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آنلاین اسپرت
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    4. مزایا و معایب داروهای کاهش وزن
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    مزایا و معایب داروهای کاهش وزن

    مزایا و معایب داروهای کاهش وزن

    داروهای کاهش وزن: جوانب مثبت و منفی پنج نسخه تأیید شده

     

     برای بیشتر مردم نسخه کاهش وزن بسیار ابتدایی است: کمتر بخورند و بیشتر تحرک داشته باشند. در سال های اخیر، داروهای بسیاری برای مبارزه با چاقی روانه بازار شده است. شکست جدید این گزینه ها در سرکوب کردن اشتها تا تحریک آن و با برجسته کردن وعده ها و خطرات این داروها در ژورنال انجمن پزشکی امریکا چاپ شده است.

     

    دکتر جیل جین، متخصص داخلی درگروه پزشکی نورث وسترن در شیکاگو، معتقد است که؛ هیچ کدام از این داروها توانایی جادو کردن را ندارند. تمام این داروها باید همراه با رژیم غذایی صحیح و ورزش همراه باشند. و اثرات این داروها در مقیاس ملایم هستند در مقایسه با روش های کاهش وزن دراماتیک که در افرادی که جراحی معده را گذرانده اند دیده می شود. اگرچه دکتر جین معتقد است این داروها برای برخی از بیماران مفید است.

     

    دکتر جین گفت: سودی در حد از دست دادن 5 تا 10 درصد از وزن بدن وجود دارد. می توانید تغییر در فشار خون، تغییر متوسط قند خون و کلسترول را ببینید.

     

    چه کسانی از داروهای کاهش وزن می توانند بهره ببرند؟

    داروهای کاهش وزن مناسب همه افراد نیستند. با توجه به دستورالعمل هایی که توسط انجمن غدد درون ریز در ژانویه 2015 منتشر شده، این داروها برای افرادی که در گروه افراد چاق طبقه بندی می شوند، مناسب است. بدین معنی که شاخص توده بدنی (BMI) این افراد 30 و یا بالاتر است. داروها برای افرادی که اضافه وزن کمی دارند ( با BMI 27 یا بیشتر) و کسانیکه که با وجود اضافه وزن سلامتی کامل دارند مفید است.

     

    دکتر جین عقیده دارد که فواید این داروها، کاهش وزن سریع تر نسبت به زمانیکه تنها رژیم غذایی و ورزش رعایت شود می باشد. این کاهش وزن سریع باعث می شود تا افراد سبک زندگی سالم را بهتر رعایت کنند. این داروها اثرات روانی بالایی دارند.

     

    این داروها تحت نظارت دقیق برای بیماران تجویز می شود. اگر آن ها طی سه ماه از مصرف این داروها حداقل 5 درصد از وزن خود را از دست ندهند، آن ها باید مصرف این داروها را قطع کنند. فواید کاهش وزن فقط تا زمانی ادامه دارد که داروها مصرف می شوند، بنابراین مصرف کنندگان داروهای کاهش وزن باید عادت های صحیح غذایی را در خود پرورش دهند.

     

    بر اساس گزارش انجمن غدد درون ریز؛ از آنجائیکه خطر مصرف دارو از رعایت رژیم غذایی و ورزش کردن بیشتر است، درمان دارویی تنها در بیمارانی به کار می رود که فواید استفاده از دارو، مضرات آن را توجیه کند.

     

    چه داروهایی در دسترس هستند؟

    از آنجایی که بیماری چاقی رواج زیادی یافته است، شرکت های داروسازی به دنبال داروهایی برای کاهش چاقی هستند. با این حال، فقط پنج دارو ( ویا ترکیب دارویی) توسط سازمان غذا و دارو برای درمان طولانی مدت چاقی تأیید شده است. در اینجا خلاصه مختصری از هر کدام بیان می شود.

     

     

    قرص ارلیستات

     

     

     در حال حاضر بدون نسخه در دسترس است. ارلیستات جزء اولین داروهای معرفی شده برای کاهش وزن است. این دارو اولین بار درسال 1999 از سازمان غذا و دارو برای فروش با نسخه، مجوز گرفت. سپس در سال 2007 فروش بدون نسخه این دارو تأیید شد. دارو با نام تجاری زنیکال (Xenical) با نسخه و با برند Alli به عنوان داروی بدون نسخه به فروش می رسد.

     

    براساس سازمان غذا و دارو، قرص ارلیستات همراه با رعایت رژیم غذایی کم کالری و کم چربی به کاهش وزن کمک می کند. دارو مهار کننده لیپاز است، به این معنی که این دارو مانع از عمل آنزیم های پانکراس که لیپاز نامیده می شوند، می گردد. این آنزیم ها چربی ها را در روده کوچک تجزیه می کنند. بنابراین مصرف قرص ارلیستات با هر وعده غذایی مانع از جذب تمام چربی ها از مواد غذایی به بدن می شود.

     

    مهمترین اثر جانبی قرص ارلیستات، مرتبط با چربی اضافه ای است که به جای جذب شدن دفع می شود و عبارتست از: مدفوع روغنی شکل، بی اختیاری مدفوع، تکرر اجابت مزاج و نفخ شکم می باشد. همچنین گزارش هایی از آسیب کبدی شدید در سال 2010 در دوازده نفر از افرادی که ارلیستات مصرف می کرده اند منتشر شده است. هرچند این امر توسط سازمان غذا و دارو تأیید نشده است. افرادی که این دارو را مصرف می کنند علائم بد عمل کردن کبد مانند چشم یا پوست زرد، خارش، کاهش اشتها، ادرار قهوه ای یا مدفوع زرد را مشاهده می کنند.

     

    تحقیقاتی که در سال 2004 در مجله Obesity Reviews منتشر شد نشان داد که مصرف ارلیستات در کاهش وزن افراد چاق مؤثر است. اما موجب ناراحتی بیشتر دستگاه گوارش نسبت به دارونما (چیزی ظاهراً شبیه به دارو بدون هیچ اثر واقعی) می شود. اگرچه کاهش وزن احتمالا کم خواهد بود. بر طبق گزارش Mayo Clinic با یک بررسی در سال 2014 دریافتند که افرادی که رژیم گرفتند و ورزش کردند، و قرص ارلیستات را برای حداقل یک سال مصرف کردند، 5.5 پوند ( 2.5 کیلوگرم) بیشتر از میانگین کسانیکه تنها رژیم گرفتند و ورزش کردند، وزن از دست دادند.

     

     

    لورکاسرین

     

     

     این دارو با اثر بر گیرنده سروتونین در مغز با ایجاد احساس سیری، مصرف کنندگان را به خوردن غذای کمتر تشویق می کند. این دارو در سال 2012 تأیید شده است و اولین دارویی است که بعد از قرص لاغری ارلیستات تأییدیه سازمان غذا و دارو را دریافت کرده است.

     

    بر اساس سازمان غذا و دارو، این دارو ( ترکیب با ورزش و رژیم) باعث کاهش وزن میانگین 3 تا 3.7 بیشتر از دارونماها می شود. در بیمارانی که دیابت نوع 2 ندارند، 38 درصد از مصرف کنندگان، 5 درصد و یا بیشتر از وزن بدن خود را از دست دادند. که این امر استاندارد بالینی برای درمان چاقی موفق است. 23 درصد از  بیمارانی که ورزش و رژیم تنها را رعایت کرده اند به این سطح از کاهش وزن رسیدند.

     

    از انجاییکه لورکاسرین بر گیرنده های سروتونین اثر می گذارد، می تواند در کنار دیگر داروهای که با این هدف مصرف می شوند، مانند مهارکننده های انتخابی سروتونین (SSRI ها) که برای درمان افسردگی به کار می روند، استفاده گردد. لورکاسرین برای مصرف زنان باردار تأیید نشده است و ممکن است عوارض جانبی مثل خواب آلودگی، سردرد و یبوست به همراه داشته باشد. تحت نام تجاری Belviq، لورکاسرین باید خوراکی و دوبار در روز مصرف شود.

     

     

    فنترمین + توپیرامات

     

    در سال 2012 تأییدیه گرفته اند. این داروی ترکیبی با نام تجاری کسیمیا ( Qsymia ) به فروش می رسد. قرص فنترمین یک محرک است که اشتها را کاهش می دهد. توپیرامات داروی ضد تشنج و میگرن است همچنین اشتها را کم می کند و احساس سیری به وجود می آورد.

    این داروی ترکیبی با عث نقص مادرزادی شکاف کام در جنین می شود. بنابراین زنانی که در سنین باروری این دارو را مصرف می کنند باید از راه های جلوگیری از بارداری استفاده کرده و هر ماه تست بارداری را انجام دهند. دیگر عوارض جانبی نادر اما خطرناک این دارو ایجاد افکار خودکشی است. بر اساس گزارش موسسه ملی بهداشت، در حدور 1 در 500 نفر از کسانیکه داروهای ضد تشنج مانند توپیرامات را مصرف می کنند رفتار یا افکار خودکشی نشان داده اند.

    مانند دیگر داروهای تأیید شده، داروی ترکیبی فن ترمین + توپیرامات باید با رژیم و ورزش منظم مصرف شود. در بررسی بالینی، بیمارانی که این دارو را مصرف کرده اند 9 درصد از وزن بدنشان را از دست داده اند در مقایسه با 1.5 درصد وزنی که بیماران استفاده کننده از دارو نماها از دست داده اند.

     

     

    بوپروپیون + نالترکسون

     

     

     بوپروپیون + نالترکسون با نام تجاری Contrave فروخته می شود. این داروی ترکیبی اولین بار در سال 2011 در کانون توجه قرار گرفت. این دارو توسط سازمان غذا و دارو به علت نگرانی هایی که در مورد عوارض طولانی مدت آن بر روی قلب و سیستم قلبی و عروقی وجود داشت، رد شد. اگرچه در سال 2014 مجوز Contrave صادر شد با این اخطار که این دارو برای اطمینان از نداشتن عوارض قلبی عروقی تحت بررسی دقیق خواهد بود.

    این دارو هشدار جعبه سیاه سازمان غذا و دارو ( دقیقترین برچسب هشدار سازمان غذا و دارو) را دارد. زیرا بوپروپیون افکار خودکشی را در فرد افزایش می دهد. این دارو قبلا برای ترک سیگار و کمک به درمان افسردگی تأیید شده بود. نالترکسون برای درمان اعتیاد به الکل و مواد مخدر به کار می رود. پزشکان کاملا مطمئن نیستند که این ترکیب دارویی با چه مکانیزمی در کاهش وزن مؤثر است. با توجه به مقاله سال 2011 در مجله داروسازی و درمان، نقطه اثر این دارو احتمالاً هیپوتالاموس است.

    در آزمایشی، 42 درصد بیماران بدون دیابت نوع 2، که این دارو را  همراه با رژیم و ورزش منظم مصرف کردند، حداقل 5 درصد از وزن بدن خود را از دست دادند. کسانیکه فقط ورزش کردند و رژیم گرفتند موفقیت کمتری داشتند و فقط 17 درصد آن ها 5 درصد و یا بیشتر از وزن خود را از دست دادند.

     

     

    لیراگلوتاید

     

     

     این دارو اولین بار در سال 2010 و برای درمان دیابت نوع 2 تأیید شد. این دارو تولید انسولین در پانکراس را تحریک می کرد. در دسامبر 2014، آژانس مصرف دارو را برای درمان چاقی گسترش داد. به عنوان  Saxenda فروخته شد. این نسخه از دارو دارای دوز بالاتری بود نسبت به زمانی که برای درمان دیابت به کار می رفت. بر خلاف دیگر داروهای تأییدی سازمان غذا و دارو که در بالا به آن ها اشاره شد، این دارو یکبار در روز باید تزریق شود.

    بر اساس سازمان غذا و دارو، 62 درصد افرادی که Saxenda را دریافت کردند، در تست بالینی 5 درصد و یا بیشتر از وزن خود را از دست دادند. در مقایسه با 34 درصدی که دارونما مصرف می کردند. این دارو همچنین دارای اخطار جعبه سیاه است. زیرا با مطالعه بر موش ها، نشان داده شد احتمال ایجاد تومورهای تیروئید با مصرف این دارو وجود دارد. هنوز ناشناخته است که آیا لیراگلوتاید همان اثر را در بدن انسان دارد. اما افراد با داشتن سابقه خانوادگی ابتلا به سرطان های خاص نباید دارو را مصرف کنند.

    بسیاری از بیماران درباره دارو های کاهش وزن می پرسند. بسیاری از مردم شرایط استفاده از این داروها را ندارند. یا به این علت اینکه آن ها اضافه وزن بالایی ندارند، یا به دلیل سایر بیماری ها که داروهای دیگری مصرف می کنند که مصرف داروی کاهش وزن را خطرناک می کند.

    برخی دیگر افراد متعهد به تغییر سبک زندگی خود که مستلزم مصرف این داروها است، نیستند. تنها نامزدهای ایده ال برای مصرف این داروها افرادی هستند که افرادی که بسیار با انگیزه هستند، متهد به تغییر سبک زندگی خود هستند.

     

     

     

    ترجمه شده توسط تیم Osport

    استفاده از این مطلب با ذکر منبع بلا مانع است.

    منبع: سایت www.livescience.com

     

     

     

     

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    22:43:39.9554
    [info]
    Service "Comment" is loaded
    22:43:39.9781
    [info]
    Translation "module/comment:default.fa" is loaded.
    22:43:39.9959
    [info]
    Service "Editor" is loaded
    22:43:40.0105
    [info]
    Route: front:news-story-index.
    debug
    profiler
    22:43:39.6192
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    db
    22:43:39.7398
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    [0.0010]
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    22:43:39.7841
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    params: [where1] front;[where2] news;[where3] module-access;[where4] guest;[limit] 1;
    22:43:39.7876
    [0.0010]
    query: SELECT `news_story`.`id` AS `id`, `news_story`.`title` AS `title`, `news_story`.`subtitle` AS `subtitle`, `news_story`.`slug` AS `slug`, `news_story`.`topic` AS `topic`, `news_story`.`topic_main` AS `topic_main`, `news_story`.`author` AS `author`, `news_story`.`text_summary` AS `text_summary`, `news_story`.`text_description` AS `text_description`, `news_story`.`text_html` AS `text_html`, `news_story`.`seo_title` AS `seo_title`, `news_story`.`seo_keywords` AS `seo_keywords`, `news_story`.`seo_description` AS `seo_description`, `news_story`.`important` AS `important`, `news_story`.`status` AS `status`, `news_story`.`time_create` AS `time_create`, `news_story`.`time_update` AS `time_update`, `news_story`.`time_publish` AS `time_publish`, `news_story`.`uid` AS `uid`, `news_story`.`hits` AS `hits`, `news_story`.`image` AS `image`, `news_story`.`path` AS `path`, `news_story`.`cropping` AS `cropping`, `news_story`.`main_image` AS `main_image`, `news_story`.`additional_images` AS `additional_images`, `news_story`.`point` AS `point`, `news_story`.`count` AS `count`, `news_story`.`favourite` AS `favourite`, `news_story`.`attach` AS `attach`, `news_story`.`attribute` AS `attribute`, `news_story`.`type` AS `type` FROM `news_story` WHERE `slug` = :where1
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    22:43:39.7991
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    query: SELECT `media_doc`.`id` AS `id`, `media_doc`.`path` AS `path`, `media_doc`.`filename` AS `filename`, `media_doc`.`attributes` AS `attributes`, `media_doc`.`mimetype` AS `mimetype`, `media_doc`.`title` AS `title`, `media_doc`.`description` AS `description`, `media_doc`.`active` AS `active`, `media_doc`.`time_created` AS `time_created`, `media_doc`.`time_updated` AS `time_updated`, `media_doc`.`time_deleted` AS `time_deleted`, `media_doc`.`appkey` AS `appkey`, `media_doc`.`uid` AS `uid`, `media_doc`.`count` AS `count`, `media_doc`.`season` AS `season`, `media_doc`.`updated_by` AS `updated_by`, `media_doc`.`license_type` AS `license_type`, `media_doc`.`copyright` AS `copyright`, `media_doc`.`geoloc_latitude` AS `geoloc_latitude`, `media_doc`.`geoloc_longitude` AS `geoloc_longitude`, `media_doc`.`cropping` AS `cropping`, `media_doc`.`featured` AS `featured` FROM `media_doc` WHERE `id` = :where1
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    22:43:39.8007
    [0.0005]
    query: UPDATE `news_story` SET `hits` = hits+ 1 WHERE `id` = :where1
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    22:43:39.8017
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    [0.0004]
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    22:43:39.806
    [0.0018]
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    22:43:39.8095
    [0.0010]
    query: SELECT DISTINCT story AS `story` FROM `news_link` WHERE `status` = :where1 AND story != :where2 AND time_publish <= :where3 AND `topic` = :where4 AND `type` IN (:where5, :where6, :where7, :where8, :where9, :where10, :where11) ORDER BY `time_publish` DESC, `id` DESC LIMIT :limit
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    22:43:39.8109
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    22:43:39.813
    [0.0004]
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    22:43:39.8141
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    22:43:39.8152
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    22:43:39.8186
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    22:43:39.8222
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    22:43:39.8234
    [0.0004]
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    22:43:39.8249
    [0.0004]
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    22:43:39.826
    [0.0004]
    query: SELECT `media_doc`.`id` AS `id`, `media_doc`.`path` AS `path`, `media_doc`.`filename` AS `filename`, `media_doc`.`attributes` AS `attributes`, `media_doc`.`mimetype` AS `mimetype`, `media_doc`.`title` AS `title`, `media_doc`.`description` AS `description`, `media_doc`.`active` AS `active`, `media_doc`.`time_created` AS `time_created`, `media_doc`.`time_updated` AS `time_updated`, `media_doc`.`time_deleted` AS `time_deleted`, `media_doc`.`appkey` AS `appkey`, `media_doc`.`uid` AS `uid`, `media_doc`.`count` AS `count`, `media_doc`.`season` AS `season`, `media_doc`.`updated_by` AS `updated_by`, `media_doc`.`license_type` AS `license_type`, `media_doc`.`copyright` AS `copyright`, `media_doc`.`geoloc_latitude` AS `geoloc_latitude`, `media_doc`.`geoloc_longitude` AS `geoloc_longitude`, `media_doc`.`cropping` AS `cropping`, `media_doc`.`featured` AS `featured` FROM `media_doc` WHERE `id` = :where1
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    22:43:39.827
    [0.0003]
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    22:43:39.8284
    [0.0003]
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    22:43:39.8294
    [0.0003]
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    22:43:39.8305
    [0.0003]
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    22:43:39.8319
    [0.0004]
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    22:43:39.833
    [0.0004]
    query: SELECT `media_doc`.`id` AS `id`, `media_doc`.`path` AS `path`, `media_doc`.`filename` AS `filename`, `media_doc`.`attributes` AS `attributes`, `media_doc`.`mimetype` AS `mimetype`, `media_doc`.`title` AS `title`, `media_doc`.`description` AS `description`, `media_doc`.`active` AS `active`, `media_doc`.`time_created` AS `time_created`, `media_doc`.`time_updated` AS `time_updated`, `media_doc`.`time_deleted` AS `time_deleted`, `media_doc`.`appkey` AS `appkey`, `media_doc`.`uid` AS `uid`, `media_doc`.`count` AS `count`, `media_doc`.`season` AS `season`, `media_doc`.`updated_by` AS `updated_by`, `media_doc`.`license_type` AS `license_type`, `media_doc`.`copyright` AS `copyright`, `media_doc`.`geoloc_latitude` AS `geoloc_latitude`, `media_doc`.`geoloc_longitude` AS `geoloc_longitude`, `media_doc`.`cropping` AS `cropping`, `media_doc`.`featured` AS `featured` FROM `media_doc` WHERE `id` = :where1
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    22:43:39.8341
    [0.0005]
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    22:43:39.8356
    [0.0003]
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    22:43:39.8367
    [0.0003]
    query: SELECT `media_doc`.`id` AS `id`, `media_doc`.`path` AS `path`, `media_doc`.`filename` AS `filename`, `media_doc`.`attributes` AS `attributes`, `media_doc`.`mimetype` AS `mimetype`, `media_doc`.`title` AS `title`, `media_doc`.`description` AS `description`, `media_doc`.`active` AS `active`, `media_doc`.`time_created` AS `time_created`, `media_doc`.`time_updated` AS `time_updated`, `media_doc`.`time_deleted` AS `time_deleted`, `media_doc`.`appkey` AS `appkey`, `media_doc`.`uid` AS `uid`, `media_doc`.`count` AS `count`, `media_doc`.`season` AS `season`, `media_doc`.`updated_by` AS `updated_by`, `media_doc`.`license_type` AS `license_type`, `media_doc`.`copyright` AS `copyright`, `media_doc`.`geoloc_latitude` AS `geoloc_latitude`, `media_doc`.`geoloc_longitude` AS `geoloc_longitude`, `media_doc`.`cropping` AS `cropping`, `media_doc`.`featured` AS `featured` FROM `media_doc` WHERE `id` = :where1
    params: [where1] 1507;
    22:43:39.8377
    [0.0003]
    query: SELECT `media_doc`.`id` AS `id`, `media_doc`.`path` AS `path`, `media_doc`.`filename` AS `filename`, `media_doc`.`attributes` AS `attributes`, `media_doc`.`mimetype` AS `mimetype`, `media_doc`.`title` AS `title`, `media_doc`.`description` AS `description`, `media_doc`.`active` AS `active`, `media_doc`.`time_created` AS `time_created`, `media_doc`.`time_updated` AS `time_updated`, `media_doc`.`time_deleted` AS `time_deleted`, `media_doc`.`appkey` AS `appkey`, `media_doc`.`uid` AS `uid`, `media_doc`.`count` AS `count`, `media_doc`.`season` AS `season`, `media_doc`.`updated_by` AS `updated_by`, `media_doc`.`license_type` AS `license_type`, `media_doc`.`copyright` AS `copyright`, `media_doc`.`geoloc_latitude` AS `geoloc_latitude`, `media_doc`.`geoloc_longitude` AS `geoloc_longitude`, `media_doc`.`cropping` AS `cropping`, `media_doc`.`featured` AS `featured` FROM `media_doc` WHERE `id` = :where1
    params: [where1] 1507;
    22:43:39.8391
    [0.0004]
    query: SELECT `media_doc`.`id` AS `id`, `media_doc`.`path` AS `path`, `media_doc`.`filename` AS `filename`, `media_doc`.`attributes` AS `attributes`, `media_doc`.`mimetype` AS `mimetype`, `media_doc`.`title` AS `title`, `media_doc`.`description` AS `description`, `media_doc`.`active` AS `active`, `media_doc`.`time_created` AS `time_created`, `media_doc`.`time_updated` AS `time_updated`, `media_doc`.`time_deleted` AS `time_deleted`, `media_doc`.`appkey` AS `appkey`, `media_doc`.`uid` AS `uid`, `media_doc`.`count` AS `count`, `media_doc`.`season` AS `season`, `media_doc`.`updated_by` AS `updated_by`, `media_doc`.`license_type` AS `license_type`, `media_doc`.`copyright` AS `copyright`, `media_doc`.`geoloc_latitude` AS `geoloc_latitude`, `media_doc`.`geoloc_longitude` AS `geoloc_longitude`, `media_doc`.`cropping` AS `cropping`, `media_doc`.`featured` AS `featured` FROM `media_doc` WHERE `id` = :where1
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    22:43:39.8402
    [0.0004]
    query: SELECT `media_doc`.`id` AS `id`, `media_doc`.`path` AS `path`, `media_doc`.`filename` AS `filename`, `media_doc`.`attributes` AS `attributes`, `media_doc`.`mimetype` AS `mimetype`, `media_doc`.`title` AS `title`, `media_doc`.`description` AS `description`, `media_doc`.`active` AS `active`, `media_doc`.`time_created` AS `time_created`, `media_doc`.`time_updated` AS `time_updated`, `media_doc`.`time_deleted` AS `time_deleted`, `media_doc`.`appkey` AS `appkey`, `media_doc`.`uid` AS `uid`, `media_doc`.`count` AS `count`, `media_doc`.`season` AS `season`, `media_doc`.`updated_by` AS `updated_by`, `media_doc`.`license_type` AS `license_type`, `media_doc`.`copyright` AS `copyright`, `media_doc`.`geoloc_latitude` AS `geoloc_latitude`, `media_doc`.`geoloc_longitude` AS `geoloc_longitude`, `media_doc`.`cropping` AS `cropping`, `media_doc`.`featured` AS `featured` FROM `media_doc` WHERE `id` = :where1
    params: [where1] 1481;
    22:43:39.8412
    [0.0004]
    query: SELECT `media_doc`.`id` AS `id`, `media_doc`.`path` AS `path`, `media_doc`.`filename` AS `filename`, `media_doc`.`attributes` AS `attributes`, `media_doc`.`mimetype` AS `mimetype`, `media_doc`.`title` AS `title`, `media_doc`.`description` AS `description`, `media_doc`.`active` AS `active`, `media_doc`.`time_created` AS `time_created`, `media_doc`.`time_updated` AS `time_updated`, `media_doc`.`time_deleted` AS `time_deleted`, `media_doc`.`appkey` AS `appkey`, `media_doc`.`uid` AS `uid`, `media_doc`.`count` AS `count`, `media_doc`.`season` AS `season`, `media_doc`.`updated_by` AS `updated_by`, `media_doc`.`license_type` AS `license_type`, `media_doc`.`copyright` AS `copyright`, `media_doc`.`geoloc_latitude` AS `geoloc_latitude`, `media_doc`.`geoloc_longitude` AS `geoloc_longitude`, `media_doc`.`cropping` AS `cropping`, `media_doc`.`featured` AS `featured` FROM `media_doc` WHERE `id` = :where1
    params: [where1] 1481;
    22:43:39.8436
    [0.0008]
    query: SELECT `media_doc`.`id` AS `id`, `media_doc`.`path` AS `path`, `media_doc`.`filename` AS `filename`, `media_doc`.`attributes` AS `attributes`, `media_doc`.`mimetype` AS `mimetype`, `media_doc`.`title` AS `title`, `media_doc`.`description` AS `description`, `media_doc`.`active` AS `active`, `media_doc`.`time_created` AS `time_created`, `media_doc`.`time_updated` AS `time_updated`, `media_doc`.`time_deleted` AS `time_deleted`, `media_doc`.`appkey` AS `appkey`, `media_doc`.`uid` AS `uid`, `media_doc`.`count` AS `count`, `media_doc`.`season` AS `season`, `media_doc`.`updated_by` AS `updated_by`, `media_doc`.`license_type` AS `license_type`, `media_doc`.`copyright` AS `copyright`, `media_doc`.`geoloc_latitude` AS `geoloc_latitude`, `media_doc`.`geoloc_longitude` AS `geoloc_longitude`, `media_doc`.`cropping` AS `cropping`, `media_doc`.`featured` AS `featured` FROM `media_doc` WHERE `id` = :where1
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    22:43:39.8456
    [0.0006]
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    22:43:39.8468
    [0.0003]
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    22:43:39.8485
    [0.0005]
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    22:43:39.8497
    [0.0004]
    query: SELECT `media_doc`.`id` AS `id`, `media_doc`.`path` AS `path`, `media_doc`.`filename` AS `filename`, `media_doc`.`attributes` AS `attributes`, `media_doc`.`mimetype` AS `mimetype`, `media_doc`.`title` AS `title`, `media_doc`.`description` AS `description`, `media_doc`.`active` AS `active`, `media_doc`.`time_created` AS `time_created`, `media_doc`.`time_updated` AS `time_updated`, `media_doc`.`time_deleted` AS `time_deleted`, `media_doc`.`appkey` AS `appkey`, `media_doc`.`uid` AS `uid`, `media_doc`.`count` AS `count`, `media_doc`.`season` AS `season`, `media_doc`.`updated_by` AS `updated_by`, `media_doc`.`license_type` AS `license_type`, `media_doc`.`copyright` AS `copyright`, `media_doc`.`geoloc_latitude` AS `geoloc_latitude`, `media_doc`.`geoloc_longitude` AS `geoloc_longitude`, `media_doc`.`cropping` AS `cropping`, `media_doc`.`featured` AS `featured` FROM `media_doc` WHERE `id` = :where1
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    22:43:39.8508
    [0.0004]
    query: SELECT `media_doc`.`id` AS `id`, `media_doc`.`path` AS `path`, `media_doc`.`filename` AS `filename`, `media_doc`.`attributes` AS `attributes`, `media_doc`.`mimetype` AS `mimetype`, `media_doc`.`title` AS `title`, `media_doc`.`description` AS `description`, `media_doc`.`active` AS `active`, `media_doc`.`time_created` AS `time_created`, `media_doc`.`time_updated` AS `time_updated`, `media_doc`.`time_deleted` AS `time_deleted`, `media_doc`.`appkey` AS `appkey`, `media_doc`.`uid` AS `uid`, `media_doc`.`count` AS `count`, `media_doc`.`season` AS `season`, `media_doc`.`updated_by` AS `updated_by`, `media_doc`.`license_type` AS `license_type`, `media_doc`.`copyright` AS `copyright`, `media_doc`.`geoloc_latitude` AS `geoloc_latitude`, `media_doc`.`geoloc_longitude` AS `geoloc_longitude`, `media_doc`.`cropping` AS `cropping`, `media_doc`.`featured` AS `featured` FROM `media_doc` WHERE `id` = :where1
    params: [where1] 1212;
    22:43:39.8531
    [0.0006]
    query: SELECT `favourite_list`.* FROM `favourite_list` WHERE `uid` = :where1 AND `item` = :where2 AND `table` = :where3 AND `module` = :where4
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    query: SELECT `favourite_list`.* FROM `favourite_list` WHERE `item` = :where1 AND `table` = :where2 AND `module` = :where3 ORDER BY `id` DESC, `time_create` DESC
    params: [where1] 515;[where2] story;[where3] news;
    22:43:39.8613
    [0.0008]
    query: SELECT `media_doc`.`id` AS `id`, `media_doc`.`path` AS `path`, `media_doc`.`filename` AS `filename`, `media_doc`.`attributes` AS `attributes`, `media_doc`.`mimetype` AS `mimetype`, `media_doc`.`title` AS `title`, `media_doc`.`description` AS `description`, `media_doc`.`active` AS `active`, `media_doc`.`time_created` AS `time_created`, `media_doc`.`time_updated` AS `time_updated`, `media_doc`.`time_deleted` AS `time_deleted`, `media_doc`.`appkey` AS `appkey`, `media_doc`.`uid` AS `uid`, `media_doc`.`count` AS `count`, `media_doc`.`season` AS `season`, `media_doc`.`updated_by` AS `updated_by`, `media_doc`.`license_type` AS `license_type`, `media_doc`.`copyright` AS `copyright`, `media_doc`.`geoloc_latitude` AS `geoloc_latitude`, `media_doc`.`geoloc_longitude` AS `geoloc_longitude`, `media_doc`.`cropping` AS `cropping`, `media_doc`.`featured` AS `featured` FROM `media_doc` WHERE `id` = :where1
    params: [where1] 1041;
    22:43:39.8689
    [0.0010]
    query: SELECT `media_doc`.`id` AS `id`, `media_doc`.`path` AS `path`, `media_doc`.`filename` AS `filename`, `media_doc`.`attributes` AS `attributes`, `media_doc`.`mimetype` AS `mimetype`, `media_doc`.`title` AS `title`, `media_doc`.`description` AS `description`, `media_doc`.`active` AS `active`, `media_doc`.`time_created` AS `time_created`, `media_doc`.`time_updated` AS `time_updated`, `media_doc`.`time_deleted` AS `time_deleted`, `media_doc`.`appkey` AS `appkey`, `media_doc`.`uid` AS `uid`, `media_doc`.`count` AS `count`, `media_doc`.`season` AS `season`, `media_doc`.`updated_by` AS `updated_by`, `media_doc`.`license_type` AS `license_type`, `media_doc`.`copyright` AS `copyright`, `media_doc`.`geoloc_latitude` AS `geoloc_latitude`, `media_doc`.`geoloc_longitude` AS `geoloc_longitude`, `media_doc`.`cropping` AS `cropping`, `media_doc`.`featured` AS `featured` FROM `media_doc` WHERE `id` = :where1
    params: [where1] 1041;
    22:43:39.8729
    [0.0010]
    query: SELECT `media_doc`.`id` AS `id`, `media_doc`.`path` AS `path`, `media_doc`.`filename` AS `filename`, `media_doc`.`attributes` AS `attributes`, `media_doc`.`mimetype` AS `mimetype`, `media_doc`.`title` AS `title`, `media_doc`.`description` AS `description`, `media_doc`.`active` AS `active`, `media_doc`.`time_created` AS `time_created`, `media_doc`.`time_updated` AS `time_updated`, `media_doc`.`time_deleted` AS `time_deleted`, `media_doc`.`appkey` AS `appkey`, `media_doc`.`uid` AS `uid`, `media_doc`.`count` AS `count`, `media_doc`.`season` AS `season`, `media_doc`.`updated_by` AS `updated_by`, `media_doc`.`license_type` AS `license_type`, `media_doc`.`copyright` AS `copyright`, `media_doc`.`geoloc_latitude` AS `geoloc_latitude`, `media_doc`.`geoloc_longitude` AS `geoloc_longitude`, `media_doc`.`cropping` AS `cropping`, `media_doc`.`featured` AS `featured` FROM `media_doc` WHERE `id` = :where1
    params: [where1] 1041;
    22:43:39.9095
    [0.0013]
    query: SELECT `news_story`.`id` AS `id`, `news_story`.`title` AS `title`, `news_story`.`subtitle` AS `subtitle`, `news_story`.`slug` AS `slug`, `news_story`.`topic` AS `topic`, `news_story`.`topic_main` AS `topic_main`, `news_story`.`author` AS `author`, `news_story`.`text_summary` AS `text_summary`, `news_story`.`text_description` AS `text_description`, `news_story`.`text_html` AS `text_html`, `news_story`.`seo_title` AS `seo_title`, `news_story`.`seo_keywords` AS `seo_keywords`, `news_story`.`seo_description` AS `seo_description`, `news_story`.`important` AS `important`, `news_story`.`status` AS `status`, `news_story`.`time_create` AS `time_create`, `news_story`.`time_update` AS `time_update`, `news_story`.`time_publish` AS `time_publish`, `news_story`.`uid` AS `uid`, `news_story`.`hits` AS `hits`, `news_story`.`image` AS `image`, `news_story`.`path` AS `path`, `news_story`.`cropping` AS `cropping`, `news_story`.`main_image` AS `main_image`, `news_story`.`additional_images` AS `additional_images`, `news_story`.`point` AS `point`, `news_story`.`count` AS `count`, `news_story`.`favourite` AS `favourite`, `news_story`.`attach` AS `attach`, `news_story`.`attribute` AS `attribute`, `news_story`.`type` AS `type` FROM `news_story` WHERE `slug` = :where1
    params: [where1] weight-loss-drugs-pros-and-cons-of-5-approved-prescriptions;
    22:43:39.9156
    [0.0009]
    query: SELECT `media_doc`.`id` AS `id`, `media_doc`.`path` AS `path`, `media_doc`.`filename` AS `filename`, `media_doc`.`attributes` AS `attributes`, `media_doc`.`mimetype` AS `mimetype`, `media_doc`.`title` AS `title`, `media_doc`.`description` AS `description`, `media_doc`.`active` AS `active`, `media_doc`.`time_created` AS `time_created`, `media_doc`.`time_updated` AS `time_updated`, `media_doc`.`time_deleted` AS `time_deleted`, `media_doc`.`appkey` AS `appkey`, `media_doc`.`uid` AS `uid`, `media_doc`.`count` AS `count`, `media_doc`.`season` AS `season`, `media_doc`.`updated_by` AS `updated_by`, `media_doc`.`license_type` AS `license_type`, `media_doc`.`copyright` AS `copyright`, `media_doc`.`geoloc_latitude` AS `geoloc_latitude`, `media_doc`.`geoloc_longitude` AS `geoloc_longitude`, `media_doc`.`cropping` AS `cropping`, `media_doc`.`featured` AS `featured` FROM `media_doc` WHERE `id` = :where1
    params: [where1] 1041;
    22:43:39.9178
    [0.0007]
    query: SELECT `media_doc`.`id` AS `id`, `media_doc`.`path` AS `path`, `media_doc`.`filename` AS `filename`, `media_doc`.`attributes` AS `attributes`, `media_doc`.`mimetype` AS `mimetype`, `media_doc`.`title` AS `title`, `media_doc`.`description` AS `description`, `media_doc`.`active` AS `active`, `media_doc`.`time_created` AS `time_created`, `media_doc`.`time_updated` AS `time_updated`, `media_doc`.`time_deleted` AS `time_deleted`, `media_doc`.`appkey` AS `appkey`, `media_doc`.`uid` AS `uid`, `media_doc`.`count` AS `count`, `media_doc`.`season` AS `season`, `media_doc`.`updated_by` AS `updated_by`, `media_doc`.`license_type` AS `license_type`, `media_doc`.`copyright` AS `copyright`, `media_doc`.`geoloc_latitude` AS `geoloc_latitude`, `media_doc`.`geoloc_longitude` AS `geoloc_longitude`, `media_doc`.`cropping` AS `cropping`, `media_doc`.`featured` AS `featured` FROM `media_doc` WHERE `id` = :where1
    params: [where1] 1041;
    22:43:39.9198
    [0.0007]
    query: SELECT `media_doc`.`id` AS `id`, `media_doc`.`path` AS `path`, `media_doc`.`filename` AS `filename`, `media_doc`.`attributes` AS `attributes`, `media_doc`.`mimetype` AS `mimetype`, `media_doc`.`title` AS `title`, `media_doc`.`description` AS `description`, `media_doc`.`active` AS `active`, `media_doc`.`time_created` AS `time_created`, `media_doc`.`time_updated` AS `time_updated`, `media_doc`.`time_deleted` AS `time_deleted`, `media_doc`.`appkey` AS `appkey`, `media_doc`.`uid` AS `uid`, `media_doc`.`count` AS `count`, `media_doc`.`season` AS `season`, `media_doc`.`updated_by` AS `updated_by`, `media_doc`.`license_type` AS `license_type`, `media_doc`.`copyright` AS `copyright`, `media_doc`.`geoloc_latitude` AS `geoloc_latitude`, `media_doc`.`geoloc_longitude` AS `geoloc_longitude`, `media_doc`.`cropping` AS `cropping`, `media_doc`.`featured` AS `featured` FROM `media_doc` WHERE `id` = :where1
    params: [where1] 1041;
    22:43:39.9245
    [0.0008]
    query: SELECT `core_block`.`id` AS `id`, `core_block`.`root` AS `root`, `core_block`.`name` AS `name`, `core_block`.`title` AS `title`, `core_block`.`description` AS `description`, `core_block`.`module` AS `module`, `core_block`.`template` AS `template`, `core_block`.`render` AS `render`, `core_block`.`config` AS `config`, `core_block`.`type` AS `type`, `core_block`.`content` AS `content`, `core_block`.`cache_ttl` AS `cache_ttl`, `core_block`.`cache_level` AS `cache_level`, `core_block`.`title_hidden` AS `title_hidden`, `core_block`.`body_fullsize` AS `body_fullsize`, `core_block`.`active` AS `active`, `core_block`.`cloned` AS `cloned`, `core_block`.`class` AS `class`, `core_block`.`subline` AS `subline` FROM `core_block` WHERE `name` = :where1
    params: [where1] system-user-bar;
    22:43:39.936
    [0.0009]
    query: SELECT `core_block`.`id` AS `id`, `core_block`.`root` AS `root`, `core_block`.`name` AS `name`, `core_block`.`title` AS `title`, `core_block`.`description` AS `description`, `core_block`.`module` AS `module`, `core_block`.`template` AS `template`, `core_block`.`render` AS `render`, `core_block`.`config` AS `config`, `core_block`.`type` AS `type`, `core_block`.`content` AS `content`, `core_block`.`cache_ttl` AS `cache_ttl`, `core_block`.`cache_level` AS `cache_level`, `core_block`.`title_hidden` AS `title_hidden`, `core_block`.`body_fullsize` AS `body_fullsize`, `core_block`.`active` AS `active`, `core_block`.`cloned` AS `cloned`, `core_block`.`class` AS `class`, `core_block`.`subline` AS `subline` FROM `core_block` WHERE `name` = :where1
    params: [where1] shop-basket;
    22:43:39.9422
    [0.0009]
    query: SELECT `core_block`.`id` AS `id`, `core_block`.`root` AS `root`, `core_block`.`name` AS `name`, `core_block`.`title` AS `title`, `core_block`.`description` AS `description`, `core_block`.`module` AS `module`, `core_block`.`template` AS `template`, `core_block`.`render` AS `render`, `core_block`.`config` AS `config`, `core_block`.`type` AS `type`, `core_block`.`content` AS `content`, `core_block`.`cache_ttl` AS `cache_ttl`, `core_block`.`cache_level` AS `cache_level`, `core_block`.`title_hidden` AS `title_hidden`, `core_block`.`body_fullsize` AS `body_fullsize`, `core_block`.`active` AS `active`, `core_block`.`cloned` AS `cloned`, `core_block`.`class` AS `class`, `core_block`.`subline` AS `subline` FROM `core_block` WHERE `name` = :where1
    params: [where1] shop-basket;
    22:43:39.9455
    [0.0007]
    query: SELECT `core_block`.`id` AS `id`, `core_block`.`root` AS `root`, `core_block`.`name` AS `name`, `core_block`.`title` AS `title`, `core_block`.`description` AS `description`, `core_block`.`module` AS `module`, `core_block`.`template` AS `template`, `core_block`.`render` AS `render`, `core_block`.`config` AS `config`, `core_block`.`type` AS `type`, `core_block`.`content` AS `content`, `core_block`.`cache_ttl` AS `cache_ttl`, `core_block`.`cache_level` AS `cache_level`, `core_block`.`title_hidden` AS `title_hidden`, `core_block`.`body_fullsize` AS `body_fullsize`, `core_block`.`active` AS `active`, `core_block`.`cloned` AS `cloned`, `core_block`.`class` AS `class`, `core_block`.`subline` AS `subline` FROM `core_block` WHERE `name` = :where1
    params: [where1] search-search;
    22:43:39.9647
    [0.0012]
    query: SELECT `news_story`.`id` AS `id`, `news_story`.`title` AS `title`, `news_story`.`subtitle` AS `subtitle`, `news_story`.`slug` AS `slug`, `news_story`.`topic` AS `topic`, `news_story`.`topic_main` AS `topic_main`, `news_story`.`author` AS `author`, `news_story`.`text_summary` AS `text_summary`, `news_story`.`text_description` AS `text_description`, `news_story`.`text_html` AS `text_html`, `news_story`.`seo_title` AS `seo_title`, `news_story`.`seo_keywords` AS `seo_keywords`, `news_story`.`seo_description` AS `seo_description`, `news_story`.`important` AS `important`, `news_story`.`status` AS `status`, `news_story`.`time_create` AS `time_create`, `news_story`.`time_update` AS `time_update`, `news_story`.`time_publish` AS `time_publish`, `news_story`.`uid` AS `uid`, `news_story`.`hits` AS `hits`, `news_story`.`image` AS `image`, `news_story`.`path` AS `path`, `news_story`.`cropping` AS `cropping`, `news_story`.`main_image` AS `main_image`, `news_story`.`additional_images` AS `additional_images`, `news_story`.`point` AS `point`, `news_story`.`count` AS `count`, `news_story`.`favourite` AS `favourite`, `news_story`.`attach` AS `attach`, `news_story`.`attribute` AS `attribute`, `news_story`.`type` AS `type` FROM `news_story` WHERE `slug` = :where1
    params: [where1] weight-loss-drugs-pros-and-cons-of-5-approved-prescriptions;
    22:43:39.9707
    [0.0007]
    query: SELECT `media_doc`.`id` AS `id`, `media_doc`.`path` AS `path`, `media_doc`.`filename` AS `filename`, `media_doc`.`attributes` AS `attributes`, `media_doc`.`mimetype` AS `mimetype`, `media_doc`.`title` AS `title`, `media_doc`.`description` AS `description`, `media_doc`.`active` AS `active`, `media_doc`.`time_created` AS `time_created`, `media_doc`.`time_updated` AS `time_updated`, `media_doc`.`time_deleted` AS `time_deleted`, `media_doc`.`appkey` AS `appkey`, `media_doc`.`uid` AS `uid`, `media_doc`.`count` AS `count`, `media_doc`.`season` AS `season`, `media_doc`.`updated_by` AS `updated_by`, `media_doc`.`license_type` AS `license_type`, `media_doc`.`copyright` AS `copyright`, `media_doc`.`geoloc_latitude` AS `geoloc_latitude`, `media_doc`.`geoloc_longitude` AS `geoloc_longitude`, `media_doc`.`cropping` AS `cropping`, `media_doc`.`featured` AS `featured` FROM `media_doc` WHERE `id` = :where1
    params: [where1] 1041;
    22:43:39.973
    [0.0009]
    query: SELECT `media_doc`.`id` AS `id`, `media_doc`.`path` AS `path`, `media_doc`.`filename` AS `filename`, `media_doc`.`attributes` AS `attributes`, `media_doc`.`mimetype` AS `mimetype`, `media_doc`.`title` AS `title`, `media_doc`.`description` AS `description`, `media_doc`.`active` AS `active`, `media_doc`.`time_created` AS `time_created`, `media_doc`.`time_updated` AS `time_updated`, `media_doc`.`time_deleted` AS `time_deleted`, `media_doc`.`appkey` AS `appkey`, `media_doc`.`uid` AS `uid`, `media_doc`.`count` AS `count`, `media_doc`.`season` AS `season`, `media_doc`.`updated_by` AS `updated_by`, `media_doc`.`license_type` AS `license_type`, `media_doc`.`copyright` AS `copyright`, `media_doc`.`geoloc_latitude` AS `geoloc_latitude`, `media_doc`.`geoloc_longitude` AS `geoloc_longitude`, `media_doc`.`cropping` AS `cropping`, `media_doc`.`featured` AS `featured` FROM `media_doc` WHERE `id` = :where1
    params: [where1] 1041;
    22:43:39.9754
    [0.0009]
    query: SELECT `media_doc`.`id` AS `id`, `media_doc`.`path` AS `path`, `media_doc`.`filename` AS `filename`, `media_doc`.`attributes` AS `attributes`, `media_doc`.`mimetype` AS `mimetype`, `media_doc`.`title` AS `title`, `media_doc`.`description` AS `description`, `media_doc`.`active` AS `active`, `media_doc`.`time_created` AS `time_created`, `media_doc`.`time_updated` AS `time_updated`, `media_doc`.`time_deleted` AS `time_deleted`, `media_doc`.`appkey` AS `appkey`, `media_doc`.`uid` AS `uid`, `media_doc`.`count` AS `count`, `media_doc`.`season` AS `season`, `media_doc`.`updated_by` AS `updated_by`, `media_doc`.`license_type` AS `license_type`, `media_doc`.`copyright` AS `copyright`, `media_doc`.`geoloc_latitude` AS `geoloc_latitude`, `media_doc`.`geoloc_longitude` AS `geoloc_longitude`, `media_doc`.`cropping` AS `cropping`, `media_doc`.`featured` AS `featured` FROM `media_doc` WHERE `id` = :where1
    params: [where1] 1041;
    22:43:39.9787
    [0.0007]
    query: SELECT `comment_root`.* FROM `comment_root` WHERE `module` = :where1 AND `type` = :where2 AND `item` = :where3
    params: [where1] news;[where2] news;[where3] 515;
    22:43:40.011
    [0.0011]
    query: SELECT `core_session`.* FROM `core_session` WHERE `id` = :where1
    params: [where1] smgtvr7jk5esdh0e9kup1croa0;
    22:43:40.0134
    [0.0011]
    query: INSERT INTO `core_session` (`modified`, `data`, `id`, `lifetime`) VALUES (:modified, :data, :id, :lifetime)
    params: [modified] 1732216420;[data] __ZF|a:2:{s:20:"_REQUEST_ACCESS_TIME";d:1732216419.7426119;s:6:"_VALID";a:1:{s:36:"Zend\Session\Validator\HttpUserAgent";s:103:"Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; [email protected])";}}PI_USER|a:2:{s:5:"field";a:3:{s:2:"id";i:0;s:8:"identity";s:0:"";s:4:"name";s:10:"مهمان";}s:4:"time";i:1732216719;}hits_news|a:1:{i:515;b:1;}FlashMessenger|C:23:"Zend\Stdlib\ArrayObject":205:{a:4:{s:7:"storage";a:0:{}s:4:"flag";i:2;s:13:"iteratorClass";s:13:"ArrayIterator";s:19:"protectedProperties";a:4:{i:0;s:7:"storage";i:1;s:4:"flag";i:2;s:13:"iteratorClass";i:3;s:19:"protectedProperties";}}};[id] smgtvr7jk5esdh0e9kup1croa0;[lifetime] 1440;
    system
    Execution time
    0.4118 s
    Included files
    597 files
    Memory usage
    12287912; peak: 12397272 bytes
    OS
    Linux
    Web Server
    LiteSpeed
    PHP Version
    7.0.33
    Pi Environment
    2.6.0-beta development
    Zend Version
    2.4.11
    Persist Engine
    file
    Cache Storage
    Pi\Cache\Storage\Adapter\Filesystem
    Module
    news
    Theme
    osportv3
    Extensions
    APC: ; Intl; cURL