Association of catalase (rs7943316) and glutathione peroxidase-1 (rs1050450) polymorphisms with the risk of type 2 diabetes (T2DM)

Reactive oxygen species are involved in the pathogenesis of type 2 diabetes mellitus (T2DM). Catalase and Glutathione peroxidase-1 are antioxidant enzymes and the activity of them is essential for the protection against damage caused by reactive oxygen species. The aim of this study was to investigate the association between genetic polymorphisms of CAT gene (rs7943316) and GPx-1 gene (rs1050450) in patients with type 2 diabetes. In this case-control study, a total of 120 Iranian patients with T2DM and 120 healthy individuals as control were included. Genotypes were determined by PCR-RFLP. A significant difference was found between genotyping distribution of CAT (–21 A/T) polymorphism.The frequency of TT genotype was increased in patients compared to controls and we observed a statistically significant difference (OR = 1.797, 95% CI = 0.975–3.318, P = 0.044). Distribution of genotypes did not differ for GPx-1 (198 C/T) polymorphism between the cases and controls subjects. This study indicated that CAT rs7943316 genotype (TT) was associated with an increased risk of T2DM. No evidence was found to support an association between GPx-1 (198 C/T) polymorphism and T2DM.     

Tramadol and the occurrence of seizures: a systematic review and meta-analysis

Abstract

Introduction: Tramadol is a synthetic opioid which is commonly used around the world to relieve moderate to severe pain. One of the serious possible complications of its use is seizures. The present study aims to investigate and summarize the studies related to tramadol and occurrences of seizures after tramadol use and factors influencing these seizures.

Methodology: Our systematic review is compliant with PRISMA guidelines. Two researchers systematically searched PubMed/Medline, Web of Sciences, and Scopus. Cohort, case-control, cross-sectional studies, and clinical trials. The risk of bias was assessed using the Newcastle–Ottawa Scale After article quality assessment, a fixed or random model, as appropriate, was used to pool the results in a meta-analysis. Heterogeneity between the studies was assessed with using I-square and Q-test. Forest plots demonstrating the point and pooled estimates were drawn.

Results: A total of 51 articles with total sample size of 101 770 patients were included. The results showed that seizure event rate in the subgroups of tramadol poisoning, therapeutic dosage of tramadol, and tramadol abusers was 38% (95% CI: 27–49%), 3% (95% CI: 2–3%), 37% (95% CI: 12–62%), respectively. Tramadol dose was significantly higher in the patients with seizures than those without (mean differences: 0.82, CI 95%: 0.17–1.46). The odds for occurrence of seizures were significantly associated with male gender (pooled OR: 2.24, CI 95%: 1.80–2.77). Naloxone administration was not associated to the occurrence of seizures (pooled OR: 0.47, 95% CI: 0.15–1.49).

Conclusions: Our results demonstrate that the occurrence of seizures in patients exposed to tramadol are dose-dependent and related to male gender, but not related to naloxone administration. Given that, most of the evidence derives from studies utilizing a cross-sectional design, the association of tramadol with seizures should not be considered to be definitively established     

Potential effect of opium addiction on lipid profile and blood glucose concentration in type 2 diabetic patients in Iran

Background: Diabetes is one of the most common chronic diseases in the world. People believe that opium improves blood glucose and lipid profiles in these patients and controversial studies show the effect of consumption of opium in controlling these indices. Accordingly, this study aimed to compare the serum levels of blood indices such as fasting blood glucose (FBS), Hemoglobin A1c (HbA1c) and lipid profile in opium users and non-users in type ΙΙ diabetic patients.

Methods: In this cross-sectional study, among type II diabetic patients referred to the Diabetes Clinic of Birjand 45 opium users and 135 non-users were selected and entered the study by the convenience sampling method.

Results: The results of this study showed that the mean serum levels of FBS, HbA1c, and serum lipid profiles were not significantly different between the two groups of opium users and non-users, but the levels of triglyceride (TG) were significantly 0.18 unit higher in the opium users, compared to non-opium users.

Conclusion: According to the results, the use of opium does not affect the indices of blood glucose, HbA1c and serum lipid profiles except triglyceride in diabetic patients. The general belief that opioid use reduces biochemical indices does not seem to be correct.

Abbreviations: FBS: fasting blood sugar; HbA1c: Hemoglobin A1c; LDL: low-density lipoprotein; HDL: High-density lipoproteins; HDL-C: High-density lipoproteins-cholesterol; BMI: Body mass index; IQR: Inter quartile range; TG: triglyceride; TC: total cholesterol; NS: non-significant; S: significant; ATN: Acute tubular necrosis     

Psychometric properties of the Persian version of the Pittsburgh Sleep Quality Index addendum for PTSD (PSQI-A)

Background  Considering the frequent occurrence of natural disasters in Iran, the need for an inventory assessing the quality of sleep in the posttraumatic stress disorder (PTSD) patients is clearly evident. The Pittsburgh Sleep Quality Index addendum for PTSD (PSQI-A) has been recently developed to assess the disruptive nocturnal behaviors in the PTSD patients. This study was aimed to explore the reliability and validity of the Persian version of the PSQI-A. Materials and methods  Eighty-five PTSD patients related to the two recent major earthquakes of Kerman Province were enrolled in the study, and 133 healthy subjects were conveniently selected as the control group. The inventory was translated and then back-translated according to standard methods. The reliability was checked by computing the Cronbach`s alpha coefficient and corrected item-total correlation. The sensitivity and specificity were assessed by comparing the PSQI-A score with the DSM-IV-TR diagnosis. Convergent validity was checked against the General Health Questionnaire 12 (GHQ-12). Results  The mean (±SD) of the two groups were 42.1(±13.8) and 34.2 (±9.8), respectively. The sex distribution was comparable in the two groups (females consisted 55% and 58% of the PTSD and control groups, respectively). There were significant differences between the items comparing the two groups except for the “acting out dreams”. Overall the Cronbach`s alpha coefficient was 0.89, and the item-total correlation of all the seven items were over 0.4 except for the acting out dreams. At cut-off of 7/8, the sensitivity and specificity were 100% and 93%, respectively. The sum score showed a correlation of 0.66 with the GHQ-12. Conclusion  Although the psychometric properties of one of the seven items of the inventory were to some extent unsatisfactory, the overall reliability and validity of the questionnaire were acceptable.     

Five-year continuation rate and reasons for early removal of Norplant in Shiraz, Iran.

Norplant has been the focus of controversy in Iran because of its relatively high premature removal rate. This study assessed the reasons for Norplant removal and its 5-year continuation rate to clarify the determining factors on elimination of this method. Subjects were identified via a retrospective chart review of Norplant users in Shiraz, Iran who were followed for 5 years. The mean age and weight of acceptors were 23.6 +/- 4.1 years and 54.4 +/- 8.5 kg, respectively. The most common reasons for removal were menstrual disturbances and personal reasons (each 41%). The 5-year continuation rate was 45%; on average, Norplant capsules were in place for 4.1 +/- 0.09 years. Norplant has been shown to be an acceptable option in other Muslim countries, so the relatively high rate of removal in Iran could not be attributed to the Norplant itself, but is probably linked to other factors that are in need of improvement.