BACKGROUND: Rapid and effective pain relief in acute traumatic limb injuries (ATLI) is one of the most important roles of emergency physicians. In these situations, opioid addiction is an important concern because of the dependency on opioids. The study aims to compare the effectiveness of intravenous (IV) fentanyl versus morphine in reducing pain in patients with opioid addiction who suffered from ATLI. METHODS: In this double-blind randomized clinical trial, 307 patients with ATLI, who presented to the emergency department (ED) from February 2016 to April 2016, were randomly divided into two groups. One group (152 patients) received 0.1 mg/kg IV morphine. The other group (155 patients) received 1 mcg/kg IV fentanyl. Patients' demographic data, pain score at specific intervals, vital signs, side effects, satisfaction and the need for rescue analgesia were recorded. RESULTS: Eight patients in the morphine group and five patients in the fentanyl group were excluded. Pain score in the fentanyl group had a significant decrease at 5-minute follow-up (P value=0.00). However, at 10, 30, and 60-minute follow-ups no significant differences were observed between the two groups in terms of pain score reduction. The rescue analgesia was required in 12 (7.7%) patients in the fentanyl group and in 48 (31.6%) patients in the morphine group (P value=0.00). No significant difference was observed regarding side effects, vital signs and patients' satisfaction between the two groups. CONCLUSION Fentanyl might be an effective and safe drug in opioid addicts suffering from ATLI.

Colorectal cancer (CRC) is one of the major reasons of mortality in the worldwide. There is clear evidence that some amino acids such as arginine can improve CRC and its complications. Hence, in this systematic review we evaluated the association between arginine intake and CRC improvement. We searched the PubMed, Scopus, ISI Web of Science, Cochrane library, and Google Scholar databases by using proper keywords to find the relevant literatures, published to March 2019. Nine human studies of 523 screened articles were included in present systematic review. The majority of studies have found a positive association between consumption of arginine and CRC improvement. Increased inducible nitric oxide (NO) synthase expression and subsequently increasing the NO concentration in the tumor and/or serum, after arginine intake may be responsible for these protective effects. Also, arginine consumption may reduce cell proliferation in CRC and it can enhance immune function after remove the tumor. Although the benefits of arginine consumption in CRC patients were reported in previous trials, the finding need replication in well-designed studies before final conclusion.
Amino Acids ; Arginine ; Cell Proliferation ; Colorectal Neoplasms ; Humans ; Mortality ; Nitric Oxide

Curcumin is the principal polylphenol of turmeric that has been used to treat various disorders. However, its anti-obesity effects in patients with non-alcoholic fatty liver disease (NAFLD) remain controversial. Therefore, we aimed to perform a meta-analysis on the effects of supplementation with turmeric/curcumin on body weight, body mass index (BMI) and waist circumference (WC) in these patients. PubMed, Scopus, Cochrane Library, and ISI Web of Science were searched until January 2019, without any restrictions. Clinical trials that reported body weight, BMI and WC in patients with NAFLD were included. Weighted mean differences (WMDs) were pooled using a random-effects model. Eight studies (449 participants) fulfilled the eligibility criteria of the present meta-analysis. Overall, meta-analysis could not show any beneficial effect of turmeric/curcumin supplementation on body weight (WMD, −0.54 kg; 95% confidence interval [CI], −2.40, 1.31; p = 0.56; I² = 0.0%), BMI (WMD, −0.21 kg/m²; 95% CI, −0.71, 0.28; p = 0.39; I² = 0.0%) and WC (WMD, −0.88 cm; 95% CI, −3.76, 2.00; p = 0.54; I² = 0.0%). Subgroup analysis based on participants' baseline BMI, type of intervention, and study duration did not show any significant association in all subgroups. The results showed that turmeric/curcumin supplementation had no significant effect on body weight, BMI and WC in patients with NAFLD. Further studies with large-scale are needed to find out possible anti-obesity effects of turmeric/curcumin.
Anthropometry ; Body Mass Index ; Body Weight ; Curcuma ; Curcumin ; Humans ; Non-alcoholic Fatty Liver Disease ; Waist Circumference

The objective of the investigation was to study the application of ultrasound reactor technology (USRT) as a disinfectant for reduction of fungi from sewage effluent. Fungi are carbon heterotrophs that require preformed organic compounds as carbon sources. USRT is an attractive means to improve water quality because of the system simplicity and no production of toxic by-products. An ultrasound reactor produces strong cavitation in aqueous solution causing shock waves and reactive free radicals by the violent collapse of the cavitation bubble. These effects should contribute to the physical disruption of microbial structures and inactivation of organisms. There was significant reduction in fungal growth, with decreased fungal growth with increasing USRT. In this study, ultrasound irradiation at a frequency of 42 kHz was used to expose suspensions of fungi to evaluate the disinfection efficacy of the ultrasound reactor. Also, this study showed that in this system more than 99% reduction of sewage fungi was achieved after 60 min.
Colony Count, Microbial ; Disinfection ; methods ; Fungi ; growth & development ; isolation & purification ; Sewage ; microbiology ; Ultrasonics

Type 2 diabetes mellitus (T2DM) is a serious public health problem accompanies with several complications. This study was conducted to evaluate the effects of chromium picolinate (CrPic) supplementation on the glycemic status and lipid profile in patients with T2DM. The patients with T2DM (n = 52) were randomly allocated into 2 groups. One group received 400 μg CrPic per day and the other group took placebo; the intervention duration was 8 weeks. Anthropometric indices and metabolic factors were measured at the beginning, and at end of the study. The patients were recommended not to change their normal diet, life style and medication. No significant changes were observed for weight, body mass index, and fasting blood glucose (FBG) in both groups; while intra-groups changes in homeostatic model assessment for insulin resistance (HOMA-IR) value was significant (p < 0.05). Results of analysis of covariance showed that there were significance differences between groups in total cholesterol, low density lipoprotein cholesterol and HOMA-IR at the end of the intervention adjusting for baseline levels (p = 0.035, 0.030 and < 0.001, respectively). In this study, oral supplementation with 400 μg CrPic for eight weeks did not alter FBG concentration as well as anthropometric parameters in individuals with T2DM. However, the modest beneficial effects of chromium supplementation on insulin resistance as indicated by HOMA-IR and lipid profile were found.

The aim of this study was to assess the effects of a nutrition education program on overweight/obese patients with non-alcoholic fatty liver disease (NAFLD). This single-blind, parallel randomized controlled trial was conducted on 82 NAFLD patients (mean age 48.89 ± 9.85 years) in Isfahan, Iran. Patients were randomly allocated to receive nutrition education program combined with usual care or usual care alone for 2 months. Metabolic markers, including lipid profile, fasting blood glucose (FBG) and dietary intakes were obtained for each patient at baseline and at the end of the study. Nutrition education intervention resulted in a significant decrease compared with usual care in serum levels of total cholesterol (TC) and triglyceride (TG) (p < 0.05). However, our intervention did not lead to a significant improvement in FBG, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), respectively (p > 0.05). Furthermore, energy and sugar intakes of patients were reduced significantly in response to our intervention (p < 0.05). Nutrition education intervention significantly reduced serum levels of TC and TG but did not affect other metabolic markers including FBG, LDL-C, and HDL-C. Also, it could reduce total energy and sugar intake. Thus, this study could be useful to use this educational program for NAFLD patients in order to influence their metabolic markers and dietary intakes. TRIAL REGISTRATION: IRCT Identifier: IRCT2014101811763N17
Blood Glucose ; Cholesterol ; Education ; Fasting ; Humans ; Iran ; Lipoproteins ; Non-alcoholic Fatty Liver Disease ; Triglycerides

0.05). However, serum IL-6 levels significantly decreased in the flaxseed oil group compared to the sunflower oil group (p = 0.017). No side effect was observed during the study due to the use of sunflower and flaxseed oils. We observed that consumption of flaxseed oil improved serum IL-6 levels but had no effect on oxidative stress and coagulation score in patients with MetS. Further studies are needed to confirm the veracity of our results.TRIAL REGISTRATION: Iranian Registry of Clinical Trials Identifier: IRCT2015012020737N1]]>
Chronic Disease ; Diet ; Energy Intake ; Flax ; Helianthus ; Humans ; Inflammation ; Interleukin-6 ; Linseed Oil ; Oxidative Stress

Stem cells transplantation (SCT) is known as a newfound strategy for multiple sclerosis (MS) treatment. Human umbilical cord mesenchymal stem cells (hUCMSCs) contain various regenerative features. Experimental autoimmune encephalomyelitis (EAE) is a laboratory model of MS. This meta-analysis study was conducted to assess the overall therapeutic effects of hUCMSCs on reduction of clinical score (CS) and restoration of active movement in EAE-induced animals. For comprehensive searching (in various English and Persian databases until May 1, 2024), the main keywords of “Experimental Autoimmune Encephalomyelitis”, “Multiple Sclerosis”, “Human”, “Umbilical Cord”, “Mesenchymal”, and “Stem Cell” were hired. Collected data were transferred to the citation manager software (EndNote x8) and duplicate papers were merged. Primary and secondary screenings were applied (according to the inclusion and exclusion criteria) and eligible studies were prepared for data collection. CS of two phases of peak and recovery of EAE were extracted as the difference in means and various analyses including heterogeneity, publication bias, funnel plot, and sensitivity index were reported. Metaanalysis was applied by CMA software (v.2), P<0.05 was considered a significant level, and the confidence interval (CI) was determined 95% (95% CI). Six eligible high-quality (approved by ARRIVE checklist) papers were gathered. The difference in means of peak and recovery phases were –0.775 (–1.325 to –0.225; P=0.006; I2 =90.417%) and –1.230 (–1.759 to –0.700; P<0.001; I2 =93.402%), respectively. The overall therapeutic effects of SCT of hUCMSCs on the EAE cases was –1.011 (95% CI=–1.392 to –0.629; P=0.001). hUCMSCs transplantation through the intravenous route to the animal MS model (EAE) seems a considerably effective procedure for the alleviation of motor defects in both phases of peak and recovery.

Stem cells transplantation (SCT) is known as a newfound strategy for multiple sclerosis (MS) treatment. Human umbilical cord mesenchymal stem cells (hUCMSCs) contain various regenerative features. Experimental autoimmune encephalomyelitis (EAE) is a laboratory model of MS. This meta-analysis study was conducted to assess the overall therapeutic effects of hUCMSCs on reduction of clinical score (CS) and restoration of active movement in EAE-induced animals. For comprehensive searching (in various English and Persian databases until May 1, 2024), the main keywords of “Experimental Autoimmune Encephalomyelitis”, “Multiple Sclerosis”, “Human”, “Umbilical Cord”, “Mesenchymal”, and “Stem Cell” were hired. Collected data were transferred to the citation manager software (EndNote x8) and duplicate papers were merged. Primary and secondary screenings were applied (according to the inclusion and exclusion criteria) and eligible studies were prepared for data collection. CS of two phases of peak and recovery of EAE were extracted as the difference in means and various analyses including heterogeneity, publication bias, funnel plot, and sensitivity index were reported. Metaanalysis was applied by CMA software (v.2), P<0.05 was considered a significant level, and the confidence interval (CI) was determined 95% (95% CI). Six eligible high-quality (approved by ARRIVE checklist) papers were gathered. The difference in means of peak and recovery phases were –0.775 (–1.325 to –0.225; P=0.006; I2 =90.417%) and –1.230 (–1.759 to –0.700; P<0.001; I2 =93.402%), respectively. The overall therapeutic effects of SCT of hUCMSCs on the EAE cases was –1.011 (95% CI=–1.392 to –0.629; P=0.001). hUCMSCs transplantation through the intravenous route to the animal MS model (EAE) seems a considerably effective procedure for the alleviation of motor defects in both phases of peak and recovery.

Stem cells transplantation (SCT) is known as a newfound strategy for multiple sclerosis (MS) treatment. Human umbilical cord mesenchymal stem cells (hUCMSCs) contain various regenerative features. Experimental autoimmune encephalomyelitis (EAE) is a laboratory model of MS. This meta-analysis study was conducted to assess the overall therapeutic effects of hUCMSCs on reduction of clinical score (CS) and restoration of active movement in EAE-induced animals. For comprehensive searching (in various English and Persian databases until May 1, 2024), the main keywords of “Experimental Autoimmune Encephalomyelitis”, “Multiple Sclerosis”, “Human”, “Umbilical Cord”, “Mesenchymal”, and “Stem Cell” were hired. Collected data were transferred to the citation manager software (EndNote x8) and duplicate papers were merged. Primary and secondary screenings were applied (according to the inclusion and exclusion criteria) and eligible studies were prepared for data collection. CS of two phases of peak and recovery of EAE were extracted as the difference in means and various analyses including heterogeneity, publication bias, funnel plot, and sensitivity index were reported. Metaanalysis was applied by CMA software (v.2), P<0.05 was considered a significant level, and the confidence interval (CI) was determined 95% (95% CI). Six eligible high-quality (approved by ARRIVE checklist) papers were gathered. The difference in means of peak and recovery phases were –0.775 (–1.325 to –0.225; P=0.006; I2 =90.417%) and –1.230 (–1.759 to –0.700; P<0.001; I2 =93.402%), respectively. The overall therapeutic effects of SCT of hUCMSCs on the EAE cases was –1.011 (95% CI=–1.392 to –0.629; P=0.001). hUCMSCs transplantation through the intravenous route to the animal MS model (EAE) seems a considerably effective procedure for the alleviation of motor defects in both phases of peak and recovery.