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Background: Performing CPR (Cardiopulmonary Resuscitation) is an extremely intricate skill whose success depends largely on the level of knowledge and skill of Anesthesiology students. Therefore, this research was conducted to compare the effect of the scenario-based training method as opposed to video training method on nurse anesthesia students' BLS (Basic Life Support) knowledge and skills., Methods: This randomized quasi-experimental study involved 45 nurse anesthesia students of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran in 2022-2023. The practical room of the university formed the research environment. The participants were randomly divided into three groups of scenario-based training, video training, and control. Data were collected by a knowledge questionnaire and a BLS skill assessment checklist before and after the intervention., Results: There was a significant difference between the students' scores of BLS knowledge and skill before and after the educational intervention in both SG (scenario group) (p < 0.001) and VG (video group) (p = 0.008) (p < 0.001). However, no significant difference was observed in this regard in the CG (control group) (p = 0.37) (p = 0.16). Also, the mean scores of BLS knowledge and skills in the SG were higher than those in the VG (p < 0.001)., Conclusion: Given the beneficial impact of scenario-based education on fostering active participation, critical thinking, utilization of intellectual abilities, and learner creativity, it appears that this approach holds an advantage over video training, particularly when it comes to teaching crucial subjects like Basic Life Support., (© 2024. The Author(s).)

Introduction: Distance education as a training method is used today to train nurses around the world. This study aimed to determine the impact of using the community of inquiry model on the quality of distance learning of airway management among anesthesia nurse students., Methods: This is a quasi-experimental study with a pre-test post-test design conducted at Ahvaz Jundishapur University of Medical Sciences. Participants were selected by census, and they were second, third, and fourth-year nurse anesthesia students (n=66). The participants were assigned to intervention and control groups (n=33 each) based on the table of random numbers. Given the three dimensions of the community of inquiry model, interventions were carried out in terms of social, teaching, and cognitive dimensions to increase social presence, teaching presence, and cognitive presence. Data collection tools included a questionnaire. The data were analyzed using Independent T-test, paired T-test, ANCOVA, and Chi-square in SPSS software, version 16., Results: The results showed that the promotion of each of the three elements of the community of inquiry model had a significant effect on the quality of distance learning of airway management. Moreover, the mean scores of these elements were significantly different (P<0.001) in the intervention and control groups [teaching presence (3.742±0.453 vs. 2.573±0.241), social presence (2.245±0.488 vs. 1.434±0.297), and cognitive presence (3.421±0.569 vs. 2.369±0.223)]., Conclusion: The community of inquiry is a practical and effective framework for the better design and implementation of distance education courses. Therefore, nursing educators and course designers are strongly recommended to use this framework in nursing education., Competing Interests: The authors declare that there is no conflict of interests., (Copyright: © Journal of Advances in Medical Education & Professionalism.)

Background: Numerous medical costs are spent each year on treating and preventing the progression of diabetes. The positive effect of apple cider vinegar (ACV) has been shown on post-prandial hyperglycemia. This study aimed to evaluate the effects of prolonged consumption of ACV on blood glucose indices and lipid profile in patients with type 2 diabetes., Methods: This study was a randomized clinical trial and the participants were adults with type 2 diabetes. Participants were divided into two groups: ACV and control. The ACV group was treated with 30 ml of ACV per day. Both the intervention and control groups received the same recommendation for a healthy diet. Before and after eight weeks, fasting blood glucose, insulin, hemoglobin A1C, insulin resistance, total cholesterol (Chol), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglyceride were measured., Results: Fasting blood glucose decreased after intervention in both groups, which was only significant in the ACV group (p = 0.01). There was a significant difference in hemoglobin A1C levels between the two groups (p < 0.001) after eight weeks. LDL was decreased in the ACV group (p < 0.001). Total Chol, LDL/HDL and Chol/HDL ratio decreased after the intervention period in the ACV group compared to the control group (p = 0.003, p = 0.001 and p = 0.001, respectively)., Conclusion: Daily consumption of ACV may have beneficial effects in controlling blood glucose indices and lipid profile in patients with type 2 diabetes., Clinical Trial Registration: http://www.irct.ir, identifier IRCT20140107016123N13., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Jafarirad, Elahi, Mansoori, Khanzadeh and Haghighizadeh.)

Introduction: Learning professional ethics can enhance the effectiveness of medical graduates as future health care providers. Therefore, this study was conducted to examine the effectiveness of professional ethics education based on a multi-method approach in organizational commitment and job involvement of senior nurse anesthesia students of Ahvaz Jundishapur University of Medical Sciences (AJUMS), Ahvaz, Iran, in 2022., Methods: This was a quasi-experimental study with a pre-test post-test design including 64 senior nurse anesthesia students of AJUMS who were selected using census method and randomly divided )using simple random method( into two groups of intervention and control (n = 32 each). For the intervention group, two 5-hour training workshops were held in 2 consecutive weeks using different training methods offered in an integrated manner, while participants in the control group received no education. Finally, the data were collected and analyzed using SPSS version 16, based on Kolmogorov-Smirnov test, paired and independent t-tests, chi-square test, and analysis of covariance., Results: Professional ethics education based on a multi-method approach had a positive effect on the organizational commitment and job involvement of senior nurse anesthesia students. There was a significant difference between the two groups in terms of their job involvement (P=0.005 and F=1.65) and organizational commitment scores (P=0.025 and F=35.56). These findings suggest that professional ethics education based on a multi-method approach can improve job involvement and organizational commitment and its dimensions (normative, continuance, and affective)., Conclusion: Teaching professional ethics by explaining the moral virtues of work, business affairs, and code of professional conduct promotes job involvement and organizational commitment of senior nurse anesthesia students., Competing Interests: None declared., (Copyright: © Journal of Advances in Medical Education & Professionalism.)

Background: Diabetes is one of the most common diseases in the world. The most important underlying cause of death in diabetic patients is the lack of self-care and management. However, there is little known about the influence of coping strategies and spiritual well-being (SWB) on self-care in diabetic patients., Aims: This study aimed to investigate the relationship between self-care activities with coping strategies and spiritual well-being (SWB) in patients with type 2 diabetes mellitus (T2DM)., Methods: In this descriptive-analytical study, we selected 236 patients with T2DM referred to the diabetes hospital clinics in the southwest of Iran. Inclusion criteria were patients diagnosed with T2DM, with the age group ranging 20-80 years, literate, not suffering from severe and debilitating complications of diabetes and lacking acute psychological illness. Exclusion criteria included refusing to complete questionnaires and cognitive or emotional impairment. Instruments include the demographic questionnaire, Summary of Diabetes Self-Care Activities, Lazarus and Folkman's Coping Strategies Questionnaire and the Spiritual Well-Being Scale (SWBS; developed by Paloutzian and Ellison). To examine the relationship between variables, the Pearson correlation and multiple stepwise regression analysis were used., Results: The findings of this study on 236 patients with T2DM (53.25 ± 10.91) including 76 (32.2%) males and 160 (67.8%) females showed the majority of participants were female, the age group was between 41 and 60 years (68.22%), had a Diploma (63.98%), were insured (63.55%) and had a moderate economic situation (55.93%). There was a direct and significant correlation between self-care activities and coping strategies ( r  = 0.163, p  < 0.05), and only a problem-focused coping strategy was considered as a predictor variable of self-care ( p  < 0.01). There was a direct and significant correlation between self-care and SWB ( r  = 0.385, p  < 0.01)., Conclusion: The results of this study showed that there is a significant relationship between self-care and the problem-focused dimension of coping strategies and SWB in patients with T2DM., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Objective: Fetal occiput posterior (OP) position is associated with more maternal and neonatal complications. This study aimed to investigate the effect of maternal position during labor on fetal OP position and pregnancy outcomes., Materials and Methods: This randomized clinical trial study included 180 primigravida women in labor with a single fetus and approved OP position. Participants were randomly allocated into three groups: semi-prone position (n=45), knee-chest position (n=45), and supine position (n=90). All participants were placed in the defined positions 15-30 min in labor until delivery. Data collected using Visual Analogue Scale and researcher made checklist. The ANOVA, Tukey post hoc, and the chi-square test were used to analyze., Results: Among all participants who had OP, after intervention 16.3% in the semi-prone position, 14/3 % in the knee-chest position, and 33.7% of the control groups remained with OP at birth (X 3 =7/87, P=0.019). The rate of natural delivery was significantly higher in the semi-prone position and knee-chest position. The duration of active phase of labor and low back pain were significantly reduced in the semi-prone and knee-chest position compared to the control groups (P<0.05). There were no differences in the duration of the third stage of labor, APGAR score, and the rate of neonatal addition to neonatal intensive care unit, using oxytocin, and perineal tears (P>0.05)., Conclusion: The semi-prone and knee-chest positions increase the spontaneous rotation of occiput to the anterior position, vaginal delivery rates as well as a reduction in duration of active phase of labor and low back pain after delivery., Competing Interests: Conflict of Interests Authors declare no conflict of interests., (Copyright © 2023 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.)

Background and Aims: Dermatological surgeons must master the factors affecting wound healing. Suturing is the most common method of wound closure. One of the significant factors in suturing that affects wound healing and cosmetic results is the distance between sutures, which has been studied very little to date. The aim of the current study was to investigate the effect of simple interrupted suture with a distance of 2 and 5 mm on the esthetic and functional results of suture closure in different age groups., Methods: In patients with two skin lesions, one wound was sutured with a distance of 2 mm and the other with a distance of 5 mm, and the wounds were evaluated 1 and 3 months after the operation using the POSAS scale., Results: Patients' opinions indicate that, in the suture intervals of 2- and 5-mm and at 1 and 3 months, the average was lower in the younger group than it was in the older group and also, as per the physician's opinion, the average in the age group under 50 years was significantly lower than that in the age group over 50 years., Conclusions: According to the results of the present study, a suture of 2-mm and a suture of 5-mm would result in different esthetic and functional outcomes depending on the patient's age. The average in the age group less than 50 years was significantly lower than that of the age group greater than 50 years., Competing Interests: The authors declare no conflict of interest., (© 2023 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

Introduction: Various nursing models are usually employed to achieve self-management and improve the quality of life in chronic conditions. Given its person-based characteristics, the 5 A nursing model can improve the quality of life of hemodialysis patients., Purpose: This study aimed to determine the role of a self-management program based on the 5 A nursing model in the quality of life of patients undergoing hemodialysis., Materials and Methods: This clinical trial was conducted on hemodialysis patients in Iran. Random sampling was adopted to assign 60 patients to intervention and control groups. After the participants completed a demographic questionnaire and the Kidney Disease Quality of Life-Short Form (KDQOL-SF), routine measures were taken in the control group. However, the 5 A nursing model was implemented in the intervention group for three months. The self-care program was executed in face-to-face sessions or via phone calls and SMSs. After three months, the quality of life was measured again in both groups., Findings: There were significant differences after the intervention between the intervention and control groups in specific dimensions of quality of life, such as cognitive functions, symptoms, sleep, dialysis, social support, and renal complications (P < 0.05). The two groups also had significant differences in the general scores of quality of life (P < 0.05)., Conclusion: The 5 A self-management intervention as a person-based model could improve self-care in hemodialysis patients. Nurses can implement this model to mitigate care costs, enhance interventions, and improve patients' quality of life., Trial Registration: Iranian Registry of Clinical Trials (IRCT20211103052955N1; 19/11/2021)., (© 2023. The Author(s).)

Purpose: The present study aimed to investigate the effect of a mini-clinical evaluation exercise (CEX) assessment on improving the clinical skills of nurse anesthesia students at Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran., Methods: This study started on November 1, 2022, and ended on December 1, 2022. It was conducted among 50 nurse anesthesia students divided into intervention and control groups. The intervention group’s clinical skills were evaluated 4 times using the mini-CEX method. In contrast, the same skills were evaluated in the control group based on the conventional method—that is, general supervision by the instructor during the internship and a summative evaluation based on a checklist at the end of the course. The intervention group students also filled out a questionnaire to measure their satisfaction with the miniCEX method., Results: The mean score of the students in both the control and intervention groups increased significantly on the post-test (P<0.0001), but the improvement in the scores of the intervention group was significantly greater compared with the control group (P<0.0001). The overall mean score for satisfaction in the intervention group was 76.3 out of a maximum of 95., Conclusion: The findings of this study showed that using mini-CEX as a formative evaluation method to evaluate clinical skills had a significant effect on the improvement of nurse anesthesia students’ clinical skills, and they had a very favorable opinion about this evaluation method.

Background: Menopause is one of the developmental stages of women. One of the most common problems during this period is sleep disorders. Sleep disorders can affect the quality of life of these people. To improve sleep disorders, auriculotherapy has received less attention due to its low cost and effectiveness, and side effects. Therefore, the aim of this study was to determine the effect of auriculotherapy on improving sleep quality in postmenopausal women aged 45-60 years., Materials and Methods: The present study is a clinical trial study that was performed on 82 postmenopausal women aged 45-60 years under the auspices of health centers in Mahshahr city, Iran from 2021-2022. Women with inclusion criteria were randomly divided into two groups (intervention and control). The intervention group underwent auriculotherapy for 4 weeks. The St. Petersburg Sleep Quality Questionnaire was completed by both groups at the beginning and 4 weeks after the start of the intervention. Finally, the data were analyzed by SPSS software version 22 and independent t -test, paired t -test and Chi-square test., Results: At the beginning of the study, both groups were homogeneous in terms of demographic variables. The results of data analysis using independent t -test showed that before the intervention, mental quality ( P = 0.513), length of incubation period ( P = 0.285), sleep duration ( P = 0.121), sleep efficiency ( P = 0.513), sleep disorders ( P = 0.685), use of sleeping pills ( P = 0.530), daily functioning ( P = 0.60), and overall sleep quality score ( P = 0.30) in the control and intervention groups were not statistically significant. However, comparing the mean scores after the intervention in the control and intervention groups showed that mental quality ( P < 0.001), incubation period ( P < 0.001), sleep duration ( P < 0.001), sleep efficiency ( P < 0.001), sleep disorders ( P < 0.001), use of hypnotics ( P = 0.002), daily functioning ( P = 0.001), overall sleep quality score ( P < 0.001), sleep duration ( P = 0.822), sleep efficiency ( P = 0.889), sleep disorders ( P = 0.889), use of sleeping pills ( P = 1.00), daily performance ( P = 0.767), overall sleep quality score ( P = 0.69) were statistically significant between the two groups. In-group comparison using paired t -test in the control group showed that mental quality ( P = 0128), length of the incubation period ( P = 1.00), and before and after the intervention did not differ significantly in the mean scores. However, a within-group comparison in the intervention group showed that mental quality ( P < 0.001), incubation period ( P < 0.001), sleep duration ( P < 0.001), sleep efficiency ( P < 0.001), sleep disorders ( P = 0.003), use of sleeping pills ( P = 0.007), daily functioning ( P < 0.001), and overall sleep quality score ( P < 0.001) before and after the intervention had a significant difference in the mean scores., Conclusion: The results showed that auriculotherapy has significant effectiveness in improving the quality of sleep, and its dimensions and can be used as an effective method in this area that can be implemented at a low cost and easily. According to reports from participants and previous studies in this field, auriculotherapy did not have any side effects and can be used as a safe way to improve sleep quality., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Education and Health Promotion.)

Introduction: Chest pain is an unpleasant and the most common symptom in patients suffering from unstable angina. This study was implemented to investigate the effect of Thai massage on severity of pain in patients with unstable angina. Methods: This study was a randomized controlled clinical trial that carried out on 70 patients with unstable angina who had been hospitalized in hospital affiliated to Ahvaz Jundishapur University of Medical sciences, Ahvaz, Iran. The participants were allocated randomly to either the intervention (n=35) or control group (n=35) between August 1, 2016 and April 30, 2017. The patients in the intervention group received routine care beside and Thai massage with the duration of 30 minutes in two consecutive days. The patients in the control group received routine care. The intensity of pain was assessed by using the numeric rating scale, five minutes before and immediately, 15, 30 and 60 minutes after the intervention. The independent t-test and repeated measures analysis of variance (ANOVA) were used to analysis data through SPSS 13. Results: After the intervention, the severity of pain was significantly diminished by about four measurement points ( P =0.001) with the linear pattern of pain reduction. Nonetheless, in the control group, no statistically significant difference in the intensity of pain was found. Conclusion: This study showed that Thai massage as non-invasive approach, concomitant with standard nursing care, has the potential to decrease chest pain. Nurses should be taught about pain relief methods for improving the quality of patient care., Competing Interests: The authors declare no conflicts of interest., (© 2023 The Author(s).)

Purpose: Menopause is associated with complications that may affect quality of life, such as hot flashes, night sweats, and mood swings. This study aimed to compare the effects of phone versus face-to-face counseling based on cognitive-behavioral therapy (CBT) for vasomotor symptoms in postmenopausal women., Methods: In this study, 40 eligible postmenopausal women were randomly assigned to face-to-face ( n = 20) and phone counseling methods ( n = 20). Six counseling sessions were held weekly for each person, and the women were requested to record their hot flashes (HF) and night sweats (NS) in a diary. HF and NS were measured at baseline, and 6 and 8 weeks after the completion of intervention. Data were analyzed using χ2, repeated measures ANCOVA, and independent t -test., Results: Means of weekly hot flashes and night sweats decreased after intervention in both groups (face-to-face group: HF frequency from 31.92 ± 7.98 to 18.83 ± 7.35, HF severity from 2.24 ± 0.28 to 1.21 ± 0.23, HF duration from 4.22 ± 1.17 min to 2.79 ± 0.91 min, NS frequency from 2.34 ± 0.31 to 1.21 ± 0.24 and NS severity from 1.70 ± 0.34 to 1.03 ± 0.29; and also in the phone counseling group: HF frequency from 33.32 ± 7.77 to 19.53 ± 7.7, HF severity from 2.23 ± 0.24 to 1.20 ± 0.18, HF duration from 4.29 ± 1.23 min to 2.68 ± 0.95 min, NS frequency from 2.33 ± 0.31 to 1.14 ± 0.16 and NS severity from 1.59 ± 0.34 to 1.01 ± 0.30). Although the differences within each group were significant ( p < 0.001), there was no significant difference between the groups after the intervention in terms of HF frequency, severity, and duration, as well as NS frequency and severity ( p > 0.05)., Conclusions: Face-to-face and phone counseling methods based on CBT had a similar effect on reducing hot flashes and night sweats. Both methods can be used for women with postmenopausal complications such as hot flashes and night sweats., Competing Interests: Absent., (Copyright © 2022 Institute of Psychiatry and Neurology.)

Background: Cystic fibrosis (CF) is a hereditary disease with a high mortality rate. The present study aimed to determine the effect of a physical activity program (PAP) on the life quality of children with CF at school age., Materials and Methods: This study conducted on 70 children with CF, the samples were randomly divided into intervention and control groups. A demographic information questionnaire and the Pediatric Quality of Life Inventory were used for data collection. This study was conducted in three stages and 2 months after the last intervention. Finally, the data were analyzed in SPSS software version 22 using the Chi-square test, independent t-test, and paired t-test at a p-value of less than 0.05., Results: The results indicated that the two groups had no significant difference in terms of demographic variables before the intervention. Moreover, it was observed that the mean scores of life quality in the physical, emotional, social, and academic performance of children in both groups before the intervention in child and parent evaluations did not show significant differences. After the intervention in the experimental group, the mean scores of life quality in all aspects significantly increased, compared to those of the control group (P<0.001). Moreover, there were no significant differences between the mean scores of life quality in the control group before and after the intervention., Conclusion: Given the effectiveness of the intervention to enhance life quality, PAP is feasible and possible in the field of CF. It has to be noted that this method is an effective way to improve life quality., (Copyright© 2022 National Research Institute of Tuberculosis and Lung Disease.)

Cleft lip and palate is a major problem that disrupts the child's family life. The present study aimed to investigate the effect of combined education on the knowledge and care and supportive performance of parents with children with cleft lip and palate. This is a clinical trial study was conducted on 40 parents referring to hospitals. The data were collected using the demographic information questionnaire, the questionnaire of parental knowledge and care supportive performance questionnaire and analyzed using descriptive and analytical tests. After education the intervention group, the mean score of parents' care and supportive knowledge significantly increased in the intervention group as compared to the control group. There was also a significant difference in the mean score of parents' care-supportive performance between the two groups ( P < 0.001). It is recommended to use the combined education as an effective method to increase knowledge and performance in parents of children with cleft lip and palate., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)

Background: Personality plays an important role in food choices. The aim of this study was to assess the association of personality traits with dietary habits and food preferences., Methods: This cross-sectional study was carried out on 224 healthy female students aged 18-30 years with a normal BMI. Dietary habits, food preferences, and personality were assessed using validated questionnaire., Results: Our results showed that neuroticism and openness were associated with low scores while conscientiousness was related to high scores of dietary habits (r = -0.33 P < 0.001, r = -0.13, P < 0.05 and r = 0.26, P < 0.001, respectively). In addition, neuroticism was correlated with preference to salty, sour and fatty foods and negatively associated with dairy products ( P < 0.05). Extraversion showed a positive correlation with preference to fast foods, ice cream, chocolate, cocoa, and negative correlation with meat. Openness was positively correlated with preference for meat and biscuit and negatively correlated with fruits ( P < 0.05). Agreeableness was related to having soft drinks and sweetened fruit juices and conscientiousness had a positive association with preference to dairy products, vegetables, nuts, food with salty tastes, and a negative association with biscuits ( P < 0.05)., Conclusions: Overall, assessing personality traits could be useful to identify young women who may be at risk of unhealthy dietary habits., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 International Journal of Preventive Medicine.)

Obesity has reached epidemic proportions globally. Among several methods for treating obesity, the use of dietary supplements is common recently. One supplement that can help in this regard might be vitamin B6 in high doses. The objective of this study was to evaluate the effect of pyridoxine hydrochloride supplementation on anthropometric indices, body composition, visceral adiposity index (VAI), and metabolic status in obese and overweight women. In this randomized controlled clinical trial, 44 obese and overweight women aged 18-50 years were selected and divided randomly into 2 groups: an intervention group (receiving 80 mg pyridoxine hydrochloride supplement for 8 weeks) and a control group (receiving placebo for 8 weeks). In the pyridoxine hydrochloride group, weight (p = 0.03), body mass index (p = 0.023), fat mass (p = 0.003), waist circumference (p = 0.005), VAI (p = 0.001), fasting insulin, insulin resistance (homeostasis model assessment of insulin resistance; HOMA-IR), total cholesterol, low-density lipoprotein, triglycerides (TG) and leptin (p < 0.001) decreased whereas adiponectin (p < 0.001) increased in comparison to the baseline values. There was a significant difference in fat mass, VAI, fasting insulin, HOMA-IR, and TG between pyridoxine hydrochloride and control groups following intervention in adjusted models (p < 0.05). The findings suggest that vitamin B6 supplementation may be effective in reducing BMI and improving body composition and biochemical factors associated with obesity., Trial Registration: Iranian Registry of Clinical Trials Identifier: IRCT20181002041206N1., Competing Interests: Conflict of Interest: The authors declare that they have no competing interests., (Copyright © 2021. The Korean Society of Clinical Nutrition.)

Background: Gestational diabetes is the most common medical complication in pregnancy, and it has many side effects for the mother and the fetus. The aim of this study was to evaluate the effect of oat bran consumption on gestational diabetes., Methods: This study is a randomized clinical trial that was performed on 112 women with gestational diabetes treated with diet. Participants were randomly divided into two groups of 56. Participants in both groups were given a diet for gestational diabetes. In addition to the diet, the intervention group received 30 g of oat bran daily for 4 weeks at lunch and dinner. Tests of fasting blood glucose and two-hour postprandial (2hpp) glucose were taken from both groups: before the intervention, and 2 and 4 weeks after the start of the intervention. Data analysis was performed using SPSS statistical software (version 22) using independent t-test, as well as Chi-square and Mann-Whitney tests. P values less than 0.05 were considered statistically significant., Results: There was no statistically significant difference between the two groups in terms of mean blood glucose before the intervention, while 2 and 4 weeks after the intervention, mean fasting blood glucose and two-hour postprandial (2hpp) glucose decreased significantly in the intervention group compared with the control group (P < 0.001)., Conclusion: Based on the results of this study, the addition of oat bran to the standard diet for pregnant women with gestational diabetes reduced fasting blood glucose and two-hour postprandial (2hpp) glucose. More detailed studies with higher sample sizes are recommended to prove the effectiveness of this valuable dietary supplement., Trial Registration: IRCT registration number: IRCT20191220045828N1 . Registration date: 2020-04-18. Registered while recruiting.

Introduction: The purpose of this double-blind clinical trial, was to examine the effect of supplementation with the synbiotic and probiotic on the mental health, quality of life, and anemia in HD patients., Methods: Seventy-five HD patients were randomly assigned to receive the synbiotic ( n = 23) as 15 g of prebiotics, 5 g of probiotic powder containing Lactobacillus acidophilus, Bifidobacterium bifidum, Bifidobacterium lactis , and Bifidobacterium longum (2.7 × 107 CFU/g each); probiotics ( n = 23) as 5 g probiotics similar to the synbiotic group with 15 g of maltodextrin as placebo; and placebo ( n = 19) as 20 g of maltodextrin. Serum hemoglobin (Hb) and albumin (Alb) were measured. Beck depression and anxiety index (BDI/BAI) was used to assess symptoms of depression and anxiety. The health-related quality of life (HRQoL) was assessed using the questionnaire SF-36., Results: From baseline to 12 weeks, synbiotic and probiotic supplementation resulted in a significant decrease in BDI and BAI score in comparison to the placebo ( P < 0.05). Between and intergroup comparison showed no significant changes between the groups in terms of HRQoL. However, the serum Hb level increased significantly in the synbiotic and probiotic group compared to the placebo group ( P < 0.001)., Conclusion: Overall, 12 weeks of synbiotic and probiotic supplementation resulted in an improvement in mental health and anemia compared with the placebo, whereas they failed to enhance the quality of life in HD patients., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Indian Journal of Nephrology.)

Bakground and Objective: Sleep disorder is among the most common problems in the life of postmenopausal women. Because of the complications of chemical drugs, many women prefer to use herbal supplements for relieving sleep problems. So, the main objective of this study was to determine the effect of the jujube seed capsule on sleep quality in postmenopausal women., Materials and Methods: This study was a double-blind clinical trial conducted on 106 postmenopausal women in Khuzestan province, southwest of Iran. All participants were selected by a simple non-probability sampling method. Data were collected through a demographic data form and the Pittsburgh sleeps quality index (PSQI). Individuals were randomly divided into intervention ( n = 53) and control ( n = 53) groups. The intervention group received 250 mg oral jujube seed capsule and the control group received a placebo capsule twice a day for 21 days. After the treatment, the PSQI was completed in both intervention and control groups. Data were analyzed using the independent t-test and the Chi-square test using SPSS software version 24, and p -value < 0.05 was considered as the significance level., Results: The results revealed that after treatment, the mean scores of sleep quality decreased in the intervention and control group. Although this difference was statistically significant in both intervention and control groups ( p -value < 0.05), more reduction observed in the intervention group ( p -value < 0.001)., Conclusion: Consumption of the jujube seed capsule had a positive impact on improving the sleep quality of postmenopausal women and could be recommended as a useful herbal medication., Competing Interests: The authors declare no conflicts of interest., (© the Author(s).)

Objective: The purpose of this study was to determine the effect of chamomile vaginal gel on dyspareunia and sexual satisfaction in postmenopausal women. The phytoestrogenic properties of Matricaria chamomilla were the reason for selection of this plant., Materials and Methods: This double-blind clinical trial research was conducted on 96 eligible postmenopausal women referring to Gotvand city Health Center No. 1 in 2018. In this research, 96 postmenopausal women complaining from dyspareunia and sexual dissatisfaction were randomly assigned into three groups (each contained 32 subjects) to receive 5% chamomile vaginal gel, conjugated estrogen vaginal cream and placebo gel, for 12 weeks. All women completed the Larsson and a four-degree pain self-assessment questionnaires. Data was analyzed using SPSS version 22. A p-value of less than 0.05 was considered significant., Results: After the intervention period, a significant difference was seen between the intervention and the placebo group in the mean sexual satisfaction (p<0.001). Also, a significant reduction was seen in painful sexual intercourse between the groups using vaginal gel of chamomile and conjugated estrogen vaginal cream (95% CI: chamomile: 0.68-1.04, estrogen: 0.63-0.98, placebo: 1.8-2.1; p<0.001)., Conclusion: Using chamomile vaginal gel can cause a reduction in painful sexual intercourse and an increase in sexual satisfaction in postmenopausal women.

Background: Iron deficiency is prevalent in overweight and obese individuals and may be induced by adiposity-related inflammation that affect iron metabolism., Objective: The objective of this study was to investigate the relationship between hematological parameters and obesity-induced inflammation among young females., Methods: A total of 170 young women (aged between 18-35 years) participated in this cross-sectional study. Obesity was assessed by BMI (body mass index), WHR (waist to hip ratio), and body fat percentage. Inflammatory and hematological parameters including hs-CRP (high-sensitivity C-reactive protein), serum Fe, hemoglobin, ferritin, transferrin, TIBC (total iron binding capacity) were measured. Dietary intakes of some nutrients (total iron, proteins, calcium, and vitamin C) were assessed according to BMI, WHR and fat mass categories., Results: Serum iron were negatively correlated with BMI ( P = 0.045, r = -0.154) and hs-CRP ( P = 0.032, r = -0.165). Hemoglobin were also negatively correlated with BMI ( P = 0.043, r = -0.155). A significant correlation was also shown between WHR with transferrin ( P = 0.034, r = 0.163) and TIBC levels ( P = 0.035, r = 0.162), hs-CRP was positively correlated with BMI ( P = 0.014, r = 0.183), WHR ( P = 0.009, r = 0.202) and body fat percentage ( P = 0.037, r = 0.353). Dietary intakes did not differ significantly among BMI, WHR and fat mass categories ( P > 0.05)., Conclusions: Obesity-induced inflammation, regardless of dietary intake of iron, can lead to iron deficiency. Therefore, weight control, especially in obese subjects is necessary to prevent iron deficiency and anemia., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 International Journal of Preventive Medicine.)

Background: Weight management is an important strategy to prevent the consequences of obesity. The aim of the study was to compare the effect of yoga practice and energy-restricted diet on resting metabolic rate (RMR), anthropometric indices, and serum adiponectin and leptin in overweight and obese women., Materials and Methods: Obese or overweight women were divided into two groups: yoga practicing and energy-restricted diet. Exercise trials consisted of 60-min Hatha yoga equal to 200 kilocalories (kcal) combined with 300 kcal restriction per day, and an energy-restricted diet consisted of 500 kcal restriction per day. The intervention period for both the groups was 8 weeks. RMR, anthropometric indices, and serum adiponectin, leptin, and lipid profiles were measured at baseline and at the end of the study., Results: RMR was increased in yoga but not in the diet group ( P = 0.001). The level of adiponectin was increased in the yoga group compared with the diet ( P = 0.035). The concentration of high-density lipoprotein-cholesterol was decreased in the diet group significantly but not in yoga ( P = 0.006). The level of leptin was decreased in both the groups ( P = 0.001), and there were no significant differences between the two groups., Conclusion: The findings of the study demonstrated the effect of yoga practicing on RMR, and serum adiponectin, in overweight and obese women. It seems yoga practice with less energy restriction compared with a common energy restriction diet and is more effective in weight management for those who are in weight loss programs., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Research in Medical Sciences.)

Background: Workplace nutrition has been identified as a priority setting that can significantly reduce cardiovascular diseases (CVD) risk factors. This study was conducted as a part of the workplace education program to improve nutritional practices and cardiometabolic status in industrial personnel., Methods: The present research was a randomized controlled field trial conducted on employees of a regional petrochemical company. The health-related priorities of the program were defined and addressed in the study in which 104 employees with dyslipidemia were randomly divided into two groups of education and control. Data were collected pre- and post-intervention, using valid and reliable multi-session questionnaires on demographic data, nutritional knowledge, and nutritional intake. Anthropometric measures, serum FBS, HbA1C, hs-CRP and homocysteine (Hcy) were assessed in both groups. In the education group, the nutrition program included five educational workshops about healthy nutrition and regular exercise along with educational messages over a 3-month period. The controls did not receive any education during the study., Results: There were no statistically significant differences between the two groups regarding the baseline variables. The education group significantly improved their nutritional knowledge ( p  < 0.001), dietary intakes ( p  < 0.005), serum FBS (p < 0.001) and Hcy levels (p < 0.001) and anthropometric indices., Conclusion: Workplace nutrition education programs can improve knowledge and reduce important CVD risk factors., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s). 2020.)

Background: Non-alcoholic fatty liver disease (NAFLD) is one of the metabolic disturbances associated with inflammation. Nigella sativa (NS) seed oil has different chemical compounds including Thymoquinone (TQ), unsaturated fatty acids, and flavonoids. NSs are used as anti-inflammatory and antioxidants in medical sciences. This study aimed to investigate the effect of NS oil on several parameters in serum levels of patients with NAFLD., Methods: Forty-four patients diagnosed with NAFLD participated in a randomized, double-blind, placebo-controlled clinical trial. Patients were randomly assigned into two groups; one receiving NS oil and the other receiving placebo (paraffin oil), for 8 weeks. Blood samples were taken from the patients at the beginning and the end of the study. Afterwards, liver enzymes (ALT, AST, and GGT), inflammatory markers (Hs-CRP, TNF-α, and IL-6), insulin, lipid profiles (total cholesterol, triglyceride, VLDL, LDL-C, and HDL-C), FBS, and blood pressure were measured., Results: Consumption of NS seed oil as supplement decreased the FBS level, lipid profiles (TG, TC, LDL, VLDL), liver enzymes (AST and ALT), hs-CRP inflammatory marker, IL-6, TNF-α, while it increased the HDL-C levels, compared to the placebo group ( P  < 0.05). Receiving NS oil had no significant effect on serum levels of insulin, blood pressure, and GGT in comparison with the beginning of the study ( P  < 0.05)., Conclusion: NS seed oil supplements may decrease the liver enzymes and lipid profiles in the patients with NAFLD and play a protective role in the liver via reducing the inflammation in this group of patients., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© Springer Nature Switzerland AG 2019.)

Introduction: Phosphodiesterase inhibitors (PDEs) increase intracellular cyclic adenosine monophosphate, which results in a wide range of anti-inflammatory effects and pathologically leads to improve asthma disease. Because no human study has surveyed the effect of PDEs on pulmonary function, except some case reports and animal researches, we decided to perform a pilot study for evaluating the effect of sildenafil (PDE5) on pulmonary function in patients with severe asthma., Methods: This randomized controlled trials study was conducted on 20 patients with severe asthma in 2019 in Iran. For case group, was prescribed sildenafil (50 mg) daily and the control group received the placebo. In the beginning of the study and one month later, volume parameters, 6-minute walk distance (6MWD), and the quality-of-life questionnaire were measured and compared in the two groups., Results: Twenty patients were entered into this study. 8 patients (40%) were male and 12 (60%) were female. The results showed that mean forced vital capacity 1 in the sildenafil group turned from 1259 ± 170 to 1603 ± 527, while in the placebo group it changed from 1135 ± 125 to 1365 ± 251 (P-value = 0.215). There is no statistically significant difference between two groups. In addition, in comparison with placebo, sildenafil did not show any significant improvement in the volume parameters, the quality-of-life questionnaire scale, and 6MWD at the end of the study., Conclusion: According to present result can be concluded that sildenafil does not improve the severity of asthma and the quality of life in patients with severe asthma., Competing Interests: There are no conflicts of interest.

Background: Kidney stone is a common and costly disease, but it may be improved by a healthy diet. The aim of this study was to evaluate the association between dietary intake and stone formation in patients with urinary stones in Shiraz. Methods: In this cross sectional study, 110 patients with kidney stone were selected from Faghihi hospital, Shiraz. Demographic information was collected, and anthropometric indices, disease-related variables, physical activity (using IPAQ), and dietary intake (using food frequency questionnaire, analyzed by Nut 4 software, to estimate micro and macro nutrients) were evaluated. Independent sample t test and one-way ANOVA were used to compare the quantitative variables between the 2 groups and multi groups, respectively. Chi square test was also used to compare qualitative variables. The correlation between variables was determined using Pearson test. Results: Out of 110 participants in this study, 37 (33.6%) were female, with the mean BMI of 27.0 ± 4.68 kg/m2, and 73 (66.4%) were male, with the mean BMI of 24.21±2.96 kg/m2. The mean intake of calcium-containing foods (p=0.02) and high-fructose beverages (p=0.03) was significantly greater in patients with calcium stones compared to those with uric acid stones. The mean intake of high-purine foods was significantly higher in patients with uric acid stones than in those with calcium stones (p=0.007). The mean intake of vitamin A (p=0.02), beta-carotene (p=0.03), and fructose (p=0.03) was significantly higher in patients with calcium stones than in those with uric acid stones, while caffeine intake was significantly higher in patients with uric acid than in those with calcium stones (p=0.01). There was a significant correlation between consumption of high-oxalic beverages (p=0.005, correlation coefficient = 0.26) and high-fructose (p=0.048, correlation coefficient = 0.18) with spontaneous stone expulsion. Conclusion: There was a significant relationship between consuming vitamin A, beta-carotene, and foods containing calcium, purine, fructose, and oxalate and formation of kidney stones. Therefore, adopting a healthy diet and increasing physical activity may be effective in the treatment of kidney stones.

Background: An appropriate snack for patients with diabetes mellitus should be considered to help them in their treatment due to their hard administrative diet. This study was conducted to evaluate the effect of dark chocolate on inflammatory markers, serum adiponectin, and certain biochemical factors in patients with type 2 diabetes (T2D)., Methods: This study was a randomized parallel clinical trial. Thirty grams of 84% dark chocolate, along with therapeutic lifestyle changes (TLCs) guidelines, were administrated to patients with T2D. Control group received only TLC guidelines. The intervention period was 8 weeks. Twenty-one subjects in dark chocolate and 23 subjects in control group completed the study. Fasting blood samples were collected before and after the intervention period and inflammatory markers, biochemical factors, and adiponectin levels were assessed., Results: Fasting blood sugar, hemoglobin A1C, low-density lipoprotein and triglyceride levels declined significantly in the dark chocolate group and this decrease was significant between the intervention and control groups. Tumor necrosis factor-alpha, interleukin-6, and high sensitive C-reactive protein were significantly decreased in the dark chocolate group. Adiponectin levels were not significantly different between the two groups., Conclusions: In this study subjects who received dark chocolate along with TLC guidelines had lower levels of inflammatory markers such as hs-CRP, TNF-α, and IL-6, compared with the subjects who were devoid of dark chocolate and followed only the TLC guidelines. Other studies should be conducted to evaluate the most effective and administrative dosage of dark chocolate as a snack along with the common treatment of diabetes., Competing Interests: There are no conflicts of interest

Introduction: Considering the fact that depression in patients with breast cancer increases the severity and complications of medical treatments such as chemotherapy (including fatigue, nausea, and cognitive problems), the identification of its related factors can be one of the important steps in reducing the complications of this disease. Therefore, the purpose of this study was to determine the relationship between psychological hardiness and resilience with depression in women with breast cancer., Materials and Methods: The present study was a descriptive-analytic study, the population of which included all women with breast cancer under chemotherapy referred to Oncology Center of Imam Hassan Mojtaba Hospital in Dezful city from July 2015 to December 2016. A sample size of 114 people was selected. Data collection instruments included demographic information form, Ahvaz Psychological Hardiness Scale, Connor-Davidson Resilience Scale (CD-RISC), and Beck Depression Inventory. Data were analyzed using SPSS ver.21., Findings: Findings showed that 61.4% of respondents had depressive symptoms. Mild, moderate and severe depression symptoms were prevalent among 37.7%, 20.2% and 3.5% of the participants, respectively. Also, there is a significant relationship between resiliency and hardiness with depression in women with breast cancer (P<0.05)., Discussion and Conclusion: The depression rate in women with breast cancer decreased if hardiness and resiliency against the disease has been increased. This means that there is a need for training courses and counseling services for women with breast cancer in order to improve their mental health status.

Introduction: Increasing life expectancy in women and having menstrual problems and hormone-associated complications have led people to use complementary and alternative medicine. In menopause, the reduction in estrogen and androgen physiologically leads to a decrease in blood flow in the volvuleous and vaginal zone, resulting in a reduction in sexual desire and arousal. Sexual satisfaction plays an important role in mental health. The aim of this study was to investigate the effect of Tribulus terrestris on sexual satisfaction in postmenopausal women., Methods: This double-blind clinical trial was conducted in 2017 with the aim of investigating the effect of hydro-alcohol extract of T. terrestris on sexual satisfaction of postmenopausal women on 60 women referred to health center number 1 in eastern Ahvaz. A total of 60 postmenopausal women were randomly assigned into two groups of 30 to receive a syrup containing T. terrestris extract at a concentration of 0.9 mg and placebo for 8 weeks. Sexual satisfaction was calculated based on Larsson questionnaire. Data were analyzed by SPSS software (version 22) and t -test was used for comparing two groups in quantitative variables and Chi-square test was used for qualitative variables. P value less than 0.05 was considered significant., Findings: After intervention, the mean of sexual satisfaction in the intervention group was significantly higher than in the preintervention group ( P < 0.005), and a significant increase in sexual satisfaction was observed in the tetanus syrup group., Results: Taking T. terrestris syrup increased sexual satisfaction in postmenopausal women., Competing Interests: There are no conflicts of interest.

Introduction: Cardiovascular disease is the main cause of disability and morbidity in many countries. Considering the significance of education in correcting unhealthy eating habits and improving nutritional behaviors that prevents cardiovascular diseases, the current study has been carried out to investigate the impacts of Beliefs, Attitude, Subjective Norms, Enabling Factors (BASNEF)-based educational program on the employees' nutritional behaviors., Materials and Methods: This study was carried out on 120 randomly selected employees of Water and Wastewater Organization of Kermanshah. Individuals were divided into the control and intervention groups. Questionnaires devised based on BASNEF model and food frequency questionnaires were collected preintervention and 3-month postintervention. Educational program was performed in four training sessions., Results: Significant differences between mean scores of knowledge and other items of BASNEF model as well as nutritional improvements were observed in the intervention group after 3 months ( P < 0.01)., Conclusion: BASNEF educational model positively affected nutritional behaviors of the employees to reducing cardiovascular risk factors., Competing Interests: There are no conflicts of interest.

Background and Objectives: This randomized, placebo-controlled trial was performed for 8 weeks to investigate the potential effects of astaxanthin (AST) supplementation on the adiponectin concentration, lipid peroxidation, glycemic control, insulin sensitivity, and anthropometric indices in participants with type 2 diabetes mellitus., Methods and Study Design: We enrolled 44 participants with type 2 diabetes who met our inclusion criteria. Eight milligrams of AST supplementation or a placebo were randomly administered once daily for 8 weeks to these participants., Results: The 8-week administration of AST supplementation increased the serum adiponectin concentration and reduced visceral body fat mass (p<0.01), serum triglyceride and very-low-density lipoprotein cholesterol concentrations, and systolic blood pressure (p<0.05). Furthermore, AST significantly reduced the fructosamine concentration (p<0.05) and marginally reduced the plasma glucose concentration (p=0.057)., Conclusions: We demonstrated that because participants with type 2 diabetes often have hypertriglycemia and uncontrolled glucose metabolism; our findings of dual beneficial effects are clinically valuable. Our results may provide a novel complementary treatment with potential impacts on diabetic complications without adverse effects.

Background and Objectives: Coronary artery disease (CAD) is a major cause of death worldwide. Chronic stable angina (CSA) is the primary sign of CAD. Oxidative stress and inflammation play a substantial role in pathogenesis and progression of CAD. The aim of this study was to investigate the effects of oral administration of powdered Melissa officinalis (MO) on biomarkers of oxidative stress, inflammation, and lipid profile in patients with CSA., Methods and Study Design: A randomized, double-blind, placebo-controlled clinical trial was performed in 80 patients with CSA. The subjects were randomly assigned to obtaineither oral MO 3 g/d (n=40) or placebo (n=40) for eight weeks. Anthropometric indices, biomarkers of oxidative stress, inflammation, and lipid profile were evaluated at baseline and post-intervention., Results: The mean serum concentrations of triglycerides, total-cholesterol, LDL-cholesterol, and malondialdehyde (MDA), and high sensitive C-Reactive Protein (hs-CRP) were lower in the intervention group compared with placebo (p<0.01) post intervention. Moreover, the mean serum concentration of paraxonase 1 (PNO1) and HDL-c were higher (p<0.001) in the intervention group compared with the control group., Conclusion: Oral MO supplementation improves the lipid profile, MDA, hs-CRP, and PNO1 in patients with CSA.

Background: Premenstrual syndrome (PMS) is one of the important health problems with high incidence in young women. The exact cause of this syndrome is not clear and some theories have been declared from hormonal factors to nutritional disorders., Objective: We investigated the correlation between serum zinc and antioxidant status with PMS., Materials and Methods: In this case-control study, forty eight young girls were selected from a total sample of 110 students residing at university dormitories including PMS (n=23) and healthy (n=25) groups based on PMS questionnaire. Dietary intake questionnaire and blood samples were collected from all participants. Serum total antioxidant capacity (TAC) and zinc concentrations were also measured., Results: Serum TAC and zinc concentrations were lower in PMS patients compared with healthy groups (p<0.01 and p<0.05, respectively). Healthy controls consumed lower servings of hydrogenated oils (p<0.05). There were significant differences in terms of muscle mass between the PMS and healthy groups (p<0.05). Both serum TAC and zinc levels were negatively correlated to PMS scores (r=-0.39, p<0.05 and r= -0.36; p<0.05, respectively)., Conclusion: This study shows that higher TAC and zinc serum levels are associated with lower risk of PMS. PMS cases have more hydrogenated oils than their normal counterparts., Competing Interests: The authors declare that there is no conflict of interests regarding the publication of this paper.

Background: Diabetic foot ulcer is a worldwide health care concern affecting tens of thousands of patients. If these ulcers left untreated, they can create severe complications., Objectives: This study was designed to examine the effect of infrared radiation on the healing of diabetic foot ulcer., Patients and Methods: This clinical trial was performed on 50 patients referred to Dr. Ganjavian hospital in Dezful city, Iran, with diabetic foot ulcer degree 1 and 2 (based on Wegener Scale). Sample size was determined based on relevant studies of the recent decade. Patients were classified into the intervention and control groups (n = 25 in each group) in terms of age, gender, degree of ulcer, ulcer site and body mass index. In this study, work progress was evaluated according to the checklist of diabetic foot ulcer healing evaluation., Results: The results of the current study showed that there was a statistically significant difference in healing ulcers (P < 0.05) and mean healing time (P < 0.05) between the two groups., Conclusions: Using the infrared plus routine dressing is more effective than using merely routine dressing.

Objective: Vitamin D appears to be involved in regulation of glycemic and inflammatory responses in gestational diabetes. The purpose of this study was to compare the serum levels of 25-hydroxyvitamin D (25(OH)D), inflammatory biomarkers and glycemic profile between gestational diabetes mellitus (GDM) and normal glucose tolerance (NGT) pregnant women., Materials and Methods: In this cross-sectional study, fasting serum levels of 25(OH)D, insulin, glucose, HOMA-IR, hs-CRP and TNF-α were measured in 45 GDM and 45 NGT women at week 20-30 gestation whom referred to Reference Medical Laboratory of Ahvaz, Iran in 1394., Results: Serum 25(OH)D levels were significantly lower (p = 0.003 ) in the GDM group compared to the NGT group which remained even after controlling for confounders. Insulin and TNF-α levels were not statistically different between groups (p > 0.05). However, in unadjusted model, HOMA-IR and hs-CRP were significantly different between groups that disappeared in adjusted model. In the GDM group, there was a negative significant correlation between 25 (OH) D and fasting blood sugar (p = 0.009) and pre pregnancy BMI (p < 0.001). Levels of 25(OH)D were also negatively correlated with pre pregnancy BMI (p < 0.001) and hs-CRP levels (p = 0.003) in the NGT group., Conclusion: The lower level of vitamin D may be responsible for impairments of some glycemic and inflammatory markers in pregnant women. This is more important in overweight pregnant women. However, further studies with larger sample size are recommended in this regards.

Background: Stroke is the second cause of death among elderly people. Oxidative stress plays an important role in brain damage after stroke. Currently, Vitamin D has been shown as an antioxidant. The aim of this study was to evaluate the status of Vitamin D, antioxidant enzymes, and the relation between them in ischemic stroke patients., Materials and Methods: This case-control study was carried out on 36 patients with ischemic stroke patients and 36 matched subjects as controls. Intake of fruits and vegetables, exposure of sunlight, serum lipid profile, concentrations of serum 25-dihydroxy Vitamin D (25(OH) D), activities of serum superoxide dismutase, and glutathione peroxidase enzymes were determined., Results: Severe Vitamin D deficiency was seen in 30% of the patients versus 11% of the controls (P < 0.05). Consumption of fruits and vegetables was lower in patients than that of controls (P < 0.05). Activities of antioxidant enzymes and intake of fruits were positively correlated in stroke patients (P = 0.02). The most potent predictors of stroke risk were hypertension, high levels of low-density lipoprotein cholesterol (LDL-C) and history of cardiovascular disease (CVD) (odds ratios: 3.33, 3.15, and 3.14, respectively, P < 0.05 for all). There was no association between 25(OH) D levels with activities of serum antioxidant enzymes and lipid profile in the two groups., Conclusion: Ischemic stroke patients have higher prevalence of severe Vitamin D deficiency and lower intakes of fruits and vegetables. Intake of fruits was positive correlated to higher antioxidant enzymes levels. High levels of blood pressure, history of CVD, and high LDL-C levels are the strongest predictors of ischemic stroke.

Background: Diabetic Foot Ulcer (DFU) is the most costly and devastating complication of diabetes mellitus which can lead to infection, gangrene, amputation, and even death if the necessary care is not provided. Nowadays, some herbal products have shown therapeutic effects on healing of DFU. So, this study aimed to assess the effects of topical olive oil on the healing of DFU., Methods: This double-blind randomized clinical trial study was conducted in Diabetes Clinic of Ahvaz Golestan hospital, Iran, in 2014. Thirty-four patients with DFU of Wagner's ulcer grade 1 or 2 were enrolled in this study. Patients who were randomly assigned to intervention group (n = 17) received topical olive oil in addition to routine cares, whereas patients in control group (n = 17) just received routine cares. Intervention was done once a day for 4 weeks in both groups, and in the end of each week; the ulcers were assessed and scored. Data was collected by demographic and clinical characteristics checklists as well as diabetic foot ulcer healing checklist, and was analyzed by SPSS version 19 software using descriptive (mean and standard deviation) and analytic (student's sample t-test, chi-square and repeated-measures analysis of variance) statistics., Results: At the end of 4(th) week, there was a significant differences between two groups regarding to 3 parameters of ulcer including degree (P = 0.03), color (P = 0.04) and surrounding tissues (P < 0.001) as well as total status of ulcer (P = 0.001), while related to ulcer drainages no significant difference was seen between the two groups (P = 0.072). At the end of the follow up, olive oil significantly decreased ulcer area (P = 0.01) and depth (P = 0.02) compared with control group. Complete ulcer healing in the intervention group was significantly greater than control group (73.3% vs. 13.3%, P = 0.003) at the end of follow up. Also, there were no adverse effects to report during the study in intervention group., Conclusions: Our results indicated that olive oil in combination with routine cares is more effective than routine cares alone, and is without any side effect. However, further studies are required in the future to confirm these results., Trial Registration: IRCT2014083014251N2.

Dietary fatty acids play a critical role in modulation of airway inflammation in asthma. This study was conducted to compare dietary intakes of essential fatty acids and serum levels of inflammatory factors in asthmatic and healthy adults, and to examine the potential relationship between inflammatory markers and dietary fatty acids. In this case-control study, 47 asthmatic patients (26 males and 21 females) were compared with 47 controls (24 males and 23 females). Blood samples were taken from case and control groups and tumor necrosis factor-α (TNF-α), high sensitive C-reactive protein (hs-CRP), leptin and adiponectin were determined. Dietary intakes were assessed by semi-quantitative food frequency questionnaire (FFQ). Dietary intakes of omega-3 fatty acids were significantly lower in asthmatic patients compared to controls (p<0.05). Serum concentrations of TNF-α, hs-CRP and leptin were significantly higher in asthmatic patients. There was a significant negative relationship between adiponectin levels and saturated fatty acid intakes in both groups, but the relationship between adiponectin and mono-unsaturated fatty acid intakes was positive and significant only in asthmatic group. No significant correlation between other inflammatory factors and dietary intakes was found in this study. Higher intake of omega-3 and lower levels of inflammatory factors in the healthy control group compared to asthmatic group may explain the protective role of essential fatty acids in asthma. Further studies with larger sample size are needed in this regard.

Objectives: Oxidative stress and inflammation have been reported to be higher in subjects with depression, but it is unclear whether this is due to inadequate dietary antioxidant intake or the pathophysiology of depression. The aim of this study was to assess the association between dietary and serum antioxidant status with depression scales in young male university students., Methods: This research was a case-control study carried out on 60 male university students (30 students diagnosed with depression and 30 matched healthy controls). Beck Depression Inventory-II was used to assess the major depressive disorder (MDD) scales. A semi-quantitative food frequency questionnaire and 2-day 24-h recalls were used for dietary assessment. Dietary and serum total antioxidant capacity (TAC) and high-sensitive C-reactive protein (hs-CRP) concentrations were also measured., Results: MDD subjects consumed less fruits (P < 0.05), legumes (P < 0.001), nuts and seeds (P = 0.003), vitamin C (P = 0.005), beta carotene (P < 0.001), lutein, and zeaxanthin (P = 0.006) than the controls. Moreover, the depressed group had lower serum TAC levels than their controls (P < 0.05). There were no significant differences in serum hs-CRP concentrations and dietary TAC levels between the study groups., Discussion: Students with depression had significantly lower intake of dietary antioxidants. However, dietary TAC and serum hs-CRP levels were not significantly different between depressed and normal university male students. Intake of foods rich in antioxidants is encouraged in male students.

Background. Obesity is considered as a low grade inflammation condition. The aim of this study was to investigate the effect of nutritional education on diet quality and biomarkers of inflammation in Iranian obese women. Method. Sixty obese women voluntarily participated in this randomized clinical trial and were randomly assigned to intervention or control group (n = 30). Intervention group was instructed to attend nutrition education sessions (1 hr/wk, for 3 months) in small groups. Diet quality scores were measured by Healthy Eating Index (HEI). Anthropometric indices and serum concentration of hs-CRP, TNF-α, and adiponectin were measured at the baseline and end of the intervention. Results. There were no significant differences in anthropometric indices of participants between the two groups at the end of intervention (P > 0.05). However, the total HEI score was significantly higher in the educated group compared to the control group after intervention (P < 0.05). The educated group also showed significant lower concentration of TNF-α and hs-CRP and higher levels of adiponectin than the control group at the end of study (P < 0.05). Conclusions. Our results provide limited evidence that higher dietary quality contributes to reduced inflammation in obese women. This effect could be independent of the weight loss.

Background: There have been few studies to examine the effect of magnesium (Mg) supplementation on liver enzymes. The aim of this study was to evaluate the effect of Mg supplementation and weight loss on liver enzymes, lipid profile, and fasting blood sugar in patients with nonalcoholic fatty liver disease (NAFLD)., Materials and Methods: This study was a double-blind, placebo-controlled, randomized clinical trial. Ultrasonography was used to diagnose fatty liver in patients with alanine aminotransferase (ALT) ≥ 40 U/L and without other hepatic diseases. A total of 68 participants (18-59 years) with NAFLD were randomly divided into two groups to receive either Mg supplement (350 mg elemental Mg per day) or placebo for 90 days. At baseline and at the end of the intervention serum ALT, aspartate aminotransferase (AST), alkaline phosphatase (ALP), total cholesterol (TCHO), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), blood sugar and serum insulin, and Mg levels were measured in fasting state. Low-density lipoprotein cholesterol (LDL-C) and insulin resistance (IR) were calculated using Friedewald formula and homeostasis model assessment of insulin resistance (HOMA-IR), respectively. All participants received lifestyle recommendations including low calorie diet and physical activity., Results: Significant decreases within the intervention and placebo groups were observed in ALT (57.00 (25) to 41.82 ± 19.40 U/L, P = 0.000; 68.50 ± 26.96 to 40.17 ± 19.40 U/L, P = 0.000 in Mg and placebo groups, respectively). Similar significant decreases were observed in AST and fasting serum insulin within the study groups. The decrease in weight was also significant in both groups (91.05 ± 13.77 to 87.60 ± 14.37 kg and 94.59 ± 16.85 to 91.45 ± 16.39 kg in Mg and placebo groups, respectively). LDL-C and TCHO were decreased significantly in placebo group but not in the intervention group. Serum Mg was increased significantly in the intervention group. No statistically significant differences were observed between the two study groups at baseline and after intervention., Conclusion: According to the findings of this study, Mg supplement does not affect liver enzymes but weight loss may have an important role in improving fatty liver disease.

Background and Aims: There are limited findings available on coronary artery disease (CAD) risk factors and nutritional pattern of CAD patients in Iran. The purpose of this study was to compare nutritional-related risk factors of CAD patients with that of matched controls., Methods: In a case-control design, dietary patterns and CAD risk factors of 108 documented patients (determined by cardiac catheterization showing greater than 70% stenosis or established myocardial infarction) whom were admitted to coronary care units (CCU) of Ahvaz teaching hospitals were compared with that of 108 gender- and age-matched subjects of normal cardiac catheterization (lesser than 40% stenosis). Measured variables consisted of blood lipid profile, smoking habits, dietary patterns, anthropometric indices and blood pressure levels., Results: Almost all patients had hypertriglyceridemia and high LDL-C levels. Odds ratios (CI 95%) for consuming fish, tea, vegetable oils were 0.55(0.31-0.91), 0.3(0.15-0.65), 0.23(0.13-0.42), respectively. However, consumption of hydrogenated fats, and full-fat yoghurt was associated with higher CAD risk (OR = 2.12(1.23-3.64) and 2.35(1.32-4.18), respectively. Patients' serum lipid profiles, sugar concentrations, and blood pressure levels were significantly higher than defined cut-off points of the known risk factors. Considerable numbers of the control group also showed high levels of the known risk factors., Conclusions: Consumption of fish, tea and vegetable oils shown to have protective effect on CAD while full fat yoghurt and hydrogenated fats increase the risk of CAD. Moreover, CAD patients obviously have higher blood lipids and sugar concentrations, blood pressure, body fat percent and BMI levels compared with their matched counterparts. We need to define specific local cut-off points with more practical criteria to detect CAD patients.

Background: There is some evidence that suggests a beneficial effect of calcium intake on serum lipid profile. The objective of this study was to determine the effect of 1000 mg calcium supplementation for 30 days on serum lipid profile in overweight or obese women., Methods: A double-blind, randomized clinical trial was conducted in 44 overweight or obese adult women (body mass index (BMI) >or=25 kg m(-2), age: 25+/-6y) receiving 1000 mg elemental calcium daily (n=24) or placebo (n=20). Serum lipids, lipoproteins and apolipoproteins including triglyceride, total cholesterol, HDL cholesterol (HDLc), LDLc, VLDLc, ApoA-I and ApoB were obtained at baseline and after intervention. Dietary calcium and energy intake were estimated using 24 h dietary recall for 3 days. Statistical analyses were performed using SPSS software., Results: No significant differences were observed in dietary, anthropometric and serum variables between groups at baseline. Although serum total, LDL cholesterol and triglycerides tended to increase in both groups, total cholesterol elevation was significant only in placebo group (P=0.01). Triglyceride and VLDLc increased significantly only in the calcium group (P=0.03). LDLc elevation was significant in both groups (P<0.05). HDLc decreased significantly in both groups (P<0.01). Apolipoproteins did not change significantly in any group. No significant differences were observed in serum variables between groups after intervention., Conclusions: No considerable beneficial effect due to short-term calcium supplementation in overweight or obese women's lipid profile was observed.