Background and ObjectiveOxidative stress plays an important role in pathogenesis of diabetes mellitus and its complications. Our previous study has shown glucose lowering effect produced by 3 months supplementation of Nigella sativa (NS) in combination with oral hypoglycemic drugs among type 2 diabetics. This study explored the long term glucose lowering effect (over one year) of NS in patients with type 2 diabetes mellitus on oral hypoglycemic drugs and to study its effect on redox status of such patients.Methods114 type 2 diabetic patients on standard oral hypoglycemic drugs were assigned into 2 groups by convenience. The control group (n = 57) received activated charcoal as placebo and NS group (n = 57) received 2g NS, daily, for one year in addition to their standard medications. Fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), C- peptide, total antioxidant capacity (TAC), superoxide dismutase (SOD), catalase (CAT), glutathione and thiobarbituric acid reactive substances (TBARS) at the baseline, and every 3 months thereafter were determined. Insulin resistance and β-cell activity were calculated using HOMA 2 calculator.ResultsComparison between the two groups showed a significant drop in FBG (from 180±5.75 to 180±5.59 in control Vs from 195±6.57 to 172 ±5.83 in NS group), HbA1c (from 8.2±0.12 to 8.5±0.14 in control VS from 8.6±0.13 to 8.2±0.14 in NS group), and TBARS (from 48.3±6.89 to 52.9 ±5.82 in control VS from 54.1±4.64 to 41.9 ±3.16 in NS group), in addition to a significant elevation in TAC, SOD and glutathione in NS patients compared to controls. In NS group, insulin resistance was significantly lower, while β-cell activity was significantly higher than the baseline values during the whole treatment period.ConclusionLong term supplementation with Nigella sativa improves glucose homeostasis and enhances antioxidant defense system in type 2 diabetic patients treated with oral hypoglycemic drugs.Trial RegistrationClinical Trials Registry-India (CTRI) CTRI/2013/06/003781

BACKGROUNDNigella sativa and its derivatives have been reported to have anti-inflammatory and bronchodilator effects, but the effects have been evaluated in only a few clinical studies.OBJECTIVESTo determine the effect of N sativa supplementation on inflammation of the airways and limitation of airflow in partly controlled asthma patients.DESIGNSingle-blind, placebo-controlled, randomized study.SETTINGAsthma and allergy clinic of a university hospital in eastern Saudi Arabia.PATIENTS AND METHODSPatients were divided into three groups. A control group (n=24) received the placebo, while NS-1 and NS-2 groups (n=26 each) received 1 and 2 g/day of N sativa, respectively, for 3 months along with maintenance inhaled therapy.MAIN OUTCOME MEASURE(S)Asthma control test (ACT) score, fractional exhaled nitric oxide (FeNO), peak expiratory flow (PEF) variability and other pulmonary function tests, IgE, serum cytokines, and frequency of exacerbations.RESULTSFEF25-75% and FEV1 (% predicted) increased significantly (P<.05) at both 6 and 12 weeks in the NS-2 group. PEF variability significantly improved in both NS-1 and NS-2 groups at 6 and 12 weeks as compared with the controls (P<.05). FeNO and serum IgE decreased significantly after 12 weeks in both the NS-1 and NS-2 groups vs baseline (P<.05). Both doses of N sativa produced a significant increase in the serum IFN-γ at 12 weeks vs baseline (P<.05) as well as a significant improvement in the ACT score at 6 and 12 weeks vs baseline (P<.001, <.01). Significantly fewer patients had exacerbations in the NS-1 group (P<.05).CONCLUSIONN sativa supplementation with inhaled maintenance therapy improves some measures of pulmonary function and inflammation in partly controlled asthma.LIMITATIONSNo bronchoalveolar lavage or sputum samples taken for measurement of asthma markers.

BACKGROUNDDiabetic patients with hypertension and dyslipidemia are at a high risk of cardiovascular complications.OBJECTIVESTo determine the effect of Nigella sativa supplementation on the lipid profile, mean arterial pressure, and heart rate in persons with type 2 diabetes on oral hypoglycemic agents (OHA).DESIGNSingle-blind, nonrandomized.SETTINGDiabetes clinic of a university hospital in Saudi Arabia.PATIENTS AND METHODSType-2 diabetic patients were recruited by purposive sampling and assigned to treatment or control at the discretion of the investigator with the patient blinded to treatment. Before the intervention and every 3 months thereafter until the end of the treatment period, the following parameters were measured: triglycerides (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and body mass index (BMI). Results at the baseline and each subsequent visit were compared between the two groups.MAIN OUTCOME MEASURE(S)Lipid and cardiovascular parameters, and BMI.RESULTSFifty-seven patients were assigned to receive N sativa 2 g daily for one year and 57 were assigned to receive an identical regimen of placebo, along with OHA. A significant decrease in HDL-C and increase in the TC/HDL-C and LDL-C/HDL-C ratios were seen in the control group. The N sativa group had a significant decline in TC, LDL-C, TC/HDL-C and LDL-C/HDL-C ratios, compared with the respective baseline data and the control group. HDL-C was significantly elevated in the N sativa group. The control group showed a significant elevation in MAP. The N sativa group had a significant reduction in SBP, DBP, MAP and HR and a significant decrease in DBP, MAP and HR as compared with the control group.CONCLUSIONN sativa supplementation improves total cholesterol, mean arterial pressure and heart rate in type 2 diabetes patients on oral hypoglycemic agents.LIMITATIONSThere were 9 subjects in each group lost to follow up; thus the sample size could not be maintained as per the sample size calculation. The study was nonrandomized and thus there was a possibility of allocation bias. (Clinical trial registration number: CTRI/2013/06/003781, Clinical Trial Registry of India).

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Objectives:To study the effect of Nigella sativa supplementation on cardiac functions in Type 2 diabetic patients treated with oral hypoglycemic agents.Background:Diabetes mellitus is associated with a high risk of cardiovascular morbidity and mortality. A number of reported beneficial effects of N. sativa on cardiovascular function were the inspiration for this study.Materials and Methods:Sixty patients with uncontrolled diabetes (hemoglobin A1c [HbA1c] >7%) and with no known cardiovascular complications were recruited from the outpatient diabetes clinic. They were assigned, by convenience, to two groups; the control group received activated charcoal as placebo while the test group received 2 g/day of powdered N. sativa for 1-year. All patients continued with their standard oral hypoglycemic agents. Echocardiography was used to evaluate the diastolic function, systolic function, and left ventricular mass (LVM) before the intervention and after 6 and 12 months of the treatment.Results:HbA1c decreased significantly in the N. sativa group but did not change in the control group. Echocardiographic assessment in the control group showed impairment in diastolic function after 12 months, but there were no significant changes in fractional shortening (FS) or ejection fraction (EF). Furthermore, left ventricular (LV) dimensions at diastole and systole, LVM, and LVM index were significantly increased. In N. sativa group, no significant changes were found in diastolic function or LVM. LV dimension at systole was decreased while FS and EF were significantly increased after 6 and 12 months.Conclusion:N. sativa supplementation may protect the hearts of type 2 diabetic patients from diastolic dysfunction while improving LV systolic function.

Objective:To identify the determinants of misconceptions about diabetes in patients registered with a diabetes clinic at a tertiary care hospital in Eastern Saudi Arabia.Materials and Methods:This cross-sectional survey was carried out at a diabetes clinic of a tertiary care hospital in Eastern Saudi Arabia, from January to December 2012. A total of 200 diabetic patients were interviewed using a questionnaire comprising 36 popular misconceptions. The total misconception score was calculated and categorized into low (0-12), moderate (13-24) and high (25-36) scores. The association of misconception score with various potential determinants was calculated using Chi-square test. Step-wise logistic regression was applied to the variables showing significant association with the misconception score in order to identify the determinants of misconceptions.Results:The mean age was 39.62 ± 16.7 and 112 (56%) subjects were females. Type 1 diabetics were 78 (39%), while 122 (61%) had Type 2 diabetes. Insulin was being used by 105 (52.5%), 124 (62%) were self-monitoring blood glucose and 112 (56%) were using diet control. Formal education on diabetes awareness had been received by 167 (83.5%) before the interview. The mean misconception score was 10.29 ± 4.92 with 115 (57.5%) subjects had low misconception scores (<12/36). On the Chi-square test, female gender, rural area of residence, little or no education, <5 or >15 years since diagnosis, no self-monitoring, no dietary control and no diabetes education were all significantly (P < 0.05) associated with higher misconception scores. Step-wise logistic regression suggested that diabetes education, gender, education and time since diagnosis were significant (P < 0.05) predictors of misconception scores.Conclusions:The strongest determinants of misconceptions about diabetes in our study population were female gender, rural area of residence, illiteracy or little education, <5 or >15 years since diagnosis, no self-monitoring, no diet control and no education about diabetes.

BACKGROUND:Energy drinks contain stimulants mainly caffeine. The use of these drinks by university students is on the rise despite concerns about their safety. This study identified the determinants of the consumption of energy drinks in a cohort of Saudi university students.MATERIALS AND METHODS:This cross-sectional study was carried out at Imam Abdulrahman Bin Faisal University in Saudi Arabia. The students who volunteered to participate (n = 1255) were asked to complete a pretested questionnaire soliciting information on gender, marital status, class and college of study, pattern of energy drinks use, reasons for use, any benefits as well as any untoward effects experienced. Data was analysed using IBM-SPSS (version 21) to determine frequencies and compare various categories of the energy drink users. Logistic regression analysis were performed to identify determinants of energy drinks consumption.RESULTS:Out of 1255 participants, 245 reported using energy drinks. Out of a total 1255 students, 903 (72%) were from medical and 352 (28%) from nonmedical colleges of the university. There were 890 junior and 365 senior students. The female participants were significantly more among both senior and junior medical students. The age of the participants (mean ± SD) was 20.2 ± 1.9 years. The frequency of energy drinks users was higher in the male nonmedical students (both senior and junior) compared to the medical students. The most significant determinants identified were male gender (odds ratio [OR] 4.2, 95% confidence interval [CI] =3.34, 6.12), and being single (OR = 2.8, CI = 1.98, 4.24). In addition, being in non-medical field of study (OR = 1.3, 95% CI=0.61-2.13) was also found to have a reasonable association with energy drink consumption.CONCLUSION:We report male gender, unmarried status, and studying in nonmedical colleges of the university as the main determinants of the consumption of energy drinks by university students. Scrutiny of the patterns and reasons for the consumption of energy drinks might help in developing educational interventions to ensure the appropriate use of energy drinks by young adults.

Objectives:To determine the effect of energy drink consumption before exercise on indices of physical performance in untrained females.Methods:This single blind placebo controlled experimental study was carried out at the Physiology Department, University of Dammam, Dammam, Kingdom of Saudi Arabia from September 2011 to May 2012, on 32 healthy female students, in a crossover design. They were given either a standardized energy drink or the placebo 45 minutes before the exercise. Time to exhaustion and the stages of Bruce protocol achieved were noted. Heart rate, blood pressure, peripheral capillary oxygen saturation, and blood lactate were recorded before and after the exercise. Maximum oxygen consumption (VO2max) was calculated by formula. Paired sample t-test was used for statistics.Results:The mean age was 19.93±0.8 years, mean height 156.40±3.83 cm, and the mean weight 51.73±3.65 kg. Time to exhaustion in the placebo group was 11.67±1.51 minutes and 11.41±1.56 in the energy drink group (p<0.157). The VO2max in the placebo group was 34.06±6.62, while it was 32.89±6.83 in the energy drink group (p<0.154). There were no significant differences between the placebo and the energy drinks groups in regards to heart rate, blood pressure, and blood lactate levels, before or after the exercise. However, there were significant differences before, immediately, and 30 minutes post exercise for all parameters between each group.Conclusion:The effects of energy drinks intake on physical performance during the exercise in our small sample does not significantly differ from placebo.