Abstract Overweight and obesity has increased in prevalence over the last two decades in many developed and developing countries including Iran. The aim of this present study was to compare the weight reduction effects of ketogenic and low calorie diets on overweight and obese Iranian children. Seventy-six overweight or obese children aged 9-16 years recruited from outpatient Ghaem Hospital, Nutritional Clinic, were randomized into two groups: a low calorie diet (n=38), a ketogenic diet (n=38). Both groups were treated for three months and followed up weekly. Fasting lipid profiles, blood sugar, uric acid, high-sensitivity C-reactive protein, , and weight were measured. Body fat percentages were measured using Bioimpedance Analysis (Tanita body composition analyzer, BC-418, Japan) for all subjects’ in each visit. Both ketogenic and low caloric diets reduced obesity indices including body fat percentage and improved lipid profiles (P0.05). However, low caloric diet had more potential beneficial effect on body fat percentage and lipid profile than ketogenic diet (P

Objective: To compare the changes in anti-malondialdehyde-modified low-density lipoprotein (MDA-LDL) IgG levels among patients undergoing off-pump and on-pump coronary artery bypass grafting (CABG) or valvuloplasty. Subjects and Methods: A total of 38, 39 and 34 patients who underwent off-pump CABG, on-pump CABG and valvuloplasty, respectively, were enrolled in this study. Serum anti-MDA-LDL IgG values were measured 24 h before and after the operative procedures and at discharge. Echocardiography was also done before surgery and before discharge. The results were compared with values from 50 healthy controls. Results: In all patients, a reduction in antibody titers was observed post-operatively. However, the decrease was significant only in the off-pump CABG - before surgery: 42.33 (25.83-58.51), after surgery: 30.86 (16.36-51.33) and at discharge: 10.96 (6.82-23.57; p = 0.027). There was a significant positive association between anti-MDA-LDL IgG levels and ejection fraction (r = 0.248, p = 0.036) and a negative association with E/E', a marker of pulmonary capillary wedge pressure, in the coronary patients (r = -0.345, p = 0.012), but no significant associations were found in patients with valvular heart disease. Conclusions: Serum anti-MDA-LDL IgG levels were associated with cardiac function indices in coronary patients undergoing CABG.

Introduction: Patients with cyanotic heart disease may have an acceptable quality of life. However, they are invariably prone to several complications. The aim of this study is search about hematologic abnormalities in cyanotic congenital heart disease patients. Materials and Methods: In this cross sectional study every cyanotic congenital heart disease patients who was referred to the adult congenital heart disease clinic was selected and asked of any possible hyperviscosity symptoms, gingival bleeding, Epistaxis, hemoptysis, hypermenorrhagia and gouty arthritis irrespective of their age, gender and primary diagnosis in a six-month period. In this regard, 02 saturation was obtained via pulse oximetry, an abdominal ultrasound was done in order to discover any gallstones and lab tests including CBC, coagulation parameters (bleeding time(BT),clotting time(CT), prothrombin time(PT),international ratio( INR), Ferritin, blood urea nitrogen (BUN) and creatinine (Cr) were provided as well. Results: A total of 69 patients were enrolled in the present study. The mean age of the patients was 22.44±5.72 with a minimum of 15 and the maximum of 46 years old. Twenty two (34.4%) of them were female and 45(65.6%) were male. Conclusion: Our patients had less hyperuricemia, there is no correlation between hyperviscosity symptoms and haematocrit level and an inverse correlation between the Ferritin level and hyperviscosity symptoms were seen.

Dyslipidemia is a leading risk factor for cardiovascular disease and is also a common feature of obesity. Curcumin is a bioactive phytochemical with well‐known antioxidant, anti‐inflammatory, and cardioprotective properties. The present study investigated the hypolipidemic activity of curcumin in obese individuals. Participants ( n = 30) were treated with curcuminoids (1 g/day), or placebo in a randomized, double‐blind, placebo‐controlled, crossover trial. Serum concentrations of total cholesterol, triglycerides, low‐density lipoprotein cholesterol and high‐density lipoprotein cholesterol, together with anthropometric parameters and high‐sensitivity C‐reactive protein were measured before and after each treatment period. Anthropometric parameters including weight, BMI, waist circumference, hip circumference, arm circumference, and body fat remained statistically unchanged by the end of trial ( p > 0.05). As for the lipid profile parameters, serum triglycerides were significantly reduced following curcumin supplementation ( p = 0.009). However, curcuminoids were not found to affect serum levels of total cholesterol, low‐density lipoprotein cholesterol, high‐density lipoprotein cholesterol, and high‐sensitivity C‐reactive protein ( p > 0.05). In summary, the findings of the present study indicated that curcuminoid supplementation (1 g/day for 30 days) leads to a significant reduction in serum triglycerides concentrations but do not have a significant influence on other lipid profile parameters as well as body mass index and body fat. Copyright © 2012 John Wiley & Sons, Ltd.

Cardiovascular disease (CVD) is a major cause of death in developed countries. Most cardiac rehabilitation programs include psychological interventions. The aim of this study was to determine the effectiveness of rehabilitation techniques in cardiac patients including psychological-physical interventions such as Meditation and Relaxation. We enrolled 45 patients with CVD and depression. The patients were allocated to 3 groups (Relaxation, Meditation and Control). There was a significant reduction on depression, systolic blood pressure and heart rate in the Meditation group compared with the control group. Our findings suggest that meditation techniques have better outcomes in cardiac patients for improving depression, reduction of systolic and diastolic blood pressure, and heart rate than relaxation techniques.

Each year, over a billion Muslims fast worldwide during the month of Ramadan. Through this religious practice, not only will one have spiritual growth, but can improve his/her diet, which is of pivotal importance in this month. Conversely, the available evidence regarding the health benefits of Ramadan fasting is scarce and highly contentious. Although Islam exempts patients from fasting, many of them fast conceivably and their clinical condition is prone to deteriorate. This is due to the persistent gap between current expert knowledge and conclusive, strong evidence regarding the pathophysiologic and metabolic alterations by fasting, and the consensus that healthcare professionals should reach, in order to manage various patient groups during this month. In this review, we summarize the results of our initial studies regarding the effects of Ramadan fasting on some clinical conditions including alterations of body composition. We also go through the important clinical results of patients who have had previous history of cardiovascular disease, type 2 diabetes, asthma and renal colic. Our studies have presented some evidence in favor of Ramadan fasting and encourage those with mentioned diseases to consult their physicians and follow medical and scientific recommendations. We attempt to present some relevant evidence clarify future scopes in this area of study, and provide suggestions for future investigations.

Background and aim of the study: Cardiopulmonary bypass (CPB) is used during on-pump coronary artery bypass grafting (CABG) and heart valvular replacement surgery, and is associated with the induction of oxidative stress. The aim of the study was to assess the association between indices of cardiac function and prooxidant-antioxidant balance (PAB) values in patients undergoing valve replacement surgery and on-or off-pump CABG.Methods: Data were obtained from 44, 33, and 41 patients undergoing off-pump CABG, on-pump CABG, and valve replacement surgery, respectively. The PAB values were measured 24 h before and after the operative procedure, and at the time of discharge. Echocardiography was performed before surgery and before discharge.Results: The changes in E/E', end-diastolic volume, end-systolic volume, left ventricular diastolic and systolic diameter were significantly related to baseline PAB values. In the valve replacement group, neither baseline nor changes in PAB values were associated with echocardiographic measurements. Also, neither off-pump nor on-pump CABG were significantly different in inducing oxidative stress (p = 0.596). When PAB values were measured in CABG patients, there was a significant difference in values between the three time points (p = 0.013). In the valve replacement group, PAB values were not significantly different between the preoperative and postoperative samples.Conclusion: The inverse association between the level of oxidative stress and cardiac function measurement may indicate that high levels of oxidative stress may be a predictor of the deterioration of cardiac function in CABG patients. However, in valvular heart disease patients the serum PAB value was not associated with changes in cardiac function. Levels of oxidative stress, as assessed by the PAB assay, were not significantly different for patients undergoing surgery with or without CPB.

BACKGROUND:Because of the conflicting results from previous studies regarding the efficacy of ginseng on lipid profile and anti-inflammatory and anti-proliferative activities of its components, we aimed to evaluate the effects of Panax ginseng on lipid profile, pro-oxidant - anti-oxidant status and high-sensitivity C reactive protein (hs-CRP) levels.METHODS:Forty Iranian hyperlipidemic patients were randomly assigned to placebo (n = 20) or control (n = 20) groups in this double-blind randomized controlled trial. The ginseng or placebo was taken two capsules twice a day for 8 weeks. Total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), fasting blood glucose, serum creatinine and hs-CRP levels and pro-oxidant - anti-oxidant balance (PAB) were estimated before and after intervention.RESULTS:There were no significant differences between the two groups with respect to changes in serum TG, LDL-C, HDL-C, and TC/HDL-C levels. Nor were there significant differences between the two groups with respect to changes in hs-CRP level and PAB from baseline to week 8.CONCLUSIONS:Our study demonstrates that ginseng does not have significant effects on lipid profile, Hs-CRP level and PAB. Further clinical studies, with a larger sample size, more prolonged period of therapy are needed to investigate the therapeutic effects of ginseng.

The relationship between serum anti-heat shock protein (Hsp)27 antibody and high sensitive C-reactive protein (hs-CRP) levels and indices of cardiac function were investigated in patients undergoing coronary artery bypass grafting (CABG) or heart valve replacement. The changes in anti-Hsp27 antibody titers and hs-CRP levels were compared among patients undergoing off-pump and on-pump CABG or valvular heart replacement. Fifty-three patients underwent off-pump, on-pump CABG, and heart valvular replacement in each group. Serum anti-Hsp27 titers and hs-CRP values were measured 24 h before and after the operation and at discharge. Echocardiography was performed before surgery and before discharge. The results were compared with values from 83 healthy controls. hs-CRP levels increased and anti-Hsp27 antibody decreased following surgery (P < 0.001 and P < 0.05, respectively), although these changes were independent of operative procedure (P = 0.361 and P = 0.120, respectively). Anti-Hsp27 antibody levels were higher at the time of discharge (P = 0.016). Only in coronary patients were anti-Hsp27 antibody levels negatively associated with E/E′ (r = −0.268, P = 0.022), a marker of pulmonary capillary wedge pressure. In conclusions, anti-Hsp27 antibody levels are associated with indices of cardiac function in coronary patients. Cardiopulmonary bypass had no significant effect on the induction of changes in anti-Hsp27 levels. Moreover, anti-Hsp27 antibody levels fell in all groups postoperatively; this may be due to the formation of immune complexes of antigen–antibody, and antibody levels were higher at the time of discharge.

Low-density lipoprotein (LDL), especially small dense LDL (sdLDL), plays a role in atherogenesis. We compared baseline sdLDL levels between healthy controls and patients with acute coronary syndrome (ACS). Blood samples were taken from patients diagnosed with myocardial infarction ([MI] n = 104) and unstable angina ([UA] n = 100). Both sdLDL and high-sensitivity C-reactive protein (hsCRP) levels were determined on admission and in the next 24 hours after the onset of symptoms. Baseline concentration of sdLDL was significantly higher in patients presenting with ACS than controls ( P < .05). In the 24 hours following ACS, the sdLDL levels decreased insignificantly in both groups of patients with ACS ( P > .05). The changes in sdLDL values were not significantly different between MI and UA participants ( P > .05). Patients with ACS have higher concentration of sdLDL compared with the controls.

We studied the immune responses to heat shock protein (Hsp)-27 and pro-oxidant–antioxidant balance (PAB) values in patients with valvular heart disease, but free of angiographically evident coronary artery disease (CAD). Patients who were candidates for valvuloplasty surgery and 30 healthy matched controls were recruited. The anti-Hsp-27 antibody titers were 0.35 ± 0.04 absorbency units (AU) in the valvuloplasty group, being significantly higher than for the controls (0.11 ± 0.02 AU; P < .05). The PAB values were significantly higher in cases (134.67 ± 13.69 Hamidi-Koliakos(HK) unit) when compared with controls (49.78 ± 6.75 HK unit; P < .05). In cases, the ejection fraction was inversely correlated with anti-Hsp-27 antibody (P < .05) but was not significantly related to PAB values (P > .05). Based on the echocardiographic findings, the patients had no evident heart failure, but the high levels of anti-Hsp-27 and PAB values in patients with valvular heart disease may indicate that these variables can be used as markers of heart failure. However, a longitudinal study is required to confirm this hypothesis.

Objectives: We studied the association between the prooxidant-antioxidant balance (PAB), anti-malondialdehyde-modified low-density lipoprotein (oxidized LDL, ox-LDL) IgG antibody and indices of cardiac function (systolic and diastolic function) in patients with coronary artery disease (CAD). Methods: Fifty-five patients with established CAD were selected, and serum levels of anti-ox-LDL IgG and PAB values were measured and compared with 40 matched healthy controls. Systolic and diastolic functions were determined for all patients. Results: PAB values were significantly higher in patients than in controls (p < 0.001), whilst serum anti-ox-LDL concentrations were not statistically different between the 2 groups (p = 0.821). However, after adjustment for high-density lipoprotein cholesterol, the patients had higher anti-ox-LDL levels (p = 0.04). Total PAB values were inversely associated with ejection fraction (r = –0.326, p = 0.031), but this was not the case for anti-ox-LDL in either group (p > 0.05). Conclusion: Serum concentrations of a marker of oxidative stress (PAB values) are inversely associated with cardiac function. PAB is a relatively simple index that could be incorporated into risk assessment in CAD patients. Anti-ox-LDL IgG antibody concentration does not appear to reflect total oxidative stress as assessed by PAB.

The cholesterol-lowering effect of Lactobacillus plantarum (L. plantarum) NCU116 on lipid metabolism of rats fed on a high fat diet was investigated. Sprague-Dawley rats were randomly divided into normal diet (ND) group, a high fat diet (HFD) group, HFD plus L. plantarum NCU116 groups with two different doses (NCU116-L, 108 colony forming units (CFU)/mL; NCU116-H, 109 CFU/mL). After treatment for 5 weeks, L. plantarum NCU116 had the potential ability to regulate lipid metabolism levels, morphology of liver and adipose tissues. In addition, the bacterium significantly improved gene expression of low-density lipoprotein (LDL) receptor and cholesterol 7α-hydroxylase (CYP7A1). These results suggest that L. plantarum NCU116 was able to alter lipid metabolism and reduce the cholesterol level, in particular, in the rats on a high fat diet through regulating gene expression of key factors relating to LDL receptor and CYP7A1.

Oxidative stress is thought to play an important role in atherogenesis. The statin group of cholesterol-lowering drugs have been shown to reduce cardiovascular events and possess antioxidant properties. We aimed to assess the effects of simvastatin on a novel measure of prooxidant-antioxidant balance (PAB) in dyslipidemic patients. The PAB assay can measure the prooxidant burden and the antioxidant capacity simultaneously in one assay, thereby giving a redox index. We treated 102 dyslipidemic individuals with simvastatin, or a placebo in a double-blind, cross-over, placebo-controlled trial. PAB values were measured before and after each treatment period. Seventy-seven subjects completed the study. We found that statin therapy was associated with a significant reduction in PAB values (P < 0.001). This effect appeared to be independent of the cholesterol-lowering effects of statins. We conclude that serum PAB values are decreased by simvastatin therapy. Regarding previous reports on the elevation of PAB in conditions associated with oxidative stress, the PAB assay, along with other markers of oxidative stress, may be applied to estimate the extent of oxidative stress in patients, assessment of the antioxidative efficacy of medication such as statins and perhaps also for the identification of those individuals who need antioxidant therapy.

Objective: This study aimed to evaluate the effects of statin therapy on serum levels of antibodies to several specific heat shock proteins (HSPs) in dyslipidemic patients.Design and methods: Participants (n = 102) were treated with simvastatin (40 mg/day), or placebo in a randomized, double-blind, placebo-controlled, cross-over trial. Anti-HSP60, 65, 70, and hs-CRP levels were measured before and after each treatment period. Seventy-seven subjects completed the study.Results: Treatment with simvastatin was associated with significant reductions in serum anti-HSP60, 65, and 70 titers in the dyslipidemic patients (10%, 14%, and 15% decrease, respectively) (p<0.001). There have been previous reports of reductions in serum CRP with statin treatment, and although median CRP levels were 9% lower on simvastatin treatment, this did not achieve statistical significance.Conclusion: While it is unclear whether HSP antibodies are directly involved in atherogenesis, our findings suggest that simvastatin inhibits autoimmune responses that may contribute to the development of cardiovascular disease. (C) 2010 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Objective: We have measured the pro-oxidant-antioxidant-balance (PAB) levels in patients with defined coronary artery disease (CAD) and compared them with concentrations in healthy subjects.Design and methods: Based on angiography results, 400 patients with stable CAD were divided into CAD- and CAD+, this being further subcategorized into groups with single-, double- and triple-vessel disease (VD).Results: The mean PAB values in the healthy subjects, was significantly lower than for other groups (P<0.001). In CAD patients, PAB levels were 123.2 +/- 43.9, which was not statistically different compared to groups with SVD, 2VD and 3VD (P>0.05). In the CAD+ group, PAB values in 1VD, 2VD and 3VD were not significantly different among patients with SVD, 2VD and 3VD (P>0.05).Conclusions: In conclusion, we found higher levels of oxidative stress in CAD+ patients compared to healthy subjects. The oxidation level was not related to measures of the extent of CAD such as number of stenosed vessels. (C) 2011 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.