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Gabapentin is an effective agent in treating uremic pruritus.

One of the most serious cancers among women is breast cancer. This disease is the first reason for the death of women due to cancer. Increasing breast cancer risk may associate with many factors including genetic, reproductive factors, people's lifestyle, metabolic syndrome (MS) and hormones. MS has been known as a risk factor for prostate, pancreatic, breast and colorectal cancers. The purpose of this review is to identify the relationship between MS components and breast cancer individually. This study was performed by researching electronic database references including PubMed, Google Scholar, CINAHL ProQuest, and web of science through 2019. The effect of MS with its components and breast cancer was reported in many studies.Nevertheless, a thorough understanding of the mechanisms involved remains a challenge.However, one can take several preventive measures, including a proper diet, which is one of the most important determinants of metabolic status. Also, general preventive recommendations are including reducing alcohol consumption, red meat and total fat in the diet. Moreover, increasing the consumption of vegetable and fruit reduce the proportion of MS patients to improve the outcome of breast cancer patients.

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

Background: Type II Diabetes Mellitus (T2DM) is a considerable problem of global health, and finding new therapies for treating the disease continues. Recently, attention has been focused on vitamin D as a potential lowering agent of T2DM’s risk factors and its complications. The present work was conducted to determine the effect of vitamin D supplements on serum lipids, uric acid, C-Reactive Protein (CRP) and also Homeostatic Model Assessment of Insulin Resistance  (HOMA-IR). Materials and Methods: Sixty patients with T2DM as well as deficiency of vitamin D and referred to Rasoul-e-Akram Hospital in 2017 were selected by convenience sampling method. To begin the study, patients’ demographic information was required, so a questionnaire including age, waist circumference, sex, height, blood pressure and weight was provided. Patients with vitamin D3<30ng/ml were treated by a daily oral dose of 2000 unit of vitamin D supplementary for 12 weeks. Serum levels of triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), total cholesterol (TC), fasting blood sugar (FBS) and Hemoglobin A1C (HbA1C) were measured before and after vitamin D intake. Analysis of data was carried out through the Software Package SPSS Ver. 24. Results: Sixty-five percent of study population (39 people) was composed of females. The mean value ± standard deviation (SD) amount of age and BMI were 46.8±8.9 years and 28.4±4.3 m2/kg. The mean ± SD systolic blood pressure (SBP), 19.3±122.8 mmHg and diastolic blood pressure (DBP) were 14.1±79 mmHg. The mean ± SD of vitamin D in patients was 11.4±4.5 ng / ml. The comparison of blood factors before and after treatment showed p value> 0.05. Conclusions: Deficiency of vitamin D should be treated and prevented, but administration of this high-dose vitamin D supplements for prevention or improvement of T2DM has not been recommended yet. Our study showed a correlation between the vitamin D intake and decreased level of FBS and Uric Acid in diabetic patients.

Background: Given the increasing prevalence of type 2 diabetes in the community and the use of metformin as one of its most common therapies as well as presence of some evidences on a link between the use of this medicine and vitamin B12 levels, we decided to measure and compare serum level of vitamin B12 among the diabetic patients under treatment by metformin and compare with its natural content. Decreased Vitamin B12 levels leads to some clinical problems including anemia, gastrointestinal disorders (diarrhea, constipation, decreased appetite, etc.,), neurological disorders (tingle, numbness, muscle weakness, etc.,) and mental disorders (memory impairment, depression, behavioral problems, etc.,). Therefore, we would determine if the duration of metformin use and dosage may be effective on serum levels of vitamin B12 among metformin-treated diabetic patients. Methods: Serum vitamin B12 level in metformin-treated type 2 diabetic patients referred to Rasoul-e-Akram Hospital and Specialist Clinic of Taban in Tehran in 2016 (306 subjects selected by convenience sampling) was determined and then compared to its normal level. Results: Of the 306 participants in the study, 120 ones were females (39.2%) and 186 ones were males (60.8%). Also, 150 ones (49%) were healthy and 156 ones (51%) were suffering from diabetes Miletus. There was a significant difference between the type 2 diabetes mellitus and healthy individuals with quantitative variables such as age, height, weight, BMI, serum cholesterol (Chol) level, LDL serum level, HDL serum level, triglyceride (TG) level. The mean blood level of Vitamin B12 level was 448.92±156.75pg/mL among all participants. A Vitamin B12 deficiency frequency of above 6% was seen among diabetic patients. In regression analysis, a model was defined based on which age, gender, diabetes and Metformin used had a significant effect on serum levels of vitamin B-12. Also, none of the variables gender, age, duration of treatment, metformin quantity, weight and BMI was associated with a deficiency of vitamin B12. Conclusion: In the diabetic group, the prevalence of Vitamin B12 deficiency was more than6%. It was also seen that age, gender, diabetes mellitus, metformin intake and metformin content had a significant effect on serum B12 levels. Therefore, measurement of serum levels of vitamin B12 in metformin-treated subjects is recommended.

Introduction: Diabetes is one of the most common diseases in the world that is accompanied with many microvascular complications. Any chronic disease such as diabetes can cause types of mood disorders such as depression in patients. The aim of this study was to evaluate the prevalence of depression in type 2 diabetics with microvascular complications. Execution Method: In this cross-sectional study, type 2 diabetics with microvascular complications that referred to Hazrat Rasoul Akram Hospital during 2016–2017 were studied. After verification of retinopathy and nephropathy in patients, 100 patients were enrolled in the study and correlated between variables such as age, sex, body mass index, medication, education, retinopathy, nephropathy, marital status, hemoglobin A1c (HbA1c), triglyceride, low-density lipoprotein (LDL) and high-density lipoprotein (HDL), blood pressure, and fasting blood sugar was investigated in patients given the possibility of depression. Results: The results of this study showed that 72% of patients were with depression and by evaluating the mentioned variables with depression disorder it was found that there was a significant relationship between fasting blood sugar, HbA1C, retinopathy, medication, and LDL with depression. Conclusion: Given the high prevalence of depression (72%) in diabetics in this study, it seems that psychiatric consultation is needed to diagnose depression in diabetics.

Background COVID-19 has different manifestations from respiratory to GI problems, and some of them are more common, but some are rare. Reporting rare cases can significantly advance our understanding of the disease. Case presentation In this case, we report an 18-year-old teenage boy with chest pain and resistant hypotension following COVID-19 infection, finally diagnosed as primary adrenal insufficiency and COVID-19 myocarditis. Conclusion Adrenal insufficiency can be life-threatening due to its adverse effects on hemodynamic and electrolyte equilibrium. In addition, COVID-19 induced myocarditis can make the situation more complicated.