Probiotics are considered as -immunomodulatory agents; their efficacy as an adjunct therapy option for rheumatoid arthritis (RA), however, remains controversial. The main aim of the present meta-analysis, therefore, was to compare available data from the published randomized, controlled trials (RCTs) recruiting adults with RA which compared probiotics with placebo. The English literature search was performed using Ovid version of Medline, EmBase, Web of Science, and the Central Cochrane library through October 2016 and supplemented by hand searching reference lists. Among 240 citations identified, 4 RCTs (153 participants; 89% female) were included. All data were pooled using a standardized mean difference (SMD) with a 95% CI. Compared to the placebo, probiotics did not change the inflammatory parameters (erythrocyte sedimentation rate, tumor necrosis factor [TNF]-α, interleukin [IL]-1β, IL-6, IL-10, and IL-12) and oxidative stress indices (total antioxidant capacity and malondialdehyde) significantly. The borderline significant reduction as a result of probiotic administration was only determined in C-reactive protein [SDM - 0.32 (95% CI - 0.65 to 0.00)]. Among disease activity indices (disease activity score [DAS], tender joint count, and swollen joint count), DAS showed a significant improvement following probiotic treatment with a SMD (95% CI) of - 0.58 (- 0.97 to - 0.19). The number of trials was too small to determine if a strain-, dose-, or duration-response effect was present. Probiotics seem to be less effective in RA; however, to reach a firm conclusion, we need further evidence.

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The main aim of this study was to develop a comprehensive nutritional planning expert system for inborn errors of amino acid metabolism (IEAAM). Metabolic Nutri-Expert System, integrated in the electronic nutritional history record, was designed to accelerate either dietitian or patient/parent knowledge acquisition and education about the particular disease and propose culturally appropriate low protein diet to improve metabolic control or maintain the present health status. The Genetic Metabolic Dietitians International (GMDI) nutritional guideline was used to estimate the recommended nutritional values in the proposed system. The recommended daily Intakes (RDIs) for patients ingesting amino acid mixture, the U.S. Department of agriculture (UDSA) nutrient list, and both Iranian and modern low protein recipes were applied to perform diet planning. The proposed system also allows the user to modify the diet as he/she likes, and to propose his/her own low protein cookery recipes as well. This comprehensive computer system, through the multidisciplinary viewpoint, aimed to at least partially replace some of the regular traditional metabolic dietitian visits and optimize the patient's metabolic control and adherence outcomes.

Estimation of essential and toxic element intakes is crucial to evaluate the risks of deficiency or toxicity. The purpose of this study was to investigate and also to compare the dietary intakes of zinc (Zn) and copper (Cu) by adults living in Shiraz, Iran, determined by two procedures: duplicate portion sampling of 21 hospital meals combined with either instrumental analysis (voltammetric measurement) or the use of food composition tables (FCTs). The level of exposure to lead (Pb) and cadmium (Cd) was evaluated as well. The daily Zn intakes of both methods were not significantly different and were higher than the RDA values except the value measured by the instrumental analysis which was lower than the RDA established for a male adult. Daily intake of Cu determined by instrumental analysis was significantly lower and closer to RDA for adults compared with the value estimated by FCTs. The dietary intakes of Pb and Cd were 313 and 61% of the respective provisional tolerable weekly intakes (PTWIs), respectively. The accuracy of two methods used for estimation of Zn intake was similar. In the case of Cu, the use of FCTs, in which the influence of environmental conditions and dietary habits of meal preparation is not taken into account, overestimated dietary intake. The risk of zinc deficiency was found in adult males. Moreover, the estimated intake of Pb, but not Cd, could be a cause of concern for Shiraz population. Thus, conducting regular periodic studies to assess the dietary intake of mentioned elements are recommended.

Increased ratio of omega-6 to omega-3 fatty acids in spermatozoa has been positively correlated with induced lipid peroxidation and elevated sperm DNA damage. Therefore, the fatty acid composition of the individuals' spermatozoa might be a determinant of fertility status. To that end, a case-control study was conducted including 56 infertile men (aged from 25 to 45 years) referring to Isfahan Fertility and Infertility Center to investigate the relationship between sperm and seminal plasma omega-6 to omega-3 fatty acid ratio with sperm DNA fragmentation. Men were grouped into high and low percentages of sperm DNA fragmentation, and seminal and sperm parameters were assessed between the two groups. Sperm parameters (WHO criteria), oxidative stress status (BODIPY and DCF staining), residual histones (aniline blue), DNA fragmentation (TUNEL and SCSA), and plasma fatty acid composition (HPLC) were assessed. Student's t-test and Pearson's correlation were used as statistical methods. Individuals with high sperm DNA damage had signi cantly lower sperm motility, higher sperm residual histone, and lipid peroxidation.Men diagnosed with high sperm DNA damage possessed higher amounts of total saturated, monounsaturated, and omega-6 to omega-3 fatty acids ratio in both sperm and seminal plasma (P < 0.05). Pearson's correlation revealed positive correlations (P < 0.05) between omega-6 to omega-3 fatty acids ratio in both sperm and seminal plasma with the percentage of sperm residual histones, DNA damage, and sperm lipid peroxidation. Overall, our results indicated that infertility caused by de ciencies in omega-3 fatty acids could be diagnosed and treated by supplementation of these fatty acids in an individual's diet.

Nowadays, the introduction of the so-called ‘diabetes technology’, either hardware/device or software, to different aspects of day-to-day living in patients with diabetes aims to improve blood glucose control and various lifestyle features. The coordination of vast context of diabetes education/training, particularly in the area of medical nutrition therapy, is considered as a great concern. On the other hand, Iranian food culture consists of a set of traditional dietary patterns and food consumption habit. The study was aimed to develop “the Comprehensive Mobile Application of Advanced Carbohydrate Counting and Diet- and Insulin-Regimen Planning” to help type 1 diabetic patients, improving their health status. The programming language of Kotlin, JavaScript, Node JS, and HTML5 was used for the mobile app development. The app was developed with the following abilities: 1) educating users on different aspects of disease control including, updated general treatment guidelines on physical activity, medical nutrition and insulin therapy, stress management, and the patient’s specific goals and dietary needs, 2) performing advanced carbohydrate counting using both picture-represented and kitchen-scale of carbohydrate foods as well as traditional Iranian foods, 3) recommending the patient’s specific insulin dose, either short- or rapid-acting, based on the carbohydrate content of the selected meal or the selected amount of Iranian foods, 4) recommending the personalized insulin dose needed for decreasing the high blood glucose levels, and 5) performing 3 and 4 simultaneously. Developing Carbulin was an effort to increase type 1 diabetes self-management using the traditional Iranian dietary pattern and menu.

Nowadays, the introduction of the so-called 'diabetes technology', either hardware/device or software, to different aspects of day-to-day living in patients with diabetes aims to improve blood glucose control and various lifestyle features. The coordination of vast context of diabetes education/training, particularly in the area of medical nutrition therapy, is considered as a great concern. On the other hand, Iranian food culture consists of a set of traditional dietary patterns and food consumption habit. The study was aimed to develop "the Comprehensive Mobile Application of Advanced Carbohydrate Counting and Diet-and Insulin-Regimen Planning" to help type 1 diabetic patients, improving their health status. The programming language of Kotlin, JavaScript, Node JS, and HTML5 was used for the mobile app development. The app was developed with the following abilities: 1) educating users on different aspects of disease control including, updated general treatment guidelines on physical activity, medical nutrition and insulin therapy, stress management, and the patient's specific goals and dietary needs, 2) performing advanced carbohydrate counting using both picture-represented and kitchen-scale of carbohydrate foods as well as traditional Iranian foods, 3) recommending the patient's specific insulin dose, either short-or rapid-acting, based on the carbohydrate content of the selected meal or the selected amount of Iranian foods, 4) recommending the personalized insulin dose needed for decreasing the high blood glucose levels, and 5) performing 3 and 4 simultaneously. Developing Carbulin was an effort to increase type 1 diabetes self-management using the traditional Iranian dietary pattern and menu.