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Comparison of Efficacy of Nortriptyline Versus Transcutaneous Electrical Nerve Stimulation on Painful Peripheral Neuropathy in Patients with Diabetes


Background and aims: Diabetic peripheral neuropathic pain (DPNP) is one of the most common complications of diabetes and is difficult to treat. Existing treatments are often inadequate at controlling pain and limited by side-effects and drug tolerance. This study assessed the efficacy of nortriptyline versus Transcutaneous Electrical Nerve Stimulation (TENS) in patients with DPNP.

Material and method: This is a randomized clinical trial study conducted on 39 patients with DPNP referring to Golestan Hospital in Ahvaz in 2017. Patients were randomly treated with TENS (18 sessions, each session 30 minutes; n=20) or nortriptyline (25 to 75 mg, once daily; n=19) for 6 weeks. Patients were evaluated for side effects and pain relief using visual analog scale (VAS).

Results: There was a significant improvement in pain with both treatments compared with baseline (p˂0.001). The patients in nortriptyline group experienced more pain relief (7.21±1.51 to 0.84±1.34) than the TENS group (7.6±1.47 to 2.75 ±2.43) (P=0.001). The 50% pain relief was observed in 14 patients (73%) in nortriptyline group, 6 patients (30%) in TENS group. Moreover, the side effects were seen in 15% of TENS and 55% of patients in nortriptyline groups (P=0.019).

Conclusion: Both TENS and nortriptyline were effective and safe in the management of DPNP. But nortriptyline showed a better performance on pain relief.

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Relationship between the night shift work and thyroid disorders: A systematic review and meta-analysis

, 340–343, 2008. Burdelak W, Bukowska A, Krysicka J, Peplonska B. Night work and health status of nurses and midwives. cross-sectional study. Med Pr 63, 517–529, 2012. Chang YS, Chen HL, Wu YH, Hsu CY, Liu CK, Hsu C. Rotating night shifts too quickly may cause anxiety and decreased attentional performance, and impact prolactin levels during the subsequent day: a case control study. BMC Psychiatry 14, 218, 2014. Fatourechi V. Upper limit of normal serum thyroid-stimulating hormone: a moving and now an aging target? J Clin Endocrinol Metab 92, 4560

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Nieimmunologiczny obrzęk płodu w wyniku talasemii alfa. Opis przypadku zdiagnozowanego i leczonego prenatalnie w Polsce

Śródziemnego, na Bliskim Wschodzie, w południowowschodniej Azji oraz w Indiach. Wraz z migracją ludności występowanie talasemii alfa zwiększyło swój zasięg do innych obszarów świata, w tym także Polski [ 1 , 2 ]. W przypadku stwierdzenia różnego stopnia mikrocytozy oraz hipochromii, przy prawidłowej gospodarce żelaza u pacjenta podejrzewa się talasemię. Badania biochemiczne, takie jak rozdział frakcji hemoglobin metodą jonowymiennej wysokociśnieniowej chromatografii cieczowej ( ion-exchange high-performance liquid chromatography – HPLC) lub elektroforeza kapilarna

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The prognostic value of mean platelet volume in cancer patients

a low MPV/PC ratio was an independent unfavorable predictive factor for OS [ 20 ]. Furthermore, in locally advanced (stage IIIA/B) inoperable NSCLC MPV, as well as PLT and ECOG performance score were found as the most significant independent factors affecting survival ( p < 0.001, p = 0.008, and, p = 0.034, respectively) [ 21 ]. Whereas, in epidermal growth factor receptor (EGFR) mutant lung adenocarcinoma, the MPV level not only influence prognosis but also predict the outcome of EGFR tyrosine kinase inhibitor (TKI) therapy. In this type of cancer, high MPV

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Optimization of Aerobic Exercise Protocols in Diabetes Mellitus: A Randomized Trial


Background and Aims: diabetes mellitus one of the non-communicable disorders which is spreading globally irrespective of nation being developed or developing. The aim of this study was to optimize the exercise protocols and to find the efficacy of these protocols on glucose control, balance, gait and proprioception in patients suffering from type 2 diabetes mellitus.

Material and Methods: 40 individuals with type 2 DM with age 35 to 60 were randomly allotted to four groups with 10 subjects in each. Cycle ergometer based aerobic exercises were given with duration of 20 or 30 minutes twice or thrice weekly for 6 weeks. Pre and post intervention was collected using Fullerton Advanced Balance scale for balance, spatiotemporal gait parameters for gait, Continuous passive motion for Proprioception and High Performance Liquid Chromatography in the laboratory.

Results: data was analysed using Design Expert software. Full factorial design was used to compare role of duration and frequency of exercise on each patient. The results showed significant effect of exercises on balance, gait, proprioception and glycated haemoglobin (HbA1c).

Conclusion: Aerobic exercises if given for 30 minutes and thrice weekly can show a significant improvement in complications in Diabetics.

Open access
The impact of arterial stiffness on cognitive status in elderly diabetic patients


With age, arteries become more rigid and pulse waves propagate faster. The pathogenic mechanisms that causes vascular stiffness in type 2 diabetes are complex but incompletely understood. An important element in the development of this phenomenon appears to be insulin resistance. One of the first line health problems that persist in the present is the failure to detect cardiovascular diseases in the preclinical stage which is important since more frequent cardiac events (myocardial infarction, sudden death) occur in people without obvious cardiovascular pathology in the medical history. One of the degenerative diseases with the greatest impact on the autonomy is dementia of elderly people. Recent studies have shown the association and even the possible involvement of cardiovascular risk factors and arterial stiffness in the pathogenesis of dementia and cognitive impairment. Although pulse wave velocity in the aorta is related to subclinical coronary atherosclerosis (being an important biomarker of cardiovascular risk in asymptomatic individuals), arterial stiffness is also a predictor of cognitive performance, cognitive decline or dementia.

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Assessment of Cardiac Autonomic Function by Post Exercise Heart Rate Recovery in Diabetics

vaccination on platelet activation and cardiac autonomic function. J Intern Med 269: 118-125, 2011. 13. Bruce RA, Pearson R, Lovejoy Jr. FW, Yu PNG, Brothers GB. Variability of respiratory and circulatory performance during standardized exercise. J Clin Invest 28: 1431–1438, 1949. 14. Watanabe J, Thamilarasan M, Blackstone EH, Thomas JD, Lauer MS. Heart rate recovery immediately after treadmill exercise and left ventricular systolic dysfunction as predictors of mortality: the case of stress echocardiography. Circulation 104: 1911-1916, 2001. 15

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Effect of Masticatory Forces Transmitted by Dental Implants on the Mandibular Bone of Patients with Type 2 Diabetes Mellitus

normal occlusion using FEA. Altair Technology Conference, India, 2013. 11. Boven GC, Raghoebar GM, Vissink A, Meijer HJ. Improving masticatory performance, bite force, nutritional state and patient's satisfaction with implant overdentures: a systematic review of the literature. J Oral Rehabil 42: 220-233, 2015. 12. Kaul AS, Goyal D. Bite force comparison of implant-retained mandibular overdentures with conventional complete dentures: an in vivo study. International Journal of Oral Implantology & Clinical Research 2: 140-144, 2011

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Evaluation of Cognitive Function in Patients with Type 2 Diabetes and Overt Hypothyroidism

–818, 2004. 10. Hogervorst E, Huppert F, Matthews FE, Brayne C. Thyroid function and cognitive decline in the MRC funded cognitive function and ageing study. Psychoneuroendocrinology 33: 1013–1022, 2008. 11. van Boxtel MPJ, Menheere PPCA, Bekers O, Hogervorst E, Jolles J. Thyroid function, depressed mood, and cognitive performance in older individuals: the Maastricht aging study. Psychoneuroendocrinology 29: 891–898, 2004. 12. Umegaki H. Type 2 diabetes as a risk factor for cognitive impairment: current insights. Clin Interv Aging 9: 1011

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The Influence of Weight Loss on Arterial Stiffness in Obese and Overweight Subjects

loss with or without exercise training on large artery compliance in healthy obese men. J Hypertens 17: 1831-1835, 1999. 12. Aucott L, Poobalan A, Smith WC, Avenell A, Jung R, Broom J. Effects of weight loss in overweight/obese individuals and long-term hypertension outcomes : A Systematic Review. Hypertension 45: 1035-1041, 2005. 13. Elobeid MA, Padilla MA, McVie T et al. Missing data in randomized clinical trials for weight loss: scope of the problem, state of the field, and performance of statistical methods. PLoS ONE 4: e

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