On the basis of the current meta-analysis, we conclude that AA is safe and effective therapy in patients with RH.

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The prevalence of diabetes has nearly doubled since 1980, mounting from 4.7% to 8.5% in overall adult population. Thyroid disorder is another common endocrine disorder with prevalence of hypothyroidism as much as 4.6% and hyperthyroidism as much as 1.3% in population according to the National Health and Nutrition Examination Survey. These two most common endocrinopathies often co-exist and mutually influence each other. They have complex links of abnormal biochemical pathways, unregulated genetic expression of many genes and hormonal malfunctions. Thyroid hormones affects the regulation of carbohydrate metabolism, lipid metabolism and pancreatic function, and on the other hand, diabetes affects thyroid function tests to variable extents. In this review article we emphasized the epidemiology of diabetes and thyroid disorders, classification of thyroidism, and finally the impact of thyroidism to the various aspects of glucose and lipid metabolism in diabetics.

PurposeDifferent students may adopt different learning approaches: namely, deep and surface. This study aimed to characterize the learning strategies of medical students at Trinity School of Medicine and to explore potential correlations between deep learning approach and the students’ academic scores.MethodsThe study was a questionnaire-based, cross-sectional, observational study. A total of 169 medical students in the basic science years of training were included in the study after giving informed consent. The Biggs’s Revised Two-Factor Study Process Questionnaire in paper form was distributed to subjects from January to November 2017. For statistical analyses, the Student t-test, 1-way analysis of variance followed by the post-hoc t-test, and the Pearson correlation test were used. The Cronbach alpha was used to test the internal consistency of the questionnaire.ResultsOf the 169 subjects, 132 (response rate, 78.1%) completely filled out the questionnaires. The Cronbach alpha value for the items on the questionnaire was 0.8. The score for the deep learning approach was 29.4± 4.6, whereas the score for the surface approach was 24.3± 4.2, which was a significant difference (P< 0.05). A positive correlation was found between the deep learning approach and students’ academic performance (r= 0.197, P< 0.05, df= 130).ConclusionMedical students in the basic science years at Trinity School of Medicine adopted the deep learning approach more than the surface approach. Likewise, students who were more inclined towards the deep learning approach scored significantly higher on academic tests.

Diabetic nephropathy (DN) is the major cause of renal disease that affects 40% of patients with diabetes. DN is characterized by the pathological urine albumin excretion rate (UAER), diabetic glomerular lesions, and loss of glomerular filtration rate (GFR). Several studies have found strong association of animal protein with the glucagon activation, insulin resistance, proteinuria, microalbuminuria, and progression of renal disease in diabetic patients. Vegan diet that excludes all animal foods such as meat (including fish, shellfish, and insects), dairy, eggs, and honey, as well as products such as leather has been found significantly beneficial on enhancing insulin sensitivity, reducing glucagon activation and incidence of chronic kidney disease (CKD), and slow the progression of DN. Other studies have suggested that avoiding animal food and shifting the source of dietary protein from animal-derived to plant-based products may be a better dietary approach than dietary protein restriction to reduce kidney disease and cardiovascular disease (CVD), particularly in CKD and diabetes patients with profound insulin resistance. Based on the literature search conducted in this study we concluded that the vegan diet is beneficial in patients with diabetes and CKD to slow the progression of the DN and renal failure. However, additional interventional studies in humans are needed to understand the mechanisms underlying the increased insulin sensitivity by vegan diets and further studies of efficacy and safety of vegan diets in patients with diabetes and DN are recommended.

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