Background Patients with type-2 diabetes mellitus (T2DM), have a higher risk of future cardiovascular diseases (CVD). Meanwhile, probiotics are shown to positively impact CVD-related parameters. This randomized controlled trial sought to evaluate the effects of probiotic supplementation on fundamental CVD-related parameters including atherogenic index of plasma (AIPs), blood pressure, the Framingham risk score, and antioxidant markers in patients with T2DM. Methods Eligible participants were randomly assigned to receive 2 capsules/day of probiotics [each containing 500 mg of L.acidophilus(5 × 1010 CFU/g), L.plantarum(1.5 × 1010 CFU/g), L.fermentum(7 × 109 CFU/g), L.Gasseri(2 × 1010 CFU/g) and 38.5 mg of fructo-oligo-saccharides], or placebo for 6 weeks. Systolic and diastolic blood pressures (SBP and DBP, respectively), mean arterial blood pressure (MAP), atherogenic indices (the ratios of TC/HDL-C, LDL-C/HDL-C, and logTG/HDL-C), the 10-year Framingham CVD risk score, as well as total anti-oxidant capacity (TAC), paraoxonase (PON) and total oxidant status (TOS) were evaluated before and after the study. Final analyses were adjusted based on baseline parameters, and potential covariates including age, sex, PUFA and sodium intakes. Results Sixty participants completed the study. Compared with placebo, probiotic supplementation resulted in a significant decrease in SBP[-9.24 mmHg(− 14.5, − 3.9)], DBP[− 3.71 mmHg(− 6.59, − 0.83)], MAP[− 5.55 mmHg(− 8.8, − 2.31)], the Framingham risk categories [medium–low(1.5) vs. 2 (medium)] and logTG/HDL-C ratio [− 0.08 (− 0.14, 0)] (All P < 0.05) at the end of the study. No significant changes were observed in the antioxidant markers. Conclusion Overall, probiotic supplementation for 6 weeks led to a significant improvement in major CVD-related parameters in populations with T2DM, suggesting the possible beneficial role of probiotics in lowering the risk of future CVDs associated with diabetes. Nevertheless, more studies are needed to confirm the veracity of these results. Trial registration: IRCT2013100714925N1 (registered on November, 9th, 2013).

Several months have passed since the onset of the COVID-19 pandemic. Multiple characteristics have been proposed as prognostic factors so far. This study aims to provide evidence on the association of neutrophil-to-lymphocyte ratio (NLR) at the hospitalization time and three desired outcomes (mortality, prolonged hospitalization, and intensive care unit [ICU] admission). We designed a single-centre retrospective observational study in Baharloo Hospital (Tehran, Iran) from 20 February to 19 April 2020. Patients with confirmed COVID-19 diagnosis via rt-PCR or chest CT imaging were included. Demographic and clinical data were obtained. The sample was divided into three groups, using tertile boundaries of initial NLR. The differences in mortality, comorbidities, hospitalization duration, drug administration, and ICU admission between these three groups were investigated. The identified confounding factors were adjusted to calculate the odds ratio of death, ICU admission, and prolonged hospitalization. Nine hundred sixty-three patients were included. In total, 151 and 212 participants experienced mortality and ICU admission, respectively. In multivariate logistic regression models, the adjusted odds ratio for mortality event in the second and third tertile of initial NLR after full adjustment were 1.89 (95% CI:1.07-3.32) and 2.57 (95% CI:1.48-4.43) and for ICU admission were 1.85 (95% CI:1.14-3.01) and 2.88 (95% CI:1.79-4.61), respectively. The optimal cut-off value of the initial NLR for predicting mortality was 4.27. Initial NLR can predict mortality and ICU admission in COVID-19 patients. Further investigations for curating the calculated cut-off can propose initial NLR as an indicator of poor prognosis for COVID-19 patients.

The aim of the present study was to compare the effects of folinic acid chitosan hydrogel and botulinum toxin A on the wound repair of cleft lip surgery in rat animal models. Cleft lip defects were simulated by triangular incisions in the upper lip of 40 Wistar rats. Then, the rats were randomly assigned to four groups: control (CTRL), chitosan hydrogel (CHIT), and folinic acid chitosan hydrogel (FOLCHIT), in which the wounds were covered by a gauze pad soaked in normal saline, chitosan hydrogel, and folinic acid chitosan hydrogel, respectively for 5 min immediately after closure; and botulinum toxin A (BOT) with the injection of 3 units of botulinum toxin A in the wound region. Fibroblast proliferation, collagen deposition, inflammatory cell infiltration, neovascularization, and epithelial proliferation and each parameter were rated on days 14 and 28. Statistical analysis was performed by Kolmogorov-Smirnov test, Shapiro-Wilk test, Kruskal-Wallis, and post-hoc tests (α = 0.05). The mean score for fibroblast proliferation was significantly higher in the FOLCHIT group compared with the BOT group at days 14 and 28 (p < 0.001, p = 0.012, respectively). At day 28, collagen deposition was significantly higher in the FOLCHIT group compared with the BOT group (p = 0.012). No significant difference was observed between the inflammatory infiltration of the study groups at the two time points (p = 0.096 and p = 1.000, respectively). At day 14, vascular proliferation of group FOLCHIT was significantly higher than groups CTRL and CHIT (p = 0.001 and p = 0.006, respectively). The epithelial proliferation in the FOLCHIT group was significantly higher than groups CHIT and CTRL at day 14 (p = 0.006 and p = 0.001, respectively) and day 28 (p = 0.012). In simulated lip cleft defects, topical application of folinic acid induces faster initial regeneration by higher inflammation and cellular proliferation, at the expense of a higher tendency for scar formation by slightly higher fibroblast proliferation and collagen deposition. While injection of botulinum toxin A provides less fibroblast proliferation and collagen deposition, and thus lower potential for scar formation compared with the folinic acid group. Therefore, in wounds of the esthetic zone, such as cleft lip defects, the application of botulinum toxin A shows promising results.

Background.Henna has been used to combat various diseases and pathological conditions of the skin. This study aimed to determine the cooling and protecting effects of henna on prevention of decubitus ulcers in critical care units.Method.This is a randomized clinical trial. It was conducted on 80 patients hospitalized in intensive care units. Patients were randomly allocated into 2 groups of control and intervention (n = 40) by blocking method. For the intervention group, along with the standard prevention cares for decubitus ulcers, henna was applied with 15 cm extent on the patients’ sacrum.Results.At the end of the study, 1 patient in the intervention group (2.7% male) and 6 patients in the control group (14.29% male, 2.85% female) had developed decubitus ulcers; this difference was significant (P = .001).Conclusion.For every patient at risk of developing decubitus ulcers, application of henna as a preventive measure is recommended.