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Background: Primary biliary cholangitis (PBC) can impact both the quality of life and the survival of patients. The study aimed to determine the survival rate and associated variables in patients with PBC. Materials and Methods: This cohort research comprised 65 patients diagnosed with PBC who were admitted to the pathology section between January 2010 and December 2019. Survival was determined by reviewing hospital medical data and following up with the patients. The impact of demographic factors, clinical, laboratory, and histopathological aspects on patient survival time was investigated using Kaplan-Meier survival analysis and Cox regression. Results: The average period of follow-up was 6.25 years with a standard deviation of 3.2 years. In surviving patients, the baseline bilirubin level was 2.83, but in deceased or transplanted patients, it was 8.95 (P = 0.002). The baseline albumin level was 3.99 in surviving patients and 3.66 in deceased or transplanted patients (P = 0.024). The incidence of cirrhosis in those who survived was 1.8%, but in patients who died or underwent a transplant, it was 40%. Out of 65 cases, 3 patients (4.7%) died and 7 (10%) had liver transplants. Survival rates of patients vary based on factors such as jaundice (P = 0.002), weariness (P = 0.03), cirrhosis (P < 0.001), and vitiligo (P = 0.033). There were notable variations in the average Mayo score between the two groups of patients who had liver transplantation and survived, with scores of 7.21 and 5.61, respectively. Conclusion: The study found that aspartate aminotransferase and alanine aminotransferase levels, baseline and final bilirubin, albumin, antinuclear antibody, the presence of cirrhosis, and jaundice significantly influenced patient survival with PBC. [ABSTRACT FROM AUTHOR]

Background: In this study, the relationship between involvement by COVID 19 and the recurrence of symptoms of rheumatoid arthritis (RA) was investigated. Materials and Methods: This cross sectional study was conducted on 112 patients with RA with and without a history of COVID 19. The severity and recurrence of RA symptoms were measured and recorded by the Disease Activity Score in 28 joints (DAS 28) index and clinical evaluations by a rheumatologist. Results: The results showed that the recurrence of RA in patients with and without a history of COVID 19 had a statistically significant difference (P < 0.001). In addition, there was a statistically significant relationship between erythrocyte sedimentation rate, visual analogue scale (VAS), tender joint count, swollen joint count, and DAS 28 and the history of COVID 19 (P < 0.05). Conclusion: The present study showed that infection with COVID 19 leads to the recurrence of joint symptoms in RA patients. [ABSTRACT FROM AUTHOR]

Background: Hypertension is one of the most important causes of cardiovascular diseases. Patients with hypertension have a lower quality of life. We aimed to evaluate the effects of mindfulness meditation on blood pressure, mental health, and quality of life in patients with hypertension. Methods: This randomized clinical trial was performed in 2019 in Isfahan. Eighty adult women with Stage I or II hypertension were included and assigned randomly to 2 groups: 12 weeks of mindfulness-based stress reduction (MBSR) and routine care. At baseline and 1 week after the end of the intervention, blood pressure, stress, depression, anxiety, and quality of life of the studied participants were measured using the Depression, Anxiety, and Stress Scale-21 (DASS-21) and 36-Item Short Form Survey (SF-36) questionnaires. The data were analyzed using the independent t-test, the paired t-test, and the MANCOVA test. Results: After the intervention, the mean systolic and diastolic blood pressures decreased significantly in the intervention group compared with the baseline (142.82±11.01 mmHg vs 133.7±510.43 mmHg for systolic pressure and 86.12±8.24 mmHg vs 79.15±6.26 mmHg for diastolic pressure) and the control group (140.18±14.27 mmHg vs 142.15±10.23 mmHg for systolic pressure and 84.62±9.22 vs mmHg 88.51±8.54 mmHg for diastolic pressure; P=0.001). There was also a significant increase in quality of life, stress, anxiety, and depression scores in the intervention group (P<0.05). Conclusion: The 12-week MBSR program resulted in a significant reduction in the mean systolic and diastolic blood pressures and improvement in mental health and different aspects of quality of life. [ABSTRACT FROM AUTHOR]

Background: Psychosomatic medicine is a systemic model of care based on the biopsychosocial model in which the physical, emotional, and social aspects of clinical conditions are considered. Family Medicine (FM) and psychosomatic medicine have many similarities in their community-based and family-based approaches. Studies have shown the necessity and effectiveness of psychosomatic medicine training for general practitioners (GPs) and family physicians. Methods: We designed a psychosomatic course for FM residents. This semi-experimental study was performed at Isfahan University of Medical Sciences, Iran, in 2018. The target population included 11 FM residents. A compact 20-hour module (4 days, 5 hours each) was designed for the training. The Knowledge and Practice of Psychosomatic Medicine Questionnaire (self-administered) for the concepts and skills of psychosomatic medicine was filled out by each of the FM residents before and after the intervention. For each resident, caring for patients was monitored and a Performance Appraisal Checklist was completed by the supervisor. Finally, the questionnaire scores before and after the intervention were compared using paired t-test. Results: The total knowledge and practice score increased significantly after the intervention (258.5 ± 40.3 vs. 174.6 ± 62.9; P = 0.002). There was also a significant increase in the mean psychosomatic care performance scores after the intervention (28.65 ± 3.52) compared with baseline (21.18 ± 5.94) (P = 0.001). Conclusion: This study showed that basic psychosomatic care training for family physician residents, even in short courses, can have a positive effect on their clinical knowledge and performance. [ABSTRACT FROM AUTHOR]

Dyslipidemia is an important cause of cardiovascular diseases with increasing rates among adult populations. Nutrition and physical activity are known to have an impact on degrees of dyslipidemia. In this article, we had a study on nutritional behaviors and physical activities among middle-aged adults with and without dyslipidemia. In this case-control study, 200 middle-aged adults were entered. One hundred adults with dyslipidemia and 100 normal adults were included in this study. Data regarding desirable or undesirable use of fruits, vegetables, dairy, saturated fatty acids, fast foods, carbonated drinks, and extra salt intake with every meal were collected. Intensity and duration of physical activities were also collected from our data bank and analyzed with SPSS software. Our results indicated that people with dyslipidemia had a significantly increased usage of fast foods and saturated fatty acids, while the normal population had increased usage of vegetables and dairy. There were also significantly increased in intensity, duration per day, and weekly days of physical activity in healthy groups. Logistic regression indicated that undesirable consumption of fast foods, dairy, fatty acids, vegetables, and undesirable physical activity increases the risks for dyslipidemia (OR=8.2, OR=16.2, OR=8.2, OR=18.3, and OR=25.3 respectively) (P<0.05). This article emphasizes the role of proper nutritional behaviors and higher physical activities in decreasing the risks of dyslipidemia, and we suggest that further preventive interventions could be made based on the results of our study. [ABSTRACT FROM AUTHOR]

Background: Placenta adherent abnormality (PAA) is abnormal attachment of the placenta to the myometrium. This abnormal placenta binding has severe clinical consequences for the mother and the fetus. We investigated the outcomes of hypogastric arterial ligation (HAL) before hysterectomy compared to hysterectomy alone in pregnant women with PAA. Materials and Methods: In this randomized controlled clinical trial, 70 patients were randomly allocated to HAL along with hysterectomy and hysterectomy alone groups (35 in each Group). The total amount of intraoperative blood loss, the need for intraoperative blood products transfusion, frequency of deep vein thrombosis, duration of surgery, duration of hospitalization, and visceral trauma were compared between 2 Groups. Results: Finally, 64 patients completed the study protocol with mean age of 33.84 ± 4.25 years. The study groups were comparable in terms of basic baseline demographic and clinical characteristics. Visceral trauma was less frequently occurred in HAL group compared to hysterectomy alone (0% vs. 15.6%; P = 0.02). Intraoperative blood loss (1525 ± 536.41 cc vs. 2075 ± 889.36 cc; P = 0.001) and were significantly lower in HAL group compared to hysterectomy alone. Duration of operation (179.06 ± 36.28 vs. 197.66 ± 39.47; P = 0.05) and hospitalization (4.97 ± 2.20 vs. 6.10 ± 2.39; P = 0.03) also were significantly lower in HAL group. Conclusion: Our findings suggest that prophylactic HAL has a protective effect on the reduction of blood loss and less visceral trauma in pregnant women with PAA. [ABSTRACT FROM AUTHOR]

Objectives: Hepatitis C virus (HCV) infection is a major public health problem worldwide with serious complications. According to the importance of intravenous drug use (IDU) as the main risk factor for HCV infection and transmission and prison as the main source of risky behaviors, this study conducted to define HCV infection and related risk factors in prison inmates with history of IDU in Isfahan province, Iran. Methods: This is a cross -sectional study which the prison inmates with IDU history in voluntary basis were enrolled. A validated questionnaire was asked and blood sample was obtained from each subject for the presence of HCV antibody. Odds ratio and logistic regression were used for data analysis and P-value < 0.05 considered significant. Results: I943 inmates with history of IDU participated in the study. The overall prevalence of HCV antibody was 41.6%. The main independent risk factors were number of injection in the month [OR: 1.006 (1.002- 1.011)], Length of drug addiction [OR: 1.05 (1.004-1.098)], multiple incarceration [OR: 1.15 (1.05-1.23)] and use of needle/syringe share inside prison [OR: 4.19 (2.22-7.9)]. In our study, marriage was a protective factor for HCV infection [OR: 0.34 (0.18-0.64)] as well. Conclusions: According to relatively high prevalence of HCV infection and associated risk factors which observed in this study it is important to primary prevention in prisons through syringe/needle exchange and counsel with imprisoned IDUs. [ABSTRACT FROM AUTHOR]

# BACKGROUND: During August 2009, novel H1N1 influenza virus began causing illness in Isfahan. Since rates of hospitalization and mortality due to the disease have varied widely in different countries, we described the clinical, radiologic, and demographic features of H1N1 hospitalized patients in a hospital in Isfahan. # METHODS: This cross-sectional study was conducted in Alzahra Hospital during September 2009 to February 2010. Totally, 216 patients with confirmed, probable, or suspected cases of 2009 influenza A (H1N1) were admitted. # RESULTS: Most patients were female (50.5%). Mean age of patients was 26.6 ± 19.5 years. The most common complains on admission were respiratory symptoms (91.6%, n= 198), fever (88.4%, n = 191), myalgia (65.7%, n = 142). In addition, 120 patients (56%) had at least one underlying medical disorder. Thirty-six patients (16.7%) died. Mortality was higher in children under 5 years old (10/36, 10%) and female cases (63.9% of died patients). Predicting variables affecting mortality were intensive care unit (ICU) admission and procalcitonin (PCT). Antiviral treatment was prescribed for 200 (92.5%) of the 216 patients. # CONCLUSIONS: Based on the findings of the present study, novel H1N1 influenza is highly prevalent among the youth. Moreover, it causes a relatively high morbidity rate. Therefore, people need to be encouraged to have vaccination against 2009 H1N1. Early diagnosis and treatment is related to less admission and shorter duration of hospitalization. [ABSTRACT FROM AUTHOR]

BACKGROUND: Pandemic 2009 H1N1 influenza A virus arrived at Isfahan in August 2009. The virus is still circulating in the world. The abnormal thoracic computerized tomographic (CT) scan findings vary widely among the studies of 2009 H1N1 influenza. We evaluated the thoracic CT findings in patients with 2009 H1N1 virus infection to describe findings compared to previously reported findings, and to suggest patterns that may be suggestive for 2009 influenza A (H1N1) in an appropriate clinical setting. METHODS: Retrospectively, the archive of all patients with a diagnosis of 2009 H1N1 influenza A were reviewed, in Al-Zahra Hospital in Isfahan, central Iran, between September 23(rd) 2009 to February 20(th) 2010. Out of 216 patients with confirmed 2009 influenza A (H1N1) virus, 26 cases with abnormal CT were enrolled in the study. Radiologic findings were characterized by the type and pattern of opacities and zonal distribution. RESULTS: Patchy infiltration (34.6%), lobar consolidation (30.8%), and interstitial infiltration (26.9%) with airbronchogram (38.5%) were the predominant findings in our patients. Bilateral distribution was seen in 80.8% of the patients. Only one patient (3.8%) showed ground-glass opacity, predominant radiographic finding in the previous reports and severe acute respiratory syndrome (SARS). CONCLUSIONS: The most common thoracic CT findings in pandemic H1N1 were patchy infiltration, lobar consolidation, and interstitial infiltration with airbronchogram and bilateral distribution. While these findings can be associated with other infections; they may be suggestive to 2009 influenza A (H1N1) in the appropriate clinical setting. Various radiographic patterns can be seen in thoracic CT scans of the influenza patients. Imaging findings are nonspecific. [ABSTRACT FROM AUTHOR]

BACKGROUND: Toxoplasmosis is a worldwide infection. Most studies on toxoplasmosis are in women in child bearing ages. We conducted an epidemiological survey on the population of the Isfahan Province to identify characteristics of the individuals associated with seropositivity. METHODS: In a cross sectional study, 599 serum samples were randomly collected for seroepidemiology of Hepatitis A and E, and were also used for titration of IgG anti-toxoplasma gondii antibody by a commercial enzyme-linked immunosorbent assay (ELISA) kit. Data were analyzed using SPSS software(15). Chi square and Fisher exact tests were employed to examine antibody status in different age, gender, education and residency groups. RESULTS: The overall prevalence was 41.4% (248/599). There was a statistical significant association between seroprevalence with age, education, and gender (p < 0.05) but not with residency state. The peak age for acquisition of the infection in females was 20-29 and in males 20-39 years old. CONCLUSIONS: Results of current study showed a moderate prevalence of toxoplasma gondii infection. However higher seroconversion rate in active social and reproductive ages, females and low educated individuals necessitate active preventive programs in these high risk groups. [ABSTRACT FROM AUTHOR]

BACKGROUND: Toxoplasmosis is a worldwide infection. Most studies on toxoplasmosis are in women in child bearing ages. We conducted an epidemiological survey on the population of the Isfahan Province to identify characteristics of the individuals associated with seropositivity. METHODS: In a cross sectional study, 599 serum samples were randomly collected for seroepidemiology of Hepatitis A and E, and were also used for titration of IgG anti-toxoplasma gondii antibody by a commercial enzyme-linked immunosorbent assay (ELISA) kit. Data were analyzed using SPSS software15. Chi square and Fisher exact tests were employed to examine antibody status in different age, gender, education and residency groups. RESULTS: The overall prevalence was 41.4% (248/599). There was a statistical significant association between seroprevalence with age, education, and gender (p < 0.05) but not with residency state. The peak age for acquisition of the infection in females was 20-29 and in males 20-39 years old. CONCLUSIONS: Results of current study showed a moderate prevalence of toxoplasma gondii infection. However higher seroconversion rate in active social and reproductive ages, females and low educated individuals necessitate active preventive programs in these high risk groups. [ABSTRACT FROM AUTHOR]

Introduction. Liver biopsy is an invasive determinator for hepatic fibrosis. Serum biomarkers can probably be used as an alternative to liver biopsy in assessment of the degree of fibrosis in patients with chronic Hepatitis C. Method. Eighty patients with chronic Hepatitis C were included in the study using simple nonrandom sampeling metod. After fulfillment of liver biopsy, the patients were categorized according to the METAVIR Scoring system. The Hepascore algorithm is computed based on age, sex, and the serum levels of total bilirubin, ô-glutamyl transferase, α2-Macroglobulin, and hyaluronic acid. The spearman and ROC tests were used. Results. According to the liver biopsy results, 12, 25, 20, 7 and 16 patients had F0, F1, F2, F3, and F4, respectively. With regard to the 0.34 cut-off point Hepascore had 67%, 56%, 64%, and 56% sensitivity, specificity, respectively, positive prediction value (PPV), and negative prediction value (NPV), respectively, for diagnosis of significant fibrosis. For a Hepascore cut-off point 0.61, sensitivity, specificity, respectively, PPV and NPB 82%, 86%, 70%, and 92% in diagnosis of severe fibrosis. For a Hepascore cut-off point 0.84, sensitivity, specificity, PPV and NPB were respectively 100%, 97%, 89%, and 100% for diagnosis of cirrhosis. Conclusion. Hepascore has a high value in diagnosis of the level of fibrosis, particularly cirrhosis. Therefore, it can be used for primary screening of patients to determine the need for liver biopsy. [ABSTRACT FROM AUTHOR]

Background and Aims: Assessment of heart failure (HF) therapy based on guideline was less frequently performed. Objectives: In this study, we aimed to evaluate the frequency of readmission or mortality in HF patients according to guideline directed medical treatment. Materials and Methods: This retrospective cohort study was done from March 2016 to March 2017 in one of the tertiary heart centers located in Isfahan, named Chamran Hospital. A total of 503 patients with a diagnosis of HF were recruited in the research. Demographic data, prescribed medication, and para-clinic information were gathered during hospitalization period. The frequency of re-hospitalization and mortality was assessed 6 months after discharge, and its relation with aforementioned variables was evaluated. Results: The mean age of participants with the dominance of males (61.8%) was 70.8 ± 11.8 years. A total of 175 (34.8%) patients had been readmitted or died during 6-month follow-up. Participants with New York Heart Association (NYHA) functional class of IV and renal diseases had raised likelihood of re-hospitalization or death (odds ratio [OR]: 5.59, 95% confidence interval [CI] = 1.42-21.5, P = 001 and OR: 2.53, 95% CI = 1.11-5.79, P = 0.02, respectively). In contrast, individuals with heart rates (HR) of 80-100 beats/min showed decreased chance of adverse clinical outcomes compared to subjects with HRs of <60 beats/min (OR: 0.08, 95% CI = 0.009-0.77, P = 0.02). Conclusion: Our data suggested that HF patients having higher NYHA functional class or kidney problems and HRs of 80-100 beats/min had increased and decreased likelihood of readmission and mortality, respectively. Several longitudinal studies are required confirming these associations. [ABSTRACT FROM AUTHOR]

Background: Female prisoners are at risk of acquiring sexually transmitted infections (STIs). There has been no previous study regarding the epidemiological status of STIs among female prisoners in Isfahan, central Iran. Objectives: The aim of this study was to investigate the prevalence and risk factors of the aforementioned infections among women incarcerated in the central prison, Isfahan, to determine appropriate prevention measures. Patients and Methods: In a cross-sectional study, all of the 163 women incarcerated in the central prison, Isfahan in 2009, were voluntarily enrolled by the census method. After completing a checklist consisting of demographic, social, and risk factors, a 5ml blood sample was taken from each individual. The sera were analyzed for markers of the hepatitis B virus (HBV; HBsAg, HBsAb, HBcAb), hepatitis C virus (HCV; HCV antibodies), human immunodeficiency virus (HIV; HIV antibodies), and syphilis (RPR). Confirmatory tests were performed on HCV antibody-positive cases. Results: The mean age of the participants in the study was 34.54 ± 11.2 years old, 94.3% of these women were Iranian, and many of them had only a primary level of education. The prevalence of HBsAg, HBcAb, HBsAb, and HCV antibodies were; 1.2%, 7.4%, 12.9% and 7.4% respectively. No positive RPR or HIV antibodies were detected. Conclusions: A significant relationship was seen between the HCV antibody, drug injection and illegal sex in the women, and also between HBc-Ab and drug injection. Regular screening, educational programs, and facilitation of access to suitable treatment care should be widely implemented in the prison population. Testing for immunity against HBV should be considered on admission, and afterwards vaccination of all prisoners and an appropriate preventative approach should be applied. [ABSTRACT FROM AUTHOR]

Background: In Iran, there is limited evidence on the prevalence of hepatitis B and C viruses (HBV and HCV) among females who engage in illegal sexual behavior. Objectives: To determine the prevalence of HBV and HCV infections and their associated factors in this population in Isfahan-Iran. Patients and Methods: In this cross-sectional study, 100 females who engaged in illegal sexual behavior during 2009-2010 in Isfahan were recruited from welfare to the DIC for women, and referrals were made among those who knew others who engaged in prostitution. Markers for HBV and HCV-Ab were measured by ELISA, and recombinant immunoblot assay was used for confirmation of HCV infection. Also, a questionnaire on demographics and prostitution-associated risk data in a face-to-face interview was completed for each participant. Chi-square and multivariate logistic regression models were used for data analysis. Results: Of the 100 samples collected, 91 were sufficient for testing. The mean age and time spent in sex work were 30.84 ± 9.34 years and 36 ± 28.5 months, respectively. HBsAg was detected in 1 (1.1%), anti-HBc in 4 (4.4%), anti-HBs in 60 (65.9%), and HCV Ab in 9 (9.9%) subjects. The evidence of vaccination was seen in 54 subjects (59.3%). There were no significant differences in the prevalence of HBV or HCV infection by estimated risk factors, and there was no independent risk factor for these infections. Conclusions: The high prevalence of HCV infection in this study indicates the need to implement preventive interventions for female sex workers and, perhaps more importantly, to involve their male clients. [ABSTRACT FROM AUTHOR]

Background: Hepatitis D virus (HDV) is dependent on hepatitis B virus (HBV) infection. Acute infection with HDV can occur simultaneously with acute HBV infection or be superimposed onto a chronic HBV infection. Objectives: This study aimed to identify cases of HDV and determine its prevalence in patients with chronic HBV infection for the first time study in Isfahan, central Iran. Patients and Methods: In a cross-sectional study in 2009, 346 who had been diagnosed for at least 6 months with chronic HBV were enrolled consecutively. Anti-HDV was measured by ELISA in the serum of these patients. Results: The study included 245 males (70.8%) and 101 (29.2%) females with a mean age of 39 ± 12.4 years. Anti-HDV was present in 8 (3.5%) HBe antibody-positive patients (p = 0.36) and in 2 (2.3%) HBe antigen- positive cases (p = 0.68). No association was found between hepatitis D and probable risk factors. Conclusions: This study demonstrates that the prevalence of HDV infection is higher in patients who are positive for HBeAb compared those who are HBeAg-positive. Therefore, most HDV antibody-positive cases in Isfahan are HBV/HDV superinfections but not coinfections. [ABSTRACT FROM AUTHOR]

Background and Aims: Patients with human immunodeficiency virus (HIV) are also likely to be at risk for other infectious pathogens including hepatitis B (HBV) and C (HCV) viruses, which complicate the clinical course, management, and therapy. The literature on the prevalence of HBV/HCV coinfection with HIV in Iran is sparse. Hence this study was conducted to investigate this coinfection pattern and its risk factors in Isfahan, Iran. Methods: All of the HIV-infected patients attending clinics for acquired immune deficiency syndrome (AIDS) research and education in Isfahan province during the period of May 1998 through April 2007 were included in this cross-sectional study. After giving their informed consent, the patients were screened for hepatitis B surface antigen (HBsAg) and antibodies to hepatitis C virus (anti-HCV), and anti-HCV-positive cases were confirmed with the RIBA test. The demographic data and information about risk behaviors were collected as well. Multivariate logistic regression was used to identify independent risk factors for HBV and HCV. Results: The subjects included 130 patients (128 males and 2 females) with a mean age of 50.23 ± 8.81 years. Most of the subjects were unemployed (61.5%) and single (56.2%). A history of imprisonment, , intravenous drug abuse, and high-risk sexual activity were reported by 83.7%, 83.5%, and 48% of the subjects, respectively. Coinfection with hepatitis viruses was observed in 78.5% of the subjects. Low levels of education, a history of imprisonment, and youth were the main risk factors for HCV/HIV coinfection (OR = 196, 114, and 0.9 respectively). Conclusions: Our study showed that there is a high prevalence rate of HCV/HIV coinfection in Isfahan, Iran, with the major risk factor being a history of imprisonment. [ABSTRACT FROM AUTHOR]

Background: Familial hypercholesterolemia (FH), an autosomal dominant disease, is associated with an increased risk of premature cardiovascular disease (CVD). This study aimed to examine the variations in serum levels of calcium, vitamin D, phosphorus, and parathyroid hormone (PTH) among FH patients, as these factors have been associated with an increased susceptibility to CVD., Materials and Methods: In this cross-sectional study, the authors used data from Isfahan FH registry. The Dutch Lipid Clinic Network (DLCN) criteria was used for diagnoses of FH patients. Control group included participants with hyperlipidemia and were unlikely FH according to DLCN criteria. All biochemical parameters were measured using standard methods., Results: A total of 131 patients (mean age, 53.1 ± 12.2; male, 51.4%) were included in the analysis. Patients with FH had lower serum vitamin D levels compared with control groups in the unadjusted model ( P = 0.028). The relationship between serum vitamin D and FH was not significant after adjustment for traditional risk factor ( P = 0.184). No significant association was observed between FH and serum calcium ( P = 0.886), phosphorus ( P = 0.463), and PTH ( P = 0.849). Besides, there was no significant association between LDL-C or total cholesterol and serum minerals in FH patients., Conclusion: This study found no significant changes in serum calcium, vitamin D, phosphorus, and PTH in patients with FH., Competing Interests: The authors declare no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Type 2 diabetes is a significant problem in today's society. Considering the possible effect of self-efficacy training on diabetes control, we aimed to investigate its impact on type 2 diabetes control., Methods: This randomized controlled clinical trial was performed in 2018 in Isfahan city. Iranian Registry of Clinical Trials (IRCT) code for this study is IRCT20190219042762N1 (https://en.irct.ir/trial/37677). In so doing, 161 patients with diabetes were divided into two groups: intervention and control. The intervention group received six self-efficacy and healthy lifestyle training sessions, and self-efficacy strategies were taught in all sessions. Metabolic indices and the data collected by Diabetes Management Self-Efficacy Scale (DMSES) were analyzed before and three months after training by descriptive and inferential statistics., Results: The self-efficacy score of the intervention group was significantly higher after training (175.7±18 vs. 163.7±26, P = 0.001). Also, the cholesterol level, LDL, and systolic blood pressure reduced significantly in this group after the intervention (167±39 vs. 179±43.7 mg/dl, 94.2±31 vs. 102.6±39 mg/dl, 115.6±1.4 vs. 120.1±1.8 mmHg, respectively. P<0.05)., Conclusion: Generally, self-efficacy training effectively improved metabolic control in patients with type 2 diabetes., Competing Interests: None., (IJPPP Copyright © 2022.)

Background: Hypertension is one of the most important causes of cardiovascular diseases. Patients with hypertension have a lower quality of life. We aimed to evaluate the effects of mindfulness meditation on blood pressure, mental health, and quality of life in patients with hypertension., Methods: This randomized clinical trial was performed in 2019 in Isfahan. Eighty adult women with Stage I or II hypertension were included and assigned randomly to 2 groups: 12 weeks of mindfulness-based stress reduction (MBSR) and routine care. At baseline and 1 week after the end of the intervention, blood pressure, stress, depression, anxiety, and quality of life of the studied participants were measured using the Depression, Anxiety, and Stress Scale-21 (DASS-21) and 36-Item Short Form Survey (SF-36) questionnaires. The data were analyzed using the independent t-test, the paired t-test, and the MANCOVA test., Results: After the intervention, the mean systolic and diastolic blood pressures decreased significantly in the intervention group compared with the baseline (142.82±11.01 mmHg vs 133.7±510.43 mmHg for systolic pressure and 86.12±8.24 mmHg vs 79.15±6.26 mmHg for diastolic pressure) and the control group (140.18±14.27 mmHg vs 142.15±10.23 mmHg for systolic pressure and 84.62±9.22 vs mmHg 88.51±8.54 mmHg for diastolic pressure; P=0.001). There was also a significant increase in quality of life, stress, anxiety, and depression scores in the intervention group (P<0.05)., Conclusion: The 12-week MBSR program resulted in a significant reduction in the mean systolic and diastolic blood pressures and improvement in mental health and different aspects of quality of life., (Copyright © 2022 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.)

Background: Diabetes mellitus is one of the major health problems in the world. Stress and mental illnesses adversely affect glycemic control. In most patients, a multidisciplinary approach including physical activity, healthy diet, and stress management is required for glycemic control. Mindfulness-based stress reduction (MBSR) is a structured group program that reduces emotional distress through self-awareness and assuming the responsibility for individual choices, and results in increased effective health behaviors. Here, we aimed to evaluate the effects of mindfulness meditation on glycemic control and mental health in patients with type 2 diabetes., Materials and Methods: This randomized clinical trial study was performed in 2018 in Isfahan city. A total number of 108 patients with diabetes mellitus type 2 were selected and allocated randomly to two groups, intervention (12 weeks MBSR program) and control (routine care). Depression, anxiety, and stress scores regarding to depression, anxiety, and stress Scale - 21 questionnaire and also amounts of fasting blood sugar (FBS) and hemoglobin A1C (HbA1C) were assessed and analyzed using independent t -test, paired t -test, Mann-Whitney U-test, and Chi-square, before and 13 weeks after educational programs., Results: The means of HbA1C, FBS, and depression, anxiety, and stress scores improved significantly after intervention in the MBSR group. Except FBS levels, all outcome variable scores' mean change was significant between the two groups., Conclusions: In general, this study revealed that mindfulness meditation could be helpful in improving the quality of mental health and lowering glycemic control indices in patients with type 2 diabetes mellitus., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Advanced Biomedical Research.)

Background: Overweight and obesity are major problems with increasing rates among adult populations. Nutritional behaviors and physical activity are the most important influencing factors. In this article, we conducted a survey on the nutritional behaviors and physical activities among normal-weight and overweight/obese adults., Materials and Methods: We conducted a survey on some of the nutritional behaviors and physical activities of 729 middle-aged adults. Data regarding desirable or undesirable use of fruits, fish, dairy products, oil, fast foods, and carbonated drinks and the intensity and duration of physical activities were collected from our data bank and analyzed using the SPSS software., Results: Our results indicated that overweight/obese people had an improper usage of fruits, oil, fast foods, and carbonated drinks and had lower physical activity. There was also a significant increase in intensity, duration per day, and weekly days of physical activity in healthy groups. Logistic regression analysis of nutritional behaviors, physical activities, and obesity also indicated that undesirable usage of oil, fast foods, and carbonated drinks and undesirable physical activity are associated with risks for overweight/obesity (odds ratio [OR] =10.70, OR = 7.45, OR = 7.48, and OR = 2.16, respectively) ( P < 0.05)., Conclusion: This article puts emphasis on the role of proper nutritional behaviors and higher physical activities in decreasing the risks of developing obesity, and we suggest that further interventions could be made based on the results of our study., Competing Interests: There are no conflicts of interest., (Copyright: © 2019 Advanced Biomedical Research.)

Background: Considering the importance of anger, aggression, violence and other misbehaviours in schoolchildren education, the present study was conducted to evaluate the knowledge and practice of students in Isfahan province regarding violence, in order to figure out the required interventions for violence-reduction., Methods: In a survey during 2008-2009, 5500 junior and senior high school students of Isfahan province were assessed in a multistage sampling process to determine their level of knowledge about various types of violent behaviors, causes of violence, its consequences, and preventive behaviors. Validity and reliability of the data collection tool (questionnaire) were assessed., Results: The study revealed that the mean scores of violent behaviors knowledge, knowledge of violent behavior outcomes, and knowledge of violence preventive behaviors, were 6.6 ± 2.1, 5.5 ± 1.9, and 4.7 ± 1.3, respectively. Sources of violent behaviors in 92% of urban students and 89% of rural students were personal reasons and family behaviors, and 85% of urban and 88% of rural students considered mass media and computer games blameworthy, and the differences were statistically significant in all cases (P < 0.0001). In terms of practice, overall, 69.7% of girls and 84.2% of boys had violent behaviors. Physical and verbal violence were 31.3% and 40.7%in girls, and 66% and 52.8% in boys, respectively (intersexes P values were P < 0.001 and P = 0.7 respectively, and intra-sex P value was P < 0.0001)., Conclusions: Results showed that girls and city dwellers were more aware of recognizing violent behaviors, outcomes, and causes, compared with boys and villagers, and in terms of general practice, violence was observed among boys more than girls. Further complementary studies in this area seem required.

Background: We conducted an epidemiological survey on seroprevalence of toxoplasma infection in women of childbearing age in Isfahan Province., Materials and Methods: In a cross-sectional study in 2010, 217 women in the age range of 10-50 years were randomly selected. The blood samples examined for the presence of IgG anti-Toxoplasma gondii antibody by a commercial ELISA kit (Dia-Pro, Milan, Italy). Chi-square and Fisher's exact tests were employed to examine the antibody status in different age, marriage, education, and residence groups., Results: The overall prevalence was 47.5% (103/217). The peak age of infection acquisition was in the range 30-40 years in rural areas and 20-30 years in urban districts. There was no significant association between residence, education, and marriage groups on the one hand and chance of T. gondii infection on the other hand., Conclusions: The findings of the study suggest a moderate prevalence of T. gondii infection, but a high prevalence in ages of high reproductive activities.

Background: Little is known about sexually transmitted infections (STIs) among females who engage in illegal sexual behavior in Iran .So, this study was conducted to obtain knowledge about the prevalence and associated risk factors in this population., Materials and Methods: In a cross-sectional study, a total of 100 women who had exchange of sex for money in previous 3 months according to self report were recruited during 2009-2010 by simple non probable sampling method in Isfahan, Iran. HIV-Ab, Chlamydia trachomatis-IgG and syphilis infection were measured. A questionnaire on demographics and prostitution-associated risk data was collected as well. Chi-square and multivariate logistic regression models were used for data analysis., Results: Of 100 participants, the samples of 91 ones could be tested for STI markers (nine samples were hemolysis or insufficient). The overall prevalence of C. trachomatis was 19.8%. There was no case with syphilis or HIV infection. Multiple logistic regression analysis demonstrated that participants who reported temporarily marriage were less likely to be infected with C. trachomatis (AOR=0.003, 95%CI=0.001-0.58). The other risk factors for the tested STIs were not statistically significant in multiple logistic regressions., Conclusion: The results of our study indicated that seroprevalence and associated risk factors of HIV and other STIs among female with illegal social behaviors is not considerable in Isfahan, Iran.