Objective: The purpose of this clinical trial was to examine the effect of omega-3 fatty acids (W-3 FAs), nanocurcumin and their combination on serum levels and gene expression of VCAM in patients with episodic migraine.Results: In this study, 80 patients were randomly divided in to 4 groups to receive for 2 months. Both serum levels and gene expression of VCAM showed remarkable decreases after single W-3 and after combined W-3 and nanocurcumin interventions. However, a borderline significant change and no remarkable change were observed after single nanocurcumin supplementation and in control group, respectively. While a significant difference between study groups in VCAM concentrations existed, there was no meaningful difference in VCAM gene expression among groups. It appears that the W-3 and combined W-3 and nanocurcumin can relieve VCAM serum level and its gene expression in patients with episodic migraine. Moreover, the combination of W-3 with nanocurcumin might cause more significant declines in VCAM level in the serum of migraine patients than when W-3 is administered alone.Trial Registration: This study was registered in Iranian Registry of Clinical Trials (IRCT) with ID number: NCT02532023.

Objective: The present study aimed to investigate the effects of nano-curcumin supplementation on adipokines levels and clinical signs in obese and overweight patients with migraine. Results: Forty-four patients with episodic migraine participated in this clinical trial and were divided into two groups nano-curcumin (80 mg/day) and the control group over 2-month period. At the baseline and the end of the research, the serum levels of MCP-1, Resistin, and Visfatin were measured using the ELISA method. In addition, the headache attack frequencies, severity, and duration of pain were recorded. The results of the present study showed that nano-curcumin can significantly reduce MCP-1 serum levels in the nano-curcumin supplemented group (P = 0.015, size effect = 13.4%). In the case of resistin and visfatin, nano-curcumin supplementation exerted no statistically significant changes in serum levels (P > 0.05). Nano-curcumin also significantly reduced the attack frequencies, severity, and duration of headaches (P < 0.05). These findings indicate that targeting curcumin can be a promising approach to migraine management. However, further comprehensive human trials are needed to confirm these findings. Trial Registration: This study was registered in the Iranian Registry of Clinical Trials (IRCT) with ID number: IRCT20160626028637N2 on the date 2020-07-10.

Rationale: Obesity is a global health concern, with intragastric balloon (IGB) placement serving as a nonsurgical intervention for weight management. However, intolerance due to severe gastrointestinal side effects often leads to premature removal, limiting its effectiveness. Botulinum toxin A (BTX-A) injection has been proposed as a potential strategy to improve IGB tolerance by modulating gastric motility. Patient concerns: This study reports a case series of patients who developed severe intolerance to IGB placement, including persistent nausea, vomiting, fluid intolerance, dehydration, and reduced urine output, necessitating medical intervention. Diagnoses: Patients were diagnosed with IGB intolerance due to obstructive gastric effects, characterized by impaired gastric emptying and intolerance to oral fluids, leading to dehydration and electrolyte imbalances. Interventions: A total of 14 patients with IGB intolerance were treated with 500 U of BTX-A injected around the pyloric canal. Prokinetic drugs were also administered to support gastric motility. Patients were monitored for 6 months following the intervention. Outcomes: Among the 14 patients, 11 (78.57%) showed a significant improvement in fluid tolerance within 12 hours of BTX-A injection and were able to retain the IGB without additional complications. Three patients (21.43%) did not improve and required early IGB removal. No major adverse effects related to BTX-A injection were observed. Lessons: BTX-A injection appears to be a promising adjunctive therapy to improve IGB tolerance in patients experiencing severe intolerance. These findings suggest a potential role for BTX-A in reducing the need for premature balloon removal, thereby enhancing weight loss outcomes. However, further randomized controlled trials with larger sample sizes are needed to confirm its efficacy, optimize dosage, and establish standardized treatment protocols.

Objective: The present study aimed to investigate the effects of nano-curcumin supplementation on adipokines levels and clinical signs in obese and overweight patients with migraine.Results: Forty-four patients with episodic migraine participated in this clinical trial and were divided into two groups as nano-curcumin (80 mg/day) and control group over a two-month period. At the baseline and the end of the research, the serum levels of MCP-1, Resistin and Visfatine were measured using ELISA method. In addition, the headache attack frequencies, severity and duration of pain were recorded. The results of the present study showed that nano-curcumin can significantly reduce MCP-1 serum levels in nano-curcumin supplemented group (P=0.015, size effect= 13.4%). In the case of resistin and visfatine, a greater reduction was found in nano-curcumin group but it was not statistically significant (P>0.05). Nano-curcumin also significantly reduced the attack frequencies, severity and duration of headaches (P<0.05). These findings indicate that targeting curcumin can be a promising approach to migraine management. However, further comprehensive human trials are needed to confirm these finding.Trial Registration: This study was registered in Iranian Registry of Clinical Trials (IRCT) with ID number: IRCT20160626028637N2.

Background: This systematic review and dose-response meta-analysis aimed to evaluate the association between serum vitamin D status and chronic kidney disease (CKD) progression. Methods: We searched PubMed, Scopus, Web of Science, and Embase for relevant observational and cohort studies published between 1990 and 2024. Eligible studies reported baseline vitamin D levels and CKD progression outcomes. We performed a random-effects meta-analysis to calculate the pooled odds ratio (OR) for CKD progression. A dose-response meta-analysis examined the relationship between serum 25-hydroxyvitamin D (25(OH)D) levels and risk, while subgroup analyses explored follow-up duration, study quality, and comorbid conditions. We assessed evidence certainty using the Grading of Recommendations Assessment, Development and Evaluation approach. Results: Eleven studies met the inclusion criteria. The pooled analysis suggested that vitamin D deficiency was associated with 33% higher odds of CKD progression (OR = 1.33, 95% confidence interval [CI]: 1.06–1.67; P = .019); however, between-study heterogeneity was considerable (I-squared heterogeneity statistic [ I ² ] = 98.2%). The pooled estimate should therefore be interpreted cautiously as an average association across heterogeneous studies. A dose-response analysis of 10 studies suggested higher odds of CKD progression per 10 ng/mL lower 25(OH)D concentration (OR = 1.18, 95% CI: 1.09–1.25), although its interpretation was limited by reconstructed category-level exposure values. Subgroup analyses showed stronger associations in studies with long-term follow-up (≥5 years; OR = 2.07, 95% CI: 1.29–3.14; P = .001) and high-quality studies (OR = 1.35, 95% CI: 1.06–1.69; P = .03). The Grading of Recommendations Assessment, Development and Evaluation assessment rated the certainty of evidence as very low for the overall association and low for the dose-response analysis, primarily because of the observational study designs and substantial between-study heterogeneity. Conclusion: Lower serum 25(OH)D levels were associated with higher odds of CKD progression. However, the observational nature of the evidence does not establish that routine screening or vitamin D supplementation can prevent renal function decline. Prospective studies and randomized trials are needed to clarify the clinical utility of vitamin D assessment and supplementation for renal outcomes.