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Abstract Background Hyperhomocysteinemia is known as an independent risk factor of atherosclerosis, but the probable role of hyperhomocysteinemia in premature Coronary Artery Disease (CAD) is not well studied. The aim of this study was to assess the role of hyperhomocysteinemia, folate and Vitamin B12 deficiency in the development of premature CAD. Methods We performed an analytical case-control study on 294 individuals under 45 years (225 males and 69 females) who were admitted for selective coronary angiography to two centers in Tehran. Results After considering the exclusion criteria, a total number of 225 individuals were enrolled of which 43.1% had CAD. The mean age of participants was 39.9 +/- 4.3 years (40.1 +/- 4.2 years in males and 39.4 +/- 4.8 years in females). Compared to the control group, the level of homocysteine measured in the plasma of the male participants was significantly high (14.9 +/- 1.2 versus 20.3 +/- 1.9 micromol/lit, P = 0.01). However there was no significant difference in homocysteine level of females with and without CAD (11.8 +/- 1.3 versus 11.5 ± 1.1 micromol/lit, P = 0.87). Mean plasma level of folic acid and vitamin B12 in the study group were 6.3 +/- 0.2 and 282.5 +/- 9.1 respectively. Based on these findings, 10.7% of the study group had folate deficiency while 26.6% had Vitamin B12 deficiency. Logistic regression analysis for evaluating independent CAD risk factors showed hyperhomocysteinemia as an independent risk factor for premature CAD in males (OR = 2.54 0.95% CI 1.23 to 5.22, P = 0.01). Study for the underlying causes of hyperhomocysteinemia showed that male gender and Vitamin B12 deficiency had significant influence on incidence of hyperhomocysteinemia. Conclusion We may conclude that hyperhomocysteinemia is an independent risk factor for CAD in young patients (bellow 45 years old) – especially in men -and vitamin B12 deficiency is a preventable cause of hyperhomocysteinemia.

Byline: Faramarz. Fallahi, Mehrdad. Roghani, Sanaz. Moghadami Background and Objective: Cardiovascular disorders continue to constitute major causes of morbidity and mortality in diabetic patients. In this study, the effect of [...]

PURPOSE: To translate, adapt, and assess the psychometric properties of the Sex After MI Knowledge Test in Iranian context (where MI is myocardial infarction). DESIGN AND METHODS: A cross‐sectional descriptive survey was performed. The sample comprised 250 patients with MI. Confirmatory factor analysis was applied to extract three indicators. FINDINGS: The Sex After MI Knowledge Test indicated good reproducibility (Cronbach's α = .76, Intraclass correlation (ICC) = 0.729, CI = 0.7280–0.781, p < .001 ICC: Intraclass correlation). Nonnormed and normed fit indices (FI) were 0.89, and incremental and comparative FIs were 0.90. Goodness‐of‐fit index (GFI) and adjusted GFI were below the criteria. After a varimax rotation, the first six items of the instrument explained 58.71% of total variance. PRACTICE IMPLICATIONS: The instrument showed acceptable psychometric properties in terms of construct validity and internal consistency. The instrument might be used to stimulate conversations patients with MI regarding sexual knowledge and concerns. [ABSTRACT FROM AUTHOR]

The compositions of the essential oils of leaf, flower and stem of Melissa officinalis L. were analyzed by GC-MS. Twenty-seven volatile components in the leaf oil, twenty-eight components in the flower oil, and thirty five components in the stem oil were identified. The main constituents of the leaf oil were: β-caryophyllene oxide (27.8%), geranial (21.3%), neral (12.9%), β-caryophyllene (8.0%) and geranyl acetate (5.6%); while the major components of the flower oil were: geranial (27.4%), neral (18.0%), β-caryophyllene (15.6%), β-caryophyllene oxide (7.5%) and E-cadina-1(6),4-diene (7.1%). The main constituents of the stem oil were: n-hexadecanoic acid (47.4%), (Z,Z)-9,12-octadecadienoic acid (14.9%), dodecanoic acid (4.6%), β-caryophyllene (4.2%) and geraniol (2.2%). Oils of the leaf and flower were almost completely composed of mono- and sesquiterpenoids, while oil of the stem is mainly consisted of the saturated and unsaturated fatty acids as well as some normal saturated hydrocarbons along with minor quantities of volatile terpenoids. [ABSTRACT FROM AUTHOR]

Context: Sulfur mustard (SM), with an old manufacturing history still remains as potential threat due to easy production and extensive effects. Objectives: Increasing studies on SM indicates the interest of researchers to this subject. Almost all human body organs are at risk for complications of SM. This study offers organ-by-organ information on the effects of SM in animals and humans. Methods: The data sources were literature reviews since 1919 as well as our studies during the Iraq-Iran war. The search items were SM and its all other nomenclatures in relation to, in vivo, in vitro, humans, animals, eye, ocular, ophthalmic, lungs, pulmonary, skin, cutaneous, organs and systemic. Amongst more than 1890 SM-related articles, 257 more relevant clinicopathologic papers were selected for this review. Results: SM induces a vast range of damages in nearly all organs. Acute SM intoxication warrants immediate approach. Among chronic lesions, delayed keratitis and blindness, bronchiolitis obliterans and respiratory distress, skin pruritus, dryness and cancers are the most commonly observed clinical sequelae. Conclusion: Ocular involvements in a number of patients progress toward a severe, rapid onset form of keratitis. Progressive deterioration of respiratory tract leads to 'mustard lung'. Skin problems continue as chronic frustrating pruritus on old scars with susceptibility to skin cancers. Due to the multiple acute and chronic morbidities created by SM exposure, uses of multiple drugs by several routes of administrations are warranted. [ABSTRACT FROM AUTHOR]

Sulfur mustard, a chemical warfare agent, has short- and long-term effects on various organs including respiratory system. Its late toxic effects on biological macromolecules among exposed veterans have not been well studied. We performed a study to determine paraoxonase-1 (PON1) activity and phenotype distribution as well as its correlation with albumin level in 289 male veterans with severe pulmonary complications who had exposure to sulfur mustard 20 years ago and in 66 age and ethnic matched healthy male subjects as controls. Serum albumin levels were lower in the veterans compared to controls ( P < 0.001). Mean basal PON1 activity was 91.61 ± 44.80 U/mL in the veteran group versus 110.27 ± 50.23 U/mL in controls ( P = 0.005). Arylesterase activity was not significantly different between the two groups. Paraoxonase to arylesterase activity ratio was significantly lower in the veterans as compared to controls ( P = 0.005), mainly indicative of decreased PON1 activity rather the enzyme level. Significant reduction was found in serum albumin and PON1 activity with disease severity. Moreover, decreased high active BB (high activity) phenotype and increased intermediate active AB (moderate activity) phenotype were found in the veterans. This condition may lead to long-term accumulation of reactive oxygen metabolites resulting in a pro-oxidation milieu, which in turn can lead to increased peroxide levels and decreased antioxidant PON1 activity. In conclusion, lower serum PON1 activity and albumin might contribute to morbidity and occurrence of other complications such as atherosclerosis and rapid aging in the veterans suffering from late toxic effects of sulfur mustard. [ABSTRACT FROM AUTHOR]

To describe the long-term health status of Sardasht civilians 20 years after sulfur mustard exposure, a historical cohort study was carried out in Sardasht (Iran) that included 372 exposed and 128 unexposed civilians. Their symptoms, diagnoses, drug use, and general health were compared. The most common complaints were about the respiratory system (93.5%), eyes (52%), skin (94.7%), and anxiety and depression (69.2%). Respiratory (42.5%), skin (75.5%), ophthalmic (19.6%), and mental (62.7%) diseases were diagnosed by specialists and they were more common in the exposed group than the control group ( P < 0.001). Most of the exposed group had used drugs (70.6%), which was more than control group (42.8%). It seems that exposure to sulfur mustard caused a lot of health problems in Sardasht. Identifying the pathophysiology of these problems can help them more, but more investigation is needed. [ABSTRACT FROM AUTHOR]

Sulfur mustard has various toxic effects. Some of the complications due to sulfur mustard toxicity are well known and some are unclear. In this study, serum total bilirubin and some hematologic parameters were evaluated in populations exposed to different doses of sulfur mustard. The sulfur mustard–exposed victims from Sardasht-Iran were divided into two groups 20 years after exposure, based on hospitalization at the time of the exposure. Studied groups were hospitalized and not hospitalized (n = 169 and n = 203, respectively). Liver function tests including total serum bilirubin, direct bilirubin, SGOT, SGPT, ALP, and hematologic parameters composed of RBC count, hemoglobin, hematocrit, and RBC indexes were evaluated. Total counts for RBC, MCV and total serum bilirubin were significantly different between the two groups, but there was no statistically significant difference in direct bilirubin, SGOT, SGPT, ALP, hemoglobin, hematocrit, MCH, MCHC between the two groups. [ABSTRACT FROM AUTHOR]

Sulfur mustard (SM) is an alkylating agent used several times by Iraqi forces as a chemical warfare agent in the Iraq-Iran war (1980–1988). Eyes, skin and respiratory system are the most sensitive organs to SM exposure. This agent has a suppressor effect on the immune system. As we did not find any study on the late rheumatologic complications of SM in the exposed victims in literature, in this study we investigated these complications in Sardasht (Iran) civilians 20 years after exposure. In a cohort study, 370 victims of Sardasht (that divided into two groups: hospitalized, n = 167, and non hospitalized, 203) in comparison to 128 control subjects from Rabat (Iran). The chief rheumatologic complaints, the physical examinations, the most probable clinical diagnosis and the rheumatic laboratory tests were compared between the study groups. The chief complaint was lower extremity pain; the most frequent physical finding was widespread tenderness and the most frequent clinical diagnosis was psychogenic pain. Among laboratory tests, only anti nuclear antibody (ANA) had significantly higher titer in the hospitalized victims than in the control subjects ( P = 0.02). The most frequent rheumatologic complications were degenerative diseases of joints and spine. There was no significant difference in inflammatory disease between the two groups, but there were more rheumatoid arthritis patients among the victims. Higher ANA titers may indicate some autoimmune disorders as late rheumatic complications of SM. [ABSTRACT FROM AUTHOR]

Mustard gas was the most extensively used chemical agent in the Iraq-Iran war (1980–1988). It affects many important organs and systems; however, its cardiovascular effects are still unclear. In a historical cohort study, we evaluated the symptoms and signs of mustard gas exposed victims (397 cases) and compared the findings with the control group (132 persons). Typical chest pain was more frequent in the exposed group (11% versus 0%, P = 0.450). In addition, exertional dyspnea was found in 50% of the exposed group versus 30% in the control group ( P = 0.162). Chest pain and dyspnea were more frequent in the exposed group and cardiac signs were the same in the two groups. Further studies must be planned for evaluating ischemic and valvular heart diseases, myopathy and other cardiovascular problems in these victims. [ABSTRACT FROM AUTHOR]

Sulfur mustard (SM) is a vesicant or blistering chemical agent that possesses mutagenic and carcinogenic properties and alkylates DNA. Little is known about the long-term effects of sulfur mustard on blood cells. The aim of this study is to examine the long-term effects of SM on peripheral blood cells in SM victims of the Iraq-Iran war (1980–1988). This study, which is a part of Sardasht Iran Cohort Study (SICS) was designed in two groups: exposed (372 participants from Sardasht) and control (128 unexposed people from Rabat). The exposed group was divided into hospitalized and not hospitalized subgroups based on the severity of lesions at exposure time. A comparison was made between the study groups’ overall blood exams. The hospitalized group had significantly higher numbers of red blood cells ( p = 0.003) than not hospitalized and the control groups. The exposed group had significantly higher HCT and MCV ( P = 0.007) than the control group. Exposure group had significantly lower numbers of PLT ( P = 0.001), WBC ( P = 0.006) and PMN ( P = 0.001) than the control group but from clinical viewpoint this difference is not valuable. Further, lymph cells ( P = 0.001) in the exposed group were significantly higher than in the control group. Our research findings suggested the probability of severe damage to bone marrow and predisposing to infection in other organs (especially lung) due to exposure to SM in the exposed group. [ABSTRACT FROM AUTHOR]

Sulfur mustard (SM) has widely been used against the military and civilians during the Iraq-Iran war (1980–1988). It mostly affects the respiratory system. A large historical cohort study was designed to evaluate the pulmonary status of non-military victims in Sardasht, Iran, in comparison with a matched control group 20 years after a single massive exposure. The exposed group was divided into two subgroups of hospitalized and non-hospitalized based on the severity of the injuries indicated by hospitalization a few days following exposure. All participants’ respiratory symptoms and signs were evaluated by internists. Dyspnea (n = 261; P = 93.2%) was the most common symptom. Chronic cough, cough severity, sputum, hemoptysis, dyspnea, pattern of dyspnea, severity of dyspnea ( P <0.001 for all), and chest pain ( P = 0.003) were statistically significantly different between the two groups. Wheezing was the most common pulmonary finding (11.4%). There was also a statistically significant difference in the auscultation of wheezing ( P = 0.045) and rhonchi ( P = 0.018) between the hospitalized and control groups. Considering objective findings, pulmonary involvement was observed in 24.3% (n = 68, P = 0.007). [ABSTRACT FROM AUTHOR]

Background: Hyperhomocysteinemia is known as an independent risk factor of atherosclerosis, but the probable role of hyperhomocysteinemia in premature Coronary Artery Disease (CAD) is not well studied. The aim of this study was to assess the role of hyperhomocysteinemia, folate and Vitamin B12 deficiency in the development of premature CAD. Methods: We performed an analytical case-control study on 294 individuals under 45 years (225 males and 69 females) who were admitted for selective coronary angiography to two centers in Tehran. Results: After considering the exclusion criteria, a total number of 225 individuals were enrolled of which 43.1% had CAD. The mean age of participants was 39.9 +/- 4.3 years (40.1 +/- 4.2 years in males and 39.4 +/- 4.8 years in females). Compared to the control group, the level of homocysteine measured in the plasma of the male participants was significantly high (14.9 +/- 1.2 versus 20.3 +/- 1.9 micromol/lit, P = 0.01). However there was no significant difference in homocysteine level of females with and without CAD (11.8 +/- 1.3 versus 11.5 ± 1.1 micromol/lit, P = 0.87). Mean plasma level of folic acid and vitamin B12 in the study group were 6.3 +/- 0.2 and 282.5 +/- 9.1 respectively. Based on these findings, 10.7% of the study group had folate deficiency while 26.6% had Vitamin B12 deficiency. Logistic regression analysis for evaluating independent CAD risk factors showed hyperhomocysteinemia as an independent risk factor for premature CAD in males (OR = 2.54 0.95% CI 1.23 to 5.22, P = 0.01). Study for the underlying causes of hyperhomocysteinemia showed that male gender and Vitamin B12 deficiency had significant influence on incidence of hyperhomocysteinemia. Conclusion: We may conclude that hyperhomocysteinemia is an independent risk factor for CAD in young patients (bellow 45 years old) — especially in men -and vitamin B12 deficiency is a preventable cause of hyperhomocysteinemia. [ABSTRACT FROM AUTHOR]

Background: Matrix metalloproteinases (MMPs) are a family of proteinases and have the vigorous capacity to degrade all parts of the extracellular matrix. MMP enzymes strongly participate in physiological processes such as normal tissue remodeling and wound healing and in pathology of pulmonary diseases. They are released in response to environmental stimuli such as toxins and regulated by endogenous tissue inhibitors of metalloproteinases (TIMPs). Sulfur mustard (SM) is a chemical toxic which can cause severe permanent damages to lung tissues. The aim of this study was assessing the possible role of MMP-9 and TIMPs in SM-induced lung symptoms and signs in exposed patients 20 years after exposure. Methods: Totally, 372 male volunteers with a history of SM exposure and 128 age- and sex-matched unexposed controls participated and were divided into three groups: normal, mild and moderate-severe. All participants underwent clinical evaluation and pulmonary function tests and serum concentrations of MMP-9 and its inhibitors were measured using the ELISA technique. Results: Serum level of MMP-9 was increased in the SM exposed group who had moderate-severe pulmonary complications compared with the SM exposed with normal lung (2.321 ±2.836 vs. 1.546 ±2.176, P = 0.001) while only the MMP-9/TIMP-4 complex was elevated in the SM exposed with normal lung individuals compared to its corresponding control group (85 ± 265 vs. 82 ± 222, P = 0.025). Although MMP-9 and its inhibitors did not show any correlation with spirometry findings, elevated circulating MMP-9 was detected in SM exposed patients with chronic chough and hemoptysis (P = 0.013 and P= 0.013 respectively). Conclusion: High level of tissue disruption and remodeling mediators could influence lung structure in long-term after SM exposure. The correlation of clinical evaluation with these factors efficiently helps us to identify important effectors. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance In Traditional Iranian Medicine (TIM), Melissa officinalis L. is commonly regarded as an effective therapy for heart palpitations. Objective Heart palpitation is a common complaint that is often benign and associated with a marked distress that makes the condition difficult to treat. Herbal medicines provide an alternative to conventional drugs for treating various kinds of diseases. This study was done as a double blind randomized placebo-controlled clinical trial to evaluate the efficacy and safety of the dried extract of M. officinalis on adults suffering from benign palpitations. Materials and methods Eligible volunteers were randomly assigned as outpatients to a 14 day treatment with 500 mg twice a day of lyophilized aqueous extract of M. officinalis leaves (or placebo). Participants in the tests, physicians and researchers were blind to group assignments. Both primary and secondary outcomes were patient-reported. Primary outcomes were obtained from two measures: mean frequency of palpitation episodes per week, derived from patients׳ diaries, and mean intensity of palpitation estimated through Visual Analogue Scale (VAS) in a self-report questionnaire. Psychiatric symptoms (somatization, anxiety and insomnia, social dysfunction and severe depression) were evaluated as secondary outcomes by General Health Questionnaire-28 (GHQ-28), before and after intervention. Results Fifty-five volunteers out of 71 recruited study subjects completed the trial. Results showed that 14-day of treatment with lyophilized aqueous extract of M. officinalis leaves reduced frequency of palpitation episodes and significantly reduced the number of anxious patients in comparison to the placebo ( P =0.0001, P =0.004 resp.). Also, M. officinalis extract showed no indication of any serious side effects. Conclusion Lyophilized aqueous extract of M. officinalis leaves may be a proper and safe herbal drug for the treatment of benign palpitations. [ABSTRACT FROM AUTHOR]

Abstract: Sulfur mustard (SM) is a blistering chemical agent which has short and long term toxicity against many organs. The respiratory tract is one of the main targets, and is the most disabling long term complication of SM. Inflammatory mediators especially IL-8 and IL-6 play the primary role in the various chronic pulmonary diseases. Sardasht-Iran Cohort Study (SICS) was designed to evaluate immunological and molecular parameters in SM exposed people 20 years after exposure. In the present study, the association of the serum levels of IL-8, IL-6, C reactive protein (CRP) and rheumatoid factor (RF) with long term pulmonary involvement was evaluated. There were 348 exposed and 120 control participants. The clinical evaluations were done for all subjects and Spirometry was performed according to American Thoracic Society Criteria. Severity of pulmonary involvement was assessed by Global Initiative for chronic Obstructive Lung Disease (GOLD) classification. The serum levels of IL-8, IL-6 and RF were assessed by ELISA assay. CRP was assessed by photometric method. The serum levels of IL-8 and IL-6 significantly decreased in the SM exposed participants compared to the control group. There were no significant associations between the serum levels of IL-8 and pulmonary symptoms (chronic cough, sputum, hemoptysis, and dyspnea), pulmonary findings (crackles, rales, and wheezing) as well as spirometry parameters. IL-6 was associated with wheezing and CRP was associated with wheezing and rales in SM exposed group. We concluded the serum levels of these inflammatory mediators probably do not have any major role in pathogenesis and persistence of pulmonary complications and do not reflect the degree of severity of pulmonary involvement following SM exposure. [Copyright &y& Elsevier]

Background: Dyslipidemia leads to micro- and macro-vascular complications. Atorvastatin is the main therapeutic drug used for dyslipidemia, but it causes side effects such as new type 2 diabetes mellitus onset and elevation of liver enzymes. Herbs may be useful in reducing atorvastatin doses. Caper fruit, an herbal drug in Persian Medicine, has hypolipidemic effects. Hence, the effect of atorvastatin therapy with and without daily caper fruit pickle (CFP) consumption was assessed on hyperlipidemia., Materials and Methods: In this single-blinded, randomized, controlled trial, 60 hyperlipidemic patients were allocated in two groups and treated with 10 mg atorvastatin plus 40-50 g CFP (A10+CFP) or atorvastatin alone (A10) for eight weeks. Biochemical parameters were measured at baseline, 4, and eight weeks of the intervention. One-way repeated measure ANOVA and mixed ANOVA were used to measure the effect of the two treatments and the interaction between the type of treatment and time on lipid profile., Results: Serum total cholesterol and low-density lipoprotein cholesterol (LDL-C) were significantly decreased in the A10+CFP group compared with the A10 group (P<0.001 and P<0.001, respectively) from baseline up to the week 8. At week 4, mean changes of LDL-C was significantly higher in the A10+CFP compared with the A10 (P=0.01). Adjusting for the baseline variables, the mean difference of alanine aminotransferase (P<0.01) and triglyceride (P=0.003) were significantly higher in the A10+CFP group at the end., Conclusion: This study reports that the intake of CFP along with atorvastatin daily may have synergistic effects which improve the lipid profile in hyperlipidemic patients., (Copyright© 2019, Galen Medical Journal.)

Background: Matrix metalloproteinases (MMPs) are a family of proteinases and have the vigorous capacity to degrade all parts of the extracellular matrix. MMP enzymes strongly participate in physiological processes such as normal tissue remodeling and wound healing and in pathology of pulmonary diseases. They are released in response to environmental stimuli such as toxins and regulated by endogenous tissue inhibitors of metalloproteinases (TIMPs). Sulfur mustard (SM) is a chemical toxic which can cause severe permanent damages to lung tissues. The aim of this study was assessing the possible role of MMP-9 and TIMPs in SM-induced lung symptoms and signs in exposed patients 20 years after exposure., Methods: Totally, 372 male volunteers with a history of SM- exposure and 128 age- and sex-matched unexposed controls participated and were divided into three groups: normal, mild and moderate-severe. All participants underwent clinical evaluation and pulmonary function tests and serum concentrations of MMP-9 and its inhibitors were measured using the ELISA technique., Results: Serum level of MMP-9 was increased in the SM exposed group who had moderate-severe pulmonary complications compared with the SM exposed with normal lung (2.321 ± 2.836 vs. 1.546 ± 2.176, P = 0.001) while only the MMP-9/TIMP-4 complex was elevated in the SM exposed with normal lung individuals compared to its corresponding control group (85 ± 265 vs. 82 ± 222, P = 0.025). Although MMP-9 and its inhibitors did not show any correlation with spirometry findings, elevated circulating MMP-9 was detected in SM exposed patients with chronic chough and hemoptysis (P = 0.013 and P = 0.013 respectively)., Conclusion: High level of tissue disruption and remodeling mediators could influence lung structure in long-term after SM-exposure. The correlation of clinical evaluation with these factors efficiently helps us to identify important effectors.

Background: 'Palpitation' is one of the most common complaints in patients referring to cardiologists. In modern medicine era, these patients suffer from much distress and some cases are known to be difficult to treat. Although the clinician's first duty is obviously to search for an organic basis for this symptom, the diagnostic evaluation is frequently unrevealing. However, clinical experience suggests that psychiatric causes are relatively common., Objectives: This research aimed to screen for mental disorders in patients complaining of palpitation and healthy persons in order to perform a preliminary comparison between them., Patients and Methods: This is a case-control study to screen mental disorders. The target population consisted of adult volunteers with benign palpitation and their matched healthy persons. They were referred during a 10-month-period to the cardiology outpatient's clinic of Mostafa Khomeini hospital in Tehran, Iran. Sampling was accidental and eventually 110 participants comprised the sample size. The measuring tool was GHQ-28 (28-item general health questionnaire) and the main variable was the questionnaire score obtained from the Likert scoring method., Results: Comparing two groups showed that the number of participants with the scores more than cut-off point in palpitation group was significantly more than healthy person group (85.4% vs. 43.6% with P < 0.001). Also the total score of GHQ-28 and scores of its subscale (somatization, anxiety, and social dysfunction) in patients complaining of palpitation were significantly more than those of the healthy participants (34.2 vs. 25.7, 8.9 vs. 6.4, 9.4 vs. 6.4, and 12.3 vs. 10.8, respectively with P < 0.001, P = 0.001, P < 0.001, and P < 0.007, respectively)., Conclusions: Palpitation is the most common symptom in psychiatric disorders such as anxiety and somatization disorders. According to the results of this study, psychiatric causes have an important role in Iranian patients complaining of palpitations (benign form). Considering this fact may lead to a more effective treatment of benign palpitations.

Background: Metabolic syndrome can cause cardiovascular disease and diabetes in the affected subjects. With 20 to 30% prevalence rate among the adult population of most countries, it is considered a pandemic problem. The guidelines currently available on the management of the specific components of metabolic syndrome highlight some lifestyle changes such as enhanced physical activity and weight reduction. Adherence to Mediterranean-style diet has been shown to be associated with lower risk of metabolic syndrome in some clinical studies., Objectives: The aim of this study was the evaluation of the effect Razavi dietary pattern, on metabolic syndrome. This is the first study performed to address this issue., Patients and Methods: Seventy five eligible subjects with metabolic syndrome were recruited into a single-blind randomized controlled clinical trial to determine the effect of Razavi diet on metabolic syndrome. Intervention was carried out by educating the Razavi diet in the experimental group while giving no dietary recommendations to the control group. The level of physical activity was similar between the two groups. Features of the metabolic syndrome as defined by the criteria of the Iranian National Committee of Obesity were assessed after two months., Results: The net reduction in the waist circumference (-2.85), weight (-1.44) and BMI (-0.58) in test group was significantly (P < 0.001) higher than the control. Decreases in systolic and diastolic blood pressure, fasting blood sugar and triglycerides were observed but were not statistically significant., Conclusions: The results suggest that Razavi diet can improve some components of metabolic syndrome leading to reduced risk of cardiovascular disease and diabetes.

Background: Insights into long-term clinical consequences of sulfur mustard have emerged from some investigations but less is known about the basic and molecular mechanisms of these complications. Sardasht-Iran Cohort Study is a comprehensive historical cohort study on Sardasht chemical victims' population which was designed to find out the long-term complications of sulfur mustard exposure and the basic mechanisms underlying clinical manifestations. This paper describes the design and methodology of Sardasht-Iran Cohort Study., Methods: In Sardasht-Iran Cohort Study, 500 individuals including 372 subjects from Sardasht, as the exposed group, and 128 subjects from Rabat, as the unexposed age-matched control group were evaluated. The exposed group was divided into two groups based on the severity of clinical complications at the time of exposure. Different samples including blood, sputum, saliva, tear, urine, and semen were collected for immunologic, hematologic, biochemical, and other laboratory analysis. Data were gathered from medical records, clinical examinations, laboratory tests, and questionnaires for psychological and lifestyle situations., Conclusion: The important distinctions setting this study apart from the previous ones are discussed. The Sardasht-Iran Cohort Study provides important information on various aspects of long-term consequences of sulfur mustard exposure. This database will provide a better position to suggest guidelines for the diagnosis, treatment, and prevention of delayed complications in the patients exposed to sulfur mustard.