Adherence to the DASH diet for 12 weeks among PCOS women had beneficial effects on BMI, AMH, insulin metabolism, SHBG, FAI, NO and MDA levels.

This study was carried out to determine the effects of magnesium and vitamin E co-supplementation on wound healing and metabolic status in patients with diabetic foot ulcer (DFU). The current randomized, double-blind, placebo-controlled trial was conducted among 57 patients with grade 3 DFU. Participants were randomly divided into two groups to take either 250 mg magnesium oxide plus 400 IU vitamin E (n = 29) or placebo per day (n = 28) for 12 weeks. Compared with the placebo, taking magnesium plus vitamin E supplements reduced ulcer length (β [difference in the mean of outcomes measures between treatment groups] −0.56 cm; 95% CI, −0.92, −0.20; p = 0.003), width (β −0.35 cm; 95% CI, −0.64, −0.05; p = 0.02) and depth (β −0.18 cm; 95% CI, −0.33, −0.02; p = 0.02). In addition, co-supplementation led to a significant reduction in fasting plasma glucose (β −13.41 mg/dL; 95% CI, −20.96, −5.86; p = 0.001), insulin (β −1.45 μIU/ml; 95% CI, −2.37, −0.52; p = 0.003), insulin resistance (β −0.60; 95% CI, −0.99, −0.20; p = 0.003) and HbA1c (β −0.32%; 95% CI, −0.48, −0.16; p < 0.003), and a significant elevation in insulin sensitivity (β 0.007; 95% CI, 0.003, 0.01; p < 0.001) compared with the placebo. Additionally, compared with the placebo, taking magnesium plus vitamin E supplements decreased triglycerides (β −10.08 mg/dL; 95% CI, −19.70, −0.46; p = 0.04), LDL-cholesterol (β −5.88 mg/dL; 95% CI, −11.42, −0.34; p = 0.03), high sensitivity C-reactive protein (hs-CRP) (β −3.42 mg/L; 95% CI, −4.44, −2.41; p < 0.001) and malondialdehyde (MDA) (β −0.30 μmol/L; 95% CI, −0.45, −0.15; p < 0.001), and increased HDL-cholesterol (β 2.62 mg/dL; 95% CI, 0.60, 4.63; p = 0.01) and total antioxidant capacity (TAC) levels (β 53.61 mmol/L; 95% CI, 4.65, 102.57; p = 0.03). Overall, magnesium and vitamin E co-supplementation for 12 weeks to patients with DFU had beneficial effects on ulcer size, glycemic control, triglycerides, LDL-and HDL-cholesterol, hs-CRP, TAC, and MDA levels.The diabetic foot ulcer (DFU) is a chronic consequence of diabetes mellitus which mainly caused by neuropathy, different grades of ischemia, and infection that coincide with poor glycemic control and diminished neutrophil function. 1 The mortality rate among diabetic patients with DFU is higher than twofold compared with nonulcer patients. 2 Based on the previous evidence, the effective management of diabetes and timely treatment of foot ulcer are implicated for decrease the morbidity and mortality of DFU. 3 The nutritional status of diabetic patients correlates with the severity of ulcer and play an important role in the reversing of wound risk. 4 According to the prior studies, the alternation of magnesium metabolism is a common feature in diabetic patients which interference with glycemic control and contributes to impaired insulin sensitivity and chronic inflammatory status. 5In addition, observational evidence shown that there is an inverse association between magnesium levels and the occurrence of foot ulcers, nephropathy and retinopathy. 6 Similarly, it is repo...

This study was performed to determine the effects of zinc supplementation on wound healing and metabolic status in patients with diabetic foot ulcer. The current randomized, double-blind, placebo-controlled trial was conducted among 60 patients (aged 40-85 years old) with grade 3 diabetic foot ulcer. Participants were randomly divided into two groups (30 participants in each group) to take either 220 mg zinc sulfate supplements containing 50 mg elemental zinc or placebo daily for 12 weeks. After the 12-week intervention, compared with the placebo, zinc supplementation was associated with significant reductions in ulcer length (-1.5 ± 0.7 vs. -0.9 ± 1.2 cm, p = 0.02) and width (-1.4 ± 0.8 vs. -0.8 ± 1.0 cm, p = 0.02). In addition, changes in fasting plasma glucose (-40.5 ± 71.0 vs. -3.9 ± 48.5 mg/dl, p = 0.02), serum insulin concentration (-8.0 ± 15.4 vs. +1.1 ± 10.3 µIU/ml, p = 0.009), homeostasis model of assessment-estimated insulin resistance (-3.9 ± 7.1 vs. +0.8 ± 5.9, p = 0.007), the quantitative insulin sensitivity check index (+0.01 ± 0.03 vs. -0.002 ± 0.02, p = 0.04) and HbA1c (-0.5 ± 0.8 vs. -0.1 ± 0.5%, p = 0.01) in the supplemented group were significantly different from the changes in these indicators in the placebo group. Additionally, significant increases in serum HDL-cholesterol (+4.1 ± 4.3 vs. +1.1 ± 5.1 mg/dl, p = 0.01), plasma total antioxidant capacity (+91.7 ± 213.9 vs. -111.9 ± 188.7 mmol/L, p < 0.01) and total glutathione (+68.1 ± 140.8 vs. -35.0 ± 136.1 µmol/L, p = 0.006), and significant decreases in high sensitivity C-reactive protein (-20.4 ± 24.6 vs. -6.8 ± 21.3 µg/ml, p = 0.02) and plasma malondialdehyde concentrations (-0.6 ± 0.9 vs. -0.2 ± 0.7 µmol/L, p = 0.03) were seen following supplementation with zinc compared with the placebo. Zinc supplementation for 12 weeks among diabetic foot ulcer patients had beneficial effects on parameters of ulcer size and metabolic profiles.

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Most of the isolated fungi in the swimming pools can cause ear, eye and allergic diseases, therefore improvement the hygiene of swimming pools for control of microbial contaminations are recommended.Background: Swimming pools can transmit contagious diseases such as; fungal disease, otitis, conjunctivitis and amoebic meningoencephalitis. Objectives: The aim of this study was to determine the level of microbial contamination and the physicochemical condition of the swimming pools. Materials and Methods:In this cross -sectional study, 200 water samples were collected from four swimming pools in Kashan, Iran. Temperature, pH and residual chlorine and turbidity of the pools were examined. Samples were concentrated through a membrane filter and sedimentation, to test for the presence of parasites, fungi, and bacteria. Results: The results of the study showed that the mean of the physicochemical parameters, except in temperature, was standard in more than 60 % of the pools. Average temperature was higher than standard. The highest chlorine level was recorded in summer. Coliform bacteria was found to be positive in 3 % of the samples. Prevalence of saprophytic and opportunistic fungi was 27 %. Twelve species of fungi were isolated; the most common were Aspergillus, Penicillium sp, Rhizopus sp, and Fusarium sp, and the highest fungi pollution was observed in the summer. Prevalence of bacterial contamination was 9 %; bacteria isolate included Staphylococcus epidermidis, Bacillus subtilis and Escherichia coli. There was a significant association found between fungal and bacterial contamination with residual chlorine (P = 0.014, 0.001). Conclusions:The results showed that there were no parasites, or pseudomonas in Kashan's swimming pools, however, the prevalence of opportunistic saprophytic fungal contamination was relatively high. Such conditions may be attributed to a high temperature and insufficient water treatment. In addition, there is a need to monitor water quality and improve staff training to increase users' knowledge and awareness of the risks.

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Objective: This study was conducted to evaluate the effects of vitamin D supplementation on the recurrence and metabolic status of patients with cervical intraepithelial neoplasia grade 2 or 3 (CIN2/3). Methods: This randomized, double-blind, placebo-controlled trial was carried out among 58 women diagnosed with CIN2/3. Participants were randomly assigned into 2 groups to receive either 50,000 IU vitamin D3 (n = 29) or placebo (n = 29) every 2 weeks for 6 months. Results: The recurrence rate of CIN1/2/3 was 18.5 and 48.1% in the vitamin D and placebo groups respectively (p = 0.02). When we excluded CIN1, the recurrence rate of CIN2/3 became nonsignificant. Vitamin D supplementation significantly decreased fasting plasma glucose (–7.8 ± 9.2 vs. –1.1 ± 8.6 mg/dL, p = 0.006) and insulin levels (–3.2 ± 4.8 vs. –0.9 ± 3.4 µIU/mL, p = 0.03), and significantly increased quantitative insulin sensitivity check index (0.01 ± 0.02 vs. 0.002 ± 0.01, p = 0.02) compared with the placebo. Additionally, there was a significant decrease in high-sensitivity C-reactive protein (–815.3 ± 1,786.2 vs. 717.5 ± 1,827.3 ng/mL, p = 0.002) and a significant increase in total antioxidant capacity (113.4 ± 137.4 vs. –53.7 ± 186.7 mmol/L, p < 0.001) following the supplementation of vitamin D compared with the placebo. Conclusions: Vitamin D3 supplementation for 6 months among women with CIN2/3 had beneficial effects on CIN1/2/3 recurrence and metabolic status; however, it did not affect CIN2/3 recurrence.

Background: In mild to moderate gallstone pancreatitis, cholecystectomy is the most appropriate treatment for prevention of further biliary attacks. However, the timing of cholecystectomy is not precisely determined. The present study was conducted to compare outcomes of very early (within 48 h) versus delayed (more than 1 week) laparoscopic cholecystectomy in patients with acute biliary pancreatitis (ABP). . Two hundred and eight cases with mild to moderate ABP were randomly assigned to 2 groups, with 104 patients in group 1 (operation within 48 h) and 104 in group 2 (operation after one week). Age, sex, biochemical parameters, clinical manifestation at the time of admission, operation time, recurrent biliary problems, relapse, peri-operative complications, conversion rate, and hospital length of stay in the two groups were recorded and compared. In addition, Ranson's score and Revised Atlanta criteria, the American Society of Anaesthesiologists Physical Status ASA-PS, Charlson Co-Morbidity Index (CCI), complexity of surgery and Clavien-Dindo score were also determined. Results: There were no differences in demographics, peri-operative complications 4 (4%) vs. 4 (4%), P ¼ 1), conversion rate (10.6% vs. 11.5%; P ¼ 0.825) and procedure time (83 vs. 81 minutes, P ¼ 0.110) between the two groups. There were no deaths in either group; however, the length of hospital stay was shorter in the early group compared to the delayed one, (3.66 AE 1.12 vs. 10.35 AE 1.76, P < 0.001). Conclusion: Cholecystectomy within 48 h decreases significantly the length of hospital stay, without any difference in conversion rate, procedure time, or complication rate.