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Abstract The present research was conducted aiming at predicting the resilience based on parenting and coping strategies in patients with psychosomatic disorders. The statistical population of the present research consisted of all patients suffering from psychosomatic disorders who had visited medical clinics related to Medical Sciences (University) of Arak County in 2019-20. The statistical sample includes 347 women, aged 18 to 55 years-old, who were selected by available sampling. Data collection tool included Young parenting, Moss and Billings coping strategies questionnaire and Connor and Davidson resilience questionnaire. Pearson’s correlation coefficient and multiple regression analysis were used to analyze the data. The findings showed that parenting (dependency, preoccupied/untransformed self) have a negative and significant relationship with resilience. Coping strategies focused on emotion, coping focused on physical restraint or physicalization of problems have a negative and significant relationship with resilience and have a positive and significant relationship with coping strategies focused on problem-solving and coping focused on cognitive evaluation. According to the findings, it can be concluded that it is possible to pave the way for increasing resilience and preventing the development of psychosomatic disorders by creating suitable conditions during the childhood, improving parent-child relationships, and by strengthening coping strategies focused on problem-solving and coping focused on cognitive evaluation.

BackgroundComplications related to diabetic foot ulcers (DFU) due to diabetes are increasing. One of the factors influencing the management and treatment of complications related to DFU is the vitamin D serum levels of patients. Therefore, we sought to comprehensively review meta-analyses from randomized controlled trials and observational studies examining the link between serum vitamin D levels and DFU outcomes in diabetic patients.MethodsWe searched PubMed, Scopus, and ISI Web of Science until September 2024 and extracted the required data from related articles according to Inclusion criteria. The certainty of the evidence and the quality of conduct of the published meta-analyses were rated using the ASMTAR 2 tools, respectively.ResultA total of 8 meta-analyses studies that met inclusion criteria were included. Based on the obtained results, it has been noted that individuals with DFU exhibit serum vitamin D levels significantly lower, ranging from −7.14 (5.44, 8.83) to −0.93 (95% CI: 0.17, 1.68) ng/ml, compared to those with diabetes but without DFU. Furthermore, individuals exhibiting severe vitamin D deficiency are found to be at least 1.82 times more susceptible to developing DFU. Conversely, administering varying doses of vitamin D supplementation has been shown to positively affect the size and number of ulcers in DFU patients.ConclusionThis study suggests a potential link between lower levels of vitamin D in the blood and the risk of DFU, hinting at the benefits of vitamin D supplementation in improving outcomes associated with DFU. However, caution is warranted due to the potential bias present in the included studies.

Background: Caffeine is commonly used as an ergogenic aid to increase strength and endurance in athletes. The results of meta-analyses in this regard are still conflicting. Therefore, the current umbrella meta -analysis was conducted to determine the effects of caffeine supplementation on muscle strength and endurance as a clear and final conclusion. Methods: Relevant studies were searched in international databases including PubMed, Scopus, and Web of Science until August 15, 2022. Meta-analysis studies examining the effects of caffeine supplementation on muscle strength and endurance were included in this study. Random effects model was used to perform meta-analysis. Additional analyses including subgroup and sensitivity analyzes were performed. Findings: In general, 9 meta-analyses were included in the study. The results showed that caffeine supplementation led to a significant increase in muscle strength (SMD = 0.18, 95 % CI: 0.14, 0.21; p

Background: Clinical studies, investigating the effect of β-Alanine (BA) supplementation on recovery biomarkers in physically active individuals, have generated inconsistent results. This systematic review and meta-analysis study aimed to clarify the clinically relevant dietary effects of BA supplementation. Methods: A comprehensive search was done in the electronic databases of Scopus, PubMed, ISI Web of Science and Embase from inception to 2022. Meta-analysis was done using the random-effects model. Pooled effect size was evaluated using standard mean difference (SMD) and 95% confidence intervals (CI). Heterogeneity of between-study was evaluated according to Cochran’s Q test and I2 . Subgroup analysis was conducted to identify the potential sources of heterogeneity. Results: Overall, 32 studies were included in the current study. The results suggested that BA supplementation increases carnosine level significantly (SMD: 0.22mmol/L, 95%CI: -0.17, 0.61, P=0.27) but no effect was shown about lactate, fatigue, VO2 , pH and bicarbonate (HCO3 - ) (P>0.05). Subgroup analysis revealed a significant association of VO2, carnosine and fatigue with supplementation dosage, gender and duration of administration respectively. Conclusion: BA supplementation emerged its beneficial effects on enhancing carnosine level which highlights its ergogenic effects. In contrast, no significant effects had been shown in term of fatigue delay and blood levels of lactate, HCO3 - , pH, and VO2 value. These results warrant more investigation in a prospective design to clarify the exact mechanism in this way.

Mandibular deviation due to premature contact of teeth in crossbite may be associated with facial asymmetry.

Summary: Background: N-acetylcysteine (NAC) as a potent anti-inflammatory and antioxidant compound, has raised scientific interest to affect endothelial function. The present systematic review aimed to summarize the potential therapeutic effects of NAC in different health status. Methods: PubMed, Web of Science, Scopus, and Google Scholar were searched up to 2023 to obtain relevant studies. The PRISMA guidelines were employed during all steps. Two reviewers independently extracted the information from the included studies. The studies investigating the effect of oral and intravenous NAC on vascular function were included in the current study. Results: A total of 4455 studies were identified. Finally, fifteen studies were included in the present systematic review. Both oral and intravenous NAC administration have been evaluated in eight and seven studies, respectively. Most of included studies, illustrated no significant changes in the markers of vascular function due to NAC supplementation. However, 3 studies showed significant reduction in the Intercellular adhesion molecule-1 (ICAM-1) level based on NAC supplementation. Whereas, there was inconsistent results in term of vascular adhesion molecule-1 (VCAM-1) and NO levels. In general, NAC supplementation had led to an improvement in the markers of vascular function (ET, FMD, SVR, CVR) in a non-significant model. Conclusion: It seems that NAC may have favorable effects in vascular dysfunction. However, more studies are needed to confirm these results and clarify the relevant mechanisms.

Inconsistencies are evident within the literature regarding the effect of cocoa consumption on anthropometric outcomes. To address the influence of cocoa consumption on weight, body mass index (BMI), and waist circumference (WC) in overweight and obese subjects we conducted a time and dose–response meta-analysis of randomized controlled trials (RCTs). Scopus, Web of Science, Embase, and PubMed/Medline were searched for relevant articles from inception until July 11, 2023. The random effects method meta-analysis compared changes in anthropometric outcomes in participants Results are displayed as weighted mean difference (WMD) with 95 % confidence interval (CI). 19 RCTs were included in the present meta-analysis. Cocoa consumption significantly decreased body weight (WMD: −0.26 kg, 95 % CI: −0.49 to −0.02, P = 0.028), BMI (WMD: −0.16 kg/m2, 95 % CI: −0.30 to −0.02, P = 0.021), and WC (WMD: −0.69 cm, 95 % CI: −1.35 to −0.03, p = 0.038). In subgroup analyses, cocoa consumption resulted in lowered body weight in dosages ≤20 g/day (WMD: −0.33 kg), and treatment duration ˃4 weeks (WMD: −0.35 kg). In the non-linear dose–response assessment, a negative correlation was found between cocoa consumption dose (up to 50 g/day) and changes in WC (P = 0.001) and body weight (P = 0.0007). Cocoa consumption is associated with a reduction in BMI, weight, and WC in overweight and obese subjects; however, statistically significant effects were only detected in doses less than 20 g/day and interventions longer than 4 weeks.

Abstract Purpose Dyslipidemia is considered as a known risk factor for cardiovascular disease. Yet various trials with wide ranges of doses and durations have reported contradictory results. We undertook this meta-analysis of randomized controlled trials (RCTs) to determine whether omega-3 supplementation can affect lipid profile in children and adolescents. Methods Cochrane Library, Embase, PubMed, and Scopus databases were searched up to March 2021. Meta-analysis was performed using random-effect method. Effect size was expressed as weighted mean difference (WMD) and 95% confidence interval (CI). Heterogeneity was assessed using the I 2 index. In order to identification of potential sources of heterogeneity, predefined subgroup and meta-regression analysis was conducted. Results A total of 14 RCTs with 15 data sets were included. Based on the combination of effect sizes, there was a significant reduction in TG levels (WMD: -15.71 mg/dl, 95% CI: -25.76 to -5.65, P=0.002), with remarkable heterogeneity (I2=88.3%, P

Abstract Objectives: Several meta-analyses have suggested the beneficial effect of vitamin D on patients infected with severe acute respiratory syndrome coronavirus-2. This umbrella meta-analysis aims to evaluate influence of vitamin D supplementation on clinical outcomes and the mortality rate of COVID-19 patients. Design: Present study was designed as an umbrella meta-analysis. The following international databases were systematically searched till March 2023: Web of Science, PubMed, Scopus, and Embase. Settings: Random-effects model was employed to perform meta-analysis. Using AMSTAR critical evaluation tools, the methodological quality of the included meta-analyses was evaluated. Participants: Adult patients suffering from COVID-19 were studied. Results: Overall, 13 meta-analyses summarising data from 4 randomised controlled trial and 9 observational studies were identified in this umbrella review. Our findings revealed that vitamin D supplementation and status significantly reduced mortality of COVID-19 [Interventional studies: (ES = 0·42; 95 % CI: 0·10, 0·75, P < 0·001; I 2 = 20·4 %, P = 0·285) and observational studies (ES = 1·99; 95 % CI: 1·37, 2·62, P < 0·001; I 2 = 00·0 %, P = 0·944). Also, vitamin D deficiency increased the risk of infection and disease severity among patients. Conclusion: Overall, vitamin D status is a critical factor influencing the mortality rate, disease severity, admission to intensive care unit and being detached from mechanical ventilation. It is vital to monitor the vitamin D status in all patients with critical conditions including COVID patients.

The integration of 3D printing technology in maxillofacial surgery in Iran represents a significant advancement in medical practice, offering unprecedented precision and efficiency in surgical procedures. Employing the Non-Adoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) framework and the WHO Health Systems Framework, this study analyzes the complex impact and challenges of 3D printing adoption within the Iranian healthcare sector. Maxillofacial surgery has seen transformative progress with 3D printing’s ability to produce accurate surgical models and customized implants. The results indicate a notable improvement in surgical precision and patient recovery times, alongside combatting identified barriers including technological access, cost, and skill acquisition. This conclusion underscores the critical need for targeted educational programs, policy support, and infrastructure development to overcome these obstacles. This paper highlights 3D printing’s potential to revolutionize maxillofacial surgery in Iran, provided that comprehensive strategies are implemented to address the current limitations and fully leverage this innovative technology’s benefits.

Background & aim: Pumpkin plant has medicinal properties in the treatment of various metabolic disorders, which despite its good effectiveness, there is still no consensus on its use during pregnancy. Therefore, the purpose of the present study was to determine and investigate the effect of using pumpkin on the treatment of non-alcoholic fatty liver disease and the occurrence of gestational diabetes in pregnant women. Methods: In the present study conducted as a randomized clinical trial in 2016, 60 pregnant women with non-alcoholic fatty liver disease were selected and randomly assigned to the group receiving the diet with pumpkin in the amount of 100 grams for 6 weeks and the group Diet recipients were divided alone. Serum metabolic indices, fatty liver grade, B-Mode ultrasound and gestational diabetes were compared between the two groups. Collected data were analyzed using Kolmogorov-Smirnov statistical tests, analysis of variance, chi-square, t-test, Wilcoxon, McNemar and chi-square. Results: The results of the present study indicated that the metabolic indices of ALT, AST, ALP, LDL, and Chol had a significant difference between the intervention and control groups after the intervention (p0.05). The amount of changes in B-Mode ultrasound after treatment was significant in both intervention (p=0.001) and control (p=0.046) groups. The point of the findings should be written in more detail, it is very dumb and incomprehensible Conclusion: Based on the obtained results, it was concluded that the use of pumpkin in pregnant mothers did not have a dissimilar effect than the placebo in the treatment of non-alcoholic fatty liver and on the incidence of gestational diabetes, so its use is not recommended for this purpose.

Background: Probiotics exert several promoting effects on the glycemic status, however, the results of meta-analyses are inconsistent. we conducted an umbrella meta-analysis, across existing systematic reviews and meta-analyses of clinical trials to determine the definite effects of supplementation with probiotics on glycemic indices. Methods: A comprehensive systematic search of PubMed/Medline, Scopus, EMBASE, and Web of Science was carried out till August 2021. The random-effects model was employed to conduct meta-analysis. Meta-analysis studies of randomized clinical trials examining the impacts of probiotics supplementation on glycemic indices were qualified in the current umbrella meta-analysis. Results: 48 articles out of 693 in the literature search qualified for inclusion in the umbrella meta-analysis. Pooled effects of probiotics on fasting plasma glucose (FPG), hemoglobin A1C (HbA1c), homeostatic model assessment for insulin resistance (HOMA-IR), and insulin levels were reported in articles 45, 21, 35, and 33, respectively. The analysis indicated a significant decrease of FPG (ES= −0.51 mg/dL; 95% CI: −0.63, −0.38, p

Background: Rheumatoid Arthritis (RA) is a systemic and chronic autoimmune disease with inflammation at the synovial joints. The purposes of this study were to evaluate the correlation between serological variables and temporomandibular disorders (TMDs) in patients diagnosed with RA, evaluated through diagnostic criteria for temporomandibular disorders (DC/TMD), and to check the influence of comorbidities on the different TMD signs and symptoms, or any serological variables. Methods: This observational cohort research study included seventeen patients affected by RA. The comorbidities and some variables from the initial serological analyses were collected from the clinical rheumatological charts. Then, the presence of any of the following TMD signs/symptoms, temporal myalgia, temporomandibular joint arthralgia, click or crepitus, was evaluated through the symptom questionnaire of the DC/TMD during clinical evaluation following the DC/TMD examination form. Results: Rheumatoid factor (RF), anticitrullinated protein antibodies (ACPA), and anti-nuclear antibody (ANA) positivity were present in 82.4%, 52.9%, and 41.2% of patients, respectively. Indicators of tissue inflammation were evaluated with median values of 21 mm/h for erythrocyte sedimentation rate (ESR) and 0.50 mg/dL for C-reactive protein (CRP). The RA patients presented comorbidities such as hypertension in 70.6% and diabetes in 23.5%. Negative ACPA had a significant association with myalgia (p = 0.03), and positive ANA was significantly associated with crepitus (p = 0.05). Conclusion: ANA and ACPA evaluation can be considered predictive serological tests associated with specific TMDs. Conversely, no influence of any comorbidities was found between different TMD signs and symptoms, or any serological variables.

Abstract Background Considering the adverse consequences of respiratory insufficiency in cleft lip and palate (CLP) patients, this study aimed to assess the pharyngeal airway dimensions in 9–12-year-old patients with unilateral CLP. This historical cohort evaluated the cone-beam computed tomography (CBCT) scans of 30 patients with non-syndromic unilateral CLP between 9 and 12 years and 30 age- and sex-matched non-cleft controls. Three-dimensional (3D) images were reconstructed by the Mimics software, and the nasopharyngeal, oropharyngeal, and total airway volumes, as well as the minimal cross-sectional area of the airway (minAx), and posterior airway length (PAL) were all measured in the sagittal plane. Data were analyzed by the Student’s t test. Results The oropharyngeal and the total airway volumes, as well as the minAx and PAL in CLP patients, were significantly smaller than the corresponding values in the control group (P 0.05). Conclusions Nine- to twelve-year-old non-syndromic unilateral CLP patients have smaller pharyngeal airway dimensions than non-cleft controls, and are therefore at higher risk of respiratory insufficiency.

Background and Aim: The main purpose of this study was to compare the metacognitive beliefs of people with hypochondriasis Covid 19 and normal people. Methods & Materials: In this research, the causal-comparative method has been used. The statistical population of the study included all people with hypochondriasis disorder Covid 19 in Arak, based on this, 30 people from the population with this disorder and 30 people from the normal population were selected by available sampling method and based on Age and education were matched. Data were collected based on the short form of the 1997 Wells Metacognition Questionnaire (MCQ-30). Multivariate analysis of variance was used to analyze the data. Ethical Considerations: The present study has been registered with the code IR.IAU.ARAK.REC.1399.036 in the ethics committee of Islamic Azad University Arak branch. Results: There was a significant difference between metacognitive beliefs in patients with hypochondriasis covid 19 and normal individuals (P

Objective: Patients with breast cancer have symptoms of anxiety, depression and anxiety. This study was aimed to investigate the effectiveness of cognitive-behavioral stress management on the clinical symptoms among patients with breast cancer. Methods: The was a quasi-experimental study with pre-test, post-test and follow up assessments. Twenty patients were randomly allocated into two groups: experimental group (10 patients) and control group (10 patients). Cognitive-behavioral stress management was administrated in 8 sessions for experimental group. The research instrument was SCL-90-R questionnaire. Data was analyzed by SPSS-25 software using repeated measure ANOVA. Results: The results showed that cognitive-behavioral intervention led to reduction in clinical symptoms in some dimensions as measured by the SCL-90-R among patients in experimental group (P < 0.05). Conclusion: The findings indicated that the cognitive-behavioral stress management could reduce clinical symptoms of patients with breast cancer. Indeed, using cognitive-behavioral stress management in cancer treatment centers can be regarded as a complementary therapy alongside medical treatments.

Background and Aim: Major Depressive Disorder (MDD) is the most common mental health condition, with a severe decline in performance, disability, and a 15% risk of suicide. Allopurinol increases the level of tryptophan in the body by inhibiting xanthine oxidase, and by elevating the level of tryptophan, i.e., a precursor to serotonin. Accordingly, it can improve the symptoms of depression. This study aimed to investigate the impact of allopurinol on MDD. Methods & Materials: In this double-blind clinical trial, 70 patients with MDD, diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders- Fourth Edition-Third Edition (DSM IV-TR) were randomly (paired & individual patient records) divided into two equal groups. Both research groups received 40 mg of citalopram daily for 6 weeks. In addition to citalopram, the intervention group received 300 mg allopurinol daily and the control group received a placebo. At the end of the third and sixth weeks, the examined patients were tested for Hamilton Depression Rating Scale (HDRS). Ethical Considerations: This study was approved by the Ethics Committee of the Arak University of Medical Sciences (Code: IR.ARAKMU.REC.1394.68). Also, it was approved by the Iranian Registry of Clinical Trials (Code: IRCT201508277373n6). Results: The Mean±SD HDRS’s score, after 3 weeks of treatment, in the control and allopurinol groups was measured as 28.42±3.1 and 23.02±3.4, respectively. After 6 weeks after treatment, the Mean±SD depression score in the control and allopurinol groups was equal to 23.28±4.1 and 20.4±1.2, in sequence. A significant difference was observed between the research groups; thus, the intervention group obtained a lower mean score in the HDRS than the controls. Conclusion: Allopurinol can improve the symptoms of depression and can also be used as an adjunct in the treatment of depression.

Background and Aim: The development of any society depends on the educational system of that society. The educational system can be efficient and successful when considering the academic performance of learners in different courses. This study aimed to investigate the effects of mental self-care education on students’ mental health and academic motivation. Methods & Materials: This was a quasi-experimental study with unequal control and experimental groups. The statistical population of this study was students referring to school counseling centers; 40 of them (n=20/group) were selected by random sampling method. The Depression, Anxiety, and Stress Scale - 21 Items (DASS-21), and Academic Performance Rating Scale were used to collect the necessary data. Psychological self-care training was presented to the experimental group in ten 2-hour sessions. Then, a posttest was conducted on the study groups. Data analysis was performed using Multivariate Analysis of Covariance (MANCOVA). Ethical Considerations: This article was approved by the Ethics Committee of the Islamic Azad University, Khomeini Branch (Code: IR.IAU.ARAK.REC.1399.001). Results: The obtained findings indicated that mental self-care education was effective on students’ mental health (P

Background. Dyslipidemia is a major public health challenge worldwide, and chia seed, a nutrient‐dense functional food, could be beneficial in metabolic disorders. This systematic review and meta‐analysis were conducted to assess how chia seed intake affects lipid profiles. Methods. A comprehensive literature search was conducted on electronic databases including PubMed, Scopus, Web of Science, Cochrane, and Google Scholar up to January 2024. All randomized controlled trials (RCTs) addressing the effect of chia seed on triglyceride (TG), total cholesterol (TC), high‐density lipoprotein (HDL), and low‐density lipoprotein (LDL) were included. Data were analyzed using a random‐effects model and reported as weighted mean differences (WMD) with 95% confidence intervals (CI). Subgroup and sensitivity analyses were also performed. The quality of studies was evaluated using the Cochrane risk of bias tool. Results. A total of seven RCTs involving 304 participants were included in the meta‐analysis. The results showed that chia consumption had no considerable effect on TG (WMD: −18.73 mg/dl; 95% CI: −55.46 to 18.00; p = 0.31), TC (WMD: −7.49 mg/dl; 95% CI: −15.60 to 0.63; p = 0.07), HDL (WMD: −2.85 mg/dl; 95% CI: −6.74 to 1.05; p = 0.15), and LDL (WMD: −8.09 mg/dl; 95% CI: −18.17 to 1.99; p = 0.11). However, subgroup analyses indicated that chia could decrease TC in patients with obesity and type 2 diabetes mellitus (T2DM) and LDL in patients with obesity. Conclusion. Chia consumption had no effect on lipid profiles including triglyceride, total cholesterol, LDL, and HDL. Nevertheless, patients with obesity and T2DM might benefit from its supplementation. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests that Oxidative stress has been shown to plays an important role in gestational diabetes mellitus (GDM) etiology. On the other hand, women with GDM are at an increased risk for complications such as endothelial dysfunction and cardiovascular diseases. Objective: To investigate the effects of alpha-lipoic acid (ALA) on the maternal circulating values of lipid profile and lipid ratios in women with GDM. Materials and Methods: Sixty women with GDM were participated in the present study. The ALA group (n = 30) received ALA (100 mg/day) and the placebo group (n = 30) received cellulose acetate (100 mg/day) for eight wk. The maternal circulating values of hemoglobin A1C, triglyceride (TG), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, triglyceride-glucose (TyG) index, atherogenic index of plasma (AIP), non-HDL-C, and lipid ratios were assessed before and after the intervention. P-value < 0.05 was considered as statistically significant. Results: The values of TyG index (p < 0.001), TG (p = 0.006), TG/HDL-C (p = 0.003), and AIP (p = 0.005) decreased significantly in the ALA group after the intervention. Conclusion: Maternal circulating values of TyG index, TG, TG/HDL, AIP decreased after eight wk of ALA supplementation in women with GDM.

Objective: The study addressed the comparable effects of premedication with dexmedetomidine (DEX), remifentanil (REM) and labetalol (LAB) before electroconvulsive therapy (ECT) on haemodynamic responses and seizure duration in psychotic patients. Materials and Methods: A double-blinded trial recruited four randomised groups of patients undergoing ECT (N = 144), including 0.5 μg/kg DEX, 0.2 mg/kg LAB, 1 μg/kg REM and 20 ml normal saline, respectively. The mean arterial pressure (MAP), heart rate (HR) and saturated oxygen were recorded every 5 min until the patient was transferred to the department. Besides, the recovery time, seizure duration and satisfaction were recorded. Data were analysed in SPSS software using analysis of variance and repeated measurement tests. Results: The MAP and HR were lower in the DEX (P < 0.001) with the longest recovery time (P < 0.001), while the time was lower in the REM. The DEX group showed shorter seizure duration, lower selected energy (P < 0.001) and the highest satisfaction (P < 0.001). Conclusion: The DEX patients appeared to have the highest satisfaction with the shortest seizure duration, as well as the lowest energy used in ECT, and if appropriate useful psychiatric treatment is provided, this adjuvant can be a great option for patients undergoing the therapy, but this reduces BP/HR while prolonging recovery time.

Introduction: Data on comparison of myo-inositol and metformin on mental health parameters and biomarkers of oxidative stress in subjects with polycystic ovary syndrome (PCOS) are scarce. This purpose of this study was to compare of myo-inositol and metformin on mental health parameters and biomarkers of oxidative stress in subjects with PCOS. Methods: This randomized controlled trial was conducted among 60 subjects diagnosed with PCOS according to the Rotterdam criteria. Subjects were randomly assigned into two groups to intake either myo-inositol (n = 30) or metformin (n = 30) for 12 weeks. Parameters of mental health were recorded at baseline and after the 12-week intervention. Fasting blood samples were obtained at baseline and the end of the study to determine biomarkers of biomarkers of oxidative stress. Results: After the 12-week intervention, changes in beck depression inventory total score (−1.0 ± 1.7 vs. −0.3 ± 0.7, p = 0.03), general health questionnaire scores (−1.7 ± 2.9 vs. −0.5 ± 1.2, p = 0.02), depression anxiety and stress scale scores (−3.9 ± 6.4 vs. −0.9 ± 1.9, p = 0.01) and plasma total antioxidant capacity (TAC) concentrations (+106.1 ± 69.6 vs. +2.1 ± 132.4 mmol/L, p

The integration of 3D printing technology in maxillofacial surgery in Iran represents a significant advancement in medical practice, offering unprecedented precision and efficiency in surgical procedures. Employing the Non-Adoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) framework and the WHO Health Systems Framework, this study analyzes the complex impact and challenges of 3D printing adoption within the Iranian healthcare sector. Maxillofacial surgery has seen transformative progress with 3D printing's ability to produce accurate surgical models and customized implants. The results indicate a notable improvement in surgical precision and patient recovery times, alongside combatting identified barriers including technological access, cost, and skill acquisition. This conclusion underscores the critical need for targeted educational programs, policy support, and infrastructure development to overcome these obstacles. This paper highlights 3D printing's potential to revolutionize maxillofacial surgery in Iran, provided that comprehensive strategies are implemented to address the current limitations and fully leverage this innovative technology's benefits. [ABSTRACT FROM AUTHOR]

Background and Aim Obsessive-Compulsive Disorder (OCD) is the fourth most common psychiatric disorder. It consists of symptoms, including intrusive thoughts, rituals, behaviors, preoccupations, and compulsions. This study aimed to evaluate the effectiveness of attention bias modification and selective serotonin reuptake inhibitors in reducing the symptoms of OCD. Methods and Materials study population comprised patients with OCD referring to the outpatient clinic of Amir Kabir Hospital in Arak City, Iran. Of them, 80 patients were randomly assigned to the two groups. The first group received the selective serotonin reuptake inhibitors, and the other group received the treatment modality to determine the effectiveness of the Yale-Brown OCD scale and dot-probe task tests. Ethical Considerations The Research Ethics Committee of Arak University of Medical Sciences approved this study (Research Ethics Code: IR.ARAKMU.REC.1396.284). Results Treatment of attention bias modification in comparison with selective serotonin reuptake inhibitors did not show a significant difference in the reduction of attention bias (P=0.377). Also, a significant difference between the two groups in reducing the symptoms of OCD (P=0.007), indicates that selective serotonin reuptake inhibitors are more effective in diminishing the symptoms of OCD. Besides the attention bias modification decreased the symptoms of OCD, but these results were not significant (P=0.228) Conclusion Attention bias modification is a significant improvement in reducing attention bias and can be used with other interventions. However, it appears that the reduction in the severity of OCD symptoms, as against this intervention, continues to be the preferred treatment for pharmacotherapy.

Abstract Background Diabetes is the most common medical condition in pregnant women and its complications affect both mother and fetus. The beneficial effects of vitamin D on gestational diabetes have been shown, though data on the effects of co-administration of vitamin D with other nutrients on pregnancy outcomes in gestational diabetes (GDM) are scarce. This study was aimed to determine the effects of magnesium-zinc-calcium-vitamin D co-supplementation on parameters of inflammation and oxidative stress, and pregnancy outcomes among women with GDM. Methods This randomized, double-blinded, placebo-controlled trial was conducted on 60 women with GDM not taking oral hypoglycemic agents. Patients were randomly assigned to take magnesium-zinc-calcium-vitamin D supplements (n = 30) or placebo (n = 30) for 6 weeks. Fasting blood samples were collected from participants at baseline and after the 6-week intervention to measure related biomarkers. Results Magnesium-zinc-calcium-vitamin D co-supplementation resulted in a significant reduction in serum high-sensitivity C-reactive protein (− 1.2 ± 3.5 vs. + 0.8 ± 2.0 mg/L, P = 0.01) and plasma malondialdehyde concentrations (− 0.3 ± 0.3 vs. + 0.3 ± 1.1 μmol/L, P = 0.003), as well as a significant increase in total antioxidant capacity levels (+ 38.2 ± 76.5 vs. -16.3 ± 93.5 mmol/L, P = 0.01), compared to placebo. We found a decreasing trend in newborns’ weight (3089.8 ± 519.9 vs. 3346.3 ± 411.1 g, P = 0.05) and the rate of macrosomia (3.3% vs. 16.7%, P = 0.08) in the magnesium-zinc-calcium-vitamin D supplemented women. Conclusions Overall, the findings of this study have demonstrated that magnesium-zinc-calcium-vitamin D co-supplementation for 6 weeks to women with GDM may reduce biomarkers of inflammation and oxidative stress. This study was retrospectively registered on 25 April 2017 in the Iranian website (www.irct.ir) for clinical trials registration (http://www.irct.ir: IRCT201704225623N109).

Objective: The aim of this study was to evaluate the effect of the co-administration of carnitine and chromium on mental health, hormonal, inflammatory and genetic parameters in women with PCOS. Methods: This randomized, double-blinded, placebo-controlled clinical trial was conducted on 54 subjects, aged 18–40 years old. Subjects were randomly allocated to take either 1000 mg/d carnitine plus 200 µg/d chromium as chromium picolinate (n = 26) or placebo (n = 27) for 12 weeks. Results: Carnitine and chromium co-supplementation, compared with the placebo, significantly improved beck depression inventory (β − 0.84; 95% CI, −1.51, −0.17; p = 0.01), general health questionnaire scores (β − 1.13; 95% CI, −2.13, −0.14; p = 0.02) and depression anxiety and stress scale scores (β − 0.96; 95% CI, −0.78, −0.14; p = 0.02). Participants who received carnitine plus chromium supplements had significantly lower total testosterone (β − 0.15 ng/mL; 95% CI, −0.24, −0.06; p = 0.002), hirsutism (β − 0.48; 95% CI, −0.91, −0.06; p = 0.02), high-sensitivity C-reactive protein (hs-CRP) (β − 1.02 mg/L; 95% CI, −1.79, −0.25; p = 0.01), and malondialdehyde (MDA) levels (β − 0.38 µmol/L; 95% CI, −0.56, −0.20; p

Abstract Objective The aim of this study was to determine the effect of vitamin D and probiotic co-administration on mental health, hormonal, inflammatory and oxidative stress parameters in women with polycystic ovary syndrome (PCOS). Methods This randomized, double-blinded, placebo-controlled clinical trial was carried out on 60 subjects, aged 18–40 years old. Subjects were randomly allocated to take either 50,000 IU vitamin D every 2 weeks plus 8 × 109 CFU/day probiotic (n = 30) or placebo (n = 30) for 12 weeks. Results Vitamin D and probiotic co-supplementation, compared with the placebo, significantly improved beck depression inventory [β (difference in the mean of outcomes measures between treatment groups) − 0.58; 95% CI, − 1.15, − 0.02; P = 0.04], general health questionnaire scores (β − 0.93; 95% CI, − 1.78, − 0.08; P = 0.03) and depression, anxiety and stress scale scores (β − 0.90; 95% CI, − 1.67, − 0.13; P = 0.02). Vitamin D and probiotic co-supplementation was associated with a significant reduction in total testosterone (β − 0.19 ng/mL; 95% CI, − 0.28, − 0.10; P

Introduction: Along with some authors through literature indicating the influence of infertility on the quality of life, this study aimed at comparing the impact of infertility on the quality of life and social support among fertile and infertile women. Materials and Methods: In this case-control study, 50 hospitalized and outpatient infertile women and 50 fertile women aged 20-40 referred to gynecology, obstetrics and infertility centers of Arak University of Medical Sciences from March 2013 to August 2013. The patients were requested to complete the Persian version of the WHOQOL-BREF (world health organization quality of life) and social support questionnaires. The demographic data and data extracted from questionnaires were collected and analyzed. Results:100 women (50 infertile and 50 fertile) with the average age of 33.70±6.53 were recruited. All patients were literate and had a high school diploma. To compare two groups regarding physical health, mental health, social relationship, quality of life, family support, friends’ support, support of other people and social support, we made use of one-way ANOVA. The score obtained from variables regarding infertile women was higher than that of fertile ones, and the difference between the two groups was significant. To compare environmental health, we used Kruskal-Wallis test. The mean score of environmental health among infertile women was higher than that of fertile women, however, the difference was not significant (P= 0.15). Conclusion: As indicated by the results, infertility reduces mental and physical health, social relationship and quality of life in women. Additionally, it was found that infertile women were less supported than fertile ones by society, family, friends and other people.

Electroconvulsive therapy (ECT) is one of the appropriate treatments for many neuropsychiatric patients, especially those with mood disorders. Short-term complications of ECT include agitation and postictal. In this study, we compared the addition of dexmedetomidine or remifentanil to thiopental as the main anaesthetic used in ECT. In this double-blind randomised clinical trial, 90 patients with mood disorders (candidates for ECT) were divided into two groups based on their therapy: dexmedetomidine or remifentanil. In the first group (DG), patients were slowly injected intravenously with 0.5 μg/kg dexmedetomidine before induction of anesthesia. In the second group (GR), 100 μg of remifentanil was slowly injected intravenously.In addition, we collected demographic information such as respiratory rate, heart pulse rate, seizure time, mean of arterial blood pressure, recovery duration and the oxygen arterial saturation recorded after recovery. Data obtained were analysed by use of statistical software, SPSS-23. The mean age of both groups was approximately 37 years with the majority being men. There was no significant difference between the two groups in terms of age and sex, blood pressure, heart rate, duration of seizures and arterial oxygen saturation before ECT. The mean blood pressure and heart rate in the recovery group were lower in the dexmedetomidine group than in the remifentanil group and the hemodynamics in the dexmedetomidine group were more stable. The recovery time in the dexmedetomidine group was longer than that of the remifentanil group (p = 0.001). Both groups had approximately the same satisfaction and the rate of agitation after ECT was the same. Both remifentanil and dexmedetomidine as adjuvants lead to a decrease in patients' post-ECT hyperdynamic responses. In our study, we demonstrated that the effect of dexmedetomidine is greater than remifentanil. On the other hand, neither dexmedetomidine nor remifentanil had a negative effect on seizure duration, but dexmedetomidine significantly prolonged recovery time, when compared to remifentanil.

Background and Aim: We are aware of no study that examined the effects of vitamin E plus omega-3 fatty acid supplementation on inflammatory and oxidative stress biomarkers in pregnant women with gestational diabetes (GDM). This study aimed to evaluate the effects of vitamin E plus omega-3 supplementation on insulin metabolism and inflammatory and oxidative stress biomarkers in pregnant women with gestational diabetes. Materials and Methods: This randomized, double-blind, placebo-controlled clinical trial was performed on 60 women with GDM. Subjects were randomly assigned to receive either 400 IU vitamin E plus 1000 mg omega-3 fatty acid supplements (n=30) or placebo (n=30) for 6 weeks. Fasting blood samples were taken at study baseline and after 6 weeks of intervention to quantify biochemical variables. Findings: Vitamin E plus omega-3 fatty acid supplementation led to a significant rise in plasma total antioxidant capacity (+187.5±224.9 vs. -32.5±136.1 mmol/L, p

Background and Objectives: Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with metabolic complications, which affects about 5-10% of women of reproductive age. The present study was designed with the objective of investigating the effect of selenium supplementation on lipid profile and indices of glucose and insulin metabolism in women with PCOS. Methods: This randomized double-blind controlled clinical trial, was conducted on 70 women with PCOS (age range, 18-40years)s. The participants were randomly divided into two groups (each 35 subjects), including the group that received selenium supplementation (200µg, daily) and the group that received placebo (100mg cellulose, daily) for 8 weeks. Fasting blood samples were collected at baseline and after 8 weeks. Data was analyzed using the analysis of covariance (ANCOVA) statistical test. Results: Selenium supplementation significantly decreased the serum insulin level (-29.83±47.29vs +9.07±77.12pmol/l, p=0.013), homeostasis model of assessment-insulin resistance (HOMA-IR) (-1.15±1.81vs +0.42±3.09, p=0.011), homeostatic model assessment beta cell function (HOMA-B) (-19.06±30.95vs +4.55±47.99, p=0.017), and increased the quantitative insulin sensitivity check index (QUICKI) (+0.03±0.04 vs +0.0009±0.05, p=0.032) compared to the placebo group. In addition, serum triglyceride level (-0.14±0.55vs +0.11±0.30mmol/l, p=0.025) and very-low-density lipoprotein (VLDL) concentration (-0.03±0.11 vs +0.02±0.06 mmol/L, p=0.025) significantly decreased after the intervention. Conclusion: The findings of this study revealed that daily intake of selenium supplement in women with PCOS may have beneficial effects on insulin metabolism indices, serum triglyceride level, and VLDL level.

Abstract Background The aim of this study was to evaluate the effect of the co-administration of probiotic and selenium on parameters of mental health, hormonal profiles, and biomarkers of inflammation and oxidative stress in women with PCOS. Data on the effects of selenium and probiotic co-supplementation on mental health, hormonal and inflammatory parameters of patients with polycystic ovary syndrome (PCOS) are scarce. This investigation was carried out to evaluate the effects of selenium and probiotic co-supplementation on mental health, hormonal and inflammatory parameters in women with PCOS. Methods This randomized, double-blinded, placebo-controlled clinical trial was conducted on 60 subjects, aged 18–40 years old. Participants were randomly allocated into two groups to intake 8 × 109 CFU/day probiotic plus 200 μg/day selenium supplements (n = 30) or placebo (n = 30) for 12 weeks. Hormonal and inflammatory parameters were measured at baseline and after the 12-week intervention. Results Probiotic and selenium co-supplementation resulted in a significant improvement in beck depression inventory (β − 0.76; 95% CI, − 1.26, − 0.26; P = 0.003), general health questionnaire scores (β − 1.15; 95% CI, − 1.97, − 0.32; P = 0.007) and depression anxiety and stress scale scores (β − 1.49; 95% CI, − 2.59, − 0.39; P = 0.009) compared with the placebo. Furthermore, probiotic and selenium co-supplementation significantly reduced total testosterone (β − 0.26 ng/mL; 95% CI, − 0.51, − 0.02; P = 0.03), hirsutism (β − 0.43; 95% CI, − 0.74, − 0.11; P = 0.008), high-sensitivity C-reactive protein (hs-CRP) (β − 0.58 mg/L; 95% CI, − 0.97, − 0.19; P = 0.004) and malondialdehyde (MDA) levels (β − 0.29 μmol/L; 95% CI, − 0.56, − 0.02; P = 0.03), and significantly increased total antioxidant capacity (TAC) (β + 84.76 mmol/L; 95% CI, + 48.08, + 121.44; P

Abstract Background One of the most controversial issues in treatment planning of class III malocclusion patients is the choice between orthodontic camouflage and orthognathic surgery. Our aim was to delineate diagnostic measures in borderline class III cases for choosing proper treatment. Methods The pretreatment lateral cephalograms of 65 patients exhibiting moderate skeletal class III were analyzed. The camouflage group comprised of 36 patients with the mean age of 23.5 (SD 4.8), and the surgery group comprised of 29 patients with the mean age of 24.8 years (SD 3.1). The camouflage treatment consisted of flaring of the upper incisors and retraction of the lower incisors, and the surgical group was corrected by setback of the mandible, maxillary advancement, or bimaxillary surgery. Mann-Whitney U test was used to compare the variables between the two groups. Stepwise discriminant analysis was applied to identify the dentoskeletal variables that best separate the groups. Results Holdaway H angle and Wits appraisal were able to differentiate between the patients suitable for orthodontic camouflage or surgical treatment. Cases with a Holdaway angle greater than 10.3° and Wits appraisal greater than − 5.8 mm would be treated successfully by camouflage, while those with a Holdaway angle of less than 10.3° and with Wits appraisal less than − 5.8 mm can be treated surgically. Based on this model, 81.5% of our patients were properly classified. Conclusions Holdaway H angle and Wits appraisal can be used as a critical diagnostic parameter for determining the treatment modality in class III borderline cases.

Synergistic approach of selenium and probiotic co-supplementation may improve clinical symptoms of patients with polycystic ovary syndrome (PCOS) by improving their metabolic profiles. This investigation was carried out to evaluate the effects of selenium and probiotic co-supplementation on weight loss, glycemic control and markers of cardio-metabolic risk in women with PCOS. This randomized, double-blind, placebo-controlled trial was conducted among 60 women with PCOS. Participants were randomly divided into two groups to receive 200 µg/day selenium plus 8 × 109 CFU/day probiotic supplements (n = 30) or placebo (n = 30) for 12 weeks. Compared with the placebo, selenium and probiotic co-supplementation resulted in a significant reduction in weight (−0.7 ± 0.5 vs. +0.1 ± 1.1 kg), serum insulin levels (−2.8 ± 3.5 vs. +0.5 ± 3.9 µIU/mL) and homeostatic model of assessment for insulin resistance (−0.6 ± 0.8 vs. +0.1 ± 0.9), and a significant increase in the quantitative insulin sensitivity check index (+0.01 ± 0.02 vs. +0.001 ± 0.02). In addition, selenium and probiotic co-supplementation significantly decreased serum triglycerides (−12.1 ± 29.6 vs. +3.1 ± 12.2 mg/dL), total- (−17.9 ± 28.5 vs. +0.1 ± 28.8 mg/dL), LDL- (−14.7 ± 24.9 vs. +1.5 ± 26.6 mg/dL) and total-/HDL-cholesterol ratio (−0.3 ± 0.8 vs. +0.2 ± 0.8) compared with the placebo. Selenium and probiotic co-supplementation for 12 weeks to PCOS women had beneficial effects on weight loss and markers of cardio-metabolic risk.

Abstract Background Magnesium and vitamin E are known to exert multiple beneficial effects, such as anti-glycemic and anti-lipidemic properties. The aim of this study was to determine the effects of magnesium and vitamin E co-supplementation on metabolic status of women with gestational diabetes (GDM). Methods This randomized, double-blinded, placebo-controlled trial was conducted among 60 subjects diagnosed with GDM, aged 18–40 years. Subjects were randomly allocated into two groups to receive 250 mg/day magnesium oxide plus 400 IU/day vitamin E supplements or placebo (n = 30 each group) for 6 weeks. Participants’ blood samples were taken to determine their metabolic profiles. Results Subjects who received magnesium plus vitamin E supplements had significantly lower fasting plasma glucose (β − 5.20 mg/dL; 95% CI, − 7.88, − 2.52; P = 0.002), serum insulin levels (β − 2.93 μIU/mL; 95% CI, − 5.68, − 0.18; P = 0.02) and homeostasis model of assessment-insulin resistance (β − 0.78; 95% CI, − 1.42, − 0.14; P = 0.01), and higher quantitative insulin sensitivity check index (β 0.01; 95% CI, 0.005, 0.02; P = 0.002) compared with placebo. In addition, magnesium plus vitamin E supplementation resulted in a significant reduction in serum triglycerides (β − 50.31 mg/dL; 95% CI, − 67.58, − 33.04; P

Abstract Background To our knowledge, no reports are available indicating the effects of synbiotic supplementation on hormonal status, biomarkers of inflammation and oxidative stress in subjects with polycystic ovary syndrome (PCOS). This research was done to assess the effects of synbiotic supplementation on hormonal status, biomarkers of inflammation and oxidative stress in subjects with PCOS. Methods This randomized double-blind, placebo-controlled trial was conducted on 60 subjects diagnosed with PCOS according to the Rotterdam criteria. Subjects were randomly assigned into two groups to take either synbiotic (n = 30) or placebo (n = 30) for 12 weeks. Endocrine, inflammation and oxidative stress biomarkers were quantified at baseline and after the 12-week intervention. Results After the 12-week intervention, compared with the placebo, synbiotic supplementation significantly increased serum sex hormone-binding globulin (SHBG) (changes from baseline in synbiotic group: + 19.8 ± 47.3 vs. in placebo group: + 0.5 ± 5.4 nmol/L, p = 0.01), plasma nitric oxide (NO) (changes from baseline in synbiotic group: + 5.5 ± 4.8 vs. in placebo group: + 0.3 ± 9.1 μmol/L, p = 0.006), and decreased modified Ferriman Gallwey (mF-G) scores (changes from baseline in synbiotic group: − 1.3 ± 2.5 vs. in placebo group: − 0.1 ± 0.5, p = 0.01) and serum high-sensitivity C-reactive protein (hs-CRP) (changes from baseline in synbiotic group: − 950.0 ± 2246.6 vs. in placebo group: + 335.3 ± 2466.9 ng/mL, p = 0.02). We did not observe any significant effect of synbiotic supplementation on other hormonal status and biomarkers of oxidative stress. Conclusions Overall, synbiotic supplementation for 12 weeks in PCOS women had beneficial effects on SHBG, mFG scores, hs-CRP and NO levels, but did not affect other hormonal status and biomarkers of oxidative stress. Trial registration This study was retrospectively registered in the Iranian website (www.irct.ir) for registration of clinical trials (IRCT201509115623N53), on 2015–09-27.

Abstract Background: Selenium supplement has multiple important effects, including anti-inflammatory effect. The aim of this study was to assess the effects of selenium supplement on gene expression of inflammatory cytokines and vascular endothelial growth factor in gestational diabetes. Materials and Methods: This randomized double blind placebo control trial was performed on 40 patients suffering from GDM aged 18–40 years old. Participants were randomly divided into interventional group receiving 200mg/day selenium supplements (n=20) and control group receiving placebo (n=20) for 6 weeks. Primary outcome was gene expression of inflammatory cytokines and VEGF which were assessed in lymphocyte of GDM patients by RT-PCR method. Results: After 6 weeks intervention, in comparison with the control group, interventional group showed down regulation of gene expression of tumor necrosis factor alpha (TNF–α) (p=0.02) and transforming growth factor beta (TGF–β) (p=0.01) and up-regulation of gene expression of vascular endothelial (VEGF) (p = 0.03) in lymphocytes of GDM. There was not any significant change following intervention with selenium regarding gene expression of interleukin IL-1 β and IL-8 in lymphocytes of GDM patients. Conclusion: 6 weeks supplementation with selenium in patients with GDM can cause down regulated gene expression of TNF-α and TGF–β, and up regulated gene expression of VEGF. Selenium supplement had not any effect on gene expression of IL-1 β and IL-8.

Background and Objectives: Ultrasonography is one of the prenatal diagnostic methods, which is applied to detect any genetic diseases, defects, and anomalies. This study aimed to evaluate the changes in foetal heart rate (FHR) and maternal heart rate due to four-dimensional (4D) ultrasonography immediately after ultrasound imaging. Materials and Methods: This descriptive study was conducted on the foetus of pregnant women who were referred to the ultrasound clinic for undergoing a (4D) ultrasonography. After filling out the demographic forms, the baseline FHR was measured at the beginning of the 2D and 4D ultrasonography. All haemodynamic parameters were recorded at the end of the combined ultrasound imaging. Data were compared before and after ultrasonography using paired t-test and correlation coefficient in SPSS software. Analysis of covariance (ANCOVA) was used to adjust the effect of baseline heart rate in foetus and sonography. Results: The mean duration of combined 2D and 4D ultrasound imaging was 1249.8 ± 257 s. Moreover, the mean 4D ultrasound duration was 246.1 ± 83.3. A significant decrease were observed in maternal heart rate following the combined ultrasonography (P < 0.001), while the changes in FHR were not significantly different after the ultrasound imaging (P = 0.394). The ANCOVA showed that sonography was not related factors for change in FHR (β = 0.006, 95% confidence interval [CI]: 0.011–0.024, P = 0.467) while the base FHR (β = 0.659, 95% CI: 0.482–0.836, P < 0.001) was directly associated with FHR change. Conclusion: The 4D ultrasonography was not effective factor on the FHR and it seems that the ultrasound imaging is a safe diagnostic method for FHR. However, we recommended long-term studies to evaluate the effect of the 4D ultrasound imaging on preterm labour, post-partum complications, and mental problems.