemic indices in women with polycystic ovary syndrome (PCOS).

Design/methodology/approach

A systematic search of the literature was conducted in PubMed, Scopus and ISI web of science to identify all randomized controlled trials (RCTs) published from the earliest record up to February 2021. The authors used a random-effects model to estimate pooled effect sizes.

Findings

A total of four potentially related clinical trials met the inclusion criteria which included a total of 198 participants. Random-effects meta-analysis showed significant effects of curcumin on fasting blood sugar (FBS) (−3.62 mg/dl, 95% CI [−5.65, −1.58], p-value < 0.001, I2 = 0.0%), insulin level (−1.67 µU/mL, 95% CI [−3.06, −0.28], p-value = 0.018, I2 = 0.0%) and homeostasis model of assessment insulin resistance (HOMA-IR) (−0.42, 95% CI [−0.76, −0.09], p-value < 0.01, I2 = 0.0%). No evidence of publication bias was discovered in the meta-analyses.

Originality/value

Present systematic review and meta-analysis of RCTs showed beneficial effects of curcumin consumption on FBS, insulin level and HOMA-IR in patients with PCOS. However, further large-scale studies are needed to confirm these results.

Diagnostic accuracy of laboratory markers for diagnosis of acute appendicitis in children

BACKGROUND

Acute appendicitis (AA), the most common abdominal emergency disease, is one of the most important causes of hospitalization of children. Studies have shown that white blood cell (WBC) count, mean platelet volume (MPV), C‑reactive protein (CRP), and erythrocyte sedimentation rate (ESR) can play an important role in the diagnostic prediction of appendicitis. Therefore, the aim of this study was to evaluate the diagnostic value of WBC count, polymorphonuclear leukocytes (PMNs) percentage, MPV, CRP, and ESR for the diagnosis of AA.

METHODS

In this study, 100 medical records were reviewed for children referred to the hospital complaining of abdominal pain and who underwent operation with a provisional diagnosis of acute appendicitis based on clinical and laboratory findings. Patients were divided into two groups according to the pathology gold standard method: AA and the other group with acute abdominal pain without appendicitis (AAP). The diagnostic accuracy of WBC, PMNs%, MPV, ESR, and CRP were compared for patients with AA and AAP.

RESULTS

A total of 100 patients (50 with AA and 50 with AAP) were identified. The sensitivity and specificity of WBC and PMNs% were 78 and 66%, and 76 and 54%, respectively; ESR was 80 and 48%, respectively; and CRP was 82 and 62% (30-89%), respectively. A low specificity (8%) and 70% sensitivity was calculated using the cutoff point of 8.1 fl for MPV.

CONCLUSION

Our data suggest that children with AA often present with significantly higher WBC count, ESR level, CRP level, PMNs%, and lower MPV level. The results of the study showed that WBC, CRP, and ESR, along with other diagnostic methods, can be useful in diagnosing AA in children. MPV is not effective in the diagnosis of AA due to its specificity; however, a significantly lower level was found in children with AA.

Gastrointestinal Symptoms and Hepatopancreatic Involvement in COVID-19 Children: A Narrative Review

Background: To the best of our knowledge, limited studies explored gastrointestinal (GI) symptoms and hepatopancreatic involvement in children with coronavirus disease 2019 (COVID- 19) infection. Objectives: This review study aimed to evaluate the GI symptoms and abnormal liver and pancreas function in children with COVID-19 infection. Methods: In this review study, databases of Scopus, PubMed, Google Scholar, and Web of Science were searched using the relevant keywords of “COVID-19,” “children,” “gastrointestinal,” “liver,” and “pancreas.” Descriptive and cross-sectional studies were reviewed in the current study, with the main focus on GI symptoms and elevated liver enzymes in children with COVID-19 infection. Results: Overall, 27 studies from countries of Iran, Spain, Turkey, Italy, and the United States were selected. Although the prevalence of GI symptoms varied in different studies, our review showed that most children with COVID-19 infection experienced GI symptoms. In addition to GI symptoms, there is the possibility of elevated liver enzymes, such as alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, and creatine phosphokinase in children with COVID-19 infection. Conclusions: COVID-19 infection may present various GI, hepatic, and pancreatic manifestations in children. The difference in the prevalence of these symptoms can probably be attributed to the geographical region of the study and the history of the disease.

Children and COVID- 19 infection: A case series of Iran

BACKGROUND

World Health Organization (WHO) declared COVID -19 infection a global pandemic. Children have milder disease than adults but different aspects of disease in children are not fully understood.

CASE PRESENTATION

We describe 5 pediatric patients with COVID-19 that referred to Amirkola Children's Hospital, Babol, Iran. The youngest patient was 4 years old and the oldest was 12 years old. Three patients were males. None of the patients had a history of contacts with symptomatic patients with COVID -19. The most common symptoms included fever, cough, anorexia, weakness and diarrhea. One patient had gastrointestinal symptoms without respiratory symptoms. All patients had elevated ESR and CRP. Three of them had lymphopenia. RT-PCR was positive in all patients. Management included supportive care, antibiotics, antiviral treatment and hydroxychloroquine. All patients were discharged with good condition.

CONCLUSION

Children may have a variety of symptoms including respiratory or gastrointestinal symptoms. Mortality is rare in children and prognosis is better than the adults.

Ultra-Processed Food Consumption and Adult Diabetes Risk: A Systematic Review and Dose-Response Meta-Analysis

(1) Background: Recent individual studies have demonstrated that consumption of ultra-processed food (UPF) may be related to type two diabetes mellitus (T2DM). We aimed to synthesize the results from these individual studies by conducting an updated systematic review and meta-analysis of observational studies evaluating the association between UPF consumption and the risk of T2DM. (2) Methods: A systematic search was conducted using ISI Web of Science, PubMed/MEDLINE and Scopus electronic databases from inception up to August 2021. Data were extracted from five studies (one cross-sectional study and four cohort studies, totaling 230,526 adults from four different countries). Risk ratios (RR) of pooled results were estimated using a random-effects model. (3) Results: Our results revealed that higher UPF consumption was significantly associated with an increased risk of T2DM (RR = 1.74; 95% CI: 1.36, 2.22; I² = 68.9%; p < 0.001; n = 5). Linear dose-response analysis indicated that each 10% increase in UPF consumption (kcal/d) was associated with a 15% higher risk of T2DM (RR = 1.15; 95% CI: 1.06, 1.26; I² = 86.0%; p < 0.001; n = 5) among adults. Non-linear dose-response analysis demonstrated a positive linear association between UPF consumption and T2DM (p_nonlinearity = 0.13, p_{dose-response} < 0.001; n = 5) among adults. (4) Conclusions: A higher intake of UPF was significantly associated with an increased risk of T2DM. However, underlying mechanisms remain unknown and future experimental studies are warranted.

Blood Circulating Levels of Adipokines in Polycystic Ovary Syndrome Patients: A Systematic Review and Meta-analysis

A body of studies has examined the circulating concentration of adipokines including apelin, vapin, resistin, and chemerin in polycystic ovary syndrome (PCOS) patients. However, their findings have been inconclusive. Therefore, we systematically reviewed available studies to illuminate the overall circulating concentration of adipokines in PCOS subjects. Cochrane's Library, PubMed, Scopus, and ISI Web of Science databases were searched from the earliest available date up to April 2021 for relevant articles. The quality of each study was assessed by the Newcastle-Ottawa Quality Assessment Scale. The pooled effect size was estimated based on the random effects model, and the standard mean differences (SMD) with a 95% confidence interval (CI) were reported. A total of 88 studies met the inclusion criteria and were included in the current systematic review and meta-analysis. The results of the analysis showed that serum levels of vaspin (SMD 0.69; 95% CI, 0.22 to 1.17; P = 0.004; I² = 90.6%), chemerin (SMD 1.87; 95% CI, 1.35 to 2.40; P < 0.001; I² = 94.4%), and resistin (SMD 0.66; 95% CI, 0.41 to 0.91; P < 0.001; I² = 92.6%) were significantly higher in the PCOS group compared to controls. However, there was no significant difference between the PCOS and control groups in relation to apelin levels (SMD - 0.17; 95% CI, - 1.06 to 0.73; P = 0.714; I² = 97.8%). We found that serum levels of vaspin, chemerin, and resistin were significantly higher in PCOS subjects compared with controls. It seems that these adipokines can be measured as a useful marker to predict the development of PCOS.

Gene Identification from Microarray Data for Diagnosis of Acute Myeloid and Lymphoblastic Leukemia Using a Sparse Gene Selection Method

Background: Microarray experiments can simultaneously determine the expression of thousands of genes. Identification of potential genes from microarray data for diagnosis of cancer is important. This study aimed to identify genes for the diagnosis of acute myeloid and lymphoblastic leukemia using a sparse feature selection method. Materials and Methods: In this descriptive study, the expression of 7129 genes of 25 patients with acute myeloid leukemia (AML), and 47 patients with lymphoblastic leukemia (ALL) achieved by the microarray technology were used in this study. Then, the important genes were identified using a sparse feature selection method to diagnose AML and ALL tissues based on the machine learning methods such as support vector machine (SVM), Gaussian kernel density estimation based classifier (GKDEC), k-nearest neighbor (KNN), and linear discriminant classifier (LDC). Results: Diagnosis of ALL and AML was done with the accuracy of 100% using 8 genes of microarray data selected by the sparse feature selection method, GKDEC, and LDC. Moreover, the KNN classifier using 6 genes and the SVM classifier using 7 genes diagnosed AML and ALL with the accuracy of 91.18% and 94.12%, respectively. The gene with the description “Paired-box protein PAX2 (PAX2) gene, exon 11 and complete CDs” was determined as the most important gene in the diagnosis of ALL and AML. Conclusion: The experimental results of the current study showed that AML and ALL can be diagnosed with high accuracy using sparse feature selection and machine learning methods. It seems that the investigation of the expression of selected genes in this study can be helpful in the diagnosis of ALL and AML.

Effect of a synbiotic on functional abdominal pain in childhood

BACKGROUND

One of the common functional gastrointestinal disorders in children is functional abdominal pain (FAP). The aim of the present study was to determine whether the administration of a synbiotic composed of fructo-oligosaccharides (FOS) and the seven types of beneficial bacteria is useful in FAP of childhood.

METHODS

In this placebo-controlled, double-blind trial, 4-15-year-old children who met the Rome III criteria for FAP were randomly divided to receive either synbiotic or placebo twice daily for 4 weeks. Primary outcome was at least 50% reduction in the number of pain episodes, and secondary outcomes were a decline of at least two scales in the pain duration and intensity based on Wong-Baker scale. Response to therapy was decrease of pain frequency/intensity.

RESULTS

A total of 67 children completed the trial (35 with synbiotic). Response rate was higher with synbiotic than placebo after four weeks (53.1 vs 11.4%; p<0.001), and synbiotic had significant superiority to placebo to relieve the duration (4.56±9.12 vs12±18.59, min/day, P=0.04), frequency (0.31±0.53vs 1.17±0.7, episode/Wk., P<.001) and intensity (2.38±2.29 vs 5.49±1.83, p<0.001) of abdominal pain.

CONCLUSION

Synbiotic compared to placebo significantly decreased the intensity, frequency and duration of FAP in children.

Management of Resistant Cyclic Vomiting Syndrome With a New Empiric Treatment in the Prophylaxis Period: A Case Report and Review of Literature

Introduction: Cyclic Vomiting Syndrome (CVS) is an idiopathic disorder, identified by recurrent stereotypic episodes of severe nausea and vomiting and intervals of normal health between episodes. There is no specific diagnostic test for CVS, and clinical features are relied on for diagnosis. Many medications have been used to treat CVS, such as antiemetic, anti-migraine, and sedative medications. Nevertheless, treatment is difficult in some resistant cases. Case Presentation: We report a child with frequent and intensive vomiting episodes after an asymptomatic 2-year period. The patient was unresponsive to many medications but was successfully treated with chlorpromazine and then controlled using olanzapine, followed by aripiprazole. We also performed a brief literature review related to this case report in international databases. Conclusions: Since CVS management has remained challenging to the clinician in the severe and resistant patients, the empiric treatment of CVS is recommended.

The effect of fasting or calorie restriction on mitophagy induction: a literature review

Mitochondrial dysfunction can be a major cause of a wide range of age-related diseases. Maintaining the normal homeostasis of mitochondria population plays an important role in ensuring people's health, which is done through the mitophagy process. Among the various stimuli for the onset of mitophagy, caloric restriction (CR) is one of the strongest non-genetic triggers for initiating the mitophagy process. The primary objective of this paper is to review the literature assessing the effect of CR on mitophagy. Medline, Web of Science, Scopus, and Google Scholar databases was searched from inception to 1 August 2019. Reference lists from all selected articles were also examined for additional relevant studies. The evidence regarding the effect of fasting or CR on mitophagy is still limited. In addition, the methodological approaches of the studies are too heterogeneous in terms of types of food restriction, study duration, and targeted tissues. Most of the studies showed that fasting or CR induced mitophagy and mitophagy-related markers such as Binp3 and Parkin. However, some studies demonstrated that mitophagy occurred both in fasting and fed state with no significant differences or may be induced in fed state. Study on the muscle tissue of subjects after exercise showed that mitophagy was upregulated in the fed state. It has been demonstrated that mitophagy in the muscle was lowered in the absence of AMP-dependent kinase and fibroblast growth factor 21 genes, both in fasted and fed conditions. Current evidence overwhelmingly suggests that CR and fasting induce mitophagy and mitophagy-related markers. Based on the current evidence that we reviewed here, it could be concluded that fasting or CR has a promising role as a novel and practical approach in the prevention of age-related diseases without any side effects by inducing mitophagy in different organs of the body. More studies will be required in future to clarify the relationship between food deprivation and mitophagy. Further studies using a variety of different types of CR and fasting states are also warranted to determine the best approach for inducing mitophagy and improving health.

COVID-19 and Digestive System in Children: A Retrospective Study

BACKGROUND

The aim of this study was to identify gastrointestinal (GI) and liver injury presentations in children admitted with COVID-19 infection.

METHODS

In this retrospective study, we studied all children with suspected symptoms of COVID-19, referred to Amirkola Children's Hospital. Clinical manifestations of the digestive and respiratory systems and liver function tests were evaluated for all cases.

RESULTS

Eighteen children were studied. The most common clinical symptoms were fever, anorexia, weakness, nausea and vomiting, cough, diarrhea, and abdominal pain, respectively. Also, 5/18 (27.8%) and 7/18 (38.9%) of cases had abnormally high alanine aminotransferase (ALT), aspartate aminotransferase (AST), respectively. Additionally, in icteric cases, direct bilirubin was raised. There was no significant relationship between pulmonary lesions and abnormal excess in ALT (P = 0.59) and AST (P = 0.62).

CONCLUSION

The findings showed that there were no severe clinical GI symptoms in children with COVID-19 infection. Besides, children with increased liver enzymes did not have more respiratory involvement than those without a rise in liver enzymes.

A Rare Inflammatory Myofibroblastic Tumor of Pancreas in a Child With Cholestasis Presentation

Inflammatory myofibroblastic tumors (IMTs) are rare with unknown etiology. As pancreas involvement is rare in IMTs, here, we report a case of a girl with IMT, referred to our hospital. A 4-year-old girl presented with chief complaints of generalized itching and jaundice. Abdominopelvic computed tomography (CT) scans with contrast showed a homogeneous isodense mass lesion in the head of the pancreas with a compressive effect on the distal part of the common bile duct (CBD). Dilatation of intrahepatic bile ducts and CBD (8 mm) was observed. Magnetic resonance cholangiopancreatography (MRCP) examination showed a dilated gallbladder without stones and intrahepatic/extrahepatic bile ducts. The CBD was dilated, and a mass was found in the head of the pancreas. Immune-histochemical studies revealed spindle myofibroblastic tissues with lymphoplasmacytic and eosinophil infiltration. All of them were compatible with pancreatic IMTs. The surgery improved the symptoms. The IMTs of the pancreas can have symptoms like pancreatic cancer. The careful evaluation by imaging and pathology is recommended.

Acute Appendicitis Associated With Typhoid Fever: A Case Report and Review of Literature

Introduction: Appendicitis could be a rare complication of Salmonella Typhi infection.  Case Presentation: we present a 13-year-old girl with typhoid fever with histology-proven acute appendicitis as a rare complication of Salmonella Typhi infection. The patient was admitted to the hospital with the chief complaints of fever, abdominal pain, diarrhea, and vomiting for more than one week. A brief review of relevant literature was also performed to explore more this rare cause of a common emergency surgical procedure.  Conclusions: In all cases with typhoid fever with persistent diarrhea and vomiting, localized abdominal pain, probable acute appendicitis should be considered as an important complication.

COVID-19 Infection and Children: A Comprehensive Review

Nowadays, COVID-19 is in pandemic stage, and concerns about the infection of children are on the rise. At first, it has been believed that children are not at risk while some evidences have shown that the risk of infection is lower in children than adults. The COVID-19 children indicated milder symptoms including cough, fever, sore throat, myalgia sneezing, and fatigue than COVID-19 adults. Lymphopenia, which is prevalent in adult cases, has not been reported in pediatric patients. The COVID-19 can also occur in neonates although vertical transmission from mothers to fetuses during pregnancy is rare. Overall, the outcome is better in children than adults. Thus far, there has been neither specific treatment for eradicating the infection nor any preventative vaccine for COVID-19, Preventive measures such as frequent hand washing, social distancing and wearing face mask are the best ways.

Effects of Lactose-Restricted Regimen in Breastfeeding Children with Acute Diarrhea

BACKGROUND

Acute diarrhea is a major cause of mortality in children. Few studies have addressed the administration of lactose-restricted diets in breastfed children with acute diarrhea. The present study was conducted to investigate the effects of a lactose-restricted regimen on breastfed children with acute diarrhea treated with zinc supplements.

METHODS

The present single-blind randomized clinical trial was conducted on children aged 6-24 months in Amirkola Children's Hospital (2015-2017). 90 children were randomly assigned to two groups. Group A was daily treated with 20 mg of zinc and a lactose-restricted diet and breast milk for two weeks. Group B received 20 mg of zinc and breast milk and an age-appropriate diet for two weeks. The data collected in all the subjects included the frequency of diarrhea and the mean duration of hospitalization and recovery from diarrhea.

RESULTS

The two groups were not significantly different in terms of mean age, weight and ratio of males to females. The mean duration of hospitalization was found to be 3.1 ± 0.8 days in group A and 3.2 ± 0.6 in group B (P = 0.3), the mean duration of recovery to be 2.9 ± 0.8 in group A and 2.6 ± 1.1 in group B (P = 0.2) and the mean frequency of diarrhea 2.9 ± 0.7 in group A and 2.8 ± 0.8 days in group B (P = 0.5), suggesting no significant differences between the two groups. No adverse effects associated with zinc therapy were reported.

CONCLUSIONS

A lactose-restricted regimen was found not to be beneficial for children with acute diarrhea under continuous breastfeeding and zinc therapy.

Abdominal pain in a patient with sickle cell disease with multiple complications

Sickle cell disease is an inherited autosomal recessive hemoglobinopathy. Acute abdominal pain is the cause of hospitalization in 10% of patients with sickle cell disease and usually occurs during vaso-occlusion or distal tissue ischemia. Determining the etiology of abdominal pain is very difficult in these patients because it is associated with several rare diagnoses, such as pancreatitis and splenic abscess in some patients. We represent a 14-year-old boy with sickle cell disease who was hospitalized due to acute abdominal pain and indicated multiple and scarce disturbances in the spleen and hepatobiliary system.

Eosinophilic Gastroenteritis and Familial Mediterranean Fever in a Child With MEFV Gene Mutation

Eosinophilic gastroenteritis (EG) is a rare inflammatory disorder affecting both children and adults. The exact etiology of the disease is not clear. A child presented with episodic generalized abdominal pain since a year ago without fever at first. After endoscopic and colonoscopic examinations, histopathological examination showed an increased number of eosinophils and diagnosis of EG was made. After elimination of dairy products from his regimen, abdominal pain attacks was reduced, but he got a fever. Familial Mediterranean Fever (FMF) diagnosis was made by genetic evaluation which showed MEV gene mutation. Symptoms were resolved with the treatment of colchicine which confirmed FMF diagnosis. © 2019 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2019;57(5):328-331.

The effect of cocoa consumption on markers of oxidative stress: A systematic review and meta-analysis of interventional studies

A number of studies have examined the beneficial effects of cocoa consumption on markers of oxidative stress in different population, however, the findings have been inconclusive. Herein, we systematically reviewed available interventional studies to elucidate the overall impact of cocoa consumption on markers of oxidative stress among adult population. PubMed, Cochrane's library, Science Direct, Scopus, Google scholar and ISI web of science databases were searched for all available literature until March 2019 for relevant studies. The Jadad scale was used to assess the quality of each study. A total of 48 studies out of 1402 met the inclusion criteria and were included in our systematic review and 16 of them were entered in meta-analysis. The pooled estimate from the random-effect model showed cocoa consumption significantly reduced malondialdehyde (SMD: -0.71; 95 % CI, -1.41 to -0.01; P = 0.048) and 8-iso-prostaglandin F2α (WMD: -43.76; 95 % CI, -76.25 to -11.28; P = 0.008) but not the other markers of oxidative stress. Our findings support the concept that cocoa consumption plays an important role in the human metabolic pathway through reducing the oxidative stress. In order to draw a firm link between cocoa and oxidative stress, more clinical trials with adequate sample size and sufficient follow-up periods are warranted.

The effect of omega-3 and vitamin E on oxidative stress and inflammation: Systematic review and meta-analysis of randomized controlled trials

Background: Several studies have investigated the effect of omega-3 fatty acids and vitamin E on oxidative stress and inflammation, but their findings are inconsistent. The aim of this meta-analysis is to elucidate the overall effects of co-supplementation with omega-3 fatty acids and vitamin E on oxidative stress and inflammation. Methods: We searched titles, abstracts, and keywords of relevant articles indexed in PubMed, ISI, Scopus, and Google Scholar databases up to December 2018 to identify eligible RCT studies. Random effects model was used to estimate the pooled effect of co-supplementation with omega-3 fatty acids and vitamin E on oxidative stress and inflammation. Results: Overall, 7 RCTs with 504 participants were included in this meta-analysis. We found that co-supplementation with omega-3 fatty acids and vitamin E decreased hs-CRP (weighed mean difference (WMD) = -2.15 mg/L; 95% CI: -3.40, -0.91 mg/L; P < 0.001) concentrations and increased total antioxidant capacity (TAC) (WMD = 92.87 mmol/L; 95% CI: 31.97, 153.77 mmol/L; P = 0.03), and nitric oxide levels (NO) (WMD: 6.95 μmol/L; 95% CI: 3.86, 10.04, P < 0.001) compared with control group. Omega-3 fatty acids and vitamin E had no significant effect on malondialdehyde (MDA) (WMD: 1.54 mmol/L; 95% CI: -1.29, 4.36; P = 0.196), and glutathione (GSH) (WMD: 20.87 mmol/L; 95% CI: -20.04, 61.6, P = 0.31) levels. Conclusion: The present meta-analysis found that omega-3 fatty acids and vitamin E co-supplementation significantly decreased hs-CRP and increased NO and TAC, although it had no significant effect on MDA and GSH.

Effect of coenzyme Q10 supplementation on fatigue: A systematic review of interventional studies

AIMS

A number of studies have examined the beneficial effects of Coenzyme Q10 (CoQ10) on fatigue in different population, but the findings have been inconclusive. Herein, we systematically reviewed available interventional studies to elucidate the overall effects of CoQ10 supplementation on fatigue among adolescent and adult population.

METHODS

PubMed, Cochrane's library, Science direct, Scopus, Google scholar and ISI web of science databases were searched for all available literature until April 2018 for studies assessing the effects of CoQ10 supplementation on fatigue. The Cochrane bias assessment tool were used to assess the quality of studies.

RESULTS

A total of 16 studies out of 1316 met our inclusion criteria and included in our systematic review. Among included studies 10 of them showed significant beneficial effects (p < 0.05) of CoQ10 supplementation on fatigue status among healthy, fibromyalgia, statin-related fatigue, multiple sclerosis and end-stage heart failure subjects. CoQ10 supplementation could alleviate fatigue, but differences between studies population should be taken into account.

CONCLUSION

It seems CoQ10 has better therapeutic effects in statin-related fatigue and fibromyalgia patients compared with the other disease related fatigue. Finally, in order to draw a firm link between CoQ10 and fatigue, more clinical trials with adequate sample size and with sufficient follow-up periods are needed.

The association between diet and mood: A systematic review of current literature

A number of studies have examined the association between diet and mood state, but the findings have been inconclusive. Herein, we conducted a systematic review to assess the association between different diet and mood state. PubMed, Cochrane's library, Science direct, Scopus, Google scholar and ISI web of science databases were searched for all available literature until December 2017 for studies assessing the association between diet and mood state. The Newcastle-Ottawa Scale and Jadad scale for reporting randomized clinical trials were used to assess study quality. A total of 18 studies out of 2857 met our inclusion criteria and included in our systematic review. Although there are not consistent findings between studies, it seems that DASH, vegetable-based, glycemic load-based, ketogenic and Paleo diets could improve mood more than the others. Further studies are needed to assess such relationship in a longer period to draw a firm link between diet and mood.

The effects of whole milk compared to skim milk and apple juice consumption in breakfast on appetite and energy intake in obese children: a three-way randomized crossover clinical trial

Background

A limited number of studies have examined the effect of dairy on satiety and short-term energy intake among children; furthermore we are not aware of any study comparing high and low-fat dairy products regarding their effect on appetite and short-term energy intake. Our objective was to assess the effect skim milk (SM) compared to whole milk (WM) and apple juice (AJ) on satiety and energy intake at lunch among 10-12 y children with obesity.

Methods

Fifty children with obesity who aged 10-12 y were randomized to consume a fixed content breakfast with 240 ml of SM, AJ, or WM for two consecutive days. The study was a three-way randomized crossover study; therefore each participant served as his/her own control. The total appetite, hunger, fullness, desire to eat and prospective consumption were measured using a visual analogue scale (VAS) before breakfast and every one hour after breakfast until a freely consumed lunch. VAS scores and energy intakes were compared using repeated measures procedure.

Results

Forty-eight participants (24 girls and 24 boys) completed the study. The energy intake was not different between SM, AJ and WM periods (adjusted mean ± standard error (SE) of energy intake: SM = 831.27 ± 30.64 Kcal, AJ = 794.92 ± 28.72 Kcal, WM = 798.87 ± 24.09 Kcal; P = 0.56). The effect was the same for either gender. Children reported higher satiety score 4 h after drinking WM with breakfast compared with SM (P < 0.05). The same association was found only in girls. Furthermore, SM significantly reduced appetite compared to AJ, 2 h after preloads in girls (P < 0.05).

Conclusions

Full-fat milk may have favorable effects on satiety but not energy intake in subsequent meal compared to skim milk among the children with obesity. Future studies with longer follow-up periods are needed to confirm these results.

Trial registration

The study protocol was registered with the Iranian registry of clinical trials on 9th October 2016 (registration ID: IRCT2016072012571N5).

Effects of Yogurt and Yogurt Plus Shallot Consumption on Lipid Profiles in Type 2 Diabetic Women

Background:

Identification of food with lowering cholesterol level properties plays a vital role to control impaired lipid profile among type 2 diabetic patients. the current study aimed to evaluate the effects of yogurt and yogurt plus shallot intake on lipid profiles in type 2 diabetic women.

Methods:

Forty-eight participants with type 2 diabetes were enrolled in this study. Participants in the first group (n = 22) received 150 ml of low-fat yogurt (1.5% fat) and those in the second group (n = 26) received 150 ml of low-fat yogurt (1.5% fat) plus shallot for 10 weeks. Serum triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC) concentrations, and fasting blood sugar (FBS) were measured before and after each intervention.

Results:

comparison of parameters between two groups after intervention showed that TG and TC concentrations decreased more in participants who consumed yogurt plus shallot than who consumed yogurt (P = 0.003 and P = 0.04, respectively), also LDL-C level of participants who were in yogurt plus shallot group was lower than that of participants in yogurt group, but this difference was marginally significant (P = 0.06). However, FBS level was not statistically different between two groups.

Conclusions:

This study found that yogurt plus shallot intake significantly decreased LDL-C, TG, and TC levels in diabetic women compared with yogurt intake.

Association of Animal and Plant Proteins Intake with Hypertension in Iranian Adult Population: Isfahan Healthy Heart Program

Background:

There is evidence regarding the relationship between dietary proteins intake and blood pressure (BP), but they had inconsistent results. Therefore, this study was designed to assess the association between different kinds of protein intake (animal and plant protein) and BP.

Materials and Methods:

Data were collected from Isfahan Healthy Heart Program. We performed a cross-sectional study among 9660 randomly selected Iranian adults aged ≥19-year-old that they were selected from three large Iranian regions in 2007. A simplified validated 48-item-food frequency questionnaire was used to assess dietary intake including all kinds of protein. Systolic and diastolic BPs were measured in duplicate by trained personnel using a standard protocol. Multivariable regressions were applied to assess the relationship between protein intake and BP levels and the presence of hypertension (HTN).

Results:

More frequent consumption of animal, plant, and total protein intake were inversely associated with BP in a crude model (P < 0.001); however, after adjustment for potential confounders this relationship remained only for plant protein (P = 0.04). The risk of HTN occurrence decreased in the highest quintile of total and plant protein consumption by 19% (odds ratio [OR] = 0.81; confidence interval [CI]: [0.65–0.96]; P for trend = 0.004) and 18% (OR = 0.82; [CI: (0.67–0.94]; P for trend = 0.03), respectively.

Conclusions:

More frequent protein intake, especially plant protein consumption was inversely associated with BP and risk of HTN among Iranian adults.

A Pediatric Case of Meckel Diverticulum with Uncommon Presentation Showing no Lower Gastrointestinal Bleeding

Meckel's diverticulum (MD) is the most common congenital abnormality of the gastrointestinal tract. Painless intestinal hemorrhage is a frequently occurring complication that relates to MD in children. Bowel obstruction is a rare complication of MD in children. We report on the case of a four-year old male child who presented with abdominal pain and hematemesis. Finally, bowel obstruction due to MD was confirmed at surgery.

The Effect of Nutrition Consultation on Dietary Diversity Score of Cardiac Patients Referred to Cardiac Rehabilitation Research Center Isfahan Cardiovascular Research Institute during 2008-2013

BACKGROUND

Dietary diversity score (DDS) measurement was used to assessment of diet quality in different disease like cardiovascular disease. One way to improve the cardiovascular patient's ability is cardiac rehabilitation program that include exercise training, nutrition consultation and psychological treatment. No study was designed to compare the DDS before and after dietary consultation among cardiac rehabilitation patients, so this study was designed to examine this purpose.

METHODS

Subjects were participated in the 2-month cardiac rehabilitation program. All patients that completed the cardiac rehabilitation program and 2 dietary records (before and after nutritional counseling in cardiac rehabilitation program) enrolled in study. Kant et al method was used for scoring dietary diversity. Data were analyzed using the statistical package for social sciences (SPSS version 20). Wilcoxon test were used to compare DDS score for each subgroup and pair sample T test was used to compare total DDS after and before nutrition counseling. P < 0.05 was considered as statistically significant.

RESULTS

The differences between DDS of grain, fruit, vegetable and meat before and after nutrition counseling were not significant (P = 0.635, P = 0.423, P = 0.826, P = 0.207 respectively), but differences of DDS for dairy and total DDS before and after nutrition counseling were significant (P = 0, P = 0.001).

CONCLUSIONS

Dietary diversity was increased after nutrition counseling among patients with cardiac disease.

Comparison of one and two-day bowel preparation with polyethylene glycol in pediatric colonoscopy

BACKGROUND/AIMS

Proper colon preparation in children has been a challenge for many years. Different regimens have been used for this purpose, but the best regimen is not determined. The aim of this study was to evaluate successful colon preparation before colonoscopy in children who were treated with one- or two-day regimen with polyethylene glycol (PEG) plus bisacodyl and clear liquids.

MATERIALS AND METHODS

In this randomized clinical trial, 100 children (2-14 years old) who were candidates for colonoscopy were enrolled and divided into two groups. The children in group one were started on 2 g/kg PEG powder (17 g in 240 mL water or another beverage) and 5 mg bisacodyl suppository (BD) the day before colonoscopy, whereas those in the other group were started on 1.5 g/kg PEG with fruit juices for two days and 5 mg bisacodyl suppository (BD) for two days before colonoscopy.

RESULTS

Compliance rates, regimens, adverse effects, and complete colonoscopy were not significantly different between the two groups. The Boston score was excellent and good in 70% of group one and 72% of group two children, respectively. Compliance rate, adverse effects, and need for enema were similar in both groups. The rate of compliance and non-requirement of enema were significantly higher in children with satisfactory colon preparation.

CONCLUSION

The one-day PEG plus bisacodyl regimen for bowel preparation is as effective as the two-day regimen in children; furthermore, it is well tolerated and has low adverse effects.

Effect of Low-fat Milk Consumption Compared to Apple Juice and Water on the Energy Intake Among 10-12-Year-Old Obese Boys: A Three-way Cross-over Clinical Trial

BACKGROUND

Appetite lowering characteristics of dairy have attracted scientists to look for its effect on energy intake particularly among children. In the present study, we tried to assess the effect of low-fat milk on total and short-term energy intake among obese boys in a randomized three-way cross-over clinical trial.

METHODS

A total of 34 obese 10-12-year-old boys were randomized to consume three beverages (low-fat milk, apple juice, or water) with a fixed energy breakfast for two consecutive days, 1 week apart. Ad libitum lunch was provided for subjects 5 h later. The energy intake from breakfast till lunch and total energy intake on intervention days, and 2 days after intervention were compared. Generalized linear model repeated measures procedure in which test beverages were considered as repeated factors.

RESULTS

Energy intake from breakfast till lunch was lower when low-fat milk consumption was included in the breakfast compared with water and apple juice (adjusted mean ± standard error: Low-fat milk = 1484.33 ± 15.30 Kcal, apple juice = 1543.39 ± 20.70 Kcal, water = 1606.6 ± 19.94 Kcal; P < 0.05). The energy intake on a day before interventions, total energy intake on intervention days, and 2 days after intervention was not statistically different between intervention periods (P > 0.05).

CONCLUSIONS

One serving of low-fat milk might affect the energy intake in a short-term period. The possible effect of frequent consumption of dairy products on long-term energy intake among children is needed to be examined.

The effect of different beverage consumption (dough, non-alcoholic beer, carbohydrated replacement drink) on performance, lipids profile, inflammatory biomarkers after running-based anaerobic sprint test in taekwondo players

BACKGROUND

After exercise, recovery is very essential in professional sport. Athletes use sport beverages to enhance endurance and physical performance. The purpose of this study was to examine the effects of Dough versus non-alcoholic beer and carbohydrate (CHO) fluid on performance, lipids profile, inflammatory biomarkers after Running-based Anaerobic Sprint Test (R.A.S.T) in Taekwondo players.

METHODS

This study was conducted as repeated measures crossover design with 22 men Taekwondo player. Subjects completed standard protocol R.A.S.T so that immediately and 1 h posterior R.A.S.T protocol received number 1 beverage. Subjects spend 2 h recovery periods. Second and third sessions trial were similar to prior trial, separated by at least 4 days, instead of number 1 beverage, participants received number 2 and number 3 beverage.

RESULTS

Data showed that average pre- and post-recovery in C-reactive protein (CRP) or Dough significantly decreased (P < 0.05), while for CHO drink and non-alcoholic beer, were not statistically significant. Moreover, the mean pre- and post-recovery in VO2 max for Dough and non-alcoholic beer significantly increased, but for other beverages, there was no significant difference (P > 0.05). About mean pre- and post-recovery in low density lipoprotein (LDL) and high density lipoprotein (HDL) there were no significant differences in all three beverages. Besides, amount of CRP was significant between three beverages (P < 0.05). There were no other within-subject differences for any of the other variables measured, including HDL, LDL, and VO2max. In addition, no significant different (P > 0.05) in dietary intake were observed between three treatment periods.

CONCLUSIONS

Dough was effective in reducing LDL and reducing inflammatory biomarkers including CRP with little effect on performance in subjects.

Leveraging bimodal kinetics to improve detection specificity

Optical microcavities are high sensitivity transducers able to detect single nanoparticles and molecules. However, the specificity of detection is dependent on the availability of an appropriate targeting moiety with minimal cross-reactivity. In the present work, an alternative approach is shown. Namely, using biotin-functionalized toroidal microcavities, the dissociation constant of biotin to two different streptavidin complexes (free and polystyrene bead) is determined. Based on the difference in affinity and in mass transport, the two complexes are identified from a mixture. By leveraging information in the binding site, improved specificity can be achieved.