The clinical investigation of citrullus colocynthis (L.) schrad fruit in treatment of Type II diabetic patients: a randomized,double blind,placebo‐controlled clinical trial

Citrullus colocynthis (L.) Schrad fruit is an herbal medicine used by traditional herbalists for the treatment of diabetes in Iran. To determine its efficacy and toxicity, a 2 month clinical trial was conducted in 50 type II diabetic patients. Two groups of 25 each under standard antidiabetic therapy, received 100 mg C. colocynthis fruit capsules or placebos three times a day, respectively. The patients were visited monthly and glycosylated hemoglobin (HbA1c), fasting blood glucose, total cholesterol, LDL, HDL, triglyceride, aspartate transaminase, alanine transaminase, alkaline phosphatase, urea and creatinine levels were determined at the beginning and after 2 months. The results showed a significant decrease in HbA1c and fasting blood glucose levels in C. colocynthis treated patients. Other serological parameters levels in both the groups did not change significantly. No notable gastrointestinal side effect was observed in either group. In conclusion, C. colocynthis fruit treatment had a beneficial effect on improving the glycemic profile without severe adverse effects in type II diabetic patients. Further clinical studies are recommended to evaluate the long‐term efficacy and toxicity of C. colocynthis in diabetic patients. Copyright © 2009 John Wiley & Sons, Ltd.     

Assessing surgical care delivery at facilities caring for higher volumes of minority children utilizing the pediatric quality indicator for perforated appendicitis: a propensity-matched analysis

The pediatric quality indicator (PDI) measures released by the Agency for Healthcare Research and Quality (AHRQ) provide an impetus for benchmarking quality of care in children. The PDI-17, aimed at studying perforation in appendicitis, is one such measure that this study aims to utilize to assess surgical care delivery and outcomes in children managed at majority–minority hospitals. The Kid Inpatient Database (2000–2012) was queried for pediatric patients (< 18 years) with a diagnosis of appendicitis, with and without perforation. Facilities were categorized into tertiles based on rates of perforation (PDI-17). Similarly, tertiles were generated based on volume of minority patients (Black and Hispanic) treated at each facility. Multivariable regression analysis adjusted for demographic parameters, hospital-level characteristics, propensity score quintiles, clinically relevant outcomes, and tertiles of minority patients treated. Of the 322,805 patients with appendicitis 28.7% had perforated appendicitis. Patients presenting to facilities caring for a higher volume of perforated appendicitis were younger with public insurance or no insurance and, however, these patients were less likely to belong to a minority group (p < 0.05). Additionally, these patients were less likely to belong to the highest income quartile (OR [95% CI] 0.45 [0.39–0.52]). Hospitals treating the highest volume of minority patients [majority–minority hospitals (MMHs)] had an 87% (OR [95% CI] 1.87 [1.77–1.98]) increased likelihood of also treating the highest rates of perforated appendicitis. Hospitals treating a high volume of complicated appendicitis are less likely to care for minority groups. Additionally, MMHs lacking experience and volume in caring for complicated appendicitis have an increased likelihood of patients with perforations which is indicative of poor healthcare access.     

Diaphragmatic hernias after pediatric liver transplantation: Experience of a high‐volume transplant center

Diaphragmatic hernias (DHs) are rare complications after pediatric liver transplantation (PLT). It is now widely accepted that DHs after liver transplantation (LT) is a pediatric related condition. PLTs (under of age 18) performed between January 2013 and June 2019 at Malatya Inonu University Institute of Liver Transplantation were retrospectively scanned. Study group consisting DHs and a control group were compared. Among 280 PLTs, 8 of them were complicated with DHs (%2.9). Median age of the patients with DH was 3.0 (0.8‐9.5) years. Median graft recipient weight ratio was 2.5 (0.9‐4.4). Five patients were below 5th percentiles in terms of pediatric weight growth chart at the time of LT. Also, 6 patients were below 5th percentiles in terms of pediatric height growth chart. There was no statistical difference between study and control groups. There are many risk factors mentioned in literature that may be primarily responsible for DHs after PLT. These factors are left lobe and large‐for‐size grafts, malnutrition, trauma or diathermy of diaphragmatic nerve and vessels and immunosuppressants. In our study, we could not specify any reason that differs in DHs. In our aspect, narrow diaphragma and thorax are exposed to high intra‐abdominal pressure from abdomen. Large‐for‐size grafts, which are specific to children, also may contribute to this affect. Excessive diathermy and trauma to diaphragmatic collaterals may aggravate the risk of DH. More patients are needed to make an exact conclusion, in order to evaluate with comparable study on this aspect.     

Magnetic and Magnetostrictive Behaviors of Laves-Phase Rare-Earth—Transition-Metal Compounds Tb1−xDyxCo1.95

The magnetic morphotropic phase boundary (MPB) was first discovered in Laves-phase magnetoelastic system Tb–Dy–Co alloys (PRL 104, 197201 (2010)). However, the composition-dependent and temperature-dependent magnetostrictive behavior for this system, which is crucial to both practical application and the understanding of transitions across the MPB, is still lacking. In this work, the composition-dependence and temperature-dependence of magnetostriction for Tb_1−xDy_xCo_1.95 (x = 0.3~0.8) are presented. In a ferrimagnetic state (as selected 100 K in the present work), the near-MPB compositions x = 0.6 and 0.7, exhibit the largest saturation magnetization M_S and the lowest coercive field H_C; by contrast, the off-MPB composition x = 0.5, exhibits the largest magnetostriction, the lowest M_S, and the largest H_C. Besides, a sign change of magnetostriction is observed, which occurs with the magnetic transition across the MPB. Our results suggest the combining effect from the lattice strain induced from structure phase transition, and the influence of the MPB on magnetocrystalline anisotropy. This work may stimulate the research interests on the transition behavior around the MPB and its relationship with physical properties, and also provide guidance in designing high-performance magnetostrictive materials for practical applications.