Background Diabetic dyslipidemia is a complex multidimensional abnormality. However, earlier studies did not focus on the prevalence of various patterns of dyslipidemia. We categorized dyslipidemia into three groups. Single dyslipidemia (7 patterns) and mixed dyslipidemia consisted of dual (16 patterns) and triple (4 patterns) combinations of different patterns of single dyslipidemia. Methods This cross-sectional study included 2097 patients with type 2 diabetes (T2D) between 2014 and 2021. We measured blood lipid profile parameters and calculated the atherogenic index of plasma (AIP) using log (TG/HDL-C). We analyzed dyslipidemia as a categorical variable and expressed results as numbers and percentages. We used Chi-square or Fisher exact tests to compare categorical variables. Results A total of 97.81% of patients had at least one lipid abnormality. High AIP (88.0%) was the most common pattern, followed by LDL-C ≥ 70mg/dl (80.1%), and low HDL-C (58.0%). 73.87% of patients had mixed dyslipidemia. The dual combination of high AIP and LDL-C ≥ 70mg/dl was the most common pattern of mixed dyslipidemia (71.1%). Additionally, 24.7% of patients had triple combination dyslipidemia. All dyslipidemia patterns were more common among women than men, except for high AIP. In patients with T2D and coronary artery disease (CAD) history, high AIP was the most prevalent pattern of dyslipidemia (87.5%), followed by LDL ≥ 70mg/dl (68.6%). Also, the dual combination of high AIP and LDL ≥ 70mg/dl was the most common pattern of mixed dyslipidemia in patients with T2D and CAD history (60.67%). Conclusion This study showed that single and mixed (dual and triple combination) dyslipidemia is common among patients with T2D. High AIP and LDL-C ≥ 70mg/dl were the most common patterns, either single or combined, in patients with or without CAD.

BackgroundNowadays, pain, nausea, and vomiting are regarded as important complications of anesthesia and surgery. The current study aimed at assessing the effect of preemptive intravenous acetaminophen on control of pain, nausea, vomiting, shivering, and drowsiness following the general anesthesia for retina and/or vitrectomy surgeries.MethodsIn a randomized, double-blind, clinical trial, 83 candidates for retina or vitrectomy eye surgery under general anesthesia were distributed into 3 groups: A) 41 patients in the control group who received 100 mL of normal saline just before the surgery and 100 mL of normal saline 20 minutes before the end of surgery; B) 21 patients in the preemptive group who received acetaminophen 15 mg/kg in 100 mL normal saline just before the surgery and 100 mL normal saline 20 minutes before the end of surgery; C) 21 patients in the preventive group who received 100 mL normal saline just before the surgery and acetaminophen 15 mg/kg in 100 mL normal saline 20 minutes before the end of surgery. Pain, nausea, vomiting, and shivering were assessed at the recovery and 2, 4, and 24 hours after the operation. Anesthesia emergence situation was assessed after arrival in the recovery room by the Richmond agitation-sedation scale (RASS) questionnaire. Blood pressure and heart rate were recorded before anesthesia induction, just after intubation, before extubation, and on discharge from the recovery room.ResultsTotal intraoperative fentanyl, duration of operation, and duration of anesthesia were not different among the studied groups. Vital signs were not statistically different among the groups at before anesthesia induction, just after intubation, before extubation, and on discharge from the recovery room. Thirty-three patients in the control group (87.8%), 11 in preemptive (52.4%), and 14 in preventive groups (66.7%) needed acetaminophen in the first 24 hours after the surgery (P value = 0.008). Pain scores measured by visual rating scale (VRS) was lower in the preemptive and preventive groups, compared with those of the control group, in the recovery (P value = 0.006), 2 hours after the surgery (P value = 0.008), and 4 hours after the surgery (P value = 0.012), but not in 24 hours after the operation (P value = 0.1).ConclusionsIntravenous acetaminophen administered as preemptive or preventive medication was effective and safe to control acute postoperative pain and analgesic request after the vitrectomy eye surgery.

Background. Postural instability is a prevalent issue among individuals with autism spectrum disorder (ASD) that affects the development of their perceptual-motor skills and social functioning. Visual and somatosensory processing deficits, hypotonia, basal ganglia dysfunction, and anxiety are some of the concurrent disorders in individuals with ASD. Nevertheless, a definite management protocol for postural instability in ASD has not been introduced yet. Hence, we aim to shed light on the available intervention strategies for postural instability in individuals with ASD. Methods. Even though several studies have been conducted on the effects of various interventions for balance control in individuals with ASD, no study has compared their efficacy, limitations, and clinical implications. Results. This review discusses diverse proposed interventions contributing to ASD postural instability, including martial arts, water-based interventions, animal-assisted therapies, trampoline, balance training, vestibular therapy, transcranial direct current stimulation, sports, play, and active recreation for kids (SPARK), and square-stepping exercise (SSE). Conclusion. Enhancing motor skills, cerebellum function, and sensory input integration were some of the main mechanisms of these interventions to improve balance control in ASD. Some interventions, such as water-based exercises and video games, were enjoyable for children with ASD and could raise their treatment adherence. In most studies, small sample sizes and the lack of a control group represented their major limitations. Therefore, future well-designed randomized controlled trials are required to assess the effects of available interventions on postural control in ASD.

Purpose Diabetes is the leading cause of kidney disease. Up to 40% of the population with diabetes experience diabetic kidney disease (DKD). The correlation of DKD with insulin resistance (IR) indices has been shown in previous studies. In this study, the objective was to evaluate surrogate IR indices, including the Triglyceride-Glucose (TyG) index, Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP), and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) to find the most valuable index for the correlation between albuminuria and IR in the type 2 diabetes (T2D) population. Albuminuria is defined as urine albumin excretion of > 30 mg/day. Methods In this cross-sectional study, 2934 participants were enrolled and evaluated for urinary albumin excretion, and albuminuria was detected in 526 of the entries. The logistic regression models and Receiver Operating Characteristic (ROC) curve analysis were performed to assess the relationship of TyG index, VAI, LAP, and HOMA-IR's with albuminuria in patients with T2D. Results The TyG index had the highest association (OR 1.67) with the presence of albuminuria in patients with T2D, followed by HOMA-IR (OR 1.127), VAI (OR 1.028), and LAP (OR 1.004). These four indices remained independent after adjustment for multiple confounders. Based on the ROC curve, TyG revealed the best area under the curve (AUC) for revealing albuminuria with sufficient accuracy (AUC: 0.62) in comparison with other measured indices. The calculated TyG index cut-off point for the presence of albuminuria was 9.39. Conclusion Among the indices, TyG index had the most significant correlation with albuminuria in patients with T2D.

Background: Decreased Lecithin-cholesterol acyltransferase (LCAT) activity, increased level of oxidized low-density lipoproteins (ox-LDL), and dyslipidemia in diabetes and cancer were studied. In this research, LCAT activity, ox-LDL, and lipid profile in patients with endometrial carcinoma, diabetes, and the combination of them, and healthy subjects were measured. Objective: The aim of this study was the evaluation of lipid profile, LCAT activity, and ox-LDL level as an oxidative stress marker in three different pathologic conditions and comparison of them to healthy metabolic state. Methods: In this case-control study, a total of 93 female participants were recruited. Participants were divided into four groups, including endometrial carcinoma with diabetes (EC with DM, n=19), endometrial carcinoma without diabetes (EC, n=17), diabetes (DM, n=31), and Healthy group (H, n=26). The level of LCAT activity, triglycerides (TG), total cholesterol, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), and ox-LDL were measured. Results: The LCAT activity was decreased in all patient groups compared to healthy controls (p-value<0.001). LCAT activity (nmol/ml/h) was significantly lower in endometrial carcinoma with or without diabetes (mean ± SD = 28.31 ± 2.78, 34.00 ± 4.97, respectively) than in patients with diabetes alone (46.58 ± 9.47). A higher level of TG and ox-LDL and a lower level of HDL-C were seen in all patient groups compared to the healthy controls (all p-values < 0.001). The decrease in LCAT activity (∆ LCAT= LCAThealthy - LCATpatient) was 31.61 in endometrial carcinoma with diabetes, 25.92 in endometrial carcinoma without diabetes, and 13.34 nmol/ml/h in diabetes alone. Conclusion: A decrease in LCAT activity and an increase in ox-LDL level were seen in both endometrial carcinoma and diabetes. The combination of endometrial carcinoma and diabetes had a sub-additive effect on LCAT activity and ox-LDL level.